book reviews, mental health, narcissists, politicians, politics, Trump

A review of Trump on the Couch: Inside the Mind of the President, by Justin A. Frank, MD…

When Donald Trump was still POTUS, I bought a bunch of books about him. I haven’t managed to finish them all, even though he was voted out of office in 2020. I’m an avid reader, but I can’t read books as fast as I once did, when my eyes weren’t so old and I didn’t need to nap so much. Besides that, I find reading about Trump alternately infuriating and terrifying, even though he’s also a fascinating character. It shocks me that he’s able to get away with what he does, although it now appears that special super power could soon be about to end.

From the beginning of Trump’s “reign”, I have believed very strongly that he is a narcissistic sociopath or a malignant narcissist, or something of that order… I remember hearing back in the 80s what a scumbag he was, but at that time, I didn’t really care too much. I was a kid. Now that I’m middle aged, and see the damage that can be wrought by corrupt leaders who are so power hungry that they completely lose sight of responsibility and decency, I care a lot more about Trump and the many people who emulate and admire him.

In late March 2020, I downloaded Justin A. Frank’s book, Trump on the Couch: Inside the Mind of the President. Frank is a psychiatrist with several decades of experience in practicing and teaching psychiatry. According to his page on Amazon.com:

Justin Frank M.D. is a highly regarded psychoanalyst and teacher. A clinician with more than thirty year’s experience, Dr. Frank used the principles of applied psychoanalysis to assemble a comprehensive psychological profile of President George W. Bush in his 2004 New York Times bestselling book Bush on the Couch: Inside the Mind of the President (HarperCollins). His newest book, Obama on the Couch: Inside the Mind of the President is being published by Free Press/Simon & Schuster on October 18, 2011. 

Dr. Frank currently writes a biweekly column for Time.com. He also contributes to HuffingtonPost.com, DailyBeast.com and Salon.com, and is a frequent writer and speaker on topics as diverse as politics, film, and theater. He is Clinical Professor in the Department of Psychiatry at George Washington University Medical Center, and the co-director of the Metropolitan Center for Object Relations in New York.

Dr. Frank did his psychiatric residency at Harvard Medical School and was chief resident at the Cambridge Hospital. He was also awarded the DuPont-Warren Fellowship by Massachusetts General Hospital.

Dr. Frank lives in Washington DC.

As you can see, Dr. Frank has written several “on the couch” books about presidents. I haven’t read the other books, as before Trump came along, I didn’t care very much about politics. It’s been said that no person is 100 percent “bad”. I suppose that if I could say one thing good about Donald Trump, it’s that he has motivated people like me to care about who is leading the country, and whether or not they are fit to be in such a position. I have never thought Trump was “fit” to be president, although I do remember thinking he’d do better than Ted Cruz. At this point, though, I think I was mistaken about that.

After I finished Mary Trump’s book about what led the people of the United States to elect her corrupt uncle, I decided to read Dr. Frank’s book. I thought it would be a good follow up. I was right, even though Trump on the Couch was published in 2018, when Trump was still parking his fat ass in the White House. Even though Trump lost the election in 2020, he’s still very much in the news, still affecting our lives with his blustery rhetoric and uncanny ability to stimulate people with the worst of values to act in destroying our democracy. Trump will never change and, in fact, I think he’s gotten even worse. Dr. Frank explains why that is, as he introduces readers to Trump’s psyche, and what caused him to turn into the unhinged orange nightmare that he is today.

Trump on the Couch starts with Trump’s story, from the very beginning. Frank writes about Trump’s family history and the dynamics that shaped Donald Trump. I noticed that Frank seems to place a lot of emphasis on Trump’s Scottish mother, Mary, who left her homeland at age 18, fleeing the poverty she was raised in during the early 20th century. Mary Trump (Trump’s mom, not his niece) came to New York and found work as a housekeeper and nanny, until she met up and coming real estate magnate Fred Trump, Sr. They married, and had five children: Maryanne, Fred Jr., Elizabeth, Donald, and Robert.

Frank explains that Mary Trump was quite reserved under normal circumstances, and she had servants to do most of the housework. Consequently, she wasn’t a very “hands on mother”, even when she was healthy. But, when Mary gave birth to Donald’s younger brother, Robert, she almost died due to severe hemorrhaging. She had to spend many months resting, and afterwards, was left in fragile health. According to Dr. Frank, this less than devoted mothering had a profound effect on Donald, who was a child who needed a lot of attention. I found myself copying and sharing some of the passages from Frank’s book explaining this:

He was also kind of mean to his little brother, as Frank notes:

He was a creep, even when he was a child.

