How
Has Donald Trump’s Mental State Affected His Presidency?
What we knew about his psychology four years
ago, and what we know today.
JULY
1, 2020 5:30 AM
It seems so clear now.
In June 2016—roughly
seven weeks before Donald Trump formally received the Republican nomination for
president—I wrote an extended essay in the Huffington Post assessing
his behaviors. The title was self-explanatory: “Too Sick to Lead: The Lethal Personality Disorder of Donald
Trump.”
By then, Trump had
supplied us with overwhelming evidence of an ineradicable pathology which
utterly disqualified him for the presidency. But few political observers wanted
to touch such a volatile subject.
His party feared him.
The media put him in their customary analytical boxes, parsing his every move
as if he were something grander, yet more normal, than a mentally disordered
demagogue bereft of principles and starved for adulation. And those mental
health professionals who dared address the obvious were chided by their peers for psychoanalyzing a
man they had never met.
But we had met
him—ceaselessly, for decades, and never more than in the year before June 2016,
when cable news frequently broadcast his appearances in their entirety. His
character disorder was klieg-lit; central to Trump’s pathology was his
uncontrollable need to flaunt it.
Most remarkable about
his psychological illness is the utter consistency of his behaviors. My
descriptions of his pathology, and how it would operate in office, are as
applicable today as they were four years ago. Save for factual references
specific to 2016, I need not change a word. This owes nothing to my special
insight, and everything to Trump’s inability to be anything other than what he
was and always will be: a man far too disturbed to occupy the White House.
That he does underscores
the core issue in 2020: Will a critical swath of voters, despite all we’ve
learned about his unfitness for the presidency, return this man to power?
No longer can we
rationalize away his disabling instability—not for tax cuts, or judges, or
ideology writ large. By deliberately averting their eyes from the incessant
manifestations of his feral inner landscape, the GOP and much of the news media
became complicit in his Electoral College victory—and the damage he has
inflicted on our democracy and society.
To capture Trump’s singular abnormality, I opened
my June 2016 article by describing a telling example from his past: his
disturbingly bizarre and infantile practice of pretending to be someone else
while calling a reporter to brag about his own romantic life. After describing
an audiotape of Trump’s pseudonymous 1991 phone call to People magazine
boasting about his supposed romantic involvement with several ultra-famous
women—made despite the fact that he was living with his future wife Marla
Maples—I pointed out that this behavior was not merely “self-aggrandizing” but
also “gratuitously cruel, heedless of all but self, reckless in his lust for
attention” and, therefore, that it reflected on Trump’s “psychological fitness
to be president.”
With this indubitably
aberrant practice as preface, I argued that there is “only one organizing
principle” that can make sense of Trump’s “wildly oscillating utterances and
behavior—the clinical definition of narcissistic personality disorder.”
The Mayo Clinic describes it as “a mental disorder in which
people have an inflated sense of their own importance, a deep need for
admiration and a lack of empathy for others.” This is bad enough in selecting a
spouse or a friend. But when applied to a prospective president, the symptoms
are disqualifying.
With Trump ever in
mind, try these. An exaggerated sense of self-importance. An unwarranted belief
in your own superiority. A preoccupation with fantasies of your own success,
power and brilliance. A craving for constant admiration. A consuming sense of
entitlement. An expectation of special favors and unquestioning compliance.
A penchant for
exploiting or disparaging others. A total inability to recognize the needs of
anyone else. An incapacity to see those you meet as separate human beings. An
unreasoning fury at people you perceive as thwarting your wishes or desires. A
tendency to act on impulse. A superficial charm deployed to disguise a gift for
manipulation.
A need to always be
right. A refusal to acknowledge error. An inability to tolerate criticism or
critics. A compulsion to conform your ever—shifting sense of “reality” to
satisfy your inner requirements. A tendency to lie so frequently and routinely
that objective truth loses all meaning.
A belief that you are
above the rules. An array of inconsistent statements and behaviors driven by
your needs in the moment. An inability to assess the consequences of your
actions in new or complex situations. In sum, a total incapacity to separate
the world from your own psychodrama.
Recognize
anyone? . . .
