Followers of Donald J. Trump often exclaim they like him because “he says it like it is“ and he is against “political correctness.” Certainly the content of Trump’s outspokenness confirms this, as his statements during the campaign were often bigoted, incited hate and violence, and blatantly false. There was little correctness, political or otherwise.

Since Trump’s ranting was so politically, culturally and morally extreme, many question why tens of millions of American were so enamored that they could also overlook Trump’s obvious inadequacies in qualifications, intellect, moral judgment, temperament, and emotional fitness. Voters were even willing to disregard the fact that many psychologists and those familiar with Trump described him as a “narcissist”  or even as a “sociopath.”

These traditional psychological diagnoses certainly seem to fit Trump, with their descriptions of behaviors that include violations of social and legal norms, greed, extreme self-absorption, bullying, impetuousness, grandiosity, lack of empathy, and feelings of entitlement.

Some pundits have stated GOP voters wanted “change” so badly they were willing to tolerate Trump’s egregious behaviors and beliefs. They say he championed issues rural white voters were concerned about, such as job losses to globalization and immigration.

However, as a clinical psychologist, I would offer a completely different interpretation of this support for Trump. I will explain why he was so popular among certain voters, not because of a shared vision for the country, but because of a shared emotional and behavioral defect. And I will discuss the negative effect Trump and his followers will have on the psychological and cultural future of our country, and what, if anything, we can do about it.

The Toxic Results of Shame Intolerance

Many people today, including those labeled as “narcissistic” or “sociopathic,” suffer from low self-worth or feelings of inadequacy. I describe the causes in detail in my book Self-Acceptance Psychology, but briefly: Negative self-image is largely due to exposure to harsh, judgmental, rejecting, or emotionally neglectful parents. It can also be caused by developmental trauma, such as abandonment through divorce or adoption, emotional or physical abuse, molestation, physical neglect, witnessing parental conflict, or parental psychological or substance abuse problems. The result is attachment insecurity, leading to poor social and emotional skills and difficulty establishing close, bonded relationships in adulthood.

In essence, a child raised in a physical threatening or emotionally sterile environment responds in certain predictable, survival-oriented ways informed by biology and evolution. Because we all have a visceral need for love and belonging, a sense of being rejected can signal an emotional threat. It is natural to react with the “fight-or-flight” or fear response. Early emotional trauma, such as harsh criticism or lack of warmth from a parent, has a particularly heavy impact on a child’s social, emotional, and cognitive development.

Based on these concepts and others, I have developed a new paradigm that offers a powerful explanation of human behavior called Self-Acceptance Psychology.

Self-Acceptance Psychology states that early developmental trauma leads to low self-worth, lack of self-acceptance, and difficulty managing shaming experiences. As a result, people can adopt one of three Counterproductive Shame Management Strategies and these define essentially all unhealthy behaviors in relationships with self and others:

  • “Other-Blaming”
  • “Self-Blaming”
  • “Blame Avoiding”

Self-Acceptance Psychology offers an evidence-based and logical alternative to traditional psychiatric categories such as “narcissistic personality disorder” and would labeled Trump and those like him as “Other-Blaming.”

Other-Blamers lash out to forestall, defend against, or attack incoming criticism. Because of early experiences of being rejected and humiliated, they have high levels of internal self-judgment or self-doubt. These mind states developed in an attempt to fix the self, which was judged to be unworthy by parents, and to gain the acceptance of others. As a result of high internal levels of self-shaming, even minor feedback or correction can feel overwhelming.

The simple way to understand Counterproductive Shame Management Strategies is the answer to this question: How does a person handle criticism?

The key behavior of “Other-Blamers” is lack of accountability. When feeling emotionally cornered and embarrassed, Other-Blamers find it difficult to admit to faults or mistakes, but instead makes excuses, rationalize, and blame others.

In contrast, those with healthy self-acceptance have accurate perceptions of messages from others, can tolerate shame, and have appropriate emotional and behavioral reactions. They can apologize gracefully and be accountable for their behaviors.

Trump Followers Want What He Has: Impunity from Criticism

I postulate that many of Trump’s followers are also Other-Blamers, of course not all to his extreme level. With the Self-Acceptance Psychology paradigm in mind, it is easy to recognize that Trump’s outrageous outspokenness triggered a positive emotional response from fellow Other-Blamers in the American public.

