disordered minds coverBook Review: “Disordered Minds: How Dangerous Personalities Are Destroying Democracy”

By Ian Hughes (Zero Books, 2018)

Hitler, Stalin, Pol Pot and Mao were not aberrations and America is not immune. This can happen any time a paranoid, sociopathic and narcissistic person is allowed into power. We could just as easily fall into a violent, destructive social death spiral leading to mass death, as has happened elsewhere in the world throughout history. And the conditions are ripe for it, with an environment seeded by huge income inequality due to unregulated capitalism, a hate-mongering and divisive leader in Trump, his besotted and ignorant followers, and lack of restraints by both Republican and Democratic politicians. 

This is the frightening premise of “Disordered Minds: How Dangerous Personalities Are Destroying Democracy,” (Zero Books, 2018), by Ian Hughes. He does offer hope in the power of democracy to control autocrats, but the rule of law only works if it is enforced and the tyrant is held to account. (Hughes is a fellow contributor to “The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President.”) 

For over three years I have been writing about the fact that narcissists destroy countries, just as they destroy individual relationships, including in “Dangerous Case.” In therapy sessions with victims of narcissistic abuse, I often have to explore over weeks or months their emotional experience of the abuse, so that they can fully understand and truly sense the emotional destruction wreaked by their abuser. This allows them to comprehend the injustice, become assertive, and break free of the unhealthy relationship. 

In the same way, many of us in the past few years have been banging a drum about Donald Trump’s dangerousness in a variety of media outlets, hoping that the message would break through and our country could break free of his dangerous authoritarian control. 

I was curious if there were new concepts in Disordered Minds that could make another book on this topic worthwhile. While the content is not significantly revelatory, with the existential threat that Donald Trump has brought to American politics, the book’s important message is worth reading, sharing, and amplifying. While I fully understand the psychology of Trump and dictators throughout history, it was still frightening to read such consistent parallels presented in the book.

Hughes does an admirable job of clearly and cogently taking on the confluence of psychology and political history. He outlines the history of dangerous personality types who regularly gain power, bringing horrific destruction — from world wars to genocides to mass starvation and incarceration. The rise of Hitler, Pol Pot, Stalin and Mao are detailed, showing very consistent and predictable patterns of psychological dysfunction that drove these leaders down their destructive paths. 

This is familiar ground for anyone following my writing and the writing of many others concerned about the pathological personalities harming the United States today (and in many other countries). I have written that narcissistic personalities in individual relationships are non-reciprocal, controlling and abusive in ways that are toxic to the relationship; narcissistic personalities in politically powerful positions can destroy a country and its sense of community and connection in exactly the same way and for the same psychological reasons — poor shame tolerance

Hughes describes that most authoritarians meet the diagnostic criteria for sociopathic, narcissistic and paranoid personality disorders. I would build on Hughes’ premise and believe it is important to highlight that the Hitlers and Stalins of world history are different only in scale and destructiveness from the run-of-the-mill abusive spouse or boss. 

The parallels in patterns of behavior and their results are the same — whether it is a narcissistic president or a narcissistic partner or parent. A narcissistic leader is engaged in an abusive relationship with his entire country, in a grander scale but in exactly the same patterns as interpersonal relationships with these toxic people.

I approach psychiatric labels from a perspective that privileges the emotion of shame. Shame drives nearly all psychological problems, especially relational problems. Those who cannot tolerate shame may choose to internalize or Self-Blame or they may avoid blaming situations (Blame Avoiders). These two types of people rarely cause significant harm in society or relationships. The third type — Other-Blamers — are toxic, because they over-react to any threat to their self-worth with fear, leading to excessive worry that others might criticize them. They imagine others are after them (paranoia), and they lash out with blame-shifting attacks, even to the point of sadism, violence and abuse (sociopathic). They can also create a larger-than-life, charismatic persona to dominate others, place themselves above the law, and grab for power (narcissistic). 

What Hughes and other writers miss about this toxic triad of personality disorders, is that the core cause is the same for narcissism, sociopathy and paranoia, which is why I consolidate with a label that I believe more succinctly addresses the main behavioral pattern. This type of person has low self-worth, so when he feels he may be shamed, he engages in maladaptive coping mechanisms to block or relieve that shame.  Notably, he blame-shifts to others. All of the varied behaviors, whether it is lying, greed, ruthlessness, selfishness, cruelty, vindictiveness, immorality, or distain all arise as an attempt to alleviate the emotional pain of shame. Other-Blamers insist on being right, and can never accept they are wrong, can never apologize and dismiss those who challenge them in any way. 

