The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President - Updated and Expanded with New Essays

by Bandy X. Lee, Robert Jay Lifton (Contribution by), Gail Sheehy (Contribution by), William J. Doherty (Contribution by), Noam Chomsky (Contribution by)

Overview

As this bestseller predicted, Trump has only grown more erratic and dangerous as the pressures on him mount. This new edition includes new essays bringing the book up to date—because this is still not normal.

Originally released in fall 2017, The Dangerous Case of Donald Trump was a runaway bestseller. Alarmed Americans and international onlookers wanted to know: What is wrong with him?

That question still plagues us. The Trump administration has proven as chaotic and destructive as its opponents feared, and the man at the center of it all remains a cipher.

Constrained by the APA’s “Goldwater rule,” which inhibits mental health professionals from diagnosing public figures they have not personally examined, many of those qualified to weigh in on the issue have shied away from discussing it at all. The public has thus been left to wonder whether he is mad, bad, or both.

The prestigious mental health experts who have contributed to the revised and updated version of The Dangerous Case of Donald Trump argue that their moral and civic "duty to warn" supersedes professional neutrality. Whatever affects him, affects the nation: From the trauma people have experienced under the Trump administration to the cult-like characteristics of his followers, he has created unprecedented mental health consequences across our nation and beyond. With eight new essays (about one hundred pages of new material), this edition will cover the dangerous ramifications of Trump's unnatural state.

It’s not all in our heads. It’s in his.

Product Details

ISBN-13:	9781250256287
Publisher:	St. Martin's Publishing Group
Publication date:	03/19/2019
Sold by:	Macmillan
Format:	eBook
Pages:	544
Sales rank:	125,478
File size:	5 MB

About the Author

Bandy X. Lee, M.D., M.Div., is Assistant Clinical Professor in Law and Psychiatry at Yale School of Medicine. She earned her degrees at Yale, interned at Bellevue, was Chief Resident at Mass General, and was a Research Fellow at Harvard Medical School. She was also a Fellow of the National Institute of Mental Health. She’s written more than 100 peer-reviewed articles and chapters, edited several academic books, and is author of the textbook Violence.
Bandy X. Lee, M.D., M.Div., is a Forensic Psychiatrist at Yale School of Medicine and a Project Group Leader for the World Health Organization Violence Prevention Alliance. She earned her degrees at Yale, interned at Bellevue, was Chief Resident at Mass. General, and was a Research Fellow at Harvard Medical School. She was also a Fellow of the National Institute of Mental Health. She has taught at Yale Law School for more than fifteen years and has spearheaded a number of prison reform projects around the country, including of the notorious Rikers Island jail of New York City. She’s written more than one hundred peer-reviewed articles and chapters, edited more than a dozen academic books, and is author of the textbook Violence.
Robert Jay Lifton, M.D., is Lecturer in Psychiatry at Columbia University and Distinguished Professor Emeritus of John Jay College and the Graduate Center of the City University of New York. A leading psychohistorian, his renown comes from his studies of the doctors who aided Nazi war crimes and from his work with Hiroshima survivors. He was an outspoken critic of the American Psychological Association’s aiding of government-sanctioned torture, as he is a vocal opponent of nuclear weapons. His research encompasses the psychological causes and effects of war and political violence and the theory of thought reform.
Gail Sheehy, Ph.D., as author, journalist, and popular lecturer, has changed the way millions of women and men around the world look at their life stages. In her 50-year career, she has written 17 books, including her revolutionary Passages, named one of the ten most influential books of our times. As a literary journalist, she was one of the original contributors to New York Magazine and to Vanity Fair since 1984. A winner of many awards, three honorary doctorates, a Lifetime Achievement Award in 2012 by Books for a Better Life, she has regularly commented on political figures, including in her acclaimed biography of Hillary Clinton.
William J. Doherty, Ph.D., is a Professor of Family Social Science and Director of the Minnesota Couples on the Brink Project and the Citizen Professional Center at the University of Minnesota. In May 2016, he authored the Citizen Therapist Manifesto Against Trumpism, which was signed by over 3,800 therapists. After the election, he founded Citizen Therapists for Democracy. He is a Senior Fellow with Better Angels, an organization devoted to depolarizing America at the grass roots level. He helped pioneer the area of medical family therapy, and in 2017 received the American Family Therapy Association Lifetime Achievement Award.
Noam Chomsky is the author of numerous bestselling political works, including Hegemony or Survival and Failed States. A laureate professor at the University of Arizona and professor emeritus of linguistics and philosophy at MIT, he is widely credited with having revolutionized modern linguistics. He lives in Tuscon, Arizona.
Judith Lewis Herman, M.D., is Professor of Psychiatry at Harvard University. She is a renowned Traumatic Stress Studies expert and author of the now classic Trauma and Recovery, which helped establish the diagnostic category of post-traumatic stress disorder. She is also Co-Founder and Former Director of Training of the Cambridge Health Alliance Victims of Violence Program, Distinguished Life Fellow of the American Psychiatric Association, and the recipient of numerous awards, including the American Medical Women’s Association Award and the International Society for Traumatic Stress Studies Lifetime Achievement Award. She authored a letter to President Obama requesting a neuropsychiatric evaluation of the then-President-elect Mr. Trump.

