America Depressed and Distressed

It is remarkable that the popular media has properly identified President Trump as a person with a narcissistic personality disorder. Sadly, this is certainly an accurate diagnosis for Mr. Trump although I prefer avoiding all such diagnoses because they just look at what is “wrong” with someone, which is never helpful. Instead of identifying someone with some kind of psychological diagnosis it is more valuable to understand the mechanisms with which someone operates and possibly the causes of these operations. Then it is important to know how to relate to those people. Diagnosing someone does not help us understand how to relate to people. Diagnoses only tell us what is supposedly wrong with someone. Let me propose to identify the psychological mechanisms that Mr. Trump uses in life, how they affect us as Americans, and how we might survive and thrive over the next four years.

President Trump most certainly fits the diagnosis of narcissistic personality disorder, or we might say he is “narcissistic.” Ultimately, we should be thinking about how we might be affected by what he says and does instead of simply calling him names and giving him a diagnosis. People with so-called narcissistic tendencies seem to act in selfish ways, and they seem very self-centered. But this is only their surface functioning. Inside such people is a much different operation. Selfish self-centered people do not have a sense of “self” inside. They are focused on external things, i.e. outside of themselves, instead of internal things that are inside of themselves. Sometimes we say that people with a narcissistic personality disorder, or any of the other personality disorders, lack a “core” of what it means to be a person. Lacking this “core” or “self”, people who act selfishly need these more from the external world because they don’t have a solid internal world. There is a deep psychological hunger inside people who are selfish. Because they feel “empty” inside, they need to “fill” up with as much external “food” as possible. Their hunger is insatiable; they are rarely satisfied. Furthermore, when they don’t get constant refreshment from the outside, they feel this deep hunger and become afraid. In a way, they are afraid of dying. They feel like they need to be “fed” by external rewards to keep them alive.

Narcissistic people, or more accurately selfish self-centered people, feed on many things that are “external,” mostly other people’s approval. Because they do not approve of themselves at a deep psychological level, they need almost constant approval from other people. The result of this constant seeking others’ approval works when everyone approves of them, but it doesn’t work when even one person disapproves of them. This constant demand for 100% approval from all people is what we see with people like President Trump. It is painful to see such a brilliant and successful person as he obviously is find it impossible to admit that everyone didn’t vote for him. His recent ludicrous assertion that there was some kind of conspiracy of “voter fraud” with millions of illegal immigrants voting against him is almost delusional. I think that if there had been only one person who voted against him, he still would be upset because he is not capable of managing the disapproval of anyone. He is deeply “hungry” inside and craves constant external rewards of some kind.

There are other ways that typify people who are narcissistic, but they all have the element of being external to oneself. People find different ways of attempting to satisfy their deep hunger. Hoarders are people who have found a way to feel satisfied only when they keep everything, whether of practical use or not. Many obese people have found excessive food to satisfy this deep psychological hunger, but only briefly. Extraverted people with this lack of inner core tend to talk too much and demand constant social engagement hoping to keep from feeling this internal hunger, while introverted people feel marginally satisfied only when they say nothing and keep to themselves. Working and dreaming are both good elements of life but if people are deeply “hungry” inside, they might work all the time to avoid feeling this hunger, and dreamers might dream all the time for the same reason. All addictions are essentially outgrowths of narcissism and the accompanying feeling of emptiness. Addictions include chemical (alcohol and drugs) as well as behavioral (sex, gambling, buying, exercise). All of these addictive elements are natural and useful, but when they are used to satisfy deep inner emptiness, they fail. An important aspect of an addiction is that the individual needs more of the substance or behavior to reach the same level of satisfaction.

Allow me to describe the cause of narcissism, that deep seated hunger that many people, like President Trump, suffer. Simply put, selfish narcissism in adults derives from natural narcissism in early childhood. Think of it this way: when I am an infant, or approximately until I am about two years old, I get most of what I want. It is a challenge to take care of infants’ demands and needs but infants get most of what they want because they don’t want much more than food, clean diapers and a bit of physical contact. But from about the age of two, things are very different. Because they can now talk, walk, and run, they see that the world is much bigger and there is much more interesting. Their wants now multiply by a hundredfold. They want more than they can have. If children of the ages two through about six receive good parenting, these children are routinely limited. They should hear “no” a hundred times more than “yes” because they simply want 100 times more than they can have. If children are not given their basic needs, they remain deeply hungry, sometimes for the rest of their lives. More common, however, is that children in these toddler years are given too much, and given to, rather than limited. This creates the 4-8-12 child that I have discussed elsewhere.

