CORE TRAITS OF CLINICAL PSYCHOPATHY

SAME PSYCHOPATH, DIFFERENT YEAR

Why Trump Remains A Clear And Ever-Present Threat To America

By Vince Greenwood, Ph.D., founder of DutyToInform.org

Like so many of my fellow Americans, I have endured what seems like an interminable, stormy affair with Donald Trump. I suppose I didn’t see it coming, especially after the harmonious and low-maintenance union with Obama. I barely paid attention to the guy prior to 2015, when he came down that escalator to the haughty drone of “Sympathy For The Devil” by the Rolling Stones (“Please allow me to introduce myself, I’m a man of wealth and taste, I’ve been around for long, long years, stole many a man’s soul and faith”). I have been in his evil thrall ever since. It seems like I should be embarrassed by my emotional fixation, but it’s hard to feel shame-faced when you are joined by 75 million other Americans.

This is not to say my feelings for the man have not … evolved. I was vaguely amused when he announced his candidacy; then titillated when he demolished the clown car retrogrades that were his rivals during primary elections; then enthusiastic in his takeover of the Grand Old Party (GOP), confident in my appraisal that he personified, and thus would make explicit, the racist, resentful, merciless rot that had become the firmament of the Republican Party; then aghast at his shocking victory; and finally enraged and despairing at his success in consolidating support from the entire GOP and 40% of the country.

But then, finally, I was done with it, done with him. Sure, there was a climactic ‘state of the union’ breakup scene on January 6th. But, two weeks later, Inauguration Day arrived and I was done with it. No more anguish about him. No more vigilance about the threat posed. No further need to ring that particular alarm bell. I could walk away. Scathed, but relieved.

Yeah, right. I got about as much closure as an anguished Michael Corleone (“Just when I thought I was out they pull me back in.”). All in, I am afraid, given this perilous moment in our country and the looming threat skulking at Mara-a-Lago.

First, allow me to introduce myself. I’m an active Blue Triber. Let’s get that on the record. Second, I am a clinical psychologist with a good deal of experience as a diagnostician. I have a lot of feeling (sense of self, a psychologist might say) wrapped up in these two roles, which helps explain my journey over the past five years.

I suppose it began on election night, where the disorientation and shock transported me back to childhood the day JFK was shot. However, the rage and despair over Trump’s 2016 victory had a constructive edge: it motivated me to read and reflect on the many articles and books that made good-faith efforts to explain how this black swan event could have happened. Not only literature on what may have led to Trump’s victory, but — since he was seen by us Blue Tribers either as a vulgar thug or a feckless celebrity — how could the election even have been competitive? This led to a lengthy essay — Into Asphyxiated Air: My Empathy Trek With Donald Trump — published in 2018, where I tried to work through the puzzle of what happened in 2016.

That effort did satisfy my particular intellectual thirst for understanding. It also stirred some empathy for the Red Tribe and evoked some humility about my righteousness. I came to appreciate some of the brutal realities that would understandably fuel resentment of the Blue Tribe and the political establishment. The Red Tribe (well, the rural, less educated, less affluent part of it) has been both screwed over and unlucky the past 50 years, with an attending loss of status and, understandably, the scorched earth feelings that accompany that loss.

I was also chastened. I was schooled in how WEIRD my fellow Blue Tribe members and I were. WEIRD is an acronym where each letter is the first word of an adjective:

WEIRD: Western, Educated, Industrialized, Rich, and Democratic.

WEIRD is a term that underscores the bubble that we Blue Tribers may live in. The demographics of WEIRD call into question social science findings that are a foundation of Blue Tribe identity. It turns out that social science research is based on samples where 96% of the subjects come from WEIRD societies and subcultures (e.g., American undergraduates), even though WEIRD societies only make up 12% of the world’s population. Many lines of research — moral psychology is a particularly relevant example — are conducted using WEIRD samples. Thus, social scientists present findings framed as essential truths but may apply to only cosmopolitan societies and subgroups. I realized we Blue Tribers may need to be more circumspect. We may be nestled in bubble wrap, which leads us to assume that our Truth is The Truth. And (gulp) Our Truth may be a minority position.

Still, my despair only deepened at the end of this intellectual journey, what I also refer to as an empathy trek, (such a Blue Tribe thing to do). We can all feel guilty about the elitist, privileged perch we hold and wary about the blue bubble, but my god, how can we not feel threatened by the existential threat from the other side? How can we not feel maddened by their rejection of science, facts, and consensual reality? How can we not feel shattered by their embrace of white nationalism and the elevation of grievance politics over democratic norms? How do we make sense of what looks like a looming Armageddon-level struggle of democracy versus some kind of post-modern fascism?

So, while I would like to think the empathy trek that I took looking into the sources of Trump’s election helped me ascend to a higher plateau of understanding, instead, I ended up on a ledge jutting out from a menacing cliff. I felt one vibration away from being inundated by a rockslide that would take me, my tribe, and my country into the abyss.

One can only tolerate anxiety for so long before angst and demoralization creep in. Prior to the 2020 election, I was tempted to withdraw from the political fray, but I was rescued by some of the clients in my psychotherapy practice. A number of them were in a good deal of anguish about what was happening to the country. What was I going to counsel them? ‘Get a life outside of politics?’ That certainly seemed like a failure of empathy and a dereliction of duty. Besides, many of them were gearing up to get involved in the 2020 election. I knew I should validate their anxiety and follow their lead.

But I was depleted by the empathy trek through Red America after the 2016 election. I needed a different path that might provide me with a burst of oxygen. So, I turned my attention from Red America’s heartlands to the entertainer-in-chief himself. In particular, I focused on efforts by mental health professionals to warn the public about the danger Trump represented. In 2019, I devoured books and articles about Trump’s possible psychiatric pathology. I was curious to see what my colleagues and other acute observers of the President had to say about his mental health.

There was an abundance of material. Fortunately, two mental health advocacy groups had sprung up to provide leadership on this issue. The World Mental Health Coalition, under the courageous leadership of Bandy Lee, M.D., and Duty To Warn published edited volumes of appraisals of Trump’s psychopathology. These volumes were edifying. There was a range of opinions on Trump, but all articles agreed that he was unfit for office.

The near unanimity within the mental health community regarding Trump’s unfitness for office did not go unchallenged. Of course, right-wing media and influencers dismissed the efforts of The World Mental Health Coalition, Duty To Warn, and others (e.g., Mary Trump, The Lincoln Project) as liberal slander (motivated reasoning would be the psychological term). But the main headwinds against diagnosing the President were the two most prominent mental health professional organizations — The American Psychiatric Association and The American Psychological Association. They criticized all efforts to evaluate Trump psychologically, asserting that they violated ethical strictures about diagnosing public figures ‘at a distance’. These strictures have been termed the “Goldwater Rule”. The Goldwater Rule is found in section 7.3 of the American Psychiatric Association’s code of ethics and proclaims that it is unethical to offer a professional opinion on a public figure that has not been personally examined and where consent has not been obtained. The Goldwater Rule asserts that you can’t diagnose someone capably without a personal interview and that you shouldn’t diagnose someone without their consent.

Nevertheless, a number of mental health professionals proceeded with analysis of Trump’s fitness, Goldwater Rule on the books or not. Although some paid the price (outrageously, Bandy Lee was fired from her faculty position at Yale for violating the Goldwater Rule), the work on Trump’s psychiatric disorder found a receptive audience, at least in Blue America (e.g. “The Dangerous Case of Donald Trump put out by the World Mental Health Coalition became a New York Times bestseller). I certainly applauded the psychological dissection of Trump in such gruesome detail. I was appreciative that his dangerousness had been laid bare.

So yes, I enjoyed these articles in a Schadenfreude kind of way. However, I also felt emboldened: this man must be stopped! At the same time, I fretted that these efforts by the mental health community were not getting the attention they deserved. These psychiatric findings should have been a game-changer, but it seemed like their impact was confined mainly to Blue America. I wasn’t alone in these feelings. I heard many of my colleagues express frustration: we seemed to be reduced to the role of shouting ‘this emperor has no clothes’. Fortunately, this frustration didn’t stop the contributors to Dangerous Case and Duty To Warn and others from working overtime to get their message out.

Then, after one long morning in a local coffee shop in the Fall of 2019 spent reflecting on the Trump psychiatric literature, I discerned that there might be an opportunity to directly contribute to their efforts. The opportunity revolved around the possibility that Trump might meet the demanding diagnostic criteria for a precise and relatively rare condition called Psychopathic Personality Disorder (PPD).

If Trump qualified for this diagnosis, there would be a significant advance in understanding his personality dynamics; it would convey our understanding of his extreme behavior; and enable us to more precisely spell out the ways in which he is a danger. This is because Psychopathic Personality Disorder is one of the best understood and most thoroughly validated conditions in the field of psychopathology. There is an extensive body of clinical and research evidence (over 69,000 studies) not only testifying to the validity of the diagnosis, but also detailing many of its features. If someone does warrant this diagnosis, we would know a great deal about the etiology of his condition, the course of his condition, the possibility of ameliorating it, and the fine details of its defining characteristics, including the dangers associated with it. Decades of extensive research have allowed us to make authoritative and precise renderings of anyone that suffers from this disorder.

I say if Donald Trump has PPD because it is a high bar to meet the rigorous criteria for diagnosing Psychopathic Personality Disorder. However, that did not stop many people, including some mental health professionals, from calling Donald Trump a psychopath. They saw a man who seemed to them reckless, callous, and able and willing to lie easily. They didn’t hesitate to attach that label to him. But that is not how clinical diagnosis works in general, and specifically not for the diagnosis of PPD. While it felt right to many to diagnose Trump as a clinical psychopath, until someone goes through the detailed steps to rule in or rule out the diagnosis of PPD, such a conclusion is not warranted. You could use the term psychopath as an adjective, but that was about it.

As of November 2019, one year out from the election, no one had taken the step of trying to formally diagnose Trump for the possibility of PPD. This is not surprising. The diagnosis of that disorder requires specialized training in the assessment tools that established PPD as a clinical entity and spurred so much research. Only a fraction of mental health professionals have undertaken the training which certifies them to make the proper assessment of PPD. (Most disorders in the two accepted Diagnostic manuals — DSM-V and ICDM — can be diagnosed by all those trained to be board-certified psychiatrists or licensed clinical psychologists. There are only a few disorders — ADHD would be another example — that require additional specialized training.)

