In the thick of the election campaign, Hillary Clinton called Donald Trump unfit to be president. Bernie Sanders called Clinton unfit to be president. Trump called every candidate unfit to be president but him. Now, in a new book, more than two dozen mental health professionals call Trump unfit to be president, saying he is mentally disturbed and a danger to America’s safety.
In an interview with ThinkAdvisor, Dr. Lance M. Dodes, a psychiatrist who co-conceived the New York Times bestseller “The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President” (St. Martin’s/Thomas Dunne October 2017), discusses traits of “significant mental derangement” that Trump exhibits and why the book was written. Dodes taught psychiatry at Harvard Medical School and is a former director of the substance abuse treatment unit of Harvard’s McLean Hospital.
The American Psychiatric Association’s Goldwater Rule states that it’s unethical for psychiatrists to give professional opinions about public figures they haven’t examined. But the book’s authors, who are affiliated with, in addition to Harvard, Johns Hopkins University Medical School, Columbia University, Stanford University, Yale and others, say they have an overriding ethical duty to warn America about Trump.
“The public trust is 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,” writes Harvard Medical School psychiatry professor Judith Lewis Herman and the book’s editor, Bandy X. Lee, assistant clinical professor in law and psychiatry at Yale School of Medicine.
The experts describe traits Trump has exhibited, based mainly on observing his public conduct and behavior, that are consistent with several psychological disorders, including sociopathy, pathological narcissism, delusional disorder, extreme hedonism and cognitive impairment — all of which are mutually inclusive, or exist simultaneously.
This is, they insist, a toxic amalgam that puts the United States at risk. Consequently, Trump should be ousted from office, Dodes argues in the interview.
He wrote the chapter contending that Trump “undeniably” shows the traits “of a paranoid sociopath — such as impulsiveness, cruelty, lack of guilt and empathy, disregard for the rights of others and loss of reality.” He thus “creates a profound risk of war since heads of other nations will challenge the sociopathic leader, who will experience that as a personal attack leading to rage reactions and impulsive actions to destroy this ‘enemy,’” Dodes writes.
The past February, The New York Times published a letter he and 34 other mental health professionals wrote warning of Trump’s “grave emotional instability … that makes him incapable of serving safely as president.” They said the Goldwater Rule “has resulted in a failure to lend our expertise … at this critical time. We fear that too much is at stake to be silent any longer.”
Others in mental health believe the book’s authors should have stayed out of the discussion about the controversial Mr. Trump.
“Not only is it unethical and a violation of the law to diagnose or assess someone you have never treated, such as the president, it also feeds the high anxiety that currently exists around the presidency,” says psychotherapist Jonathan Alpert, known as “The Wall Street Therapist” and who is based in New York City. He wrote “Be Fearless: Change Your Life in 28 Days” (Center Street 2012). “If a professional is truly concerned, they’ll do their best to soothe the nation’s anxiety, not fuel it.”
ThinkAdvisor recently interviewed Dodes, 70, an addiction specialist who has a private practice in Beverly Hills, California. He was elected a distinguished fellow of the American Academy of Addiction Psychiatry and is author of “The Sober Truth” (Beacon Press 2014). Here are excerpts from our conversation:
THINKADVISOR: Why did you and 26 other mental health professionals write this book?
LANCE DODES: The duty to warn applies. It’s our duty to tell people about Trump. Our nation is facing a crisis because we have the most psychologically ill president — certainly in my lifetime — and he’s a very serious danger to the country. He’s dangerous because he’s ill. If he had a heart condition instead of a psychological condition, I would have expected cardiologists to speak up.
But the American Psychiatric Association’s 1973 Goldwater Rule states that it’s not ethical for psychiatrists to give professional opinions about public figures they haven’t examined.
Not only must that [rule] be overlooked when a dangerous person like Donald Trump is [at issue], it never applies to the kinds of diagnoses we’re talking about.
When the rule was promulgated, they were referring to a diagnosis [based on] a person’s inner conflicts and fantasies that are causing them trouble. That has zero to do with making a diagnosis from afar, which you can do. You don’t need an interview with someone to know when they’re lying, cheating, stealing and are delusional, as is the case with Trump.
What’s your overall assessment of him?
He has the most dangerous combination of emotional problems for anyone who could possibly be president. [For one], he’s a sociopath — what the DSM [Diagnostic & Statistical Manual of Mental Disorders] calls “antisocial personality disorder.” He meets every single criterion for it.
What’s an example?
It doesn’t matter to him that he says things that aren’t true or that he contradicts himself. The truth doesn’t matter to Trump because that’s not what he’s about. He’s about enhancing himself moment to moment.
What are the disorders other contributors to the book describe Trump as having?
Malignant narcissism, delusional disorder, extreme hedonism [etc.]. None of these are mutually exclusive. All the labels overlap, and they all point to his dangerousness.
So the objective is having Trump ousted from the presidency?
That’s why we wrote the book. He has to be gotten out of office.
You wrote that if he stays, “He’ll gain more power and less grasp on reality, engender more criticism, producing more paranoia, more lies and more enraged destruction.” That doesn’t sound like a rosy future.
It’s an extraordinarily dangerous future.
Just what threat does Trump pose?
There are two main threats. The risk of war is the most immediate danger. This is not just a person who could take a machine gun and go to the top of a building [and kill] — as horrible as that is — this is a person who has the nuclear codes. So the risk to our country and the world is great.
What might he do?
He’s a great danger for making erratic, sudden decisions in his moments of rage and moments when he loses touch with reality. He’s shown to be prone to both of those. So the danger of his doing something impulsive like that — which he has already done — is enormous.
How has he shown that?
He launched 59 missiles at Syria [within 72 hours] of seeing an image on the news that he didn’t like — reversing his stated Middle East policy and because he wanted to do something dramatic to show how powerful he is.
What other evidence is there of Trump’s being erratic and making decisions in the moment?
He fired James Comey, the head of the FBI, after hearing him testify in unwanted ways before Congress. He’s had abrupt changes in policy, both domestic and foreign. He’s created international tensions with Mexico, Germany, France and Greece. He’s changed positions rapidly on people he leaned upon for good advice. And then there are his midnight tweets. All of these are impulsive actions.
Please elaborate on your statement that “he loses touch with reality.”
Accusing President Obama of bugging Trump Tower is an example. He loses touch with reality when he’s challenged and enraged. He needs to believe he’s right even if he’s shown to be wrong. This is a very disturbed man.