WEBVTT - Kerry Sulkowicz: Is the President Mentally Fit? 0:00:05.160 --> 0:00:09.480 Hello, John Mulner. Hi Katie, So this is very exciting listeners. No, 0:00:09.600 --> 0:00:12.719 I am not cheating on Brian with my husband John, 0:00:12.920 --> 0:00:16.920 but Brian is on a family vacation and we thought 0:00:16.920 --> 0:00:20.560 it might be fun for me, for John, and hopefully 0:00:20.640 --> 0:00:24.480 for you to have my husband fill in because we 0:00:24.520 --> 0:00:28.160 obviously talk all the time about a lot of different issues, 0:00:28.640 --> 0:00:32.360 and this guest was actually John's idea. We had a 0:00:32.400 --> 0:00:35.600 conversation of fascinating conversation I thought I thought I was 0:00:36.120 --> 0:00:41.280 I thought I was fascinating, Thank you, But with Carrie Sulkowitz, 0:00:41.320 --> 0:00:44.640 who is a psychiatrist and a psychoanalyst, and it was 0:00:44.680 --> 0:00:47.280 your idea to have him on the podcast. Why Mulner, 0:00:47.320 --> 0:00:49.040 why did you think that was a good idea? Well, 0:00:49.120 --> 0:00:52.640 we were having lunch and Carrie was sharing his views 0:00:53.040 --> 0:00:56.560 of President Trump and some of his behaviors which so 0:00:56.600 --> 0:01:00.160 many people are talking about trying to understand, and he 0:01:00.240 --> 0:01:05.160 had a very clinical, analytical assessment of some of the 0:01:05.200 --> 0:01:07.720 things that we're seeing. And I asked him if he'd 0:01:07.760 --> 0:01:09.720 be willing to come on and talk to you about it. Now. 0:01:09.760 --> 0:01:11.520 I didn't know you were gonna invite me to sit in. 0:01:12.120 --> 0:01:14.399 I don't know what I'm doing here. But let's get 0:01:14.400 --> 0:01:18.640 Brian back quickly. But it was really interesting to hear him, 0:01:18.760 --> 0:01:21.760 and I was somewhat surprised when he said he would 0:01:21.840 --> 0:01:26.160 come on. Yeah. Well, I was pleasantly surprised because a 0:01:26.200 --> 0:01:30.640 lot of mental health professionals don't think it's appropriate to 0:01:30.920 --> 0:01:36.880 opine about the pathology of public officials, certainly the president 0:01:36.920 --> 0:01:40.320 of the United States. But Carry was willing to do that. 0:01:40.959 --> 0:01:44.560 And willing I think he thinks it's really critically important 0:01:44.560 --> 0:01:47.319 to do. One thing to note, though Kerry is not 0:01:47.440 --> 0:01:51.920 your average psychiatrists or psychoanalyst. He actually stopped his clinical 0:01:51.920 --> 0:01:56.360 practice some time ago. He now advises CEOs and senior 0:01:56.560 --> 0:02:00.520 leaders on leadership and management. So here he is Dr 0:02:00.600 --> 0:02:05.680 Carry Sulkowitz. Thank you so much for coming on the podcast. 0:02:05.800 --> 0:02:08.280 Thank you so much for inviting me. So I should 0:02:08.280 --> 0:02:11.239 point out, John, you and Carrie know each other pretty 0:02:11.240 --> 0:02:14.440 well from when you were a partner at Brown Brothers Harriman, 0:02:14.800 --> 0:02:16.760 that's true here in New York. Tell me a little 0:02:16.760 --> 0:02:21.000 bit about your relationship. Well, Carrie was hired as an 0:02:21.040 --> 0:02:25.320 executive coach for Brown Brothers and UH and I had 0:02:25.360 --> 0:02:27.880 a chance to work with him, and he helped me 0:02:27.919 --> 0:02:30.920 think about my career and my relationship with other partners 0:02:30.960 --> 0:02:34.160 at the firm and how to help grow the business 0:02:34.200 --> 0:02:36.320 that I was involved in, and then from that a 0:02:36.400 --> 0:02:41.600 personal friendship grew. So you're really an executive coach, would 0:02:41.600 --> 0:02:46.279 you say, now, Carrie, or an executive what? Actually, notwithstanding 0:02:46.280 --> 0:02:48.440 what John just said, which I appreciate, I actually don't 0:02:48.440 --> 0:02:51.280 like that term executive coach, even though I'm sure I've 0:02:51.280 --> 0:02:54.680 been called far worse things. Katie. I'm I'm a psychiatrist 0:02:54.680 --> 0:02:58.000 and a psychoanalyst who about twenty two years or so ago, 0:02:58.000 --> 0:03:02.120 stumbled into the business world and started today consultancy, advising 0:03:02.200 --> 