Donald Trump's presidency is dangerous and destructive. Because he is an autocrat and petit-fascist, he has repeatedly demonstrated contempt for American democracy. His personal and political behavior has diminished America on the world stage. He has torn apart basic assumptions about political normality in an effort to expand his power. His speech and actions, first as a candidate and now as president, have either expressly or tacitly encouraged political violence against nonwhites, Muslims and any other group the American right-wing views as its enemies.

There is considerable evidence to suggest that Trump is personally corrupt and is using the presidency to enrich himself, his family and other members of his cabal at the literal expense of the American people. His behavior also indicates that he is likely beholden to Russian President Vladimir Putin instead of the people and interests of the United States.

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These matters are made worse by Donald Trump's clear and obvious mental health challenges, which include malignant narcissism, chronic if not pathological lying and sociopathy.

What can be done about this national and global emergency? Why do Trump's voters and other supporters continue to back him with what seems like blind loyalty? Has the chaos and malignant reality that Trump has forced upon the American people negatively impacted our mental health and well-being? If Donald Trump is in fact a malignant narcissist, what sort of threat does he pose to world peace?

In an effort to answer these questions I recently spoke with Dr. John Gartner, a former assistant professor of psychiatry at the Johns Hopkins University Medical School and founder of the Duty to Warn advocacy group, an organization that is supported by thousands of people in the United States and abroad who are dedicated to sounding the alarm about Donald Trump. Gartner is also a contributing writer for the new book "The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President."

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Duty to Warn is now endorsing political candidates who promise to work to remove Donald Trump from the White House under the provisions of the 25th Amendment, and to seek to restrain his authority to use nuclear weapons.

A longer version of this conversation can be heard on my podcast, which is available on Salon’s Featured Audio page.

How do you think Donald Trump won the presidency?

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I do have a theory about the nature of demagoguery and leadership as it relates to our deepest human programming. If you go back to chimpanzees -- who are our closest relatives -- it used to be believed that human beings were the only animals that committed murder. Chimpanzees would charge at each other and pound their chests and throw heavy rocks into the river to show that they were vigorous, but nobody actually really got hurt.

A troop of chimpanzees which was originally observed by Jane Goodall got so big that it split into two groups. What they noticed was one of the alpha males would get very excited and then the other males would get worked up too. The alpha male would then lead them on a march to the edge of the territory where they will wait till the next male from the other troop comes along. Then, basically as a gang, they will run down the hill and beat him to death, and will do that until they’ve killed enough males that they can take over their territory and their females.

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Who won the evolutionary battle there? The group that had the homicidal alpha male. There is something deep in our programming that says, if a homicidal alpha male shows up and he’s protecting my group, regardless of what his other faults are, we’ve got to follow him. That’s very primal programming. The demagogues, whether it’s someone like Trump or Hitler or [former Serbian leader Slobodan] Milosevic, manipulate people so that instead of being a German you are an Aryan, instead of being a Rwandan you are a Tutsi or Hutu, instead of being a Yugoslav you are a Serb or Croat.

Now it’s our gene pool against their gene pool. Trump and his people just made it very explicit. Trump's basic theme is “I am the alpha male of the white people. If you want to live follow me” -- and they did.

Trump is a classic racial authoritarian. During the 2016 election the mainstream news media was obsessed with a narrative in which white working-class "anxiety" somehow drove his support. The data tells us this is not true. Trump's election was a result of white racism. Moreover, a lot of people voted for him to hurt other people. Do you think this observation is correct?

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I think that’s actually accurate and very insightful. Trump is a narcissist, paranoid and demonizes anyone who opposes him. Trump has an antisocial personality and exhibits signs of sociopathy. Sadism is another part of this dynamic. These are people who truly get pleasure from harming and hurting and degrading other people. Trump feels powerful when he destroys and degrades and bullies other people. It's a rush for him, it’s exciting, it’s gratifying; he gets off on it. That kind of dark energy is also infectious. We saw this at Trump's rallies when he would encourage violence against protesters and other people.

Many of Trump's voters have a libidinal attachment to him. They are actually in love with the idea of Trump, which is why they remain immune to facts and empirical reality.

He’s a cult leader. As such, his charisma is transactional. The followers endow the authoritarian leader with authority that is completely impervious to facts and reality.

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In the future, how do you think Trump's voters will rationalize supporting his disastrous and embarrassing presidency?

The Bulletin of Atomic Scientists has moved the "Doomsday Clock" closer to midnight. To be honest, I think it’s actually chiming at midnight right now. I don’t think people have any idea how close we are the point of no return. I think there is an 80 percent chance he’s going to push that nuclear button. Why? Number one, Trump is a malignant narcissist. As far as I know, I cannot recall a single malignant narcissist in history who did not start a major war.

Now add one more factor: Under the surface, this [Robert] Mueller investigation is turning him and his family into cornered animals. They are guilty of treason, guilty of money-laundering, guilty of collusion, guilty of obstruction of justice. They are guilty as sin and they know it. The noose is tightening around their necks and, unlike Richard Nixon, Trump and his cabal are not going to leave gracefully.

