Donald Trump evidently believes he is above the law. Last week, he fired Attorney General Jeff Sessions and replaced him with Matthew Whitaker, a political operative from Iowa whose only apparent qualification is his public opposition to special counsel Robert Mueller's investigation into the Russia scandal. This is but the most recent example of Trump's apparent efforts to obstruct justice.

Trump's lack of respect for the country's long-standing democratic norms and institutions also extends to America's alliances, security arrangements with its allies and friends, and the international order more broadly. To that end Trump has threatened to remove the U.S. from NATO, hailed the merits of nationalism (while barely pretending that does not mean white nationalism), tried to surrender U.S. security to Russian President Vladimir Putin and proclaimed on numerous occasions that America will now stand (mostly) alone in the world.

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Donald Trump is also a habitual liar who is at war with the truth and empirical reality. For Trump the world (and reality) must be bent to his will. His supporters love him because of all these traits and behaviors, not despite them. Their adoration for Trump is almost libidinal.

Donald Trump is an authoritarian in waiting who acts as though he believes himself to be God. How does he convince himself that the rules do not apply to him? What is the role of violence in Trump's appeal and power? Is Trump responsible in some ways for the Pittsburgh synagogue massacre and the other hate crimes and acts of violence which have taken place during his campaign and now presidency? What role does violence play in Donald Trump's cult of personality? How do his apparent mental pathologies help him to manipulate his supporters and the American people at large?

In an effort to answer these questions I recently spoke with Dr. Justin Frank. This is our second conversation for Salon. 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. He is the author of the bestselling books "Bush on the Couch" and "Obama on the Couch." His most recent book is "Trump on the Couch: Inside the Mind of the President."

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Our conversation has been edited for clarity and length. In the last few weeks America has seen an outbreak of high-profile violence and tragedy. There was the apparent hate crime killing of two black people in Louisville, the "MAGAbomber," who attempted to assassinate numerous prominent Democrats, and then the Pittsburgh synagogue massacre. Donald Trump repeatedly failed to respond to those events with any kind of human empathy or decency. How do we explain this behavior?

Trump is unable to manage anxiety. Therefore, he cannot help the American people manage their anxiety. Trump's pathology leads him to get rid of everything that makes him anxious. He impulsively encourages violence. He impulsively is divisive. Donald Trump impulsively externalizes his own fear of his inner chaos -- he has had to struggle against this fear ever since he was two-years-old. Here is another problem: One of the roles of a president or other leader is to function as a lawgiver figure, a type of parental figure for a society. In that way presidents and other leaders function as a superego figure.

They set the tone for behavior, for morality, for right and wrong. What Trump has done is he has given the superego permission to become violent. He has sanctioned violence which is very disturbing. Donald Trump is like a person who has road rage. But he has the world's biggest bully pulpit and is able to express this rage in front of everyone.

Because Trump is president, he has a deep impact on so many people. If anyone is unstable or people are angry, even if it is justifiable, a leader gives permission to express it. It comes and goes in waves. It may have gotten worse because of Trump's anxiety about the midterms. I worry that Trump's anxiety has translated into an even greater externalization of his aggression.

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Donald Trump stimulates more and more attacks because he has to get rid of his fears of being attacked. He essentially externalizes this anxiety and fear. So many people want to argue that Trump is Machiavellian with his obsession about immigrants and that "caravan" from Latin America -- that this is some ploy to get re-elected and help the Republicans. That’s part of it, but the main thing is to manage his own anxiety. Unfortunately for us, when he does that, Trump functions like a father figure who says, “OK kids, you’re on your own. You can do whatever you want.”

I and others have compared Donald Trump to Charlie Manson. He is giving his followers permission and encouragement for violence. He also leads a political cult. Do you think that is a fair read of the situation?