Narcissism is natural for children of the ages two through six: they want everything and feel “hungry” for everything. The task for parents during these years is go give to their children what they need but not much of what they want. Parents and children who have migrated these challenging years well lead to these children understanding that they do not get everything they want. If they learn this important lesson during the toddler years, they are then prepared to engage the social world during the elementary school years where they learn how deal with other people. They learn the importance of sharing, and the intrinsic value of giving. Most importantly, they learn to care about other people because they have been cared for and they care about themselves. If they do not adequately get through the toddler years, they lack self-care and certainly care for others.

No one gets through the early childhood years of natural narcissism unscathed. As a result we all suffer some remaining narcissism, i.e. wanting more than we can have. This adult narcissism shows itself in undue anger when we don’t get what we want, selfishness, and jealousy of what others have. It is very important to understand that we all have at least some of this leftover childhood narcissism if we are to deal with the narcissistic self-less people in our lives. It is not just President Trump who is narcissistic. We also are all narcissistic to some degree. And we know plenty people who suffer from the same lack of development. Being around anyone who is narcissistic is a challenge. Children who are psychologically undeveloped are a challenge because they throw fits when they don’t get what they want. Adults throw different kinds of fits. You can deal with a four-year old’s natural narcissistic demands by saying “no” and taking the consequences: he hates you. But it is much harder to deal with the adult who wants everything, whether your time, your property, your money…or your vote.

Mr. Trump wanted my vote. And he is angry that he didn’t get it. He is throwing a temper tantrum because he didn’t get what he wanted: everyone’s vote. He will continue to be angry. He will continue to be demanding. He will continue to be selfish and self-centered because he does not have a good sense of self and personal core. We will hear him whining about one thing and another, all of which amount to the fact that he can’t have everything and he can’t have everyone like him. There will be more tweets and public statements, the substance of which will be how he isn’t getting everything that he thinks he deserves. He is not capable of accepting loss, disappointment, mistakes, and people’s disapproval. And he will be in our faces about it. He is a man of 70 who has a brain and life experience that is certainly well beyond those years. But he has the emotional structure, and hence the social ability, of a four-year old. We need to accept this phenomenon, which I called the 4-8-12 phenomenon in another blog. But the real task is how to feel, what to think, and what to do over the next four years dealing with his four-year old temper tantrums without being angry or afraid. This is no easy task. It will be distressing. It already is distressing. It could easily be depressing.

If we are to avoid the anger that is the essence of depression, and the fear that is the essence of anxiety, we need to attend to how we really feel. That feeling is sadness. Narcissism, like its cousins anxiety and depression, is contagious. When I am around a depressed or anxious person, I will tend to become depressed or anxious. When I am around a narcissistic person, I will tend to become narcissistic. It is something like, “He is getting everything he wants. I want to have everything I want.” This is real dangerous. It is dangerous enough to be angry at him all the time; it is more dangerous to be afraid all the time of what he might do; but it is much more dangerous to become narcissistic, i.e. become more selfish, self-centered, and self-less. We can do better.

My suggestions for your mental health, your social health, and your physical health:

  • Note the incipient narcissism that occurs in you when you are confronted by Trump’s narcissism. I could say, “Don’t stoop to Trump’s level,” but that would be wrong because it would suggest that you are superior to Trump.
  • I prefer to say, “Be mature in the face of immaturity,” “Be honest in the face of dishonesty,” “Be generous in the face of selfishness,” and “Be yourself. Don’t let yourself be dragged into thinking and feeling that is childish.” You are a mature, honest, and generous person. Be that way. Stand tall.
  • Be sad. It is sad that Mr. Trump has been elected. It is sad for me. It is sad for many people. It is sad for the country. It is sad for the world. If you can continue to feel sad, you will avoid the tendency to be angry and anxious, which are simply the result of repressing the feeling of sadness.
  • If you are a person of faith and prayer, do as Jesus said: pray for your leader. If you have a different philosophical perspective, you may profit from meditation and personal reflection. If you are a person of wit, use it carefully and constructively. If you are one who writes, write. If you write poetry, write. If you sing, sing. If you dance, dance. Be yourself. You will be well. Stay well.

