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“Donald Trump is a textbook narcissist.” We’ve all heard that many times over the past 6 years. But what, exactly, does that mean? What is a narcissist? And what makes mental health professionals believe that our former president is one?

Join us as Dr. Karyne Messina from Suburban Hospital | Johns Hopkins Medicine discusses narcissism, as well as her book, “Aftermath: Healing from the Trump Presidency.”

Dr. Karyne Messina

Dr. Karyne Messina is a psychologist and psychoanalyst. She’s also on the medical staff of Suburban Hospital—Johns Hopkins Medicine. Her books include: “Misogyny, Projective Identification and Mentalization: Psychoanalytic, Social and Institutional Manifestations,”“Aftermath: Healing from the Trump Presidency,” “Aftershock: How Populism and Projective Identification are Changing the Political Landscape Around the Globe,” and “It’s Not Me, It’s You! How Narcissists use Projective Identification to Get What They Want and How to Stop Them”(coming Spring 2022)

Gabe Howard

Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, “Mental Illness is an Asshole and other Observations,” available from Amazon; signed copies are also available directly from the author.

Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can’t imagine life without. To learn more about Gabe, please visit his website, gabehoward.com.

Producer’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: You’re listening to Inside Mental Health: A Psych Central Podcast where experts share experiences and the latest thinking on mental health and psychology. Here’s your host, Gabe Howard.

Gabe Howard: Welcome to this week’s episode of Inside Mental Health: A Psych Central Podcast, I’m your host Gabe Howard, and I want to thank our sponsor, Better Help. You can grab a week free by visiting BetterHelp.com/PsychCentral. And calling into the show today we have Dr. Karyne Messina. Dr. Messina is on the medical staff of Suburban Hospital Johns Hopkins Medicine. She wrote the book Aftermath: Healing from the Trump Presidency and is an expert on narcissism. Dr. Messina, welcome to the show.

Dr. Karyne Messina: It’s such a pleasure to be here, Gabe, I’m really delighted.

Gabe Howard: We are delighted to have you. Now in the past several years, whenever I do a show on narcissistic personality disorder, the guest will inevitably cite former President Trump as a textbook case during the show. However, this is the first time that a guest has written a book on the subject. Now, I know that using any public figure as an example of anything is going to polarize the audience. However, not every public figure has a following willing to attempt overthrowing the government at their suggestion. As an expert, Dr. Messina, have you found that your book steals focus from your work on narcissism?

Dr. Karyne Messina: Well, I think sometimes I’m encouraged not to talk about President Trump. While he’s a poster child, I have been in groups and they’ve asked me not to mention my book, so hopefully, that answers your question.

Gabe Howard: It does, it does answer the question. So let’s start at the very beginning. Dr Messina, what exactly is a narcissist?

Dr. Karyne Messina: Okay, so narcissists and I’ll say, there’s healthy narcissism, there are people with narcissistic traits and there are people who have a narcissistic personality disorder. I would say Donald Trump is in the latter category. When people have a disorder, it’s as if they’re like an egg. On the outside of an egg, on the shell, you could hit it with your finger. Maybe something else. It feels pretty sturdy. Once you crack that everything falls out, it oozes out. There’s nothing left. And narcissists often talk about, when you can get them to talk about it, about feeling empty. So it’s like when the egg is cracked. They sometimes fly under the radar, though, and not when they’re blatant as the former president or people like that. But some narcissists, or most of them, are very charming. They can be attractive and funny, but when they’re narcissistically injured, in other words, when the egg does crack, that’s when they’re so internally or psychically bruised. People refer to narcissistic injuries. Often when they’re narcissistically injured, that’s when the other side of them comes out and all of the defenses come out. Narcissism is characteristic of people who lack empathy. They don’t really understand another person, nor do they care to try to figure out what another person is feeling. I knew somebody many years ago, and this wasn’t my patient, but he was in treatment for many, many years. And he learned how to say the right things. If someone came home, he knew to say, Oh hi, how was your day? But he didn’t really care. He would talk to me about it. He didn’t really care. He just learned the right thing that one is supposed to say if one is going to be in a relationship.

