Definition of NPD from the Annual Review of Clinical Psychology:
“Narcissistic Personality Disorder (NPD): an enduring pattern of grandiose beliefs and arrogant behavior together with an overwhelming need for admiration and a lack of empathy for (and even exploitation of) others.”
No big deal. Just sounds like another asshole, right? You might even argue you need those characteristics to lead. This is where the “disorder” part is critical to understand as a risk. One of the writers of this piece has Major Depressive Disorder.
What if we are dealing with what Eric Fromm calls Malignant Narcissism?
Although all the frameworks used have explanatory power, the one that most closely fits the tyrants studied here is that of the narcissist with severe superego deficiencies.
An individual with such psychological characteristics may have some advantages in rising to power, and his behavior may be an effective response to some real-life factors, but once he has consolidated his position his reality-testing capacities diminish. Fantasies held in check when his power is limited are apt to become his guides to action. As a consequence, his behavior becomes more erratic, he runs into difficulties in meeting his goals, and hisparanoid defenses become more exaggerated.
The finale of a tyrant’s career depends on the particulars of his political and social situation
But ’tis a common proof,
That lowliness is young ambition’s ladder,
Whereto the climber-upward turns his face:
But when he once attains the upmost round,
He then unto the ladder turns his back,
Looks in the clouds, scorning the base degrees,
By which he did ascend.
~ William Shakespeare, Julius Caesar, Act II, Sc. i, 11. 21-27
Having mental illness is not something to be ashamed of. It doesn’t mean someone is a “bad” person. The point is, with so much power, the negative traits of Narcissistic Personality Disorder become weaponized. We’ve all personally witnessed the recognizable manifestations of this disorder in Trump’s behavior and actions.
This is very relevant to the presidency ; his personality disorder affects all of us. The point is, a malignant narcissist, when in power, affects the entire world, and this realization is frightening and relevant to each and every of planet Earth’s inhabitants.
Larkin Poe performs Mad As A Hatter in The Convent Club chapel.
Here is a list of NPD symptoms from The Mayo Clinic:
- Having an exaggerated sense of self-importance
- Expecting to be recognized as superior even without achievements that warrant it
- Exaggerating your achievements and talents
- Being preoccupied with fantasies about success, power, brilliance, beauty or the perfect mate
- Believing that you are superior and can only be understood by or associate with equally special people
- Requiring constant admiration
- Having a sense of entitlement
- Expecting special favors and unquestioning compliance with your expectations
- Taking advantage of others to get what you want
- Having an inability or unwillingness to recognize the needs and feelings of others
- Being envious of others and believing others envy you
- Behaving in an arrogant or haughty manner
“Although some features of narcissistic personality disorder may seem like having confidence, it’s not the same. Narcissistic personality disorder crosses the border of healthy confidence into thinking so highly of yourself that you put yourself on a pedestal and value yourself more than you value others.”
We have watched as journalists increasingly notice the behavior, but haven’t connected the dots with a potential disorder— at least publicly. After meeting with Trump in New York, in a piece titled, “Donald Trump’s Demand for Love,” New York Times columnist Frank Bruni observed:
“Winning the most powerful office in the world did nothing to diminish his epic ache for adoration or outsize need to tell everyone how much he deserves it.That was perhaps the most interesting part of the meeting, the one that makes his presidency such a question mark. Will he tilt in whatever direction, and toward whichever constituency, is the surest source of applause? Is our best hope for the best Trump to be so fantastically adulatory when he’s reasonable that he’s motivated to stay on that course, lest the adulation wane?”
As Trump begins to flip-flop on some campaign promises and continues using Twitter as a means of attack, both sides are finding themselves questioning what this presidency is really going to be like. Post-election, Trump’s thumbs are manning his Twitter account seemingly unrestrained, keeping the focus on him with tone deaf, inappropriate tweets.
The press and a growing “Resistance” movement consume his fast food diet of Fox News induced tweets, while trying to feed the country with the heartier fare of conflicting business interests, unsettling cabinet choices, blatant nepotism, and their grim national consequences and dangerous precedent.
For us, this is like watching a journalist covering a blind president, and wondering why he never looks you in the eye. No matter how much you treat him like a sighted person, he will not change. You can take to social media and complain about how you were right in front of him and he didn’t see you. You can drone on about how unfair it is, how the previous president always looked you right in the eye. In fact, all the previous presidents did. The dude is blind, you guys.
