From the book: The Dangerous Case of Donald Trump by Bandy Lee, MD, MDiv
Personality Disorder #3 – Delusional
Trump’s disconnect from reality is seen in his insistence on matters that are demonstrably false (Obama is not an American, I won the popular vote, my inauguration crowd was the largest in history, Corona virus is a Democratic hoax, mail-in voting involves significant fraud, etc). According to Right Wing Watch, Donald Trump proclaimed or implied that 58 conspiracy theories were true before he was even elected. The list has grown substantially since then, including some that are truly bizarre, e.g., Obama had a Hawaiian government bureaucrat murdered to cover up his true birth certificate, Antonin Scalia was murdered, Ted Cruz’s father was involved in assassinating President Kennedy, Obama wiretapped Trump Tower.
Trump’s rigidly held, demonstrably false beliefs, that are impervious to any contradictory facts indicate that he is truly impaired, not just shrewd and calculating. Although some of his delusional statements benefit him, others do not, and some are even politically self-destructive. He makes many good-sounding – but unrealistic and delusional – promises to his supporters, and he has no intention or ability to fulfill most of them. He holds his supporters in contempt, as he does “weaker” human beings in general, and uses them only as props for his domination and adulation. He appeals to his supporters’ need for revenge against their perceived oppressors. He and his admirers justify their atrocities by projecting the weak and undesirable parts of themselves onto their “enemies.” They share contempt for those they dehumanize.
Once we dehumanize the Others and imbue them with malicious motivation directed at us, we can rationalize any act of violence we perpetrate as self-defense. That’s exactly what the Nazis did against Jews, Poles, Gypsies, and other non-Aryan people, and what Trump does against Muslims, immigrants, Democrats, and anyone critical of him. The sycophants around him magnify and hide his pathology. Their loyalty can be increasingly fierce and undying as his paranoia, grandiosity and impulsivity grow with his power. Any degree of success is followed by even more aggressive, irritable, reckless, impulsive behavior. He has no patience for dissent, contradictory facts or caution. He follows no advice but his own.
Like anyone with a delusional disorder, he never thinks he has a problem. He can appear normal, logical, high functioning, and even charming so long as his delusion is not challenged. But he maintains beliefs with absolute certainty in spite of irrefutable contrary evidence. He tends to be extremely thin-skinned and humorless, especially regarding his irrational beliefs. His dogmatism is central to his existence and is chronic, even lifelong. His words and actions seem consistent and logical IF you accept the delusion.
Three examples of Trump’s uncanny ability to believe his own undeniable falsehoods are in the last five minutes of his CIA address (January 2017). He declared that he was “a thousand percent behind” the CIA, and accused the Fake Media of making up anything contrary. And yet there were innumerable previous tweets about the incompetence and dishonesty of the “so called intelligence community.” His stunning falsehood lacked the shrewdness of a typical pathological liar.
A minute later in the speech, he described his disappointment that it was raining as he started his inaugural speech, but then said “God looked down and said, ‘We’re not going to let it rain on your speech.’” He then insisted that the rain stopped immediately and it became “really sunny” before it “poured rain right after I left.” The video of the event showed that rain started as Trump began to speak and it never got sunny or subsequently poured. If he believed what he said, he is delusional. If not, he is lying.
The third statement that was irrefutably false was that his inaugural audience was packed “all the way to the Washington Monument.” Claiming that photos to the contrary were Fake News is another example of a grandiose delusion.
These three falsehoods in five minutes exemplify scores of others – he claimed to know more than all the generals; he said he has the best temperament of anyone ever to be president; he still claims that the “Central Park Five” who were wrongfully convicted of raping a jogger in 1969 and later exonerated by a confession of the actual rapist and by irrefutable DNA evidence were guilty; he still insists he saw on TV thousands of Muslims in New Jersey celebrating the collapse of the World Trade Center towers; he claimed that Hillary Clinton won the popular vote with 3-5 million illegal votes; and he bragged that he won the presidency by the greatest electoral landslide since Reagan when, in fact, he trailed five of the previous seven electoral totals. There are many other examples because Trump lies regularly and reflexively, telling the truth only when it suits his purposes. The conclusion that fits these observations is that he believes whatever he says because he has underlying delusions of grandeur and paranoia.
A delusional disorder also helps explain Trump’s open admiration for dictators Kim Jong-un, Saddam Hussein, Bashar al-Assad, and Vladimir Putin. Trump aspires to absolute tyranny. An unopposed dictator can demand adulation and eradicate all enemies. The greater and more ruthless the tyrant, the bigger an inspiration he is. Unbridled aggression in pursuit of power are seen as a template for what is possible.
Trump has said he admires Kim Jong-un for overpowering the tough generals, being boss and wiping out his own relatives. Kim brutally killed his uncle, his uncle’s aides, his aunt, all of their children and grandchildren, and at least two generals.
Trump gives Bashar al-Assad an “A” for leadership. Actually, al-Assad killed thousands of civilians and could someday be charged with crimes against humanity.
Trump says what Hussein did so well was kill terrorists without talking or reading them their rights. Hussein also gassed more than 100,000 Kurdish citizens and buried alive tens of thousands of survivors.
But Vladimir Putin may be Trump’s favorite tyrant because “… he says great things about me, . . . he’s really very much of a leader . . . very strong control over his country . . . and look, he has an eighty-two percent approval rating.” In fifteen years of tyranny, Putin has ordered journalists shot, dissidents poisoned, and citizens imprisoned. But all that matters to Trump is being flattered and the aspiration to absolute power.
Trump’s thirst for adulation is rivaled only by his obsession for vengeance, even for the tiniest of slights. He provokes and encourages violence at his rallies and threatens anyone he sees as an enemy. He blames others for anything he characterizes as a failure, never apologizes, never takes responsibility for anything negative, and never admits to a mistake. He admires despots but almost never praises former US presidents. He insulted the Prime Minister of Australia, the Chancellor of Germany and the Prime Minister of Montenegro, all allies.
Someone who has a grandiose and paranoid delusion would be extremely dangerous during a false-alarm nuclear attack, such as happened during President Carter’s term, or the Cuban missile crisis during President Kennedy’s term. Trump’s rapid, impulsive tweets are examples of his frighteningly irrational reactions to imagined threats.
Persistent paranoid thinking indicates a paranoid character structure. Such a person sees exaggerated danger and malevolent intent everywhere. All major totalitarian leaders of modern times have manifested paranoid thinking. Their view of a hostile world motivates them to persistently increase their power by suppressing freedom of the press and media, jailing or killing perceived political opponents, and militarizing their political power. Hitler did this rapidly as soon as he was able. Trump has been restrained by the greater strength of our democratic system and its balance of powers, not by his lack of paranoid thinking.
Both Hitler and Trump began by insisting on their country’s dangerous decline. For Hitler, Jews represented an existential threat; for Trump, it’s illegal immigrants. Both invented “facts” to create an enemy. While both used their arguments to feed their base of supporters, they also may believe their own paranoid delusions.
Every progressive social advance has engendered resistance from those threatened by change. Not every resistance, however, has been fueled by someone who ignores reality and professes “alternative facts.” Trump is also motivated to hate any goodness and success of others that he cannot attain. For example, he has consistently attacked anything associated with President Obama. We must not underestimates the importance of his adult paranoid character with its apocalyptic vision of a weak America that only he can save from the liberals who oppose his authority. Professing a delusional reality with ”alternative facts” increases confusion and anxiety in vulnerable people. It also threatens a democracy dependent on objective truth.