Prevalence and symptoms: On Thursday, February 27, Lawrence O'Donnell performed a public service.
The cable news host was breaking the rules! At the end of his hour-long program, he introduced a repeat guest:
O'DONNELL (2/27/20): The coronavirus crisis is going to get worse for Donald Trump. Even though the president will probably stay physically healthy throughout the crisis, his mental health could decline each day of the crisis.The book to which O'Donnell referred had been assembled by Yale psychiatrist Bandy X. Lee.
Some mental health professionals, like our next guest, believe that the president's mental health has been, and will continue to be, in decline. The incompetence of Donald Trump and his administration is on dramatic and dangerous display every day now.
Joining us now is Dr. Lance Dodes, the former assistant clinical professor of psychiatry at Harvard Medical School. Dr. Dodes is a contributor to the best-selling book “The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President.”
During 2017, Lee attempted to trigger a discussion of President Trump's mental health. In January 2018, a New York Times editorial put an end to this effort.
All across the upper-end press, obedient members of the guild agreed to avoid any such debate or discussion. In doing so, they were following a time-honored rule off the cliff and onto the rocks below.
The journalistic rule in question is the so-called Goldwater Rule. Generally speaking, it holds that psychological and psychiatric assessments should be kept out of political journalism.
The Goldwater Rule is an excellent rule—until you find yourself with a president who seems to be mentally ill. In typical fashion, the New York Times stuck its head in the sand with its influential editorial.
Two years later, Dr. Dodes took a different approach. O'Donnell's interview started like this:
O'DONNELL: Dr. Dodes, what do you think you were watching last night when the president participated in that press conference, where we went from a president who seems to know nothing about what's going on—worried about the stock market—to public health experts explaining things that the president then immediately contradicted?The conversation went on from there. You can peruse the full transcript here.
DODES: Well, I think that what was on display is what we really ought to have already known. As you pointed out, Lawrence, this man is about himself. He really is not about the country. He's not about public health.
Although he has already severely damaged the country by being a psychopath or sociopath, in many ways he's damaged democracy. I think people's lives will be lost now. Individual lives will be lost because of the way he's mishandling the coronavirus issue.
So you know, as you pointed out, he lies. He has contradicted his own health officials. And in a very dangerous move, he's apparently muzzled them so that they now can't speak out...
The misstatements and muzzling to which Dodes referred have of course continued, and have probably worsened. We ask you to focus on one point only—Dr. Dodes' striking use of the word "sociopath."
Is it possible that Donald J. Trump is a "sociopath?" Plainly, that's what Dodes said—and Dodes is a high-ranking psychiatric specialist. (At this site, we rarely refer to anyone as an "expert.")
Needless to say, the fact that Dr. Dodes said it doesn't make it true. But as the president's public behavior continues to deteriorate, it seems to us that the press corps should be exploring the president's possible mental health problems rather than giving him several free hours, every night, to misinform the public and to slime all comers.
Is it possible that Donald J. Trump could possibly be a "sociopath?" Let's think about that for a while:
As far as we know, the term "sociopath" isn't a formal psychiatric diagnosis. That said, the term is sometimes informally used by specialists and professionals, as was the case on O'Donnell's program that night.
It's widely said that the colloquial term corresponds to a specific diagnosis. This is the way the matter is explained by Psychology Today:
What Is a Sociopath?So says Psychology Today, at least in that one post. In the absence of a wider discussion within the cowering upper-end "press corps," we'll have to rely on such presentations in what we show you today.
Sociopathy is an informal term that refers to a pattern of antisocial behaviors and attitudes, including manipulation and deceit, that often arises from environmental factors. Sociopaths may or may not be criminals.
In the Diagnostic and Statistical Manual of Mental Disorders (DSM), sociopathy is most closely represented by Antisocial Personality Disorder. It is important to note that sociopathy is not a formal diagnosis, but is often invoked in discussing people on the antisocial spectrum, who generally display callous behavior with little regard for others.
Sociopaths are often difficult to identify until one is very familiar with their behavior. Sociopaths are often manipulative, lie frequently, lack empathy, and have a weak conscience that allows them to act recklessly or aggressively, even when they know their behavior is wrong.
As we start, we'll recommend one key statement from that brief synopsis: "Sociopaths may or may not be criminals." Here's why we point to that:
Informally, laypersons may associate the term "sociopath" with the most extreme, most unusual types of criminal conduct. We may think of Son of Sam; we may conjure Jack the Ripper.
