Trump’s Mental Health Called Into Question

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Our collective malady: Donald Trump’s mental health crisis is America’s problem

Experts: Trump’s “denial of reality” and “primitive projections” are imploding. He’s even more dangerous


Senior Writer


To properly respond to Donald Trump and the level of extreme danger he represents — especially as he faces multiple criminal prosecutions — requires understanding some specific aspects of Trump’s behavior and motivations. 

Trump has shown a wide range of pathological behavior over the past seven years or so. He has an unhealthy fascination with violence. He lacks impulse control and empathy. He revels in cruelty. He compulsively lies and exhibits traits of malignant narcissism. He is a confirmed sexual predator and misogynist. He has a tenuous relationship to reality, and increasingly retreats into victimology and a persecution complex. He believes himself to be almost literally superhuman and often behaves like a cult leader.

In my many conversations with mental health experts during the Age of Trump, one of their consistent themes has been the suggestion that if the ex-president was not a rich white man he would likely have been arrested or otherwise removed from normal society decades ago.


Folks, the wait was worth it: Donald Trump is going to prison

Trump’s pathological behavior is in no way separate from his role as leader of the neofascist MAGA movement and larger white right. One repeated error made by the mainstream media and the larger political class is to divide Trump’s obvious mental health issues from his political behavior and the ascendancy of his movement.

Fascism and other forms of illiberal politics are not “merely” political problems. In reality, such things are a societal force and imaginary that both harness and generate collective mass sociopathy and other forms of physical, emotional, psychological, intellectual and spiritual pathology. Sick societies produce sick leaders; sick leaders have sick followers; in combination, those forces produce sick political movements. Collectively, these are manifestations of a condition of malignant normality that can all too easily end in societal destruction. 

After four indictments on a wide variety of charges for which he potentially faces imprisonment, Donald Trump has reacted in entirely predictable fashion, lashing out at many of his perceived enemies, including President Biden, Attorney General Merrick Garland, special counsel Jack Smith, Fulton County District Attorney Fani Willis, the Democratic Party, the FBI and others he views as part of a “deep state” plot against him and his MAGA movement. Consider this recent fundraising email from Trump:

I honestly believe that Joe Biden doesn’t love America.

Right now, our once great country is falling apart. Inflation is ravaging our economy. Our border is in complete disarray. Our enemies are openly spying on us and getting away with it. And our justice system has been replaced by a weaponized legal system that criminalizes dissent.

We are a nation in decline.

If I were in the White House right now, I would dedicate every waking hour and every fiber of my being to fix this mess.

But what’s Crooked Joe doing as America burns?

… Spending millions and millions of YOUR taxpayer dollars to wrongly indict, arrest, and possibly even JAIL his leading opponent.

The truth is: Crooked Joe doesn’t care if our country burns to the ground. He only cares about his own power.

But I trust you know that I truly care about America. Nothing motivates me more than my endless love for our country.

Look, I didn’t have to run for president. I didn’t have to challenge the Deep State. 

I’m not in this battle for fame or fortune. I’m in this battle to save our country and nothing else.

That’s just one in a lengthy series of emails on the same theme: Biden and the Democrats and their voters are existential enemies of the nation, and the twice-impeached, four-times-indicted ex-president is the only person who can defeat them.

Rather than mocking or deriding these rants, it is better to understand them as problematic and dangerous. This is classic projection: Trump is projecting his inner views and pathological sense of self-identity outward onto others.

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Trump’s projections and his evidently unstable behavior may provide insight and map onto what he and his followers will do next — up to and including potential acts of political violence — in response to his impending criminal trials amid the 2024 presidential campaign. I asked Dr. Marc Goulston, a prominent psychiatrist, former FBI hostage-negotiation trainer and author of the bestsellers “Just Listen” and “Talking to ‘Crazy’,” for his insights into Trump’s inflammatory rhetoric and what it reveals about the ex-president’s state of mind. He responded by email:

If we took out the words “Joe” or “Biden”  from his rants and asked non-dictator world leaders to choose whom they seemed to describe more accurately, Biden or Trump, I’m guessing most would say it’s a better description of Trump and what he is or would do to America.

So even to the untrained eye it is clear that Trump is projecting a lot of negativity on Biden. If that is so, what lies beneath? 

