Living with a Narcissistic President

Narcissism has been perhaps the most destructive human trait throughout history; if we examine the personality structure of those who have inflicted the most suffering on others, it stands out along with sociopathy (which has several areas of overlap) as the most prevalent trait.

For the individual, an intimate relationship with a narcissist creates a well understood set of symptoms and dynamics, and tremendous pain and distress.

The narcissist commands our constant attention. Our internal response is one of threat, fear, hyper-arousal, anticipatory anxiety and difficulty stepping away from the cause of our distress, or even identifying it. It seems as if something terrible will happen if we withdraw our attention from the narcissist; and the moment we try to they draw us back in, either through seduction or threats. The worst thing that can happen, in their psychological world, is to be left alone with their sense of inadequacy, unlovability and emptiness, and thus they must constantly stir the pot, craving love and intimacy yet unable to tolerate it.

Under the sway of the narcissist, our world shrinks as we focus more and more exclusively on him/her. We begin to feel crazy; since they seem so sure of themselves and yet it makes no sense to us, we begin to doubt our own perceptions. For people with a shaky sense of self, this can result in identifying strongly with the narcissist, submitting to them; thus the sycophants throughout history who surround the powerful figure, kowtowing to and enabling them.

In our current situation, we have such a figure at the helm or our government. In myself, and in my patients, I see the same phenomenon: a sense of helplessness, dismay, fear, powerlessness and despair that such a person is causing so much damage and nothing can be done about it. It becomes a sick, addictive focus of attention; one is unable to take their eyes off this person, and the cascade of his words and actions each more horrible and inhuman than the last.

My fellow psychiatrists have written extensively about this in the media. Having worked with very disturbed patients for decades, both in hospital settings and in the office, psychiatrists all know what this is. It is an extremely destructive pattern of behavior, and it seems more than odd that non-psychiatrists are not more interested in the professional opinions of doctors. Perhaps it reflects the current trend of science-denial and alternative facts, where expertise and professional training count for less than unfounded beliefs and tribal instincts.

Once a disease is correctly diagnosed, we move toward treatment. In the relationship with a pathological narcissist, the only effective treatment is to remove oneself from the relationship, to sever the tie. In my view, the only way we can begin the process of healing as a nation and as individuals is to end the relationship with this figure by removing him from office; in the meantime, the best we can do is minimize the damage he can do and reduce the attentional reward he gets from his constant provocations. On a personal level, in addition to efforts toward limiting the damage he can do to our institutions, environment and standing in the world through political and legal action, we must step back from an obsessive focus on his awfulness. In place of this, I suggest reading great literature, playing and enjoying music, close relations with friends and family, exercise and daily spiritual practice such as meditation or prayer.