Here Comes Your 19th Nervous Breakdown: the Mental State of Donald Trump

The attitude of the media and the American people towards Donald Trump’s personality has been the longest emperor-has-no-clothes tale ever told. A man who has been called a “fucking moron” by one of his own appointees, has been routinely praised for his wiliness and his political acumen, his intuitive knowledge of the American people. An intuitive knowledge that in his own mind extends to medicine—he tells us that doctors are amazed at his knowledge of complex medical issues which he somehow acquired without any study of medicine. He just knows it. On the basis of his knowledge of medicine he has offered advice on possible cures of the covid-19 infections such as the injection of Lysol. And it’s true. Doctors are amazed.

At the same time there has been a skeptical counter current. Explanations and comments about his more puzzling or even bizarre statements and actions—apart from their political content—have ranged across a spectrum of treating them mere personal foibles to more serious imputations about his personality. That is, from merely dismissing these things as Trump-being-Trump all the way to his being a pathological liar and, of course, narcissist. But this latter term has, with few exception, only been used in the media in its popular sense. Namely, that he is an extremely selfish person. Only a few stories in the mass media have gone beyond mention of narcissism as people use it in common parlance to quote medical authorities who speak of narcissism in a real pathological sense. A sampling of their remarks shows how seriously doctors regard Trump’s mental illness.

“Trump has no policy on any issue because his mental impairment means he cannot think strategically or in abstract terms,” tweeted John M. Talmadge, MD, a physician and clinical professor of psychiatry at U.T. Southwestern Medical Center. “He cannot weigh options, assess risk, or foresee consequences. Concepts like fairness, justice, honor, and integrity quite literally do not register. You can see this in every interview or press encounter. He never states an abstract thought or idea. Instead he falls back on simple adjectives: disgraceful, horrible, low-intelligence, perfect, innocent, nasty, stupid, fake, etc. He’s driven by negative emotion, often paranoid and often insulting, vulgar, vitriolic.”

Daniel Gilbert, a professor of psychology at Harvard University, suggested that Trump should be detained involuntarily to assess his mental health. It followed a tweet by Trump in which he claimed he would “totally destroy and obliterate the Economy of Turkey (I’ve done before!)” if Turkey did anything that “I, in my great and unmatched wisdom, consider to be off limits.”

“Am I the only psychologist who finds this claim and this threat truly alarming? Wouldn’t these normally trigger a mental health hold? Right and Left must set aside politics and agree that there is a serious problem here,” Gilbert wrote on Twitter.

Dr. Lance Dodes formerly of Harvard Medical School told MSNBC that Trump had, “a fundamental need to be all-powerful and all loved and can’t stand challenges. He can’t stand anything that disagrees with him, and the more you challenge him, the more unhinged he becomes, the more paranoid, and the more violent, potentially. He doesn’t really love anyone except himself. That’s not a slur, that’s a psychological fact. People like him are about him. If he’s not useful to him, he stops loving him. That’s part of the essential emptiness of Donald Trump. He doesn’t have real relationships with people.”[1]

But these commentaries on the President’s mental state have floated on the billows of the media and vanished like a small cloud, a dream.

Narcissism is a central psychoanalytic concept in Freud. Probably no thinker before him or since has devoted so much consideration to subject. We are all inescapably narcissistic in some degree in Freud’s view. Freud uses it to explain such phenomena as falling in love, the bonding of groups like the military or the person’s patriotic attachment to a nation. While Freud did not discuss narcissism per se as a serious mental illness—a psychosis in psychoanalytic terms—megalomania, one of narcissism’s attributes, does play a role in his discussion of a psychosis, paranoia, “The Case of Schreber.”

The scandal of terminology looms here with the term narcissism. Suffice to say that from Freud onward all serious discussion of narcissism involves megalomania—a trait attributed to Trump—and megalomania is one of the characteristics whereby narcissism becomes a serious pathology since it signals the subject’s detachment from reality.