0:03:05.520 CEOs and boards and management teams, really trying to apply 0:03:05.800 --> 0:03:09.840 a clinical perspective to working with leaders and helping them 0:03:09.840 --> 0:03:12.040 on the various challenges they face every day. Well, we 0:03:12.080 --> 0:03:14.200 have so much to talk about, Carry, I'm really and 0:03:14.400 --> 0:03:18.040 me I call you Carry, Dr k Um. So much 0:03:18.080 --> 0:03:23.400 to talk about about leadership, about mental health, mental fitness 0:03:23.440 --> 0:03:26.320 when it comes to our current president. But first I 0:03:26.400 --> 0:03:29.520 want to talk a little bit about you. How did 0:03:29.520 --> 0:03:31.920 you get into this field in the first place. I 0:03:31.919 --> 0:03:35.800 thought it was fascinating that your parents were both Holocaust survivors. 0:03:36.480 --> 0:03:40.520 Can you tell me specifically sort of how your interactions 0:03:40.560 --> 0:03:46.320 with your parents and trying to figure out their pathology 0:03:46.360 --> 0:03:51.800 and their past influenced you going into psychiatry. Yeah, it did. Um. 0:03:52.640 --> 0:03:55.800 They were wonderful people. They're both gone now, unfortunately, but 0:03:56.640 --> 0:04:00.200 it was clear that they were both quite damaged by 0:04:00.240 --> 0:04:02.240 the experience of the world, though it left them with 0:04:02.280 --> 0:04:06.120 certain kinds of strength and resiliency as well. Um, And 0:04:06.200 --> 0:04:09.880 my fascination in part was, you know, how did leaders 0:04:09.880 --> 0:04:13.560 of countries get large groups of people to do good things, 0:04:13.560 --> 0:04:15.360 and especially how did to get them to do bad things, 0:04:15.400 --> 0:04:17.120 including the kinds of things that had happened to my 0:04:17.240 --> 0:04:21.320 parents and many other people who were um incarcerated in 0:04:21.360 --> 0:04:25.240 the Holocaust. So that was rattling around in my head 0:04:25.279 --> 0:04:26.880 as a kid, although I didn't know what to do 0:04:26.920 --> 0:04:29.040 with it. It certainly didn't feel like something that might 0:04:29.040 --> 0:04:31.760 become a career. And I also had a bit of 0:04:31.920 --> 0:04:34.000 my son the Jewish doctor syndrome, and so knew that 0:04:34.000 --> 0:04:36.600 I had to go to medical school uh and did. 0:04:37.360 --> 0:04:40.560 But as a psychiatrist I went into private practice and 0:04:40.839 --> 0:04:43.360 loved some aspects of it. I liked helping people still 0:04:43.400 --> 0:04:46.400 do like the intellectual underpinnings of it, but was a 0:04:46.400 --> 0:04:48.400 little too restless to be sitting in an office all 0:04:48.480 --> 0:04:51.320 day seeing one patient after another. And then actually met 0:04:51.320 --> 0:04:54.960 a my first entrepreneur at a cocktail party, um about 0:04:55.000 --> 0:04:58.120 twenty two years ago. And it turns out that leaders 0:04:58.160 --> 0:05:01.480 need somebody to talk to, and he probably had a 0:05:01.480 --> 0:05:03.040 couple of extra glasses of wine that made it a 0:05:03.040 --> 0:05:05.000 little easier, and he opened up to me about some 0:05:05.040 --> 0:05:07.320 of the challenges he was having being a CEO of 0:05:07.320 --> 0:05:09.480 a startup. And I thought it was just an interesting 0:05:09.520 --> 0:05:11.880 cocktail party conversation until he asked me if I would 0:05:11.920 --> 0:05:14.159 be interested in advising him in his company. That was 0:05:14.200 --> 0:05:17.640 really the beginning of my new career. How does advising 0:05:17.800 --> 0:05:22.760 CEOs differ from advising patients in a clinical setting in 0:05:22.800 --> 0:05:25.080 a number of ways, Katie. First of all, I want 0:05:25.080 --> 0:05:26.960 to make it clear that when I'm advising a CEO, 0:05:27.040 --> 0:05:30.200 they're not my patient. Um My, My work with him 0:05:30.240 --> 0:05:33.800 is undoubtedly informed by my background as a clinician. Uh. 0:05:33.839 --> 0:05:35.960 It kind of comes in handy sometimes to understand something 0:05:36.000 --> 0:05:39.320 about human behavior and various ways people have of dealing 0:05:39.400 --> 0:05:44.200 with complicated feelings. But I'm not treating anybody, um. I 0:05:44.240 --> 0:05:46.480 