This post represents an opinion based on my professional experience as a psychiatrist and mental health researcher, both generally and pertaining to personality disorders. In the peer-reviewed paper, Personality Disorders: A Dimensional Defense Mechanism Approach (American Journal of Psychotherapy, 2010), I put forth the theory that personality disorders arise from extreme and enduring expressions of normal psychological defense mechanisms. The central notion being that while mild to moderate versions of these psychological defenses are healthy and adaptive, defending us from stress and suffering, severe and enduring levels represent psychopathology. For example, avoidance is a survival defense when we face dangerous or threatening situations, motivating withdrawal. However, when avoidance advances to the level where the person avoids objectively non-threatening occurrences that offer the potential for reward, and in an ongoing fashion, it is highly dysfunctional, and known as Avoidant Personality Disorder. These individuals fail in life by default, avoiding work, romance, and even friendships. Likewise, dependence is a healthy defense against stress based on our social evolution, such that it is natural to turn to others for comfort and support. However, if dependence progresses such that the person cannot function without a given person or persons, always clinging to them, it represents psychopathology in the form of Dependent Personality Disorder.
Then there is Narcissistic Personality Disorder, a form of psychopathology that generates as much confusion about its nature as suffering for others. Narcissism is a normal and healthy psychological defense at lower levels of the spectrum, consisting of compensating for insecurities and weaknesses with strengths. For example, if you are tongue-tied and shy but good looking, it is natural to stand and not say much at a party, and if not good looking but speak well, talk a great deal. When a person has profound insecurities and weaknesses perceived or real, the compensation can become extreme producing Narcissistic Personality Disorder. The reasons for why extreme and enduring expressions of this psychological defense comprise psychopathology include:
• The overcompensation is so intense that it causes suffering for those around the person. For example, intrusive, aggressive, and domineering behavior.
• The individual is so immersed in their own dynamic that they cannot empathize with others ensuring callous behavior; this lack of empathy mimics the lack of remorse characterizing Antisocial Personality Disorder, and the combination of these two disorders represents a force from the proverbial hell; think evil James Bond villains, but in reality.
•The profound insecurities are analogous to an open physical wound such that the slightest abrasion elicits a painful reaction, producing what is known as narcissistic rage.
• Of great significance, the over-compensation rarely addresses the underlying insecurities. For instance, if the insecurity is that as a child the person felt neglected by parents and potential friends, the over-compensation might be to intrude into as many social events as feasible dominating them through strength and bravado. Unfortunately, this overcompensation does not address the fears, self-doubts, and attachment/bonding issues the person developed as a child and carried forward.
• The insecurities and resulting overcompensation are so unbalanced that the person typically crashes at some point, and given the suffering they rain down on others, few are there to truly help. For instance, in a business setting the person sexually or otherwise accosts a fellow employee related to the overcompensation and need to dominate, and then is fired with no severance. As a mental health clinician, Narcissistic Personality Disorder individuals almost never present requesting help for their personality issue, which they are blissfully unaware of, but instead seek help due to the depression and/or anxiety ensuing from the crash. Their insecurities make it more challenging to accept the setback and perhaps learn from it. A therapist might get a hint of intense narcissism early on, but usually only when the depression and/or anxiety is resolving, at which point entitlements and critiques of the therapist and others emerge. Attempts to address the insecurities and overcompensation almost invariably result in more disrespect and critiques. From my experience treating people with personality disorders, while mild to moderate levels of Narcissistic Personality Disorder are actually treatable via a combination of addressing the underlying insecurities and assisting the person in relinquishing the overcompensation, there does not seem to be any hope for severe levels.
Now we come to Donald Trump, President of the United States of America, who definitely seems to suffer from Narcissistic Personality Disorder. I have to qualify this by indicating that the only way that I can be sure is to conduct a formal assessment with him, but that is about as likely as him opening the doors to ever person in Central America and Mexico who wants to live in the United States. Highly relevant to the assertion that he has Narcissistic Personality Disorder are the insecurities. The relevant information is derived from the references listed at the end of the article. Donald Trump’s early life experiences virtually ensured profound insecurities and self-doubts. His father was a critical disciplinarian who did not demonstrate any emotional support for his children. Lack of praise and severe criticisms were the norm, and the children were hit or grounded for days due to any violation of the rules. At age 7 Donald Trump was sent to a harsh military school when his father discovered that he took the subway to buy a switchblade knife. This military school inflicted further harsh punishment. Regarding his mother, she appears to have been absent emotionally and for a time physically, and did not provide the support that might have helped compensate for his father’s treatment. Essentially, Donald Trump was abused and neglected during his early years, and this trauma appears to have produced profound insecurities and self-doubts, establishing the insecurity part of Narcissistic Personality Disorder. Trauma can be a major contributor to the insecurities that underlie this form of psychopathology.
