As a therapist for many years, I can say with confidence that Donald Trump needs therapy. He has difficulty telling the truth, admitting mistakes, empathizing with others, impulsivity, vindictiveness, and aggressiveness. These traits are symptoms of severe psychological pathology. His coping mechanisms are fragile, therefore when he feels threatened, he calls people names, takes irrational actions, curses, lies, and surrounds himself with people he can control. A competent President has stable, positive self-esteem is intellectually capable of grasping complex problems, has leadership skills, and is driven to govern in loyalty to the Constitution. Trump’s pattern of violating the rule of law should have led to his removal from office. However, his skill at the practice of cronyism has protected his destructive patterns and allowed him to weaken the foundation of our democracy.
Sociopaths lie, cheat, manipulate, and are disloyal to anyone they view as useless to their self-interests. Narcissists live their lives in allegiance to themselves over all others, at all costs. This explains why Trump has fired, disparaged, and rejected countless appointees of his own party once he believes they are no longer 100% loyal and under his full control. The narcissist can be extremely cruel, without remorse. Their pattern of lying is their primary coping mechanism to counter their feelings of shame and the fear of being exposed as an imposter.
In her book, Mary L. Trump writes Trump’s father’s had a cruel, demeaning parenting style, and the Trump household was filled with tension and judgment. Because Trump does not talk about his feelings or identify empathetically with the feelings of others, it is difficult to imagine him being honest and vulnerable with a therapist. Clients with personality disorders have robust defense mechanisms that separate them from their feelings and from facing the uncomfortable realities of life. To see things as they are frightened of the disordered personality patient. They rely on their outward expressions of confidence and bravado to compensate for their shame, insecurities, and fears.
In therapy, Trump would have to face the truth about how his father, Fred Sr. molded him into his cruel image and how together they emotionally abused his older brother Freddy. The release of repressed anger towards his father could stop his pattern of displacing anger wrongfully on others. However, it is difficult to imagine him becoming vulnerable enough to experience these long-repressed feelings. He probably would not see the point of experiencing painful, deep feelings, because living in his world of lies and detachment from reality is emotionally more comfortable.
Trump needs help to see himself as others experience him. His disconnect from his own deeper truths disables him from connecting to others in a meaningful way. His narcissism is a replacement for an authentic relationship with his true self and eliminates the possibility of experiencing a sincere, genuine connection with another person.
A treatment plan for Trump would include the goals of being honest, eliminating inner, negative self-talk, strengthening self-esteem, feeling empathy for others, and understanding and facing the difficulties of his childhood. His narcissism would require clinical strategies that delivered an adequate level of attention and validation from the therapist. Establishing an authentic bond is how trust develops in therapy which allows for the possibility of insight, openness, and change. People who suffer from narcissism and sociopathy have poor self-reflective skills. This deficit limits their ability to see another person’s point of view or care about how their behavior is making others feel. PD patients are more reactive to how others make “them” feel.
Trump has been his own worst enemy. His decision to focus exclusively on pleasing his base has alienated over half of the American population from supporting him. His policies have marginalized minorities, immigrants, and lower socio-economic communities and as a result, have created the image of him as a cruel dictator. His consistent proclamations of how he is smarter than generals, scientists, judges, etc. have put into question both his intelligence and his mental instability.
In therapy, Trump would be asked to look at his part in the level of anger, disrespect, and rejection he consistently experiences from masses of people in this country and around the world. Although his weak ego relies on blaming the “far-left” Democrats, the truth is massive movements led by Republicans are underway to block his re-election.
Becoming President was probably the worst thing that could have happened to Trump. Being President of the United States is the ultimate validation of greatness, but carries with it the risk of massive failure, criticism, and rejection. For a person with a weak ego, the constant stress and criticism create anxiety and leads to aggressive moves to regain emotional balance. Therapy might help Trump understand his strengths and accept his weaknesses in a way that would not annihilate his self-esteem and cause him to lash out irrationally and impulsively. It could also teach him to understand his feelings, be able to contain them, and develop new constructive coping mechanisms to replace the destructive ones. That sounds great, but because Trump has to see himself as perfect, receiving therapy would be seen by him as a sign of weakness.
The point of these imaginings of Trump in therapy is to make Americans realize that without professional help, the chaos he has caused as President can become even more catastrophic. Characteriological pathology worsens with age. We cannot continue to lose hundreds of thousands of Americans to COVID-19, poverty, and potential national security betrayals by Trump.
His unfitness for office should lead the Congress to legislate the inclusion of a psychiatrist to the White House medical staff. Americans deserve the assurance that the person they elected to be President can manage the stress of the job. Additionally, if they have underlying psychological issues that could affect their judgment, a mental health professional would be on staff and ready to help. The Trump presidency is a wake-up call that the mental wellness of a president should be monitored.