When Donald Trump spoke yesterday about his decision to withdraw from the Paris climate accord, he seemed to ad-lib one of his broader concerns:

“At what point does America get demeaned? At what point do they start laughing at us as a country? … We don’t want other leaders and other countries laughing at us anymore, and they won’t be. They won’t be.”

It’s hard to overstate the degree to which Trump obsesses over this point. In his mind, being laughed at appears to be the single worst reaction a person or a country can experience, and so he seems to evaluate decisions based less on merit and more on whether they’ll generate laughter from others.

A month ago, for example, Trump sat down with Time magazine, which asked about his decision to launch a strike on Assad forces in Syria, despite having promised to do the opposite before the election. “I think we have to be a strong nation,” he replied. “I think we were being laughed at by the world. They’re not laughing anymore.”

There’s no real-world reason to believe anyone was laughing at the United States over its reluctance to attack multiple sides in Syria’s civil war, just as there’s no evidence of laughter being curtailed in the wake of Trump’s strike. But it’s becoming increasingly obvious that it’s the lens through which this president sees the world: Trump is paranoid about ridicule that doesn’t exist, and he makes decisions based on his desire to stifle laughter that only he can hear.

This is a longstanding point of concern for him. In the Reagan era, Trump insisted that “bad guys” were “laughing at” the United States. In 2011, The Atlantic ran a piece noting Trump making the same argument about international laughter, at Americans’ expense, during the Clinton, Bush, and Obama eras.

“Everyone is always pointing and laughing at America, in Trump’s view,” The Atlantic piece noted. “A psychologist might have a field day with this.”

Trump’s interest in this may actually be intensifying. Twice in recent weeks, the president turned to Twitter to express his concern that his Russian allies are “laughing at” the United States.

Paul Waldman wrote a great piece on this for The Week

It is Trump’s gift to future biographers that he makes so little attempt to hide his psychological issues, but the desire to avoid being laughed at truly stands out…. As much as he cares about winning and getting the better of someone, defeat is marked by the ultimate humiliation of being laughed at. Yet ironically, no president in history has ever been laughed at as much as Trump…. And today there is without a doubt not a single human being on planet Earth who is laughed at more than Donald J. Trump…. The Center for Media and Public Affairs, which has tracked the jokes in late-night monologues for years, found that in his first 100 days Trump was the target of over 1,000 jokes from Fallon, Kimmel, Colbert, et al, on pace to easily surpass the record set in 1998 when in the midst of the irresistibly salacious Lewinsky scandal the hosts told 1,700 jokes about Bill Clinton. Comedy Central even commissioned a weekly show starring a Trump impersonator, so viewers can laugh at him for an entire half hour at a time.

Paul concluded, “There comes a time for every president when they have to choose between doing the right thing and doing what will make them look good. If you have a powerful fear of being laughed at, your decisions will be shaped by avoiding the thing that scares you. The results may not be funny at all.”

The piece ran on Wednesday – the day before Trump abandoned international leadership on climate change so that other countries won’t be “laughing at us anymore.”

Update: Let’s not forget Trump’s reaction when Barack Obama openly ridiculed him at a White House Correspondents’ Dinner.