Just last week, a guest in the Oval Office fainted during a White House announcement on the topic of weight-loss drugs, requiring the event to be cut short. President Donald Trump looked over at the fallen man with a small group gathered around to help him, and then turned to stare straight ahead, without even a hint of concern or sympathy on his face.
Indeed, the look on Trump’s face (see photo above) was one of utter indifference. The man could have been dying (thankfully, he did recover), but the President couldn’t be bothered. Trump almost looks immobilized in that picture, frozen in place and disengaged from the situation transpiring just a few feet away.
The event prompted me to once again explore not just the social influence of human compassion, as individuals are motivated to assist and support others in distress or need, but also its psychodynamic origins.
Where does compassion come from? What is it that “turns on” our compassion for another, and why was it apparently missing in Donald Trump that day?
I’ve written on this subject before, but the recent incident offers a fresh stage for our consideration. Of course, we shouldn’t expect moral perfection of any leader, but a president does have a certain obligation of representing to the people how someone with wisdom, integrity, understanding, and compassion carries and conducts himself, or herself, in the world.
The people not only look to their leaders for vision and strength; they also look up to them for inspiration, profiles in humility and courage, and for moral clarity in uncertain times.
To understand what I am calling the psychodynamics of compassion, an enlightening deep-dive into word etymology is in order. Compassion is from Latin, meaning “to suffer with” another, or more accurately, to stand with and share someone’s experience of pain, hardship, or loss, with a desire to alleviate their suffering in some way.
A desire to help is what motivates the behavior that demonstrates compassion in action. In ancient Greek, the word is sympathy (sympátheia), which has essentially the same meaning picked up in the later Latin term.
But the deeper Greek history of the concept holds an additional surprise. Another word, empathy (empátheia), attaches the prefix em- (in or within) to reveal something more going on. Today, empathy and compassion are used almost interchangeably, with empathy adding the idea of cognitive discernment to the feeling of compassion and its caring outreach.
Psychotherapy teaches that counselors can develop empathy through reflection on their clients’ upbringing and early life, circumstances and worldview, current beliefs and other factors that may be contributing to and amplifying their suffering. With this broader framework in mind, treatment plans can be designed with strategies for adjusting beliefs, setting goals, and taking action in a healthier direction.
Empathy doesn’t merely add therapeutic reflection and cognitive discernment to the more visceral-emotional response of compassion (or sympathy), however.
The suffering within ourselves because of what we perceive happening to someone else is not so much caused as awakened by it, coming about by a process of inner knowing – more gnostic than epistemic, more “I’ve been there and know how it feels” than “I can see you’re having a hard time.” In other words, empathy is our inner resonance with the human experience.
Without empathy, our sympathy (or compassion) easily gets stalled in pity: “Poor thing. I feel terrible for you.”
Our empathic understanding of what chronic pain feels like, what going hungry feels like, what being lost or confused feels like, what losing something or someone precious to us feels like – in short, our deep acquaintance with the human condition – activates our sympathetic response to someone else who is suffering a similar experience.
Knowing what that feels like, we are unsettled and want to help them through it, or at least come alongside and fortify (literally comfort) them with our non-anxious presence and emotional support.
How we show up for another is called compassion (or sympathy), but the precursor of compassion is empathy.
In that photo, the deadpan look and blank stare on Trump’s face are the telltale signs of a critical absence of empathy. He didn’t rush over to check on the man or lend a hand, motivated by a desire to do something helpful.
It’s possible that Trump didn’t even feel compassion for the man, an apathy (‘no feeling’) which might be traced deeper inside Trump himself, to a lack of empathy because he has no point of reference from his own experience for what it feels like to falter and lose your legs in a public forum.
Or maybe he did have the experience once, but subsequently suppressed his embarrassment, “forgot” the episode, and now saw in this man’s struggle an annoying weakness holding up his photo-op.
Trump’s more general lack of compassion, showing up in his attitudes toward and remarks about people whose experience is entirely foreign to him – immigrants, the poor, women, and minorities – is rooted in his deficient acquaintance with what it’s like to be without a home, without resources, without respect, or without a voice. Indeed, his treatment of such people seems motivated out of an irrational fear that their mere proximity threatens to pull him into a darkness he cannot understand and may not escape.
Perhaps our contemporary “recession of compassion” is a social liability that individuals of great wealth and privilege bring with them into the shared human experience, like a virus destined to cut the bonds of sympathy that hold a community together.
For their political acumen, business success, or television celebrity, we rush them up the ballot to higher positions of power and authority, only to discover that they lack the wisdom, integrity, understanding and compassion – now in a word, the empathy – to serve for the good of all.
We should be more careful from now on.

I agree with all of this. I’m convinced no one on the planet is less capable of empathy. No one on the planet is so utterly self-absorbed and unable to comprehend anything other than in terms of its immediate impact on him.
You didn’t, however, consider another factor. It’s likely that at least part of that reaction is a result of dementia. That vacant look is a reflection of the (likely) fact that his brain is to a large extent no longer functioning. The way he glitches out when speaking has been convincingly, to me, described/diagnosed as phonemic paraphasia, one symptom of dementia. I don’t think there’s much question that he’s well down the road of significant neurological decline.
I say “ right on”. A late happy birthday to you! SK