President Trump’s interview this week with the New York Times made headlines for his revelation that he would never have chosen Jeff Sessions as attorney general if he had known Sessions would recuse himself from the Russia investigation. Here at STAT, however, we combed through the transcript of the Oval Office interview for something else: examples of the emotional subtexts that psychiatrists and psychologists told us offer a window into the president’s mind.

Overall, Trump was more articulate than he has been in some recent appearances, an important reminder than his tortured syntax might reflect not mental decline but emotional stress: He seemed comfortable with the reporters. Nevertheless, the workings of Trump’s mind, as inferred by experts who have described their observations to STAT since January, shone through. “Most of the now-familiar Trumpian patterns are here,” said psychologist John Montgomery of New York University. Among them:

The New York Times
The New York Times

This was a quick pivot from a brief answer to a question about working with Senate Majority Leader Mitch McConnell. Trump instead used the question to extol his own knowledge. It’s an example of what psychologists call “compulsive more-than behavior”: a deep need to never feel even slightly less than others in terms of knowledge, intelligence, power, or popularity. That need often arises when someone finds the idea that he could fall short of anyone on virtually any measure a profound threat to his sense of self. Montgomery and other experts all cautioned that they have never spoken to Trump, but are drawing inferences from his past behavior and public statements.

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The New York Times

This account of Trump’s speech in Poland on July 6 came in response to a question about his trip to Paris a week later. The “greatest speech ever” claim fits with psychologists’ view that Trump displays signs of a narcissistic personality. (Although some psychiatrists assert that he has narcissistic personality disorder, Trump shows no signs of the “distress” or “impairment” that such a diagnosis requires.) A key facet of that personality type is grandiosity, an exaggerated sense of one’s own importance, specialness, and success. Later in the interview, Trump said he had “done more than” any other president in his first five months in terms of legislation and other accomplishments. “It does seem to be very difficult for Trump to think about foreign and domestic policy issues outside his prism of ‘more than,'” a need to portray himself as superior on virtually all measures, Montgomery said. “It’s all about winning, dominance, being ‘more than’ other people,” which may be a way of compensating “for inner feelings of ‘less than.'”

The New York Times

Perceiving unfairness is a common trait of people who see enemies everywhere. Here, and also when he announced last month that the U.S. would pull out of the climate accord, Trump insisted that he had been saddled with a bad deal. Allowing oneself to be taken advantage of is a sign of weakness, something people who need constant reminders of their superiority cannot bear. Solution? “Get out.” The allusion to his core supporters “loving” what he did suggests the need for adulation that characterizes people with narcissistic personalities.

The New York Times

Macron was so critical of Trump’s rejecting the Paris climate treaty that he publicly invited U.S. scientists to move to France. People with an inflated sense of self-worth are often blind to the negative views that others hold about them.

The New York Times

See above. It’s not clear from the transcript, or even the tape of the interview, whether Trump is making a joke at his own expense. Macron told reporters in May that his handshake with Trump at their meeting that month was symbolic, showing that France would not bow to the U.S.

The New York Times

Psychologists believe that people who are deeply threatened by feeling “less than” protect themselves by asserting to others (and themselves) that they are in fact “greater than,” sometimes to the point of ignoring reality. According to a recent poll, 82 percent of French voters view Trump unfavorably, somewhat short of “they love you.”

The New York Times

From the late 1980s to 2017, Trump’s sentences have become shorter and syntactically simpler. He uses more words of fewer syllables, and the percentage of unique words out of total words has fallen, indicating that he repeats himself more. These are standard measures neurologists use to assess the complexity of speech, which can fall along with the cognitive decline that typically marks normal aging but also disease-related cognitive impairment.

The New York Times

The “headaches” are those he got after the outcry over his firing of FBI Director James Comey. That led to the naming of a special prosecutor to investigate the alleged Russia collusion, arguably a serious threat to Trump. Refusing to acknowledge error or even missteps — the firing was, instead, “great” — is common in people who need to be right because admitting a mistake threatens their fragile self-image, which is often at the root of a narcissistic personality.

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