I am one of that fraction of mental health professionals that had the training that allowed me to consider undertaking such an evaluation. However, the evaluation procedure for PPD requires access to a great deal of information about the patient. The examiner must collect, integrate, and interpret multiple sources and kinds of information. Securing the relevant data typically necessitates a collaborative interview with the patient. This was, ahem, not forthcoming with Trump.

Not to worry, there is an abundance of informant and archival information on the guy. A partial list of sources would include:

  • 13 autobiographical efforts (according to his Wikipedia page)
  • 68 biographies, many of which are richly sourced
  • Hundreds of interviews from print, radio, and television
  • Over 17,000 tweets since he announced his candidacy
  • Social media material from his Facebook page and YouTube productions
  • Court records
  • Details of financial dealings that made it into the press
  • Investigative reporting
  • Congressional hearings
  • Tell-alls by his “friends” and former staff and colleagues

Trump is arguably the most chronicled celebrity/President/person in history. There was no need for an interview. The resulting treasure trove of data was sufficient to proceed with the evaluation.

And, so, I did. The findings were published on Medium.com in May of 2020 under the title Duty To Differentially Diagnose: The Substance Behind The assertion President Trump Has A Serious Psychiatric Disorder. Spoiler alert: Trump did meet the diagnostic markers for PPD. He cleared the bar easily. His score on the key rating scale for PPD — The Hare Psychopathy Checklist — put him in the moderate to severe range of the disorder.

The article on Trump entered the bloodstream of the body politics and, like my colleagues at World Mental Health Coalition and Duty To Warn, I hoped it might have some small impact — either in persuading undecided voters or encouraging Blue Tribers to contribute even more money, to bang on more prospective voter’s doors, or whatever it took to take back our country. I had no illusion of reaching Republicans, although a few from ‘Magaland’ read the article and kindly offered to do what they could to destroy my career.

I had the fantasy that perhaps my findings could ‘influence the influencers’, those with a megaphone to the public, such as network anchors, Oprah, Al Franken, et.al. who, armed with my article, could speak more clearly and authoritatively on Trump’s dangerousness. In fact, I did get shoutouts from some public intellectuals — Lincoln Project founders (George Conway, Bill Kristol), one of my intellectual role-models (Andrew Sullivan), Frank Rich, Barton Gelman of the Atlantic magazine, and a few others.

There was one influencer whose support was particularly gratifying and consequential. This influencer was Tony Schwartz, an American journalist who has worked at the New York Times, New York Post, Esquire, and New York Magazine. He has written books on business productivity and values-directed living. But he is best known for ghost-writing Trump: The Art of the Deal (Schwartz wrote the entire book).

During the speech announcing his candidacy, Trump referenced Art of the Deal as proof of his “genius deal-making”. Indeed, the book contains one self-flattering vignette after another. This was, Schwartz notes, a profoundly misleading picture. Schwartz acknowledges that he presented Trump as more accomplished, more ingenious, more family-oriented, and more of a Horatio Alger than was warranted. In an interview with The New Yorker, Schwartz admits that, as a ghostwriter, he was “trying hard to find my way around” behavior that he found “if not reprehensible, at least morally questionable”.

The process Schwartz adopted in writing the book was noteworthy. It was clear from the start that Trump was an impossible subject to interview due to his superficiality, incapacity for introspection, and abysmally low attention span. As an alternative, the two men agreed that Schwartz would have up close and personal access to Trump. Thus, starting in 1985, Schwartz spent eighteen months hanging out with Trump in his office, riding with him in his helicopter, attending business meetings throughout the city, and even spending weekends with him at his Manhattan apartment or traveling with him to Mar-a-Lago. As a result, Schwartz — noting Trump’s apparent lack of any close friends — believes he got to know Trump better than anyone outside his family.

Schwartz was horrified by Trump’s character. To deal with the cognitive dissonance between his personal reactions and the hagiographic book project, Schwartz took to writing his thoughts, many of them acute psychological observations, in a private journal. As a result, Schwartz gained unique insight into Trump (also the rewards flowing from being a “co-author” of a mega-bestseller). However, he paid a steep price. “I put lipstick on a pig,” he said. “I feel a deep sense of remorse that I contributed to presenting Trump in a way that brought him wider attention and made him more appealing than he is.” Schwartz had not spoken publicly about Trump since he published the book in 1987, but broke his silence in a tell-all interview in The New Yorker in 2016. He has been an outspoken Trump critic ever since. (In 2016, he also pledged all royalties from “The Art of the Deal” to charities working with groups that were particular targets of Trump’s bombastic rhetoric.)

So, by the time Tony Schwartz read my article in the Spring of 2020, he was an ardent and engaged Never-Trumper. He had written an article for the edited volume put out by The World Mental Health Coalition. He had absorbed much of the literature put out by mental health professionals on Trump. He was trying to get the word out on Twitter (272k followers) about the danger Trump posed based on the psychological traits he had observed up close.

Tony reached out to me after reading the article. He noted that many of the points emphasized in the piece reinforced his views of Trump. But also, he stressed, the delineation of the three core dimensions of the psychopathic personality structure (remorselessness, impulsivity, and drive to dominate) truly captured his experience of the man. To hear this was gratifying. It may just be a sample of one, but, in Tony’s case, it may be the one who has more experiential knowledge of the man than anyone outside his family.

Tony and I began collaborating to get the material on Trump and PPD out to as large an audience as possible. He used his connections to get the article in front of editors at major publications. However, the article was far too long to be published in popular platforms such as The New Yorker or Politico.

In short order, Tony published a much shorter article on Medium.com (with links to my longer piece) titled Psychopath-In-Chief. The article quickly rose to number one on the site and began getting a lot of attention on social media. As a result, my article started generating many views and shares. That was my hope: I thought I had important information to share about the President’s psychological profile. I hoped it would receive some sunlight. Now, overnight, that had happened. Tony was the linchpin.

I was counseled by some colleagues- savvier in the social media landscape than I- that if I wanted to sustain the proliferation of these ideas, I needed to create a website and an associated Twitter account to disseminate the findings on Trump. That summer of 2020, I launched DutyToInform.org and @DutyToInform. I also started writing shorter articles that tried to elucidate the link between Trump’s core psychopathic traits and his conduct in office. That Fall, I kept my head down and tweeted and published and hoped I was contributing to the conversation on Trump’s unfitness for the Presidency.

TRUMP’S DEFEAT AND THE TRANSITION

On November 2, 2020, a week out from the election, trepidation got the better part of me. I published an article -The System Is Blinking Red — For Mayhem And Unconscionable Behavior From The President . The polls indicated that Biden would likely prevail, and I was taking a shot at how Trump might behave during the interregnum. The key predictions put forth in that article were:

  • “Engage in bogus claims of voter fraud.”
  • “Efforts to whip up the base for chaos and crisis.”
  • “Continue to signal to right-wing extremist groups to ‘stand by’.”
  • “Encouragement of thuggery by Trump caravans.” (‘his people’)
  • “Declare victory prematurely in an attempt to subvert election results.”
  • “Explicitly incite violence from armed militias.”

I am not holding myself out to be Nostradamus. While in early November it was not possible to predict specifically an assault on the Capitol to undermine a lawful election, the ability to predict something like that with a meaningful degree of certainty was straightforward. That ability flows from the extensive research and accompanying insights that go along with the diagnosis of PPD. Once I established that Trump suffers from the disorder, to predict the manifestations of it is simply a connect-the-dots exercise.

ELEMENTS OF PSYCHOPATHIC PERSONALITY DISORDER

Time to provide a summary of the essential elements of PPD. The defining feature of the disorder is the presence of three core traits or clusters of traits as follows:

1. Impulsivity: Traits here include restlessness, dereliction, greater than normal need for stimulation, inability to plan, poor attention to detail, deficits in perseverance, inability to defer gratification, and unreliability.

2. Drive to dominate: This cluster of traits includes an arrogant interpersonal style, hostility, grandiosity, a ‘win at all costs’ stance, demands for loyalty, and a focus on one’s egocentric interests.

3. Remorselessness: There are two facets to this cluster: the inability to bond with or have empathy for others, which leads to callousness; and the inability to experience shame, guilt or fear, which leads to selfish, reckless, and dangerous behavior.

These three clusters of traits are hard-wired, immutable, and govern the individual’s behavior.

Armed with this knowledge of the deep trait structure of PPD, on November 2, 2020 I noted qualities in Trump based on these three different core traits clusters of PPD:

Because of his impulsivity, Trump can’t help but:

  • Act quickly without considering the consequences
  • Take huge risks since he craves sensation-seeking
  • Be driven by what captures his immediate self-interest
  • Continue to display no aptitude for governance
  • Fail to plan or persevere with any substantive task

Because of Trump’s drive to dominate and arrogant, deceitful mode, he can’t help but:

1. Lie with impunity to get others to bend to his will

2. Demand fealty from others

3. Engage in frantic efforts to avoid loss of status

4. Focus on “winning” at all costs. Win for the sake of winning

5. Be ruled by egocentric concerns

6. Foment divisiveness

Because of his remorselessness, he can’t help but:

  • Blithely ignore norms, the tragedy of lost lives, or appeals from anyone to rein in his reckless and derelict behavior
  • Have no limits on his behavior since he has no limiting sense of concern for the well-being of others
  • Deflect all blame for any damage he may inflict. Deny any responsibility
  • Have no feeling of discomfort to the suffering by others
  • Have disregard and disdain for others

Again, the above depictions of Trump’s behavior between election day and the inauguration were not post hoc characterizations but predictions made on the basis of his diagnosis. Of course, Blue America and Red America saw Trump’s behavior during this period quite differently. However, these differences were not so much in the perceptions of how Trump actually behaved, but in each tribe’s appraisal of it. What Blue America appraised as deceitful and dangerous (i.e., “Stop The Steal”), Red America saw as righteous and thrilling. Still, even when Trump’s behavior is valorized by many, it does not obscure the reality that such behavior is consistent with the three core trait clusters of PPD.

TRUMP’S REACTION TO THE ELECTION RESULTS

On November 2, 2020, when I tried to predict how Trump might behave if he lost, I should have realized that those bets placed on his PPD trait structure would start paying out within minutes of the election turning against him. When Trump came on TV after midnight of election day, clearly unhinged, ranting that the election had been stolen from him, I knew it was over (even if not officially announced by the networks until four days later).

