Psychiatrist says Trump's 'glaring psychological problems' were misinterpreted and led us to disaster

Dr. Bandy X. Lee was interviewed by Prof. Johanna Fernández, author of The Young Lords: A Radical History (UNC Press, 2020), a history of the Puerto Rican counterpart of the Black Panther Party. She is the editor of Writing on the Wall: Selected Prison Writings of Mumia Abu-Jamal (City Lights, 2015) and with Abu-Jamal a special issue of the journal Socialism and Democracy, titled The Roots of Mass Incarceration in the US: Locking Up Black Dissidents and Punishing the Poor(Routledge, 2014). She teaches 20th Century U.S. history and the history of social movements at Baruch College (CUNY) and hosts "A New Day" on WBAI. She interviewed Dr. Lee, forensic psychiatrist and author of Profile of a Nation, for her "Race, Class, and Revolution" class at MayDay Space in New York. This is a two-part series. The first part of the interview series can be read here.

Where does politics begin and psychiatry end in assessing social problems?

As you know, we just experienced hundreds of thousands of unnecessary deaths, the near-loss of our democracy, and traumatization of a nation as a result of a president's mental unfitness, and so we cannot say the two areas are always separate. If the psychological dangers and unfitness were addressed earlier on, as would have been routine for any other job, we may have avoided these predictable consequences. Mental health issues do not stop at the political realm, and a high political office does not make one immune from mental problems.

At the same time, just as political matters should not be labeled as psychiatric, psychiatric issues should not be labeled as political. Politicians are supposed to consult with experts in areas that exceed their ability to handle—and not pretend that it is politics as usual—just as mental health experts should not comment on areas outside their expertise. Mislabeling can lead to catastrophes, as we have seen under Donald Trump, when glaring psychological problems were interpreted as political strategy or "3-D chess."

We associate Nazism or Stalinism with certain countries, while portraying Adolf Hitler, Idi Amin, or Pol Pot as such exceptional "monsters" that they would never be replicated on our soil, when the psychological characteristics they display are quite common—and it was handing them power that was exceptional. If we fail to understand the personality types that relentlessly seek but cannot handle power, which transforms them into grotesque megalomaniacs who run their countries to the ground, we will forever be vulnerable to them. We need to engage those who are best poised to detect these signs early, before they entrench themselves in the political structure, and that would be mental health experts.

Didn't Barack Obama deploy more structural violence against immigrants than all previous American presidents? Why not focus on this? Isn't talk about sociopathy a distraction from the real problems?

Absolutely, we need to consider the larger context—but the two are interlinked. When present, we need to point out elements of pathology in the culture that push individuals into violence, even when they may not have initially been inclined. George W. Bush might be another example of someone who was not a dangerous personality, but he was used for dangerous purposes. When I was asked to comment on the Iraq War at the World Economic Forum, I focused not on him but on our nation as suffering from a "narcissistic personality disorder" writ large. I called out Donald Trump because he is a dangerous personality, but he was simultaneously also the personification and instrument of a dangerous culture. People have asked me to comment on Joe Biden, but I have not, since he exhibits no concerning signs of relevance to doing his job, although whether he can refrain from the pressures of our violent military-industrial complex remains to be seen.

How is it helpful to discuss disorder, whether in an individual or in a society? Disorder by definition leads to destruction, no matter the stated intentions, whereas healthy, rational, and well-informed choices are always life-affirming, occasional human errors or accidents notwithstanding. Disorders can be more pernicious than criminality alone, since simple criminality at least benefits the self. It is when criminal-mindedness combines with pathology that all manner of atrocities become possible, for even the actor who is supposedly "benefiting" will eventually destroy oneself.

Prevention is critical, since, once pathology spreads, the ability to recognize that something is wrong is gone, too. This is where mental health professionals have an important role, for we have an independent duty to warn authorities and the public, as part of our responsibility to society, if the relevant people are not recognizing the dangers. One of the reasons why the American Psychiatric Association's silencing of mental health experts under the Trump administration was so alarming was because it stripped the public of its one defense against victimization—and this was after it looked the other way throughout Barack Obama's presidency when psychiatrists were constantly diagnosing him incorrectly with "narcissistic personality disorder" on Fox News. It also said nothing about those who incorrectly diagnosed Trump—as long as the diagnosis was favorable. It only aggressively shut down conscientious mental health professionals who were not unethically diagnosing but responsibly alerting about the dangers, since we were inconvenient to a dangerous government.

Recently there have been individuals who have been very destructive in social movement organizations locally. Some believe these individuals are on the NPD spectrum. How should we address these problems in social movements?

There is an epidemic of narcissistic and sociopathic personalities in our culture, even more disproportionately in leadership positions. This is a ubiquitous problem that is compromising organizational goals, hurting associates, and harming society. While psychological issues are understandably a difficult topic in the social movement world, where we often believe we ought to focus on social and economic problems and not make "ad hominem attacks," we must recognize this is a real problem. We need to be informed, recognize red flags, and set boundaries for our daily protection.