Philip Zimbardo, Ph.D., Professor Emeritus at Stanford University, is a scholar, educator and researcher. Zimbardo is perhaps best known for his landmark Stanford prison study.

Among his more than 500 publications are the bestseller The Lucifer Effect, and such notable psychology textbooks as Psychology: Core Concepts and Psychology and Life.

He is founder and president of The Heroic Imagination Project, a worldwide nonprofit teaching people of all ages how to take wise and effective action in challenging situations. He also continues to research the effects of time perspectives and time perspective therapy.

Rosemary Sword is codeveloper of Time Perspective Therapy and coauthor of The Time Cure (in English, German, Polish, Chinese, and Russian), The Time Cure Therapist Guidebook, Wiley, 2013; Time Perspective Therapy: Transforming Zimbardo’s Temporal Theory into Clinical Practice, Springer, 2015; Living and Loving Better, McFarland, November 2017; and Time Perspective Therapy: An Evolutionary Therapy for PTSD, McFarland.
Craig Malkin, Ph.D., is author of the internationally acclaimed Rethinking Narcissism, a clinical psychologist, and Lecturer for Harvard Medical School with 25 years of experience helping individuals, couples, and families. His insights on relationships and narcissism have appeared in newspapers and magazines such as Time, The New York Times, The Sunday Times, Psychology Today, Women’s Health, Huffington Post, and Happen Magazine. He’s also been featured multiple times on NPR, CBS Radio, and the Oprah Winfrey Network channel, among other stations and shows internationally. Dr. Malkin is President and Director of the Cambridge, Massachusetts–based YM Psychotherapy and Consultation, Inc., which provides psychotherapy and couples workshops.

Tony Schwartz is the founder and CEO of The Energy Project, a consultancy that helps leaders become bigger human beings and transformational leaders.

Tony has delivered keynotes, workshops, and trainings at Fortune 500 companies and organizations around the globe including Apple, Unilever, Microsoft, PWC, Google, Ralph Lauren, the National Security Agency, Stanford Children’s Hospital, and the Children’s Aid Society.

Tony has written over 100 articles for the Harvard Business Review, including “Manage Your Energy, Not Your Time,” which was selected recently as one of the five most influential articles HBR has ever published. Tony shared this honor with Peter Drucker, Michael Porter, and Clayton Christensen.

Tony has also written for publications including the New York Times, the Washington Post, Forbes, and Fast Company. Tony’s groundbreaking books include The Power of Full Engagement: Managing Energy, Not Time, which spent 28 weeks on the New York Times Bestseller List, and The Way We’re Working Isn’t Working: The Four Forgotten Needs That Energize Great Performance, which was also a New York Times and Wall Street Journal bestseller.

Tony graduated Phi Betta Kappa from the University of Michigan. As a journalist for the first two decades of his career, he worked as a reporter and staff writer for the New York Times, Newsweek, New York magazine, and Esquire.

Tony is married to Deborah Pines, a psychotherapist. They have two daughters and four grandchildren.

Lance Dodes, M.D., is a Training and Supervising Analyst Emeritus at the Boston Psychoanalytic Society and Institute and retired Assistant Clinical Professor of Psychiatry at Harvard Medical School. He is the author of many academic articles and book chapters describing a new understanding of the nature and treatment of addiction, and the books: The Heart of Addiction; Breaking Addiction; and The Sober Truth. He has been honored by the Division on Addictions at Harvard Medical School for “Distinguished Contribution” to the study and treatment of addictive behavior, and been elected a Distinguished Fellow of the American Academy of Addiction Psychiatry.
John D. Gartner, Ph.D., is a clinical psychologist. He taught in the Department of Psychiatry at Johns Hopkins University Medical School for 28 years. He is the author of In Search of Bill Clinton: A Psychological Biography and The Hypomanic Edge: The Link Between (a Little) Craziness and (a Lot of) Success in America. He practices in Baltimore and New York.

Michael J. Tansey, Ph.D., is a Chicago-based clinical psychologist, author, and teacher. He is a graduate of Harvard University (A.B., '72, Personality Theory) and Northwestern University Feinberg School of Medicine (Ph.D., '78, Clinical Psychology).

In addition to his full-time practice, he was an Assistant Professor teaching and supervising students, interns, residents, and post-doctoral fellows. He has been in private practice for over 35 years with adults, adolescents, and couples.

The co-author of Understanding Countertransference, a book on empathy and the therapeutic process, he has written numerous professional journal articles as well as blog posts on The Huffington Post.

