Trump vs the People: a Psychiatrist’s Analysis

Many people, including members of Trump’s inner circle, have commented on his mental and emotional instability.  The following uses a professional point of view, where possible, to understand his psychology and way of operating, based, of course, on publicly available material.  I include a section at the end on how best to stop his march to unlimited power.

There is a “Goldwater” rule in the therapeutic community that one should not try to diagnose politicians.  This was broken in January 2017 with an article reportedly backed by almost 60,000 psychologists, announcing that Trump suffers from “malignant narcissism” (egotism, selfishness), and is a danger to the American people. The authors felt that “Goldwater” was overridden by a duty to warn, under the Tarasoff rule, which sets aside confidentiality if the person presents a threat to others.

I cannot claim objectivity when, in fact, I’m furious with Trump, and frightened of the direction he is taking.  I fear that he is working toward becoming a fascist dictator.    And he is destroying any chance of a reasonable future for our children and grandchildren.

I believe that his apparent instability is very calculated.  It gains attention, which his narcissistic personality craves, and which keeps his brand name selling, selling, selling.  It also keeps everyone around him off balance, so that he can amass control.  He even boasts about doing it.  And it works for him.

Trump has, against all expectations, succeeded in become the President of the United States, which also makes him the Commander-in-Chief of the US Armed Forces.  It puts his finger on the nuclear button, so he can hold the whole world hostage.  Is he satisfied?  Will he settle down and serve the people?

Not so far.  Now that Trump has been in office for 2 months, we can see that the psychologists were correct with their diagnosis of malignant narcissism.  He is a threat to 99.9% of us.  His presidency is ego-driven and megalomaniacal.   His goal is personal power and profit rather than the welfare of the people who elected him. 

During Trump’s short time in office, his family has cost Americans extraordinary amounts of money while Trump lines his own pocket.  He refuses to divest from his businesses, which have gotten a boost since he’s taken office. This means Trump is literally pocketing profits made from taxpayer dollars.

He seems to believe he is above the law.  He has fits when judges block his immigration policies, and when he can, fires anyone who thwarts him.

I believe Bernie Sanders has it right.

Trump’s goal, Sanders said to the Guardian, “is to end up as leader of a nation which has moved in a significant degree toward authoritarianism where the president of the United States has extraordinary powers, far more so than our constitution has provided for or the values of the American people support.”

Timothy Snyder, author of  On Tyranny: Twenty Lessons from the Twentieth Century,  which studies the rise to power of Hitler and others, says fascism happens quickly, within a year or two, once a megalomaniac gets into power.  We only have a limited window of opportunity to stop Trump.  

Trump is attempting to control the public’s perception of reality by accusing the most respected news sources of promulgating or distributing “fake news”.  Of course, he is the master of this art.  As in Orwell’s prophetic noel, 1984, he turns truth on its head and does his best to confuse everyone.  A recent article by Todd Gitlin analyzes his modus operandi.

His proposal of a huge expansion of the military budget implies that he intends to conquer the world.  “The world is in trouble, but we’re going to straighten it out, OK? That’s what I do – I fix things,” Trump said in a speech on 2/2/17.

He has no concern for the future, gutting all regulations that protect the environment.  His Director of the Office of Management and Budget recently said “The EPA is a waste of money”.

Trump has grandchildren; will they thank him 50 years from now, when food is scarce and there are many more climate refugees?  Or will they be billionaires living underground, eating hydroponic food?  And how many of his beachfront hotels will be under water in 20 years when climate change has raised sea level to the point of flooding coastal cities?

Perhaps he is like Louis XVI just before the French Revolution: “Apres moi, le deluge”.

We have let a megalomaniacal predator, a man who has appointed a Cabinet full of predators, take over our government.  We are watching the Trump administration take a wrecking ball to everything we hold dear:  the rule of law, the Constitution and the Bill of Rights, the health of our environment, our national parks, the US leadership among nations, tolerance of people who are different from us, and worst of all,  the future of our children and grandchildren.

Yet almost half of the electorate voted for him, and his approval rating, though falling, is still 37%.  What is going on in this country?

Using professional diagnostic codes, this article will look at how Trump was able gain enough votes to win the Electoral College.  (Of course, he had lots of help, from Republican state rules that disqualify voters of color, from GOP manipulation of voting machines, from the divided and corrupt Democratic Party).  And he continues to have significant support.

First, let’s look at Trump from a medical point of view.  In 2016, he produced a letter which may be fake from his “doctor of 35 years” (Dr. Bornstein, a gastroenterologist) stating that he would be “the healthiest individual ever elected to the presidency”  – statement no MD could make in good conscience.