As far as we know, the psychiatric disorder in question is far more prevalent than that. In another post at Psychology Today, some basic statistics are provided:
In 1994, the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders was published (the DSM-IV)... Regarding sociopaths (the DSM uses the equivalent term Antisocial Personality Disorder or ASPD), it said that overall prevalence “in community samples is about 3% in males and 1% in females.”If we assume that those assessments are generally accurate, so-called sociopaths really aren't one in a million, like a Son of Sam. Those studies produced assessments which comport with something we were told long ago:
Between 2001 and 2005, the National Institutes of Health (NIH) funded the largest study ever done regarding the prevalence of personality disorders in the United States. Structured interviews were done with approximately 35,000 people who were randomly selected to be representative of the U.S. adult population in a variety of ways including age, income, gender and region. This study found that 6.2% of the general population would meet the criteria for [Narcissistic Personality Disorder] and 3.7% would meet the criteria for ASPD (5.5% male and 1.9% female).
Something like 3-6 percent of men could be so diagnosed. Very few of these people are Son of Sam, but they may be profoundly disordered.
Is it possible that Donald J. Trump is a "sociopath?" Could that explain the increasingly ridiculous and ugly behavior our cable networks are choosing to broadcast for two hours every night?
Could our commander be disordered in that particular way? Below, we show you ten of the Mayo Clinic's list of "signs and symptoms" for the technical disorder in question:
SymptomsPersistent lying or deceit? Callous disrespect for others? Arrogance, a sense of superiority, being extremely opinionated? Lack of empathy for others?
Antisocial personality disorder signs and symptoms may include:
1) Disregard for right and wrong
2) Persistent lying or deceit to exploit others
3) Being callous, cynical and disrespectful of others
4) Using charm or wit to manipulate others for personal gain or personal pleasure
5) Arrogance, a sense of superiority and being extremely opinionated
6) Recurring problems with the law, including criminal behavior
7) Repeatedly violating the rights of others through intimidation and dishonesty
8) Impulsiveness or failure to plan ahead
9) Hostility, significant irritability, agitation, aggression or violence
10) Lack of empathy for others and lack of remorse about harming others
Do those characteristics sound like anyone you may have seen in the public square?
When we watched the president's performance at last Saturday's televised marathon, we came away thinking that we had watched a rolling check-list of those symptoms and signs.
We thought we'd watched a rolling self-diagnosis. We googled the Mayo Clinic's site once again. Check, check, check, we said.
("Recurring problems with the law?" Despite the financial power he has long wielded, our president has routinely been in legal trouble on the civil side. His business life has been an extended series of cons and scams. So it goes with the many diagnosable "sociopaths" who aren't Son of Sam.)
When he introduced Dr. Dodes, O'Donnell said this: "Some mental health professionals, like our next guest, believe that the president's mental health...will continue to be in decline."
The president's absurd behavior at yesterday's "briefing" suggested that this prediction may have been correct. For ourselves, we've been telling you since last year that we may not even have a presidential election this fall.
In part, we based that warning on the exclusive nocturnal briefings we receive from future experts. But after watching the lunacy from Wisconsin this week, are you still unable to imagine what may lie ahead?
In Monday's New York Times, Jennifer Senior joined O'Donnell is breaking away from the herd. She said we need to start discussing the president's mental health.
She suggested a second possible diagnosis—Narcissistic Personality Disorder. But Jennifer Senior got it right when she made that general recommendation, although this too must be said:
There's little chance that our upper-end press corps would be able to execute such a challenge. Even if the spirit was willing, the skill level would be very weak.
This is the state of American mental hygiene in this, the fourth year of President Trump. So it goes at the current state of the evolution of "the rational animal."
We think that conversations should proceed, but it almost surely won't. And if that discussion did proceed, what happened wouldn't be pretty.
Tomorrow: Where do psychiatric disorders come from?
Additional disclosure: In our view, it will fall to today's 9-year-old kids to rebuild our intellectual culture. It's said that the Irish saved civilization. It seems to us that our 9-year-old children will have to follow suit.
In afternoon posts like these, we've been starting to describe one way they might start.
We're pursuing this subject because it's interesting—because it isn't stupendously dumb.