Why is it so difficult to address these issues in our organizations internally?

First, the most dangerous personalities disguise themselves so well that an early scholar called the condition a "mask of sanity." Even if you recognized them, they are intimidating, and so you end up coddling and protecting them, rather than exposing or holding them accountable, especially if you wish to avoid their cruelty, wrath, and vindictiveness. We need systematic provisions against them, both in government as well as in private organizations.

What is the value of psychiatry, despite its politics?

Politics, media companies, and corporations are making use of psychological knowledge more than ever to control people's behavior for profit. Citizens would do well to educate themselves, and mental health professionals to share their knowledge with the public, not just to serve the wealth and power that hire them. The CIA, the FBI, and the courts all make use of psychiatrist evaluations, most of the time without personal interviews, and the public should not be deprived of psychiatric assessments, especially when a nation's own president is posing a danger—which is arguably even greater than that of a foreign leader.

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I warned of Trump's psychological danger — and Americans suffered for the failure to stop him

In the recent escalation of anti-Asian violence, there are important immediate causes and then more enduring societal ones.

In March 2020, I wrote in Raw Story: "The greatest risk factor of disease and death is not being considered, and that is Donald Trump. If he continues in this presidency, he is on course for having three main effects: First, he will make a deadly pandemic much worse. Second, he will stoke divisions between 'believers' and 'unbelievers' in his alternative reality. And third, he will vastly augment suffering, which he will … direct into widespread violence … by calling the novel coronavirus 'Chinese virus,' simultaneously deflecting blame and creating new targets for attack."

As his presidency continued full-term, without repudiation or any reckoning for the violence he has incited, Asian-Americans have become victimized. Mental health professionals have since the beginning warned of his psychological dangerousness, among which is his tendency to project his own unacceptable actions onto others, as he did when he scapegoated Asians through derogatory phrases such as, "Chinese virus" and "Kung flu."

Just as his dehumanization of immigrants and desperate migrants led to unprecedented hate crimes and mass shootings, we have seen a more than an 800 percent increase of reported verbal and physical assaults over the course of a year, which is most certainly a gross underestimate. Furthermore, the recent mass murder at the Georgia spas made clear that Asians, particularly women and elders, are not safe.

Meanwhile, we now know that Donald Trump was responsible for at least 40 percent of the now 560,000 Covid-19 deaths, according to a Lancet report; that up to 97 percent of the deaths were unnecessary, according to a Columbia University report; and that all deaths beyond a hundred thousand "could have been mitigated," according to the former White House coronavirus response coordinator. This immense suffering has been displaced onto Asian-Americans as scapegoats, through the former president's unique, pathological ability to read his followers and to re-channel blame for his own failures onto others.

The Trump presidency was a public health emergency from the start, and violence is a societal and cultural disorder, more than an individual one. Individual circumstances may vary, but of greater significance is the cultural shift that pushes vulnerable individuals into violence where previously they may not have been. The January 6 insurrection, the mass killing of Asian-Americans, and the reign of white supremacist terrorism and intimidation are all interrelated and exacerbated as the result of a former president being so "successful" in avoiding accountability for his actions.

After two impeachment acquittals—which he and his followers interpret as exonerations—and no other prosecutions yet in sight, he is well-positioned to continue to inspire responses that make the pandemic worse, to embolden those who subscribe to his version of reality where he never fails and is never responsible, and to redirect the suffering of the populace against his targets of choice. We need vigorous delegitimizing of his actions and influence, to curtail a violent culture that will give rise to epidemics of violence, including anti-Asian violence.

Societally, we need to recognize that the deadliest violence occurs through societal structures, not through individual actions. Structural violence, be it economic inequality, sexism, or racism, is responsible for more than 10 times all the suicides, homicides, and deaths from civil strife or wars combined—that is, all deaths from behavioral violence, year after year. Structural violence such as racism is also the most potent stimulant of behavioral violence, giving rise to epidemics of hate crimes, murders, and acts of terrorism.

We must call out these cultural forces that threaten safety and our collective thriving. We must hold leaders responsible for their destructive rhetoric, and oppose legislation that disadvantages minority groups, such as voting restrictions, which is essentially the usurpation of the people's voice.

Asian-Americans have been self-silencing and silenced, alternately valorized or feared and othered. They have, in general, tried to fit in with the dominant culture in order to secure safety and survival, but this is a false sense of security through compliance and collusion.

Striving for true unity in diversity, not by conformity but by emphasizing our common humanity, equality amid differences, and justice for all will benefit all of society. African-Americans have a long history of such struggles, meeting oppression and hate with nonviolent strength, humanity, and compassion. We need to emphasize how much we have to learn from and are interdependent with all non-dominant groups and join forces. African-American struggles are also Asian struggles. Native American struggles are also Asian struggles. Latinx-American struggles are also Asian struggles. And so on.

