Diagnosing Trump and the Definition of Mental Illness

This piece on the current debate over diagnosing Trump and whether or not to reassess the 'Goldwater rule', etc. is interesting ground on which to retread an issue of ethics and psychology with which I've long felt unsatisfied.

What’s missing in Gartner’s diagnosis, according to Frances, is the key element to diagnosing all mental illness: suffering. 

“Everyone has a personality,” Frances says. “It’s not wrong to have a personality; it’s not mentally ill to have a personality. It’s only a disorder when it causes extreme distress, suffering, and impairment.”

Trump’s willingness to lie and endless self-promotion are traits that have, so far, worked out largely to his advantage. He’s president of the United States, after all. 

But people who have a true narcissistic personality disorder, Frances explains, experience a crash of some sort, even if they can’t see it for themselves. They’ll lose their jobs, their spouses and children will abandon them, and their “bubble of grandiosity [will] burst,” he says. “They feel absolutely miserable, can’t function, can’t face the world.” (Research has found that a narcissistic personality can, to an extent, help you move up in the world.)

The real world can sometimes furnish examples interesting enough to rival thought experiments for their ability to reveal non-empirical principles and or our (isolated) intuitions.  If the definition of mental illness includes that a necessary condition of one is some kind of negative experience derived from the pathology, yet one, who exhibits all the rest of it is so insulated by wealth from any negative experience from it, does he have it?