The mainstream media is concerned with the politics, policies, and propaganda of President Donald Trump, but underplays the central question of his presidency: Is Donald Trump psychologically fit to be president of the United States and commander-in-chief? Over the past twelve months, psychiatrists and clinical psychologists have produced two books (“The Dangerous Case of Donald Trump” and “Rocket Man: Nuclear Madness and the Mind of Donald Trump”) to warn that our dangerously disordered president is a threat to domestic and international security. According to an article in Newsweek in March 2018, most Americans agree that Donald Trump is unfit to be president.
The mental health experts who have produced these books have had to ignore the ethical principle of the American Psychiatric Association known as the “Goldwater Rule,” which prohibited psychiatrists from diagnosing a public figure they had not personally interviewed. The erratic behavior of Donald Trump as a candidate in 2015-2016 and as president in 2017-2018 has led to a challenging ethical principle known as the “duty to warn” because of the danger he has created. In every area of American policy, Trump’s actions and statements have created the highest level of domestic and international anxiety since the end of World War II.
For the past several years, we have witnessed what psychiatrists have referred to as Trump’s malignant narcissism, citing his claims that he knows more than anyone else and that only he can fix our problems. His demonization of the press and his opponents as well as his treatment of minorities and his handling of immigration issues point to paranoia . The separation of immigrant families demonstrated the lack of empathy that accompanies narcissism.
His claims about the size of his inauguration crowd and the weather conditions that day suggest that he is delusional. His lack of impulse control is particularly worrisome in a nuclear age that presents no real checks and balances on a commander-in-chief’s role in the use of nuclear weapons. Similarly, his inability to process information rapidly and dispassionately, and his unwillingness to accept information from experts, particularly in the intelligence community, are dangerous attributes.
The combination of paranoia and impulse control is most worrisome because it can lead to destructive acts. According to White House sources, a series of Trump’s rants were followed by the declaration of a trade war that could hurt global economic output and would find the United States vulnerable to tariff retaliation from others. The ugly exchanges between the United States and North Korea and once again the United States and Iran raises the potential for more unwinnable wars similar to our experience in Iraq and Afghanistan. There are no limits to Trump’s bombast.
As a result, Trump has faced an unusual level of public criticism from his own appointees, including chief of staff John Kelly, former secretary of state Rex Tillerson, former national security adviser H.R. McMaster, and most recently Director of National Intelligence Dan Coats. Since 
Kelly and McMaster were general officers, and the professional military is not permitted to criticize a sitting president, their views were particularly striking. The criticism by Tillerson and McMaster cost them their jobs, and they were replaced by loyalists, Mike Pompeo at the State Department and John Bolton at the National Security Council, who are far more supportive and even obsequious toward the president and less likely to moderate Trump’s impulsive behavior.
The mere thought of Trump and Bolton discussing national security policy and the use of force is particularly frightening. Both men have impulsive and explosive natures, and are obsessively fixated on undoing the legacy of Barack Obama. Trump’s biographers point to dangerous elements of irritability and aggressiveness as well as a pattern of deceitful behavior in his personal life. Both men have engaged in irresponsible talk about nuclear weapons; Trump told interviewers that it was pointless to have nuclear weapons unless we were willing to use them. Bolton has favored preemptive attacks against Iran and North Korea. Trump ignores intelligence assessments, and Bolton has a record of misusing intelligence in past statements to the UN General Assembly and Security Council.
Long before his bizarre behavior in July at the NATO summit in Brussels, the state visit to the UK, and the horrendous Helsinki summit with Russian President Vladimir Putin, Trump has demonstrated an obsession with blowing up the Obama legacy and the dignity of his presidential opponent Hillary Clinton. He has walked away from the Iran nuclear accord and the Paris climate accord; challenged the resumption of relations with Cuba; and alienated long-time allies in the European Union and NATO. Trump has angered Canada and Mexico with calls to renegotiate NAFTA; initiated tit-for-tat measures with China; and infuriated the leaders of Britain, France, and Germany. Conversely, he seeks close relations with authoritarian figures, including Putin, Chinese leader Xi Jinping, and Turkish President Recep Tayyip Erdogan.
While the mainstream media continues to discuss Trump in terms of some doctrine or playbook, it has failed to speculate on the terrible consequences of a commander-in-chief who is a malignant narcissist without impulse control. Trump’s instability and unpredictability were on display throughout the campaign and the first months of his presidency, but his “diplomatic” endeavors in June and July with regard to North Korea, NATO, the European Union, and Russia were erratic and impulsive.
His first public appearance as president at CIA headquarters in January 2017 provided ample evidence of his delusional and hyperbolic tendencies. His senior staff, including cabinet members, have given off-the-record accounts of his tantrums and lies. His public appearances have demonstrated incredible ignorance, on the one hand, or outright deceit, on the other. It’s not a matter of Trump’s lack of a “moral compass,” but the absence of any compass whatsoever. It begs the question of whether the President is even compos mentes.
The dizzying pace of policy reversals and the back-and-forth over Russian interference in the 2016 election in the wake of the Helsinki summit provided more evidence of a lack of psychological maturity and self-regulation. Trump’s truckling toward Putin is inexplicable, and the confusion over his possible military and diplomatic commitments in their private talks have flummoxed his national security team. At best, he is an erratic president; at worst, he is mentally ill.
