The Dangerous Case of Donald Trump

1. Malignant Normality: A Threat to Ethical Standards

In this way, a dangerous president becomes normalized, and malignant normality comes to dominate our governing (or, one could say, our antigoverning) dynamic.

Normalization of the Unacceptable. Malignant normality refers to the process by which destructive or unethical behaviors become accepted as standard practice within a society. This normalization can occur when political and military currents influence what is considered desirable or "normal," even if those behaviors are harmful or evil.

Historical Examples. The author draws parallels to Nazi doctors who adapted to the horrors of Auschwitz and American psychologists who justified torture, illustrating how professionals can become complicit in unethical practices when they are normalized by institutions or political leaders. These examples highlight the danger of allowing political circumstances to override ethical codes.

Trump's Influence. The Trump administration's actions, such as violating institutional requirements and threatening democratic viability, can become normalized simply because they occur within the context of the presidency. This normalization poses a significant threat to ethical standards and democratic processes, requiring vigilance and resistance from professionals and citizens alike.

2. The Witnessing Professional: An Ethical Imperative

As psychological professionals, we act with ethical passion in our efforts to reveal what is most dangerous and what, in contrast, might be life-affirming in the face of the malignant normality that surrounds us.

Beyond Neutral Observation. Witnessing professionals are those who use their knowledge and skills to expose malignant normality and bear witness to its malignance. This role goes beyond neutral observation, requiring a combination of disciplined professional approach with the ethical requirements of committed witness.

Ethical Responsibility. Professionals have a larger ethical responsibility that includes who they work for and with, and how their work either affirms or questions the directions of the larger society. This responsibility extends beyond patients and disciplinary standards to include a "duty to warn" when the public is at risk.

Activist Witnessing. The author advocates for an activist witnessing professional who combines scholarship with activism, using their expertise to expose dangerous forms of normality. This approach requires disciplined knowledge, ethical passion, and a recognition of the urgency of situations involving profound instability and untruth.

3. The Goldwater Rule: A Double-Edged Sword

Otherwise, a rule originally conceived to protect our profession from scandal might itself become a source of scandal.

Protecting Professional Integrity. The Goldwater rule, or Section 7.3 of the APA code of ethics, prohibits psychiatrists from offering a professional opinion on a public figure unless they have conducted an examination and have been granted proper authorization. This rule aims to preserve professional integrity, protect public figures from defamation, and safeguard the public's perception of psychiatry.

Balancing Ethical Principles. While the Goldwater rule is reasonable, it must be balanced against other rules and principles of professional practice, such as the duty to alert the public when a person in power shows signs of clear, dangerous mental impairment. The public trust is violated if the profession fails in its duty to warn when the risk of inaction is too great.

Emergency Exception. The author argues that an emergency exists when a person who holds the power of life and death over us all shows signs of clear, dangerous mental impairment. In such cases, a physician should breach the trust of confidentiality and intervene without consent, and breach the Goldwater rule.

4. Dangerousness: A More Critical Assessment Than Diagnosis

Assessing dangerousness is different from making a diagnosis: it is dependent on the situation, not the person.

Focus on Behavior, Not Label. Assessing dangerousness is distinct from making a diagnosis, as it depends on the situation, not the person. Signs of likely dangerousness due to mental disorder can become apparent without a full diagnostic interview and can be detected from a distance.

Duty to Protect. Mental health professionals and physicians have considerable power to detain people against their will if they pose a danger due to likely mental illness. This power underscores the importance of assessing dangerousness, especially in individuals who hold positions of authority.

Standards of Practice. The public trust is violated if the profession fails in its duty to alert the public when a person who holds the power of life and death over us all shows signs of clear, dangerous mental impairment. The president of a democracy should be subject to the same standards of practice as the rest of the citizenry when it comes to dangerousness.

5. Extreme Present Hedonism: Unfit for Leadership

An extreme present hedonist will say or do anything at any time for purposes of self-aggrandizement and to shield himself from previous (usually negatively perceived) activities, with no thought of the future or the effect of his actions.

Living in the Moment. Extreme present hedonists live and act in the present moment, frequently with little to no thought of the future or the consequences of their actions. This personality type is characterized by impulsivity, a lack of foresight, and a propensity to dehumanize others in order to feel superior.

Unbalanced Time Perspectives. The author argues that Donald Trump embodies an extreme present hedonist, with totally unbalanced time perspectives. This assertion is based on the plethora of written and recorded material on him, including interviews, videos, and tweets.

Consequences of Impulsivity. The extreme present hedonist's impulsive thought leads to an impulsive action that can cause him to dig in his heels when confronted with the consequences of that action. This impulsiveness can lead to misunderstandings, lying, and toxic relationships, as well as potentially devastating future outcomes.

