The intense effort to make direct use of psychological and psychiatric theory for a clearly political purpose, to remove President Trump from office, is unprecedented. In response to what are seen as Mr. Trump’s many personal, political, and policy provocations, his critics, including former President Obama,1 have made a determined and persistent case that he is “unfit” to be president. Sometimes this argument is put forward in the form of a psychiatric based diagnosis regarding Mr. Trump’s supposed severe psychopathology.2 At other times it is framed as the damage his presidency will inflict on American politics and democratic institutions,3 including their so-called “Guardrails of Democracy” (see Chapter 3). The term “unfit,” as will be evident, covers a great deal of diverse territory.
Many of the accusations about Trump’s unfitness muddle and inappropriately mix clinical and political domains. Politically, Trump has been repeatedly characterized as a Nazi,4 a dictator,5 a racist,6 a traitor,7 the greatest threat to our own country,8 a threat to American democracy,9,10 a threat to our world order11 and worse.12 Each of these diverse accusations are “political” in nature, but often they are ultimately based on some psychiatric or psychological theoretical foundation. The accusations vary widely in the nature of the behaviors that make Trump unfit. However rarely, if ever, are such characterizations accompanied by a careful analysis of evidence on their behalf.
There are many ways of being “unfit” for the presidency—characterologically, psychologically, temperamentally, and politically. What is striking is that Trump has been accused of being unfit on the basis of all of those, and on several others as well. The result is a mélange of unfitness accusations that rely more on anti-Trump animus than they do on any fair-minded understanding of political or psychology theory. They are put forward by individuals with a wide diversity of backgrounds and training, often, but not always, irrelevant to the pronouncements they make.
Anyone can make a politically charged accusation of unfitness on the basis of no more evidence than their own opinions, and many anti-Trump critics do exactly that. However, accusations made by persons trained in psychology, whatever form that training takes, and it varies widely among anti-Trump critics, are in a different position. They often have some training in psychological theory and the basic elements of conducting research. They ought to be familiar with the standards of gathering evidence from a variety of sources and not only the ones that reflect their views. They should be familiar with the idea of weighing all the evidence fairly and considering alternative formulations. They should be very sensitive to being “objective,” which, if that term means anything at all, requires them to take care and be scrupulous about not allowing their own views to weigh heavily in their analysis, especially of controversial presidents like Trump with whose views they clearly vehemently disagree.
Individuals who can professionally lay claim to the title “psychologist,”13 and even those who can’t do so legally as is the case with the vague title “mental health professional,” have both increased professional status and responsibilities. Being trained and familiar with psychological theory gives you more standing to use psychology for analysis. Yet such individuals should be expected to be familiar with and to abide by the professional canons of research described above, as they relate specifically to the use and misuse of psychological theory. That would apply to all those with psychological training, even if it is not specifically medical, that is, acquired in conjunction with becoming a medical doctor (MD).
An additional and more forceful set of ethical constraints apply to those medically trained in psychiatry. The so-called Goldwater rule prohibits them from making diagnoses without having worked with the subject psychologically and without their permission. Anti-Trump psychiatrists have tried to counter this prohibition in two ways. First, they insist that they have a “duty to warn” and to keep the public from suffering the harm they feel is occurring because of Trump’s presidency. Second, they say they have switched the rationale of their efforts from psychiatric and psychological diagnoses to the question of Trump’s “dangerousness.”
Psychiatrists in the forefront of the remove-Trump effort claim that they are not “diagnosing” Trump. Rather, they say, they are observing and analyzing his clear and immediately disqualifying level of “dangerousness.” Their assessment of Trump’s of dangerousness is, paradoxically, not based on any special political expertise they have beyond reading and interpreting the latest headline or Trump tweet, but on their training in psychology. So they are in fact making a clinical diagnostic judgment, but substituting the term dangerousness for diagnosis. Paraphrasing Shakespeare14: “A diagnosis by any other name,” for example “dangerousness,” is still a diagnosis.
In the sections that follow, we take up some of the most basic issues of assessing President Trump’s psychological fitness for office at a distance whether in the form of a psychiatrically framed diagnosis or psychologically framed political diagnosis of dangerousness. We first take up the meaning and nature of the term “unfitness” for the presidency. We then analyze a startling and informative prologue to Trump unfitness arguments: The psychiatric assessment of Republican presidential candidate Senator Barry Goldwater in 1964.
Finally, we turn to a major effort by anti-Trump psychological professionals to assess Trump’s dangerousness as a rational for opposing and removing him from office. That is the work of Bandy Lee MD, who has published a widely noted book whose title reflects its perspective: The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President.15 Many of the contributors to that book have some professional psychological background, though not necessary in the fields that would train someone to be knowledgable about the clinical or psychiatric assessments they freely make.
The contributors all clearly feel very strongly about their views The question to be addressed here is the extent to which their familiarity and training in psychological theory, however relevant, is put into the service of their views. Or, whether their views are a reasonable and legitimate set of inferences that can be drawn from their analyses. The analysis that follows is not focused on whether such efforts are or are not within APA Goldwater Rule guidelines. That topic has been and will continue to be debated.16 We are interested here in the question of whether the “duty to warn,” or assessments of “dangerousness” void, or simply avoid that rule.
We also ask whether so-called “mental health experts,” who conclude that President Trump is unfit for office and should be removed, adhere to basic procedures of psychological assessment and analysis. Those procedures would include, as noted, attention to the nature, extent, and adequacy of their evidence. Do those who make these accusations show any awareness or deal with the impact of their own clearly strong and deeply held political viewpoints? The failure to seriously engage these issues reflects a clear and avoidable substantive professional and ethical lapse.
On the Nature of Presidential Unfitness
One can think of any clinical “diagnosis” as a theoretical category with functional psychological consequences. Psychiatric diagnosis consists in placing individuals into established medical categories of psychological functioning and impairment. These categories can claim some behavioral, motivational, and predictive validity based on the continuing assessment of evidence from past and ongoing research. In the hands of skilled trained professionals making these placement judgements relies on extensive clinical training, personal knowledge of the person being assessed, and familiarity with the class of such people into which they diagnostically fit. The placement of a person in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders-V points to varied levels of dysfunction and impairment in the numerous categories of “Disorders.”17
Again, clinical and psychiatric assessments of individuals are enormously complicated. They involve much debated, highly complex clinical and definitional issues.18 Among them is the issue of differential diagnosis in medicine and psychiatry because many diagnostic facts are compatible with more than one diagnostic category. For example, a cough can be part of disease syndromes as diverse as a cold or a lung tumor. In psychiatry, paranoid trends in the personality do not necessarily signal the presence of a paranoid character. The latter may or may not be accompanied by a flight of ideas, interior logic (meanings and connections which are not generally shared) or non-sequential reasoning, all of which may indicate a major thought disturbance.
Most clinical entities frequently present a mixed symptom picture. For example, in considering Trump’s supposedly pathological narcissism one might first wish to consult this caution from the American Psychiatric Association, “It may take extended clinical observation, informant interview, or detailed history to distinguish impulsive, socially intrusive, or inappropriate behavior from narcissistic, aggressive, or domineering behavior to make this differential diagnosis.”19 Or, “Individuals with antisocial personality disorder also often have personality features that meet criteria for other personality disorders, particularly borderline, histrionic, and narcissistic personality disorders.”20 These complexities are rarely taken into account by those whose personal and political animus against the president have overwhelmed their professional training and judgment, and the ethical standards that frame them.21
Prologue to Trump Psychological Unfitness Claims: The Goldwater Assessment Fiasco22
The country has been down this road before. In the summer of 1964, a mass-circulation magazine sent a letter and a questionnaire to 12,356 psychiatrists, all members of the American Psychiatric Association, and asked them to provide their professional assessment of the mental health and psychological suitability of Barry Goldwater for president. Results of this survey were then published in two lengthy articles in the ironically named September/October issue of FACT Magazine, shortly before the election.
