President Trump and His “Defiance Disorder”


“Oh my God, he just tweeted this,” said Reince Priebus, President Trump’s former chief of staff. The tweets in question essentially banned transgender individuals from serving in the military. Priebus was supposed to attend a meeting that very same day to discuss four different policy options instead of the total ban, but there was “no longer need for a meeting.” Incidents like this are not uncommon in President Trump’s administration. His erratic behavior has been noticed, not only by his aids and the media but also by the rest of the world. Questions about Trump’s mental and physical wellbeing are rampant. Many individuals and professionals have attempted to diagnose the president from afar. But are any of the diagnoses valid? These individuals are not President Trump’s official health care providers. President Trump’s aids are present in the White House and they have daily, firsthand observations of his behavior, but they aren’t trained healthcare professionals. On the other hand, healthcare professionals who have attempted to diagnose the president, don’t have a presence in the White House. All of these factors have impacts on the validity of these diagnoses.

The scene laid out above was recounted in Howard Kurtz’s book, Media Madness: Donald Trump, the Press, and the War over the Truth. Kurtz works for Fox News, and has worked for the Washington Post as well. In his book, he claims that “Trump’s aides even privately coined a term for Trump’s behavior—‘Defiance Disorder’” (Parker, 2018). According to an article published by the Washington Post, this phrase refers to the President’s “seeming compulsion to do whatever it is his advisers are most strongly urging against, leaving his team to handle the fallout.” This statement specifically refers to Oppositional Defiant Disorder, ODD, which is a childhood disorder characterized by negativistic, argumentative, and hostile behavior patterns (Sue, Sue, Sue, Sue, 2017). Furthermore, this disorder can only be diagnosed in children. While the validity of this term can be argued, evidence revealing that the president has made his staff feel like he would do whatever he wanted and they would be left to clean up his messes cannot.

“Kurtz describes White House aides waking up one Saturday morning in March, confused and ‘blindsided,’ to find that Trump had — without any evidence — accused former president Barack Obama on Twitter of wiretapping him during the campaign…‘Nobody in the White House quite knew what to do,’ Kurtz writes.” (Parker, 2018)

The president also allegedly replaced Reince Priebus with then-homeland security secretary John Kelly without informing him. Kurtz writes “Typically, Trump announced the decision without telling Priebus and without having made a formal offer to Kelly.” Kurtz is not the only one to write a book about the inner-workings of the Trump administration. In his book, Fire and Fury: Inside the Trump White House, journalist Michael Wolff claims, “people close to Donald Trump consider him a ‘moron’ who acts ‘like a child” (Frisk, 2018).

Conflicting and misleading statements from Trump and his top aides have fueled questions about the White House’s credibility. It has sowed mistrust and instability within the West Wing and left some congressional Republicans wondering if they have a “good faith negotiating partner in the president” (Pace, 2018). A former GOP leadership aide said that Republicans were having difficulty negotiating with White House officials because of “the president’s willingness to undermine his own team’s public and private assurances” (Pace, 2018). White House officials have been put in a predicament which is resulting in them urging lawmakers to ignore some of the president’s statements. Representative Charlie Dent of Pennsylvania has been openly critical about the president, stating “Disorder, chaos, instability, uncertainty, intemperate statements are not conservative virtues in my opinion” (Pace, 2018). The president seems comfortable changing facts that vary in scope from the size of his inaugural crowd to the scope of tax bills (Pace, 2018). Furthermore, “the president rarely appears to be embarrassed or ashamed about repeating statements that have been proven false” (Pace, 2018). This has a serious impact on the credibility of the Trump Administration. A survey from Quinnipiac University showed that fifty-four percent of Americans believe that Trump is not honest, and numerous reports corroborate these findings. When a majority of the public feels as though the President is not honest, it is no surprise that they doubt his well-being.

Concerns about the president’s health, both mental and physical, extend beyond the White House. President Trump’s personal doctor, Harold Bornstein, declared him “the healthiest individual ever elected to the presidency” (Strauss, Dickerman, Eizenstat, Kruse, 2017). Yet that didn’t stop Politico Magazine from claiming “no occupant of the Oval Office has evinced less interest in his own health” (Strauss, et al., 2017). The president seems to believe that exercise leads to health complications (Strauss, et al., 2017). Mental health professionals started a petition on change.org, stating:

“We…believe in our professional judgment that Donald Trump manifests a serious mental illness that renders him psychologically incapable of competently discharging the duties of President of the United States. And we respectfully request he be removed from office, according to article 4 of the 25th amendment to the Constitution, which states that the president will be replaced if he is ‘unable to discharge the powers and duties of his office.’” (Gartner, n.d.)

