Yale psychiatrist explains why Trump's aborted Iran attack is a 'mental health issue': He 'failed every criterion of a basic mental capacity evaluation'

Yale psychiatrist explains why Trump's aborted Iran attack is a 'mental health issue': He 'failed every criterion of a basic mental capacity evaluation'
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Personal Health

Writing in the New York Times Monday, former national security adviser Susan Rice wondered how the U.S. came to the brink of war with Iran, after President Trump approved and then cancelled air strikes in the span of ten minutes.


“How on earth did we find ourselves 10 minutes from an idiotic war without the president having weighed the consequences?” Rice asks.

“As a former national security adviser who has participated in many decisions about whether and when to use force, I am more certain than ever that our national security decision-making process is dangerously dysfunctional,” she adds.

Raw Story spoke with Dr. Bandy X. Lee, a forensic psychiatrist and a renowned expert on violence, about the president’s impulsive behavior on the world stage.

Lee, who is on the faculty at Yale School of Medicine, has been consulting with the World Health Organization since 2002 and teaching at Yale Law School since 2003. She is author of the authoritative textbook, “Violence: An Interdisciplinary Approach to Causes, Consequences, and Cures,” president of the World Mental Health Coalition, and editor of the New York Times bestseller, “The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President.” She and her coauthors recently prepared a definitive mental health analysis of the Mueller report.

Raw Story: You said last week that the president’s ordering and then canceling an air attack on Iran was likely a prelude to war. What did you mean by that?

Bandy X. Lee: Last week’s harrowing instability should reveal that we live in a world too dangerous to have a leader who constantly creates crises and then pulls back at last minute so that he might be deemed a savior. People should see that this is different from normal, competent decision making.

In our report, he failed every criterion of a basic mental capacity evaluation. What we saw in real time was exactly what we would expect from the results of our evaluation. If we wish to keep ourselves safe, it should be very clear now that we need an intervention.

Mental capacity has many criteria. It requires the ability to take in correct information: he ordered an airstrike without knowing what casualties it would cause. It requires the ability to process information: war hawks found it easy to persuade him, since he cannot think for himself in a meaningful way. It requires an ability to consider consequences: he would not be able to foresee a limitless war if he cannot see in advance the results of a single strike.

It also requires the stability to stay with a decision: he cannot stick to a decision outside of external influence, the last thing he hears, or the pain of criticism. His decision to order an airstrike without basic information is as impulsive as his abrupt cancellation of it, and regardless of his reasons, the process is dangerous.

On top of this, it should not be mistaken that he is violent in his leanings, no matter what he says. Courageous people may fight to end wars, but violent individuals are often cowardly and cruel, capable of atrocities. Modern technologies that kill millions at a time without ever having to confront a single person you are harming are the perfect weaponry for someone who is violent and not courageous.

The reasons he opposes war now—to win adulation—will be the same reasons for which he will be eager for war in the future—to maintain adulation. This may not seem logical, but that is precisely what lacking capacity means. His mental weakness will also make him easy for those who want war inside or outside our nation to manipulate.

Raw Story: So you don’t think he is employing a political strategy as he kicks off his 2020 presidential campaign?

Bandy X. Lee: If you’re thinking in terms of political strategy, he has already “gaslighted” you. When someone is rationally incapable, the “primitive” brain takes over—and this, unfortunately, is more powerful than the rational mind in whipping up mass hysteria and leading a population to destruction like a hypnotist or a pied piper. He would like everyone to think it is a political strategy, but for him it is a primitive drive for survival.

Our report, by the way, was definitive: collateral information, not personal examination, is what is most useful in a functional exam—although we gave the president a chance to be examined for his benefit. Already we could not have better, more abundant data, thanks to the Mueller report.

Raw Story: What do you think are the barriers to taking action?

Bandy X. Lee: Education, or the lack thereof. If we knew enough to understand what more we need to know, we would be consulting experts in this area and learning about mental incapacity. Our track record should show that we know what we are talking about. Assuming rationality and denying what is before our eyes is exactly what a mentally incapable person would want us to do.

In fact, one reporter at our recent conference at the National Press Club commented that the biggest news story is that this issue is not the biggest story in the news. It was at one point, but the American Psychiatric Association aggressively stepped in, and now most people believe the Goldwater rule applies to all mental health professionals at all times, when it applies only to some psychiatrists in a fraction of situations. The media gave the Goldwater rule as an excuse not to cover our interdisciplinary conference, when the thirteen experts were not psychiatrists but one. But suppressing information does not make the issue go away.

The people actually know this. In fact, since my interview with Salon went “viral” over the weekend George Stephanopoulos’ interview with Donald Trump came out, I have been inundated with messages desperately asking me — pleading with me, sometimes quite eloquently — to speak up more on the issue. By the week’s end, it felt paralyzing to receive such heartfelt messages but nothing from the press, which still does not seem to see the Iran crisis as a mental health issue. You are the exception, of course!

Raw Story: What do you think is the solution?

Bandy X. Lee: It may seem contradictory, but the more dire the situation, the greater the need to take a moment and step back. There is a saying in medicine: “In an emergency, first check your own pulse.” We must stop reacting to the latest crises, which are predictable, and consider what we are doing.

So far, as a nation, it looks like we are enabling a president who believes he will win, who may not leave his office, and who will likely cause a devastating war before anyone can effectively disagree. Mental health is fundamental and larger than politics: you have to have basic mental capacity to have political and military capacity. Our report outlines the most immediate management, and if we were consulted, we would have other recommendations.

Bandy X. Lee: Yes. But despite the efforts of a number of Congress members and others, the president’s mental capacity, a requirement for his ability to discharge the duties of his office, does not have a formal hearing. Chairman John Yarmuth has graciously offered to organize a Congressional meeting where I and my colleagues will present the results of our report as well as a video of highlights from our interdisciplinary conference.

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