Trump’s Personal Pathology Is America’s Foreign Policy

The world is hostage to an unwell president.
December 6, 2019
Featured Image
WASHINGTON, DC - SEPTEMBER 09: Republican presidential candidate Donald Trump (2nd L) talks with journalists during a rally against the Iran nuclear deal on the West Lawn of the U.S. Capitol September 9, 2015 in Washington, DC. Thousands of people gathered for the rally, organized by the Tea Party Patriots, which featured conservative pundits and politicians. (Photo by Chip Somodevilla/Getty Images)

In Ukraine, Donald Trump’s comprehensive misconduct of foreign relations has ripened into the most pregnant of our current public controversies—an impeachment inquiry. But his psychological unfitness for world leadership was apparent well before he took the oath of office.

Since first announcing his candidacy, Trump’s behavior has suggested a man with deep personal pathologies. For too long, too many closed their eyes to this dreadful reality; sober journalists ducked the obvious by disclaiming psychological expertise. But no more. George Conway put it well when he analogized this awakening to the shock of seeing pro quarterback Alex Smith sustain a horrific injury:

Even without the benefit of medical training, and even without conducting a physical examination, viewers knew what had happened. They may not have known what the bones were called or what treatment would be required, but they knew more than enough, and they knew what really mattered: Smith had broken his leg, very badly. They knew that even if they were not orthopedists, did not have a medical degree, and had never cracked open a copy of Gray’s Anatomy. They could tell—they were certain—something was seriously wrong.

And so it is, or ought to be, with Donald Trump. You don’t need to be a weatherman to know which way the wind blows, and you don’t need to be a mental-health professional to see that something’s very seriously off with Trump—particularly after nearly three years of watching his erratic and abnormal behavior in the White House. Questions about Trump’s psychological stability have mounted throughout his presidency. As they must.

The Mayo Clinic describes narcissistic personality disorder as “a mental condition in which people have an inflated sense of their own importance, a deep need for excessive attention and admiration, troubled relationships, and a lack of empathy for others.” Mayo further explains that “beneath this mask of extreme confidence lies a fragile self-esteem that’s vulnerable to the slightest criticism.”

Does any of that sound familiar?

Then compare Mayo’s list of symptoms to the multi- faceted demands of democratic leadership in a dangerous and complex world. Those afflicted with NPD “have an exaggerated sense of self-importance”; “have a sense of entitlement”; and “require constant, excessive admiration.” They “expect to be recognized as superior even without achievements that warrant it.”

There’s more. Individuals with NPD “exaggerate achievements and talents”; are “preoccupied with fantasies about success, power, brilliance”; and “believe they are superior and can only associate with equally special people.” They “belittle or look down on people they perceive as inferior”; “expect special favors and unquestioning compliance with their expectations”; and “take advantage of others to get what they want.”

And still more: They are “envious of others and believe others envy them”; “have significant interpersonal problems and easily feel slighted”; “react with rage or contempt and try to belittle the other person to make themselves appear superior”; “have difficulty regulating emotions and behavior”; and “become impatient or angry when they don’t receive special treatment.” All this covers “secret feelings of insecurity, shame, vulnerability and humiliation.”

One need not be a doctor to read the literature, look at Donald Trump, and grasp that the organizing principle for his external behaviors lies within.

Add to these emotional distortions a couple of traits from NPD’s cousin, sociopathy—an addiction to lying and a belief that the rules don’t apply to you—and you have a day in the life of America’s president.

Americans have been so preoccupied with Trump’s daily shredding of our domestic social fabric that they have have tended to ignore the wreckage of our foreign policy and the concomitant dangers to national security.But these failures, too,are a result of who and what Donald Trump is.

Trump’s self-absorption is total; his inability to accurately perceive external reality is profound. Because this renders our president deeply antisocial and anti-historical, his worldview begins and ends with “Trump.”

As a result, he entered office unable to appreciate America’s objective strengths in conducting our foreign relations. These matchless blessings included friendly neighbors; peerless economic vitality; our leadership of important global institutions; the strength of our alliances and multilateral relationships; and a reputation, for all our faults, as a democracy which embraces political freedom and human rights. Encased in his feral inner landscape, Trump saw these assets as vulnerabilities.