would also say an important distinction is that when I'm 0:05:46.480 --> 0:05:50.640 working with the CEO. The CEO is part of the client, 0:05:50.680 --> 0:05:53.000 but the client is always the organization itself, and so 0:05:53.080 --> 0:05:55.159 it allows me an access to the CEO of the 0:05:55.160 --> 0:06:00.200 management team, the board, a more systemic immersion in the life, 0:06:00.320 --> 0:06:03.159 the business, the culture of the organization. And when you're 0:06:03.160 --> 0:06:06.720 dealing with CEOs who have all that authority and power 0:06:06.880 --> 0:06:10.560 within an organization, how does that sort of authority reflect 0:06:10.600 --> 0:06:14.680 itself in the personality of the of the leaders of organizations. 0:06:14.480 --> 0:06:17.080 The CEO, as I would say, are people first and foremost, 0:06:18.160 --> 0:06:20.000 but there are people who are affected by the roles 0:06:20.000 --> 0:06:22.240 that they're in, and those roles change them in some 0:06:22.360 --> 0:06:28.200 profound ways. Um CEOs are isolated. They are inherently lonely. 0:06:28.600 --> 0:06:31.200 The nature of power is such that it inhibits the 0:06:31.279 --> 0:06:34.880 upward flow of information to them, and so they often 0:06:35.000 --> 0:06:37.120 don't really hear what they need to hear, what's going 0:06:37.160 --> 0:06:40.479 on down below. And they also don't have anybody to 0:06:40.520 --> 0:06:43.280 really confide in inside their organization for the same reason, 0:06:43.600 --> 0:06:46.120 so they need somebody to talk to their lonely. They're isolated, 0:06:46.160 --> 0:06:50.640 their anxious, They're dealing with complexity, ambiguity every day, so 0:06:50.800 --> 0:06:53.159 they're constantly faced with new challenges that they don't know 0:06:53.200 --> 0:06:55.560 the answer to, and so how do you how do 0:06:55.600 --> 0:06:59.880 you find it? When you then challenge CEO, who's you 0:07:00.120 --> 0:07:04.000 to making a decision and having a decision implemented? Where 0:07:04.040 --> 0:07:07.960 you say, well, is that the right of course of action? 0:07:08.080 --> 0:07:10.720 Is that the right decision? Have you weighed other factors? 0:07:11.440 --> 0:07:13.600 I do that all the time. I challenge CEOs, but 0:07:13.600 --> 0:07:15.360 I don't necessarily do it in the first few minutes 0:07:15.360 --> 0:07:19.120 of talking to them. Have you ever had as CEO 0:07:19.360 --> 0:07:24.400 say you're fired? You know, there have been some engagements 0:07:24.400 --> 0:07:26.000 a few of them that haven't worked out, but it 0:07:26.040 --> 0:07:28.200 happens pretty rarely. I mean, I try to be patient. 0:07:28.240 --> 0:07:31.280 I try to establish a relationship. I try to establish 0:07:31.320 --> 0:07:34.280 some trust, which of course doesn't happen immediately. I should 0:07:34.280 --> 0:07:36.120 also point out that there is a self selection that 0:07:36.160 --> 0:07:37.880 goes on in terms of the kinds of CEOs that 0:07:37.960 --> 0:07:40.080 I work with, that I bet a lot of them 0:07:40.360 --> 0:07:42.840 wouldn't want anything to do with someone like you, with 0:07:42.880 --> 0:07:47.400 all due respect, no no, no disrespect taken there. It's 0:07:47.440 --> 0:07:52.800 absolutely true. The really egregiously narcissistic, difficult, horrible CEO is 0:07:52.840 --> 0:07:55.240 the bad bosses that people talk about. For the most part, 0:07:55.520 --> 0:07:58.239 they're not calling me, they're well, they're not self aware 0:07:58.360 --> 0:08:00.360 enough to call you, right, And that's the it. Self 0:08:00.360 --> 0:08:02.320 awareness is really the key here. The ones that call 0:08:02.400 --> 0:08:04.520 me have a modicum of self awareness, at the very least. 0:08:04.520 --> 0:08:07.440 Nobody's ever fully self aware, but they have some sense 0:08:07.480 --> 0:08:09.800 of their own loneliness, their own need to have somebody 0:08:09.840 --> 0:08:13.000 to talk to. There may be people problems on their team, 0:08:13.080 --> 0:08:16.120 there may be leadership challenges that they're facing that they 0:08:16.160 --> 0:08:18.000 don't know how to deal with, and they need someone 0:08:18.040 --> 0:08:20.080 to bring that perspective to bear. I want to talk 0:08:20.120 --> 0:08:23.520 to you about sort of the need to have someone 0:08:23.560 --> 0:08:27.520 in the organization be the truth teller for the leader. 