Opinion by Hal Brown, MSW
I won’t get into it here since most of you are well aware of the controversy that developed when numerous psychotherapists went public diagnosing Donald Trump as a malignant narcissist. Of two of best known ones, Dr. John Gartner first made the diagnosis and the other, Dr. Bandy Lee didn’t go that far but rather made a case for his getting a psychiatric assessment. Even though she didn’t offer a diagnosis herself, Lee edited the best seller “The Dangerous Case of Donald Trump” where some of the authors made a case for various diagnoses. Of course in the title of the book the word case doesn’t mean instance, rather it means case as in psychiatric case.
Making a public diagnosis of living public figures is generally and correctly frowned upon by mental health professionals. Much has been written about The Goldwater Rule saying psychiatrists should never diagnose public figures. This is a rule from The American Psychiatric Association the general public wasn’t even aware of before Trump ran for and became president.
Now we live in an era when we have members of Congress like Marjorie Taylor Greene and Lauren Boebert. Boebert’s latest statement led to titles like this from AlterNet: Lauren Boebert's latest bonkers conspiracy theory has Twitter users convinced she is losing it. The article begins: “Rep. Lauren Boebert (R-Colo.) has a new deranged conspiracy theory about the upcoming 2022 primary election and Twitter users are convinced the newly-elected lawmaker has lost her mind.”
Bonkers, losing it, and lost her mind aren’t exactly psychiatric terms. They are just what people often say to describe people who are acting in ways that suggest something “ain’t right in their head.”
Marjorie Taylor Greene has said or tweeted so many things that it makes no sense for me to elaborate on them since other have already done this, for example in “Rep. Marjorie Taylor Greene's history of spreading bizarre conspiracy theories, from space lasers to Frazzledrip.”
In the instance of Greene and Boebert there is an excellent reason why a psychiatric diagnosis can’t be made just based on observation, even having numerous examples. It is because of the nature of the behaviors they exhibit. Unlike Trump whose extreme narcissism and characteristics of sociopathy were obvious, these two express beliefs that are obviously not based on fact and they suggest they are delusions. Delusions are in a different kettle of psychiatric fishiness.
There is a psychiatric diagnosis of delusional disorder (Reference):
Delusional disorder, previously called paranoid disorder, is a type of serious mental illness called a psychotic disorder. People who have it can't tell what's real from what is imagined. Delusions are the main symptom of delusional disorder. They're unshakable beliefs in something that isn't true or based on reality.
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Delusional disorder, previously called paranoid disorder, is a type of serious mental illness called a psychotic disorder. People who have it can’t tell what’s real from what is imagined.
Delusions are the main symptom of delusional disorder. They’re unshakable beliefs in something that isn’t true or based on reality. But that doesn’t mean they’re completely unrealistic. Delusional disorder involves delusions that aren’t bizarre, having to do with situations that could happen in real life, like being followed, poisoned, deceived, conspired against, or loved from a distance. These delusions usually involve mistaken perceptions or experiences. But in reality, the situations are either not true at all or highly exaggerated.
A bizarre delusion, by contrast, is something that could never happen in real life, such as being cloned by aliens or having your thoughts broadcast on TV. A person who has such thoughts might be considered delusional with bizarre-type delusions.
People with delusional disorder often can continue to socialize and function normally, apart from the subject of their delusion, and generally do not behave in an obviously odd or bizarre manner. This is unlike people with other psychotic disorders, who also might have delusions as a symptom of their disorder. But in some cases, people with delusional disorder might become so preoccupied with their delusions that their lives are disrupted.
Note above that neither Greene nor Boebert don’t believe that they are being followed, poisoned, deceived, conspired against, or loved from a distance. They don’t fit into the categories of delusions:
- Erotomanic (someone is in love with them)
- Grandiose
- Jealous
- Persecutory
- Somatic
- Mixed
Instead they believe what have come to be known as conspiracy theories. Certainly belief in something that can’t be scientifically proved is not a sign of being mentally ill. In the age of Covid I’ve discovered that many perfectly normal and intelligent people believe in the debunked theories of anti-vaxxer Dr. Zach Bush for a current example a doctor rated as a five duck quack. These people aren't delusional.
In another category, believing something as a matter of faith is different than believing in an outlandish easily disproved conspiracy therapy. The fact that about 85% of the world’s population believes in God is the most frequently used example. The existence of God, of a God by any definition, is impossible to disprove or prove scientifically.
When something is considered a psychiatric disorder the assumption is that it is harmful to the individual and in some cases makes them dangerous. Not every belief that many consider weird or strange is a symptom of a disorder. Here’s an instance where psychiatry as a discipline hasn’t kept up with a behavioral manifestation which a majority of people describe using words like crazy, deranged, or bonkers. Not all aberrant, unusual, or idiosyncratic behavior needs to be considered a disorder.
Simply put:
A psychiatric disorder is a mental illness diagnosed by a mental health professional that greatly disturbs your thinking, moods, and/or behavior and seriously increases your risk of disability, pain, death, or loss of freedom. (VeryWell Mind) You can find a more technical definition from DSM-5 here.
In order for me to make a diagnosis of either of these members of The House of Representatives I would have to assess them in person to see if they actually met the criteria for a psychiatric diagnosis. Not only is it unlikely either of them will fly to Oregon for me to do this, but because my license to practice has long expired I’d be unable to do so. I do know a really good clinical psychologist who happens to have an office near Washington who I could refer them to.
The Poll: Even if one or both of these two get even more outrageous can they sustain the news coverage they have now?