The Dire Dangers of Narcissism
Though I’m professionally distant from today’s media luminaries, I have a particular personal interest in the current narcissistic spectacle du jour: I went to college and was friends with Harvey Weinstein nearly a half a century ago.
With an admixture of feelings, I watch the scandal unfold. I’m horrified and angry at what Weinstein is charged with perpetrating. I’m confused and saddened by my former friend’s behavior. Yet, I’m not surprised, given what I remember about Harvey when we were students. That’s not to say I could have predicted this. I don’t identify with interviewees solicited by journalists to tell what they knew of ignominious scoundrels before they committed their heinous acts. Harvey Weinstein—from first impression of him being grandiose, sycophantic, and magnanimously generous to the progression of his unstable and rampant ambition—was intense, needy, insecure, ingratiating, and over-the-top in his endeavors.
I’m not invested in justifying or scourging Harvey. He’ll get whatever the consequences of his actions bring—spiritually and legally. I feel sorry for him, but ever more sorry for, and indignant about, the victims he is accused of abusing, exploiting, bullying, and oppressing. Such injustice must be vindicated—but that is not up to me. As a psychologist, my goal is to unravel and shed light upon the inner forces that develop into disastrous behavior. Since I consorted with Harvey and knew him well decades ago, I want to lay bare the seminal roots of an accused tyrant before he became one.
As a psychologist, I have something to contribute by explaining the wily dangers of narcissism, thus allowing potential victims to be informed and better protected. As an American citizen, I am alarmed and wary about the course and future of our country, our people and our principles. As a father, husband, and person with strengths and weaknesses who is desirous of healthy relationships, I, too, am vulnerable. Narcissism is an insidious monster, born of a needy and unstable ego that lurks for years, nursing its perceived wounds, until it explodes in aggressive and blind perpetrations. A healthy self-image must be nurtured. It can be achieved by hard work that includes the basis for self-respect and the practice of respect for others. Though the development of narcissism is neither predictable nor clearly delineated, certain factors may contribute to a self-aggrandizing ego and overbearing sense of entitlement:
- a “silver-spoon” upbringing, where material things and excessively indulgent opportunities became integral elements in the family culture;
- exposure to a series of traumas and humiliations;
- use of embarrassment to modify childhood misbehavior;
- employing self-flagellation to cope with insecurity; or simply
- relying on an escapist fantasy and the transformative illusion of becoming a legend and hero in one’s mirror.
Though we may recoil from the exaggerated hubris of the narcissist, we should also be respectful and thankful for not traveling along such an isolating and destructive path. As my mother often said: “There, but for the grace of God, go I.” To live a life of worthiness and honor, one must embrace gratitude and humility.
What Happened to You, Harvey Weinstein?
Do you remember me, Harvey? I know you’ve got a lot on your mind these days; but I’ll bet that if you heard my name, you’d say, “Mark… how the hell are you doing?” We go back a long way, Harvey, to some wild days at the University of Buffalo.
Remember the crowd? Janis Siegel (affectionately called Pumpkin), who went on to acclaim as a singer with Manhattan Transfer. And the creative and iconic Jay Beckenstein, jazz saxophonist with Spyrogyra.
Remember those all-nighters, the 4:00 AM greasy burgers at Your Host Restaurant? The anguished, drugged-out rants and discussions about the universe, who we were, and where we were going?
We grew up and went out in the world to different places. You were amazing, Harvey: intense, sycophantic, driven, disturbed, and needy. I identified with you—Jewish kids from New York, arrived in a blue collar city, ready to take over and show how much we knew and how things should be done.
You floundered, and then soared. It wasn’t long before you traded academics for an entrepreneurial path, on your way to becoming a juggernaut. You founded Harvey & Corky Productions, bringing big-name musical talent to downtown Buffalo. You soon rubbed shoulders with the top names and icons of our generation. It must have been intoxicating, far beyond the drugs that most used to reach for peace and imagined self-importance.
Throughout the years, I watched your movies and cheered you on. There goes Harvey Weinstein—I knew him in college; we were friends. I envied your success. From my intimate knowledge of your personality, I suspected that you were not happy or fulfilled. How could you be, never filling the immense void within you with something other than riches and accolades? Not to diminish your sweeping achievements. But you were so needy and insecure. How could anything the world had to offer be enough?
I wrote to you fifteen years ago, hoping to reconnect. But I never got a response.
Apparently, you tried to fill your deep inner void with surreptitious trysts, using your money and influence to sway and dominate young women—impressionable and aspiring beauties you used for your lustful and egotistical purposes. You used your money, power, and influence to lord it over people, to take advantage of them, and to coerce their silence. The chickens have come home to roost; the truth will not be hidden; you are exposed and in trouble.
It’s not for me to judge you Harvey. I just want to tell you something about women and men and power and accountability.
Females are not immune from deceit, hypocrisy, and the fleshly litany of sins. But females are to be protected and respected. They are “weaker” in some sense, but immensely more powerful than men in many respects. Our society inherently imposes on women mixed messages, psychological traumas, economic discrimination, and often the raw end of many deals. Our culture exalts and worships physical appeal, but quickly disregards and discards worthwhile human beings when their outward beauty fades. Ironically, we exalt and worship physical beauty, and yet we exploit it. The fleeting blooms of pulchritude and stardom leave women vulnerable and with undeserved dismissal or ostracism. Too many men strut their machismo, stricken with envy (and with the fantasy) that a woman can have sex any time she wants (whereas many men have to feel they must lure or seduce). Unfortunately, some men act out of this context to take advantage and force or exploit women. When the playing field becomes overly imbalanced, many women either withdraw into resentful passive aggressiveness—avoiding or manipulating intimacy—or act out with hostile projection—rejecting men or typecasting them as insensitive and only interested in exploitative sex. Though there’s plenty of blame to spread around, men bear the burden—historically, we have been at fault by dominating women and isolating them from full and equal participation in society.
With your overarching success, Harvey, you now have trouble (tsouris, in Yiddish) on a grand scale. My heart aches for you, and I pray for you.