0:08:27.680 --> 0:08:29.040 I think I read a piece that you wrote in 0:08:29.040 --> 0:08:34.079 the Harvard Business Review about how leaders pick people they 0:08:34.080 --> 0:08:37.840 can confide in, but that those confidants can ultimately be 0:08:37.920 --> 0:08:42.600 exceedingly damaging to the CEOs to most CEOs have a 0:08:42.640 --> 0:08:45.560 tendency and do they have to fight against this of 0:08:45.880 --> 0:08:51.320 picking sickophants and people who will basically echo and and 0:08:51.679 --> 0:08:56.840 be a yes person right right so? And and how 0:08:56.880 --> 0:08:59.960 big a problem is that I wouldn't make the generalization 0:09:00.080 --> 0:09:02.840 that most CEOs tend to pick sick of fans part 0:09:02.840 --> 0:09:04.720 of what I was trying to to say in this 0:09:04.840 --> 0:09:07.199 article that you mentioned in the Harvard Business of You 0:09:07.240 --> 0:09:10.360 a number of years ago, is that the the confidante 0:09:10.360 --> 0:09:13.800 that a CEO chooses is an absolute reflection of the 0:09:13.880 --> 0:09:18.000 CEOs psychology to begin with. So the better CEOs, and 0:09:18.040 --> 0:09:20.440 we can talk about what a better CEO is, but 0:09:20.480 --> 0:09:22.800 the better CEOs, the ones that are more self aware, 0:09:22.800 --> 0:09:24.959 the ones that are more attuned to the fact that 0:09:25.000 --> 0:09:27.880 they need someone to talk to to help them think 0:09:27.920 --> 0:09:29.880 through things, are not going to pick the sick of fans. 0:09:30.040 --> 0:09:32.240 They're going to pick the ones who talk straight to them, 0:09:32.240 --> 0:09:35.520 who speak truth to power, so to speak. Um, the 0:09:36.040 --> 0:09:39.040 ones who are more narcissistic, the ones who are more 0:09:39.040 --> 0:09:42.040 fragile in terms of their self esteem, they're the ones 0:09:42.040 --> 0:09:43.800 who are going to pick the sick of fans who 0:09:43.800 --> 0:09:47.000 just tell them what they want to hear. Is Narcissisms 0:09:47.040 --> 0:09:48.480 come up a couple of times. I have a feeling 0:09:48.520 --> 0:09:50.400 it may come up more in the discussion as we 0:09:50.440 --> 0:09:53.520 go on. But but to some extent, would all CEOs 0:09:54.200 --> 0:09:59.880 have a level of narcissistic characteristics or behaviors or is 0:10:00.000 --> 0:10:02.920 not necessarily true? That's a great opportunity for you for 0:10:02.960 --> 0:10:05.280 me to give you my thirty second lecture on narcissism. 0:10:05.320 --> 0:10:08.800 Thank you. The term narcissism, certainly as it's used in 0:10:08.880 --> 0:10:12.000 popular culture, is never meant as a compliment. Uh. It's 0:10:12.040 --> 0:10:14.600 usually meant as an epithet. It's thrown around a lot 0:10:14.640 --> 0:10:18.920 too casually. But narcissism is something that is better thought of, 0:10:19.080 --> 0:10:21.080 at least in my view, as something that exists on 0:10:21.120 --> 0:10:23.640 a spectrum, and we all have some of it, right, 0:10:24.160 --> 0:10:27.480 There's a degree of healthy narcissism that is necessary for 0:10:27.520 --> 0:10:29.600 any of us to be successful in life, to care 0:10:29.679 --> 0:10:31.720 about how we show up for work every day. I 0:10:31.760 --> 0:10:35.120 think of that that musical avenue que. Everybody's a little 0:10:35.120 --> 0:10:38.280 bit racist. I always think everybody is a little bit narcissistic. 0:10:38.800 --> 0:10:41.480 That's right, everybody is a little bit narcissistic. And in fact, 0:10:41.559 --> 0:10:43.360 some people could use a little bit more of it. 0:10:43.720 --> 0:10:47.640 The people who are too shy and retiring and and 0:10:47.640 --> 0:10:50.960 and hide away and or don't put enough attention into 0:10:50.960 --> 0:10:54.440 how they appear, or don't take pleasure in their work. 0:10:54.480 --> 0:10:56.560 Those are all aspects of what I would describe as 0:10:56.600 --> 0:10:59.000 healthy narcissism. So if you think of it on a 0:10:59.080 --> 0:11:02.960 spectrum with healthy narcissism at one end