As It Happens

Stop saying Trump has narcissistic personality disorder, says psychiatrist who defined it

The man who wrote the clinical definition of narcissistic personality disorder says U.S. President Donald Trump doesn't have it, and to suggest otherwise is "insulting to the people who have mental illness."
Donald Trump may be a 'world-class narcissist,' but he doesn't have narcissistic personality disorder, insists the man who defined the term. (Win McNamee/Getty Images)

Read Story Transcript

Allen Frances says he's tired of "amateur diagnosticians" insisting that U.S. President Donald Trump has narcissistic personality disorder. 

And he should know. As the chair of the task force that wrote the Diagnostic and Statistical Manual of Mental Disorders IV, Frances literally helped write the definition of NPD.

In a letter to the New York Times, Frances, a retired Duke University professor, wrote that Trump "may be a world-class narcissist, but this doesn't make him mentally ill, because he does not suffer from the distress and impairment required to diagnose mental disorder."

He was responding to another letter to the Times — signed by 35 psychiatrists, psychologists and social workers — declaring Trump mentally unfit for the job of commander-in-chief. In doing so, they were flouting a longstanding American Psychiatric Association ethical policy barring mental health professionals diagnosing public figures from a distance. 

It's a very strange society that thinks that it's somehow worse to call Donald Trump mentally ill than to call him evil.- Psychiatrist Allen Frances

Asked why he felt the need to respond, Frances told  told As It Happens guest host Helen Mann: "I don't think Donald Trump qualifies for a mental disorder."

But make no mistake, Frances is no fan of the president. 

"It's insulting — insulting to the people who have mental illness, who do suffer a great deal of distress and impairment — to be lumped with someone like Donald Trump," he said.

'Psychiatric name-calling'

Frances has long spoken out against what he sees as a tendency to over-diagnose mental ilness, and he says he's especially weary when people do it to explain behaviour they don't like

"When people are bad, they should be labelled appropriately and denounced for their behaviours. We should not use mental illness to slur someone," he said. "It's a very strange society that thinks that it's somehow worse to call Donald Trump mentally ill than to call him evil."

While he admits Trump appears to fit some of the DSM-V criteria for the disorder, that's not enough.

"Having traits doesn't mean you have a disorder. Having a personality doesn't mean that you have a mental illness. It also has to cause considerable, clinically significant distress and impairment," he said. 

As for his colleagues? He believes they are well-meaning, but should find political avenues to express their concerns rather than resorting to "psychiatric name-calling."

DMV criteria for narcissistic personality disorder are:

  • Exaggerated sense of self-importance.
  • Expecting to be recognized as superior even without achievements that warrant it.
  • Exaggerating your achievements and talents.
  • Being preoccupied with fantasies about success, power, brilliance, beauty or the perfect mate.
  • Believing that you are superior and can only be understood by or associate with equally special people.
  • Requiring constant admiration.
  • Having a sense of entitlement.
  • Expecting special favours and unquestioning compliance with your expectations.
  • Taking advantage of others to get what you want.
  • Having an inability or unwillingness to recognize the needs and feelings of others.
  • Being envious of others and believing others envy you.
  • Behaving in an arrogant or haughty manner.

Source: Mayo Clinic.


To encourage thoughtful and respectful conversations, first and last names will appear with each submission to CBC/Radio-Canada's online communities (except in children and youth-oriented communities). Pseudonyms will no longer be permitted.

By submitting a comment, you accept that CBC has the right to reproduce and publish that comment in whole or in part, in any manner CBC chooses. Please note that CBC does not endorse the opinions expressed in comments. Comments on this story are moderated according to our Submission Guidelines. Comments are welcome while open. We reserve the right to close comments at any time.

Become a CBC Member

Join the conversation  Create account

Already have an account?