By Hal Brown, MSW, Retired psychotherapist
This is a follow-up to my diary “How I think the president will cope with losing”
I wasn’t the only mental health professional to write about whether they saw signs Trump could be heading towards a psychotic break. Back in March of 2018 I speculated on the subject in a Daily Kos diary. In that story I cited the Daily Beast article by author Gail Sheehy and psychotherapist Rosemary Sword “How Close Is Donald Trump to a Psychiatric Breakdown?”
Since at least 2018 there have been numerous article and interviews by and with mental health professional laying out evidence that Trump was on the brink of have a break with reality, that is a psychotic episode, which rendered him both unfit and dangerous to be the Commander in Chief. It seems like once or twice a week I get a Google News alert to an article with an interview with one of the more prominent mental health professionals saying that either he was showing signs of dementia, mental illness, or both.
Here’s a result of a web search for Trump mentally ill which have been published online in the past year.
Yet though hell and high water Trump has avoided a descent into madness so blatant and obvious his behavior would have necessitated invocation on the 25th Amendment because nobody, not even his most loyal sycophants who are the only ones empowered to initiate the 25th (Pence and the majority of the Cabinet or the majority of the entire Congress) could deny he was incapable of governing.
This would entail his demonstrating not just in private (his sycophants would be likely to hide this) but also in public that he was having an episode of one or another form of acute psychosis. See charter below:
I was a psychotherapist for 40 years and have been trying to understand Trump’s psychopathology since he was a serious contender for the nomination.
Without turning this into a dissertation complete with links to references, some to my own diaries, you won't click on, I want to cut to the chase.
Trump is coping in his usual way with the news that does not bode well, to put it mildly, for his chances of reelection. He will continue to deal with bad news the way he always has.
I think we may, and I say may, have seen some evidence he succumbed to a fleeting bout of depression like when he was walking off the helicopter his return from Tulsa. However, this could have been fatigue mixed with a rare “I don’t give a fuck about how I look for the cameras” moment.
He knows that his base won’t care and all he is concerned about is how his base perceives him.
While people with personality disorders can succumb to psychotic episodes when under extreme stress, in general this happens with those with personality disorders different from the combination of narcissistic personality and anti-social personality disorder which those who have ventured to diagnose Trump have determined him to have. It could happen but the nature of Trump’s disorder, sometimes referred to as malignant narcissism, is that his psychological defenses have time and again proved highly effective in warding off anxiety and depression, let alone an actual psychosis.
I certainly could be wrong. Sure, he was unhinged and disjointed in Tulsa taking 14 minutes to riff on his walk down the ramp at West Point and his holding his glass with two hands, and he prattled and jabbered in a yammering stream of consciousness with his golden oldies trying out some newer bits. He probably could see what with the glare of the light that much of his audience was nodding off.
He went on for one hour and 41 minutes and while I didn't watch it I am sure that if he showed signs of psychosis it would have been reported.
I could have missed something in the psychiatric literature, but I’ve never heard of someone in the throes of an acute psychotic episode being able to pull it together for that long.
Trump could yet have a psychotic episode. However, after seeing how often he has bounced back from so many potential disasters, I just don’t see it happening. As things get worse and worse for him I see him just becoming more Trump-like.
He will be error prone. He will take the bait so obviously put in a trap by Democrats like Nancy Pelosi with her morbidly obsess comment a month ago and anti-Trump Republicans in the Lincoln Project, which openly admits they are trying to get under Trump’s skin. Trump opens himself to more and more ridicule as rather than ignoring this deliberate provocations he gives them more publicity with his schoolyard retorts.
Hopefully his behavior will syphon off enough votes to assure he loses. As Anthony Scaramucci who is associated with The Lincoln Project, said “If we can pull 3 to 5% of his 2016 voters, that’s all we need.”
I don’t think Trump will have a psychotic episode and I hope he doesn’t. This is not because I have the milk of human kindness running though my veins. It’s because Trump needs to be hoist by his own petard.
Besides, psychotic episodes are usually readily treated with short-term hospitalization and medication so even if temporarily removed under the 25th Amendment he’d be back to work in short order to do could do whatever damage he could do to the nation before he lost the election.
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Since I am not an expert on dementia or Alzheimer’s I have not ventured an opinion on the signs he may be in the early stages. Tried and true psychological defenses only have so much utility in masking the ravages of actual brain disease.