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I agree. Donald Trump is the Charles Manson of American politics. It’s very important for Trump to believe that his hands are clean so to speak. He can invite other people to express his destructiveness so he doesn’t have to carry it out. For Trump, words are the equivalent of weapons. Trump does not need a gun. Words are his bullets. He enables other people to buy their own guns and fill the barrels with his tweets and just shoot people. It’s a very disturbing quality.

Manson is not the only person you can use as an example here, but it is a dramatic way to get people to pay attention.

I had a patient who was on the inpatient psychiatric ward. This patient used to walk down the hall, light a match and throw it over his shoulder. It became clear that he wanted to set the ward on fire, but he was going to leave it up to chance in his mind. If the match landed and went out, he’d light another match and do the same thing. It was a way of denying responsibility, psychologically, for him.

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That is Trump. Such behavior is the sign of what’s called a thought disorder. It’s a sign of a person who is unable to think properly. In some ways it would be much better if Trump would just say whatever horrible thing he wants to. Instead, he gets other people to do it. He then avoids responsibility. That kind of abdication of thought is what makes Donald Trump, in my opinion, unfit to be president. He wants other people to do the thinking and acting for him. It is bad enough for anybody to behave that way, but to have the president of the United States act like that is very dangerous.

There is another serious problem with Donald Trump as well. When a child has hyperactive tendencies and they go untreated, a whole cycle of problems can begin. This is Trump. It limits not only his intellectual development, but these problems mean that as an adult he also can’t listen to other people. He can’t think properly. Trump doesn’t understand what people are saying. It’s not like he doesn’t agree with it. Because Trump does not understand, he therefore has to retreat to name-calling or going to his base to whip up a frenzy of activity. Donald Trump on a fundamental level does not understand complex issues. He has never had to think about or grapple with them because it makes him too anxious.

This is why Donald Trump always says things such as, “I have the best words,” or “I’m the smartest person, I know things other people don't." Together such comments signal something extremely disturbing. As a psychoanalyst it appears to me that Donald Trump is presenting behavior of what is called “unconscious grandiosity.” Donald Trump is close to thinking that he is God. It’s called the “God complex” and it’s essentially saying, “I know more than anybody else.” At some deep level Donald Trump thinks he is the deity and he does in fact know more than anybody else. Trump believes that he is God as a manifestation of a defensive grandiosity in order to compensate for his ignorance and not really knowing things.

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There is often a tendency in the mainstream American news media -- never mind among his apologists, defenders and enablers -- to say that Trump is just kidding when he talks about violence, that it is all "harmless" political theater. In reality Donald Trump is not playing. Always believe the autocrat.

Everything Trump says must be taken seriously. Donald Trump is erotically attached to violence. He is excited when he does those professional wrestling moves at his rallies. He is like a child. The problem is, Trump has nuclear weapons and he’s the president. Trump's attraction to violence is not like someone laughing at slapstick comedy where an actor trips and falls down. It is really a pleasure that’s very visceral and deep and destructive. Trump has had this attraction to violence since he was two years old. Donald Trump has constant and consistent themes of violence in his speech and behavior. The content may be different but it is always the same tune. But even with all his distractions, the message is always there. It is always about aggression, bullying, divisiveness and attacking tradition.

Why is there so much denial in the American news media and the public at large about Trump's threats of violence? It is almost as though people think that they will somehow be exempt or safe.

When we were children we had night terrors. Your mother or father or other caregiver would come into your room and calm you down. The terrors would go away. When the child grows up they start organizing those scary thoughts and feelings and separating them in their mind into good and bad. What Trump does is he adds to the night terrors. He has found a way to reactivate them in the American people. Trump then says, “I can make America great again. I will turn on the lights. I’ll make everything OK."

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How do we explain the dozens if not hundreds of hate crimes and other violence by Trump's supporters? The SPLC and other groups have documented how Trump supporters, very often wearing Trump regalia like MAGA hats, have attacked people while chanting his name and slogans. Is this just pathology seeking out pathology?

