This doctor says Trump's not crazy: He doesn't even 'remember what happened yesterday'

This conclusion has been reached after more than four years of observing Trump's public behavior. Other mental health professionals, most notably the president's niece, Mary Trump, who is a psychologist, as well as Dr. Justin Frank (author of "Trump on the Couch") have reached the same conclusion after expertly observing Trump's behavior for years or decades.

After being hospitalized several weeks ago for COVID treatment, during which he was administered an experimental cocktail of drugs, Trump has behaved in an even more erratic and aberrant manner.

Donald Trump's mind and mental health are like the nuclear reactor at Chernobyl. These last days before Election Day are a countdown for a man who, if he is defeated, will experience a meltdown that spreads his poison all over the world.

As documented by the Washington Post, Trump has lied more than 20,000 times while president. In these last few weeks, his lies are becoming more frequent and outrageous.

Trump is now claiming that he somehow defeated the coronavirus pandemic. In reality, the United States is falling deeper into a season of death. The virus is spreading largely unchecked, with more than 227,000 people dead in total and upwards of 70,000 new cases a day.

During his second and final presidential debate with Joe Biden, Trump sounded remarkably callous and cruel in his discussions of the death and suffering caused by his negligence and incompetence during the pandemic.

Because fueling his ego, grandiosity and malignant narcissism are more important than the lives of others, Trump continues to host rallies where his followers gather unmasked by the thousands. Public health experts have now directly tied Trump's events to the spread of the virus and resulting illnesses and deaths. Trumpism literally is a death cult; his followers are human biological weapons.

On Tuesday, in Omaha, Nebraska, Trump again showed that he does not care about the health and safety of his followers. After a rally at an airfield, many of Trump's supporters were left behind in freezing temperatures when the buses they were promised did not appear. Many people were forced to walk several miles from the rally site back to their vehicles, and dozens of them required medical attention.

As president, Donald Trump has significant influence over the behavior of the American people. His mental pathologies have infected tens of millions of his followers, and have caused PTSD and other forms of stress and trauma for those Americans who oppose his regime.

But for all of Donald Trump's evident mental pathologies, could it be that he is even more dangerous than previously understood? That's the contention of Dan McAdams, who is the Henry Wade Rogers Professor of Psychology and a professor of education and social policy at Northwestern University. He is the author of almost 300 articles and chapters as well as seven books, including "The Art and Science of Personality Development" and "The Redemptive Self: Stories Americans Live By."

McAdams' work has been featured in leading media outlets such as the New York Times, the New Yorker, the Atlantic, USA Today, the Wall Street Journal, NPR, CNN and elsewhere. His most recent book is "The Strange Case of Donald J. Trump: A Psychological Reckoning."

In this conversation McAdams warns that Donald Trump's greatest threat is caused by the fact that he exists only in the present moment, a man without a future or a past who lacks any sense of a life narrative, story or ethics beyond winning at all costs. This aspect of Donald Trump is the greatest threat to the country and the world.

McAdams also cautions that Donald Trump is a unique and strange person who defies any singular category of mental diagnosis, and shares his concern that leaders like Donald Trump inevitably bring ruin and destruction to the countries they lead.

But all may not be lost. At the end of this conversation, McAdams offers hope that Trump's followers will be dejected and broken once he is removed from office, and that America's political and cultural institutions will be strong enough for healing to begin.

You can also listen to my conversation with Dan McAdams on my podcast "The Truth Report" or through the player embedded below.

This conversation has been edited for clarity and length.

How have you made sense of the Age of Trump?

For the first time here in America we have a full-blooded authoritarian leader. This has happened in other countries at other times, most notably the 1930s in Italy and Germany, of course. But for Americans this was all news. I've spent several years trying to understand Donald Trump using the standard vocabulary, nomenclature, ideas and theories from psychological science to make sense of him and his life. But they have only proved somewhat helpful in that quest.

I end up just being flummoxed by the strangeness of the man. I believe that he does not neatly fit the categories. He's not the typical malignant narcissist. He's unbelievably disagreeable, but in ways that nobody would ever fathom. There are so many things about Donald Trump that are peculiar. My book is entitled "The Strange Case of Donald J. Trump." I cannot help but to emphasize the strangeness of Donald Trump — it is as if he is a type of one-off when it comes to human nature.

Even at this point, there are many millions of Americans who are still in shock that Trump even became president.

The 50% or so of the American populace who are strongly opposed to Donald Trump never got over election night 2016. It was a traumatic experience. It was an event that people have flashbacks over. People are in therapy about what happened that night.

Many people keep hoping against hope that somehow it is all going to go away — that Trump's time in office is this weird anomaly that happened to American culture and somehow we are going to go back to some type of pre-Trump normal. I do not believe things will be the same again in this country. What many Americans will never get over is the feeling that this is not the country they thought they lived in before Trump was elected.

