Trump's Dementia: The Failing Brakes
By Abbas Sadeghian, Ph.D.
Clinical Neuropsychologist
Donald Trump has always been Donald Trump. He did not suddenly become narcissistic at eighty. He did not suddenly become impulsive, extraordinarily sensitive to criticism, obsessed with winning, or prone to making claims that are demonstrably false. Those characteristics have been visible for decades. What concerns me as a clinical neuropsychologist is something different: Trump has changed, and the change has become increasingly pronounced.
The important comparison is not Donald Trump with Joe Biden, another older politician, or some hypothetical healthy younger president. In neuropsychology, when evaluating cognitive decline, one of the most important comparisons is with the individual's own previous level of functioning. The relevant comparison is Trump today with Trump several years ago. In that comparison, I see deterioration in several areas of cognitive functioning. These are not isolated verbal mistakes. They form a pattern.
Mary Trump: An Important Window Into Donald Trump
Before discussing Donald Trump's cognitive decline, it is important to distinguish what is new from what has been present throughout most of his adult life. In making that distinction, the writings of his niece, Mary L. Trump, Ph.D., have been particularly useful.
Mary Trump is a trained clinical psychologist and the daughter of Donald Trump's older brother, Fred Trump Jr. Her 2020 book, Too Much and Never Enough: How My Family Created the World's Most Dangerous Man, provided something psychologists, journalists, biographers, and political observers could not obtain simply by watching Donald Trump on television: an inside account of the family environment in which his personality developed.
Mary Trump described Fred Trump Sr. as an emotionally harsh and controlling father who placed enormous importance on strength, winning, money, and dominance while treating vulnerability as weakness. She described what happened to her father, Fred Jr., when he failed to conform to his father's expectations, and how Donald learned a very different lesson from watching his older brother's experience. According to her account, Donald adapted to his father's world by becoming increasingly aggressive, competitive, grandiose, and intolerant of weakness.
Her writings have been useful to everyone trying to understand Donald Trump because they supplied a developmental history. We had watched the adult Donald Trump for decades, but Mary Trump gave us a view of the child, the father who shaped him, the brother whose experience provided a warning, and the family system in which certain behaviors were rewarded while others were punished.
Her later memoir, Who Could Ever Love You: A Family Memoir, added further detail about dysfunction within the Trump family and Donald Trump's behavior within that family. Her accounts help distinguish characteristics that have existed for decades from changes appearing later in life. His grandiosity is not new. His extraordinary sensitivity to criticism is not new. His need to win is not new. His difficulty admitting mistakes is not new. His tendency to divide people into loyalists and enemies is not new.
This distinction is essential to my clinical assessment. I consider malignant narcissism a longstanding component of Donald Trump's personality. Mary Trump's writings help us understand its developmental background. What concerns me now is what has been added to that longstanding personality structure: deterioration in cognitive functioning.
The Five Cognitive Abilities
The public frequently equates cognition with memory. Memory is important, but it is only one component of cognition. For purposes of this discussion, I am organizing Trump's functioning into five broad cognitive abilities: executive functions, memory, attention and concentration, language, and constructional/visuospatial abilities.
Executive functions are the supervisory abilities of the brain. They include planning, judgment, inhibition, decision-making, cognitive flexibility, organization, self-monitoring, and the ability to modify behavior when circumstances change. Memory involves learning, retaining, retrieving, and using information. Attention and concentration allow us to select relevant information, remain focused upon it, and resist distraction. Language includes naming, word retrieval, comprehension, verbal expression, and organization of discourse. Constructional and visuospatial abilities allow us to perceive spatial relationships and organize or reproduce visual information.
These abilities interact continuously, but they can also be affected differently by neurological disease. A person can have relatively good memory but poor executive functioning. Another person can remain verbally fluent while losing the ability to organize what he is saying. Someone can know who and where he is while showing serious deterioration in judgment and self-monitoring.
Next Page 1 | 2 | 3 | 4 | 5 | 6
(Note: You can view every article as one long page if you sign up as an Advocate Member, or higher).
Post Article Comment and Rate This Article
