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The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President - Updated and Expanded with New Essays (27 Psychiatrists ... Mental Health Experts Assess a President) Kindle Edition
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.
- LanguageEnglish
- PublisherThomas Dunne Books
- Publication dateMarch 19, 2019
- File size5.4 MB
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Editorial Reviews
Review
"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
About the Author
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.
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.
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.
Excerpt. © Reprinted by permission. All rights reserved.
The Dangerous Case Of Donald Trump
37 Psychiatrists And Mental Health Experts Assess A President
By Bandy X. LeeSt. Martin's Press
Copyright © 2019 Bandy X. LeeAll rights reserved.
ISBN: 978-1-250-21286-3
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,
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...)Excerpted from The Dangerous Case Of Donald Trump by Bandy X. Lee. 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.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
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- Publication date : March 19, 2019
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About the authors

Rather than rattle off my credentials, which, you can easily find on my website, I’d rather tell you the story behind why I decided to write Rethinking Narcissism. People need help– desperately. They’re lost, surrounded by empty caricatures and fear mongering when it comes to any discussions of narcissism. Unlike most writers and speakers on the subject I haven’t just been touched by narcissistic personality disorder directly—my mother struggled with it’s throughout her life, as you learn if you read my book—I’ve studied it in depth. And I’m dismayed by the confusing and misleading information that seems to have exploded onto the scene in the last decade. As a clinical psychologist with over 25 years helping people cope with variety of problems, including pathological narcissism, I know too well the kind of damage that personality disorders can wreak in people’s lives. But I also know that narcissism takes many forms, not just the loud, preening, primping, boastful version that most experts talk about. The startling truth is that many narcissists could care less about looks or fame and money and some can be extremely quiet. And if you don’t know what all dangerous narcissism has in common, then you can’t spot the real red flags. I wanted to make it easy for people to protect themselves when necessary and find hope when it’s possible. Because that’s what I needed my relationships. And that’s what I needed to help people as therapist. By researching the subject directly and drawing on my own experience, I’ve been able to provide a much clearer path to coping with and leaving destructive relationships. My greatest hope is that you find the clarity that you need to do just that. Not in months or—worse—years. But in weeks or days. And that’s why I wanted to rethink narcissism.

Prudence Gourguechon MD is a psychiatrist and psychoanalyst who writes and consults about the hidden and complex psychological forces that underlie business decisions, leadership, business relationships and personal career transitions. For 20 years she's been dedicated to transporting the powerful insights of modern psychoanalysis (which did not freeze intellectually in Freud's day!) into the everyday arenas where decisions that deeply affect modern life are being made.
After 35 years as a practicing clinician, Dr. Gourguechon now serves leaders in business and finance as an advisor who can help them make the best decisions for their companies and themselves.
She is a senior contributor for Forbes.com on leadership strategy where she writes about topics related to the intersection of psychology and business including psychological resistance to diversity and inclusion efforts, the importance of assessing leader character and cognitive ability, empathy and self-awareness as essential business skills, and the folly of assuming we are rational actors.
Dr. Gourguechon is widely recognized as an expert in human behavior and has been quoted in the New York Times, the Wall Street Journal, the Atlantic, CNN.com among many other media outlets. She has appeared as a commentator on MSNBC's The Last Word with Lawrence O'Donnell and CNN's Smerconish shows.
She is currently working on a new book entitled "Starting Older: Understanding and Making the Most of a New Life Stage" which is a roadmap for 60-somethings who need to answer the question "What do I do now?" as they face the need for career change but want and need to continue to be productive. Dr. Grouguechon argues that the concept of retirement from a generation ago is no longer relevant. And that in fact, the emergence of a new life phase is a once in a millennium occurrence. She outlines the process that individuals entering this new life phase need to go through in order to enjoy it with maximum vitality and creativity.
To contact Dr. Gourguechon, have your name added to her mailing list or get more information on her consulting services please visit www.invantageadvising.com.