In order to heal from the societal sickness that starts in the mainstream white American culture but spreads through the externalization and projection of its problems, and the generation of inter-generational trauma for non-whites, we need first to name our wounds and affirm our diverse identities. By embracing and drawing upon our cultural roots of who we are, and by cultivating a sharing of our uniqueness and commonality in working through the suffering we feel in our lives, we can help all of us, including the dominant class, to heal.

The World Mental Health Coalition, which is dedicated to promoting societal mental health, has recently launched a Project for National Healing with a series of Truth and Reconciliation Town Halls. Its inaugural town hall was held on March 13, 2021, with the theme: "Racism, White Supremacy, and Societal Mental Health." We need concrete steps to call out the societal problems that the four years of Donald Trump's presidency have represented, magnified, and spread. At the same time, we are called to share the gifts of our unique backgrounds as Blacks, Latinx, Native Americans, and Asians, as part of the life-affirming restoration that must occur.

Expert on Trump's real legacy: A mental health pandemic that rages unabated

As U.S. Covid-19 deaths have exceeded 500,000, an article in the Lancet lays much of the responsibility squarely on Donald Trump.

While much has been said about the Jan. 6 Capitol attack, the true scandal is how and why a psychologically dangerous person was allowed to preside over more American deaths in one year than those by all the terrorists and foreign enemies in one hundred years.

If impeachment for inciting violent insurrection was too slow, occurring a week after the event as he held onto full nuclear powers, for the deadliest assault that was killing thousands of Americans every day, impeachment did not even happen.

Ignoring the dangerous psychology and mental unfitness in a U.S. president has led to multiple disasters for the nation and the world.

Whereas Joe Biden has tackled the pandemic with admirable single-mindedness and speed, he may already have inherited an impossible mission. Herd immunity, or achieving immunity in 70% to 85% of the population, may be elusive for a problem that spiraled out of control for nearly a year. The Trump presidency was emblematic for ignoring the mounting problem, sabotaging public health efforts, and even threatening governors who tried to follow Centers for Disease Control and Prevention (CDC) guidelines. And now, rampant infection has allowed mutation into different variants, Donald Trump's "Project Warp Speed" itself was a hoax with an alarmingly slow start, and a mental health pandemic may hamper the vaccination of more than half of U.S. adults.

Ignoring the dangerous psychology and mental unfitness in a U.S. president has led to multiple disasters for the nation and the world. It remains conjecture whether we would even have a pandemic had Donald Trump's pathological envy of his predecessor not dismantled his highly-praised pandemic-preparedness systems, or his anti-science compulsion not bled the CDC dry, such that it needed to pull out its China team just months before the novel coronavirus outbreak.

Experts Blocked

Before a large portion of the population became "psychologically immune" to facts and sound advice, mental health professionals were making a breakthrough, raising the issue to the number one topic of national conversation and receiving invitations from all the major news programs. Then, the American Psychiatric Association (APA) stepped in to block us permanently from the major media.

In early 2017, when the APA changed its ethical guidelines to create a gag order on public figures, in time to shield Donald Trump from criticism, some of us estimated that, if he were not held accountable for mental unfitness—the number one emergency of the presidency and the cause of most other crises—then no other accountability would gain traction. Indeed, Congress members who depended on us to "educate the public medically so we can act politically" could no longer act, and the entire nation acculturated to a malignant normality that culminated with a largely preventable plague and a violent insurrection based on pure fabrication.

On the Comeback

Currently, after committing perhaps the greatest act of terror against one's own government this nation has seen, he has not only roamed free for almost two months but has practically announced that he will have another go at it. At least this is what can be extrapolated from his recent statements, interviews, and promise to speak at the Conservative Political Action Conference. Since opportunities to contain him and his influence through Senate conviction were not taken, he seems emboldened to undermine the new administration and to reassert himself on the political scene. However, we are not helpless, and here is what the president can do:

First, prosecute Donald Trump. Whereas Biden does not have direct prosecutorial power, which is the domain of the Department of Justice or the states, he has considerable moral authority and influence as president. If he truly wishes "reconciliation" and "unity", he should heed the advice of mental health experts, who have long warned that the current situation is too far beyond normalcy to apply rational logic. With pathological personalities, the correct management consists of limit setting, containment, and full and speedy prosecution of Donald Trump and all who helped orchestrate his criminal acts. Biden should help reclaim what has been lost by emphasizing and affirming lawfulness, morality, and reality. The sooner this can happen, the sooner we will have the safe space to begin our national healing.

