Back on Jan. 26, I wrote a diary explaining Donald Trump’s behavior through the lens of narcissistic personality disorder (NPD), of which he is a textbook case. Today, nine months later, I want to talk about how the symptoms of NPD of the malignant type have not just influenced but defined his presidency.
I am not a psychiatrist or psychologist, but educated myself about NPD for personal reasons. I first learned how it affects others the hard way. The pros agree with me that Trump has NPD and/or anti-social disorder, which in combination are known as malignant narcissism, as attested to by the comments on my diary and the recently-released book The Dangerous Case of Donald Trump (though in the book they hint rather than specifying). My focus is more on NPD because to me malignant narcissism carries the narcissistic trait lack of empathy to an extreme. But whatever words you use to describe it, enough mental health pros agree that Trump is dangerously insane that 67,000 have signed a petition and others have marched in the streets in multiple cities urging his removal.
But before we get into the meat, let me address common emotional reactions.
If you have found yourself feeling shocked, anxious, terrified, enraged, sickened, dismayed, despairing, horrified, violated, disoriented, embarrassed, ashamed, numb, depressed, insomniac, driven to addictive behavior, or tempted to harm yourself or someone else: don’t self-blame or self-condemn. All these reactions, even the most extreme ones, are normal for people of sound mind whose lives are impacted by someone with NPD. If you think you are failing somehow, if you feel you are being weak in the face of it—stop!—you’re not. Narcissists can affect the most strong, capable, well-adjusted people in this way. Narcissists are so emotionally destructive that these reactions are completely normal. N.B., I’m not saying you shouldn’t get help if you need it. Lots of people who’ve had experiences with narcissists need help.
NPD and malignant narcissism have strongly entered the political discourse in the US now, triggered by Trump’s ascendance. However, it’s generally seen piecemeal. Here I’ll try to present the complete picture, both to empower readers in aid of the emergency political goal of saving American democracy and rule of law, but also to protect themselves from other narcissists who want to enter their lives, organizations, etc. A textbook malignant narcissist in the media fishbowl of the US presidency and frequently expressing himself uncensored provides a rare educational moment.
I also think the mainstream media needs to study NPD more. As I said in the previous diary, normalizing him is gaslighting yourself, and media normalizing him are gaslighting the public. But it is actually difficult not to, for three reasons: 1) NPD disguises itself as normalcy; 2) people don’t understand NPD unless they’ve studied it or known someone close who has it, so they can’t put their finger on what’s wrong; and 3) NPD behaviors defy belief, so people can easily go into denial about their significance or even their existence. This coping mechanism can be strengthened by fear, especially if they are counting on a narcissist somehow, which the entire human population has been doing for nine months.
Hence the repeated futile media attempts to read strategy into his spewings and spot the ever-elusive pivot. There is no rational strategy and there will be no pivot. The overall motivation is malignant NPD, a pivot is literally impossible, and journalists who don’t see this are in denial.
Here are the NPD criteria from the two most recent editions of America’s mental health bible, the Diagnostic and Statistical Manual of Mental Disorders, compiled:
[DSM-IV]
1. An exaggerated sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).
2. Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
3. Believes he is "special" and can only be understood by, or should associate with, other special or high-status people (or institutions)
4. Requires excessive admiration
5. Has a sense of entitlement
6. Selfishly takes advantage of others to achieve his own ends
7. Lacks empathy
8. Is often envious of others or believes that others are envious of him
9. Shows arrogant, haughty, patronizing, or contemptuous behaviors or attitudes
[DSM-5] A. Significant impairments in personality functioning manifest by:
1. Impairments in self functioning (a or b):
a. Identity: Excessive reference to others for self-definition and self-esteem regulation; exaggerated self-appraisal may be inflated or deflated, or vacillate between extremes; emotional regulation mirrors fluctuations in self-esteem.
b. Self-direction: Goal-setting is based on gaining approval from others; personal standards are unreasonably high in order to see oneself as exceptional, or too low based on a sense of entitlement; often unaware of own motivations
AND
2. Impairments in interpersonal functioning (a or b):
a. Empathy: Impaired ability to recognize or identify with the feelings and needs of others; excessively attuned to reactions of others, but only if perceived as relevant to self; over- or underestimate of own effect on others.
b. Intimacy: Relationships largely superficial and exist to serve self-esteem regulation; mutuality constrained by little genuine interest in others’ experiences, and predominance of a need for personal gain
B. Pathological personality traits in the following domain:
- Antagonism, characterized by:
- Grandiosity: Feelings of entitlement, either overt or covert; self-centeredness; firmly holding to the belief that one is better than others; condescending toward others.
