Showing posts with label mental health. Show all posts
Showing posts with label mental health. Show all posts

January 9, 2023

If Trump believes some of his pronouncements he may be clinically delusional

 If Trump believes some of his pronouncements he may be clinically delusional
By Hal Brown, MSW


I am tired of writing about Trump's psychopathology. Today's HUFFPOST story "Trump Says Biden 'Convinced' Putin To Bomb Ukraine In Mar-a-Lago Campaign Speech" prompts me to write yet another blog story about the question as to just how mentally ill the beleaguered former president might have become. 

We know he's a malignant narcissist, but how can we tell whether he is veering into becoming a delusional psychotic? 

In half of my 40 year career as a psychotherapist I worked in a community mental health center. Most of the severely mentally ill patients I worked with had been stabilized on medication so I only had a few chances to see someone exhibiting the delusions that were manifest prior to being stabilized on medications. Those times I did see patients who weren't medicated their delusions were the more typical. Several patients off medication had religious delusions and another believed a movie star was in love with him to the extent he ended up at the airport trying to board a plane without a ticket to be with his lover in Hollywood.

When a clinician does a diagnostic assessment they evaluate the patient's rational thinking and reality testing. A simple mental status exam includes the following (reference):

    • Thought process
      The flow and coherence of thoughts, inferred from a client’s observable behaviors, especially speech. For example, if the client’s speech is rambling and disorganized, the examiner may infer that their thinking is also disorganized.
    • Thought content
      Thought content can be inferred from spontaneous speech and direct questioning by the examiner. For example, the examiner might ask, “Have you ever heard things other people don’t hear or seen things other people don’t see?” An answer of “yes” to such questions raises the possibility of hallucinatory thought content.
    • Insight
      How aware is the client of their own strengths and limitations?
    • Strengths and limitations
      Traditional forms of the MSE have been designed to record any cognitive, emotional, or behavioral deficits. 
      Consider how a clinician would fill out portions of a standard mental status form like this, in particular the parts below, for Trump:

Here's more 

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. From WebMd

Perhaps Trump is already so detached from reality that any mental health professional would diagnosis him as having a psychosis. There's no way to tell how much of his pronouncements are performances and what he really believes.

Anybody who truly cares about his well-being ought to be very concerned about his lapsing into a psychotic state. Consider what you would do if you had a loved one who was expressing some of the beliefs Trump has been expressing.

Those who consider him the leader of the GOP, those cult members who blindly follow him, should also ask themselves whether they are being led by someone who is so unmoored from reality that they may be clinically delusional.

Another question which researchers could well look into is whether someone who deliberately uses gaslighting (defined as manipulating someone so as to make them question their own reality) for their own purposes can eventually gaslight themselves.

Marjorie Taylor Greene as an example of a low information and gullible person as opposed to being delusional

Just yesterday Rep. Greene addressed her pervious belief in QAnon conspiracy theories:

Wanting to believe something is different than actually believing it. Consider the poster on the wall of the X Files' Fox Mulder's office:

If someone doesn't have the ability to apply logical thinking to beliefs like those promulgated by QAnon ( including that the Clintons were responsible for murders, that the Democratic Party was responsible for a satanic child sex trafficking ring and that the California wildfires were caused by space lasers owned by a Jewish family) and gets all their information from one-sided sources they are vulnerable to being manipulated. Nobody wants to admit they were gullible and, as MTG said, that they were "sucked into" believing something that any logical person wouldn't believe.

This doesn't mean they are clinically delusional. It may suggest that they have a low IQ but above average intelligence isn't a requirement for holding public office. 

If anyone running for a major political office had to have above a 120 IQ and pass a battery of psychological tests I venture to suggest that the GOP side of the House would look very different. To the delight of Democrats, the GOP itself wouldn't be having to deal with this guy:



Ben Kalom replied on this site...

Thanks for blending in criteria. This helps secure our assertions that he is not mentally fit to hold any public office.

Mentally fit - I do not believe it matters whether genetics, experiences, trauma, parenting or personal choices have led us to this place of a fellow who simply blathers about in social media. He has no ability to filter. Delusional disorders is the correct section of DSM 5-TR to be reading and giving consideration. That section, in addition to considering his personality disorder cluster, should be the hub of any diagnostic conversation wheel we use to chat about how best to manage our feelings about him, vis-a-vis his repeated insistence on being vocal on social media.

There is a misperception of who might be considered "mentally ill." What I am referring to is the first defense he threw out to his crowd, "I'm rich!" Is there something about being wealthy that magically inoculates a person against mental disorder? I would offer the converse argument. Mo' money, mo' crazy. You need sage and sound counsel to help you manage your false-bottomed sense of total safety and security while living on this planet.

Donald simply does not know when to shut the f#$k up.

I am reminded of a training video in which Dr. Sal Minuchin was interviewing a patient with disorganized thinking. To characterize just how disturbing it is to the treatment professional to work with these folks day after day, Sal could not restrain himself and uttered, "What are you talking about??" in a most directive manner, hoping to encourage the client to get back on track.

