@bigheadfred @mystery-ak @Freya @Oceander @txradioguy @CatherineofAragon @Quix@Suppressed"Full title: The psychiatrist who wrote the guide to personality disorders says diagnosing Trump is “bullshit”
Allen Frances is a psychiatrist who wrote the rules for diagnosing personality disorders in the Diagnostic and Statistical Manual of Mental Disorders. The DSM is the No. 1 tool mental health professionals have for making diagnoses."
Let's get the truth out here:
The title makes it sound like Allen Frances wrote every DMS manual ever written. That is ridiculous and not true. Neither did he write the "rules for diagnosing personality disorders". Hundreds of psychiatrists did that. He was only the "chair" of the DSM-IV Task Force - that is only one DSM diagnostic manual book. Frances says he wrote the definition for Narcissistic Personality Disorder so he probably did for the DSM-IV. As "chair' of the group, his people would have held meetings with the psychiatrists and complied the material and sent it to the publisher.
Here is who Frances is:
Allen Frances, M.D., was the chair of the DSM-IV Task Force and of the department of psychiatry at Duke University School of Medicine, Durham, NC. Before this position, he was a professor at Cornell University, Ithaca, New York.
Frances wrote a book, “Against Out Of Control Psychiatric Diagnosis, DSM-V..” You see, we don't use his DSM-IV any more, it is out of date. The new one is the DSM-V, and Frances doesn't like it so he wrote a book against it. (Can you say sour grapes?)
David J. Kupfer, M.D, is the chair of the DSM-V Task Force; Professor of Psychiatry at the University of Pittsburgh School of Medicine. This is the new manual used today, the DSM-V, which Frances is complaining about.
Here is a description of the DSM-V:
"The Diagnostic and Statistical Manual of Mental Disorders DSM–V, is the product of more than 10 years of effort by hundreds of international experts in all aspects of mental health. Their dedication and hard work have yielded an authoritative volume that defines and classifies mental disorders in order to improve diagnoses, treatment, and research."
Now, as to a diagnosis, when someone "should" get a diagnosis, Frances is correct:
"But they ignore the further requirement that is crucial in defining all mental disorders—the behaviors also must cause clinically significant distress or impairment."
That is rule one a psychological examiner learns. If a person is running his/her life without significant distress that affects his/her life, he/she should have no diagnosis. I recall an example used in my training, and the question was this: If a burglar is a successful burglar and living well, feeling fine, should he/she be tested and get a diagnosis? Now we come to another consideration - if the person is operating successfully for him/her self, BUT HARMING OTHERS, an intervention is required, in this case, the police to stop the behavior. It is possible, the burglar could realize, with counseling, his/her behavior must change but the behavior must stop.
Psychologist Gartner says, “The thing about people with personality disorders … they don’t have distress related to their disorder; they cause distress in other people,” he says. “They’re in complete denial about the nature of their illness or even having an illness.” But “as someone who has been an expert and a teacher of severe personality disorders in 35 years, this is the worst case I have seen in my career,” he says."
I want to add what Psychologist Miller said:
“You always want collateral information,” Miller says. “If I was seeing a patient for anything, I would want to talk to their spouse or children, if possible. ... You might get more nuanced information.”
Gartner is correct and so is Miller. Gartner would be more correct if he incorporated Miller's advice. When I made an evaluation, the first thing to happen was an interview with the patient, whether an adult or a child (in a child's case, always talked to the parents, too.) I wanted information about this person since birth. Was the birth normal? From there, I got every bit of information possible about the behavior of this patient from birth until now. Only after that, did the testing begin.
That is why I researched Trump's background/behavior from the time he was born until now. Gartner should have done that. I agree with Gartner, Trump's personality disorder is the worst I have come across. But, you see, I believe the two psychologists and Frances are all missing a cause for his behavior; there is more wrong than Narcissistic Personality Disorder, so perhaps Frances stopped with his specialty, Narcissistic Personality Disorder, when he should have considered other causes that might be present also. I think there is a reason why Trump must promote himself all the time, which looks like Narcissistic Personality Disorder. But added to that, he must be perfect all the time and be the "best" all the time, and attack anyone almost forever if there is the slightest disagreement. His childhood behavior suggests a learning disorder and I have tested many hundreds of students for learning disorders, I recognize the behavior. If one attaches a learning disorder, which fosters feelings of inadequacy, to a Narcissistic Personality, you get an aggressive person who will not stop until everyone in the world declares him the best. His deception of everyone would be complete then - only he would know he was not the best. Due to these likely disorders, and sleeping only 3-4 hours a night, I think the strain of the 24 hr. a day job, trying to prove he is the best to cover his inadequacy, and constantly attacking others to keep proving it, will cause a mental breakdown or a heart attack or a stroke.
The above is my opinion responding to the article presented here.