Whatever one’s political views of Donald Trump, his candidacy for President has created an important discussion of Narcissistic Personality Disorder in the media.  The specific narcissistic trait which Trump (and everyone with the disorder) exhibits is grandiosity.  In “The Narcissist in Chief,” an opinion piece by two Emory psychologists published September 6, 2015, in the New York Times, Lilienfeld and Watts define grandiosity as “an amalgam of flamboyance, immodesty, and dominance.”  Grandiosity could also be defined as the opposite of low self-confidence, or in other words, excessive self-confidence; it is seen in people who seem to be full of themselves, as the expression goes, people who beat back any criticism, no matter how justified, with the coping mechanism of denial (like when Trump recently denied that he was mocking a journalist’s disability after the latter failed to back Trump up on one of his claims).
The authors of this Times piece described a study they conducted in which experts rated the grandiosity of every American president.  Among the fascinating findings of the study, the two Presidents who rated the highest in grandiosity, Teddy Roosevelt and Lyndon Johnson, became two of the most successful leaders in American history.  In this fair and balanced piece, the authors discuss the upside as well as the downside of electing a president who scores high on the trait of grandiosity.  They are “gifted stage performers who are persuasive and decisive.”  On the other hand, grandiose people “retaliate harshly against people who criticize them,” they “accumulate resources for themselves at others’ expense,” they are “overconfident when making decisions, overestimate their abilities and portray their ideas as being innovative when they are not.”  Grandiosity is also associated with “negative outcomes, including stealing, abusing power and bending rules.”
Lilienfeld and Watts discuss another American President, Richard Nixon, as being a classic example of the second sub-type of narcissist, the vulnerable, shy, “self-absorbed, thin-skinned” variant of the disorder.
Many people who are not mental health professionals understand that an individual’s personality drives their thoughts, feelings, and behaviors.  And that psychologists, psychiatrists, psychoanalysts, social workers, and other professionals who study and try to understand and treat people with grandiose or shy narcissism or any other type of personality disorder can in some cases address the negative consequences of the disorder for the patient and the people around him.
One established fact that makes it notoriously difficult to treat personality disorders is that the person does not see anything wrong with his behavior.  The problem behavior is so entrenched in his personality that he sees no need for change.  He himself does not suffer, he makes the people around him suffer, and it is sometimes the people around him who make him seek treatment.
As someone who takes a professional interest in all of these issues, I am following the intersection of politics and emotional problems in our elected leaders with great interest.  The field of mental health continues to actively research and debate issues related to maladaptive personality traits and disorders, even in people who outwardly appear to be extremely successful, like Trump (a fact which serves to illustrate the complexity of human personality).
Do excessive self-esteem and low self-confidence exist on a spectrum, or are they all-or-nothing traits?  How do these traits develop and what is the best treatment for them?  How do anxiety and depression, two of the most common presenting complaints in people who consult mental health professionals, flow from a given patient’s personality traits?  How do coping mechanisms such as Trump’s habit of denying any kind of criticism maintain intact what may in some ways be an extremely distorted personality?
Whatever one’s view of  the current political situation in this country, it is giving rise to important discussions which bear watching of critical issues in the field of mental health.

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