Although psychologists are ethically not supposed to make mental health diagnoses in absentia, a provision of the APA states that issues adversely affecting the general public supersede the issue of diagnosis. In this light, I submit the following.

My wife and I were watching Fareed Zakaria on January 12, as we usually do on Sunday, and he enumerated the numerous times in the past couple of years where Trump has said and done something that, seemingly inexplicitly he had done the opposite soon after. But this behavior is only inexplicable if you consider it from a position of what's rational, wise, understandable in normal adult terms. In what has been considered through the years in the best interest of the US and the rest of the world. Much of Trump's behavior can be understood as stemming from a deep sense of inadequacy, from severe parental lacks during childhood, which had led to a never-ending search for validation, love and adulation. That's appropriate for a five-year-old, not for an adult. For example, he obviously feels inadequate when compared to Barack Obama. That' why he claimed he had more people attending his inauguration than Obama did. And why he's been so intent on undoing the Affordable Care Act, which is considered Obama's major achievement. In naming different movements like socialism, capitalism, etc., we need to have a new designation: narcissism. Dictators, who are described usually as power-mad, or money-mad are, at their cores, motivated by primitive narcissism.

We are , or course, all narcissistic to some extent. But adults who have gotten the requisite strokes to their self esteem while growing up, don't need it in such a primitive way as people who haven't gotten it during childhood. Or they at least felt loved and appreciated for who they were, not solely for their achievements. Trump obviously didn't get that. And he clearly wants to be a dictator. We psychologists know that therapists through the years have been very unsuccessful in treating primitive narcissists in psychotherapy because they didn't understand them and did things like confronting them. For example, "you didn't get the love and appreciation you needed from your parents, so try to get it from me." That was bound to make this type of patient depressed and/or enraged because it triggered shame rather than curiosity about themselves. It wasn't until Heinz Kohut came along, that we began to understand these patients and work with them more effectively. But psychotherapy doesn't work when the narcissistic behavior serves a primitive narcissist, one with a personality disorder. Then therapy is impossible. Those people don't even seek treatment. It's only when the narcissist is hurting and wants help, that we have any chance of aiding them.

I don't see us "helping" Trump, because what he most wants is glorification,, not addressing his grandiosity. But we do need to understand him and world leaders like him, and know how to deal with them. Which is, when possible, to remove them from office Therefore I support the demands of the World Mental Health Coalition, headed by Dr. Bandy Lee, that Trump be required to undergo a mental health examination. He will, of course refuse, and do it violently, but, at the least, this information needs to get out into the public. We, as a planet and as a country, can't afford to have such a damaged, personality-disordered person as head of state.