In 1964, the Republican Party nominated Barry Goldwater, United States Senator from Arizona, as its presidential candidate. Senator Goldwater had established himself as a leading spokesman for the conservative wing of his party. He espoused strong views on reducing government involvement in the lives of its citizens and equally strong views on the importance of a strong national defense and tough international stance vis-à-vis the Soviet Union. In part because of these views and in part because of some campaign statements, Senator Goldwater was viewed in some quarters as a political “extremist.” During his nomination acceptance speech, he stated, “extremism in the pursuit of liberty is no vice,” which became a frequently repeated quote to support that contention.
The FACT covering letter asking psychiatrists to evaluate the psychological fitness of Senator Goldwater began by stating that “Mr. Goldwater’s illness is not just an emotional maladjustment, or a mild neurosis, or a queerness,” but rather that he shows “unmistakable signs of paranoia.”23 Having already provided a preliminary diagnosis, the letter then asked whether it is possible “to determine conclusively, without a psychiatric interview, on the basis of what is known about him, whether Goldwater is a paranoid.” And, in case the point was not getting through, the cover letter also asked whether, “he seem[s] callous to the downtrodden and needy.” It also asked whether respondents could “offer any explanation of his public temper tantrums and his occasional outbursts of profanity.”24
The Psychiatric Assessment of Senator Goldwater: Prelude to the Trump Claimed Fitness Assessment Muddles
The effort to psychiatrically diagnosis Senator Goldwater made clear almost all of the methodological and political issues that have surfaced in connection with similar efforts to diagnose President Trump. What follows are a sampling of the responses to the assessment of Senator Goldwater that underline the same issues that appear in efforts to do so with President Trump, whether psychiatrically, psychologically, or politically.
General Diagnostic Dissensus: One psychiatrist wrote, “There is no doubt that Mr. Barry Goldwater is ‘mentally deranged’.”25 Another felt he was, “intellectually honest, reliable, consistent and emotionally mature.”26 Another believed that he was “grossly psychotic,”27 while another believed him to be “exceptionally well-adjusted.”28 The wide range of conclusions regarding the general level of Senator Goldwater’s “mental health” is matched by the equally wide range of specific diagnostic assessments made at the level of clinical conceptualization.
Differential Diagnosis: One respondent characterized Goldwater as a “compensated schizophrenic,”29 while another felt that he had “a narcissistic character disorder with not-too-latent paranoid elements.”30 Yet another mentioned the presence of a “severe obsessive-compulsive neurosis,”31 while another wrote that, “My main concern regarding Goldwater is how suicidal is he?”32
Politically Biased Diagnosis: Political Scientist Arnold Rogow wrote that many who chose to answer the letter were “strong supporters of peace, integration and the welfare state,” and concludes that it was, “inevitable that Goldwater … would be disliked by a number of psychiatrists, some of whom were not hesitant to translate their [political] dislike into the language of the consulting room.”33
One psychiatrist, for example, assessed the Senator as having a:
brittle, rigid personality structure … capable of either shattering like a crystal glass or bolstering itself by the assumption of a paranoid stance of more power over others. In his book The Conscience of a Conservative, his position is one of anachronistic authoritarianism, using the Constitution in a litigious way … He seems unaware that modern nationwide transportation and communication have increased identification of the population with the nation as a whole—rather than the states …34
Another respondent explicitly linked Goldwater’s rejection of a major Federal government role in domestic policy to his sense of inferiority stating that35:
Goldwater’s insecurity and feelings of inadequacy cause him to reject all changes and to resent what he considers to be excessive power by the Federal government. His rejection, may in fact, reflect a threat by a father-image, namely someone [the Federal government] who is stronger than he, more masculine and more cultured.
Among the respondents who considered Goldwater psychologically fit to become president, almost a dozen linked psychiatric health with conservative politics. For example, one respondent wrote36:
In my opinion Senator Goldwater is a highly-motivated patriotic American. I feel he is a mature, emotionally stable individual who is eminently qualified to hold the office of President … and to lead the fight against socialism and the force of the far left, which seem so strongly entrenched in our present government.
Another respondent presents us with a mixed political/psychiatric syllogism of curious logic:
We have long needed the opportunity for the public to choose between conservatism and modern socialism. Barry Goldwater’s candidacy offers this choice. He is a sane man.37
Efforts to assess Donald Trump’s fitness fair no better.
Varieties of Trump’s Claimed Unfitness
The issue of the use or misuse of a single psychological term to characterize a president who is clearly more complex than his caricatures is distinct from the question of what presidential characteristics, or lack therefore, constitute “unfitness” for the office. One anti-Trump pundit with no relevant training of any kind, and no standing except as the husband of senior White House advisor Kellyanne Conway, writes that Trump is “unfit” for office because his, “narcissism makes it impossible for him to carry out the duties of the presidency in the way the Constitution requires.”38 How, exactly, does the Constitution prescribe how the president is to carry out his duties? This critic doesn’t say except in a very general way noting that the Constitution requires that the president: “shall take care that the laws be faithfully executed” or “faithfully execute the Office of President of the United States.”
In Mr. Conway’s thinking, Mr. Trump’s narcissism is a given, and its magnitude severely interferes with his ability to “faithfully” carry out his responsibilities. His 110,000 word article is a lawyer’s brief for his viewpoint in which anonymous accusations and the citation of like-minded sources and views that support his position are the only evidence provided. Trump’s clearly tongue -in- cheek remarks (“I’m a stable genius”) are taken literally as dispositive clinical and diagnostic evidence. No information that runs counter to his views is presented and some material facts that he presents as true, are demonstrably false.39
Anti-Trump criticisms like George Conway’s ultimately rest their claims of Trump’s unfitness on the pathology of Trump’s psychology40:
The question of whether Trump can serve as a national fiduciary turns more on his narcissistic tendencies than his sociopathic ones, but Trump’s sociopathic characteristics sufficiently intertwine with his narcissistic ones that they deserve mention here …
But when you line up what the Framers expected of a president with all that we know about Donald Trump, his unfitness becomes obvious. The question is whether he can possibly act as a public fiduciary for the nation’s highest public trust … Given that Trump displays the extreme behavioral characteristics of a pathological narcissist, a sociopath, or a malignant narcissist—take your pick—it’s clear that he can’t.
Mr. Conway has no training whatsoever in psychology. His conflation of three different clinical terms “pathological narcissist, a sociopath, or a malignant narcissist,” and his advice to us to “take your pick,” suggests he has little real knowledge about or interest in the underlying accuracy or substance of what he is writing.
