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Bandy X. Lee M.D., M.Div.
Bandy X. Lee M.D., M.Div.

Escalating Dangers in the Trump Era

Independence of the mind goes hand in hand with independence of the nation.

Now that we have watched America put children in cages, and families are now to be concentrated in camps, we cannot avoid the association with other times and places of mass atrocities. This time it is the children of migrants and asylum seekers, but next time it could be closer to home—this is how it usually goes. The stark explanation of such atrocities is that leaders make all the difference. They can bring about the mass suffering of minority groups and political foes with little resistance from the broad populace and indeed often with substantial cheerleading.

In our nation’s birth month, while celebrating the first and most successful democracy of the modern era, we might pause to consider what a momentous gift we have. Autonomy and independence, without dependence on an external authority, is a status this nation has won after difficult strife. But to prevent the turning of freedom from oppression into perpetration of oppression, citizens must actively assume their rights and responsibilities.

Benjamin Franklin said, “Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety” (Franklin, 1755). The same applies to the mind. Submission brings its own safety and comfort, but creates a condition for symbiosis to occur with a leader who is impaired with a drive to dominate rather than to govern. Such a combination has historically given rise to scapegoating and mass suffering, in which one may delight at first, but the same tendency turns inward and destroys oneself also.

We have enough information from his actions, his known life history, and the many reports by others, to know that Donald Trump is dangerous in this manner. A recent study has found that he his Twitter usage widely instigates hate crimes (Weill, 2018), which is a predictable result from his psychological makeup. The future course of Donald Trump’s traits is that they are likely to worsen rapidly when he is granted great power, as we are already seeing in this presidency. The president should therefore be understood for what he is: a sick man, not a calculating politician.

To accomplish his feats of deception, he lies relentlessly and remorselessly. According to the Washington Post, Trump has made over 3,000 false or misleading claims since taking office, and his lies have been escalating (Kessler, Rizzo, and Kelly, 2018). This level of lying—whether intentional or delusional—is pathological.

What seems like strength to his followers—bold truth-telling—is actually nonstop lying without remorse. What seems like an effective strategy—relentlessness at getting his way—is actually a pathological drive that overwhelms ordinary reason. A severely pathological mind has no conflict with itself and is unstoppable, which is why it is usually fruitless to surround such a person with “normal” people. Even some of the healthy individuals might start to take on the alternative reality of the pathological mind (a phenomenon known as “shared psychosis”).

As Trump gains experience in the White House, he increasingly casts aside any advice with which he disagrees. His confidants describe the president to reporters as newly emboldened and ready to ignore the cautions of those around him (Haberman, 2018). There is the false hope that giving him what he demands will help appease him, but the opposite is true: since no external reality can gratify problems in the mind, he will experience even greater disappointment, paranoia, and rage—and without empathy or grounding in reality, any level of destruction is possible.

Further, Trump is psychologically incapable of compromise. He must always see himself as the victor. When any of Trump’s threats is countered, he escalates, whether vis-à-vis allies or foes. He will muscle his way to victory, lest he expose a weakness to himself and others. Sadly, this dynamic is likely behind the nature of the follow-up to the June 12, 2018, summit with Kim Jong-Un, after receiving criticism that he has come away with very little (which was also predictable). The secretary of state’s recent visit has resulted in the following statement from North Korea: “The U.S. side came up only with its unilateral and gangster-like demand[s] for denuclearization … counter to the spirit of the Singapore summit meeting” (Donati and Jeong, 2018).

That his psychological makeup was bound to bring greater instability and danger, not peace, even from a peace summit, was warned against elsewhere (Lee, 2018). Similarly, regarding his separation of children from families, he may have yielded in the face of public revulsion, but the degree to which he shows unconcern for reuniting them (Goodman, Shaikh, and Rivas, 2018) exposes his underlying cruelty and desire for revenge. The solution for a dangerous mindset is limit-setting and containment, but he has rather removed the minimal personnel checks and constraints he had.

The public and foreign counterparts are not used to dealing with U.S. leaders with severe mental pathology. When pundits or foreign leaders attempt to explain Trump’s actions, they habitually resort to political categories—that Trump is appealing to his base; that he is bluffing; that he is merely posturing in advance of a future compromise. These are projections of normal behavior onto the actions of a severely impaired leader, because the realm of pathology is usually outside the imagination of a normal observer. The particular traits that Trump displays are among the most dangerous possible for the U.S. and the world.

Because the dangers are not yet contained, world leaders have been scrambling. Can we convince him to stay in the Iran nuclear deal? Can we rely on him not to launch a trade war? Can we cajole him with a Nobel Prize to keep peace with North Korea? Can we count on him not to blow up the world if the special counsel’s investigations closed in too tightly? They should realize by now that the answer to each of these questions is in the negative.

The world is full of individuals with Trump’s characteristics who lust after power. Usually, society helps contain them, and well-functioning democracies keep them from taking command. In less functioning ones, they may take charge as would-be saviors, only to become despots. Their promises of glory and greatness of the nation initially build momentum. But the destination of unopposed disease is always the same: death and destruction. If Congress continues to fail to act, then we may get to the point where it becomes the mental health profession’s responsibility to take medical measures, to save not only the organism that is this great nation but to prevent lasting and devastating damage.


Donati, J., and Jeong, A. (2018). North Korean nuclear talks are thrown off balance as accounts by U.S. and Pyongyang clash. Wall Street Journal. Retrievable at:…

Franklin, B. (1755). Reply to the Governor. Pennsylvania Assembly, November 11.

Goodman, A., Shaikh, N., and Rivas, L. (2018). From separating families to jailing asylum seekers, Trump admin. accused of criminalizing migration. Democracy Now. Retrievable at:…

Haberman, M. (2018). Newly emboldened, Trump says what he really feels. New York Times. Retrievable at:

Kessler, G., Rizzo, S., and Kelly, M. (2018). President Trump has made 3,001 false or misleading claims so far. Washington Post. Retrievable at:…

Lee, B. X. (2018). Peace or war on Korean Peninsula? Korea Herald. Retrievable at:

Weill, K. (2018). Hate crimes spiked after Trump’s anti-Muslim tweets, study finds. Daily Beast. Retrievable at:…

About the Author
Bandy X. Lee M.D., M.Div.

Bandy Lee, M.D., is a forensic psychiatrist at Yale School of Medicine and project group leader for the World Health Organization Violence Prevention Alliance. She also authored the textbook Violence.

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