Malignant Narcissism

-by Helen Klein

The term Malignant Narcissism is finding widespread usage in reference to Trump. It has been noted in recent articles in U.S. News and World Report and the Huffington Post. This term is certainly worthy of further discussion. Basically, it is an extreme mix of Narcissistic Personality Disorder with aspects such as paranoia, aggression and antisocial personality. Other symptoms may include an absence of conscience, the psychological need for power and a sense of importance (grandiosity). As an adjective, malignant means disposed to cause harm, suffering or distress deliberately, and feeling or showing ill will or hatred; it is very dangerous or harmful in influence or effect. In medical terms, malignancy means getting worse. A malignant narcissist is not only narcissistic but also hostile and destructive. The last place you would want a malignant narcissist is in the Oval Office.

Each day more is in the news about Trump’s possible mental disabilities and whether he is unfit for office. Carl Bernstein has recently raised the issue in an interview on CNN. He noted that there has been discussion even within the Republican Party about Trump’s emotional maturity, stability, and fitness to rule. “We are having too many bizarre moments with this new President. Something very disturbing is going on here. I talked about the tweets being an MRI of his psyche. These remarks (about fraudulent voters) are likewise an MRI of his psyche, and it is not a very pretty place.”

Specifics on how to remove Trump from office either by impeachment or by the 25th Amendment are now frequently discussed on line, in print and on television news shows. A recent poll indicates that 40% of Americans are in support of impeachment. This is unprecedented, or as Trump has said, unpresidented. And he has only been in office for two weeks!

Trump’s apparent functional problems and personality issues have long been on display, and anyone paying attention during the campaign could see the warning signs. Historically, there have always been red flags. Of particular concern were the interviews with Tony Schwartz, author of Art of the Deal, and Barbara Res, Trump’s electrical engineer for eighteen years, whose descriptions of Trump were very unflattering.

In spite of the facts that came to light, many voters were oblivious to his incompetence and instability or just did not care, attracted by his lack of political correctness, big mouth, bullying and downright lies as well as his vacuous showmanship. They cheered him on as though our government and our democracy were simply a reality show. That so many Trump supporters and Republicans continue to deny the facts is truly alarming. However, this denial/avoidance may well be on its way out. A storm is coming. The ugliness of this man is being peeled away one layer at a time, and the pace is picking up each week.

Now that Trump is actually President, his absurd, dangerous, uncouth behavior is on display for the world to see. He insults heads of state, shows disregard for the law and the Constitution and lacks respect for judges, government officials and scientists. His behavior and words have long since ceased to be amusing. His ignorance knows no bounds, and his vocabulary and speech patterns are consistent with a middle school student at best. For any American who cares about our democracy and our place in the world community, the past two weeks have been an embarrassment. More and more Americans are appalled.

It would be worthwhile to review the specifics of Narcissistic Personality Disorder, which were described in a previous blog, as this is the prominent underlying theme for Malignant Narcissism.

Narcissistic Personality Disorder: A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and presented in a variety of contexts, as indicated by five (or more) of the following:

• Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).
• Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
• Believes that he or she is “special” and unique and can only be understood by, or associate with, other special or high-status people (or institutions).
• Requires excessive admiration.
• Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations).
• Is interpersonally exploitative (i.e., takes advantage of others to achieve his or her own ends).
• Lacks empathy: is unwilling to recognize or identify with the feelings or needs of others.
• Shows arrogant or haughty behaviors.

Malignant Narcissism: This is not an official psychiatric diagnosis as per the Diagnostic and Statistical Manual of Mental Disorders (DSM V). Rather, Wikipedia defines it as follows:

Malignant Narcissism is a hypothetical, experimental diagnostic category. As a hypothetical syndrome, malignant narcissism could include aspects of narcissistic personality disorder as well as paranoia.

Malignant narcissism is a psychological syndrome comprising an extreme mix of narcissism, antisocial personality disorder, aggression and sadism. Often grandiose, and always ready to raise hostility levels, the malignant narcissist undermines organizations in which they are involved, and dehumanizes the people with whom they associate.

In an article in U.S. News and World Report by Susan Milligan (1/27/2107), John D. Gartner, Ph.D., psychologist at Johns Hopkins University Medical School, minces few words about the President in his professional assessment of Trump and describes him as having Malignant Narcissism.

“Donald Trump is dangerously mentally ill and temperamentally incapable of being president,” Gartner said, citing his movements and behavior, pointing out the president’s tendency for grandiosity, sadism, aggressiveness, paranoia, and anti-social behavioral patterns. Trump, Gartner says, has "malignant narcissism," which is different from narcissistic personality disorder and which is incurable.

“We’ve seen enough public behavior by Donald Trump now that we can make this diagnosis indisputably,” Gartner added.

Gartner acknowledges that he has not personally examined Trump, but says it's obvious from Trump's behavior that he meets the diagnostic criteria for the disorder, which include anti-social behavior, sadism, aggressiveness, paranoia and grandiosity. Trump's personality disorder (which includes hypomania) is also displayed through a lack of impulse control and empathy, and "a feeling that people ... don't recognize their greatness.”

