When I first meet with a new patient to do an assessment, one of the things I watch for is the way they speak about subjects. Specifically, I listen for how specific they are. (Couldn’t help myself!) 

There are many reasons for this, as it can indicate problems with recall or memory, how conflict averse they are, how self-confident they are, how they perceive relationships, their attachment and trauma history, and their emotional awareness skills.

It can also indicate the poor shame tolerance that is the core of narcissistic or sociopathic behavior, or what I call Other-blamer traits. Those who don’t like to be held accountable or are ashamed of some part of their behavior will very often give vague answers to questions that are very pointed. For example:

Q: “How many drinks of alcohol do you generally have in a week?” 

A: “Oh, I drink socially.” 

Actually, this person probably drinks to excess, but doesn’t want to admit that. A person with a healthy drinking habit can probably acknowledge a specific number of drinks:  “I drink two beers on Friday night usually and sometimes a glass of wine with dinner on Saturday.” 

With couples, I listen for this vagueness as well, because it can indicate that the dissembler is an Other-blamer who has difficulty being wrong. This personality type avoids being pinned down by details as a way to skirt accountability. 

Q: “Your husband says you have run up quite a bit of credit card debt without telling him. How much debt do you have?

A: “It’s only one card.”

Q: “How much is on that card?”

A: “I’m paying on it every month.” Or “I’m not really sure. Last time I checked…Maybe a few thousand.” (And it’s really $80 grand.)

Narcissists also may try to bury their lack of knowledge or poor behavior in an avalanche of words, and this is what our current president does every day. Read any part of this bizarre transcript of a press event President Donald Trump held with Italian president Sergio Mattarella and your head will start spinning — which is exactly what the Other-blamer wants to happen. One way of gaslighting a victim is to overload them with a stream of words, so that it becomes difficult to sort out the lies from the truth.  The victim will become distracted and not know where to begin to counterattack all the various subjects and mistruths that have been spewed out by the narcissist. 

Now, it is likely that Trump may suffer from dementia, as evidenced by the complete lack of coherence of content, poor word finding, simplistic word choices, lack of complex sentence structure, and grammar befitting a five-year old.

But I also find that people with poor shame tolerance, such as pathological narcissists/sociopaths, also struggle to give direct answers, because they might be held accountable for that answer. When you listen carefully or read a transcript,  the Other-blamer can sound quite confused and confusing.

Consider this Trump garble: “Again, we only had 28 soldiers. It was 26, 28. I got all different numbers. It ends up being 28, between the 26, 28. Two people, and they’re fully accounted for.”

He states a number, then changes it, then changes it back. (Which is it, the confused victim/press/American public, wonders.) Then he blame-shifts by saying he “got all different numbers” — a clear sign of an Other-blamer. It’s not his fault he doesn’t know the number, it’s his briefer’s fault. Then it’s a freefall of words and numbers that make no sense and seem to serve no purpose — except to protect the Other-blamer’s fragile ego. Most of us, if we didn’t remember the number of soldiers, would either avoid mentioning the number or just admit we don’t remember if it was 26 or 28 or would just mention a general number, such as “about two dozen.” 

Other-blamers get in trouble because they want to be viewed as all-knowing and a “stable genius”, so they may speak in definitive proclamations: “26 soldiers,” but then they begin to doubt themselves and want wiggle room in case they are wrong. So they start to hedge their answer. Watch for this type of weasel language and you may find yourself an Other-blamer.  

Based on the transcript, it’s not even really clear what these numbers refer to, another verbal tic of the president’s. His language is often vague and without context because I’m sure this gives him cover to walk it back later: “Oh, I wasn’t talking about the number of soldiers, I was talking about the number of tanks…”

Later Trump says: “I know the fake news doesn’t make it look that way, but we’ve removed all of our, as we said, 50 soldiers, but much less than 50 soldiers. They’re now in a very, very safe location, heading into an even safer location.” Nowhere in the previous transcript does he say 50 soldiers or “much less than 50 soldiers.” (We’ll ignore the many lapses in grammar in Trump’s rant — “fewer than!”) Here he is throwing out yet another number. Don’t you feel confident the president knows what he’s talking about? 

And then he can’t even seem to land on a declarative statement about the safety of our soldiers:  Are they “very, very safe” or “even safer?” Of course, Trump is well known for his excessive use of superlatives. Nothing can be just “safe.” Most people could identify this as a linguistic trait of a narcissist. Other-blamers want everything around them to be “the best,” because they cannot stand to be average or inferior, as this threatens their already weak sense of self. Healthy individuals can admit when they are not the best at a task; Other-blamers struggle with humility. To identify a narcissist, consider: Can they admit fault, admit weakness, be vulnerable or ask for help? Probably not. 

There is so much to analyze in this or any transcript of the president’s language. Clearly, there is something seriously amiss with Trump’s emotional and/or cognitive functioning. If someone presented with this verbal output in my office I would at the very least refer them for a neuropsychological consult. Very likely, I would contact their family member or emergency contact to address the fact that someone needs to help them manage their life in ways that would not endanger other people or themselves. 

It is shocking that mental health professionals have spoken up about this president’s severe and dangerous psychological under-functioning for three years and he is still in office. We need a system to analyze future presidents and vice presidents for cognitive and psychological functioning before they are elected. Mental health professionals need to be permitted to speak up and educate the public on the very obvious signs of a severe narcissist or sociopath, so that we do not elect another wannabe dictator ever again.

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