Second, stem Trumpism. One of the tragic effects of an uncontained and prolonged, highly pathological presidency has been a mental health pandemic, or "shared psychosis" at alarming levels, which has worsened our collective mental health and torn apart communities, families, and couples. As a result, we find ourselves living in different realities, sometimes in the same household, and mourning family members who are still living but lost to us. The personality cult Donald Trump has cultivated is not a formal cult of relatively small numbers isolated from the rest of society but indoctrinated from the very positions of president and mainstream "news". Rather, the isolation is psychological, in that vulnerable individuals are psychologically conditioned to reject facts and logic and to accept only a false, "authorized reality," without the need for physical insulation from the world. I outline a multi-step course in my Profile of a Nation: Trump's Mind, America's Soul, but the first step to recovery is to discredit and to keep Donald Trump out of public life.

Third, divest from corrupt associations. When the APA intervened to help entrench the Trump presidency, it denigrated its own field, reinforcing public misconceptions of psychiatry as mere speculation that anyone could do, yielding little knowledge without some mythical advantage of a private examination and being a stigmatized field that, unlike all others, the public should never hear from experts about. It deprived the American people of critical knowledge, just as those in power were employing psychological techniques for illegitimate control, and subsequently took funds and privileges from the Trump administration, with its affiliates receiving one windfall after another for their institutions in ways that are asymmetric from other institutions of science and medicine under the same administration. The Biden administration does not have to go along with a "mental health association" that has harmed public health by sidelining the field it purportedly represents, and should not appoint without an investigation Jeffrey Lieberman, the foremost enabler of the Trump presidency, to any position under Health and Human Services Secretary Nominee Xavier Becerra, whose confirmation is this week.

The World Mental Health Coalition, which formed in part to step in where the APA failed in its societal leadership, is forming a Truth and Reconciliation Commission to research how and why a mental health emergency went unaddressed under the Trump presidency. We are also available for consultation regarding fitness tests for presidential and vice-presidential candidates, the prevention of dangerous leadership, and the promotion of societal mental health.

Trump's pathology infects the millions who follow him -- and this narcissistic symbiosis could grow even worse

In 2017, Dr. Judith Herman and I stated in The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President: "Power not only corrupts but also magnifies existing psychopathologies, even as it creates new ones."

We warned of an authoritarian cult of personality and growing contempt for the rule of law, which would spread throughout the culture unless stopped. Donald Trump's presidency was dangerous not because of his individual afflictions but his capacity, as president, to amplify and exacerbate society's defects, especially if he faced no accountability.

To the end of his presidency, he was not contained or held accountable. The American Psychiatric Association advanced a perverse version of "the Goldwater rule" to silence expert alarms, the way the Department of Justice revived a controversial internal Office of the Legal Counsel memo to place a president above the law. As a result, Donald Trump may have left the office of the presidency, but "Trumpism" not only continues but flourishes. As the House managers in the impeachment trial have reminded us with their effective use of videos of the Capitol insurrection, the Trump infection, once spread, manifests in deadly, violent behavior.

Donald Trump may have left the office of the presidency, but 'Trumpism' not only continues but flourishes.

We have already seen copycats arising everywhere in lesser positions. Marjorie Taylor Greene, a newly-elected Republican representative from Georgia, has shocked many with her brazen promotion of dangerous QAnon conspiracy theories and endorsement of violence, including execution, against Democrats.

Even while being stripped of her committee assignments, she responded with defiance: "I woke up … laughing thinking about what a bunch of morons the Democrats are for giving someone like me free time." Rep. Lauren Boebert (R-Colo.) is a similar personality, having flaunted her carrying a pistol in violation of the District of Columbia's anti-gun laws, argued for the right to bring firearms onto the House floor, and on Jan. 6 tweeted about the whereabouts of the House Speaker Nancy Pelosi (D-Calif.), as the insurrectionists were actively looking for her in the Capitol.

Lack of Accountability

For mental health experts who have been warning against these dangers for years, this behavior is only expected: criminal minds see lack of accountability as a green light. Lesser examples of emboldened behavior include Capitol riot suspect Jenny Cudd asking to leave the country on vacation, while Kenosha, Wis., shooter Kyle Rittenhouse is not only out on bond but changing his address without permission and making it difficult for the authorities to find him

A dangerous president has shown that he absorbs a powerful message when an OLC memo protects all criminality, including those that threaten national security, or that "the Goldwater rule" silences all criticism, even when doing so endangers public health. Trump came to believe he could even destroy democracy to stay in power.

Disabling any kind of intervention, therefore, not only kept a problem from being solved, but enabled it. Allowing a criminally-minded and mentally-impaired person to continue in the presidency for four years has sent a powerful message to similar personalities as Greene or Boebert: that elected office could serve as a cover for lawlessness or incapacity. We as a society have mobilized delusions of grandeur, impunity, and omnipotence as a legitimate way of warding off intolerable inner feelings of inadequacy, inferiority, and powerlessness.

Epidemic of Violence

As a specialist in public health approaches to violence prevention, it is not difficult for me to see that these are the conditions for epidemics of violence, including the increasing rate of violence among women. Violence is not an issue of individual mental illness but of societal disorder, and the conditions that encourage violence are well-known.

