The ad above was published on page three in today's NY Times. It reads:
As mental health professionals, we have an ethical duty to warn the public that Donald Trump is an existential threat to democracy. His symptoms of severe, untreatable personality disorder—malignant narcissism—makes him deceitful, destructive, deluded, and dangerous. He is grossly unfit for leadership.
Trump exhibits behavior that tracks with the American Psychiatric Association’s Diagnostic and Statistical Manual’s (DSM V) diagnostic criteria for “narcissistic personality disorder,” “antisocial personality disorder,” and “paranoid personality disorder,” all made worse by his intense sadism, which is a symptom of malignant narcissism. This psychological type was first identified by German psychologist Erich Fromm to explain the psychology of history’s most “evil” dictators.
Detractors object that we mental health professionals cannot render such a diagnosis without first examining the patient, citing the “Goldwater Rule.” We believe that we have an overriding ethical duty to warn the public of the danger this individual poses. History has taught us that in such circumstances, saying nothing is never the more ethical choice.
Since the Goldwater Rule was adopted, the field has modernized the DSM diagnostic system, which relies exclusively on “observable behavioral criteria.” For many years, we’ve all observed thousands of hours of Trump’s behavior, reinforced by the observations of dozens of individuals who have interacted with him personally. Using the DSM V, it is easy to see that Trump meets the behavioral criteria for antisocial personality disorder. Even a non-clinician can see that Trump shows a lifetime pattern of “failure to conform to social norms and laws,” “repeated lying,” “reckless disregard for the safety of others,” “irritability,” “impulsivity,” “irresponsibility,” and “lack of remorse.”
Because of their sadism, malignant narcissists often derive joy from inflicting suffering on others because they disregard the emotions and wellbeing of other people—especially their perceived enemies. For example, according to first-hand accounts, Trump watched the violence he unleashed on January 6 for three hours on TV with “glee,” watching his favorite parts “over and over” on “rewind.”
To make matters worse, Trump appears to be showing signs of cognitive decline that urgently cry out for a full neurological work-up, including an MRI and neuropsychological testing. These symptoms include: a dramatic decrease in verbal fluency, tangential thinking, diminished vocabulary, overuse of superlatives and filler words, perseveration, confabulation, phonemic paraphasia, semantic paraphasia, confusing people (not just names), as well as exhibiting deteriorating judgment, impulse control, and motor functioning (including a wide-based gait). We suspect the results of such an evaluation would be disqualifying. If, as we suspect, Trump does have organically based cognitive decline, it will only get worse over time, grossly degrading his already impaired judgment, impulse control, memory, attention, reality testing, and capacity to process information, while dramatically exacerbating the symptoms of his toxic personality disorder.
People suffering with mental illness are no more likely to be dangerous than the general population. Malignant narcissism is the very rare exception. Without question, malignant narcissists have been history’s most grandiose, paranoid, and murderous leaders. Inevitably, they escalate until they are completely out of control, ultimately destroying themselves and the nations they lead.
As mental health professionals we feel a desperate duty to warn our fellow citizens of this imminent catastrophic public danger before it’s too late.
I signed it. So did over 200 other mental health professional including my friends Dr. John D. Gartner, who started the Duty to Warn movement and was the first to go public in 2017 warning about Trump's dangerous maligant narcissism in this USA Today article, and psychoanalyst Howard Covitz who, like Gartner, I've known personally since 2017.
I personally asked eight people who I know to sign it. While I am disappointed more didn't do so I was gratified to see that two of them did.More than 230 doctors say Trump is too unstable to serve in open letter connected to George Conway’s PAC
Letter states that the Republican candidate ‘appears to be showing signs of cognitive decline that urgently call for a full neurological workup’
The Anti-Psychopath PAC’s advertisement was published the same week as another full-page ad in the New York Times, signed by over 200 survivors of sexual assault and gender violence. One signatory, a former girlfriend of the late sex offender Jeffrey Epstein, alleged in an interview that Trump had groped her. This ad aimed to remind voters of Trump’s legal troubles, including a recent civil case in which he was found liable for sexual abuse against writer E. Jean Carroll.
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