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
- 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.
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.