Thus Trump’s view of the post-World War II global order is essentially dystopian. The world’s liberal democracies built a system in which America promoted global stability by advocating democracy, free trade, and international institutions which facilitated cooperation and ameliorated conflict. But Trump saw it as trap in which America was played for the sucker by its “allies,” cheated by trading partners, menaced by Muslims, and invaded by foreigners spreading crime and taking jobs.

To repel these presumptive “threats,” Trump offered his own distinctive and boundless grandiosity—casting himself as a one-man solution, a peerless negotiator who would subjugate our foes (frequently, in fact, our allies) through the sheer force of his unique personality. He would make Mexico pay for his wall; seize Syrian oil; rip up unfair trade deals; force those chiselers in NATO to pay up; and exert his will without the trouble of maintaining alliances or exercising considered global statesmanship

Blinded by his insoluble inability to accurately process external reality, Trump had no design for realizing his most fantastical promises—let alone any grasp of the long-term consequences to America stemming from his zero-sum instincts. In his fantasies of greatness, Trump-as-Superman was strategy enough.

For nearly three years, we have seen the consequences of this worldview. He disparages our intelligence agencies when they reach conclusions which displease him. He treats the State Department with contempt, compelling an exodus of career professionals and eviscerating our diplomatic capacity. He replaces the language of democracy with venality and vulgarity, He greets the world’s autocrats as his geopolitical kin. The global image of America has become the gargoyle visage of a bigot and bully.

Inevitably, Trump’s craving for attention and inability to transcend his own impulses leads to verbal incontinence, intellectual incoherence, and contradictory actions. Nor is this likely to change: Trump’s subjective and ever-shifting sense of reality and addiction to instantaneous self-gratification leave him utterly incapable of thinking strategically.

For Trump, there is no strategic through-line. While the Chinese think in epochs, Trump thinks in fragments of news cycles dissociated from each other, his frequently self- cancelling behaviors driven by his oscillating needs of the moment. He threatens North Korea’s dictator with “fire and fury”; then conducts vapid kabuki summits and “falls in love” with Kim Jong-Un’s “beautiful letters.”And when Kim, unimpeded, treats America with accelerating contempt while developing a nuclear arsenal which could eradicate Seattle, Trump browbeats our South Korean allies about the cost of their defense, and compels the Japanese to wonder whether North Korean missile tests will require developing their own nuclear capacity.

In Trump’s mind, he deserves the Nobel Peace Prize; in reality, he has made the region a far more dangerous place.


But these head-spinning spasms of psychic subjectivity aggravate dangers in every corner of the globe. Trump threatens Iran with “obliteration like you’ve never seen before,” then withdraws American troops from Syria, licensing Iran to pursue its goals in the region. He confuses our allies and emboldens our enemies, both of whom understand that his emotional lability translates into geopolitical incompetence. Vladimir Putin can barely conceal his laughter—and sometimes does not try.

Writing in the Atlantic, William Burns summarizes Trump’s dysfunction:

However sound his instincts on some policy issues—such as pushing back against predatory Chinese trade practices—Trump has badly undermined American influence through his erratic unilateralism, disdain for expertise, and obsession with diplomacy as an exercise in narcissism. It is exactly the wrong prescription for this plastic moment in world affairs, when we are no longer the only country calling the shots, and when diplomatic tools to cajole and coerce friends and foes alike are more important than ever.

The results are predictably grim. Partners are insecure and hedging, worrying about the ‘brain death’ of crucial alliances. Adversaries feel the wind in their sails, with Russian state television crowing over dysfunction in Washington and vulnerability in Kyiv. The international landscape is hardening against us, and our diplomatic toolkit is being emptied by design and disuse…

Why shouldn’t authoritarian rivals conclude that the only thing that matters is the vanity of an eminently manipulable president? Why shouldn’t allies lose confidence in the requests of our diplomats when they can be overturned by the next tweet?

Why, indeed?

But there is no one left around Trump to point out these obvious problems. Because he is psychologically unable to abide dissent or respect expertise, Trump has replaced professionals with sycophants—degrading our State Department and demoralizing its best people. The epitome of these enablers is the pompous puppet Mike Pompeo, our shrinking secretary of State, who has survived this long only through abject subservience.

