BEDLAM IN HIS BRAIN: Call it insanity, mental illness, or cogntive impairment, Trump gave us ample evidence he needs professional help, by Hal Brown, MSW

Bethlem Royal Hospital, also known as Bedlam, was England’s first asylum for the treatment of mental illness. 
Bedlam has become a word meaning a scene of uproar and confusion.

What Trump did last night in the debate may not offer a precise psychiatric or medical diagnosis though it does demonstrate that his mind is not working properly. I don't like to use the dated and coloquial term "insanity" in place of mental illness, but I do so because it gets the point across. In fact Trump also used the word "insane" in the debate.  He was trying to make his point when he repeated his unsupported claim that "millions of people" are "pouring into our country from prisons, jails, from mental institutions and insane asylums."

Trump is lumping  people who, through no fault of their own, have a mental illness with people who have commited crimes. This is interesting because he has both committed crimes and, after this, I have to say he also has a mental illness. 

I wrote yesterday (here) that the debate could provide evidence that he has early dementia, mania, or a combination of the two. What I am left with is the fall-back diagnosis clinicians use when someone has elements of several diagnoses but not enough of them to fulfill the requirment for making a firm diagnosis. This is to say they have an atypical condition with symptoms of two or more disorders. Trump may be showing us what happens when someone with a narcisstic personality disorder gets dementia or mania. Trump meets the diagnostic criteria for this disorder.

The fact is that old insane asylums like Bedlam actually had many patients who manifest behavior very much like what Trump expressed during the debate. Before the first medications, Thorazine and lithium for example, were able to control psychosis and mania these hosptials were filled with raving and ranting patients whose words made no logical sense. Patients with dementia were among those who ended up in these hospitals in addition to people with those with scizophrenia and bi-polar disorder (previously called manic-depressive disorder).

In my 40 years as a psychotherapist I saw just a few patients whose symptoms were as blatant as Trump's. This is because my program was outpatient and by the time they came to us they'd already been stabilized on medication. I only saw them when they stopped coming for a period of time, went off their medication, and then came back.

(Aside: As I have this on, just this second, Joe Scarborough said "any sane Republican" in reference to what Trump should have done differently and then used the word "addled" to decribe his performance.)

The word "sane" has now become the prefix to the newest word in the media, sanewashing. I have seen it hyphenated and as two words. I expect it will end up being on the top of lists of words added to the dictionary in 2024.

Even Fox News, much to the rage of Donald Trump in the spin room afer the debate, didn't try to sanewash his debate performance.

You can call it mental illness, insanity,or cognitive impairment, but what this debate showed is that if Trump was anybody else his family would be seeking professional help for him.

Updates: Later shows following Morning Joe on MSNBC are not focusing on the cognitive impairment Trump demonstrated in the debate.  They are talking about the policies he tried to expound on. They are sanewashing.

This is another indication of cognitive disorderL

'What’s wrong with Trump?' Onlookers stunned as ex-president smiles at 9/11 memorial event

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The debate may help determine if Trump has dementia and it may also demonstrate whether or not he has mania. By Hal Brown, MSW

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Peter Baker's OpEd in The NY Times, As Debate Looms, Trump Is Now the One Facing Questions About Age and Capacity (subscription) addresses the what he calls "the rambling sometimes incoherent statements" Trump makes. What struck me in his column was the following (my italics):

Stephanie Grisham, who served as Mr. Trump’s White House press secretary but broke with him after the Jan. 6, 2021, attack on the Capitol and spoke at last month’s Democratic National Convention, said that Mr. Trump “can be disciplined when he wants to be” and that she expects him to get through Tuesday’s debate without looking diminished, given the rules and time limits.

For me this is a crucial test for clinically assessing Trump's mental acuity and may give others in the medical or mental health profession who, like me, have speculated about the possiblity, in some cases, the likelihood, that Trump has early dementia.

Mary Trump, a clincial psychologist and Trump's niece, wrote about this the other day 

Excerpt:

It’s deeply disturbing that somebody as unhinged and incoherent as Donald is allowed to run for the presidency in the first place (and that leaves aside all of the other disqualifying things about him), but the disturbance is compounded when you consider that corporate media can’t seem to muster any urgency in the face of Donald’s increasingly bizarre behavior. On any given day, he is demonstrably untethered from reality—and it often seems that the reason the warning lights aren’t constantly flashing red is because nobody covering him expects otherwise.