- Attention seeking: Excessive attempts to attract and be the focus of the attention of others; admiration seeking.
Translating into plain language: The core of NPD is self-esteem so extremely low that the only way the sufferer can fend off utter self-loathing is by denial that his self-esteem is low and constant reassurance from outside that he has significance. This need can never be satisfied and so becomes an intense addiction, affecting him 24/7. If he is powerful he will require excessive admiration from underlings, such as Trump’s twice-daily dose of positive news about him that WH staff feeds him or Cabinet members taking turns fawning at a nationally-televised Cabinet meeting.
This need is so strong it feels to him like a matter of life and death (as it genuinely is to a very young child) so that all other concerns fade by comparison, including the well-being of other people—similar to someone drowning who, in utter panic, drags those trying to rescue him to their deaths. Sociopathy, or more formally, anti-social disorder, can have a biological factor in its inability to normally feel emotions, and that may be a factor for Trump, too.
All other behavioral symptoms flow from this hellish emotional state, viz:
People with NPD cover up their sense of worthlessness by attention-seeking, e.g. Trump’s entertainment career and need to emblazon his buildings—or even a hurricane shelter wall—with his name. The more other people are seeing, hearing and talking about him, the less he feels invisible and therefore doomed. Note: if narcissists can’t get positive attention, they’ll take negative—either way, it shows their significance.
Narcissists create a false persona of an impressive person. Naturally that requires lying (which is also used to trick people into fulfilling the narcissist’s aims). Trump lies constantly. That includes taking undue credit, such as for the economy; making false promises—which is common with campaigning politicians, but which Trump took way beyond normal by claiming to represent average Americans; concealing truth, e.g. his tax returns; and grandiose boasting such as “I alone can fix the system,” his claim to have a higher IQ than Rex Tillerson, his false touting of numerous legislative successes and even his fake Renoir. Exaggeration fuels his linguistic love of superlatives.
He’s particularly inclined to lie on the topic of how much he is appreciated, e.g. Trump’s claims that he actually won the popular vote and drew a larger inauguration crowd than Obama’s, his lie about receiving a fulsome call from the head of the Boy Scouts after an embarrassing speech, and the fake Time magazine cover lauding his business acumen posted at several of his resorts. Bizarre, yes; for NPD, normal.
People with NPD study how to appear normal by rote-learning behaviors from normal people around them. Trump’s hand gestures, for instance, can give the impression of precision or being straight up. Narcissists can even seem charming, through flattery and telling others what they want to hear, which is how likely Trump has acquired his reputation of agreeing with whomever he last spoke to.
However, they can never fully feign normal human relationships due to their lack of empathy. Trump’s astonishingly tone-deaf words are far too many to list, but where his lack of empathy is most striking is during other people’s crises, e.g. turning away in disgust from a man who desperately needed medical help. With disasters, he’s a disaster, apparently exercising favoritism depending on race and/or whether the afflicted area voted for him: Houston and Florida were treated reasonably, but California was ignored, and his treatment of Puerto Rico is beyond appalling, including neglect, personal attacks in response to accurate criticisms and victim-blaming. He even made 9-11 about himself and his properties.
But possibly the best specific example of lack of empathy is Trump’s responses to the combat death of Sgt. La David Johnson. First he neglected to make a condolence call to Johnson’s widow, Myeshia Johnson, until forced to by public pressure. He then asked Gen. John Kelly how to handle the call—remember, narcissists learn normal behaviors from normal people around them; would Barack Obama ever have needed such advice?
In the call, he used a line Kelly suggested, “he knew what he was signing up for,” but didn’t have sufficient empathy to deliver it correctly, as I posited and was confirmed by Ms. Johnson: “the tone of his voice and how he said it” hurt rather than comforted her. Worse, he didn’t even take care to learn Sgt. Johnson’s name. Then, rather than apologizing as a normal person would do, Trump repeatedly attacked the person who made it public and even claimed Ms. Johnson was herself lying.
Trump’s attacking those who rightly criticize him is an example of the NPD tendency never to take responsibility for anything that makes them look bad. Here’s another: Trump on his repeated legislative failures. “I’m not going to blame myself. I’ll be honest.” The flip side of this is projection, i.e. seeing one’s own traits in others. Narcissists are masters of accusing others of the same wrongdoing they themselves are committing. Accordingly, Trump’s accusations, such as “crooked Hillary,” rigging the election, “fake news,” etc., are a useful pointer to his own crimes.
