I wasn’t surprised by Donald Trump’s rage-tweet attack on Reps. Ilhan Omar, Ayanna Pressley, Alexandria Ocasio-Cortez and Rashida Tlaib, any more than I was surprised by the maturity and sobriety of their response. After all, Trump’s racism is legendary, and telling them to “go back where you came from” is not just textbook racism, it’s a schoolyard bully’s taunt. And a racist schoolyard bully is the sum and substance of what Trump is.

In fact, one expert, physician and psychiatrist Dr. Frederick "Skip" Burkle, told me that autocratic leaders typically have histories of being bullies, and that that the most important thing about them that the public needs to understand. I first contacted Burkle by way of counselor and therapist Elizabeth Mika, whose chapter in “The Dangerous Case of Donald Trump” (Salon review here) explained that "Tyrannies are three-legged beasts": the tyrant, his supporters and the society as a whole. That perspective is vital to understand our specific predicament, which is historically unique only within our national borders.

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The generic predicament of racism is nothing new — particularly for the Republican Party. (See “The Long Southern Strategy.” Salon author interview here.) What is new is Trump’s malignant psychology, a character disorder shared by dozens of destructive autocratic leaders whose patterns of murderous rule Burkle described in a 2015 paper, “Antisocial Personality Disorder and Pathological Narcissism in Prolonged Conflicts and Wars,” drawing on decades of experience as a world leader in emergency public health crises such as war and conflict, as well as his background in psychiatry and pediatrics. A recent follow-up paper (“Character Disorders,” for short), focused on the negative impact autocratic leaders have on health security, human rights and humanitarian care.

Bullies-in-chief around the world

Burkle cites examples like Idi Amin in Uganda, Slobodan Milosevic in the former Yugoslavia, Kim Jong-un in North Korea, Moammar Gadhafi in Libya and Omar al-Bashir in Sudan, who “have emerged first as saviors and then as despots, or as common criminals claiming to be patriots.”

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Amin and Milosevic are particularly apt figures to compare with Trump, given their roles in fomenting genocidal ethnic strife in Uganda and Bosnia respectively. Once in power, such a leader “thrives on continuing conflict and never seeks peace,” Burkle wrote — as a predictable description of all autocratic leaders. Characteristically they befriend and admire other autocratic leaders who have more power than themselves. Burkle reminds us that Hitler modeled himself after Mussolini and that Hitler and Stalin allied in the invasion of Poland. Before World War II started, these leaders, along with Japanese officials, met to divide up the world. But when one has power the other desires, conflict can result — as it did in Hitler’s eventual invasion of Russia.

“These autocrats are simply an adolescent bully in an adult’s body,” Burkle told me in early June, I’d written a two-part story [here and here] about Trump’s lies and his threat to democracy. Burkle and others were distraught by political leaders’ profound misunderstanding of autocratic leaders and their inability to change, because of developmental failures in their youth — failures that cannot be overcome.

Burkle cited Nancy Pelosi, “who said only yesterday that she was waiting for [Trump] to be more ‘presidential,’" lamenting, “She does not have a clue.” Pelosi may be Mitch McConnell’s political opposite, but when it comes to understanding who and what Trump is, she is no better off.

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Trump himself supplies first-hand testimony. "In the second grade I actually gave a teacher a black eye — I punched my music teacher because I didn't think he knew anything about music and I almost got expelled,” he wrote (or at least his ghostwriter did) in “The Art of the Deal” (quoted here.) "When I look at myself in the first grade and I look at myself now, I’m basically the same. The temperament is not that different," he told biographer Michael D'Antonio.

Burkle’s work in wars and conflict has brought him face-to-face with foreign leaders who not only frustrate and impair the work done by humanitarians and their partners, but are actually the cause of much of the suffering they seek to alleviate. So he has first-hand experience of what autocratic leaders have done around the world over a period of decades. Because of the common cognitive and emotional arrest in adolescence, he says, their shared behaviors are “predictably predictable across all cultures and borders”.

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But Burkle also has first-hand experience of garden-variety schoolyard bullies, from an early age. He started first grade early, when he encountered his first bully. “I got pushed from behind on this knoll, and I went down, and fell and I turned around and there's this kid double my size sort of laughing with everybody. And I just ran back up the knoll and just tackled him out of anger.” Naturally, they both ended up in the principal’s office. “This kid — more than double my size — the first thing out of his mouth, and I remember looking at him being so surprised, he said, ‘Oh! He started this. He pushed me!’ So they're always blaming it on everybody else. And they get away with it,” Burkle said. “We were both talked to, but by responding I had to take part of the blame.”

This is the essence of bullying — not just the violence and intimidation, but the narcissist’s hallmark sense of impunity, backed up by effortless deceit, blame-shifting and manipulation. I see now that Trump’s latest effort to disavow the “Send her back” chant he inspired fits perfectly into the package, alongside the violence and intimidation bullies are most notorious for. But violence and intimidation are just part of the package. It’s a big mistake to confuse the part with the whole.