No amount of research is going to change this. No matter how often the press and public exhausts itself unpacking tweets about Hamilton, spending hours of research, with documentation, interviews, and cross-referencing, we believe, from our experience, it will continue.
Trump’s seeming “strategies” are very characteristic of a hard-wired psychiatric disorder, for its sufferers, is essentially untreatable— there is no medication for it, and therapy is rarely sought or effective.
The Goldwater Rule
Some may wonder how such important information about an elected official could be overlooked, but it hasn’t been. It’s just not talked about. The reason? The Goldwater Rule.
The psychiatric community is gagged by an ethics rule enacted in short-sighted reaction to a lawsuit brought on by presidential candidate Barry Goldwater after the 1964 election. He sued FACT magazine for running the results of a very unscientific and misleading poll of 1,189 psychiatrists, about Goldwater’s mental health before the election.
The poll was unfair, but there’s a very big difference between questioning a candidate’s mental health and that of a president. It is not only fair, but an imperative responsibility.
If Michael J. Fox exhibits all the publicly noticeable symptoms of Parkinson, it’s not unfair to come to the conclusion he may have it. However, in 1964, mental health disorders were considered something to be ashamed of, instead of the physical conditions we now know they are. And so, the American Psychiatric Association added the Goldwater Rule:
“On occasion psychiatrists are asked for an opinion about an individual who is in the light of public attention or who has disclosed information about himself/herself through public media. In such circumstances, a psychiatrist may share with the public his or her expertise about psychiatric issues in general. However, it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement.”
Psychologists and psychiatrists commenting on a health problem that so seriously impacts the public good is consistent with the Hippocratic Oath, which says in part:
“I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.”
The rule hasn’t precluded many psychologists from speaking out anyway, but they have been overlooked. One of the most powerful pieces on the subject was a cover story in The Atlantic by Dan McAdams, a professor and chair of the Northwestern University Department of Psychology. I
In a comprehensive piece “Narcissism: Donald Trump Playing Donald Trump,” cAdams addresses the very relevant nature of narcissistic psychological pathology and its impact on a presidency:
“A cardinal feature of high extroversion is relentless reward-seeking. Prompted by the activity of dopamine circuits in the brain, highly extroverted actors are driven to pursue positive emotional experiences, whether they come in the form of social approval, fame, or wealth. Indeed, it is the pursuit itself, more so even than the actual attainment of the goal, that extroverts find so gratifying. When Barbara Walters asked Trump in 1987 whether he would like to be appointed president of the United States, rather than having to run for the job, Trump said no: “It’s the hunt that I believe I love.”
Indeed, anger may be the operative emotion behind Trump’s high extroversion as well as his low agreeableness. Anger can fuel malice, but it can also motivate social dominance, stoking a desire to win the adoration of others. Combined with a considerable gift for humor (which may also be aggressive), anger lies at the heart of Trump’s charisma. And anger permeates his political rhetoric.
The real psychological wild card, however, is Trump’s agreeableness—or lack thereof. There has probably never been a U.S. president as consistently and overtly disagreeable on the public stage as Donald Trump is. If Nixon comes closest, we might predict that Trump’s style of decision making would look like the hard-nosed realpolitik that Nixon and his secretary of state, Henry Kissinger, displayed in international affairs during the early 1970s, along with its bare-knuckled domestic analog. That may not be all bad, depending on one’s perspective.”
So the question we must ask is, “Can a diagnosis be made by observing someone’s behavior?” One of us is a recovering alcoholic with thirteen years of sobriety. When I was an active alcoholic, my symptoms were classic. I personally believe anyone familiar with alcoholism, observing my behavior and especially its impact on others, would be able to responsibly diagnose me. In fact, given the danger to myself and others, I think they would be remiss not to.
Alcoholism affects the brain — arguably one of the most important organs right up there with our lungs and heart. This is why the Surgeon General now classifies addiction as a brain disorder. I believe I could be responsibly diagnosed if I’d been a major public figure during my active alcoholism years.
Mental health is physical health. Brains and central nervous systems are an integral part of the human body. In our experience, NPD can be red-flagged by the negative impact on those the afflicted person interacts with — in the case of the presidency, its impact on all American lives.