Because Trump was such a bratty little bastard, his father, who was quite strict, but mostly absent, decided to send Trump to a military boarding school. Trump went to New York Military Academy, where he ended up doing somewhat well, because it was a place where being ruthless and competitive was celebrated. But being at boarding school further separated Trump from his mother, and exacerbated his anxiety about maintaining control in every situation. Frank also writes that he thinks Trump may have a form of dyslexia, which makes it hard for him to comprehend language the way that most people do and causes more anxiety, which makes him less empathic to other people.

I noticed that Frank focused a lot on the psychodynamic aspects of mental health evaluation. His theories came across as very Freudian to me, with a lot of emphasis on Trump’s childhood and parents– particularly his mother. I found his observations to be interesting and mostly accurate, although I’m not sure the Freudian approach is always the best one when analyzing people today. But then, I know I don’t have Frank’s expertise or experience. Frank also frequently mentions the Austrian-British psychoanalyst and author, Melanie Klein, who was also very much influenced by Sigmund Freud. I wondered what approach Carl Jung would have taken toward Trump.

Frank follows Trump’s life to his time as POTUS, where he notes a lot of the antisocial and, frankly, unacceptable attitudes Trump brazenly displays toward women, people of color, or anyone else whom he doesn’t consider a “winner” of some sort. I enjoyed the analysis of Trump’s childhood the most interesting part of the book, as Frank explains how Trump’s upbringing helped make him in to who he is today. Once again, I found myself sharing astute quotes from the book:

There were a few times when I found Frank’s observations rather alarming, even though Trump left office. A lot of people would like to see Trump re-elected in 2024. I fear that outcome, because Trump can’t be controlled, and if he has nothing to lose, he will stop at nothing to get what he wants. He can’t legally run for a third time as president, but he made it very plain during his first term, that he’d like to change the laws so that he can stay in power for the rest of his life. And Frank makes it plain that Trump is the type of person who absolutely hates to lose, and can’t tolerate playing fairly. He has no sense of honor or decorum.

Dr. Frank’s book, Trump on the Couch, is very comprehensive, with detailed chapters on what he thinks makes Trump tick. He includes an extensive bibliography, as well as a glossary, that includes some Trump specific terms that explain certain traits and behaviors specific to Trump. One reviewer on Amazon.com recommended reading the glossary before reading the book. I don’t think that’s a bad idea. The reviewer also included this comment from Frank about Trump’s behavior and other people’s reactions to it:

“Idealization is the product of extreme splitting, beyond the simple internal world of good and bad, and into one that is ideal and awful. It transforms the perception of reality into something better; it may lay dormant in the unconscious and emerge when one falls in love or has a baby. Just as lovers see themselves – their best selves – in another, the electorate usually idealizes their candidate for higher office. Thus, Ann Coulter sounded like a betrayed lover when Trump signed a budget that didn’t include funding for the wall he promised her. When people feel understood by a leader – or by a therapist – they idealize that person. Trump’s base felt that he understood their frustration and pent-up rage, so they idealized him more than any American president in decades. He promised to ‘drain the swamp’ and destroy the self-centered elites. They [Trump’s supporters, not the self-centered elites] idealized him so much that he said he could shoot someone on Fifth Avenue and not lose a vote, and no one corrected or contradicted him. They loved him: never have there been such long lines at campaign rallies as there were at Trump’s. He tapped into unconscious recall of the infant’s love for the parent, who can magically understand the child even before he has words” (pages 245-246).

However, because this book is hostile toward Trump’s image, I feel quite certain that Dr. Frank’s analysis comes only from books, interviews with people who know or have been exposed to Trump, and watching the way Trump behaves in public. He clearly didn’t interview Trump himself, which I think would make it difficult for his “diagnosis” to be taken as seriously as it might. And some people will read this book and think it’s “unfair”, because it’s biased against Trump. It’s quite obvious that Justin A. Frank is not a Trump admirer. But he does have to sell books to make the endeavor worthwhile, so my guess is that he sort of pandered to the “base” who would be interested in reading this book.

Overall, I found Dr. Frank’s analysis of Donald Trump to be accurate and interesting. Trump on the Couch is a quick and easy read, and will probably offer “confirmation bias” to those who are concerned about Trump’s influence on people. I do think it’s worth reading in 2022, even though it was written when Trump was still in office. Trump has made it clear that he’s not giving up on another run at the White House, even though he’s currently plagued with serious legal and financial issues. Dr. Frank makes it plain that people like Trump don’t change, and tend to get worse instead of better. Trump himself has said that he’s basically the same person he was when he was about eight years old. Let that sink in… and vote accordingly.