and unhealthy or 0:11:03.000 --> 0:11:06.280 pathological variations at the other end. I think it's just 0:11:06.360 --> 0:11:08.760 a more holistic way, even though I think sometimes people 0:11:08.800 --> 0:11:10.360 want to see things as black and white, like you 0:11:10.360 --> 0:11:12.200 either have it or you don't. But narcissism is not 0:11:12.280 --> 0:11:15.000 like pneumonia or appendicitist that where you either have it 0:11:15.080 --> 0:11:17.280 or you don't. So on a scale of one to ten, 0:11:18.080 --> 0:11:21.480 one being not enough narcissism and tend being way too much, 0:11:21.480 --> 0:11:24.960 what sort of balance are we looking for in the 0:11:24.960 --> 0:11:29.040 most effective uh, corporate leaders or political leaders that you 0:11:29.040 --> 0:11:31.120 see where we're on the scale? Does that fun? You 0:11:31.200 --> 0:11:33.200 sound like the finance guy that I know you to be. 0:11:34.440 --> 0:11:37.560 I need a number. Carry, Give me a number for you, 0:11:37.640 --> 0:11:42.320 I will say somewhere between five and seven. But I 0:11:42.320 --> 0:11:46.160 don't think that way, so I don't. We'll save that 0:11:46.200 --> 0:11:50.760 for a private conversation. I'm not gonna weigh in on 0:11:50.800 --> 0:11:54.120 this conversation, but let me I mean carry our most 0:11:54.160 --> 0:11:57.920 successful people. Do they rate high on the narcissism scale? 0:11:58.600 --> 0:12:03.800 Because I feel like narcissists can be exceedingly charming, They're 0:12:03.800 --> 0:12:07.440 really good at get getting what they want, UM often 0:12:07.559 --> 0:12:11.280 high emotional intelligence. Am I crazy? No, you're not crazy. 0:12:11.360 --> 0:12:14.320 But I would say that that narcissism and emotional intelligence 0:12:14.360 --> 0:12:17.040 are not mutually exclusive up until a point, and then 0:12:17.080 --> 0:12:21.080 when you cross over into the more pathological realm of narcissism, 0:12:21.400 --> 0:12:24.880 then emotional intelligence falls off a cliff and you lose 0:12:24.920 --> 0:12:27.360 that ability to read other people. You lose the ability 0:12:27.400 --> 0:12:30.480 to empathize, and that's really critical here, the ability to 0:12:31.200 --> 0:12:34.439 transiently put yourselves in the emotional shoes of somebody else. 0:12:34.520 --> 0:12:37.240 That's my definition of empathy, by the way, is an 0:12:37.240 --> 0:12:40.480 absolutely essential quality of a really good leader. But if 0:12:40.480 --> 0:12:43.520 you're really narcissistic, the only person you care about is yourself. 0:12:44.000 --> 0:12:49.480 You can't relate to understand care about emotions. The other 0:12:49.520 --> 0:12:53.040 side empathy is the other side of the coin with 0:12:53.080 --> 0:12:55.719 respect to narcissism. At the at the severe end of 0:12:55.720 --> 0:12:58.760 the scale of narcissism, there's very little empathy. I hate 0:12:58.760 --> 0:13:03.040 to dive in to narcissism too deeply, but I dated 0:13:03.080 --> 0:13:06.280 a guy who I thought was a narcissist, not not 0:13:06.360 --> 0:13:09.520 my husband, and um, you know, I spent a lot 0:13:09.559 --> 0:13:11.440 of time in the self help section of Barnes and 0:13:11.520 --> 0:13:15.880 Noble because I had never experienced a narcissistic personality. And 0:13:15.920 --> 0:13:18.120 one of the things that I think is misunderstood and 0:13:18.200 --> 0:13:21.320 carry your you're the expert. But from all the reading 0:13:21.360 --> 0:13:25.680 that I've done is you know, narcissist staring at his 0:13:25.800 --> 0:13:30.120 reflection in the in the pond or whatever. And the 0:13:30.200 --> 0:13:36.560 mythology of narcissism it seems to connote someone has incredible 0:13:36.800 --> 0:13:40.760 hubrists and think so highly of himself or herself. But 0:13:40.840 --> 0:13:44.040 what I thought was interesting, this comes from deep, deep, 0:13:44.120 --> 0:13:49.680 deep insecurity and this feeling that it's really overcompensating for 0:13:49.800 --> 0:13:54.000 feeling less than And is that accurate? That is accurate. 