I’m a retired psychotherapist so when I use the word psychotic or it’s variations I use it advisably, but non-mental health professionals have been using it more and more frequently in the past month. I used it in my title yesterday (right).
Simply put Psychosis is characterized as disruptions to a person's thoughts and perceptions that make it difficult for them to recognize what is real and what isn't. (Reference)
Today Lucian Truscott, IV used the word in his Salon article: “Mass rallies, crazy decisions, grandiose posturing: This is what living in a dictatorship feels like.”
After describing the behavior over the week that would justify the title he wrote “It was like watching a man in the midst of a psychotic breakdown” and then went on to add a few more things Trump did.
In a Newsweek article about George Conway (George Conway Says Trump Is a 'Malignant Narcissist': He's 'Both Mentally Disordered and Evil’) there’s a good exposition on the fine line between what can be called psychotic and what is aberrant behavior:
Conway engaged in a Twitter thread between several doctors and neurologists on Thursday discussing Trump's psychiatric condition. "The word 'insane' is not currently in vogue and has nonspecific meaning both psychiatrically and legally. It is usually used for people with psychosis. Trump is delusional, but not psychotic," Eliot Ivanhoe, a classical acupuncturist and neurologist, tweeted." He is, however, nuts, crazy, mad, bonkers, and certainly not sane. I call him 'INSANE.'"
In response, Conway argued that Trump "is legally and diagnostically sane." "But he suffers impairment from at least two diagnosable personality disorders, and needs a full workup for possible onset of dementia. He's obviously unfit. He'd be drummed out of any other job," the lawyer explained. "Colloquially, though, we can say he's nuts."
Later, Conway responded to another tweet discussing whether Trump is "crazy" or "evil." "Malignant narcissists, virtually by definition, are both mentally disordered and evil," Conway tweeted.
Dr. Ivanhoe (above) who is a neurologist said Trump is delusional but not psychotic, however Delusional disorder is a rare mental illness in which the patient presents delusions, but with no accompanying prominent hallucinations, thought disorder, mood disorder, or significant flattening of affect. (Wikipedia) Trump is certainly “rare” and the other syndrome many in the duty to warn movement of mental health therapists including myself consider him to suffering from (making us suffer from) is malignant narcissism, another rare condition.
“Delusional disorder is an illness characterized by at least 1 month of delusions but no other psychotic symptoms, according to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). [1] Delusions are false beliefs based on incorrect inference about external reality that persist despite the evidence to the contrary; these beliefs are not ordinarily accepted by other members of the person's culture or subculture.” (Reference)
The word made it into the subtitle in a Vanity Fair article: “Federal Reserve Caves to Trump, Dumps Lighter Fluid on U.S. Economy: The president’s psychotic tantrums finally break the Fed—just in time for 2020.”
Here on Daily Kos Kerry Elaveld wrote “Americans debate whether Trump is psychotic or just 'psychotic-like’” after Lawrence O’Donnell aired his interview with psychiatrist Lance Dodes.
He wrote:
Whatever Trump’s diagnosis, it's particularly bleak and dangerous that this man is running the country and in possession of the nuclear codes, among other forms of recourse. Still, people are debating whether Trump is actually psychotic or narcissistic with delusions of grandeur or perhaps suffering from rabid dementia eating away at his brain and making him particularly irritable.
and concluded:
Whatever ails Trump, sane observers around the globe may be concluding as one tweeter noted that whether Trump is technically psychotic is a "distinction without a difference."
Many mental health professionals would probably take issue with that characterization, but she has a point. If Trump ultimately does something catastrophic (and arguably already is), who cares whether he's experiencing psychosis, dementia, or simply the grandiosity of a malignant narcissist? The tragic consequences will ultimately be the same.
Republicans, as a party, have signed on to support this raving lunatic, whatever the consequences. Democrats, by failing to act to save the country and the globe from an obvious mad man will be equally responsible for whatever havoc he wreaks as well as the harm he has already done.
There are two ways to look at the notion that “whether Trump is technically psychotic is a ‘distinction without a difference’ “ because technically, that is, clinically there is a difference. If a person is clinically psychotic they need immediate assessment and treatment.
However the fact is that in the media we have gone from pundits who aren’t mental health professionals calling Trump crazy, unhinged, or saying things like “descent into madness” (which Anthony Scaramucci just said on “Morning Joy”) and so on to using psychiatric terminology with the words psychotic, psychotic-like and delusional.
For months the focus of those alarmed by what Trump is doing to our democracy has been on removing him through the process of impeachment or making sure he isn’t reelected. Discussion of the 25th Amendment languished.
Now Trump’s own behavior has brought his mental stability into question.
Addendum:
As I write this a half hour into watching “Morning Joy” it is all they are talking about.
Saturday, Aug 24, 2019 · 3:54:35 PM +00:00 · HalBrown
UPDATE: Antisocial personality is another DSM-5 Disorder. It used to be called sociopathic disorder. Malignant narcissism is a combination of this with narcissistic personality disorder. None of these are psychotic disorders, however to understand Trump it is crucial to grasp all of his psychopathology.
by Paul Rosenberg
Sunday, Aug 25, 2019 · 2:23:25 PM +00:00 · HalBrown
Morning Joy went a giant step further on Sunday and interviewed Harvard psychiatrist Lance Dodes who was on Lawerence O’Donnell earlier in the week. His comments were even stronger and he called Trump psychopathic at least twice.