That President Donald Trump is a narcissist comes as no shock to anyone who has witnessed his rise to fame over the past few decades, and particularly as he ascended to the White House in 2016.
But many individuals who meet the requirements of a narcissistic personality diagnosis would not be so dangerous as the current U.S. president, even with access to the power his office bestows.
Why? Because Trump is not your everyday, garden variety narcissist — his apparent sadistic traits reveal a malignant narcissism.
Speaking with Salon, Dr. John Gartner, a former professor of psychiatry at the Johns Hopkins University Medical School, said it this way:
“When I first started talking about Trump as a malignant narcissist, people could see the narcissism, the paranoia and the antisocial element. But the fourth component of malignant narcissism is sadism.
"You see it in everything he does, from the separating of the children at the border to how Trump tortures anyone who doesn't give him what he wants. There's a way in which he takes a kind of manic glee in causing harm and pain and humiliation to other people.”
And there is no reason to believe Trump will “pivot” or be otherwise tamed: this is not the way of the malignant narcissist. In fact, his rise to power only exacerbates the symptoms of his disordered condition.
“Malignant narcissists deteriorate. When they gain power, they become more inflamed in their grandiosity and in their paranoia,” Gartner said.
“They also become more unrestrained in their sadism and in their will to power. Malignant narcissists like Trump are antisocial and have a willingness to do anything to get and keep power. The noted psychologist Erich Fromm actually argued that such personalities then begin to verge on psychosis at that point, becoming so grandiose and paranoid that they really live on the boundary of psychosis and reality.”
Trump’s situation is compounded further by what appears to be the cognitive decline of old age, thoroughly evidenced by his waning ability to communicate concise and coherent thoughts.
His cognitive decline, like the grandiose narcissism and paranoia, can only worsen as time wears on, Gartner said.
“Cognitive deterioration only goes in one direction. It doesn't stand still and it doesn't get better. No, Trump is not ready for the nursing home. But that doesn't mean he's capable of managing the White House. Once you factor in nuclear weapons the possibilities are truly horrific.”
How does the story end?
Possibly not well, according to Gartner.
“It all reminds me of the saying about how people go broke very slowly and then all at once. I think that's what we're heading for right now. What if there is a global crisis like a war? What if Trump refuses to step down, if he is impeached and convicted? It is a coup that is not moving slowly anymore. It is accelerating.”