Why this clinical psychologist is now sounding the alarm about Trump’s disturbing pathologies

"Trump’s malignant narcissism is at a different level"

Published August 13, 2020 6:45AM (EDT)

 U.S. President Donald Trump speaks during an event with citizens positively impacted by law enforcement, in the East Room of the White House on July 13, 2020 in Washington, DC. The president highlighted life-saving actions by law enforcement officers and cited these examples as a potential negative effect that defunding the police would have on the lives of Americans. (Drew Angerer/Getty Images)
U.S. President Donald Trump speaks during an event with citizens positively impacted by law enforcement, in the East Room of the White House on July 13, 2020 in Washington, DC. The president highlighted life-saving actions by law enforcement officers and cited these examples as a potential negative effect that defunding the police would have on the lives of Americans. (Drew Angerer/Getty Images)

This article originally appeared on AlterNet.

Dr. Alan Blotcky is a practicing clinical psychologist in Birmingham, Alabama, where he works in private practice to diagnose and treat a variety of mental health conditions and disorders. But he's recently been speaking out to join the group of mental health professionals raising alarms in public about President Donald Trump's behavior, arguing that insights from their profession are vital to understanding his condition and his inability to function adequately as a national leader.

In a piece for DC Report last month,  Blotcky state his conclusion starkly: "Trump is incapable of being our pre-eminent public servant because he has malignant narcissism."

"I have not met and interviewed Trump," he acknowledged. "But I have had access to his statements, speeches, tweets, recordings, pictures, documents and much more. Books and articles have weighed in as well."

To better understand his assessment of the president and the role he thinks mental health professionals can play in politics, I interviewed Blotcky over the phone. What follows is our conversation, lighlty edited for length and clarity.

Cody Fenwick: What do you think a clinical psychologist like yourself can bring to the public understanding of Trump that isn't evident to the reporters and other observers who watch him every day?

Alan Blotcky: I think the lay public is not very sophisticated when it comes to psychological things. And I'm not dissing the public, I just think most people don't know the difference between normal and abnormal, and degrees of abnormal. So I think what psychologists and other mental health professionals can bring is vital context in understanding the severity of what we're seeing.

The term "narcissist" is used in the public now in a variety of ways, but Trump's malignant narcissism is at a different level. I've heard some people out there say: 'Well, all politicians are narcissistic.' There may be some truth to that. But not all politicians have malignant narcissism.

So I think what mental health professionals, psychologists, and I can do is help people understand that this is severe. This is beyond everyday narcissism. This is a severe psychiatric disorder.

Some people have criticized the contribution of psychologists in the discussion of Trump because they fear it may stigmatize mental health, or mental illness, and people seeking out mental health care. Do you have any fears about that at all?

No, not at all. I think that's a red herring, myself. Everybody that has a psychiatric disorder is different. And there are tens of dozens of different psychiatric disorders. So we're not casting a everybody in the same light, and we're not suggesting that.

I guess that gets a little bit into the Goldwater Rule, [which bars mental health experts from offering professional opinions on public figures]. The Goldwater Rule was established back in the 1960s by the American Psychiatric Association. I think many psychiatrists probably abide by that. 

But then there's the counterbalance which is the duty to warn. The duty to warn says if you see a mental health problem or problems that impact people in society, then you have a duty to talk about that and bring that out into the open. Which is what I think a lot of us are trying to do.

I'm not worried about stigmatizing people, because everybody is different. The disorder, or disorders, that Donald Trump has is very different than if you have depression, or anxiety, or even schizophrenia or bipolar disorders. Those are very different kinds of illnesses. And one of the ways they're different is they respond to medication. Donald Trump's problems don't respond to medication.

So how would you characterize the key features of his "malignant narcissism"?

He's what I would describe as somebody who has a personality disorder that has narcissistic and anti-social features. I think he has both of those. 

Look, I think it's the same thing that you've read about and reported about; there's really nothing new about that. It's a stable, constant, entrenched problem. It doesn't come and go. It's not going to magically disappear. It's a part of him. It's who he is, and he needs treatment for it.

The primary features? Grandiose self-image, dishonesty, impulsivity, his tendency to scapegoat and to gaslight. All of those features that have been talked about in the press are exactly accurate. It's just that I don't know if the public as a whole appreciates the fact of how problematic it is and how severe it is.

I think Trump wants to be a dictator. He would like to be in an autocracy, not a democracy. And that's a direct reflection of his narcissistic and anti-social personality disorder. And that's part of what I'm concerned about. If he were to be re-elected, he would be empowered and emboldened to do what he wants to do. And he would literally push this [country] towards an autocracy and a dictatorial position for himself.

Has there been any of his recent behavior, in particular, that has concerned you?