However, there were two and a half months left before Inauguration Day. These would be dominated by Trump’s one-note public relations and political pressure campaign, coined “Stop The Steal!” Trump’s impulsive traits of irresponsibility and failure to plan were on full throttle during this time. In that two-month period, that set of traits worked to the country’s advantage (assuming you are in the camp that believes liberal democracy is a good thing). It was clear that Trump wanted to subvert a free and fair election that he had lost. It was also clear that he was incapable of pulling it off.

It now appears history will judge this period as consequential, a time when trusted norms of democracy were shattered. It was certainly, even by Trumpian standards, dangerously chaotic and reckless. However, in real-time, believing that Trump was headed to the ash heap, I have to admit I found it somewhat… delicious.

We now know that on election night, Trump, along with his family and close confidants, were feeling jubilant after the results from Florida, Ohio, and Iowa suggested that he would once again defy expectations and recapture the White House. However, a few hours later, when Fox News called Arizona for Biden, Trump apprehended that he had lost. At that moment, he entered an angry and aggrieved state (a frequently visited emotional way station of a clinical psychopath), and effectively launched the “Stop The Steal!” campaign. At 2:30 a.m. he came on TV and declared, in a petulant and combative mode, that he had won, but that a fraud was being perpetrated and the election was being stolen from him.

And, from all the reporting and appearances, he never deviated from that emotional state or from that one-note message for the next nine weeks. But what did he actually do during that period? Basically, he just yelled and whined at whoever was in his proximity or who he had on the phone. Oh, and he would fulminate at the TV screen. He hectored (only hectored) his advisors, the Vice President, the Attorney General, election officials, and GOP allies about the steal and demanded that it be stopped. But in turn, they kept their mouths shut but inched away from him, recognizing his claims were absurd and that he didn’t have the executive skills or temperament to pursue them, to pull off his coup. Not to worry for accomplices for Trump: there was a second tier of conspiracy theory types waiting in the wings to step in.

For much of his presidency, Trump’s inflammatory, right-wing populist rhetoric served his interests. It was instrumental in ginning up his base and getting out the vote of “his people”. But this demagogic mode was not sufficient for the aim of overturning the election. First, because of the seditious element in his rhetoric, he was being de-platformed by many media outlets. Second, the task — his coup — required a modicum of planning, focus, and organization. As we saw with the response to Covid, he was incapable of such organization. He didn’t even have a plan of a plan. Yes, his new minions and most loyal toadies came up with a few Hail Mary plays which he signed into executive orders. But that was it. Michael Wolff, in his book Landslide, which gave the inside account of the Oval Office during the transition, summarized it well, “Beyond his immediate desires and pronouncements, there was no ability — or strategy, or chain of command, or procedure, or expertise, or actual person to call — to make anything happen.” Trump’s contribution was limited to belligerent, bloviated bleating.

In real-time, from election day until January 6th, a part of me couldn’t help but stand back and chuckle at the unfolding burlesque show: the frivolous lawsuits laughed out of court, the return of the most whacked-out conspiracy theorists (Sidney Powell, Michael Flynn, the My Pillow CEO Mike Lindell) to Trump’s inner circle, the rage directed at his toady Attorney General for acknowledging the reality of there being no evidence of election fraud, and the discomfiture of the supposed ‘adult in the room’ establishment Republicans who had to tap dance around this tawdry spectacle.

The Return of Rudy Giuliani

This Through The Looking Glass inversion of reality seemed to reach its pinnacle when Rudy Giuliani bullied his way back onto center stage. Over the previous couple of years, Rudy had been excommunicated by the Trump family and inner circle advisors. Indeed, by late Fall 2020, Rudy had become an obese, addled, two-fisted drinker. But he would not be denied the limelight. He told Trump exactly what he wanted to hear about the stolen election (The machines! Dead people casting ballots! Suitcases of votes coming in the back door! Communist money in Venezuela! It was a landslide!). Giuliani also encouraged Trump’s worst (i.e., most genuine) impulses. So, the two of them, like an express train barreling down the tracks, blew past one-way station of consensual reality after another, one-way station of democratic norms after another.

There was a moment when the farcical underside of their efforts was made visible. In late November, they called for a key press conference, held at the Republican National Committee headquarters, to spell out the multiple paths to take back the stolen election. Rudy took the lead. He had prepared a list of chicaneries surrounding the election, which he began delivering in staccato fashion. What he hadn’t prepared for was to give his remarks in a small, crowded, hot room with poor ventilation. He began sweating profusely, and then, unbeknownst to him, streams of black hair dye, loosened by the sweat, started running down both sides of his face. In the Twitter and Instagram world, the image of Rudy dabbing at this gunk running down his face became one of the most emblematic (and shared) moments of the Trump effort. It was arresting in a Hieronymus Bosch kind of way.

Trump was furious about the optics (“What’s going on with this shit dripping off his face?!”). But Rudy and the conspiracy nuts had a plan. It was an absurd, fevered concoction — Pence would not certify the electoral votes; the loyal Trumpers in Congress would filibuster and obfuscate and delay and the election would instead be decided by individual state legislatures which were majority Republican; and Trump would be declared the winner. If people were upset, well, Trump had martial law to quell any unrest. Trump, who was unable ever to formulate, much less execute, a plan for any substantive or thorny issue during his term (never even tried, really), seized upon it.

Psychopathic Personality Disorder: The Ultimate Trump Whisperer

In the earlier, lengthier essay where I demonstrated how Trump met the exacting criteria for Psychopathic Personality Disorder, I also presented some scientific information about PPD traits — what researchers have discovered through research studies of the clinical psychopath. I tried to give the reader a feel for being a psychopath, the inner experience of being snared by these traits. In this essay, I would like to convey what it was like for Trump — as a clinical psychopath — particularly during this interregnum period: his experience of it, not just our judgment of him. I attempt this to hopefully deepen our understanding of the man so we might anticipate his future behavior. I have some confidence in my ability to do this because — drum roll — the deep psychology of Trump is pretty much the deep psychology of any psychopath.

This is not an entirely speculative exercise. In the past few months, several detailed, well-sourced accounts (see Landslide by Michael Wolff, Peril by Bob Woodward and Robert Costa, Betrayal by Jonathan Karl) of what was going on in the Oval Office during that time between the election and the inauguration. We have a detailed tic-tock of Trump’s behavior in this period and reports of what he seemed to be thinking and feeling. We should also note Trump has always been a what-you-see-is-what-you-get character. The problem with Trump is not a lack of access to his florid psyche, but making sense of it.

Before taking a more thorough look under the Trump clinical psychopath model hood, there are four points to keep in mind about Trump and Psychopathic Personality Disorder. First, he has been subjected to a thorough and objective evaluation that demonstrates he meets the demanding criteria for PPD (details of that evaluation can be found here and here). If someone warrants this diagnosis, we can then speak with a great deal of authority about their psychopathology because of the extensive research-based knowledge on PPD.

Second, PPD is Trump’s primary diagnosis. While Trump, because of his extreme and aberrant ways of thinking, feeling, and behaving, may arguably meet diagnostic criteria for other disorders, PPD is the fundamental and governing source of these pathologies (The argument that PPD deserves to be the primary diagnosis for Trump is spelled out in the original essay and a recent paper).

Third, each of the three defining traits of PPD — impulsivity, drive to dominate, and remorselessness — are linked to particular brain abnormalities. At present, there are no treatments for these abnormalities. They are immutable. Thus, the clinical psychopath can’t help but experience the world through the prism of these traits and behave in accordance with them.

Fourth, each trait label refers to a cluster of related tendencies. For example, impulsiveness doesn’t just refer to one’s difficulty in controlling impulses, such as expressing anger without reflection, or the inability to refrain from indulging. It also includes tendencies such as the incapacity to plan, disorganization, irresponsibility, fecklessness, recklessness, sensation-seeking, lack of discipline, low frustration tolerance, and garrulousness.

These last two points — about the presence of brain dysfunction and clusters of traits in PPD — are illustrated in the case study of Phineas Gage.

The Case of Phineas Gage

On September 13, 1848, Phineas Gage, the foreman of a construction crew laying down railroad tracks in Vermont, suffered a grievous accident. He was using a tamping rod to pack explosive powder into a hole when the power detonated unexpectedly, propelling a 43-inch long and 1.25-inch diameter rod up thru his left cheek, obliterating a section of his brain, before exiting his skull and landing eighty feet away. Amazingly, Gage walked back to his lodgings and summoned a doctor. When the physician rode up, Gage greeted him, “Doctor, here is business enough for you.”

Thus, Phineas Gage became one of the more famous cases in cognitive neuroscience history. The damage from the accident was limited to a portion of the prefrontal cortex. The changes Gage displayed after the accident enabled us to learn about the specific brain functions of that area of the brain. Before the accident, Gage had been described as considerate, mild-mannered, and hard-working. After the accident, he was described as abusive and garrulous in his manner, dishonest, unreliable in his duties, and incapable of restraint when it conflicted with his desires.

The prefrontal cortex, the same area Gage injured, has been described as the personality center of the brain. It helps us control our impulses and serves as a braking system, so we don’t act without considering consequences. It enables us to defer immediate gratification for long term rewards, and put the brakes on behavior that clashes with our values and moral principles. Researchers, using tools such as functional magnetic resonance imaging (fMRI), determined that psychopaths have less grey matter in this area of their brains. Their brains also show less connectivity between the prefrontal cortex and the amygdala, thus compromising their ability to integrate rapid-fire impulses with higher cortical functions, such as reasoning and self-regulation.

TRUMP’S IMPULSIVITY CLUSTER

The cluster of PDD traits under the descriptor impulsivity are linked to limitations that flow from these brain abnormalities first identified in Phineas Gage. One of the key dimensions of this impulsivity cluster is reflected in the descriptor “egocentric”. The term egocentric has a negative connotation in the general culture but has a more precise clinical meaning in the study of psychopathy. Egocentrism is a pathology, a limitation that constrains both how the psychopath perceives the world and his ability to respond to it flexibly.

The psychopath’s attentional field is limited to a “what’s in it for me?” boundary. He cannot engage the world beyond the immediate present and personally relevant. His attention is tethered, captured by the immediate frustrations, provocations, and opportunities of the moment. The sizing up of the situation along the lines of his egocentric needs is automatic and natural. It is not complicated by other factors such as his deeper aims, accommodating to other people’s interests, or worries about future consequences. The subjective experience of reacting to the environment for the psychopath is not reflective or deliberate but reflexive and rapid-fire. This is hard-wired. This is not a choice.

