Should medical professionals diagnose Donald Trump's mental health?: Today's talker 'Those with borderline personality disorder are notorious for operating on the premise that feelings create facts.'

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President Donald Trump's erratic behavior and denial of facts have made medical professionals — and the public at large — wonder about his mental fitness. Here's a roundup of opinion about Trump's mental health:

I agree, Trump is not psychotic

Many have justifiably said that President Donald Trump suffers from narcissistic personality disorder, but that does not adequately explain many of his dysfunctional actions. The additional diagnosis that psychology professionals appear to be missing is borderline personality disorder (BPD) — also called by the more descriptive term emotionally unstable personality disorder.

In 1998, Paul Mason and Randi Kreger made the important distinction between those suffering from BPD who are high-functioning and low-functioning. If Trump has BPD, he falls into the high-functioning category, meaning he can have a normal or even high "general intelligence" but his "emotional intelligence" (controlling emotions and having empathy for others) is severely deficient.

BPD is the hardest to understand and diagnose of all the mental illnesses, with professionals often missing the diagnosis when the person is high-functioning. Many high-functioning people with BPD appear entirely normal to the outside world. In most cases, the ones who see the pathological behavior are those close to the person. In Trump's case, the public at large is able to see symptoms of the disease on display. I agree, Trump is not psychotic, but like others who appear to have BPD, he is driving those around him crazy with his actions.

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On Trump's mental fitness, the experts are silenced and the public's in the dark

BPD has been likened to a lava lamp because of the ever-changing personalities these individuals display. This is because they lack an identity and don't know who they really are or what they believe. As a result, they routinely imitate the persons around them to take on their identities. Trump doesn’t really know who he is or what he believes. As a result, he takes on the beliefs of the people he is talking to. When the next person or group comes along, he takes on their beliefs.

Those with BPD are notorious for operating on the premise that "feelings create facts." When they feel a certain way about something, they consider it a fact and will defend that belief irrespective of the truth, logic or independently verifiable facts. This is one reason why they have lapses in reality testing and are known for their chronic lying. Does this sound like Trump’s “fake news” mantra?

The American Psychiatric Association uses nine criteria to diagnose borderline personality disorder. A person must display at least five to receive the diagnosis. Trump appears to satisfy eight. Here is a simplified list:

Abandonment fears (he needs constant attention) – YES Relationship problems due to chronic faultfinding – YES Identity disturbance (unstable self-image) – YES Reckless impulsivity (sex, spending, bankruptcies) – YES Self-mutilation and/or suicide attempts – NO Emotionally unstable – YES Emptiness (a bottomless pit of needs) – YES Difficulty controlling anger – YES Lapses in reality testing – YES

Mental health professionals need to seriously consider and openly debate the possibility that Trump has this mental illness.

Mark Osterloh is a medical doctor and ophthalmologist, and author of "Faultfinders: The Impact of Borderline Personality Disorder."

What our readers are saying

Any legitimate, reliable and ethical mental health professional with an ounce of integrity would not be violating his code of ethics. They are prohibited from offering any kind of diagnosis or critical analysis of individuals they have not met with and/or tested. Their motives or their feelings aren't relevant. Their intentions aren't relevant. Any reputable mental health professional who violates the code of ethics and standards is doing more damage to his field and the public than President Donald Trump.

— Andrew Zaelit

Trump's behavior might be tolerable for your odd and eccentric uncle, but not for someone who is supposed to be the leader of the free world.

— Steve Evets

Many have said that Trump's policies and statements are those of the last person he spoke to. One has to wonder what influence Russian President Vladimir Putin had in their private conversation in Helsinki.

— Scott Hardy

But more important, doctors, can you prescribe a medication for all those never-Trumpers who are suffering from the virulent malady called "Trump Derangement Syndrome"? This is a more pressing problem, I think.

— Jerry Krygier

What others are saying

American Psychiatric Association, statement: "We at the APA call for an end to psychiatrists providing professional opinions in the media about public figures whom they have not examined, whether it be on cable news appearances, books or social media. Armchair psychiatry or the use of psychiatry as a political tool is the misuse of psychiatry and is unacceptable and unethical. ... A proper psychiatric evaluation requires more than a review of television appearances, tweets and public comments."

Bandy X. Lee and Thomas Singer, Daily News: "The censorship on Trump’s mental health has already had an effect. Whenever professionals have spoken up to warn about the dangers we saw in the current presidency, the new rule has given cover for those who use the APA's position to claim that we are acting unethically; that psychiatrist opinion does not count; that the president is 'just a jerk' or does not have a certain disorder (which also breaks the rule, but that did not matter). The restriction has helped to keep the public in the dark and to convey the false notion that the mental health field is divided, when it largely agrees on the dangerousness of the president’s mental makeup. Silencing mental health professionals falsely reassures the public that things are not as bad as they appear and hence do not require intervention."

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