I have some advice for you, Harvey, my dear old friend: it’s time for you to make amends, to acknowledge your wrongdoing, to seek forgiveness, and to make restitution—no holds barred. I know you must now resort to posturing for strategic legal reasons, but you are going to sacrifice a lot of money to pay for your mistakes. You can no longer “buy” people (and certainly not their silence). You will feel alone, and will be alone. You will have to give up the pretenses you have long abused to fill the abyss and mollify the gargantuan ego that hides the empty Harvey Weinstein.
Yet, there is someone valuable, tender, sensitive, worthwhile inside the blustering and offensive Harvey. This is an opportunity to find out who you really are, to change the offensiveness, and to develop into an honorable person.
God has used you, Harvey, and he is not done yet. Through these scandals, he is using you writ large to teach others; and he is bringing you to your knees in the hope that you will stay there and begin to acknowledge and worship him.
Truer riches await you, my friend, if you will only repent and ask for divine forgiveness and guidance. You must also seek forgiveness from the people you hurt, so many of them. It’s time to be open, sincere, and humble. You must unequivocally repent.
Years ago, you founded a big company—Miramax—named after your parents, Max and Miriam Weinstein. What would they think of their son now? I never knew Max or Miriam, but I am sure they always loved you. Why, Harvey, has it been so difficult for you to feel love?
The Harvey Weinstein I knew nearly half a century ago could never relax. He always had to prove something, to get more and show more. You were an intense and difficult person. But you were likable, Harvey, and you didn’t have to try so hard.
The term narcissism is taken from Greek mythology. Narcissus was the son of the river god Cephissus and nymph Liriope. He was proud, in that he disdained those who loved him. He was drawn to a pool, where he saw his own reflection in the water and fell in love with it (himself), not realizing it was merely an image.
Today, narcissism is a psychiatric diagnosis and considered a mental disorder. It is also often used disparagingly in common parlance and description. Narcissism involves extreme selfishness, with a grandiose view of one’s own talents and a craving for admiration, and has come to characterize a personality type. Narcissists think extremely highly of themselves and are often driven to seek validation of their worthiness and inflated self-opinion by soliciting and even demanding the approval of others. They delude themselves that their boorish machinations and manipulations of others testify to their own self-worth. Though they may be capable of compassion and empathy, narcissists are so preoccupied with their own selfish interests and with validating themselves that they typically ignore or do not consider or recognize others’ needs, even the people closest to them.
Narcissists’ classic “me-first” posture often leads them to resort to aggressive acts that allow them to dominate or “win,” regardless of the costs. They love and need to be the center of attention, often usurping the limelight, dominating conversations, and controlling situations and people to serve their own ends.
It is when they are challenged or confronted with reality that the true pathological character of narcissists flagrantly emerges. Narcissists’ fragile self-image and ego structure do not allow them to acknowledge the egregious nature of their self-importance. Thus, is it is rare for them to apologize or admit wrongdoing. Remorse and repentance for their offensive actions almost never occurs (think Trump).
Thus, narcissists often have a problem with reality-testing; that is, they can only perceive events and circumstances from the same perspective as others when such “reality” supports and buttresses themselves in a positive and flattering light. Unfortunately, this infrequently happens. Instead narcissists twist and distort reality to suit their own views, inevitably causing confusion, alienation, and damage to relationships and the integrity and well-being of others. They constantly use people in devious ways, and invariably deny their motives and the unpleasant effects upon others. Narcissists have confounding and appalling obsession to blame others for what they themselves have done. A psychological term for this is projection. This is denial at its craftiest, and it is infuriating (again, think Trump).
When dealing with and referring to people who thought too highly of themselves, a dear friend of mine use to quip. “I’d like to buy you for what you’re really worth, and sell you for what you think you’re worth.”
We can shake our heads in disbelief or disgust at narcissism, and we can mock this condition with humor. However, don’t underestimate the dire danger of narcissism as the disorder affects all those who come into contact with the narcissist. Narcissists cannot have good relationships because they view others as opportunities to validate and gratify themselves. In psychoanalytic terms, they have poorly developed object relations. In plain language, this means that they cannot separate and distinguish between themselves and the legitimate perceptions, opinions, values, desires, and needs of others. What others experience (including hurt or neglect perpetrated by the narcissist) is blocked by the arrogant, center-stage prominence of the narcissist’s own needs.
Dealing With Narcissists
Because narcissists live in a bubble of self-absorption and denial, it’s very hard to break through their manipulations and defenses. Normal people (allowing for differences among individuals) have varying abilities to admit mistakes, acknowledge wrongdoing, apologize with sincerity, recognize their flaws and trespasses along with the negative impact upon others, and modify their behaviors to minimize the negative effects of selfishness. Not so with narcissists, as this is the core of their personality disorder.
It may be helpful to review the following guidelines in dealing with people you suspect of narcissism:
Expect self-centeredness and reality distortion
Because narcissists’ self-absorbed attitudes and responses are often provocative, it’s tempting to react with consternation, indignation, umbrage, and the like. However, if you keep your dismay and outrage to yourself, you’ll be in a better position to question the behaviors with a strategy of setting limits. Instead of expressing your emotional reactions to narcissistic self-centeredness, practice the strategies listed below.
Refrain from demonstrative emotional reactions
Tie responses to facts, evidence, and questions
When faced with narcissists’ bold claims, quietly question the bases for such statements. Or, just ignore them. For example, someone may proudly announce, “These people don’t know how to drive. I happen to be one of the best drivers on the road.” You could say, “ I guess so. But there is the issue of your three moving violations and numerous parking tickets.” Or, you could just let it go, and smirk to yourself.
Sometimes, simply questioning the basis for outrageous statements is enough to slow down the narcissist’s bluster. Remember Trump’s tirades about how he “knows more about Isis than any general in the military,” and his defiant complaint that he is “the victim of the greatest witch hunt in history”? There is no shutting down such an ego. However, one might ask, “Where did you acquire your military knowledge, and why were you not consulted and solicited before you became president?”
“Please give us some details about the other witch hunts against which you compare your own alleged persecution.”
And don’t expect an intelligent and coherent response to your questions!
Preface accountability and confrontations with acknowledgment and legitimate praise
Narcissists perceive questions, challenges, and alternate opinions—even facts—as threats to and defamation of their integrity. Therefore, it’s helpful to preface and intersperse your messages of accountability with reasonable and relevant praise toward the person whom you’re trying to get to really listen to you. Even appealing to their putative sense of discernment and justice may get you farther along on your attempts to bring reality into the conversation.
