Re:

To the editor

Allen Frances (NYT, 2/15/17), an eminent psychiatrist, contradicts himself by chastising those psychiatrists who have diagnosed President Trump from afar.  He asserts that President Trump while a 'world class narcissist' does not suffer from a personality disorder because one criterion, subjective distress and impairment, is not present. 

Not having examined President Trump personally, how can he exclude the presence of subjective distress?  Moreover, independent of President Trump's diagnosis, how can he exclude 'impairment' given the obvious trouble he has displayed in carrying out his functions as President?

Dr. Frances is correct that ultimately it is a political solution that is needed.  But it is neither stigmatizing to people with mental illness nor inappropriate for experts on the mind to offer their perspective and insight into the current turmoil facing this country.

Respectfully

Larry S. Sandberg MD