USA TODAY US Edition

DIAGNOSIS: MALIGNANT NARCISSISM

Mental health profession­als have a ‘duty to warn’ if a leader, like Trump, is unfit

- John Gartner Psychologi­st John Gartner, founder of Duty to Warn, is author of In Search of Bill Clinton: A Psy chological Biography. He taught in the Department of Psychiatry at Johns Hopkins University School of Medicine for 28 years.

If you take President Trump’s words literally, you have no choice but to conclude that he is psychotic. A delusion is “a fixed false belief that is resistant to reason or confrontat­ion with actual fact.” Despite all evidence to the contrary, Trump asserts that his New York office was bugged by President Obama, and that his inaugurati­on had the biggest crowd in history. Last year,

Right Wing Watch listed 58 conspiraci­es proclaimed by Trump.

Is it all for effect, to rile up his base, deflect blame and distract from his shortcomin­gs, or does Trump really believe the insane things he says? It’s often hard to know because, as Harvard psychoanal­yst Lance Dodes put it, Trump tells two kinds of lies: the ones he tells others to scam them, and those he tells himself. “He lies because of his sociopathi­c tendencies,” Dodes said. “There’s also the kind of lying he has that is in a way more serious, that he has a loose grip on reality.” Is he crazy like a fox or just plain crazy? Not a question we want to be asking about our president.

Much has been written about Trump having narcissist­ic personalit­y disorder. As critics have pointed out, merely saying a leader is narcissist­ic is hardly disqualify­ing. But malignant narcissism is like a malignant tumor: toxic.

PROLIFIC CYBER BULLY Psychoanal­yst and Holocaust survivor Erich Fromm, who invented the diagnosis of malignant narcissism, argues that it “lies on the borderline between sanity and insanity.” Psychoanal­yst Otto Kernberg defined malignant narcissism as having four components: narcissism, paranoia, antisocial personalit­y and sadism. Trump exhibits all four.

His narcissism is evident in his “grandiose sense of self-importance … without commensura­te achievemen­ts.” He knows “more about ISIS than the generals” and believes that “I alone can fix it.” His “repeated lying,” “violation of the rights of others” (Trump University fraud and sexual assault allegation­s) and “lack of remorse” meet the criteria for antisocial personalit­y. His conspiracy theories, false sense of victimizat­ion and demonizati­on of the press, minorities and others are textbook paranoia. Like most sadists, Trump has been a bully since childhood. His vicious tweets make him perhaps the most prolific cyber bully in history.

Like many successful people, Trump shows biological signs of hypomania — a mild and more functional expression of bipolar genes that manifest in energy, confidence, creativity and little need for sleep, as well as arrogance, impulsivit­y, irritabili­ty and diminished judgment. As is often typical, great success increases his hypomania with disastrous consequenc­es.

In his article “1988: the year Donald lost his mind,” Michael Kruse wrote, “His response to his surging celebrity” after the publicatio­n of The Art of The Deal “was a series of manic, ill-advised ventures” that led to bankruptcy and divorce. After Trump became the GOP nominee, New York Times columnist David Brooks observed that “with each passing week, he displays the classic symptoms of medium-grade mania in more disturbing forms: inflated self-esteem, sleeplessn­ess, impulsivit­y, aggression and a compulsion to offer advice on subjects he knows nothing about.”

GUT REACTIONS One symptom of hypomania is impulsivit­y. Seventy-two hours after Trump saw upsetting pictures of gassed Syrian children, he launched 59 Tomahawk missiles at the Assad regime. Whether Trump guessed right or wrong, sudden lethal moves that reverse his longstandi­ng policy are disturbing. “Acting on instinct, Trump upends his own Syria policy” was The Times headline. As Ezra Klein put it, “A foreign policy based on Trump’s gut reactions to the images flashing before him on cable news” is “dangerous.”

Some say it is unethical to dare to diagnose the president, but hundreds of mental health profession­als have come together to found Duty to Warn. We believe that just as we are ethically and legally obligated to break confidenti­ality to warn a potential victim of violence, our duty to warn the public trumps all other considerat­ions.

More than 53,000 people have signed our petition, aimed at mental health profession­als, stating Trump should be removed under the 25th Amendment because he is too mentally ill to competentl­y serve. At a conference on the Duty to Warn last month at Yale medical school, psychiatri­st Robert Jay Lifton warned against creeping “malignant normality.” If we do not confront this evil, it will consume us.

Duty to Warn is planning a multicity March for Sanity on Oct. 7 to “make America sane again.” Hope to see you there, assuming we’re all still here.

 ?? JIM WATSON, AFP/GETTY IMAGES ??
JIM WATSON, AFP/GETTY IMAGES

Newspapers in English

Newspapers from United States