Surely a political press corps that spent months arguing that President Biden’s age rendered him mentally unfit, wouldn’t look the other way when the Republican candidate, the oldest person to run for president in American history, is not only old but decompensating before our very eyes. The difference of course is that Biden is aging while Donald is dementing.

So did Dr Jeffrey Kuhlman, a former White House medical director who worked with former Presidents George W Bush, Bill Clinton and Barack Obama. Here's an excerpt from this article:

Speaking from his office in Florida, Dr Kuhlman said: “Watching Trump on TV during rallies, he doesn’t exhibit critical decision-making capability.

“When I hear his words, his thought patterns – he changes course.” 

He added: “If someone is going to be president until age 82, medically we would want to make sure they are not exhibiting accelerated cognitive decline or progressive dementia, which one in six Americans in their 80s have.”

In his opinion, Dr Kuhlman was confident that Trump “has cognitive decline”, which he said is very common with ageing and can reduce someone’s “executive function” to organise, plan, and problem-solve. 

Back to Stephanie Grisham saying that Trump "can be disciplined when he wants to be” and that she expects him to get through Tuesday’s debate without looking diminished, given the rules and time limits."

If Trump has dementia it is doubtful that he will be able to get through the debate, no matter what the rules and time limits are, without demonstrating symptoms. In fact, the rules and times limits may frustrate him and exacerbate the symptoms.

Someone with dementia can't turn off their symptoms. One can't tell someone with dementia to turn off their symptoms for 90 minutes. Can you imagine one of his advisors telling him that he has to be disciplined during the debate? 

I will keep an open mind as I watch the debate. If Trump does manage a coherent performance I will reassess my opinion that he most likely has dementia. 

I will also be watching for signs that Trump is suffering from mania. Like with dementia, someone with this disorder can't control the symtpoms.

If he has mania there's a good chance he will have a manic episode during the debate.  This hasn't been a focus of experts or of the media.

Here's a definition of mania from Wikipedia. Note that a symptom is a flight of ideas. This is excessive speech at a rapid rate that involves causal association between ideas. We often see this with Trump although he calls it "the weave" as if it is a brilliant oratory device.

Mania, also known as manic syndrome, is a mental and behavioral disorder defined as a state of abnormally elevated arousal, affect, and energy level, or "a state of heightened overall activation with enhanced affective expression together with lability of affect." During a manic episode, an individual will experience rapidly changing emotions and moods, highly influenced by surrounding stimuli. Although mania is often conceived of as a "mirror image" to depression, the heightened mood can be dysphoricas well as euphoric. As the mania intensifies, irritability can be more pronounced and result in anxiety or anger.

The symptoms of mania include elevated mood (either euphoric or irritable), flight of ideas and pressure of speech, increased energy, decreased "need" and desire for sleep, and hyperactivity. They are most plainly evident in fully developed hypomanic states, however, in full-blown mania, these symptoms become progressively exacerbated. In severe manic episodes, these symptoms may even be obscured by other signs and symptoms. 

If Trump doesn't have dementia and does have mania this can often be successfully treated with medication. 

Trump will have about 45 minutes, five minutes short of the typical 50 minute hour most therapists devote to their patients, to provide me with enough information to do what I had to do in my 40 years as a psychotherapist. This was to determine at least a tentative diagnosis to submit to insurance companies. 

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Prestigious Coumbia Journalism Review asks "is the press sanewashing Donald Trump?" By Hal Brown, MSW

 

Above: My photo, click to enlarge.

Read CJR article here.

Their article begins:

There’s a hot new term doing the rounds among media critics: “sanewashing.” The term itself actually isn’t new, and it wasn’t born in media-criticism circles, per se; according to Urban Dictionary, it was coined in 2020 on a Reddit page for neoliberals (which Linda Kinstler wrote about recently for CJR), and meant “attempting to downplay a person or idea’s radicality to make it more palatable to the general public.” (It was deployed in discussions around, for example, “defunding the police.”) Recently, though, various observers have applied the term to media coverage of Donald Trump. Aaron Rupar, a journalist who is very active on X, has been credited with coining “sanewashing” in this specific context, but the term appeared to really blow up last week, after Parker Molloy wrote a column about it in The New Republic. (She expanded on the idea as a guest on the podcast Some More News.) The word has since been picked up by media bigwigs including Paul Krugman and Rachel Maddow, and appeared in outlets from Ireland to India.

