If Donald Trump were your patient, how would you evaluate his behavior over the last year or so? Is Donald Trump’s behavior devolving, as predicted by the medical literature?
Yes, but in ways that I think are even more ominous than when we spoke almost a year ago. Trump is a malignant narcissist. Erich Fromm, the noted psychoanalyst who studied Nazi Germany — and the person who introduced the diagnosis of “narcissism” — explained that in such personalities their grandiosity, their narcissism, their paranoia, conspiracy theories, sociopathy, criminal behavior and sadism all go into overdrive when they get power. Those traits are also inflamed when a narcissist is challenged or attacked.
And there is a feedback loop as well, where because they’re gaining power — which inflames their narcissism and their paranoia and their freedom to act on their criminal impulses — of course that means there will be opposition and resistance to them. Narcissists like Donald Trump then demonize and try to brutalize and invalidate anyone who does not kiss his ring. Trump has systematically eliminated every single guardrail on his power and behavior in the White House.
There is literally nobody, not one person, who can tell him “no” right now, intervene against him. But there is another element to Trump’s dangerous behavior that we should be paying very close attention to. I believe that Donald Trump is having a hypomanic episode.
Many reporters and journalists have described Trump’s recent behavior as manic. Concerned observers highlight Trump’s tweets, which have greatly increased in number.
A hypomanic episode is not the same as a manic episode. “Manic” is only partially accurate in describing Donald Trump because when somebody is manic, they think they’re Jesus Christ, which means they are psychotic and usually end up in the psychiatric hospital. But when someone’s hypomanic, they become more agitated, more energized, more impulsive. They act out more aggressively with poorer judgment. A hypomanic person does not listen to anybody. They do not delay their activity. They do not accept feedback from anybody else.
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