A person with NPD is so insecure at heart that he has an extreme need to control others, especially in how they view him. Trump’s fascistic streak arises from this: hence his attacking judges who rule against his will, threatening to revoke news media licenses and calling media other than Fox “the enemy of the people.”
Overcompensating for dismal self-esteem produces a delusional sense of entitlement, i.e. the feeling that everything ought to go the way he wants, that he deserves better treatment than others, and that rules and norms don’t apply to him. It manifests in everything from Trump’s violations of the Emoluments Clause to things as petty as calling other world leaders by first name while they respectfully call him “Mr. President,” shoving aside another head of state to be in front at a photo-op, treating his Secret Service detail as servants, and requiring two scoops of ice cream while everyone else gets one. He demands loyalty while never returning it.
Possibly the most striking example of delusional entitlement came after the firing of FBI director James Comey. Trump’s staff worked hard to create a pretext to cover up the real reason—to stop the Trump-Russia collusion investigation—only to see Trump announce in a TV interview that this was exactly the reason. Pundits were baffled as to why he would so incriminate himself. It is standard NPD: he feels he is so extraordinary that he is entitled to fire an FBI director so as to interfere with an investigation against himself. He actually doesn’t understand why he is not. I would hypothesize that he feels the same way about Russian election interference: it was good for him so how could it be wrong? The root of rules and norms—including the principles under which America was founded—is empathy, as we create them so as not to hurt each other; NPD, remember, lacks empathy.
This total disregard of norms frees the narcissist to be exploitive, violating conflict-of-interest prohibitions, investment loan contracts, business contracts, sexual assault laws, etc.; this is where NPD extends to criminality. Trump’s entire business, entertainment and political career is characterized by exploitation.
Competitiveness and envy (of others, and the notion that others envy him) accompanies a need to dominate for fear of being dominated (and thus rendered insignificant). His dominance behaviors are primitive enough to have been likened to those of chimpanzees. Admitting someone else is factually correct if it makes him look bad, or apologizing, seems like defeat, so he will never do so, no matter how socially appropriate. He’s made hurricane size into a contest, maintains the delusion about his inauguration audience to this day, and has verbal pissing contests with Kim Jong-Un utterly without regard to the worldwide terror he is causing.
Looking at narcissistic rage and vindictiveness (which in Trump is arguably worsening, along with his boasting), it is useful to remember how, to the narcissist, being seen as significant feels like a matter of life and death—kill or be killed. Here is his own description of his worldview (emphasis added):
The world is a vicious and brutal place. We think we’re civilized. In truth, it’s a cruel world and people are ruthless. They act nice to your face, but underneath they’re out to kill you … Even your friends are out to get you: they want your job, they want your house, they want your money, they want your wife, and they even want your dog. Those are your friends; your enemies are even worse! (Think Big: Make It Happen in Business and Life, 2007).
Trump’s verbal attacks (full list) and incitements of violence at rallies are well-known (though he felt entitled to avoid the hardship of combat personally through deferments). He also victimizes through executive and legislative initiatives. I see two patterns to his victimizations: the better-known one is attacking people who have thwarted his will or offended him, such as Barack Obama. But he also has a desire to harm people who are vulnerable in some way.
Women, minorities, children, Muslim travelers, undocumented immigrants, would-be immigrants, refugees, people with pre-existing conditions, Dreamers, transgender people in the military, hurricane-devastated Puerto Ricans, fire-devastated Californians, students who have been sexually assaulted, the disabled (whose disabilities he’ll mock), five minority boys falsely accused of murder whom he still wants dead, and even two Gold Star families, have all been victims of his verbal abuse, his policies, or both.
In my view, this is a form of projection: his deep-level self-hate for being vulnerable he projects onto others. This and a racist upbringing are the sources of the racism that made him ally with rather than properly condemn Nazis and white supremacists.
His sexism has the additional motive of exploitation, resulting in sexual abuse.
NPD also has impulsiveness, moodiness and disorganized thinking. As NPD expert Joanna Ashmun noted, a narcissist is really a six-year-old in a grown-up body, lacking reason and ruled by emotion. It is telling that Trump himself admits that he is ”basically the same” as in first grade. Any number of mortifyingly incoherent interviews exemplify this, as do leaked reports of Trump screaming at White House television sets and openly denigrating even his Republican allies in Congress on Twitter. (Some have blamed his word-salad speeches on senile dementia or Alzheimer’s as well. These can co-exist with NPD.)
