Why Saying Donald Trump Has Narcissistic Personality Disorder (NPD) is Unnecessary, Unethical, and Harmful to People with Mental Health Conditions

All over the Internet, you see articles along the lines of “Therapists agree that Donald Trump has Narcissistic Personality Disorder (NPD),” or “A Neuroscientist Explains…” or therapists saying they will be using clips of Donald Trump in their classes.

This needs to stop!

First, I need to preface this by saying this is not an argument whether Trump has NPD or not. It is an argument that we should not even be discussing his diagnosis, because:

1. Donald Trump should not be President because of his words, actions, and views. That is absolutely enough reason to be against him. We do not need to diagnose him with something to create a new reason why we should not vote for him. (There is undoubtedly enough solid evidence already!)

(Really, you could stop reading here. That’s my biggest point, and it doesn’t need any further explanation. But if you’re interested, there are a few other reasons.)

2. Associating Donald Trump with NPD means that people with NPD will be associated with Donald Trump. (I certainly wouldn’t wish that upon anyone.) It is increasing the stigma of not just NPD, but also other mental health conditions. And why should one stop at NPD? I fear that this argument would be extended to other mental health conditions and other important positions. For example:
“We can’t elect Senator Patrick Kennedy to be a President because he has bipolar disorder, and his mood swings would destroy our international relations.”

3. Diagnosing someone who is not your patient and sharing their diagnosis without their consent is unethical, as stated in the code of ethics for psychiatrists, psychologists, and therapists. In order to diagnose, you must be trained on and fully knowledgeable of the DSM. Psychiatrists, psychologists, and therapists typically take AT LEAST one full hour to assess a new patient’s mental health history in order to properly diagnose them.

The American Psychiatric Association states “When a personal examination has not been performed and when a psychiatrist is asked for a professional opinion about a person in light of public attention, a general discussion of relevant psychiatric topics — rather than offering opinions about that specific person — is the best means of facilitating public education” (https://www.psychiatry.org/psychiatrists/practice/ethics). The American Association for Marriage and Family Therapists warn against the impact of public statements (https://www.aamft.org/iMIS15/AAMFT/Content/legal_ethics/code_of_ethics.aspx), and the American Psychological Association states “psychologists provide opinions of the psychological characteristics of individuals only after they have conducted an examination of the individuals adequate to support their statements or conclusions” (Section 9.01, http://www.apa.org/ethics/code/index.aspx).

4. This is something often forgotten by nearly all, including numerous clinicians: people diagnosed with personality disorders are, first and foremost, people—people who have treatable illnesses. Not everyone with a PD or mental illness is the same and not everyone with NPD is a “horrible person.”
Burnt out or old school clinicians and medical professionals have told me that people with PDs are “too hard to deal with.” Some have even gone so far to say that they are “untreatable.” But there is hope. I’ve seen people with PDs move on to graduate from the clinics where I worked, gain meaningful roles and activities, and have strong relationships.

5. Yes, I have in fact worked very closely with many people with NPD and other PDs as a case manager at an intensive outpatient mental health clinic and other jobs in mental health. It can be very hard, but they are not evil people. Just because someone has a diagnosis does not mean they are a bad person!

Note: There is typically a distinction between mental illness and personality disorders. However, I’m considering both them under the umbrella of “mental health conditions,” because the general public does not know the difference, as well as similarity of symptoms, comorbidity, and the need to be knowledgeable of both to make a diagnosis.

So please, world, start saying that Donald Trump should not be President because of who and what he is—and then stop before bringing mental health into this. You have more than enough evidence already.

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