One of the things Trump cannot tolerate is feeling powerless or helpless, which triggers something called “impotent rage.” That is the rage of powerlessness, and the more powerless and now imperiled he feels, the greater his rage. …

[T]he more Trump is feeling destroyed by the indictments the more he needs to destroy Biden. Trump is a gambler and not a very effective one, given his real financial dealings from the past several decades. His current gamble is that he will be re-elected so he can pardon himself for everything and create a Justice Department to do his bidding, or that if another Republican is elected they will pardon him for fear of alienating Trump’s base.

Or if he believes he didn’t lose the 2020 election — a more likely possibility is that he can’t believe he lost to Joe Biden — he could convince himself that he isn’t paranoid, but that Biden, the Deep State and the Justice Department are truly out to get him, which would justify in his mind his attacking them before they destroy him.

I also asked Dr. Lance Dodes, a retired assistant clinical professor of psychiatry at Harvard Medical School and a training and supervising analyst emeritus at the Boston Psychoanalytic Society and Institute, for his assessment of Trump’s behavior and language. He also responded by email:

Donald Trump has always relied on primitive psychological defenses, including denial of reality, as in his long history of inventing “alternative facts” and fake news. Another of his primitive mechanisms is projection and its more severe form, “projective identification.” In the latter case, he reverses identities to claim that those opposed to him have exactly the amoral traits that define himself, for example, calling President Biden “Crooked Joe.” This dangerous capacity to project his identity onto another person, in order to shift responsibility and anger away from himself, is common in tyrants and would-be tyrants. For example, they routinely claim that truly democratic leaders are antidemocratic while they, who are actually antidemocratic,seize power for themselves to “restore democracy.”

Projective identification can be a surprisingly effective technique, since it simultaneously attacks the honest person while pretending the dishonest one is against the very things he is [himself]. This worked for Trump in 2016, and to the extent he is able to con people into thinking that he is the honorable person being victimized by bad people, he can win again.

In a recent interview with Salon, Dr. Marcel Danesi, author of the new book “Politics, Lies and Conspiracy Theories: A Cognitive Linguistic Perspective,” explained how fascists, authoritarians and demagogues use emotions and rhetoric in sophisticated ways to control their followers. I asked Danesi for his analysis of how Trump’s attacks on Biden fit into that model:

Trump’s strategy has always been to attack back when under threat, or even better to attack first. It is a major tactic of political manipulators throughout history, whereby they blame the blamer, without any proof, denying any wrongdoing and thus deflecting attention away from themselves. Just like a character from an Orwellian dystopia, he uses use words to obscure the truth, including irrelevant responses or feigning offense via denial. 

This strategy is right from the Machiavellian playbook. In “The Prince,” Machiavelli warned that any admission of wrongdoing is the death knell of the prince’s rule and loosens his mind control over people. … Trump’s current attacks on the judiciary are a calculating, Machiavellian strategy of deflection by projection — blaming others for employing his own tactics. Interestingly, in an article Orwell wrote in 1940, he pinpoints the core of this strategy, writing that the manipulator portrays himself as a martyr, a victim, the “self-sacrificing hero who fights single-handed against impossible odds.” The intent is to portray himself as fighting against an invisible enemy — the same enemy that Trump’s followers are purported to be fighting.

Trump’s strategy is not new. It has always existed. In ancient Greece, the aristocrat Cleon was elected in 424 B.C., using oratory that resonated with people … instilling a mistrust of intellectuals and even aristocrats opportunistically, despite the fact that he was an aristocrat himself. He called them liars, responsible for all the ills that were endemic to society. 

Trump’s attempt to cling on to power and avoid accountability is actually a simple one that has worked from time immemorial — blame the deep state (whatever that may be) as the enemy engaged in a takeover of the “real America.” As Machiavelli wrote in various works, never admit any wrongdoing, accuse others of the wrongdoing, and do it over and over, and the prince will enhance his chances to keep people in a mind fog. 

Donald Trump’s mental health and diseased mind are not likely to improve, given the pressures he now faces. And as goes Trump, so goes the Republican Party, the MAGA cult and the larger white right.

In total, Donald Trump’s poor mental health and aberrant behavior amount to a political, social and legal crisis for America and the world. He must be defeated at the polls and prosecuted in the courts, but even that will not be enough.

To paraphrase historian Timothy Snyder, the Trump era is America’s “collective malady.” It will take years of collective hard work, grit and determination to get better.


Chauncey DeVega is a senior politics writer for Salon. His essays can also be found at He also hosts a weekly podcast, The Chauncey DeVega Show. Chauncey can be followed on Twitter and Facebook.

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