'Mentally disturbed' Trump will only become more dangerous as he struggles to tolerate reality: psychiatrist

Last Wednesday, thousands of Donald Trump's white supremacist supporters, at his de facto command, launched an assault on the U.S. Capitol with the goal of stopping Joe Biden from becoming the next president. While investigations are ongoing, some people in the mob may have planned to kidnap or assassinate members of Congress they consider "traitors," along with Vice President Mike Pence, who presided over the ceremonial count of the electoral votes. Trump's fascist mob was well equipped for the task, as some of their members were armed with guns and other weapons, and clad in paramilitary gear.

Five people have now died during and after the Capitol attack. Dozens more were injured. This Trump-inspired uprising is likely not over and may be in its early stages. There are credible reports by the FBI and other American law enforcement agencies that right-wing paramilitaries and other domestic terrorists are planning even more violence across the country in the days leading to Biden's inauguration next week. This attack was not an isolated event: The entire Age of Trump has been typified by right-wing violence. When Trump finally leaves office, the right-wing violence he has enabled and permitted may only get worse.

On Wednesday, by a vote of 232 to 197, Trump was impeached by the House of Representatives for a second time, on this occasion for "incitement of insurrection." All 222 Democrats (along with 10 Republicans) voted to impeach, while four Republicans abstained. Trump is now the only president to have been impeached twice, and clearly rivals only Andrew Johnson or James Buchanan for the shameful distinction of being the worst president in American history.

Instead of being cowed by the violence at the U.S. Capitol and his second impeachment, Trump, like other autocrats and fascists, appears even more desperate and emboldened. On Tuesday, during a visit to his "border wall" in Texas, Donald Trump warned the Democrats and the American people that there will be consequences — implying more violence by his followers — for his impeachment or removal. Trump then claimed the Democrats were causing the country "tremendous anger, and division and pain," another example of stochastic terrorism aimed at inciting violence by his political cult members against their shared "enemies".

Under pressure from Republican leaders and his remaining White House advisers, Donald Trump released a video on Wednesday evening in which he "condemned" political violence and claimed that his "true supporters" would never engage in such behavior. This is patently insincere: From the beginning of his 2016 campaign, Trump has encouraged political violence by his followers and other cult members. Moreover, during the assault on the Capitol Trump was reportedly gleeful and excited.

Ultimately, the disaster that is Trump's presidency did not need to happen. It was all a choice.

Those Americans who voted for Donald Trump in 2016 (and in even larger numbers in 2020) are responsible.

The Republican Party, which embraced Donald Trump and his vile anti-democracy movement, is responsible.

A news media which normalized Trump's fascist and authoritarian white supremacist regime are responsible.

Those who denied the obvious warnings about Trump's coup attempt — and who mocked or tried to silence the people who were trying to warn the public — are responsible.

Writing at the Atlantic, Tom Nichols locates the disaster of Trump's presidency and America's national peril as a moment comparable to the Cuban missile crisis or the darkest moments of Nixon's presidency:

We can't keep hoping for the best or relying on those not in charge to keep Trump in line. Even one day more is too long for him to be in the White House. We escaped disaster over just a few days in 1962 and in the dark of an autumn night in 1973. Peace was kept, in part, by the presence of steady professionals such as Schlesinger and the Kennedy team, the likes of whom are nowhere to be found in Trump's Washington.

We no longer have a margin for error. A second impeachment is the only reliable solution, and it should take place immediately.

The disaster that Nichols describes could have also been prevented if warnings from many leading mental health professionals had been listened to and then acted upon. Since at least 2015, they have sounded the alarm and tried to educate the public about Donald Trump's pathologies, his malignant narcissism and his psychopathic or sociopathic tendencies.

Dr. Lance Dodes is one such voice. He is a retired assistant clinical professor of psychiatry at Harvard Medical School and a training and supervising analyst emeritus at the Boston Psychoanalytic Society and Institute.

In our most recent of several conversations, Dodes explains that Trump's coup attempt and other dangerous behavior are a function of the president's obvious mental pathologies, and observes that this disaster was totally and utterly predictable. Dodes warns that Trump believes that he is a godlike figure — and that when that delusion is shattered, Trump will become even more dangerous. At the end of this conversation Dr. Dodes implores the country's leaders to remove Donald Trump as rapidly as possible, noting that if this man were a private citizen he would already be in prison or a secure mental health facility

This conversation has been edited for clarity and length.

The dominant narrative in the American news media is that Donald Trump is stupid, a crook, a charlatan, a buffoon, etc. Such claims have done the work of minimizing how dangerous he is to the country and the world. While so many tried to deny the likelihood of Trump attempting a coup against the United States, that is exactly what happened. This is the greatest crisis facing this country since the Cuban missile crisis.

