The Dangerous Case of Donald Trump

27 Psychiatrists and Experts Assess a President

by Dr. Bandy Lee

   Reviewed by Theresa Welsh

Does the Donald Trump presidency pose a clear and present danger to all Americans and to the world? This book, essays by a group of mental health professionals who have studied the public pronouncements and behavior of President Trump, says yes.

BACKGROUND

The book arose out of a conference hosted by the book's author, Dr. Bandy Lee, called The Duty to Warn Conference, held on April 20, 2017 at Yale University. Dr. Lee disagreed with the "gag order" of her professional organization, the American Psychiatric Association, against members speaking publicly about Trump's perceived mental health status. She felt the organization went beyond the "Goldwater Rule" against publicly diagnosing someone who you have not seen professionally. She felt that mental health professionals also have a responsibility to the public to speak out about what they see as behavior and traits that are dangerous in a public official and could bring considerable harm to society. In the case of a president with access to nuclear weapons, the results could be deadly for millions of people. Increasing instances of what appeared to be unstable actions and a history of bullying behavior convinced Dr. Lee to "do something" about Donald Trump. So she began arranging for the conference.

Dr. Lee found many of her colleagues agreed with her assessment of Trump as dangerous, but most, in the beginning, were reluctant to go public with their professional opinion. They feared retaliation from the Trump people or being ostracized in their profession. She states that "only two dozen physically attended the conference in an atmosphere of fear, about a hundred tuned in online, and hundreds more got in touch with me for recordings or in a show of support" when the conference was over.

When Dr. Lee got around to requesting papers for a book, she found herself swamped with submissions, and several publishers immediately wanted the book. The finished book benefits from the ultimate decision by so many to come forward with their views on Trump, and Dr. Lee's wise choice of the final contents; I found all the essays to be interesting and well-written.

ORGANIZATION OF THE CONTENTS

The book takes on the problem of the Trump presidency in three parts:

  • First, how these professionals see the known behavior of Trump before and after his election win,
  • Second, how mental health professionals should approach the question of whether to speak out or not, as to Trump's fitness for the office and,
  • Third, how the Trump presidency is affecting Americans, especially the majority who did not vote for him.

The third section is especially interesting for people like me who were appalled and frightened at the prospect of someone they consider so unqualified, uninformed and unfit for the office -- besides being a person whose values and actions do not reflect America -- becoming President of the United States. In the liberal community where I live, awash in Bernie voters, the disbelief and shock was almost palpable.

WHAT THEY SAY ABOUT DONALD TRUMP

John D Gartner, in his essay (Donald Trump is: A) Bad B) Mad C) All of the Above) states:

Donald Trump is so visibly psychologically impaired that it is obvious even to a layman that 'something is wrong with him'. "

This seemed to be the thinking of many of the writers. They felt Trump's history of selfish behavior, lying, cheating his subcontractors, lewd comments and inappropriate behavior toward women, impulsive actions and speech, vengeance and cruelty towards others, denial of readily provable facts and lack of remorse and empathy were obvious traits of the man. In their lives as mental health professionals, they recognized symptoms of a personality disorder, potentially dangerous in a president. They came to the conclusion that they indeed do have a "duty to warn."

The psychiatrists/psychologists who weighed in on exactly what's wrong with Donald Trump used a number of different labels to describe his deficiency. Authors Sword and Zimbardo called him an Extreme, Present Hedonist. This is someone who is always in the present moment without a thought to the future impact of his words or deeds. Many mentioned narcissism, explaining different levels of this personality trait which is basically an inflated sense of one's importance coupled with selfishness and lack of empathy for others. Narcissists need constant reassurance of their greatness and feed on the adulation of an audience. Narcissism can become a diagnosis when it becomes so pronounced that professionals use the label Narcissistic Personality Disorder (NPD).

But even worse is the general label malignant narcissist, which Erich Fromm, who first defined it in 1964, called "the quintessence of evil." Fromm was a refugee and holocaust survivor from Nazi Germany who had a lifelong obsession with "the psychology of evil." He came up with this term to describe Adolph Hitler. Many of the essay writers see the same traits in Donald Trump and label him a malignant narcissist. Others use the terms sociopath or personality disorder or delusional disorder or cognitive impairment or severe character pathology.

Especially concerning is the label sociopath. A sociopath is always a threat to society. This is an individual who reacts to disappointment with rage, blames others, holds delusional beliefs and is capable of criminal behavior. Sociopaths "project" their own faults onto others they attack. Consider that Trump claimed Hillary Clinton is "the most corrupt person to ever seek the presidency" when evidence coming to light every day seems to indicate that description would fit Donald Trump. He claimed SHE misused funds in the Clinton Foundation when he used funds in his OWN foundation to fund a giant portrait of himself. Donald Trump consistently accuses those he doesn't like of faults that he himself exhibits.

