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Yale psychiatrist calls for mental evaluation of Trump: His ‘psychological dangerousness’ is an ‘existential threat’

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President Donald Trump. (AFP/File / Nicholas Kamm)

On Tuesday, former acting FBI director Andrew McCabe said he’d launched an investigation into President Donald Trump because he thought he presented a threat to the United States. In response, the president railed against McCabe on Twitter, calling him a traitor and perpetrator of a coup.

Raw Story spoke with Yale psychiatrist Bandy X. Lee, who has long argued that the President presents a danger to the US and the world due to severe mental impairment.

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Lee is a Yale forensic psychiatrist and president of the World Mental Health Coalition, a body of thousands of mental health professionals who share concerns about Donald Trump’s mental capacity. They’re working on an independent expert panel that would assess presidential fitness as a service to the public as well as any political body that wishes to consult. Her views represent those of the World Mental Health Coalition and herself.

Tana Ganeva: Would you agree with the director that Trump presents a threat to the United States?

Bandy X. Lee: Definitely, and this is what we have been saying since the beginning. This situation did not come about suddenly, but it is what we have been speaking about since over two years ago. That his psychological dangerousness would translate into an assault on democracy and human rights (and the people in general), a culture of violence domestically and geopolitical belligerence abroad, and even an existential threat to the survival of the human species because of the technology he has at his disposal—and we can add onto that his acceleration of climate catastrophe—is precisely what we have been saying since his election.

It may have sounded hyperbolic at the time, but there were precise reasons behind our saying so, and things have unfolded exactly as we warned, according to the timeline we estimated. All this was discussed at the conference I held at Yale School of Medicine in April 2017, the proceedings of which are in the public-service book, The Dangerous Case of Donald Trump.

The second edition will soon to be released with a dozen more essays outlining the social, cultural, political, military, and environmental consequences of his psychological impairments—and the adverse effects will continue as long as we refuse to address a mental health issue as a problem of mental health, which would allow correct assessment and correct intervention.

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Mental health is an essential part of overall health. Just as you cannot predict “very good health“ into the distant future, you cannot declare “very good health,“ as White House Dr. Sean Conley has done, when someone is so mentally impaired. There was a blog stating that one would not consult an astrologer to address a flu pandemic, and yet we have continued to consider our current situation as a political and not a medical problem. As long as we deny, minimize, and disbelieve the nature of the problem, we are allowing pathology to win, for we will not be able to access proper recognition of the problem and mount an effective response. This is what has been happening for over two years.

Tana Ganeva: Can you describe the disorder that you think Trump suffers from?

Bandy X. Lee: I generally do not diagnose from a distance, and frankly, Mr. Trump’s personal health is the least of my concern. Also, diagnosing him with one disorder can trivialize his condition, which probably reflects multiple disorders. I am of the camp that believes that a full assessment is necessary to make a diagnosis—which is why I have been stating that we need an evaluation.

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The American people, who are his employers, have every right to demand one, most essentially a fitness for duty exam before he continues another day, another hour, or another minute at his job. Every employer has a right to this, and the public will be surprised how often employees are stopped in the middle of their jobs and asked to pass a fitness for duty exam before they return—for jobs far less consequential and for impairments much less severe than Mr. Trump’s.

If we are unable to do this, it calls into question whether we are a democracy (where the leader serves the people) or an autocracy (where the people serve the leader). What may not be as well known is that autocracy unfolds more effectively when the leader is mentally impaired and capable of spreading pathology, than if the leader were healthy. Very simply, preference for autocracy represents what we call a “regressed” state, where you revert to wanting to be dependent on a strong parental figure rather than being self-reliant. That state is normal in children, but when you regress as an adult or are stuck because of arrested development, then it is pathological and will not be life-affirming. My responsibility as a health professional is not to Mr. Trump, who is not my patient, but to society, as the protection of public health and safety is one of our direct responsibilities.

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Tana Ganeva: Aren’t most politicians narcissists? What do you think makes Trump different?

Bandy X. Lee: Most mental pathology is not something entirely new but a difference of degree. Dr. Craig Malkin gave an eloquent description in our book: narcissism is a spectrum, and what you really need to worry about is the extreme end. If you have what is called narcissistic personality disorder, then you can fall into a “psychotic spiral“ under stress and lose touch with reality to degrees where you are no less sick than someone who has schizophrenia.

You can also go into rage reactions in response to criticism or others’ failure to meet your expectations of adulation, and that can quickly turn into extreme violence. Mental health professionals, who have seen hundreds of cases of the same condition can tell apart healthy narcissism from malignant narcissism, ordinary lying from pathological lying, and so on: this is what we do all day.

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Just as people untrained in mental health underestimated the level of Mr. Trump’s pathology and did not understand the gravity of what was to come, you can “know“ he is unwell or is dangerous but not truly be able to appreciate what this means. A mental fitness evaluation does not distinguish the type of diagnosis as much as severity and whether you are impaired to do your job and pose a danger. Diagnosis is irrelevant when we are speaking about job performance; a schizophrenic patient can get good treatment and be fully functional. So the message of our book was threefold: One, the president is worse than he appears; two, he will grow worse over time; and three, eventually he will become uncontainable. The remedy is proper treatment.

Tana Ganeva: What’s your greatest fear for the US and world that someone with Trump’s condition is in many ways one of the most powerful people on earth?

Bandy X. Lee: He is already the most powerful person on earth, in all of history, simply because of the power that is granted his office in this day. And he has the personality structure to desire to use it to the fullest—we can see this in his national emergency, but we will likely see it in his relentless temptation to use nuclear weapons.

My greatest fear is the “uncontainable“ part I described earlier. It pertains to our ability as a society to respond appropriately. Without intervention, we will inevitably grow sicker, and where there is a loss of mental health, deepening illness comes with a loss of ability to pull ourselves out of the illness.

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The typical reaction is alarm in the beginning, then habituation or “normalization,” and then exhaustion and paralysis coupled with a segment that will enthusiastically embrace our own destruction. If we turn helpless and give in, or if the latter segment grows, we are doomed. Right now, we seem to be in a gridlock. Another danger exists if we were getting better, and in the process his followers turn on him—and they are prone to, the way he himself turns on his supporters, in what we call an “idealization-devaluation” cycle—then it would be experienced as a dramatic loss of self, and not yet contained, he would be inclined to bring the whole world down with him if he were “to go down.” This would be the most dangerous moment.

Tana Ganeva: On Tuesday, the New York Times revealed that President Donald Trump had pressured acting AG Matthew Whitaker to replace prosecutor on Michael Cohen case. Are you worried about the President’s reaction?

Bandy X. Lee: I am not too worried about these momentary events. They may seem urgent, but the press would also do well to rise above merely reacting to daily minutiae, which facilitates Mr. Trump’s pathology, and to gain an upper hand to help prevent events from occurring in the first place. One does so by first consulting experts (as you are, but this is rare!) and developing a deeper understanding of the situation.

This would help relieve stress, since dealing with illness on its terms depletes you. Currently, Americans are suffering from record levels of stress and anxiety since this presidency, according to American Psychological and American Psychiatric Association data, and part of this is because we are not addressing the elephant in the room.

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If we are capable of addressing it for what it is, a mental health problem, then we will be empowered for recognizing the truth and being able to put the right words to it, not to mention knowing about proven interventions. Mr. Trump has a very typical presentation that is dealt with effectively all around the country every day; we have not applied the standard method to treating it, and this is unfair to the president, also. If someone were physically ill, you wouldn’t say, “We already know he’s seriously ill; we don’t need a doctor.” Why would you do that with someone who is mentally unwell?


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