When I deal with pie-in-the sky people who live inside dreams inflated by their own sense of self-worth and entitlement, I find it prudent to ask, “I understand that, given your abilities and track record (?!), you expect this to work out as you’ve favorably planned…, but because you are smart, have you formulated an alternative scenario and plan?”
Set boundaries and repeat if-then consequences as they pertain to the narcissist’s behaviors
Inevitably, narcissists repeatedly step on the toes of others. Their transgressions may be verbal and/or they may take vindictive actions (hello again, Mr. Trump). Their self-aggrandizement can make it hard to keep a straight face; or, their attitude of entitlement may carry implicit threats for noncompliance or resistance. (Harvey Weinstein got away with his egregious behavior in large part due to his political and economic influence, much of which he wielded against much less powerful women. When he ultimately confronted a woman who was formidable and courageous, she pulled the plug, and the dirty slimy water that had accumulated in the bathtub over the decades slurped down the drain. Harvey was left sitting naked and shivering in his own filth.)
Granted, it’s not for individuals to take on the President of the United States. But the collective violations and outrage are propelling Trump to his comeuppance. Kudos to the brave people who have spoken the truth and challenged Trump, even at risk to their own reputations and careers! That takes integrity, confidence, and courage!
And Harvey? My old friend, your bullying and predation have ironically transformed the zeitgeist. Your secret life of lust, aggression, and intimidation now exposed has caused trauma and harm—shame on you! However, the notoriety has caused a groundswell of indignation, objection, and cries for justice. You have become the agent of change, long overdue.
The message is clear: If you abuse or intimidate women, it will come to light and you will pay.
Solicit commitments, promises, and contracts in writing
Remember that, as part of their sense of entitlement, narcissists do not hesitate to change the rules—including their agreements, commitments, promises, and respect for others’ needs—when it suits their purposes. Therefore, it’s wise to make a habit of solidifying commitments and promises in writing, with dates and signatures if possible. Though the self-entitled may scoff and sneer at such requests, pretend you are prone to mistaking the details, since your memory might not be as good as theirs (!) and remind them of the pithy saying, Black and white on paper is a lot clearer than the gray matter of the brain.
In other words, play dumb, like a fox. The narcissist may pity you and indulge you.
At the very least, keep your own meticulous records with details of words, actions, and dates. E-mails and texts establish a continual, accessible, and practical audit trail, useful for holding the narcissist accountable, especially when deception and conflict arise.
Be prepared for breaches of trust, intimacy, and fidelity
Precautions and attentiveness notwithstanding, you cannot change the basic flawed character of the narcissist. That’s not to say that people don’t change. Life experience, traumas, pain, and consequences are all great teachers. They even teach to the seemingly robust and impregnable bravado of narcissists (and, at best, it takes awhile). In his own way and with his own timing, God chips away at the lives and consciences of the foolish and hurtful. At his own discretion, he causes miracles to happen.
But the very nature of narcissism attacks trust, empathy, and consideration. Don’t be surprised when the narcissist (repeatedly) violates boundaries, flaunts rules, and sabotages trust, intimacy, and even your own faith. Remain loving, but be cautious and be prepared. Your sensitivity and good intentions are no match for the power of narcissism. Engaging in an argument or a major adversarial battle with a narcissist can be akin to stepping into the ring with a mixed martial arts fighter. No holds are bared. Be prepared for the unexpected. Be on guard. Protect yourself at all times. Expect hyperbole, manipulated facts, concocted falsehoods, inconsistencies, and outrageous lies. It’s all part of the package.
Narcissism’s Dire Consequences
Donald Trump and Harvey Weinstein are but two notorious narcissistic icons—caricatures writ large in a field of opportunism. Their transgressions leave us aghast, wondering how such egregious behavior could have escalated and continued.
Surely, someone like Weinstein, if indicted and convicted of a crime or crimes in a court of law, must be thwarted and punished. Trump is a much more complex matter involving political and constitutional issues that are still in the process of unfolding. However, the important take-home message is that there are many like them—young, old, male, female, prominent, less significant—who foist their attitudes and perpetrations upon the unsuspecting and vulnerable, the psychologically and experientially less sophisticated, and those with fewer defenses and resources.
Narcissists may be overtly offensive, or they may be furtive and wily—sheep in wolves’ clothing. In a culture that has inveterately promoted self-centeredness and a “me-first” value system, narcissists may seem to embody the cultural virtues, to blend in and prevail over the competition. But you will recognize them by their intransigence and lack of compassion for the basic welfare and psychological well-being of others. As legends in their own mirrors (or pools, as with the Greek Narcissus), they deem themselves the only ones who matter.
As a society, we should focus attention on identifying, dissuading, and modifying the development of narcissistic character. Respect for women—pervasive societal, legal, accommodating respect—is surely a good place to start. We are beginning to painfully learn those lessons.
But the battle against misogyny is not enough. Parents must teach their children that the world does not “owe” them. The government should provide more than minimal education and health care—service, schooling, and training that focuses on character development and resources for the ravages of character failure, including disorders of emotional bonding, anxiety, depression, trauma, and the depredations of addiction.
We need to return to God, individually and collectively. Each of us determines our own personal relationship with or abandonment of our Creator. Religion should not be forced. But spiritual living should be foundational and institutionally encouraged. The development of the soul and its conscience and compassion is incompatible with the “me-first” ethos that culturally reinforces narcissism.
When tragedy strikes, we become voracious Monday morning quarterbacks. We scrutinize the history of assassins and predators, looking for clues that should have exposed them earlier. However, social autopsies on misfits will not relieve us of the larger problem, nor will those efforts alone avert the perverse development of unhealthy, megalomaniac egos.
We must become a society, through and through, that values humility and teaches people, rank and file, to put others first. Against such a social norm, the Trumps and Weinsteins will identify themselves early as faulty people who need discipline, correction, and guidance to develop true and healthy self-love.
Narcissism may never be eliminated, for we are a prideful and sinful species. With regard to selfish insensitivity, some are given to robust excess, even to the point of outright cruelty. Recoil as we might from Trump and Weinstein, we should learn that we need to expose them earlier in order to prevent the devastating potential of narcissism from exerting its will.
Farewell to the Harvey I Knew
We can’t live in the past. The Harvey Weinstein I knew nearly a half century ago has gone his own way, as have I.