Do these essay writers have a point? I couldn't argue with their descriptions of Donald Trump and their contention that these kinds of personality disorders are a danger to all of us. I find other things, some not mentioned, also distressing, like Trump's inability to inspire or lift us up as other eloquent presidents have done (think Kennedy, Reagan, Obama); his inability to provide basic comfort and sympathy to families of victims of military attacks, terrorist attacks or just crazy killers; his childish and limited vocabulary that depends on repeating superlatives like "great" "tremendous" or "wonderful" and multiple use of "very" in badly-put-together sentences or non-sentences (he does not appear to be educated); his bloviated descriptions of himself as "smart" and "I know more about ISIS than the generals" and "I alone can fix it." It is difficult to see how voters could have failed to notice all these deficiencies.

WHAT SHOULD MENTAL HEALTH PROFESSIONALS DO?

In the section of essays on the mental health professionals' view of speaking out vs. not speaking out, one essayist tries to explain how the public could have misunderstood some of the qualities they saw in Trump and like what they perceived as his going against "political correctness" or thinking the rough comments showed he is "authentic" or "tells it like it is." Some people confuse cruelty with strength. But this essayist felt this misunderstanding heightens the need for mental health professionals to offer a personal opinion informed by their professional experience, discussing openly the malignant nature of Trump's narcissism, that he is a person who does not learn from his mistakes or grow into the office.

Another essayist writes about Trump's paranoia and compares him to totalitarian heads of state and says such people "consistently produce ideas and responses that find exaggerated danger and malevolent intention in others and in the situations he encounters." This essayist accepts the comparison with Hitler. He says Trump has not shut down the free press and killed his opponents because he cannot get away with it in our democracy and mental health professionals need to point this out. This essayist writes:

" While it is true that the restraints operating in our country have prevented Trump from moving as swiftly as Hitler did, this can be attributed to the balance of powers and the greater strength of our democratic traditions rather than to any sense that Trump's patterns of emotional thinking are greatly different from those that motivated Hitler. "

Another one of the essayists tried to bring the discussion away from mental health diagnoses or labels and simply look at Trump's dangerous tendencies. Do you want a president who had to ask "If we have nuclear weapons, why can't we use them?" Or, one that advocates using torture on our enemies? Or one who maintains an insidious lie even when the lie is exposed? (Obama's birthplace, the Central Park jogger case, size of his inaugural crowd, etc.) One who encourages his supporters to punch and beat protesters? One who believes he can get away with anything? ("I could stand in the middle of 5th Ave and shoot someone and I wouldn't lose any support.") Think about it!

Another essayist affirms the negative response by large numbers of Americans and even people in other nations to the election of Donald Trump. The Women's March on Washington following the election was the largest protest gathering in the history of the United States. There were marches all around the country and in some foreign countries protesting the choice of Trump as president. This writer also makes the following observation:

" Unable to tolerate criticism and perceived threats to his ego, and with a documented obsessive need to be admired, he (Trump) has notably selected as his advisors either family members or people who, in clinical jargon,' enable' his illness. "

TRUMP'S EFFECT ON AMERICA

The last section of the book is essays dealing with how America reacted to the election of Donald Trump. With all the polls showing Clinton had a sizable lead, few people thought Trump would be our president. And yet, it happened.

I know I felt total despair and disbelief on election night 2016. The next morning, after a restless night of worry, I wrote in an email to my family members "... the sun still rose this morning ... " I could hardly believe the world was still intact after such a devastating event. I did not know how I, or we as a nation, would or could go on with a man who is a pathological liar; who treats women like disposable objects; who bullies his way through life, disregarding the rights and feelings of others; who cheats on his wives, avoids paying taxes; cheats employees and people attracted to his phony Trump University; who couldn't make money running a casino but claims to be a big business success; who advocates bringing back torture; who threatens his opponents with jail and even murder; who appears to not understand how our government works and who, along with his sons, has expressed total contempt for the US government; who insults our security agencies and has failed to fill necessary government jobs because he does not think he needs professionals; who admires the tyrants of the world like Putin, Erdogan, and Duterte... HOW such a man could become our president??? How could ANYONE have voted for this man?

These final essays show me that I was not alone in responding with despair to the election. These therapists saw a lot of patients suffering from trauma after the election, feeling "exposed, vulnerable and helpless" according to essay writer Betty Teng, a hospital trauma therapist. Another therapist said his patients were suffering more than patients he saw after the 9/11 attacks. That was one finite attack, but the Trump presidency is worse because "Trump was elected by those among us and his aggression feels incessant and never-ending."