David M. Reiss, M.D., attended Northwestern University (Chemical/Biomedical Engineering; Medical School) and has maintained a private psychiatric practice in California since 1982. Dr. Reiss has evaluated/treated over 12,000 persons; has served as Interim Medical Director of Providence Hospital (MA), and has recently been associated with the Brattleboro Retreat (VT). Dr. Reiss is a California Qualified Medical Examiner and a member of professional organizations including the Society for Exploration of Psychotherapeutic Integration, Sports Lawyers Association and International Psychohistory Association. Dr. Reiss has appeared in all media formats addressing clinical issues and psychological aspects of social and political phenomena.
James A. Herb, M.A., Esq., has practiced law in Florida for 40 years. He is a Florida Supreme Court certified circuit court mediator, and a certificated arbitrator. He is a professional member of the National College of Probate Judges. He is author of four chapters in Florida law practice books and has chaired or spoken at more than 50 legal seminars.
Leonard L. Glass, M.D., M.P.H. is a psychiatrist and psychoanalyst in Newton, MA. He is Associate Professor of Psychiatry (Part-time) at Harvard Medical School and a Senior Attending Psychiatrist at McLean Hospital. Dr. Glass was President of the Boston Psychoanalytic Society and Institute and was a Distinguished Life Fellow of the American Psychiatric Association until he resigned in protest of the Goldwater Rule in April 2017. He has written professionally about the psychology of men, psychiatric casualties of large groups, and boundary issues in psychotherapy. He has also authored popular articles about spectator violence at sporting events and road rage.
Henry J. Friedman, M.D., is Associate Professor of Psychiatry, Harvard Medical School, Part-time, on the Editorial Boards of Psychoanalytic Quarterly, American Journal of Psychoanalysis, and the Journal of the American Psychoanalytic Association, with main interests in the therapeutic action of psychoanalysis and analytic psychotherapy. Friedman is also Chair of the “Meet the Author” at the Biannual Meetings of the American Psychoanalytic Association.
James Gilligan, M.D., is Clinical Professor of Psychiatry, Adjunct Professor of Law, and Collegiate Professor of Arts and Sciences at New York University. He is a renowned Violence Studies expert and author of the influential Violence: Our Deadly Epidemic and Its Causes, as well as Preventing Violence and Why Some Politicians Are More Dangerous than Others. He has served as Director of Bridgewater State Hospital, Director of Mental Health for the Massachusetts prison system, President of the International Association for Forensic Psychotherapy, and as a consultant to President Clinton, Tony Blair, Kofi Annan, the World Court, the World Health Organization, and the World Economic Forum.
Diane Jhueck, L.M.H.C., D.M.H.P., has operated a private therapy practice for several decades. In addition, she performs mental health evaluations and detentions on individuals presenting as a danger to self or others. In a previous social justice career, she was a women’s specialist at the United Nations, in New York. She founded The Women’s and Children’s Free Restaurant, an empowerment project that has been in operation for 30 years. She founded the People’s AIDS Project and was an Assistant Regional Manager for Feeding America. She directed agencies addressing food aid, domestic violence, anti-apartheid, low income housing, and LGBTQ rights.
Howard H. Covitz, PhD, ABPP has combined the practice of psychoanalysis in the suburbs of Philadelphia with a variety of other interests. He has taught university-level Mathematics, Psychology, and Biblical Characterology (1968-2011), was Training Analyst at the Psychoanalytic Studies Institute and Institute for Psychoanalytic Psychotherapies, and its Director (1986-1998). He also ran a school for disturbed inner city adolescents in the 1970’s. His Oedipal Paradigms in Collision (1998, reissued in 2016) was nominated for Gradiva Book of the Year Award. His connectedness to wife, grown children, and grandchildren motivate his writing and thinking.

Betty P. Teng, M.F.A., L.M.S.W., is a trauma therapist in the Office of Victims Services of a major hospital in lower Manhattan. A graduate of Yale College, UCLA's graduate School of Theater, Film, and Television and NYU’s Silver School of Social Work, Ms. Teng is in psychoanalytic training and practices at the Institute for Contemporary Psychotherapy.

She is also an award-winning screenwriter and editor whose credits include films by Ang Lee, Robert Altman, and Mike Nichols.

Jennifer Contarino Panning, Psy.D., is a Licensed Clinical Psychologist and Owner of Mindful Psychology Associates, a small group practice in Evanston IL. She received her doctorate in Clinical Psychology from Chicago School of Professional Psychology in 2003, and completed trainings at Northern Illinois University and Northwestern University. Panning opened her private practice in 2004, and now has three psychologists and a postdoctoral fellow on staff. She specializes in the treatment of mood disorders, eating disorders, college student mental health, stress and trauma utilizing an integrative approach of CBT, mindfulness, and DBT, and is also trained in clinical hypnosis.