The annals of business
are filled with such people, some of whom wind up in jail, others of whom die
rich. But however puissant they become in their chosen realm, their sickness of
mind and spirit cannot ruin a country. That power is reserved for presidents.
Indeed, Trump’s rise
simply swells his unwarranted belief that he can stride the world like a
colossus—naked of judgment, knowledge, temperament or preparation. This
reflects a fatal deficit in those who suffer this disorder—they cannot see
themselves as they are.
To the contrary, their
grandiosity is a defense against feelings of inadequacy too deep and painful to
acknowledge. By the consensus of mental health experts, this emotional
impairment has a last fatal ingredient—there is no cure. For a man like Donald
Trump, life offers no lessons, no path forward save to continue as you have
until, like Icarus, you fly too close to the sun.
This disability
involves far more than a set of discrete character flaws, however grave,
including those which suggest a lack of trustworthiness. We survived the
dishonesty and paranoia of Richard Nixon, after all, albeit at considerable
cost and only after forcing him from office.
But in many ways Nixon
was well-equipped for the presidency, capable of navigating the larger world
and understanding complex situations and people—as in China and its leaders. He
did not reflexively substitute a grossly inflated sense of self for knowledge,
strategy or preparation. His tragedy, and ours, was that his crippling inner
wounds outstripped his proven strengths.
Donald Trump is
altogether different—and infinitely more dangerous. He is afflicted with a
comprehensive and profound character disorder which leaves no corner of his
psyche whole. And this dictates—and explains—every aspect of his behavior.
Take his recourse to
bullying and slander. “I’m a counterpuncher,” he rationalizes. “[I]’ve been
responding to what they did to me.” Now we understand, Donald—your enemies made
you do it.
Really? So Heidi Cruz
made him ridicule her looks on Twitter? That handicapped reporter made him
imitate his disabilities at a rally? . . . And on and on—the
list of enemies he must demean is infinite.
A recent example
typifies his psychological imbalance. Speaking at a rally in San Diego, he
tried to shame an otherwise obscure federal judge in the city, who is presiding
over a lawsuit against Trump University. Trump called the Indiana-born judge a
“Mexican,” a “hater of Donald Trump” and a “very hostile person” who had
“railroaded” him. Heedless of his position or his audience, Trump wallowed in
his personal grievances so long that his listeners grew restive. And so, yet
again, the campaign for president descended into the poisonous murk of Trump’s
inner world.
This astoundingly
graceless and unpresidential behavior is far too pointless and indiscriminate
to qualify as strategy or tactics. The common thread in all this lashing
out—often at those who can’t fight back—is that it has nothing to do with
issues, or anything else one would expect from a normal candidate. It is
another symptom of Trump’s pathology—the visceral reflex to humiliate and
degrade anyone who displeases him, no matter the context or situation.
Take the media. Where,
one might ask, would Trump be without its constant and credulous attentions?
But, like everyone else, the media can never do enough to feed his needs. He
threatens the owners of newspapers with reprisals by the federal government,
talks of changing libel laws to facilitate lawsuits for statements which
affront him, proposes revoking FCC licenses for media which ruffle him. CNN is
“very unprofessional”; like so many others, Fox has treated him “very
unfairly.”
He refers to the media
which cover him as “scum.” He singles out by name reporters who dare to
challenge him. . . . After all, Trump says, he’s “fighting for
survival”—ever victimized by hostile forces who fail to recognize his innate
superiority.
Opposition of any kind
enrages him. He incites reprisals against protesters. He threatened violence in
Cleveland as payback for the GOP’s “unfairness.” He fuels anger against
Hispanics, Muslims, and other minorities whom he perceives as inimical. And
never—not once—does he take any responsibility for stirring these toxic pots.
For one of the symptoms of his disability is an absence of conscience or
accountability.
So what did women do
to him, one wonders? The offense was obviously grave, for his misogyny is
endless and, it seems, uncontrollable. One can but identify the same symptoms
which drive his comprehensive impulse to demean—the need to dominate,
displeasure at feeling thwarted and, of course, a profound lack of empathy for
anyone but himself.
But for “Trump,” ever
beset, his empathy is boundless. His view of others vacillates wildly based
solely on their deference—or lack of it. . . .
