Sunday, January 07, 2018

Trump is now dangerous – that makes his mental health a matter of public interest

This world authority in psychiatry, consulted by US politicians, argues that the president’s mental fitness deserves scrutiny
... To make a diagnosis one needs all the relevant information – including, I believe, a personal interview. But to assess dangerousness, one only needs enough information to raise alarms. It is about the situation rather than the person. The same person may not be a danger in a different situation, while a diagnosis stays with the person.

It is Trump in the office of the presidency that poses a danger. Why? Past violence is the best predictor of future violence, and he has shown: verbal aggressiveness, boasting about sexual assaults, inciting violence in others, an attraction to violence and powerful weapons and the continual taunting of a hostile nation with nuclear power. Specific traits that are highly associated with violence include: impulsivity, recklessness, paranoia, a loose grip on reality with a poor understanding of consequences, rage reactions, a lack of empathy, belligerence towards others and a constant need to demonstrate power.

There is another pattern by which he is dangerous. His cognitive function, or his ability to process knowledge and thoughts, has begun to be widely questioned. Many have noted a distinct decline in his outward ability to form complete sentences, to stay with a thought, to use complex words and not to make loose associations...Cognitive decline can result from any number of causes – psychiatric, neurological, medical, or medication-induced – and therefore needs to be investigated. Likewise, we do not know whether psychiatric symptoms are due to a mental disorder, medication, or a physical condition...

[Is Trump on drugs? This has been something that has been wondered about before: his Studio 54 days as Disco Donald, his manic behavior, manic speech, the snorting during one of the debates, his alarming slurring of his words during his Jerusalem speech.]
...
...Mental illness, or even physical disability, does not necessarily impair a president from performing his function. Rather, questions about this capacity mobilised us to speak out about our concerns, with the intent to warn and to educate the public, so that we can help protect its own safety and wellbeing.

[That is not true. As Dr. Lee goes on to say, in effect, the American people are as crazy as Trumpie is. You cannot educate this public.]

Indeed, at no other time in US history has a group of mental health professionals been so collectively concerned about a sitting president’s dangerousness.

Pathology does not feel right to the healthy. 

[That is an interesting formulation. It is sooo true. It just does not feel right, you know there's something wrong but sometimes it's difficult to put your finger on it. "To the healthy:" NOT the American public.]

It repels, but it also exhausts and confuses. There is a reason why staying in close quarters with a person suffering from mental illness usually induces what is called a “shared psychosis”. Vulnerable or weakened individuals are more likely to succumb, and when their own mental health is compromised, they may develop an irresistible attraction to pathology. 

["Vulnerable or weakened individuals"=Johnstown, Pa residents. Dr. Lee is dancing around it because he doesn't want to say the American people are crazy. This becomes less clear before it becomes more clear but it does become more clear. Critical passage there, critical passage.]

When signs of illness become apparent, it is natural for the physician to recommend an examination. But when the disorder goes so far as to affect an individual’s ability to perform her function, and in some cases risks harm to the public as a result, then the health professional has a duty to sound the alarm.

[Less clear: You "sound the alarm" to alert other people, right? You sound this alarm to alert the American people, right? No. What good would it do to sound the fire alarm to the arsonists? The American people. The ones who "share psychosis" with Trump. The ones who put him in the "dangerous position" as president. Dr. Lee means other-other people.]

The progress of the special counsel Robert Mueller’s investigations was worrisome to us for the effects it would have on the president’s stability. We predicted that Trump, who has shown marked signs of psychological fragility under ordinary circumstances, barely able to cope with basic criticism or unflattering news, would begin to unravel with the encroaching indictments. And if his mental stability suffered, then so would public safety and international security.

Indeed, that is what began to unfold: Trump became more paranoid, espousing once again conspiracy theories that he had let go of for a while. He seemed further to lose his grip on reality by denying his own voice on the Access Hollywood tapes. Also, the sheer frequency of his tweets seemed to reflect an agitated state of mind, 

[Yes, good point.]

and his retweeting some violent anti-Muslim videos showed his tendency to resort to violence when under pressure.

Trump views violence as a solution when he is stressed and desires to re-establish his power. Paranoia and overwhelming feelings of weakness and inadequacy make violence very attractive, and powerful weapons very tempting to use – all the more so for their power. His contest with the North Korean leader about the size of their nuclear buttons is an example of that and points to the possibility of great danger...

[The Cuckold Syndrome]

Screening for risk of harm is a routine part of mental health practice, and there are steps that we follow when someone poses a risk of danger: containment, removal from access to weapons and an urgent evaluation. When danger is involved, it is an emergency, where an established patient-provider relationship is not necessary, nor is consent; our ethical code mandates that we treat the person as our patient.

[More clear: What I said about that other one pales in comparison to this one. This is the mother of all critical passages. Dr. Lee means here an involuntary commitment to a mental hospital. "Containment," removal from access," removal from OFFICE, involuntary removal, the 25th Amendment: that is what Dr. Lee is dancing around there.]
...
 Mental health experts routinely perform capacity or fitness for duty examinations for courts and other legal bodies, 

[Which is how I know about it. In Florida it is called "Baker Acting" a person.] 

and offer their recommendations. This is what we are calling for, urgently, in doing our part as medical professionals. The rest of the decision is up to the courts or, in this case, up to the body politic.

https://www.theguardian.com/commentisfree/2018/jan/07/donald-trump-dangerous-psychiatrist