By Hal Brown, MSW
As I searched the web prior to writing this story I found this on the New York Magazine website. It says much of what I intended to write about.
One of the questions clinicians like me have been unable to answer is the extent to which Trump believes his lies. In New York Magazine Jonathan Chait put it this way:
One of the very few remaining mysteries surrounding Donald Trump — a very simple man prone to blurting out his feelings around the clock in whatever medium he has available — is whether or to what degree he is conscious of his lies.
Chait goes on to ask the question mental health experts can only speculate on: is he a sociopathic liar, delusional, or both?
He goes on to make the precise point I intended to write about:
A point in favor of “delusional” comes via CNN, which reports that Trump not only insists he actually won the 2020 election but has maintained at times that he will not vacate the premises on January 20, when his term ends. “In his moments of deepest denial,” it reports, “Trump has told some advisers that he will refuse to leave the White House on Inauguration Day, only to be walked down from that ledge.”
This is no joking matter if he wasn’t in fact joking.
There are numerous definitions of delusional disorder if you look it up. The first one on a Google search is from The Cleveland Clinic and it will suffice for my purposes:
Delusional disorder, previously called paranoid disorder, is a type of serious mental illness — called a “psychosis”— in which a person cannot tell what is real from what is imagined. The main feature of this disorder is the presence of delusions, which are unshakable beliefs in something untrue. People with delusional disorder experience non-bizarre delusions, which involve situations that could occur in real life, such as being followed, poisoned, deceived, conspired against, or loved from a distance. These delusions usually involve the misinterpretation of perceptions or experiences. In reality, however, the situations are either not true at all or highly exaggerated.
People with delusional disorder often can continue to socialize and function quite normally, apart from the subject of their delusion, and generally do not behave in an obviously odd or bizarre manner. This is unlike people with other psychotic disorders, who also might have delusions as a symptom of their disorder. In some cases, however, people with delusional disorder might become so preoccupied with their delusions that their lives are disrupted.
Trump is not known for expressing self-mocking or self-effacing humor. His humor, such as it is, tends to be cruel mockery of others.
I’ve never read that Trump enjoys kidding around. I’ve never seen him laughing spontaneously in what I would call a healthy way. He only time he seems to be enjoying himself is when he’s basking in the admiration of his sycophants or attacking his opponents.
I wrote the other day that Nixon was a psychiatrically unimpaired president who had a normal grief reaction when he knew he would have to resign. He became clinically depressed and resorted to alcohol to ease his distress. Trump is not only the worst president in history he is also the most psychiatrically impaired, and the nature of his disorder is that he is prone to having a severe reaction to what is called a narcissistic injury.
In that diary, I listed the following ways Trump could decompensate (deteriorate) when the reality of his loss suck in:
- Avoidance and non-psychotic denial
- Easily distracted
- Impaired judgement
- Defiance of norms (more pardons, appointment of unqualified people to position, etc)
- Not able to evaluate negative consequences of decisions
- Delusional and paranoid ideas not at the level of psychosis
- Narcissistic rage at setback and towards enemies (article) leading to...
- Extreme narcissistic rage triggered by minor upsets in addition to rage attacks against perceive enemies leading to...
- Uncontrolled rage attacks for no discernible reason
- Manic behavior (not psychotic)
- Manic symptoms extreme enough to be part of bipolar psychosis
- While this is not in character, he could experience various levels of depression from minor to debilitating major depression
- Delusional level denial (a psychosis — up until Jan. 20 if he believes he will be inaugurated)
- Paranoia (psychotic — for example, unseen forces are out to get me, the CIA has bugged the White House, physical manifestations he attributes to sonic waves directed against him)
- Acute psychosis (auditory and or visual hallucinations)
- Catatonic state (one of three types)
You can tick off examples which suggest Trump’s behavior which indicate he is moving towards the more severe impairments on this list.
This is what was reported in CNN:
In his moments of deepest denial, Trump has told some advisers that he will refuse to leave the White House on Inauguration Day, only to be walked down from that ledge. The possibility has alarmed some aides, but few believe Trump will actually follow through.
"He's throwing a f***ing temper tantrum," an adviser said. "He's going to leave. He's just lashing out."
If the advisor who said Trump said this in the midst of a fucking temper tantrum is true it could be a more benign explanation than him being clinically delusional unless you factor the fact that having a president who is prone to temper tantrum in charge of our nuclear arsenal in no joking matter.
Trump will have the ability to start a war until noon on January 20th. I can’t think of anything more dangerous than a raging delusional president who believes the election was stolen having the nuclear button.
Addendum: I wrote about Trump’s lie and the chances he might become psychotic in September, here.