He does not exercise, eats junk food, consumes diet coke all day, gets only 3-4 hours of sleep/night, and needs to lose at least 20 pounds. This is not a healthy life style, even for a young person, and at 70, Trump is the oldest man ever to become president.

There have been questions raised about whether he has some brain dysfunction, because of some of his odd expressions, memory problems and impulsive behavior.  His father died of Alzheimer’s.

Diet coke contains an artificial sweetener, aspartame, which metabolizes to the amino acids aspartic acid and phenylalanine, and methanol.  Excessive aspartic acid leads to neural degeneration, and over time, to Parkinson’s, multiple sclerosis, or Alzheimer’s.  Methanol is a deadly neurotoxin.  What has Diet Coke done to Trump’s brain?

There is also speculation that he has used amphetamine-like diet pills for years.  His constant sniffing during the presidential debates raised the question of cocaine use.  Trump firmly denies any illegal drug use.

Psychiatrically, Trump  fits into several categories under the general heading of Personality Disorders.  The following are taken from the latest Diagnostic and Statistical Manual- ICD-10.

F60.2 Dissocial (Antisocial) Personality Disorder

At least 3 of the following:

1 callous unconcern for the feelings of others;

2 gross and persistent attitude of irresponsibility and disregard for social norms, rules and obligations;

3 incapacity to maintain enduring relationships, though having no difficulty in establishing them;

4 very low tolerance to frustration and a low threshold for discharge of aggression, including violence;

5 incapacity to experience guilt and to profit from experience, particularly punishment;

6 marked proneness to blame others, or to offer plausible rationalizations, for the behavior that has brought the person into conflict with society.

In other words, Antisocial Personality Disorder applies to criminals, con artists, and people without scruples.  Is it a form of insanity?

According to Black’s Law Dictionary, the definition of criminal insanity is “a state of mental illness where a person is unable to determine between right and wrong and as a result will commit unlawful acts.”    Surely, Trump has repeatedly demonstrated that he doesn’t know the difference between truth and lies, right and wrong, and doesn’t care, which makes him criminally insane.

He wouldn’t be able to use the M’Naughton defense (not guilty by reason of insanity) to plead innocence in a court of law, since sociopaths are excluded from that defense.

However, his criminal insanity might provide ample justification to remove him from office under the Twenty- Fifth Amendment.

He also fits into the category of:

F60.4 Histrionic Personality Disorder

At least 3 of the following:

1 self-dramatization, theatricality, exaggerated expression of emotions;

2 suggestibility, easily influenced by others or by circumstances;

3 shallow and labile affectivity;

4 continual seeking for excitement, appreciation by others, and activities in which the person is the centre of attention;

5 inappropriate seductiveness in appearance or behaviour;

6 over-concern with physical attractiveness.

Associated features may include egocentricity, self-indulgence, continuous longing for appreciation, feelings that are easily hurt, and persistent manipulative behavior to achieve own needs.

In laymen’s terms, such people are often called “drama queens”.

Because of limited space, rather than give examples, I refer the reader to the paper referenced above, which gives many instances of Trump’s behaviors that fit these descriptions.    No doubt the reader can supply some as well.

People with these personality disorders are usually considered untreatable by psychiatry.  They tend to think they are above the law, and to be out of touch with reality.  They often become suicidal when their fantasies crash into reality, and  end up in a mental hospital.  Or their disregard of the law may land them in jail or prison.  How did this man end up in the White House instead?

Trump was born with a long silver spoon in his mouth, inheriting wealth and the real estate business from his father.  Money has always protected him from the consequences of his misbehavior, and gave him a huge head start on his business career.

Trump claims an IQ of 155.  He has been able to turn his usually maladaptive personality traits into success by a combination of ruthlessness, showmanship, and unlimited ambition.  Being sociopathic, he is a master manipulator.  Being histrionic, he knows how to keep himself in the spotlight, and get the constant attention he craves. Hosting the reality TV show Executive Apprentice for 14 years gave him lots of experience with the media, and got him name recognition.

The following quote is from an article in Vanity Fair.

Jeff Jenkins, Co-President of Entertainment and Development for Bunim/Murray: “Donald Trump has over a decade of experience delivering sound bites on his former game show that need to be very short, clear, and effective,” …I think that we sometimes forget the enormous reach of celebrity and fame.

A recent article in The Guardian makes the point that “Donald Trump won the election with the support of the majority of men against a highly-qualified female opponent, despite his reported behaviour. Or … because of it?”  It argues that the widespread indulgence in internet porn made male voters less concerned about ethics and more accepting of Trump’s blatant sexism.