6. Pathological Narcissism: A Toxic Political Force

At the heart of pathological narcissism, or NPD, is what I call Triple E: Entitlement, Exploitation, Empathy-impairment.

Narcissism on a Spectrum. Narcissism exists on a spectrum, with moderate levels being healthy and beneficial, while extreme levels can be pathological and dangerous. Pathological narcissism, or narcissistic personality disorder (NPD), is characterized by a strong need to be treated as special, a tendency to exploit others, and empathy-impairment.

Malignant Narcissism. When NPD combines with psychopathy, it forms a pattern of behavior called malignant narcissism. This involves seeing other people as pawns in a game of kill or be killed, and can lead to dangerous functional impairments, such as increasing paranoia, impaired judgment, and volatile decision making.

Psychotic Spiral. Pathological narcissists can lose touch with reality in subtle ways that become extremely dangerous over time. As their special status becomes threatened, they bend the truth to fit their story, leading to a psychotic spiral characterized by increasing paranoia, impaired judgment, volatile decision making, and gaslighting.

7. Trump's Trust Deficit: The Core Problem

The fundamental bedrock of human development is the formation of a capacity to trust, absorbed by children between birth and eighteen months. Donald Trump has boasted of his total lack of trust.

Foundation of Human Development. The capacity to trust is fundamental to human development, yet Donald Trump has repeatedly boasted of his total lack of trust in others. This lack of trust permeates his worldview and influences his relationships, both personal and political.

Erosion of Trust. As president, Trump is systematically shredding trust in the institutions he now commands, including the intelligence community, the judiciary, and the media. His belligerent behavior and disrespect for leaders of our closest allies also undermine international relations.

Dangerous Consequences. A leader who does not trust his subordinates cannot inspire trust, and his failure to trust or inspire trust is even more dangerous on a global scale. This can lead to volatile decision-making, isolation, and a reliance on conspiracy theories, all of which pose a threat to national and international security.

8. Sociopathy: A Severe Disturbance of Empathy

The failure of normal empathy is central to sociopathy, which is marked by an absence of guilt, intentional manipulation, and controlling or even sadistically harming others for personal power or gratification.

Lack of Empathy. Sociopathy is characterized by a lack of empathy, guilt, and remorse, as well as a tendency to manipulate, deceive, and harm others for personal gain. This condition represents a severe disturbance in an individual's emotional makeup.

Successful Sociopaths. While some sociopaths end up as criminals or outcasts, others are skilled at manipulation and can achieve high status and power. These "successful sociopaths" may appear psychologically healthy, but they are still severely emotionally ill.

Dangerous Traits. The author argues that Donald Trump exhibits several traits of sociopathy, including a lack of empathy, lying and cheating, loss of reality, and rage reactions and impulsivity. These traits, combined with his position of power, create a profound danger for America's democracy and safety.

9. The Trump Effect: Bullying and Societal Division

One person can affect an entire nation, and nowhere do we see this more clearly than with “the Trump Effect,” which was originally defined as an increase in bullying in schools caused by the rhetoric used by Donald Trump during his campaign.

Rise in Bullying. The "Trump Effect" refers to an increase in bullying and hate crimes, particularly in schools, caused by the rhetoric used by Donald Trump during his campaign and presidency. This effect has led to fear, anxiety, and stress among students, especially those from marginalized groups.

Emboldened Hate Groups. The president's rhetoric has emboldened hate groups and individuals to engage in acts of violence and discrimination against Jews, Muslims, Mexicans, and other minority groups. This has created a climate of fear and division in American society.

Dehumanization. The author argues that Trump's behavior promotes the dehumanization of others, which is a trait of narcissism and bullying. This dehumanization can lead to further violence and discrimination, as it makes it easier to justify harming those who are seen as less than human.

10. Trauma, Time, and Truth: The Erosion of Reality

When it comes to dangerousness, should not the president of a democracy, as First Citizen, be subject to the same standards of practice as the rest of the citizenry?

Trauma and the Election. The election of Donald Trump has been experienced as traumatic by many Americans, particularly those targeted by his rhetoric. This trauma is rooted in the destabilizing nature of his behavior and the erosion of trust in institutions and norms.

Time and Truth. The author highlights two key components of trauma: time and truth. Trump's constant stream of extreme tweets and impulsive actions disrupt the ability to process information and make sense of events, while his insistence on "alternative facts" undermines the very notion of objective truth.

Erosion of Reality. By denying access to time and calling our perceptions of truth into question, Trump shuts down our ability to reflect, causes us to doubt reality, and thus encourages reactivity and stress. This creates a state of crisis that is detrimental to individual and national mental health.

Last updated: March 29, 2025