The Narcissist in Our House


An ongoing concern of many, including myself, is that this nation somehow managed to elect a man with a personality disorder. If that doesn’t mean anything to you then let me briefly explain. The definition of a personality disorder is a deeply ingrained and maladaptive pattern of behavior of a specified kind, typically manifest by the time one reaches adolescence and causing long-term difficulties in personal relationships or in functioning in society.

If you or anyone you know is unfortunate enough have been diagnosed with a personality disorder via the Diagnostic and Statistical Manual (DSM-IV or DSM-V) we use as psychologists to diagnose patients, then you might know that this is bad news. People who have personality disorders are commonly thought of as extremely difficult to deal with. They are the kind of people that are often categorized as “crazy” or “volatile” in their behavior towards others.

In the psych business people with personality disorders are considered to be some of the most difficult patients you can work with professionally. One of the many concerns is that there is no “cure” for a personality disorder and there currently are no medications that effectively treat them. Hence, the best prognosis for someone with a personality disorder is that if they identify that they have a problem enough to at least work to improve the way they interact with others. Unfortunately, many people with personality disorders do not believe they have a problem and instead deflect any negative feedback and always find blame in the actions of others rather than looking inside. Not surprisingly, one hallmark of personality disorders is a marked lack of empathy.

The essential features of a personality disorder are impairments in personality, functioning and the presence of pathological personality traits. The first criterion for a diagnosis is impairment in self and interpersonal functioning. The person’s identity would be derived from ego-centrism where their self-esteem is based on personal gain, power, or pleasure. In addition, their self-direction and goal setting would be based solely on personal gratification. For these people there is an absence of prosocial internal standards associated with failure to conform to lawful or culturally normative ethical behavior.

The next criteria is an impairment in interpersonal functioning as demonstrated by an absence of empathy and a general lack of concern for feelings, needs, or suffering of others. These people show a lack of remorse after hurting or mistreating others. They can also demonstrate impairment with intimacy. For many people with a personality disorder there is an incapacity for mutually intimate relationships. Instead they view relationships as exploitation is a primary means of relating to others, including by deceit and coercion; use of dominance or intimidation to control others. Is any of this starting to sound familiar?

The last criteria area is a list of pathological personality traits in various domains:

  1. Antagonism as characterized by manipulativeness and frequent use of subterfuge to influence or control others; use of seduction, charm, glibness, or ingratiation to achieve one’s ends. [MAKE AMERICAN GREAT AGAIN, BUILD A WALL aka SAY ANYTHING TO GET ELECTED]
  2. Deceitfulness: Dishonesty and fraudulence; misrepresentation of self; embellishment or fabrication when relating events. [TRUMP UNIVERISTY, SIX BANKRUPCIES]
  3. Callousness: Lack of concern for feelings or problems of others; lack of guilt or remorse about the negative or harmful effects of one’s actions on others; aggression; sadism. [BULLYING: ALICIA MACHADO, MEGYN KELLY, ROSIE O’DONNEL, HRC…. GRAB HER BY THE PUSSY BECAUSE I’M FAMOUS AND THEY WILL LET ME DO ANYTHING]
  4. Hostility: Persistent or frequent angry feelings; anger or irritability in response to minor slights and insults; mean, nasty, or vengeful behavior. [TWITTER, TWEET, TWEET]
  5. Disinhibition characterized by irresponsibility and a disregard for – and failure to honor – financial and other obligations or commitments; lack of respect for – and lack of follow through on – agreements and promises. [REMEMBER ALL THOSE SMALL BUSINESSES AND CONTRACTORS HE NEVER PAID!!]
  6. Impulsivity, such as acting on the spur of the moment in response to immediate stimuli; acting on a momentary basis without a plan or consideration of outcomes; difficulty establishing and following plans. [CONSTANT FLIP FLOPPING ON ISSUES, GOING BACK ON CAMPAIGN PROMISES; HE ONCE WAS A DEMOCRAT, HE ONCE WAS PRO-CHOICE,]
  7. Risk taking: Engagement in dangerous, risky, unnecessarily and without regard for consequences; boredom proneness and thoughtless initiation of activities. [TWEETS, TANTRUMS, THREATS]

Many people have heard of various personality disorders, the most well known is Borderline Personality Disorder which is seen more in women than men. A less common, yet still well known one is Narcissistic Personality Disorder, which is seen more in men than women. In our culture we have a tendency to casually throw mental health terms around calling someone who is very organized “OCD” or calling someone who seems sure of themselves a “narcissist” but the actual pathology behind these terms is quite concerning.