While violence is the end-product of a long process, a lack of political will—or even the use of violence as a political tool for amassing power—has hampered prevention. Instead, our nation has fostered and propagated it. It is now remarkable that a former president's act of insurrection, sedition and even treason, according to some Constitutional scholars, will likely remain without conviction because of the physical threats his followers pose for senators who might vote in favor of it.

In my first public-service book, I emphasized that he would grow more dangerous with time, and that, without intervention, his dangers would eventually spiral beyond control. Our failure to contain him and his followers has created a "silent pandemic" that contributes to other societal mental health problems, including a worsening of the viral pandemic itself, as well as drug addiction, depression, suicides, and homicides. In my most recent book, Profile of a Nation: Trump's Mind, America's Soul, I outline two major dynamics that are a consequence of allowing Donald Trump's pathologies to spread.

Wounded Leader

"Narcissistic symbiosis" is one, referring to the magnetic collusion that happens when a narcissistically wounded leader and followers meet. The leader, hungry for adulation that can compensate for an inner sense of inadequacy and worthlessness, projects grandiose omnipotence, while the followers, who are needy from societal stress or developmental injury, yearn for a parent figure whom they can emulate.

Such bonds make "shared psychosis," also called "folie à millions" ("madness among millions") at the national level, more likely to occur. Shared psychosis refers to the infectiousness of severe symptoms that goes beyond rational strategy or ordinary group psychology. When a highly symptomatic individual is granted an influential position with prolonged exposure to the public, conditions are set for the person's symptoms to spread. Delusions, paranoia, or violence-proneness transmit to previously healthy individuals especially powerfully. The treatment is the removal of exposure, as we have seen with the dramatic fall of approval ratings following the ban of Donald Trump from various social media platforms.

Disordered Thinking

This is not the end, however, and "the ecology" must change. The culture needs to stop normalizing, legitimizing, and glorifying disordered thinking, for once it is admitted into the mainstream, it will not go away or give up power easily, and is not amenable to facts or logical persuasion. As stated at our recent National Town Hall, we must convict, set limits on violent behavior, and return society to justice, order, and reality. We must also address the socioeconomic conditions that gave rise to poor collective mental health in the first place by reducing economic, racial, and gender inequalities.

Once an individual or a group succumbs to pathology, it is characteristic to make further maladaptive choices that descend one further into sickness. One such choice may be to use violence to ward off narcissistic needs or challenges against one's cherished delusions. This is why prevention, before resistances develop, is important. Mental health professionals who understand pathological dynamics need to engage actively with social scientists, policymakers and politicians for urgently needed interventions.

Mental health expert explains why Donald Trump must be convicted

The Trump presidency may be over, but Donald Trump's dangers continue. This is because we have yet to contain the number one emergency, which is the spread of mental pathology.

Without addressing this mental health pandemic, even the Biden administration's admirable efforts to contain the viral pandemic may meet with obstacles. Similarly, without conviction and prosecution, which is the first step to containing this mental health pandemic, hopes for "reconciliation" and "unity" may also be for naught.

Mental health professionals knew from the start that Donald Trump had the psychological makeup to become very dangerous with presidential powers. Following our 2017 assessment, I and thousands of my colleagues at the World Mental Health Coalition issued more than 300 pages of letters, petitions, and statements asserting that Donald Trump's dangers would spread and erupt. In March 2020, we issued a "Prescription for Survival," stating that the president's removal through the 25th Amendment, impeachment, or resignation—or at least removal of influence—was essential to avoiding widespread unnecessary deaths.

Trump uses words and directly incites violence. Research on violence shows that rhetoric can be more efficient than specific orders or direct assaults in causing epidemics of violence.

A failure to contain led to a most dramatic demonstration of dangers on Jan. 6, but it was long in coming. Over the summer of 2020, I wrote a new public-service book, Profile of a Nation, to warn that, "he is truly someone who would do anything,… no matter how destructive, to stay in power." Indeed, the near-massacre of lawmakers he caused at the Capitol, save for a few heroes, proves how close he came to causing the kind of chaos that may have permitted him to remain.

Donald Trump's campaign to rig an election that he lost through endless lies, abuses, and multiple attempts to rig an election that he lost eventually led to his fomenting deadly violence and near-loss of our democracy. As we did with the Mueller report, his recent phone call with Georgia's secretary of state, and his "Save America" rally speech, mental health professionals can explain how Donald Trump uses words and directly incites violence. Research on violence shows that rhetoric can be more efficient than specific orders or direct assaults in causing epidemics of violence.

The World Mental Health Coalition, of which Dr. Lee is president, will be holding a special online national town hall, "The Imperative to Convict Trump," on Sunday, Feb. 7, at 2 p.m. EST.

Speakers include: Laurence Tribe, constitutional scholar, Harvard Law School; Norman Eisen, former special counsel for Trump's first impeachment and trial; Richard Painter, former chief White House counsel for George W. Bush; Rep. Gerry Connolly (D-Va.), member, House Oversight Committee, and chairman, House Subcommittee on Government Operations; Claire Finkelstein, criminal lawyer, University of Pennsylvania; Ruth Ben-Ghiat, historian, New York University; Bandy Lee, moderator and president, World Mental Health Coalition

Tickets are $5 for students and low-income individuals, $25 general.