“Donald Trump is not anyone’s patient, so there is no confidentiality rule to apply here. We speak out about public figures because it is a public service. In the field of psychiatry, we call this “duty to warn.” When you gag the people who actually know the best about these things, then you leave the public with uninformed lay opinions.
The APA defends the Goldwater rule with claims to talk about mental health and politicians “would be insulting to people who have mental problems.” This is ridiculous. Nobody is mixing up somebody who is a sociopath like Donald Trump with somebody who has anxiety or depression or even a known illness like schizophrenia.
No one is going to make this mistake.
Anybody can read the DSM and then look at Donald Trump and the thousands of hours of interviews and evidence publicly available about him, and see whether he either meets this criteria for speech and behavior or he does not. The fact is, he does.”
No one “leaked” any confidential information from his patient file at a hospital. The relevant data present themselves on TV and Twitter constantly. Donald Trump wants everyone to know his name and to watch his behavior and listen to his rants; there can be no more obvious statement regarding this person’s attention seeking monomania.
We cannot not see Donald Trump’s anti-social behavior or hear his delusional takes on the world, which bear only a coincidental transient resemblance to anything we collectively consider to be “truth.”
We believe, if we’re all exposed to someone who has the flagrant symptoms of NPD at such a frequent and daily level, we need to get very familiar with what that means very fast, because it can seriously impact our national security, freedom of the press, and individual freedom of speech. It’s hard for us to watch people allude to NPD behavior as a political strategy, without saying something.
NPD is not a minor condition. Personality disorders (PD) are organized into three “clusters” based on their similar symptoms and characteristics. Narcissism is in Cluster B, together with Antisocial personality disorder, Borderline personality disorder, and Histrionic personality disorder. The disorder has recognizable and diagnosable features.
So, if someone defines narcissism as confidence or an inflated ego, they don’t know what NPD is. Most people don’t. We certainly didn’t, until we sought treatment and understood what we were dealing with and how it was affecting our very identities.
That’s why we feel strongly that Americans need to know how they may be affected. Our society often normalizes this pathology — specifically in men, who are the majority of the afflicted. One major characteristic of NPD is a lack of empathy. That is not a healthy characteristic for anyone who is supposed to look out for the interests of all Americans.
There are tests for NPD, and we believe presidential candidates should undergo a rigorous mental health exam for fitness to serve, especially for any conditions that would affect national security, domestic stability, the economy, or cause civil unrest, to name a few. If a candidate needs to be in functional physical health, mental health must by definition be included.
While Trump’s meteoric rise was seen by many as a partisan issue, to us, it feels like a grave national security issue and a public health crisis. Imagine the advantage a foreign power would have in understanding and exploiting any predictable behaviors and reactions of a president with a personality disorder?
Regarding public mental health, NPD by its very nature is manifested in the relationships between the narcissist and those he is in contact with. That is why the most common route to diagnosis is via the NPD’s victims, who often suffer from narcissistic abuse. Psychiatrists with expertise in Cluster B disorders and NPD pathology should have been part of the election and post-election narrative, as a public service.
At a 2015 rally in Iowa, Trump himself said of Ben Carson, now tapped for HUD Secretary, “I don’t want a person that’s got pathological disease. I don’t want him. He’s saying he’s a pathological liar. He actually said he’s got pathological temper and then he defined it as a disease. Pathological, there’s no cure.”
Not only is there no cure, but for narcissism in particular, it is rare to seek counseling, because of their egotistical persona. It is their victims who most commonly seek help. Narcissistic abuse is a subject we’re both painfully and thoroughly familiar with. We have seen our own symptoms crop up in the public psyche. We are seeing abuse victims targeted in the same way we were targeted.
Narcissists crave attention, and it doesn’t matter if it’s positive or negative attention. That’s how they get their fix of what is known as narcissistic supply. From our perspective, having been sources of this supply, we see how the media has played a similar role. To us, watching Trump’s rallies and hearing his plans for a “victory tour“ are red flags.
Whether he has NPD or not, Trump has spent 17 months systematically chipping away at the public’s confidence in our branches of government and the media, particularly The New York Times. He prioritizes discrediting journalists who criticize him to an alarming degree. But it is not alarming if you understand narcissism.
