I wrote this essay in early May, hoping the Albany Times Union would run it on their op ed pages, but they still haven’t gotten around to it, so I’m finally publishing it here. It’s more urgent than ever, but people still don’t seem to understand how drastically ill he is.
Duty to Warn: The Danger of Donald Trump

Robert DeNiro called Donald Trump crazy so many times in an at-home interview with Stephen Colbert last week that I lost count. The word “crazy” is being flung around more and more frequently, not just on late-night TV shows but on news shows as well. It’s not an official diagnosis, but it’s anything but a joke.
Before the 2016 election, the Times Union published my column speculating whether Trump might be bipolar. His hyperactivity, his staying up and tweeting in the wee small hours reminded me of my own behavior when I was escalating into mania. But by January, 2017, when he was sworn in, I realized that the state of his mental health is far more dangerous.
I put off writing more about Trump, because his increasingly outlandish behavior left me confused. For my own mental health, I tried to ration my news intake and banish thoughts of our horrible president from my mind. But now that his pathological behavior during the COVID-19 pandemic is costing thousands of lives, I feel the obligation to drill down for a closer look.
My research led me to a book first published in 2017, The Dangerous Case of Donald Trump, in which 27 psychiatrists, psychologists and other mental health professionals took on their duty to warn the public about his erratic behavior. An updated edition published in 2019 includes ten additional essays and warns that during his time in office, far from growing into his role as president, he has become increasingly unhinged.
In his essay, “Donald Trump is: A) Bad B) Mad C) All of the Above,” clinical psychologist John D. Gardner writes, “There are a lot of things wrong with him—and together, they are a scary witch’s brew.” Malignant narcissism, the term most often used to describe him, was introduced by Erich Fromm in the 1960’s. Fromm, a refugee from Nazi Germany, developed the diagnosis to explain Hitler and called it “the most severe pathology. The root of the most vicious destructiveness and inhumanity.” It has four components: narcissistic personality disorder, antisocial behavior, paranoid traits, and sadism.
Malignantly narcissistic leaders like Hitler and Stalin display grandiosity, self-confidence, and the assurance that they know what the world needs. Trump believes he knows more than anyone about anything. He also has antisocial personality disorder, or sociopathy. Such individuals lie, exploit the rights of others, and are devoid of remorse or empathy. Trump’s lack of empathy has been widely discussed, especially during this pandemic, and it’s typical of the sociopathic individual. His former mentor, the nefarious lawyer Roy Cohn, said that in terms of feelings for other human beings, Trump “pisses ice water.”

Experts speculate that he has grandiose and paranoid delusions that are disconnected from reality. Lately these have been on full display, most flagrantly when he suggested shining light and injecting bleach into the body as a cure for COVID-19. The next day, after intense blowback, he claimed he had been speaking sarcastically. But footage of the briefing shows he was deadly serious.
According to Lance Dodes, a retired professor of psychiatry at Harvard Medical School, recent brain research has shown that sociopaths have abnormalies.in the prefrontal cortex and the amygdala, areas closely associated with essential cognitive and emotional functions. He warns that the paranoia of severe sociopathy in a president creates a profound risk of war, since other world leaders will inevitably disagree with or challenge him, and he’ll experience this as a personal attack, leading to rage reactions and impulsive actions to destroy the perceived enemy. And remember, he holds the key to the nuclear codes, with the power to destroy all life on earth.
The character traits described above tend to worsen with age and with the accumulation of power. Then there’s the issue of cognitive decline. Psychiatrist David Reiss points out the significant decline in Trump’s cognitive performance in videos over the past 15 years. His syntax and vocabulary have regressed to a more simplistic level. It’s worth noting that his father suffered from Alzheimer’s disease.
As noted by the book’s editor Bandy Lee, a forensic psychiatrist at Yale School of Medicine and organizer of the Yale “Duty to Warn” conference that gave rise to this volume, it’s imprudent to attempt mental health diagnoses without treating the patient in person, and it’s judged unethical by the American Psychiatric Association. But those criteria don’t apply if a person is deemed a danger to self or others. In that case, it’s imperative that clinicians speak out to warn others, as the 37 writers have done in this fascinating and alarming book.
With the presidential election just six months away, it’s critical that concerned citizens take this information to heart, spread the word and vote accordingly. The future of America, and the entire planet, depends on it.

You’re welcome to share this column, but please be sure to credit me and give the link to this website. I hold the copyright. And subscribe by clicking on the menu to the right so that you won’t miss future posts. Comments welcome.
About Victor Juhasz: he’s just about the most brilliant illustrator around, IMHO. He’s most frequently seen in ROLLING STONE. If you Google his name, you’ll find lots of illustrations, some of which are for sale as posters. I may even buy some myself.
Al Cannistraro says
I think it’s fairly self-evident that Trump is unfit for the presidency by virtue of character, personality, mental dysfunction, and even at times his actual mental status. Also his values that clash with those that normal people of good character.
The more important issue is the shameful fact that Republican office holders and party leaders support him either explicitly or implicitly.
My letter in the TU from March or April:
Time for Republicans to Fire Donald or be fired themselves
Clearly, Republican public office holders and party leaders of sound mind and good character, at all levels and locations, should now be calling on Donald Trump to step down immediately or be removed. Republicans must tell him he’s “fired.”
The reasons are self evident, given the dire COVID-A9 situation and the downside dangers associated with inept national leadership. But if an illustration is required, merely compare the content of the daily COVID-19 press briefings presided over by Trump and by Gov. Cuomo, and compare as well the comportment and degrees of contact with reality on display.
To remain silent amounts to culpable enablement. Perhaps the silent Republicans themselves should step down or be fired.
Julie Lomoe says
Hi Al. Thanks so much for commenting. I basically agree with what you say, but I’m not sure the Republicans understand how profoundly ill he is. Nor does the media. Every time he does something newly outrageous, they try to analyse him—“What was his strategy? Why did he do this?” The answer: he didn’t think or decide rationally—his actions come from very primitive areas of the brain that bypass rational thought.
I like your letter. Nice and pithy. With the decline in advertising and thus of news pages, the TU has less and less space to devote to commentary. A week ago, I submitted a piece comparing his rally in Albany to the recent one in Tulsa, and how he lied about the crowd size in both. It’s lighter reading, appropriate for Sunday, so I was hoping to see it in today’s paper, but no such luck. If they don’t run it soon, I’ll post it here.