Varieties of Trump’s “Unfitness” Revisited
Some argue that Trump should be removed from office, via impeachment41 or the use of the 25th Amendment,42 on the basis of his variously described “unfitness,” often based on no more than a single tweet,43 or the characterization of Mr. Trump as “tweeting hysterically at the media.”44 Or, it is said he is unfit because “he is an unstable conspiracy theorist with an authoritarian streak,”45 or because “he is a TV addict,”46 or because of his short attention span,47 or because the Mueller Report provided ample evidence of Trump’s “pervasive and profound pattern of lack of capacity,”48 or because his behavior is simply not “normal.”49
Trump is also believed to be “unfit” for the presidency because he “appeared to be disengaged” from the recovery of Puerto Rico from Hurricane Maria,50 in spite of the enormous pre-storm efforts that the administration made.51 He is said to be unfit because when publicly attacked during a major prime time speech at the Democratic national convention by the father of a marine killed in action, Trump responded.52 He was said to be unfit because he did not stand up for President Obama when one of his (Trump’s) supporters publicly raised the issue (in his, the supporter’s mind) of President Obama’s Muslim background.53 He is said to be unfit because he lacks the “temperament or strength of character” to serve as president.54 He is unfit because of “sleep deprivation,[which] we know, can make you cranky and temperamental, and throw off judgment.”55 He is unfit because he is “Not prepared to be President.”56
He is unfit because his “lack of knowledge, seriousness and impulse control make him too dangerous to put in the presidency.”57 And he is unfit because, “Trump’s Typos Reveal His Lack of Fitness for the Presidency.”58 If none of these many varied and sundry reasons suffice, one set of critics list 153 things that Trump has said or done that make him unfit.59
Trump’s Presidential Demeanor as a Reflection of Unfitness
Mr. Trump’s irreverent, iconoclastic style, his failure to act “presidential,” and his “fight club” presidency are proof to his detractors that he is “unfit” to be president and, as a result, should be impeached and removed from office. That formulation is put forward very directly by the ordinarily moderate and sensible Washington Post columnist Robert Samuelson60:
Imagine, if you will, the consequences if Trump had embraced this pivotal distinction [between campaigning and governing]. He need not have jettisoned many of his policy preferences. He could have still favored lower taxes, fewer regulations, tighter immigration controls, tougher trade policies against China and more pressure on our NATO allies to raise military spending. He might even have gently chided the Federal Reserve to loosen credit. Agree or disagree, these views are not wildly outside the political mainstream.
What mattered was tone—the ability to debate issues without impugning the character of his opponents. To be sure, partisan debate is full of exaggerations and simplicities. Still, it usually respects some bounds of truth and civility. Following this traditional path, Trump might have boosted his popularity … Even fierce critics might have conceded that, in practice, the “boring” Trump wasn’t so bad.
The last two sentences are highly dubious. Given the centrality and therefore the high stakes in involved revising the eight major pillars of policies that Trump has taken on, the fierce by any means necessary opposition to Trump’s Restoration presidential purposes, the president’s fight back response is understandable. It is not likely to be defused by more polite urging that for example, our NATO allies should contribute more to the costs of their defense, or of the other listed Trump policies that critics disdain.
Au contraire. These and other Trump policies are efforts to replace the now dominant paradigms, and it is this effort that has helped fuel the ferocious opposition to the president. As to Samuelson’s ode to civility, very brutal and vicious personal attacks against Trump, his administration and his family have been plentiful since he won the Republican nomination (see Chapter 3). As noted, they include a Times Square billboard ad that depicts Trump being tied up and abused,61 and a tweet made public by Barbara Streisand depicts Trump killed by being impaled on Nancy Pelosi’s high heels.62 A picture depicting someone holding Trump’s severed bloody head63 shocks, but only briefly. Shortly thereafter, New York’s Public Theater revival portraying Trump as Julius Caesar and being assassinated64 entered the mainstream. Are these examples of “tone” just fine?
Samuelson supports his civility argument with a small list of Trump policies that “are collapsing.” In his view, Trump has made no progress in limiting North Korea’s nuclear arsenal. Leaving the Iran treaty has “emboldened” them. Trade negotiations with China have “fallen short.”
Trump’s policies “collapsing”? These are not serious criticisms, and they are surprising from someone of Samuelson’s usual thoughtfulness. The North Korean nuclear issue has been an extremely difficult and complex one for over half a century. Iran was “emboldened” to test missile components and supported terrorism throughout the Middle East long before Trump came into office. And it’s unclear what the ongoing, drawn out, complex and extremely difficult US–China trade negotiations have fallen short of at this point. A Phase I agreement has been signed. Isn’t that a milestone that would require some analysis? Shouldn’t an assertion that these efforts have “collapsed” be based on some idea of what is in the agreement and what remains to be done?
Diagnosing Trump’s Dangerousness: Bandy Lee MD and the Dangerous Case of Donald Trump
Accusations that Trump is unfit because of one or more of his psychological traits is more than a collage industry, it is a major and thriving hub of the anti-Trump narrative. Rather than examine the literally thousands of such accusations, we proceed by examining in some detail a major effort to organize and publicly advance the psychologically framed and biased narrative that Trump is a clear and severe danger to the country and the world.
In focusing on Trump’s “dangerousness” Dr. Lee and her contributors hope to bypass the ethical prohibitions against what they are doing. In fact, they still make the same extensive and questionable use of psychiatric and psychological terms and diagnoses, and run into the exact same problems. Simply putting the proscribed anti-Trump diagnosis into a new category, dangerousness, does not avoid the issues they try to finesse.
This effort was spearheaded by a psychiatrist, Dr. Bandy Lee and the contributors to a book she published entitled: The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. The book’s title is inaccurate in several respects. Several of the book’s contributors are not “mental health experts,” even by a loose understanding of that term. These include respectively a lawyer, a ghost writer for a major media personality, a “time perspective therapist”—whatever that is, a journalist, and a philosophy professor. Many of the other “mental health experts” have not earned the highest level degrees in the professions that would be most germane to providing the professional standing to make the kinds of psychological judgments they offer. What all the contributors do share is a clearly vehement aversion to all things Trump and a shared level of common assumptions and conclusions.
Twenty-Seven Psychiatrists and Mental Health Experts on Trump’s Dangerousness
The Dangerous Case of Donald Trump tries to avoid the professional and ethical issues associated with violating the Goldwater rule by claiming that it is not interested in a psychiatric diagnosis of the president. Rather it is interested in assessing the degree of his “dangerousness.” That assessment ultimately turns out to involve making a diagnosis, which they assert, in theory is not based on psychopathology using the DSM-5 and related psychological categories. However their more political diagnosis of dangerousness relies on the very same DSM-5 categories.
In the paradoxical words of Dr. Lee65:
Dangerousness is about the situation not the individual; it is more about the effects and the degree of impairment than on the specific cause of illness, and it does not require a full examination but takes into account whatever information is available. Also, it requires qualified professional error on the side of safety, and may entail breaking other ordinary binding rules to favor urgent action.
This is a recipe for a slapdash analysis drawing on “whatever information” that can further the presumptions that frame the effort. Dr. Lee in effect creates her own definition of the term she intends to use and not surprisingly finds it perfectly acceptable, even praiseworthy given the need for “urgent action.” It provides her and her contributors amply leeway, in theory, to bypass the ethical concerns that led to the Goldwater rule. In practice, the book stumbles over the very same ethical and assessment issues that Dr. Lee’s definition seeks to reassure readers have been resolved through the power of her definition.
Given that almost every chapter in the book focuses directly on President Trump’s dire and immediate psychological pathology and dangerousness, Dr. Lee adds this odd paradoxical disclaimer66:
In spite of its title, I would like to emphasize that this book is not about Mr. Trump. It is about the larger context that has given rise to his presidency, and the greater population that he affects by virtue of his position.
Dr. Lee’s own introduction to the book states,67 “Some would argue that by paying attention to the president’s mental state, we are colluding with him in deflecting attention from that by which he should be ultimately be judged: his actions … Certainly mental disturbance is not an excuse for tyrannical behavior; none the less, it cannot be ignored.”
