Diagnosing President Putin

Russian President Vladimir Putin has maintained a form of high office for more than 20 years. Russia has a long history and social norms and practices in Russia are not the same as in the United States. Mental health issues are becoming more acceptable to discuss in the U.S. It’s difficult to know what is acceptable in Russia because the state maintains tight control over its media.

In spite of Putin’s authoritarian control over Russia, his approval rating rarely drops below 60%. This is partly because of the nature of a strongman leader. When life is in question, where it is difficult to tell right from wrong and truth from untruth, everyday people will accept leadership by a strongman who appears to have all the answers.

Putin has long had a reputation of being intelligent. This is part of the reason he is so feared. His ability to manipulate, to be insidious while appearing agreeable, results in a powerful person to reckoned with.

In 2022, President Putin is 69 years old and his mental health has come into question. Let’s be clear, there is no question that a person who takes power and maintains power in the way that Putin has done for the last 20 years already has a number of mental health concerns and most likely should have a number of diagnoses. What is disconcerting now is that Putin’s cognitive abilities may be degrading.

For a long time, people would point to Putin’s alleged strategic prowess from his days as a member of Russia’s infamous KGB as evidence of his intellect, cunning, and ability to lead. Over time, and due to the nature that someone in his position is always at risk of being assassinated, Putin’s inner circle has become smaller and smaller. As a result, Putin is surrounded by a small cadre of individuals who are essentially yesmen. They tell Putin what he wants to hear and they are willing to do what he asks of them without question. In this position, it’s no wonder that Putin has little reason to question himself or his own tactical and strategic intentions.

Putin’s overstepping into Ukraine while the majority of the rest of the world is telling him he will be punished may be a sign that Putin’s reign is coming to an end. The sanctions against Russia are hurting everyday citizens who mean no harm to anyone else. The result of the Russia-Ukraine conflict in 2022 may result in Russia becoming an outlier in the global economy, cut off from the rest of the world for all intents and purposes. This is a major loss for the Russian people and for their economy.

Putin may be moving into Ukraine now, in what seems like an attempt to rebuild the Soviet Union (USSR) in part because there is a human tendency to see the end of your life as the end of the known world. This cognitive bias causes people to make poor judgments. Putin is not going to live forever and it’s possible that because of his own personal mental health issues he has difficulty seeing beyond himself. So this begs the question, what exactly are Putin’s primary mental health issues.

Narcissistic Personality Disorder and President Putin

Narcissistic Personality Disorder (NPD) has been discussed in recent times a fair amount after much consideration was given to the possibility that U.S. President Donald Trump may have this disorder. There is a strong possibility that this is precisely the disorder afflicting President Putin. Personality disorders are notoriously difficult to treat. They require frequent therapy sessions as well as a strong will, personal focus, and determination on controlling your thoughts and actions. Many individuals who have personality disorders have found help from Dialectical behavior therapy (DBT).

DBT is a form of therapy that focuses on teaching clients how to manage their day-to-day lives using methodic scheduling, thought pattern training, and behavioral modifications. For DBT to be effective, clients need to regularly attend therapy sessions with a trained DBT therapist and be receptive to unlearning negative thoughts and behaviors so that they can function in a more positive and healthy lifestyle.

DBT was originally intended for treating those who struggle with Borderline Personality Disorder (BPD). Those with BPD tend to have extremely challenging lives that need to take life one day at a time. Years and years of taking life one day at a time is difficult and tiresome.

A difference between those with BPD and those with NPD is that those with NPD are more likely to be unapologetic for their life choices, actions, and behaviors.

Signs and Symptoms of Narcissistic Personality Disorder

Those who have Narcissistic Personality Disorder (NPD) are likely to display a number of troubling characteristics that make everyday life difficult for those who interact with them on a regular basis. NPD requires treatment in order for a person to gain perspective about how they are perceived by others and how they can make better life choices in order to be a more functional person who can contribute to society as opposed to causing harm in the lives of others.

Common signs that a person may have NPD can include:

An exaggerated sense of self-importance
Sense of entitlement
Insistence on constant admiration
Demand to be recognized as superior even if they have not attained achievement that merit admiration
Exaggerate their personal achievements
Exaggerate their talents and abilities
Preoccupation for fantasies and delusions of grandeur
- These often include dreaming about great success, gaining and sustaining power, being a genius or displays of brilliance, desire for a sexual partner who possesses unrealistic societal norms for beauty and perfection
Belief in their superiority and insistence on only engaging with those who are equally on their level
- It’s important to recognize that this is a warped perception of superiority or intellect and that these individuals do not usually merit their self-described importance leading others confused
Tendency to monopolize conversations
Tendency to belittle and look down on those who they perceive as inferior
Expect that they deserve special favors and, circumstantially, that they are “above the law”
Demand compliance from others
Have unrealistic expectations that others cannot possibly live up to
Take advantage of others and manipulate others to bend to their will and get what they want
In some instances those with NPD have difficulty or an inability to feel empathy not unlike a sociopath
Difficulty or inability to comprehend the needs of others and why others feel differently than they do
Susceptible to envy
Belief that others should envy them
Tendency towards arrogance
Often come across as conceited, boastful, pretentious
Insist on having the best across all categories
Instance that their sense is what is best is best
- This can mean that the car they drive or the watch they wear or the clothes they wear are “the best” simply because they have decided these possessions are the best based on the premise that they chose these items and they make the best choices

Those who have NPD have great difficulty with criticism. They tend to become agitated, angry and have aggressive outbursts in response to others not treating them as they wish to be treated. When a person with NPD is in a power position, they may take these measures to extremes.

A person with NPD who feels personally slighted because they are not receiving special treatment in a situation is likely to become impatient if not angry with others. They tend to have tense and fraught personal relationships and maintain relationships based on their strict personal beliefs and conditions.

Those with NPD react with rage or contempt when someone shows opposition to them or does not recognize their inflated personal beliefs of superiority. They lash out and belittle others who do not treat them as they wish to be treated. It goes without saying that these are indications of a person who has great difficulty regulating their emotions and behaviors. Dialectical behavioral therapy (DBT) may be able to help those with NPD rein in their temper and aggression towards others.

Individuals with NPD may have symptoms of depression or mood shifts in response to not fulfilling goals they set for themselves. In many instances, they are likely to blame others for the fact that they were unable to achieve these goals. If they do accept a level of personal blame this is going to feel particularly bad and they will have difficulty managing their mental health and emotional health in response to these situations which are likely to be viewed as extreme failures due to a tendency towards black and white thinking.

People who have NPD secretly are insecure. They may feel a strong sense of shame or embarrassment. They may live in fear of humiliation and often feel that they are a fraud. This vulnerability is often turned outwards as a means of self-preservation.

Treatment for Narcissistic Personality Disorder

If someone you know shows signs of having Narcissistic Personality Disorder (NPD) it is important that they enter treatment to deal with their personal issues so that they can function in everyday society without causing substantial harm to themselves and others. NPD is a destructive condition that causes strife in the lives of those who interact with individuals who struggle to comprehend and control their misguided perceptions about themselves, others, and the world at large.

A person with NPD can benefit greatly from regular treatment with a counselor who is trained in dialectical behavior therapy (DBT). Through DBT, a person with NPD can learn to move through their day-to-day lives without inflicting pain on others. DBT can help a person with NPD manage their unrealistic thoughts and distorted perceptions about how the world operates. Doing so can allow them to function in society in a way that is more rational and reasonable.

Diagnosing President Putin