I completely agree. Most professionals in mental health have long understood that far from being a buffoon, or the naïve idea that he is "crazy like a fox," he is severely mentally disturbed. Unfortunately, starting in 2016 the official psychological organizations in this country failed to speak out. The American Psychiatric Association actually threatened to throw out those of its members who understood the problem and had the courage to speak up, falsely claiming that speaking out would be unethical. Ironically, this meant that they threatened the most ethical and courageous members of the profession. If they had done their ethical duty to society it would have given the country a chance to save itself from the deaths and suffering of the past four years.

How do you think the mainstream news media has handled Trump's mental health?

Poorly, because many of them saw Trump is just a buffoon, or believed the psychologically ignorant idea that he is just being clever. As a result they didn't recognize they were dealing with a dangerous and delusional psychopath whose endless lies needed to be openly and vigorously challenged. Many in the media covered his every tweet as if it was true. He was yelling at White House journalists saying, "You're fake" from the beginning of his term and it was years before they objected. The reporters should have said, "No, Mr. Trump, you cannot talk to the free press that way." They should have covered his assault on the free press as a major story. The media failed to do their job to protect the country.

If he were a private citizen, how would Donald Trump be treated by law enforcement and other authorities?

At this very moment he would be in jail for having incited a riot. But the multiple other crimes he's committed over many years would have put him in jail years ago. If he were in any other position his complete incompetence dealing with the pandemic would have led him to be removed from any responsible position regarding the health or welfare of Americans.

In terms of mental health, is a diagnosis a type of prediction in terms of future behavior?

That's the most valuable part of making a diagnosis. When Trump was first elected, many hopeful people said, "He's been horrible, but he'll grow into the job." The impossibility of that was easy to predict because of his diagnosis. If a few people in my field hadn't incompetently denied his condition, and if the American Psychiatric Association hadn't tried to gag its members, the public could have been made clearly aware of his diagnosis and been in position to far better understand and deal with him and his behavior.

While the assault on the Capitol was taking place, Trump was reportedly excited and transfixed by the spectacle. This is part of a broader pattern in which Trump has repeatedly shown a fascination or obsession with violence. How does this fit into your warnings about Trump's mental health and behavior?

This man is fundamentally different from virtually all the people that you've ever known. The pain and suffering of others mean nothing to him. It's hard to get that across because we all say, "He must be like us," which is a normal expectation. He is nothing like us. We don't know exactly what's going to happen, but we know that he is going to continue to act on his delusional beliefs and he will continue to have no conscience about what he does to cause suffering to others.

Here is my prediction. Donald Trump does not care if he is impeached or removed from office by the 25th Amendment. Either one serves his goal of declaring that he was betrayed and that there is a plot against him and his supporters. He will declare himself a type of shadow president and cause chaos and destruction. His behavior is only going to bet worse. Trump will not stop seeking revenge on the American people.

Four years ago, we said he was going to get worse. And we're still saying he can only get worse. The closer and closer he gets to being what he would consider a loser, the more dangerous he becomes.

How were you feeling as you watched Trump's coup attack and its aftermath?

It was horrifying and terrifying to see the insurrectionists get into the Capitol building, partly because it was obvious that there was some plot going on; this wasn't just a mob on its own. There was a clear risk of a coup successfully led by Donald Trump. A few years ago, I said on MSNBC that among the risks Trump posed were that he would start a nuclear war, but that there were also other risks: that he would try to create an emergency, declare martial law and dissolve Congress. It's never been a secret that Trump wants to be like Putin or Hitler or Stalin or his friend in North Korea. He wants to be a supreme tyrant, and in his mind that's what he is. Anyone who threatens that delusion is his mortal enemy. If he could have taken over via a coup, he would have.

We can't read the man's mind, but based on his public behavior and the personality type, what do you think his internal monologue is right now?

Trump is a very simple person. He says outwardly, "I am being persecuted" and he says the same thing to himself. His beliefs are not affected by reality.

Donald Trump also has a type of God complex. He is a delusional megalomania. His followers believe him to be a type of God as well. What happens to Trump and his followers when he loses his power?

It would be a sign of greater mental health if Trump were able to become depressed with a loss, because it would mean he has accepted the loss. But as we have repeatedly seen, he cannot tolerate that reality. When he loses power, rather than becoming depressed, he becomes more delusional. He attributes the problem to persecution by his enemies and mercilessly attacks them. That's what the coup attempt was.

The American Psychoanalytic Association, of which you are a member, recently issued a statement of concern regarding Donald Trump's mental health and the safety of the United States and the world. How did this come about?

I'm proud that the American Psychoanalytic Association became the first and so far only major national psychological organization to say that Trump must go. I wish the statement had come out four years ago, but I'm glad they're the first to break away from the self-imposed paralysis of the major psychological organizations. And I hope the country will listen.

What should happen next?

In an ideal world Trump would be voted out today via the 25th Amendment. If he were not president, he would have already been in jail or contained in some safe facility.