Translation: This book in which every chapter, but one,68 takes up the specific issue of the level of President Trump’s dire level of psychological dangerousness, based on assessments of his severe level of psychiatric disturbance, is not about President Trump. Moreover, by using the same essential psychological categories that one would use for psychiatric diagnosis, but calling the result “dangerousness,” one can unconvincingly try to finesse and avoid the ethical responsibilities that accompany your professional training and title.
Given the book’s disclaimer and reassurance that it is not attempting to provide a psychological or psychiatric diagnosis it is a bit of a surprise to find that the first and longest book chapter concludes by referring to: “our case that Donald Trump is mentally unfit to be president of the United States.” Readers will also be surprised to find another very early chapter devoted to Trump’s “Delusional Disorder.”69 Perhaps by the fifth chapter, readers will not be surprised to find that the book’s disclaimer and reassurances are not supported by its content—to wit, the following question asked and answered: “Could [the author’s list of Trump behaviors] be expressions of significant mental derangement? The answer to that question is emphatically;Yes’.”70 And, of course, there are the de rigueur labelings of Trump’s “malignant narcissism”71 throughout the volume.
How Dangerous Is Donald Trump?
Leaving aside the large question of whether a diagnosis using psychiatric and psychological categories for analysis is still a diagnosis, one is left with the three questions. How dangerous is Donald Trump? Why is he dangerous? How do we know that he is dangerous?
The first question is easily answered. Every single author who addresses the issue of Trump’s dangerousness expresses the view that Trump is an immediate and dire danger:
Only in an emergency, should a physician breach the trust of confidentiality, and intervene without the consent, and only in an emergency should a physician breach the Goldwater rule. We believe that such an emergency now exists.72
While there have surely been American presidents who could be said to be narcissistic, but none have shown sociopathic qualities to the degree seen in Mr. Trump. Correspondingly, none have been so definitely and so obviously dangerous.73
[Trump] evinces the most destructive and dangerous collection of psychiatric symptoms possible for a leader. The worst case scenario is now our reality … the election of Donald Trump is a true emergency, and the consequences are likely to be catastrophic …74
Why Is Trump Dangerous?
That Trump is a very present, immediate, and dire danger is agreed to by almost every single one of the book’s twenty-seven contributors. Why Trump’s presidency is such a severe and present danger is not. Opinions vary, and the small sampling that follows cannot really do justice to the very large and diverse hypothetical calamities that a Trump presidency could, might, or may inflict on the country or the world—primarily war, nuclear or conventional. Other named consequences, like Trump’s supposed lack of “flexibility to switch gears … to deal with the functions of his job,” is exactly the opposite of a trait for which he is often criticized:
Fostered by the flattery of underlings and the chants of crowds, a political leader’s [née Trump] grandiosity may morph into grotesque delusions of grandeur. Sociopathic traits may be amplified as the leader discovers he can violate the norms of civic society and even commit crime with impunity.75
As is the case for extreme present hedonists, Trump is “chumming” for war, possibly for the most selfish of reasons: to deflect attention away from the Russian investigation.76
As pathological narcissists [née Trump] become increasing thought disordered their vision becomes clouded … On a global scale, as it did with Nixon, that if it feeds your ego, step up military action.77
As President, Trump is systematically shredding trust in institutions he now commands. [examples given are the intelligence community, the judiciary, and the media].78
In only the first four months of his presidency, he teed up for starting wars in three places, Syria, Afghanistan and North Korea.79
The paranoia of severe sociopathy (referencing Trump) creates a profound risk of war, since the heads of other nations will inevitable disagree with or challenge the sociopathic leader, who will experience the disagreement as a personal attack, leading to rage reactions and impulsive action to destroy the “enemy.”80
“See something, say nothing” seems to be the motto of the APA when it comes to national security. History will not be kind to a profession that aided the rise of an American Hitler through its silence.81
… surpassing the devastation of climate, health care education, diplomacy, social services, freedom of speech and liberty and justice for all [policies for which Trump is responsible for damaging] nothing is more incomprehensible than the now plausible prospect of all-out nuclear war … because of this very real existential threat …82
Trump anxiety disorder, albeit not a formal diagnosis … Symptoms of Trump anxiety disorder include: feeling a loss of control; helplessness; rumination/worries, especially about the uncertain sociopolitical climate while Trump is in office; and a tendency toward excessive social media consumption.83
This is potentially tragic for those people and issues ignored as a result of the dysfunctional relationship with this president. I am experiencing personally, as I spend much more time reading news articles, organizing rallies, writing letters and making phone calls[rather than] working to improve the mental health system.84
He doesn’t appear to have the flexibility to switch gears in order to deal with the functions of his job.85
How Do We Know That What Is Claimed About Mr. Trump’s “Dangerousness” Is True?
It is one thing to use clinical labels, whatever they may be, and quite another to provide evidence that they fit and are appropriate. Almost all the entries in this book, with one exception, assign diagnostic labels to President Trump, without much evidence for their assertions beyond their having been made. Efforts from those authors who do try to provide evidence are instructive. “Reportedly” is a well-worn word in these entries, as in “reportedly” Trump did this, or “reportedly” Trump said that.86 Efforts to follow through on and evaluate these “reportedly” reports are non-existent.
Incomplete Quotes, Lazy Analysis, and Factual Dishonesty
Interestingly, the use of the term “reportedly” refers to a number of reports that we now know are simply wrong. For example, the meme that Trump “demanded loyalty” from his then Attorney General is cited by several authors.87 We now have available James Comey’s memos of his conversations with President Trump and that part reads88:
He [Trump] then returned to loyalty saying “I need loyalty.” I replied that “he would always get honesty from me.” He paused and said that’s what he wants, “Honest loyalty.” I replied “you will get that from me.”
Comey further writes that he understood that exchange to be consistent “with what I had said throughout the conversation. I will serve the president with loyalty to the office, the country, and the truth.” However, almost all the reporting of that exchange, including those used to provide evidence in this book, say “Trump demanded loyalty,” period. The further clarifying exchange about “honest loyalty,” or Comey’s written statements of what he took from the exchange were, and are, not reported leaving a damaging but factually false impression. Those errors are not corrected in a subsequent edition.
Another entry, written by two psychiatrists, fault Trump’s presumed ignorance, and hence his unfitness, by directly relying on a reporter’s assertion that Trump “could not answer the simple question of ‘What are the top three functions of the American government?’”89 At first, it seemed that the reporter and the authors were referring to the three basic branches of American government, but on further inspection that proved not to be the case. The article referred to in the two psychiatrist’s bibliography, criticized Trump for not naming the top three functions that the author of the article thought should have been there. Trump named national security, health, and welfare—three key responsibilities as the government’s top three functions. The authors criticized Trump for not saying “domestic tranquility,” “conducting war, promoting peace and encouraging prosperity”90 which were the three that the author of the quoted article thought were right.
It’s hard to see how the two sets of answers—Trump’s and the reporter who criticized him for giving essentially the same “right” answers that she provided, differ. It is even harder to understand after reading the article, why the two psychiatrists drew upon that article to make their Trump-ignorance claim. One wonders if they actually read or understood it.
Finally, along similar lines, several authors make reference to Trump’s comment: “I alone can fix it,”91 delivered at the Republican National Convention. One contributor uses this as evidence that Trump “finds himself to be uniquely superior.”92 Another chapter using this quote begins one section entitled “The Narcissistic Personality” with that quote and a framing for its elements: “Believing that you’re better than others,” “believing that you’re special and acting accordingly,” and so on.93
The reality is quite a bit more prosaic. Mr. Trump said94:
I have joined the political arena so that the powerful can no longer beat up on people that cannot defend themselves. Nobody knows the system better than me, which is why I alone can fix it. I have seen firsthand how the system is rigged against our citizens, just like it was rigged against Bernie Sanders—he never had a chance.