Harper West, M.A., L.L.P., is a licensed psychotherapist in Clarkston, MI. She graduated from Michigan State University with a degree in journalism and worked in corporate communications, later earning a master’s degree in clinical psychology from Michigan School of Professional Psychology.

Ms. West is the developer of Self-Acceptance Psychology, which challenges the biological model of mental disorders and offers a new paradigm that reframes emotional problems as adaptive responses to fear, trauma, shame, and lack of secure attachment. Her self-help book Pack Leader Psychology won an IBPA Ben Franklin Award for Psychology.

Luba Kessler, M.D., is a psychiatrist and psychoanalyst in private practice. Born in the post-Holocaust displacement in the Ural mountains, she has lived and received her education in the Soviet Union, Poland, Italy, and the U.S. The journey included essential lessons in history, geography, culture, art, and politics. Post-graduate training and faculty appointments followed in psychiatry at Hillside Hospital on Long Island and psychoanalysis at NYU Psychoanalytic Institute (now Institute for Psychoanalytic Education affiliated with NYU Medical School). She is Editor of Issues in Education for The American Psychoanalyst of the American Psychoanalytic Association.
Steve Wruble, M.D., is an accomplished singer-songwriter and storyteller. He won The Moth StorySLAM and uses a pseudonym to protect his privacy. Dr. Wruble is also a Board-certified child and adult psychiatrist in private practice in Manhattan and Ridgewood, NJ, at the Venn Center. He specializes in anxiety disorders, trauma, and attention-deficit hyperactivity disorders. He attended medical school in his hometown of Memphis, TN, and did his general psychiatry residency at Northwestern University. He then did his child psychiatry fellowship at the Institute for Juvenile Research at the University of Illinois at Chicago, where he was Chief Fellow.
Thomas Singer, M.D., is a psychiatrist and Jungian psychoanalyst practicing in San Francisco. In addition to private practice, he serves on Social Security’s Hearing and Appeals Mental Impairment Disability team. His interests include studying the relationship between myth, politics, and psyche in The Vision Thing and Ancient Greece, Modern Psyche Series. He is the editor of a series of books exploring cultural complexes that includes Placing Psyche, Listening to Latin America, Europe’s Many Souls, The Cultural Complex, and a book in preparation on Asia. He is current President of National ARAS, an archive of symbolic imagery that has created The Book of Symbols.
Elizabeth Mika, M.A., LCPC, of Gifted Resources in Northern Illinois (in the Chicago area) received her degree in clinical psychology from Adam Mickiewicz University in Poznan, Poland. She specializes in assessment and counseling of gifted children and adults. Her professional interests include creativity and mental health, learning differences and learning styles, multiple exceptionalities, and emotional and moral development of the gifted and not only.
Edwin B. Fisher, Ph.D., is a clinical psychologist and Professor in the Department of Health Behavior in the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill. He is a past-president of the Society of Behavioral Medicine and editor of Principles and Concepts of Behavioral Medicine: A Global Handbook (Springer, 2017). In addition to community and peer support in health and health care, asthma, cancer, diabetes, smoking cessation, and weight management, he has written on concepts of psychopathology including depression and schizophrenia and on the relationships among mental illness and physical disease.
Nanette Gartrell, MD., is a psychiatrist, researcher, and writer who was formerly on the faculties of Harvard Medical School and University of California, San Francisco. Her 47 years of scientific investigations have focused primarily on sexual minority parent families. In the 1980s and ’90s, Dr. Gartrell was the principal investigator of groundbreaking investigations into sexual misconduct by physicians that led to a clean-up of professional ethics codes and the criminalization of boundary violations. The Nanette K. Gartrell Papers are archived at the Sophia Smith Collection, Smith College.
Dee Mosbacher, M.D., Ph.D., is a psychiatrist and Academy Award-nominated documentary filmmaker who was formerly on the faculty of University of California, San Francisco. As a public-sector psychiatrist, Dr. Mosbacher specialized in the treatment of patients with severe mental illness. She served as San Mateo County’s Medical Director for Mental Health and Senior Psychiatrist at San Francisco’s Progress Foundation. The Diane (Dee) Mosbacher and Woman Vision Papers are archived at the Sophia Smith Collection, Smith College. Dr. Mosbacher’s films are also contained within the Smithsonian National Museum of American History collection.

Read an Excerpt

CHAPTER 1

UNBRIDLED AND EXTREME PRESENT HEDONISM

How the Leader of the Free World Has Proven Time and Again He Is Unfit for Duty

PHILIP ZIMBARDO AND ROSEMARY SWORD

In the summer of 2015, we commenced what would become an ongoing discussion about Donald Trump. He had just thrown his hat in the ring as a Republican presidential candidate, and our initial conversation was brief: he was in it for the publicity. For us, as for many Americans, Donald Trump had been in the periphery of our consciousness for years, first as a well-publicized New York City businessman and later as a mediocre television personality. And like most, we didn't take him seriously. Why would we have? He had no political experience, and he failed to show any real interest in philanthropy, much less in helping the American people or non-Trump businesses. His products were made outside the United States, and multiple lawsuits indicated he didn't pay those small businesses that supplied him with goods and services. He had also created Trump University, for people who wanted to get certified in business administration, at a fee of $43,000 for one year. It was a scam — the same lessons were available online for free for anyone, and the mentors who were supposed to give students personal guidance were rarely available. Students who took Trump University to court won their lawsuits, and Trump U got dumped. Simply put, Donald Trump was a businessman interested primarily in personal gain, sometimes using unscrupulous methods.