Rather than rattle off my credentials, which you can easily find on my website, I’d rather tell you the story behind why I wrote Rethinking Narcissism. People need help– desperately. They’re lost, surrounded by empty caricatures and fear mongering when it comes to any discussions of narcissism. Unlike most writers and speakers on the subject I haven’t just been touched by narcissistic personality disorder directly—my mother struggled with it throughout her life, as you'll learn if you read my book—I’ve studied it in depth. And I’m dismayed by the confusing and misleading information that seems to have exploded onto the scene in the last decade. As a clinical psychologist with over 25 years helping people cope with variety of problems, including pathological narcissism, I know too well the kind of damage that personality disorders can wreak in our lives. But I also know that narcissism takes many forms, not just the loud, preening, primping, boastful version that most experts talk about. The startling truth is that many narcissists couldn't care less about looks or fame and money and some can be extremely quiet. And if you don’t know what all dangerous narcissism has in common, then you can’t spot the real red flags. I wanted to make it easy for people to protect themselves when necessary and find hope when it’s possible. Because that’s what I needed in my relationships. And that’s what I needed to help people as a therapist. By researching the subject directly and drawing on my own experience, I’ve been able to provide a much clearer path to coping with and leaving destructive relationships. My greatest hope is that you find the clarity that you need to do just that. Not in months or—worse—years. But in weeks or days. And that’s why I wanted to rethink narcissism.

Bandy X. Lee, M.D., M.Div., is a forensic and social psychiatrist and a world expert on violence who taught at Yale School of Medicine and Yale Law School for 17 years before joining the Harvard Program in Psychiatry and the Law. She earned her degrees at Yale, interned at Bellevue Medical Center, was Chief Resident at Massachusetts General Hospital, and was a Research Fellow at Harvard Medical School. She was also a Fellow of the National Institute of Mental Health. She worked in several maximum-security prisons, played a key role in initiating reforms at Rikers Island, co-founded Yale’s Violence and Health Working Group, and has led a violence prevention collaborators group for the World Health Organization. She is currently President of the World Mental Health Coalition and co-founder of the Violence Prevention Institute. She’s written more than 100 peer-reviewed articles and chapters, edited seventeen academic books, and is author of the internationally-acclaimed textbook, Violence (Wiley-Blackwell, 2019). She is also a New York Times bestselling author who has penned over 300 opinion articles for outlets such as the Guardian, the New York Times, the Boston Globe, the Independent, and Politico.
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Customers find this book important and well-written by 37 mental health professionals, providing a thorough and well-documented analysis of Trump's mental health. The book receives positive feedback for its factual content and professional approach, with one customer noting its unique structure of short essays from different perspectives. While many find it frightening and dangerous, opinions about its morality are mixed, with several customers highlighting the lack of empathy.
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Customers find the book highly readable, describing it as important and well worth reading, with one customer noting it's a must-read for those interested in our future.
"...Excellent book. People need to open their eyes and minds...." Read more
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Customers find the book tremendously insightful and informative about mental health, describing it as an important read on a critical topic.
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"...Provoking. Insightful. Critical context. I only wish it were made available for streaming on-line for free to encourage a much broader listener-ship...." Read more
Customers find the book informative, well-documented, and analytical, with one customer noting its thorough inquiry and symposium format.
"...concerning Trump's defective personality, I found this book to be very informative and professional." Read more
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"This is an excellent analysis of Donald Trump from some of the country's top health care professionals as well as those who know Trump well...." Read more
"Well documented, researched and written." Read more
Customers appreciate the writing quality of the book, noting that it is well-constructed by 37 mental health professionals, with one customer highlighting the short essay format from different perspectives.
"This book is well written, scholarly, and well referenced...." Read more
"Well written with excellent sources listed. A wish more people would have read this before they voted for Donald Trump" Read more
"Well documented, researched and written." Read more
"...of the final contents; I found all the essays to be meaningful and well-written. -- -- ORGANIZATION OF THE CONTENTS..." Read more
Customers appreciate the book's authenticity, finding it factual and convincing with excellent verifiable credentials.
"...book written by mental health professionals with excellent verifiable credentials. It is not political...." Read more
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"This book is well written, scholarly, and well referenced. It is based on facts-- as shown by Mr. Trump's own words and actions-- and not based on..." Read more
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Customers praise the book's pacing, noting its professional execution and well-organized structure from multiple viewpoints.
"A brave and brilliant piece of work by America's pre-eminent mental health experts. Everyone should read this book...." Read more
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"Excelent" Read more
Customers have mixed reactions to the scariness level of the book, with some finding it frightening and disturbing, while others appreciate its serious approach.
"Frightening but very clear about why Trump's behavior patterns create a present danger for our country...." Read more
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Customers have mixed views on the book's approach to morality, with several noting its lack of empathy, while one customer appreciates its professional courage and non-partisan reasoning.
"...their diagnosis of Trump as hedonistic, narcissistic, bullying, dehumanizing, lying, misogynistic, paranoid, racist, self-aggrandizing, entitled,..." Read more
"A brave and brilliant piece of work by America's pre-eminent mental health experts. Everyone should read this book...." Read more
"...of complex social issues, and he has not performed any notable feats of good judgment relative to practical matters...." Read more
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The Dangerous Case of Donald J Trump
Top reviews from the United States
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- Reviewed in the United States on September 3, 2025Format: PaperbackVerified PurchaseLearned a lot from this book. A good read.
