“The world is run by sociopaths,” is a sentiment I run across frequently these days, although it is debatable whether sociopaths tend to rise to the top. Despite a 3% estimate of sociopathy in the general population, Patric Gagne, the author of a groundbreaking memoir written from the point of view of a sociopath, claims the condition is poorly understood. In Sociopath: A Memoir, she describes the frustration of a UCLA librarian who has the same difficulty as Gagne in locating clear definitions of sociopathy. The collapsing of sociopathy and psychopathy under the behavioral diagnosis “antisocial personality disorder” in the DSM had further muddied the waters by then.
Although fictional characters with ASPD from The Joker to Martin Blank to Rotten Ralph abound, the number of nonfiction books about sociopathy is relatively small, and I know of only one other book, Confessions of a Sociopath, written from the point of view of a sociopath specifically about the condition. Gagne’s book is refreshingly free of “privilege” jargon, although being white and relatively well-off likely helped keep her out of the criminal justice system.
In an interview with the The New York Times, Gagne mentions that the philosophy of karma has helped rein in some of her behavior. Interestingly, other writers have explored the potential appeal of Buddhism to sociopaths, and author Kevin Dutton described commonalities between Tibetan monks and psychopaths in his 2012 book The Wisdom of Psychopaths.
Image: Hong Kong Budha.jpg/ Wikimedia Commons
The New York Times piece on Gagne elicited a range of comments, from those praising Gagne’s self-awareness and desire to shed light on sociopathy to those adamant that she should not be trusted or given a platform and/or that sociopaths are unworthy of empathy. Many who have doubts about Gagne have been victimized in the past by someone they consider a sociopath. The reddit commenter kra225 offered a significant rebuttal to those who have questioned Gagne’s story and credentials:
Her legal name is Patricia J. Cagle, and she is married to David Gange. It's not a pseudonym (fictitious name): Patric is a reasonable abbreviation of Patricia (as opposed to say Pamela), and the use of her husband's last isn't uncommon. Moreover, that may be the name she identifies with.
Her father is Jerry Cagle, and yes, he is a 'big wig' in the music industry. Google him. While he doesn't mention children on his website, the details provided about his upbringing in Mississippi correspond with the details provided in the book.
She received a Ph.D. in clinical psychology from The Chicago School in 2008. They no longer offer this program of study, only a PsyD.
Please attend the American Psychological Association annual meeting for lively debates about diagnostic criteria, what we call things, and arguments about how the DSM - V is a fundamentally flawed document that should be rethought (DSM - VI, anyone?)
The DSM was compiled by committee. That means that, like the compilation of the Bible, there were likely many compromises, votes, revotes, and rewriting. (Fun fact, Revelations was almost not included, but proponents were able to muster JUST ENOUGH votes.)The psychological community is not in agreement about sociopathy, psychopathy, and their lumping under Anti-social Personality Disorder. The DSM may be our guidebook (psychological Bible), but it isn't without flaws. Otherwise, it wouldn't have 5 versions with conflicting disorders, diagnostic criteria, and treatment suggestions.
Her explanation of how to diagnose a person with sociopathy or psychopathy is in line with scoring the Psychopathy Checklist—revised (PCL-R).
All individuals experience their disorders differently.
We (all humans, sociopath or not) are unreliable narrators of our own lives. There is a good bit of research on this.
An individuals perceptions are their reality. (Basic psychological concept)
Rejecting what one feels are inadequate definitions, diagnostic criteria, etc. is part of science. Clearly outlining your proposed changes is scientific and further discourse.
How does one fact check the emotional responses and private behaviors of an individual. As far as her discussion of sociopathy, these are her ideas, assessments, and recommendations. She clearly states they are counter to the DSM - V.
Currently, we treat comorbidities of ASPD (anxiety, explosive anger, and depression) with medication. There are no medications for ASPD and, in turn, none for sociopathy and psychopathy. Cognitive Behavioral Therapy (CBT) and Rational Emotive Behavior Therapy (REBT) have shown some success for those scoring between 22-29 on the PCL-R.