0:13:54.520 --> 0:13:56.760 I'm gonna run a follow some of the self help 0:13:56.800 --> 0:13:59.560 book writers, but that's one of the problems with any 0:13:59.600 --> 0:14:02.160 self help book is that it's necessarily general. They're certainly 0:14:02.200 --> 0:14:05.240 intended to be helpful, and I don't question the intentions, 0:14:05.240 --> 0:14:08.160 but they don't necessarily get into the deeper underpinnings of this, 0:14:08.240 --> 0:14:11.640 which actually helps us empathize with the narcissists. I think 0:14:11.679 --> 0:14:14.280 that's because you know, I read a lot. You know, 0:14:14.400 --> 0:14:16.640 I was went through a bad period of my life 0:14:16.679 --> 0:14:18.880 and I read a lot about this and a lot 0:14:18.960 --> 0:14:23.760 about modeling about um, you know, someone forming a sense 0:14:23.800 --> 0:14:27.160 of self very early on in their life and how 0:14:27.200 --> 0:14:31.960 that contributes later to this narcissistic personality disorder. That's right. 0:14:32.920 --> 0:14:34.840 We I want to make it really clear that when 0:14:34.840 --> 0:14:38.120 we're talking about whether it's narcissism or sociopathy or a 0:14:38.120 --> 0:14:41.040 whole host of other psychological phenomenon that may come up 0:14:41.040 --> 0:14:44.320 in this conversation, we're not passing moral judgment about any 0:14:44.360 --> 0:14:48.440 of it. These are not moral judgments. These are clinical assessments, 0:14:48.440 --> 0:14:50.320 and those are two very very different things. We have 0:14:50.360 --> 0:14:53.160 to keep them separate to your question, Katie, about the 0:14:53.280 --> 0:14:55.160 roots of narcissism, which I think is really what you're 0:14:55.160 --> 0:14:58.160 asking about. It's not about somebody's a bad person and 0:14:58.200 --> 0:15:00.400 that they're spoiled and need to be lapped on the 0:15:00.440 --> 0:15:03.080 wrist or somehow received some kind of training. The roots 0:15:03.080 --> 0:15:06.040 of narcissism, certainly from a psychoalytic point of view, go 0:15:06.200 --> 0:15:10.000 way back to early childhood and usually are an individual's 0:15:10.400 --> 0:15:14.800 very understandable response to certain kinds of emotional deprivation or 0:15:14.840 --> 0:15:18.800 trauma in their early years. And it's hard to generalize 0:15:18.800 --> 0:15:22.200 about that because, as we know, children can be scarred 0:15:22.200 --> 0:15:26.000 in all sorts of ways, infinite ways. But the people 0:15:26.000 --> 0:15:30.000 who come up through childhood and early adulthood and develop 0:15:30.080 --> 0:15:34.760 into a narcissistic character. M have not had easy childhood's, 0:15:34.840 --> 0:15:37.200 even if they look like they have grown up in 0:15:37.680 --> 0:15:42.720 households of great privilege. It's time for us to take 0:15:42.720 --> 0:15:45.520 a quick break. When we return, we'll talk with Dr 0:15:45.600 --> 0:15:48.760 Carry Sulkowitz about the mental health of the most powerful 0:15:48.920 --> 0:15:52.360 man in the world. No, not you, Mulner, the President 0:15:52.520 --> 0:15:58.680 of the United States. That's right after this, and now 0:15:58.840 --> 0:16:03.760 back with Dr Carry psychoist. One of the reasons we 0:16:03.760 --> 0:16:07.160 were interested in having you come in, Carrie, is talking 0:16:07.200 --> 0:16:10.240 about the pathology and the President of the United States, 0:16:10.280 --> 0:16:14.880 Donald Trump. There has been a lot of conversations about 0:16:15.000 --> 0:16:19.200 his mental state or whether he is actually mentally fit 0:16:19.800 --> 0:16:25.640 to lead the country. And narcissism is specifically malignant narcissism 0:16:25.680 --> 0:16:28.960 has come up quite a bit. What's the difference between 0:16:28.960 --> 0:16:32.360 your run of the male narcissist and a malignant narcissist. 0:16:34.160 --> 0:16:36.840 Let me back up a minute if I can, um 0:16:37.040 --> 0:16:41.840 I want to avoid the psychiatric approach and take the 0:16:41.840 --> 0:16:44.400 more psychoanalytic approach here and discussing it. Frankly, I think 0:16:44.400 --> 0:16:46.680 it's more helpful to people who are listening to this 0:16:46.760 --> 0:16:49.160 and who are looking to understand tell us the difference. 