Lasch’s (1978) study of the ‘culture of narcissism’ is discussed as a model socio-psychoanalytic inquiry. However, in fragmented societies, the search for an encompassing diagnosis is less useful than a strategy of identifying states of mind active in specific situations. In studying more malignant phenomena, paranoid states are important, especially in their combination with narcissism. Hofstadter’s (1964) essay on the paranoid ‘style’ is a key reference point. Comparing Lasch and Hofstadter invites a consideration of broad issues concerning the relations between culture and psyche, and between leaders and followers. The paper ends with a short commentary on narcissistic and paranoid states of mind in the case of President Trump.