The Kirkus review seems biased to me. They did not like Gange. I have read reviews for other memoirs of similar plausibility, and they received more positive reviews.Good memoirs often read like fiction. They are full of self-aggrandizing. They are written by people with the need to get their story out into the world. Recreating dialogue, combing individuals, and not sticking to strict time are often utilized.
All in all, Gagne’s book should make for a provocative and enlightening book discussion.
Top Image: Shallow Focus Photo of Person in Red Coat With Clown Face Paint.jpg/ Wikimedia Commons
I read a book awhile back, by Jon Ronson I believe, who spent sometime studying the sociopath "industry". He took a class to learn how to give a standard test for sociopathology, then went around giving it to all kinds of supposedly normal people in different walks of life. What he found is both surprising and amusing. He makes a similar claim as I recall - that people who tend to end up as CEOs or in other leadership roles tend to fail (or pass, depending on your point of view) that test. I'll see if I can find it... here it is: https://www.thriftbooks.com/w/the-psychopath-test_jon-ronson/254514/?resultid=a9a7e77c-1ae3-4638-91f6-fc437a76046d#edition=6493210&idiq=3967108
There is another book on a related topic whose name and author I don't recall now; this was a woman, a psych graduate student as I recall, who wanted an inside view of mental hospitals, so she devised a study plan that was known to her advisor wherein she faked some kind of mild insanity to get herself committed. Once committed she dropped her affective pretenses and acted normal. She expected that they would fairly quickly realize she had been acting and go WTF? and toss her out of there. What she found was it was next to impossible for her to convince them she was sane and to release her. Every attempt to explain what she had done and why was interpreted by all the psych doctors and nurses as further manifestations of her denial of a real illness. Even the intercession of her advisor was not immediately acted upon. It turned out to be a rather scary experiment, especially when non-voluntary drugs became involved.
Cleckley's "The Mask of Sanity" is an early book about sociopaths. I remember reading it in the eighties but don't remember much about it now.
So in other words, Ronson found that the people who end up as CEOs tend to be sociopathic? That is a big question, since a lot of people with ASPD tend to end up in prison for (non white collar, lower level) crime, and the medium piece I linked to (https://medium.com/@showmesomethingreal/questioning-sociopathy-a-survivors-critique-of-patric-gagne-s-new-memoir-c859c9f60ad9) is an illustration of the relatively low-rung crime that sociopaths get involved in. OTOH, you have to look at the behavior of some people in power and wonder what is motivating it if they are not in fact sociopathic/psychopathic. And apparently not all sociopaths commit crime (https://www.webmd.com/mental-health/signs-sociopath), which makes lumping sociopathy under ASPD problematic.
I am familiar with The Mask of Sanity but have read that it is fairly academic so haven't tried to tackle it. It gets referenced a lot, and Gagne refers to his checklist in her book.
It seems like there is a lot in this realm, including the fictional portrayals of sociopaths, that is muddled.
"Sociopathy" has become an overused, or possibly inflated term, demonstrating "concept creep" its own way. Sometimes I think the same when I see "narcissism" used loosely, though I know it's still in the DSM Manual as one of the Cluster B personality disorders. Question: how does a random reddit commentator become an expert on this topic?
You're right - many flavors of human behavior have become highly medicalized. How many times in casual conversation now does one hear how someone is "probably on the spectrum" for example? It's ridiculous. And become somewhat meaningless. "The Myth of Psychotherapy" (Tomas Szasz) was prescient. Another '80s book.
He's probably not random - writes like he's in the industry, probably staying anonymous is a protective measure. But we have no way of knowing.
Possibly not random, I can understand your point. I think there's so much overinflation of these terms, though, and the medicalization of many otherwise just semi-normal human experiences has gone entirely too far. The "trauma-informed" trope applied to anything is one example of. many of "concept creep" at work. I've seen "trauma-informed pedagogy," and yes, of course, "trauma-informed librarianship", and the latter certainly isn't serving us well, pandemic or not, or any other collective experiences in the past decade.
Of course we can't know a random commenter's credentials, but I would give his/her comments the same weight as comments on a Substack post. What I can check seems to be correct, although it is Gerry Cagle, not Jerry.
I confess I only made it 80% of the way through Mask of Sanity. Not my field. I got interested in it due to conversations with my then girlfriend (now wife) who had several jobs managing deranged people and was thinking about a career in it.
