Mind Over What Matters...

I’ve written in the past several pieces about how the mistakes Trump makes with words in his speeches are not “glitches” or “slurring,” but what mental health experts call paraphasia, which is one of the early signs of dementia.  That’s when the person makes up non-existing words in place of the actual word they’re trying to say.  They often then change the direction of what they were saying.
 
One of the leading experts in this field who has been prominent in his addressing Trump’s cognitive decline is Dr. John Gartner, a psychologist, psychotherapist, and former assistant professor at Johns Hopkins University Medical School.  He’s also the founder of Duty to Warn, a collection of mental health professionals who have been warning about Trump failing mental faculties since he took office in 2017.  He's also one of the 37 experts in the field who participated in the book, The Dangerous Case of Donald Trump:  37 Psychiatrists and Mental Health Experts Assess a President.  You can find the book here.

Gartner has said that he tells people to take a good look at Trump because "This is the best you will ever see him," since dementia is a degenerative disease, and Trump will not be getting any better.

He gave an interview the other day with attorney Jay Kuo, subtitled, "An expert’s view of Trump’s mental slide into dementia," where he address the situation over time and presented four examples that demonstrate how close Trump is moving towards full dementia.

​The whole article is extremely interesting -- extensive and detailed, as well as accessible -- which you can find here.  But several passages leap out and bear being singled out.

But something that he says somewhat near the beginning is important to reference at the very start.  He addresses the criticism (much from non-professionals) that it’s unprofessional for mental health experts to diagnose Trump without him being a patient. What he responds is, in actual practice, making such diagnoses are actually common, and for a very good reason.  As he puts it --
 
“I don’t know if people know this, but in real life, in day-to-day clinical practice, we diagnose dementia based on behavioral observation and informant reports every day of the week. Thousands of medical charts would back me up on that. An ‘interview’ with a demented person doesn’t usually yield a lot of information, for obvious reasons.
 
"As a professional community,” he continues, “thousands of us have observed hundreds of hours of Trump’s public behavior.  We also have dozens of informant reports.  So, all the people hyperventilating about 'diagnosing from a distance' should take a breath. This is more business as usual than you might think. In real life, we’ve institutionalized tens of thousands of patients on far less data."
 
All that leads Dr. Gartner to is overall point.  That the evidence for Trump’s dementia is this: Trump shows an overall decline from his own cognitive baseline, with marked progressive deterioration in four areas: ability to use language, memory, behavior, and gross and fine motor skills.”
 
Among the specifics he points to are:
 
Gartner notes that Trump has shown a “shocking decline from baseline" from when he first announced his run for the presidency in 2015.  At that point, Trump was “highly articulate. He spoke in polished paragraphs with a sophisticated vocabulary. Now, his vocabulary is impoverished, and he often can’t finish a sentence or even a word. Typical of dementia patients, he repeats himself and overuses superlatives and filler words.”
 
In terms of memory, Gartner explains that some things are perfectly ordinary.  “Forgetting names and dates is normal for people who are aging.” But forgetting is different from confusion.  “By stark contrast,” he points out, “the Dementia Care Society says ‘confusing people and generations’ is a sign of advanced dementia. And this is the type of profound memory disturbance we’re seeing in Trump.” 
 
Like confusing President Biden with President Obama, and Nikki Haley with Nancy Pelosi with evidence of cognitive decline.  Rather than Trump just joking, as his staff tried to point out, Gartner says, "The more plausible explanation is that once again we are watching the workings of his demented mind in real time.  Obama and Biden have something very important in common in Trump’s brain that can allow them to be fused in his molten mind: two Democratic presidents who bested and humiliated him have become one imaginary super-villain."
 
In Michael Wolff’s book on Trump, where he was granted unprecedented access to the Oval Office, he wrote that Trump would often not recognize old friends. “I don’t mean he forgot their names,” Gartner says. “He acted as if he’d never seen them before in his life. If you’ve ever had a relative with dementia you know how heartbreaking that stage of decline can be-- to have to remind a loved one of who you are.
 
“Trump is almost there.”
 
