I was thinking about how Trump’s utter disregard for people’s feelings and his lack of empathy was demonstrated once again in his comments about homelessness.
“We can’t let Los Angeles, San Francisco and numerous other cities destroy themselves by allowing what’s happening,” he said, adding that the homelessness crisis is prompting residents of those cities to leave the country. “They can’t believe what’s happening.”
“We have people living in our … best highways, our best streets, our best entrances to buildings ... where people in those buildings pay tremendous taxes, where they went to those locations because of the prestige,” he said. “In many cases, they came from other countries and they moved to Los Angeles or they moved to San Francisco because of the prestige of the city, and all of a sudden they have tents. Hundreds and hundreds of tents and people living at the entrance to their office building. And they want to leave. And the people of San Francisco are fed up, and the people of Los Angeles are fed up.” LA Times
I thought I’d write a column about how Trump’s lack of empathy intersected with his cruelty and narcissism. In searching for some references I came across an article by a psychologist who specializes in treating people with narcissistic personality disorder which I thought was worth sharing. I found it noteworthy that although it was first published on Quora June 28th and then republished in Psychology Today on August 3, 2019 there is no mention of Donald Trump. It is an entirely non-political article.
However you can read it either as I did as a psychotherapist thinking what it would be like having Donald Trump in therapy, or as a non-therapist wondering how Trump would handle being in therapy.
Dr. John Gartner’s documentary #UNFIT is coming out soon (read my Kos column about it here). After reading the following article I thought about a very different kind of movie. It would be about what it would be like if a defeated and emotionally shattered Trump lost the election, was divorced by Melania, had some of his closest allies turn on him, and suffered a debilitating mental breakdown.
What would it be like to see him in therapy with a therapist like the one Robin Williams played in Good Will Hunting?
(Therapist) Sean McGuire: It's not your fault.
Will Hunting: I know that.
Sean McGuire: Look at me, son. It's not your fault.
Will Hunting: I know.
Sean McGuire: No. No you don't. It's not your fault.
Will Hunting: Alright.
Sean McGuire: It's not your fault... It's not your fault.
Will Hunting: Don't {mess} with me.
Will Hunting: Don't mess with me.
Will Hunting: Don't {mess} with me, alright. Don't {mess} with me, Sean. Not you!
Will Hunting: Don't mess with me, alright. Don't mess with me, Sean. Not you!
Will Hunting: [tearing]
Will Hunting: [openly crying] Oh God! I'm so sorry...
Sean McGuire: {To hell} with them. Okay? [end of scene]
Sean McGuire: To hell with them. Okay? [end of scene]
Sean McGuire: To hell with them. Okay? [end of scene]
How about if he was like Tony Soprano in therapy with Dr. Melfi?
Although Dr. Melfi may be tempted to believe Tony will never change, she is still compelled to help him. However, at the end of the series, Dr. Melfi is given advice by her own psychiatrist, Dr. Eliot Kupferberg, about the work that other psychiatrists' had done about sociopaths and their behavior. He advised her that, based on the findings of the psychiatrists, that by counseling Tony, she was actually aiding his criminal behavior and that, if Tony was indeed a true sociopath, there was no possible way therapy could help him other than to further empower him as a criminal and to give him new ideas.
Dr. Melfi is seen following up on this information and it seems that she is convinced of the information that she has been given. At her last session with Tony, she observes him tearing out a page from one of her magazines, and confronts him about it, ending with telling him that she can no longer help him. Tony is clearly surprised, and confused about why she would want to stop after having treated him for 7 years. She never reveals to him the information she learned, and Tony walks out of Dr. Melfi's office. Before leaving, Tony put's back the page he tore from the magazine and walks out. Dr. Melfi looks at Tony one last time before closing the door to her office.
Read this article and see what you think the process of therapy would be like for Trump and for the therapist.
— by Elinor Greenberg, Ph.D (see her bio here)
As you can see from the title she breaks down the treatment of patients into 10 stages. She says that successful treatment usually takes 5-10 year.
These are the stages with my greatly abbreviated descriptions.
Stage 1—Symptom Relief or Appeasement
Most clients with NPD do not enter therapy in order to reflect or change. They usually come to get relief from unpleasant feelings and symptoms or to please someone important to them.
Stage 2—Avoid Future Pain
It is still all about them at this stage without any desire to understand or change their impact on other people. It is about understanding other people’s impact on them.
Stage 3—Identify their Coping Mechanisms
In this stage I am helping people understand and identify their primary defense patterns.
Stage 4—Create New Coping Mechanisms
Now that the person knows what they do and why they do it, the old narcissistic strategies do not simply disappear.
Stage 5—Form New Habits
The basic goal now is two-fold: (1) Inhibit the old, automatic narcissistic habits and (2) Substitute the new, more desirable patterns.
Stage 6—Impact on Other People
Stage 7—Focus on Childhood Pain
Stage 8—Update the Inner Voice
Before they can develop emotional empathy for other people, most people with NPD need to empathize with themselves.
Stage 9—Empathy for Other People
Once they understand their own pain and have their harsh, devaluing inner voice more under control, they can start to look outward at other people.
Stage 10—Authenticity
They take baby steps forward and try and be more authentic with other people. If this goes well, their reliance on their old “false self” defenses diminishes and they become more spontaneous and joyful.
The is the authors "Punchline." The above is a highly abbreviated sketch of the therapy for narcissistic personality disorder. As you can see, it is complex, involves multiple stages, and is likely to take a long time. There is a lot of ground to cover. Sometimes people do not want to do all of this, or cannot do it all. Everyone who keeps plugging away at evolving eventually improves. How much depends on their willingness to keep working on themselves.
If you found this article interesting be sure to read the comments.
This is a thought exercise. I don’t think there is a chance in hell that Trump would ever enter therapy.
On the poll by close I mean anybody who knows Trump well, from family members to people who interact with him frequently.