Too Much and Never Enough: How My Family Created the World’s Most Dangerous Man

After a decade during which Donald floundered, dragged down by bankruptcies and reduced to fronting for a series of failed products from steaks to vodka, the television producer Mark Burnett gave him yet another chance. The Apprentice traded on Donald’s image as the brash, self-made dealmaker, a myth that had been the creation of my grandfather five decades earlier and that astonishingly, considering the vast trove of evidence disproving it, had survived into the new millennium almost entirely unaltered. By the time Donald announced his run for the Republican Party nomination in 2015, a significant percentage of the American population had been primed to believe that myth.

To this day, the lies, misrepresentations, and fabrications that are the sum total of who my uncle is are perpetuated by the Republican Party and white evangelical Christians. People who know better, such as Senate majority leader Mitch McConnell; true believers, such as Representative Kevin McCarthy, Secretary of State Mike Pompeo, and Attorney General William Barr; and others too numerous to name, have become, unwittingly or not, complicit in their perpetuation.

None of the Trump siblings emerged unscathed from my grandfather’s sociopathy and my grandmother’s illnesses, both physical and psychological, but my uncle Donald and my father, Freddy, suffered more than the rest. In order to get a complete picture of Donald, his psychopathologies, and the meaning of his dysfunctional behavior, we need a thorough family history.

In the last three years, I’ve watched as countless pundits, armchair psychologists, and journalists have kept missing the mark, using phrases such as “malignant narcissism” and “narcissistic personality disorder” in an attempt to make sense of Donald’s often bizarre and self-defeating behavior. I have no problem calling Donald a narcissist—he meets all nine criteria as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)—but the label gets us only so far.

I received my PhD in clinical psychology from the Derner Institute of Advanced Psychological Studies, and while doing research for my dissertation I spent a year working on the admissions ward of Manhattan Psychiatric Center, a state facility, where we diagnosed, evaluated, and treated some of the sickest, most vulnerable patients. In addition to teaching graduate psychology, including courses in trauma, psychopathology, and developmental psychology, for several years as an adjunct professor, I provided therapy and psychological testing for patients at a community clinic specializing in addictions.

Those experiences showed me time and again that diagnosis doesn’t exist in a vacuum. Does Donald have other symptoms we aren’t aware of? Are there other disorders that might have as much or more explanatory power? Maybe. A case could be made that he also meets the criteria for antisocial personality disorder, which in its most severe form is generally considered sociopathy but can also refer to chronic criminality, arrogance, and disregard for the rights of others. Is there comorbidity? Probably. Donald may also meet some of the criteria for dependent personality disorder, the hallmarks of which include an inability to make decisions or take responsibility, discomfort with being alone, and going to excessive lengths to obtain support from others. Are there other factors that should be considered? Absolutely. He may have a long undiagnosed learning disability that for decades has interfered with his ability to process information. Also, he is alleged to drink upward of twelve Diet Cokes a day and sleep very little. Does he suffer from a substance- (in this case caffeine-) induced sleep disorder? He has a horrible diet and does not exercise, which may contribute to or exacerbate his other possible disorders.

The fact is, Donald’s pathologies are so complex and his behaviors so often inexplicable that coming up with an accurate and comprehensive diagnosis would require a full battery of psychological and neuropsychological tests that he’ll never sit for. At this point, we can’t evaluate his day-to-day functioning because he is, in the West Wing, essentially institutionalized. Donald has been institutionalized for most of his adult life, so there is no way to know how he would thrive, or even survive, on his own in the real world.

At the end of my aunts’ birthday party in 2017, as we lined up for our pictures, I could see that Donald was already under a kind of stress he’d never experienced before. As the pressures upon him have continued to mount over the course of the last three years, the disparity between the level of competence required for running a country and his incompetence has widened, revealing his delusions more starkly than ever before.