I'm not the only mental health professional who says that Trump needs a rigorous neuropsychiatric evaluation to rule out a cognitive illness, by Hal Brown, MSW

 The article, above, Trump's Repetitive Speech Is a Bad Sign has been summarized in RawStory with the title Psychiatrist flags 'alarming' debate tic — and urges Trump to seek a neurologist, the EconoTimes with the title Psychiatrist Urges Donald Trump to Seek Neurological Exam After 'Alarming' Debate Behavior Raises Cognitive Concerns, and elsewhere.

They save me from the task of summarizing it. Still, I recommend that you read the entire article here.

I have been writing about this issue ever since the debate firmed up my own diagnostic assessment that Trump had a cognitive disorder, either early dementia, mania, or a combination of the two. But then again I am not an eminent mental health professional. I was what could be called a country psychotherapist for 40 years because I practiced in rural areas and graduated from what was once called a cow college, originally Michigan Agricultural College, now Michigan State University. 

The author of this article is what can be called eminent. He's  Richard A. Friedman, who  also has a Wikipedia page.

Two days ago I wrote BEDLAM IN HIS BRAIN: Call it insanity, mental illness, or cognitive impairment, Trump gave us ample evidence he needs professional help. 

My conclusion was the same as psychiatrist and professor Friedman's. This is that this debate showed is that if Trump was anybody else his family would be seeking professional help for him.

The number one reason Trump should never set foot in the Oval Office is that he will destroy democracy. The related reason is that dementia never gets better and as I wrote yesterday there will be a point where his symptoms will be so severe he'd be removed through the 25th Amendment and J.D. Vance would become president.

The country would go from having a sociopathic president who was mentally impaired, irrational, and unstable like Idi Amin who didn't have nuclear weapons, to having a sociopathic one who is as sane, rational, and calculating as Vladimir Putin, Kim Jong Un who do have nukes, and dare I say, as Adolph Hitler was. 

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Consider sane malignant narcissist J.D. Vance as president. By Hal Brown, MSW

Trump is a narcissistic sociopath (aka malignant narcissist), but also after the debate he has given us conclusive proof that he has an organic brain disease - dementia, mania, or a combination of the two. Of course this makes him even more dangerous. But there is another element to consider. 

This means that if elected there's a good chance his condition will deteriorate to the point that he will be removed through the 25th Amendment and then we will have J.D. Vance as president. He too is a malignant narcissist, but he doen't have an organic brain disease. 

Remember, Hitler was a sociopath but there has been controversy among experts over whether or not he suffered from organic psychopatholgy (see Wikipedia). I am not an expert on Hitler but my own impression is that no matter whether or not he might have had any of the disorders listed in the following chart none of them significantly impaired his ability to think rationally.

Click to enlarge image

I don't see any indications that J.D. Vance suffers from any organic, or brain, psychopatholgy. Narcissistic sociopathy is psychopathogy, but it is a personalty disorder. He fits into the category of people without severe organic mental disorders that led to the coining of the term "the banality of evil" by Hannah Arendt. Below from Wikipedia:

Famed is Hannah Arendt's invention of the phrase the "banality of evil"; in 1963, she stated that for a Nazi perpetrator as Adolf Eichmann, mental normality and the ability to commit mass murder were not mutually exclusive. Harald Welzer came to a similar conclusion in his book Täter. Wie aus ganz normalen Menschen Massenmörder werden (Perpetrators: How ordinary people become mass murderers).

We all know the kind of country J.D. Vance wants to turn the United States into.

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BEDLAM IN HIS BRAIN: Call it insanity, mental illness, or cogntive impairment, Trump gave us ample evidence he needs professional help, by Hal Brown, MSW

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

'What’s wrong with Trump?' Onlookers stunned as ex-president smiles at 9/11 memorial event

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