But of course, something did come of it, and so on February 13th, Dodes and 34 other psychiatrists, psychologists and social workers published a letter in The New York Times stating that “Mr. Trump’s speech and actions make him incapable of safely serving as president.” As Dodes tells me, “This is not a policy matter at all. It is continuous behavior that the whole country can see that indicates specific kinds of limitations, or problems in his mind. So to say that those people who are most expert in human psychology can’t comment on it is nonsensical.” In their letter, the mental health experts did not go so far as to proffer a diagnosis, but the affliction that has gotten the most play in the days since is a form of narcissism so extreme that it affects a person’s ability to function: narcissistic personality disorder.
The most current iteration of the DSM classifies narcissistic personality disorder as: “A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts.” ...
For many in the mental-health field, the most troubling aspect of Trump’s personality is his loose grasp of fact and fiction. When narcissism veers into NPD, it can lead to delusions, an alternate reality where the narcissist remains on top despite clear evidence to the contrary. “He’s extremely quick, like nanoseconds quick, to discern anything that could conceivably threaten his dominance,” says biographer Gwenda Blair, who wrote The Trumps: Three Generations of Builders and a President. “He’s on it. Anything that he senses – and he has very sharp senses – that could suggest that he is anything except 200 percent total winner, he’s got to stomp it out immediately. So having those reports, for example, that he did not win the popular vote? He can’t take that in. There has to be another explanation. It has to have been stolen. It has to have been some illegal voters. It can’t be the case that he lost. That’s not thinkable.”
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If Trump does have NPD, and the setbacks to his agenda keep coming, his magical thinking about the limitlessness of his power will only continue to clash with reality, and many in the mental-health field believe that would only exacerbate the problem. “I think we’re actually looking at a deteriorating situation,” says Gartner. “I think he’s going more crazy.” As Dodes’ letter to The New York Times states, Trump’s attacks against “facts and those who convey them … are likely to increase, as his personal myth of greatness appears to be confirmed.” Still, no matter how monumentally he fails in the next four years, says biographer Gwenda Blair, “there’s no doubt he’s going to think he’s done a great job. That isn’t even open to question.”