A mad and dangerous king

A lot of the discussion lately about Trump's unfitness for office has focused on the obvious signs of dementia and the discoloration on his hands/neck. But as he becomes increasingly more volatile, it is important to remember that, before any of these symptoms showed up, he met the criteria of someone with disturbing mental health issues. 

Due to the stigma associated with talking about mental health, a lot of people don't know how these illnesses are diagnosed. The standard format for doing so is to review whether their behavior meets certain criteria outlined in the Diagnostic and Statistics Manual of Mental Disorders (DSM). So, for example, a person is diagnosed with Narcissistic Personality Disorder (NPD) if they exhibit at least five of the following:

• Having a grandiose sense of self-importance, such as exaggerating achievements and talents, expecting to be recognized as superior even without commensurate achievements
• Preoccupation with fantasies of success, power, beauty, and idealization
• Belief in being "special" and that they can only be understood by or associated with other high-status people (or institutions)
• Demanding excessive admiration
• Sense of entitlement
• Exploitation behaviors
• Lack of empathy
• Envy towards others or belief that others are envious of them
• Arrogant, haughty behaviors and attitudes

After having observed Donald Trump on the national stage for over 10 years now, it doesn't take a rocket scientist (or psychiatrist) to conclude that the President of the United States exhibits all nine characteristics that are associated with NPD. When it comes to his increasingly volatile behavior, this explains a lot.

The president didn't bother to explain why he started a war with Iran, nor did he develop a plan for its implementation. That's pretty classic for someone exhibiting behaviors associated with Antisocial Personality Disorder (what we used to call sociopathy). In order to be diagnosed with that disorder, a person must exhibit at least three of the following:

• Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest
• Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
• Impulsivity or failure to plan ahead
• Irritability and aggressiveness, as indicated by repeated physical fights or assaults
• Reckless disregard for safety of self or others
• Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations
• Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.

One could argue that Trump's NPD keeps him from personally engaging in physical fights or showing a reckless disregard for his own safety. He merely has others do the violence for him. But otherwise, we have a president who regularly engages in criminal behaviors, lies compulsively, has been a con artist for his entire adult life, and never shows an ounce of remorse for the pain he has inflicted on others. But also notice that one of the behaviors associated with APD is impulsivity, or failure to plan ahead. For years it has been obvious that Trump shoots first and aims later. It is horrendous to see that one playing out now in his war with Iran.

In addition to dementia, two things are happening that escalate Trump's NPD and APD. The first, as Leah McElrath pointed out above, is that the president is facing his own mortality, which makes him more dangerous.

Josh Marshall did a great job of articulating the second contributor.

A couple months ago, I said that we were starting to see a pattern. As Trump grew less popular and less powerful at home, he would need to compensate to maintain his psychic equilibrium. He’d lean more and more into the presidency’s prerogative powers that are untrammeled and unrestrained regardless of what’s going on at home or how much support he has. He’ll be increasingly aggressive and violent in those realms of power and he’ll become more constrained and limited in others. In Trump’s world, there is dominating and there is being dominated. For him, the latter is a psychic death. So leaning hard into these prerogative powers where a president is, in effect, all powerful amounts to a kind of grand and bloody self-care...

To my mind, Trump is doing these things abroad precisely because he’s lost control of the situation at home.

I wish there was some magic wand we could wave to stop all of this. But unfortunately that moment passed on November 5, 2024 when too many people voted for this mad man. The important thing right now is to stop normalizing what's going on and name the fact that this president is a mad and dangerous king.