Psychoanalyst explains the bizarre and dangerous reason Trump lacks 'the ability to cope with' reality

Dr. Justin Frank literally wrote the book on Donald Trump’s mind and behavior. In “Trump on the Couch,” Frank tracks Trump’s life from childhood to adulthood and reveals a man who is mentally unfit in many ways — from his intelligence, values, emotions and temperament down to the deepest parts of the psyche — to be president of the United States of America.

This article was originally published at Salon

In the conclusion of Frank’s book he warned that Donald Trump would represent a dire threat to the safety, security and future of America and the world. In all, the power of the presidency is too vast and the opportunities for abusing that power are too great for a personality and mind such as Donald Trump’s to resist.

On both a day-to-day basis, and in crises such as the Russia and Ukraine scandals and now the coronavirus (all of which are largely self-made and self-inflicted) Donald Trump’s poor mental health has only gotten worse. Unfortunately, the presidency, with its unique burdens and responsibilities, have not forced Trump to become a better person and to rise to the occasion. Instead, he has been caught in the undertow of a public downward spiral.

Trump’s lies, delusions, greed, corruption and malignant narcissism have thrown the United States and the world into peril as this unstable president has confronted the coronavirus pandemic in increasingly erratic fashion. It’s a crisis of science and empirical reality that he cannot simply wish away or ignore, much as he has tried.

In addition to “Trump on the Couch,” Frank is also the author of bestsellers about the previous two presidents, “Bush on the Couch” and “Obama on the Couch.” He is a former clinical professor of psychiatry at the George Washington University Medical Center and a physician with more than 40 years of experience in psychoanalysis.

In this conversation, Frank told me that Donald Trump is essentially a sociopath who has no feelings of care, concern or empathy for other human beings. More frightening still, Frank raised the possibility that Trump is not capable of feeling guilt or remorse. Not only will Trump feel no responsibility for the thousands if not millions of Americans who may die in the coronavirus pandemic, Frank said, he is likely to blame Barack Obama and the Democrats for the carnage. Trump’s followers, Frank warned, now perceive him as an infallible deity, and will obey his commands — even at the risk of their own lives.

You wrote a book about the dangers represented by Donald Trump because of his mental health. You warned that he should not become president. Did you believe that Trump’s behavior and the damage he is causing to the country and the world would get this bad?

Here is a quote from my book “Trump on the Couch”: “Failure to intervene places the nation’s people, rights and institutions at increasing risk of ending up as collateral damage in the wake of the externalization of Trump’s epic internal struggle.”

In other words, the struggle between building and breaking is an epic one for Trump. Trump’s impulses towards breaking things has been winning and we are all going to be victims of it. The only way to deal with Trump is to remove him from office. Trump cannot be reasoned with. In many ways Trump is like a space alien, a force totally foreign to our world and human society.

I think this book predicted this, and that the only way to deal with it is stop him. You cannot reason with him. Like I said before, he’s like an alien. He is a force.

During these last few days at his “briefings” on the coronavirus, and through his pronouncements on Twitter, Trump’s behavior has further devolved. He cannot help himself. At this point, his behavior is like an entry from the Diagnostic and Statistical Manual of Mental Disorders.

Trump says the media itself hates him. He insists that media coverage of his response to the virus is unfair and negative. Beyond Trump’s malignant narcissism and sociopathy lies paranoid thinking.

Trump escalates his attacks. A characteristic of paranoid thinking is rigidity — he never gives up his paranoid worldview about whatever he fears attacked by. Thus, the press remains the enemy, and if he feels that the market is tumbling down and is losing the battle against the virus, he escalates his suspicion of questions, feeling attacked more often than not.

In his press conference on Monday, when he had free rein to ask a question himself, he first attacked the press with a question to Dr. [Deborah] Birx. He said, “We have a lot of very angry media all around this room, and they want one of these seats. Because of social distancing we are keeping them empty. Will there ever be a time when all those really angry, angry people who don’t like me much to start off with — and now they really don’t like me — will there ever be a time when those seats are full like they used to be?” It’s as if he misses them, since paranoid people also need enemies for friends. The paranoid Trump needs them to feel complete, to keep his projected hatred nearby.

On Monday he also tweeted that the cure may be worse than the disease, and that social distancing can wreak havoc on our economy. Will he end social distancing because he needs the attention at his rallies?

President Trump himself is a public health risk. What I mean is that his paranoid behavior risks America’s physical and emotional health. Because he is obsessed with the press being out to ruin him, he cannot accurately assess reality — even the reality of his own intelligence services. He ignored the threat of coronavirus when presented with it on Jan. 24. He didn’t even think much about it because it didn’t fit with his delusional belief system about “fake news.”