In college, you looked up to me, Harvey. In your desperate neediness, you couldn’t see through my pretense, my needing to appear hip and avant-garde. If I’d had your talents, Harvey, perhaps I would have gone much farther astray than I did. Money and fame eluded me, but I guess I was luckier than you. And life did not let me get away with what, in my insouciant arrogance and ambition, I secretly wanted to.
If we could have coffee, I’d share with you some of the ordeals that happened in my life, what I’ve learned and about the people who taught me. Despite many setbacks and traumas, I’ve been fortunate. I have loved and been loved. Women have been great teachers to me, some intimate, some maternal, and many have been platonic, wonderful influences. I have learned to respect women and to not take advantage of them. Except for my wife, I regard them as sisters, mothers, and daughters. I treat them with biblically directed protection, respect, and deference. I joke (respectfully) about the differences between men and women. I note with professional acumen the stereotypes that frequently characterize the brains and demeanors of the two sexes. I’ve written a book about this, too, aimed at improving harmony and satisfaction in marriage relationships.
With maturity, I have more confidence and less need to prove myself or be the center of attention. I’m more able to appreciate the difficulties women have in a male-dominated world. I’m grounded enough to speak up and to model for males how to respect, value, protect, and share equally with females.
With God’s help and the stringent sanctions of many people who knocked me off my self-constructed pedestal and put me in a proper place, I’ve tamed most of my narcissistic tendencies.
The Harvey Weinstein I knew has grown and devolved. Farewell naïve and callow college buddy. I still recognize you, Harvey; beneath the atrocities, there is a boy, now a man, desperate for satisfying love. I hope this is God’s way of teaching you how to find it.
— Mark Steinberg, Ph.D.
“What we are going to have to decide as a caucus is: What is the best thing for the country?” Representative Adam B. Schiff, the chairman of the House Intelligence Committee, said on ABC’s “This Week.” “Is the best thing for the country to
- take up an impeachment proceeding because to do otherwise sends a message that this conduct is somehow compatible with office? Or is it in the best interest of the country
- not to take up an impeachment that we know will not be successful in the Senate?”
.. And even as the president and his allies trumpeted their vindication — “I have never been happier or more content,” Mr. Trump wrote on Twitter on Sunday morning — they also lashed out at their perceived enemies.
“The Trump Haters and Angry Democrats who wrote the Mueller Report were devastated by the No Collusion finding!” Mr. Trump wrote on Twitter, less than two hours after wishing the country a happy Easter. “Nothing but a total ‘hit job’ which should never have been allowed to start in the first place!”
They also singled out the testimony of certain aides who testified before Mr. Mueller’s team and conservative lawmakers who criticized Mr. Trump’s behavior as outlined in the report.
On Saturday night, Mr. Trump, ostensibly in response to a scathing statement from Senator Mitt Romney, Republican of Utah, shared a video mocking Mr. Romney’s unsuccessful presidential run in 2012.
Mr. Giuliani added to the criticism of the Utah senator, calling Mr. Romney a “hypocrite” for his statement. Mr. Romney had said he was “sickened at the extent and pervasiveness of dishonesty and misdirection” from administration officials, “including the president.”
Bear in mind that Extreme Narcissists always need to prove that they are “winners” in comparison to other people they view as “losers,” though their methods vary.
The Know-It-All Narcissist
This person is always eager to give her opinion, even when unsolicited, and believes she knows more than anyone else, no matter the topic under conversation. She likes to lecture, and she has a hard time listening because she’s too busy thinking about what she wants to say next.
.. Be open to her views without necessarily endorsing them. It also helps to have a sense of humor. If you’re not triggered by her superior or condescending manner, you might find the Know-It-All Narcissist a bit absurd and ultimately harmless.
The Grandiose Narcissist
This type more clearly demonstrates a familiar kind of narcissism we all recognize: He sees himself as more important, and more influential, than everyone else. He touts his own accomplishments, exaggerates their importance, and wants to elicit your envy or admiration. He believes he is destined for great things. When charismatic and driven, his achievements may actually match his ambition and you may find yourself drawn into an admiring orbit around him.
- How to Cope: His assertions of superiority might make you want to stand up for yourself and compete. Don’t. Any challenge will only cause him to escalate his efforts to appear superior. On the other hand, you may find yourself drawn to a Grandiose Narcissist with charisma because you want to share in his superiority. He might strike you as a sort of celebrity, a person you’d like to submit to and serve. Be careful not to give too much: The Grandiose Narcissist won’t feel grateful and will do nothing to help you unless there’s something in it for him. If necessary, he will discard you without a second thought.
The Seductive Narcissist
Unlike the other types of Extreme Narcissist discussed here, this one manipulates you by making you feel good about yourself. At first, she will appear to admire or even idealize you, but her ultimate goal is to make you feel the same way about her so she can use you. She wants your support and admiration and will flatter you in order to get it. But when she has no further use for you, she’ll give you the cold shoulder.
- How to Cope: It helps to be humble. Don’t be swayed by flattery or excessive admiration, as wonderful as it may feel to receive it. Watch how she treats other people who may be her rivals or cast-offs. Seeing them suffer under her callous indifference might give you a glimpse into your own future, once you’ve outlived your usefulness.
The Bullying Narcissist
This is the man who builds himself up by humiliating other people. Though he may share common traits with the Grandiose or Know-it-All Narcissist, he is more brutal about the way he asserts his superiority. He often relies on contempt to make others feel like losers, proving himself a winner in the process. He will belittle and mock you, and when he needs something from you, he may become threatening. At his most toxic, he will make you doubt yourself and your value as a human being.
- How to Cope: As cowardly as this may sound, the best thing to do is avoid ruffling his massive ego. Don’t fight back in obvious ways to stand up for yourself: A direct challenge will only escalate his assault on your personality. In the face of his attacks, you’ll need a very strong belief in your own self-worth, without having to prove it, and if you find you can’t bear such treatment in silence, you might want to put as much distance between you two as you can manage.
The Vindictive Narcissist
While it’s possible to co-exist with a Bullying Narcissist, provided you don’t pose too obvious a threat, once you become the target of a Vindictive Narcissist, she will try to destroy you. You may have challenged her superior status in some way you don’t even recognize, and as a result, she needs to prove you the ultimate loser by destroying you. She’ll talk trash about you to friends and family. She might try to get you fired. If she is your ex-wife, she might try to turn your children against you and spend years tying you up in family court.