We also knew that, for decades, Trump had flip-flopped, switching political parties — first a Democrat, then a member of the Reform Party, then a Republican, then a Democrat, and finally a Republican again. Surely, it seemed, "The Donald" was in the running merely to gain media coverage, to place himself in a better position to make even more big deals and to up-level his product line: Donald J. Trump.

Then, as the months progressed, we became increasingly concerned that, given his "straightforward" or "outsider" presentation and his charisma, he would appeal to people who were unaware of the dangers of narcissism in extremis, or of the offensive behaviors that can accompany it. While we are not trying to diagnose here (which would be close to impossible in any case), we would like to call the reader's attention to associated behaviors that include but are not limited to condescension, gross exaggeration (lying), bullying, jealousy, fragile self-esteem, lack of compassion, and viewing the world through an "us-vs.-them" lens. Having observed the schoolyard bully tactics Trump employed during the Republican debates, and his absurdly boastful presentation during interviews, we felt it was important to raise awareness about this set of behaviors. So, in January 2016, we published an online Psychology Today column about bullies and the hostile social environments they create in schools and businesses (Sword and Zimbardo 2016a).

As Trump's campaign, and his narcissism, gained momentum, so did our efforts to make people aware of the potential dangers he posed for our democracy. In March 2016 we published a column about the narcissistic personality (Sword and Zimbardo 2016b). In it, we shared clinically documented narcissistic behaviors, hoping it would be easy for readers to come to their own conclusions that Trump fit every example. We did not mention his numerous romantic dalliances, or the growing number of sexual harassment lawsuits he faced, or his three marriages, in which he traded up for younger, more beautiful women. Each of these, on its own, is not exceptional, but it doesn't take a mental health professional to determine that these behaviors, coupled with his ever-shifting political party affiliations (changes that could be viewed as having been made to bolster his image and ego), indicated that this person's main focus was self-interest, and were incongruent with one important character trait the American people have come to appreciate in their president — at least up until November 2016: stability.

Furthermore, through our observations, it was glaringly apparent, based on Zimbardo's time perspective theory (Zimbardo and Boyd 2009), later developed into time perspective therapy by Sword and Sword (Zimbardo, Sword, and Sword 2012), that Trump embodied a specific personality type: an unbridled, or extreme, present hedonist. As the words suggest, present hedonists live in the present moment, without much thought of any consequences of their actions or of the future. An extreme present hedonist will say whatever it takes to pump up his ego and to assuage his inherent low self-esteem, without any thought for past reality or for the potentially devastating future outcomes from off-the-cuff remarks or even major decisions. Trump's behavior indicates that his time perspectives are totally unbalanced. It's not necessary for him to take the Zimbardo Time Perspective Inventory (either the long or short forms) in order for us to come to this conclusion. Our assertion that Trump qualifies as among the most extreme present hedonists we have ever witnessed comes from the plethora of written and recorded material on him, including all his interviews, hundreds of hours of video, and his own tweets on his every personal feeling.

What follows is meant to help readers understand how we've come to the conclusion that Donald Trump displays the most threatening time perspective profile, that of an extreme present hedonist, and is therefore "unfit for duty."

Time Perspective Theory and Time Perspective Therapy (TPT)

We are all familiar with the three main time zones: the past, the present, and the future. In TPT, these time zones are divided into subsets: past positive and past negative, present hedonism and present fatalism, and future positive and future negative. When one of these time perspectives is weighed too heavily, we can lose out on what's really happening now and/or lose sight of what could happen in our future. This can cause us to be unsteady, unbalanced, or temporally biased.

Being out of balance in this way also shades the way we think, and negatively impacts our daily decision making. For instance, if you are stuck in a past negative experience, you might think that from now on everything that happens to you will be negative. Why even bother planning for your future? you might think. It's just going to continue to be same old bad stuff. Or, if you are an extreme present hedonist adrenaline junky intent on spiking your adrenal glands, then you might engage in risky behaviors that unintentionally endanger you or others because you are living in the moment and not thinking about the future consequences of today's actions. If you are out of balance in your future time perspective, constantly thinking and worrying about all the things you have on your endless to-do list, you might forget about or miss out on the everyday, wonderful things happening in your life and the lives of your loved ones in the here and now.

