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Edwin B. Fisher is a clinical psychologist and professor at the University of North Carolina at Chapel Hill and is a past president of the Society of Behavioral Medicine. This column was first published by the Chicago Tribune.

At the height of the Cuban missile crisis, Premier Nikita Khrushchev wrote to President John F. Kennedy, “I have participated in two wars and know that war ends when it has rolled through cities and villages, everywhere sowing death and destruction.”

Warning of the “knot of war,” he continued, “a moment may come when that knot will be tied so tight that even he who tied it will not have the strength to untie it. … Let us take measures to untie that knot. We are ready for this.”

Such words from President Vladimir Putin are unimaginable.

The political scientist and Pulitzer-winning biographer of Khrushchev as well as Mikhail Gorbachev, William Taubman, notes, “Leaders make a difference, especially in totalitarian and authoritarian regimes.” From the pained looks on senior officials, the dressing down of those hesitant to embrace his actions and his now near total self isolation, it seems clear that the invasion of Ukraine is, indeed, Putin’s decision and Putin’s war.

So who is Putin?

We have joked about the shirtless horseback riding and staged ice hockey games in which, in full uniform and pads, well into his 60s and stumbling on his skates, the leader is able — or allowed — to score a goal. He accepts adulation as if it recognizes his prowess rather than indulging play acting. The frequency of these displays suggest great importance to his sense of himself.

Putin’s biography ”First Person: An Astonishingly Frank Self-Portrait by Russia’s President” quotes one of his grade school teachers: “I think Volodya is a good person. But he never forgives people who betray him or are mean to him.”

In paranoia, the accusations and attacks draw our attention. But it is the projection of danger and threat onto others that is fundamental. The deep sense of being wronged, victimized, damaged, all create a fog in which the paranoia becomes rationale. Well-documented are slights, wrongs, humiliations and diminishment of Russia that Putin perceives, and for which he will never forgive.

Similarities between Putin and former President Donald Trump have been noted, including shared affinity for authoritarian rule. The contrast, however, is more instructive. Far from Trump’s self-absorption, Putin identifies himself with a deep emotional sense of Mother Russia.

At about 10 or 11, he eschewed school dances and other socializing and began a dedication to judo and exercise that continues to the present. “If I hadn’t gotten involved in sports, I’m not sure how my life would have turned out.” Beyond his great interest in physical prowess, this shows a broader pattern of finding identity through seizing on something outside himself and internalizing it, dedicating himself to it.

For Trump, there is no connection between self and values or people outside himself, but for Putin there is no separation between self and the dedication to his dream of Russian greatness. The fusion of these, the great importance of the cause to his sense of self, may help explain his uncompromising dedication now. Whether that fusion is sufficient to explain the brutality in Aleppo, Syria, and now the bombing of Ukraine is not clear.

Masha Gessen and others have noted the postwar Leningrad of Putin’s childhood was desolate and brutal, , a community version of the kinds of childhood experiences that now are widely recognized as a prelude to adult violence.

Putin combines steely dedication to his image of Mother Russia, belief of perceived wrongs to Russia and thereby to himself, paranoid resentment and determination to be recognized as strong. He doesn’t care about the cost of humiliating himself in cringeworthy displays, humiliating his senior colleagues or killing tens of thousands. Those who have followed him closely echo each other in describing his getting worse. His authority makes him almost impervious to the judgments of others. The pickling of all these in the crock of his increased and near total isolation have propelled his move to war.

Together, they may block any reversal of course.