You can see these traits in all of the tyrants Hughes writes about. For example he describes Leon Trotsky as self-righteous. “He demanded that others agree with him, convinced that he was always right.” (p. 45) They tend to punish those who contradict or challenge them, often leading to purges, death camps, slavery, and “re-education” camps. Other-blamers in power often dislike those they view as more intelligent: Trump regularly has targeted “the elites” as the cause of the country’s problems. Chairman Mao orchestrated his “Cultural Revolution” to foment violence, targeting his rivals, and closing universities. Teachers and intellectuals were denounced, beaten and sent to labor in the countryside. Hitler was a “man who experienced any criticism as intolerable” and had “an astonishing rigidity of thinking.” (p. 74) 

In personal relationships, this inability to compromise or apologize leads to high-conflict arguments over meaningless problems. In dictators, this stubbornness and inability to change course can be horrifically deadly. Hughes describes how Chairman Mao engaged in bizarre economic plans that led to starvation for millions of people. He forcefully collectivized farms and industry through violence and coercion in his “Great Leap Forward.” In 1958 one-third of the workforce, or 2.5 million people, were diverted from food production and put onto a massive irrigation project.  Mao had no expertise in farming, but insisted he knew best and proposed completely non-scientific farming methods, such as planting the seeds closer together and throwing massive amounts of garbage on the fields to supposedly boost production. The result was predictable: mass starvation. Mao had “a total inability to change course even with the catastrophic consequences were clear.” (p. 66) Pol Pot had an “unwavering belief in the correctness of his childishly simplistic vision for Cambodia,” as he, too, engaged in forced resettlement from cities to countryside that led to starvation. (p. 88) 

Hughes notes that dangerous personality disorders can act together and can draw in even psychologically normal people as followers. In the same way, Other-Blamers can draw in weaker people to do their work in destroying relationships — the lay jargon for this type of person is “flying monkey,” from the movie “Wizard of Oz.” 

He draws on research by Art Padilla who said tyrants need a “toxic triangle” of “destructive leaders, susceptible followers, and conducive environments.” (p. 103) Hughes points to the “injustices of capitalism — gross inequality, social divisions and widespread impoverishment”  present in unregulated capitalism that lead to the rise of disordered minds in politics and government. He noted that leaders are not isolated individuals, but require a pathological group to enable their rise. The Republican Party certainly qualifies as having sociopathic/narcissistic qualities at this time and stands silent in the face of Trump’s authoritarian take-over of the country because it serves their careerist desire to stay in power and their narcissistic fear of losing an election. 

The patterns Hughes describes in how dictators gain control exactly matches how abusive partners gain control of a relationship:  First, they charm and coerce. They portray themselves as successful, dominant and strong. “Freed from anxiety, self-doubt, and guilt, they strike normal people as having qualities they themselves would like to possess. The combination of a powerful mask of ideology, and the potent attraction which pathological individuals hold for many psychologically normal people means that, tragically, we often willingly place power in their hands.” (p. 34-5) 

Then they start to alter reality, question the victim’s sanity, and will dispute facts until the victim begins to feel confused and “crazy.” New patients of mine often report feeling “crazy” in their relationships, a sure sign that I am dealing with the victim of Other-Blamer abuse. Note the blame shifting in this language as Hughes notes the “detrimental effects [narcissists] have on the ability of psychologically normal people to think. When faced with someone with such a personality disorder, normal people experience confusion. The reason for this lies in the dissonant nature of personality-disordered people’s thought processes. In conversation, such individuals will commonly insist on something which is clearly not true, or stridently question the most obvious of facts.” (p. 26)

In groups or countries, this growing collective confusion and “erosion of normal reasoning creates further opportunities for pathological individuals to gain influence. People with normal sense of psychological reality find themselves in conflict with the newly dominant group and leave, while more individuals with personality disorders are attracted to the group and join.” (p. 27)

Political leaders and narcissistic abusers both try to control the people and messages that reach their victims. Abusers tell their partners to not see friends or family, to avoid having these people state the facts to the victim. Political leaders use propaganda and control of the media to limit the facts that reach citizens. 

Messages from Other-blamers are about being victimized, wronged, misunderstood, and treated unjustly — messages that resonate with like-minded Other-Blamers in the population who also enjoy finding someone to hold accountable rather than themselves. 