In delusional disorder, there's no thesis, no theme, no specific argument, no path that gets to anywhere. It is walking with a person who is lost in the forest and then finds yet another distraction. Being lost is the entire point of their delusion. It is how they guard against the reality of life. Life breaks through their ordinary protections with ordinariness.

THat's much, much more than they can handle.

The warning we who study the disordered persons and the qualitative/quantitative means by which they've gotten into the swamp they are in, need to heed is in the sheer number of people who are also in that swamp with him, and who came to that swamp, expecting to find a country club swimming pool. His ability to hold them in a promise of prosperity has increased whatever disordered thinking and feeling these folks experienced prior to believing his siren song.

Crazy draws more crazy to itself. There's kinship in delusional status.

Is Donald delusional? I think I agree with that assertion, and I encourage other helpers and human services workers and professionals to see the dead poseys in the hands of their clients, and although you want to be kind and offer unconditional positive regard, keep the truth in your head that no matter what else you hear, those flowers are dead.

Donald is holding out dead flowers to his followers. That's what he's selling them. Dead flowers, purporting to re-animate them and make them alive again...

If you are a realist like I am, then you see how difficult it will be to convince folks who drank his dead flower tea to walk away from believing the delusional reality they've walked through the looking glass and entered.

Below from Tibel:

Click above to enlarge

December 24, 2022

Are Taylor Greene, Fuentes, and millions of Americans with fringe beliefs mentally ill?

Are Taylor Greene, Fuentes, and millions of Americans with fringe beliefs mentally ill? 
By Hal Brown, MSW

Marjorie Taylor Greene, on learning about the beliefs of Nick Fuentes the anti-gay, anti-woman, anti-Black, antisemitic incel who dined with Trump said about him: “I’m worried about kids that would follow him. And that’s a shame. But no, I don’t want to have anything to do with him. They showed me some [of Fuentes'] videos. I could not believe the stuff he says. I mean, it was shocking.”

Read the article which led me to write this essay. It includes Taylor Greene's reaction shown above.

Click above to read article


In January 2022, Fuentes launched, a streaming platform that he said would be “anti-gay, anti-woman, anti-Black, [and] antisemitic.” A month after launching the platform, he said women aren't "as rational as men" and should be beaten by their partners. He added a racist twist by saying that Black men understand this...

... Fuentes has also said that he thinks future politicians should take an incel "message to the men and say, ‘Hey men, hey men, vote for me, I’ll destroy feminism [and] ... make it harder for women to become whores [and]... incentivize women to be in monogamous marriages for the long term and to have and raise kids.”

A year ago VICE listed every conspiracy Marjorie Taylor Greene believed in, or said she believed in. Nobody can tell what she and others with fringe beliefs that are demonstrably untrue really believe and what they claim to believe to get attention.

How many beliefs do such people, have to have to be diagnosed as having a delusional disorder or another psychiatric condition?

Consider this article published in The Conversation:


I found that many QAnon followers revealed – in their own words on social media or in interviews – a wide range of mental health diagnoses, including bipolar disorderdepressionanxiety and addiction.

In court records of QAnon followers arrested in the wake of the Capitol insurrection, 68% reported they had received mental health diagnoses. The conditions they revealed included post-traumatic stress disorder, bipolar disorder, paranoid schizophrenia and Munchausen syndrome by proxy – a psychological disorder that causes one to invent or inflict health problems on a loved one, usually a child, in order to gain attention for themselves. By contrast, 19% of all Americans have a mental health diagnosis.

Consider that in addition to Marjorie Taylor Greene and Nick Fuentes two more people in the news, Herschel Walker and very recently George Santos show indications of having a mental illness.

It bears consideration to note that until the MAGA era descriptive colloquial phrases like batshit crazy were't common in descriptions of people in the news. Now they are ubiquitous. Unfortunately using this phase and others like "clown car" and "cray-cray" in a title is clickbait and tells you that you probably won't be reading a serious analysis of someone by a mental health professional.

More serious writers define people with unshakable fringe beliefs as delusional. These days most but not all involve what have come to be called conspiracy theories.

My laptop dictionary has two definitions of delusional. They are very different:

  • characterized by or holding false beliefs or judgments about external reality that are held despite incontrovertible evidence to the contrary, typically as a symptom of a mental conditionhospitalization for schizophrenia and delusional paranoia | he was diagnosed with a delusional disorder
  • based on or having faulty judgment; mistakentheir delusional belief in the project's merits never wavers | I think the guy is being a bit delusional here.
People who fall into the first group need treatment. People in the second group may benefit from re-education. Unfortunately many people in the later group belong to a peer group of people with the same beliefs, QAnon for example, and their only media source of information comes from the far-right media  which gives credence to conspiracy theories.I haven't even gotten into the promotion of The Big Lie which even Trump who started it never believed.

Amazing! Trump just got some bigots pissed off. By Hal Brown, MSW

  I had to read the RawStory article shown above three times to figure out what happened. Trump was showing his supposed support for law enf...