Mental Health Professionals and the President Trump Diagnosis

Over the past year, I have experienced several occasions at which mental health professionals voiced their opinion–up to a diagnosis–of President Donald Trump. It always struck me as extremely odd that those opinions more often than not contained elements of personal disdain, anger, or, sometimes it seemed, outright hatred.

Don’t mental health professionals, more than anyone, want to consider the often difficult conditions in which someone suffering from a set of symptoms–that are according to their manual diagnosable under a common label and category–finds themself in? And regardless of whether or not their assessment of President Trump could ever be considered objectively true… assuming that it is from their position, wouldn’t that instill in those professionals a sense of care and sensitivity, especially the sensitivity around the diagnosis as something that causes the diagnosed a lot of pain?

At the very least, I would have wanted for mental health professionals to approach Trump with an attitude of “how would life be like in those shoes? how could I understand him and his motivations? what is driving him?” This typically requires a lot of empathy and the capacity to look beyond the consequences of someone’s behavior.

As someone who has cheated on former boyfriends of mine, I can understand how they, as the people who got hurt directly, would have difficulties asking themselves, “what contributed to this behavior?” But people do typically not engage in what is considered morally wrong behavior for the purpose of hurting people, or because they actively ignore the negative consequences. The motivation lies in something positive they want to get from it, and understanding that seems so much more helpful when trying to approach these people about the behavior that is painful for others, instead of labeling them as “cheaters” or “selfish”.

Do I believe President Trump is mentally ill? Well, only as ill as a large part of society is. And I want to briefly describe the growing disconnect I experience when people talk about him. As a discloser, I am not a mental health professional–I don’t even have an academic degree, for that matter–and have merely worked in an IT and data analysis support role in the field of psychological science and research for the past 15 or so years.

First, my experiences of President Trump, all of which are second-hand, in the sense that I never met him in person, would lead me to the following general observations and inferences:

While he was still a real-estate developer in New York, Donald Trump seemed to want to be part of a Manhattan group of peers very, very much. And he was rejected many, many times, but tried again, and again, and again. From that I infer that one of his strongest motivators in life has been a desire for belonging. A desire for approval from his peers, and an increasing willingness to incur ridicule and laughter from those he would consider “not getting it”, that is those not interested in winning this approval, those playing a different game, if you will.

In light of that, I believe that his thoroughly enjoying the crowds at rallies, the people seemingly approving of him, through applause and cheering, makes for one of the most exhilarating experiences in his life. Maybe it’s his coping mechanism… In those moments, he doesn’t see his supporters as low-lifes, which is an often thinly veiled characterization of them–let’s just think back to the “basket of deplorables” comment, and how little outrage this garnered in the media, and sometimes outright support, even now.

And, as a necessary aside, please compare this to the outrage about the “shithole countries” language. I mean, what a hypocrisy, to say that talking about foreign nations using derogatory terms is “bad behavior”, but then the media using similarly disrespectful language when talking about Trump’s voters, fellow Americans no less.

But President Trump’s language leads me to another conclusion: when he is in front of crowds, he wants, and maybe by now craves and needs, their approval. He calls himself a genius, a claim I do not necessarily support, but I think he is certainly smart enough to know exactly what the crowd wants to hear. Just as a skilled stand-up comedian will refine their routine with every telling, Trump’s use of foul language, humor, hyperbole, as well as his making fun of readily available targets (for his audience) all speak to his ability to engage a crowd in ways that those on the receiving end will resonate with, will approve of, and will respond to with the desired applause and cheering.

Does that mean Trump is not dangerous? Well, that depends on how you define dangerous as a personal rather than a situational characteristic. “The situation” absolutely comes with grave risks, particularly an escalation of violence in a way that would make use of nuclear weapons an almost inevitable aspect.

From those who are emotionally close to Trump, who consider themselves his friends and family, I have really only ever heard how much they like him. And as much as I believe people can always delude themselves, I do not believe in conspiracy theories. So the simplest and most parsimonious explanation I have for their account of President Trump is that in one-on-one settings where he feels at ease and supported, he is probably gregarious and non-threatening. These occasions have probably become very, very rare for him. Maybe one explanation for his very frequent escape visits to a beloved activity in solitary peace: golf.

This all leaves me with the thought that his life, both before and after the election, probably has been tough for him. For someone to crave approval so much as to draw the ire and condemnation of half the nation on him, and still not give up (for the approval of the other half) is a remarkable show of determination, whatever else it is. Most people I know would find it difficult to cope with a handful of detractors, but President Trump got used to it during his real-estate years. And from his perspective he came out on top, so he kept going. This may be a reason for his loyal supporters to admire him the most, his unwavering “sticking to his guns”.

Over the past few months, I have sometimes wished that, as a friend, I could just tell him something like, “Hey, Donald, you know, it’s OK. I know it probably hurts a lot to see that so many people don’t get you. They really are just totally scared that, because you are President now, you could do something out of the spur of the moment that would make their lives a disaster, and so they wish you would stop yourself more often when you come up with the next quip. The people who don’t like you are just afraid that what they perceive as a lack of self control will, well, cost them their lives. So, uhh, I know this sounds like I also don’t trust you, and I know it’s really important for you to be trusted… But could you maybe just ask me or some other good friend before you tweet about North Korea, to take a look at it first? It’s just, you know, it could really end up bad…”

I believe and would hope that such an approach has a higher chance of reaching through his defenses than a constant stream of criticism, labels, diagnoses, accusations, declarations of unfitness, inferences of racism, etc.

Whatever objective reality may or may not exist, and whatever diagnosable condition President Trump may or may not have, I would hope that mental health professionals, more than everyone else, would understand that approaching any human being with an attitude of pressure and a clear lack of empathy really can hardly be considered the gold standard of treatment, medically or interpersonally.