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‘A Failure to Develop an Inner Sense of Worth or Self-Esteem’
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‘A Failure to Develop an Inner Sense of Worth or Self-Esteem’

Part 4 of Our ‘Inside the Mind’ Series: A Leading Psychiatrist Takes a Detailed Look into Trump’s Narcissistic Pathologies 

Mary Trump’s book, Too Much and Never Enough: How My Family Created the World’s Most Dangerous Man, is an extraordinary account from the perspective of a family member of the president who happens to have the rare insight of a clinical psychologist.  Her conclusions complement and confirm those of thousands of mental health experts who have also come forth about a U.S. president in historically unprecedented ways.  Dr. John Zinner, one of those psychiatrists, is also a leading psychoanalyst and clinical professor at the George Washington University School of Medicine, who previously served in the U.S. Public Health Service and as the former head of the Unit on Family Therapy Studies at the National Institute of Mental Health (NIMH). 

For this, Part 4 of our series, “Inside the Mind of Donald J. Trump,” Zinner was interviewed by Bandy X. Lee, a Yale forensic psychiatrist and a frequent contributor to DCReport. She is the editor of The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President.

Lee: You researched and published about severe narcissistic disorders at the NIMH and identified these traits in the president from the start.  What are their most important features, and which descriptions did you find most salient in Dr. Mary Trump’s accounts? 

Zinner: At the present time, we in the United States are experiencing an unspeakable tragedy.  More than 165,000 of us have died in the past six months, countless numbers of us are or have been ill, tens of millions are unemployed, millions are in danger of becoming homeless.  We are being struck by a “perfect storm,” a combination of a deadly pandemic combined with an utter failure in leadership by the very person who should have been in charge of preventing this terrible national emergency.  Donald Trump has failed us because he is, as he has always been, incompetent, and he suffers from extremely severe mental disorders, which render him incapable of attending to any issue beyond his own personal need for adulation.

The mental condition he suffers most from is formally known as a severe instance of “narcissistic personality disorder,” which is well established in the psychiatric literature.  The core problem in this disorder is the failure in childhood and beyond to develop an inner sense of worth or self-esteem.  This makes one’s worth entirely dependent upon admiration from others.  This dependency likely derives from his parents’ valuing the child, Donald, only to the extent that he met their needs, rather than their recognizing his uniqueness, and their being sensitive and responding to his needs for consistent comfort and nurturing.

Trump feels, deep down like a ‘loser,’ ‘failure,’ ‘weak,’ ‘dumb,’ ‘fat,’ ‘ugly,’ ‘fake,’ and ‘crooked.’  These self-denigrating pictures of himself, Trump projects onto others whom he transforms into enemies.

John Zinner

As Mary Trump notes, Donald’s father, “Fred was and always had been the ultimate arbiter of his children’s worth.”  Donald’s mother, Mary, was, in the author’s view, “the kind of mother who used her children to comfort herself rather than comforting them.”  Compounding this parental failing was Mary’s extended absence beginning when Donald was about two and one half, because of illness and her persistent emotional unavailability beyond that.  This left Donald in the care of a harsh and non-nurturing father.

As a result of his total dependence upon external affirmation, Donald Trump feels, deep down like a “loser,” failure,” weak,” dumb,” “fat,” “ugly,” “fake,” and “crooked.”  These self-denigrating pictures of himself, Trump projects onto others whom he transforms into enemies.  Nevertheless, these traits are his own subconscious views of himself, for which he compensates consciously by creating a grandiose image of himself as unique, a “stable genius,” entitled to special treatment and better at everything than anyone else.

You have commented before that we know a remarkable amount about Donald Trump and that you reject the so-called “Goldwater rule,” which has been used to prohibit not only diagnosis but any commentary on a public figure since this presidency.  Can you explain your position? 

It is not a rule.  It is really a principle or a standard, which is very different, because the preamble of the code of ethics of the American Psychiatric Association that establishes the basic guidelines for the ethical canons says that a psychiatrist’s responsibility, “first and foremost,”  is to his or her patients and to society and to his colleagues and himself, in that order.  It does not include a public figure.

In Part 5 of ‘Inside the Mind of Donald J. Trump’

Mary L. Trump and her new book. (Simon & Schuster, left, and Peter Serling/Simon & Schuster via AP)

Coming next: Two mental health experts assess the most dangerous man in the world. Dr. Bandy X. Lee in conversation with Dr. Mary L. Trump.

Read Part 1, Part 2 and Part 3 of our series.

 

Do you agree with Dr. Trump that Donald Trump is “the world’s most dangerous man”?  What could be coming?  What are the possibilities we need to be aware of in the coming months? 

What makes Donald Trump so dangerous is the brittleness of his sense of worth.  Any slight or criticism is experienced as humiliation and degradation.  To cope with the resultant hollow and empty feelings, he reacts with what is referred to as narcissistic rage.  He is unable to take responsibility for any error, mistake or failing.  His default in that situation is to blame others and to attack the perceived source of his humiliation.

These attacks of narcissistic rage can be brutal and destructive, for reasons that are also part of his disturbance.  Especially, these include an extreme lack of empathy, compassion, authentic guilt, remorse, or, fundamentally, caring about the other person(s).  Donald Trump genuinely cares for no one but himself.  He lacks the capacity to feel regret or to avoid the harm he can cause to others.  He can derive a sadistic pleasure for the hurt he may create.

What makes Donald Trump so dangerous is the brittleness of his sense of worth…  To cope with the resultant hollow and empty feelings, he reacts with what is referred to as narcissistic rage.

These dangerous qualities should not be underestimated.   Donald Trump will stop at nothing to secure the adulation he yearns for by fulfilling his grandiose, often delusional, images of himself.  He has and is willing to allow the death of countless citizens by COVID-19, rather than admit he has failed to respond and that the scientists, whom he denigrates, knew all along what works best in dealing with the pandemic.

At this point, expect that Donald Trump will do everything he can do to disrupt the coming election so that he would not have to experience what he fears most, that is defeat, to be a “loser.” One of his current tactics is to disable the postal service so that mail-in balloting will be rendered ineffective.

He is currently spending his days watching television and “tweeting,” as another way of venting his rage.  Thus, he is both nonfunctioning as well as dysfunctional.  The government seems to be presently run by his aides, standing in for the president.  Such seems the case in it being Vice President Pence withdrawing federal agents from the streets of Portland.

You were among the first to alert about the magnitude of his dangers by writing a letter to the military.  Do you still believe they have a role?

The only definitive way of dealing with the dangers he poses to us seems to be to vote Trump out of office.  Meanwhile, we do the best we can in working for his and his enablers’ defeat as well as protecting ourselves from the consequences.  We must support the public health initiatives our scientists insist upon, and work in our communities to ensure that these health initiatives are carried out.

Inside the Mind Part 4 of Our Series: President Donald J. Trump

Featured image: AP

August 12, 2020