0:16:49.200 --> 0:16:51.920 So the difference and I'm both, I'm trend as a 0:16:51.960 --> 0:16:56.360 psychiatrist and psychoanalyst, But the psychiatric approach is largely a 0:16:56.400 --> 0:16:59.200 medical based approach that is focused on the diagnosis of 0:16:59.200 --> 0:17:02.560 mental illness and and of course the treatment of that illness. 0:17:03.400 --> 0:17:05.600 When it comes to talking about a public figure, it's 0:17:05.600 --> 0:17:09.080 something that I think is frankly not that helpful. There's 0:17:09.080 --> 0:17:11.000 a whole controversy around that which we can get into 0:17:11.040 --> 0:17:14.160 as well, the so called Goldwater water, the Goldwater Rule. 0:17:14.560 --> 0:17:17.240 But I I think I find it personally less interesting 0:17:17.280 --> 0:17:20.880 to try to attach a label uh to a president 0:17:20.960 --> 0:17:23.199 or to anybody else for that matter. And more I 0:17:23.240 --> 0:17:27.600 want to try to understand observable behavior, behavior that's observable 0:17:27.640 --> 0:17:29.000 to all of us, not just to those who are 0:17:29.000 --> 0:17:32.880 clinically trained, as well as the appeal of that behavior 0:17:33.000 --> 0:17:35.200 to people who support him and like him and don't 0:17:35.280 --> 0:17:39.840 question him. Let's talk about your analysis as a result 0:17:39.880 --> 0:17:44.120 of everything that you've witnessed, that you've seen the president's behavior, 0:17:44.280 --> 0:17:49.280 the president's way of communicating via tweets, speeches, that he's given, 0:17:49.560 --> 0:17:55.480 his behavior rallies. What do you think about his personality 0:17:55.960 --> 0:17:58.840 or his pathology. And I'm going to try to put 0:17:58.880 --> 0:18:02.720 this in terms that are certainly informed by my clinical perspective, 0:18:02.720 --> 0:18:04.359 but that really come through the lens of being an 0:18:04.359 --> 0:18:08.000 advisor to leaders. That's the That's the lens that interests 0:18:08.040 --> 0:18:10.120 me the most, and I think is most relevant because 0:18:10.359 --> 0:18:11.960 for better or worse, he is the leader of the 0:18:12.000 --> 0:18:15.080 free world, at least the leader of this country. Uh. 0:18:15.160 --> 0:18:17.800 And after all the talk about narcissism, I would say 0:18:17.840 --> 0:18:20.800 that his narcissism is only one part of what we 0:18:20.840 --> 0:18:24.840 are dealing with here. Uh. In fact, his narcissism, while 0:18:25.040 --> 0:18:27.080 so obvious. I mean, look, Katie, you don't have to 0:18:27.119 --> 0:18:31.280 be Sigmund Freud to decide that Donald Trump is narcissistic 0:18:31.560 --> 0:18:35.280 as an adjective, what about malignant le narcissistic? Well, malignant 0:18:35.359 --> 0:18:38.000 is a is a word that is used to describe 0:18:38.040 --> 0:18:41.320 the extremes. It's not a black or white, sharp distinction. 0:18:41.800 --> 0:18:43.560 But he is. He is out there in terms of 0:18:43.680 --> 0:18:47.960 his his clear focus on himself. But the reason why 0:18:48.119 --> 0:18:50.720 I want to move a little bit beyond his narcissism, 0:18:50.760 --> 0:18:52.800 even though I'm not in any way diminishing the importance 0:18:52.800 --> 0:18:55.760 of it, particularly the lack of empathy is that while 0:18:55.880 --> 0:19:02.480 his narcissistic behavior is so obvious, so overt, the very 0:19:02.520 --> 0:19:05.719 fact that it is so prominent obscures other aspects of 0:19:05.760 --> 0:19:08.000 his psychology and his behavior than, in some ways are 0:19:08.000 --> 0:19:11.359 more troubling to me. I should also point out that 0:19:11.480 --> 0:19:15.440 narcissism alone has never precluded anyone from being president, and 0:19:15.560 --> 0:19:19.160 if we look at the modern presidents of this country, 0:19:19.800 --> 0:19:22.560 some of the more narcissistic ones have been arguably very 0:19:22.600 --> 0:19:25.720 successful presidents, and those who were on the lesser end 0:19:25.760 --> 0:19:29.520 of the narcissistic spectrum arguably have been less successful as presidents. 