It’s time we talked openly about Donald Trump’s mental health.

In late 2015, we commenced what would become an ongoing conversation about then-presidential candidate Donald Trump’s mental health.

We were concerned that, given his “straightforward” or “outsider” presentation and charisma, he would appeal to people who were unaware of the dangers of his obvious narcissistic personality type, and the offensive behaviors that can accompany it. These behaviors include but are not limited to condescension, gross exaggeration (lying), bullying, jealousy, fragile self-esteem, lack of compassion, and viewing the world as Us-vs.-Them. Having observed the schoolyard-bully tactics Trump employed during public debates, as well as his boasting presentation during interviews, we felt it was important to raise awareness about his behaviors. So in January 2016, we posted Bullies: An Exploration Into Different Types of Bullies.

As Trump’s campaign, and his narcissism, gained momentum, so did our efforts. In March 2016, we posted The Narcissistic Personality: How to Spot a Narcissist, in which we shared clinically documented narcissistic behaviors and hoped it would be easy for readers to see that Trump fit every example.

And then on January 31 of this year, Psychology Today’s editors posted Shrinks Battle Over Diagnosing Donald Trump: Chaos in the White House Fuels Discord Amongst the Experts. The article reported on a petition by author and psychologist John Gartner, Ph.D., declaring that Trump has “a serious mental illness that renders him psychologically incapable of competently discharging the duties of President of the United States.” Gartner, a former professor of psychiatry at Johns Hopkins, is currently in private practice in New York and Baltimore. To date, more than 26,000 psychologists, psychiatrists, and other mental-health professionals have signed his petition, which has no legal power but drives home the point that these professionals are gravely concerned about the mental health of our president. The point of the editors’ post was to highlight the conflict within the mental-health field: While some believe it is possible to diagnose through observation, some feel it is unethical and inappropriate to do so, while still others question whether or not psychology should be used to address issues of governance at all.

Duty to Warn

Journalist Lawrence O’Donnell has taken it upon himself to champion Gartner’s effort to help educate the public. On his MSBC program, The Last Word, he recently spoke with Gartner and Lance Dodes, M.D., a retired professor of psychiatry at Harvard Medical School, in a segment titled “Mental-Health Experts Say Donald Trump Is Unfit to Serve.” Gartner contended that mental-health professionals have a duty to warn the public of dangerous individuals in their midst. According to Gartner, mental-health professionals can observe a person’s behavior and words, from afar, and diagnose that person. He claimed that the idea of the psychiatric interview as the gold standard for assessment is not true, and added that we have thousands of hours of Trump’s behavior in front of us. He continued:

“As far as ethics go, I would argue with my colleagues that those who don’t speak out are being unethical. If we have knowledge and understanding about the unique danger that Donald Trump presents through our psychiatric training and we don’t say something about it, history is not going to judge us kindly.”

Dodes was asked by O’Donnell to watch and comment on a much-played clip of Trump claiming during a debate that he had lost “hundreds” of friends on 9-11. Dodes’ said there were two pieces to Trump’s lying: First, he lies because of his sociopathic tendencies — “He lies in the way a person scams people; he’s trying to sell an idea or a product by telling you something that’s not true.” The other aspect of his lying was more serious — his loose grip on reality. For example, when he lies and has been told that what he said is not true, he still carries on with the lie. Dodes said that this indicates Trump cannot accept an aspect of reality and therefore rejects it, making his grasp on reality, and his attention to it, loose. “This is an extremely dangerous trait in a president,” Dodes continued. “And that makes him unqualified.”

Both Gartner and Dodes agreed that as far as the depth of mental illness, this is the “worst case” scenario. Gartner added, “He’s just sane enough to ‘pass’ but is detached from reality.” Gartner argued that what is real for the president is fluid, meaning that it’s malleable. Combine this non-reality with paranoia, and being at a hand’s reach of the nuclear codes is troubling. “He actually imagines he is under attack by people who are not actually attacking him,” Gartner said, creating “a very dangerous combination of someone who can act on his paranoid fantasies in a way that can have catastrophic consequences.”

The Elephant in the Room

On his next broadcast, O’Donnell interviewed author Lee Siegel, who recently wrote an article for the Columbia Journalism Review titled, “Avoiding Questions About Donald Trump’s Mental Health Is a Betrayal to Public Trust.” (Dodes appeared again as well, and both enlightening segments can be viewed here.)

It’s important to note that Siegel wrote:

“Mental illness does not need to be professionally diagnosed. We don’t need to be told by a doctor that the guy coughing and sneezing at the other end of the train car is probably sick … When someone is compulsively lying, continuously contradicting himself, imploring the approval of people even as he is attacking them, exalting people one day and abusing and vilifying them the next, then the question of his mental state is moot. The safe thing to do is not just to stay away from him, but to keep him away from situations where he can do harm.”

In “Time Perspective Therapy” Terms

Through our observations, we can see Trump as embodying an unconstrained present hedonist — living only in the present moment and saying whatever it takes to pump up his ego and assuage his inherent low self-esteem, without thought of past reality or potentially devastating future consequences. He is the poster boy for a time perspective that is totally unbalanced. Unfortunately, given his personality type, there is little hope of reversal or any meaningful improvement.

Our Future

What can we do? Be observant. Be vigilant. Share this article to spread awareness. Write or call your elected government officials and state your concerns about Donald Trump’s mental health. And hope that with the backing of 26,000 mental-health therapists (a number that continues to grow — last month the number was 18,000) in agreement that he is mentally unfit to be President of the United States, we will have a new, mentally fit president as soon as possible through some judicially appropriate political action.

No matter whom you voted for in the election, or if you didn’t vote, we the people did this — at least those of us representing an Electoral Colleges majority. We need to correct this threat to our ecology, our society, and our international relations soon — before it’s too late.

Source: Rosemary K.M. Sword and Philip Zimbardo Ph.D.,