WASHINGTON — By the time President Trump arrived in El Paso on Wednesday, on the second leg of a trip to meet with people affected by mass shootings in two cities, he was frustrated that his attacks on his political adversaries had resulted in more coverage than the cheery reception he received at a hospital in Dayton, Ohio, the first stop on his trip. So he screamed at his aides to begin producing proof that in El Paso people were happy to see him.
One of those people was Tito Anchondo, who had lost his brother and sister-in-law, Andre and Jordan Anchondo, when a gunman opened fire on a Walmart last Saturday and killed 22 people. Mr. Anchondo traveled to the University Medical Center of El Paso on Wednesday to meet Mr. Trump, and as the president stood by and flashed a thumbs-up during a White House photo opportunity, the first lady, Melania Trump, cradled Mr. Anchondo’s 2-month-old nephew, whose parents had both been gunned down.
By Friday, the photo had been widely disseminated after it became clear that the infant had lost his parents in a mass shooting, and had been brought back to the hospital after being discharged earlier in the week. In El Paso, Mr. Anchondo said that the attention surrounding his visit with the president had only brought more pain to his family.
“It’s just been really hectic,” Mr. Anchondo said during a brief interview at the family’s auto body shop, adding that he and his family had received hounding hate calls after the photograph circulated, and that people were harassing him on Facebook.
The episode was one result of Mr. Trump’s frustration over his news coverage and of the angry reaction that by the end of the trip had led to a mishmash of White House-distributed photographs, tweets and videos that focused on the president instead of people affected by the shootings.
Mr. Trump first became aware of the negative headlines watching television aboard Air Force One, and bellowed at the small coterie of advisers traveling with him, including Mick Mulvaney, his acting chief of staff. He was especially upset after he saw footage of a news conference held by Senator Sherrod Brown, Democrat of Ohio, and Mayor Nan Whaley of Dayton, a Democrat, but no positive images of himself while visiting Dayton’s Miami Valley Hospital. Not long afterward, his aides began distributing photos and video of the president at the hospital flanked by selfie-taking doctors and nurses.
“The President was treated like a Rock Star inside the hospital, which was all caught on video,” Dan Scavino, the president’s social media director, wrote on Twitter. “They all loved seeing their great President!”
Mr. Trump’s staff had kept reporters away from the president during his visit to avoid overwhelming patients recovering from the shooting, according to three people briefed on what took place. But when Mr. Trump saw the result, he was furious.
Aides have long said that Mr. Trump is heavily reactive to news coverage, and when he does something that he believes he should have been praised for — such as Wednesday’s visits to the cities — he grows furious when he does not receive accolades. But he has not adjusted his often casual approach to tragedy, including his penchant for flashing a thumbs-up sign in photographs.
Acting as a consoler in chief is “absolutely a central part of the presidency,” Michael Beschloss, the presidential historian, said in an interview. Observing Mr. Trump’s approach, he added, “it’s easier for a president who is a natural uniter.”
A senior White House official who traveled with Mr. Trump disputed the idea that what he had done in El Paso was insensitive, saying that Mr. Trump’s thumbs-up showed his “authentic” self, and that Mr. Trump wants to be seen as both approachable and supportive of the people he meets.
People who have had the job of steering presidents through the aftermath of tragedies had different views on how Mr. Trump conducted himself.
Ari Fleischer, who served as President George W. Bush’s press secretary after the Sept. 11, 2001, attacks, said presidents who visit with grieving families often reflect what those families want. In Mr. Bush’s case, he signed Bibles and other mementos from grieving families days after the attacks.
“It wasn’t that he wanted to leave behind his mark,” Mr. Fleisher said. “He did it because he understood years later that it would have meaning to them.”
President Barack Obama had a similar experience. In 2012, as Mr. Obama visited the relatives of schoolchildren and adults who had been killed in the shootings at Sandy Hook Elementary School in Newtown, Conn., he was handed the infant granddaughter of Dawn Hochsprung, the school’s principal who was among the victims. Ms. Hochsprung’s daughter posted to Twitter a photo of the president smiling with the baby, adding that her mother would have loved to have seen it.
But Joe Lockhart, who served as press secretary to President Bill Clinton when he traveled to visit families of 13 people killed in the 1999 Columbine shooting in Littleton, Colo., said that Mr. Trump’s approach — namely his administration’s effort to showcase support for him — had failed the victims. He called the videos that Mr. Scavino distributed “disgusting.”
“If, in my readout, I said, ‘Oh, people just warmed up to the president, and they just loved him,’” Mr. Lockhart said, “I would have had my office cleaned out that afternoon.”
Part of the concern that some of Mr. Trump’s advisers had heading into Wednesday was that the president would veer off script, and they wanted to make the visits as brief as possible, said those familiar with what took place.
Their concerns were given weight when raw video posted by someone at University Medical Center circulated on Twitter, showing Mr. Trump talking up his rally crowds and comparing himself to Beto O’Rourke, the former Democratic congressman from El Paso who is running for president.
Still, in El Paso, a city with an already fraught relationship with the president because of his comments about immigrants and because the gunman had targeted Mexicans, a group of people he has repeatedly vilified, Mr. Trump had defenders.
Adolpho Telles, the chairman of the El Paso Republican Party, said that Mr. Trump’s visit had been unfairly politicized and that he saw nothing inherently wrong with the president’s interactions, including the thumbs-up.
“The guy is honest,” Mr. Telles said, “he says what he’s thinking. I don’t always like the way he puts it, but I know his message.”