Impulses (“What’s in it for me? How do I win the moment?”) are then triggered frequently and easily by the egocentric demands of the moment. Such impulses are then acted out quickly with no hesitation or restraint. An impulse, for the psychopath, does not mark the beginning of a process of weighing, deliberating, and mindful choosing but the short-circuiting of it.

Thus, President Trump’s behavior was often described by insiders as impulsive, erratic, “labile”, and it was. But beneath his volatile surface behavior, there was rigidity. He was a prisoner of this one-note focus on his needs and his inability to stop himself from immediately trying to satisfy them. He was a prisoner of his pathology.

The associated trait of “superficiality”, also part of the impulsivity cluster, further shackled him. The clinical meaning of this term refers to the psychopath’s inability to process his triggered emotions in the upper parts of the brain, where crude impulses are refined to more complex, “deeper” states (e.g., tenderness, melancholy, pride, empathic pain, gratitude, enchantment). However, as noted earlier, the neurological infrastructure to develop deeper aims or values is either deficient or not functioning with the psychopath. Thus, he has no bedrock of deeper aims or values that could bolster his efforts to persevere or even take on demanding situations.

The psychopath is a stuck needle of responding only to the thwarted needs of the moment. The daily struggle 99% of us have between “I want” (impulses in the moment) and “I should” (weighed against deeper aims or values) just doesn’t take place with the psychopath. All of his battles are in one dimension with two moves (what’s in it for me? how do I win the moment?). One early Trump critic was on to something about his hard-wired limitations when he noted “he is a man untroubled by the rumblings of a soul”. There is no Shakespearean depth in the man, not even the capacity for it. It’s Willy Loman all the way down.

This superficial egocentricity helps illuminate what many close observers have noted about Trump’s presidency. Henry Kissinger, former Republican Secretary of State, who is considered the dean of the foreign policy establishment, supported Trump with enthusiasm once he was elected. He was optimistic about Trump’s ‘America First’ proclamations. However, a few years into theTrump era, he stated:

“The entire foreign policy is based on a single unstable individual’s reaction to perceptions of slights and flattery. If someone says something nice about him, they are our friend; if they say something unkind, if they don’t kiss the ring, they are our enemy.”

We are all now depressingly familiar with the mantra describing Trump’s behavior as “shocking but not surprising”. The fact that the thrust of the foreign policy agenda of the most powerful and influential nation on earth is boxed in by the demands of the damaged psyche of one man is shocking. But not surprising. Suppose one is president and unfortunate enough to meet the rigorous diagnostic criteria for Psychopathic Personality Disorder. In that case, one is in the throes of enduring, immutable, and rigid personality traits that will have their way with the inevitability of a gravitational field. There are certain experiences beyond the capacity of the clinical psychopath such as deliberation, complexity, the weighing of pros and cons, the trust gained from long-standing relationships with allies, values-based considerations, the professional work of the State Department, or all of the substance generated by foreign policy experts. Trump’s PPD psychopathology was destined to prevail. Yeah, so not surprising, just shocking.

Superficial egocentricity is the trait most implicated in Trump’s sophomoric approach to foreign policy. Other traits in the impulsivity cluster — particularly those under the descriptor “irresponsibility”, such as fecklessness, disorganization, inattention to detail, failure to plan, low frustration tolerance, and dereliction, help explain the general workings and daily chaos as detailed in the litany of richly sourced accounts of the Trump White House.

The flavor of the irresponsibility traits, as elaborated in the psychopathy research literature, is mostly about not getting the job done, not following through on one’s obligations or promises. Psychopaths avoid responsibility because they recognize they have neither the skills nor the temperament to handle complex problems. This is what Tony Schwartz observed in his 18 months at Trump’s side. Psychopaths are wired to be disorganized, unfocused, easily bored, and undisciplined. This set of traits leaves them overmatched in trying to take on a thorny or complex issue that requires sustained focus.

Here, we also have to acknowledge that Trump is a paradox. He has been enormously successful in real estate, celebrity TV, and consolidating political power. There is no denying his skills in the political arts. He seems to have a brilliant understanding of the media and how to manipulate public opinion. He is a ratings wizard. However, he is congenitally unequipped to handle tasks requiring discipline, planning and frustration tolerance. A close reading of The Art of the Deal, although it sets out to lionize his achievements and skills, does not contradict the basic thesis of his irresponsibility and incompetency in a large swath of duties and responsibilities. He is skilled and successful in certain contexts, but markedly incompetent and derelict in tasks that require planning, discipline, and sustained focus.

Trump’s limitations flowing from his set of irresponsibility traits are legion. Those that have tried to work with him closely uniformly bemoan his distractibility (“the attention span of a gnat”). A head of state described a 60-minute meeting with him as “60 one-minute meetings”. He was uninterested in policy. He had no clue as to how to execute the quotidian details of governance. Most days were taken with watching Fox News or hectoring others about the latest insult he had experienced. Michael Wolff, who probably had the most insider access to Trump during his presidency, paints him as administratively incompetent to a comical degree in Landslide:

he was often pursuing a series of personal concerns, vendettas, fancies, most often figments of the moment, while the executive branch itself carried on its business. The job of aides was to snatch or negotiate time with him, or decisions from him, on pressing executive functions while he pursued his other concerns-and to do this during his 11 a.m. to 6 p.m. schedule in the office.

Michael Lewis, in his book The Fifth Risk, describes Trump’s determination to shirk the administrative demands of the office. Trump actively undermined the transition process after he won the election. He quickly disbanded the transition team headed by Chris Christie, telling him, ‘we can take an hour off from the (Inaugural) party to learn everything we need to know about running the government.’ Conducting an orderly and substantive transition meant taking on the responsibility of governance. Trump wanted nothing to do with that.

Trump’s disdain over the details of governing masked his inadequacy to solve problems that required discipline, deliberateness, and focus. He bragged about not reading briefing papers and wouldn’t even tolerate power point presentations. He seemed to get away with, even revel in, the political incorrectness of his approach. But then Covid-19 struck.

Trump’s Covid Response Based on his Characteristic of Impulsivity

The federal nonresponse to Covid was entirely predictable. The crisis demanded discipline and hard work. Trump was not about to wade into those waters. Golf weekends or coronavirus task force meetings? No contest. Oversee a coordinated federal response? Ha! He didn’t attend coronavirus task force meetings and became bored with the daily press conferences as soon as it became clear they were hurting his poll numbers. As we look back, it is clear there was never even a plan of a plan. There was chaos and neglect all the way through.

The set of skills needed in a President to develop a detailed and comprehensive response to Covid — a response that would not leave the rest of the civilized world aghast — was simply not there. He was overmatched. We paid the price.

It is a challenge to explain the depth of the psychopathology of a clinical psychopath. The psychopath sees the world and approaches the world in a way that is foreign to most of us. For the clinical psychopath, it is an immediacy of reaction of a whole different order. The psychopath has a reflexive rejection to having any second thoughts, to any hesitation, to any self-criticism. This antipathy to any constraint undermines even rudimentary acts of reflection, reason, or judgment.

The superficial egocentricity described above accounts for the narrow attentional field of the psychopath. There is a ‘don’t give a shit’ psychological infrastructure that undergirds his irresponsibility and dereliction. This is not someone who is simply ADD on steroids. This is a different creature.

It was all so ludicrous. But then, the line between the ludicrous and the dangerous during the Trump era had always been thin and fungible. The transition between the election and the inauguration erased it. A terrifying example of this impulsivity cluster was Trump’s abandonment of the duties of the Presidency during the 2020 transition. Wolff reports:

This election challenge, this very issue of his survival, had made everything else meaningless. All daily briefings were cancelled, including national security briefings. All efforts to return his attention to pandemic issues, vaccine rollout, or critical intelligence failed. And there was, quite categorically, no possibility of engaging him in, or even discussing with him, transition matters. What’s more, he had cut off all communication with Senate leadership. (page 139)

Although the country was put in peril by “Stop The Steal”, this cluster of traits (thankfully) also ensured he would not be able to competently execute a coup.

However, the impulsivity cluster of traits does not explain why he was pursuing a coup. They don’t explain the driving force behind the “Stop The Steal” mission. They don’t explain inciting a mob to assault the Capitol to overthrow a free and fair election. For that, we have to turn to a second cluster of traits termed drive to dominate.

TRUMP’S DRIVE TO DOMINATE CLUSTER

The impulsivity cluster of traits is marked by low energy, difficulty focusing, and careless irresponsibility. The drive to dominate cluster is marked by high energy, a singular focus, and cunning exploitation, but only in one dimension of life. Because of his impulsivity, those in the psychopath’s orbit have to clean up the mess caused by his irresponsibility. Because of his drive to dominate, all those in his orbit need to protect themselves from his aggressive selfishness.

This drive to dominate others has a singular focus quality that separates the psychopath from the great majority of us. There is a ‘different creature’ quality to it. Here again, the abnormal brain of the psychopath is implicated in the drive to dominate cluster of traits. Psychopaths have an inherited neuro-developmental abnormality — a functional deficit in the paralimbic area that is responsible for processing emotions — whereby they cannot experience much, if at all, three emotional states: fear, shame, and guilt. Psychologists call these states “inhibitory” emotions because they guide us to be sensitive to and cautious toward threat situations, and lead us to have an appropriate concern for the effects our actions might have on others, and thus curb our selfish or immoral tendencies. Absent these humanizing emotions, psychopaths cannot establish an empathic or loving connection to others.

If someone cannot experience the deeper feelings of love, tenderness, or compassion, they have no motivation to protect, sacrifice, or feel responsible. If others just don’t matter much, there is no basis to feel obligated to another. Instead of expressions of empathy, there are acts of callousness and selfishness. Relationships — whether marriages, friendships, colleagues, or, in the case of Trump, a country — are one-sided, loveless, and instrumental.

This deficit is tragic. Imagine going through life without the ability to give or receive deep love. For so many, it is the answer to ‘what in life really matters?’ Modern psychology has validated that love really does make the world go round. We call it the attachment drive. It turns out that it is not just infants and children that need a secure connection with a loving other. We all need such attachments throughout our lifespan. Those without that kind of connection are at risk for a range of painful psychological, health, and social consequences.

Even though the psychopath doesn’t feel bereft over this missing dimension in his life, from our perspective, he is. He can’t even get on the field in the game of life called love. This lack of access to ‘what makes the world go round’ is not by choice but instead by neurological design. However, it turns out there is another playing field where he can discharge all his energy and focus. It is a playing field that galvanizes him. He is not totally bereft. He is the fulsome alpha male.

