Most Americans have spent most of Donald Trump’s time in public life thinking him, treating him, as if he were normal. From when he first descended the Trump Tower escalator in 2015, formally to announce his candidacy for the presidency to the present moment, when we feverishly debate the legalities of his having stashed top-secret documents at his home in Palm Beach, we discuss who he is and what he did as if he were ordinary. Just another man, just another president, just another leader. We do not think about him, talk about him, as if he were that which he decidedly is – abnormal, aberrational.
In part we do this because Trump has many fervent followers. Many American voters eager to follow where he leads. Many Republican elites eager to be in his good graces. If Trump were widely described as mentally ill what would that say about his tribe and his team? Surely the chattering classes have been inhibited from describing Donald Trump as “crazy” or “mad” because to say that about him would call into question his legions of ardent supporters.
So, we remain obsessed with the former president while continuing to compare him, as if he were normal, to his predecessors, especially Richard Nixon. But Donald Trump is so unnormal, so strange, so odd, so peculiar, that the comparison is as mistaken as misguided. We must think of him differently. We must think of Donald Trump as mentally unfit.
His addiction to lying, his inability to separate fact from fiction, and his extreme paranoia are not just oddities. They are symptoms of a sickness. But so long as we continue to treat him as just another leader gone rogue his followers will remain faithful. To say that Trump is somewhat corrupt will not pry his followers loose. To say that he is somewhat sick might.
There is a small literature on leadership and mental illness. In the 1970s was a subfield called psychohistory in which a few historians, political scientists, psychologists, and psychiatrists fused history and psychoanalytic analysis to study political leaders. Since then, since psychoanalysis was marginalized, has been what professor of psychiatry, Nassir Ghaemi, describes as a “perspective on mental illness that is scientifically and medically sound.” This psychiatry, he argues, can be “an extremely useful tool for historians.”*
Ghaemi’s perspective is confirmed by the introduction in recent years of a variety of terms, all of which describe leaders who are in some way outside the range of what is considered psychologically normal. These terms include mental illness, mental disease, or mentally abnormal; abnormal personalities or abnormal temperaments; and political paranoia. Of course, what matters even in those cases to which any of these terms apply, is not the disease itself. What matters is how it effects the leader’s capacity to lead. Abraham Lincoln and Winston Churchill both suffered from depression. It does not, then, suffice to say that a leader is mentally abnormal. The question is, what is the effect of their abnormality?
In the late 1990s a psychiatrist and political scientist coauthored a book titled, Political Paranoia: The Psychopolitics of Hatred. ** Though the book appeared long before Trump ever imagined becoming president, how it describes “individuals with a paranoid personality disorder” applies to many of Trump’s most distinguishing traits and behaviors. Such individuals:
- Believe that others are exploiting, harming, or deceiving them – they perceive themselves as victims.
- Are preoccupied with the loyalty or trustworthiness of associates and friends.
- Read hidden demeaning or threatening messages into benign remarks or events.
- Persistently bear grudges – they are unforgiving of perceived insults, injuries, or slights.
- Perceive attacks on their character or reputation that are not apparent to others – and they are quick to react angrily and to counterattack.
Do these signs and symptoms sound familiar?
In 2017 another book came out, this one focused only on Trump, to which 27 psychiatrists and mental health experts contributed chapters.*** In retrospect it constitutes a clear and present warning. This is not to argue that everything in the book was right. Rather it is to say that its overarching argument was prescient. “We need to avoid uncritical acceptance of this new version of malignant normality.”
Of course, hardly anyone paid attention. In large part this is because psychiatry is still regarded with suspicion, as not quite a science. And it’s because psychiatrists themselves are leery about speaking out, worried they will be seen as professionally suspect or politically biased. It’s also because we ourselves prefer to remain in denial. We don’t want to hear that our leader is an unbridled hedonist; or a pathological narcissist; or delusional; or cognitively impaired; or abusive or dangerous; or bad or mad, or maybe both. Not only is the information disturbing it is disabling. Even if it’s true it doesn’t seem like there’s much if anything we can do about it.
But is that true? Is there anything to be done? Well, we could start by calling it out.
Let’s assume that psychiatrists, psychologists, and other mental health professionals are not all quacks. This could mean that when an American president breaks all norms, threatens the very democracy on which the system is based, and denies reality, he (she) would be identified by experts such as these as being so out of the range of normal that he (she) is mentally ill. Such a judgement would of course still be contentious and even fractious. But at least it would give license to those professionally educated and equipped to name an illness when they see it. Rather than being sidelined, they would be mainstreamed.
Donald Trump is not well. Since November 2020 he has been politically unwilling and, or, psychologically unable to acknowledge his electoral defeat. He has instigated a violent attack on the United States Capitol. And he has stolen top secret documents from the United States government. He is not just morally and ethically impaired. He is mentally and psychologically impaired. Time to stop skirting this truth. Time to bring physical and mental health out into the open and to ask how we protect the presidency from ever again being victimized by someone who is in either way unfit. The mechanisms currently in place manifestly are not up to the task.
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* A First-Rate Madness: Uncovering the Links Between Leadership and Mental Illness (Penguin, 2011), p. 5.
** Robert Robins and Jerrold Post (Yale University Press, 1997).
*** Bandy Lee, ed., The Dangerous Case of Donald Trump (St. Martin’s Press, 2017).