The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President

You already know a lot about this book just from the title. What got my attention right away was that it's not written by one person like the vast majority of the books about Donald Trump. Instead, it is a collection of essays by 27 different psychology professionals, whether working psychologists or psychiatrists. These people are all highly trained and are so concerned about the mental health of the President of the United States that they are violating the spirit of the ethical guidance from their professional organizations--namely, not to analyze the mental health of someone you have never examined.

What motivated the choice to make these insights public? This controversial decision is explained at the outset by Drs. Herman and Lee: "the public trust is also violated if the profession fails in its duty to alert the public when a person who holds the power of life and death over us all shows signs of clear, dangerous mental impairment." Given the power at his command, they feel that the mental health of the president should get at least as much scrutiny as that of other citizens. They have concluded that Donald Trump has a serious personality disorder and is a danger to the country. For that reason, they feel that they must honor their "duty to warn" the public of the danger he poses, (just as they have a professional "duty to warn" if a patient is a danger to himself or others.)

Since the president appears unwilling to undergo a genuine physical examination--much less a mental health one--these professionals can give the public insights based on the unusually plentiful record of Donald Trump's public actions, comments and even tweets. As both candidate and president (and even during the decades before), Trump was someone who sought the limelight and whom the media found fascinating and worth extensive coverage. He was also very accessible, very quotable and much quoted. Although these psychologists have never examined him, they have a lot of real-time observations to work with, as well as so many available written interviews, articles and books, many in Trump's own words.

They also feel that, as professionals, they can address some of the questions the public has about the behavior and comments of the president, including,"Is this unusual but normal? Or is it something that should make me worried, even afraid?"

You know the answers these authors all reach from the title. But they each take a different focus in their individual chapters. Here's a sample: "Unbridled and Extreme Present Hedonism", "Pathological Narcissism and Politics: A Lethal Mix"; "Sociopathy"; "Donald Trump: Is (a) Bad, (B) Mad, (C) All of the Above)"; "Why 'Crazy Like a Fox' versus 'Crazy Like a Crazy' Really Matters' 'Cognitive Impairment, Dementia and POTUS"; and so on.

Some psychologists write about the effect of a president like this on the American public. "How a President Freezes Healing and Promotes Crisis", "In Relationship with an Abusive President', and "Who Goes Trump?Tyranny as a Triumph of Narcissism".

There is also a chapter about the 25th amendment. And a conclusion by Noam Chomsky. One non-psychologist who provides an interesting chapter is Tony Schwartz, who wrote The Art of the Deal with Trump. In 2016 Schwartz donated his help to the Clinton campaign for free as "penance" for writing the book that brought Trump to the public attention and helped mythologize him. It's something Schwartz has regretted ever since, even donating the 2015-2016 proceeds from it to charity. Schwartz's chapter is titled, "I Wrote The Art of the Deal with Donald Trump: His Self-Sabotage Is Rooted in His Past" and considers his strict father and early life somehow gave him the idea that everything in life is either a success or a failure--and he can't accept failure.)

The writers have different styles, but generally include a wealth of real-life examples and write in a way that avoids jargon. On the face of it, it would seem that Trump's supporters wouldn't want to have anything to do with this book. However, it's not a left-wing hatchet job; it's professional psychologists analyzing the President of the United States in his actions and comments. If anything, it seems more important for his supporters to read and think about all this than it would be for his critics (even if Trump supporters wind up rejecting its conclusions, they'll be well-informed on why so many people feel that way). A valuable and unique contribution to the literature about the Trump presidency.

Despite the title, this isn't really a medical book. Its a bunch of people cashing in on Trump. 27 medical professionals got together and wrote a series of disjoint essays vaguely about Trump, packaged it up into a book and will probably make a whole lot of money for themselves. One of the main authors themselves admits right at the start that "the main point of this book is not about Mr. Trump" (p. 19). This is followed by the rather breathtaking claim that American Society as a whole is mentally ill by reason of Trump's election and that will be the subject of the book. And in spite of the book being presented as a book by medical professionals, the epilogue is co-written by Noam Chomsky.

