Dare I Demention It Again...

 
There was a very good article in The Hill last week on Trump's "confabulation" (a term in psychiatry for when people remember false information in vivid detail), that the article notes is considered "one of the clearest early signs of dementia".  The article gives many examples of this with Trump, most recently his false story of his uncle teaching Unabomber Ted Kaczynski – who went to a different college from where Trump’s uncle taught…and who wasn’t known to the public until 11 years after Trump’s uncle died.
 
The author of the piece (which you can find here), Chris Truax, is not a psychiatrist, but an attorney (fairly high up in MAGOP ranks, who served as Southern California chair of John McCain’s primary campaign in 2008).  However, he addresses this by pointing out that if one doesn’t want to go the level he is in labeling Trump’s cognitive state as dementia – he just wants people, at the very least, as the most basic starting point, to be honest and recognize factually the troubles Trump is having.  As he writes --
 
“If you aren’t comfortable with labeling this as dementia, that’s fine. But there is no question that the president — the man tasked with making critical life and death decisions for both the country and the world — is struggling with mathematical concepts, has vivid “memories” that are not rooted in reality and has an increasingly foggy grasp of past events that did happen. That’s not a medical diagnosis. These are facts we can see for ourselves and we all know, even those of us who voted for Trump three times, that this can’t be allowed to continue.”

His details and observations are meticulous and many.  My only quibble is when he writes near the end – “Whatever dementia issues Joe Biden may have, there is no denying that his staff was superb at managing them and protecting both Biden and the country. Trump, however, doesn’t have those guardrails.”
 
There have been no psychologists or psychiatrists I’m aware of who have written articles, given interviews or collaborated on an anthology even suggesting that Joe Biden has dementia.  The most that such medical professionals have said is that President Biden was showing normal signs of cognitive decline from aging.  That’s completely different from showing signs of dementia, which is a disease and is degenerative and can leave the patient unable to function.
 
As for Trump though, that’s not the case.  And I say this not even remotely as a doctor.  But over the past six years when I first started writing about Trump’s cognitive decline, I've quoted from actual expert psychologists and psychiatrists who've written extensive articles in major publications, given interviews to medical journals, and even joined together to publish a book with a collection of their articles by 37 medical professionals. (The first edition had 23 -- so the number participating has grown by a lot.) It's these psychologists and psychiatrists who explain in specifics why they see signs of dementia in Trump. And it's them, experts, who I'm referencing.
 
As I wrote online in a discussion yesterday, what laymen (like myself) may see as lies or normal forgetting, or repeating stories that a person has convinced themselves are true, medical professionals who actually treat the illness not only see as a sign of dementia, but the signs to them are so common that they have medical names for them. (Like, for just one example, paraphasia. Which to others may seem like forgetting a name, but 'paraphasia' is the *way* Trump forgets a name, makes up a similar-sounding false name and quickly changes the subject mid-sentence that -- to psychologists -- is something totally different. That's just one example of many.)
 
For instance, last August I wrote a piece here about an article that was in a medical
publication, Stat.  The article dealt with the issue, dealing with several doctors, experts in the field, who have been looking at patterns of Trump’s speech -- at the heart of which is one particular doctor who has been studying Trump’s past speeches and comparing how the linguistics have changed over time, and how that fits with others who have cognitive issues.  Issues that might seem normal to the general public, but not to experts.  One point mentioned, for instance, is Trump’s common pattern of suddenly veering off topic and going into a totally different, almost unrelated subject -- something that to most people may appear usual but, because it’s not, actually has a medical name.  As the medical article notes –
 
“This shifting from topic to topic, with few connections – a pattern of speech called tangentiality – is one of several disjointed and occasionally incoherent verbal habits that seem to have increased in Trump’s speech in recent years, according to interview with experts in memory, psychology and linguistics.”
 
So, what we laymen see as “It looks like he just made a normal mistake,” and what actual psychologists and psychiatrists who treat dementia observe are two very different things.  Indeed, medical professionals who have written about Trump explain that there's a difference, too, in someone who is just repeating false stories and forgetting their lies, and the way Trump (or any person with dementia) repeats false stories with such specificity in ways he is convinced is the truth, yet that can't possibly be true, but won't waver, despite when others who were directly involved in the event explain what actually happened.
 
Just yesterday, in fact, Trump demonstrated this – another example of “confabulation” that Mr. Truax wrote about.  In a racist rant meltdown on social media, when Trump attacked highly popular Black podcaster Charlamagne tha God, calling him (among many other things) a "racist sleazebag" – and ranting about just imagine if he called himself "God", ignoring that he regularly retweets images of his base doing just that! – Trump once again bizarrely claimed that he ended the Rwanda genocide…which actually ended in 1994, when Trump was partying with Jeffrey Epstein.  And further, he stated that seven million people died then – when the population in Rwanda at the time was 7.1 million!!  It’s troubling enough to make these claims.  But it appears to be indication of dementia confabulation – or just “cognitive decline” for those who prefer niceties – when a person keeps repeating what is not remotely possible.
 
To be clear, someone with dementia can exhibit a normal condition of covering up lies they keep repeating. But that doesn't mean they aren't also exhibiting signs of dementia, and the two overlap. So, the dementia gets excused as something normal, when it may well be the underlying condition.
  
I've posted far too many articles quoting experts here to link to them.  But anyone interested should feel free to search my site for "Gartner" (who is Dr. Jack Gartner formerly of Johns Hopkins) for many articles and interviews quoting him and others. Or "Bandy," who is Dr. Bandy Lee who was editor of that anthology collection on Trump. But here at least is one link to my article on the book.

​So far, few reporters have gone so far as addressing even the possibility that Trump has shown signs of early dementia.  (And to be clear, “early dementia” is dementia, but the person is still functioning.)  Lawrence O’Donnell on MSNBC does point to it as outright dementia, but there aren’t many.  Mostly it’s “cognitive issues.”  Of course, if this was President Biden, it would be – and was – headline stories.
 
At some point, and it appears that we’re barreling there soon, we may get there.  Hopefully before Trump does.