Coverage of the President usually opens with a cunning line that drags Donald Trump followed by scathing jabs that, at this point, feel like muscle memory. Ill-informed. Erratic. Self-destructive. Abusive. Bigoted. Paranoid. Insecure. Spiteful. They all serve to capture the singularity of this moment; a time when, yes, even President Challenges Own Secretary of State to IQ Test is a real-life headline.

It all funnels down to a simple message: he’s "nuts."

Trump’s fellow republicans have dubbed him “utterly amoral,” a “delusional narcissist,” and most recently, unable to “demonstrate the stability nor some of the competence” needed for the presidency. Among the American public, one in three believe Trump’s mental health is “poor.”

St. Martin's Press

But with the release of a new book, The Dangerous Case of Donald Trump, these thin notions around the president’s instability are fortified for the first time, invigorating the probes surrounding the mental health of the president. Edited by Professor Bandy Lee, a forensic psychiatrist at the Yale School of Medicine, the book introduces 27 psychiatrists and mental health experts who make the case that “anyone as mentally unstable as this man should not be entrusted with the life-and-death-powers of the presidency.” Its impact might amount to conscience-clearing, but a deeper look reveals a new way to discuss just how volatile Trump and the American way of life has become.

You might recall news from earlier this year of Dr. Lee organizing a ethics conference that explored Trump's mental health and how psychiatry experts should respond. The experts recognized that Trump is not the first president to harbor symptoms of mental illness—a 2006 study found that roughly half of our past presidents likely suffered from mental illness—but he's the first to pose a significant threat requiring action. This book is their response, and it holds nothing back.



Assembled are the country’s heavy-hitters in the field of psychology to break down the president’s personality traits, which they find consistent with narcissistic personality disorder, sociopathy, paranoia, hypomania, and other illnesses. Their assessment spans Trump's life with a focus on his campaign and the early months of his tenure (taunting North Korea will have to be added if Lee and company ever update epilogue).

Getty Images

In the book, Philip Zimbardo, of the Stanford prison study, writes that Trump has a “specific personality type: an unbridled, or extreme, present hedonist” and “narcissist.” John Gartner, a 28-year veteran psychologist at Johns Hopkins University Medical School, outlines how Trump is a “malignant narcissist” and “evinces the most destructive and dangerous collection of psychiatric symptoms possible for a leader.” Retired Harvard psychiatry professor Lance Dodes writes that Trump’s “sociopathic characteristics are undeniable."

Don't give him too much credit. Lee said she has seen thousands of individuals like Trump in her years of work at the intersection of violence prevention and psychology. “But they’re usually not in positions of power,” she said. “They’re usually in jail or prisons,” the settings where she mostly works.

"We sound an alarm when there’s risk of harm. And we as a profession are late in sounding the warnings."

In every chapter, the authors cop to the impossibility of definitively diagnosing the president without clinical interviews. What it's really about "is pointing out the danger,” which is different from making a diagnosis, Lee said. “We have a moral and civic duty to warn and to protect the public. We sound an alarm when there’s risk of harm. And we as a profession are late in sounding the warnings."

The “duty to warn” is how these experts claim to evade the American Psychiatric Association’s “Goldwater rule,” which states that “it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement.” Lee says the lines are blurred when the stakes are this high, when there is a “serious mental instability impacting the public sphere.” They have a duty to the public, not just individual patients. In writing the book, Lee and her colleagues were “not so much deterred by the Goldwater rule as we were by fear of being targeted by a litigious president or some of his violence prone followers.”

Getty Images

The book has not yet been trolled by the #MAGA audience or the phony #MAGA bots. (Trump’s brand of denialism doesn’t warrant Twitter attention to those with the letters PhD after their name.) Lee said that criticisms have come mostly over email from people who couldn’t put a coherent sentence together. When asked whether or not the book aims to persuade #MAGA believers, Lee said, “They may be beyond convincing. And I’m not appealing to that audience. We shouldn’t alter our message to placate those who are unwell because they’re already on a course that is self-destructive.”