I think Ronson wouldn't say CEOs tend to be sociopathic. He'd formulate that sentence something like "one finds a higher than average percentage of sociopaths in leadership positions). The difference being that if their density in general population is 3% and in CEO population is 4% the latter sentence is correct, but the former is not (CEOs 'tend' to not be sociopaths 96:4).
But Ronson does contradict one thing I remember from Cleckley. Clecklely seemed to be saying that real sociopaths are great at fooling people, but only for short periods of time. They can't sustain anything because it's not real. So they can't hold real jobs very long and bounce around to keep working people who don't know them. Hmmm. Might fit right in to a political position though. ;-)
One of the groups my wife worked with were severely autistic. She won't even watch movies depicting "autistic" personalities because she says they do such a horrible job of it. But they've broadened it out so much that it can mean almost anything.
There's nothing groundbreaking about Gagne's memoir. [1] For a compact, current, reliable and highly accessible overview of psychopathy, see Essi Viding's superb Psychopathy: A Very Short Introduction (Oxford UP, 2020). The Kindle is only $6.99. [2]
[1] https://archive.ph/RfTgj ("Her credibility feels especially thin when she talks about scholarship. Despite many mentions of 'my doctorate' and 'my research,' her book never cites that research; it hardly ever cites other researchers, either. Her academic credentials have been a matter of public scrutiny, with both Redditors and a recent Times reviewer pointing to the unavailability of her dissertation online. She does have a doctoral degree and did complete a dissertation, but I couldn’t locate any published papers by her in the usual databases." The author of the New Yorker piece is a pre-eminent evolutionary anthropologist: https://www.manvir.org/ )
[2] https://www.amazon.com/Psychopathy-Very-Short-Introduction-Introductions/dp/0198802269 ("Despite a vague sense that sociopathy denotes a serious antisocial behavior, no separate, well-validated assessment instrument for sociopathy exists... In short, sociopathy is a label that chiefly exists to denote serious antisocial behavior in public speak -- but is ill-defined and not used in mainstream scientific research or clinical/justice system assessments. It would be better if this term would fade from use altogether, yet it appears curiously popular in the media...")
Wow. I'll say... I was trying to find the title of another book and used the search term "sociopath" in titles on thriftbooks and turned up titles like:
"Confessions of a Sociopath",
"Everyday Sociopaths,"
"Tin Man: Memoirs of a Sociopath,"
"Sociopaths in Love,"
"The Spiritual Sociopath," and
"Shakespeare for Sociopaths."
I'm not making these up - that was a few from page 1 of 6. The weirdest one was:
Thanks! I don't have any more in the pike at the moment, but I second Micheal Dudley's prior recommendation of "Shakespeare Was a Woman." It's excellent.
TikTok is full of people claiming to be sociopaths and narcissists, and they post videos to help others understand them, but then again TikTok users diagnose themselves with everything under the sun. That said - considering the possible rather high percentage of sociopaths, or people with ASPD - probably a good proportion are indeed what they claim to be. I know I've met people who are "off", yet surrounded by a large supportive friend group, including one whose direct relative murdered her family member in cold blood on a whim, and another whose family member killed animals. You cannot talk to people about whether there's a genetic connection, because they won't hear of it. "The Gift of Fear" is a great book that cuts through a lot of the smoothing over that most of us attempt.
The one whose close family member murdered a family member when he "snapped" - she snapped at me as well over a small issue, and I took many steps back because it was so unnerving, and she and I and her close friends have never spoken again. I think she's actually taken some aggressive steps towards me.
I don't know what to think about the TikTokers either, although I assume it's a mix in terms of legitimacy. One of the things Gagne discusses in her book is the number of people who are fascinated by her disorder and/or tell her they wish they could be a sociopath. Although her book title is meant to grab attention (and may or may not have been her idea), I didn't get the sense from her book that she wrote it merely to cash in (despite allegedly being a sociopath).
That's a good theory... also some worked in the entertainment industry so perhaps thought it would help them get ahead. And I think at least in one or two cases it was people who felt hobbled by caring too much about what others thought of them.