- Reviewed in the United States on November 7, 2017Does the Donald Trump presidency pose a clear danger to all Americans and to the world? This book, essays by a group of mental health professionals who have studied the public pronouncements and behavior of President Trump, says yes.
-- -- BACKGROUND
The book arose out of a conference hosted by the book's author, Dr. Bandy Lee, called The Duty to Warn Conference, held on April 20, 2017 at Yale University. Dr. Bandy disagreed with the "gag order" of her professional organization, the American Psychiatric Association, against members speaking publicly about Trump's perceived mental health status. She felt the organization went beyond the "Goldwater Rule" against publicly diagnosing someone who you have not seen professionally. She felt that mental health professionals also have a responsibility to the public to speak out about what they see as behavior and traits that are dangerous in a public official and could bring considerable harm to society. In the case of a president with access to nuclear weapons, the results could be deadly for millions of people. Increasing instances of what appeared to be unstable actions and a history of bullying behavior convinced Dr. Lee to "do something" about Donald Trump. So she began arranging for the conference.
Dr. Lee found many of her colleagues agreed with her assessment of Trump as dangerous, but most, in the beginning, were reluctant to go public with their professional opinion. They feared retaliation from the Trump people or being ostracized in their profession. She states that "only two dozen physically attended the conference in an atmosphere of fear, about a hundred tuned in online, and hundreds more got in touch with me for recordings or in a show of support" when the conference was over.
When Dr. Lee got around to requesting papers for a book, she found herself swamped with submissions, and several publishers immediately wanted the book. The finished book benefits from the ultimate decision by so many to come forward with their views on Trump, and Dr. Lee's wise choice of the final contents; I found all the essays to be meaningful and well-written.
-- -- ORGANIZATION OF THE CONTENTS
The book takes on the problem of the Trump presidency in three parts:
**-- First, how these professionals see the known behavior of Trump before and after his election win,
**-- second, how mental health professionals should approach the question of whether to speak out or not, as to Trump's fitness for the office and,
**-- third, how the Trump presidency is affecting Americans, especially the majority who did not vote for him and many of whom (myself included) were appalled and frightened at the prospect of someone they consider so unqualified, uninformed and unfit for the office, besides being a person whose values and actions do not reflect America, becoming President of the United States.
-- -- WHAT THEY SAY ABOUT DONALD TRUMP
John D Gartner, in his essay (Donald Trump is: A) Bad B) Mad C) All of the Above) states:
. . . . " Donald Trump is so visibly psychologically impaired that it is obvious even to a layman that 'something is wrong with him'. "
This seemed to be the thinking of many of the writers. They felt Trump's history of selfish behavior, lying, cheating his subcontractors, lewd comments and inappropriate behavior toward women, impulsive actions and speech, vengeance and cruelty towards others, denial of readily provable facts and lack of remorse and empathy were obvious traits of the man. In their lives as mental health professionals, they recognized symptoms of a personality disorder, potentially dangerous in a president. They came to the conclusion that they indeed to have a "duty to warn."
The psychiatrists/psychologists who weighed in on exactly what's wrong with Donald Trump used a number of different labels to describe his deficiency. Authors Sword and Zimbardo called him an Extreme, Present Hedonist. This is someone who is always in the present moment without a thought to the future impact of his words or deeds. Many mentioned "narcissism," explaining different levels of this personality trait which is basically an inflated sense of one's importance coupled with selfishness and lack of empathy for others. Narcissists need constant reassurance of their greatness and feed on the adulation of an audience. Narcissism can become a diagnosis when it becomes so pronounced that professionals use the label Narcissistic Personality Disorder (NPD).
But even worse is the general label "malignant narcissist," which Erich Fromm, who first defined it in 1964, called "the quintessence of evil." Fromm was a refugee and holocaust survivor from Nazi Germany who had a lifelong obsession with "the psychology of evil." He came up with this term to describe Adolph Hitler. Many of the essay writers see the same traits in Donald Trump and label him a malignant narcissist. Others use the terms "sociopath" or "personality disorder" or "delusional disorder" or "cognitive impairment" or "severe character pathology."