Indeed, the diagnosis fits the bill of Psychology Today’s definition of malignant narcissism, which, when described, sounds like Donald Trump almost to the letter. Carrie Barron, M.D., who wrote the magazine’s blog on Malignant Narcissism, says the disorder “renders these individuals scary, dangerous, and ruthless.”

Malignant Narcissists will go to great lengths to achieve their aim.  They can be intelligent, high functioning (hold an important job for example) soft-spoken, charming, tearful/seemingly emotional, gracious, well mannered, kind and have the ability to form relationships. They may lie, falsely accuse, dramatize, smear, cheat, steal, manipulate, accuse, blame or twist to get what they want and feel justified in doing so. Because they are entitled, egocentric and desperate, they do not experience it as wrong. They are determined to gratify their wishes and furious if thwarted. Their desire can be so consuming that there is little comprehension of, respect for or ability to empathize with the other.  They lack guilt or remorse and tend to feel or pronounce that it is they who have been mistreated.

Seth Davin Norrholm, Ph.D., has also addressed this issue regarding Trump in the Huffington Post article, Malignant Personality Disorder: An Interactive Checklist (2/2/2017).

In light of Donald Trump’s unprecedented behaviors during phone conversations with two of our closest allies and his continuing early-morning habit of tweeting out his pathology in the form of foreign policy, I have created this brief checklist describing the signs of one of the most severe expressions of personality as described by mental health professionals: grandiose/malignant narcissism. Perhaps this can serve as a guide as you evaluate what you see and hear from the new president.

✓Behavior... Real World Example
✓ Possesses an exaggerated sense of self-importance...”I alone can fix it”
✓ Acts as though privileged and entitled... Members Only
✓ Shows little empathy... Fake Tears
✓ Blaming own failures and shortcomings on others or circumstances... 3-5 Million Illegal Voters
✓ Attributes personal difficulties as being due to external factors
(i.e., not claiming responsibility)... Lousy Earpiece
✓ Critical toward others... Obama’s the Worst
✓ Extreme reactions in response to perceived slights or criticisms... (e.g., rage, anger, hostility)... Crowd Size Matters
✓ Little psychological insight into his own behavior... Sacrifices
✓ Reality distorting defenses... Alternative Facts
✓ Pathological self-esteem maintenance... Alternative Facts Part Deux
✓ Often becomes entangled in power struggles... One President at a Time
✓ Little care for moral values and manipulation of others... Stiffed
✓ Treats others primarily as his audience... Trump History Month?
✓ Believes conventional rules of conduct do not apply to him... Conflicted
✓ Persistently dismissive or arrogant...140 Characters at a Time
✓ Holds grudges/may dwell on perceived slights or insults for a long time... But it was a Landslide
✓ Portrays himself as a victim who is misunderstood or mistreated... Witch Hunt
✓ Little or no remorse for others to whom he caused harm or injury... No Regrets

The grandiose/malignant narcissist will go to great lengths to protect the identity and the world within which he operates…An increase in symptom severity or duration is more likely when the narcissist is surrounded by sycophants, family, and enablers.

In a Psychology Today article (8/21/2016), F. Diane Barth addresses When a Malignant Narcissist Starts to Unravel. She refers to information supplied by her colleagues, Dan Shaw and Preston Ni. This information is particularly disheartening.

Narcissistic individuals, such as those who view themselves as “supreme leaders,” demand “total submission and compliance” from those who fall under their domain…It can be difficult to move out from that position, because by doing so you threaten not only the person’s basic beliefs about himself, but also an underlying vulnerability that he has hidden from himself and from the world.

This kind of pathological narcissism is an attempt to hide from underlying vulnerability: “His delusion of infallible omnipotence, however, is his way of completely denying how profoundly unstable his mind really is.”

(Such a person becomes) like a living piece of shrapnel, exploding on everyone in his way. This kind of explosiveness can result when one’s already shaky internal stability is threatened. And it usually happens when the admiration and attention that provides some kind of balance for that person has dried up.

Fromm called such people malignant narcissists, people out of touch with reality who exhibit more and more extreme behaviors as the pressures of living up to their delusion of perfection mount, and as they inevitably become exposed to scrutiny and criticism. All too often, enraged by challenges to their fantasy of omnipotence, they lead followers on to acts of violence, against others or even against themselves… When it comes to political leaders, in the history of the 20th century, the extreme nationalistic narcissism that claims exclusive validity of one nation and the right to deny life and freedom to members of another, the mass murders perpetrated by dictators-- this horrific, tragic history is still being written and still being perpetrated.

Alarm appears appropriate at this stage. Trump has not yet been faced with an actual crisis. His objectives and tactics are already meeting with resistance even from within his own party, and he has not been handling this well.

What is Nancy Pelosi waiting for? What horror would Trump have to commit before she publicly challenges his fitness for office?