Another interesting discussion point would be the way sociopathic behaviors have spread through society. I think "ghosting" people, for example, is in most cases a sociopathic behavior.
May I address what seems to me to be the "elephant in the room" of this discussion: What is the proper characterization of Donald J. Trump, and who should make it? I made some online queries.
Responses to queries regarding the Goldwater rule:
“The Goldwater rule was introduced by the American Psychiatric Association (APA) in response to an article published in Fact magazine in 1964. The article, titled “The Unconscious of a Conservative: A Special Issue on the Mind of Barry Goldwater,” questioned Senator Barry Goldwater’s psychological fitness for the presidency. Psychiatrists were polled about Goldwater’s suitability for office, which led to the creation of the Goldwater rule.”
"Dr. Leonard Glass, a former distinguished life member of the American Psychiatric Association (APA), played a significant role in revising the Goldwater rule. The original rule, Section 7.3 of the APA’s ethical code, prohibited psychiatrists from diagnosing public figures without a personal examination. However, with the presidency of Donald Trump, the APA ethics committee issued a “reaffirmation” of the rule in 2017, going beyond the original scope. Dr. Glass and other mental health experts have since advocated for a modification of the rule, allowing for more nuanced discussions about public figures’ mental health while maintaining ethical standards."
“Dr. Glass resigned from the American Psychiatric Association (APA) due to its new interpretation of the Goldwater rule. The rule remains a topic of debate among psychiatrists and ethics experts.”
Response to query regarding “malignant narcissism” (term coined by Erich Fromm in 1964):
“Malignant narcissism is a psychological syndrome characterized by an extreme mix of narcissism, antisocial behavior, aggression, and sadism. Individuals with this personality type are grandiose, always ready to escalate hostility levels, and tend to undermine families and organizations they are involved in. They dehumanize the people with whom they associate. It’s important to note that malignant narcissism is not formally recognized as a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but many mental health experts use this term to describe a specific set of personality traits. These traits combine elements of narcissistic personality disorder (NPD) and antisocial personality disorder (APD). Some common characteristics associated with malignant narcissism include:
1. NPD Traits:
o Grandiose fantasies and behavior.
o Lack of empathy for others’ emotions.
o Significant need for attention, admiration, and recognition.
o Inflated sense of self-importance.
o Belief in personal specialness and superiority.
o Sense of entitlement.
o Tendency to take advantage of others.
o Arrogant or conceited behavior.
o Envy of others and belief that others envy them.
2. APD Features:
o Consistent disregard for other people’s feelings.
Remember that diagnosing someone with malignant narcissism is complex and should be done by mental health professionals. If you encounter someone with these traits, it’s best to seek professional guidance and avoid labeling them without proper assessment.”
Response to query regarding physicians’ duty to inform:
"The duty to report certain conditions to public health or law enforcement authorities is one that falls on all physicians and other health care workers as part of their duty to protect the public from harm."
My personal comment: The long audiovisual record of Donald Trump’s behavior as well as his personal online statements gives psychiatrists a more than ample basis for the formation of a professional diagnosis of Donald Trump’s character. Since Donald Trump is one of the two people who WILL be elected President this November and given his promise to decapitate the civil service that restrained him in his first term, the DUTY to report this individual who represents a public danger HAS BEEN MASSIVELY JUSTIFIED.
I do think the APA shouldn't diagnose someone from afar but speculation by writers on the personality traits of figures in power seems fair game. Everything is a spectrum, and Trump does seem to show narcissistic traits, but I have no way of knowing if he has full-blown NPD. There could also be many past and present figures in power who suffered from various degrees of mental illness and/or personality disorders who were still able to carry out their duties effectively (there are some jobs that require a high degree of stress where some amount of sociopathic traits could be a help). As far as aggression it was a pretty peaceful time on the wars front under his tenure. And to be fair, there are those who question whether Biden is showing signs of dementia, which, depending on the severity, is something that probably should disqualify someone from a job.
