Donald Trump Case

The following is a case study of my patient, Donald J. Trump, of Manhattan, New York. The patient has come for treatment of exhaustion and stress since the start of his campaign for the President of the United States of America. After an initial clinical interview and a mental status exam, of the patient, along with stress related symptoms there is are apparent signs of narcissistic personality disorder. The following are the findings and treatment options discussed with the patient to work through his psychological disorder.
During the mental status exam, the patient’s appearance was that of a typical business man. He wore a suit and had his hair perfectly in place. His speech and thought process had ebb and flow during different portions of the sessions. When asked questions about himself the patient was overly excited and wanted to reiterate the fact that he was an extremely important
person in the business world and has made billions of dollars. He expressed that his opinions and ideas for his campaign were brilliant and better than any of the other candidates. However, when asked any follow up question that allowed for open dialog he resorted back to name calling of others and bringing the focus back to himself, and his greatness.
Throughout each of our sessions it was evident that the patient had a self image of grandiosity and spoke of many occasions where he allowed self-enhancing or self-serving behaviors to interfere with personal and business relationships, which was a strong indicator of narcissistic personality disorder. The patient spoke of many times in his career where he was not able to identify or process the emotions that caused reactions to his behavior. The patient seemed to not be aware that his behavior could be interpreted by outsiders as obnoxious, aggressive, hostile or abrasive.
During one of the sessions, we discussed his childhood and incidents that could be seen as hostile. The patient explained, "In the second grade I actually gave a teacher a black eye — I punched my music teacher because I didn't think he knew anything about music and I almost got expelled," Trump says. "I'm not proud of that, but it's clear evidence that even early on I had a tendency to stand up and make my opinions known in a very forceful way. The difference now is that I use my brain instead of my fists."
The DSM-IV describes narcissistic personality disorder as “a pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lake of empathy.” Of the nine criteria’s listed under DSM-IV, the patient shows strong signs of five.
They include, “a grandiose send of self-importance”, “arrogant, haughty behaviors or attitudes”, “lack of empathy”, “preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love” and “beliefs of being special and unique.”
Since there is limited research on the success and study of narcissistic personality disorder, a recommendation of cognitive therapy was introduced, to work on the grandiosity of the disorder. Since the patient is in a high stress and fast pace environment, I suggested different coping strategies to relieve stress and tension, with breathing exercises and other relaxations exercises. It was important to make sure the patient did not feel overwhelmed with the treatment because I did not want him to progress into a state of depression, which is a common occurance in this
disorder.
After several sessions, for the diagnosis of narcissistic personality disorder, there has been small steps made to the treatment. However, as the patient continues on the campaign trail, there are more evident triggers that have delayed or taken the treatment off the corrective path. We will continue to work with the patient, but in the end, there will have to be commitment made by the patient to want to change. For now, he believes that the specific identifiers of the diagnosis are what is attracting his followers and so he is continuing his campaign in a state of narcissism.