Through the interpretation put forth by most pundits, Trump’s millions of followers appear to be blind to his obvious flaws. Instead, we can understand that it wasn’t that Trump’s followers didn’t recognize his character defects, it was that they instinctively recognized them and actually liked these aspect of his personality.

His tendency to “say it like it is” had a magnetic pull for Other-Blamers, because they, too, desperately want to be able to spout off opinions and not be challenged or questioned. Just like Trump they hate being criticized because it brings on feelings of shame that seem unbearable. They roared their approval at rallies when Trump intimidated and dominated others to gain acquiesce and submission. Other-Blamers saw nothing wrong with Trump lashing out in a rage at a reporter or impulsively calling for violent protests. In fact, they applauded it.  This is exactly what they want to do in their lives. Trump’s supporters loved it when he refused to admit he was wrong, because they, too, do not like to be held accountable. In his entitlement, over-confidence and bloated ego, they saw themselves and felt vindicated. They could relate to his lack of accountability and fear of criticism and shame, because they suffered from these same traits. Seeing them in a successful billionaire, they concluded that these were not faults, but positive attributes.

And the relationship was reciprocal. Because Trump and his Other-Blamer followers were simpatico, he could instinctively feed them exactly the messages to which they would react viscerally.

Other-Blamers know a lot about fear, because they spend their lives in fear of being judged and found unworthy. Trump could channel their shared insecurities and speak directly to their deep fears of being passed over and made to feel unworthy — whether by women, minorities or the threat of foreign trade — just as he feels dread at being found out as “less than.”

Commentators wondered how Trump could be so brazen in his errors in fact and judgment, yet his followers would not falter in their loyalty. Trump’s Other-Blaming followers would find criticizing him to be unfathomable, because they instinctively know that criticism is so deeply painful. They want to protect him from criticism, just as they long to be protected from it.

Other-Blamers value loyalty — as in “you don’t challenge me and I won’t challenge you, because we both know how frightening that criticism would be.” This is how they can turn a blind eye to Trump’s faults. They, too, want to surround themselves with people who will ignore their faults, because hearing about a fault feels devastating to an Other-Blamer.

Because Other-Blamers are uncomfortable with self-awareness and accountability, they are very well defended against hearing criticism of Trump, just as they are well defended against hearing criticism of themselves.

In addition, they would not admit Trump had any faults because once these loyal followers chose Trump they were never going to doubt that decision. That would trigger feelings of self-doubt — that they had made an incorrect decision and had to walk it back.

And just as Trump’s followers ignored his immoral behavior, Trump ignored the outrageous behavior of his followers and egged it on, even inciting violence at his rallies.

They were a mutual admiration society of deeply troubled psyches.

Conversely, I also suspect that some Trump supporters were attracted to him because he is similar to Other-Blamers they experienced in their lives, such as a domineering or abusive parent. For this type of person, their developmental experience of relationship is an unhealthy connection with an Other-Blamer. As a result, Trump’s behavior seems normal and acceptable. They have come to believe that this behavior signals a “leader,” when it really exemplifies a deeply fearful, insecure person who has learned to mask his insecurity with braggadocio and bullying. Clinicians very often see this pattern in traumatized and submissive clients.

Yet another group of people damaged by Other-Blamers experience a very different response. They sense that these predators are dangerous, are intuitively tuned in to their fear, and are deeply frightened. [

Many mental health clinicians have reported in the past few months about patients who recognize in Trump the predatory behaviors that they experienced at the hands of cruel parents, domestic abusers, molesters, and rapists. They are, with good reason, deeply fearful and re-traumatized. Many people since the election are reacting in very emotional ways, evidence of this accurate primal fear of the predator.

Characteristics of Other-Blamers

Let’s take a deeper look how shame intolerance plays out in specific behaviors in Other-Blamers such as Trump.

Lacking in accountability:

Other-Blamers have very little capacity to admit fault, be remorseful, or apologize, because it would trigger shame. Other-Blamers often cannot admit they were at fault even if the facts are staring them squarely in the face.