There seems to be no bottom to Trump’s pathological behavior.

There is no bottom. The only time you know about a bottom in human behavior is when a person reflects back on their behavior. One can say they hit rock bottom only in the past tense. One does not have the perspective in the middle of the journey. Everything that Donald Trump does is making things worse with the coronavirus. He has dismissed the reality of the virus. He was late to respond. He called it a hoax, ignored the experts and did not order more tests for the virus.

It is very important to understand that if a person has a lifelong history of lying, the first person you lie to is yourself. The reason people lie to themselves is they do not want to face facts and reality. When a person lies like Trump does, they are attacking reality itself on an unconscious level. It even impacts how a person perceives things. For example, Trump could not perceive the dangers of the virus and therefore he is ill-equipped to respond to the pandemic. Because Donald Trump lies about reality so much, he does not have the ability to cope with it.

Donald Trump has told at least 16,000 public lies. He is a pathological liar. What happens when someone with that sickness is forced to confront reality? For example, what does a mind such as Trump’s do when he actually sees thousands of people dead from the coronavirus — something he very recently suggested was a hoax.

In my experience such a person will conjure up new lies. I’ve actually seen it happen in hospital settings. You can’t convince a person out of a preconception if the person has been lying to themselves as extensively as Trump has. It is almost impossible. Donald Trump could see dead bodies lying in the street from the coronavirus and step over them. Trump would say to himself, “Why are all these people lying around? How did that happen?” Trump would never think that he had anything to do with all of the deaths.

There is a part of Trump that is not even fully aware of the depth of his destructiveness. Trump recently sent out a tweet that said, “The world is at war with a hidden enemy. We will win.” Unconsciously Trump is at war with an internal enemy, which is between wanting to be a builder and wanting to be a destroyer. The internal enemy is Trump’s inner destructiveness.

The “hidden enemy” is also hidden from Trump himself. Other people see that Trump is the real “hidden enemy.”

The hidden enemy is the president of the United States because he is the enemy of our collective well-being, of our feeling of safety, of our security, of leading the country in a time of crisis.

The coronavirus is just one of many scandals for Donald Trump. There was Russia, Ukraine and impeachment, his numerous other scandals of malfeasance and corruption, etc. How do you connect the dots between these events?

One of the things that happens to every paranoid person — and Trump is a very paranoid person — is that the more they attack other people, the more frightened of other people they then become. So the more Trump attacks say the press, the more frightened of the press he becomes. The more he attacks Joe Biden, the more frightened of Joe Biden Trump becomes. Donald Trump is afraid of his actions coming back to hurt him.

When a person expresses hatred, and expels it, the hatred does not just dissipate. That hatred can bounce back at you. In psychoanalysis and psychiatry there is a term called the “return of the repressed.” The thing that you’ve forgotten and gotten rid of can come back to get you.

The coronavirus is finally a reality he cannot attack and somehow alter or make go away. The coronavirus is reality coming back to get Trump. Unfortunately, the virus is hurting the rest of the American people and the world. Whatever Trump believes, he cannot stop the coronavirus with a wall.

Trump has gone from saying the coronavirus was a hoax to claiming he was the first person to have used the term “pandemic” to describe it. How does his mind make such a huge move?

How does a mind like this convince itself? Because he really believes he’s the first person to have said it’s a pandemic. He really believes it.

Trump also believes he’s the first person to realize that Abraham Lincoln was a Republican. Trump is like a child who discovers something and says, “Did you know this?” It is all new to Trump, so therefore he thinks he discovered it before anyone else.

When a person such as Donald Trump has a long history of lying to himself, he has eradicated or attacked reality. This means for Trump the coronavirus is a “hoax.” It’s “fake news.” Such claims are how Donald Trump protects himself from reality, especially if that reality is something negative about himself that he wants to reject.

But then reality must seep in. In this case, the coronavirus is penetrating Trump’s delusional reality. Now Trump goes from calling the coronavirus a hoax to imagining himself as some type of savior who was the first person to realize the dangers posed by the virus. Now Trump tells people he will make everything all better. This is very dangerous. Trump believes he can control reality, like some type of god. In clinical terms this what is called a “manic triumph.” Trump believes he is going to triumph over the danger that he created. This also explains why Trump said that he is not responsible for the coronavirus pandemic because then he is free to say it is a threat that he alone can stop.