There is this repeated cycle of hope and despair with America and the Age of Trump. People are hopeful that some scandal, or his crimes against democracy and the country, will stop him. But that never happens. If anything, impeachment and every revelation of his wrongdoing has made him stronger. What does that cycle of ups and downs, hope and disappointment, do to people?

Going back to the 1970s, Donald Trump wins when he wears people out. Trump's modus operandi has always been to be more persistent, to hang in there and to run out the clock. As president he tried to win by outlasting everyone else. He did this in the real estate market. He did this to his creditors in the 1990s.

Trump has shown unlimited energy to promote himself. I do not believe that there is anyone else on the planet with that much self-promoting energy.

Every day, Donald Trump he is fighting what he considers to be a battle of survival, and then he either wins or loses. Trump has been like that his whole life. Trump wakes up the next day and starts all over again with that behavior. Trump does not even remember what happened yesterday. Other human beings remember what happened on Monday when it is Tuesday. As human beings we develop long-term narratives about how our lives work. But not Mr. Trump. For him it is new every day.

It is not a cognitive deficit. Trump has always behaved that way. He's always had this tremendous ability to just forget about the past and to deal with the present moment. That is part of what makes Trump so powerful in the minds of his supporters. He's not hiding anything. He's not thinking about yesterday. He's not worried about two weeks from now. He looks at the crowd, and he's 100% all there in the moment.

Outside observers often think, "Oh my God, there is something behind all of that performance and behavior!" The answer is no. Trump is always what we see. He is Donald Trump playing "Donald Trump" all the time.

Donald Trump is totally authentic as he fakes his way through the role. Trump is a perfectly authentic fake. There is nothing behind the mask. Trump has boundless energy because he does not have to worry about yesterday or tomorrow.

What does Trump's living in the "forever present" with no thought for the future or the past do to a country in terms of truth, reality and decision-making more generally?

It dooms a democracy. It dooms a culture and the broader development and health of a culture. Democracy and society depend on people taking some sort of long-term view. If there is no long-term vision or understanding of reality, then what works for such a person like Donald Trump is whatever he or she needs at that moment to win the fight.

For example, on a given Monday Trump will say, "Nancy Pelosi is the worst person on the planet." On Wednesday, it is a totally different fight. He does not have any memory of Monday and thus he will then say, "Well, you know what, Nancy and I were getting along today." And on Friday, Donald Trump is in another place. It is all moment to moment.

Other people do not live that way. It is not sustainable. To survive long-term a people, a nation, cannot have leaders who behave like Donald Trump.

Many mental health professionals would respond that such behavior shows that Donald Trump is mentally pathological.

People can label said behavior however they would like to. But here is what we must take into account in these discussions about mental illness and Donald Trump.  Any of the diagnostic categories are supposed to describe a compromise in one's functioning such that a person cannot get along in life and be successful.

Donald Trump is the president of the United States. He clearly has been successful. He has clearly gotten along in life. Moreover, I do not think that Donald Trump suffers from a mental illness. His behavior does not make him upset. His behavior motivates and drives him.

So yes, a person can throw those diagnostic categories about, but they are not helpful in this case. They do not help to explain how Donald Trump came to be. Donald Trump is much stranger than any diagnostic category.

Moreover, let us assume that we label Donald Trump as having narcissistic personality disorder or being a sociopath. Who cares? The labels are interesting to the clinicians, but are we going to say in this country that people who have mental illnesses should not be president?

If that is the conclusion, then Abraham Lincoln should not have been president because he clearly suffered from clinical depression. However, Lincoln used that mental illness in way that was powerful and productive. I do not consider mental illness as a deal-breaker when it comes to public office. But in my mind, Donald Trump is way more strange than any mental illness category that one can apply or create.

We must also grapple with the fact that many "successful" people such as CEOs and other "high-achieving" people are sociopaths. Moreover, sometimes that personality type may be of benefit to them.

That is true. But I am not comfortable with the term "mental illness." Let us discuss instead personality disorders such as narcissistic personality disorder. Steve Jobs met all nine criteria for narcissistic personality disorder. Only five are sufficient for the diagnosis. But Steve Jobs had other characteristics as well. He was a genius, for one, which helped him negotiate life.

Donald Trump is not a genius. Trump is also not as competent as other high-functioning narcissists we see in the world. And yet Trump has been extraordinarily successful through the use of brute-force leadership. That type of leadership is useful in certain contexts such as the military or sports. But there should also be leadership by expertise. Trump is almost 100% brute-force leadership. I do not believe that the United States has ever had such a president.

Donald Trump, again, is not like other human beings.

I have spent my entire career, some 30 years, studying how people create stories about their lives. This is part of human nature. Each of us is walking around with a story in our minds about how we came to be who we are. The story helps to ground us. It gives us a moral framework and help us make sense of who we are, who we were, who we will be in the future. This a called a "narrative identity."

