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Trump and the Pathology of Narcissism
Trump and the Pathology of Narcissism
Diagnosing the president was off-limits to experts until a textbook case entered the White House
By Alex Morris
April 5, 2017
A shorter URL for the above link:
At 6:35 a.m. on the morning of March 4th, President Donald Trump did what no U.S. president has ever done: He accused his predecessor of spying on him. He did so over Twitter, providing no evidence and lest anyone miss the point doubling down on his accusation in tweets at 6:49, 6:52 and 7:02, the last of which referred to Obama as a “Bad (or sick) guy!” Six weeks into his presidency, these unsubstantiated tweets were just one of many times the sitting president had rashly made claims that were (as we soon learned) categorically untrue, but it was the first time since his inauguration that he had so starkly drawn America’s integrity into the fray. And he had done it not behind closed doors with a swift call to the Department of Justice, but instead over social media in a frenzy of ire and grammatical errors. If one hadn’t been asking the question before, it was hard not to wonder: Is the president mentally ill?
It’s now abundantly clear that Trump’s behavior on the campaign trail was not just a “persona” he used to get elected that he would not, in fact, turn out to be, as he put it, “the most presidential person ever, other than possibly the great Abe Lincoln, all right?” It took all of 24 hours to show us that the Trump we elected was the Trump we would get when, despite the fact that he was president, that he had won, he spent that first full day in office focused not on the problems facing our country but on the problems facing him: his lackluster inauguration attendance and his inability to win the popular vote.
Since Trump first announced his candidacy, his extreme disagreeableness, his loose relationship with the truth and his trigger-happy attacks on those who threatened his dominance were the worrisome qualities that launched a thousand op-eds calling him “unfit for office,” and led to ubiquitous armchair diagnoses of “crazy.” We had never seen a presidential candidate behave in such a way, and his behavior was so abnormal that one couldn’t help but try to fit it into some sort of rubric that would help us understand. “Crazy” kind of did the trick.
But of course, something did come of it, and so on February 13th, Dodes and 34 other psychiatrists, psychologists and social workers published a letter in The New York Times stating that “Mr. Trump’s speech and actions make him incapable of safely serving as president.” As Dodes tells me, “This is not a policy matter at all. It is continuous behavior that the whole country can see that indicates specific kinds of limitations, or problems in his mind. So to say that those people who are most expert in human psychology can’t comment on it is nonsensical.” In their letter, the mental health experts did not go so far as to proffer a diagnosis, but the affliction that has gotten the most play in the days since is a form of narcissism so extreme that it affects a person’s ability to function: narcissistic personality disorder.
The most current iteration of the DSM classifies narcissistic personality disorder as: “A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts.” A diagnosis would also require five or more of the following traits:
1. Has a grandiose sense of self-importance (e.g., “Nobody builds walls better than me”; “There’s nobody that respects women more than I do”; “There’s nobody who’s done so much for equality as I have”).?
2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty or ideal love (“I alone can fix it”; “It’s very hard for them to attack me on looks, because I’m so good-looking”).
3. Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people or institutions (“Part of the beauty of me is that I’m very rich”).
4. Requires excessive admiration (“They said it was the biggest standing ovation since Peyton Manning had won the Super Bowl”).?
5. Has a sense of entitlement (“When you’re a star, they let you do it. You can do anything. Grab them by the pussy”).
6. Is interpersonally exploitative (see above).?
7. Lacks empathy, is unwilling to recognize or identify with the feelings?and needs of others (“He’s not a war hero . . . he was captured. I like people that weren’t captured”).?
8. Is often envious of others or believes that others are envious of him or her (“I’m the president, and you’re not”).?
9. Shows arrogant, haughty behaviors or attitudes (“I could stand in the middle of 5th Avenue and shoot somebody, and I wouldn’t lose any voters”).
NPD was first introduced as a personality disorder by the DSM in 1980 and affects up to six percent of the U.S. population. It is not a mood state but rather an ingrained set of traits, a programming of the brain that is thought to arise in childhood as a result of parenting that either puts a child on a pedestal and superficially inflates the ego or, conversely, withholds approval and requires the child to single-handedly build up his or her own ego to survive. Either way, this impedes the development of a realistic sense of self and instead fosters a “false self,” a grandiose narrative of one’s own importance that needs constant support and affirmation or “narcissistic supply” to ward off an otherwise prevailing sense of emptiness. Of all personality disorders, NPD is among the least responsive to treatment for the obvious reason that narcissists typically do not, or cannot, admit that they are flawed.
Trump’s childhood seems to suggest a history of “pedestal” parenting. “You are a king,” Fred? Trump told his middle child, while ?also teaching him that the world? was an unforgiving place and that ?it was important to “be a killer.” Trump apparently got the message: He reportedly threw rocks ?at a neighbor’s baby and bragged? about punching a music teacher in? the face. Other kids from his well-?heeled Queens neighborhood of Jamaica Estates were forbidden from playing with him, and in school? he got detention so often that it? was nicknamed “DT,” for “Donny Trump.” When his father found ?his collection of switchblades, he? sent Donald upstate to New York Military Academy, where he could be controlled while also remaining aggressively alpha male. “I think his father would have fit the category [of narcissistic],” says Michael D’Antonio, author of The Truth About Trump. “I think his mother probably would have. And I even think his paternal grandfather did as well. These are very driven, very ambitious people.”
