Editor's Note: This story has been corrected because Tufts was accidentally listed twice as each physician's former employer. In fact, Dr. Abraham taught at Tufts and Dr. Lee taught at Yale.
A group of 36 top mental and medical health experts issued a public statement on Tuesday warning that President Donald Trump is quite literally losing his mind — and, unless he is removed from power, will put the entire world in danger.
Referring back to a statement they issued last month, the group argued in its statement (obtained by AlterNet) that Trump’s “mental instability, coupled with his sole, unchecked authority to launch nuclear weapons, makes him a clear and present danger to the safety of all Americans.” Because they have not personally treated the president, they did not officially diagnose him, but offered instead a detailed description of his publicly-exhibited symptoms including “bizarre and impulsive behavior, rambling digressions, factual confusions, unexplained sudden changes of course in strategic matters, both national and international, and his deeply impaired judgment.”
Since their initial statement to Congress, the doctors added that Trump “has exhibited more signs of grandiosity, e.g., posting images of himself on social media shaking hands with God, acting like Jesus, and dressing as a Pope. And he has continued nocturnal bingeing on social media posts that are filled with accusations of multiple conspiracies against him, as often as 150 times a night. Most worrisome are his outbursts of extreme, seemingly uncontrollable rage, such as his threat to destroy Iran, saying, ‘A whole civilization will die tonight, never to be brought back again.’”
Because the president alone can launch a nuclear attack, and do so without his orders being subject to review, the experts expressed alarm that “these policies, combined with an emotionally unstable leader, is a formula for unspeakable tragedy waiting to happen. For this reason above all others, the group of medical experts urged that lawful steps be taken to remove the president from office.”
In response to this statement, as well as specific claims made by the psychiatrists whom AlterNet interviewed for this article, White House spokesman David Ingle accused Trump’s physician critics of behaving unethically by offering an “armchair diagnosis.”
“If it quacks like a duck, it may actually just be a Democrat hack doctor,” Davis Ingle told AlterNet by email. “President Trump is the sharpest, most accessible, and energetic president in American history and any so-called medical professionals engaging in armchair diagnosis or false speculation for political purposes are clearly breaking the Hippocratic Oath they’ve sworn to.”
The letter’s chief signatory, psychiatrist Dr. Henry Abraham (formerly of Tufts University), disputed that the psychiatrists behave unethically by calling out the president’s perceived infirmities. In the 1960s, the American Psychiatric Association attempted to apply the principles of the Hippocratic Oath to modern politics through the so-called “Goldwater Rule,” which denounces psychiatrists who offer clinical assessments of public figures they have neither officially diagnosed or been given permission to analyze. By Abraham’s accounting, however, the Goldwater Rule should not be applied to Trump.
“The ‘Rule’ is more of a guideline which a past president of the American Psychiatric Association raised the possibility of resulting in ‘rigid overscrupulosity’ while another, my colleague former APA president Alan Stone famously objected that it constituted a fruitless effort to ‘legislate against stupidity,’” Abraham told AlterNet. Citing his recent Substack post which described that “this is not an academic exercise” because “the president’s condition appears to be deteriorating,” he added that “there has been a frightening progression of symptoms. These include grandiosity without moral safeguards, paranoia, impulsivity, vindictiveness, easy misperception of being harmed, moments of omnipotence, uncontrolled rage, and sole control over the use of nuclear weapons in a time of war. As a psychiatrist reviewing these, I can only say Yikes!”
When asked how Trump could be legally removed from power, Abraham said that “the solutions have to be political. They include invoking the 25th amendment, impeachment, or convincing him to resign as Nixon did. None of these are an easy lift, especially with a loyalist cabinet and Congress. But the irony is that our leaders don’t lead as much as they follow. A recent poll by the Washington Post-ABC News-Ipsos group found a majority of [Americans] do not believe the president is physically or mentally able to discharge his duties. The public is waking up to these dangers. As they do, the political landscape may shift towards removal of a defective and dangerous leader.”
Dr. Bandy X. Lee, a psychiatrist formerly from Yale University and one of the 36 psychiatrists behind the letter, argued that the focus on applying the Goldwater Rule is “a fallacy.”
“Overemphasizing ‘the Goldwater rule’ was a fallacy, in my view, that has nothing to do with ethics or actual science, and served only to deprive the public of critical knowledge,” Lee told AlterNet. “As I recently told the BMJ, ‘Diagnosing, through a personal examination with confidential information, is done for the patient, while detecting signs of danger, based on publicly available data, is done for society.’”