Trump is the exception. He does not have a story in his mind about how he came to be. This is not a small thing. It is why Trump is able to live in the moment. He is able to play "Donald Trump" the character repeatedly, because there is no animating narrative in his mind about who he is and where his life is going. None.

But again, not having a strong narrative identity — or not having one at all — is not a sign of any particular mental illness. In the DSM there are mentions of "emptiness" and so forth, but that is not necessarily a criterion for mental illness.

It's just something we all assume that just about everybody has, and now we run into an individual who's remarkably strange in that regard. And a lot of people still don't really believe it. They keep thinking there's something else to him. He's strategic. He's playing the long game and so forth. But no. There is no strategic or long game with Donald Trump. Trump is like the alpha chimp who is always playing the short game, a brute-force game, to win at all costs.

What would Donald Trump say if you were to ask him, "Who are you in your own life story?"

People have tried to do that very thing. Going back to the 1980s, journalists and biographers have asked Mr. Trump such questions. He refuses to answer.

Trump scoffs. He changes the subject. He can't answer such questions. Trump will summon a memory from here or there, but the memory does not really reveal anything substantive because in his mind he has just always existed. Trump cannot offer a narrative about how he has become who he is today. Such a narrative makes no sense to him. Such a question also does not make sense to children either.

I have repeatedly argued that Donald Trump the human being does not really exist. He is a character, a symbol without substance, one on which people impose meaning. Is that analysis correct? What would it feel like to be such a person?

Your characterization of Donald Trump is a good one. Of course, Trump is a human being. He's flesh and blood. He's not an apparition. There is a substance and a reality to him there as a human. But when we think of how persons operate in the world, it is not clear to me that Donald Trump would say to you, assuming he knew what the criteria even are, that he is in fact a person.

It is hard to say if Donald Trump is miserable. It is hard to say that he has not done well in life. He is always Donald Trump playing "Donald Trump." There is not a person behind that behavior, or a narrative, or complexity. Donald Trump is a force of sorts, and that is how he sees himself.

Does Donald Trump believe in right and wrong? Is there some type of ethical governor on his behavior?

Donald Trump has a philosophy of life. It is: "Man is the most vicious of all animals, and life is a series of battles ending in victory or defeat." That's it. That is what he believes. Right from wrong has to be understood in that context. It is Hobbesian. What is right is what wins, what is strong. You either win or you lose. It's victory or defeat.

When Trump says, "Life is a series of battles ending in victory or defeat," he does not just mean that life ends in victory or defeat. What Trump really means is that every battle ends in victory or defeat. Life is a series of battles, one after another. Monday, there's a battle, Tuesday, there's a battle, Wednesday, there's a battle. There's victory or defeat in the battle and then you start all over. For Donald Trump there really is no moral framework beyond his version of survival of the strongest.

I don't think he has a moral framework. It's very interesting: How does somebody grow up without one of those things? If he's going to win, everybody else has to lose, so he has to reverse everything that Barack Obama did. Everything. He didn't care about these things, he doesn't even know what they are. He didn't even know what NAFTA was. He just didn't like it because it was something that was around when Obama was around, so he did away with it. Trump does not know what these things are. He just wants to turn it around and go the other way, and that gives him a victory because somebody always has to lose. Alliances like NATO and trade pacts, they make no sense to him. They are ideally win-win propositions. We help you, you help us.

That is not how the world works in Donald Trump's mind. If you're the strongest and the smartest and the most stable genius on the planet, you do not need such relationships. You just win. You have to keep winning.

Trump is version 1.0 of a 21st-century American fascism. What comes next?

I'm not sure there'll be a version two. I am not saying that everything is going to be fine. Democracy in the United States can go into a tailspin. It is very fragile and there is nothing natural about it. If American democracy is failing, then Donald Trump certainly is playing a role in it. But ultimately, I have more faith in the country's political and social American institutions than that. I actually believe that the country will recover from this moment.

In a sense, Donald Trump is part of a much bigger phenomenon. I also do not believe that Donald Trump can be duplicated. I do not imagine a Trump 2.0. But I do imagine that Trump's core base, about 30 million people, who want a Trump 2.0, that will become very frustrated because they will have missed their moment. When Donald Trump is gone, it is going to be very hard for his supporters to recreate the magic that they had with him.

How would Donald Trump respond to being defeated in the 2020 presidential election?

It is very difficult to imagine Donald Trump admitting defeat. He's never done it. In any domain of his life, be it personal life or business life, Trump has never for a moment admitted to any kind of misstep or defeat. Will Trump even leave the Oval Office? Will he step off the White House grounds? Will he show up to the inauguration? Here in America we have never had to ask these kinds of questions before.