The Accelerated Unraveling of Donald Trump

By Leonard L. Glass, Edwin B. Fisher, and Bandy X. Lee

June 13, 2020

Photograph: Gerd Altmann

The last few weeks have seen a marked and unmistakable deterioration in Donald Trump’s mental functioning. While his unfounded embrace of conspiracy theories have been a hallmark of his shaky capacity to assess external reality, in the past he only had to promote his views with enough gusto and repetition, buttressed by references to “people are saying” and Fox talking heads to seem to carry the day on social media. Many viewed him as, if not entirely plausible, at least consistent, confident, and entertaining. But a succession of bizarre and outrageous assertions have been so obviously disturbed that even normally quiescent Republican leaders and military officers have felt compelled to break their silence. His judgment is badly damaged and his desperate flailing to regain his supremacy is impossible to miss.

He seized on an absurd claim from an extremist newsfeed to assert that the 75-year-old man pushed to the ground and badly injured was, in fact, an Antifa plant and provocateur. The week before, he had peaceful protesters gassed so he could walk across the park and stand in front of a church he doesn’t attend holding a bible like a seized trophy. His imperative need to posture, to make a display of his authority and religious adherence, blinded him to the obvious implausibility of his claims to religiosity and supremacy. Stating he wants to “dominate the streets,” he called up the infantry from Fort Bragg to encircle our nation’s capital and the National Guard to patrol its streets. He presented himself as Nixon 2.0, claiming to be our tough “Law and Order President,” but was humiliated when exposed to have taken to a bunker. These are examples of the dangerous fragility that we and our 34 co-authors of The Dangerous Case of Donald Trump, along with countless other mental health professionals, have warned against for the past three years. All these raise a key question: Who can contain him?

President Trump is dangerous because of his psychology: his self-absorption, recklessness, cruelty, and a crippling need for power, control, and praise. The impact of his disorder can be measured in the excess lives lost: more than a quarter of the world’s Covid-19 deaths, from a country just one-24th of the world’s population. Some substantial proportion has resulted from denial, false reassurances, incompetence, and hucksterism instead of sober attention to the profound challenges facing us. His delay has been lethal, as documented by a Columbia University study identifying 30,000+ deaths that might have been avoided by just a week’s earlier action.

The president’s impairments are serious, overt, and broadly manifest so that even non-professionals have recognized them: “mad and decomposing” (Michelle Goldberg); “chest-pounding advertisement of his own gnawing insecurities” (George Will); “something’s very seriously off with Trump” (George Conway). As the recognition of President Trump’s failures widen and his desperate attempts to avoid electoral defeat become more frantic, the world now faces the reality we warned of long ago: vengeful, unpredictable, impulsive, reckless, heedless of impacts on others — in short, acutely dangerous.

Although talk of the president’s state of mind has become commonplace, the obvious next step, what to do about the elephant in the room, has received little attention. In few other situations would one so unfit for his job get to keep it. The time has passed for awaiting the president’s acknowledgment that he is overmatched by the challenges. He must be contained or removed.

We warn against greater dangers ahead. What he may do with his war powers and our nuclear arsenal could dwarf current suffering. Who would have thought a month ago that he would call in the army on his own city? What will he do next? How will he react if he orders the army into a state and the governor or generals defy him or the Supreme Court disallows it? On November 4th, will he have the forbearance to abide by the election results?

To save lives and ensure our democracy, we as mental health experts urge those in Congress, the judiciary, and those of character in the administration to recognize the need to act. The 25th Amendment seems an unlikely remedy given Trump’s cabinet of craven acolytes. But it is urgent — very likely a matter of life or death for many, many people — that he not be left free to wield his immense power with the chaotic impulsivity of recent weeks. Congressional or judicial actions must be taken to limit his ability to do further great harm to our fellow citizens, the nation, and even the world.

Leonard L. Glass, M.D., M.P.H., is an associate professor of psychiatry at Harvard Medical School. Edwin B. Fisher, Ph.D., is a professor of health behavior at Gillings School of Global Public Health, University of North Carolina-Chapel Hill. Bandy X. Lee, M.D., M.Div., is an assistant clinical professor in law and psychiatry at Yale University School of Medicine.

Forensic psychiatrist, violence expert, president of the World Mental Health Coalition (, and editor of "The Dangerous Case of Donald Trump.”

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