Playing the victim — something Trump has perfected to a T — is absolutely crucial to a bully’s success, as Burkle’s first experience showed. Trump’s followers wallow in victimhood with him, especially in the aftermath of his own vicious attacks — a classic expression of collective narcissism (more on this below). Commentators and media practices demanding equal consideration of “both sides” further reward the bullying behavior in all its aspects, even if they may include some narrowly targeted criticism of the most specific, blatant violence or threats.

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That same kid later picked on Burkle in high school before getting kicked out, he says. “They never stop, and they have their targets that they like. But that also started my interest in, 'Who are these people, OK? And why is he doing this?' I remember spending an awful lot of time in my life saying, 'Why are people like this?'”

The bully’s arrested development

A major focus of Burkle’s attention is developmental failure. A degree of “healthy narcissism” is necessary during childhood in building a fragile ego, but childhood is where narcissism belongs. Children around the world “are sort of identical,” he said. “When we mix children from different cultures they get along well right away,” but that’s not the case for adolescents who’ve developed marked differences.

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“Every single culture in the history of our world — even ones that don't know any culture outside themselves — they've always given special attention to adolescence and advanced education, and recognized something unique happens there,” he told me. What happens is learning to be part of a larger, less concrete, more abstract and unpredictable world, which entails a multitude of specific skills and cognitive capacities such as reasoning, insight and debate with a significant emotional dimension, as Burkle explains in his “Character Disorders” paper:

For many, they feel for the first time personal anxiety, doubt, shame, depression, guilt, sorrow, make embarrassing mistakes, learn new avenues by modeling other more mature adolescents and adults, and develop both age-appropriate neurologically and socially beneficial developmental tasks, eventually leading to a sense of accomplishment.

This is the deeper meaning of the saying, “You’re only young once.” The kind of cognitive/emotional/social development that occurs during adolescence is a one-shot deal. And Trump missed his shot, just like all others with character disorders. Because they’ve never grown up, they remain very similar, like children: Vladimir Putin, Rodrigo Duterte, Trump, Mohammed bin Salman — they all recognize their reflections in one another. The fact that they all get along so well should chill us to our bones.

Not all narcissists are bullies, but all bullies are narcissists: A sense of superiority is foundational for bullying behavior. The broader lens of narcissism is how Mika approaches things. If talking about bullies tends to focus on sadism, talking about narcissism focuses on “a grandiosely overblown sense of one's greatness and importance, an ego — or false self — that eclipses everyone and everything around it,” Mika said. “It often strikes us as comical and buffoonish, so unreal as to appear purposely exaggerated, but the fact is that narcissism stems from emotional and cognitive deficits rooted in a severe developmental arrest that makes growth and change very difficult, if at all possible.”

She went on to note the most significant consequence — a severely impaired or total lack of conscience, which “manifests in an inability to empathize with others or even see them as fellow human beings,” resulting in “lack of compassion, capacity for guilt and healthy shame.” It also results in “disregard for higher values, such as truth, justice and equality.”

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The disregard for truth is especially useful as a bully "relentlessly creates his own version of reality that serves to protect his overblown and fragile false self,” Mika said. As a result, “He tends to be immune to cognitive dissonance resulting from the inevitable for most of us confrontation of our beliefs, especially about ourselves, with reality as mirrored to us by others and the world.”

For Mika, the greatest damage caused by "narcissistic arrest" is the "inability to love,” she said. “To love one has to be able to connect with one's own and another's true self, and this is very difficult for a narcissist as his existence is focused on enlarging and constantly defending his gargantuan false self.” The result explains volumes: “People who are unable to empathize with and love others relate to them through control and domination.”

Mika and Burkle differ somewhat on the development of abstract thought. “Some narcissists are brilliant, though one-sided, abstract thinkers," Mika said. "They may create seminal works in their domains, but their emotional growth is stunted, and this manifests in their problematic relationships with others. However, in politics, one does not need to be a brilliant narcissist to advance.”

Trump’s well-known lack of interest in reading anything at all is typical of the type, though perhaps extreme. His inability to present any details to bolster claims about “terrific” deals or plans is not a masterful strategy of playing things close to the vest. All he’s hiding is a handful of Jokers.

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Mature politics vs. bullying

In “Character Disorders,” Burkle writes:

Despite their seductive talents and uncanny ability to speak to universal concerns of every citizen, [bullies turned autocrats] never attain mature abstract reasoning and avoid discussions and debates that demand levels of reasoning, observation, and objectivity, or issues that do not personally boost their own power and prestige. They expend emotional energy covering up their limitations and turn to lies, fabrications, childish insults, and unrelenting boastful opinions of themselves.

