Trump's pathology infects the millions who follow him -- and this narcissistic symbiosis could grow even worse

In 2017, Dr. Judith Herman and I stated in The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President: "Power not only corrupts but also magnifies existing psychopathologies, even as it creates new ones."

We warned of an authoritarian cult of personality and growing contempt for the rule of law, which would spread throughout the culture unless stopped. Donald Trump's presidency was dangerous not because of his individual afflictions but his capacity, as president, to amplify and exacerbate society's defects, especially if he faced no accountability.

To the end of his presidency, he was not contained or held accountable. The American Psychiatric Association advanced a perverse version of "the Goldwater rule" to silence expert alarms, the way the Department of Justice revived a controversial internal Office of the Legal Counsel memo to place a president above the law. As a result, Donald Trump may have left the office of the presidency, but "Trumpism" not only continues but flourishes. As the House managers in the impeachment trial have reminded us with their effective use of videos of the Capitol insurrection, the Trump infection, once spread, manifests in deadly, violent behavior.

Donald Trump may have left the office of the presidency, but 'Trumpism' not only continues but flourishes.

We have already seen copycats arising everywhere in lesser positions. Marjorie Taylor Greene, a newly-elected Republican representative from Georgia, has shocked many with her brazen promotion of dangerous QAnon conspiracy theories and endorsement of violence, including execution, against Democrats.

Even while being stripped of her committee assignments, she responded with defiance: "I woke up … laughing thinking about what a bunch of morons the Democrats are for giving someone like me free time." Rep. Lauren Boebert (R-Colo.) is a similar personality, having flaunted her carrying a pistol in violation of the District of Columbia's anti-gun laws, argued for the right to bring firearms onto the House floor, and on Jan. 6 tweeted about the whereabouts of the House Speaker Nancy Pelosi (D-Calif.), as the insurrectionists were actively looking for her in the Capitol.

Lack of Accountability

For mental health experts who have been warning against these dangers for years, this behavior is only expected: criminal minds see lack of accountability as a green light. Lesser examples of emboldened behavior include Capitol riot suspect Jenny Cudd asking to leave the country on vacation, while Kenosha, Wis., shooter Kyle Rittenhouse is not only out on bond but changing his address without permission and making it difficult for the authorities to find him

A dangerous president has shown that he absorbs a powerful message when an OLC memo protects all criminality, including those that threaten national security, or that "the Goldwater rule" silences all criticism, even when doing so endangers public health. Trump came to believe he could even destroy democracy to stay in power.

Disabling any kind of intervention, therefore, not only kept a problem from being solved, but enabled it. Allowing a criminally-minded and mentally-impaired person to continue in the presidency for four years has sent a powerful message to similar personalities as Greene or Boebert: that elected office could serve as a cover for lawlessness or incapacity. We as a society have mobilized delusions of grandeur, impunity, and omnipotence as a legitimate way of warding off intolerable inner feelings of inadequacy, inferiority, and powerlessness.

Epidemic of Violence

As a specialist in public health approaches to violence prevention, it is not difficult for me to see that these are the conditions for epidemics of violence, including the increasing rate of violence among women. Violence is not an issue of individual mental illness but of societal disorder, and the conditions that encourage violence are well-known.

While violence is the end-product of a long process, a lack of political will—or even the use of violence as a political tool for amassing power—has hampered prevention. Instead, our nation has fostered and propagated it. It is now remarkable that a former president's act of insurrection, sedition and even treason, according to some Constitutional scholars, will likely remain without conviction because of the physical threats his followers pose for senators who might vote in favor of it.

In my first public-service book, I emphasized that he would grow more dangerous with time, and that, without intervention, his dangers would eventually spiral beyond control. Our failure to contain him and his followers has created a "silent pandemic" that contributes to other societal mental health problems, including a worsening of the viral pandemic itself, as well as drug addiction, depression, suicides, and homicides. In my most recent book, Profile of a Nation: Trump's Mind, America's Soul, I outline two major dynamics that are a consequence of allowing Donald Trump's pathologies to spread.

Wounded Leader

"Narcissistic symbiosis" is one, referring to the magnetic collusion that happens when a narcissistically wounded leader and followers meet. The leader, hungry for adulation that can compensate for an inner sense of inadequacy and worthlessness, projects grandiose omnipotence, while the followers, who are needy from societal stress or developmental injury, yearn for a parent figure whom they can emulate.

Such bonds make "shared psychosis," also called "folie à millions" ("madness among millions") at the national level, more likely to occur. Shared psychosis refers to the infectiousness of severe symptoms that goes beyond rational strategy or ordinary group psychology. When a highly symptomatic individual is granted an influential position with prolonged exposure to the public, conditions are set for the person's symptoms to spread. Delusions, paranoia, or violence-proneness transmit to previously healthy individuals especially powerfully. The treatment is the removal of exposure, as we have seen with the dramatic fall of approval ratings following the ban of Donald Trump from various social media platforms.

Disordered Thinking

This is not the end, however, and "the ecology" must change. The culture needs to stop normalizing, legitimizing, and glorifying disordered thinking, for once it is admitted into the mainstream, it will not go away or give up power easily, and is not amenable to facts or logical persuasion. As stated at our recent National Town Hall, we must convict, set limits on violent behavior, and return society to justice, order, and reality. We must also address the socioeconomic conditions that gave rise to poor collective mental health in the first place by reducing economic, racial, and gender inequalities.

Once an individual or a group succumbs to pathology, it is characteristic to make further maladaptive choices that descend one further into sickness. One such choice may be to use violence to ward off narcissistic needs or challenges against one's cherished delusions. This is why prevention, before resistances develop, is important. Mental health professionals who understand pathological dynamics need to engage actively with social scientists, policymakers and politicians for urgently needed interventions.