As applied to Trump, the idea is that major mainstream news outlets are routinely taking his incoherent, highly abnormal rants—be they on social media or at in-person events—and selectively quoting from them to emphasize lines that, in isolation, might sound coherent or normal, thus giving a misleading impression of the whole for people who didn’t read or watch the entire thing.  

Excerpts:

As I see it, newsroom policies discouraging remote diagnoses of mental health are generally to be followed, even if they shouldn’t curb any and all discussion in this area; also, Trump does have (or at least is associated with) policies that merit scrutiny, however incoherently he articulates them, and—as even some critics acknowledge—there has been at least somesharp recent coverage centering the incoherence. The idea that “the media” as a whole has ignored Trump’s fitness for office is very hard to sustain. Nonetheless, I find the sanewashing criticism persuasive, on the whole. Too often, major outlets clean up Trump’s language—especially in shorter formats, like headlines and ledes—to the point where it barely resembles what he actually said. 

The article asks "if journalists are sometimes sanewashing Trump, why are they doing it?" Here's part of the answer:

Could it be that elite journalists think so little of Trump that they effectively condescend to him by cleaning up his speech? Do they think that picking meaning out of his word salads makes them sound clever or original? Is he held to a lower standard than his opponents because the latter are expected to speak in full sentences and he never has been? Is Trump sounding incoherent simply old news at this point, in an industry that prizes novelty?

The article concludes:

Tomorrow night, viewers will get an unadulterated dose of Trump when they tune in for his debate against Harris on ABC. Well, somewhat adulterated; Harris will be there too, of course, and Trump’s mic will be muted when she is talking—to the frustration of Harris’s team, which wanted her to be able to grill Trump in real time and also reportedly saw benefit in letting viewers hear Trump acting out. Ironically, it was Biden—who agreed to the terms for the debate before dropping out—who demanded muted mics; even Trump’s opponents, it seems, can’t agree on whether it’s best to shut him up or let him be heard. Unlike at the Biden-Trump debate in June, a “pool” of journalists will reportedly be close enough to the stage to hear the candidates this time. It might end up being their job to tell us what Trump said off-mic. Unavoidably, it’ll be all our jobs to describe what Trump said with the mics on.

"The Columbia Journalism Review (CJR) is a biannual magazine for professional journalists that has been published by the Columbia University Graduate School of Journalism since 1961. Its original purpose was 'to assess the performance of journalism in all its forms, to call attention to its shortcomings and strengths, and to help define—or redefine—standards of honest, responsible service.' " (Wikipedia) Columbia is ranked as the third best journalism school in the country.

The CJR is asking a rhetorical question in their title. Their article answers the question. They know that reporters with a semblance of journalistic chops know the answer is "damn right it is."

We expect this kind of sanewashing from right-wing media but it is when it comes from what we like to consider objective reporters, some of whom actually have degrees in journalism and were assigned articles in the Columbia Journalism Review to read in college, it is appalling. 

As the CJR points out, the follow-up coverage of tomorrow's debate will be a measure of how responsible journalists are in doing their jobs.

Read previous blogs here.

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Hitler was the quintessential fearmonger of the 20th Century, Trump is the consumate 21st Century fearmonger. By Hal Brown, MSW

Above image from Perchance AI

At a Wisconsin rally yesterday, after saying he'd eliminate the Dept. of Education,

Trump also described a bizarre scenario he believes parents should be worried about when their kids are in school, just days after a deadly school shooting took place at a high school in Georgia.

"Can you imagine you're a parent and your son leaves the house and you say, 'Jimmy, I love you so much. Go have a good day in school.' And your son comes back with a brutal operation," Trump told the crowd, falsely suggesting that school faculty or administration staff somehow perform gender-affirming surgery on students.

Trump made a similar claim a week ago, incorrectly claiming that "the school decides what's going to happen with your child" regarding such surgeries.

Fact-checks by Snopes, CNN and PolitiFact have concluded that this claim is false. There is no evidence that schools in the U.S. are performing, or sending students to receive, these types of surgeries. Gender-affirming surgery is very rarely performed on minors, and both surgeries and less invasive forms of gender-affirming care require parental consent under current medical standards. This is from HUFFPOST

It's come to this: respected fact checking groups have to report on ludicrous claims made by Trump. It is obvious to reasonable people that what he says about some things are so far beyond "mere" lies that they belong in a nightmare or a bad LSD trip. 