What about the overcompensation side? In this regard his father’s ruthless drive for success and encouraging this from his children set the stage. While his older brother, Freddy, was consumed by the abusive and neglectful upbringing, eventually succumbing to alcoholism and passing away at 42, Donald, on the other hand, seems to have had more capacity to use his strengths to compensate for the insecurities. Those strengths largely consisting of the ability to dominate people, convince them to do as he wishes, and focus on winning at all costs, essentially adopting this pattern of behavior from his father who applied such behavior to succeed in business. Much like his father he also works relentlessly in the pursuit of success. Readers might now think that this could just set him up for success like his father, but recall the reasons for why the extreme and enduring expression of the narcissistic psychological defense comprises psychopathology, and relate these to Donald Trump’s behavior:
• His overcompensation is so extreme that it has caused enormous suffering, such as: tens of thousands of Americans dying of Covid-19, an occurrence potentially influenced by his not listening to medical authorities and following their advice in regards to masks and vaccines; the many women who allegedly were sexually abused by him; Hispanics and others deemed undesirable arrested without due process and shipped away; threats to take over countries that have been allies of the United States; disruptions to countless businesses from his volatile and discriminatory application of tariffs; personal attacks on those he feels have crossed him using the power of the presidency. The list is virtually endless and grows by the day.
• He is so immersed in his own psychological dynamic of compensating for insecurities that there is not even the pretense of empathy; at least a psychopath can usually fake it. Unless a person aligns views and goals with those of Donald Trump, he does not show any concern, compassion, or remorse. Instead, he spins reality to blame others.
• Trump has been described as having the thinnest skin of any politician, derived from the open wound of his unhealed insecurities, such that any negative comment elicits a rage response.
• The overcompensation behavior does not address the underlying insecurities. Perhaps at some point early in his life, psychotherapy assisting him in realizing that he actually is a worthy person and the treatment by his father was not an accurate valuation of his worth and integrity, might have put him on the road to solidly bolstering those insecurities. Ironically, the overcompensation behavior to a large extent only succeeds in confirming his weaknesses, limitations, and vulnerabilities. He could be established as President of the Universe, have thousands of venues named after him, win several Nobel Peace prizes, change the United States of America to the United States of Trump, have his picture on every US currency denomination (other than the lowly $1 bill that the other “lesser” presidents can share), capture Greenland and Canada; none of these actions in isolation or combination address the underlying insecurities, and hence, are doomed to fail.
• The unbalanced nature of the profound insecurities and overcompensation is setting him up for falls, much like many of his business failures in the past. He has alienated prior allies such as Canada and most European countries, has engaged in racial and sexual discrimination insulting his perceived enemies, and is trying to control virtually all aspects of American (and world) affairs. Even though he seems to get away with everything, it can be a very slippery slope for those with Narcissistic Personality Disorder, and when they crash few are there to support them. What it will take only time can tell, but the possibilities for a crash are numerous as he adds to the list of those who despise him.
In summary, Donald Trump based on my research, experience treating personality disorders, and the information accessed, almost certainly has Narcissistic Personality Disorder, and an extreme level. This extremity is demonstrated by how essentially his internal mental state of anger, hatred, and conflict, derived from the narcissistic dynamic, has been externalized to the larger world generating much anger, hatred, divisions, and conflict. Let us hope for the crash that often occurs with intense levels of narcissism, but not such that too much further suffering is inflicted on the world!
REFERENCES:
Bowins, B. (2010). Personality Disorders: A Dimensional Defense Mechanism Approach. American Journal Of Psychotherapy, 64(2), 153-169.
Petschauer, P.W. & Fuchs, S. (2020). The Abusive and Troubled Childhood of Donald Trump. Clio’s Psyche, 27(1), 1-147.
Stevens, J. (2020). Donald Trump is the product of abuse and neglect. His story is common, even for the powerful and wealthy. PACEs Connection. https://www.pacesconnection.com/blog/donald-trump-is-the-product-of-abuse-and-neglect-his-story-is-common-even-for-the-powerful-and-wealthy
Trump, M.L. (2020). Too Much and Never Enough: How My Family Created the World’s Most Dangerous Man. https://www.amazon.ca/sp?ie=UTF8&seller=A32YA0EFV1HQWW&asin=1982141468&ref_=dp_merchant_link&isAmazonFulfilled=1