Further reading:

  • “Narcissism as Evil” by R. Johnson and D. Brock. In the three volume set on Evil edited by J. Harold Ellens published by Praeger
  • The Power of Positive Sadness by R. Johnson and D. Brock to be published in March, also by Praeger
  • The 4-8-12 blog, and the forthcoming book

Social Esteem

Much has been written about self-esteem including thousands of professional journal articles and hundreds of books. When we are discussing self-esteem, we are looking at low self-esteem, namely where one does value oneself or feels inadequate in some way, or perhaps many ways. I remember doing a project in graduate school on self-esteem looking at various aspects of it including cultural differences. I remain interested in the cultural and subcultural aspects of self-esteem particularly as it is seen in America’s subcultures. Simplistically stated, there appear to be problems with low self-esteem in the Latino, Native American, and the African-American communities. Interestingly, there does not seem to be such a difficulty in the Asian subculture and communities. Caucasians seem to fall somewhere in between these two poles with some White people liking themselves and many disliking themselves.

My psychotherapy practice is largely limited to men and children. The children I see are usually brought to me, and sometimes mandated to come to see me, because of some sort of “behavioral” problem. Perhaps they are too easily or too often angered; they may tend to throw things or hit people; they may be mean to other people; they may tend to disregard property; they may resist some or all of schoolwork; they may be regularly dishonest. Interestingly, many of these so-called behaviorally challenging children seem to have good self-esteem: they like themselves. They are often happy with themselves, and enjoy life a good bit of the time. They may laugh a lot, joke a lot, and play a lot. So this phenomenon of a very challenging child who seems to like him/herself is a challenge for any therapist and certainly for parents and teachers. The problem as I see it is that many children with high self-esteem do not have good social-esteem.

What is social-esteem? It is akin to self-esteem, in which I value myself. Social esteem is valuing other people. A truly developed person has developed many areas of life, namely development in academic pursuits, vocational pursuits, relationships, and care of property. In other words a developed person cares for him/herself in conjunction with caring for other things, particularly people. Many people, for instance, properly value property so that it can be protected, used, and possibly given away. Other people value their vocations and work as evidence of a valuing of society in general and making life better. Many more people value relationships and focus their attention on what is going on between oneself and other people. We could examine all of these different kinds of “esteem,” but my focus in this article is to focus on the social-esteem aspect, and in particular, the difficulty many kids (and many adults) have valuing other people.

Note that I said valuing other people. Valuing other peole is not the same as liking people, loving peole, seeking their approval, or finding ways to relate to them. Social-esteem is seeing another person as a creation of God and hence valuable in him/herself, something to be treasured and admired in some way. Importantly, valuing other people is good for the person doing the valuing. Ultimately, valuing other people should not be an effort. It might be effortful to like someone or love them, but valuing others should come naturally.

It is not possible to have too high a self-esteem. You can’t like yourself too much because true self-esteem naturally generates social-esteem. What happens is this: as I grow in self-esteem I consequently grow in self-awareness. If I grow in self-awareness, I will simultaneously see what is good about me and what is not so good about me. I will see what I am good at and what I am not good at. So as I grow to admire what I am good at, my self-esteem grows. And at the same time I grow in humility as I see that others are good at something that I am not good at. Humility and self-esteem are natural partners in life. So if self-esteem grows, so does humility, which is based on my awareness that I am not good at some things that other people are good at. For instance, I am not good at music, art, colors, beauty; and I am only marginally good at various physical things like athletics and carpentry. Luckily, my income is not based on my athletic skill or ability in the trades, much less on my artistic (in)ability. My self-esteem, however, is not based on plumbing and basketball, much less on my artistic skill, so I can see others who are skilled in these endeavors when I am not able to perform adequately.

Social-esteem is based on self-esteem, as well as the humility that self-esteem can engender. The Apostle Paul said that one needs to have pride in oneself (Gal. 6, 4) but also watch to avoid feeling conceited (Gal. 5.26). Psychoanalyst Karen Horney said that the true origin of envy is gratitude. In other words, she said that if I truly envy the other person for his/her ability or success, I value that achievement and that other person. And if I value that other person, I will gracefully appreciate that other person with gratitude for that person’s ability or success. I will not envy that other person thinking that I should have what he or she has because what that person has is not the same as what I have.