Which brings us to a
central problem of Trump’s warped psychology—he believes that filling the
presidency requires nothing but the wonder of himself. This gives the lie to
GOP’s most craven rationalization of its own capitulation: that a suddenly
docile Trump will, as president, defer to a cadre of wise and experienced advisers
drawn from the party establishment.
This is pernicious
nonsense. Consistent with his character disorder, Trump proudly insists that
his chief adviser is himself. Even were he so inclined, in order to learn from
others he must know enough to discern good advice from bad. But such is his
pathology that he feels no need to learn much of anything from anyone. And so,
from the beginning, he has plunged us down the bottomless rabbit hole of his
intellectual emptiness.
His ignorance and
grandiosity form a lethal compound. He disowns NATO, unaware that he is playing
into Putin’s hands . . . and imagines negotiating one-on-one
with North Korea’s psychotic leader. . . . Oblivious to the
appalled reaction around the globe, he promises to compel the respect of world
leaders through “the aura of personality.”
His equally spurious
domestic “proposals,” such as they may be, reflect nothing but the unreality of
his own self-concept. . .
But to talk of Trump
in terms of issues is to flatter him. Most of what he says is provisional, ever
subject to change, and based on nothing but his needs at the
moment. . . .
One can forecast the
inevitable day-to-day damage to our country—the lashings out, the abuses of
power, the mercurial and confidence-destroying lies and changes of mind, the
havoc his distorted lens would wreak upon our institutions and our spirit. But
most dangerous of all is the collision between a volatile world, a leader
unable to perceive external reality, and the often-unbearable pressures of the
presidency. That Trump’s judgment would crack time and again is certain—the
only question is how dangerous the moment.
So how have we fallen prey to a man who, by
the damning evidence of his own behavior, is psychologically unfit to be
president? When did boasting top coherence; mindless posturing become strength;
a talent for ridicule supplant experience or judgement; a gift for scapegoating
surpass wisdom or generosity? Why must we even contemplate someone with this
stunted inner landscape as the world’s most powerful man?
Why, indeed? But that
was then—2016. In 2020 America’s electorate has experienced three and a half
years of the most aberrant presidency in our history. We have no excuses left.
Our president’s sickness
is ever on display. According to the Washington Post, as of May 29
Trump had made more than 19,000 false or misleading claims in
a little over 1,200 days in office. During this time, we have witnessed his
manipulation of the Justice Department, attacks on the rule of law, refusal to
honor congressional subpoenas, fascination with authoritarian leaders,
assertions of unlimited power, and attempts to solicit or compel electoral assistance
from foreign governments.
Hungry for attention, he
subjects us to a constant stream of scurrilous tweets, false accusations, rank
divisiveness, unhinged conspiracy theories, blatant racial innuendos, shameless
denials of reality, reflexive self-pity, unbounded grandiosity, puerile insults
to real or imagined enemies, and claims of superior expertise in a multitude of
areas where his abysmal ignorance is manifest. His sole concern is for himself.
This confluence of
anti-social behaviors would be shocking in a relative or coworker; in a
president, they are frightening and disorienting. Since his inauguration, Trump
has debased the coinage of the presidency, eroded the boundaries on
presidential misconduct, and poisoned the well of civic decency. His crippling
dysfunction is now ours.
These behaviors have caused an increasing number
of mental health professional to issue warnings about Trump’s psychological
condition. In 2017, forensic psychiatrist Bandy X. Lee edited a book, The
Dangerous Case of Donald Trump, that included essays from dozens
of psychiatrists, psychologists, and mental health professionals. And last
December, two weeks before Trump’s impeachment, Dr. Lee submitted to Congress a petition, with 650 other
psychiatrists, psychologists, and mental health professionals as co-signatories,
which included this disturbing admonition:
What makes Donald Trump so dangerous is the
brittleness of his sense of worth. Any slight or criticism is experienced as a
humiliation and degradation. To cope with the resultant hollow and empty
feeling, he reacts with what is referred to as narcissistic rage. He is unable
to take responsibility for any error, mistake, or failing. His default in that
situation is to blame others and to attack the perceived source of his
humiliation. These attacks of narcissistic rage can be brutal and destructive.”