Chances are you either know or have known someone with a personality disorder in your lifetime. These people live among us. I have had several clients who have had either a parent, relative, or friend who has a personality disorder and usually they come to therapy with anxiety and depression that stems from the burden of that relationship. In many cases they have to cut that person out of their life to maintain their own sanity. In other cases, they have to draw strong boundaries as a means of dealing with that person on their own terms as they are continually berated and devalued by that individual.

Now for our case study. No need for a made up patient of Joe Smith to explain this, we’ll just use POTUS. Narcissistic Personality Disorder – The essential features of a personality disorder are impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits. To diagnose narcissistic personality disorder, the following criteria must be met:

A. Significant impairments in personality functioning manifest by:

  1. Impairments in self functioning (a or b):
    1. Identity: Excessive reference to others for self-definition and self-esteem regulation; exaggerated self-appraisal may be inflated or deflated, or vacillate between extremes; emotional regulation mirrors fluctuations in self-esteem. [OBSESSED WITH FAME. CONSTANT NAME DROPPING. I’M BEST FRIENDS WITH PUTIN ALTHOUTH I HAVE NEVER MET HIM]
    2. Self-direction: Goal-setting is based on gaining approval from others; personal standards are unreasonably high in order to see oneself as exceptional, or too low based on a sense of entitlement; often unaware of own motivations. [EVERY FIXTURE IN MY HOUSE IS MADE OF GOLD, SELF PORTRAITS EVERYWHERE, MY NAME IS ON ANYTHING FROM STEAK TO WINE TO GOLF COURSES TO PHONY UNIVERSITIES]

2. Impairments in interpersonal functioning (a or b):

    1. Empathy: Impaired ability to recognize or identify with the feelings and needs of others; excessively attuned to reactions of others, but only if perceived as relevant to self; over- or underestimate of own effect on others. [NEVER APOLOGIZES TO ANYONE. ONLY RESPONDS TO CRITICISM WITH ACCUSATIONS AND EXCUSES. MADE FUN OF A DISABLED REPORTER AND STILL DENIES HE DID SO]
    2. Intimacy: Relationships largely superficial and exist to serve self-esteem regulation; mutuality constrained by little genuine interest in others‟ experiences and predominance of a need for personal gain. [ON HIS THIRD TROPHY WIFE. “I GO THRU THE ROOF WHEN DINNER IS NOT READY WHEN I COME HOME”]
  1. Pathological personality traits in the following domain:

a. Antagonism, characterized by Grandiosity: Feelings of entitlement, either overt or covert; self-centeredness; firmly holding to the belief that one is better than others; condescending toward others. [SELF EVIDENT. HAVE YOU EVER EVEN ENCOUNTERED ANYONE SO SELF ASSURED OF THEIR BULLSHIT?]


c. The impairments in personality functioning and the individual’s personality trait expression are relatively stable across time and consistent across situations.

  1. The impairments in personality functioning and the individual’s personality trait expression are not better understood as normative for the individual’s developmental stage or socio-cultural environment. [REPUBLICANS MIGHT ARGUE THAT HIS BEHAVIOR IS “NORMAL” BECAUSE HE HAS A RIGHT TO HIS ENTITLEMENT BECAUSE HE CAME FROM A WEALTHY FAMILY WITH A SILVER SPOON IN HIS MOUTH]      
  2. The impairments in personality functioning and the individual’s personality trait expression are not solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma). [REPUBLICANS WOULD ALSO LIKELY TRY AND FIND ANY EXCUSE RATHER THAN ADMIT THAT THEIR POTUS HAS NPD FOR ORGANIC REASONS]


So there you have it. POTUS meets every criterion for Narcissistic Personality Disorder (NPD). It’s a slam-dunk diagnosis. There are various historical figures that are also thought to have NPD. To name a few there is Hitler, Stalin, Ted Bundy, Lee Harvey Oswald, and Saddam Hussein… not good company. This is not good news for America when your POTUS is in the same league as dictators and serial killers.