So how does social-esteem develop, or fail to develop? Social-esteem is based on self-esteem and self-enhancement. In other words, I need to see myself as valuable by being and doing something valuable. Real self-esteem is based on achievement and success. And success in based on trial and error, namely many trials and many errors. What we see in much of society today, and with many of the children I see, is self-esteem that is built on parental approval. Oddly, many of these very challenging kids have been loved…and loved…and loved. But they haven’t been limited; they haven’t been encouraged; they haven’t been challenged. They have been loved to a fault. And love is not enough. Indeed, love is probably the basis for self-esteem: if I am loved, I will naturally feel that I am valuable. That is the start of it, and many people do not get started in this way. But for many others, they get loved and loved and loved, but they don’t get the encouragement, limitation, and challenge to develop further self-esteem based on trials and errors.

I try to help kids build their self-esteem, usually with measures of love, limitation, encouragement, and challenge. This is difficult, if not almost impossible, in a one-hour time period. I often wish I could take the kid outside and help him learn to throw a ball, paint a picture, watch a bird fly, or write a story because it is only in doing these things that kids feel great. I use the term “great” in place of good, or even successful, because greatness is not built on better than. In that same Pauline passage I quoted above, the Apostle says to avoid thinking of yourself as better than others, just great. Too much self-esteem is built on better than someone. Desiderata says it well: “Do not compare yourself with others for always there will be persons greater and lesser persons than you.”

What can be done, especially by parents, for kids without good social-esteem? An important question, but I don’t have much of a good answer because social-esteem is based on truly valuing oneself and then naturally valuing others equally. Social-esteem comes primarily from being social, namely being in the company of others kids, some of whom are better than you, some worse than you at some skill, and all of whom are working together. This is what I think is the best ingredient of group activities, whether athletic, artistic, or communal, where kids have to cooperate with teammates to succeed. Social-esteem can also be developed in any group activity where kids cooperate with one another, challenge one another, and improve in some skill or some activity.

Social-esteem is the cure for narcissism, which simply stated, is the undue care about oneself over other people. It is natural for infants and toddlers to be “narcissistic,” namely concerned about their own welfare and success. Childhood should ideally be a time when kids are given the opportunity for cooperation and competition during which they learn that they are good at some things while other kids are good at other things. Adolescence should be a time when kids (now teenagers) try out their new found skills of self-esteem and social-esteem. Adulthood should be a time when we spend more and more time concerned about others’ development based on the value of our own success and failures.

A final word of suggestion and caution: it is not helpful to tell a kid (or anyone) that he or she “doesn’t care about anybody but him/herself.” This is just a criticism, and while largely true, it is not helpful to say or to hear. Rather, a child who, indeed, seems to care primarily about him/herself needs first to build self-esteem, first by trial and error, and subsequently by developing social-esteem. This is no easy project, but it is a way of seeing the “problem” with seemingly selfish kids find a way to have both self-esteem and social-esteem.

Men’s Greatest Fear

I just finished an hour with a patient I have been seeing for some time. Andy (let’s call him Andy) has what I call the “typical male disease.” He is afraid of female disapproval. We spent much of the hour dealing with how he can honorably and gracefully deal with the disapproval he regularly gets from his girlfriend. He admits that he never had any kind of role model from men who knew how to deal with women, to say nothing of dealing effectively with their disapproval. But Andy’s difficulty is not atypical. Most men are afraid of female disapproval, and many are desperately afraid of it. Andy, like most men, didn’t present the situation as a fear of disapproval, but like most men, talked quite a bit how Sherry tends to criticize, challenge, and sometimes verbally assault him. His was a rather typical desire to “figure out” what to say and how to debate with Sherry about the things she says to him. His desire was to find out how he could combat her arguments, make sense of what she was saying, and render an appropriate response to her attacks. No such luck. Responding to female criticism with rational and facts never works.

Now I admit that Andy is a bit of an extreme form of “typical male” because he developed an unfortunate capacity of lying and fabricating that is not all that uncommon with men. Lying is one of the typical ways men deal with female disapproval. Perhaps “lying” is a bit strong because sometimes it is just not telling the entire truth, or saying something that the man hopes will be true in the future. Lying is just one of the ways men tend to have for avoiding dealing with female disapproval. Other ways include what amount to excesses: excesses in things like alcohol, eating, working, playing, watching TV, and sleeping. And very often men tend to fly right off the handle when they hear some kind of criticism from the women in their lives. Or they avoid conversation entirely and hole up in their man caves. Many of these typical male-like avoidances develop because men don’t really know how to talk, especially about feelings, and especially about feelings to women.

