This posting has two more parts

               Trump outside the circle of psychodynamics.

For a none American who knows the USA reasonably well watching what is happening there, for the last two years, is unsettling. I thought that I can fairly understand historical events if I meant to analyze them, but I am not sure anymore. The election process in the USA with Trump’s role in it, ending being elected by a twist in the process, backed by minority popular voters who became the only recognizable political force in the country, succumbing the will of the Republican Party to its will, creating a cult of Trump, and changing the balance in democracy in the country is too much to fathom. All that need acrobatic political analytic efforts to explain. Understandably, mental health professionals directed their attention to Trump the person. He is a glaring case of “strangeness” that is also difficult to make sense of. They did not ask the question: how on earth could that man-whoever he is - be the president of such an impressive country, accepted by millions of Americans, and become an unchangeable political power. They tried to understand him to understand and explain the phenomena, instead of understanding the phenomenon first to explain him.

I want to explain my basic stand about social evolution. There is no leader (from Moses to Ghandi and Mao) that could initiate a people’s movement which could change the course of history. Those historical movements create leaders or find them and make them lead the people to achieve their aspirations. Germany of after Versailles looked for a Hitler to avenge their humiliation and chose the Jews to project on them their sense of isolation and helplessness. There is another factor that I will mention by the end of the posting which is equally decisive in having a wider view of matters.  Trump looks like that kind of leader. He-as an individual- is of no real qualities to lead the USA anywhere. But what the US aspires to achieve seems to need a period of “Trumpism”. The USA stumbled over him by mere chance. However, there is no doubt that Trump as an individual is a fascinating pathological specimen.

1.     The Problem of Diagnosis:

Mental health professional, and psychoanalysts in particular, have a inclination to giving psychodynamic explanations to human phenomena. They usually get away with that-without any demands for justifying themselves- because human phenomena are engendered by psychical dynamics, which is the domain of their expertise. Sometimes the ease dictates taking this venue in understanding, but most of the time this tendency tempts to overlook or disregard important non-psychodynamic issues in the phenomenon which could be more significant. Trump is a model of this case. He is amazing in magnifying some of the purist psychopathological conditions which analysts and psychiatrists know well. Even a beginner could still get few things right about his personality because of that. As an analyst, and watching experienced colleagues trying their hand in that ‘attractive’ exercise I also tried-mostly silently- to participate. I did not have anything new to add. I was not completely convinced that Trump is just a case of psychopathology of psychodynamic nature. I had two reasons for my doubt. My initial feeling was that he is a facade of a social phenomena that is brewing in the USA, thus working on the individual forecloses on the phenomenon. He seemed to have come-unexpectedly- as a suitable leader for social change. The second is purely professional. As a clinician I was tempted for a long time to use the obvious to categorize Trump. but all my attempts failed to give me a satisfying result.

There is no arguing about the mental unwellness of Trump. Even his ardent supporters could not find in him any signs of mental stability to counter the attack on his mental condition (that is why he is more of a social phenomena than an individual case). Even the notion that he is acting erratically as a strategy did not hold much water because he got himself confused by his own erratics. However, the two main areas of psychopathology the professionals focused on were narcissism and character disorders emanating from narcissism. Trump’s speeches and his compulsive depiction of himself in self-aggrandizement terms made narcissism jump the line in the choice of diagnosis.  However, Dr. R. Jackson was one (to my knowledge) who thought of neuropsychological testing because the man exhibited unmistakable features of lack of contact with external reality, even his own. The man was incessantly talking nonsense about himself to his political base (a bad case of arrogant ignorance, and self-centeredness) with no sign of being aware of what is happening outside his opinions regarding local and international affairs. His opinions were considered by him and by his supporters as realities. All his speeches even those pertaining to important issues were always and quickly turned into personal issues (I said to myself !!!!).

To make it easy to discuss this feature in Trump I will mean by reality ‘issues’. He is totally unable to discuss issues; they instantly change to opinions, his off course. Opinions about issues then become the reality of the issues: “We have the greatest recovery in history”, “this is the worst agreement ever been reached”.  A second feature is the instability of those realities.  Although his realities [opinions] are totally his creation they are unstable and change easily because they are not formed in relation to a real situation in the first place. Trump, and the white house never admit making mistake because in actuality there was nothing right or wrong with the issue; it was only an opinion not a fact. After the fiasco of the G7 meeting he said that he does not care that the relationship with the seven allies has deteriorated and that they are now terrible. The following day, as a reaction to a journalist suggesting that he alienated his best allies, he immediately denied that there is any problem with the relationship with the allies and that they are 10. Changing an issue into an opinion and holding on to the opinion as the substitute for ‘reality’ gives Trump a feeling that whatever he says is real (not noticing that he is not talking about reality). This is what the press and critiques call lies!! It is important to emphasize that this happens not as strategy political maneuver but come as an authentic assessment of matter.