I read a book awhile back, by Jon Ronson I believe, who spent sometime studying the sociopath "industry". He took a class to learn how to give a standard test for sociopathology, then went around giving it to all kinds of supposedly normal people in different walks of life. What he found is both surprising and amusing. He makes a similar claim as I recall - that people who tend to end up as CEOs or in other leadership roles tend to fail (or pass, depending on your point of view) that test. I'll see if I can find it... here it is: https://www.thriftbooks.com/w/the-psychopath-test_jon-ronson/254514/?resultid=a9a7e77c-1ae3-4638-91f6-fc437a76046d#edition=6493210&idiq=3967108
There is another book on a related topic whose name and author I don't recall now; this was a woman, a psych graduate student as I recall, who wanted an inside view of mental hospitals, so she devised a study plan that was known to her advisor wherein she faked some kind of mild insanity to get herself committed. Once committed she dropped her affective pretenses and acted normal. She expected that they would fairly quickly realize she had been acting and go WTF? and toss her out of there. What she found was it was next to impossible for her to convince them she was sane and to release her. Every attempt to explain what she had done and why was interpreted by all the psych doctors and nurses as further manifestations of her denial of a real illness. Even the intercession of her advisor was not immediately acted upon. It turned out to be a rather scary experiment, especially when non-voluntary drugs became involved.
Cleckley's "The Mask of Sanity" is an early book about sociopaths. I remember reading it in the eighties but don't remember much about it now.
So in other words, Ronson found that the people who end up as CEOs tend to be sociopathic? That is a big question, since a lot of people with ASPD tend to end up in prison for (non white collar, lower level) crime, and the medium piece I linked to (https://medium.com/@showmesomethingreal/questioning-sociopathy-a-survivors-critique-of-patric-gagne-s-new-memoir-c859c9f60ad9) is an illustration of the relatively low-rung crime that sociopaths get involved in. OTOH, you have to look at the behavior of some people in power and wonder what is motivating it if they are not in fact sociopathic/psychopathic. And apparently not all sociopaths commit crime (https://www.webmd.com/mental-health/signs-sociopath), which makes lumping sociopathy under ASPD problematic.
I am familiar with The Mask of Sanity but have read that it is fairly academic so haven't tried to tackle it. It gets referenced a lot, and Gagne refers to his checklist in her book.
It seems like there is a lot in this realm, including the fictional portrayals of sociopaths, that is muddled.
"Sociopathy" has become an overused, or possibly inflated term, demonstrating "concept creep" its own way. Sometimes I think the same when I see "narcissism" used loosely, though I know it's still in the DSM Manual as one of the Cluster B personality disorders. Question: how does a random reddit commentator become an expert on this topic?
You're right - many flavors of human behavior have become highly medicalized. How many times in casual conversation now does one hear how someone is "probably on the spectrum" for example? It's ridiculous. And become somewhat meaningless. "The Myth of Psychotherapy" (Tomas Szasz) was prescient. Another '80s book.
He's probably not random - writes like he's in the industry, probably staying anonymous is a protective measure. But we have no way of knowing.
Possibly not random, I can understand your point. I think there's so much overinflation of these terms, though, and the medicalization of many otherwise just semi-normal human experiences has gone entirely too far. The "trauma-informed" trope applied to anything is one example of. many of "concept creep" at work. I've seen "trauma-informed pedagogy," and yes, of course, "trauma-informed librarianship", and the latter certainly isn't serving us well, pandemic or not, or any other collective experiences in the past decade.
"Trauma-informed librarianship" (https://www.libraryjournal.com/story/Working-Toward-Wellness-Exploring-Trauma-Informed-Librarianship) does seem vague in comparison to, say, some of the specialized, practical training librarians have received in interacting with homeless patrons.
Of course we can't know a random commenter's credentials, but I would give his/her comments the same weight as comments on a Substack post. What I can check seems to be correct, although it is Gerry Cagle, not Jerry.
You did get me to wondering if there was an official way to reference a "comment" in a research bibliography. Indeed there is...
https://library.nic.bc.ca/c.php?g=705605&p=5019999
It may be that perverse incentives have caused sociopathic behavior, although the people involved are not actual sociopaths.
I confess I only made it 80% of the way through Mask of Sanity. Not my field. I got interested in it due to conversations with my then girlfriend (now wife) who had several jobs managing deranged people and was thinking about a career in it.