Psychology in Ancient Greece

To appreciate that other playing field, we have to take a brief side trip to ancient Greece.

The godfather of philosophy, Plato, should also be considered the world’s first consequential psychologist. He was the first to name and enlighten the world about the critical elements of human nature (what he termed as the “soul”). He noted three components to our soul: a reasoning part of our nature and then two independent driving forces that capture our focus and set the fundamental goals in our lives.

One he called Eros, which is the drive mentioned above for a secure love connection. The other he called Thymos, which is a Greek word for “spiritedness”. Thymos, as Plato explains, is a drive for recognition of our worth. It is a drive for status. Plato saw it as a profound and universal drive to behave in ways that we feel are praiseworthy and, more importantly, seen by others as such. Thymos is about self-assertion and securing respect and prestige. When Thymos is frustrated, shame and resentment are triggered.

Plato noted that resentment is evoked when our own worth is not recognized and when the worth of those groups with whom we identify is not recognized. This resentment over what is seen as invalidation is often channeled into political identity and action, and Thymos is the psychological driver of our current politics of resentment.

Plato’s formulation of the two fundamental, emotionally powerful components of human nature has held up remarkably well. Evolutionary psychology testifies to the adaptive advantage of Eros, of taking care of our loved ones and bonding with a mate, the giving and receiving of love. Thymos, the driver of seeking status from our peers and within the community, is also deeply wired. From the hunter-gatherers of the stone age to the present, our brains have evolved to seek status because that has meant access to the most desirable mates, the best food, clothing, and shelter, and more excellent protection from hardship and enemies.

Thymos is part of our nature that cannot (and should not) be vanquished. Like the drive to bond and procreate, Thymos is more powerful than reason, which must cater to its preeminence. Thymos, along with Eros, sets the fundamental goals of our lives, to which reason is but a tool to try to reach them.

Plato set out to define more precisely what it means to be human, and he succeeded. Psychological studies underscore the robust correlation between status and well-being. The best predictor of happiness is attaining status as defined by the respect one receives from their peers. Although we tend to disavow playing the status game, we are designed to do so. Along with love, it is the arena that gives life meaning. It is the second force that makes the world go round; the second answer as to what gives life meaning and animates us.

However, Thymos does not automatically lead to admirable behavior. Over the millennia, we have observed three basic strategies employed to win the status game: success, virtue, or dominance. Being successful, particularly in a way that benefits others (e.g., the best hunter or seamstress in a hunter-gatherer tribe) earns status. Being virtuous earns status since such behavior is instrumental in the group’s survival. Those that display concern, sacrifice, and trustworthiness to the group are held in high regard.

It is the third strategy — dominance — that can be problematic.

If status is acquired by only using the dominance strategy, that status can seem unsatisfying and fragile. Respect earned ‘at the barrel of a gun’ is tainted. If one is rigidly domineering, they are frequently seen as arbitrary and selfish. This is more likely to lead to a loss of prestige than its accumulation. If one can blend the dominance strategy with some virtuous elements, it can be somewhat successful, as you might see with a benevolent dictator. The clinical psychopath cannot do this. He can only operate in the one gear of dominance. He cannot sustain the con of presenting himself as virtuous. He is easily threatened by the loss of his status because it is inherently fragile.

This limitation is what we mean when we say Trump is singularly focused. His brain deficiencies have primed him to be all in on the status game, but he has to play it with the core strategy of virtue unavailable to him. Trump used the success strategy to pursue status. And he achieved success (or at least notoriety) in real estate, celebrity TV, and amassing political power. But his primary strategy, as is inevitable with the clinical psychopath, is the drive to dominate.

What is the nature of the psychopath’s drive to dominate? To provide a comprehensive answer to that question, we need to take another brief trip, this time to the science lab.

Hare Psychopathy Checklist

The publication of the Hare Psychopathy Checklist (PCL) in 1980 was the origin of an empirically-based understanding of psychopathy. The checklist was revised and optimized and republished in 1991 as the Hare Psychopathy Checklist-Revised (PCL-R). The Hare Checklist emphasized and operationalized the emotional and interpersonal traits that were highlighted by the early pioneers (see especially Cleckley’s Mask of Sanity) studying the disorder. The Checklist de-emphasized the later emphasis on criminal and antisocial patterns, which broadened the category of psychopathy to a larger and less homogeneous group. The Checklist provided a valid and reliable tool for assessing psychopathy. Operationalizing the key constructs of the disorder enabled an accumulation of research. It became widely used and generated an explosion of studies. By February of 2020, there was over 69,000 studies on psychopathy, as documented by Google search scholar.

Thus, there is an abundance of data to help us delineate the fine details and the deep structure of Psychopathic Personality Disorder. The challenge with the voluminous and expanding data set is finding a way to distill it. Some investigators turned to factor analysis, a robust data reduction technique that enables us to explore and identify primary, underlying factors in a large data set. It is a tool often used in personality research to reduce findings of many specific traits, behavioral observations, and other meaningful data points into more basic underlying factors or clusters of traits.

Factor analytic approaches were instrumental in identifying the three distinct clusters of traits in psychopathy: impulsivity, drive to dominate, and remorselessness. This development has been significant. We no longer have to rely only on the theories of a few experts in the field but instead can refer to efforts of thousands of investigators. Therefore, with the confidence born of this extensive research, we can assert that these three trait clusters are at the heart of PPD.

The Comprehensive Assessment of Psychopathic Personality

Another meaningful contribution to our understanding of the essence of PPD occurred in 2012 with the development and validation of a conceptual model called The Comprehensive Assessment of Psychopathic Personality (CAPP). CAPP was an attempt by a group of leading experts in the field to develop a “map of the territory” of PPD. They started by reviewing the relevant scientific, clinical, and professional literature on PPD, and culling the most cited traits. They then conducted interviews with leading experts of PPD, the purpose of which was to zero in on the cardinal trails of the disorder. From these efforts, a list of 33 traits emerged. For each trait, they created a three-word adjectival phrase to better capture the flavor of the trait.

The CAPP developers then sorted the 33 traits into six “domains”. These domains — Self, Emotional, Attachment, Dominance, Cognitive, and Behavioral — have often been used in empirically derived models of personality functioning. Two of the six domains are relevant to the ‘Drive to Dominate’ cluster of traits: The Dominance domain and the Self domain. The Dominance domain reflects difficulties in how we treat others in our status-seeking (thymotic) efforts. The Self domain reflects difficulties in identity, self-awareness, and emotional intelligence. The entitled arrogance of the Self domain drives the lying, cheating, and bullying of the Dominance domain.

For the dominance domain and the self domain there were six associated traits, as follows:

Dominance Domain

  1. Antagonistic — hostile, disagreeable

2. Domineering — arrogant, overbearing

3. Garrulous — glib, verbose

4. Deceitful — dishonest, deceptive

5. Manipulative — devious, exploitive

6. Insincere — superficial, slick, evasive

Self Domain

1. Self-aggrandizing — self-important, conceited, contemptuous condescending

2. Self-centered — egocentric, selfish, self-absorbed, controlling

3. Sense of uniqueness — sense of being extraordinary, pretentious exceptional, special

4. Sense of entitlement — demanding, insistent, duplicitous sense of being deserving

5. Self-justifying — minimizing, denying, blaming, calculating

6. Sense of invulnerability — sense of being invincible, unbeatable, indestructible

In the list of traits in the Dominance domain — how the psychopath actually treats people — two themes emerge. First, there is a kind of hostile aggressiveness of manner, as captured by the traits antagonistic, domineering, and garrulous. Second, there is the default mode of lying and cheating, as captured in the traits of deceitful, manipulative, and insincere. In common, less charitable vernacular, the psychopath is a lying, cheating bully. He may dress it up in a smooth con at times, but this is his default mode.

Two themes also emerge in the list of traits in the Self domain — how the psychopath thinks about himself. First, there is an arrogant self-image, as captured by the traits of self-aggrandizing, sense of invulnerability, and sense of uniqueness. Second, there is a feeling of deserved privilege, captured by the traits sense of entitlement, self-justification, and invulnerability. In common, less charitable vernacular, the psychopath is a full-of-himself brat. At times, he may turn on a kind of alpha charm, but he ultimately demands special treatment because of his supposed superior qualities.

This research-supported depiction of the cluster of traits under the ‘drive to dominate’ descriptor enables us to understand and predict with more precision the domineering ways of the clinical psychopath. Trump’s behavior from election night to January 6th was a textbook example of a ‘full-of-himself-brat’ who defaulted exclusively to the ‘lying-cheating-bully’ mode. His personality structure limited him to such behavior.

The books that detail Trump’s behavior in the Oval Office during the transition provide a blow-by-blow account that confirms the ubiquity of his destructive traits. Late on election night, when the vote began turning against him, Trump shifted immediately into a defiant mode and the “Stop The Steal” was underway. He launched a direct assault on our democratic system without a moment of reflection. As noted earlier, at 2:30 am he came on TV and demanded the vote be stopped, asserting with no basis in fact: “This is a fraud on the American public…We were getting ready to win this election. Frankly, we did win this election…This is a very big moment. This is a major fraud in our nation…We want all voting to stop…To me, this is a very sad moment, and we will win this. And as far as I’m concerned, we already have won it.”

The “Stop The Steal” campaign was off and running. It was win at all costs, by the bully tactics of lying and cheating.

The typical day in the Oval Office during the transition involved an unstructured milling around of “advisors”, who were subjected to one-way conversations about the “steal”, occasionally interrupted by “meetings” of fawning supplicants. Trump never made an attempt at executive functioning. Executive duties were patched together by other staff. GOP House and Senate leaders were delighted to fill the policy void. This was life in the Trump White House. If we had a time-lapse video of the Oval Office from the day after the election until January 6th, we would see a one-act play, repeated on a constant loop. It would show Trump in a full garrulous dungeon, having one-sided conversations with whoever happened to be in the Oval Office (he wasn’t attending to the business of the country, so it was mostly political advisors who would drift in willy-nilly), or he could whine to on the phone. His manner was wheedling, petulant, hectoring. There were no substantive conversations about challenging the election results, no hint of personal reflection about the facts on the ground regarding the so-called fraud. Instead, there were rants in which he would play the victim, lob wild accusations, and demand something “must be done” without any coherent sense of what that might be.

As the clock ticked down to the certification of the election results, he became more cajoling and then intimidating. His possible illegal call pressuring the Georgia Secretary of State to ‘find’ more votes was recorded for the world to hear. He made a similar call to Michigan lawmakers to demand the appointment of new electors who would vote for him despite losing the popular vote by 154,000, and to the Speaker in the Pennsylvania House to help overturn the election results there.

