Mental health expert: Donald Trump is like a serial killer who remains a great danger to society
President Donald Trump gestures in total shock during a campaign rally at the Giant Center. (Shutterstock)

The House Jan. 6 committee's public hearings have made it increasingly clear that Donald Trump and his confederates attempted a coup to nullify the results of the 2020 presidential election and, in effect, end American democracy. The coup plot involved every branch of government including the courts, Congress, the Department of Justice and (at least potentially) the military. It was nationwide and included plans to rig the Electoral College results and alter actual vote totals at the state level. Contrary to what too many public voices have continued to suggest — in a collective state of willful denial — Trump's coup plot was highly sophisticated and came very close to succeeding.

It is equally clear that the Capitol attack of Jan. 6 was not spontaneous or purely coincidental. Donald Trump and his confederates welcomed and incited the lethal attack as a central element of the attempted coup. The violence of Jan. 6 appears to have been a pretext for Trump to invoke the Insurrection Act and declare a national emergency as a means of remaining in power indefinitely.

Former CBS News anchor Dan Rather summarized the nature of the threat to American democracy, writing in his newsletter that there "is nothing past tense" about Jan. 6, "even though the date itself is about 18 months ago":

The currents that exploded that day are, and will continue to be (with an emphasis on the present and future tenses), a direct threat to the continuation of the United States as a democratic republic.
The congressional committee investigating the insurrection represents not merely a fact-finding exercise to correctly document history, as important as that mission would be. They are firefighters battling a blaze of autocracy and unconstitutional depravity sweeping across the country.

The House Jan. 6 investigation has three immediate goals. Primarily, it is an attempt to offer a public accounting of Trump and his confederates' crimes against democracy, both on that day and in a larger context. As part of that accounting, the House select committee is also attempting to make clear that the Republican plot against democracy is continuing and that the country remains in extreme peril.

The House Jan. 6 hearings are also intended to serve as a de facto criminal indictment of Donald Trump and several of his co-conspirators, which may finally compel Attorney General Merrick Garland to seek prosecution. These hearings also appear to confirm that Trump is a mentally unwell person, perhaps a sociopath or psychopath, who continues to be a great danger to the American people and the world.

To discuss those issues and others, I recently spoke with Dr. Lance Dodes, one of America's foremost mental health professionals. He is a retired assistant clinical professor of psychiatry at Harvard Medical School and a training and supervising analyst emeritus at the Boston Psychoanalytic Society and Institute. He was a contributor to the bestselling volume "The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President." Dodes belongs to a small and courageous group of mental health professionals who consistently sounded the alarm about Trump, both before and during his presidency, arguing that he should never have been allowed to hold high public office and should have been removed at the earliest opportunity.

In this conversation, Dodes argues that the Jan. 6 hearings offer further validation of his warnings about Trump, and discusses why so many Americans, especially among the political class and mainstream media, remain in denial about the dangers the Trump movement represents. The "revelation" that former Education Secretary Betsy DeVos and other members of the Cabinet discussed removing Trump by way of the 25th Amendment comes as no surprise, he says.

Dodes still views Trump as a mentally pathological person with grandiose desires for power and little or no regard for human life. He argues, however, that Trump is legally sane and culpable for his actions on and around Jan. 6, 2021 and beyond — but if Trump is eventually indicted, Dodes warns, he will encourage his followers to engage in massive acts of violence and destruction.

I'm angry on behalf of all the mental health professionals who argued that Trump was dangerous and were met with deflections and denials and condemnation. I consistently offered a platform to those mental health professionals who tried to warn the American people and the world, but the mainstream media and political elites largely avoided the issue. Now it's been confirmed that Trump's own Cabinet members viewed him as unstable and discussed removing him.

Donald Trump is not like other human beings, and you can't treat him as if he is. He is a severe sociopath, and his willingness to see others suffer and die pushes him into the realm of a psychopath.