Further, Lee explained to the London Independent, Trump
was “doubling and . . . tripling down on his delusions”;
“ramping up his conspiracy theories”; and “showing a great deal of cruelty and
vindictiveness” in his “accelerated, repetitive tweets.”
Recent examples
include his vicious allegations that, twenty years
ago, Joe Scarborough murdered a woman who worked in his Florida congressional
office. In reality, she died of a heart attack when Scarborough was 500 miles
away. But Trump’s cruelty caused her anguished widower to implore Twitter to
delete his sadistic tweets.
A related sign of
emotional instability is Trump’s obsession with projecting dominance and
strength—the underside of which is a debilitating admixture of neediness and
insecurity.
Recent examples abound.
Some would be seriocomic were he not America’s president:
·
As reported by Ashley
Parker and Josh Dawsey in the Washington Post, Trump sidetracked a
cabinet meeting with a lengthy re-enactment of his supposedly stellar
performance—three years prior—on a cognitive screening test.
·
After taking refuge in
an underground bunker when protesters ringed the White House, he furiously
denied it—claiming to have been conducting a snap inspection tour.
·
When a videotape
captured his halting descent down a ramp after speaking at West Point, Trump
delivered a rambling fifteen-minute revisionist history at his rally in
Tulsa—blaming, among other things, slippery shoes.
Other examples are
alarming, indeed ominous. His constant calls to “dominate” the streets during
protests following the death of George Floyd. His threats to deploy active duty
troops on American soil. His misuse of military personnel to clear peaceful protesters
near Lafayette Square—all so that he could hold a borrowed Bible aloft in front
of a damaged church, a videotaped piece of authoritarian theater.
The gnawing hunger of Trump’s misshapen psyche
dominates Carl Bernstein’s appalling new account for CNN of the president’s
conversations with foreign leaders, detailing in the starkest terms the
consequences of investing someone of his pathology with the power of the
American presidency.
Trump was so consistently unprepared for
discussion of serious issues, so often outplayed in his conversations with
powerful leaders like . . . Vladimir Putin and Turkish president
Recep Erdoğan, and so abusive to leaders of America’s principal allies, that
the calls helped convince some senior U.S. officials—including his former
secretaries of state and defense, two national security advisers and his
longest-serving chief of staff—that the president himself posed a danger to the
national security of the United States . . . [and] to conclude
that the president was often “delusional,” as two sources put it, in his dealings
with foreign leaders.
Central to these
conversations was Trump’s disabling absorption with himself: “Trump incessantly
boasted to his fellow heads of state, including . . . North
Korean dictator Kim Jong Un, about his own wealth, genius, ‘great’
accomplishments as president, and the ‘idiocy’ of his Oval Office
predecessors. . . . In his phone exchanges with
Putin . . . the president talked mostly about
himself . . . [while] obsequiously courting Putin’s admiration
and approval.” Adds Bernstein: “The common, overwhelming dynamic that
characterizes Trump’s conversations with both authoritarian dictators and
leaders of the world’s greatest democracies is his consistent assertion of
himself as the defining subject and subtext of the calls.”
But for allies, Trump’s
manner was the opposite of his pandering to the authoritarians: bullying,
abusive, and riven with grievances. “Everything was always personalized,” a
source told Bernstein, “with everybody doing terrible things to rip us
off—which meant ripping ‘me’—Trump—off.” With females, Trump added a withering
misogyny. “His most vicious attacks,” Bernstein relates, “were aimed at women
heads of state. In conversations with both [Theresa] May and [Angela] Merkel,
the president demeaned and denigrated them in diatribes described as
‘near-sadistic.’”
Other consistent
features of these phone calls were Trump’s ignorance and dissociation from
reality. “Two sources,” Bernstein reports, “compared many of the president’s
conversations with foreign leaders to Trump’s recent press ‘briefings’ on the
coronavirus pandemic: free form, fact-deficient stream-of-consciousness
ramblings, full of fantasy and off-the-wall pronouncements based on his
intuitions, guesswork, the opinions of Fox News TV hosts and social media
misinformation.”
Bernstein concludes by
quoting a senior official who summarizes the grip of Trump’s personality
disorder on his conduct of foreign affairs: “There was no sense of ‘Team
America’ or of . . . certain democratic principles and
leadership of the free world. . . . The opposite. It was like
the United States had disappeared. It was always ‘Just me.’”