And then there were meltdowns. He lashed out at Pence, Bill Barr, the White House counsel — people he viewed as subordinates who were now committing insurrection by refusing to kowtow to the “Stop The Steal” mission.

It was all one gear. He would bully and bluster his way to retaining the presidency. After all, that mode had certainly paid off in his real estate ventures and his pursuit of the nomination and presidency in 2016. But it wasn’t a strategy. It was preternatural, the only mode available to him.

Psychopaths tolerate two kinds of relationships: transactional and fawning admiration. The transactions are one way and exploitive. All of life is a game to be won. If you are in the psychopath’s orbit, you will eventually be used. Love, respect, and obligation are not in play. It’s all a transaction. Nevertheless, many people want to be in that orbit, drawn to either the charisma of the psychopath or the power he may have attained. The price of admission is to act as a fawn and show unquestionable loyalty. The drive to dominate trait requires it. How else could you respond to a rigidly self-aggrandizing character who demands affirmation?

This marker of obsequious loyalty was laid down within hours of Trump’s 2016 inauguration when he tweeted out the blatant misinformation about the crowd size at the ceremony. Trump was not delusional. He could see the photos as well as all of us. It was a pure power play. A reality that does not flatter his grandiose self-image must instead bend to his will. All those that worked for him were on notice to defer to his self-aggrandizing drive. Most did. Still, the attrition rate in the Trump White House far exceeded any previous administration. The Chief of Staff position, in particular, became a cruel joke. Trump had no interest in what anyone else had to convey.

However, this ramshackle Potemkin Village dissolved during the transition after the 2020 election. There was no pretense of attending to the business of the country. “Stop The Steal” was the exclusive focus. And you either told Trump what he wanted to hear and unabashedly supported his diatribes, or you were excommunicated. Members of his campaign team who gently tried to present the numbers to him: fired. His legal team, who failed to spin victory from all the lawsuits claiming fraud: gone. Allies in Congress, close advisors, even family members backed away from the man, just trying to hold on until January 20th when the reality principle would have its way. The Oval Office was seriously starting to de-populate, so it was time to bring in the clowns.

What a cast of characters, more fitting for the cantina scene from Star Wars than a serious effort to challenge the election results. The leader was the daft, but irrepressible Giuliani. Trump had come to mock Giuliani, noting his deterioration into a babbling, disheveled, near 300-pound wreck who had the pallor of a man with a serious drinking problem. But Rudy spoke sweet power to the truth about the naysayers in the administration: “They are lying to you, Mr. President. Your people are lying to you.” He also expressed certainty about the chances of overturning the election. And he was a talking head, a good attack dog one at that. And he had some ideas as to how to proceed; they were loony propositions, but at least it was something.

Trump recruited Sidney Powell, a lawyer, after seeing her on Fox News. She was to help with the legal efforts and messaging. In the key news conference at the Republican National Headquarters (the one where Rudy’s hair dye melted and ran down his face), she laid out a case for foreign interference, declaring “communist money in Venezuela” was used to develop voting machines with software to shift votes from Trump to Biden, a conspiracy with links to…Clinton! Soros! The Chinese!

A whole gang of deep-weed conspiracy theorists competed for Trump’s attention. Dave Bossie, a right-wing gadfly, was put in charge of the election challenge. Michael Flynn and Mike Lindell (the My Pillow guy) enthusiastically joined the fray. Steve Bannon (not a nut, but more than willing to say the crazy thing) insinuated his way back into the inner circle. Support on the Hill dwindled to the spotlight-searching, rump back-benchers — Jim Jordan, Louie Gohmert, Matt Gaetz, Mo Brooks, and a few others.

At the end, while the country was left unattended, Trump was left to the fanciful encouragements of the former mayor on New York, who reportedly spent most of his day drinking, or whackadoodles such as the My Pillow Guy. You’d think there would at least be some embarrassment about subjecting the country to this farce. You’d think.

The demand for fidelity to his self-aggrandizement leaves the psychopath in a social world populated primarily by sycophants and fellow opportunists. It’s a relational world that looks barren and sad to us. But the psychopath is quite at home in this world.

The 19th century German philosopher, Friedrich Nietzsche said, “He who has a why to live can bear almost any how.” This maxim assumes we can be the narrator of our own stories, the freedom to choose our values, and the wherewithal to struggle to try to attain them. And the majority of us — with a measure of discipline, insight, and humility — can at least attempt that struggle. But, as we have noted, the psychopath cannot.

The psychopath’s life story is pre-wired and compromised. His superficial egocentricity restricts his attention to the immediate situation and only to those aspects that meet his needs, interests, and desires. And the spectrum of those needs, interests and desires is limited. The inability to empathize and love vitiates his ability to connect, not only to a significant other, but also to friends, the community, even ideas and values. The psychopath only operates in the gear of dominating others for his self-interest. It’s all about the next sale, the ka-ching. The psychopath is always, and only, closing (“All I want to do is this: I just want to find 11,780… Fellas, I need 11,000 votes, give me a break.” — pressuring the Georgia Secretary of State to find just enough votes to overtake then-President-elect Biden).

If Nietzsche had grown up in a world populated by psychopaths, he might have instead produced the maxim ‘If your why is confined to selfish aims, then you can entertain any how, no matter how immoral, to achieve them.” What makes it so easy for Trump to lie not only so frequently but casually; to shrug off personal responsibility for actions that are harmful to others; to treat others callously; to shatter so many norms, and take a wrecking ball to our democracy? The answer lies in his PPD diagnosis, particularly in the third cluster of traits that define the disorder.

TRUMP’S REMORSELESSNESS CLUSTER

The set of traits revolving around remorselessness captures the heart of the PPD affliction. It’s what gives the psychopath this “he’s just a different creature” quality. Martha Stout, a contemporary leading psychopathy expert and author of The Sociopath Next Door illuminates that quality in a description that might, er, remind you of someone:

Imagine — if you can — not having a conscience, none at all, no feelings of guilt or remorse no matter what you do, no limiting sense of concern for the well-being of strangers, friends, or even family members. Imagine no struggles with shame, not a single one in your whole life, no matter what kind of selfish, harmful, or immoral action you have taken… Now add to this strange fantasy the ability to conceal from other people that your psychological makeup is radically different from theirs. Since everyone simply assumes that conscience is universal among human beings, hiding the fact that you are conscience-free is nearly effortless…You can do anything at all, and still your strange advantage over the majority of people, who are kept in line by their conscience, will most likely remain undiscovered… Maybe you are someone who craves money and power, and though you have no vestige of conscience, you do have a magnificent IQ. You have the driving nature and intellectual capacity to pursue tremendous wealth and influence, and you are in no way moved by the nagging voice of conscience…You choose business, politics, law, banking, or any of a broad array of other power professions, and you pursue your career with a cold passion that tolerates none of the usual moral or legal encumbrances. When it is expedient you doctor the accounting and shred the evidence, you stab your employees (or your constituency) in the back, tell lethal premeditated lies to people who trust you, attempt to ruin colleagues who are powerful or eloquent, and simply steamroll over groups who are dependent and voice- less… You have a special talent for whipping up other people’s hatred and sense of de- privation… And all this you do with the exquisite freedom that results from having no conscience whatsoever… You become unimaginably, unassailably, and maybe even globally successful. Why not? With your big brain, and no conscience to rein in your schemes, you can do anything at all. (pg. 1)

Even though it sounds like his bio, Stout wrote that description before Trump came onto the political scene. Her description of the psychopath as an almost otherworldly super-villain may seem exaggerated, but she is in good company. I found similar quotes from the pioneers in psychopathy — Hervey Cleckley, Robert Hare, Kent Kiehl — all along the lines of “there’s just something different” about the psychopath.

This “just different from others” quality is reflected strongly in the cluster of traits under the descriptor remorselessness. After all, the impulsivity cluster can seem like it is just ADD on steroids (although it is much broader). And the drive to dominate cluster can seem like just arrogance or narcissism, or even an attractive boldness and persuasiveness (although it is a dangerous and profound deficit). But what seems to separate psychopaths from the human pack is their callous treatment of others and the lack of remorse in any situation where they may have caused harm.

To talk more precisely about this cluster, we should again turn to the Comprehensive Assessment of Psychopathic Personality (CAPP) model, which spells out the cluster in the following manner:

Attachment Domain

  1. Detached — remote, distant, cold

2. Uncommitted — unfaithful, undevoted, disloyal

3. Unempathic — uncompassionate, cruel, callous

4. Uncaring — inconsiderate, thoughtless, neglectful

Emotional Domain

1. Lacks Anxiety — unconcerned, unworried, fearless

2. Lacks Emotional Depth — unemotional, indifferent, inexpressive

3. Lacks Remorse — unrepentant, unashamed, unapologetic

The Attachment Domain of personality functioning refers to difficulties in relationships, such as the failure to form close, stable emotional bonds with others. The fundamental traits that emerge here from the empirical wash, as well as the input from clinical experts? The psychopath is detached, uncommitted, unempathic, and uncaring. The Emotional Domain reflects problems in the tone, depth, and appropriateness of one’s emotional responses. The salient psychopathic traits in this domain include: lacks anxiety, lacks emotional depth, and lacks remorse.

If we just focus on the psychopath himself, your heart breaks for the ‘suffering soul’ (the meaning of the origin of the word psychopath from the German word psychopastiche) who has this condition. For the overwhelming majority of us, two quests make life precious: the pursuit and realization of love; and the constant struggle to be our best selves, what the ancients called the pursuit of virtue. While these humanizing, life-enhancing drives may expose us to heartache and self-criticism, they are simply off the table for the psychopath. Where love and conscience should be, lovelessness and guiltlessness reside. Compared to perhaps all other psychiatric conditions, this is the one you would take a bullet for to prevent your child from acquiring.

Note that this remorselessness cluster of traits is all about the absence of humanizing qualities. Martha Stout’s description of the psychopath as having a “hole in his psyche” is apt. Our modern, scientific understanding of the disorder places the deficit of emotional reactivity and processing at the center of the inability to love or feel the pangs of conscience. And now, thanks to multi-pronged research efforts and advances in brain imaging technology, we can identify some of the functional consequences and underlying anatomical sources of the disorder.

