Whenever I write about Donald Trump’s psychopathology (see my Trumpolgy articles) the same one or two commenters often lambast me. See the first comment in yesterday’s story for a typical example. The commenter says: “ Sadly for Duty to Warn, Trump, and our honest political discourse, there is no possible way to “rule in” or “rule out” any of the things those associated with Duty to Warn say about Trump’s supposed mental illness: no possible way to ‘rule in’ or ‘rule out’ a diagnosis of Narcissism, Malignant Narcissism, Personality Disorder, Psychopathy, Anti-Social Disorder, Bipolar Disorder, etc. That is because, despite 50 years of a dedicated effort to do so, neuroscientists have not been able to identify any physical or physiological pathology associated with any psychiatric illness”
Other critics of mental health professionals making clinical assessments of Trump based on their observations of behavior say that the American Psychiatric Association’s Goldwater rule prohibits making a public diagnosis of anyone without examining them and getting their permission. The well know psychiatrist Robert Jay Lifton discusses this will Bill Moyers here.
I regularly discuss the psychology of Donald Trump with other psychotherapists, a half dozen in a private online group and about six or seven retired therapists in the coffee shop in the senior community where I live. While we sometimes get into the weeds debating the finer points of his diagnosis we agree that his psychopathology is severe and dangerous. Most of us think he fits the criteria for malignant narcissism laid out first by social psychologist Erich Fromm who is even more well known than Robert Jay Lifton who is prominent in the Duty to Warn movement, the association of mental health professionals and other concerned citizens who advocate Trump’s removal under the 25th Amendment on the grounds that he is psychologically unfit.
Malignant narcissismis a psychological syndrome comprising an extreme mix of narcissism, antisocial behavior, aggression, and sadism.[1]Often grandiose, and always ready to raise hostility levels, the malignant narcissist undermines families and organizations in which they are involved, and dehumanizes the people with whom they associate.[2]
Malignant narcissism is a hypothetical, experimental diagnostic category. Narcissistic personality disorderis found in the Diagnostic and Statistical Manual of Mental Disorders(DSM-IV-TR), while malignant narcissism is not. As a hypothetical syndrome, malignant narcissism could include aspects of narcissistic personality disorderas well as traits of antisocial personality disorderand paranoia. The importance of malignant narcissism and of projectionas a defense mechanismhas been confirmed in paranoia, as well as "the patient's vulnerability to malignant narcissistic regression". Wikipedia
I was trained as a psychoanalytically oriented psychotherapist. I view the psychiatric illnesses which used to be called the neuroses as having their roots in early childhood experiences. Now, these are listed in the Diagnostic and Statistical Manual (DSM) under obsessive–compulsive disorder, obsessive–compulsive personality disorder, impulse control disorder, anxiety disorder, hysteria, and a great variety of phobias. Some depressive disorders may have both biological and psychodynamic causes.
Most of my friends and colleagues had similar training but, like me, adapted their approaches to fit their clients and would describe themselves as eclectic. Several of my online colleagues are psychoanalysts. Peter Lovenheim’s article should resonate with us because it looks at the psychodynamic causation of psychopathology. It does with me. In fact, I have said in discussions many times that I thought Trump’s psychopathology was caused by mommy issues dating back to his early childhood.
I have been thinking about writing about this subject for some time but it would have been a daunting task so I put it on my Daily Kos back burner. Now Lovenheim has saved me the trouble.
Here are the first three paragraphs of his article. I hope it intrigues you enough to read the entire piece and comment on it. I will respond to serious comments and questions throughout the day, but will not answer those who are bringing up the same old same old arguments and criticisms against diagnosing Trump.
Donald Trump is easily the most psychoanalyzed president of modern times. His decision-making style and behavior have been hotly debated by journalists, voters, politicians, world leaders and pundits who have bestowed upon him any number of fanciful, grave-sounding mental conditions, calling him, among other things, a narcissist, a sociopath, a psychopath and a paranoiac. Trump has said he distrusts mental health professionals, so we don’t have access to a formal assessment of his psychology. But colloquially speaking, perhaps the best explanation for the president’s behavior dates back to his earliest interactions with his mother.
Although I’m not a psychologist, I have spent years researching a major field of psychology known as attachment theory for a book. According to the science of attachment—developed in the second half of the 20thcentury by British psychotherapist John Bowlby—we’re hardwired at birth to attach to a competent and reliable caregiver for protection because we are born helpless. The success or failure of this attachment affects all our relationships throughout life—in the workplace, on the athletic field, with loved ones—and yes, even in politics. Children who bond successfully with a primary caregiver—usually this is the mom but it could also be the dad, grandparent, nanny or other adult—grow up with what is termed a “secure” attachment. As adults, they tend to be confident, trusting of others, resilient in the face of setbacks, and able to enjoy long, stable relationships. Children who fail to achieve a successful attachment, on the other hand, may as adults have a lack of comfort with intimacy, difficulty trusting others, a constant need for reassurance from relationship partners, and a lack of resilience when faced with illness, injury or loss.
The biographical record is fairly strong on Trump’s failure to development a healthy emotional attachment to either of his parents. It may have contributed to his tumultuous personal life, but it also endowed him with some traits that made him well-suited to his late-career entry in politics. CONTINUED
In order to understand why Trump is Trump we must understand how he was raised. We have to have a grasp of the concept of attachment avoidance and attachment anxiety.
Finally, much of the president’s behavior, both before and since he took office, is clearly consistent with attachment avoidance: His powerful sense of self-reliance and near-inability to acknowledge self-doubt; his bragging about his sexual relations; his almost complete lack of close friends; his multiple marriages; and his unstable relationships with White House staff, Cabinet members and congressional leaders of both parties.
Trump’s almost compulsive need to be in the spotlight might be evidence of attachment anxiety if it were aimed primarily at needing approval. But in the president’s case, it appears to be more about needing admiration. Overt narcissism or grandiose self-regard, the leading attachment researchers Mario Mikulincer and Philip R. Shaver report, is associated with attachment avoidance.
Hopefully, this timely Politico article will help you gain a deeper understanding of what makes Trump tick.