Borderline Personality Disorder - Or Why Does Donald Trump Fly Into Rages So Often?

The Link Between Borderline Personality Disorder and Anger | Psychology Today

In an article today in Psychology Today, psychologist, Bernard Golden, Ph.D, explains the link between Borderline Personality Disorder (BPD) and Anger.

Although he doesn't name him, most of his article reads like a description of Donald Trump and his frequent loss of self-control and bouts of angry shouting, which characterised his term in the White House, when aids would frequently be sacked in a fit of rage because they had had the temerity to question him or hint at disagreement.

To us in Europe it often seems America was being run from the bedroom of an over-privileged, petulant adolescent that someone had given a Twitter account to and told him he runs the world, where the most bizarre things were tweeted in the small hours of the morning and the world would wake up to the latest outburst and half-baked policy announcement.

This behaviour is explained by his borderline personality disorder, as described by Dr Bernard Golden

KEY POINTS

• Borderline Personality Disorder (BPD) involves instability of self-image, relationships and emotions.
• The above symptoms contribute to a heightened sense of threat and related anger.
• A number of biosocial developmental models explain the development of borderline personality disorder.

Borderline personality disorder (BPD) is a severe and complex personality disorder associated with instability in interpersonal relations, behavior, and emotions. Emotional dysregulation is a key contributor to BPD, involving difficulties in regulating emotions in order to support an individual’s pursuit of goals and behaving effectively in a variety of contexts.

Anger and aggression are key features associated with BPD — most often related to fears of abandonment, unstable relationships, an unstable self-image, emotional instability, and chronic feelings of emptiness. As such anger may be sudden, intense and difficult to calm down. When more intense, it is often described as “borderline rage”.

[…]

The symptoms of borderline personality most often first appear during teenage years and early twenties[. I] worked with one young man early in my practice who clearly articulated the impact of “feeling empty”. On one occasion he stated, “How am I supposed to know what career I wish to pursue? I have no idea what I like. I don’t know who I am!” Another client reported getting drunk on weekends and seeking to have a physical altercation. It was as if this gave him some meaning against a blank slate presented by the weekend.

Bout's of uncontrollable rage can be triggered by feeling criticized, slighted or rejected, increasing the person's fear of abandonment or rejection and this can be heightened by stress leading to a heightened sense of threat.

Trumps notorious incompetence, as shown by his inept response to the COVID-19 pandemic, must have added to his stress as he struggled to cope with something he didn't understand while posturing as an expert on the subject, and just looking more foolish in the process. But maybe his self-evident lack of self-awareness protected him to some extent, though it’s hard to believe he didn't realise deep down how he wasn't coping.

"What's terrifying isn't Trump telling people to inject bleach – it's people refusing to tell the president he's wrong"

Tom Peck, The Independent

He didn't understand the science but, due to his narcissism, he refused to accept that others knew better than he did how to deal with the crisis. His response was to abuse and vilify those who tried to give him the advice they were paid to give him and to encourage others to ignore the measures to mitigate the pandemic they were recommending.

The result was a COVID-19 death rate that far exceeded that of third-world economies, while Trump insisted it was a mild disease that would soon be over, after first dismissing it as a hoax, then catching it himself and ending up in ICU on a ventilator because he had politicized it to the extent that face-mask wearing in the White House spelled the end of a career and his election rallies became super-spreader events.

The causes of his BPD can be understood when considering Trump's childhood. As Dr Golding explains in general terms:

There are a number of biosocial developmental models regarding the development of borderline personality disorder. These emphasize developing in an environment that is invalidating and having adverse childhood experiences in combination with genetically linked vulnerabilities. Specifically, these might include impulsivity and emotional instability.

Some of these theories highlight specific areas of functioning as providing an understanding of emotional triggering for individuals with BPD. Some focus on emotional regulation. Others focus on cognitive aspects, including cognitive-emotional patterns that cause those with BPD to have greater expectations of rejection than those without BPD (Cavicchioli and Maffer, 2019).

In one study of individuals with BPD, it was found that half of the group also had suffered from two or more anxiety disorders (Quenneville, Kalogeropoulou, Lise-Kung, et. al., 2019). Additionally, greater childhood mistreatment was associated with greater severity of illness, impulsivity and trait anger.

Some researchers have found that those with BPD exhibit a negative bias in decoding social cues (Kleindienst, Hauschild, Liebke, et. al., 2019) They found that those who exhibited more chronic symptoms of BPD were more likely to assess happy facial expressions as being less happy than those without BPD.

Exploring the neuroscience of BPD, one group of researchers has found through magnetic resonance scanning with males, that those with BPD showed less activation of the prefrontal area of the brain during the viewing of happy and angry faces (Bertsch, Krauch, Roelofs, et. al., 2019). Additionally, they found that reduced functioning of this area of the brain was associated with impaired emotional control and with greater acting out of anger.

[…]

One study found that anger rumination was greater for those with BPD when compared to a healthier population (Oliva, Ferracini, Amoia, et. al., 2023). Anger rumination has been found to be positively associated with anger feelings and aggressive/impulsive behaviors.

Since these seem to be more descriptive of adolescent or immature personality types, one might expect Trump to have grown out of them, or at least learned to control his emotions, however:

For some disorders, symptoms tend to remit as an individual ages. While this may be true in general, one study of BPD found that, while younger adults with BPD were more likely to have emotional dysregulation, be impulsive, aggressive and self-injurious and have intense feelings of emptiness, older patients were still impaired primarily with regard to impulsiveness, emotional regulation and social functioning (Martino, Gammino, Sanza, et. al., 2020).

If opinion polls are correct, it looks as though America is about to inflict on itself a president who is clinically insane and unfit for public office, and the world can watch as American democracy commits suicide at the behest of far-right extremists in bed with evangelical Christian frauds, who are waiting in the wings for an opportunity to take over. Whilst pretending to be patriotic, they would like nothing more than the collapse of American democracy and government by an autocratic despot under their unaccountable control because they feel entitled to it and are fed up with the American people not agreeing with them.

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