Sorry DSM: Trump Really Is Crazy

Yes, he is frightening, but Donald Trump is also fascinating and intriguing. Who is he? How does he think? Why does he do the strange things he does?

In an earlier essay, I asked the question: what political archetypes or historical figures can best help us understand the mind and the behavior of President Donald Trump? Can we best understand him as The Donald, a crass New York wheeler-dealer? As a divine-right King, like Henry VIII? As a Mafia Don? As Donald Trumpanovich, the oligarch-wannabe?

Yes. Yes to all of the above. The shoes all fit. And yet we still don’t really know him, nor can we comfortably predict his behavior.

That is because one important piece is still missing: his mental illness.


My conclusion is that one can only understand Donald Trump if you see him as The Poster Child for Narcissistic Personality Disorder. On a scale of one to ten, Donald is a perfect ten. In golf terms, he’s ten under par. In beauty-contest terms, he’s Ms. World.

Too bad I’m wrong.

As I cruised around on the Net to inform and illustrate my profile of President Donald Trump, I came across a Letter to the Editor that spoiled my conclusion.

The letter was written to the New York Times on February 14, 2017. The author was Professor Emeritus Allen Frances of Duke University Medical College. Professional Frances is a Psychiatrist, and not only that, he chaired the task force that wrote the bible of psychiatry: the Diagnostic and Statistical Manual of Mental Disorders. Simply put, you cannot label someone as mentally ill unless you can point to chapter and page in the DSM.

Professor Frances wrote:

He may be a world-class narcissist, but this doesn’t make him mentally ill, because he does not suffer from the distress and impairment required to diagnose mental disorder. Mr. Trump causes severe distress rather than experiencing it and has been richly rewarded, rather than punished, for his grandiosity, self-absorption and lack of empathy. It is a stigmatizing insult to the mentally ill (who are mostly well behaved and well meaning) to be lumped with Mr. Trump (who is neither).

In other words, if Donald Trump is not bothered by his narcissism, then he is not mentally ill. To call him mentally ill is an insult to people with NPD who realize it is a problem in their life and want to change themselves.

OK, so Donald Trump is not crazy. He’s just a world-class Narcissist who makes other people feel crazy.

Another Professor — of Psychology at Northwestern University — penned a portrait of Trump for the The Atlantic. Prof. Dan McAdams agrees with me that Trump is a Narcissist and adds that Donald’s main goal in life is “to win.” Our President fits the “Warrior” archetype. Every conflict is a battle; every battle must be won — and you win by never admitting defeat. Karl Rove adds the insight that when this Warrior actually appears to lose, he still triumphs by proclaiming “It’s not my fault, it’s your fault.” (Fox Business, June 6, 2017)

The American Psychiatric Association (whose members write and revise the DSM) tells us that there are 10 different “personality disorders.” These disorders can be grouped into clusters. Cluster A includes people who mainly manifest “odd or eccentric behavior.” Cluster B covers those with “dramatic, emotional or erratic behavior.” Cluster C picks up those with “anxious or fearful behavior.”

I believe that Donald Trump is so unique that he deserves his own cluster: Cluster D. Here are the hallmarks of Cluster D:

· Greatly admires himself

· Expects and requires constant admiration from others

· Regularly exaggerates his accomplishments

· Lies, lies about lying

· Insults or undermines anyone who challenges or criticizes him

· Is jealous of others, and thinks that people are jealous of him

· Has no compunction about cynically using others to achieve his goals

· Rewards others only when it serves his own self-interest, or when compelled by a judge

· Lacks empathy, but occasionally pretends to be empathetic or sympathetic

· Has no other long-term goal beyond self-aggrandizement

· Experiences great anger when frustrated

· Never apologizes, never admits that he might be wrong about any action or statement

· Sees women as ornamental

· Sees men as either potential rivals or inferior minions, but…

· Admires a handful of men who appear to have king-like power

Yes, Donald Trump is the quintessential Narcissist, but he is also sui generis, meaning so unique as to defy comparison with anyone or anything else. When Prof. McAdams attempted to write Donald’s “psychological portrait,” the only other person he could imagine as being similar was Steve Jobs. Unsuccessful megalomaniacs are a dime a dozen, but successful ones are exceedingly rare.


Since I love my iPhone, I can appreciate that narcissists can sometimes accomplish great things. This will not be the case with Donald Trump.

Toss the psychiatrists aside. Donald Trump is a very sick man. His thinking is so distorted that, as our President, he is a tremendous threat to every person on the planet.

You cannot understand President Donald Trump unless you realize that he only cares about one person in the entire world: himself. Nothing and nobody else matters. Not even Ivanka, who he sees as an extension of himself. A staggering Narcissist, he is in constant search of “narcissistic supply,” which means constant praise and admiration. This is his addiction, and it must be fed every day, every hour.

The television and the small screen are the pools in which this Narcissist admires himself. If they don’t reflect back with total adulation, he becomes dangerously unsettled. No domestic or global crisis means as much to him as the crisis caused by personal criticism and perceived failure.

It has been said that no one truly knows Donald Trump. This may include Donald Trump himself. To begin to understand himself, Donald would have to adopt the mental trick of standing outside himself, of being self-observant. Not Happening.

One person who stood a very good chance of understanding Donald Trump is Tony Schwartz, the man who spent a year hanging out with him in his office and in the field. He wrote The Art of the Deal by jotting down what Trump said to others and said about himself. Trump got the final cut, and took out anything that might unburnish his image, so it is fairly reasonable to allow Trump to claim to be the author.

For a period of time, Schwartz spent more time with Trump than anyone else, including family. His recent Washington Post takeaway on Trump is devastating:

Early on, I recognized that Trump’s sense of self-worth is forever at risk. When he feels aggrieved, he reacts impulsively and defensively, constructing a self-justifying story that doesn’t depend on facts and always directs the blame to others.

The Trump I got to know had no deep ideological beliefs, nor any passionate feeling about anything but his immediate self-interest. He derives his sense of significance from conquests and accomplishments.

Trump can devolve into survival mode on a moment’s notice. Look no further than the thousands of tweets he has written attacking his perceived enemies over the past year. In neurochemical terms, when he feels threatened or thwarted, Trump moves into a fight-or-flight state.

No importuning by his advisers stands a chance of constraining him when he is this deeply triggered. The more he feels at the mercy of forces he cannot control — and he is surely feeling that now — the more resentful, desperate and impulsive he becomes.

So there you have it. None of the historical figures or archetypes can encompass Donald Trump. He is a unique person on the world stage, and we have to try to understand him in order to restrict — and hopefully end — his period of political power.

By Adam Corson-Finnerty

October 24, 2017

Adam Corson-Finnerty is a writer and Democratic activist who believes that Trump should be impeached. He lives with his wife and six cats in Bucks County, Pennsylvania.


Trump Resister, Grandfather, Environmentalist, Feminist, Quaker.