This would be clear in Trump’s case if we simply compared his statements with other public figures, Burkle told me, and pointed to South Bend, Indiana Mayor Pete Buttigieg as an example. “When Trump called Buttigieg some stupid adolescent name, like bullies always do, the news went wild," Burkle said. "They went right to Buttigieg trying to get a response, thinking that Buttigieg was going to give something right back to him, at the same level. The way he surprised everybody, he just looked at them and said, ‘I don't care.’ And that's way you have to be. Buttigieg totally understands Trump.”

But Buttigieg also understands his privileged position as a white male. The congresswomen of color Trump is currently attacking have no such privilege, and attacks against them are simultaneously collective attacks on targeted communities they have a duty to defend — a complicating factor they deal with in different ways, but always with a level of maturity that Trump could never even dream of. In the four women's joint press conference responding to Trump’s attacks, they struck a common theme of not taking the bait, while at the same time standing up for those being attacked, invoking America’s promise, and vowing to keep fighting to fulfill it. Unlike Trump’s many attacks on America, they conveyed care and concern for how we’ve fallen short.

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“We don’t leave the things that we love,” said Ocasio-Cortez. “And when we love this country, what that means is that we propose the solutions to fix it.”

“This country was founded on the radical idea that we are created equal and endowed by our creator with inalienable rights,” Omar said. “And yes, we have a long way before we fully live up to those values. It is for this reason precisely that we have to take action when a president is openly violating the oath he took to the Constitution of the United States and the core values we aspire to.”

“I encourage the American people and all of us, in this room and beyond, to not take the bait,” said Pressley. “This is a disruptive distraction from the issues of care, concern and consequence to the American people that we were sent here with a decisive mandate from our constituents to work on, everything from reducing the cost of prescription drugs to addressing our affordable housing crisis, to ensuring that the American people have more than health insurance, but health care.”

Finally there was Tlaib, who added: “We cannot allow these hateful actions by the president to distract us from the critical work to hold this administration accountable to the inhumane conditions at the border, that is separating children from their loved ones and caging them up in illegal, horrific conditions.”

“We can easily observe the work of a properly functioning conscience in the actions of the four congresswomen whom Trump chose as most recent targets of his narcissistic rage,” Mika said. “It is no accident. Malignantly narcissistic individuals react with the greatest rage to those who somehow evoke their sense of weakness, inferiority and imperfection, and individuals representing a higher level of moral development often do just that by their sheer existence.”

What’s more, Mika added, "target status is magnified" if the target in question happens to represent a minority:

... because few things irk a narcissistic bully like a morally and emotionally advanced "other." The ideals of equality, inclusion, justice and compassionate concern for people that these congresswomen espouse are alien to Trump and his psychologically similar sycophants and followers whose worldview is based on narcissistic us versus them distinctions. Such ideals not only conflict with their desires for power, but also expose their deficits of conscience and thus are considered especially threatening.

Collective narcissism: The bully’s backup gang

Finally, we need to consider the role of collective narcissism — both narrowly within the power structure supporting a narcissistic leader, and more broadly in his popular base. Regarding the latter, Mika said, “Trump's bullying behavior serves a restorative function, patching up holes in the false self of his followers as well. The scapegoating tactics used by him make it possible for him and his followers to retain the notion of their superiority and blameless victimhood.”

As noted above, Trump has attacked America numerous times, so there’s a surreal quality to his scapegoating these four women of color for their far more thoughtful critiques. But it’s precisely the accuracy of those critiques that makes them so painful for collective narcissists to bear, and so necessary for them to be rid of:

This is how scapegoating, the fuel of collective narcissism, works — it shifts our unacknowledged sins onto select others who may differ from us only in some details (Freud called it narcissism of small differences) and so it makes it justifiable in our eyes to punish them for those projected sins. We thus purge our individual and collective sense of inferiority, shame and guilt without ever acknowledging it, and this lets us to maintain the narcissistic image of ourselves as pure, intact, and yes, always superior to others.

Then there’s the narrow form of collective narcissism, which Burkle writes about in “Character Disorders”:

When the political party aligns itself with the narcissist, it becomes "operationally and collectively narcissistic." Once collective narcissism exists, the autocrat can be assured of sustaining his power base, demanding total loyalty, with followers speaking from the same playbook and daily-drilled sound bites, where disloyalty is severely punished.

More pointedly, Burkle told me, “If the collective narcissism pack is large enough, and powerful enough, it's almost impossible to get the narcissist, the autocrat, out of power.”

So long as Democratic leaders and the media remain oblivious to or ignorant of what’s actually going on psychologically — not just with Trump, but his followers as well — they will continue to misjudge the situation, even as they repeatedly say how abnormal it is. And the danger will only continue to grow.

This situation is abnormal in American history. But it’s depressingly normal for a country where a narcissistic bully has gained power. We need to reorient ourselves around that fundamental fact, and stop pretending that what’s been normal in the past provides any sound guidance now. Clinging to that illusion is, in itself, a subtle form of collective narcissism: the belief that “It can’t happen here,” the refusal to look ourselves in the mirror and confront what we truly are — which is the only way we can ever live up to what we wish to be.