I recently wrote an editorial making the case that Donald Trump scores extraordinarily high on political scientist Lawrence Britt’s fascism scale.

Since that piece published, Trump’s longest-serving chief of staff, General John Kelly, publicly agreed he meets the definition of a “fascist.”Mark Milley, retired army general and former chair of the Joint Chiefs of Staff under Trump, told journalist Bob Woodward that Trump is “fascist to the core.”

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Since his entry into the presidential sweepstakes in the summer of 2015, political historians and pundits have described Trump’s statements and actions with terms like “unprecedented,” “abnormal,” and “surprising.” They’ve described him as “breaking norms,” “going against traditions” and “standard practices,” “violating rules,” “a disrupter” and a “street fighter.”

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Whenever we think Trump can’t go any deeper into his distorted sense of the world, he always stuns, placing our country in greater and greater danger.

Jeffrey Goldberg’s article in The Atlantic in 2020 exposed further broken ground in Trump’s inexorable excavation to the bottom. Goldberg detailed Trump’s utter contempt for the U.S. military and the personnel who risk everything for love of country. Trump referred to these people as “suckers” and those caught or killed by the enemy as “losers.”

This might not be as serious had Trump remained in his golden tower on Fifth Avenue, filling out additional Chapter 11 bankruptcy forms. In his role as the dysfunctional Commander in Chief, though, the pain and suffering to Gold Star and Blue Star families and the hit to military morale ultimately impact us all. 

Though Trump’s conduct is certainly unprecedented and surprising in the annals of presidential history, when examined under the psychological lens of personality disorders, it comes into clear focus.

Trump’s place in the DSM

One does not need a Ph.D. in psychology to identify Donald Trump as someone suffering from personality disorders. He clearly manifests many, if not all, of their symptoms.

The American Psychiatric Association (APA) defines a personality disorder as: “…a way of thinking, feeling and behaving that deviates from the expectations of the culture, causes distress or problems functioning, and lasts over time… Without treatment, the behavior and experience is inflexible and usually long-lasting. The pattern is seen in at least two of these areas: way of thinking about oneself and others; way of responding emotionally; way of relating to other people; way of controlling one’s behavior.”

APA enumerates 10 specific types of personality disorders organized under three categories or “clusters.” Most associated with Donald Trump are two disorders within Cluster B’s “dramatic, emotional, or erratic behavior,” summarized as:

Antisocial (a.k.a. Sociopathic) Personality Disorder 

Someone who repeatedly discounts or infringes on the rights of others and is unreliable. A person with antisocial personality disorder often violates social norms and rules, constantly and pathologically lies, manipulates, cheats, betrays others, acts rashly or impulsively, lacks remorse, shame, and guilt, needs constant emotional and physical stimulations, is often paranoid, and acts as an authoritarian.

Narcissistic Personality Disorder

According to Greek legend, a young man was so fascinated and awestruck by his own image reflected on the surface of a pool that he sat lovingly gazing at the water’s edge for so long that he succumbed to his own vanity and eventually transformed into a flower that carries his name: “Narcissus.”

In its Diagnostic and Statistical Manual II (DSM), the APA lists “Narcissism” as an emotional problem and “Narcissistic Personality Disorder” (NPD) with a number of characteristics. These include:

·       An obvious self-focus in interpersonal exchanges

·       Problems in sustaining satisfying relationships

·       A lack of psychological awareness

·       Difficulty with empathy

·       Problems distinguishing the self from others (having bad interpersonal boundaries)

·       Hypersensitivity to any insults or imagined insults

·       Vulnerability to shame rather than guilt

·       Haughty body language

·       Flattery towards people who admire and affirm them

·       Detesting those who do not admire them

·       Using other people without considering the costs of doing so

·       Pretending to be more important than they actually are

·       Bragging and exaggerating their achievements

·       Claiming to be an “expert” at many things

·       Inability to view the world from the perspective of other people

·       Denial of remorse and gratitude

And yet, Trump has not transformed into a beautiful, fragrant flower.

