Thursday, May 13, 2021

Comments by Hal Brown MSW

Showing 3 of 3 comments.

  • Gracie,

    I am sorry you had these experiences and learned the hard way how toxic these people are.

    In my 40 years of practice I saw many people, mostly women, who felt trapped in close relationships with extreme or malignant narcissists. If you do a web search for surviving living with a narcissism you will find numerous articles…

    If you search Amazon there are dozens of books with title like “Emotional and Narcissistic Abuse: The Complete Survival Guide to Understanding Narcissism, Escaping the Narcissist in a Toxic Relationship Forever, and Your Road to Recovery”

    Here’s a very brief therapy primer for treating victims of abusive relationship:

    Once a trusting relationship is built, successful therapy with such people has several primary aspects. As therapists we help our clients build their self-esteem and gain insight as to what in their own personality keeps them in such a toxic relationship. But we also educate them as to why their abuser will never change no matter how many times they promise to do so. We essentially diagnose them from A DISTANCE as extreme narcissist, sometimes combined with sociopaths, who are often master emotional manipulators. We sometimes recommend they read books on the subject.

    Americans are married to Trump. Some married him the way women marry abusive men, falling in love with someone who manipulated them. Impeachment should have been a divorce. It didn’t work.

  • Steve, I see you live in Portland too, but this is besides the point since what with Covid-19 it may be 1-2 years before we can even consider discussing our different opinions. in person.

    That being said I think whether done from a distance or not diagnosis has never been precise. When I started working the DSM was nothing more than a little booklet with pages held together by plastic clasps. The the pressure of insurance companies led to the requirement we diagnose. My psychoanalyst friends find making a diagnosis irrelevant for most of their patients when push comes to shove would probably just say they were neurotic or for those who species in the most difficult clients perhaps borderline and if they needed a diagnosis would use the code we used in community mental health for years, 309.28.

    I think the conceptualization of Trump as a malignant narcissist which was first offered by John Gartner is very useful. As I’m sure everyone reading this knows the personality type never made it into a DSM after it was described by Erich Fromm as a combination of NPD, sociopathic disorder, aggression, and sadism. He described it as a “severe mental sickness” representing “the quintessence of evil”. He characterized the condition as “the most severe pathology and the root of the most vicious destructiveness and inhumanity” (Wikipedia)

    No less than the distinguished psychoanalyst Otto Kernberg built on Fromm’s conceptualization. Again from Wikipedia, he noted that “malignant narcissism includes a sadistic element creating, in essence, a sadistic psychopath. In his article, “malignant narcissism” and psychopathy are employed interchangeably. Kernberg first proposed malignant narcissism as a psychiatric diagnosis in 1984.”

    Of course it never became a diagnostic category, but this doesn’t mean the combination of other disorders can’t exist in one person. Add to that the third element of what is called the Dark Triad along with sociopathy and extreme narcissism, megalomania, and the power of the president, and you have an incredibly dangerous psychopathology.

    Who better to explain this to the public, and to members of Congress as Bandy Lee has to Democratic members, than mental health experts? Those who understand this have a moral and ethical responsibility to sound the alarm as Bandy Lee who doesn’t diagnose outright diagnose but still makes the case for Trump having a psychiatric assessment, and others like those in my first comment have been doing. Should we leave it up to lawyers like George Conway who wrote GEORGE CONWAY SAYS TRUMP IS A ‘MALIGNANT NARCISSIST’: HE’S ‘BOTH MENTALLY DISORDERED AND EVIL’ in Newsweek?

    I don’t think so. If you had a client who told you their spouse or partner was abusing a child or threatening to harm someone it would be very clear that even without the legal backing of Tarasoff you would also have a duty to warn – a moral and ethical obligation to use what you know as a psychotherapist to protect someone in danger.

    As the book title says, in the dangerous case of Donald Trump because of our being experts in assessing psychopathology in person and , when we have an incredible amount of data from observations, from afar we are the only people with the training and expertise to warn about the most dangerous person in America.

  • Thank you for this behind the scenes account which explains a great deal. As one of the early members of John D. Gartner’s Duty to Warn group I am surprised it is the first that I learned of it. (A video of a Gartner speech was also presented as part of the Yale conference – you can read it here:

    Both the APA and Dr. Allen Frances did a lot of harm. The later is the psychiatrist who says that because he wrote the DSM criteria for narcissistic personality disorder he is the only one qualified to say Trump doesn’t fit the definition because he doesn’t suffer or perceive any ill effects. (see ).

    Since 2016 as much as eminent mental health professionals like Bandy Lee, James Gilligan, Lance Dodes, John Gartner, Justin Frank, Robert Jay Lifton, Phillip Zimbardo, David Reiss, Steven Buser and others including not so eminent ones like myself, tried to warn about Trump’s dangerous psychopathology our reasoning was relegated to progressive venues and media outlets like Salon, The Atlantic, MSNBC , and Daily Kos where I post my stories. In fact, only John Gartner as far as I can tell made it into the mainstream media with articles published in USA Today.

    We all could have health with the argument put for by Allen Francis because it is a ludicrous one (people with NPD like those with anti-social personality, don’t usually suffer, they make other people suffer). The leaders of the American Psychiatric Associate and their adherence to the Goldwater rule as if it was superglued to the Hippocratic Oath really kept the responsible mental health community from getting the message out that Trump was dangerous not only because he was an autocratic and but also because he was a malignant narcissist with no conscience or empathy and is an exemplar for The Dark Triad, the deadly combination of extreme narcissism, sociopathy, and megalomania.