Shortly after our third child arrived, I needed housecleaning help. So we hired a woman noted for her efficiency and energy. As her recommendations promised, Jane (pseudonym) cleaned wonderfully well. Maury met her one evening, looked at her bulging eyes and insisted she see a doctor immediately.

President Trump’s behaviors are worrying mental health professionals in the same way that Jane’s eyes indicated that something was wrong. The president’s tweets and comments and his vacillating moods and positions, sometimes even undercutting his own party, are scary.


Mental health professionals have expressed concerns about the president’s functioning, but cannot diagnose any individual they have not professionally evaluated.

True, I never thought President Trump would be the right person to lead our country. While some attributed Trump’s obnoxious comments about women, the physically impaired or Senator McCain’s prisoner of war status as simply “campaign rhetoric,” my feeling was that these comments were unfortunately a measure of the man.

I don’t think Vice President Pence’s goals and political positions are any more acceptable to most liberals or even some moderates than are Trump’s, but Pence’s demeanor, speech and personal interactions make him a much more desirable person to be leading our nation. At least, he would not insult our longtime allies, tweet incessantly or make impossible promises.

In February 2016, my column in this newspaper [Huntington, WV Herald-Dispatch], “Narcissist as president would be dreadful,” identified some of the problematic characteristics of a narcissist. I noted that such personalities are often attractive because they ooze confidence and offer simplistic answers to difficult problems, such as the president’s promise to easily repeal and replace Obamacare with something much better. Finding that about 22 million Americans would be hurt by the proposed changes, while a small number of really rich folks will get a bonus, wasn’t what was promised.

The Diagnostic and Statistical Manual-5 (DSM-5) is the accepted guideline that mental health professionals use for identifying and diagnosing mental health disorders. There are nine specific items that are linked to narcissistic personality disorder behaviors.

These include a grandiose sense of self-importance, a preoccupation with fantasies of power, success, intelligence, etc., and a sense of entitlement. Additionally, seeing oneself as special and unique and only associated with high status individuals, needing constant admiration from others, exploiting people for personal gain, lacking empathy, envying others and believing that others envy them and demonstrating arrogant and haughty behaviors and attitudes are seen frequently. This is a long-term behavior usually established by the beginning of adulthood. Genetic and environmental issues reportedly may influence this functioning.

When I worked as a licensed psychologist, I rarely encountered clients with narcissistic personalities. While this diagnosis is not overly common, the real reason I did not see such clients was that they usually are not uncomfortable and believe any problems they have are caused by others. Expecting change from a mature adult whose behaviors have much in common with a narcissistic personality is folly.

Our twittering president’s comments are not only ridiculously “unpresidential,” but also cruel, inappropriate and sapping energy and progress from our government.


Following Trump’s recent irrational tweets regarding Mika and the “Morning Joe” show, Sen. Ben Sasse (R-Neb.) chirped back, “Please just stop. This isn’t normal and it’s beneath the dignity of your office.”

“This isn’t normal” is the gist of President Trump’s behavior. While medication readily treated Jane’s medical condition, there’s no panacea for those who display characteristics of a personality disorder. It’s why many mental health professionals are worrying about the man leading our nation.

[Diane W. Mufson is a retired psychologist. Her e-mail is  Mufson regularly contributes to the Huntington, WV Herald-Dispatch editorial page and this article first appeared in the Herald-Dispatch on Thursday, July 13, 2017. Photographs by Pixabay.]