During the 2016 presidential campaign I was stunned and often revolted by Donald Trump’s aggressive and insulting verbal behavior and political tactics. His comments about Carly Fiorina’s face angered and disgusted me. At times, his ad hominem attacks on political opponents were beyond impolite. Such behaviors were harshly labeled as unpresidential by pundits.

As a psychiatrist and psychoanalyst, I took note of Trump’s obvious narcissistic preoccupations and relentless insecurity about criticism. his impulsive, punching, and counterpunching Tweets that created social media chicken and egg dilemmas. Did Trump’s political Tweet-punches create the liberals’ and liberal media’s hatred of Trump and their incipient fake news attacks on Trump, or was Trump primarily asserting and righteously defending himself? In the long run both Trump and the mainstream media seemed to relish and profit from the combat. They have created and coauthored a modern American political reality TV world of  P.T. Barnumesque proportions. Ordinary buttoned-up, focus group-prepared politicians seemed bland and colorless in comparison to Trump the outrageous bully.

I also noted Trump’s hypomanic behavior and personality style. My earliest associations  about Trump were to Teddy Roosevelt. Like a classic hypomanic personality, Trump seems to need little sleep and demonstrates unending energy and drive.

• The only man who never makes a mistake is the man who never does anything. 
• Far better is it to dare mighty things, to win glorious triumphs, even though checkered by failure... than to rank with those poor spirits who neither enjoy nor suffer much, because they live in a gray twilight that knows not victory nor defeat.

-- Theodore Roosevelt

Unlike TR, who read many books a week, Trump seemed to pride himself in his minimalist reading program.

Over time, however, I became fascinated and increasingly impressed with Trump’s successful campaign despite his blatantly unorthodox political tactics and narcissism. I reminded myself that narcissism is not necessarily a psychiatric curse word. The psychoanalytic term for the complex area of self-love and dignity is narcissism, or the narcissistic sector of our personality. It is important to note that narcissism is not necessarily a synonym for selfishness or self-absorption. In a normal personality, self-love matures and develops through anxieties and challenges, just as the ability to love others also has the opportunity to grow and mature.

It was Sigmund Freud who first observed that we love anaclitically (relating to the mother who nurtured us or the father who protected us) or narcissistically (relating to the self we wish we were, the self we used to be, or in affiliation with another self that reflects favorably upon us). Anaclitic literally means “leaning on,” and refers to an infant’s utter dependence on its mother or mother substitute for its sense of well-being and actual survival. Anaclitic love is normal behavior in early childhood, but not in adulthood. Trump seems in his adulthood to have developed a strong reaction formation to any elements of a need for anaclitic love. Trump can very well protect and nurture himself, thank you very much, you mothers and fathers.

Narcissism is neither “good” nor “bad” in itself; an appropriate amount of narcissism is necessary for healthy self-esteem, empathy, and creative expression. Too much or too little narcissism interferes with a person’s relationships with others: a significant deficit of narcissistic love often causes low self-esteem and feelings of shame or rage; an excess is associated with arrogance, entitlement, and self-centeredness. When we mature and individuate, (i.e., develop our own individual personalities, separate and distinct from all others), with relative freedom, we integrate the love we have found in our parental figures and move along in our own struggles and mistakes in loving. Trump has made plenty of mistakes in loving, but despite significant arrogance and self-centeredness, has had victories as well. He finally found a remarkable, talented, and strong woman, Melania, to love and be loved. His children are attractive, talented, loyal, admiring, and devoted to Donald Trump.

In my opinion, Trump’s obvious narcissism is a prominent thread within the complex skein of his remarkable ego strength and type A personality. A strong ego is not egotistical in the common-sense usage of the expression “big ego,” but indicates accurate intuition, street-smart intelligence, and judgement. Strong enough to withstand the attacks of bitter Democrats who never thought Trump would win the presidency. Strong enough to take on “the swamp” of Washington politics, politically correct liberal university professor enemies, and a massively anti-Trump and vicious liberal American press. Even smiling, hypocritical Trojan Horse Republican party enemies like John McCain and Mitt Romney were targets of Trump’s withering unpresidential tweets.

As Trump said early in his first campaign, he knows personally where all the political bodies are buried in Washington and how the pay-to-play swamp game is negotiated, and deals are made.