There is something peculiar about psychiatric terminology. So, for example, we have “attention deficit disorder” and “narcissistic personality disorder” as common diagnosis. But, the defining characteristic of ADD is that the patient pays a surfeit of attention to too many things. There is no deficit. Similarly, the narcissistic personality is not disordered. Indeed, the behavior of the narcissist is constant, habitual and, ipso facto predictable.

So, what accounts for the perverse terminology? I suspect it is a consequence of failing to maintain the distinction between the perspective of the observer and the experience of the observed. “Disorder” does not actually refer to regular, predictable behavior. Rather is reflects the perception of the observer that behavior is not “normal,” not what is expected. Which suggests that most of psychiatry and psychology is fixed on identifying or categorizing what the practitioners observe, rather than assisting the patient looking for help.

These thoughts were prompted by another interview with Michael Cohen who’s written another book about Trump and managed to accurately “predict” how Trump would respond to events. Cohen explained that its easy because the narcissist’s behavior is always the same.

Interestingly, the interviewer wanted to know why it took Cohen so long to “come to his senses.” The answer to that is simple; our brains are programmed to register difference and change. We do not notice the routine. Indeed, I’d argue that Trump’s schtick is mesmerizing. Cohen said that the routine of prison had woken him.

Trump’s wardrobe reminds me of nothing so much as the uniforms we wore at school and sometimes changed out for gym clothes.