Definitions of “sociopaths” and “narcissists” include phrases such as “lacking in remorse, guilt or empathy for the impact of their behaviors on others.” While this is a true result, the cause is  a reluctance to apologize for bad behavior, something that would trigger shame.

Unlike Harry Truman who placed a sign on his desk stating “The Buck Stops Here,” Trump appears to be completely lacking in accountability. This trait, not just his mammoth ego, is the defining characteristic that makes him fundamentally unsuited to the presidency. Balanced leaders can own their mistakes promptly and gracefully.

Trump’s long-standing pattern of refusing to settle lawsuits, even when that may be the most cost-effective or suitable response, is an example of his inability to back down in an argument. He has had numerous occasions during the campaign when there is video evidence of his statements and he will vehemently deny his comments or change the subject.

Excuses are an Other-Blamer’s default setting. Like a chess master, Other-Blamers will also set up excuses far in advance to forestall embarrassment. Trump’s premature allegations of a “rigged” election are an example of how he was afraid of a humiliating loss, so he seeded the ground with this excuse ahead of election day as a fallback position to cushion his fragile self-worth — “See, I didn’t lose. It was rigged.”

Stubbornness, “black-and-white” thinking, a tenacious refusal to accept facts:

Once an Other-Blamer states a belief, do not expect that they will change course easily. And if they do change course, do not expect them to admit that fact openly.

Other-Blamers see the world through a very narrow field of their own unshakeable perception. Facts or other viewpoints are inconvenient truths they would prefer not to acknowledge because then they might be judged as wrong and incur shame.

Once an Other-Blamer forms an opinion — say that global climate change is a hoax — they are not swayed by facts to the contrary. You may as well save your breath. The Other-Blamer is far more concerned with preventing his own psychic pain than knowing the truth about a situation.

Trump followers have a remarkable ability to believe only the “facts” that coincided with their preconceived world view. Known as confirmation bias, this is tendency to favor information that makes one feel good about oneself. This trait exists in all humans, but I contend that is much worse in Other-Blamers because of their poor shame tolerance. They desperately look outside themselves to gain facts, relationships, and experiences that do not challenge their current outlook.

Lashing out at others, excessive blame of others for problems, impulsivity:

Other-Blamers favor the “fight” response when threatened. They have learned that attacking others verbally or physically garners a submissive response from challengers. This protects the Other-Blamer from a shaming criticism or truth either now or in the future. Bluster, intimidation, and bullying are tactics they use to ensure a feeling of emotional safety.

Trump’s blatant bigotry, misogyny, and xenophobia are all versions of an Other-Blamer’s desire to lash out and affix blame elsewhere —anywhere but near the Other-Blamer. Trump’s followers love having others to blame for their lot in life. They often literally lash out at others with aggressive, confrontational behaviors.

Trump’s tendency to threaten to file lawsuits certainly fits a pattern of intimidating to get others to back down.


Because of their insecurity, Other-Blamers have a great need to appear all-knowing. This leads them to act imperiously, as if they understand every issue and know every answer. Complex or subtle issues — which are largely what a president will face — frustrate Other-Blamers who have a fear of appearing indecisive, weak, or uninformed.

They have learned that stating an opinion loudly and confidently gets others to self-censor or acquiesce.

Intolerant of dissent or criticism:

It should go without saying that a leader should be open to nuanced thinking, the opinions of others, and challenges to his or her ideas. Trump’s inability to tolerate dissent is a likely reason many of his business ventures have failed. He was afraid to hear criticisms of his ideas, so he shut down realistic feedback that might have been helpful to their success.

Trump is well-known for having difficulty handling any type of challenging question. He changes the subject in illogical ways, as evidenced throughout the debates. He deflects by name calling and personally attacking his opponent (“nasty woman”) or lashing out in personal attacks at the questioner.

To Other-Blamers, almost any question is “nasty,” because to be challenged signals a possibility of being wrong or looking uninformed— a proposition loaded with the potential for shame.

Values personal loyalty:

Other-Blamers value loyalty among close associates and surround themselves with “yes men” who do not challenge them. Trump’s heavy reliance on his family are clear signs of this. His children are on his transition team. He has even had them sit in on early diplomatic meetings, which violates diplomatic security and protocol. He wants them to serve on his White House staff, which may violate regulations against nepotism.