SIX MAIN TIME PERSPECTIVES IN TPT

1. Past positive people focus on the good things that have happened.

2. Past negative people focus on all the things that went wrong in the past.

3. Present hedonistic people live in the moment, seeking pleasure, novelty, and sensation, and avoiding pain.

4. Present fatalistic people feel that planning for future decisions is not necessary because predetermined fate plays the guiding role in one's life.

5. Future positive people plan for the future and trust that things will work out.

6. Future negative people feel the future is predetermined and apocalyptic, or they have no future orientation.

THREE MAIN TP BIASES

1. Past bias: Good and bad things happen to everyone. Some of us view the world through rose-colored glasses (past positive), whereas others see the world through a darker lens (past negative). We have found that people who focus primarily on the past value the old more than the new; the familiar over the novel; and the cautious, conservative approach over the daring, more liberal or riskier one.

2. Present bias: People who live in the present are far less, or not at all, influenced by either past experiences or future considerations. They focus only on the immediate present — what's happening now (present hedonism). Decisions are based on immediate stimulus: internal hormonal signals, feelings, smells, sounds, the attractive qualities of the object of desire, and what others are urging them to do. Present-biased people who are influenced by past negative experiences are likely to feel stuck in the mire of the past now (present fatalism).

3. Future bias: No one is born thinking about how to plan for the future. A number of conditions, including living in a temperate zone (where it's necessary to anticipate seasonal change), living in a stable family or stable economic/political society (where a person learns to trust promises made to him), and becoming educated, can create future-positive-oriented people. In general, future-oriented people do very well in life. They are less aggressive, are less depressed, have more energy, take care of their health, have good impulse control, and have more self-esteem. Those stuck in the past, and locked into negative memories, feel fatalistic about the present and may have lost the ability even to conceive of a hopeful future (future negative).

Healthy Versus Unhealthy Time Perspectives

Through years of research, we have discovered that people who live healthy, productive, optimistic lives share the following traits — what we call an "ideal time perspective":

• High past positive/low past negative;

• Low present fatalism/moderate selected present hedonism; and

• Moderately high future-positive orientation.

Conversely, we have found that people with pessimistic time perspectives, usually due to trauma, depression, anxiety, stress, or posttraumatic stress, share the following time perspective profile:

• High past negative/low past positive;

• High present fatalism and/or high present hedonism; and

• Low future/no future orientation.

Having a dose of selected present hedonism in one's overall time perspective profile is important because enjoying oneself and having fun is a healthy part of life. Yet, too much of a good thing can cause numerous problems.

Present Hedonism and Arrested Emotional Development

As just mentioned, present hedonists live and act in the moment, frequently with little to no thought of the future, or the consequences of their actions. Most children and teenagers are present hedonists. Each day, they build on past experiences, but their concept of the future is still under development. People suffering from arrested emotional development, usually caused by a childhood trauma, are also present hedonists. Without therapy, the ability to mature emotionally beyond the age of trauma is difficult to impossible. When they reach adulthood, they may be able to hide their lack of emotional maturity for periods, but then, when in a stressful situation, they revert to behaving the emotional age they were when they were first traumatized. Depending on the degree to which the childhood trauma affected the person suffering from arrested emotional development, they may find that, over time, their present-hedonistic time perspective has morphed into extreme present hedonism.

Without proper individual assessment, we can only make a best guess as to whether Donald Trump suffers from arrested emotional development, which may or may not be a factor in his extreme present hedonism. Yet, with access to the extensive amount of print and video media exposing his bullying behavior, his immature remarks about sex, and his childlike need for constant attention, we can speculate that the traumatizing event was when he was sent away to military school at the age of thirteen. According to one of his biographers, Michael D'Antonio, Trump "was essentially banished from the family home. He hadn't known anything but living with his family in a luxurious setting, and all of a sudden he's sent away" (Schwartzman and Miller 2016). This would help explain his pubescent default setting when confronted by others.

Extreme Present Hedonism

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. Coupled with a measure of paranoia, which is the norm, extreme present hedonism is the most unpredictable and perilous time perspective due to its "action" component. Here's how it works:

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. If the person is in a position of power, then others scramble either to deny or to find ways to back up the original impulsive action. In normal, day-to-day life, this impulsiveness leads to misunderstandings, lying, and toxic relationships. In the case of Donald Trump, an impulsive thought may unleash a stream of tweets or verbal remarks (the action), which then spur others to try to fulfill, or deny, his thoughtless action.

Case in point: Trump's impulsive tweet "How low has President Obama gone to tapp [sic] my phones during the very sacred election process. This is Nixon/Watergate. Bad (or sick) guy!" (Associated Press 2017) caused members of his staff to scramble to find evidence to make the false and slanderous claim "real." That one extreme present hedonistic tweet has led, ironically, to multiple investigations into the Trump campaign's possible Russian connections at the expense of taxpayers' hard-earned dollars.