You know what? You'll have a field day. Every time he opens his mouth now — it's lies, projections, gaslighting. I mean, everything he says. [His recent] comments that Biden is going to get rid of the Bible and hurt God. Every comment he makes like that is how dishonest he is. And his gaslighting is unbelievable.

Yeah, I found that comment particularly noteworthy and interesting. He says a lot of stuff, but it's so ridiculous and over-the-top that no one could actually believe that. So who's he actually trying to convince of that?

I think part of the problem with Trump is he's been around now for four years. I'm afraid that his craziness is becoming normalized. In other words, people just sit back and say: 'Oh that's Trump, what's the big deal? Let's just keep going.'

Well, that's not the way he should be. It's not normal, it's not healthy, it's not OK for our country. And it shouldn't become normalized. We shouldn't become desensitized to it. That's where a country can get into problems. 'Let's just re-elect him 'cause we sort of know who he is, and he may be crazy, but he's OK.' Well, no, he's not OK. It can't become normalized. It can't become that that's the new definition of what our president should be. Not at all.

Do you think some of his pathologies have had a role in how the coronavirus pandemic has played out?

Oh my God. In my opinion, his inaction, his denial, his willful inaction to deal with the pandemic, by itself, disqualifies him to be president, in my mind. He thinks he can just say: 'Everything's going to be OK, don't worry about it, and everybody just sit back and do what they want to do.' And it's so contrary to the data and the science. He has pushed way the public health experts. They should be guiding this ship, not Donald Trump's gaslighting. 

In my mind, honestly? I think his handling of this has been criminal. I really think he should be criminally charged for accessory to mass murder. Because he's sitting back and absolutely doing nothing while tens of thousands of Americans are dying. And I think his handling of this pandemic is a prime example of how his pathology has gotten in the way. And it's totally unacceptable because it's causing deaths. We're no better off than we were in March.

So how would you say pathology has affected the response? Because of his narcissism, he can't accept that he's done anything wrong?

Right. He can't accept that anything's wrong. He won't listen to anybody. He thinks he's the smartest person. He thinks he has all the answers. And he's a showman. He thinks he can just convince the public that everything's OK. 'Let's just open up the economies, and everybody will believe it. Just keep going. Who cares if we lose 200,000 Americans? Nobody will notice if I just keep telling them it's not a problem.' That's the kind of attitude he has! Instead of being a president, where he should have taken decisive nation steps to defeat this pandemic.

I know this would drive him crazy, but Barack Obama would have handled this thing months ago. And we would have been in far better shape.

I certainly think that's true, but one thing you could say is: It's a hard problem. Solving a national response to a pandemic is a hard problem, so that could be a mistake that anybody who's not good at being president could make. But you seem to be saying that …

Look, you check this out. Did he not do away with the pandemic office before? He was warned that pandemics were a serious problem to be on the watch for. He was notified of it in 12 different meetings I think, in January and February. And he did aboslutey nothing except deny it and deny it, and deny it. So that's him, and his pathology.

You know why he denied it? Because he knew that the economy would suffer and he didn't want the economy to suffer. Because he wants to be re-elected. So it was all about him and his re-election chances. And he didn't want the public to be upset about that, so he tried to sweep it under the rug, hoping that it would go away. And here we are six months later, and he's still not doing anything except denying it, denying it, denying it.

It seems like he thinks he can will his preferred reality into existence just by repeating it over and over.

And that's what magical thinking is. That's the definition of magical thinking. You think if you have the thought, it will magically happen. If you say the words, it will magically happen. That's magical thinking.

That's like what little babies do, that's what little children do. That's not what an adult president of the United States should do.

And that's a component of his malignant narcissism?

Yes. That's a component of his narcissism. He's so grandiose, and he's so self-absorbed, he thinks that if he wants something to happen, it will just happen. He'll make it happen. If he says the words, people will do it. And that's just not reasonable, reality-based, adult kind of thinking.

Yeah. Another way you could describe it is that it's just immature. Is it a kind of arrested development?

Yeah. It's a kind of — we use the term 'primitive.' But that means basically very young, like he didn't develop properly. He was raised in a horrific kind of family environment. And I think you can trace a lot of this back to his family.

The problem is, Donald Trump never thinks he has any problems, issues, or anything, so he doesn't get help. He's like in a cocoon. And I think he' s probably just surrounded by a few isolated sycophants who tell him what he wants to hear. And that's who he has lived his life.

He really has developed this alternative universe in his head. And he lives in that alternative universe. And he thinks, because of magical thinking, that if he thinks that way, it'll just happen that way. And it doesn't. 

So I think his handling of this pandemic, really — I'm not a lawyer — but I think it's criminal. And it certainly disqualifies him to be president again.

By Cody Fenwick

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Clinical Psychologist Donald Trump Dr. Alan Blotcky Malignant Narcissism