I think Ronson wouldn't say CEOs tend to be sociopathic. He'd formulate that sentence something like "one finds a higher than average percentage of sociopaths in leadership positions). The difference being that if their density in general population is 3% and in CEO population is 4% the latter sentence is correct, but the former is not (CEOs 'tend' to not be sociopaths 96:4).
But Ronson does contradict one thing I remember from Cleckley. Clecklely seemed to be saying that real sociopaths are great at fooling people, but only for short periods of time. They can't sustain anything because it's not real. So they can't hold real jobs very long and bounce around to keep working people who don't know them. Hmmm. Might fit right in to a political position though. ;-)
One of the groups my wife worked with were severely autistic. She won't even watch movies depicting "autistic" personalities because she says they do such a horrible job of it. But they've broadened it out so much that it can mean almost anything.
Bouncing around is probably more likely.
There's nothing groundbreaking about Gagne's memoir. [1] For a compact, current, reliable and highly accessible overview of psychopathy, see Essi Viding's superb Psychopathy: A Very Short Introduction (Oxford UP, 2020). The Kindle is only $6.99. [2]
[1] https://archive.ph/RfTgj ("Her credibility feels especially thin when she talks about scholarship. Despite many mentions of 'my doctorate' and 'my research,' her book never cites that research; it hardly ever cites other researchers, either. Her academic credentials have been a matter of public scrutiny, with both Redditors and a recent Times reviewer pointing to the unavailability of her dissertation online. She does have a doctoral degree and did complete a dissertation, but I couldn’t locate any published papers by her in the usual databases." The author of the New Yorker piece is a pre-eminent evolutionary anthropologist: https://www.manvir.org/ )
[2] https://www.amazon.com/Psychopathy-Very-Short-Introduction-Introductions/dp/0198802269 ("Despite a vague sense that sociopathy denotes a serious antisocial behavior, no separate, well-validated assessment instrument for sociopathy exists... In short, sociopathy is a label that chiefly exists to denote serious antisocial behavior in public speak -- but is ill-defined and not used in mainstream scientific research or clinical/justice system assessments. It would be better if this term would fade from use altogether, yet it appears curiously popular in the media...")
Wow. I'll say... I was trying to find the title of another book and used the search term "sociopath" in titles on thriftbooks and turned up titles like:
"Confessions of a Sociopath",
"Everyday Sociopaths,"
"Tin Man: Memoirs of a Sociopath,"
"Sociopaths in Love,"
"The Spiritual Sociopath," and
"Shakespeare for Sociopaths."
I'm not making these up - that was a few from page 1 of 6. The weirdest one was:
"Sociopath's Guide to the Zombie Apocalypse".
Have you read Gagne's book?
Nice. Thanks, I have been enjoying your Bold Book Discussions series Susan!
Thanks! I don't have any more in the pike at the moment, but I second Micheal Dudley's prior recommendation of "Shakespeare Was a Woman." It's excellent.
TikTok is full of people claiming to be sociopaths and narcissists, and they post videos to help others understand them, but then again TikTok users diagnose themselves with everything under the sun. That said - considering the possible rather high percentage of sociopaths, or people with ASPD - probably a good proportion are indeed what they claim to be. I know I've met people who are "off", yet surrounded by a large supportive friend group, including one whose direct relative murdered her family member in cold blood on a whim, and another whose family member killed animals. You cannot talk to people about whether there's a genetic connection, because they won't hear of it. "The Gift of Fear" is a great book that cuts through a lot of the smoothing over that most of us attempt.
The one whose close family member murdered a family member when he "snapped" - she snapped at me as well over a small issue, and I took many steps back because it was so unnerving, and she and I and her close friends have never spoken again. I think she's actually taken some aggressive steps towards me.
I don't know what to think about the TikTokers either, although I assume it's a mix in terms of legitimacy. One of the things Gagne discusses in her book is the number of people who are fascinated by her disorder and/or tell her they wish they could be a sociopath. Although her book title is meant to grab attention (and may or may not have been her idea), I didn't get the sense from her book that she wrote it merely to cash in (despite allegedly being a sociopath).
That’s so weird - why would they want to be a sociopath? Maybe just terrible people looking for an excuse?
