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Donald Trump has had a rocky first workweek in office. He can’t stop making false statements about the size of his inaugural crowd and the election’s popular-vote margin. According to insider accounts — his White House is leaking like a sieve — he is upset that the nation and the media don’t realize how great he is. He is still sending ill-advised tweets, including one this morning in which he, despite having not communicated with Chicago’s leadership on the idea, threatened to send “the feds” to the Windy City to deal with the gun-violence problem there (apparently he saw an O’Reilly Factor segment on it). This has not been a normal first few days for a president, by any means.

This isn’t new, of course. There’s a decades-long pattern of Trump acting in a very unusual manner by the standards of normal, well-adjusted adulthood. Throughout the campaign and the first days of his presidency, observers have scrambled to try to understand him, to try to find some framework that can explain what’s going on.

The only such framework that has even come close to accomplishing this is the psychological trait of narcissism — specifically, the idea that Trump is so narcissistic he might meet the criteria for Narcissistic Personality Disorder, as it’s called in the DSM V. Whether or not he would cross this diagnostic threshold, narcissism experts like Wendy Behary, a clinician who has worked with big-name clients struggling with NPD, seem to agree that his behavior bears all the hallmarks of a deeply narcissistic person. That’s why I found it so interesting to talk to Behary after Trump won, and that’s why I decided to email her to get her thoughts on what she’s seeing so far from Trump’s time in the Oval Office.

It’s worth noting, as always, that we don’t know Trump has narcissistic personality disorder — the only way to know for sure would be for him to be diagnosed by a clinician, and the odds of that happening are about equal to the odds that Trump will, as he promised in his inaugural address, wipe “radical Islamic terrorism” from the face of the earth. But in this case, NPD might simply be the best theory available to explain his propensity to behave so oddly, so consistently. In addition to the aforementioned behavior, it’s safe to say that no other president in recent memory would have devoted a large chunk of a speech in front of a memorial wall to deceased CIA agents to self-aggrandizement and lying about the size of his Inauguration Day crowd — let alone attacked the parents of a soldier who had been killed in action, let alone called into Fox & Friends to insult Alicia Machado, et cetera. Trump really is an odd figure, and viewing his behavior through the lens of NPD shouldn’t be seen as endorsing the general principle of pseudo-diagnosing famous people at a distance — that’s a fraught exercise that should almost always be frowned upon, to be sure — but rather as an acknowledgement that we don’t have much else to go on.

That out of the way, Behary, who is the author of Disarming the Narcissist: Surviving and Thriving With the Self-Absorbed and who runs a clinical practice in New Jersey, said that it wasn’t surprising Trump has spent so much time obsessing over the size of the crowd that witnessed his swearing-in and broadcasting false claims about it. “He has to believe it,” Behary said of his fixation. “He consciously overrides the ‘truth’ because the ‘truth’ would be fraught with shame — the narcissist’s kryptonite. Clinical experts call this an overcompensation or a (necessary) distortion to maintain his (narcissistic) extraordinariness. In plain-speak it’s fiction — revisions of reality to keep the narcissist fully supplied with supreme specialness.”

Behary said that deep down, though, there’s likely some part of Trump hat understands his inauguration-crowd size wasn’t particularly impressive, and also that he did, in fact, lose the popular vote. “We know he must be aware of the truth at some deeper, albeit disallowed, level of consciousness,” she explained. “Disallowed” basically means the state of sorta knowing something, but not allowing it to carve out a place in one’s consciousness — narcissists “have so little capacity to adjust the volume of their inner demanding critics and their unrelenting expectations for their greatness” that they just can’t deal with this sort of information, according to Behary. “For a narcissist this [behavior of ignoring or pushing back against obvious truths] is explained by the intensity of the reaction and the hiccuping focus on an issue related to their rank, status, and approval ratings — i.e., he surely ‘doth protest too much.’”

One of the most noteworthy things about the last few days, as Eric Levitz pointed out on this site, has been the extent to which Trump’s White House is leaking damaging and embarrassing information about him. This is very unusual for the early days of a presidency, when there’s typically something of a lid on the flow of information from the White House to the media.

Behary explained that, to a narcissist, this sort of spotlight on one’s personal shortcomings can feel devastating. “Because image, status, and righteousness are the most important part of their identity and worth, the person with NPD is crushed by any adverse information related to their performance, appearance, correctness, or social standing,” she said. “While most humans would be bothered by negative reviews, the narcissist experiences this as an assassination of their identity.” So on top of whatever else is going on in Trump’s head, he’s likely quite aware of — and deeply affected by — the sheer volume of negative information circulating about him at the moment, both from his own White House and from other sources.

Finally, Behary also had some suggestions for staffers facing the imposing task of interacting with — and trying to rein in — such a troubled president. In particular, she suggested “learning the art of empathic confrontation,” a strategy she uses in her own practice that involves, basically, stepping down the narcissist’s level and trying to cajole them by making it clear to them they are harming their own interests. It’s “a way of understanding (empathy) their makeup and their frustrations, impulses, and their sense of entitlement while also holding them accountable (confrontation) for damaging and destructive actions … helping them to appreciate and predict the consequences of their negative behaviors.” This was a theme she also highlighted in our last chat, when she explained that one way then–President Obama could influence Trump would be not by making moral or straightforwardly rational cases for Obama’s preferred policies, but rather by appealing to Trump’s desire to be beloved. So, to oversimplify a bit, it’s not “Do this because it’s the right thing to do,” but rather “If you don’t do this, your reputation could suffer.”

Other than that, Behary had only one other piece of advice for Trump’s staffers: “For your own survival, get a good therapist, now!”