Talking to women can be very different than talking to men. I often tell men, like I did with Andy and with another man I saw today, that they have not had enough (female) disapproval to learn how to handle it. For the most part women experience a great deal of disapproval during their adolescent years, largely verbal, while we men usually experience disapproval with what they have done, like sports and academics. Our relationships with people, particularly men, are not word-based, but rather action-based. We can hear criticisms and challenges about the things we do (or don’t do), but we rarely hear criticisms or gossip about who we are, how we look, how much we weigh, and who we happen to be going with. So we men do not come into adulthood ready for criticism about what we say and what we don’t say, and generally are quite ill-prepared for dealing with women who have had much more experience with criticism that is word-based and person-based rather than action-based.

This lack of experience with being criticized, or analyzed, or “helped” by females does not serve us well in our romantic relationships. Men are quite ill prepared for being challenged. It very often hits a man like a thousand of brick when his girlfriend, lover, or wife challenges him about what he has said, what he has not said. For a woman, I think, it is just a matter of course to challenge the man in her life and expect some kind of discussion or debate like she may have had with her girlfriends growing up. It seems to the man that when a woman comes after him with some kind of challenge or criticism, that she is “finding fault with him” or criticizing him unfairly whereas she is simply done what she has done with her girlfriends…and enemies.

The results of this bad mix of a person (the male) who has lived a life mostly oriented towards things physical and factual to be confronted by a person (the female) who likely has spent more time in the realm of talking, discussing, challenging, and exploring…and of course, feeling. When a man hears that his wife, partner, or girlfriend is “hurt,” he usually doesn’t know what to do. First, men try to “fix” what happened; then they try to explain what happened or what was said; and then they avoid the discussion altogether. Eventually, men get angry and say something crude to the woman, which only makes matters worse. The situation is something like this: Female: “I am just trying to help you (by telling you what is wrong with you),” but the man hears “what is wrong with him,” and certainly doesn’t understand that the woman is trying to “help” him. So he goes into fixing, explaining, avoiding, or angering. And when he reaches this last place, he is in real trouble because he will be louder, likely use more swear words, possibly throw something, and maybe make some outlandish statement. I think the man has no clue what has happened, and the woman equally has no clue to how she actually started this arrange. The man is hurt but doesn’t know it. The woman has, indeed, been critical, but doesn’t know it.

When I see women in my office, I usually immediately hear all kinds of feelings together with all kinds of diagnoses. A woman I just saw for the purposes of a Social Security disability assessment told me that she suffers from ADD, PTSD, OCD, depression, and anxiety. There is also this unfortunate propensity to find a psychological diagnosis to explain life’s difficulties in the culture at large, but women are much more inclined to use such diagnostic terms to “understand” themselves and others. Men tend to be much less so inclined. So when a woman kindly says to her boyfriend that he suffers from OCD or something, she thinks that this helps the man. It does no such thing. It only makes him defensive. How many men have been diagnosed as alcoholic…when they were truly alcoholic…only to defend their drinking as normal? Diagnoses of all kinds rarely help an individual understand him/herself. Diagnoses only put people in boxes…and keep them in boxes with minimal chance of growing.

So what is to be done? Let me offer some simple suggestions, largely oriented towards the man as he encounters a female that he likes, loves, or lives with:
–Realize that the woman is truly trying to help when she criticizes.
–Realize that when she “helps” you with some criticism or diagnosis, this “help” hurts you. It is very important to know that criticism always hurts. And “hurt” is not a word that is in most men’s vocabulary. It should be. Women do not have any monopoly on hurt, and we men need to nudge ourselves into the hurt arena.
–Remember whenever you have become angry, you have been hurt. This is no easy task, and you might have to do it post hoc.
–Do your best to slow the conversation down. We men just don’t go as fast and furious with feeling words of any kind…except for anger, unfortunately.
–Acknowledge the woman’s superiority in feelings and in words. While you may be better at other things, the woman is almost certainly better at words and feelings.
–You may need to slow down the conversation as you try to find “hurt” and such in place of anger, defense, avoidance, or fixing. Your female friend will not understand this need to slow down the conversation. You might say, “Just give me a second to get my thoughts and words together. I don’t want to blow off what you are saying. And I am trying hard to find what I really feel so we can communicate.
–Note that the previous suggestions will take months to learn to do