Presidential Psychopathology: Clinical Psychology Views

Part 2: Exploring questions about the president's mental health.

Posted Sep 30, 2020

What kinds of questions and answers do two licensed clinical psychologists have about Trump?

In this post, I interview Dr. Alan Blotcky in part II of a series entitled "Presidential Psychopathology: A View from Clinical Psychology." Topics covered include authoritarianism and personality pathology. On Twitter, Dr. Blotcky writes in his biography that he is a "Clinical psychologist, Writer, Blogger, Expert witness, Divorce, Child custody, Parental alienation, Criminal, Texas-Ex, Ph.D. Vanderbilt."

Dr. Blotcky has written articles published in Rawstory. He has been featured in Salon, and most recently, he was published in The New York Daily News for his opinions on the psychopathology of Donald Trump (aka POTUS). His most recent article in the Daily News was co-authored by Seth Norrholm, a faculty member at Wayne State University. It was entitled, "Say It Plainly: The President is a Psychopath" and was published on September 24, 2020.

As far as I know, Blotcky's and Norrholm's publication in the Daily News represents the first of its kind in that a fully credentialed, licensed clinical psychologist applies the diagnostic label "psychopath" to the president on paper and in print. It represents a major shift as the majority of licensed clinical psychologists have not weighed in diagnostically on Donald Trump.

The article in the Daily News—as well as the other mentioned above—provide the public with the perspective of one licensed clinical psychologist on the mental functioning of Trump. In this post, that perspective is further contextualized via questions from another licensed clinical psychologist (myself). Accordingly, I hope the reader finds the questions and the answers below helpful and engaging at a different level, or as a follow-up to the linked articles above.

The Interview

The questions that follow have been on my mind since 2016 but have become crystalized more recently as my understanding of Antisocial Personality Disorder (ASPD) has deepened. Further, my personal appreciation for the historical overlap between anti-fascism efforts during World War II between federal agencies and academic psychology has grown, as it was news to me.

For example, a propaganda unit in the OSS, a precursor to the CIA, included a famous psychoanalyst, Ernst Kris, and actually contracted the famous personality psychologist, Henry Murray, to write a case report of Hitler. My questions below derive from my close study of some of the above-mentioned authors, as well as relevant historical literature. 

Dr. Winarick: In my opinion, Trump meets every textbook definition of a demagogue. Every demagogue has their followers. For Trump, many of his voters can be considered his followers. What explains why some people follow demagogues whereas others do not? 

Winarick 2020
"How to identify an American pro-fascist" published by Friends of Democracy Inc. Reprinted in Allport, G. (1954)
Source: Winarick 2020

Dr. Blotcky: I [personally] consider Trump to be a demagogue. He appeals to emotions and prejudices, not rational arguments or data. Some marketing research1 has indicated that some conservatives' brains light up in response to Trump. He is entertaining, he provokes emotions, and he elicits prejudices. Certain people like to be entertained. They may be waiting to see his next outrageous comment or act. Some people are mesmerized by his showmanship and bravado.

Dr. Winarick: Among Trump’s followers, there probably exist different segments or subtypes of individuals. Some distinguishing characteristics may be socio-economic status (SES)—i.e. some of his supporters are low SES, some high SES, and some middle. Do you think, in general, there are different factors underlying support for a demagogue at different levels of socioeconomic status? If so, how do such individuals differ or not differ?

Dr. Blotcky: I think there is research2 that shows that people with lower education and lower SES are prone to be attracted to Trump. Why? I think some of them may be attracted to Trump's apparent anger, resentments, "rebelliousness," anti-government attitude, and proclivity to incite chaos. These are people who may feel that they have been left behind by the government. They may feel they have gotten a raw deal economically. They may be angry and resentful.3 They may want to disrupt and even blow up our current political system. Thus, they may be attracted to Trump's rebelliousness and chaos. It is a sense of shared grievances.

Dr. Winarick: I think there are some universal buttons that Trump may push which attract followers based on primal human nature—e.g., in-group/out-group conflict, unbridled aggression, pure sensation, and pleasure-seeking, as well as a sort of celebration of indecency. Do you think there may be an evolutionary basis for why Trump has followers? 

Dr. Blotcky: Certain people like authoritarian leaders. They believe in allegiance to a strong leader. Many of his supporters likely see him as capable of changing our political landscape. However, in some cases, they may not able to see Trump's negative qualities.

Dr. Winarick: How would you characterize the psychological functioning of a group of Trump followers?

Dr. Blotcky: Trump's supporters likely have many different reasons for their allegiance to him. These may include shared rebelliousness and chaos and grievance; a shared sense of omnipotence; influenced by fearmongering; attraction to authoritarianism; and impact of his demagoguery. A shared sense of omnipotence may be the least important factor of them all. Probably a small number of supporters have become enmeshed with Trump's sense of grandiosity. But there are some who think they can ride off into the promised land on the back of Trump's grandiosity and superiority and bravado.

Dr. Winarick: After World War II, academic psychology described and explained the followers of pro-fascist demagogues as “authoritarians” because they displayed a specific set of values and behaviors, namely prejudice. How do you think prejudice plays a role in support for Trump? Do you think his followers are authoritarians?

Dr. Blotcky: Prejudice is likely a factor with some supporters. Immigration as a factor is included. Fearmongering is aimed at exacerbating prejudice and anti-immigration sentiment. We know that fear-mongering works, especially with some vulnerable people. 

Dr. Winarick: How much of a role does emotional contagion play in garnering a following for Trump? Does Trump do anything you can point to in order to facilitate emotional contagion (e.g., prosody, pitch, repetition, etc.)? 

Trump follower
Source: Shutterstock

Dr. Blotcky: Trump has gotten some success in this area by repeating certain buzz words. If you hear something repetitively you begin to accept its truthfulness, even if it is proven false via data. But this strategy may fall short or break apart in certain situations, like in the middle of a pandemic where tens of thousands of Americans are dying.

Dr. Winarick: Do you think Trump meets the diagnostic criteria of “physically aggressive”? I am unsure about this one. It's possible that evidence in support of it being present comes from allegations of sexual assault. Any thoughts about this?

Dr. Blotcky: I have never seen Trump hit anyone. But he has attempted to incite physicality at some of his rallies. And he has potentially increased the risk of hostile conflicts in cities by sending in federal troops when they were not requested.



1 An article published in 2016 in the Washington Post describes a company that conducted research in which neural activity was measured using "electroencephalograms, galvanic skin responses, eye tracking, and microfacial recognition." 

2 Research shows that unhappiness predicted voter behavior in 2016, with higher levels of unhappiness linked with individuals voting for Trump. The authors operationally define unhappiness as including socioeconomic status (SES) with lower levels of SES associated with greater levels of unhappiness. 

3 Research shows that over the past fifty years the happiness gap between high SES individuals and low SES individuals has heightened i.e., unhappiness is linked with low SES more strongly in recent years and vice versa.

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders - 5th edition.

Bogage, J. (23rd June, 2016). Whom are you voting for? This guy can read your mind. Washington Post.

Freud, S. (1921). Group Psychology and the Analysis of the Ego. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XVIII (1920-1922)

Twenge, J.M. & Cooper, A.B. (2020). The expanding class divide in happiness in the United States, 1972 - 2016. Emotion.

Ward, G., De Neve, J., Ungar, L.H., & Johannes, C. (2020). (Un)happiness and voting in U.S. presidential elections. Journal of Personality and Social Psychology.

Allport, G. W. (1954). The Nature of Prejudice. Cambridge, MA.