A frightening common element of the rise of dictators is that as the pathological minority asserts control, it brings out of the woodwork others who suffer from personality disorders. In Cambodia, Germany, China and Russian, each town’s bullies and tyrants were unleashed from social constraints and emerged to exert a sadistic, brutal and terroristic control over their neighbors. “Society quickly becomes stratified on the basis of psychological abnormality and normality, with the small percentage of psychologically deviant individuals holding sway over the normal majority of the population.” (p. 28) 

In an interesting but frightening side note, I couldn’t help but compare Trump to Mao when Hughes described Mao’s fascination with chaos, turmoil and destruction. Mao said that peace and prosperity are boring. Trump’s endless Tweeting, rapid-fire 180-degree changes in policy, and personal attacks on rivals and foreign dignitaries provokes a feeling of chaotic unpredictability that certainly does not bring peace to anyone.  


As an expert in abusive relationships I know the pattern that many of us read about in the newspapers — a woman breaks up with or divorces a man and he retaliates by killing her, or even their children or bystanders. Other-Blamers are so filled with their own self-loathing that they cannot tolerate rejection or betrayal of any kind, even if that rejection is due to their own abusive behaviors. They cannot be accountable for that fact, so they must blame-shift, lash out and harm their partner in retribution or attempt to destroy anything she might value, including her children. 

Given this well-known pattern it was interesting to read that Hitler engaged in exactly the same sort of blame-shifting thinking, but on a national scale, and with horrific consequences. In the last weeks of the war, “When he realized that Germany might lose, he stuck rigidly to his belief that it was in the interest of humanity that the loser should be annihilated.” (p. 86) It was as if Hitler felt his own country had personally betrayed him by losing the war. Heaven forbid he blame himself for taking any role in the horrific destruction of World War II. “[D]uring the last days of the war he gave orders for anything still standing in Germany to be blown up, and for the German population to be deprived of any means of survival.” (p. 86)

This very dangerous “burn the house down” strategy of Other-Blamers is what is most concerning about Trump. At his disposal are world-destroying nuclear weapons that are sent at his word only without question, with no approval by Congress or military leaders. Will Trump destroy the world in a fit of pique because he believes we shamed or betrayed him, rather than admit he might be wrong? If he loses the election and feels the soul-stinging betrayal of the entire country rejecting him, will he retaliate in a horrific way? I hope someone is watching him closely in November 2020.

Donald Trump, dangerous

Republican U.S. presidential candidate Donald Trump speaks during a campaign rally at the Treasure Island Hotel & Casino in Las Vegas, Nevada June 18, 2016. REUTERS/David Becker – RTX2GYKG


With narcissistic abusers or Other-Blamers, the only solution is to establish rules for the relationship and assertively call the Other-Blamer out to hold them accountable for their behaviors.

In the same way, the rule of law in democracies is the way to contain Other-Blamers in power who have urges toward autocracy. Hughes writes that democracy is a system of defense against dangerous personalities and “is all that stands between us and the psychopathic visions of the Stalins, Hitlers, Maos and Pol Pots who live among us still.” (p. 108)

“In peacetime, people with these disorders are restrained by the rule of law and the norms of civilized culture. When societies begin to crumble under the forces of social or economic upheaval, violent conditions provide an outlet for this disordered minority to display their terrifying hidden talents. As society becomes more and more stratified on the basis of psychological deformity, the descent into hell gathers pace.” (p. 101). In Trump’s America, the rule of law is already abrogated, as the Justice Department has decided that Trump cannot be charged or indicted for any crimes — a violation of the basic democratic premise that laws apply to all people equally. (This legal concept has been used since the signing of the Magna Carta in 1215). For democracy to work, rule of law must apply to citizens and leaders alike. 

This can be especially difficult because sociopaths and narcissists believe fully that they are above the law, because they instinctively know that rules and norms are present in society to restrain them.

Trump has clearly altered our expectation for civility, with his constant assault on norms, whether it is not releasing his tax returns to chronic pathological lying to crassness of behavior to corruption throughout his administration. In his sadistic incivility he is clearly in a league with tyrants throughout history. 


For those of us who understand narcissistic personalities, witnessing Donald Trump extremely pathological behavior go unchecked by our democratic system has been nothing short of horrifying and traumatizing. I often feel I am watching a slow-motion train wreck and I can predict the conclusion, yet know one else seems to comprehend the significance.

It is well known that the pathological personalities Hughes describes and that I label Other-Blamers destroy interpersonal, social and governmental systems. The toxic Other-Blamer personality in charge of a country is destructive in the same way that personality is destructive in a marriage or family. Because they fear and despise being held accountable due to their poor shame tolerance, they hate morals, social norms and the rule of law. 

Hughes describes democracy is a moral system, and I believe we can compare democracy to a healthy human interpersonal relationship. All healthy relationships require respect, decency, kindness, fairness, and reciprocity. In the same way, democracy provides the rules that reduce inequalities, balance power, promote equality and justice, limit self-interest, and work to promote the common good. 

