• Dr. Bandy Lee, M.D., M.Div.

Trump’s Mental Unhealth – Chapter 3: Truly Behind Trump’s Following is Not Health

If you haven't already, check out Chapter 1 and Chapter 2 of Dr. Bandy Lee's 'Trump's Mental Unhealth' column.


Dr. Mary Trump’s new book, Too Much and Never Enough: How My Family Created the World’s Most Dangerous Man, matches almost precisely our analysis from three years ago, in The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President. Assessing him as “dangerous” is only the beginning of our agreement. We concur that he is mentally “incapable” of leading and a “mass murderer”—things we have said since last year and last month. Now that independent analysis of public health meets intimate experience of a household, there could be no more thorough evaluation. Then where is the response? What are the consequences?


If a change in his devotees’ minds is what the authorities are waiting for, then they should know by now that no amount of incompetence, egregious behavior, or destruction of democracy is going to bring them around. There must be a line if we are to survive: we are now accepting the incapacity to handle a job—any job—for even a day, let alone years, and almost entirely avoidable 150,000 American deaths, with no end in sight. We must recognize “malignant dysfunction” for what it is and not equate it with health.


How are we to understand his following? We highlight four aspects here: 1) narcissistic symbiosis; 2) cultic programming; 3) a “battered nation syndrome”; and 4) shared psychosis.


Narcissistic symbiosis


Two manifestations of the narcissistically wounded self fit together like lock and key: “the mirror hungry personality” and “the ideal hungry personality.” Trump has an “injured self” that feeds off of confirming, admiring, and mirroring responses to protect against feelings of inadequacy and worthlessness. To nourish the famished self, he displays a sense of grandeur, omnipotence, and strength in order to evoke the attention of others.


His posture of absolute certainty is very attractive to those consumed by doubt and uncertainty. There is mutual intoxication and dependence, whereby Trump reassures his followers by filling their void, who in turn reassure him of his self-worth. Trump was able to tap into the existing rhetoric of the white supremacist alt-right in the United States, which is a form of idealizing the self by denigrating others in an attempt to ward off deep feelings of inferiority. He provides for them a sense of completeness and security.


Cultic programming


The many millions of Trump supporters are a patchwork of diverse yet distinct groups.  They range from fervent followers among Christians and the alt-right, to traditional Republicans who vote the party line, to pro-lifers, National Rifle Association (NRA) members, and the poor and out of work.  Others are wealthy with “practical” motivations capable of mentally walling off the harms that arise from Trump’s tax cuts for the rich and his government deregulations.  Trump’s campaign was an unrelenting recruiting machine, using the rhetoric and techniques of cults, which has now established into a hierarchical structure.


White House staffers, some of whom are family members, are at the top. Then there is a coterie of aides who are loyal and subservient to the leader, carrying out directives and instilling doctrine. Each moderating force is replaced until the leader is surrounded by “yes men” and “yes women.” His former political aide Manigault Newman and his former “fixer” Michael Cohen both described escaping “the cult of Trumpworld.” Lev Parnas, an associate of Trump’s personal attorney Rudolph Giuliani, experienced Trump as a “cult leader.”


“Battered nation syndrome”


What explains the passivity of the rest of the nation? After attacking Portland, the president has now vowed to send federal agents into Chicago and New York in a desperate, authoritarian move. In early June 2020, we warned that he would use force not to allow a losing election for him. In early 2017, we warned that psychological dangerousness in a president would translate into cultural, geopolitical, and civic dangerousness. When have we had enough? We can understand the helplessness in the context of a nation in an abusive relationship with Trump.


A “battered nation syndrome” can be conceived after the “battered woman syndrome” or “battered man syndrome” in domestic violence situations, where the physically or emotionally “battered” comes to respond with avoidance or numbing of emotions. The mental health fields have extensive experience with victims who remain loyal to callous and reckless personalities, for the same reasons that politicians and the public seem to display with Trump.


As hard as it may be to believe, insistence on staying in an abusive relationship appears among those who are embarrassed to admit they made a poor choice. Others are not blind to his flaws but actually idolize him for what he seems to have: impunity for bad behavior. Still others persist out of a desire to keep trying, downplaying disappointments and hoping for more presidential behavior.


Shared psychosis


In addition to narcissistic predisposition, cultic programming, and the psychology of abuse, there is actual contagion of mental symptoms. This type of transmission can actually be more efficient than other forms of infection, since it does not require physical exposure but only emotional bonds. This is the reason we noted at the onset of the coronavirus pandemic that it was above all imperative that we gain control over “the mental health pandemic.”


The technical term for this is shared psychosis or, more recently, induced delusional disorder. When there is severe mental pathology in an influential figure, symptoms can transmit from the primary person to others, whereby secondary persons or groups come to feel, think, and behave as if they themselves had the primary disorder. Induced delusions function like primary delusions in that they are equally resistant to evidence and truth. Delusions are more infectious than strategic lies because the primary person is genuinely convinced of them and the emotional pressure for others to believe them is strong. When they spread across a culture, it may be called a “cultural disorder.”


Recognizing induced delusions can be helpful, as we know from the scientific literature that, when contact with the inducing individual is removed, the symptoms usually subside. If removal is not possible, reducing exposure is necessary, as we have already outlined. Screening for mental impairment before individuals take positions of influence can help prevent epidemics from occurring in the first place.

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About the contributor:

Photo credits: Macmillan and Yale

Dr. Bandy Lee, M.D., M.Div., is a forensic psychiatrist at Yale School of Medicine for 17 years who taught at Yale Law School 15 of those years, was a research fellow at the National Institute of Mental Health, and a consultant with the World Health Organization since 2002. She is author of the textbook, Violence (Wiley-Blackwell, 2019) and editor of The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President (Macmillan, 2017 and 2019). She is also president of the World Mental Health Coalition, which issued a “Prescription for Survival” and a statement, “Great Danger to the Nation.” For donations to her organization, a tax-deductible 501(c)3, please go here.


#trumpsmentalunhealth #mentalhealth #narc #narcissism #drbandylee #marytrump

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