There are maybe eight essays directly on Trump's mental health. The rest of the book is about relaxing medical ethics and the supposed impact that Trump is having on the mental health of the country. Many of the voices in this book want to roll back patient protections as well as shift the burden of proof to the accused in mental health settings. They are in fact calling for dramatic changes in the name of the supposed "Trump Crisis" that will roll back professional standards in mental health to what they were in the 1950s.

You can tell alot about a polemic by how fast and how often it plays the Hitler card. The Hitler card is played an average on one of every 19 pages. As far as the first to drop it, .Robert Jay Lifton drops it in the Foreword. He explains how Americans are just like the Nazi Doctors in the death camps. That to accept Trump as President is just like working in a death camp. After making the point, without explanation, he immediately says he is not making the point he just made. He then goes on to develop a concept he calls the "witnessing professional activist". What it effectively means is that the highest standard of professional ethics should be a *political* standard rather than a technical standard. Its badly written and argued, but it effectively sets the stage for the book. This is about mental health or a diagnosis or any technical medical issue. This is just a bunch of professionals using their credentials to politically vent. And if you don't agree with them.....well you are in their opinion no different than a nazi collaborator.

In the prologue, three of the authors attempt to explain their views of professional ethics. They invent a new standard for ethics where obligations to a patient (or individual) should always be weighted against an equal set of obligations "to society". They go so far as to say that even doctor-professional confidentially is something that should be weighed against what a professional owes to society. Their thinking is thin and anti-intellectual that they don't bother to think through the broader implications of that. Extended beyond Trump, the idea that professionals first duty is to the community rather than the individual is an astonishing thing to assert.

They also describe a concept called an "assessing diagnosis". Its not actually new in this case. Its a throwback to how involuntary commitment was done before the 1970s. Its based on the idea that a doctor knows "crazy" when they see it and that its better to err on the side of taking immediate action to preserve "public safety" than to waste time trying to prove that someone is dangerous. Again, they don't look at the general implications of the standards they are setting. If they talk about anything at all to justify themselves, its death camps, GITMO, torture or the CIA. Softball examples to gloss over the impact of pushing the ethnics of their profession back to the bad old days of the 1950s.

As well, the assert that the test for the ethics should be based on the end pursued. Basically if they are working for the government, the highest possible standard of ethics should apply. But if they are "resisting" the state, basically anything goes. .

In part (1) of the book, nine sets of authors offer nine completely different diagnosis of Trump's mental health issues. One of Trump's ghostwriters with a degree in American Studies is invited to provide a diagnosis which says alot about how the serious the book is. The problem with the section is that the claims by the various professionals are are all over the map. The lack of any common conclusions through diagnosis points to the problem of employing these methods: That there is effectively no method and no professionalism in the evaluation.

The second part of the book consists of six sections that attempt to make the case the remote professional mental health diagnosis of public figures is justified by a duty to the community that overrides any ethical obligation to a patient or client. Some raise a standard of "dangerousness". But (again) there is no thought given to the broader implications of what they are suggesting. They are essentially suggesting that the importance of a person in society (police officers, politicians, pilots, firefighters) should increase the ability of random mental health professionals to intervene in their lives. And what of the claim that obligation to patient and community are equal? Again, as is in so much of the book, the content is non-intellectual and simply focused on establishing a reason to justify actions toward Trump.

The final part of the book is a series of poorly written pieces that reach out from Trump to the whole of society. Thus we get something on the birther movement, we get a claim that the whole country is an "abusive" relationship with Trump, we get claims that Trump as president is getting in the way of people's "healing" and creating mental illness.

We end with a crackpot *legal* interpretation of the 25th amendment by doctors.

