A Therapist's Perspective on Trump

"When someone shows you who they are, believe them the first time."
-Maya Angelou

I know we’re all ready for this election to be over. I may not change anyone’s mind at this point, but I want to offer what wisdom I have based on ten years of experience in mental health. There has been a lot of speculation about Trump’s mental status. Is he narcissistic? Sociopathic? Brilliant? On cocaine? And how do we cope with the grossness of this election? In an attempt to detach myself from the noise and outrage, I have started looking at Trump with my therapist hat on.

Right now I work at a hospital, doing assessments for addiction and psychiatric services. I can tell you that if Donald Trump walked through our doors, I would immediately:

1)     Give him a drug screen. Sniffling aside, his speech and behavior are so erratic that I would suspect he was under the influence of something.

2)     Flag him as someone no one should be alone with. His emotional dysregulation sends up red flags that he can’t be trusted to stay calm and respectful.

3)     Recommend that he get treatment appropriate for personality disorders.

While it’s not appropriate for anyone to diagnose someone without interviewing them in person, we have a LOT of information to go on based on interviews, decades in show business, and dozens of sources. And although I cringe when the word “narcissist” gets thrown around too much, it has clinical meaning and is actually quite appropriate in his case. Narcissistic Personality Disorder involves a special combination of grandiosity, ego-centricity, entitlement, and insecurity, and it would be first on my differential.

The thing about this disorder, though, is that it can’t be treated the way depression can. If Trump had a mood disorder, I’d say we should extend compassion and make sure he gets treatment, because there is goodness and humanity in him as well. Personality disorders are different. They are pervasive, pathological character traits that extend throughout all areas of life and throughout a person’s lifetime.

Can they get better? Sure. But they are not “healed.” They are unlearned. A person has to have enough motivation to learn entirely different ways of behaving and thinking. What motivates them are rewards and consequences. Trump will not change because someone tells him, “You hurt me.” Appealing to empathy won’t work because he doesn’t have any and he doesn’t see the benefit. He might be motivated if someone told him, “If you keep acting this way, you lose your wealth/we cancel your show/we don’t vote for you.”

 Unfortunately, our culture often rewards certain pathological traits. That’s why many people with high levels of psychopathy, for example, make great CEOs and surgeons. Donald Trump has been rewarded throughout his lifetime by making money, getting attention, getting attractive women to marry him, and now getting votes. He sees far more reward in staying the same than he ever would in changing. The man is SEVENTY years old. I hate to say this as a therapist, but he’s probably a lost cause.

I think Trump’s supporters are hoping that he will use his cunning for the good of the country. Instead of acting in his own self-interest, he will act in the best interest of the country. However, based on all the evidence we have about him, I see no shred of evidence to say that he is capable of acting in the best interest of a group:

·       Not his investors. (Mark Cuban, an actual billionaire who pays taxes and has never declared bankruptcy, asked an important question: Has anyone said, “Donald Trump made me rich”?)

·       Not his contractors. (He stiffed them and claimed they did low-quality work. We’ll never know. Remember the USA Freedom Girls who sang and danced at one of his rallies? He stiffed them too.)

·       Not his employees. (He ran casinos into the ground because it made him money.)

·       Not his charity. (He used his charity to pay off lawsuits and buy paintings of himself.)

·       Not his family. (Note the number of wives and mistresses and accusers.)

What makes people think that, if elected President, he would suddenly be able to think communally rather than selfishly? His history shows that he acts only out of self-interest. Period. Why do we think electing him would change him?

Just because he’s pathological doesn’t mean he isn’t smart. He’s a world-class con artist. He tells people what they want to hear and makes them feel what they want to feel. As a result, masses of people project onto him what they want to see. When people meet with him individually, they are charmed and sing his praises. That’s entirely in line with narcissism: social interactions are carefully calculated to win people over toward his own gain.

So what are we to do?

How do we keep ourselves from sinking into the dark hole of despair? What bothers me most is the fact that so many people hear Trump’s hatred and say, “Well, I don’t like it, but it’s not a dealbreaker.” By supporting him, we continue to reinforce his self-centeredness and bad behavior. He forces his supporters to rationalize his behavior. By doing that, he gets his slime all over them.

I think there is a bright side. Donald Trump is forcing our country’s dark underbelly into the light. Our country has a history of denying, minimizing, and smoothing over its dark side. Just a few years ago, the Supreme Court said that we don’t need Affirmative Action because racism is basically over. Now, we can no longer deny that racism is still rampant, misogyny is real, we consistently deny facts and science, and we worship celebrity and wealth. He’s not wrong when he says that celebrities can get away with almost anything. Look at Woody Allen. Look at Joe Paterno (he was honored by Penn State at homecoming this year).

Trump represents the logical extension of cultural problems that were already there. He is forcing us to face the darkness that is still among us. I think he gets some credit for the Black Lives Matter movement gaining so much traction. I think people are listening to sexual assault survivors anew because of his words. We can no longer deny that we have real problems. I am hoping that by becoming our villain, by becoming the symbol of the worst parts of us, he will instigate some sort of catharsis that moves us toward progress and makes us all better people.

We can hope.