But, for now, all else is overshadowed by Trump’s
catastrophic mishandling of COVID-19—a case study in the literally lethal
consequences of his hydra-headed disorder. This is precisely what I meant when,
in 2016, I wrote about the dangerous collision between “volatile world, a
leader unable to perceive external reality, and the often–unbearable
pressures of the presidency.” Trump need not precipitate a nuclear exchange for
his warped psychology to cause tens of thousands of needless American deaths.
It has. Last month
disease modelers at Columbia estimated that we would have incurred
roughly 36,000 fewer fatalities had Trump initiated social distancing one week
earlier, and 54,000 deaths had it started two weeks earlier. Instead, fearful
that acknowledging the seriousness of the coronavirus would have adverse
political consequences, Trump chose misleading the public over protecting
lives.
Inexorably, the deadly
pandemic overwhelmed Trump’s self-created alternate reality—in which denying
its lethality substituted for action. So he substituted yet another fantasy:
that his proactive leadership in fighting the virus had saved countless lives
and defeated the pandemic.
Even as the death toll
mounted, he urged state governments to reopen the economy—dismissing
life-saving public health measures recommended by his own government.
COVID-19, he told Sean Hannity, is “fading away.” A week
later, we suffered the greatest number of new cases since the pandemic began.
Events in the real world
provide a roadmap of Trump’s delusions. The coronavirus spiked in the states
that were the swiftest to reopen. The European Union has banned Americans as threats to public
health. Contradicting Trump, Anthony Fauci warned Congress that “the
virus is not going to disappear,” adding that “we are still in the middle of a
serious outbreak.”
No matter to Trump. In
his imaginary America, the real problem became that we were testing too much,
thereby increasing the count of new cases.
By then, as his
pathology dictates, Trump had put blame for the pandemic on China, the World
Health Organization, the media, Barack Obama, the intelligence community, and
the CDC. And he had discovered the real victim of COVID-19: himself. In Vanity
Fair, Gabriel Sherman reported Trump telling a confidant: “This is so
unfair to me! Everything was going great. We were cruising to reelection!”
Instead, the pandemic
has underscored Trump’s complete indifference to other human beings. And not
just the vulnerable, the sick, and the dead. He insisted that West Point
graduates return to hear his commencement speech in the middle of a pandemic.
He scheduled large indoor rallies in Tulsa and Phoenix, surefire
super-spreaders, so that he could bask in adoring crowds.
When public health
officials in Charlotte inquired about health measures for the GOP convention,
Trump moved it to Jacksonville—simply to ensure himself a jam-packed arena
filled with unmasked faces, risk be damned. Over a three-week period of public
statements amid the pandemic back in April, the Washington Post reported,
Trump spoke for some thirteen hours—of which he spent two hours attacking
others, forty-five minutes praising himself and his administration, but just
four-and-a-half minutes expressing rote sympathy for coronavirus victims and
front-line workers.
Further, the Post related in late May, “The coronavirus
pandemic has spawned a whole new genre of Trump’s falsehoods. The category in
just a few months has reached 800 claims, with his advocacy for
hydroxychloroquine as a possible cure, based on minimal and flimsy evidence,
already reaching Bottomless Pinocchio status.” As Trump’s confidant told
Sherman: “He lives in his own fucking world.”
In that world, Trump is
free from the constraints of constitutional democracy.
To stave off defeat, he and his party are
striving to prevent the universal voting by mail necessitated by the pandemic,
while groundlessly asserting that the mail-in balloting currently available
guarantees massive voter fraud by the Democratic Party. Already, Trump is claiming that the 2020 election
“will be, in my opinion, the most corrupt election in the history of our
country, and we cannot let this happen.”
This is insane. But an
increasingly serious body of opinion anticipates that Trump will try to
maintain power by denying the legitimacy of the November election. This
captures how completely Trump’s sickness has consumed us—expecting our
president to subvert American democracy is becoming our new normal.
The problem of Trump
transcends party or ideology, and so does our need to be rid of him. For there
is no constitutional guarantee against a president too mentally ill to respect
its terms—and a party too craven to stop him.
Until further notice, we
have both.
