Less Than Artful Choices: Narcissistic Personality Disorder According to Donald Trump

Debate on personality disorders, classifications, diagnoses, and treatments is well worthwhile, and a colorful spokesperson never hurts.

Donald Trump was born in 1946. 34 years later, in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the American Psychiatric Association’s hefty volume of mental disorder classifications, the term “Narcissistic Personality Disorder” (NPD) first appeared as a diagnosable disease – Trump would doubtless say it was created in his honor (characteristic #1 of NPD: An exaggerated sense of self-importance). After all, the newly-minted personality disorder made its debut only nine years after he took the helm of his father’s company… and renamed it from Elizabeth Trump & Son to The Trump Organization.


The most recent DSM, DSM-IV, is currently under extensive revision, with DSM-V scheduled for publication sometime in 2013, and both its listed diseases and their definitions are undergoing extensive scrutiny and contentious debate. On the chopping block are five of the ten or so so-called personality disorders, including NPD. Among the reasons for the cut are the frequent overlap between disorders, the general lack of stability of symptoms, and the range of those symptoms in reality, as compared to the either/or approach of the manual (either you have a disorder or you don’t). So, before NPD becomes a thing of the past, at least in its current form, I thought we’d take a moment to reflect on some less than artful choices – or the things that make Trump look like he just stepped out of the fourth edition, symptom by symptom.

A caveat: I am obviously exaggerating, both Trump and narcissism. But debate on personality disorders, classifications, diagnoses, and treatments is well worthwhile, and a colorful spokesperson never hurts.

So, without further ado, Trump’s quotable illustration of the hallmarks of NPD, defined according to DSM-IV as, “A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy.” The disorder is indicated by at least five of the following:

1.     An exaggerated sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)

 A sense of one’s own importance, a grandiose feeling that one is alone responsible for any achievement is a hallmark of the narcissist. Grandiosity is one of the central tenets of a narcissistic personality. Narcissists tend to take credit for everything, as if no one else contributed to the end product. Witness Trump’s declaration that, “When people see the beautiful marble in Trump Tower, they usually have no idea what I went through personally to achieve the end result. No one cares about the blood, sweat, and tears that art or beauty require.” What do you know: not only is Trump a developer and an artistic visionary, but he seems to be a stellar architect and construction worker as well.

And history will agree (naturally). “Anyone who thinks my story is anywhere near over is sadly mistaken,” says Trump. Sadly, indeed.

2.     Preoccupation with fantasies of unlimited success, power, brilliance, beauty or ideal love

 How many presidential runs does it take for the process to be defined as a preoccupation rather than an occupation?

I’d leave it at that, except for the existence of this little gem: “My fingers are long and beautiful, as, it has been well documented, are various other parts of my body.” Not only all-powerful, but all-beautiful, too. The man has it all.

3.     Believes he is “special” and can only be understood by, or should associate with, other special or high-status people (or institutions)

 To narcissists, the “little people” or anyone beneath them (which is mostly everyone) don’t matter. Trump’s lambasting of Rosie O’Donnell is a good case in point: “Rosie O’Donnell called me a snake oil salesman. And, you know, coming from Rosie, that’s pretty low because when you look at her and when you see the mind, the mind is weak. I don’t see it. I don’t get it. I never understood – how does she even get on television?”

Clearly, Rosie lacks the power to understand the dazzling intellect that is Donald Trump. Trump needs someone of equal status to appreciate his immensity. But it can’t be Larry King, because as he told King, “Do you mind if I sit back a little? Because your breath is very bad. It really is. Has this been told to you before?”

4.     Requires excessive admiration

 No matter the sincerity, as long as the praise comes frequently and at a high enough volume. Says Trump, “All of the women on The Apprentice flirted with me – consciously or unconsciously. That’s to be expected.” Clearly. Admired, wherever he may go, even when he’s talking about himself in the third person, as in, “Love him or hate him, Trump is a man who is certain about what he wants and sets out to get it, no holds barred. Women find his power almost as much of a turn-on as his money.”

As he puts it, “Nobody but a total masochist wants to be criticized.”

5.     Has a sense of entitlement

The world owes the narcissist everything; he, in turn, owes it nothing.

I think Trump’s attitude can be summed up with this approach to marriage: “I wish I’d had a great marriage. See, my father was always very proud of me, but the one thing he got right was that he had a great marriage. He was married for 64 years. One of my ex-wives once said to me, ‘You have to work at a marriage.’ And I said, ‘That’s the most ridiculous thing.’”

6.     Selfishly takes advantage of others to achieve his own ends

I don’t have a quote for this one, but perhaps we can talk to one of his ex-wives.

7.     Lacks empathy

Narcissists don’t sympathize with the feelings of others. Who are these “others,” anyway? No one matters except for me.

I won’t recreate the Rosie rampage in full, but sentiments like, “I’ll sue her because it would be fun. I’d like to take some money out of her fat ass pockets,” capture the spirit.

8.     Is often envious of others or believes others to be envious of him

Here, it seems like Trump is dominated by the second sentiment, the expectation that everyone is envious of his success. Everyone wants to be Trump. As he puts it, “The old rich may look down their noses at me, but I think they kiss my ass.”

9.     Shows arrogant, haughty, patronizing, or contemptuous behaviors or attitudes

Again, other people don’t matter. They can be treated like nothing, because who are we kidding – nothing is the closest description of what they are.