- How to Cope: Whenever possible, distance yourself before the damage to your psyche and your reputation has gone too far. More so than with the other types of Extreme Narcissist, your approach here must be legalistic: Vindictive Narcissists often know how to disguise their true nature from people other than their victims, so your survival will depend upon having hard evidence. Preserve everything, especially toxic emails, texts, and other communication. Get witness statements from any friends who may have been spectators to the behavior. If necessary, hire a lawyer.
First, people who go into the White House to have a meeting with President Trump usually leave pleasantly surprised. They find that Trump is not the raving madman they expected from his tweetstorms or the media coverage. They generally say that he is affable, if repetitive. He runs a normal, good meeting and seems well-informed enough to get by.
Second, people who work in the Trump administration have wildly divergent views about their boss. Some think he is a deranged child, as Michael Wolff reported. But some think he is merely a distraction they can work around. Some think he is strange, but not impossible. Some genuinely admire Trump. Many filter out his crazy stuff and pretend it doesn’t exist.
.. Third, the White House is getting more professional. Imagine if Trump didn’t tweet. The craziness of the past weeks would be out of the way, and we’d see a White House that is briskly pursuing its goals
.. there are two White Houses. There’s the Potemkin White House, which we tend to focus on: Trump berserk in front of the TV, the lawyers working the Russian investigation and the press operation.
Then there is the Invisible White House that you never hear about, which is getting more effective at managing around the distracted boss.
.. The anti-Trump movement suffers from insularity. Most of the people who detest Trump don’t know anybody who works with him or supports him.
.. gets viewers addicted to daily doses of righteous contempt and delicious vindication.
.. The movement also suffers from lowbrowism. Fox News pioneered modern lowbrowism... “For Wolff’s book, the truth seems almost a secondary concern to what really matters: engagement.”.. In every war, nations come to resemble their enemies, so I suppose it’s normal that the anti-Trump movement would come to resemble the pro-Trump movement.. It’s a struggle over what rules we’re going to play by after Trump. Are we all going to descend permanently into the Trump standard of acceptable behavior?.. There’s a hierarchy of excellence in every sphere. There’s a huge difference between William F. Buckley and Sean Hannity, between the reporters at this newspaper and a rumor-spreader. Part of this struggle is to maintain those distinctions, not to contribute to their evisceration.
The Sackler dynasty’s ruthless marketing of painkillers has generated billions of dollars—and millions of addicts.
An addiction specialist said that the Sacklers’ firm, Purdue Pharma, bears the “lion’s share” of the blame for the opioid crisis.
.. The Brooklyn-born brothers Arthur, Mortimer, and Raymond Sackler, all physicians, donated lavishly during their lifetimes to an astounding range of institutions, many of which today bear the family name: the Sackler Gallery, in Washington; the Sackler Museum, at Harvard; the Sackler Center for Arts Education, at the Guggenheim; the Sackler Wing at the Louvre; and Sackler institutes and facilities at Columbia, Oxford, and a dozen other universities. The Sacklers have endowed professorships and underwritten medical research. The art scholar Thomas Lawton once likened the eldest brother, Arthur, to “a modern Medici.
.. Marissa Sackler, the thirty-six-year-old daughter of Mortimer
.. she finds the word “philanthropy” old-fashioned. She considers herself a “social entrepreneur.”
.. When the Met was originally built, in 1880, one of its trustees, the lawyer Joseph Choate, gave a speech to Gilded Age industrialists who had gathered to celebrate its dedication, and, in a bid for their support, offered the sly observation that what philanthropy really buys is immortality:
.. the Sacklers are now one of America’s richest families, with a collective net worth of thirteen billion dollars—more than the Rockefellers or the Mellons.
.. Purdue Pharma—a privately held company, based in Stamford, Connecticut, that developed the prescription painkiller OxyContin.
.. four out of five people who try heroin today started with prescription painkillers.
.. a hundred and forty-five Americans now die every day from opioid overdoses.
.. it’s in 1996 that prescribing really takes off,” Kolodny said. “It’s not a coincidence. That was the year Purdue launched a multifaceted campaign that misinformed the medical community about the risks.” When I asked Kolodny how much of the blame Purdue bears for the current public-health crisis, he responded, “The lion’s share.”
.. Although the Sackler name can be found on dozens of buildings, Purdue’s Web site scarcely mentions the family, and a list of the company’s board of directors fails to include eight family members, from three generations, who serve in that capacity.
.. The Sacklers were especially interested in the biological aspects of psychiatric disorders, and in pharmaceutical alternatives to mid-century methods such as electroshock therapy and psychoanalysis.
.. In 1942, Arthur helped pay his medical-school tuition by taking a copywriting job
.. He recognized that selling new drugs requires a seduction of not just the patient but the doctor who writes the prescription.
.. in selling new drugs he devised campaigns that appealed directly to clinicians, placing splashy ads in medical journals and distributing literature to doctors’ offices. Seeing that physicians were most heavily influenced by their own peers, he enlisted prominent ones to endorse his products, and cited scientific studies (which were often underwritten by the pharmaceutical companies themselves).
.. “Most of the questionable practices that propelled the pharmaceutical industry into the scourge it is today can be attributed to Arthur Sackler.”
.. Arthur’s techniques were sometimes blatantly deceptive.
.. “More and more physicians find Sigmamycin the antibiotic therapy of choice.”
.. The Saturday Review tried to contact some of the doctors whose names were on the cards. They did not exist.
.. One Librium ad depicted a young woman carrying an armload of books, and suggested that even the quotidian anxiety a college freshman feels upon leaving home might be best handled with tranquillizers.
.. Win Gerson, who worked with Sackler at the agency, told the journalist Sam Quinones years later that the Valium campaign was a great success, in part because the drug was so effective. “It kind of made junkies of people, but that drug worked,”
.. By 1973, American doctors were writing more than a hundred million tranquillizer prescriptions a year, and countless patients became hooked.
.. He scoffed at suggestions that there was a conflict of interest between his roles as the head of a pharmaceutical-advertising company and the publisher of a periodical for doctors.
