Newer readers of this website may not be familiar with the diagnosis of malignant narcissism. Not all clinicians weighing in on why Trump is unfit to be president choose to proffer a diagnosis. Among those who do, including the founder of Duty to Warn, John D Gartner, and I, have settled upon malignant narcissism as fitting Trump like the proverbial glove.
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Unfortunately, this is not a well-known term among the general public. Malignant narcissism was a diagnosis first described by Erich Fromm and then expanded uppon by the psychoanalyst Otto Kernberg.
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The name Erich Fromm is familiar to every undergraduate social science major (not just psychology), Otto Kernberg is familiar to every psychoanalyst, to just about every psychotherapist.
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Fromm, Kernberg, and others described a real constellation of symptoms that didn't fit into any single DSM diagnosis. That's why they came up with malignant narcissism.
Much has been written about Trump having narcissistic personality disorder. As critics have pointed out, merely saying a leader is narcissistic is hardly disqualifying. But malignant narcissism is like a malignant tumor: toxic.
Psychoanalyst and Holocaust survivor Erich Fromm, who invented the diagnosis of malignant narcissism, argues that it “lies on the
borderline between sanity and insanity.” Otto Kernberg, a psychoanalyst specializing in borderline personalities, defined malignant narcissism as having
four components: narcissism, paranoia, antisocial personality and sadism. Trump exhibits all four.
His narcissism is evident in his “grandiose sense of self-importance … without commensurate achievements.” From viewing cable news, he knows "more about ISIS than the generals” and believes that among all human beings on the planet, “I alone can fix it.” His "repeated lying," “disregard for and violation of the rights of others” (Trump University fraud and multiple sexual assault allegations) and “lack of remorse” meet the clinical criteria for
anti-social personality. His bizarre conspiracy theories, false sense of victimization, and demonization of the press, minorities and anyone who opposes him are textbook paranoia. Like most sadists, Trump has been a bully
since childhood, and his thousands of vicious tweets make him perhaps the most prolific cyber bully in history.
From USA Today article
While rare, it was real, and it needed a name. Unfortunately, the psychiatrists writing the various editions of the DSM decided not to include it. This was a setback to the field because leaving it out as a standard diagnosis left a gap in how a clinician was to utilize the DSM. The manual is like a reverse engineered cookbook.
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Early in Trump’s run for president, many mental health professionals looked at all his behaviors as saw how they fit into the DSM cookbook diagnosis for Narcissistic Personality Disorder. Despite the fact that Allan Francis, MD, who says he wrote the criteria saying Trump couldn’t be diagnosed with this because he didn’t feel personal discomfort, many others said Trump did feel discomfort explaining that being thin-skinned was a kind of discomfort.
It was easy to go to the DSM-5 and check off the behaviors and characteristics everyone was observing in Trump.
- Grandiosity with expectations of superior treatment from others
- Fixated on fantasies of power, success, intelligence, attractiveness, etc.
- Self-perception of being unique, superior and associated with high-status people and institutions
- Needing constant admiration from others
- Sense of entitlement to special treatment and to obedience from others
- Exploitative of others to achieve personal gain
- Unwilling to empathize with others' feelings, wishes, or needs
- Intensely envious of others and the belief that others are equally envious of them
- Pompous and arrogant demeanor Wikipedia
In most case, the DSM-5 says typically this without commensurate qualities or accomplishments. The key word here is typically.
There is no similar numbered checklist for malignant narcissism, but it isn't impossible for someone who has observed hundreds of hours of Trump objectively to concluded he is a malignant narcissist.