Third, Dr. Gartner discusses paraphasia and gives a long, but by no means comprehensive list of examples where Trump has used “non-words in place of real words, that usually include a fragment of the actual word.”  Among them --
 
“mishuz” (for missiles)
“Chrishus” (for Christmas)
“space-capsicle” (for space capsule)
“combat infantroopen”(for combat infantry)
“sahhven country”(for sovereign country)
“renoversh” (For renovations)
“supply churn” (for supply chain)
“Liberal-ation (for liberation”)
“benefishers” (for benificiaries)
“stat-tics, suh-tic-six” (for statistics)
“crimakle” (for criminal)
“transjija” (for transition)
“I know Poten”
“We will expel the wald-mongers.”
 
And a great many more, covering “Semantic aphasia,” such as when trying to say “Three years later,” Trump instead said, “Three years lady, lady, lady.”  And the “Complete loss of verbal language,” such as “Gang boong.  This is me.  I hear bing.”  And “Tangential thinking,” where Trump “drifts from one unrelated thought fragment to another”  Where the “narrative is literally incoherent,” rather than “rambling.”  For instance, recently outside of the Manhattan courtroom, Trump said, “We can’t have an election in the middle of a political season. We just had Super Tuesday. And we had a Tuesday after Tuesday already.”

And Gartner makes clear that this is not just an articulation problem, as some have suggested, but a brain problem.  “But all those competing explanations are disproven by one fact. Trump commits these aphasic errors in his written posts, as well, proving the problem is in his brain, not his articulation.”  Like when Trump wrote, ““Joe Buden DISINFORMATES AND MISINFORMATES”.
 
And finally, the fourth of the signposts that Dr. Gartner points is motor performance.  He quotes dementia expert Elisabeth Zoffmann, an assistant professor of Forensic Psychiatry at the University of British Columbia, who told Salon that Trump evidences a “wide-based gait, commonly found among patients with dementia. Video online shows that he swings his right leg in a semi-circle as if it were dragging a dead weight. He has also shown deterioration in his fine motor coordination, for example having difficulty drinking a bottle or a glass of water without two hands.”
 
Dr. Gartner makes clear that he’s not alone in his concerns about Trump, and has started a petition from medical professionals warning of the danger. “We needed a chorus of professional voices. To summon them I reached out to colleagues and put a petition for licensed medical and mental health professionals online that states in part:

“Our diagnostic impression of Trump is probable dementia. From our years of training and experience, we are convinced that, while a definitive diagnosis would require further testing, Donald Trump is showing unmistakable signs strongly suggesting dementia, based on his public behavior and informant reports that show progressive deterioration in memory, thinking, ability to use language, behavior, and both gross and fine motor skills.”

"We have over 500 valid signatures," he says (and had to discard 2/3 of the signatures that couldn't be confirmed as professionals), "and that number is growing. However, to me, more persuasive than the number of signatures, are the comments left by the signers explaining their professional reasoning and describing the symptoms of dementia they see in Trump."

Furthermore, he makes a significant distinction between Trump and the accusations many Republicans have made of President Biden being “confused” and “incoherent,” arguing that he’s aging badly. But as Dr. Gartner explains, "his State of the Union address disproved any of these claims – he is a high-functioning elderly president. All of this focus on Biden’s age has distracted commentators and reporters from the obvious decline in Trump’s functioning."

Gartner says, "I call it the 'double lie.' Pathologizing Biden’s normal aging is the first lie. Normalizing Trump’s dementia is the second.  The sorts of small lapses we’ve seen in Biden are part and parcel of normal aging."  As he explains, "Joe Biden’s calling the current president of France by the old president of France’s name is like me calling my youngest daughter by my oldest daughter’s name, which I do all the time."

The article is much longer than this, with far more detailed examples.  It's easy reading though, and highly worth checking out.  Again, you can find it here.

"My grave concern," he says, " -- we are now seeing Trump at an early, yet very troubling, stage of dementia. I’ve seen from Donald Trump in the past six months, his speech is riddled with cognitive errors, misattributions, and odd digressions indicating a significant decline in functioning."

More to the point, Gartner states bluntly:  "Based on his current accelerating rate of decline, it seems very unlikely that Trump could see out a second term without falling off the cliff and becoming totally incapacitated."