Pompeo is the opposite of James Mattis; he chooses sycophancy to serve himself. In his imagined future, he is not simply a future Republican senator from Kansas, but Trump’s eventual successor. Unlike Trump, Pompeo is sane: quite deliberately, he has catered to Trump’s narcissism, fronting for Trump as he trashes the State Department and repeatedly commits gross political malpractice.

The result of Pompeo’s calculating cowardice is baneful—a dearth of sound advice and institutional engagement which empowers Trump’s mindless solipsism. Pompeo countenanced Trump’s love affair with Kim. He choked down Trump’s betrayal of the Kurds. He watched as Trump publicly contemplated canceling our mutual defense treaty with Japan; threatened to pull U.S. troops out of South Korea; mocked our NATO allies as deadbeats; and dismissed the E.U.

Little wonder that Trump has said “I don’t think I’ve had an argument with Pompeo.” Why would he need to? Pompeo never disagrees with him, thereby encouraging Trump to pretend that the intellectual, moral, and strategic Sahara of his foreign policy is as grand as Trump needs to believe – freeing Trump to do his worst, unimpeded.

But it is Pompeo’s performance with respect to Ukraine which best encapsulates Trump’s degradation of diplomacy and perversion of policy. He stood aside as Trump attempted to blackmail the new Ukranian president into serving his personal political interests, allowing Trump to subcontract the dirty work to Rudy Giuliani. Pompeo licensed Trump to bully and then fire Ambassador Marie Jovanovich. He listened to Trump’s coercive call to President Zelensky, thereby acquiescing in the corruption of American aid. And then, when all this was done, Pompeo pretended to ABC’s Martha Raddatz that he knew nothing about the call before admitting, ten days later, that he had heard it all.

In sum, Mike Pompeo has pretzeled himself to be the flawless lackey Trump demands: spineless, mendacious, unprincipled, and disloyal to his own subordinates. As two seasoned former American diplomats write of Pompeo’s tenure: “At the very least, Pompeo enabled the smear campaign to go unchallenged, acquiesced in the Giuliani back channel with Ukraine and failed to say a word in defense of Bill Taylor, George Kent or Marie Jovanovich. These are breathtaking acts of craven cowardice and beneath the dignity of any Secretary of State.”

All of which perfectly captures the Trump effect: His immutable character disorder moves those who serve him to adopt the corrupt and cowering ethos of minions in a banana republic.


The organ of government best constructed to maintain its integrity is America’s military, steeped in discipline and tradition. But, even there, Trump has been an agent of corrosion. His degradation of military standards and professionalism repeats, yet again, his ongoing enslavement to self, his disdain for advice, his contempt for institutions, his personalization of power, and his blatant politicization of decisions which should be nonpolitical.

Having conveniently avoided serving in the military himself, Trump fetishizes a primitive idea of “toughness.” In so doing, he undermines the authority of senior military officials, makes peremptory decisions, and treats our armed forces as a personal satrapy. The result has been a crisis of confidence in our commander-in-chief among senior military leaders, who view him as uniquely dangerous to America’s national security.

After interviewing “officers up and down the ranks, as well as several present and former civilian Pentagon employees,” Mark Bowden wrote:

Military officers are sworn to serve whomever voters send to the White House. Cognizant of the special authority they hold, high–level officers epitomize respect for the chain of command, and are extremely reticent about criticizing their civilian overseers. That those I spoke with made an exception in Trump’s case is telling, and much of what they told me is deeply disturbing. In 20 years of writing about the military, I’ve never heard officers in high positions express such alarm about a president.

In impressive detail, Bowden summarizes their concerns about Trump’s fitness for world leadership—which parallels the warnings of our foreign policy and national security communities. First, Trump scorns expertise:

Trump has little interest in the details of policy. He makes up his mind about a thing, and those who disagree with him—even those with manifestly more knowledge and experience—are stupid, or slow, or crazy.

As a consequence, Bowden writes, “Trump rejects the careful process of decision-making that has long guided commanders in chief. Disdain for process might be the defining trait of his leadership.”