.. a company he owned, MD Publications, had paid the chief of the antibiotics division of the F.D.A., Henry Welch, nearly three hundred thousand dollars in exchange for Welch’s help in promoting certain drugs. Sometimes, when Welch was giving a speech, he inserted a drug’s advertising slogan into his remarks.
“The Sackler empire is a completely integrated operation in that it can
- devise a new drug in its drug development enterprise, have the drug clinically tested and
- secure favorable reports on the drug from the various hospitals with which they have connections,
- conceive the advertising approach and prepare the actual advertising copy with which to promote the drug,
- have the clinical articles as well as advertising copy published in their own medical journals, [and]
- prepare and plant articles in newspapers and magazines.”
.. A panel of senators assailed him with pointed questions, but he was a formidable interlocutor—slippery, aloof, and impeccably prepared—and no senator landed a blow.
.. Arthur’s children fought bitterly with Gillian, and sparred with Mortimer and Raymond, over the estate. They accused Gillian of trying to steal their inheritance, and of being “inspired variously by greed, malice, or vindictiveness toward her stepchildren.”
.. A family lawyer told the children, “There were no absolutely white lilies here on either side.”
.. for the Romans, the poppy was a symbol of both sleep and death.
.. MS Contin became the biggest seller in Purdue’s history. But, by the late eighties, its patent was about to expire, and Purdue executives started looking for a drug to replace it.
.. “In terms of narcotic firepower, OxyContin was a nuclear weapon.”
.. Highly regarded doctors, like Russell Portenoy, then a pain specialist at Memorial Sloan Kettering Cancer Center, in New York, spoke out about the problem of untreated chronic pain—and the wisdom of using opioids to treat it.
.. Describing opioids as a “gift from nature,” he said that they needed to be destigmatized.
.. claiming that it was indicative of “opiophobia,” and suggesting that concerns about addiction and abuse amounted to a “medical myth.”
.. the American Pain Society published a statement regarding the use of opioids to treat chronic pain. The statement was written by a committee chaired by Dr. J. David Haddox, a paid speaker for Purdue.
.. the F.D.A., in an unusual step, approved a package insert for OxyContin which announced that the drug was safer than rival painkillers, because the patented delayed-absorption mechanism
.. launched OxyContin with one of the biggest pharmaceutical marketing campaigns in history
.. A major thrust of the sales campaign was that OxyContin should be prescribed not merely for the kind of severe short-term pain associated with surgery or cancer but also for less acute, longer-lasting pain: arthritis, back pain, sports injuries, fibromyalgia.
.. Purdue similarly spoke of reaching patients who were “opioid naïve.”
.. “the goal should have been to sell the least dose of the drug to the smallest number of patients.” But this approach was at odds with the competitive imperatives of a pharmaceutical company, he continued. So Purdue set out to do exactly the opposite.
.. Purdue had a speakers’ bureau, and it paid several thousand clinicians
.. The marketing of OxyContin relied on an empirical circularity: the company convinced doctors of the drug’s safety with literature that had been produced by doctors who were paid, or funded, by the company.
.. OxyContin’s success can be attributed partly to the fact that so many doctors wanted to believe in the therapeutic benefits of opioids.
.. Purdue gave money to continuing medical education, to state medical boards, to faux grassroots organizations.”
.. Purdue instructed sales representatives to assure doctors—repeatedly and without evidence—that “fewer than one per cent” of patients who took OxyContin became addicted. (In 1999, a Purdue-funded study of patients who used OxyContin for headaches found that the addiction rate was thirteen per cent.)
.. Internal budget plans described the company’s sales force as its “most valuable resource.” In 2001, Purdue Pharma paid forty million dollars in bonuses.
.. The fact that Purdue is privately held is a major reason that the Sacklers’ connection to OxyContin has remained obscure.
.. Mortimer Sackler .. He renounced his U.S. citizenship in 1974, reportedly for tax reasons, and lived a flamboyant life in Europe, shuttling among residences in England, the Swiss Alps, and Cap d’Antibes.
.. If you ground the pills up and snorted them, or dissolved them in liquid and injected them, you could override the time-release mechanism and deliver a huge narcotic payload all at once
.. Purdue insisted that the only problem was that recreational drug users were not taking OxyContin as directed.
.. One night, after four months on the drug, she died in her sleep, from respiratory arrest, leaving behind a six-year-old son. Her mother, Marianne Skolek Perez, was a nurse.
.. Robin Hogen .. had launched a vigorous campaign to defend the drug, warning newspapers to be careful about their coverage
.. He had also enlisted Rudolph Giuliani, the former mayor of New York, and his associate Bernard Kerik to preëmpt any government crackdown.
.. “We have to be politically Machiavellian, often, to win the day,”
.. Purdue’s senior medical adviser, J. David Haddox, who insisted that OxyContin was not addictive. He once likened the drug to a vegetable, saying, “If I gave you a stalk of celery and you ate that, it would be healthy. But if you put it in a blender and tried to shoot it into your veins, it would not be good.”
.. it was Purdue’s position that OxyContin overdoses were a matter of individual responsibility, rather than the drug’s addictive properties.
.. Howard Udell, Purdue’s general counsel, who had been a longtime legal adviser to the Sacklers
.. Udell was clearly aware, however, of the abuse potential of OxyContin. According to court documents, his own secretary became addicted to the drug, and was subsequently fired by Purdue.
.. for Purdue and the Sacklers, “there was a sense almost of betrayal—how could people put the availability of that product in jeopardy by abusing it for pleasure?”
.. the dangers of OxyContin were intrinsic to the drug—and Purdue knew it.
.. They could sleep through the night—a crucial improvement over conventional painkillers, such as morphine
.. Roughly half the women required more medication before the twelve-hour mark.
.. the claim of twelve-hour relief was an invaluable marketing tool. But prescribing a pill on a twelve-hour schedule when, for many patients, it works for only eight is a recipe for withdrawal, addiction, and abuse.
.. many people who were not drug abusers—and who took OxyContin exactly as their doctors instructed—began experiencing withdrawal symptoms between doses.
.. patients were coming to them with symptoms of withdrawal (itching, nausea, the shakes) and asking for more medication. Haddox had an answer. In a 1989 paper, he had coined the term “pseudo-addiction.” As a pain-management pamphlet distributed by Purdue explained, pseudo-addiction “seems similar to addiction, but is due to unrelieved pain.”