For more information, please go here, and for a video statement, see here.

The ideal course would have been swift impeachment and conviction. Impeachment happening a week after the actual incident was already a poor precedent, prompting us to write to the speaker of the House: we would not allow a serial killer to be on the loose with bombs, ammunition, and assault rifles for days—and yet we permitted a serial mass killer, by the order of hundreds of thousands, for weeks with access to nuclear weapons capable of destroying all civilization. We urged clear and speedy actions, given that each day of delay had an adverse effect on the population's demoralization and trauma without justice, and on Trump enablers' opportunities to subvert the momentum for impeachment.

Impeachment Backfire

As we know from past experience, tepid impeachment proceedings could even backfire and boost Donald Trump's standing. As we have repeatedly emphasized, once with over 800 mental health professional signatories, even the most impeccable political calculations, without consideration of psychological factors in his case, would likely also fail politically.

Given a recalcitrant Senate, psychological influences are especially critical. Some of this might have been mobilized to advantage had impeachment occurred the day after violent insurrection and sedition, and conviction as soon as the following day, with amplification of public outcry if the Senate refused.

Since this did not happen, the next best course would be to have a complete trial with as much evidence and testimonies as possible, including those of Capitol police officers who were injured during the incident, to maximize pressure on the Senate to convict.

More High Crimes

Additional articles of impeachment would also be helpful, including his role in the soon-to-be half-million Americans who perished from the pandemic; the economic misery while he and his cronies profited; the human rights abuses as he kidnapped and placed children in concentration camps; and the aid and comfort he gave to neo-Nazi and white supremacist terrorist groups throughout his presidency, to compose an "encyclopedia of articles" more commensurate with reality that we recommended since the first impeachment.

Unless conviction promptly removes former presidential privileges and sets restrictions on future campaigns for political office, Donald Trump will likely use the acquittal to claim that he is innocent of all charges. He will claim that the second impeachment was another "hoax" intended to victimize him, using it to discredit all subsequent indictments and prosecutions.

Back on the Stump

He will resume holding rallies, continually pushing the narrative that he was the real victor in 2020, threatening further social and political divisions. He will blame the poor state of the country he created on the Biden administration, just as easily as he claimed credit for the long-term benefits that the Obama administration's policies generated, as he aims to return to power as the savior who will "make America great again." As long as positive reinforcement through a lack of accountability persist, he will not stop.

A failure to convict will, furthermore, have a devastating effect on the public's mental health. The country is already traumatized from four years of normalizing, legitimizing, and even glorifying deadly criminality, abusive behavior, and severe pathology. Members of Congress who experienced normal emotional distress as happens after a life-threatening event will not be able to have closure, as will the American people after the violation and desecration of their seat of government.

Unhealthy Bonds

A failure to convict will continue to entrap those who support him, whose unhealthy emotional bonds prevent them from seeing the damage that is being done to their personhood, livelihood, health, and even lives. It is a disservice to collude with their psychological defenses against the pain of disappointment, further entrenching them in potential future trauma upon learning the truth.

Clear boundaries need to be set that a leader should not abuse, let alone kill, the people he has sworn to serve.

The first step to healing a massive mental health pandemic is to convict, set limits, return to reality, and restore the standards of lawfulness, order, and safety. We should not continue to permit a dangerously unfit person who held high office to spread unmitigated violence, trauma, and mental pathology. Mental health professionals who routinely manage dangerous personalities have vital knowledge to contribute to society and should be consulted.

Trump has plunged into a psychotic spiral and is now fighting for his psychic survival

Since March 2020, our body of mental health experts, the World Mental Health Coalition, has urgently recommended that Donald Trump be removed from the presidency, whether via the 25th Amendment, impeachment, resignation, or an involuntary psychiatric hold. Following his incitement of violent insurrection where five people were killed and a massacre of lawmakers was attempted, we have issued a call for his removal from the presidency for medical reasons.

While a second impeachment is a step in the right direction, without actual conviction and removal, the public remains vulnerable. As president, Donald Trump officially controls access to weapons capable of destroying civilization.

As independent mental health professionals with detailed knowledge of the president's condition, we have urged a reopening of the possibility of Section 4 of the 25th Amendment, or any other means of removal of presidential powers, including a psychiatric evaluation for immediate safety measures.

There is abounding evidence of Donald Trump's severe mental impairments, and the following can serve as medical data of a dangerous mindset that is important for consideration, be it for the 25th Amendment, the senate trial, or informed, critical behavioral management in the coming days.

Previously, we analyzed his lengthy phone call with Georgia's secretary of state, Brad Raffensperger. Similarly, his speech at the "Save America" rally before the Capitol offers shocking proof of his dangerous mindset. In the speech, Donald Trump shows signs of delusions, paranoia, grandiosity, pathological narcissism, and other serious symptoms.

Delusions are fixed false beliefs that are not amenable to facts or reason, and when rigid, can evoke a violent response to challenges. For example, no amount of proof, failed lawsuits, and ratification of election results would change Donald Trump's mind about the election being stolen: "All of us here today do not want to see our election victory stolen by emboldened radical left Democrats, which is what they're doing…. We will never give up. We will never concede." Delusions, or beliefs their purveyor is truly convinced of, are more effective than strategic lies in spreading across populations through emotional bonds.

His grandiosity entitles him "to try and give our Republicans, the weak ones … the kind of pride and boldness that they need to take back our country….. So let's walk down Pennsylvania Avenue." As president, he does not have to give explicit orders to orchestrate his followers in an attack: "You have to show strength, and you have to be strong," while enumerating his targets, suffices.

Donald Trump also gives ultimatums: "Our country has had enough. We will not take it anymore…. we will stop the steal." Only a reality that comports with his disordered, wishful thinking is possible to him, regardless of evidence, and he specifies his target: "The States got defrauded…. All Vice President Pence has to do is send it back to the States to recertify, and we become president, and you are the happiest people." In response, his followers went as far as to mount a noose and gallows.

He displays delusions of grandeur, stating that his and his followers' mission is "to save our democracy." Only he should be in the position of president, and if his audience fails, they will see the nation's destruction: "We want to get this right, because we're going to have somebody in there that should not be in there and our country will be destroyed."

Donald Trump claims they "built the greatest political movement in the history of our country…. There's never been a movement like that." He instructs his followers not to lose it: "Don't let them talk, 'Okay, well we promise,' I've had a lot of people, 'Sir, you're at 96% for four years.' I said, 'I'm not interested right now. I'm interested in right there.'"

Donald Trump's paranoia, or perceiving threat where it does not exist, is another risk factor for violence. Donald Trump repeatedly imposes his paranoid world view whereby they are the ones under "siege", in order to promote himself as the only one who can save them: "We've done things like nobody's ever thought possible. And that's part of the reason that many people don't like us, because we've done too much, but we've done it quickly…. And now we're out here fighting."

Perpetrators of abuse commonly cut their victims off from other sources of information, which Donald Trump does by demonizing legitimate media, which he calls, "fake news": "It's all part of the suppression effort…. The American people do not believe the corrupt fake news anymore, [or] the people who want to deceive you and demoralize you and control you, big tech, media."

Donald Trump has a history of recklessness, impulsivity, lack of empathy, a loose grip on reality, and intolerance of challenges to his fragile sense of self. His defeat as president of the United States has plunged him into a violent, psychotic spiral, and he is now fighting for his psychic survival. This has now escalated to inciting his followers to commit acts of violence against elected officials and the general public.

The mental health emergency that Donald Trump poses to the nation has been the defining characteristic of this presidency. We must not make the mistake again of overlooking psychological factors. Donald Trump continues to be a danger to himself and others, and correct management in the coming days and weeks will be critical to containing his ability to mount further violent upheavals, as well as to keeping our nation safe.

Bandy X. Lee, MD, MDiv, is president of the World Mental Health Coalition ( She can be followed at her web site ( or on Twitter (@BandyXLee1).

Trump's real danger is how 'he's recruited his followers to an alternative reality': Mental health expert

On Christmas Eve, Donald Trump threatened to derail a pandemic relief bill that took 9 months to reach bipartisan agreement on, plunging millions into uncertainty as he vacationed and golfed. By waiting until Sunday evening before abruptly signing the bill, he allowed unemployment programs to lapse, which will lead to delays and loss of benefits for countless Americans out of work.

This occasion gives us another glimpse of just how far he is willing to go with his anger (at congressional Republicans for not backing his false voter fraud claims), his revenge (against Americans for rejecting him), and his cruelty (of finding pleasure in inflicting suffering on those he despises). Now, he is calling on thousands to come to Washington, DC, to challenge Congress' final approval of Joe Biden and Kamala Harris on January 6.

Over the weekend, David Ignatius wrote a Washington Post article by the title: "Until Biden's Win is Certified, the U.S. Remains Vulnerable." This is what mental health experts have been trying to say since before the election. Donald Trump lost the election, and his legal challenges never had a chance, but just as with the pandemic, the dangers are not confined to the virus or, in this case, the law. Rather, the real dangers are where he has weakened systems or has recruited his followers to an alternative reality.

A Psychological Take on the News (December 28, 2020)

The most dangerous weeks lie ahead, and mental health problems need to be dealt with through mental health. So please consult us at, or visit me at (Dr. Lee does not take payment for any of her services related to this topic).

