Trump’s Psychopathology and the Government Shutdown

-by Helen Klein

What is becoming increasingly clear is that despite Dr. Ronny Jackson’s gushing superlatives about Trump’s clean bill of health that extend beyond the physical, Trump’s personality make up and his mental/cognitive functioning are dead center in this shutdown mess. All arrows point to Trump. Now that the Republicans have hit a wall with Trump during the negotiations, even they are being forced to recognize his impairments in judgment and decision making, although of course they won’t do anything about it. They cannot help but realize with increasing disgust that they cannot control him, nobody can control him and he is one sick and crazy dude. Hello!

Is Graham going to make another about turn in his view of Trump? Compare his quote from February 2016, “I think he’s a kook. I think he’s crazy. I think he’s unfit for office,” to his quote in November 2017, “What concerns me about the American press is this endless, endless attempt to label [Trump] some kind of kook not fit to be president.” He may soon need to eat those words.

Dr. Jackson’s findings and conclusions regarding Trump’s recent physical were discussed in a DWT post a few days ago, The Physical, by this author.

Kurtz, who worked at The Post from 1981 to 2010, writes that Trump’s aides even privately coined a term for Trump’s behavior-- “Defiance Disorder.” The phrase refers to Trump’s seeming compulsion to do whatever it is his advisers are most strongly urging against, leaving his team to handle the fallout.

Dana Milbank, in his January 17 editorial in the Washington Post, “Is Trump’s Doctor Okay?” was “alarmed, not about the President’s health but the doctor’s.”

And not just his heart! The doctor rhapsodized about Trump’s vision, his stamina (“more energy than just about anybody”) and above all his mental acuity, which, Jackson made sure to note, he examined only “because the president asked me to.” Trump is “very sharp, and he’s very articulate... Very, very sharp, very intact... Absolutely no cognitive or mental issues whatsoever... The president did exceedingly well.”

From "The Physical:"

In conclusion, while Trump’s basic general health appears satisfactory, Jackson’s presentation of the findings leaves much to be desired and is alarming to many. His use of over the top superlatives was unwarranted and uncalled for. His conclusions about Trump’s mental, cognitive and language skills are well beyond that indicated from a routine physical and appear misleading, unethical, unprofessional and even untrustworthy. Unfortunately, Jackson gives the impression of being a political lackey rather than a professional doctor of medicine. This is worrisome. One wonders if there were any findings he is hiding.

On Twitter, Matt Taibbi from Rolling Stone and Matt Damon humorously questioned even the factual aspects of the findings.

Here are some excerpts from Gail Collins’ January 17 editorial in the New York Times, Donald Trump Gets His Sanity Grades:

Donald Trump has passed his mental test. This may come as either a relief or a shock.

But the big news was the mental test. Trump took something called the Montreal Cognitive Assessment and got a perfect score. Not perhaps the highest bar possible, unless you were concerned about whether he can identify pictures of animals and draw hands on a clock. But the test can be useful if there is, for some reason, concern that the subject is suffering from... um, dementia.

But about the president’s mental report. It didn’t measure judgment, and there was no score to indicate whether the test-taker would, if faced with a question of what to do about immigration policy, change his position 12 times in 24 hours. Whether he would confide to several million Twitter followers that the country “needs a good shutdown”? Whether he thinks of himself as a “very stable genius.”

Maybe Jackson could have given him a passing grade without going so far over the deep end. Something like: “Identified the camel picture, and no problems you could lock him up for.”

So here we are. Our current president is in O.K. physical condition and has “absolutely no cognitive or mental issues whatsoever.” The doctor says so. And really, he’s doing better than Woodrow Wilson, his jaw is intact and everything’s fine, unless you count a terrible attention deficit disorder and rampaging narcissism as mental issues. If so, they don’t come up on that test with the camel.

Up top you can watch Saturday Night Live's lovely skit about Dr. Jackson. Hopefully heron't be a recurring character.

Mental and cognitive issues and jokes aside, the bottom line in this shutdown mess is Trump’s psychiatric issues. These have been described in the media by a variety of professionals and were also reviewed in a previous DWT post. Concern in this realm is really nothing new, but it keeps getting buried in importance. Now it is raising its ugly head and is an unavoidable aspect of the mess we are in.