0:19:30.160 --> 0:19:32.840 To foot put this in terms of narcissism alone, I 0:19:32.840 --> 0:19:36.320 think misses the complexity of the issue. Carrie, give us 0:19:36.320 --> 0:19:40.320 some background on the Goldwater Rule, when that came about, 0:19:40.359 --> 0:19:45.280 and why that limits other medical professionals from opining on 0:19:45.320 --> 0:19:49.399 public figures. The Goldwater rule traces its history back to 0:19:49.480 --> 0:19:52.560 the nineteen sixty for presidential election, when very Goldwater was 0:19:52.600 --> 0:19:56.240 running for president. Of course, he didn't win, but during 0:19:56.280 --> 0:19:59.760 that campaign, a magazine that existed at the time that's 0:19:59.800 --> 0:20:04.360 lo gone called Fact Magazine, published a survey of American psychiatrists. 0:20:04.400 --> 0:20:08.600 Members of the American Psychiatric Association UM and many of 0:20:08.640 --> 0:20:12.879 them felt that Goldwater was unfit to serve by virtue 0:20:12.880 --> 0:20:15.000 of his mental health, and that in particular, that he 0:20:15.040 --> 0:20:17.639 had a paranoid personality. That's what they said in the 0:20:17.680 --> 0:20:21.840 magazine published that survey. Of course, the election was over, 0:20:21.960 --> 0:20:26.480 Goldwater lost, and after the election he sued not the psychiatrist, 0:20:26.520 --> 0:20:29.840 but he sued the magazine itself for libel, and this 0:20:29.920 --> 0:20:34.040 case dragged out for a number of years. Ultimately he won, 0:20:34.640 --> 0:20:37.960 but it sent the psychiatric profession reeling. The American Psychiatric 0:20:38.000 --> 0:20:41.399 Association and in particular, studied this problem and came up 0:20:41.440 --> 0:20:44.120 with what then became known as the Goldwater Rule, which 0:20:44.119 --> 0:20:46.440 if I remember correctly, came out in the early seventies, 0:20:46.440 --> 0:20:48.439 So there was a long period of time between the 0:20:48.440 --> 0:20:51.159 election and the issuance of this rule, which has just 0:20:51.240 --> 0:20:54.680 recently been updated even more strongly by the A p A. 0:20:54.960 --> 0:20:58.680 Which basically says, if you do not have personal experience 0:20:58.880 --> 0:21:04.080 with an individual, seeing them face to face, um, you're 0:21:04.080 --> 0:21:06.800 in no position to evaluate them. That's right. That The 0:21:06.880 --> 0:21:10.159 rule basically says two simple things. One is that you 0:21:10.240 --> 0:21:12.679 can't make a diagnosis at a distance. You can't make 0:21:12.680 --> 0:21:15.280 a diagnosis without actually examining the patient. And then the 0:21:15.280 --> 0:21:18.040 corollarity of that is, if you do examine someone as 0:21:18.080 --> 0:21:24.000 a patient, then you're bound by reasons concidentiality. But I'm yeah, 0:21:24.119 --> 0:21:26.120 But my own view is I actually find the gold 0:21:26.119 --> 0:21:29.800 Water rule invalid and not helpful and frankly stifling of 0:21:29.880 --> 0:21:32.880 freedom of speech. I think it's I agree with one 0:21:33.000 --> 0:21:36.439 narrow aspect of it. It's not responsible to be slinging 0:21:36.480 --> 0:21:40.000 around diagnoses as epithets. But that's not what we're talking 0:21:40.000 --> 0:21:42.200 about here. Uh And so I actually find the gold 0:21:42.200 --> 0:21:47.640 Water Rule relatively irrelevant to the current discussion. Any commentator, 0:21:47.720 --> 0:21:52.160 whether you're trained clinically as a psychiatrist, psychologist, psychoanalyst, or 0:21:52.240 --> 0:21:54.600 anybody else for that matter, can comment on the mental 0:21:54.640 --> 0:21:57.200 state of of another person. It's nice to be able 0:21:57.240 --> 0:21:59.399 to comment on it if you have some training and 0:21:59.440 --> 0:22:03.880 doing so. Um. And these days, there is an abundance 0:22:04.160 --> 0:22:08.399 of publicly available information about public figures that there wasn't 0:22:08.520 --> 0:22:10.639 back in nineteen sixty four. Well, that's what I was 0:22:10.680 --> 0:22:12.280 going to ask you about. I mean, so as you 0:22:12.640 --> 0:22:17.359 compare uh, in person sessions with a person compared to 0:22:17.920 --> 0:22:21.879 social media articles, speeches, things that are in the public record, 0:22:22.560 --> 0:22:26.199 other information the public domain. What's the qualitative difference between 0:22:26.200 --> 0:22:28.520 the two as you as you're trying to form a judgment, 0:22:28.600 --> 0:22:31.119