We watch as the media are being attacked and summoned for doing their jobs: informing Americans about important issues that affect them. We both know that people with this disorder take any and all criticism personally and find it near impossible not to react. This is known in psychology as narcissistic injury and narcissistic rage.
It is frustrating to watch people try to analyze the puzzling behavior we are so familiar with. The New York Times even published an exhaustive list of people, places, and things Trump has insulted from his Twitter account. If Trump does have this mental health condition, we are concerned it could result in crisis.
Scrolling through Twitter, we watch as journalists we respect start to show signs of fatigue at having major stories ignored. We know the feeling. We recognize it. In fact, for one of us, the debates were like a typical argument with the narcissist in our life:
What concerns us is that, from our observations, we are governed by a person with the same malevolent behavior we spent years trying to disengage from, at no small price. if NPD is a factor, we feel strongly that the public needs exemplary reporting and that the press be armed with the knowledge to respond accordingly. Trump is riddled with unprecedented conflicts of interest before even taking office, and we feel his mental health issues are not only relevant, but imperative.
We urge the press and public to understand what Narcissist Personality Disorder is. It manifests as impairments in the way someone functions and interacts with others, combined with the specific pathological personality trait of antagonism, characterized by grandiosity and attention seeking. We feel the finer points are something the public should promptly familiarize itself with.
The negative effect of NPD happens in stages, and we watch Trump’s relationship with both his supporters and his detractors, and it is very familiar to us.
In a classic NPD relationship, first comes the love-bombing: the narcissist tells you what you want to hear.
Then they manage down expectations: doing whatever they want, and expecting or demanding that you accept it without incident. Now, the pathological lying comes full force: you call them out on what they said or did and they vehemently deny it, making you question your sanity.
Then comes the devalue stage: because you questioned or criticized them, they discredit you. Now, the discard: the punishment and alienation begins, and any attempts to please them are used to gain more control over you. It doesn’t end there. The cycle continues and the disorder becomes your new normal. It’s not.
We often had to translate language from the narcissists in our life from NPD-speak into English. Some examples of things the president-elect has said that are very similar to the NPD-type statements we are so familiar with:
Our Translation: Celebrate me! Shower me with love and adoration! Worship me! I am your king! Fall in line!
Our Translation: Dishonest media saying thousands of protestors!
Our Translation: I am not a fraud! You don’t know me! I made people millionaires! I’m a national hero!
Our Translation: I’m a winner, not a loser!
Our Translation: I saved thousands of jobs! I’m a hero to my subjects in Kentucky!
Our Translation: I’m a winner! No matter where I go, I win! Nobody beats me at anything EVER!
People with NPD target victims
For us, watching the election has been an exercise in re-traumatization. One of us has survived a parent who was a narcissist, and know how it feels to be mistreated and feel pathologically beholden, incapable of realizing that what was happening was abnormal. Healing has been arduous:
There are typical consequences and known reactions of approaching someone with NPD. If you think an alcoholic in denial is a tough nut to crack, you ain’t seen nothin’ yet. Though narcissism can appear across all social strata, it’s a cookie cutter disorder in that the behavior, reactions, and strategies, as NPD abuse victims know well, are identical. We think it’s important to study this and understand that there are strong reactions to be factored in to approaching anyone with NPD.
We also think it is past time to name things and call them what they are:
“Fake news is propaganda.
The powerful demanding apologies from artists is censorship.
Business dealings while in office are corruption.
Threatening protesters and petitioners is authoritarianism.
Declaring a minority an internal enemy and calling for militarized unity is fascism.
Everything starts with naming these things in public.
Resistance starts with plain speaking.”
(From @AlexSteffan on Twitter
From our perspective, we don’t feel the press or the public can afford complacency or submissiveness about the possibility of this scenario. The press and people who voted both for and against Trump have a right to understand the kind of person he is, and the kind of president he will be. From our hard-won experience, doing nothing, or tolerating negative behavior from a narcissist, does not protect you or keep the peace — it is an invitation for more bad treatment. So we feel the question of a president’s health — both mental and physical — merits asking.
As our 26th president put it:
“To announce that there must be no criticism of the President, or that we are to stand by the President, right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public.”
~ Theodore Roosevelt