This blog entry is presented less as a political opinion than a medical opinion, but the political implications are staggering. I believe America has elected a sociopath as its next President, and, as a “mental health professional” that concerns me – in fact, it terrifies me.

What is a sociopath?

The current diagnostic term (per the new DSM-5) for the condition I’m referring to is “anti-social personality disorder” and, if you care to, you can go to the manual and read a long description of the symptoms. It all sounds like Donald Trump, almost comically so, from “inflated and arrogant self-appraisal” to “glib, superficial charm.”

I’m the first to admit there’s a worrisome aspect to mental health diagnoses, which is that they appear subjective. There’s no blood test, no pathogen you can stick under a microscope or obvious physiological indicator of disease. There’s just a description of human behavior and emotions. That hardly seems medical.

Nonetheless, the irregular human behaviors and troubling emotions that define mental illness – including sociopathy – are real and, they exist on a spectrum, so when they are severe, they can be very serious indeed. We all feel down once in a while, but if you witnessed the effects of catatonia in someone suffering from major depression, its severity might startle you. Likewise, knowing someone slightly “kooky” is different from encountering someone suffering from the hallucinations and delusions produced by severe schizophrenia.

Sociopathy is unique and troubling in part because of a peculiar paradox: the more severe the condition, the more difficult it can be to detect. It’s hard to see what isn’t there, and sociopathy, unlike schizophrenia or depression, is about the absence of normal controls on a person’s behavior. It’s easier to notice something new, that doesn’t belong in someone’s psyche, than something we take for granted that’s missing. And what’s missing in a sociopath is the very humanity that might make it hard for him to hide his condition.

So what is sociopathy, really? In brief, it amounts to the absence of a conscience. Whatever it is within us that we call empathy or caring or concern or connection to others, doesn’t exist in a sociopath.

My father, a psychiatrist who ran a secure ward at a state mental hospital, used to quip: “You know the true sociopath because he’s the one you lend money.”

What Dad meant was that the most severe sociopath is the one who can even fool a psychiatrist. And it really happened sometimes – my father used to recount in amazement stories about sociopaths talking their way right out of secure mental wards.

How do they do it? A sociopath has the amazing ability to tell you exactly what you want to hear. It’s as though they possessed empathy – astonishing powers of empathy – in the sense that they can intuit your desires, and sense what it is that you need to hear them say in order to produce a predictable emotional response. This creates a frightening ability to control others simply through insincere words and the inauthentic play-acting of emotions.

A moment after they tell you something – and this is the truly chilling aspect of sociopathy – a sociopath might be with someone else and say precisely the opposite of what they just said to you, with appropriate emotions displayed, simply because they sense that other person needs to hear something else and the sociopath wishes to control them, as well.

A sociopath will tell anyone whatever it takes, complete with apparently sincere emotions, to create the desired response in them, and thus influence their actions.

This phenomenon is sometimes called being a “pathological liar” and I’ve run into examples where the lying itself becomes the end goal – sociopaths who concoct stories to see how long they can fool people, then revel in being found out, as if that heightened the pleasure of the entire enterprise of deceit.

It’s been said that all criminals – at least, criminals with the intent to commit their crimes, perhaps not criminals who had to steal from necessity, due to poverty or desperation – are sociopaths. That’s because it is our consciences that keep us from doing things we know to be wrong. As members of a community, we sign on to a social compact, an understanding with other people, to care for one another, at least to the minimal extent that we agree not to commit acts we define as crimes because they hurt others.

The most dangerous sociopaths are the ones who are less concerned with fooling people or even stealing from people than they are with controlling people. They don’t want to be found out. They want the lies to go on forever so they can continue controlling those around them….

Which brings us to Donald Trump, our next President, and why I believe he’s a sociopath, and thus very dangerous, especially in his new role leading our nation.

First observation: Donald Trump tells lies without the least hesitation.