Dr. Karyne Messina: But generally, relationships don’t work out too well, not equal relationships. They are really, really entitled. They think they deserve certain things. And just because of who they are, it doesn’t matter whether they earned these things, they just think they’re entitled. Entitled to whatever it is that they want. And when they don’t get it, they often have this narcissistic injury, this crack. They lack accountability. They have a great need for control. And the other side of that coin is that they’re very threatened when they lose control. They typically lie, are very grandiose, they are the best, the greatest and the best. And I mean, we certainly know that the former president would talk about that often, talked about himself as being great and wonderful in various settings, in rallies. They’re very manipulative, often haughty and arrogant, and they have black and white thinking. It isn’t a gray world with good and bad. Which brings in a major defense of narcissists, which is projective identification. But just to simplify that means that they shift blame. It’s never them. It’s always somebody else. And we certainly saw that a lot in the last administration.

Gabe Howard: One of the criticisms that always comes up when citing a former president is, well, they all do it, they all do it. I must have seen this in my email a thousand times. Well, you’re picking on this particular politician, but they’re all narcissists. Now, even in research for this show, I see that politicians are often listed as having narcissistic personality disorder, or they’re called narcissists in the media. What set Trump apart? Because I notice that you didn’t write a book called Aftermath: Healing from Any Other Administration.

Dr. Karyne Messina: Yeah, there’s no healing from the Bush or Clinton or any other administration, yes, you’re right about that. I think because Donald Trump actually, as you pointed out, I mean, certainly there are theories about and I believe he did try to overthrow the government, but he’s right on the money in terms of being a narcissist. If you look at every single descriptor, you’ll find that Donald Trump does fit in the category of that description. However, I would like to say that there is a range in the narcissistic spectrum. There’s actually something called healthy narcissism. Healthy narcissism is a state where people take care of themselves.

Gabe Howard: So it is important to understand that narcissism does exist on a spectrum, so just because somebody is for lack of a better word, very narcissistic doesn’t automatically mean that just because somebody doesn’t model the same behavior, that doesn’t mean that they’re not narcissistic. They just might be less narcissistic.

Dr. Karyne Messina: Well, the way I think of it is traits. They have traits and these things that I mentioned empathy, entitlement, the need for control, if they have a couple of those traits to say, if they lack accountability and maybe they exaggerate, that’s another trait of a narcissist. They wouldn’t be someone who would have a disorder. There’s no certain number, but when you start adding these things up, when it really interferes with their relationship or their ability to have a relationship with another person, then that moves more towards the disorder category.

Gabe Howard: How do you know when you’re in a relationship with a narcissist and I don’t mean a romantic relationship? It could be a friendship or a coworker situation, but how can you tease that out?

Dr. Karyne Messina: You know, as I said, they can be charming, attractive, funny, so until the egg is cracked you might not know. But if you see that someone lacks empathy. Like you have a problem, but they don’t really care about talking about that. Even if you’ve talked with the person for hours on end about his or her problem, there’s not reciprocity in terms of talking about problems and issues. One big thing is that the person’s entitled. They think they deserve something. People will say, Well, I deserve that, a car like that. I don’t have that kind of car, but I deserve it. They think they deserve things because of who they are or who they know or what they do, and they’re special and that should be recognized. They get easily hurt. You can’t criticize them in any way, even if it’s constructive. Nobody likes to be criticized, I guess, but they really do something with it. Either they lash out, they usually is a pretty strong reaction to being hurt, and they are right. If you’re with somebody and person is always right and you can’t ever make a point or they can’t watch something on TV and see that somebody is making a point different than theirs, if they’re not right, then you can see some of the narcissistic injury kind of behaviors come out. So that’s another clue. And if you’re with anybody like this in romantic relationships, that’s not good news. If it’s not too late, it probably would be good to not continue the relationship. Also this one is a little surprising to people. When I mentioned that there are vulnerable narcissists. They have an intense fear of being abandoned. So rather than lashing out, these people tend to cling. They don’t want to let people go. Sometimes you see that in marriages and marriage counseling where somebody is narcissistically injured. But rather than being angry, they get real clingy.

Gabe Howard: Dr. Messina, now I’ve heard of malignant narcissism, how was that different from just plain old regular narcissism?

Dr. Karyne Messina: As difficult as it is to be with a narcissist, somebody who has a narcissistic personality disorder. Generally speaking, there aren’t things that are criminal or a severely destructive it isn’t it isn’t severely destructive pathology. When it comes to malignant narcissism, we’re talking about inhumane acts exhibited by say dictators or tyrants, and it’s often associated with people like Hitler and Stalin. And there’s antisocial behavior, a lack of remorse, destructiveness, deceitfulness, disregard and a real violation of others. Paranoid thinking and a sense of persecution, difficulty trusting anybody. Everybody, I think everybody is after them or not loyal to them, therefore they are bad.