Robert Hare, developer of the Hare Psychopathy Checklist and author of Without Conscience, devised some creative studies that identified the key functional deficits in the emotional processing abilities of psychopaths. In a seminal study in 1991, Hare presented a series of neutral words (e.g., table, house, tree, lap) and then a series of emotional words (e.g., love, pain, mother, hate) to a group of prisoners who scored in the psychopathic range on the Psychopathy Checklist. He compared their brain activity to a group of non-psychopaths presented with the same words. The non-psychopaths reacted more intensely and rapidly to the emotional words. The psychopaths reacted to the emotionally charged words the same as to the neutral words.

More critically, the brain imaging showed that psychopaths processed these emotional words in the upper part of the brain (temporal lobe area) that is responsible for understanding language and problem-solving. In contrast, non-psychopaths processed the emotional words in the midbrain (paralimbic area) responsible for emotional regulation.

These findings were reinforced in later studies by Hare and his colleague, Dr. Kent Kiehl, who is considered the leading expert on brain imaging and psychopathy. In one study, diagnosed psychopaths were asked to rate morally offensive statements compared to neutral statements (e.g., having sex with a mother vs. listening to music). In another study, psychopaths were shown gruesome or morally offensive images (e.g., a man’s face beaten to a bloody pulp, a picture or Osama Bin Laden). In both studies psychopaths reacted less intensely and in the part of the brain designed for language and problem-solving. They simply do not experience the appropriate emotional reactions to moral wrongs or situations that normally evoke compassion.

When almost all of us see a gut-wrenching or morally offensive situation, we automatically and rapidly react to it in the emotional part of the brain. But for the psychopath, that part of the brain seems to have gone cold. The empathy response is just not there. Instead, they react to such situations more neutrally and analytically, tapping into the part of the brain that, for example, is trying to solve an algebra problem. Hare notes, “it was as if they could only understand emotions linguistically. They know the words, but not the music, as it were.”

We now know that psychopaths respond radically differently to three types of situations: those involving threat, the possibility of punishment, and witnessing the distress of others. Psychopaths are famously calm in situations that most of us would find frightening. A telling anecdote from the biography, “Trump Revealed” (2016), comes from a babysitter. With all the good judgment typical of an adolescent, this teenage babysitter takes his five-year-old charge on an urban adventure. They venture into a sewer system under construction in Manhattan. Shortly after entering, the teenager quickly becomes panicky, “it was pitch black, and you couldn’t see the entrance.” But the five-year-old pressed on into the gathering darkness. “The thing that amazed me,” that teenager, now turned 84, said, “was that Donny wasn’t scared. He just kept walking.”

The insensitivity to the threat of punishment is a crucial factor in understanding the development of psychopathy. After all, childhood punishment or the fear of such punishment for breaking the rules, acting selfishly, and so on, sets the stage for developing a moral code and for considering the rights and feelings of others. Recent studies reveal that psychopaths display this lack of anxiety at a very early age. This insensitivity to punishment undermines their ability to develop a conscience. At best, they only consider whether they might get caught for their deceitful, rule-breaking, or callous behavior.

Distress in others does not register for the psychopath. They display significant problems in recognizing the nuances of voice or facial expressions, particularly ones involving fear. In addition, they show a diminished responsiveness to situations where someone is in distress. Hare, in his book “Snakes In Suits”, shares an anecdote of when he was asked to consult with Nicole Kidman for the movie “Malice”, in which her character was supposed to display psychopathic tendencies. As a way of coaching her about the emotional life of a psychopath, Hare gave her the following prompt:

You’re walking down the street, and you come across an accident at the corner. A young child has been struck by a car and is lying in a pool of blood. You walk up to the accident site, look briefly at the child, and then focus on the grief-stricken mother. After a few minutes of careful scrutiny, you walk back to your apartment, go to the bathroom, stand in front of the mirror, and practice mimicking the facial expressions and body language of the mother. (p 54)

The brains of psychopaths function differently, but are they structurally different? Thanks to the development of a brain imaging technology called functional Magnetic Reasoning Imaging (fMRI), we know the answer to that question. Dr. Kent Kiehl is the neuroscientist who has pioneered the use of fMRI to investigate psychopathy. He oversees the Mind Research Network at the University of New Mexico, which has the world’s most significant sample of brain scans of psychopaths.

Kiehl has identified different regions of the brains of psychopaths that are abnormal compared to non-psychopaths. These brain regions map directly onto areas referred to as the paralimbic system. They include regions of the insula, the anterior and posterior cingulate cortex, the amygdala, the anterior superior temporal gyrus (areas around the midline of the brain), and the orbitofrontal cortex (a region of the prefrontal cortex that is right behind and above the eyes).

The paralimbic system mediates the essential functions that are so problematic in psychopathy: motivation, goal-seeking, self-control, the modulation of alarm and fear, and the processing of one’s own emotions and emotional input from the outside world. The functional deficits associated with the abnormal brains of psychopaths align with the core traits of psychopathy. Kiehl postulates that paralimbic abnormalities are the primary source of Psychopathic Personality Disorder. The observation bolsters this assertion that individuals who suffer a stroke or some other injury to the paralimbic region, such as our famous patient Phineas George mentioned earlier, often then display psychopathic traits. Accumulating evidence points to faulty neural circuitry in the paralimbic system of the brain as the primary cause of PPD.

It’s not just mental health experts who report the reaction “there’s just something different”, but also the parents of children who grow up to be psychopaths. These anguished parents note that such children are different from their peers and markedly so from their siblings. The heartbreaking difference reported is the inability to love or develop a conscience. Two decades of research has validated their observations with children who display aggressive and antisocial behavior. Psychopathy, because it is such a severe and fateful diagnosis, is not given as a formal diagnosis for children. Instead, the more inclusive diagnosis of Conduct Disorder is used. However, investigators have identified a subgroup of these conduct-disordered children who display “callous-unemotional (CU)” traits. CU traits are synonymous with the remorseless cluster identified in the adult psychopath. These children are impervious to punishment. They seem to have zero empathy. They bully and can be cruel to animals. They are deceitful and seem immune to socialization.

This set of CU traits is stable from childhood through adulthood. They predict the eventual diagnosis of adult psychopathy. And they have been linked to faulty paralimbic development.

Does Donald Trump have compromised paralimbic circuity or an under-functioning amygdala? Since the former President has refused any type of psychological examination, it is, uh, unlikely he would collaborate in a fMRI procedure. But while we can’t get a direct measure of his possible brain abnormalities, we can look for the presence of CU traits as a child as an indicator of budding psychopathy.

There is no record of Trump undergoing a psychological evaluation as a child. However, there have been many biographies, although most focus on his adult years. Three that provide some detail on his early years are Trump Revealed: The Definitive Biography of the 45th President by Michael Kranish and Marc Fisher, Too Much and Never Enough by his niece, Mary Trump, who has a Ph.D. in clinical psychology, and The Strange Case of Donald J. Trump by Dan McAdams. Their accounts do lend support to the presence of the callous and unemotional style linked to adult psychopathy.

The term “unemotional” in this line of research is synonymous with the following traits: lacks anxiety, lacks remorse, and is unfazed by the prospect of punishment. We noted earlier his babysitter’s report of his fearlessness as a five-year-old in the gloom of the Manhattan sewer system. Trump’s father, Fred, by all accounts, was a harsh and intimidating man. Trump’s older brother, Freddy, who was Mary’s father, was traumatized by his father’s critical and demanding manner and succumbed to death at age 43 to alcohol-related conditions. Donald Trump bragged he was never intimidated by his father, unlike his other siblings. Mary Trump reports that Trump’s fearlessness was the impression of other family members as well. Trump was a constant and unrepentant rule-breaker, both at school and home. Trump spent so much time in detention at Kew-Forest elementary school that his classmates nicknamed the punishment “DT’s”, which was short for “Donny Trumps”. He was in constant arguments with his teachers. At home, his mother acknowledged she couldn’t control him. People remember him as a child who never backed down.

Many remember Trump as a bully, and there are numerous examples of callous behavior. For example, Mary Trump reports he “tormented” his little brother Robert and stole his toys. A neighbor told biographers that, after she had put her son in a playpen in the backyard and then went inside for a few minutes, she returned to see that Donald, five or six at the time, was throwing rocks at the toddler. Another neighbor remembers seeing Donald jump off his bike one day and thrash a little boy. When he was a bit older, Trump and a friend, imagining themselves being gang members, began collecting switchblades. Fred Trump discovered the cache of knives when Donald was in the seventh grade, which reportedly triggered his time in military school.

While it required some digging by biographers to unearth facts about Trump’s childhood, once he crossed the celebrity threshold, it was easy to obtain data about his personality traits. And, of course, once he announced his run for the presidency, he became the most observed and chronicled man on the planet.

During the first couple of years of his presidency, Trump lied casually (approximately 10,000 times according to the Washington Post fact-checker) and polarized the electorate shamelessly (trolled Blue America, only governed for Red America). However, for a period, the country seemed to avoid catastrophe, in no small part because his dereliction of duty resulted in few achievements of his stated mean-spirited policy goals.

Trump’s Covid Response based on his Characteristic of Remorselessness

We saw the impact of Trump’s impulsivity cluster of traits on his handling of Covid. It is also instructive to examine Trump’s disastrous response to Covid through the prism of his cluster of remorseless traits. We have described the structural neurological abnormalities of the brains of psychopaths. These abnormalities result in functional deficits in the psychopath’s ability to experience:

  • Fear and alarm
  • Empathy and compassion
  • Shame and guilt

As a diagnosed psychopath, Trump was devoid of these feeling states. Without access to such emotions to help guide his perceptions and reactions, Trump’s callous behavior in the face of the crisis was inevitable.

Trump’s inability to process emotions related to threat situations helps us understand his sluggish response to Covid-19. In January, when he was getting alarming reports about the virus from the intelligence agencies and senior officials, he dismissed them. He compared the virus to the common flu and called it a “hoax”. In February, he took no action to develop testing or provide supplies for the looming health care crisis. He seemed blind to the scale of the risk. He was genuinely whistling past the graveyard, not out of fear but rather its absence.

Trump’s lack of empathy and compassion sealed America’s poor outcome with the virus. Only a psychopath would react to the alarming numbers of deaths as disembodied facts. Only a psychopath could respond to the wrenching images coming out of Europe at the beginning of the pandemic with all the intensity and depth of someone attending a matinee action film.

