Psychiatrist warns Trump may be 'at significant risk for deteriorating into full-blown psychosis'

Kerry Eleveld
and
Daily Kos
22 August 2019

Donald Trump's verbal outbursts and Messianic claims of being "the second coming" and "the chosen one" have once again reignited a controversy over just what exactly is wrong with the pr*sident of the United States. Not only did he compare himself to Jesus several times in a single day, Trump also had a lot of trouble with the basic enunciation of words like "obstacle" and "applicable," called the prime minister of Denmark “nasty” for declining to sell Greenland to the U.S., and declared all Democratic American Jews “disloyal to Israel.”

Whatever Trump’s diagnosis, it's particularly bleak and dangerous that this man is running the country and in possession of the nuclear codes, among other forms of recourse. Still, people are debating whether Trump is actually psychotic or narcissistic with delusions of grandeur or perhaps suffering from rabid dementia eating away at his brain and making him particularly irritable.

One mental health professional and contributor to the updated version of The Dangerous Case of Donald Trump argued Wednesday that Trump isn't technically psychotic.

"Trump is narcissistically irrational & grandiose w paranoid traits. His reality is defined by how he feels, not objective facts ("impressionistic thinking')," tweeted Dr. David Reiss. But according to the psychiatric diagnostic manual known as the DSM, Trump is not psychotic. "He is dangerously racist, impulsive, irrationally self-centered; not clinically psychotic," Reiss concluded.

That said, later in the tweet thread, Reiss added, "he is (at least theoretically) at significant risk for deteriorating into full-blown psychosis."

Another Dangerous Case contributor, Dr. Lance Dodes, settled on the term "psychotic-like" in an MSNBC appearance Wednesday night.

"He can't stand anything that disagrees with him, and the more you challenge him, the more unhinged he becomes, the more paranoid, and the more violent, potentially," Dodes told Lawrence O'Donnell. "There's something fundamentally different about him from normal people. It's a psychotic-like state. The more you press him, the more you see how disorganized and empty he is. The more he flies into a disorganized rage."

Trump becoming increasingly volatile is exactly what the 27 mental health professionals who authored the original Dangerous Case book in 2017 warned would happen. Torn between an ethical code not to diagnose anyone they hadn't personally treated and the "duty to warn" that they ultimately prioritized, the cohort forged ahead with a publication that few mental health professionals had the courage to sign onto.

Sure enough, two years later, Trump appears to be ragefully unraveling before our very eyes. The Washington Postreported Thursday that Trump feels particularly slighted by the fact that the American Jewish community doesn't more universally love him and, therefore, is predictably lashing out at the group with an onslaught of anti-Semitic tropes. Trump’s tongue lashing results from “a manifestation of frustration of not getting the recognition and the praise and the support that he feels like he deserves,” according to one senior administration official. Other former Trump officials are particularly concerned by Trump's erratic escalation, according to the New York Times, saying they are "increasingly worried" by his behavior.

Whatever ails Trump, sane observers around the globe may be concluding as one tweeter noted that whether Trump is technically psychotic is a "distinction without a difference."

Many mental health professionals would probably take issue with that characterization, but she has a point. If Trump ultimately does something catastrophic (and arguably already is), who cares whether he's experiencing psychosis, dementia, or simply the grandiosity of a malignant narcissist? The tragic consequences will ultimately be the same.

Republicans, as a party, have signed on to support this raving lunatic, whatever the consequences. Democrats, by failing to act to save the country and the globe from an obvious mad man will be equally responsible for whatever havoc he wreaks as well as the harm he has already done.