The Washington Post‘s Jennifer Rubin said in a column published Wednesday that she is genuinely concerned that Pres. Donald Trump is so out of touch with reality that he doesn’t know he’s lying.

Trump, she said, is clinging to obvious and easily disproven falsehoods in spite of the damage they are doing to his credibility as a leader. For instance, the belief that he only lost the popular vote because of “illegal voters.”

ADVERTISEMENT

“The media, understandably, try to understand why Trump would tell such an easily debunked falsehood,” wrote Rubin, who strongly supported Gov. Mitt Romney (R-MA) in his run against Pres. Barack Obama in 2012, but did not support Trump in 2016. “Why lie when he is president anyway, by virtue of the electoral college? Why get this badly off track?”

“The supposition among pundits, elected officials and political insiders is that Trump, like his argument over the inaugural crowd size, ‘lies’ to make himself feel better. His staff salutes, repeats his lies and then gets bashed,” Rubin said.

“What if, however, he thoroughly, ‘honestly’ believes his crazy, unsubstantiated claims? When he denies saying something, what if he honestly does not, cannot recall statements that now come back to haunt him?” she asked.

She pointed to Trump’s dogged refusal to drop his “birther” antics as well as his contention at once point that Sen. Ted Cruz (R-TX)’s father was a friend and possible co-conspirator of Pres. John F. Kennedy’s assassin Lee Harvey Oswald.

Trump, Cruz said during the 2016 campaign, is a “pathological liar.”

ADVERTISEMENT

“He doesn’t know the difference between truth and lies. He lies practically every word that comes out of his mouth. And he had a pattern that I think is straight out of a psychology textbook. His response is to accuse everybody else of lying,” Cruz said in the days after his primary defeat for the Republican nomination.

Rubin questions whether Trump can distinguish truth from falsehood.

“In the campaign, he became convinced, for example, that Arab Americans in New Jersey celebrated after 9/11. Now he becomes convinced of other, equally ludicrous assertions. Kellyanne Conway, Sean Spicer and others know what he is saying is nonsense (‘Alternative facts‘? Puh-leez.) They do not have the nerve to tell him that what he believes cannot be true. and therefore cannot be uttered by the president of the United States without raising questions about his mental/emotional stability. They are lying if they repeat his claim, but maybe he is sincere,” she said.

ADVERTISEMENT

She quoted Sen. Chuck Schumer (D-NY), who said, “In general you cannot run a country unless you know the facts. If you’re going to believe your own facts, whether it’s about what Putin is doing in the world or what jobs or companies are doing here, you aren’t going to be able to govern, so I worry about it.”

Rubin was careful to stipulate that she is not at this time calling for measures laid out in Sec. 4 of the 25th Amendment, which states that “if the President is unable to discharge the powers and duties of his office, the Vice President shall immediately assume the powers and duties of the office as Acting President.”

ADVERTISEMENT

“We are calling for someone, perhaps his children, to see if they can prevail upon him to stop behaving in this way, for if not, legitimate worries will mount about whether he is able to carry out his duties,” she said.

Furthermore, every Republican official should be called to account and asked: “Is he lying or is he unable to separate what he wants to believe and what exists, literally, in front of his eyes?”

The former, she said, makes him “morally unfit” for the office. The latter is actually much more frightening and poses the threat of “a constitutional crisis the likes of which we have never seen.”

ADVERTISEMENT

“With Trump,” she concluded, “we have learned the past provides no guarantees.”