The Elephant in the Room Revisited

The president may be causing anxiety throughout the nation.

Posted Jul 01, 2019

Source: pixabay

In our February 2017 column, The Elephant in the Room, we shared our concern as mental health professionals about the dangerousness of Donald Trump as the recently inaugurated President of the United States. Then, in the first chapter of the book, The Dangerous Case of Donald Trump, we detailed Trump’s bias toward extreme present hedonism, including his dehumanization of people he doesn’t like or cannot relate to, lying, misogyny, paranoia, self-aggrandizement, and narcissistic and bullying personality traits. We warned at the time that Trump was “‘chumming’ for war, possibly for the most selfish of reasons: to deflect attention away from the Russia investigation,” and we were worried that another unbalanced leader elsewhere in the world might take the bait.

More than two years later, his conduct has worsened and we teeter on the precipice of a potentially devastating war, not with North Korea as previously feared, but a different dangerous regime in Iran.

The most dangerous case

Bandy Lee is our colleague and the editor of The Dangerous Case of Donald Trump. She is a forensic psychiatrist and expert on violence at the Yale School of Medicine, a consultant for the World Health Organization, and a professor at Yale Law School. She also heads the World Mental Health Coalition. Recently, Lee, along with coauthors of The Dangerous Case, excluding the authors of this column, prepared a definitive mental health analysis of Trump based on the findings of the Mueller Report.

To demonstrate that the president has thought about how starting a war can be politically advantageous, Lee has cited the following tweets:

  • "In order to get elected, @BarackObama will start a war with Iran" (November 29, 2011)
  • "Now that Obama’s poll numbers are in tailspin—watch for him to launch a strike in Libya or Iran. He is desperate" (October 9, 2012)
  • "I predict that President Obama will at some point attack Iran in order to save face!" (September 16, 2013)

"What people assume about others often tells us a great deal about how they themselves think and operate," Lee said in a recent interview.

So, how does Trump’s behavior affect American citizens?

Nationwide stress

In the American Psychological Association's 2016 “Stress in America” study, in which 3,400 American adults were surveyed, 63 percent of participants viewed the future of the country as “a significant source of stress” and 56 percent said that they are “stressed by the current political climate.” In the 2018 edition of the APA survey, the number of participants viewing the future of the country as a significant stressor increased to 69 percent — and among those who saw the political climate as a source of stress, the number jumped to 62 percent.

Here are a few suggestions to help manage stress during this politically charged time:

  • Stay informed, but know your limits. Consider how much news you take in and how that information is affecting you. If you are preoccupied by national events and it is interfering with your daily life, cut back on your news intake and limit social media discussions. Some people find it helpful to schedule a short block of time in the morning and one in the evening to catch up on the news without checking every new update during the day.
  • Find commonalities with others. Every day we come into contact with people whose beliefs differ from our own. If the topic of political differences arises, try to identify commonalities within your different views. Sometimes different views can come from a similar underlying principle. Be open to hearing the other person’s story, and consider validating how they feel. When we frame our thinking this way, it can be easier to tolerate or understand people with different views and maybe work together toward a common goal. If it’s difficult to discuss political issues in a calm, constructive manner, disengage from the conversation.
  • Find meaningful ways to get involved in your community. Identify issues that are important to you, and research organizations that work on those issues. Contact them and see how you can join their efforts. Consider getting involved in local politics, where it can be possible to see the direct impact of your efforts. Attend a city council meeting or a town hall meeting to listen to and share your ideas with elected officials. Taking such proactive steps to address your concerns can lessen feelings of stress.
  • Seek solace. Faith-based organizations and other community organizations can provide vital emotional and spiritual support during stressful times. Engaging in soothing activities, such as meditation, progressive relaxation or mindfulness, can also help you connect to the present moment and find some peace.
  • Take care of yourself. Because stress can have a physical and emotional impact on your overall health, find activities you enjoy to help you recharge and reduce your stress, such as exercising, listening to your favorite music or spending time with close family and friends. It’s important to prioritize getting enough sleep, eating healthy, and avoiding ineffective coping mechanisms such as alcohol and substance use.

Uphill battle

The analysis of the Mueller Report conducted by Lee, et al, shows the authors were right about Trump being unfit for office, as well as choosing the safety of the nation over politics: “The APA can no longer claim this is ‘armchair psychiatry,’ since the information in the Mueller Report is exactly what we would look for in a capacity evaluation, not merely public documents, and here it is under sworn testimony .. .the public needs to have access to expertise — it should not be a mechanism for exclusion but a service. Knowledge empowers the public, and special knowledge can be important.”

The most important job in the world

If Trump was an employee in a corporation he did not own and conducted himself as characterized in the Mueller Report, he would have been fired and likely indicted. In this scenario, if the court required testing, especially prior to returning to a job, he would have taken exams which would reveal that, as Lee states, “he fails every criterion for doing any job that requires rational decision making.”

We have a suggestion for our governmental leaders: In corporate vetting processes, prospective employees are frequently given psychological exams to help the employer make more informed hiring decisions and determine if the prospective employee is honest and/or would be an asset for the company. Such tests are used for positions ranging from department store clerk to high-level executive. Isn’t it time that the same be required of candidates for the most important job in the world?


Kaschak, E. (2019). Terrorist in Chief. New York, NY: Wall Street International.

Keller, J. (2019). Research Suggests Election has been Detrimental to Many Americans' Mental Health. Santa Barbara, CA: Pacific Standard. 

APA (2017). Managing Stress Related to Political Change. Washington, DC:

Sword, R., & Zimbardo, P. (2017) The Elephant in the Room. New York, NY:

Lee, B., et al. (2017) The Dangerous Case of Donald Trump. New York, NY: St. Martin's Press.