PSYCHOLOGICAL DIAGNOSES OF TRUMP. TAKE CAUTION.
Is Donald Trump emotionally unstable? In the psychological community there is far from a consensus on this issue. On the one hand are psychologists who say Trump displays unmistakable signs of narcissistic, paranoid, and antisocial personality disorders, and they have issued public pronouncements saying this toxic combination puts America at great risk.
But, and this is a big but, making professional diagnoses without any face-to-face contact, or without evaluating results from formal psychological testing, is problematic, if not unethical. In fact, the American Counseling, Psychological, and Psychiatric Associations follow the Goldwater Rule: It is unethical to give a professional opinion about someone who has not been examined and tested in person.
Many mental health professionals maintain, however, that Trump’s spoken record is filled with such extreme indications of pathology, and the consequent danger to the country is so great, that they have an obligation to inform the public.
Other professionals say public pronouncements bearing on Trump’s stability are inappropriate. Professionals should not be applying emotionally-laden labels in the absence of valid diagnostic data. Also, just because someone fits the general profile of a personality disorder does not mean the person is a danger to others. Many effective leaders are narcissists, a trait that can be essential to their leadership abilities. Some of us also have colleagues who say that many college students would score high on antisocial scales, but do not pose a danger to the institution.
When considering this issue and evaluating the different opinions, we believe you should be very cautious. There is an important distinction between offering a formal diagnosis vs. saying that particular ways of acting are characteristic of particular diagnoses.
We believe that psychological diagnosis should be based on hours of face-to-face therapeutic contact, and on data from formal measuring instruments with documented reliability and validity. Professional opinions based on indirect observation, such as visual and print media, are impressionistic and opinionated. While perhaps a step beyond pure speculation, such opinions should be considered at best to be educated guesses.
And remember, if a professional were privy to formal assessment data, that information would fall under doctor-client confidentiality and could not be shared.
The bottom line is this: It is one thing for the citizen counselor, psychologist, or psychiatrist to send a letter to a newspaper or magazine and complain about Trump’s confrontational interpersonal style. It is quite another thing, however, for that writer to extrapolate from those observations and declare publicly that Trump is mentally ill.
We believe Trump’s fitness for office should be discussed in a political, not a psychological, context.
Psychology and Stress 
I am compelled to comment on this. At first, I truly believed this was going to be something that I did not want to read, but I am thankful that I stuck it out all the way to the end. On Saturday, February 18, 2017, my husband and I witnessed a historical event: a Presidential rally in Melbourne, Florida, with President Donald Trump and First Lady Melania Trump. We spent 45 minutes driving there, we parked a good 1/2 mile away and waited 2 hours in a line that was probably 1.5 miles long. This was a once-in-a-lifetime event not to be missed. Within 5 minutes of our finally getting near the stage in the hanger, the plane rolled up, the stairs were positioned and the door opened. A native Washingtonian by birthright, I have seen these planes many times, but this was the closest that I have ever been to one, let alone seeing the Commander in Chief exit it along with the First Lady. The music played loud and the 10,000 in attendance cheered, clapped, and were beyond delighted to see him. He spoke for over 45 minutes on topics such as Fake News, Obamacare and Building the Wall and not once did I get the notion that this is someone who has any selfish intentions, a hidden agenda of any kind or anything negative. This is someone who has sacrificed his next 4 years and is dedicating his time to ensuring improvements to the system that has been broken. He wants a better system, a safer country and one that prospers again. He doesn’t want war, he doesn’t want to have companies farm out the work oversees and he doesn’t want people to abuse the system and sit home and collect money and not earn it. That is NOT narcissism, that is someone who is looking out for the people that he serves. He is serving each American, regardless of their skin color, because we all bleed red.
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Thanks for the comment, Sandy. Sounds like you had an inspirational time at the campaign rally you described. That’s wonderful. The relevance of your comment to our blog post, however, is not at all clear because you enter the political playing field. You advocate for Trump and you use his positions to take issue with professionals who say he fits the profile of a narcissistic personality. Our blog, on the other hand, advocates for no political position, nor does it discuss the accuracy of diagnoses mentioned. The blog simply presents two incontrovertible facts: (1) some psychologists are making public diagnoses of Trump without any direct evaluation from therapeutic interaction or from formal psychological testing; (2) Professional associations state it is unethical to make such public pronouncements in the absence of formal evaluation. We state our agreement with the professional associations and conclude that diagnoses should remain in the practitioners’ offices and should not be expressed in the public, political arena. Thus, the blog, unlike your comment, deals with a professional psychological issue, not a political one. There’s a big distinction.
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