No. Disorganized minds need another mind to help them organize their thinking, in this case to justify their expression of their anger. When a person wears one of Trump's MAGA hats they are essentially living inside of their father. Other Trump supporters who express their loyalty in similar ways are also living inside of their mothers. The MAGA hats makes them feel like they are therefore immune from certain kinds of considerations, such as compassion for other people. This allows them to identity with a destructive aggressor. Trump has permitted and encouraged violent behavior, aggression. Trump's MAGA hats mean, in essence, that his supporters are living inside of the president.

This is very profound. It is the behavior one sees in cults. For instance, you can have a religious cult and the leader is all powerful. You submit to everything they say. When Trump says, “Don’t believe the crap you see from these people, the fake news. What you’re seeing and what you’re reading is not what’s happening,” George Orwell could not say that better.

What Trump is saying in a basic way is, "The only way you can be safe is to be on my side and believe in me. Otherwise, you’re going to be attacked."

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How would you explain the accused "MAGAbomber," the man in Florida who allegedly sent all those mail bombs? What is his relationship to Donald Trump?

He is the same. The MAGAbomber is just Trump writ large. He’s following the orders. It’s what you do when you’re in a cult. Remember, everybody in a cult is not at the same level of psychological development as everybody else in the same cult. They may all love the leader and revere the leader, but each member still has their own different psychologies and different tendencies to do things their own way.

The MAGAbomber is essentially an extreme version of a person who is saying, “I’m going to do everything Daddy says. I’m going to attack everybody who’s bad. All my neighbors are bad. I’m going to scare the hell out of them and do it.” The MAGAbomber is one version. The bigot who shot up the synagogue in Pittsburgh is another version. The man who tried to do a repeat of Charleston and ended up killing two black people in Louisville is another version.

Again, Trump's music, so to speak, is one of hatred, destructiveness, instilling fear. It’s all about living out Trump’s internal conflicts and fears on the world stage. He’s the puppeteer and we’re the puppets. The MAGAbomber is just a different kind of puppet.

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Trump and the right-wing media's obsession with the supposed "caravan" of refugees coming from Latin America is another reflection of the relationship between racism, anxiety and violence. How does this work?

As a psychoanalyst, the caravan represents future babies that his mother is going to bring into the world. Trump doesn’t want any more little siblings. He doesn’t want any more people to get a piece of the pie. He wants it all.

Immigrants unconsciously can represent future babies who are a threat. For Trump and those who think like him, the "caravan" is also a reflection of the idea that black and brown people are going to take away white people’s jobs. There is also an element in this obsession where the "caravan" and nonwhites are viewed as being dirty, human pollutants by Trump and his supporters.

Donald Trump was explicitly told by leaders of the Jewish community to not go to the memorial for the victims of the Pittsburgh synagogue shooting until he renounced white nationalism, Antisemitism and other types of racism and bigotry. Of course he went anyway. Most decent human beings would not have done such a thing. What is going on inside his mind? Does he experience shame?

No, but that is the point. When they say, "Don’t come," to him it’s a challenge. Ultimately, it has nothing to do with the subject. When someone tells Donald Trump "You can’t do it," he says, “I’m going to do it.” Donald Trump cannot accept being told "No."

He will not accept it. Going to Pittsburgh is just another example of Trump's defiant streak. This is why he is obsessed with deregulation. He hates any rules that limit him.

If Donald Trump showed up at your practice and said, “I just want to be a better person. People don’t like me. Give me some advice.” What would you tell him?

The first thing I would say is “Mr. Trump, who loves you? Who do you love? What’s important to you?" I would just get down to basics about life and love, because there’s no other way to deal with him. You have to get through on a deep emotional level and everything else is just noise to him. I would also say to Donald Trump, "Tell me how you broke your heart."

He has a lot of internal pain.

Yes. Donald Trump has run away from this pain his whole life, and he’s been successful at doing so. I would directly address that issue very simply, very slowly and very directly. He would have to experience a breakdown because he’s avoided all of those feelings his whole life. This would be the approach necessary to help him put things back together in a healthy way.