Yale psychiatrist explains how Trump's psychosis has spread to his rank-and-file supporters -- and much of the GOP

The president’s personal lawyer and former New York City Mayor Rudolph Giuliani wrote an opinion piece by the title, “The Supreme Court Should Step In to Rule this Impeachment Unconstitutional,” where the Washington Post reports him as donning the “constitutional scholar” cap in “very colorful terms.”

Just over a week ago, Giuliani had made the dramatic statement that he was prepared not only to testify at the president’s upcoming impeachment trial but would even try the case.  Giuliani has mystified observers for some time, which is why I am responding to a request to analyze his words here.

First, allow me to remark on methodology.  Ordinarily, I state that analyzing a public figure is complex, and have previously declined to comment on Kim Jong-un or Vladimir Putin.  In order to offer a responsible analysis that is medically sound, an abundance of high-quality information is necessary.

Rarely do we have the amount that Donald Trump offers, with decades of candid interviews and clips; numerous collateral reports by close associates, many under sworn testimony; and direct, unfiltered, near-hourly reporting of thoughts (a full diagnosis needs more, although a personal examination is not the deciding issue, as it can in some cases be harmful in assessing personalities that deceive or charm).

With Giuliani, however, I can make an exception.

Power may corrupt ordinary individuals, but it radically transforms dangerously pathological figures beyond what people can imagine.

I can do so because, like many of Trump’s followers, he seems to be an extension of the president’s psychology.  How is this possible?  There can be a contagion of symptoms, as in the phenomenon of “shared psychosis,” further explained below.  I also have some references on  Giuliani as a long-term New Yorker that corroborate my assessment.  Finally, I feel justified in sharing the findings because of the danger he poses (as a strong adherent to the original “Goldwater rule,” I am opposed to commenting frivolously on public figures unless they pose a danger to public health).

I have regularly been “translating” Trump and his followers as a public service, using my understanding of the president’s defense mechanisms, repeatedly validated against other data: whatever he says about others is very revealing about himself.  I apply the same method for his followers because their shared psychosis, or the transmission of mental symptoms among close contacts over time, including via the media or the Internet, renders their psychological structure extremely similar.

Adopting Trump's Delusions

Unlike Trump, I have closely interacted with many Trump supporters and can personally attest to their uniformity in many psychological respects.  Especially when the primary pathology rests in a powerful figure, otherwise healthy people can adopt his cognitive distortions, delusions, and other symptoms as their own.  My experience with multiple cases in state hospitals and among gangs in prisons, in my 22-year career as a forensic psychiatrist, has been impressive.  Shared psychosis disappears just as dramatically when the contact is interrupted (we may consider Trump’s former fixer Michael Cohen here).

Here is a sample “translation” of Giuliani’s words, or interpretation of what his subconscious may be telling us, from his opinion piece: “Republicans’ obsession from day one not to impeach President Donald J. Trump, without regard to substance or process, led us to change the grounds for our argument every couple of months.  In doing so we have punted everything from Russian collusion to obstruction of justice, to quid pro quo, to bribery.”

Projecting Trump's Criminality onto Biden

By offering to try the case several days ago, Giuliani revealed a grandiosity so high, he does not seem to notice how he often harms his client or reveals how corrupt he is willing to be by trying a case for which his client is defendant (and he potentially co-conspirator).  When he said he would prosecute “as a racketeering case,” he was inadvertently “confessing” his and the president’s level of criminality by projecting it onto Joe Biden.  He even narcissistically added that he “kind of invented” such prosecutions.

DC Report’s Editor-in-chief, investigative reporter David Cay Johnston, countered that Giuliani’s subordinates tried and won “the RICO (Racketeer Influenced and Corrupt Organizations) cases Rudy claims credit for,” that other prosecutors won cases “years ahead of his subordinates,” and “the RICO law was the brainchild of Prof. G. Robert Blakey.”

This pattern is consistent with my own experience of him as mayor of New York City, where I grew up in an environment of violence that I once considered the norm.  I witnessed, through the late 1980s and early 1990s, numerous activist groups entering our neighborhoods, building gardens and bringing art projects.  When one of them came into my bullet hole- and gang-ridden school, it had an inspirational effect on all the teenagers, including myself: robust literature now proves that positive reinforcement is far more effective in preventing violence than any level of policing or punishment.  Thus, when the mayor belatedly intervened with his police force and claimed all credit for the drop in violence, it already seemed disingenuous then; I know it to be blatantly false now.

Trump Unable to Handle Power

Why is this relevant?  I believe it is important for mental health professionals to make distinctions, where applicable, between normal style and pathological traits that can cause harm.  A pathologically narcissistic individual, for instance, would not be able to handle power—even as one hungrily seeks it—but would more likely develop delusional levels of grandiosity or impunity.  Delusions, in turn, are more effective at mobilizing mass psychology than rational strategy, and puzzling features emerge even from formerly respectable attorneys such as Jonathan Turley and Alan Dershowitz.

We have seen a comical and innocuous-seeming Trump morph into a grotesque authoritarian willing to destroy every facet of civilized society in order to build and maintain his cult of personality.  His irrationality ironically helps make his supporters fervently anti-interventionist one day and supportive of an obvious “wag the dog” war the next, according to his desires.  Power may corrupt ordinary individuals, but it radically transforms dangerously pathological figures beyond what people can imagine or prepare for.  Needless to say, those who are suffering from similar narcissistic wounds are the first to be attracted to such a power figure and to succumb to a shared psychosis, and Giuliani may exemplify how severely it can affect a person.

Dr.  Bandy X.  Lee is a forensic psychiatrist at the Yale School of Medicine, president of the World Mental Health Coalition, and editor of  The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President.