Donald Trump is going to be like Bonnie and Clyde; he’s going to shoot his way out. The best way for him to shoot his way out is to start a war and distract from his misdeeds, rally the country behind him and -- most importantly from a psychological perspective -- to transform the feeling of being a weak victim of a massive criminal investigation into that of an omnipotent destructive and powerful leader by destroying and killing millions of people.

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When you ask me, “What are people going to say about it?” What are Germans saying now about the Holocaust? None of them were Nazis. No one is going to be proud of what they did if they don't stand up to Donald Trump now.

There is an abundant evidence to show that Donald Trump is a malignant narcissist with sociopathic tendencies. Yet some psychologists and psychiatrists continue to hide behind the so-called "Goldwater rule."

They are ridiculous cowards. We are afraid to speak up because of the Goldwater rule? Are you kidding me?

If you were to explain in simple terms why the Goldwater rule doesn’t apply here, how would you explain it to a layperson?

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The American Psychiatric Association is a guild. Its main interests are the those of the American Psychiatric Association and American psychiatrists. This is very, very important. They are just trying to stay out of the way of anyone powerful who might get angry at them and interfere with them making money. It is that simple. The Goldwater rule is not an example of psychiatric ethics. It is an example of psychiatric corruption where they put the needs and the money of their profession above the welfare and the survival of the American public.

If Donald Trump were a private citizen presenting these types of behaviors, what do you think a mental health clinician or a primary care physician would say?

Imagine Donald Trump is your relative instead of the president. He’s having increasingly dark moods, becoming increasingly erratic and unraveling. At the same time, he has access to weapons and he’s threatening to wipe countries or people off the face of the Earth. If that were anyone other than the president, they would be brought by the police to the local psychiatric hospital for involuntary evaluation.

This is the greatest psychiatric emergency in the history of the United States and maybe in the history of the world, but we can do nothing about it. Because Trump is the president, we can’t call the police and have him evaluated. We can’t even get the gun out of this hand. We should take this seriously. We would do that if somebody was in a mall with a gun and one hostage, one potential victim. Here we are talking about maybe every living person on earth.

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Just thinking about the practical politics here. What was the epiphany that led you to start the Duty to Warn advocacy group? And what has the response been like?

It started with the petition that I put online, which now has 65,000 signatures. It was a petition for mental health professionals saying that Trump is too severely mentally ill to be president and should be removed under the 25th Amendment. From the momentum of the petition there were then 15 Duty to Warn meetings all around the country. And now there is the book "The Dangerous Case of Donald Trump," which is on the New York Times bestseller list. The book is needed, and so popular because we are professionals who have the authority to say that Trump is dangerously mentally ill. We are validating it with knowledge, expertise and facts.

Some have suggested that you are engaging in a dangerous politicization of the fields of psychology and psychiatry, akin to the way the Soviet Union once used the stigma of "mental illness" to silence dissidents. How do you respond?

First of all, in the Soviet example the state was using psychiatry to repress the population. We are not trying to weaponize mental health to bolster a repressive state. Instead, we are saying there is a repressive leader and are trying to defend against fascism, not bolster it. The German Psychiatric Association did nothing when Hitler rose to power. The American Psychiatric Association did nothing when Donald Trump rose to power.

The first level of damage was when the public was not adequately warned or informed about Donald Trump's mental health before they voted. They were voting with, “Oh, he’ll pivot and become presidential,” whereas we could have told them no, he’s going to deteriorate and become deadly and dangerous. The second level of damage is that by not denouncing, day after day after day, the crazy and destructive things that Trump is saying and doing, we are normalizing it. He is showing abhorrent, destructive behavior and when mental health professionals are silent they are normalizing this dangerous state of affairs.

What about the criticism that by using language and concepts such as "malignant narcissism" and "sociopathy" to talk about Donald Trump you and your colleagues are further stigmatizing private citizens who are mentally ill?

Mental illness is a big category, just like physical and other illnesses. But there are some illnesses that could be so severe they can make it impossible for you to function in your job. The nature of malignant narcissism makes it impossible for someone to be a constructive leader.

Working from the general to the specific, what do you see in your practice in terms of how patients are being impacted by this political moment and Trump's presidency?

It’s affecting people very powerfully. There is an enormous amount of anxiety. It is almost at epidemic levels due to Trump. The real truth of it is that if you are not having a panic attack right now, you are not paying attention. If somebody is trying to kill you and you are afraid, that’s not anxiety, that’s fear. It is rational.

What does that sort of stress do to people?

Stress is very destructive. It’s destructive mentally; it’s destructive physically. This is especially true for members of the groups that Trump has targeted, such as immigrants and minorities. Then there is also the general sense of existential dread that everybody is feeling. In addition to existential dread, there are also the negative feelings when you watch TV and you are like, “Wait a minute, that’s crazy. How can this be happening? How could people not be reacting to this?” This is that normalization of the abnormal. Ultimately, we are under such great stress because our sense of reality is under attack.

Do you think that Donald Trump is happy right now? An unhappy leader is a very dangerous leader.

I think Donald Trump is in a state of constant rage and agitation. We are hearing from sources inside the White House that he has dark moods, is yelling at people, screaming at CNN at 3 in the morning. This is terrifying, because you are right: Someone who’s in a state of agitation and anger is more likely to act out in a destructive and impulsive way. We have all the warning signs that this guy is ready to blow.