NPD in a leader invariably creates chaos in the organization as he remakes it in his own image, producing confusion, lack of purpose, paranoia, secrecy, internal divisions, frequent turnarounds as he blames and fires people for his own malfeasance, and ultimately a weakening of the entire organization and everything it supports. His underlings are forced to become narcissistic enablers, engaging in uncharacteristically dishonorable ways, even at the cost of their own reputations.
For the narcissist personally, the ultimate result of his offensive behavior is isolation. This confirms his basic feeling of worthlessness, prompting more narcissistic rage. It’s an unending cycle that is immensely dangerous as long as he has power.
Incidentally, Dr. Allen Frances may have “written the criteria,” but when he says Trump doesn’t have NPD, I don’t buy it. His argument is based on the idea that Trump is not in distress. Nonsense—see Trump’s worldview above. In his mind, there is no such thing as love. Anyone who believes that is in serious distress. Imagine it for two seconds and you’ll see.
In my first Trump/NPD diary, I provided a summary guide for how to deal with narcissists, so let’s revisit that.
For Tip #1, keep expectations extremely low and Tip #2, do not normalize, I provided a list of things never to expect from narcissists, including Trump. See how well you think it’s aged:
Honesty, loyalty, reciprocity, change due to the gravity of a position, reasonableness in negotiation, learning through experience, maturation, adaptability, courage, ability to handle adversity, aspiration to genuine excellence, genuine altruism, humility, guilt or shame for wrongdoing, equanimity, sincere gratitude, sincere appreciation, sincere praise, admission that he is wrong, returned favors or improvement of the condition.
#3 addresses bafflement: If you are trying to figure out why he would do something crazy, ask yourself, “How might it be motivated by a need to feel significant?” Discount all other motivations. Your questions will be answered. See above for all the ways the need manifests.
#4 is Keep interactions distant. You can’t avoid being affected by Trump, but for other narcissists: don’t depend on them for anything and never make yourself vulnerable to them. Don’t loan them money or do work for them without 100% payment upfront. Don’t trust anything they say, especially if it’s boastful. Basically, don’t get invested financially, emotionally or any other way in relationships with them.
Tip #5 (just as written in January) is also one to check for aging:
Expect those around him to be damaged. They are either brainwashed into being extensions of him, parroting his thoughts, faking same for personal gain, or bewildered by the madness. Expect chaos in any organization he leads: good people will resign in disgust or be fired, while marginal people ascend to powerful positions.
One thing I forgot to write in January is that narcissists attract other narcissists, as they understand each other—but they end up competing with and offending each other. I think Steve Bannon is also a malignant narcissist, though I don’t have space here to get into why I do.
#6, Do not attempt to reason with or educate him. Doesn’t happen. I’m sure every single person around Trump has tried. Notice how much difference it’s made.
#7, Manipulate him by using his disorder, doesn’t apply to Trump unless you’re White House staff or in Congress, etc., but we’ve learned how they’ve flattered, got him to enact their ideas by convincing him they were his ideas, and even fed him fake news to push personal agendas.
#8 is the most pressing: Get rid of him as fast as possible.
In regular life with an average narcissist, two techniques work best:
- Stop giving him what he so desperately needs. Once a narcissist realizes someone is no longer a source of approval, admiration and adoration, he’ll be off like a shot looking for the next sucker.
- Expose him. Narcissists also tend to flee when they realize people are onto their tricks.
However, if he is President of the United States of America, he has to be gotten rid of legally. Many people have said Trump, if pushed hard enough, will resign to save face as Nixon did. I think Trump is too delusional and too addicted to the immense sense of significance he gets from being president to ever resign.
It has to be either impeachment/removal or enactment of the 25th Amendment.
What is absolutely necessary in the meantime is for Americans, especially Americans with political power and/or the ability to influence the public discourse, to accept that Donald Trump, for all the reasons laid out above, is mentally ill and unfit to be president. It is a very hard and frightening thing to do, but truth is truth. We deny it at our peril; only accepting it equips us to act appropriately. To the degree that you have political power and ability to influence the public discourse, please engender that acceptance in yourself and others.
Only that way will enough people be able to act appropriately and do what must be done.
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