.. Pseudo-addiction generally stopped once the pain was relieved—“often through an increase in opioid dose.”
.. though Sackler presided over the tremendously successful launch of OxyContin, he has never given an on-the-record interview about the drug.
.. Purdue refused to concede that it posed risks. Company leaders worried mainly that attempts to stem overdoses might deprive pain patients of access to the drug.
.. it had maintained a contract with I.M.S., a little-known company, co-founded by Arthur Sackler, that furnished its clients with fine-grained information about the prescribing habits of individual doctors. Purdue’s sales representatives used the data to figure out which doctors to target.
.. “They know exactly what people are prescribing,” Kolodny said. “They know when a doctor is running a pill mill.”
.. James Greenwood, a Pennsylvania congressman, asked Friedman whether Purdue would take any action if, say, I.M.S. data revealed that a rural osteopath was writing thousands of prescriptions.
Friedman replied that it was not up to Purdue to assess “how well a physician practices medicine.”
.. overprescribing generated tremendous revenue for the company.
.. such prescribers were given a name that Las Vegas casinos reserve for their most prized gamblers: whales.
.. in 2004 Blumenthal filed a complaint against Purdue, on behalf of the State of Connecticut.
.. If OxyContin was being widely prescribed at intervals of fewer than twelve hours, the company might lose its “two pills a day” marketplace advantage against cheaper alternatives, like generic morphine, and insurers could start refusing to cover the costs.
.. “These pronouncements about how safe the drug was emanated from the marketing department, not the scientific department. It was pretty shocking. They just made this stuff up.”
.. In 2006, Purdue settled with Hanly’s clients, for seventy-five million dollars
.. Rudolph Giuliani had tried, on Purdue’s behalf, to get the lead prosecutor to scuttle the case.
.. Arlen Specter, the Republican senator from Pennsylvania, remarked that such fines amounted to “expensive licenses for criminal misconduct.”
.. one of his fixations was the unethical behavior of tobacco companies.
.. the tobacco companies had more money to spare than Purdue does. “To resolve the opioid problem, you’re going to need billions,” he said. “Treatment alone could be fifty billion dollars or more. And you need prevention and education programs on top of that.”
.. Prescriptions are expensive, and taxpayers often foot the bill, through programs like Medicaid. Then, as the ruinous consequences of opioid addiction take hold, the public must pay again—this time for emergency services, addiction treatment, and the like. Moore feels that the Sackler family, as the initial author and a prime beneficiary of the epidemic, should be publicly shamed.
.. They duped the F.D.A., saying it lasted twelve hours. They lied about the addictive properties. And they did all this to grow the opioid market, to make it O.K. to jump in the water.
.. Purdue fought the suit with its customary rigor, pushing to move the proceedings elsewhere, on the ground that the company could not get a fair trial in Pike County, Kentucky—the rural stretch of coal country where the state intended to try the case.
.. The report was revealing in ways that Purdue may not have intended: according to the filing, twenty-nine per cent of the county’s residents said that they or their family members knew someone who had died from using OxyContin. Seven out of ten respondents described OxyContin’s effect on their community as “devastating.”
.. Sackler’s demeanor during the session reminded him of Jeremy Irons’s portrayal of Claus von Bülow, the aristocrat accused of murdering his wife, in the 1990 bio-pic “Reversal of Fortune.” “A smirk and a so-what attitude—an absolute lack of remorse,”
.. the 1997 Pikeville High School football team. “Nearly half the players had died of overdoses, or were addicted,” he said. “It was going to be a pretty good visual.”
.. Purdue has sometimes claimed to have never “lost a case” related to OxyContin, but it’s more accurate to say that the company has never allowed a case to go to trial, often settling rather than litigating the culpability of the company—and the Sacklers—in open court.
.. the main reason these folks don’t go to trial,” Denham said. “Because all these documents could end up in the public record.” The Kentucky prosecutors were required to destroy millions of documents, or return them to Purdue.
.. The idea that they’re fighting so hard to keep this deposition hidden should tell you something.
.. These were urbane, expensively educated, presumably well-informed people. Could they conceivably be unaware of the accumulated evidence about the tainted origins of their fortune?
.. Someone who knows Mortimer, Jr., socially told me, “I think for him, most of the time, he’s just saying, ‘Wow, we’re really rich. It’s fucking cool. I don’t really want to think that much about the other side of things.’ ”
.. I wondered whether philanthropy might represent, for at least some of the Sacklers, a form of atonement. But, when you consider the breadth of the family’s donations, one field is conspicuously lacking: addiction treatment, or any other measures that might serve to counter the opioid epidemic.
.. companies often make a minor tweak to a branded product shortly before the patent expires, in order to obtain a new patent and reset the clock on their exclusive right to produce the drug. The patent for the original OxyContin was set to expire in 2013.
.. Purdue had long denied that the original OxyContin was especially prone to abuse. But, upon receiving its patents for the reformulated drug, the company filed papers with the F.D.A., asking the agency to refuse to accept generic versions of the original formulation—because they were unsafe.
.. Younger people, who can less readily secure prescriptions for pain—and for whom OxyContin may be too expensive—have increasingly turned to black-market substitutes, including heroin.
.. “How the Reformulation of OxyContin Ignited the Heroin Epidemic.” A survey of two hundred and forty-four people who entered treatment for OxyContin abuse after the reformulation found that a third had switched to other drugs. Seventy per cent of that group had turned to heroin.
.. Purdue pinpointed “communities where there is a lot of poverty and a lack of education and opportunity,” adding, “They were looking at numbers that showed these people have work-related injuries, they go to the doctor more often, they get treatment for pain.”
The Xalisco boys offered potential customers free samples of their product. So did Purdue.
.. Purdue likes to emphasize that there are many other powerful painkillers, and that OxyContin never had more than two per cent of the market for opioids
.. But most painkillers are prescribed for very short periods—following surgery, for instance—and in relatively small doses, whereas OxyContin’s sales have been driven by long-term, high-dose prescriptions
.. If one measured market share by the actual volume of narcotics administered, OxyContin’s would be considerably higher. Some doctors I spoke with estimated that it could be as high as thirty per cent.