A book has even been published titled The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. The president has been called out on his slurred speech, incoherence, and “increasingly erratic (and Freudian) tweets” (Levitz, 2018). Michael Wolff said “…inside of 30 minutes he’d repeat, word-for-word and expression-for-expression, the same three stories…” the repetitions would become more frequent, and Wolff claimed that Trump’s tweets were often a manifestation of these repetitions (Levitz, 2018). Journalist Eric Levitz argues that Wolff’s reporting establishes that Trump’s cognitive decline is affecting his daily functioning. Levitz writes that in response to President Trump’s tweet about “the size and potency of his nuclear button” one hundred mental-health professionals signed a statement claiming the president is “further unraveling” in ways that contribute to his “belligerent nuclear threats” (Levitz, 2018). They “urge those around him” and elected officials to take urgent action to “restrain his behavior” in order to diminish the potential of “nuclear catastrophe that endangers not only Korea and the United States but all of humankind” (Levitz, 2018).

Levitz argues that the president can be diagnosed from afar. The basis of this claim is that we have detailed accounts of the president’s behavior from people who work closely with him. He does not mention the possibility that these accounts are biased. They are not confidential conversations with a healthcare professional, in fact, they are the opposite. If the same people who have issued statements about the president’s health were to speak to a therapist, perhaps they would say something different. Generally, when a psychologist or psychiatrist makes a diagnosis, they have met with the individual being diagnosed and observed their behavior first-hand. They may meet with people who interact with the individual consistently, but those accounts alone are not usually the base for the diagnosis — they act more as supporting documents. How efficient is it to analyze someone using only testimonies from others?

Esquire magazine conducted a rather interesting “experiment” to determine whether the president’s behavior could be deemed “irascibly childish” (Fontana, 2017). They claim “His speeches and tweets are dominated by the kind of constant name-calling, defensive outbursts, mendacious gossip and repugnant innuendos usually overheard during schoolyard recess” (Fontana, 2017). They described “symptoms” to Dr. Megan Seltz, a clinical psychologist specializing in children with cognitive disorders. Dr. Seltz was under the impression that the patient whose symptoms were presented was an 8-year-old boy. Dr. Seltz’s opinion at the conclusion of the interview was that this hypothetical child is exhibiting signs of conduct disorder, but she could not diagnose him without a complete evaluation (Fontana, 2017). The source of all this controversy and diagnosis from afar seems to be that Trump publicly displays symptoms of mental disorder or neurological problems, and there is no office or position in place to evaluate his mental health.

The need for a role to determine a person’s mental capability to run a country is becoming increasingly more evident, as seen in Dr. James Hamblin’s article in The Atlantic. He writes, “A president could be actively hallucinating, threatening to launch a nuclear attack based on intelligence he had just obtained from David Bowie, and the medical community could be relegated to speculation from afar.” Factors such as age, and the magnitude of the weapons we now possess play a role on how stressful taking a seat in the oval office can be. The Constitution sets a lower limit for the age of the president, but there is no upper limit set. President Trump is seventy-two years old. Ronald Reagan was seventy-three when elected for his second term, making him the oldest president elected. Trump, if elected for a second term, will take his place.

With age, comes cognitive decline and a loss of brain matter. According to Dr. Hamblin, “After age 40, the brain decreases in volume by about 5 percent every decade” with the most apparent loss being in the frontal lobe, which controls speech and motor functioning. While this reasoning may not seem like enough to warrant the creation of a new role, it certainly raises the question of if there should be an upper age limitation as well. The magnitude of our weapons today is such that it is possible to “unilaterally destroy a continent, or the entire planet, with one quick decision” (Hamblin, 2018). Dr. Hamblin explains that the people responsible for actually launching missiles are tested three times a month on their ability to execute protocols. They are required to score at least 90 percent. He goes on to explain that ‘down-playing’ the president’s mental decline is not far from precedent. Franklin Delano Roosevelt hid his polio-induced paralysis from the public so as not to be seen as “weak or helpless.” It must be taken into consideration that the country’s circumstances during FDR’s presidency were immensely different. FDR became president during the height of the Great Depression, when 13 million Americans were unemployed. The country needed a strong leader to help boost morale. While unemployment rates are high today, they are not nearly at the same scale. It is also easier to hide paralysis than a mental illness. Hamblin also points out Trump’s speech patterns and how his ability to speak clearly and convey a message has declined over time. He mentions that the 25th Amendment assumes that “the president would be willing to undergo diagnostic testing and be forthcoming about any limitation,” and that this would be difficult with a person who has become known for “denying any hint of weakness or inability” (Hamblin, 2018). If a president had a mental disorder that impaired judgment, they also would not be likely to disclose information that might make them seem “weak.”