These worrisome characteristics were in full view before the election. At a campaign rally in Iowa in 2015, Trump declared that “I’ve had lots of wars of my own. I’m really good at war. I love war….” When former secretary of state Tillerson referred to Trump as a “fucking moron,” it was in response to Trump’s case for expanded nuclear forces and the willingness to use such forces against non-nuclear states. Since assuming the presidency, Trump has declared war on governance, intelligence, diplomacy, law enforcement, public service, and fact-finding, particularly in the scientific community. His loose language on expanding the nuclear arsenal and the usefulness of low-yield nuclear weapons has led to congressional discussion to check the president’s unilateral authority to launch nuclear weapons.
When Vice President Dick Cheney proposed radical changes to nuclear doctrine and use of force in the administration of George H.W. Bush, the National Security Council and the Pentagon pushed back and Bush’s national security team rejected such notions. There is no evidence that Secretary of Defense James Mattis is pushing back. Furthermore, Trump now has in place a virtual war cabinet that includes Bolton at the National Security Council; Pompeo, an uberhawk, at the Department of State; and Gina Haspel, the CIA’s advocate for torture and abuse as the director of the agency.
The mainstream media describe Secretary of Defense Mattis as the only moderating “adult in the room” in the Trump administration, but he has kept his head below his breast plate since the Helsinki summit and has made no public comments in the wake of the president’s unprecedented attack on NATO and his coziness toward Putin during the crucial period in July. It is unlikely that Mattis will be able to successfully challenge, let alone moderate, the most bellicose cabinet in U.S. history.
Trump’s truckling to Putin has fed speculation that he has become a victim of Russian “kompromat” due to excessive money laundering or salacious conduct in Moscow during his business trips. If Trump has indeed been compromised, then Robert Mueller’s will have evidence from numerous intercepted messages. But even without evidence, it is noteworthy that Trump appears willing to use Putin’s talking points on such issues as Montenegro; NATO; and the European Union.
Trump’s very first encounter with Russian officials in 2017 presaged his awkward behavior toward Putin. In dealing with Russian Foreign Minister Sergei Lavrov and Ambassador Sergei Kislyak in the White House in May 2017, Trump boasted that he gets “great intel. I have people brief me on great intel every day.” Trump even shared sensitive intelligence obtained from Israel with the Russians, which angered the intelligence community as well as members of the National Security Council. A year later, when faced with the differing opinions of his intelligence tsar, Dan Coats, and the Russian president, Trump sided with Putin.
Trump’s body language with Putin was particularly striking. No macho handshakes as with French President Macron. No shoving aside as with Montenegrin President Dukanovic. No arrogance and bullying as with British President May and German Chancellor Merkel. The visuals with Putin are remarkable. We see a very nervous and withdrawn Trump; an obsequious Trump; a Trump who reifies the policy positions of Putin. The only other head of state who gets such a submissive attitude is Israeli President Bibi Netanyahu. And like Netanyahu, Putin displayed at the joint press conference a confident, even smirking, manner that pointed to success. Yet, Trump cannot stop talking about how tough he is on Russia.
Some of Trump’s truckling speaks to ignorance. Only a fool would describe Putin’s offer to allow U.S. questioning of indicted Russian military intelligence officials in exchange for Russian questioning of Americans suspected of illegal activity as “incredible.” Putin’s list of Americans included former ambassador to Moscow, Michael McFaul. Indeed, the proposal was incredible…incredibly unacceptable. But it took Trump and his national security team nearly four days (and a 98-0 vote in the Senate) to reject what press spokesman Sara Huckabee Sanders referred to as Putin’s “sincere” proposal. A day earlier, Sanders referred to Putin’s proposal as “under consideration,” which prompted even Secretary of State Pompeo, a diplomatic neophyte, to preemptively reject Putin’s “incredible” offer. Perhaps Trump has not been compromised by Russian intelligence, but he acts as if he were.
If Trump were not president of the United States, he would not be able to obtain a security clearance. (There has never been a White House staff, moreover, that has had greater difficulty in obtaining security clearances to see highly sensitive information.) Bolton could never obtain Senate confirmation of a key national security position, which explains his posting as National Security Adviser that has no such requirement. Trump’s temperament and his “war cabinet” have jeopardized U.S. alliances and compromised international understandings on trade, migration, and climate change. No president in U.S. history has done more harm to U.S. credibility and standing in the global community. The twin dangers of war, even nuclear war, as well as climate catastrophe are on the horizon.
The assassination of President John F. Kennedy in 1963 and the fact the Vice President Lyndon B. Johnson had once suffered a heart attack as well as the advanced years of the Speaker of the House of Representatives and the President pro tempor of the Senate led to the passage of the 25th Amendment in 1967 to regulate the succession to a president who is deemed “unable to discharge the powers and duties of his office.” Trump has demonstrated he is unfit to serve, but the amendment requires a vote of the majority of the Cabinet as well as two-thirds of the House and Senate to validate such a succession. Like the possibility of impeachment or indictment, the invocation of the 25th Amendment is extremely unlikely.
It remains to be seen what the Mueller investigation and the possibility of “kompromat” stemming from money laundering or salacious behavior in Moscow will do to the Trump presidency. Trump presumably believes that he won’t be impeached and that he can’t be indicted. Our limited experience with impeachment suggests it is unlikely that even real change in the Congress as a result of the November elections will lead to impeachment. Andrew Johnson and Bill Clinton survived the impeachment vote in the House of Representatives in 1868 and 1998, respectively. Only Richard Nixon voluntarily left the White House in 1974 to avoid an impeachment that the Senate probably would have validated.
In the meantime, these issues are distractions from the real threat to the United States and the American people, which is the irrational and impulsive nature of the president himself. As a result, the American people and the entire international community are held hostage. Two more years of Trump’s demagoguery and misogyny will do incalculable harm to American democracy.