Another concerning characteristic of extreme present hedonists is the often unwitting — we like to give some extreme present hedonists the benefit of the doubt — propensity to dehumanize others in order to feel superior. This lack of foresight and compassion is also a trait of narcissism and bullying, which we address later in this chapter.

Donald Trump's Extreme Present Hedonistic Quotes

It could be argued that almost anyone can be presented in a negative light when scrutinized or quoted out of context. However, when one runs for the highest office in the land, and then wins that prize, such scrutiny is expected. In the case of Donald Trump, a rich trove of recorded examples gives us a strong picture of the inner workings of his unbalanced psyche. The following well-known quotes, which we've organized into categories — some of them overlap multiple categories — compiled by Michael Kruse and Noah Weiland for Politico Magazine ("Donald Trump's Greatest Self Contradictions," May 5, 2016) illustrate his extreme present hedonistic penchant for off-roading from his script and/or saying or tweeting whatever pops into his mind, making things up, repeating fake news, or simply lying:

DEHUMANIZATION

• "Sometimes, part of making a deal is denigrating your competition" (The Art of the Deal, 1987).

• "When Mexico sends its people, they're not sending their best ... They're sending people that have a lot of problems, and they're bringing those problems with us. They're bringing drugs. They're bringing crime. They're rapists. And some, I assume, are good people" (Republican rally speech, June 16, 2015).

• "Written by a nice reporter. Now the poor guy. You ought to see this guy" (remark made while contorting his face and moving his arms and hands around awkwardly, at a campaign rally in South Carolina, November 24, 2015, about journalist Serge Kovaleski, who has arthrogryposis, a congenital condition that can limit joint movement or lock limbs in place).

LYING

• "Made in America? @BarackObama called his 'birthplace' Hawaii 'here in Asia'" (Twitter, November 18, 2011).

• "I watched when the World Trade Center came tumbling down ... And I watched in Jersey City, New Jersey, where thousands and thousands of people were cheering as that building was coming down. Thousands of people were cheering" (at a rally in Birmingham, Alabama, November 21, 2015). The next day, This Week host, George Stephanopoulos, pointed out that "the police say that didn't happen." Trump insisted otherwise: "It was on television. I saw it happen."

• "In addition to winning the Electoral College in a landslide, I won the popular vote if you deduct the millions of people who voted illegally" (Twitter, November 27, 2016).

MISOGYNY

• "You could see there was blood coming out of her eyes. Blood coming out of her — wherever" (remarks during CNN interview with regard to Megyn Kelly, following the previous night's Fox News debate co-moderated by Kelly in which Kelly asked Trump about his misogynistic treatment of women, August 7, 2015).

• "Look at that face! Would anybody vote for that? Can you imagine that, the face of our next president? ... I mean, she's a woman, and I'm not supposed to say bad things, but really, folks, come on. Are we serious?" (remarks in Rolling Stone interview with regard to Republican presidential candidate Carly Fiorina, September 9, 2015).

• "When you're a star, they let you do it. You can do anything ... Grab 'em by the pussy ... You can do anything" (off-camera boast recorded over a hot mic by Access Hollywood in 2005 and published by the Washington Post in October 2016).

(Continues…)

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Copyright © 2019 Bandy X. Lee.
Excerpted by permission of St. Martin's Press.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents

TITLE PAGE,
COPYRIGHT NOTICE,
DEDICATION,
FOREWORD TO THE SECOND EDITION The Dire Warning of Mental Health Experts Jeffrey D. Sachs, Ph.D.,
PROLOGUE TO THE SECOND EDITION Professions and Activism Stephen Soldz, Ph.D., and Bandy X. Lee, M.D., M.Div.,
FOREWORD TO THE FIRST EDITION Our Witness to Malignant Normality Robert Jay Lifton, M.D.,
PROLOGUE TO THE FIRST EDITION Professions and Politics Judith Lewis Herman, M.D., and Bandy X. Lee, M.D., M.Div.,
INTRODUCTION Our Duty to Warn and to Protect Bandy X. Lee, M.D., M.Div.,
PART 1: The Trump Phenomenon,
Unbridled and Extreme Present Hedonism: How the Leader of the Free World Has Proven Time and Again He Is Unfit for Duty Philip Zimbardo, Ph.D., and Rosemary Sword,
Pathological Narcissism and Politics: A Lethal Mix Craig Malkin, Ph.D.,
I Wrote The Art of the Deal with Donald Trump: His Self-Sabotage Is Rooted in His Past Tony Schwartz,
Trump's Trust Deficit Is the Core Problem Gail Sheehy, Ph.D.,
Sociopathy Lance Dodes, M.D.,
Donald Trump Is: (A) Bad, (B) Mad, (C) All of the Above John D. Gartner, Ph.D.,
Why "Crazy Like a Fox" versus "Crazy Like a Crazy" Really Matters: Delusional Disorder, Admiration of Brutal Dictators, the Nuclear Codes, and Trump Michael J. Tansey, Ph.D.,
Cognitive Impairment, Dementia, and POTUS David M. Reiss, M.D.,
Donald J. Trump, Alleged Incapacitated Person: Mental Incapacity, the Electoral College, and the Twenty-Fifth Amendment James A. Herb, M.A., Esq.,
PART 2: The Trump Dilemma,
Should Psychiatrists Refrain from Commenting on Trump's Psychology? Leonard L. Glass, M.D., M.P.H.,
On Seeing What You See and Saying What You Know: A Psychiatrist's Responsibility Henry J. Friedman, M.D.,
The Issue Is Dangerousness, Not Mental Illness James Gilligan, M.D.,
A Clinical Case for the Dangerousness of Donald J. Trump Diane Jhueck, L.M.H.C., D.M.H.P.,
Health, Risk, and the Duty to Protect the Community Howard H. Covitz, Ph.D., A.B.P.P.,
New Opportunities for Therapy in the Age of Trump William J. Doherty, Ph.D.,
PART 3: The Trump Effect,
Trauma, Time, Truth, and Trump: How a President Freezes Healing and Promotes Crisis Betty P. Teng, M.F.A., L.M.S.W.,
Trump Anxiety Disorder: The Trump Effect on the Mental Health of Half the Nation and Special Populations Jennifer Contarino Panning, Psy.D.,
In Relationship with an Abusive President Harper West, M.A., L.L.P.,
Birtherism and the Deployment of the Trumpian Mind-Set Luba Kessler, M.D.,
Trump's Daddy Issues: A Toxic Mix for America Steve Wruble, M.D.,
Trump and the American Collective Psyche Thomas Singer, M.D.,
Who Goes Trump? Tyranny as a Triumph of Narcissism Elizabeth Mika, M.A., L.C.P.C.,
The Loneliness of Fateful Decisions: Social Contexts and Psychological Vulnerability Edwin B. Fisher, Ph.D.,
He's Got the World in His Hands and His Finger on the Trigger: The Twenty-Fifth Amendment Solution Nanette Gartrell, M.D., and Dee Mosbacher, M.D., Ph.D.,
PART 4: Sociocultural Consequences,
Persistent Enslavement Systemic Trauma: The Deleterious Impact of Trump's Rhetoric on Black and Brown People Kevin Washington, Ph.D.,
Traumatic Consequences for Immigrant Populations in the United States Rosa Maria Bramble, L.C.S.W.,
To Trump, Some Lives Matter Ellyn Uram Kaschak, Ph.D.,
The Charismatic Leader-Follower Relationship and Trump's Base Jerrold M. Post, M.D.,
PART 5. Humanity's Perpetuation and Survival,
The Myth of Nuclear War James R. Merikangas, M.D., with Tarannum M. Lateef, M.D.,
The Age of Thanatos: Environmental Consequences of the Trump Presidency Lise Van Susteren, M.D., and H. Steven Moffic, M.D.,
The Goldwater Rule and the Silence of American Psychiatry: A 2017 Symposium Nassir Ghaemi, M.D., M.P.H,
Is the Commander in Chief Fit to Serve? A Nonpartisan Test that Marries U.S. Army Leadership Standards with Psychoanalytic Theory Prudence Gourguechon, M.D.,
Disordered Minds: Democracy as a Defense Against Dangerous Personalities Ian Hughes, Ph.D.,
Congress Should Establish an Alternative Body to Assess the President Norman Eisen, Esq., and Richard Painter, Esq.,
EPILOGUE Reaching Beyond the Professions Noam Chomsky, Ph.D., and Bandy X. Lee, M.D., M.Div.,
NOTES,
APPENDIX Transcript of the Yale Conference (online),
ABOUT THE EDITOR,
COPYRIGHT ACKNOWLEDGMENTS,
COPYRIGHT,

Editorial Reviews

"This is an historic work in the history of American psychiatry. We have never been in this place before." —Lawrence O'Donnell

"There will not be a book published this fall more urgent, important, or controversial than The Dangerous Case of Donald Trump...profound, illuminating and discomforting" —Bill Moyers

"The stand these psychiatrists are taking takes courage, and their conclusions are compelling." —The Washington Post

“When I first heard about the conference that gave rise to this book at Yale, I was worried that a manifesto would come out with a diagnosis…. That is not what happened: what happened is a very thoughtful assessment based on lots of public data, which gives us a very clear way of thinking about the terrific vulnerabilities of our current president that elicits a duty to warn.” - Samuel Barondes, Professor Emeritus and Former Chair of Psychiatry at the University of California, San Francisco

“This insightful collection … is a valuable primary source documenting the critical turning point when American psychiatry reassessed the ethics of restraining commentary on the mental health of public officials in light of the ‘duty to warn’ of imminent danger.” - Estelle Freedman, the Robinson Professor in U.S. History at Stanford University

From the Publisher