Hyperbole? Clearly. Narcissistic? Not really. Trump has, in reality, spent an adulthood working the levers of the system as has almost every major business player seeking some favorable government ruling advantage. Does his familiarity with “the system” give him standing to say he knows the system? Yes, he has actually had an adulthood, starting with his apprenticeship with his father, of such familiarity.
Does his publicly stated promise to take this issue as a major focus of his presidency make him unusual, perhaps unique? Yes. As noted, Trump does see his restoration ambitions as including reforming a number of the country’s basic institutions. Trump’s convention assertion is also a strategically made election promise designed to reinforce his campaign stance as an outsider. He has followed through on efforts to reform some major domestic and international institutions including the FBI, DOJ, CDC, NSC, VOA, WHO, WTO, and others. These are unusual presidential efforts in their seriousness and range.
The Politics of Trump Psychiatric Assessments
In the chapters than make up Lee’s book there are also many ordinary author appeals to authority/ies to buttress their claims. In almost all of these entries, the authorities cited are like minded progressives (liberals, Democrats—whatever one’s preferred term). Among such cited authorities are vehemently anti-Trump individuals from the worlds of entertainment and politics: Eric Schneiderman (former New York State Attorney General), Morning Joe, Woody Guthrie, Adam Schiff, Rob Reiner, Rachel Maddow, Thomas Friedman, Lawrence O’Donnell, and Donny Deutsch.95 CNN, MSNBC, the New York Times, and the Washington Post—reliable anti- Trump media outlets are credited by one contributor with helping to save the country and preventing Trump “from doing more harm, from going the really radical route of Hitler.”96
The Goldwater diagnostic assessment was riddled with partisan political views, both liberal and conservative, undercutting any claim of professional objectivity. The same is true of Dr. Lee’s Trump effort except that all the bias flows in one direction, consistent with liberal or progressive thinking. A few examples should suffice.
One psychiatrist clearly reflecting his idealization of previous Democratic presidents and their policies wrote: “That society [American society as a result for FDR’s New Deal] reached the principle for its decency under the presidency of Barack Obama, who personified what it means to be a stable leader of a great and powerful nation.”97 Another, co-authoring his entry with Dr. Bandy Lee, who apparently approved of the sentiment, wrote98:
About a week into Trump’s term, the [Doomsday Clock] clock was moved again to two and one half minutes to midnight … I do not want to say that it is solely the impact of the Republican Party—obviously, that is false—but they are certainly in the lead openly advocating and working for the destruction of human species.
One of the oddest moments among many in the book comes when one of the contributors, a clinical psychologist, reports on his reading of Trump’s mind and dreams. He writes, “There is considerable evidence to suggest that absolute tyranny is DT’s wet dream.”99 The evidence?
Trump is noted to have said some very limited positive things about some very unsavory leaders with whom the United States has to deal. Trump pointed to the high odds against Kim Jong-un gaining power after his father died. He also noted Saddam Hussein’s harsh and effective measures against terrorists trying to bring down his government. He further noted that Bashar Al-Assad was still in power in spite of US policy under President Obama to remove him. And he noted that President Putin had played a weak domestic and international hand very effectively.
It is true that Trump has expressed the wish to get along with Russia. Yet, he has also been extremely tough on them strategically, providing lethal arms to Ukraine and imposing tough economic sanctions. None of this supports the author’s view that Trump “has tried to become more of the tyrant he wants to be, not less.”100
On Thinking That What You Think You Know Is Right
The various chapters in the Lee book provide very odd answers to the question of how do we know what we think we know and say in print about Trump? One contributor, a psychiatrist echoing Chief Justice Brennen on pornography, writes about Trump, “Sometimes a person’s dangerousness is so obvious that one does not need professional training in either psychiatry or criminology to recognize it.”101 This article then simply applies a string of psychiatric labels to Mr. Trump. Apparently evidence is optional as well.
Finally, there is the very basic and unasked question of why so much of the behavior that has come to define Trump and his presidency is so obvious and public? His tweets and rallies give an immediate window into his thinking and concerns at any particular time. His fights are public, as are his unorthodox views on a variety of subjects like waterboarding (Trump uses these words “torture” or “waterboarding” interchangeably in his private conversations).102
Yet it is these very same public statements and views that form the basis of diagnoses of Trump as suffering severe psychological impairment. The dilemma is unwittingly spelled out in two contributions to Dr. Lee’s book. In one, a psychiatrist who says that Trump has, “significant mental derangement” writes of him, “those who are good at manipulation, at appearing charming and caring, at concealing their immoral or illegal behavior and can bully their way to the top, do not end up as outcasts or in prison. There is a term for these people: successful sociopaths.”103
The problem here is immediately clear. If there is one thing that Trump has not tried to do, it is to keep his psychology and his views under wraps. He has not tried to appear “charming and caring.” Quite the contrary. Trump is clearly not afraid or inhibited to say what he thinks. Indeed, critics sometimes give the impression in talking about how Trump’s presidential demeanor is part of the rationale for his unfitness that they would prefer he learn how to project and display more of the virtues they associate with their preferred presidents, whether they are real or contrived.
Nor has Trump taken pains to conceal what his detractors claim are his immoral or illegal behaviors. His conversation with the Ukraine president was in Trump’s mind “perfect,” and in his opponents’ view grounds for impeachment. Trump did not need to make the transcript of that conversation public but did so in large part because he believed that he had done nothing wrong. Ditto for holding the next meeting of the G-7 at his MAR-a-LAGO golf club in Florida. That too was done publicly.
This dilemma was directly framed again, though not really addressed or resolved in another contribution to Dr. Lee’s book, to wit104:
Most abusers try to hide socially unacceptable actions; they are often polite to others, but abusive to a partner. Sadly, Trump makes no effort to mask his verbal abuse.
One could take the view that Trump’s inability to hide or mask his psychology is one reflection of its unbridled and uncontrollable will to power. As such, it would then become an indicator of the degree of his severe pathology. Paradoxically, in this formulation, an ability to mask pathology and “act normally” indicates higher level functioning.
Or, one could take the also somewhat paradoxical position that Trump is, in many ways, the most transparent of presidents. He does not, for the most part, try to hide or sugarcoat his personal views of his enemies or their motivations to destroy him, his family, his administration, and his presidency’s purposes. A number of his anti-critic salvos are startling for their bluntness, off-putting for the level of their personal nature, and unprecedented in their public nature. His policy views are also frequently bluntly stated, devoid of the usual hedging, and have not often been heard in the policy debates of the last four decades. That makes them startling and lightning rods for his critics.
A fair point would be that while Trump’s honesty about what he thinks and says may reflect either transparency (Trump supporters’ view) or pathology (Trump critics’ views), they are data that must be taken into account. That would require drawing some analytical lines that so far have not been in evidence. It would require honesty in reporting more fully what Trump actually said rather than only a part of an exchange that supports a particular anti-Trump narrative, as with Mr. Comey. It would require distinguishing between understandable and even supportable responses to harsh and inaccurate anti-Trump claims and accusations, and responses that cross the line into regrettable and avoidable behavior like his comments on Senator McCain’s military service or his unnecessary fight with the Democratic congresswoman riding in the car with a woman whose husband had just been killed in combat.
It would require honest acknowledgement that many disagreements with Trump are, basically, policy disagreements. They should be treated and debated as such. The assertions regarding Trump’s presumed psychiatric mental health issues, using the same criteria to further the narrative of his “dangerousness” should not serve as proxy for policy debates.