On the basis of these things narcissism has long been found in both the leading professional manual of all diseases, the International Classification of Diseases (ICD) and the leading US manual of mental diseases, the Diagnostic and Statistical Manual of Mental Disorders (DSM). Under the entry “Disorders of Personality,” the DSM-IV-TM (1996) the symptoms of narcissism are: “Deficient conscience; unscrupulous, amoral, disloyal, fraudulent, deceptive, arrogant, exploitive; a con artist and charlatan; dominating, contemptuous, vindictive.” In the next edition DSM-V another symptom is added, “Intense envy of others, and the belief that others are equally envious of them.”

Erich Fromm, a psychoanalyst associated with the Frankfurt School, in 1964 described a form of narcissism he called “malignant narcissism,” A few years later Edith Weigart following Fromm described yet another of symptom of the disorder as the “regressive escape from frustration by distortion by and denial of reality.”[2]

Consider the following recent actions and statements and acts of Trump in relation to these things: His obsession with the cockamamie theory that TV news show host Joe Scarborough murdered a former employee. His suggestion that a seventy-five-year-old man who was shoved to the ground by Buffalo police could be “an ANTIFA provocateur.” The man, Peter Gugino, had to be hospitalized for a skull fracture, and Trump tweeted, “@OANN I watched, he fell harder than was pushed. Was aiming scanner. Could be a set up?” Then his cringe-worthy envy of Greta Thunberg when she was named Time’s Person of the Year. His photo-op at the church near the White House. A stunt bears closer focus.

That photo-op was apparently his way to forestall his “tiny visit” to the White House bunker from being mistaken for a sign of his cowardice—other accounts if narcissism emphasize that the other side of the narcissist’s obsessive need for admiration is the continual fear of what others may think of him.[3] Here again as Freud emphasizes, the unconscious never lies. In lying it tells the truth. If you have ears to hear it. So Trump sicced the cops on the peaceful demonstrators in Lafayette Park. Then he and his entourage strolled over to the church where he was photographed brandishing a Bible that may have been a gift from Stormy Daniels.

The aftermath of the “infamous photo-op”—as it was soon being called in mass media—shows how Trump’s mental disintegration has begun to envelope and involve others. Trump and his Attorney General Barr and adviser Peter Navarro all offered conflicting explanations of the planning and purpose of the bizarre event and his flunkeys in trying to abet him and clean up his mess, instead up entangled in his disorder.

Trump’s howlers and bungling would all be—in his own rhetoric—the greatest farce Gilbert and Sullivan never wrote, except that all of his words and deeds do not merely hurt his chances for reelection. They aggravate and worsen all of the other crises that have engulfed the rest of us. Not merely those that have happened 2016, but those that preceded, preeminently the climate crisis.

For weeks now, virtually everything Trump has said or done in public has only added to his downward spiral to the point where his loss to Joe Biden—the Democratic version of Elmer Fudd—seems all but certain. Here too the narcissist’s aggressive attitude and destructive impulses towards others can at some point turn against himself is also remarked by some. Elsa Ronningstam wrote in 1997 that, “the patient attempts to triumph over the analyst by destroying the analysis and himself…”

All of this is beginning to seep slowly in news coverage. There are numerous reasons for the news media’s timorous coverage of Trump. Elections are covered as sporting events, horse races and ballgames, and the news media fear they’ll lose their audience if the score in the bottom of the second inning is 10 – 0.

Part of my reason for writing this is in the probably vain hope that it will stop certain comments about Trump made by those on both the right and the left that are repeated ad nauseam. Among his miserable supporters these consist of what changes he needs to make to get himself “back on the right track.” For Christsake you idiots, he’s on track. It is the same track he has always been on, the one laid out for him by his mental malady. He’s not going to change. He can’t. He’s a lunatic. Among his opponents, I would like to put a stop the preface they put before their expressing their anger at something he’s said or done: “I don’t know why he does this…” Some of us do know why. He’s a lunatic. That’s why. Why did Caligula make his horse his consul?

Even there Trump outdid the emperor. He made his horse’s ass Peter Navarro his chief adviser.

As I say it’s likely futile to hope that what I say here will stop those people from annoying the shit out of the rest of us. As though we don’t have enough to put up with as it is. A pandemic of the virus heaped on top of a long national epidemic of idiocy. That said, more to point is that, is one final question.