I have been frustrated for so many years now, really since 2016. I've said this so many times in various settings, but people don't quite get it. Donald Trump is not like other human beings, and you can't treat him as if he is. The news media refused to accept that. He is a severe sociopath, and his willingness to see others suffer and die pushes him into the realm of a psychopath. He lacks the core of normal empathy, and the ability to appreciate that other people have rights. He is a very sick man. Yet the media and others treated him like an ordinary person.

How did you respond to the reports that Betsy DeVos and other Cabinet members actively considered invoking the 25th Amendment to remove Trump from office?

In the end they lacked the moral courage that was required to stand up and say, "This is not right, and I'm going to do whatever I can to protect democracy." All those politicians whose main goal has been to protect Trump are traitors, in the same way that Trump is a traitor. It's hard to act. It's heroic for people in public office and other positions of power to act, because they have to put themselves at political risk. There were no heroes among Trump's party.

Given what has been revealed by the House committee hearings, one would think that the mainstream media would be discussing Trump's mental health. But for the most part they are continuing with the same dangerous habit of normalizing Trump's mental pathologies and the danger he represents. Why aren't you and your colleagues being interviewed across the 24/7 cable news channels?

I have been a guest on MSNBC, with Lawrence O'Donnell. I wasn't interviewed elsewhere on a major network. The media has got to do a much better job looking at how they colluded with this assault on democracy, and why it wasn't a headline every day that our democracy is under attack. The New York Times published a letter by me and 30 or so other mental health professionals in early 2017. A month or two later I wrote another letter, because it was obvious that things were only getting worse with Trump. The Times didn't publish it. They told me they had covered that topic already.

Very few major institutions in this country spoke up. The worst was the American Psychiatric Association, which should have been leading the effort to help people understand Trump psychologically and the danger he presented. Instead, they actively tried to suppress criticism about Trump's mental health. They threatened to throw people out of their organization if they spoke up. The Goldwater rule never applied to this situation, and was touted to protect the reputation of the APA at the cost of protecting truth, democracy and mental health.

People still don't quite understand the enormous danger from Trump. He is a man much in the mold of Hitler. Trump is completely dishonest and lacks the ability to understand what other people want or care about. It's all about him. He is adamantly opposed to democracy. He seeks to be a king, and is in fact a tyrant.

What is your general response to the House Jan. 6 hearings?

What fills me with despair is that I am afraid that the people who need to hear this information about Trump are not listening to it. I just don't know how much impact the facts are going to have on the people who are listening to Fox News.

What have the hearings revealed about Donald Trump, and his mental state and behavior, that you think is particularly noteworthy?

There's nothing new here. Once you understand what is wrong with Donald Trump mentally and emotionally, and how deeply different he is from normal human beings, the rest of it follows.

I have repeatedly written that Trump is the most dangerous man in this country and one of the most dangerous people in the world. I also use moral language to describe Trump: He is evil. Why are so many people still in denial about Trump's obvious pathologies, which are a matter of public record? They keep expressing shock over these revelations when, as you say, there's really nothing new.

Most of us would like to believe that our leaders are loving and kind people who are looking out for us. When a truly evil person came to power, we were unable to react appropriately.

Most of us would like to believe that there are benevolent powerful authorities at work in the world, leaders who are loving and kind. In this country, many of us were brought up to believe that the leaders of the country are fine people who are looking out for us. We want to believe it. When a truly evil person came to seize power, the country, the free press, was unable to react appropriately, and we still see people who are "shocked."

Reporters and commentators repeatedly proclaim that they are shocked that Trump wanted Mike Pence to be killed, and that he actually encouraged his attack force to do such a thing at the Capitol on Jan. 6. What are the psychological processes at play in such extreme denial?

