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Using Nassir Ghaemi's Psychiatric Terminology to Describe President Trump (REVIEW ESSAY)

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Duluth, Minnesota (OpEdNews) March 13, 2020: The op-ed columnist Maureen Dowd (born in 1952) published "Trump's Crazy Fantasy World" in the New York Times (dated March 7, 2020). In it, she previews the American journalist Jonathan Karl's forthcoming aptly titled new 368-page book, Front Row at the Trump Show. No doubt we should think of Donald J. Trump (born in 1946) as a showman putting on a show for journalists like Jonathan Karl (born in 1968) so that he (Trump) can see himself covered in the news media.

According to Maureen Dowd, here's Jonathan Karl's big scoop: When Mick Mulvaney (born in 1967) became President Trump's acting chief of staff (a position he no longer holds), he urged senior White House staffers at a weekend retreat at Camp David to read Nassir Ghaemi's 2011 book A Fist-Rate Madness: Uncovering the Link Between Leadership and Mental Illness. Dr. Nassir Ghaemi, M.D., is an Iranian American professor of psychiatry at Tufts University School of Medicine and the director of the mood disorders program at Tufts Medical Center in Boston.

Ghaemi's superficial and, at times, glib book is somewhat similar, in certain respects, to two books published in 2005: (1) The Hypomanic Edge: The Link Between (a Little) Craziness and (a Lot of) Success in America by John D. Gartner, Ph.D. (New York: Simon & Schuster) and (2) American Mania: When More Is Not Enough by Peter C. Whybrow, M.D. (New York: W. W. Norton).

Ghaemi does not mention either book about Americans or any of the other books in which authors use psychological concepts to discuss historical figures, except for Freud's posthumously published co-authored work about Woodrow Wilson. As a matter of fact, Ghaemi is critical of all psychoanalytic approaches and of cognitive-behavioral approaches to depression (because they fail to recognize what he refers to as depressive realism which he contrasts with the delusion of optimism).

The prefix "hypo" is Gartner's term hypomanic means less than full-blown manic. Ghaemi uses the term hypomanic to mean mild or low-level manic symptoms (pages 61 and 140). He also refers to mild depression symptoms (page 61). But a full-blown manic episode involves a psychotic break from reality. However, even regularly sustained hypomanic tendencies such as those discussed by both Gartner and Whybrow do not necessarily signal the onset of a full-blown hypomanic episode.

But what exactly are we supposed to learn from the examples of Americans discussed by Gartner and by Whybrow who manifested certain persistent but low-level manic tendencies, but who evidently never experienced a full-blown hypomanic episode? For example, are we supposed to learn just how elastic certain mental-illness terminology is?

Now, even though Ghaemi does superficially discuss certain Americans in detail, including President Abraham Lincoln, President Franklin D. Roosevelt, President John F. Kennedy, and the Reverend Dr. Martin Luther King, Jr., Ghaemi also superficially discusses Winston Churchill, Adolf Hitler, and Mahatmas Gandhi. However, like Gartner and Whybrow, Ghaemi also does not claim that any of his examples experienced a full-blown hypomanic episode a psychotic break with reality. So what exactly are we supposed to learn from the examples discussed by Ghaemi? Evidently, we are supposed to learn how well-known mentally ill leaders are different from mentally normal leaders, some of whom are also discussed by Ghaemi.

No doubt Mick Mulvaney's recommendation of Ghaemi's 2011 book to senior White House officials hinged on Ghaemi's glib characterizations that they might readily apply to characterize President Donald J. Trump. As a loyal member of Team Trump, Mick Mulvaney would want to arm senior White House staffers with Ghaemi's weaponized psychiatric terminology in defense of Trump whose critics often resort to their own use of weaponized psychiatric terminology to characterize and criticize him. In this way, perhaps the combative Mick Mulvaney wanted senior White House officials to fight fire with fire, and Ghaemi may have seemed to Mick Mulvaney to provide Trump's apologists and defenders with a certain psychiatric fire-power they could appropriate and perhaps use. Or at least use silently in their own minds to resist the psychologized criticisms of Trump.

In Ghaemi's "Introduction: The Inverse Law of Sanity" (pages 1-19), he sets forth what he himself refers to as the Inverse Law of Sanity: "[W]hen times are good, when peace reigns, and the ship of state only needs to sail straight, mentally healthy people function well as our leaders. When our world is in tumult, mentally ill leaders function best" (page 3).

But was the obviously mentally ill Trump with his persistent mildly manic symptoms elected president in 2016 because peace did not reign, eh? Or was he elected in 2016 because he was an effective salesman selling a delusion of optimism the delusion that Ghaemi explicitly and emphatically associates with the mentally healthy? In Trump's case, his delusional optimism may be his primary way of building up his resilience.

The American salesman's tragic propensity for the delusion of optimism is commemorated in the American playwright Arthur Miller's famous 1949 play Death of a Salesman. Arguably the tragic sense of life of what Ghaemi refers to as depressive realism is expressed in the Irish playwright and novelist Samuel Beckett's 1953 play Waiting for Godot.

Ghaemi argues that the mental illnesses of mania and depression appear to promote four key elements involved in crisis leadership: (1) realism, (2) resilience, (3) empathy, and (4) creativity.

But Trump famously lacks realism rather he lives in an alternative reality. Perhaps Trump could claim a certain creativity in filing for bankruptcy and a certain resilience in bouncing back from bankruptcy. But how is Mick Mulvaney going to persuade us about Trump's empathy by his bromance with thugs like Putin? But hold on perhaps Ghaemi says something else that Mick Mulvaney picked up on.

Ghaemi says, "First and most important, mental illness doesn't mean that one is simply insane, out of touch with reality, psychotic. The most common mental disorders usually have nothing to with thinking at all, but rather abnormal moods: depression and mania. These moods aren't constant. People with manic-depressive illness aren't always manic or depressed. Thus they aren't always insane; in fact, they're usually sane. Their illness is the susceptibility to mania or depression, not the fact of actually (or always) being manic or depressed. This is important because they [such people] may benefit as leaders not just directly from entering and leaving those mood states, from the alternation between being ill and being well" (pages 10-11; his emphases).

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Thomas James Farrell is professor emeritus of writing studies at the University of Minnesota Duluth (UMD). He started teaching at UMD in Fall 1987, and he retired from UMD at the end of May 2009. He was born in 1944. He holds three degrees from Saint Louis University (SLU): B.A. in English, 1966; M.A.(T) in English 1968; Ph.D.in higher education, 1974. On May 16, 1969, the editors of the SLU student newspaper named him Man of the Year, an honor customarily conferred on an administrator or a faculty member, not on a graduate student -- nor on a woman up to that time. He is the proud author of the book (more...)

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