Assessing the Twenty-Seven Mental Health Experts’ Take on Donald Trump
Dr. Lee’s book fails on two very basic grounds. First, the “mental health experts” reach very diverse and often incompatible conclusions about Trump’s psychology. This is made very clear in an interview with Dr. Lee by a another, more professional and scholarly psychiatrist and published in Psychodynamic Psychiatry105:
Question: One could argue that your edited volume supports the ongoing need for the Goldwater Rule. Experts offer various diagnoses where emphasis depends upon one’s own perspective, and there is a risk of “throwing whatever you can at him to see what will stick.” For example, he is an “extreme present hedonist” as well as narcissist and bully (Zimbardo and Sword), narcissistic personality disorder with psychopathy (Makin), paranoid (Friedman), sociopathic (Dudes), mistrusting (Sheehy), impaired relationship with reality (most contributors), delusional disorder (Tansey), possible hypomanic temperament (Gartner), cognitive impairment. What do you make of the varied readings of Trump?
Dr. Lee: If you read them carefully, they are not actual diagnoses …The list was deliberately meant to be relatively “comprehensive” … as an exhaustive list of potential differential diagnoses that the public would benefit from knowing about, without our weighing in particularly on one diagnosis.
Here Dr. Lee acknowledges that she and her contributors are indeed making psychological and psychiatric diagnoses. She believes that her project is rescued by the making of “an exhaustive list of potential differential diagnoses that the public would benefit from knowing about, without our weighing in particularly on one diagnosis.” The Goldwater prohibition is meant to caution regarding the making of public diagnosis. That issue is not avoided by making many diagnoses instead of one.
Moreover, each individual author did weigh in on one, or several, psychological and psychiatric diagnoses that they claimed characterized Trump. Collectively there were many, varied diagnoses, though most chapters focused in on one. In so doing, contributors were presented, and presented themselves, as qualified to do so. Their Trump observations, assertions really, were meant to be buttressed by what they doubtlessly felt was their professional authority. The fact that all these “mental health experts” reached very different conclusions echoes the diverse clinical and political views in the Goldwater assessment fiasco. This undercuts confidence both in their conclusions, the validity and legitimacy of their assessments, and their ethical lapses in providing them.
Second, and equally important, only one of the book’s twenty-eight entries (see directly below), discussing cognitive assessments, raises an issue that permeates and undercuts the whole effort, namely whether the attempted diagnosis is psychiatric or political “dangerousness.” This author writes106:
Based on the limited information available, persons with professional training could provide public opinions regarding a candidate’s intellect [and by inference other traits], but the database that even professionals can use remains inadequate and incomplete, and differentiation between objective and clinically “solid opinions versus political biased propaganda is an insurmountable problem. At the current time, I view this as a problem without any solution in the near future.”
Dr. Reiss concluded by worrying that, “pernicious manipulation by unscrupulous clinicians cannot be avoided.”107 He concludes thusly108: “applying clinical/ medical knowledge to a political process is practically complex and daunting with regard to the issues of objectivity, the setting of parameters (e.g., for qualification/disqualification) and the avoidance if ill-informed and /or malicious manipulation.”
One wonders, reading through the rest of the entries in this book, how Dr. Reiss’ paper highlighting a fundamental flaw in the whole effort, made it through the editor’s review process.
“Mental Health Experts” Opine to Congress: Impeach Trump. We’ll Testify
During the House impeachment hearings, Dr. Lee and her group of “mental health experts” petitioned Congress to immediately remove President Trump from office. They also offered to testify against him. A cornerstone of the argument that anti-Trump “mental health experts” made against allowing him to remain in office was because, among other things, the “president lacked the ability to make rational decisions.”109
Their particular claims were a hodge-podge of political disagreements, dire and wholly speculative warnings of potential disaster (“We bear in mind that Donald Trump, as President, has the unfettered authority to launch nuclear weapons at any time for any reason”), and factual errors (the separation of families crossing the South border without permit was a policy initiated by President Obama).
The petition to Congress actually contains the following analysis (emphasis added):
Without this external affirmation, President Trump has revealed that he feels, deep down, like a loser, a failure, weak, dumb, fat, ugly, fake, “crooked.” We know this because these self-denigrating pictures of himself, President Trump projects onto others, whom he transforms into enemies, and compensates consciously by creating a grandiose image of himself as unique, a stable genius.
The organizers of this petition apparently feel that on the basis of their familiarity with Trump’s tweets, that they have unique insight into the unconscious origins of his motivation. That astounding position in itself would qualify as “grandiose,” aside from being wholly dependent on claimed “expertise,” rather than real evidence. Their claim is fatally compromised by the level of unsubstantiated speculation, its public political nature, their reliance on presumed personal knowledge of Trump’s unconscious motivations that they can’t possibly intuit from his tweets, the lack of serious analysis that goes beyond quoting the latest headline, and their obvious and raw anti-Trump animus.
There is however one final element to consider in the analysis in the group Dr. Lee has assembled to diagnosis Trump and that is their dismissal of any views that differ with theirs. Dr. John Zimmer, one of the three major signers of the petition to Congress to impeach and remove Trump from office because of his dangerous mental impairments was asked about Republicans who defend Trump.
He110 “dismissed Republicans who defend Mr. Trump by claiming that his style as that of a blunt-talking New York businessman as ‘simply ignorant about the whole area of psychology that pertains to him.’” He continued, “These aren’t alternative viewpoints,” Dr. Zimmer explained, calling one “the product of very sound psychology … that comes from mainly from psychoanalytic theory, but is very established and sound and studied,” and the other “just ignorance and dismissiveness.”
QED.
Notes
1.
Issac Stanley-Becker and Sean Sullivan. 2016. “Obama: Trump Is ‘Unfit to Serve as President’,” Washington Post, August 2.
2.
Greg Sargent. 2016. “Republicans Nominate Dangerously Insane Person to Lead America, Then Panic When He Proves He’s Dangerously Insane,” Washington Post, August 16; see also John Gardner and Steven Buser (eds.). 2018. Rocket Man: Nuclear Madness and the Mind of Donald Trump. New York: Chiron Books.
3.
Michael D’Antonio. 2016. “Trump Never Wanted to be America’s President; He Wants to be Its Czar,” CNN, November 16; see Max Boot. 2016. “The Nazi Echoes in Trump’s Tweets,” Los Angeles Times, October 17; and Robert Kagan. 2016. “This Is How Fascism Comes to America,” Washington Post, May 18. For a dissent of the Trump-as-Nazi view, see Rich Lowry. 2018. “The Tawdry and Dumb Nazi Charge,” Politico, June 27.
4.
Adil E. Shamoo and Bonnie Bricker. 2017. “It’s Time to Take the Nazi-Trump Comparisons Seriously,” Foreign Policy in Focus, August 23.
5.
Brooke Singman. 2019. “Nadler Likens Trump to ‘Dictator,’ Threatens Barr with Contempt After Hearing Boycott,” Fox News, May 2.
6.
Michael Gerson. 2018. “Trump Has Revealed Who He Is. Now It’s Our Turn,” Washington Post, January 15.
7.
James Risen. 2018. “Is Donald Trump a Traitor?” The Intercept, February 2; see also Max Boot. 2018. “We Just Watched a U.S. President Acting on Behalf of a Hostile Power,” Washington Post, July 16.
8.
