He's lived in an alternate reality for his entire life.
Roy Cohn taught him to project, to deflect, to blame his accusers of anything he's accused of.
Mark Burnette created the fictional "Apprentice" character, so that Trump...in "real life"...could inhabit his "happy place," where he was a fabulously successful billionaire businessman, rather than a guy with three marriages and six bankruptcies.
I've written about your question a number of times on DU. "Going with my gut," after having to witness his garbage for decades, I'd say:
1). WHATEVER is "true," what's at the HEART of it is that he DOESN'T care.
2). What he DOES "care" about is attention, fawning praise, and idealized public image of himself, things he can eat, things he can spend, and women...willing or unwilling...that he can have sex with, but even WITH whatever money he has, I can't imagine ANY woman with a level of self-esteem low enough to have sex with him in 2026. No idea what's in Melania's pre-nup. If sex is a condition, I'm sure she's figured multiple ways to "get it over with" as quickly as possible and only when the pre-nup demands it. She's allegedly had it re-written on an unspecified number of occasions. Maybe she took a hit on her eventual payday to have it removed altogether.
3). Any "crack in the armor" / "slipping of the mask" would "expose him as a fraud." Now, that's already accomplished by readily available fact-checking. But every time that happens he screams "FAKE NEWS," and the MAGAts believe him, so the audience for that is limited to about 2/3 of the country, and IN that group, a LOT of people have gone numb and just don't care. And he knows this. A major part of his strategy is to be so consistently loud-mouthed and obnoxious that he simply wears people down and wears them out.