Trump, quite predictably, is now saying that the Democrats and Barack Obama are really responsible for the coronavirus pandemic. Well, if the Democrats are the disease, what do you do with the disease? You eradicate the disease. Trump and his mouthpieces are again encouraging violence against their “enemies.”

Yes, it is an encouragement to violence. Ironically, it is the coronavirus which is threatening and attacking Trump when he himself is a germ-phobic person.

In your book “Trump on the Couch” you document Trump’s germ phobia. How is he resolving his deep fear of germs and his reaction to the coronavirus pandemic?

A germaphobe is a person who is frightened of germs, and they see them everywhere. The germs unconsciously represent parts of the self that have split off from the whole. It is another manifestation of deeply troubled feelings and beliefs that in some way are poisonous. For Trump, those germs are his destructive impulses.

When he talks about the coronavirus pandemic, Trump does not appear to care about the harm it is causing people. He always defaults to himself and then seeks praise from the members of his court. Trump appears to be incapable of empathy or sympathy or any level of human concern for others.

When Trump is basically saying, “Me! Me! Me! Me! Me!” it reflects a lack of genuine love from his parents, either one or both of them. Such behavior is an effort to compensate oneself by loving yourself more and more and more. That is narcissism or grandiosity. Those are behaviors and feelings which are compensatory for not feeling loved. That describes Donald Trump.

He delivered the eulogy at his father’s funeral. Trump said one or two sentences about his father and the rest of the speech was about himself. He does the same things today. None of Trump’s behavior as president is new.

Trump has repeatedly shown that he has no internal governor on his behavior. There seems to be a total inability to act in a moral and virtuous way. Is such a life liberating? Is it terrifying? Thrilling?

It is in fact liberating, frightening and terrifying. It’s all of those things for Trump. It feels momentarily liberating because, “I’ve triumphed over guilt. I’ve triumphed over any anxiety about wrongdoing.” And then it’s terrifying, because of the return of the repressed. “I’m going to get it back. They’re going to come and get me.” All that hatred is going to come back at Trump. He fears it. “All the enemies of the people, the press, is going to come back and get me.”

It is all so terrifying. The destructiveness is terrifying because ultimately you can end up destroying something you may also love. Trump may have loved his Trump Towers, but he’s destroying them, one after the other. It truly is an epic struggle in Trump’s mind.

Let’s assume one of the worst-case scenarios, that the coronavirus may kill more than a million people in the United States. Will Trump have some type of emotional breakdown because of this loss of life? President Lincoln was horribly guilty about all the deaths in the Civil War. Will Trump have similar feelings?

No. It is not an option. Donald Trump does not feel guilt. He is incapable of it. I have not seen Trump ever display any form of guilt for his behavior.  If there were a million dead, Trump would still say that Obama did it. Trump would still say the Democrats did it. Now Trump calls the coronavirus the “Chinese Virus.” Trump would say it is the Chinese who did it. Trump is never responsible for his own behavior.

Donald Trump learned from his father to never admit he is wrong. That lesson there is also to never have any guilt for one’s behavior. One would think that repressing all that guilt would cause Trump or someone like that to have nightmares. But I don’t think that Trump does.

Trump leads a political cult. Until very recently, he has been telling his supporters that the coronavirus is a hoax, and that they should go out and hug each other, gather in large groups, and mock the scientists and Democrats. How do we make sense of Trump’s followers and the love and loyalty they feel for him?

The followers are listening to their god. One of these people was interviewed and he said if he died from the coronavirus at least he would die believing in Christ. There are many fanatics in the world. They are very disturbed and sick people. These fanatics yearn for an all-powerful protector. Trump’s followers feel safe and triumphant because of him. It is a grandiose self-destructive fantasy between Trump and his followers.

As in other cults, the members are in love with the leader. Trump’s followers are very damaged people. As such, whatever Trump commands them to do they will do, even if it means getting sick and dying from the coronavirus.

That is correct. Such a level of mass fanaticism is very disturbing, and is something that we have not seen in the United States on such a large scale. We have seen it with Jim Jones and other cults. People follow the cult leader to their doom. Of course, there was a similar type of fanaticism in Germany with Adolf Hitler. Trump’s followers really need a strong leader to make them feel safe. It could be a strong father figure, a god, anyone who is powerful enough to make them feel loved and safe.

Trump’s followers, like other cult members, also want someone who will accept their aggression and destructiveness as being good and normal. These people are devoted to Trump. That devotion is more important than anything else.

What’s going to happen next?

The only chance the American people have is to vote Donald Trump out of office.