Too Sick to Lead: The Lethal Personality Disorder of Donald Trump
/.../In 1991, Sue Carswell, a reporter for People, experienced a phenomenon familiar to her peers: calls from supposed PR guys named “John Miller” or “John Barron”, gratuitously boasting about Trump’s wealth, business success and romantic prowess. Most bizarre, all agreed, was that the caller spoke and sounded exactly like Trump himself. But this particular call was immortalized on tape.
As others had, Carswell recognized the distinctive voice and accent. Distinctive, too, was the callousness and narcissism of an abysmal — and unbalanced — human being.
Trump was 44 then, and living with his future second wife Marla Maples. Nonetheless, his boastful “representative” shared for public consumption that “Trump” had “three other girlfriends”, detailing at length his alleged romance with Nicholas Sarkozy’s future wife Carla Bruni. But not all women were so lucky — for the benefit of People’s readers “Miller” described how Madonna stalked Trump at a charity ball before facing the ultimate devastation: “He’s got zero interest that night.”
But “Miller” could not stop over-sharing. Among the other women desperately seeking Donald, it turned out, was Kim Basinger. So at least for the moment, Carswell’s caller confided, Marla Maples was out of luck — Trump’s gift of a ring did not suggest that he would marry her. But Trump believed in “the marriage concept”, his alter ego added, making sure that People’s readers understood the stakes: “When he makes a decision, that will be a very lucky woman.”
Trump being Trump, Carswell also learned that “Trump” was doing “tremendously well financially.” On one level, this incredible performance evokes being trapped in a bar with a twenty-something blowhard of a salesman, whose braggadocio becomes more appalling and preposterous with every rum and Coke.
But here’s the thing which takes his performance from odious to pathological — Trump wanted a larger audience for his particular brand of self-aggrandizing swill, one in the millions, and was willing to assume a false identity to get it. It didn’t matter if he was lying; he didn’t care who got hurt. All that counted is what he needed in the moment.
Carswell played the tape for Maples who, after bursting into tears, confirmed that the voice was Trump’s. But the reporter need not have bothered .
Trump’s signature was in his words: gratuitously cruel, heedless of all but self, reckless in his lust for attention. Were he, say, Anthony Weiner, the call would have been another media-driven nail in the cross of his public career, fresh evidence of an emotional disorder which rendered him unfit to be a third-tier Congressman — let alone mayor of New York.
To meet his needs, Donald Trump wants us to make him president. To meet its own needs, the media — particularly cable news — is helping him.
It has been three weeks since this damning tape surfaced. The story vanished in a day. Confronted with the tape on Today, Trump told an obvious lie — “it was not me on the phone” — wrapped in his ineradicable narcissism : “I have many many people who are trying to imitate my voice and... you can imagine that... Let’s get on to more current subjects.”
The media complied.
But there is nothing more “current” or important than Donald Trump’s psychological fitness to be president. All the hyperventilation of the media — parsing his “positions”, pontificating on his  strategy” and intuition — is a poisonous form of the “political correctness” he otherwise deplores, normalizing the abnormal by shoehorning him into the usual analytic boxes. And what it yields is, in great part, rubbish.
There is only one organizing principle which makes sense of his 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?
Then how, his admirers say, do you account for Trump’s “success” in building a business and branding his persona? That’s simple enough: in some areas of life, at least to a point, narcissism and self-aggrandizement serve success. All that is required is a certain intelligence and a sense of how a lack of behavioral constraints can overwhelm more normal folk.
Thus Donald Trump. If your life’s work is building hotels and casinos, this pathology can work for you — especially if your dad has started you out with a few million dollars in chips. You can bully subcontractors, sue your enemies, and bury your misjudgments in a slew of bankruptcies and self-glorification. You can make Trump University sound like Harvard. You can use the media to create your own reality and sell it to the credulous. You can leverage your money to make your own rules.
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? His mockery of John Kasich’s table manners was payback for opposing him? And who can forget Marco Rubio sweat glands — “Little Marco” deserved it, after all, for standing in the way.
Or Megan Kelly, whose question about sexist behavior forced him to accuse her of menstrual moodiness. Or the Ricketts family, who he threatened with reprisal for funding his opposition. Or the Republican governor of New Mexico — an Hispanic woman — who he trashed for failing to appear with him.
Or any other Republican who won’t climb on his bandwagon. “That choker” Mitt Romney, a “stupid” man who “walks like a penguin.” Or Nikki Haley, or the long-since defeated Jeb Bush — both recent subjects of Trump’s gratuitous ridicule. 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. At rallies, he pens up journalists   in areas they are not permitted to leave. A week ago, he used rally to abuse reporters who had raised legitimate questions about his self- proclaimed contributions to veterans causes, calling one a “sleaze”, and expressing anger that the media did not praise 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. One hesitates to consider what would happen should Vladimir Putin, who Trump elevates for flattering him, challenge Trump as president.
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 the 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 advisors drawn from the party establishment.
This is pernicious nonsense. Consistent with his character disorder, Trump proudly insists that his chief advisor 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; blithely proposes nuclear proliferation in Asia; muses aloud about using nuclear weapons; and imagines negotiating one-on-one with North Korea’s psychotic leader. He proposes a trade war potentially ruinous to the world economy. He abets ISIS and Al Qaeda by scapegoating all Muslims at home and abroad. 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. His tax plan is absurd on its face. His astonishing proposal to trash America’s credit by defaulting on our debt reveals an inability to differentiate between running a casino and a country. His posturing for the NRA is as dangerous as it is dishonest.
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. After all, he tells us, “Everything is subject to negotiation, but I can’t and won’t be changing much, because voters support me because of what I’m saying and how I’m saying it.”
Such is his imbalance that he cannot distinguish between a real issue, like combating ISIS, and exhuming the hoary and discredited conspiracy theories surrounding the death of Vincent Foster. When it comes to protecting the planet, global warming is a “hoax”; when it comes to protecting his seaside Scottish golf course, he cites climate change as the reason for demanding that the locals stem the rising tides with, naturally, a wall.
Disclose his tax returns? That’s for lesser beings — like every other candidate in the modern era. Never mind that he excoriated Mitt Romney for not disclosing his; for Trump himself, it’s “none of your business.” Once again the unifying factor is the symptoms of this pathology: his need for adulation — for sure Trump is not nearly as rich as he claims; his lack of empathy — his charitable giving is no doubt paltry; and his compulsive rule bending — he likely paid little or no tax.
As for his excuse for nondisclosure — an audit — this is a transparent lie. But Trump lies and changes stories so routinely that we are becoming numb. The only constant is the gnawing hunger of Trump’s misshapen psyche. What is most terrible to contemplate is investing his pathology with the power of the presidency.
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?

Much of the answer lies in a failure of our institutions — governmental, economic, political and social — to maintain our trust. This has bred a popular flailing born of frustration and despair: the desire to tear down those structures which, all too many feel, have betrayed us. We can see it in the refusal of Trump’s followers to accept any criticism of their leader; see it, too, in the cadre of Sanders supporters who insist that electing Trump will unleash the chaos from which revolution springs. For all too many, anger has drowned reason.

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