Just for one example, look how he has picked the easiest target in the LGBTQ+ community to convince parents that schools will do gender changing surgery on their kids without parental consent even though this would be both impossible and illegal, and such surgeries on minors is rare and with younger children non-existent (reference).

As reported in the NPR article, "The number of U.S. adults who identify as LGBTQ+ doubled in 12 years, new poll shows:"

The number of American adults who identify as LGBTQ+ has more than doubled in the last 12 years, according to new polling from Gallup. The latest results show that 7.6% of U.S. adults now align themselves with the LGBTQ+ community — up from 3.5% in 2012, when Gallup started collecting this data. Compare that to four years ago, when the figure was 5.6%.

There are just too many members of the LGBTQ+ community and others who know and love them for Trump to go after them.

Attacking schools trying to do transgender surgery on children, and I used this term warily, is going after the lowest hanging fruit of prejudice and represents the ginning up of irrational fear. Instead of lashing out against something like same sex marriage which 71% of Americans support  and understand, Trump is trying to convince voters that so-called woke Democrats want to allow schools to change the physical sex of their children. 

This is like his saying doctors want to execute newborn babies. As obvously absurd as this claim is, it also had to be fact-checked.

Trump is the consummate fearmonger of the 21st century. He hasn't managed to outdo Hitler, at least not yet, but he sure is trying. 

He fearmongers on other topics. For example he posted the following:

"Therefore, the 2024 Election, where Votes have just started being cast, will be under the closest professional scrutiny and, WHEN I WIN, those people that CHEATED will be prosecuted to the fullest extent of the Law, which will include long term prison sentences so that this Depravity of Justice does not happen again. We cannot let our Country further devolve into a Third World Nation, AND WE WON’T! Please beware that this legal exposure extends to Lawyers, Political Operatives, Donors, Illegal Voters, & Corrupt Election Officials. Those involved in unscrupulous behavior will be sought out, caught, and prosecuted at levels, unfortunately, never seen before in our Country."

Trump has not only predicted that if he loses this may be the last election we'll have or that the country will be destroyed,  he has even threatened that we'd have World War III if he isn't elected (see Newsweek article). In other words, he is claiming that unless you elect him the country will be reduced to a radioactive wasteland.

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Update:

By coincidence the war against trans and the LGBTQ+ community was being discussed by Melissa Murray, subbing for Ali Velshi, on MSNBC after I wrote this blog. They were talking about how Project 2025 emphasized this on pages four and five.

Here's an article from The Advocate on this topic: POLITICS

Project 2025: A blueprint for the oppression of LGBTQ+ Americans

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Trump has a new apologist with linguist James McWhorter who says he has mastered 'the weave" speaking style, by Hal Brown, MSW

 

James McWhorter is a Columbia University linguist who explores how race and language shape our politics and culture. He just had this column published in The NY Times:

He begins his column this way:

Donald Trump’s word-salad oratory has always been a distinctive feature of his public life, leaving some observers to grasp for a novel way to describe it. Last week Trump himself gave it a name, one that sounds kind of like a ’70s dance: “the weave.”

“You know what the weave is?” he asked the crowd at a rally in Johnstown, Pa. “I’ll talk about like nine different things, and they all come back brilliantly together, and it’s like, friends of mine that are, like, English professors, they say, ‘It’s the most brilliant thing I’ve ever seen.’”

I wonder if somewhere in the recesses of his mind, one of those English professors is me.

The "friend" reference refers to this

During a rally in Johnstown, Pennsylvania, on August 30, Trump asserted that what the “Fake News” describes as rambling is actually a genius-level rhetorical device he calls “the weave.”

“You know, I do the weave,” Trump said. “You know what the weave is? I’ll talk about like nine different things, and they all come back brilliantly together, and it’s like, friends of mine that are, like, English professors, they say, ‘It’s the most brilliant thing I’ve ever seen.’”

This is far from the first time Trump has tried to deny or explain away allegations of incoherence. When he kept publicly mixing up the names Barack Obama and Joe Biden, he said we just don’t understand sarcasm. After a Wall Street Journal poll that found nearly half of respondents didn’t think Trump is mentally up to the presidency, he bragged about passing a dementia test years earlier, and challenged Rupert Murdoch and the paper’s editors to do the same. And in response to reports that he had a bizarre public post-DNC meltdown, Trump insisted in a Truth Social post that Fox News called him first (which wasn’t the issue) and that Maureen Dowd is “gilted” (whatever that means).