.. Purdue acknowledged that even patients “who take OxyContin in accordance with its F.D.A.-approved labeling instructions will likely develop physical dependence.”
.. It may also be that OxyContin has achieved market saturation.
.. Last year, in Ohio, a state particularly hard hit by the epidemic, 2.3 million residents—roughly one in five people in the state—received a prescription for opioids.
.. “Opioids really do afford pain relief—initially,” he said. “But that relief tends to diminish over time. That’s, in part, why people increase the dose. They are chasing pain relief from a drug that has failed.
.. The Sackler family and Purdue Pharma could have taken responsibility in a similar spirit: apologizing for their role in unleashing a national catastrophe while noting that, during the nineties, they had relied on a series of mistaken assumptions about the safety of OxyContin. But Purdue has continued to fight aggressively against any measures that might limit the distribution of OxyContin, in a way that calls to mind the gun lobby’s resistance to firearm regulations.
Confronted with the prospect of modest, commonsense measures that might in any way impinge on the prescribing of painkillers, Purdue and its various allies have responded with alarm, suggesting that such steps will deny law-abiding pain patients access to medicine they desperately need. Mark Sullivan, a psychiatrist at the University of Washington, distilled the argument of Purdue: “Our product isn’t dangerous—it’s people who are dangerous.”
.. after Purdue made its guilty plea, in 2007, it assembled an army of lobbyists to fight any legislative actions that might encroach on its business. Between 2006 and 2015, Purdue and other painkiller producers, along with their associated nonprofits, spent nearly nine hundred million dollars on lobbying and political contributions—eight times what the gun lobby spent during that period.
.. Since Purdue made it more difficult to grind OxyContin pills, prescriptions have reportedly plummeted by forty per cent. This suggests that nearly half of the original drug’s consumers may have been crushing it to get high.
.. In August, 2015, over objections from critics, the company received F.D.A. approval to market OxyContin to children as young as eleven.
.. the Sacklers continue to receive some seven hundred million dollars a year
.. the real future of OxyContin may be global
.. But the Sackler family has only increased its efforts abroad, and is now pushing the drug, through a Purdue-related company called Mundipharma, into Asia, Latin America, and the Middle East
.. Part of Purdue’s strategy from the beginning has been to create a market for OxyContin—to instill a perceived need by making bold claims about the existence of large numbers of people suffering from untreated chronic pain.
.. Mundipharma commissioned studies showing that millions of people in these countries suffered from chronic pain.
.. In Mexico, Mundipharma has asserted that twenty-eight million people—a quarter of the population—suffer from chronic pain.
.. In China, the company has distributed cartoon videos about using opioids for pain relief; other promotional literature cites the erroneous claim that rates of addiction are negligible.
.. The term “opiophobia” has largely fallen into disuse in America, for obvious reasons. Mundipharma executives still use it abroad.
.. “It’s a parallel to what the tobacco industry did,” Mike Moore told me. “They got caught in America, they saw their market share decline, so they export it to places with even fewer regulations than we have.
.. Yale, announced that the university will rename a residential college that was named for John C. Calhoun, because Calhoun’s “legacy as a white supremacist and a national leader who passionately promoted slavery as a ‘positive good’ fundamentally conflicts with Yale’s mission and values.”
.. in the time it likely took you to read this article six Americans have fatally overdosed on opioids.
.. “A truly philanthropic family, looking at the last twenty years, would say, ‘You know, there’s several million Americans who are addicted, directly or indirectly, because of us.’ Real philanthropy would be to contribute money to taking care of them.
.. adding their name to a building—it rings hollow. It’s not philanthropy. It’s just a glorification of the Sackler family.”
.. more than two and a half million Americans have an opioid-use disorder.
.. “If the Sacklers wanted to clear their name, they could take a very substantial fraction of that fortune and create a mechanism for providing free treatment for everyone who’s become addicted.”
.. Alfred Nobel, the inventor of dynamite, created the Nobel Peace Prize.
.. the descendants of John D. Rockefeller have devoted resources to addressing climate change and critiquing the environmental record of the oil company he founded
..tobacco-company C.E.O.s: “We asked them, ‘What do you want?’ And they said, ‘We want to be able to go to cocktail parties and not have people come up and ask us why we’re killing people.’
.. An addicted baby is now born every half hour.
.. In places like Huntington, West Virginia, ten per cent of newborns are dependent on opioids.
Trump himself is the offense. Everything that springs from him, every person who supports him, every staffer who shields him, every legislator who defends him, is an offense. Every partisan who uses him — against all he or she has ever claimed to champion — to advance a political agenda and, in so doing, places party over country, is an offense.
.. We must remind ourselves that Trump’s very presence in the White House defiles it and the institution of the presidency. Rather than rising to the honor of the office, Trump has lowered the office with his whiny, fragile, vindictive pettiness.
.. This latest episode is simply part of a body of work demonstrating the man’s utter contempt for decency.
.. [Republicans] have surrendered any moral authority to which they once laid claim — rightly or not. If Trump goes down, they all do.
.. A madman and his legislative minions are holding America hostage.
.. It is what it is and has been from day one: The most extraordinary and profound electoral mistake America has made in our lifetimes and possibly ever.
.. We must always remember that although individual Americans made the choice to vote affirmatively for him or actively withhold their support from his opponent, those decisions were influenced, in ways we cannot calculate, by Russian interference in our election, designed to privilege Trump.
.. We must remember that we now have a president exerting power to which he may only have access because a foreign power hostile to our interests wanted him installed.
.. Trump simply lied when he said that he would have won the popular vote were it not for millions of illegal votes.
.. He is banking on your becoming overwhelmed by his never-ending antics.
.. Trump is an abomination, and a cancer on the country, and none of us can rest until he is no longer holding the reins of power.
Branson wrote. “Even before the starters arrived he began telling me about how he had asked a number of people for help after his latest bankruptcy and how five of them were unwilling to help. He told me he was going to spend the rest of his life destroying these five people.”
Branson “found it very bizarre” that Trump was unwilling to talk about anything else. “I told him I didn’t think it was the best way of spending his life. I said it was going to eat him up, and do more damage to him than them,” Branson wrote. “There must be more constructive ways to spend the rest of your life.
.. Branson highlighted the real estate mogul’s “vindictive streak” as the most frightening thing about this election, warning it “could be so dangerous if he got into the White House.”