To summarize:  Trump sold himself to the American people as a successful businessman.  He knows how to create and maintain conflicts that attract unending attention, and how to portray himself as a winner.  He titillates and attracts male voters with his slurs against women.  All of this works beautifully for a presidential campaign, which for most people is a form of entertainment.

Running a presidential campaign is not very different from running a reality TV show.  The executive has control over his staff, and his main job is to entertain and dazzle the public into electing him.  No wonder a man who knows how to provide endless entertainment was able to capture the attention and votes of so many people!   During the campaign, reality TV was more influential than the reality of climate change.

Manipulation of public perception doesn’t work so well once Trump has to actually deal with reality as POTUS, as we are seeing.  The real world is not a media audience.  He loses control, and has temper tantrums.  His administration is chaotic, with lots of infighting and poorly thought out initiatives.

He is running into massive opposition, and tolerating it badly.  The “deep state”, including the intelligence community, Democratic leaders, and much of the press are doing their best to paint him as allied to and influenced by Russia. The courts are blocking his immigration bans.  The Atlantic just ran a story on his ongoing ethical conflicts of interest.

The people are constantly marching, demonstrating, organizing against his policies.

Another Personality Disorder is emerging now.

F60.0 Paranoid Personality Disorder

Personality disorder characterized by at least 3 of the following:

1 excessive sensitiveness to setbacks and rebuffs;

2 tendency to bear grudges persistently, i.e. refusal to forgive insults and injuries or slights;

3 suspiciousness and a pervasive tendency to distort experience by misconstruing the neutral or friendly actions of others as hostile or contemptuous;

4 a combative and tenacious sense of personal rights out of keeping with the actual situation;

5 recurrent suspicions, without justification, regarding sexual fidelity of spouse or sexual partner;

6 tendency to experience excessive self-importance, manifest in a persistent self-referential attitude;

7 preoccupation with unsubstantiated “conspiratorial” explanations of events both immediate to the patient and in the world at large.

Trump’s accusations that Obama wiretapped his campaign, and that the press is purveying fake news are good illustrations.

Trump is maintaining support by projecting the image of a strong energetic leader, which appeals to people raised in authoritarian families.  (See George Lakoff’s Don’t Think of an Elephant for an analysis of how the GOP has been deliberately fostering this family structure for several decades.)   Trump plays to the egotism and paranoia of a large segment of Americans, by appealing to racism, sexism, xenophobia and patriotism- the classic strategy of fascist leaders.  His rudeness and cruelty gives legitimacy to behaviors of people who like to express those qualities.

Climate denial is a major factor in his continued popularity.  Trump’s insistence on denying climate change appeals to many voters who don’t want to face the future, and would prefer to believe that science is not to be trusted.   A recent study shows that people tend to choose ignorance over possible bad news.

Hillary knew this too and the topic of climate change was carefully avoided in all three campaign debates.

Yet the attack on the environment is probably the worst of all of Trump’s hateful policies. While his targeting of racial and religious groups is reprehensible, and his assault on services to the poor such as MediCal and Social Security is appalling, the consequences of refusing to recognize climate change will be disastrous to the future of our children and grandchildren.

What do we do now, with a paranoid, histrionic, sociopathic megalomaniac in the White House?

Unfortunately, at this point we are not only dealing with Trump, but also with the likeminded billionaires he has put in key positions, as well as a gleeful Republican Congress that is hastening to implement his policies Corporate America may have been slow to warm up to Donald Trump, but once Trump secured the nomination, “the big money began to recognize an unprecedented opportunity,” Monbiot wrote. “His incoherence was not a liability, but an opening: his agenda could be shaped. And the dark money network already developed by some American corporations was perfectly positioned to shape it.” 

We are up against an administration that is getting rid of all the regulations that protected workers and the environment, and putting in laws that will curb dissent or make it illegal.  The local police are being formed into a national army by way of immigration raids.  Many states and the Congress are pushing forward on these policies, which are hastening the doom of the biosphere..

Yet, as Bernie Sanders says, “Despair is not an option”.

In a way, Trump has done us a huge favor, by waking us up to the difference between entertainment and reality.  His aggressive policies of hatred toward Muslims and Mexicans have aroused the best in our culture, as millions rally in support of targeted populations.  His appointment of one billionaire after another has alerted us to our true interests as people, which are being trampled on.

People are leaving their TV sets and laptop screens to go to the streets, to confront their Congresspeople at town hall meetings, to boycott banks and corporations that support Trump policies, and to gather with friends and neighbors and strategize on other responses.