Trump supporters were also very loyal, despite his egregious behaviors. They were merely exhibiting the behavior that they, too, would like in their lives — to have their bad behavior tolerated by loyal and unquestioning followers.

Fear-based behavior:

Trump is notoriously thin-skinned, quick to anger, and impulsive. Author Tony Schwartz considered Trump to be “pathologically impulsive and self-centered.”

Although they are clever at hiding it, Other-Blamers are highly fearful, on guard for incoming shaming messages. They have habituated their brain to view the world as threatening and attacking. This leads them to rely on the emotional “survival brain,” not the deliberative, logical cortex. The resulting elevated “fight-or-flight” reactivity leads to shame-driven anger that is volatile and irrational. A cycle then ensues: Living in a chronic fear state leads them to view the world as more threatening than it really is (negativity bias), triggering even more fear and reactivity.

Fear is connected to anxiety-based behaviors, such as impulsivity, impetuousness, poor frustration tolerance, short attention span, and poor concentration, all of which Trump is well known for.

Approval seeking:

Lacking healthy self-acceptance and loaded with low self-worth, Other-Blamers need to gain attention and approval from others to feel good. Trump’s bragging and grandiosity are extreme and long-standing. Jane Mayer in The New Yorker noted that author Tony Schwartz “saw Trump as driven not by a pure love of dealmaking but by an insatiable hunger for ‘money, praise, and celebrity.’  … Schwartz told me that Trump’s need for attention is ‘completely compulsive.’”

The need for approval may drive Other-Blamers to form unhealthy coalitions with those who feed their need for approval. Some have surmised this is the reason for Trump’s affection for Vladimir Putin.

Emotionally healthy people do not seek the approval of others to fill an emotional void.

Lying and manipulativeness:

“‘Lying is second nature to him,’ Schwartz said. ‘More than anyone else I have ever met, Trump has the ability to convince himself that whatever he is saying at any given moment is true, or sort of true, or at least ought to be true.’”

Lying is tied both to the need to exaggerate achievements to seek approval and to the need to deflect blame and shame. They become adept at twisting their responses, avoiding direct answers, and avoiding topics, all in the service of avoiding being held accountable.

Lying is second nature to Other-Blamers because they lie to themselves constantly. To routinely shift blame to others takes extremes of self-deception.

Dominating others:

Other-Blamers attempt to dominate others to keep criticism at bay and thereby forestall feelings of inadequacy. They try to control, manipulate, or intimidate others to set up relationships with people who will be submissive and will not challenge, correct, or blame them. Trump’s well-documented behaviors of bullying, demeaning, name calling and scapegoating exemplify this. Unfortunately, a leader who surrounds himself with submissive “yes men” is hardly likely to hear a balanced range of opinions and facts.


Other-Blamers often fail to conform to social norms, will violate laws, and feel above the law. These behaviors also arise due to an inability to tolerate shame. Trump’s business dealings, allegedly fraudulent universities, and bankruptcies offer numerous examples.

Yet rather than be contrite about his bankruptcies, Trump continues to brag about them.

An inability to be self-reflective, learn, or change:

Extremely defensive Other-Blamers lack the emotional resources to feel guilt, shame, or embarrassment. These pro-social emotions were formed by evolution to help us learn from mistakes, admit fault, and change our bad behavior. Although shame feels uncomfortable to those who lack self-acceptance, that discomfort is designed to move us toward moral conduct.

Other-Blamers experience an infinity loop of psychological problems that makes it difficult for them to self-correct. They learned early in childhood to manage feelings of overwhelming shame by off-loading it to others. They cannot bear the criticism of others. Over a lifetime of refusing to acknowledge fault, Other-Blamers spiral into a severe lack of self-awareness that makes it nearly impossible to address their personality and character flaws.

Other-Blamers lack self-reflection because it might stir up feelings of inadequacy, which they avoid assiduously. If they took a good look at themselves they might find they were behaving inappropriately, which would feel shameful, so they avoid this self-awareness and accountability at all costs.

In contrast, wise leaders are very self-aware, able to hear about their faults, and learn from their mistakes.

