How does he know? He hasn’t evaluated the president directly. But he did pen the criteria that define the condition.
Frances, the former chair of the Department of Psychiatry at Duke University, said as much in a letter to The New York Times that was published Tuesday.
In it, Frances responded to efforts by mental health professionals to suggest that Trump is not competent to serve as president on the basis of his mental health.
Numerous petitions have either declared Trump “psychologically incapable” of serving as president, or else urged the Republicans to insist that Trump be evaluated for his mental fitness.
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Calling Trump mentally ill is a “stigmatizing insult” to people who live with mental conditions, Frances wrote in the Times letter.
“He may be a world-class narcissist, but this doesn’t make him mentally ill, because he does not suffer from the distress and impairment required to diagnose mental disorder,” he added.
“Mr. Trump causes severe distress rather than experiencing it and has been richly rewarded, rather than punished, for his grandiosity, self-absorption and lack of empathy.”
In an interview with CBC’s “As It Happens,” Frances said that “most people with mental illness are decent, well-behaved, well-meaning people, and Donald Trump is none of these, so it’s a slur against them.”
“I think the psychiatrists who are violating that policy are doing it in a well-meaning way, but one that is self-defeating,” Frances said.
The Diagnostic and Statistical Manual of Mental Disorders sets down a series of criteria for deciding whether a person has narcissistic personality disorder.
They include an grandiose sense of self-importance; arrogant behaviour; carrying on a sense of entitlement; and needing regular praise and admiration.
Frances doesn’t deny that Trump exhibits some traits that are associated with the disorder.
But in a recent blog for Psychology Today, he said that people should “challenge Trump on his outrageous behaviours and constant lies, not on his mental status.”