The lies are near-constant, and on their face, many are absurd. The lie about President Obama not being born in the United States could be disproven in a moment by posing the simple thought problem: Where would Obama’s mother, the teenage daughter of middle-class Midwesterners scraping by on modest salaries in Honolulu, fly to in order to give birth outside her own home country? Fiji? Japan? The Philippines? Chile? Any alternative, non-US locale she could have chosen (ignoring the question of why would she would go to all the trouble of choosing one in the first place and then somehow faking a US birth certificate) would involve an expensive, lengthy flight across thousands of miles of ocean just to place her near-penniless, American, teenage self for no particular purpose, outside the US. Likewise, the endlessly repeated lie that Obama is Muslim (particularly offensive, because it implies there is something wrong with being Muslim) is also flatly absurd, since Obama was raised by his Christian mother and grandparents and barely met, let alone knew, his Muslim father, a visiting graduate student from Kenya. It is absurd to imagine Trump actually believes such nonsense.

However, Trump knew those lies would produce the desired response in an audience of racist, anti-Muslim extremists who hated Obama, and so Trump told those lies. And these are only two of dozens and dozens of outrageous, hateful mistruths he initiated or perpetuated before, during and even after the campaign. Trump knew he could control people, excite them, fire them up, by telling them exactly what he sensed they wanted to hear. He continues to lie, and lie and lie and lie, in order to give whoever is listening to him a chance to hear whatever it was they want to hear and thus fall under his control.

Second observation: Donald Trump has no fixed values, morals or ethical precepts.

Sociopaths have no “inside” – there is no person there, no one you can sustain an authentic join with (to put it in psychotherapy terms.) That’s because they don’t see other people, only themselves. Trump has been a pro-choice, apparently liberal Democrat. He has also been an anti-choice, apparently far-right Republican. He used to like Hillary Clinton and defend her against attacks he viewed as unfair. Now he says she’s a criminal, a “nasty woman” whom he has vowed to imprison.

A normal person holds to a belief system. He is attached to certain people in his life, or certain groups of people – someone or something outside himself, that means more to him, perhaps, than his own personal needs and concerns. His views may evolve, but he won’t flip back and forth from one view to another without a thought, because he has invested in a belief structure and the values it represents. A sociopath has no such anchor. That’s why Trump can, without compunction, switch positions instantly on issues that ordinarily divide people strongly. He doesn’t care about anything except himself. To himself, he is all that exists, all that matters.

Third observation: Donald Trump has no lasting, meaningful relationships with other people.

It is no secret that Donald Trump has cheated on each of his wives. In fact, we’ve heard him brag, on a recording, about his habit of sexually assaulting women. When that tape was released he showed no remorse, no regret – he dismissed it as “locker room talk.” I believe he meant that. I believe women are merely sources of sexual pleasure, and beautiful trophies, to Trump. I do not believe he is capable of any empathy towards a woman (or anyone else) and he is certainly incapable of a meaningful relationship with another person, meaning a relationship that goes any deeper than sex or trophy ownership or perhaps rewarding (or punishing) a loyal (or disloyal) lackey.

Trump’s children are little more than trophies or faithful retainers whom he controls through his money, and the other people he keeps around him are, for the most part, lackeys who have proven their loyalty to him through political favors. For Trump, there is no “best friend” or “closest confidant.” There is no evidence of close, mutually nourishing relationships.

How did Trump get where he is?

An astonishing aspect of sociopaths is their charisma. Free from any authentic emotional ties or moral or ethical concerns, they focus entirely on performing for their audience, and providing that audience whatever it craves. They also play strange mind games that leave normal people flummoxed because the ordinary rules of human interaction are not being observed.

One of my friends, watching one of Trump’s Presidential debates, observed in disgust: “This is like a fourth grader on the playground: ‘No, I’m not a doody head – you’re a doody head!’”

He was commenting on Trump’s constant throwing back at Secretary Clinton anything negative she said about him. But in fact, no fourth grader (except maybe a sociopathic one) would take things to the bizarre lengths Trump did during this campaign. Whatever truth Clinton pointed out about his own behavior was twisted around into an accusation and hurled back at her. She was alternately “a liar,” “nasty,” “crooked,” “belonged in jail,” and on and on. In fact, it was Trump who was, by any objective measure, constantly lying, behaving in a nasty manner, crooked (his con artist schemes, failure to pay contractors, etc.) and so forth. His frenetic display was plainly and simply a mind game, and it worked. How could Clinton point out that Trump constantly lied when he never stopped accusing her of constantly lying?