Trump’s Effect on Our National Psychological Health

I believe that a Trump presidency is not just a political problem, but a sign of a worrying trend in our moral behavior, cultural stability, and psychological fitness as a nation. Just as Other-Blaming parents produce Other-Blaming children, we will soon have an emotionally immature president who is setting the moral and emotional tone of the country.

The fundamental problem with a Trump presidency is not merely that his uninformed, impulsive decision-making will lead to policies that will harm us. It is that his character defect of Other-Blaming will also normalize this behavior in others and encourage its full expression among those who may have been held in check by past expectations of socially accepted behavior. If the uptick in racial violence is an indicator, he has given his Other-Blaming followers a big green light to act out.

I am concerned that a Trump presidency may lead to an increase in the severity or frequency of expression of Other-Blaming behaviors, which will have a very negative effect on individual relationships and our entire society and culture. I would not be surprised if domestic violence, child abuse, and racial assaults increase.

Other-Blamers have a tremendous negative impact of the emotional health of everyone they come in contact with. Other-Blamers are the root cause of most of the relationship difficulties people experience. (Aided to some degree by the deferential behaviors of Self-Blamers and Blame Avoiders they interact with.)

Despite their toxic behavior, Other-Blamers rarely show up in therapy because of their aversion to the shaming experience of self-awareness and accountability. But they certainly are the subject of therapy quite often. As a clinical psychologist, I see the victims of Other-Blamers in my therapy office every day. The damage caused by Other-Blamers is significant, including high-conflict marriages, estranged families, inappropriate parenting, criminal behavior, substance abuse, domestic violence, child abuse, emotional abuse, and a general under-functioning in life.

Under the reign of an Other-Blamer president, fact-based civil discourse, compromise, and fair play may also suffer — as they have already been wounded by the GOP’s behavior in recent decades. It seems as if the ability to be accountable is a fading attribute today. Long gone is The Greatest Generation’s selfless sacrifice, responsibility, and humility.

Additional Causes of Other-Blaming Behavior

Trump is not the only one to blame for this concerning trend toward lack of accountability.

Much has been written about the fact-free zone that is social media and how this impacted the election. The wild west environment of social media fostered and empowered Other-Blamers. It allowed Other-Blamers to ignore facts and bully others with impunity. They banded together and gained group affirmation for saying what was once impermissible to say.

Other-Blamers are kept in check by prompt, calm, assertive boundary setting and enforcement of social norms. But without these influences, Other-Blamers grow in cohesiveness, which leads to boldness and presumption of power. Other-Blamers will take as much ground as they can get. So they need boundaries and filters, such as traditional journalism, to reign them in.

Briefly, other causes of the trend to increased Other-Blaming that must be addressed are:

  • our national deficit in emotional intelligence and psychological awareness
  • parenting that is shame-based or permissive and does not hold children accountable
  • an over-emphasis on individualism that leads to a loss of healthy national collectivism and cohesion

What Can We All Do? 

Prior to this election, most people believed a president should be a moral figurehead, as well as a political and governmental leader. His or her behavior should be representative of our highest aspirational values, beliefs, and cultural norms.

It is clear to most thoughtful people that Trump’s behavior does not reflect the highest ideals held dear by our nation.

Yet Trump is now communicating to millions that immoral behavior is acceptable.

Behaviors are a moral choice. If a politician spouts hateful, divisive, bigoted speech, then society has a right to judge that as immoral. If a politician advocates for war crimes and violation of international treaties, that should be judged as immoral. If a politician lies repeatedly and is unapologetic, that is immoral.

We must, as a country, address the behavior of Trump and his followers directly and immediately. We must refuse to be silent about Other-Blaming behavior, because silence empowers. We must not back down from this moral discussion. We must all, on a daily basis, firmly hold people accountable for their Other-Blaming behaviors — even if they become uncomfortable at this experience.

Unfortunately, now that millions of Other-Blamers have been encouraged to misbehave, it may be difficult to get that genie back in the bottle.

However, we must remember that Other-Blamers intimidate, gaslight, and shame others to get them to experience self-doubt and become submissive. We must not fall victim to this scenario.

Mental Health Professionals Must Speak Up

For several decades, in collusion with pharmaceutical companies, psychiatrists have propagated the Diagnostic and Statistical Manual (DSM) as an immutable source of truth about “mental disorders.”