Alarm bells

Two years into his presidency, a distinguished group of leading mental health clinicians, researchers, and practitioners sounded the alarm, saying it was their duty to report the clear and present dangers to the Trump’s personality disorders posed to the body politic.

The group published a book titled The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President as part of their “duty to warn” of the dangers posed and enacted by then-President Trump. Instead of retaining extreme power, they said, Trump requires care and treatment so he no longer poses so much danger to himself and the world.

Reporter for The Bulwark, Tim Miller has said, “Donald Trump checks all the boxes of a person with narcissistic personality disorder, but the mainstream press goes out of its way not to cover his apparent pathologies — and ends up normalizing them.”

On his podcast in August, Miller interviewed George Conway, Board President of the Society for the Rule of Law and President of Anti-Psychopath PAC. “He is a quintessential narcissistic sociopath, and with that, you understand essentially everything about him,” said Conway. “You understand his racism; you understand his misogyny; you understand his authoritarianism; you understand his criminality; you understand his erraticness: Everything about him, once you understand his personality type.”

Within the social climate of the United States, the stigma regarding emotional and mental disorders has diminished somewhat over the past few decades. Some individuals who have the means to afford treatment actually boast about it, or at least no longer feel the shame that others have experienced in seeking help.

I once felt this shame and lived in the shadows that others might discover my diagnoses in the areas of psychological disorders. Though I have sought treatment for over 40 years, only during the last decade or so have I “come out of the closet” in talking with others about my post-traumatic stress disorder, moderate agoraphobia (fear of leaving my home, fear of open spaces), social stress disorder, bulimia, and misophonia (certain sounds – eating sounds, some consonants in spoken words – trigger extremely negative emotional or physiological responses).

With years of psychological therapy, today I lead a relatively good and productive life. But I have also never been the President of the United States.

Donald Trump’s documented disorders, however, make clear that his motivation to attain the highest office in the land is based on enriching his personal fortune and status, and his current run is motivated by his desire to stay out of jail for the serious criminal charges directed against him.

Trump’s grifting was evidenced by his attempt to pressure the British to sponsor its national golf tournament at his Scottish golf course and resort; by attempting to hold a G-7 conference at his Mara-Logo resort; by giving massive tax cuts to himself and his wealthy friends; by pushing for severe relaxation of environmental quality and fair trading standards to benefit corporations and industry at the peril of our climate and health; by engaging in nepotism in hiring family members; by flagrantly violating emoluments laws; by his alleged “mishandling” of campaign and inaugural funding and by hiding this by never exposing his tax forms.

His so-called “America First” policies act as a veritable political agoraphobia, isolating our nation from the remainder of the world and separating us from our strong former alliances. Trump’s narcissistic sociopathic personality disorder, along with his inability to feel empathy and his general incompetence also resulted in needless deaths during the pandemic.

Who is America?

Political pundits have predicted Trump’s political demise many times. They keep saying something will bring him down, from his misogynistic “Access Hollywood” statements to his saying John McCain is not a war hero because he was captured to his denial on the stage in Helsinki directly next to Vladimir Putin that the Russians did not interfere in the 2016 presidential election to referring to some neo-Nazi white supremacists as “good people” to failing to acknowledge and call out the Russians for placing bounties on our military personnel to calling members of our armed forces “suckers” and “losers.”

How did Trump, someone who clearly suffers from serious personality disorders, garner enough support from the electorate in 2016 to have vanquished 16 Republican candidates and his Democratic challenger and win the right to occupy the most important and powerful position in the world?

Does Trump’s meteoric ascendancy reflect a collective narcissistic sociopathic personality disorder in the broader U.S. body politic?

Is there a line over which his supporters will not cross as he descends further into the abyss? The upcoming election may answer these questions.

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