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healthcare, mental health, musings

Death of a head shrinker…

A few days ago, I read an article in The New York Times about new drugs that can help treat obesity and perhaps “end the stigma” of being overweight. I’m old enough to have seen a lot of so-called magic bullet obesity drugs on the market. I remember in the late 90s, there was Meridia, which used to be advertised on TV all the time. This ad showed pleasingly plump women in loud prints, breezily lumbering along with smiles on their faces… The ads promised that the drug would help fat people control their appetites and lose weight. Then it was voluntarily withdrawn from the U.S. market in 2010, because it was shown to increase risk of heart attacks and strokes.

I remember this ad so well…

In the 1990s, there was also the Fen-Phen combo of drugs, which was said to be very effective in helping people lose weight. Bill says his ex wife took that combination for awhile. Apparently, she was very upset when it was taken off the market. I remember that combination of Fenfluramine and Phentermine was removed because it supposedly caused heart valve problems as well as high blood pressure. Ex, indeed, reportedly had issues with her heart, other than the fact that it’s so small. She had to have surgery at some point.

And then there was the drug my former psychiatrist gave me. For some reason, my former shrink felt besides the antidepressants I definitely needed, I should also take Topamax to help me lose weight. Topamax is a drug that is used for stopping seizures, curing migraines, and treating bipolar disorder. My shrink didn’t give it to me for those purposes, though. He prescribed it because one of the side effects of Topamax is decreased appetite. He felt I was too fat, and Topamax would help me lose weight.

Granted, I wanted to lose weight… and I was tired of hearing him harp on my body when I went to see him for prescription refills. So I tried Topamax for awhile. I often got the third degree from pharmacists, since I was also taking Wellbutrin, which is said to cause seizures in some people (but not me). Pharmacists would become alarmed at the drug combination and question me, and I would have to tell them that I wasn’t taking Topamax because I have seizures. It was embarrassing.

The Topamax did kill my appetite, which Bill didn’t like, because I didn’t want to cook or eat dinner. It also made carbonated beverages taste terrible, which wasn’t a bad thing, since I was addicted to Diet Pepsi at the time. But even with health insurance, the drugs were expensive, especially since I was also taking name brand Wellbutrin (the generic version didn’t yet exist). I also didn’t lose a lot of weight, much to the psychiatrist’s dismay. He wondered if I had a slow thyroid.

I remember feeling really horrible about his comments. At the time I was seeing him, I had actually lost a lot of weight because I was waiting tables and didn’t have time to eat or sit down. The pounds came off pretty easily and most people thought I looked pretty good. However, I was constantly sick during that time, partly because I was fresh from the Peace Corps and kept getting skin infections and also because I was run down because I was always working. I developed a distinct disdain for that shrink because even though I suffered greatly from body image issues, eating disorder issues, anxiety and depression, this guy kept harassing me about my figure… even after I was happily married to Bill, who didn’t care that I wasn’t skinny.

I was reminded of this shrink the other day, as i read the article in The New York Times the “new” magic bullet drugs that could help people shed pounds and the scorn and harassment that comes from being overweight. I shared the article on Facebook and my former therapist, who is now a friend, commented that the article is interesting. I wrote that I thought his “friend”, the psychiatrist, should see it. My former therapist wrote, “Yes, but he’s dead.”

I hadn’t known the former head shrinker had died. I went looking for his obituary, and lo and behold, there it was. He actually died two years ago. I had no idea. Several people had left kind comments about his memory. If I’m honest, I could see how they came to their conclusions about him. On the surface, the former head shrinker was “nice” enough. I remember thinking he had kind of a gentle, steady air about him. But he also really pissed me off on a regular basis by calling me “kid” when I was a grown and married woman, making comments that were belittling, and giving me a hard time about not being thin when I already had terrible issues with self esteem. I got the impression that he had a personal bias. I also didn’t like it when he acted in a paternalistic way. He was very much an old school kind of doctor who treated me like a child. It wasn’t very helpful at a time when I was trying to launch.

Fortunately, I only went to see that doctor for medication. I saw my therapist, a younger, hipper, and more empathetic guy, for psychotherapy. I will give the head shrinker credit, too. He was a competent psychiatrist in that he found the right drug for me. Wellbutrin changed and maybe even saved my life. Within just a few days of taking it, I felt like a completely different person. After taking it for several years and then getting off the drug, I still haven’t gone back to the awful way I used to feel every day… the way that was normal for me, but made other people think I was legitimately crazy. People used to ask me if I was bipolar all the time. They don’t anymore, although I don’t spend much time around other people anymore.