None of this really made any sense, but presumably these arguments, much like Trump’s meandering rally tirades, were crystal clear to his many English-professor friends. It’s lucky for Trump that academics who have no problem breaking down his Ulysses-esque political messaging make up such a huge portion of the American electorate!

 

Read article in NY Magazine.

This linguist suggests Trump's incoherent word salad is deliberate. I disagree.

I do not think Trump uses this speech pattern or style skillfully. I do not think it is deliberate. I don't even think this is a powerful tool with his cult. He may get laughs telling shark stories at rallies but I expect that many in the audience are completely lost when he says things like this.

Like other shrinks (for example Harry Segal,  Lance Dodes, and his neice Mary Trump, I have done some writing about Trump (see Google search for some of my essays) having dementia and have concluded that there is a good chance that he is in the early stages. 

McWhorter seems to be engaging in what is now being called "sane washing" (see this article) and also "Donald Trump's incoherence makes the media's double standard hard to hide" by Heather "Digby" Parton in Salon. She writes:

Donald Trump, on the other hand, has been speaking nonsense and spouting gibberish on the campaign trail and the media is covering for him by pretending that his verbal incontinence actually makes sense or by ignoring it altogether. Yes, there's been some mordant chuckling in the media over his bizarre comments about "the late great Hannibal Lecter" and his meandering tales about electric boats and shark attacks. Those stories are all delivered with a twinkling eye-roll as if to say "Oh that wacky Trump, there he goes again" as if it's just a funny little anecdote, apropos of nothing.

Read her entire article. She lays it out far better than I could.

There have been other recent articles about how the MSM, including the NY Times, is doing this. The authors of these article sometimes try to translate incoherent word salad into something that makes sense. I say they are adding dementia detergent to Trump's word salad stained speech and trying to wash it out. McWhorter, as a linguist, has no expertise in dementia. I think, whether he is doing this deliberately or not, he has become an apolgist for Trump. 

Note in this article McWhorter only mentions dementia once:

No friend of his am I (nor an English professor exactly — my field is Linguistics), but I wrote in 2018, in response to speculation even then that Trump was suffering some kind of dementia, that in listening to him we must realize that informal, occasionally jumbled speech is not automatically incoherent.

I think the crucial paragraph in the recent McWhorter article is:

However, the distinction between public and private speech is key here, so I am unconvinced that his current speech patterns can be analyzed as evidence of dementia. Instead, they’re characteristics of casual speech as it has always existed.

This is the only time dementia is referred to.

I have never heard anyone speak casually the way Trump does unless you count the seriously mentally ill patients who went off their medication in my old community mental health program

McWhorter seems to be saying that Trump uses "the weave" deliberately and skillfully. I certainly don't.  He begins with the 2015 example which could be a deliberate use of the weave but also a sign of early dementia:

Look, having nuclear — my uncle was a great professor and scientist and engineer, Dr. John Trump at M.I.T.; good genes, very good genes, OK, very smart, the Wharton School of finance, very good, very smart — you know, if you’re a conservative Republican, if I were a liberal, if, like, OK, if I ran as a liberal Democrat, they would say I’m one of the smartest people anywhere in the world — it’s true! — but when you’re a conservative Republican they try — oh, they do a number ….

In this example the elements are all related, albeit losely. Compare this to his recent bacon comment. None of the elements are related. 

You take a look at bacon and some of these products,” Trump said at a recent town hall in Wisconsin. “Some people don’t eat bacon anymore. And we are going to get the energy prices down. When we get energy down — you know, this was caused by their horrible energy — wind, they want wind all over the place. But when it doesn’t blow, we have a little problem.”

The most publicized comment about sharks and electrocution can most charitably be decribed as free association. This is a technique used in psychoanalysis to uncover unconconscious meanings.  In fact, if Trump was in traditional psychoanalysis this is what he'd be doing if he was asked to free associate to a dream about being on a sinking electric boat. 

If Trump doesn't have early dementia he may be suffering from mania which for him would be a good thing since there are medications to treat this.  

Addendum:

It isn't only the word salad that demonstrates that Trump has lost mental acuity. Consider how he says things that ultimately can be used to his detriment, for example what he said about E. Jean Carroll yesterday.

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