This was sociopathy in action in its purest form. If you look back in history, it is littered with sociopaths who played similar tricks with dishonest words and false accusations – men like Stalin, Mao, Hitler, Mussolini and others, who lied their way to pinnacles of power. They employed the classic sociopathic trick of telling whomever they were addressing whatever it was they wanted to hear, with no concern for whether it was true or other people were hurt as a result. The sole aim was controlling others, and anything was fair game, even the cruelest and most outrageous lie, so long as it achieved their ends.

The big question: What does Trump want?

All this raises the most troubling question of all, which is the nature of Trump’s ultimate goals. Clearly, this is not a man who cares about anyone else – that’s been abundantly demonstrated through his willingness to hurt or cheat others in order to take their money or achieve fame or sex or whatever else he happens to find shiny and attractive.

In attempting to understand Donald Trump, we have to accept that he is a primitive person. This is not an intellectual, and the rumors are he hasn’t read a book in years. His taste isn’t exactly refined in other areas, either. The interior of his apartment at Trump Tower is decorated like a child’s idea of a palace – gold, mirrors, bad paintings in gilt frames.

With Trump, instant gratification is the end goal. He wants young, thin, big-chested blond women for sex. He wants as much money as he can get – no amount, no matter how large, is ever enough, and he possesses no countervailing concern for those who lack the basic necessities. Trump is not particularly imaginative in his desires – he lusts for all the usual tired accoutrements of conspicuous consumption: limousines, airplanes, mansions, all that stuff. And he wants power, represented by other people having to bow before his authority and do what he wants. I think that’s about it in terms of Trump’s appetites, and meeting those appetites is the sum of his aspirations.

At this point he has as much power as a man can accumulate – he is President of the United States. And he has a lot of money, although not as much as he claims.

I can see a few wrinkles coming. Mostly, I envision Trump growing disenamored with the job of President in a peaceful democratic republic.

A few issues:

Keeping up appearances. Even at 70 years of age, Trump is used to living like a party boy. It might be difficult for him to continue, as President of the United States, to have casual sex with multiple women, and sexually assault women with impunity. If he does, as rumors have suggested, dabble in cocaine and other party drugs, it might become awkward to use them while living in The White House. If nothing else, he will be contained within a tight bubble of security in the sedate city of Washington, DC, which might begin to feel confining.

The job itself. It is hard to imagine Trump interacting with disadvantaged children on The White House lawn at the Easter Egg Roll. It would be out of character for a man who lacks interest in anything that doesn’t gain him power or money or sex. It is staggeringly difficult to imagine Trump visiting wounded veterans at Walter Reed Hospital, or observing the usual solemn ceremonies on Veteran’s Day or Memorial Day. The selfless duties – the stuff a President is supposed to do because he actually cares about his country and his fellow citizens, will have no meaning or appeal to a sociopath like Trump. He would make a better generalissimo than a President.

Actually accomplishing an agenda. Trump’s only interest is himself, and satisfying his primitive appetites for money, sex and power. Now that he’s attained power, he has no particular use for it, at least in terms of how it could improve the lives of others. I cannot envision Donald Trump partaking in the painstaking negotiations involved in writing legislation or advocating for policy change within a legislative system. My suspicion is that he will focus instead (a bit like Nixon) on abusing the police and investigatory powers at his disposal in order to control others. I could see him ordering that his enemies be audited by the IRS, or having them bugged or followed or otherwise harassed and monitored by the FBI or NSA. I could envision him using such threats to intimidate and control members of the press who displease him with negative coverage.

The ultimate concern:

My greatest worry around Trump is that he will grow bored of tormenting his enemies, and will have amassed as much power and money – perhaps even as many young, thin, large-chested blond women – as he could possible use in a hundred lifetimes. At that point he might turn his attention outside America’s borders and decide he wants to rule the planet.

A sociopath with the world’s largest armed forces and a massive nuclear arsenal at his disposal is a frightening prospect, but right now that’s our reality.

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Please check out The People’s Therapist’s legendary best-seller about the sad state of the legal profession: Way Worse Than Being a Dentist: The Lawyer’s Quest for Meaning



And now there’s a new Sequel: Still Way Worse Than Being a Dentist: (The Sequel)

My first book is an unusual (and useful) introduction to the concepts underlying psychotherapy:Life is a Brief Opportunity for Joy



I’ve also written a comic novel about a psychotherapist who falls

in love with a blue alien from outer space. I guarantee pure reading pleasure: Bad Therapist: A Romance