At the beginning of his first presidential campaign, Trump said that he could kill somebody in the middle of Fifth Avenue and get away with it. That tells you how this man's mind works. What happens to another person's life means nothing to him. How many people's lives has he ruined in one way and another? That's what he does. The easiest way to understand Donald Trump is to think of him as a serial killer or a monster. The word "monster" means a creature without empathy, without caring, willing to kill or maim or hurt or destroy anything in its path for its own purposes, a sadistic creature lacking normal human capacities. There's nothing shocking about Trump's behavior when you see him for the fundamentally disordered person that he truly is.

To be even more specific, when we see pundits and other public voices proclaiming that Trump's conduct was shocking or unimaginable, do they actually believe it? Are they just feigning that response because it's not acceptable to tell the whole truth about this man? Or are they just profoundly immature about reality and so privileged that they have never encountered such people?

If a tiger attacked a person, you would not be shocked. You have to understand, that's what Trump is. You can't think of him as a regular person. Stop expecting him to be like you or your neighbors.

They're ignorant, and I don't say that as an insult. They're literally ignorant of human psychology. If a tiger attacked a person, you would not be shocked. So you have to understand, that's what Trump is. You can't think of him as a regular person because he is vastly different from a normal human being. To say you are shocked by anything he does means you just don't understand how extraordinarily different Trump is from other people. "Evil" is good word to describe him, and once you stop expecting him to be like you or your neighbors or anyone else in your life, then you're not surprised anymore.

The American people need to grow up. Part of that is accepting that human evil is real, and that there are evil people here in America. Once you accept that evil is real and that human monsters are real, then you can understand Trump, fascism and these other anti-human and antisocial threats. But if you are repeatedly shocked by evil, or pretend to be, then you are actually defenseless against it.

There are some people who don't grasp the concept of psychopathy. I've had the same thought that you did: They must have never seen it. If you've never seen somebody who has that gaping maw at the bottom of their psyche where there's nothing but sadism and pain for others, if you haven't met people like this, you don't understand that evil can exist in people.

As a mental health professional, how do you make sense of Mike Pence? Trump basically tried to have him assassinated. Yet Pence still, for the most part, remains loyal to him.

He appears to need to have somebody powerful to attach himself to, no matter whether the person is evil or not. He appears to be a sycophant. Pence is probably not quite as bad as Trump, but he seems to be a small and dishonest person.

How will Donald Trump respond if he is finally prosecuted by the Department of Justice for his crimes?

He won't be able to accept it. He'll respond just as he did to his loss in the 2020 election. For Trump, anything other than worshipful obedience is an unjustified attack. He'll get the most expensive lawyers available to him. He'll accuse other people of being guilty of the exact things he and his party are doing. Trump and the Republicans will call the Democrats "fascists" when they are the true fascists. They already claim that Democrats are the authors of the Big Lie, when of course it is them. Trump will attack, and will be willing to destroy anybody who stands in his way. It would be nothing to him to kill Mike Pence, be it literally or figuratively. Other people do not matter to Donald Trump.

Based on his public statements and other behavior, Trump would in all likelihood tell his followers to engage in acts of violence and terrorism to defend and protect him if he is prosecuted. It appears that Merrick Garland and the Department of Justice are terrified of that possibility.

It's the same thing Trump did on Jan. 6, absolutely. Whether he would succeed is another matter. Once Trump incites more violence, the question will be whether his followers obey him, and whether the country's leadership will have the courage to act to prevent a coup.

Does Donald Trump know what he's doing? Is he responsible for his actions? Those questions loom over any decision to prosecute Trump.

Donald Trump certainly knows what he's doing. That's a different question from whether he has personal insight into his behavior. He doesn't know that he is a sociopath. He's too far gone. He has a psychotic core, in that he is fundamentally out of touch with reality when it comes to his view of himself as a godlike figure, as we've seen in his many grandiose and delusional statements. But does he know what he's doing? Of course Donald Trump knows what he's doing.

So he is legally culpable? Is he sane enough to be held responsible for his actions?

I'm not an attorney, but it seems to me that Donald Trump is legally culpable for his behavior, just as any serial killer is. He's not insane in the legal sense.