The weakness of the book is that its very much on the defensive and that there is no professional consensus offered on Trump. It demands to make sweeping and dangerous changes to professional ethics based entirely on one man becoming president. Trump will last only a few years as President. But making professional obligations to the community equal to those of the client would be something we would be stuck with forever. If the profession accepts the concept of "assessing diagnosis" applied to Trump, what is to stop that concept from being extended to the homeless and the poor? I really don't think the authors care. I don't see anything in the book other than a set of people taking an opportunity to make a fast buck off Trump being president. Its so badly argued and so badly written that it will hurt rather than help their cause.

This book brings to our attention the equivalent of local, national and global concerns that plague us every day. In the case of Donald Trump: UNHEEDED SIGNS, WARNINGS & PSYCHIATRIC DIAGNOSTIC CRITERIA: Pathognomonic Politics in the USA 2016 revisited in March 2017 corroborates and underscores the message of this tome.

Does the Donald Trump presidency pose a clear 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. Bandy 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 meaningful 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 and many of whom (myself included) 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.

-- -- 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 to 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." It is difficulty 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." But this essayist felt this 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 Trumps has not shut down the free press and killed his opponents because he cannot get away with it in our democracy. 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, 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 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 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 gloom and despair to the election. These therapists saw a lot of patients suffering from trauma after the election. 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. Yes, I voted for Hillary Clinton, but my vote was more about not wanting Trump than it was about wanting Clinton. Following the election, there was a wave 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. It felt like an attack on our country, a country of diversity held together by shared American values. At least it was, until we elected Donald Trump President of the United States.

I was left full of anger, at the unexpected result and at all those people who voted for Trump. And I actually knew some people who DID vote for him. They seemed to have bought into some of what Trump said and that, combined with their not liking Clinton, accounts for their vote. Some Trump votes were reluctant votes (they would have liked a better choice of candidates) and no doubt some who voted for him must have regrets. But I think the reason he won is complicated and cannot be reduced to the standard "a bunch of disaffected 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 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. 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 (the Women's March happened right after the election, an immediate incredibly strong reaction) is encouraging and the inability he has shown to actually accomplish anything has limited the damage. Our democratic processes have worked, as the judicial branches have shot down his more outrageous executive orders and, 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.

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 too-long 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. "

This book is written by supposed mental health professionals who diagnose a man whom they have never examined in person, a requirement to any medical diagnosis. At best its an under researched ill thought out book at worst its medical malpractice.

This is a very important and very timely book. Each of the authors has provided excellent information for anyone who would like to be informed about the psychiatric and psychological analyses of the very unusual personality demonstrated by the President of the U.S. It will raise your awareness of the risks the country is sustaining and willl provide you with expert "situational awareness." I recommend this book to anyone with an open mind or anyone convinced that #Resist is the best approach.

Critics of this book say there should be no expert commentary on the behaviors of the MOST POWERFUL LEADER IN THE WORLD because it violates professional ethics, effectively blocking the truth by putting a gag on the experts who could help us understand. Should we turn to vague understandings of pop psychology to explain the unusual behavior of the POTUS? What is our alternative if the experts cannot speak?

It’s a pleasant read. The variety of contributors offering their professional assessment provides a unifying theory of how unfit Donald Trump is to serve as President of our Republic. It clearly lays the groundwork to support how Professional Psychiatrists can state their claims in an ethically unbiased manner. If you enjoy reading complete sentences that utilize age-appropriate punctuation and grammar then I would recommend you purchase this book.

I am encouraging everyone to read this essential text. Our nation has never before had to deal with the reality of such a mentally ill man. No less than twenty-seven professionals have weighed in and provide clear insight into the mind of this malignant narcissist. Donald Trump is not only incapable of empathy, he is dangerous. Please read this book and judge for yourself why mental health professionals felt the imperative to warn our nation.

Clear and present danger--and a duty to warn, sums up the the assessment of twenty seven psychiatrists and mental health experts. We have a malignant narcissist in the Oval Office. He and his minions are attacking the checks and balances in our republic. He attacks the free press, minorities, anyone who disagrees with him, and praises tyrants and dictators. This book is fast and easy reading as far as lack of medical jargon goes, but be prepared to be appalled. I'm sending this to my Republican congressman, who so far has been voting with the Republican herd