Their images and videos became Exhibit A for the winning 2024 campaign of President Donald Trump and his loyal followers, as Democratic rival Kamala Harris struggled to steer her party toward a more centrist presentation. Younger and louder representatives of the Left’s farthest-flung fringes seemed unable to suspend their very public and performative shows of boundless and negative emotions. The Trump team exploited those moments of zealotry to alarm average flyover voters.
Whether those extreme sentiments played out as unreasoned and self-righteous tantrums, screaming, intolerance, or outright hatred, they all emerged in the name of supporting an agenda that protesters insisted was so enlightened and compassionate that it warranted vitriolic rhetoric. However, the Republican sweep of the White House and both houses of Congress hints that something about enthusiastic progressive expression led the sort of noncommitted voters Harris sought to reject the then-vice president’s message.
Whether they’re throwing soup at Van Gogh masterpieces to attack the petroleum industry or shouting down guest speakers at universities, young progressives’ consistent behavior patterns of extreme attention-seeking and narcissism fall squarely under the symptoms list for Cluster B Personality Disorders. The related patterns beg the question if a vocal driving force of the modern Democratic Party suffers from a diagnosable, though treatable, mental illness.
According to Dr. Marschall Runge, author of The Great Healthcare Disruption: Big Tech, Bold Policy, and the Future of American Medicine, it’s possible these officially recognizable disorders could lead people to act out negatively in the political theater.
“While I don’t have data on how Cluster B traits might manifest in activism, the concept is plausible,” Runge said. “I need to be broad because there is activism of all kinds — left, right, and center — but there is not likely a sharp line between Cluster B traits and exaggerated behaviors.”
Over the years, Runge has been the executive vice president for medical affairs for the University of Michigan, dean of the University of Michigan Medical School, and CEO of Michigan Medicine. He puts Cluster B Personality Disorders into four general categories: antisocial, borderline, histrionic, and narcissistic. While each type has its distinct list of symptoms, common threads run through all four diagnoses. He listed:
- Emotional intensity: Public outbursts, social media rage cycles, or impulsive “cancel culture” behaviors.
- Narcissistic traits: Grandiosity or belief in being uniquely righteous or morally superior, exploitation by way of using movements to gain personal fame or power, and lack of empathy, such as dismissing or attacking centrist voices or differing opinions.
- Histrionic traits: Dramatization with highly theatrical messaging and exaggeration of harm or threat, and attention-seeking or needing to be the face or voice of a movement.
- Antisocial traits: A disregard for laws or norms, such as justifying harmful or illegal actions as a means to an end.
Runge believes these factors could be playing out in the activist class as social media amplifies Cluster B-style behaviors such as emotionality, conflict, and “performativity.”
“(Social media) often rewards (Cluster B) with attention and validation,” he said. “Online movements can sometimes radicalize individuals who are vulnerable, including those with underlying personality disorders or traits.”
Dr. Claudia Ressel-Hodan was in private practice as a therapist for decades in the Midwest and Florida before retiring. She drops Cluster B disorders squarely in the lap of a simple and familiar human vice — selfishness.
“Anyone suffering from any of the Cluster B personality disorders are focused on themselves rather than others’ needs,” Ressel-Hodan said. “The antisocial individual will care less about social norms and is more likely to hurt others in their process for a cause without remorse.”
While the most extreme examples of such malignant narcissism result in the deadliest acts of terrorism, Ressel-Hodan points to more common incidents in which activists aggressively damage property or inconvenience members of the public to call attention to a chosen cause. For example, environmental protesters in various major cities will string themselves across busy roads or flood their numbers onto freeways to stop traffic in the hope of calling attention to climate change, without considering how their actions might wreck a commuter’s day.
As for the histrionic sufferer, Ressel-Hodan describes someone acting out for attention and fame under the guise of activism or a higher calling. She cites danger in such cases because, if a given moment blends enough heightened narcissism with a cause the perpetrator sees as important enough, violence can result. The histrionic can come to believe laws and rules of conduct no longer apply in favor of “the cause.”
“The narcissist will never take others’ views into consideration because they only believe they could be right in any sort of policy debate,” she added. “And, the borderline sufferers will act desperately in many settings, including the political scene, because of their highly impulsive behavior. [The borderline disorder victim] will very likely act out and get swept up by a group cause for the attention it gives them.”
Finally, Ressel-Hodan makes a simple case for how to identify the politico without any of these defects.
“Those with stable personalities will express their causes in a controlled, socially acceptable way,” she said.
However, Dr. Nancy McWilliams, visiting professor emerita and clinical visiting faculty at Rutgers University, not only doesn’t buy into the idea of progressives suffering from borderline personality disorders, but she’d just as soon do away with the entire diagnosis concept.
“Those questions are kind of impossible for me because I’ve never liked the [Diagnostic and Statistical Manual of Mental Disorders] cluster system,” McWilliams said. “I find that the whole personality disorders section of the DSM conflates normal personality with psychopathology.”
The author of Psychoanalytic Psychotherapy: A Practitioner’s Guide and Psychoanalytic Diagnosis: Understanding Personality Structure in the Clinical Process suggests that those who share her skepticism tune into her written work.
“All my writing about personality types and levels of organization has been critical of the DSM for reifying and objectifying psychologies that are much more nuanced,” she explained. The disorders’ “subjective aspects need to be taken into account, not just what is externally observable.”
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Looking beyond individual cases and their possible conduct, Runge sees the phenomenon of political “acting out” as a dangerous result of political groups promoting and approving extreme behaviors.
“The erosion of empathy, dialogue, and moderation in public discourse is worsened when rigid personality patterns dominate group dynamics,” Runge said.
John Scott Lewinski, MFA, is a writer based in Milwaukee.