Trump has a mental disorder, Dr. Jackson. While an assessment along these lines is not part of a routine physical, you had no professional basis for any statement ruling this out.

Narcissistic Personality Disorder is a key player here, which Howard Dean noted last week on Lawrence O’Donnell’s The Last Word on MSNBC. Even a superficial glance at the designated features listed in the Diagnostic and Statistical Manual of Mental Disorders- Fifth Edition, the bible for mental health professionals, reflects a slam dunk for Trump – he meets all 9 features, well beyond the required 5 for the diagnosis.

Here is a refresher to remind everyone what we are dealing with:

Symptoms of Narcissistic Personality Disorder

The definition of NPD states that it comprises of a persistent manner of grandiosity, a continuous desire for admiration, along with a lack of empathy. It starts by early adulthood and occurs in a range of situations, as signified by the existence of any 5 of the next 9 standards (American Psychiatric Association, 2013):

• A grandiose logic of self-importance
• A fixation with fantasies of infinite success, control, brilliance, beauty, or idyllic love
• A credence that he or she is extraordinary and exceptional and can only be understood by, or should connect with, other extraordinary or important people or institutions
• A desire for unwarranted admiration
• A sense of entitlement
• Interpersonally oppressive behavior
• No form of empathy
Resentment of others or a conviction that others are resentful of him or her
• A display of egotistical and conceited behaviors or attitudes

A summary of the features is helpful:

The most important characteristics of NPD are grandiosity, seeking excessive admiration, and a lack of empathy. These identifying features can result in a negative impact on an individual’s interpersonal affairs and life general. In most cases, on the exterior, these patients act with an air of right and control, dismissing others, and frequently showcasing condescending or denigrating attitudes. Nevertheless, internally, these patients battle with strong feelings of low self esteem issues and inadequacy. Even though the typical NPD patient may achieve great achievements, ultimately their functioning in society can be affected as these characteristics interfere with both personal and professional relationships. A large part of this is as result of the NPD patient being incapable of receiving disapproval or rebuff of any kind, in addition to the fact that the NPD patient typically exhibits lack of empathy and overall disrespect for others.

Malignant Narsissism, while not an official DSM-5 category, zeros in on other factors affecting Trump’s recalcitrant stance and blatant unconcern about the shutdown. Trump has no conscience. He thrives on causing disorder, mayhem and destruction. He gets a kick out of others’ misery. Now he has the power of the Office of the President to create chaos on a YUGE scale. Sad to say, he may be finding this reinforcing. The only downside for him is that he had to miss the one-year celebration party in Florida. Naturally, this was held anyway to rake in lots of bucks.

Malignant narcissism is a psychological syndrome comprising an extreme mix of narcissism, antisocial behavior, aggression, and sadism. 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.

All Aboard! by Nancy Ohanian

This description is particulary noteworthy regarding Trump. He is certainly raising hostility levels, undermining our institutions and demeaning those around him.

To distinguish between narcissist and malignant narcissist:

A narcissist will deliberately damage other people in pursuit of their own selfish desires, but may regret and will in some circumstances show remorse for doing so, while a malignant narcissist will harm others and enjoy doing so, showing little empathy or regret for the damage they have caused.

Unfortunately, Trump appears to fit the latter description.

Furthermore, Eric Fromm, the social psychologist who coined the term Malignant Narcissism in 1964, described it as a “severe mental illness” representing “the quintessence of evil” and “the most severe pathology and the root of the most vixious destructiveness and inhumanity.” The British psychoanalysist, Herbert Rosenfield, decribed this condition as “a disturbing form of narcissistic personality where grandiosity is built around aggression and the destructive aspects of the self become idealized.”

Trump has never been held accountable for his behavior so why should he be now? Frankly, HE DOES NOT GIVE A SHIT. He has demonstrated over and over that he does not care about our country, our democracy, our institutions, the American people or the planet for that matter. He only cares about himself. He seems to enjoy denigrating others and take pleasure in their suffering. He is clearly a RACIST who has no compassion whatsoever for the Dreamers-- as far as he is concerned, they could be shipped back to whereever (aka their “shithole” countries). And he has Miller and Cotton, two evil anti-immigrant racists, whispering in his ear to keep him on track lest he be influenced in another direction. He has extremist minders keeping him in their clutches. They will likely hover at any future meetings.

