PSYCHOLOGICAL DIAGNOSES OF TRUMP. TAKE CAUTION.
Is Donald Trump emotionally unstable? In the psychological community there is far from a consensus on this issue. On the one hand are psychologists who say Trump displays unmistakable signs of narcissistic, paranoid, and antisocial personality disorders, and they have issued public pronouncements saying this toxic combination puts America at great risk.
But, and this is a big but, making professional diagnoses without any face-to-face contact, or without evaluating results from formal psychological testing, is problematic, if not unethical. In fact, the American Counseling, Psychological, and Psychiatric Associations follow the Goldwater Rule: It is unethical to give a professional opinion about someone who has not been examined and tested in person.
Many mental health professionals maintain, however, that Trump’s spoken record is filled with such extreme indications of pathology, and the consequent danger to the country is so great, that they have an obligation to inform the public.
Other professionals say public pronouncements bearing on Trump’s stability are inappropriate. Professionals should not be applying emotionally-laden labels in the absence of valid diagnostic data. Also, just because someone fits the general profile of a personality disorder does not mean the person is a danger to others. Many effective leaders are narcissists, a trait that can be essential to their leadership abilities. Some of us also have colleagues who say that many college students would score high on antisocial scales, but do not pose a danger to the institution.
When considering this issue and evaluating the different opinions, we believe you should be very cautious. There is an important distinction between offering a formal diagnosis vs. saying that particular ways of acting are characteristic of particular diagnoses.
We believe that psychological diagnosis should be based on hours of face-to-face therapeutic contact, and on data from formal measuring instruments with documented reliability and validity. Professional opinions based on indirect observation, such as visual and print media, are impressionistic and opinionated. While perhaps a step beyond pure speculation, such opinions should be considered at best to be educated guesses.
And remember, if a professional were privy to formal assessment data, that information would fall under doctor-client confidentiality and could not be shared.
The bottom line is this: It is one thing for the citizen counselor, psychologist, or psychiatrist to send a letter to a newspaper or magazine and complain about Trump’s confrontational interpersonal style. It is quite another thing, however, for that writer to extrapolate from those observations and declare publicly that Trump is mentally ill.
We believe Trump’s fitness for office should be discussed in a political, not a psychological, context.