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| Bethlem Royal Hospital, also known as Bedlam, was England’s first asylum for the treatment of mental illness. Bedlam has become a word meaning a scene of uproar and confusion. |
What Trump did last night in the debate may not offer a precise psychiatric or medical diagnosis though it does demonstrate that his mind is not working properly. I don't like to use the dated and coloquial term "insanity" in place of mental illness, but I do so because it gets the point across. In fact Trump also used the word "insane" in the debate. He was trying to make his point when he repeated his unsupported claim that "millions of people" are "pouring into our country from prisons, jails, from mental institutions and insane asylums."
Trump is lumping people who, through no fault of their own, have a mental illness with people who have commited crimes. This is interesting because he has both committed crimes and, after this, I have to say he also has a mental illness.
I wrote yesterday (here) that the debate could provide evidence that he has early dementia, mania, or a combination of the two. What I am left with is the fall-back diagnosis clinicians use when someone has elements of several diagnoses but not enough of them to fulfill the requirment for making a firm diagnosis. This is to say they have an atypical condition with symptoms of two or more disorders. Trump may be showing us what happens when someone with a narcisstic personality disorder gets dementia or mania. Trump meets the diagnostic criteria for this disorder.
The fact is that old insane asylums like Bedlam actually had many patients who manifest behavior very much like what Trump expressed during the debate. Before the first medications, Thorazine and lithium for example, were able to control psychosis and mania these hosptials were filled with raving and ranting patients whose words made no logical sense. Patients with dementia were among those who ended up in these hospitals in addition to people with those with scizophrenia and bi-polar disorder (previously called manic-depressive disorder).
In my 40 years as a psychotherapist I saw just a few patients whose symptoms were as blatant as Trump's. This is because my program was outpatient and by the time they came to us they'd already been stabilized on medication. I only saw them when they stopped coming for a period of time, went off their medication, and then came back.
(Aside: As I have this on, just this second, Joe Scarborough said "any sane Republican" in reference to what Trump should have done differently and then used the word "addled" to decribe his performance.)
The word "sane" has now become the prefix to the newest word in the media, sanewashing. I have seen it hyphenated and as two words. I expect it will end up being on the top of lists of words added to the dictionary in 2024.
Even Fox News, much to the rage of Donald Trump in the spin room afer the debate, didn't try to sanewash his debate performance.
You can call it mental illness, insanity,or cognitive impairment, but what this debate showed is that if Trump was anybody else his family would be seeking professional help for him.
Updates: Later shows following Morning Joe on MSNBC are not focusing on the cognitive impairment Trump demonstrated in the debate. They are talking about the policies he tried to expound on. They are sanewashing.
This is another indication of cognitive disorderL
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