David Rothkopf. 2017. “The Greatest Threat Facing the United States Is Its Own President,” Washington Post, July 4. Rothkopf’s indictment of President Trump’s “fitness,” employ the litany approach to supporting their assertions. Supposed examples supporting his view are asserted in a single sentence or as part of one. On occasion, “evidence” is presented in the form of links to others who have made the same accusations. Occasionally phrases like “tweeting hysterically at the media” or “his malignant and ever-visible narcissism” are made without further discussions or evidence—inviting the similarly inclined reader to share the author’s assumptions. No actual evidence is considered. Assertions, not vetted and validated, are felt to suffice. And for many, they often do.
9.
Steven Levitsky and Daniel Ziblatt. 2018. How Democracies Die. New York: Crown.
10.
Yascha Mounk. 2018. The People vs. Democracy: Why Our Freedom Is in Danger and How to Save It. Cambridge, MA: Harvard University Press.
11.
Anca Gurzu. 2019. “Labour’s Thornberry: Trump Is a ‘Threat to Our World Order’,” Politico, April 27.
12.
I have in my files a very large number of these kinds of guilty by conclusion, not by evidence assertions, already noted in endnote 8 above, that almost always rely on the author’s conclusions regarding the latest Trump political tempest—without much effort to gather and weigh evidence beyond those that support their presumptions—usually quotes of liked minded people.
13.
The term, and the training necessary to use it, may be specified in state law. In New York State, the term “psychologist” is so defined, but a term like “therapist” is not. Individuals with PhD’s in Clinical or Counseling Psychology obviously have psychological training but may or may not be state licensed for a variety of reasons. The same is true of many persons who hold MSWs in Social Work.
14.
Shakespeare 1600, Act-II, Scene-II.
15.
Matthew Lee. 2017. “AP FACT CHECK: Overlooking Doubts on Syria Chemical Weapons,” ABC News, April 10.
16.
Richard C. Friedman MD and Jennifer Downey MD. 2018. “Editorial: Psychiatric Ethics and the Goldwater Rule,” Psychodynamic Psychiatry, Vol. 46, No. 3 (Fall), pp. 323–333.
17.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing.
18.
As noted in the last chapter, two recent articles on the major issues surrounding the American Psychiatric Associations Revision (DSM-5) of its Diagnostic and Statistical Manual (DSM-IV) were recently published online in which twenty-four psychiatrists with diverse views engaged each other in trying to answer the following six most essential questions in psychiatric diagnosis including the nature and definition of a mental disorder and the validation of evidence used to support these formulations. See James Phillips, Allen Frances, Michael A. Cerullo, John Chardavoyne, Hannah S. Decker, Michael B. First, Nassir Ghaemi, Gary Greenberg, Andrew C. Hinderliter, Warren A. Kinghorn, Steven G. LoBello, Elliot B. Martin, Aaron L. Mishara, Joel Paris, Joseph M. Pierre, Ronald W. Pies, Harold A. Pincus, Douglas Porter, Claire Pouncey, Michael A. Schwartz, Thomas Szasz, Jerome C. Wakefield, G. Scott Waterman, Owen Whooley and Peter Zacher. 2012. “The Six Most Essential Questions in Psychiatric Diagnosis: A Pluralogue Part 2: Issues of Conservatism and Pragmatism in Psychiatric Diagnosis,” Philosophy, Ethics, and Humanities in Medicine: PEHM, Vol. 7, No. 8 (April).
19.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth ed.). Arlington, VA: American Psychiatric Publishing, p. 103.
20.
Ibid., p. 661.
21.
Cf., Bandy Lee, MD et al. 2017. The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. New York: Thomas Dunne Books.
22.
The section that follows draws on Stanley A. Renshon. 1996. The Psychological Assessment of Presidential Candidates. New York: New York University Press, chapter 5.
23.
Ralph Ginzberg. 1964. “Goldwater: The Man and the Menace,” Fact, Vol. 4, No. 2–4, p. 3.
24.
Arnold Rogow. 1970. The Psychiatrists. New York: Putnam.
25.
Ginzberg 1964, p. 54.
26.
Ginzberg 1964, p. 62.
27.
Ginzberg 1964, p. 63.
28.
Ginzberg 1964, p. 54.
29.
Ginzberg 1964, p. 3.
30.
Ginzberg 1964, p. 3.
31.
Ginzberg 1964, p. 37.
32.
Ginzberg 1964, p. 40.
33.
Rogow 1970, p. 129.
34.
Ginzberg 1964, p. 24.
35.
Ginzberg 1964, p. 30.
36.
Ginzberg 1964, p. 63.
37.
Ginzberg 1964, p. 42.
38.
George T. Conway III. 2019. “Unfit for Office,” The Atlantic, October 3; see also Rothkopf 2017. Both Conway and Rothkopf’s indictment of President Trump’s “fitness,” employ the litany approach to supporting their assertions in which single one-sided assessments of Trump’s behavior or policies are aggregated to make the unfitness claim.
39.
Cf., Conway writes that Trump “ordered the revocation of the security clearance of a former CIA director who had criticized him.” He did not. See John Bennen. 2019. “Remember When Trump Said He’d Revoked Brennan’s Security Clearance?” NBC, May 28.
40.
Conway 2019, emphasis added.
41.
Laurence H. Tribe. 2017. “Trump Must be Impeached. Here’s Why,” Washington Post, May 13; see also Allan J. Lichtman. 2017. The Case for Impeachment. New York: Dey St. Books; and Laurence Tribe and Joshua Matz. 2018. To End a Presidency: The Power of Impeachment. New York: Basic Books.
42.
Ross Douthat. 2017. “The 25th Amendment Solution for Removing Trump,” New York Times, May 16; Phil McCauslandl. 2017. “Democratic Bill Lays the Groundwork to Remove Trump from Office,” NBC News, July 3; and Michael Isikoff. 2017. “Bill to Create Panel That Could Remove Trump from Office Quietly Picks up Democratic Support,” Yahoo News, June 20.
43.
Lauren Gill. 2018. “Trump ‘Psychologically Unfit,’ Nuclear Tweet Is Grounds for Removal, Former Bush Ethic Lawyer says,” Newsweek, January 3.
44.
Rothkopf 2017.
45.
John McCormack. 2016. “Unfit to Serve,” The Weekly Standard, May 16.
46.
Emily Joffe. 2017. “Is Donald Trump a TV Addict?” Politico, July 7.
47.
David Brooks. 2017. “When the World Is Led by a Child,” New York Times, May 15.
48.
Tana Ganeva. 2019. “Bandy X. Lee Discusses What Prompted Her to Speak Out About the President’s Psychological Problems,” Salon, May 7.
49.
Megan McArdle. 2019. “When will Trump Supporters Finally Say, ‘Okay, This Is Not Normal’?” Washington Post, August 23.
50.
Michelle Goldberg. 2017. “An Unfit President Fails Puerto Rico,” New York Times, October 3.
51.
A comprehensive after report on the Federal government’s efforts during the 2017 hurricane season including its preparation and response to Hurricane Maria that hit Puerto Rico can be found in FEMA 2018. https://www.fema.gov/media-library-data/1531743865541-d16794d43d3082544435e1471da07880/2017FEMAHurricaneAAR.pdf.
52.
Stanley-Becker and Sullivan 2016.
53.
Jonathan Capehart. 2015. “Unfit for the Oval Office,” Washington Post, September 21. Thomas Caplan. 2016. “John Kasich Calls Trump Unprepared to be President,” New York Times, April 1; see also Chas Danner. 2015. “Donald Trump Responds to Muslim Question Controversy [Updated],” New York Magazine, September 20.
54.
Alexander Burns. 2016. “Donald Trump Seeks Republican Unity But Finds Rejection,” New York Times, May 6.
55.