This is the material we clinicians use to reach a diagnosis. It is evident that the only certain and assured element in this picture is its uncertainty and unpredictability of Trumps responses.. 

2. Narcissism and Character Formation

Trump has a difficulty-almost an impossibility- in dealing with anything that is not him. For the last two years he did not discuss, explain, justify one of his grand statements about what he accepts or rejects. “the Iran agreement is the worst agreement ever”. He did not say what was wrong with it, He always followed those kinds of statements with complementing statements about his unmatched ability to do better. The important part in this unfailing observation turns any subject into a personal matter. He changes what is not him into him or his in order to be able to talk about.  I mentioned in another place that Trump does not lie or contradict himself because whatever he says is not coming from judging something that existed outside him but only something different that he ‘now’ considers true. To lie one has to know the truth of what he intends to change, but if he changes it first and then talks about what he changed as the fact you would not be lying.  A lie is an intentional conscious distortion of what is real, thus Trump is incapable of truly lying because he does not know or have any reality. The most vivid moments in his encounters with the media is when asked about his Russian contacts. He vehemently denies the existence of that matter because it seems to him that it did not happen. What confirms this ‘ridiculous fact’ is the lack of intention or preparation or thinking of lying. His so called lies come spontaneously as reactions to the issue raised at the moment. The two features of the absence of reality and the absence of intentionality in Trump’s comportment refute the diagnosis of narcissism or character disorder, but strongly suggest a rather alarming psychopathology of another kind.

Narcissism is an unconscious behavioral condition that in some cases could become compulsive behavior. The narcissist does not talk about the qualities that constitute his narcissism; he lives those qualities preconsciously, but mostly unconsciously. A narcissistic woman who thinks she is pretty carries herself as a beautiful woman; seldom would she mentions that verbally. A narcissist would have an image of himself and develops an affective relationship with that image and lives it instead of living his real life. Narcissism is getting captivated by an image of the self and loosing contact with the true self. This is why there is narcissistic self- hate like the man who is obsessed by his image as a short person. The narcissist has an image of himself and believes others see it and evaluate it the same way he does. Trump has no such narcissistic image. He describes for himself an image of him of him and keep repeating it in order complement his loss of identity. He even describes that image to others to see, almost like someone who is not sure people will notice him spontaneously. No narcissist would tell others “I am so rich, I am a genius, I bet you are so happy that God gave you me to be your president.”. A narcissist would like to hear people say that bout him, though not say it himself. No narcissist would lower himself by telling people what they should see in him because he believes that his narcissistic qualities are self- evident. Trump is not sure of how people see him or even if they see him at all. He keeps painting that picture nonstop. One of the related feature in Trump is the exaggerated adjectives he uses all the time to assure himself that he will be seen as real.

Character formations happen over the time of growing up as defensive mechanisms against external pressures (the parental and social demands) and internal pressures (sexual and aggressive). Character structures reveal the basic childhood experiences and their interplay in structuring the intrapsychical formations. Previously, when the psychoanalytic theory included the psychosexual modality of development, analysts were able to notice the workings of a stage of development (oral for instance) in the formation of a character type (oral personality). Freud has an interesting and thought-provoking paper on that subject (Libidinal Types. 1931).  This way of looking at character formation is long gone. Yet, what replaced it (Ego, Self, Projective\Identifications, Enactment), etc. did not do much more than distorting the concept. Any suggestion of a character formation that describes Trump in those new contexts will face the problem of defining the character. The man has no definable character. Moreover, if he is a mixture of charters we will not be able even to settle on that because the mixture is not even stable enough to allow predictability. Therefore, I have to say that any diagnosis of Trump’s character misses the obvious: the man has no definable stable character formation. The old explanation of character formation would tell that Trump did not deal with neither external nor internal pressure to develop and require a charter formation. This goes well with what we noticed before about his handicap in dealing with reality of any sort. We also noticed his substandard ability to control his inner pressures and act them out uncontrollably, whether with lawyers, women, colleagues, etc.

If Trump is not able to deal and mange reality, and has no character formation that gives him a stable place in the society, at least as a predictable entity, what is the psychoanalytic diagnosis of such condition? We might encounter all those features in any psychopathological condition because they indicate absence and lack of what should be there and not the presence something that could be defined.