Following the election, the news was full of stories of hate crimes as bigots and bullies (even school children) felt empowered to publicly insult and threaten those "others" they didn't like, immigrant communities were seized with fear and alt-right propagandists ramped up their anti-minority rhetoric. What kind of changes would the election of a bully like Trump bring for those who felt helpless? We are a country of diverse cultural and religious backgrounds, held together, not by race or ethnicity, but by shared American values. At least that was America before we elected Donald Trump President of the United States.

Trump will continue to claim that our opposition to him is just us not liking that we lost. But this level of alarm and despair at the outcome goes beyond that. It left many Americans angry and afraid and wondering how such a thing could have happened and what, if anything, they could do about it.

Yes, I voted for Hillary Clinton, but my vote was more about not wanting Trump than it was about wanting Clinton. The unexpected election result left me full of anger, at the Trump win and at all those people who voted for Trump, who, I felt, I could NOT forgive. And I actually know some people who DID vote for him. They seemed to have bought into some of what Trump said. His voters seemed to feel estranged from the traditional party positions and were attracted to the idea of bringing more jobs back to our shores. Those messages resonating, combined with a dislike of Clinton, accounts for their vote. Some Trump voters cast reluctant votes (they would have liked a better choice of candidates) and no doubt some who voted for him must have regrets.

Some Trump voters were one-issue voters. One of the essay writers tells us about his Jewish father who supported Trump because of his stated strong support for Israel. His son thought that was not enough to make up for the man's deficiencies, but noted that many voters look at only one issue: abortion, gun rights, gay rights, etc. They are willing to overlook everything else if the candidate is on the right side of their issue.

Many explanations have been put out there (and let's not forget that Clinton actually won the popular vote) but I think the reason Trump won is complicated and cannot be reduced to the standard "a bunch of disgruntled old white men who lost their factory or coal mine jobs voted for him." That is too simple an explanation and goes against the actual findings of who his voters were. Many were employed at good jobs with above-average income.

We have to admit that Trump's despicable qualities actually look good to some people. Maybe some people would like to be as rich and powerful as he is and don't mind that he is contemptuous of our system of government and threatens anyone who disagrees with him. Perhaps they would be ok with an authoritarian government led by a tyrant who can issue orders that go unquestioned. Have we created a lot of citizens with vapid materialistic goals, no conscience and a lack of understanding of basic American values as expressed in the Bill of Rights and inherent in our co-equal, three-branch government system (judicial, legislative, executive) ?

One essayist comments:

" Is Trump the end product of our culture of narcissism? Is he what we get and deserve because he epitomizes the god or gods we currently worship in our mindless, consumerist, hyperindulgent cult of continuous stimulation and entertainment? "

The same essayist compares the Trump victory to words from George Orwell's futurist book, 1984, which says the people in Orwell's frightening vision of an authoritarian takeover could be "made to accept the most flagrant violations of reality..." That is what Donald Trump is intent on doing to all of us.

In my own case, as the year moved forward and I tried to adjust, I found myself getting physically ill. I spent most of the month of June in the hospital with a life-threatening condition. I came to believe that my anger at having to live in a world where Donald Trump is President of the United States had caused my illness. If I wanted to go on with my life, I had to get my anger under control and begin to believe that this too shall pass. I had to rediscover the goodness in the American people. The one-year-later election in November 2017 that brought out scads of new candidates opposed to Donald Trump has given me a lot of hope for our future. The Rachel Maddow show on MSNBC put up a row of photos of white men who were defeated for seats in the state of Virginia House of Delegates. Under it appeared a row of photos of the winners. All but one were women! (and he was running because his girl friend, a journalist, was killed on live TV and he wanted to continue her ideas) And the faces were not all white. The contrast was so amazing! These are the faces of our new leaders who resist the low-life approach of a bully like Donald Trump.

History is cyclical and we have had bad times before (how would it have been to live during the Civil War, for example?) and have come through them. The outpouring of resistance to the Trump agenda is encouraging, (the Women's March happened right after the election, an immediate incredibly strong anti-Trump reaction fueled by "woman power"). The inability Trump has shown to actually accomplish anything has limited the damage. Our democratic processes have worked, as the judicial branch has shot down his more outrageous executive orders and the legislature forced him to accept sanctions against Russia; even as I write this, Special Prosecutor Robert Mueller is turning up evidence of ties between people in Trump's orbit and Russian oligarchs tied to Vladimir Putin. There is a real possibility that Trump will not be able to finish out his term of office. He might be forced out through resignation, impeachment or the 25th amendment.

The statements of the professionals in this book are another helpful development. While they were slow and cautious about speaking out, their voices matter and we the public should heed their warnings.

I'll end this review with these words from essayist Howard Covitz:

" He (Trump) displays all the signs of a seriously personality-disordered person and has repeatedly spoken of using violence. And the outcome? The outcome, if he is indeed as ill as some sizable portion of the mental health community suspects, could well be potentially devastating to a significant percentage of humanity."



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Art work by Amy Welsh

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