Lacking any gear of compassion, Trump barreled forward in the only gear he possessed: win-at-all-costs-political-domination. He refused to wear a mask and mocked those who did; he tweeted out support to protestors who flaunted social distancing guidelines; he doled out ventilators and protective equipment to governors based on their political leanings and sycophancy to him; he peddled exaggerations about the administration’s achievements and bogus treatments; and he conducted rallies and White House events that became super-spreader events.

Trump has no capacity for shame or guilt that might have served as a brake on his impulse to deceive and divide. We now know from Trump’s interview responses to Bob Woodward for his book “Rage” that he was fully briefed in January of 2020 about the lethality and transmissibility of the virus. And yet he lied shamelessly to the public from the beginning about the threat (“the 15 people (infected) within a couple of days is going to be down close to zero, that’s a pretty good job we’ve done”, “It’s going to disappear. One day like a miracle, it will disappear”, “This is a flu. This is like the flu”.)

A core feature of psychopathic shamelessness is the refusal to take responsibility. This trait was on full display throughout America’s regrettable response to Covid, “Nothing more could have been done. Nothing more could have been done. I acted early. I acted early,” he blathered to Woodward. At a press conference in June of 2020, Yamiche Alcindor of PBS News Hour asked the President, “are you concerned that downplaying the virus maybe got some people sick?” Given the opportunity to express at least a smattering of empathy or responsibility, Trump — in what we can recognize as a trailer for the con he was going to play if he lost the election — seemed to ignore the question and replied, “Well a lot of people love Trump. A lot of people love me. You see them all the time. I guess I am here for a reason, and for the best of my knowledge I won. And I think we are going to win again. I think we are going to win in a landslide.”

And so, no surprise, Trump petulantly asserted victory in front of the cameras at 2:30 am on election night. And he kept claiming throughout the transition period and on January 6th at the ellipse, “We won. We won in a landslide. This was a landslide.” This was right before he incited his unvaccinated army to descend on the Capitol, “We will never give up… we will not take it anymore… we will stop the steal… if you don’t fight like hell, you’re not going to have a country anymore.”

If that rhetoric meant delegitimizing a duly elected president, meant taking a wrecking ball to our democracy, so be it. There were no embers of shame, guilt, or anxiety that might slow him down. “The more bizarre shit becomes, the more Trump likes it,” a West Wing aide said about Trump’s state of mind during the transition period. Picture a chimp juggling a hand grenade.

Michael Wolff, in the final few paragraphs of “Landslide”, having completed his reporting on the absurd spectacle of the transition, grapples for a perspective on what he witnessed and dug up:

Without the capacity to register shame, and ever fueled by grievance, or at least the drama of grievance, and a shamelessness that always allowed him to rewrite the grievance as an insult upon all the faithful, he was a maximally reliable phoenix. He had been impeached twice, disgraced in the eyes of at least half the country multiple times, more, and defeated for re-election — without any of this seeming to much penetrate or alter his sense of self.

The fact that all the modern standards of opprobrium, obloquy, disgrace, public mortification, and general measures of accountability did not bow him was at the core of liberal rage and frustration. His ability to stand up to the moral wrath of the liberal community seemed also to be at the core of the continuing awe and devotion of so many others.

And given the incompetence that surrounded him, the stumblebums who attended him, and his own stubborn refusal to listen to more considered and cautious counsel, to tolerate anyone whose talents might actually be clear and need to be credited, the heroic point could hardly be missed: It was only him. He was a team of one.

He walked into the storm alone and came out alone.

The fact that he survived, without real support, without real assistance, without expertise, without backup, without anybody truly minding the store, and without truly knowing his ass from a hole in the ground, was extraordinary. Magical. (pgs. 289–290)

Well put. Is Donald Trump unique? Yes. Was he fortuitous? Certainly. Is he magical? No. It is a subtle distinction but one worth making. Donald Trump is no sorcerer. He is the Fantasia version of Micky Mouse at the mercy of animated broomsticks, rather than their animator. He is at the mercy of his destructive traits. He is a garden-variety psychopath, nailed to that cross by a comprehensive, reliable, and valid diagnostic system that delivers that judgment scientifically. He is destined to suffer in a particular way because of the brain abnormalities associated with the disorder. More precisely, he is at the mercy of three hard-wired clusters of traits. Donald Trump is no sorcerer or master puppeteer, but rather a puppet, dancing robotically to the strings of impulsivity, the drive to dominate, and remorselessness.

Like any diagnosed psychopath, Donald Trump has had to suffer a life devoid of love, depth, conscience, or any hope of self-discipline. It is a life incapable of developing a caring obligation toward others, incapable of remorse for callous or immoral behavior, and incapable of pursuing anything beyond his egocentric needs. It is a cold and empty life, marked by the absence of ‘the rumblings of a human soul’.

And, of course, it is also a life destined to inflict harm and suffering on others.

America Was Ripe for a Trump Takeover

That Donald Trump actually became president is unique, even extraordinary, but not incomprehensible. After all, psychopathic traits are a good fit for the Machiavellian dark arts associated with political success. David Shapiro, a respected early theorist of psychopathology, makes the point in his text, Neurotic Styles, that psychopaths possess the ‘malignant charms’ that can result in some real-world success:

It is well to remember, however, that the impulsive (psychopathic) style may, in certain areas of living, be quite adaptive. These areas seem, in general, to be ones where readiness for quick action or expression and/or a facility and competence of a sort that be developed in pursuit of immediate and egocentric interests can be useful. It is well known, for example, that many impulsive people possess considerable social facility and are often socially very charming and engaging. They may also be quite playful, in contrast, for instance, to the heavy, over deliberate, and somewhat dull quality of some obsessive- compulsive people, and, given a good intellectual endowment, they may be witty and entertaining. There is no doubt also, that many actual as well as fictional “men of action,” have excellent practical competency and a capacity for quick and unhesitating action… have a keen, practical intelligence that is suited to the competent execution of their short-range, immediate aims. (p. 147)

Our current delineation of psychopathy underscores Shapiro’s observation. Trump’s preternatural ability to lie casually, destroy norms shamelessly, dominate ruthlessly, and sow division through grievance politics, have been instrumental in accumulating political power.

Although the environment does not play a major role in developing psychopathy, Trump’s particular background is noteworthy. In “Too Much But Never Enough”, Mary Trump noted Trump’s bragging, shamelessness, and impressive branding skills even as a teenager and young man. She observed that Donald was clearly the favorite of his tyrannical father, who seemed to relish in fueling Donald’s self-aggrandizement. Few psychopaths are born into wealth end up in prison. As soon as he graduated college, Trump immersed himself in the world of commercial real estate. As the family business took on more ambitious projects in Manhattan, Trump inserted himself in city politics, where he began honing his ‘malignant charms’ in the political realm.

And when Trump formally entered the political fray in 2015, he was welcomed into a media environment in Red America that embraced his ‘beyond truth and shame’ expressive style. Fox News, talk radio, evangelical TV, and other conservative media companies had become purely political operations, ratings-driven conglomerates absent of any journalistic standards or accountability. They have become colossal profit-making machines that have no compunction in trafficking in heated exaggerations (“Joe Biden wants to defund the police!”), outrageous conspiracy theories (that deep state and global elites manufactured the pandemic), and fear-mongering (the coming “invasion” across the border taking aim on our suburbs).

The tabloid-style of social media also invited the delivery of emotionally provocative content that was untethered from reality. Trump’s twitter feed was but one example of a delivery system designed to stoke emotion, deepen polarization, blunt reason, and control the narrative for half the country.

Likewise, the political ground in the GOP had become a fertile field for the introduction of the psychopathic sensibilities of winning at all costs and promoting deceitful and divisive narratives. Major contributions to this evolution include:

  • Gingrich’s slash and burn mode of political combat.
  • George W. Bush’s administration’s disdain for the “reality-based” community as “clueless.”
  • Mitch McConnell’s contempt for Senate rules and norms.

Trump was exquisitely designed for this more depraved political landscape. He had the psychopathic chops to lie with impunity, ridicule elites, sow division, scapegoat immigrants, swallow the dog whistle of racism, and play the grievance card. His rallies were improvisational masterpieces. The stagecraft was right out of “Celebrity Apprentice” and “World Wrestling Entertainment”. He pitted the “real” Americans (God-fearing, flag-loving, beer-drinking, hard-working) against the “other” Americans (snobbish elites and the tax-eating, job-usurping brown skinners). He personified the divisive message, which converted to rapture with the GOP base.

But make no mistake. Trump was an outlier in GOP land only in style, not substance. He is the apotheosis of Nixon, Reagan, the Bushes, McConnell, and the rest of them. They had seeded the psychological ground for Trump’s particular set of traits to flourish. With street smart cunning, he understood the heretofore disavowed, but beating, heart of his party and the passions it represented. Misinformation, winning at all costs, loss of decorum, white nationalism, grievance, and identity politics had already become the GOP land’s cash crops. It was easy harvesting for a man who didn’t just want to exploit those sensibilities but exuded them.

Trump was no sorcerer. He had the benefit of great wealth. His psychopathic trait structure was an asset, not a liability in the current media and political landscape. But let’s give the brash tycoon his due: he possessed an impressive set of skills for the historical moment. These included: how to read a crowd; how to move a crowd; how to brand and make a label stick (“sleepy Joe”); how to turn failure and disgrace into gold; how to spin a privileged life into a capitalist fairy tale, as he did in “The Art Of The Deal”. Perhaps most critically, his years in front of the camera with Celebrity Apprentice had sharpened his skills as a Reality TV star. He understood the fundamental modus operandi of that genre: to be riveting. Trump was not simply swept up in our descent into tribal warfare. He was a skilled protagonist.

Students of history, or more precisely the history of history, view it as an ongoing clash of values that progresses to new understandings and new political arrangements that can ripple out arcs of greater justice and freedom. But history also reveals many moments where regression wins out, and our better angels take a hit. We seem to be at such a moment now.

There are always crucial moments within this epic drama of history where individual actors can play an outsized role. A protagonist can tip the balance in one direction or another, can lead us out of darkness — think Lincoln, think Churchill — or into the gloom of an underground sewer system — think Putin, think Trump.

By all means, have empathy for the ‘suffering soul’ of the psychopath, but, for Trump’s sake and ours, recognize he is a clear and ever-present danger.

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Vince Greenwood, Ph.D., is a clinical psychologist who lives and works in Washington D.C. He founded DutyToInform.org.

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Vince Greenwood, Ph.D.

Vince Greenwood, Ph.D., is a clinical psychologist who lives and works in Washington D.C. He founded DutyToInform.org.