Five years ago, as Trump was beginning his presidency, I read a bunch of articles from psychs and pseudo-psychs on their “duty to warn” about his narcissistic personality disorder . . . his DSM categorized insanity if you will. I did what I usually do – I found out who edited the journals on personality disorders and who the leading expert was.
Turns out, the top gun on narcissistic personality disorders is a guy named Allen Frances. Wikipedia describes him as “currently Professor and Chairman Emeritus of the Department of Psychiatry and Behavioral Sciences at Duke University School of Medicine. He is best known for serving as chair of the American Psychiatric Association task force overseeing the development and revision of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Frances is the founding editor of two well-known psychiatric journals: the Journal of Personality Disorders and the Journal of Psychiatric Practice.”
Frances figured that Trump may well be a narcissist, but that he doesn’t have a narcissistic personality disorder – that the disorder has to include distress or impairment. Not pain for other people, but pain for the person with NPD. In https://www.statnews.com/2017/09/06/donald-trump-mental-illness-diagnosis/ Francis writes “Trump is an undisputed poster boy for narcissism. He demonstrates in pure form every single symptom described in the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for narcissistic personality disorder, which I wrote in 1978. But lots of successful people are extremely narcissistic without being mentally ill — think most celebrities, many politicians, and a fair percentage of writers, artists, lawyers, doctors, and professors. To qualify for narcissistic personality disorder, an individual’s selfish, unempathetic preening must be accompanied by significant distress or impairment. Trump certainly causes severe distress and impairment in others, but his narcissism doesn’t seem to affect him that way.”
Okay – I suspect being narcissistic helps folks achieve the presidency – but let’s look at what the criteria are in DSM: https://www.mayoclinic.org/diseases-conditions/narcissistic-personality-disorder/symptoms-causes/syc-20366662
Signs and symptoms of narcissistic personality disorder and the severity of symptoms vary. People with the disorder can:
- Have an exaggerated sense of self-importance
- Have a sense of entitlement and require constant, excessive admiration
- Expect to be recognized as superior even without achievements that warrant it
- Exaggerate achievements and talents
- Be preoccupied with fantasies about success, power, brilliance, beauty or the perfect mate
- Believe they are superior and can only associate with equally special people
- Monopolize conversations and belittle or look down on people they perceive as inferior
- Expect special favors and unquestioning compliance with their expectations
- Take advantage of others to get what they want
- Have an inability or unwillingness to recognize the needs and feelings of others
- Be envious of others and believe others envy them
- Behave in an arrogant or haughty manner, coming across as conceited, boastful and pretentious
- Insist on having the best of everything — for instance, the best car or office
At the same time, people with narcissistic personality disorder have trouble handling anything they perceive as criticism, and they can:
- Become impatient or angry when they don’t receive special treatment
- Have significant interpersonal problems and easily feel slighted
- React with rage or contempt and try to belittle the other person to make themselves appear superior
- Have difficulty regulating emotions and behavior
- Experience major problems dealing with stress and adapting to change
- Feel depressed and moody because they fall short of perfection
- Have secret feelings of insecurity, shame, vulnerability and humiliation
And I can’t help wondering if it doesn’t take an exaggerated sense of self-importance to even think about running for president? I mean, I could probably do a better job than Joe Biden, but I don’t believe I would be a good president. Still, when I look at that list from Mayo, I see some behaviors that fit Biden. Carter and Bush not so much – but there’s been a hell of an ego in each of our last 3 presidents.
Getting back to Frances – “ lots of successful people are extremely narcissistic without being mentally ill — think most celebrities, many politicians, and a fair percentage of writers, artists, lawyers, doctors, and professors.” And that gets me to the question: Why did a bunch of psychs decide to diagnose Trump but not diagnose Biden? Biden has a pretty good record in the category of “react with rage or contempt and try to belittle the other person to make themselves appear superior.” From my perspective he merits the public psych definitions as much as Trump did.
Fortunately, I’m a sociologist and demographer – DSM isn’t my bible. Still, it seems to me that, when Allen Frances points out that “lots of successful people are extremely narcissistic without being mentally ill — think most celebrities, many politicians, and a fair percentage of writers, artists, lawyers, doctors, and professors” maybe we need to look at narcissism as a qualifying politicians to run for office – and believing that you’re the best person to run the United States may require a huge level of narcissism.
On the other hand, having the supreme narcissist in Washington DC is probably better than having him just down the road.