They have fabricated and promoted a theory of “mental illness” based on alleged and scientifically unproven “brain disease.” Yet these supposed diseases are nothing more than emotions and thoughts that result in behaviors. (These ideas have been widely discussed in many books by authors such as Robert Whitaker and Peter Breggin, on anti-psychiatry websites, and are summarized in Self-Acceptance Psychology.)

The disease model has elevated mental health professionals into a false position of sagacity with the supposed ability to “diagnose” these imaginary “mental illnesses.” By claiming sole right to assess and diagnose those with things like “personality disorders,” it has led to the public abdicating its right and ability to judge some people as plainly behaving in inappropriate ways.

Any one of the general public is fully capable of judging whether a person’s behaviors are socially or morally acceptable. One does not need a 900-page manual and years of training to do so. As psychiatrist Matthew Goldenberg writes: “You Don’t Need a Psychiatrist to Know There Is Something Wrong With Donald Trump.”

Many people react to Trump with a natural fearful response.  Mental health professionals should not deny this accurate and intuitive reaction by refusing to discuss it. I spend much of my time in therapy sessions getting passive Self-Blamers and Blame Avoiders to accurately read and respond to their emotions and intuitions and set boundaries in relationships with Other-Blamers. I believe psychologists and others should encourage people to honor their justified threat-based reactions to Trump. Fear gives us motivation to act in our own self-protection.

There are some psychologists who believe they should not “diagnose from afar” without personally interviewing or assessing an individual. That assumes that the DSM “diagnostic categories” are some mystical code that only mental health professionals can understand. If we strip away the voodoo of Latinate names, numeric codes, and arbitrary symptom lists, anyone can look at a person’s long-term behaviors and use their intelligence, observation skills, intuition, and common sense to judge whether that person is emotionally healthy.

Trump has a 50-year public record of his behaviors, statements, and emotional reactions to assess. Based on these very obvious facts I do not believe mental health professionals — or any member of the public — should withhold judgment about his fitness for office. In fact, it could be considered immoral to be silent about them, given the possibility for harm that may result from that silence.

In the past, mental health professionals have also avoided criticizing people with these character flaws because they felt as if it was “shaming” and because the Other-Blamers would over-react. However, if we recognize that these behaviors are not a “mental disorder,” but just behavioral choices, it would be inappropriate not to address them.

I believe that mental health professionals must begin to view behaviors in some part as moral choices. Rather than continuing to label “narcissism” and “sociopathy” as “mental illnesses,” psychologists must reframe them as emotional and behavioral problems that can be managed by the individual and hold the individual accountable. Certainly we can be compassionate as to the causes of a person’s emotional difficulties, but to ignore the broad and deep implications for Other-Blaming behavior will only encourage more of the same.

This behavior has always been damaging on an individual level — and is now damaging at a national level. Dr. Alan J. Lipman has written about Trump: “He is a candidate with the potential to bring a democratic republic down with him.”

At this crucial juncture in our nation’s history, mental health professionals must speak up loudly and often. This is no longer just a political issue but an issue of safety for perhaps millions of people and for the long-term health of our planet.

People who have healthy levels of empathy and are not extreme Other-Blamers have great difficulty comprehending the motivations of these deeply troubled people. But once you understand the paradigm that an Other-Blamer has great fear of being shamed, the pattern of traits and reactive behaviors will become obvious. And the danger from Trump’s extreme Other-Blaming will also become obvious.

Remember that Other-Blamers have difficulty being empathic, compassionate, or even aware of the needs of others. Their goal in life is to avoid being shamed; they cannot be concerned about others. They are in an existential emotional struggle to protect their fragile self-image.

All his life Trump’s behavior has been extremely self-centered — meaning he will do anything in his power to avoid being blamed or shamed. In his emotional panic, he will have great difficulty considering acting in ways that serve his constituents. While Trump may not have conscious intentions to harm the country, his unstable emotional mind state, character, and personality will almost certainly lead him in that direction.

I believe we need a leader of the United States of America who is emotionally balanced, self-aware, self-accepting, and able to regulate his or her emotions so that policy choices are based not on emotional self-preservation in the moment, but on the long-term needs of the country and world.


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