Most decent people know that to build a loving, trusting relationship with a partner or friend, they must operate by these social norms. Democracy is a formalization of these same social norms to ensure that citizens have healthy relationships with each other and the government has a respectful relationship with its citizens. In contrast, Other-Blamers operate from a set of beliefs and values that are the antithesis of a healthy relationship. 

Hughes notes about disordered personalities: “People with these disorders are unable to accept the constraints of living with a democratic society. The language of democracy  — fairness, equality, freedom of conscience, freedom of thought, freedom for every individual to find meaning in life, the right to dignity, and equality of social relationships — is a language which is utterly incomprehensible to them. People with these disorders struggle to live within democracy’s moral strictures and, should the opportunity arise, will gladly tear down the constraints which democracy imposes upon them.” (p. 129) 

Other-Blamers seem to represent in human history one pole of the the following opposing values, with healthy social democracy on the other pole:  individuality vs. community, competition vs. cooperation, selfishness vs. generosity, intolerance vs. tolerance, injustice vs justice, and hate vs. love. Certainly these traits can exist in all humans to some degree, but people like Trump are extremely pathological in their character traits, making them unable to live in harmony with others who do follow the moral path.  

Hughes writes of Mao’s effect on China: “Hatred took the place of love and tolerance; the barbarism of ‘It is right to rebel!’ Became the substitute for rationality and love of peace. It elevated and sanctified the view that relations between human beings are best characterized as those between wolves.” (p. 57)


How do we prevent future tyrants and control the current authoritarians in our midst? 

Hughes briefly states that dangerous personalities are the result of failures in love and care in early childhood, but fails to expand to proposed a solution. I join many others who advocate that society must break the cycle of childhood emotional neglect where narcissistic parents raise even more narcissistic children. We must provide excellent parenting education for all on the importance of warm, emotional attachment and responsiveness toward children. We must stop the use of shame-based and behaviorally based punitive styles of parenting (“What’s wrong with you?” “Why did you do that?”), and corporal punishment. Parents must model good shame tolerance to teach children it is acceptable to be wrong, to admit weakness, to apologize, and to be accountable.

Educating high school students about how to manage shame, how to be assertive, and how to identify blame-shifting relationship patterns would also help stop the proliferation of narcissists in society. 

I advocate for the ultimate solution of teaching mindful self-compassion skills to everyone, as self-acceptance is the antidote to shame and low self-worth.

Hughes also briefly mentions as a solution the fact that the topic of pathological political leaders has not received adequate attention because of the so-called Goldwater rule that says it is unethical for psychiatrists to speak up about someone they have not personally examined. “The rules of ethics which govern the conduct of psychiatrists and psychoanalysts also, paradoxically, prevent a more productive interaction between mental health professionals and political scientists in elucidating the connections between people with dangerous personality disorders and political violence and corporate misconduct.” (p. 35)  

The book I co-authored, “The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President,” was cited as an example of clinicians bravely ignoring the Goldwater rule. The Dangerous Case of Donald Trump

Mental Health professionals must be allowed and encouraged to speak up individually and as groups about the personality disorders that are readily apparent in very public individuals seeking to gain political power. To silence the very experts who could guide the country during an authoritarian takeover makes it more likely unstable individuals will gain a national platform without any accountability for their behaviors.

Requiring a psychological profile of candidates for president and vice president would be another meaningful solution. “The strongest protection is the most obvious — to ensure that individuals with dangerous personality disorders do not achieve positions of power or influence at any level of society — within communities, within organizations, or within nations.” (p 173.)

Hughes also advocates strengthening social democratic principles and norms to balance the widespread injustices and inequalities of capitalism. Controlling neoliberal economic and political philosophies that limit the role of the state is also key. 

The individuality, competitiveness and selfishness inherent in capitalism must be restrained.  “At the beginning of the twenty-first century, we therefore find ourselves in a position where one facet of capitalism — financial capitalism — is fueling increasing levels of inequality, while the other facet — industrial capitalism — is destroying the global habitat upon when we depend. This is a crisis of capitalism orders of magnitude greater than that which the world experienced a century ago.” (p. 164). 

Hughes concludes with this: “Given the scale of suffering they cause, and the existential challenges we now face, devising the means to reduce this dangerous minority’s malignant influence is the overriding moral imperative in the century ahead.” (p. 175)

I could not agree more. 

You may also like:  

Accountability: It’s the Root of Moral Behavior and Trump Doesn’t Have Any

The Psychological Dangers of a Humiliated Donald Trump

Shame: The Emotion that Drive’s Trump’s Behavior and Causes Tyrants, Narcissists and Sociopaths


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