Lee added, “The Goldwater rule only concerns the former; the former is a prohibition, while the latter is an obligation, and conflating the two could result in massive harm--as it has. We declare explicitly in our Statement that we are not diagnosing but warning against signs of danger, which are extreme to the point of warranting the president's immediate lawful removal from office, for medical reasons.” In Trump’s case, the symptoms include “marked deterioration in cognitive functioning, evidenced by disorganized and tangential speech, rambling digressions, factual confusions, unexplained sudden changes of course in strategic matters, both national and international, episodes of apparent somnolence during critical public proceedings”; “grandiose and delusional beliefs, including assertions of infallibility, imagery of himself as Pope suggestive of a divine mission, being a mythical warrior hero, depicting himself as combat pilot—dropping feces on civilians, and claims that his decision-making authority is unlimited—with no need to consider domestic and international laws and constrained only by his ‘own morality’”; and “severely impaired judgment and impulse control, reflected in reckless threats of violence, advocacy of lethal force against civilians, encouragement of extrajudicial actions by armed supporters, repeated threats and often actions—judicial, prosecutorial, police, military, and by invoking emergency powers—against political opponents and others who disagree with him.”
The symptoms also include “significant loss of self-control (disinhibition) and getting stuck on the same thoughts or actions, unable to let go or move on (perseveration), including seemingly compulsive, manic-like late-night communications—e.g., 150 social media posts in one night—fixation on perceived enemies, persecutory ideas, and prolonged, disproportionate attacks on specific individuals and institutions” and “escalating violence that threatens national and global stability. As Commander-in-Chief of our military—more than 5000 nuclear warheads in inter-continental missile silos, on submarines, and in bombers around the world, are ready for launch solely upon his order, and no one now has the authority to countermand his order.”
To eliminate the crisis posed by Trump’s deteriorating mental state, Lee urged congressional leaders to “immediately retake their constitutional authority over war, before further escalation renders the question moot, convene urgent consultations with senior military and intelligence officials, to create a circuit breaker capable of preventing the use of nuclear weapons and formally initiate Section 4 of the 25th amendment.”
Lee has a track record of accurately predicting crises that will emerge from Trump’s public mental state. Prior to the 2020 election, she predicted that Trump would attempt a coup if he lost to former President Joe Biden because of his severe narcissistic traits.
“Just as one once settled for adulation in lieu of love, one may settle for fear when adulation no longer seems attainable,” Dr. Lee told this journalist for Salon in October 2020. “Rage attacks are common, for people are bound to fall short of expectation for such a needy personality—and eventually everyone falls into this category. But when there is an all-encompassing loss, such as the loss of an election, it can trigger a rampage of destruction and reign of terror in revenge against an entire nation that has failed him.”
She continued, “It is far easier for the pathological narcissist to consider destroying oneself and the world, especially its ‘laughing eyes,’ than to retreat into becoming a ‘loser’ and a ‘sucker’ — which to someone suffering from this condition will feel like psychic death.”
While there is no precedent for a president being involuntarily removed from power through the 25th amendment, former presidential adviser David Gergen told this journalist for Salon in 2017 that his ex-boss, President Richard Nixon, was secretly subverted by his own associates when his drinking led them to fear he was losing his mind. At the time, Gergen was alarmed at Trump’s seemingly erratic behavior from his first term.
“If you go back to the Nixon era, right toward the end during the Watergate period, when Nixon was drinking heavily and had become erratic, the secretary of defense at that time was Jim Schlesinger, an extraordinarily bright man and very principled,” Gergen told Salon at the time. “And he told the joint chiefs, if you get an order from the president to fire a nuclear missile, you do not do that. Don’t take an order from the commander in chief until you call me and I give you personal approval, or you get the personal approval of the secretary of state.”
Schlesinger, Gergen pointed out, was skirting the law by acting as he did.
“Nixon was the commander in chief,” Gergen recalled, “and Schlesinger in effect was saying, ‘We’re going to override the commander in chief if in fact we think it’s coming from some sort of aggressive personality or he’s just pissed off. Whatever it may be.’ And I’ve asked people in the Defense Department, ‘Do you think there’s a similar arrangement today between [Secretary of Defense Jim] Mattis and the four-star generals?’ And the answer they’ve given me back — I don’t think there’s any reason to believe he’s giving such an order … [is] that if they’re given an order that they think comes from an erratic personality, they will double-check it with the secretary before they carry it out.”