Imaging Trump's Brain

04/01/2016 03:33 pm ET Updated Apr 02, 2017

When Donald Trump said he went to a "good school" I was flattered, because that's where I teach. When he said he has a "good brain" it got me thinking. What would modern brain science say is going on in there?

I'm not a psychiatrist but if I were I wouldn't be allowed to speculate about that. Ever since 1964 when hundreds of shrinks embarrassed themselves by telling a magazine that Barry Goldwater was crazy they've pretty much respected the "Goldwater rule" against long-distance diagnosis.

I'm not a psychologist either, but psychologists haven't been nearly so reserved about making judgments concerning Mr. Trump's mental state. Many have publicly concluded that he has narcissistic personality disorder, which is a mental illness. The afflicted have an inflated sense of self-importance and lack of empathy. The treatment is psychotherapy.

If you're not sure that this diagnosis applies to Mr. Trump consider one of the items on the widely used Narcissistic Personality Inventory: "The thought of ruling the world (a) frightens the hell out of me or (b) If I ruled the world it would be a better place."

Case closed.

But still I wondered what the brain scientists would say. One of their tools is functional magnetic resonance imaging (fMRI), basically a big clanking magnet that tracks oxygenated blood as it moves around in the brain. Now imagine we put Mr. Trump in an fMRI device that can show what parts of the brain are most active when he's thinking about himself or looking at pictures of himself. The second part of the experiment is what he enjoys most so that wouldn't be hard to arrange, but getting him to lie very still in the machine would be tough. If we could what would be the most active parts of his brain?

In 2014 a group of neuroscientists from the University of Pennsylvania (the "good school" Mr. Trump referred to), and the University of Michigan (also a pretty good school), reported some surprising findings. They found that narcissism was significantly associated with activity in a network of brain areas associated with social pain while being excluded from a game. (For the wonks, those areas are the anterior insula, dorsal anterior cingulate cortex and subgenual anterior cingulate cortex.) The scientists said that "narcissistic individuals might appear to be mentally healthy and socially nonchalant on the surface, but in reality, the trait is also associated with being socially needy and defensive." Evidently frequent Twitter blasts are one way of staying in the game.

When these brain regions are active people also make a lot of dopamine, which is associated with stress. Mr. Trump might want to keep track of that. Although his doctor assured us that if elected he "would be the healthiest individual ever elected to the presidency," those stress-related chemicals can do a lot of damage later in life.

Real narcissists aren't like you and me. In another experiment scientists found that if you zapped most people's brains while they were looking at their own picture they wouldn't recognize themselves. That didn't work with the narcissists, who had no trouble recognizing themselves.

But there's hope for narcissists. Other experiments have shown that if you send a tiny electrical pulse to just the right region you can change attitudes and perceptions, at least for a while. It would be interesting to see what Mr. Trump would be like if the narcissism neurons were dialed down.

Of course people may be more or less narcissistic and in many ways they can be very successful, like Mr. Trump likes to remind us he is. No doubt some degree of grandiosity is required to make a serious run for President of the United States. It takes a good dose of self-love to think one is qualified to have access to the nuclear codes. The trouble starts when those with the disorder drag others into their universe. They are often powerful personalities with exaggerated goals of perfection, entitlement, a lack of boundaries and the feeling that they are not accountable for their actions. Emotional entanglement with them can be dangerous.

Or maybe we should consult a brain surgeon. Dr. Ben Carson assured us that there are two Donald Trumps.

But multiple personality disorder is a whole other diagnosis.