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Narcissism Expert Says Calling Trump Mentally Ill Is A Misdiagnosis

The cover of "Twilight of American Sanity" by Dr. Allen Frances.
William Morrow
The cover of "Twilight of American Sanity" by Dr. Allen Frances.
Narcissism Expert Says Calling Trump Mentally Ill Is A Misdiagnosis
Narcissism Expert Says Calling Trump Mentally Ill Is A Misdiagnosis GUEST: Dr. Allen Frances, author, "Twilight of American Sanity"

Questions about the mental health and fitness of President Trump continue to be raised in several members of Congress has called for him to receive a psychiatric evaluation. If there is a problem with the president's fitness to serve, is it his mental health or the nation ? A doctor is asking that same question. Dr. Allen Frances is the author of "Twilight of American Sanity: A Psychiatrist Analyzes the Age of Trump" . Welcome to the program. It is my pleasure. In February, 35 mental health professionals sent a letter to the New York Times declaring that the belief that trumps mental state -- he is incapable. You wrote a rebuttal that he is not mentally ill. How can anyone say he is or is not if he is not been examined ? The people who are making the diagnoses are well-meaning. They want to do something. If you have a hammer, a psychiatric diagnosis what you look like. There is no evidence that the diagnoses that he is been offered, the narcissistic disorder or, that does not make sense for him. He has always made -- he is always been like this. He will not be eliminated from office. That will never happen. The problems in diagnosing this, first, a terrible statement. He is competent and well-meaning. We have had mentally ill presidents. Abraham Lincoln had serious depression. Winston Churchill had serious depression. Mental illness is not the problem. It is being a bad person. If we regard him as mentally ill, we underestimate his cunning. In some ways, he is crazy like a fox. Things he does is terrible for the country not because he is mentally ill but because he is selfish. The third reason is, we will not solve the problems with psychological name:. We need Congress to tame this guy. We have to start figuring out ways to prevent his finger from being on the nuclear button and prevent him from declaring war. We missed the point. You wrote the criteria for narcissistic personality disorder which some experts say they believe that Trump suffers from that. How does Trump differ from the classic symptoms of that disorder in your opinion ? He is a world class reining world champion of narcissism but to meet the criteria for mental DeSales -- disorder, you also have to distress or impairment. He causes the distress in others. He creates tremendous impairment everywhere he goes but he does not feel the stress himself. He is incapable of that. Instead of being impaired, he is been given our highest office. He made billions of dollars. He is gotten beautiful women. His narcissism has been terrible for the people around him but not for him. You have not spoken with President Trump. You have not analyzed him. How do you know he is not distressed by his behavior ? There is no doubt that people that are very narcissistic yet distressed when they do not get everything going their way. Is that enough to be clinically significant? No. Actually, this is a good point to make. I was there in 1978 when we decided to include narcissistic personality order in the official diagnostic system. We did it for clinical purposes because patient show up in doctors offices when the wife gets fed up and when they lose their job because the boss is fed up or they get old. We never dreamed that something developer clinical purposes would be used as a kind of psychological name-calling in the political arena and it would distract attention from the vital political steps that need to be taken to contain this most dangerous of presidents. You said that blaming Trump Mrs. the underlying societal sickness that made his election possible. What is that ? I started writing this two years before Trump. Who dreamed he would become the president of the United States? I was concerned about my grandchildren that we were headed in a direction ignoring threats that we would hand the world to our kids much worse than the world that we were given. The ones I discussed that were most troubling to me were global warming, and hundreds of millions of people may be gone because of global warming and overpopulation. Every trouble spot in the world is troubled because of an increase of the population. The world population has tripled in my lifetime. The countries that are troubled, it is an ongoing problem. How is ignoring or having different political ideas about those particular issues, how is that delusional ? I think our society, ignoring the fact that global warming and climate change and resource depletion, these will create disastrous problems. That is just as problematic as the delusional patient who gets into very serious trouble because they ignore the reality of the world. If America was your patient, how would you begin to coax them to see through this delusion? I think the only way we will move beyond what is hopefully a temporary insanity is to use reason. The tendency as people is to react quickly and unconsciously and emotionally. Emotional parts of our brain are more powerful than the rational brains. The reading -- the reason that is powerful, if we are able to see through the polarization, to see through the propaganda, the American people are sensible. The polarization is less amongst the people than the French groups and politicians. We can come together as a country with proper leadership. I have been speaking with Dr. Allen Frances , the author of "Twilight of American Sanity: A Psychiatrist Analyzes the Age of Trump" . Thank you. Thank you.

Questions about the mental health and fitness of President Trump continue to be raised.

Last month, Rep. Zoe Lofgren, a California Democrat, called for Trump to get a psychiatric evaluation. And in July, Sen. Susan Collins, a Maine Republican, and Sen. Jack Reed, a Rhode Island Democrat were caught on a hot microphone discussing Trump’s mental health:

Reed: I think he’s crazy.


Collins: I’m worried.

Reed: I don’t say that lightly and as kind of, you know, a goofy guy. Uh, oof. And you know, the, uh, this thing, you know, if we don’t get a budget deal —

Collins: I know.

Dr. Allen Frances has heard these arguments before—that Trump is delusional or has narcissistic personality disorder—and thinks they do a disservice to people with diagnosed mental illness. He should know: Frances is the former chair of the psychiatry department at Duke University and wrote the definition of narcissistic personality disorder for the Diagnostic and Statistical Manual, a psychiatric reference guide.

RELATED: Should Psychiatrists Be Allowed To Publicly Analyze Donald Trump’s Sanity?


Frances, who now lives in Coronado, wrote a letter to The New York Times in February after about 35 mental health professionals said they didn’t think Trump was mentally capable of serving safely as president. While Trump’s detractors have labelled him a narcissist, Frances wrote that in order to have a diagnosed disorder, those behaviors would need to cause Trump clinically significant distress. Frances has expanded on the letter in a new book, “Twilight of American Sanity: A Psychiatrist Analyzes the Age of Trump.”

“I hate it when psychiatric diagnosis is so carelessly misused to mislabel as mental illness every conceivable example of simple bad behavior,” Frances wrote. “Lumping (Trump) with the mentally ill stigmatizes them more than it embarrasses him.”

Frances joins KPBS Midday Edition on Wednesday with more about the dangers of diagnosing politicans from afar and whether American society can be called “delusional.”

Corrected: November 30, 2023 at 10:57 PM PST
Editor's note: An earlier version of this article didn't include the full context for Sens. Collins and Reed's remarks.