Clients don’t matter. As Trump puts it, “When I build something for somebody, I always add $50 million or $60 million onto the price. My guys come in, they say it's going to cost $75 million. I say it's going to cost $125 million, and I build it for $100 million. Basically, I did a lousy job. But they think I did a great job.” Take them for the suckers they are; that’s the ticket.

The media doesn’t matter. According to Trump, “You know, it really doesn’t matter what (the media) write as long as you’ve got a young and beautiful piece of ass.” The piece of ass doesn’t matter, either; any will do.

Other businesses don’t matter. As Trump says, “If you want to buy something, it’s obviously in your best interest to convince the seller that what he’s got isn’t worth very much.” 

But it’s ok. Trump doesn’t have to be nice. After all, it’s not like he wants to run for office or anything: “I'm not running for office. I don't have to be politically correct. I don't have to be a nice person. Like I watch some of these weak-kneed politicians, it's disgusting. I don't have to be that way.”

Too bad. We need a good candidate. Because according to Trump, “One of the key problems today is that politics is such a disgrace. Good people don’t go into government.”

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Image source: Vaccaro et al, 2020/Harvard Medical School
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An unexpected culprit

The new research examines the mechanisms at play in sleep-deprived fruit flies and in mice — long-term sleep-deprivation experiments with humans are considered ethically iffy.

What the scientists found is that death from sleep deprivation is always preceded by a buildup of Reactive Oxygen Species (ROS) in the gut. These are not, as their name implies, living organisms. ROS are reactive molecules that are part of the immune system's response to invading microbes, and recent research suggests they're paradoxically key players in normal cell signal transduction and cell cycling as well. However, having an excess of ROS leads to oxidative stress, which is linked to "macromolecular damage and is implicated in various disease states such as atherosclerosis, diabetes, cancer, neurodegeneration, and aging." To prevent this, cellular defenses typically maintain a balance between ROS production and removal.

"We took an unbiased approach and searched throughout the body for indicators of damage from sleep deprivation," says senior study author Dragana Rogulja, admitting, "We were surprised to find it was the gut that plays a key role in causing death." The accumulation occurred in both sleep-deprived fruit flies and mice.

"Even more surprising," Rogulja recalls, "we found that premature death could be prevented. Each morning, we would all gather around to look at the flies, with disbelief to be honest. What we saw is that every time we could neutralize ROS in the gut, we could rescue the flies." Fruit flies given any of 11 antioxidant compounds — including melatonin, lipoic acid and NAD — that neutralize ROS buildups remained active and lived a normal length of time in spite of sleep deprivation. (The researchers note that these antioxidants did not extend the lifespans of non-sleep deprived control subjects.)

fly with thought bubble that says "What? I'm awake!"

Image source: Tomasz Klejdysz/Shutterstock/Big Think

The experiments

The study's tests were managed by co-first authors Alexandra Vaccaro and Yosef Kaplan Dor, both research fellows at HMS.

You may wonder how you compel a fruit fly to sleep, or for that matter, how you keep one awake. The researchers ascertained that fruit flies doze off in response to being shaken, and thus were the control subjects induced to snooze in their individual, warmed tubes. Each subject occupied its own 29 °C (84F) tube.

For their sleepless cohort, fruit flies were genetically manipulated to express a heat-sensitive protein in specific neurons. These neurons are known to suppress sleep, and did so — the fruit flies' activity levels, or lack thereof, were tracked using infrared beams.

Starting at Day 10 of sleep deprivation, fruit flies began dying, with all of them dead by Day 20. Control flies lived up to 40 days.

The scientists sought out markers that would indicate cell damage in their sleepless subjects. They saw no difference in brain tissue and elsewhere between the well-rested and sleep-deprived fruit flies, with the exception of one fruit fly.

However, in the guts of sleep-deprived fruit flies was a massive accumulation of ROS, which peaked around Day 10. Says Vaccaro, "We found that sleep-deprived flies were dying at the same pace, every time, and when we looked at markers of cell damage and death, the one tissue that really stood out was the gut." She adds, "I remember when we did the first experiment, you could immediately tell under the microscope that there was a striking difference. That almost never happens in lab research."

The experiments were repeated with mice who were gently kept awake for five days. Again, ROS built up over time in their small and large intestines but nowhere else.

As noted above, the administering of antioxidants alleviated the effect of the ROS buildup. In addition, flies that were modified to overproduce gut antioxidant enzymes were found to be immune to the damaging effects of sleep deprivation.

The research leaves some important questions unanswered. Says Kaplan Dor, "We still don't know why sleep loss causes ROS accumulation in the gut, and why this is lethal." He hypothesizes, "Sleep deprivation could directly affect the gut, but the trigger may also originate in the brain. Similarly, death could be due to damage in the gut or because high levels of ROS have systemic effects, or some combination of these."

The HMS researchers are now investigating the chemical pathways by which sleep-deprivation triggers the ROS buildup, and the means by which the ROS wreak cell havoc.

"We need to understand the biology of how sleep deprivation damages the body so that we can find ways to prevent this harm," says Rogulja.

Referring to the value of this study to humans, she notes,"So many of us are chronically sleep deprived. Even if we know staying up late every night is bad, we still do it. We believe we've identified a central issue that, when eliminated, allows for survival without sleep, at least in fruit flies."

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