That's a good theory... also some worked in the entertainment industry so perhaps thought it would help them get ahead. And I think at least in one or two cases it was people who felt hobbled by caring too much about what others thought of them.
Another interesting discussion point would be the way sociopathic behaviors have spread through society. I think "ghosting" people, for example, is in most cases a sociopathic behavior.
May I address what seems to me to be the "elephant in the room" of this discussion: What is the proper characterization of Donald J. Trump, and who should make it? I made some online queries.
Responses to queries regarding the Goldwater rule:
“The Goldwater rule was introduced by the American Psychiatric Association (APA) in response to an article published in Fact magazine in 1964. The article, titled “The Unconscious of a Conservative: A Special Issue on the Mind of Barry Goldwater,” questioned Senator Barry Goldwater’s psychological fitness for the presidency. Psychiatrists were polled about Goldwater’s suitability for office, which led to the creation of the Goldwater rule.”
"Dr. Leonard Glass, a former distinguished life member of the American Psychiatric Association (APA), played a significant role in revising the Goldwater rule. The original rule, Section 7.3 of the APA’s ethical code, prohibited psychiatrists from diagnosing public figures without a personal examination. However, with the presidency of Donald Trump, the APA ethics committee issued a “reaffirmation” of the rule in 2017, going beyond the original scope. Dr. Glass and other mental health experts have since advocated for a modification of the rule, allowing for more nuanced discussions about public figures’ mental health while maintaining ethical standards."
“Dr. Glass resigned from the American Psychiatric Association (APA) due to its new interpretation of the Goldwater rule. The rule remains a topic of debate among psychiatrists and ethics experts.”
Response to query regarding “malignant narcissism” (term coined by Erich Fromm in 1964):
“Malignant narcissism is a psychological syndrome characterized by an extreme mix of narcissism, antisocial behavior, aggression, and sadism. Individuals with this personality type are grandiose, always ready to escalate hostility levels, and tend to undermine families and organizations they are involved in. They dehumanize the people with whom they associate. It’s important to note that malignant narcissism is not formally recognized as a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but many mental health experts use this term to describe a specific set of personality traits. These traits combine elements of narcissistic personality disorder (NPD) and antisocial personality disorder (APD). Some common characteristics associated with malignant narcissism include:
1. NPD Traits:
o Grandiose fantasies and behavior.
o Lack of empathy for others’ emotions.
o Significant need for attention, admiration, and recognition.
o Inflated sense of self-importance.
o Belief in personal specialness and superiority.
o Sense of entitlement.
o Tendency to take advantage of others.
o Arrogant or conceited behavior.
o Envy of others and belief that others envy them.
2. APD Features:
o Consistent disregard for other people’s feelings.
Remember that diagnosing someone with malignant narcissism is complex and should be done by mental health professionals. If you encounter someone with these traits, it’s best to seek professional guidance and avoid labeling them without proper assessment.”
Response to query regarding physicians’ duty to inform:
"The duty to report certain conditions to public health or law enforcement authorities is one that falls on all physicians and other health care workers as part of their duty to protect the public from harm."
My personal comment: The long audiovisual record of Donald Trump’s behavior as well as his personal online statements gives psychiatrists a more than ample basis for the formation of a professional diagnosis of Donald Trump’s character. Since Donald Trump is one of the two people who WILL be elected President this November and given his promise to decapitate the civil service that restrained him in his first term, the DUTY to report this individual who represents a public danger HAS BEEN MASSIVELY JUSTIFIED.
I do think the APA shouldn't diagnose someone from afar but speculation by writers on the personality traits of figures in power seems fair game. Everything is a spectrum, and Trump does seem to show narcissistic traits, but I have no way of knowing if he has full-blown NPD. There could also be many past and present figures in power who suffered from various degrees of mental illness and/or personality disorders who were still able to carry out their duties effectively (there are some jobs that require a high degree of stress where some amount of sociopathic traits could be a help). As far as aggression it was a pretty peaceful time on the wars front under his tenure. And to be fair, there are those who question whether Biden is showing signs of dementia, which, depending on the severity, is something that probably should disqualify someone from a job.