A brief look at his behavioral history stemming from childhood is notable. He punched his second grade teacher in the face! His father sent him to military school because of his unruly uncontrollable behavior. He appears to have had Conduct Disorder, another DSM-5 category. Trump has always has been a bully who has bulldozed his way into adulthood using threats and intimidation. He has never kept his promises-- he has cheated a long trail of contractors and workers without the slightest guilt. He has shown no morality or ethics and a complete disregard for the law. And he has always gotten away with it! To him, scoffing at rules has been highly effective and this has become his M.O. He has NEVER been held accountable for his criminal shenanigans. What are a few fines here and there (e.g., $25 million for Trump University)? (One question that arises is - how has he managed to snub the justice system and the IRS for his extensive money laundering, which has apparently been going on for decades? This does not say much for our justice system).

Trump has a low bar for whom he associates with-- he is loyal to no one. All he cares about is how he will personally benefit from relationships. “He sucks up and shits down.” He was in bed with the Italian mafia for many years-- this is covered in a documentary film by the Dutch, for one-- and later with the Russian mafia for more than a decade. As Simpson from Fusion testified to the House Intelligence Committee, the Russian mafia, the Russian security services and the Russian government are all entwined and headed by Putin. Many Russians danced at Trump’s Inaugural balls. The extensive list of the folks surrounding Trump in the White House as well as many of his appointees SCREAM of Russia. Does he care one whit about being a traitor? He has shown over and over that he does not. He carries on about The Wall but not about Russian interference in our democracy, the greatest threat to our security in history. Trump admires Putin and loves Russia!

Trump is likely running around the White House rubbing his hands with glee about the shutdown. Too bad Wolff is no longer there to supply us with some juicy quotes. Trump has stated that what our country needs is “a good shutdown.” He loves confrontations. He loves blowing things up. He never backs down. He loves sticking it to others in the face. Malignant narcissism is written all over this. Putin must be laughing his head off. Trump has brought us down. He is destroying our government one tantrum at a time.

Trump does not even care about his positions on much of anything, which shift back and forth with the wind. This weekend Schumer said that negotiating with Trump is like negotiating with “Jell-O.” Even McConnell said he has no clue what Trump wants. Trump enjoys keeping everyone guessing and on tenderhooks. He is the all powerful, the master of the universe. His ego is on steroids.

His ignorance is YUGE. He does not read, he does not listen, he does not attend, he does not process. His speech is off topic and incoherent, a “word salad.” He makes Sarah Palin look like an orator. Trump may well have Attention Deficit Hyperactivity Disorder and a Language Disorder (some indications of a language disorder are reduced vocabulary (word knowledge and use), limited sentence structure (e.g., ability to put words and endings together to form sentences based on the rules of grammar) and impairments of discourse (e.g., ability to use vocabulary and connect sentences to explain or describe a topic or series of events).

Thus Trump appears to be a man with many clinical diagnoses. He thrives on chaos and consults only himself in the mirror, as he knows better than everyone. He has no idea of the costs, human or financial, of a shutdown that may continue for weeks. And as long as he does not personally have to pay for it out of his own pocket, he does not care. He continues to enrich himself on our dime. He is thrilled that there is a domestic crisis. He loves being the center of attention, and that he surely is. His delusions of grandeur are our reality.

It seems doubtful that Trump will back down or that the right wingers in the House will either.

In a January 17 piece, Trump’s Enablers Destroy Their Reputations for Nothing, Brian Buetler writes:

In this world, they (McConnell and Ryan) are too ineffectual and paralyzed by fear of Trump’s outbursts to negotiate with Democrats in good faith, even when they know they need Democratic votes to keep the government from shutting down.

After a year of abdicating their constitutional obligations on Trump’s behalf, he returns the favor by making routine governance impossible.

The precise mechanisms are different, but in one respect, they’re suffering the same fate as Graham. Like him, they put a career’s worth of political cache on the line for Trump without condition, and in both cases he flushed it unblinkingly down the shithole.

It seems we will be in shutdown mode for a long haul. I hope I am wrong.