Over Two Dozen Psychiatrists Send a Grave Warning About Trump's Mental Health

More than two-dozen renown mental health experts have combined to write a just-released book entitled, The Dangerous Case of Donald Trump (Saint Martin’s Press, October 2017). In it, they alert America to what many adults across the nation appear to instinctively recognize: our President’s behavior evinces a level of odd conduct/impairment that could well be dangerous to our country. The difference is, the authors are extraordinarily well-trained experts who have spent decades counseling mentally ill individuals and studying the effects of their behavior on themselves and others. As the authors assert, no individual’s potential mental impairment could pose a greater risk to the wellbeing of our nation than one who occupies the White House and who is possessed of the nuclear codes.  However, the authors walk a tightrope in going public with their concerns. 

     Before they decided to write this book, the authors had to confront The Goldwater Rule.  In 1973, the American Psychiatric Association enacted Section 7 of its Principles of Medical Ethics, to provide that it is unethical for a psychiatrist to provide a medical diagnosis with regard to an individual who the physician has not personally examined, and from whom the doctor has not obtained consent to discuss the patient’s condition in a public format. The Rule is named after Senator Barry Goldwater who in the 1960s had staked out a number of extreme positions that alarmed many Americans. In 1964, as Goldwater ran for President, a magazine polled psychiatrists as to whether they felt the senator was mentally fit for the highest position in the land. Nearly 1200 physician respondents opined in the negative. This occurrence led to ethical restrictions on long distance diagnoses that occurred without an in-person mental evaluation and consent. 

     The authors of The Dangerous Case of Donald Trump acknowledge the Goldwater Rule and do not dispute its logic or its imperative. However, they discuss at some length a higher principal they describe as “The Duty To Warn.” Their salient point is that where a person occupies the highest public office and poses a substantial danger to others, including the nation, medical experts – those who by training are the most qualified to provide informed information – have a greater ethical duty to warn the populace. Otherwise, the ethical system lapses by permitting the at-risk individual to continue to pose the danger while those who best able to differentiate a genuine from not actual threat are muzzled.

     Thereafter, the authors walk a tightrope between describing, generally, mental conditions of concern, with discussions of Trump’s public expressions and conduct, versus delivering a specific, individual diagnosis of our President. The awkward dance aside, the reader is left with several rather clear and frightening impressions. The authors discuss grandiosity and narcissism and discuss the distinctions that lead, generally, to a Narcissist Personality Disorder. They quote extensively from the public record of Trump’s objectively false statements, and they contrast mere lies with his insistence that others accept his wished-for realities. They discuss repeated instances where he has shown an alarming lack of empathy for individuals and a need to crush real and imagined rivals, beyond those possessed by merely “aggressive” politicians. They review his impatience and extreme lack of ability to focus on particular topics for an extended period. They explain why his reaction to real and imagined insults and his lashing out extends well beyond the range of critical human responses – responses that do not comport with behavior essential to responding to emergency circumstances. 

   The Dangerous Case of Donald Trump raises complex questions that, with luck, our nation will never have to face, but which, nevertheless, present a genuine possibility. What if our President suddenly led us into a serious military conflict with say, North Korea, even potentially a nuclear one, that was viewed by a majority of Americans as very much unnecessary or unjustified? Of course, who gets to say in emergency circumstances that the President’s actions were unnecessary or unreasonable? Our system of government has built in safeguards that trust in our leaders. They are not designed to question choices made because of concerns related to mental fitness. Our constitutional structure, appropriately, makes the removal of a sitting president very difficult to achieve and requires substantial evidence. The Impeachment process is slow, involving investigation, articles of impeachment voted out by the House of Representatives, and a subsequent trial and conviction in the Senate. The Twenty-fifth Amendment to the Constitution provides more quickly for the removal of the President from office if he becomes incapacitated. Section four is the only part of the amendment that has never been invoked. It provides for the removal of a President upon an affirmative vote by the Vice President and a majority of his cabinet.  If the President contests the decision, resolution falls to the entire Congress, with both houses having to agree by a two-thirds supermajority that he is or remains incapacitated. Needless to say, such an extreme event would pose the gravest emergency for our nation, one not easily resolved. This would be especially so if the fundamental contention arose from concern about the President’s mental condition, which, inherently, can involve difficult judgments for laypersons to make, especially those predisposed to consider every decision in terms of its political ramifications. 

     It may be well worth Americans reading The Dangerous Case of Donald Trump so that come the next election – and with the hopes of no intervening emergency – voters can add this information to their considerations of whether President Trump deserves a second term. 

This was written by Craig Benedict, a former DOJ prosecutor specialiazing in environemntal crimes.