In 1994, President Jimmy Carter called for a system that could independently evaluate a president’s health and capacity to serve (Hamblin, 2018). “Carter called on ‘the medical community’ to take leadership in creating an objective, minimally biased process—to ‘awaken the public and political leaders of our nation to the importance of this problem’” (Hamblin, 2018). Twenty-five years later and we still haven’t taken action on this proposal. The questions surrounding President Trump’s mental health have spurred new proposals. Representative Jamie Raskin introduced a bill that would create an 11-member “presidential capacity” commission (Hamblin, 2018).

Dr. Hamblin claims that some may attempt to diagnose Trump from afar for the purpose of “political criticism” (Hamblin, 2018). According to him, this is dangerous for two reasons: (1) Labeling is “counterproductive” to the field because it increases the amount of stigma associated with psychiatric diagnosis, and (2) attributing Trump’s behavior to mental illness risks “devaluting mental illness” (Hamblin, 2018). It is a mental health professional’s job to be unbiased and non-judgemental. Hamblin suggests that a Carter-esque committee be formed, composed of “nonpartisan medical and psychological experts” that “need not have the power to unseat a president, undo a democratic election” (Hamblin, 2018). Hamblin recognizes that bias does play a role, but to a certain degree. And this degree isn’t large enough to render it “useless in assessing presidential capacity” (Hamblin, 2018).

The role of this proposed committee would be to issue a statement regarding the president’s fitness to execute the duties of the office he holds, the rest would be up to the people and their elected officials. This would attempt to provide the public with a transparent analysis of the person running the country. “The same cannot be said of the president’s cognitive processes,” Dr. Hamblin concludes, “We are left only with the shouts of experts from the sidelines, demeaning the profession and the presidency.”

References:

Fontana, K. (2017, October 11). How Do You Solve a Problem Child Like Donald Trump? Retrieved March 17, 2019, from https://www.esquire.com/news-politics/a49595/donald-trump-child-psychologist/

Frisk, A. (2018, January 22). Does Donald Trump have ‘defiance disorder?’: New book claims president’s aides think so. Retrieved March 16, 2019, from https://globalnews.ca/news/3979922/donald-trump-defiance-disorder-new-book-aides/

Gartner, J., Ph.D. (n.d.). Mental Health Professionals Declare Trump is Mentally Ill And Must Be Removed. Retrieved March 17, 2019, from Mental Health Professionals Declare Trump is Mentally Ill And Must Be Removed

Hamblin, J., Dr. (2018, January 03). Is Something Neurologically Wrong With Donald Trump? Retrieved March 17, 2019, from https://www.theatlantic.com/health/archive/2018/01/trump-cog-decline/548759/

Levitz, E. (2018, January 04). The President Is Mentally Unwell – and Everyone Around Him Knows It. Retrieved March 17, 2019, from http://nymag.com/intelligencer/2018/01/trump-is-mentally-unwell-and-everyone-around-him-knows-it.html?gtm=top

Pace, J. (2018, March 24). Trump’s impulses put White House credibility on the line. Retrieved March 17, 2019, from https://apnews.com/0a508c9559db4200aebe9d92c3c857ee

Parker, A. (2018, January 21). ‘Defiance Disorder’: Another new book describes chaos in Trump’s White House. Retrieved March 16, 2019, from https://www.washingtonpost.com/politics/defiance-disorder-another-new-book-portrays-chaos-in-trumps-white-house/2018/01/21/9362d160-febd-11e7-93f5-53a3a47824e8_story.html?noredirect=on&utm_term=.ca1502a70a99

Strauss, B., Dickerman, S., Eizenstat, S. E., & Kruse, M. (2017, July 18). Is the President Fit? Retrieved March 17, 2019, from https://www.politico.com/magazine/story/2017/07/18/is-the-president-fit-215385

Sue, D., Sue, D. W., Sue, D., & Sue, S. (2017). Essentials of Understanding Abnormal Behavior.

(3rd ed.). [Chegg]. Retrieved from https://ereader.chegg.com/#/books/9781305854703/

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