The opposite of despair is faith.  Everyone now working for the future against all odds must be leaning on faith at some level- faith that the battle is still worthwhile, and that the tide can be reversed, even at this late hour.  Whether it is faith in a higher power, in the universe, in the Force, or in human creativity, it is necessary to keep going.  We are being pushed by our very DNA, which is using us as a vehicle to make sure it perpetuates itself.

This is a spiritual battle, a battle between the forces of life, love, peace, justice, caring for the future generations, against the forces of greed, selfishness, and ruthlessness toward the people and our children and grandchildren, not to mention all the other creatures on the planet.

Many people are responding to the situation with very appropriate thinking and actions.  The following suggestions are meant to be a helpful guide.

+ Be clear that we are in an emergency situation. We only have a few months to prevent fascism, and can’t wait until the next election.  We have to pace ourselves, but work as hard as we can right now.  We have to meet, lobby, write, demonstrate, – do everything we can and more.

+ Take care of ourselves. Breathe, don’t be overwhelmed by the shock and awe tactics, get enough sleep and exercise, eat well, take time to relax.

+ Ask everyone you know- family and friends, what they are doing to stop Trump. Point out that we can’t afford apathy any more.  Get them mobilized as much as you can.

+ Reach out to Trump supporters. Don’t waste time with hardcore right wingers.   Many people still feel it’s only fair to give him a chance, or that the President should be respected.    We all have relatives or friends in this category.  They might be open to looking at the reality of what he is doing  Explain how he and his policies are dangerous and must be resisted.

+ We can learn much from the Standing Rock Hunkpapa. This small tribe was able to  interrupt the building of the Dakota Access Pipeline (DAPL) for nearly a year.  Using only nonviolent methods, the Lakota have mobilized support from over 200 Native American tribes, were backed by  millions of people.   They call themselves Protectors, not protestors, protectors of their sacred land and water, which they hold in trust for future generations.   Though the pipeline is being completed under Trump, who is a major investor, the battle is continuing through the courts, and many other pipeline projects are being held up now.

Some of their lessons:   Restoring a sense of the sacred is effective.  Nonviolence works.  Courage and willingness to endure hardship are essential to success.  The enthusiasm of young people is crucial.  Perseverance furthers.  Social media forms an essential tool.  Believe in miracles.

+ Like sailors on a sinking ship, we need to pray for help. This may not seem like a practical suggestion, but it actually accomplishes many things.  It helps us to remain nonviolent in the face of provocation, and put our egos aside in the interest of the greater good.  It opens us to wisdom and inspiration.  We can pray for courage, stamina, calm- the qualities we need personally to sustain us during these hard times.

+ Timothy Snyder, author of On Tyranny: Twenty Lessons from the Twentieth Century,  gives instructions for preventing tyranny from getting established: Don’t obey in advance. Believe in truth. Stand out. Defend institutions. Be calm but as courageous as you can be.

+ As so many are already doing, we need to leave our laptops and TV sets, and meet our neighbors. There is power in numbers.  We need each other.

+ Young people are the most important group to mobilize. They have the most energy, and their future is at stake.

A groundbreaking climate lawsuit, brought against the federal government by 21 children, has been hailed by environmentalists as a bold new strategy to press for climate action in the United States. It argues the federal government has violated the constitutional right of the 21 plaintiffs to a healthy climate system.  But the Trump administration, which has pledged to undo Barack Obama’s climate regulations, is doing its best to make sure the case doesn’t get far.

Brought by the Children’s Trust, this lawsuit may well be the most significant action taking place, and deserves our full support.  It addresses the central issue of our time- the loss of a habitable planet.  If we take caring for our grandchildren as our guide for action, we can’t go wrong.

Answer hate with love. It’s ironic that so many of Trump’s supporters claim to be Christian, yet they go along with his policies of hating Mexicans, Muslims, gay and trans people, etc. They forget what Jesus said.  “Love your neighbor as yourself”.  This is the greatest law of all.

Carol Wolman, MD is a graduate cum laude of Radcliffe College.  She received her medical degree from Harvard, and is a diplomate of the American Board of Psychiatry and Neurology.  She has been practicing psychiatry for 40 years. 

She has been an activist for peace and ecology for 60 years.  With her husband, Robert Clapsadle, she worked with the Bigfoot Riders on a film commemorating the centennial of the Wounded Knee massacre, and on several other films.   She organized a group to impeach GW Bush, and then ran for Congress 3 times on an impeachment platform. She also has written many op-ed pieces, which are archived at  Recently she has been active in the Sanders campaign, and has been supporting the Lakota Water Protectors at Standing Rock.