I run a weekly group at a community clinic that teaches a certain kind of therapy, Dialectical Behavioral Therapy (DBT), which is thought to be helpful for people with personality disorders. One of the main tenants of this therapy is helping people see the middle ground in situations rather than only categorizing the world into extremes of good and bad. People with personality disorders have an uncanny ability to think in all or nothing terms. We call this a black and white thinking process. This means that everything is either amazing or horrible, there is never a middle ground, and there is never a compromise of information. DBT teaches the middle path where you integrate the opposing forces.

There are three things that concern me most moving forward with this knowledge about POTUS. One is that he functions with his NPD as though it were an asset that helps him maneuver the world unencumbered by other people’s feedback. This is someone who will act impulsively and unapologetically regardless of the context and given any flack will never stop to self reflect. The only way a person with NPD could improve their behavior is to admit to themself they have a problem and then work to gain more insight into their deficit of thought. But how can this happen if the bullying and behavior this man has demonstrated has led him to the most powerful office in the world?

Another great concern I have is that he only thinks in black and white and yet what we truly need is a negotiator. We don’t need someone who can “make great deals” because for him those great deals are only on his own terms, which could include not holding up to his end of the bargain. We need someone who can put themselves in the shoes of the person they are dealing with, show some empathy for the opposing side, and then make a compromise. Obama was actually very good at this yet some people saw him as “weak” because he was able to strike deals with Iran, Cuba, and other countries by finding the middle ground. With this POTUS, there will only be action in extremes.

My last concern is that this is a highly impulsive man who has his finger on the button for countless life or death situations for thousands, millions, perhaps billions of people. This man now has the nuclear codes for this country and actually questioned defense department officials several times about why they don’t use nuclear as if it were an easy solution to ongoing problems like ISIS. I honestly now fear nuclear war is a possibility and I never thought that I would type these words, yet I do not trust this man one bit because I understand the pathology behind his erratic behavior.

As we hold our breathe for the next four years (hopefully less…) may we use this dilemma as a pivotal moment in modern history to not make the same mistakes that were made in Nazi Germany and Stalin’s Russia yet again. Only a true narcissist can think so much of their own life while thinking so little of others. For the people who voted for DT they seem to have mistaken the idea of “strong leadership” for a megalomaniac. Some of Obama’s last words to us in his goodbye speech were reminding America why we have chosen democracy over authoritarianism.

The global wave of nationalism has led us down a rabbit hole that will be difficult to climb out of. My greatest hope for this country in the next four years is that this nightmare will somehow unites us on a deeper level, that we can start to appreciate all that we have rather than continually asking for more. Life without empathy is a life without authentic connection with other people. DT may never have experienced empathy, but most of us have, and now is the time to use it as a tool to unite. We need to use the power of our connections to each other as human beings as a weapon, stronger than any nuclear warhead. Without each other, without valuing each other’s lives, without real authentic connection, empathy and compassion we are nothing but automatons, nothing but sheep being led to the slaughter.


This blog is dedicated to President Barack Obama and his family who have been an inspiration to me and many Americans. He has skillfully balanced his leadership with pragmatism, compromise, and optimism and demonstrated to us compassion, empathy and humility while being in the most powerful position in the world for 8 years. He has made me proud to be an American again.

I am not a religious person but every political speech ends in “God Bless America” and my last thoughts on this inauguration day are “Please have Mercy on us Dear Lord/God/Higher Power Above please, please have Mercy.”

Posted 1.20.17

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