I am a board-certified psychiatrist and, as such, supposed to be gagged by the “Goldwater Rule,’’ which prohibits psychiatrists from making public comments on the mental health of anyone they have not treated. But silence is not the answer.

In Monday’s front-page article “Executive analysis, from afar,’’ Dr. Allen Frances stated that personality disorders require “the presence of clinically significant distress and/or impairment,’’ and suggested that our current president does not meet these criteria.

A man who must repeatedly lash out at anyone who makes the slightest criticism of him or his family is impaired. A man who must lie outrageously in order to convince himself and others of his greatness is both impaired and probably in distress.

While anyone who believes of himself that he can be the leader of the free world is likely to have an inflated sense of self-worth, a person who cannot speak a single sentence without referring to how great he is has a more significant problem. Such a man requires nonstop adoration, and a president of the United States will never have that. As our current president has discovered, there are many people in this country and abroad who do not adore him.

The danger is that a man who needs constant adulation and cannot get it may become increasingly desperate. He may look for approval wherever he can find it and may escalate in his resolve to stomp out disapproval, no matter the cost.

Dr. Susan Shelton

Falmouth