As a “textbook example of [ Trump’s] ill-informed decision-making”, several generals singled out his precipitous withdrawal—by tweet—of American troops from Syria. Bowden writes:

The downsides of withdrawal were obvious: It would create a power vacuum that would accept effectively cede the fractured Syrian state to Russian and Iran; it would abandon America’s local allies to an uncertain fate; and would encourage a diminished ISIS to keep fighting. The decision—which prompted the immediate resignations of the secretary of defense, Gen. James Mattis, and US special envoy to the mission, Brett McGurk—blindsided not only Congress and America’s allies but the person charged with actually waging the war, Gen. Joseph Votel, the commander of the US Central Command.

This is not the first such debacle, nor will it be the last. Or, quite possibly, the worst. An impetuous president immune to fact or advice is an inherently destabilizing, and potentially devastating, force in world affairs.

A dangerous corollary, our military leaders told Bowden, is that “Trump trusts only his own instincts.” Specifically, “Trump believes that his gut feelings about things are excellent, if not genius. Those around him encourage that belief, or they are fired.”

The result is that Trump “resists coherent strategy.” Bowden notes an inevitable consequence: “To operate outside of an organized process, as Trump tends to, is to reel from crisis to rapprochement to crisis, generating little more than noise.” (See, e.g., North Korea.)

A further accelerant to misjudgment is that Trump “is reflexively contrary”: Specifically, Bowden’s sources report, “Trump resents advice and instruction. He likes to be agreed with.” No commander-in-chief can proceed in this way without creating global dangers; in the case of Trump, so lacking in judgment or constraints, it is like juggling nitroglycerin.

Finally, our military leadership confirms the obvious: Trump “has simplistic and antiquated notions of soldiering “—a costly deficit which, in the last two weeks, has become the stuff of headlines.

Summarizes Bowden: “Having never served or been near a battlefield, several of the general said, Trump exhibits a simplistic, badly outdated notion of soldiers as supremely ‘tough’—hard men asked to perform hard and sometimes ugly jobs. He also buys into a severely outdated concept of leadership. The generals, all of whom have led troops in combat, know better than most the war is hard and ugly, but their understanding of ‘toughness’ goes well beyond the gruff stoicism of a John Wayne movie. Good judgment counts more than toughness.”

But not for Trump. Instead, he revels in indiscriminately murderous and sadistic notions of martial manhood divorced from consequence, military discipline, or the constraints of the Geneva Convention.

This twisted conception of heroism feeds his apparent belief that soldiers accused of war crimes should not be prosecuted, let alone punished. This has led him to repeatedly disrupt the military justice system by intervening in cases where soldiers were prosecuted for violating our standards for conducting warfare.

Variously, he pardoned former Army Lieutenant Michael Behenna, convicted for murdering an Iraqi prisoner. He pardoned former Army Lieutenant Clint Lorance, sentenced for murder after ordering his soldiers to fire on three unarmed Afghan men riding a motorcycle, killing two. He spared former Green Beret Matthew Golsteyn from standing trial for the murder of unarmed Afghan he suspected of being a bomb-maker. Most famously, he intervened in the case of Navy seal Eddie Gallagher, who posed for pictures with the dead ISIS prisoner he was accused of stabbing.

These prosecutions upheld the military’s determination to observe the laws of war—not simply as a matter of humanity, but to maintain self-respect and preserve the respect of others. The values Trump scorns are deeply ingrained among our military professionals: It is important to note that both Lorance and Gallagher were reported by their fellow soldiers. As a general told Bowden: “If you treat civilians disrespectfully, you’reworking for the enemy! Trump doesn’t understand.”

Trump’s intervention in the Gallagher case led to quiet but strenuous efforts by senior Pentagon officials and military leaders to dissuade him from undercutting the “good order and discipline” essential to military cohesion. Trump refused. When Secretary of the Navy Richard Spencer protested, Trump had him fired.

Said Senator Jack Reed, an Army veteran: “This was an outrageous, irresponsible interference by President Trump in the military justice system. It signaled to people that they can operate outside the rule of law and the Geneva Convention.”

