Narcissistic Personality Disorder is a diagnosis that’s been tossed about a lot these days. Many mental health professionals have publicly stated that Donald Trump suffers from NPD. This is controversial because ethically we’re not allowed to give diagnoses to people we haven’t personally evaluated (that’s fair). And, once we’ve evaluated them, we’re silenced by the rules of patient confidentiality (also fair). But what we can do is look at people’s public behavior and see how it lines up.
What does NPD look like? Simply put, people who suffer from NPD believe they’re special, demand excessive admiration and demonstrate arrogance. They rarely have empathy and frequently exhibit aggression in close relationships. They also tend to be highly materialistic, self-promoting and impulsive, usually don’t learn from their mistakes, and often get into legal or disciplinary trouble.
This description makes it sound like narcissists are in love with themselves. Oddly enough, it’s actually the opposite. Narcissists need to think highly of themselves because, in reality, they’re quite self-loathing. They never feel truly loved nor do they know how to love; they’re hollow inside. They use other people for things like sex, money and emotional validation. Most of all, they use others for control so that they have some sense of power and don’t appear like the insignificant people they know themselves to be. It’s like everyone around them is holding up a mirror. If narcissists like what they see, everything is good. If they don’t, things can get ugly.
While all this sounds horrible, what is odd about people suffering from NPD is that they can be – and often are – 
charming, intelligent, witty, charismatic, talented and fun. In fact, given the strong desire of people with NPD for fame, fortune and power, many of them are found in high positions within politics, religion and business. Perhaps unsurprisingly, people with NPD can be master manipulators. They often show interest and appreciation for others, making people feel good, but it’s all in service of their larger agenda. Their charm enables them to draw people to them so that they will give them what they want but eventually people will figure it out. And if you cross them in some way? Then you need to watch your back.
So, what about Donald Trump? Well, his public behavior certainly meets every criteria for NPD. However, this could merely be a role he’s playing. Let’s hope that it is because, if it isn’t, then we have someone truly dangerous at the helm of our country. But if he does, in fact, suffer from NPD, then here’s what we can expect. He will constantly promote himself. Narcissists must remind people of their significance, so get used to hearing about how great he is. He will be impulsive, like tweeting ridiculous accusations that are easily disprovable. He won’t do anything that isn’t completely in his own self-interests (no empathy, remember?). The needs of the American people, avoiding conflicts of interest, providing transparency, and doing what’s right will hold no appeal because there’s nothing in it for him.
Narcissists feed off of people who suck up and tell them what they want to hear, so any negative feedback will result in either aggression or dismissal. Thus, we should expect those who make unfavorable comments to be punished in some way. The press corps isn’t there to make people feel good, so they will become enemies. Remember that photo op of his dinner with Mitt Romney? That could’ve been payback for Romney’s negative statements about Trump before the election. Republican members of Congress who thwarted Trumpcare also should look out.
On the flip side, people who recognize his need for approval and hold up a positive mirror will become trusted advisers because they give him what he desperately needs. I imagine Ivanka and Jared Kushner are masters at this. They probably present their agenda in such a way that he’ll respond, like by suggesting people will love him if he does it, insinuating it will be make him look good, or implying it will antagonize his enemies. Since people with NPD don’t tend to learn from mistakes, if anything goes badly, we can expect that he will double down instead of admitting defeat or simply moving on. This could be what is behind his continued insistence on the large inaugural crowds and on the Obama wiretapping claims.
People suffering from NPD need admiration, especially from those deemed worthy. As such, we should expect Trump to seek out the adulation of not only roaring crowds but also of people he admires. These will be people who are in high positions or who have demonstrated strength and success at getting what they want. You know, people like Vladimir Putin. We would do well to remember that the “worthy” won’t be Nobel Laureates or people who cure disease because it’s not the actual accomplishment that matters, it’s the attention. That’s why narcissists are obsessed with fame and celebrity. Thus, we can anticipate more “surprise” visits to White House tourist groups and the trotting out of any celebrity willing to interact with him. And the Trump rallies won’t go away anytime soon.
We should expect Trump to find people he can control. Those who refuse to do his bidding will quickly find themselves on the outside, replaced by those who will give him what he wants. It’s probably no coincidence that he’s been married three times (Ivana Trump was undoubtedly history once she showed herself to be a good independent business woman) and there have already been personnel shakeups in the White House. There will be more because there’s a huge emphasis on loyalty, almost to the exclusion of all else. Many will find that difficult. Sean Spicer’s loyalty looks to be killing him.
Remember how narcissists are, at heart, self-loathing? Well, this deep fear of not being good enough can be scary because it often leads to dependency on the wrong people. Narcissists don’t trust based on competence, intelligence or experience (the criteria you want in making high level decisions). No, they trust based on loyalty and those viewed as extensions of themselves. For Trump, that will mean Ivanka and Kushner are the only ones he truly trusts. This could explain their vastly increased roles – Kusher in particular suddenly seems responsible for everything – and Steve Bannon’s demotion from the National Security Council. Everyone in the administration should be warned that official position won’t matter. If Reince Preibus thinks he’s going to be incredibly powerful, he’s in for a rude awakening.
Since I’ve never met the man, I can’t say for certain whether Donald Trump suffers from NPD. However, his public behavior sure makes it look as though he does and that’s pretty terrifying, especially when you consider what’s still to come. One of the problems with narcissists is that things tend to be fine while there aren’t many challenges to their sense of self. But once the mirrors start reflecting numerous negative images (as is inevitable for a job like POTUS), then the shaky self-image starts to disintegrate. This can lead to depression, paranoia and emotional withdrawal. They also act out and, because there’s a lack of empathy, they don’t care about the consequences. In other words: disaster. So let’s hope Trump is playing a role. But either way, fasten your seatbelts; it’s going to be a bumpy ride.