Mental health expert: Donald Trump 'will do anything' to stay in power

Two thousand twenty was the deadliest year in U.S. history, with 400,000 more deaths than the previous year, and one American dying from Covid-19 every 30 seconds. This week, Donald Trump issued 15 pardons and 5 commutations to mass murderers, corrupt cronies, and human rights violators, in contempt of the rule of law. He also demanded changes to a desperately needed pandemic relief bill, prolonging the deprivation of millions who are going hungry or are without jobs.

This week, he "tweeted": "Our embassy in Baghdad got hit Sunday by several rockets…. Guess where they were from: IRAN…. If one American is killed, I will hold Iran responsible. Think it over." Again, he is flirting with international war.

In my "Profile of a Nation," completed over the summer, I wrote: "with an election looming, he will likely refuse to concede the results, call the election a fraud, and refuse to leave office." I also said: "We must come to the recognition that he is truly someone who would do anything, no matter how terrible, no matter how destructive, to stay in power."

Mental health problems need to be dealt with through mental health. This is why we put together "The Dangerous Case of Donald Trump" in 2017, petitioned Congress with over 800 signatures in 2019, and issued videos of over 100 senior mental health professionals three months ago, stating Donald Trump needed to be removed from the presidency.

A Psychological Take on the News (December 23, 2020)

Each day is a chance to do it right. Please start by consulting us at, or visit me at (Dr. Lee does not take payment for her books or any other services related to this topic).

Mental health expert: Trump's powerful 'psychological abuse' makes it difficult for his 'cult' to quit him

The rollout of the Covid-19 vaccine distribution has been very encouraging and hopeful, but the next several months remain challenging. What determined the pandemic's scope and severity was not the microbe but the mental health of the president, and, by extension, of his followers. Instead of protecting the population, the Trump administration engaged in campaigns of disinformation, starting with hydroxychloroquine, how masks are dangerous, and how Covid-19 itself is a conspiracy.

Extracting individuals from a cult or an abusive relationship can be difficult because it is not a matter of presenting facts or appealing to logic. Cult members and victims of abuse are emotionally "hooked" into the relationship, unable to see what may be obvious to outsiders about the harm that is being done to them. After a while, the magnitude of the deception conspires with their own psychological protections against pain and disappointment, which cause them to avoid seeing the truth.

It is much easier to believe that the person one has pledged undying devotion to is worthy of that loyalty, than to face the fact that one has been duped. Psychological abuse is powerful, and perhaps the most destructive form of abuse, as it takes over one's agency and critical faculties.

A Psychological Take on the News (December 18, 2020)

For how to handle Trump followers, please read my "Profile of a Nation," or consult us at and at (Dr. Lee does not take payment for her books or any other services related to this topic).

Mental health expert calls for invoking 25th Amendment: 'Every day Donald Trump is in office, we are in danger'

I would like to echo what a good friend from the Harvard Kennedy School of Government has said: “Today is a good day to invoke the 25th Amendment.”

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Mental health expert: 'Mass killer' Donald Trump's 'preoccupation' with election shows his 'extreme indifference to human life'

The daily death toll from Covid-19 has now reached 3000 for the first time, exceeding the number of people killed in 9/11.  Centers for Disease Control and Prevention director Robert Redfield warned that this staggering death rate would probably continue for the next 60 to 90 days.

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Mental health expert explains how Donald Trump's 'dangerous' delusional beliefs 'could lead to violence'

Retired FBI assistant director, Frank Figliuzzi, said that his degree of concern for violence is “the highest it has been since the Trump administration has been in power.”  Law enforcement is trained to intervene when the threats are imminent or have already happened.  Mental health professionals are trained to respond to psychological signs of danger, preferably before things have happened.  Both our lights have been blinking red for a very long time.

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Expert: Donald Trump's election rhetoric could unleash another wave of violence

Seventy percent of the 74 million who voted for Donald Trump believe he won the election and the Democrats stole it from him.  About a week ago, a top Georgia official, Gabriel Sterling, implored with the president: “Stop inspiring people to commit potential acts of violence…. someone’s going to get killed.”  More recently, a caller told a House Committee Vice Chairwoman Cynthia Johnson, who is Black, that she should be “swinging from a … rope.”

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Forensic psychiatrists: Donald Trump does not pass the smell test for an insanity defense

Yesterday, renowned forensic psychiatrist Dr. James Merikangas and I published a statement with DC Report that President-Elect Joe Biden should encourage prosecution of Donald Trump if he wishes to forge more bipartisan relationships in Washington.  This is because the usual approach of conciliatory gestures, “reaching across the aisle,” or bypassing the law “for the sake of national unity” usually does not work with pathological personalities.

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Expert: Donald Trump’s psychological makeup makes defeat a humiliation he cannot abide — at any cost

The United States has now exceeded 15 million confirmed cases of Covid-19, with casualties at the rate of one Pearl Harbor attack per day.  Over 100,000 have been hospitalized, overwhelming medical systems, and this is still before the spike of Thanksgiving weekend, when over 1 million traveled by air.

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