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Gabe Howard: We’re back discussing narcissism with Dr. Karyne Messina.Obviously, the majority of us are not going to have firsthand accounts with Donald Trump. We’re not going to interact with him one on one. So this question is more designed for what if we have that, that Donald Trump in our lives? What are some things that a person can do if he or she does have to directly interact with a narcissist?

Dr. Karyne Messina: Well, don’t allow yourself to be pushed around. Chances are when they think they’re right and they think you’re wrong, they push their agenda onto you. Or their attitude or their decision about something. Also, just don’t go along with their demands. If they say, Well, we have to do it on Sunday at two o’clock, well, maybe you’re busy Sunday at two. So it’s good not to give up your own agenda just because they want to do it at a certain time. Set your own boundaries and stick to them. There are things that people want to do and the things that they don’t want to do. And while we always compromise, you will never get any compromise from a person with a narcissistic personality disorder, so it’s important to recognize that pretty early and set your boundaries and stick to them. Another important thing is, I mentioned projective identification. What that is is that they project something about themselves they don’t like onto other people. Sometimes it’s so natural, they don’t even, it’s so automatic. They don’t even recognize they’re doing it. And most narcissists aren’t that self-reflective anyway. But if they project something, it’s important not to accept those projections, so it’s almost as if you just push it back to them. Donald Trump did that all the time. I don’t recall when anything came of any problem, whether it was a domestic problem or things around the world. I don’t recall it ever being his fault. You know, presidents have gotten up and they said things, well, perhaps we shouldn’t have done this or that, or they’ll say it in some kind of interview, but I don’t think Donald Trump ever admitted to anything that he took that was wrong or not optimal. It was always the best. The greatest. No mistakes, including winning the last election, which you clearly didn’t win. I think he’s still going around saying he did. Clearly, he didn’t

Gabe Howard: Dr. Messina, let’s talk about some solutions and your book, “Aftermath: Healing from the Trump Presidency,” does offer some. Now, obviously, we can’t go through the entire book here on this show, but is there anything that you recommend to our listeners in order to move forward? Because, as you’ve said, a lot of people were stunned by President Trump’s behavior. They’re still stunned by President Trump’s behavior, and many people are still reeling from the attack on the Capitol on January 6.

Dr. Karyne Messina: Well, obviously it’s a daunting task. What we can do is try to bridge the divide in America and also just in general. Another thing people can do is learn to mentalize. And so what that means, it’s a psychological word, it was used at the Menninger Clinic a lot to help people with borderline personality disorders, but it’s good for all of us. And it’s listening in an atmosphere of respect without judgment. So it’s talking to another person without judging or just listening to what they have to say, listening to a red state person, as long as they’re respectful, when they’re not respectful, then that’s where I draw the line. But as long as they’re just expressing their views, I think it’s important to listen without judging them. And that’s not easy because we all, you know, are very polarized. If you’re a red state person, it’s hard to listen to blue state people.

Gabe Howard: Thank you so much for that, and I agree with you, you know, there’s a quote that I like it is by columnist Doug Larson, and it is wisdom is the reward you get for a lifetime of listening when you would have preferred to talk. I try to remember that often, don’t always succeed, but I absolutely think that listening is very, very important. I completely agree that we have to have our boundaries. We should not be abused, but I really don’t think we are listening to each other. And I really think that we’re never going to reach any compromise. We’re never going to get together and we’re never going to heal and move forward if we’re just talking at each other, arguing with each other. Now, Dr. Messina, where can folks find you and your book?

Dr. Karyne Messina: They can find it on Amazon. I have a website that talks about some of the ideas that I talked about today. It’s Karyne-Messina.com. Karyne-Messina.com.

Gabe Howard: Dr Messina, thank you so much for being here, I really appreciate it, thank you.

Dr. Karyne Messina: Well, thank you so much.

Gabe Howard: Oh, you are very welcome and a big thank you to all of our listeners. My name is Gabe Howard and I am the author of “Mental Illness Is an Asshole and Other Observations.” I’m also a nationally recognized public speaker and I would love to be at your next event. You can grab a signed copy of my book and I’ll even include free swag just by heading over to gabehoward.com. Wherever you downloaded this episode, please subscribe or follow the show. It’s absolutely free. And hey, word of mouth is our best advertising. Please recommend the show to friends or colleagues. I will see everybody next Thursday on Inside Mental Health.

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