At the very least, the growing debate over Trump’s mental health raises the question of what having an NPD president would mean. “I hated President Bush, but it never occurred to me or any of my colleagues that he was mentally ill,” says John Gartner, a psychologist who taught in the department of psychiatry at Johns Hopkins University Medical School for 28 years and who has been one of the most vocal critics of upholding the Goldwater Rule in this case, going so far as to say that Trump suffers from “malignant narcissism,” a term for the triumvirate of narcissistic, paranoid and antisocial personality disorders (with a little sadism thrown in for good measure) that was invented to describe what was wrong with Hitler. “Even though I disagree with everything he believes in, I would be immensely relieved to have a President Pence,” Gartner says. “Because he’s conservative. Not crazy.”
Of course, having a mental illness, in and of itself, wouldn’t necessarily make Trump unqualified for the presidency. A 2006 study published in the Journal of Nervous & Mental Disease found that 18 of the first 37 presidents met criteria for having a psychiatric disorder, from depression (24 percent) and anxiety (eight percent) to alcoholism (eight percent) and bipolar disorder (eight percent). Ten of them exhibited symptoms while in office, and one of those 10 was arguably our best president, Abraham Lincoln, who suffered from deep depression (though, considering the death of his son and the state of the nation, who could blame him?).
The problem is that, when it comes to leadership, all pathologies are not created equal. Some, like depression, though debilitating, do not typically lead to psychosis or risky decision-making and are mainly unpleasant only for the person suffering them, as well as perhaps for their close friends and family. Others, like alcoholism, can be more dicey: In 1969, Nixon got so sloshed that he ordered a nuclear attack against North Korea (in anticipation of just such an event, his defense secretary had supposedly warned the military not to act on White House orders without approval from either himself or the secretary of state).
When it comes to presidents, and perhaps all politicians, some level of narcissism is par for the course. Based on a 2013 study of U.S. presidents from Washington to George W. Bush, many of our chief executives with narcissistic traits shared what is called “emergent leadership,” or a keen ability to get elected. They can be charming and charismatic. They dominate. They entertain. They project strength and confidence. They’re good at convincing people, at least initially, that they actually are as awesome as they think they are. (Despite what a narcissist might believe, research shows they are usually no better-looking, more intelligent or talented than the average person though when they are, their narcissism is better tolerated.) In fact, a narcissist’s brash leadership has been shown to be particularly attractive in times of perceived upheaval, which means that it benefits a narcissist to promote ideas of chaos and to identify a common enemy, or, if need be, create one. “They’re going to want attention, and they’re going to get attention by making big public changes and having bold leadership,” says Campbell. “So if things are going well, a narcissistic leader’s probably not what you want. If things aren’t going well, you’re like, ‘Eh, let’s roll the dice. Let’s get this person out there to just make some big changes and shake things up.’ And then we pray to God it works.”
This dissociation from reality, paired with Trump’s knee-jerk need to assert his dominance, has led many mental-health professionals to feel that, no matter what the specific diagnosis, the traits themselves are enough to render Trump unfit for office, and that a shrink’s “duty to warn” overrides the Goldwater Rule in this instance. “Psychiatrically, this is the worst-case scenario,” says Gartner. “If Trump were one step sicker, no one would listen to him. If he were wearing a tinfoil hat, if he were that grotesquely ill, he wouldn’t be a threat. But instead, he’s the most severe and toxic form of mental illness that can actually still function. I mean, in his first week in office, he threatened to invade Mexico, Iran and Chicago. And thank God someone finally stood up to Australia, you know? Glad someone had the balls to put them in their place.”
Indeed, it was Gartner’s fear that “Trump is truly someone who can start a war over Twitter” that led him to start a petition on January 26th that called on mental-health professionals to “Declare Trump Is Mentally Ill and Must Be Removed,” invoking Section 4 of the 25th Amendment to the Constitution, which states that the president should be replaced if he is “unable to discharge the powers and duties of his office.” Gartner’s petition currently has 40,947 signatures. Congresswoman Karen Bass’ petition, #DiagnoseTrump, has 36,743.
Not that any of these petitions are likely to make a difference. In order for Section 4 to be invoked, Congress or the vice president along with a majority of Trump’s handpicked Cabinet would have to call for his removal, which has never happened under any presidency. And even if Trump did something that warranted impeachment, 25 Republicans in the House would have to break ranks to pass the resolution on to the Senate, where two-thirds of that body would have to condemn him, meaning that no fewer than 19 Senate Republicans would need to vote in favor of an ouster. Many of those Republicans come from districts where #MAGA is practically gospel, meaning that these numbers are not just daunting, they’re all but unthinkable.
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