October 12, 2016

3 Competing diagnostic labels for Donald Trump

I am not big on diagnostic labels so it is with some reluctance that I am writing this. Lately I have been reminded of some of them a lot. Frequently, Donald Trump is referred to as a narcissist and an authoritarian which, I think, is understandable. The narcissist association has to do with how he frequently describes himself in ridiculously positive terms (“I have a great brain”, etc). The authoritarian part has to do with his domineering behavior and ideology.

But I am also often reminded of another disorder. For example when I heard him brag about how he sexually assaults women. What is striking is that while he is describing deplorable behavior he is not talking in a contrite way but rather quite proudly. Also, when talking about having paid no taxes, you’d expect an apologetic tone of voice but Trump brags about it and claims it was brilliant of him to use the tax code this way.

The antisocial personality disorder 

This pattern of speaking proudly of what most people would consider shameful behavior reminded me of something I read decades ago when I was still studying psychology. I read the passage in the book Abnormal psychology (by Davison & Neale). I don’t have the book anymore, so I’ll have to rely on my memory (if readers can find the original passage, please send it to me).

That passage described the antisocial personality disorder. It was about a man who sat in a restaurant with a group and about how he asked the group to pay attention to how he could make the waitress feel bad and do precisely what he wanted. Then he proceeded to do that. The behavior itself is bad enough, but the distinctive thing is the antisocial person also brags about it. This shows a strong disregard of other people’s feelings and an unawareness of social norms.

Remembering this, I looked up what the antisocial personality disorder’s symptoms are and I found this:
  • Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest
  • Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
  • Impulsivity or failure to plan ahead
  • Irritability and aggressiveness, as indicated by repeated physical fights or assaults
  • Reckless disregard for safety of self or others
  • Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations
  • Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another
What do you think? Does this apply to Trump?


Viewing this, it seems that antisocial personality disorder is as good a diagnosis as narcissistic and authoritarian personality disorder would be. Perhaps this illustrates how relative diagnostic labels are (considering all three labels seem to apply). Also, I doubt whether diagnostic labels are very helpful when providing therapy. I doubt whether such diagnoses can be clearly translated into treatments. Also, diagnostic labels are frequently, I think, too easily applied to people who deviate just somewhat from the norm thereby stigmatizing relatively normal people.

At best, perhaps, labels like these are descriptions of somewhat frequently occurring dysfunctional behavior patterns. Now that the stakes are so high, perhaps it is useful to point out that Trumps behaviors seem to resemble some well-known diagnostic labels from clinical psychology.

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