Wrote Spencer: “It was also a reminder that the president has very little understanding of what it means to be in the military, to fight ethically, or to be governed by uniform set of rules and practices.”


But in truth, it was even worse than that. In his infinite narcissism, Trump apparently means to exploit these intrusions to serve his reelection campaign, using our military leadership as a straw villain to rile his base. He was sticking up for our “warriors,” Trump brags, against the subversive “deep state.” In return, Lorance praises him on Fox News, and Gallagher calls Trump “a true leader and exactly what the military needs.” Already, Trump is musing aloud about taking Lorance, Golsteyn, and Gallagher with him on the campaign trail, and even parading them on stage at the 2020 Republican convention.

To a president so devoid of constraints and detached from all but self, the laws of war, the chain of command, and the system of military justice meaningless abstractions. In Trump’s vision of the presidency, our professional military is little more than his personal property, expected to adhere to his amorality, and ever-ready to be exploited according to his will.


Writ large, this comprehensive personalization of power results in a foreign policy based on transient self-gratification, conducted by man who, divorced from past or future, careens through international relations like a human wrecking ball.

The relentless engine of Trump’s external conduct is his own inner turmoil. But while it may be one thing, as Trump brags about himself, to be “unpredictable,” it is quite another to be unable to predict, or even anticipate, one’s own impulses. Immune to advice, hungry for headlines, and infatuated with his self-concept as a reality TV dealmaker, Trump has become a chew toy for cold-eyed realpoliticians with sustained strategic goals.

Particularly lethal is Trump’s inability to distinguish friend from foe – or, worse, to confuse them. He has precipitated a breakdown in our relationships with key democratic allies—Britain, France, Germany, Japan, South Korea. He withdrew from the TPP, empowering Chinese expansionism in Asia. He has essentially abdicated America’s role in the Middle East, leaving Israel, Iran, Saudi Arabia, Turkey, and Russia to scrap over the creation of a combustible new order. He has alienated Canada and Mexico and launched ill-advised and erratic trade wars with stable trading partners.

As we saw at this week’s NATO summit, our allies have noticed. Painfully aware that Trump is a dangerous fool, they deal with him accordingly.


So do our adversaries, with this difference: While Trump wantonly insults and undermines our democratic allies, he embraces autocratic rulers worldwide – including America’s worst enemies .

He praises the murderous Kim Jong-Un and caters to the butcher Mohammed bin Salman. He admires a brutal Philippine autocrat for doing “an unbelievable job on the drug problem”—by which our president means a systematic policy of extrajudicial murders. He lionizes the most oppressive leader in Egypt’s modern history.

He has abandoned our Kurdish allies to the ethnic cleansing of Turkey’s Erdogan. He signed a bill sanctioning China for human rights abuses in Hong Kong only in the face of veto proof majorities in Congress—and then hedged his willingness to enforce its provisions.

And at summit upon summit he plays the fawning dummy to Vladimir Putin’s ventriloquist.

Autocrats of the world understand Trump. They know that he will come to their meetings unprepared, unadvised, and envious to his core. They understand that the reason Trump favors them is not because he is confused about America’s interests—he barely knows what those interests are. It is because they personify the pathology of his aberrant inner being.

It is these strongmen—not democratic leaders such as Angela Merkel and Emmanuel Macron—who are Trump’s desired peer group. And they understand too well that so long as they cater to his boundless need for flattery, they can do as they please.


Especially pernicious is Trump’s fixation with the authoritarian leaders of Russia and China. For what is at stake in these relationships is the global balance between liberal democracy and illiberal authoritarianism.

Russia has interfered in elections in Italy, France, England, and America. Putin has rescued the murderous Assad regime and destabilized Eastern Ukraine. He is waging a war of disinformation and subversion aimed at undermining Western democracies by destroying both the idea of objective fact and the credibility of democratic values.

Meanwhile, China is pursuing its longtime goal of penetrating institutions in emerging–market democracies, pilfering intellectual property, and investing its money and diplomatic energies to gain influence and economic leverage around the world. In addition, that is, to threatening Hong Kong, menacing Taiwan, and militarizing the South China Sea.