That quote continues, “The severely sleep-deprived are more impulsive, less adaptable and prone to snappish decisions, and they have trouble listening to others. They miss out on essential REM time, which allows people to process emotions and events in their lives. Smaller things set them off.” See Timothy Eagan. 2016. “A Unified Theory of Trump,” New York Times, February 26.
56.
Caplan 2016.
57.
Ramesh Ponnuru. 2016. “How Clinton Can Demolish Trump,” Bloomberg, May 26.
58.
John McWhorter. 2019. “Trump’s Typos Reveal His Lack of Fitness for the Presidency,” The Atlantic, January 11.
59.
Chris Kirk, Ian Prasad Philbrick, and Gabriel Roth. 2016. “153 Things Donald Trump Has Said and Done That Make Him Unfit to Be President,” Slate, November 7.
60.
Robert J. Samuelson. 2019. “Why We Should Impeach and Remove President Trump,” Washington Post, October 20, emphasis added.
61.
Abha Bhattari. 2019. “Retailer Buys Controversial Trump-themed Billboard in Times Square,” Seattle Times, October 18.
62.
Leah Mcdonald and James Gordon. 2019. “Barbra Streisand Shares a Gruesome Cartoon of Nancy Pelosi Impaling and Killing Trump with a Giant Heel,” Daily Mail, October 20.
63.
Chancellor Agard. 2017. “Kathy Griffin Bloody Trump Pic Defended by Photographer,” Entertainment, May 30.
64.
Liam Stack. 2017. “Et Tu, Delta? Shakespeare in the Park Sponsors Withdraw from Trump-Like ‘Julius Caesar’,” New York Times, June 11.
65.
Bandy Lee MD. 2017 “Introduction,” in Bandy Lee (organizer), The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. New York: St. Martin’s Press, pp. 11–22, p. 14.
66.
Lee MD. 2017, p. 18, emphasis added.
67.
Judith Lewis Hermann MD and Bandy Lee MD. 2017. “Prologue: Professions and Politics,” in Bandy Lee (organizer), The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. New York: St. Martin’s Press, pp. 1–10, p. 8, emphasis added.
68.
David M. Reiss MD. 2017. “Cognitive Impairment. Dementia, and Potus,” in Bandy Lee (organizer), The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. New York: St. Martin’s Press, pp. 126–135.
69.
Michael J. Tansey. 2017. “Why ‘Crazy Like a Fox’ Versus ‘Crazy Like Crazy’ Really Matters: Delusional Disorder, Admiration of Brutal Dictatorships, the Nuclear Code, and Trump,” in Bandy Lee (organizer), The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. New York: St. Martin’s Press, pp. 110–125.
70.
Lance Dodes MD. 2017. “Sociopathy,” in Bandy Lee (organizer), The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. New York: St. Martin’s Press, pp. 83–92.
71.
Lee MD. 2017, pp. 58, 84, 94, 98, passim.
72.
Phillip Zimbardo and Rosemary Sword. 2017. “Unbridled and Extreme President Hedonism,” in Bandy Lee (organizer), The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. New York: St. Martin’s Press, p. 6.
73.
Dodes MD. 2017, p. 91.
74.
John D. Gardner. 2017. “Donald Trump Is (A) Bad, (B) Mad, (C) all of the Above,” in Bandy Lee (organizer), The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. New York: St. Martin’s Press, pp. 93–109, p. 107, emphasis added.
75.
Hermann MD. and Lee MD. 2017, p. 7.
76.
Zimbardo and Sword 2017, p. 47.
77.
Craig Malkin. 2017. “Pathological Narcissism and Politics: A Lethal Mix,” in Bandy Lee (organizer), The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. New York: St. Martin’s Press, pp. 51–68, p. 62.
78.
Gail Sheehy. 2017. “Trump’s Trust Deficit Is the Core Problem,” in Bandy Lee (organizer), The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. New York: St. Martin’s Press, pp. 75–82, p. 76.
79.
Sheehy 2017, p. 81.
80.
Dodes MD. 2017, p. 91.
81.
Gardner 2017, p. 107.
82.
Tansey 2017, p. 121.
83.
Jennifer Contarino Panning. 2017. “Trump Anxiety Disorder,” in Bandy Lee (organizer), The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. New York: St. Martin’s Press, pp. 235–243, p. 237.
84.
Harper West. 2017. “In Relationship with an Abusive President,” in Bandy Lee (organizer), The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. New York: St. Martin’s Press, pp. 244–260, p. 258.
85.
Steve Wruble MD. 2017. “Trump’s Daddy Issues,” in Bandy Lee (organizer), The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. New York: St. Martin’s Press, pp. 268–280, p. 274.
86.
Cf., Lee MD. 2017, pp. 63, 72, 120.
87.
Ian Schwartz. 2018. “CNN Focus Group of Trump Voters: ‘Exactly What I Voted for’,” Real Clear Politics, February 13, p. 72.
88.
James Comey. 2017. “My Notes from Private Session with PE 1/6/17,” emphasis added. https://www.documentcloud.org/documents/4442900-Ex-FBI-Director-James-Comey-s-memos.html.
89.
Nanette Gartrell MD. and Dee Mosbacher MD. 2017. “He’s Got The World in His Hands and His Finger on the Trigger: The 25th Amendment Solution,” in Bandy Lee (organizer), The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. New York: St. Martin’s Press, pp. 319–342, p. 348.
90.
Laura Brown. 2016. “Government Stumps Trump,” U.S. News and World Report, March 31.
91.
Lee MD. 2017, pp. 36, 95.
92.
Dodes MD. 2017, p. 95.
93.
Zimbardo and Sword 2017, pp. 36–37.
94.
Politico Staff. 2016. “Donald Trump 2016 RNC Draft Speech Transcript,” Politico, July 21.
95.
Lee MD. 2017, pp. 96, 99, 100, 165, 255.
96.
Henry J. Friedman MD. 2017. “On Seeing What You See and Saying What You Know: A Psychiatrist’s Responsibility,” in Bandy Lee (organizer), The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. New York: St. Martin’s Press, pp. 160–169, p. 165.
97.
Friedman MD. 2017, p. 166.
98.
Noam Chomsky and Bandy Lee MD. 2017. “Epilogue,” in Bandy Lee (organizer), The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. New York: St. Martin’s Press, pp. 356–359, p. 358, emphasis added.
99.
Tansey 2017, p. 115, emphasis in original.
100.
Tansey 2017, p. 119, emphasis in original.
101.
James Gilligan MD. 2017. “The Issue Is Dangerousness, Not Mental illness,” in Bandy Lee (organizer), The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. New York: St. Martin’s Press, pp. 170–180, p. 173.
102.
Jonathan Swan. 2019. “Trump Said CIA Director Gina Haspel Agreed with Him ‘100%’ on Torture,” Axios, November 17.
103.
Dodes MD. 2017, pp. 84–85.
104.
West 2017, p. 254.
105.
Larry Sandberg MD. 2018. “Interview with Bandy Lee,” Psychodynamic Psychiatry, Vol. 46, No. 3, pp. 335–355, emphasis added.
106.
Reiss MD. 2017, p. 128.
107.
Reiss MD. 2017, p. 131.
108.
Reiss MD. 2017, p. 134, emphasis added.
109.
World Mental Health Coalition. 2019. “PETITION TO THE JUDICIARY COMMITTEE OF THE U.S. HOUSE OF REPRESENTATIVES,” December 5.
110.
Zimmer quoted in Andrew Fineberg. 2019. “Trump’s Mental State Is deteriorating Dangerously Due to Impeachment with Potentially ‘Catastrophic Outcomes,’ Psychiatrists Urgently Warn Congress,” The Independent, December 4.