In 2007, before we moved to Germany the first time, I requested my records from the shrinks. I needed them because the Army required all of my medical records so I could be evaluated for the EFMP (Exceptional Family Member Program). This was supposedly a must before they would send us to Germany, but as it turned out, the National Guard (Bill’s official employer– he was a full time “federalized” Guardsman) didn’t give a fuck about my EFMP status the way the regular Army would have. I was forced to join the EFMP, but it turned out that I could have skipped the whole process and the National Guard wouldn’t have been the wiser. It would have been nice if I had known that, since the whole EFMP screening process was traumatic for me on many levels. I won’t get into that now, though. I think I reposted about my experience with the whole EFMP business. Thank God Bill is retired.

Unwisely enough, I read the notes my shrinks wrote about me. My cool therapist wrote positive, affirming notes. The dead head shrinker wrote things that upset me… like, for instance, I had a “garish” appearance. I was a bit taken aback by that. People have described me in a lot of ways, but never “garish”. That implies that I looked tacky, gaudy, or like a clown. And I didn’t see what my choices in makeup and clothing had to do with my mental well-being. Isn’t it better if someone with depression isn’t wearing black? He also made comments about my weight in his notes… and on more than one occasion, seemed a bit frustrated that his chemical cures weren’t slimming me down. I know very well that I’m not a thin person… but he made it sound like I was just disgustingly obese. When I was seeing him regularly, I wore a size 14 or 16… which is pretty average among American women, even if it’s not ideal in terms of most women’s most attractive body size.

It was a little strange reading about this man’s death. I mean, I know it had to happen… he was old enough, although he was several years younger than my father was when he died. I noticed the obituary didn’t mention a wife. I remember he was married when I saw him. I’d heard she was his third wife, and she had been about my age, while the shrink was old enough to be my dad. He’d had a young daughter back in the late 90s, which would mean she’s a young adult now. He also had four other children. I remember thinking that I hoped his youngest daughter didn’t have weight issues when she was growing up. I had a feeling he would ride her about them. And I guess, just based on his obituary, that his wife was no longer married to him when he passed a couple of years ago. He was a tall, somewhat handsome man, and he didn’t have a weight problem. But that didn’t stop him from having problems of his own.

I don’t like seeing doctors. I haven’t seen one since 2010, when Bill made me go because we thought my gallbladder might need to come out. It turned out it wasn’t bad enough to be yanked. One of the reasons I don’t like seeing doctors is because of that shrink… as well as the horrible OB-GYN who did my very first (of only two) gynecological exams. She physically and mentally hurt me so bad and shamed me so much that I became a bit phobic of medical people, even though I have a background in healthcare. Now I don’t go to doctors unless I’m about to die.

But maybe I shouldn’t blame these doctors for turning me off of their services so much… They’re only human, right? I’m sure they had my best interests in mind when they fat shamed me. The OB-GYN wrongly predicted I would get very fat in Armenia. I actually lost a lot of weight there. I did gain it back, but then I came home and waited tables and lost even more weight. And then I gained it back when I quit waiting tables… which was a good move for my overall health– especially my mental health– even if I didn’t have as pretty a package for people to look at. I’m glad to hear about the new drugs that might help people lose weight. I think it’s a good thing to think of obesity as a medical problem rather than a character flaw. However, this is not the first time I’ve heard about drugs that can help with weight loss… and so many of them turn out to be harmful.

Well… one more week to go before Bill is home. I continue to try to keep the faith. Last night, I was thinking about places I might like to visit when we’re finally able to travel again. Funnily enough, I’m planning based on whichever place is the least likely to give me a hard time rather than where I’d really like to spend time. One of the many luxuries of living in Germany is that there are plenty of places to see, and a lot of them are not so hard to drive to. Last night, I was thinking about visiting Krakow, Poland. It’s about a 9 hour drive from where we live. Maybe we can go there this year… after my second vaccine next month.

Also… I guess I’ve now arrived. Yesterday, I was made aware of someone having made a cloned account from my Facebook profile. It had one of my photos from last year, a cover photo using a picture I took in Rothenburg in 2018, and claimed I was a Mexican living in Nashville. I reported the profile, but Facebook naturally says they can’t do anything about it because it “doesn’t violate standards”. Meanwhile, they can give me bullshit warnings because they claim one of my comments was racist hate speech when it was really a criticism of a racist game being pitched on Facebook. They really need to get some real people evaluating these reports again. Facebook sucks, and is becoming more of a joke by the day. Anyway, I left several more complaints, along with a profane comment on the cloned profile. I doubt it will amount to anything. I changed my passwords, just in case.

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