Given Trump’s downward mental spiral—which is accelerated by the very crises he exacerbates—his impending exit seems certain. But how will that happen? How will that be accomplished? How will his mental disorder affect even that?

If Trump loses the election Joe Biden has rightly expressed concern that he will not accept the result. Biden has spoken of the possibility that the military may have to remove him from the White House. Here Biden shows himself more perceptive than most of the media pundits. This is not idle chatter or sound bytes for his campaign. Biden hardly needs to campaign. Trump’s relentlessly negative campaign has begun—and it’s against himself. All Biden need do is appear on TV once a week and make some anodyne statement to remind people he’s alive.

Regarding possible scenarios for Trump’s exit, an episode long before he entered politics shows an instance of how his stubborn refusal to exit was handled. The scene was Atlantic City 1989.

Epilogue: Donald Trump and Keith Richards

In December of 1989, the Rolling Stones were near the end of a US tour, and the idea of their adding a pay-per-view concert to the end of the tour was floated. I might add that this was exactly twenty years after the disastrous concert at Altamont, when the Stones faced similar problems arranging that free concert at the end of their 1969 tour. The main problem in each case was finding a venue on very short notice. The 1989 tour manager Michael Cole tried Las Vegas without result and turned to Atlantic City where he found a venue available. But the deal would have to include Donald Trump as one of the producers. When Cohl told the Stones of Trump’s involvement, their reaction Cohl said was, “We’re not going to be affiliated with Donald Trump. At all. Screw you.”

Possibly the Stones were thinking back to the violence at Altamont which culminated with one of the Hells Angels stabbing to death a man waving a gun in front of the stage while the Stones were playing. Whatever. Kohl told them he would “manage” Trump, and finally the Stones relented and agreed to a deal under three conditions: Trump could do no news conferences. He could not attend the concert. And he could not even be on the premises.

The night of the show began inauspiciously–as events had at Altamont. Trump gave himself top billing: “Donald Trump Presents The Rolling Stones.” Keith Richards was livid. It got worse. Just as in so many other situations in his life, something bad on his account he proceeded to make worse. As someone said of him, the only time he stops shooting himself in the foot is when he stops to reload.

After the billing became known, Kohl was told that Trump was giving a press conference in the room where the Stones were to give their pre-concert press conference. Kohl went to Trump and reminded him of the conditions he had agreed to. Trump protested, “But Michael, they begged me…they begged me.” Kohl stood firm and Trump left. A short time later while Kohl was with the Stones, a crew member came and said that Trump was back at it.

At that point Keith Richards pulled out a large stainless-steel pocket, stuck it in the table and said to Kohl, “What the hell do I have you for? Do I have to go over there and fire him myself? One of us is leaving the building. Either him or us.”

Kohl went back to Trump whose response was a predictable escalation. He was furious. He said, “You don’t know anything! Your guys suck!”

Trump had with him according to Kohl “three shtarkers.” Thugs, that is. Two of them put on gloves, the third a set of brass knuckles. Kohl called the head of Stones security on his walkie-talkie and said he had a problem and needed some help. The head of security must have previously had dealings with Trump and anticipated accordingly. He told Kohl to look behind himself. Kohl saw forty members of the security crew walking in with tire irons, hockey sticks and screw drivers in hand. Kohn turned back to Trump and said, “Now are you gonna go, Donald?”

Trump and his thugs slouched out. This time for good.

In May of 2016 when Trump was winning primaries and looking like the certain Republican nominee, the Atlantic City episode was mentioned to Keith Richards in a BBC interview. Richards’ reply was, “Now America has to get rid of him. Don’t say I didn’t warn you.”[4]


1) These comments can be found at

2) All of this can be found in the Wikipedia entry “malignant narcissism.”

3) In passing, we might also remark his strange use of adjectives. A tiny visit, a perfect phone call, a beautiful economy—this too is surely symptomatic.



Daniel Beaumont teaches Arabic language & literature and other courses at the University of Rochester. He is the author of Slave of Desire: Sex, Love & Death in the 1001 Nights and Preachin’ the Blues: The Life & Times of Son House. He can be contacted at: