Donald Trump’s narcissism is a large concern, but the Goldwater Rule says we should ignore the 300 pound menace in the Oval Office.
Donald Trump’s Narcissism
We’re not supposed to talk about Donald Trump’s narcissism. This is not because Trump’s projections, where he employs a mindless, repetitive tactic of accusing his opponents of his miserable failings as a human being; chief among which is insisting that someone else is “a liar and a crook” before Trump’s followers can realize that he is, in fact, the ultimate liar and crook.
No, when it comes to Trump’s narcissism, there are actually professional injunctions against speaking the obvious. Hard to believe, but true. It’s the First Amendment and obvious truth, vs medical ethics and political correctness.
The Goldwater Rule
This problem began with the 1964 Presidential campaign, when over a thousand polled psychiatrists declared that Barry Goldwater was unfit to be President. The American Psychiatric Association (APA) objected to this behavior, and passed the ‘Goldwater Rule’: a psychiatrist should never offer a professional opinion on a patient she has not personally examined.
It was a nice ‘Catch 22’, because psychiatrists are also not allowed to reveal anything they know about a patient they have examined, at least not without the patient’s permission. A bit of a problem, that: given the outsized egos and other dysfunctions of those seeking power and fame, knowledge of a candidate’s sanity might be even more important than, oh, say, knowledge of his tax returns. A group of mental hygienists and other scholars have argued forcefully that Donald Trump represents an extreme, and unprecedented threat which endangers the modern world, and warrants a reconsideration of the Goldwater Rule.
Nevertheless, in considering Donald Trump’s narcissism it is my opinion that the Goldwater Rule isn’t necessarily an obstacle.
Narcissistic Personality Disorder
First, consider that different international professional bodies have issued varying criteria for narcissism. Currently the APA officially labels the problem as ‘Narcissistic Personality Disorder’ (NPD) and lists the following diagnostic criteria:
- Grandiosity with expectations of superior treatment from others
- Fixation on fantasies of power, success, intelligence, attractiveness, etc.
- Self-perception of being superior, unique, and associated with high-status people and institutions
- Needing constant admiration from others
- Sense of entitlement to special treatment and to obedience from others
- Exploitative of others to achieve personal gain
- Unwilling to empathize with others’ feelings, wishes, or needs
- Intensely envious of others, and the belief that others are equally envious of them
- Pompous and arrogant demeanor
Arguing Against Trump’s Narcissism
Despite the arguments for Trump’s narcissism by a large number of experts, in a letter to the New York Times, another supposed expert in the field responded that Trump does not fit the criteria.
I say ‘supposed,’ because his letter gives reason to question his conclusions. The author starts with a problem, claiming that “Most [italics added] amateur diagnosticians have mislabeled President Trump…” I seriously doubt there is evidence to support this statement. That would be a picayune concern, except that this is exactly the sort of error an ‘amateur diagnostician’ would make.
The psychiatrist then says that he wrote the criteria for NPD, listed above. To invoke the polite name for a popular card game, “I doubt it.” A committee wrote that criteria; he simply chaired the committee. This, too, would present a minor problem, except for the itching irony: it suggests a touch of narcissism in an expert on narcissism.
The writer, unfortunately, then moves on to a couple of stunners. First, he argues against Trump’s narcissism, insisting that the president does not qualify for NPD, because “he does not suffer from the distress and impairment required to diagnose the mental disorder.”
If that is a necessary symptom, and he wrote the criteria, then why didn’t he include it in the diagnostic criteria?
The Goldwater Rule Works Both Ways
Finally, the writer himself is violating the Goldwater Rule. By publicly rejecting Trump’s narcissism, he is giving a professional opinion on a patient he has not examined. The APA has made it clear that the rule works both ways: a clinician may not offer a diagnosis of disease, nor health.
I wonder how the APA responded to this violation?
I am no psychiatrist, so I’m not bound by the Goldwater Rule. I have, however, spent some years studying narcissism and the dark tetrad for my own writings on mental dysfunction in government throughout civilization. But even then, the point is moot. I don’t need to argue for Trump’s narcissism. I merely need to point out that the APA requires that, in order to make the diagnosis of NPD, the subject must meet five of the above listed criteria.
Or to reverse the process, the clinician needs to eliminate five of them.
So rather than discuss Trump’s narcissism, I simply need to invite the layman to indicate which five do not apply to Donald Trum.
Personally, I’m not sure anyone could convincingly eliminate even one.
2019.03.21: I have updated this post to link to the most recent edition of the volume. I attended the book launch for it at the National Press Club in Washington, DC. The event included a conference in which a blue-ribbon panel of diverse experts voiced extreme concerns about Trump (in the video, you can occasionally see my bald head at one of the front tables). For reasons which aren’t immediately clear, the media apparently blacked out the event. In addition, in response to the alarms from this book, the American Psychiatric Association—ironically, in what appears to be a authoritarian, even Trumpian fashion—brushed aside the concerns expressed by these highly respected scholars, and simply doubled down on their position, prompting some to refer to this hardened attitude as ‘The Trump Rule.’
The historical roots of narcissism in government, and of much other mental illness and horror throughout civilization, are covered in depth in my recent book, Kings, Conquerors, Psychopaths: From Alexander to Hitler to the Corporation, available at The University of Louisiana Press and Amazon.
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Picture courtesy of Max Goldberg.