China wants to compromise democratic institutions from within; Russia means to degrade them from without. In short, they are attempting to do to Western democracies what Trump is doing to America.

Worse, they understand that their interests align with Trump’s. In 2016 Trump eagerly welcomed Russia’s electoral interference to enhance his chances of winning; now he clearly wants them to redouble their efforts in 2020. As for China, he has openly asked them to “start an investigation into the Bidens.”

That is the crux of Trump’s damage to our country, foreign and domestic: psychologically incapable of feeling loyalty to America or honoring his oath of office, he willingly betrays both. Putin understands what millions of Americans will never accept: for Trump, America is not a place to be cherished, a repository of freedom and hope he is honor-bound to protect—it is merely a soundstage for his psychodrama of self. Genuine love of country is beyond him.


Ask why it is that Trump refuses to rebuke Putin for his electoral aggression in 2016, or to safeguard our election in 2020. Why does he dismiss the findings of our intelligence agencies based solely on Putin’s word? Why does he rationalize Russia’s past aggression in Crimea, and defer to Putin in Syria? Why, over the vehement objections of our allies, does he call for Russia’s reinstatement in the G7?

Indeed, Trump is so objectively subservient to Russia’s global interests than it raises serious questions as to whom he serves, and why. The most obvious explanation is that, in his emptiness, he wants to be like Putin – and wants Putin to help him win again in 2020.

Hence, our president’s machinations in Ukraine: His efforts to suborn Ukraine’s new reformist government distills both the multiple betrayals of American interests inherent in Trump’s politics of self and in his corrupt entanglement with Russia.

Once again, William Burns describes this pathology well:

It’s not just the Trump administration’s acts of bureaucratic arson, such as the systematic sidelining of career officers or historic proposed budget cuts, which have brought applications to the Foreign Service to a two-decade low. And it’s not just its acts of political arson, such as the groundless, McCarthyist attacks against career professionals perceived be disloyal to the Trump regime. It’s a cronyism and corruption that infected so much of our diplomacy and that we see on full and gory display in the Ukraine scandal.

The House impeachment inquiry has put this scandal in bold relief, spelling out facts beyond dispute. In brief:

Trump and his factotum, Rudolph Giuliani, pressured Ukraine to open an investigation into Joe Biden and his son Hunter. Their bogus pretext was the assertion that Biden, as vice president, went after Ukraine’s head prosecutor because he was probing Burisma, a shady Ukrainian company which employed Hunter for grossly inflated compensation. While Hunter’s employment was obviously seamy, there is absolutely no evidence—none—that the accusation against Joe Biden is true. In fact, it is the opposite of true: With international support Biden was acting on behalf of the Obama administration in calling for the dismissal of the prosecutor precisely because he, himself, was standing in the way of anti-corruption efforts, including against companies such as Burisma. To the extent that Biden’s actions had any relationship to his son’s interests, they ran counter to them.

In addition, Trump and his enablers wanted Ukraine to announce an investigation of the theory that Ukraine was involved in the 2016 hacking of the Democratic National Committee. This, too, was a false charge, one which had been completely discredited by American intelligence agencies. Where did it come from? Russia. It was Russian disinformation, planted in order to cover the tracks of their own meddling in the 2016 election. And Trump ignored American intelligence work in order to push our ally into doing Russia’s bidding.

This summary of his conduct is bad enough. But consider its elements: In pursuing this scheme, Trump blackmailed an American ally, attempted to corrupt a fragile new Ukrainian administration, slandered an American ambassador, and undermined his own State Department.

Moreover, he weakened Ukraine at a crucial juncture in its fight against Russian aggression. And he repeatedly lied and dissembled to the American public, further dividing the country and roiling the already rancorous state of a politics that he has done so much to poison.

In sum, Trump abused his power to conduct foreign policy to subvert America’s foreign policy—simply to serve himself. This is a rank betrayal of the oath of office. At bottom, the impeachment process is about Trump’s pathological contempt for the national interest, and for the presidency itself..

He is, indeed, too sick to lead.

Richard North Patterson

Richard North Patterson is a lawyer, political commentator and best-selling novelist. He is a former chairman of Common Cause and a member of the Council on Foreign Relations.