The book exists to change the course of the public’s conversation around Trump’s mental health, from a dialogue centered on diatribes calling him childish or a clown to one that centers his perpetuation of “malignant normality.” Introduced in the foreword by Robert Jay Lifton, one of America’s leading psychohistorians, the term signifies the dangers of normalizing a president who lies and makes bombastic or joking statements about nuclear weapons, for instance. This coupled with the cult-like support from his base and the others blindly defending his behavior, creates a malignant normality that will prove destructive.

"Every single therapist I know is currently treating Trump Anxiety Disorder."

Academic jargon aside, Lee is satisfied if the expertise brought forth in the book confirms and illuminates suspicions or questions about the president. "Most people just see what they see and will not know about the patterns that underlie the outward behavior,” she said. This is the greatest benefit the book: conceptualizing and aiding understanding of the apparent psychopathology in the West Wing. It beckons us to step back from the daily news cycle and take stock of the underlying conditions of Trumpism while also taking stock of the past, illustrating how Trump is not a recent creation but the apotheosis of a collective American narcissism.

Trump is a bit of a perfect storm, one that resists a static classification. And there will be countless opportunities to revisit the conversation because, according to Lee and her colleagues, Trump's malignant character traits will only worsen with time.

“These signs, his behaviors, are not going to disappear. The president is not going to pivot or become more normal with time. We can expect that things will only get worse… The patterns we lay out fit certain pathological patterns, and the inevitable course is that things will intensify. For instance, the kind of fights and rage reactions that are emerging. This is because reality and human relations will never satisfy Mr. Trump’s expectations, and therefore he’s likely to have more conflicts and generate more false realities in order to fulfill his emotional needs.”

Lee is on point here. It feels like the country is crumbling as we inch closer to war with North Korea and the institutions of America succumb to Trump's ongoing assaults. The system can't cope with the symptoms of its leader. The downward spiral is accelerating, and perhaps this book is too late to create life-affirming responses to the magnitude of dysfunction coming out of the administration. (We're sending pleas to Obama now.) This book takes the experts off the bench with resounding voices of resistance, but does it matter anymore in this existential plunge we seem so incapable of handling?

The last, and perhaps most important section of the book targets the Trump impact on the rest of us, our own spiraling illness. It feels pervasive now. Trump is begetting more Trumps. Trump’s mental state is having its way with the mental health of his base and his opposition.

Getty Images

“There is a massively unhealthy phenomenon going on and it is stoked and encouraged by an impaired leader... Upholding [Trump] in his position normalizes pathology, this is why we’ve seen an enormous spike in hate crimes.” Lee describes Trump-style denialism and proclivity for violence, along Trump anxiety disorder, all as growing illnesses of the Trump age that will require much healing once he’s out of office.

Lee and company see to that healing among the people they serve every day. “Every single therapist I know is currently treating Trump Anxiety Disorder,” said Lee. “Trauma patients especially have had a recurrence and exacerbation of symptoms because Mr. Trump exhibits a lot of the characteristics of abusers, so reminders of the abuse worsens their symptoms. And those who did not have symptoms are now exhibiting more distress and anxiety.”

On top of this, the authors are pressuring lawmakers to set up a commission of mental health experts to evaluate future presidents on their mental fitness for office. In the same way that all military officers are put through mental evaluation, Lee argues we ought to do the same for the commander in chief. “The fact that we don’t do this is a glaring omission,” she said.

Their timing is right and their presence critical. We need language to combat a combative president with abnormalities unlike anything we've seen from leaders past. It's safe to assume the 45th President won't read the book. But our representatives and future leaders ought to.

*Note: Dr. Lee does not speak on behalf of Yale University, Yale School of Medicine, or Yale Department of Psychiatry



Nick Pachelli Nick Pachelli is a writer and editor in New York.

This content is created and maintained by a third party, and imported onto this page to help users provide their email addresses. You may be able to find more information about this and similar content at piano.io