Especially concerning is the label "sociopath." A sociopath is always a threat to society. This is an individual who reacts to disappointment with rage, blames others, holds delusional beliefs and is capable of criminal behavior. Sociopaths "project" their own faults onto others they attack. Consider that Trump claimed Hillary Clinton is "the most corrupt person to ever seek the presidency" when evidence coming to light every day seems to indicate that description would fit Donald Trump. He claimed SHE misused funds in the Clinton Foundation when he used funds in his OWN foundation to fund a giant portrait of himself. Donald Trump consistently accuses those he doesn't like of faults that he himself exhibits.
Do these essay writers have a point? I couldn't argue with their descriptions of Donald Trump and their contention that these kinds of personality disorders are a danger to all of us. I find other things, some not mentioned, also distressing, like Trump's inability to inspire or lift us up as other eloquent presidents have done (think Kennedy, Reagan, Obama); his inability to provide basic comfort and sympathy to families of victims of military attacks, terrorist attacks or just crazy killers; his childish and limited vocabulary that depends on repeating superlatives like "great" "tremendous" or "wonderful" and multiple use of "very" in badly-put-together sentences or non-sentences (he does not appear to be educated); his bloviated descriptions of himself as "smart" and "I know more about Isis than the generals." It is difficulty to see how voters could have failed to notice all these deficiencies.
-- -- WHAT SHOULD MENTAL HEALTH PROFESSIONALS DO?
In the section of essays on the mental health professionals' view of speaking out vs. not speaking out, one essayist tries to explain how the public could have misunderstood some of the qualities they saw in Trump and like what they perceived as his going against "political correctness" or thinking the rough comments showed he is "authentic" or "tells it like it is." But this essayist felt this heightens the need for mental health professionals to offer a personal opinion informed by their professional experience, discussing openly the malignant nature of Trump's narcissism, that he is a person who does not learn from his mistakes or grow into the office.
Another essayist writes about Trump's paranoia and compares him to totalitarian heads of state and says such people "consistently produce ideas and responses that find exaggerated danger and malevolent intention in others and in the situations he encounters." This essayist accepts the comparison with Hitler. He says Trumps has not shut down the free press and killed his opponents because he cannot get away with it in our democracy. Mental health professionals need to point this out. This essayist writes:
. . . . " While it is true that the restraints operating in our country have prevented Trump from moving as swiftly as Hitler did, this can be attributed to the balance of powers and the greater strength of our democratic traditions rather than to any sense that Trump's patterns of emotional thinking are greatly different from those that motivated Hitler. "
Another one of the essayists tried to bring the discussion away from mental health diagnoses or labels and simply look at Trump's dangerous tendencies. Do you want a president who had to ask "If we have nuclear weapons, why can't we use them?" Or, one that advocates using torture on our enemies? Or one who maintains an insidious lie even when the lie is exposed? (Obama's birthplace, the Central Park jogger case, etc.) One who encourages his supporters to punch and beat protesters? One who believes he can get away with anything? ("I could stand in the middle of 5th Ave and shoot someone and I wouldn't lose any support.") Think about it!
Another essayist affirms the negative response by large numbers of Americans and even people in other nations to the election of Donald Trump. The Women's March on Washington following the election was the largest protest gathering in the history of the United States. There were marches all around the country and in some foreign countries protesting the choice of Trump as president. This writer also makes the following observation:
. . . . " Unable to tolerate criticism and perceived threats to his ego, and with a documented obsessive need to be admired, he (Trump) has notably selected as his advisors either family members or people who, in clinical jargon,' enable' his illness. "
-- -- TRUMP'S EFFECT ON AMERICA
The last section of the book is essays dealing with how America reacted to the election of Donald Trump. With all the polls showing Clinton had a sizable lead, few people thought Trump would be our president. And yet, it happened.
I know I felt total despair and disbelief on election night 2016. The next morning, after a restless night of worry, I wrote in an email to my family members "... the sun still rose this morning ... " I could hardly believe the world was still intact after such a devastating event. I did not know how I, or we as a nation, would or could go on with a man who is a pathological liar, who treats women like disposable objects, who bullies his way through life, disregarding the rights and feelings of others, who cheats on his wives, avoids paying taxes, cheats employees and people attracted to his phony Trump University, who couldn't make money running a casino but claims to be a big business success, who advocates torture, who threatens his opponents with jail and even murder, who appears to not understand how our government works and who, along with his sons, has expressed total contempt for the US government, who admires the tyrants of the world like Putin, Erdogan, and Duterte... HOW such a man could become our president??? How could ANYONE have voted for this man?
These final essays show me that I was not alone in responding with gloom and despair to the election. These therapists saw a lot of patients suffering from trauma after the election. Trump will continue to claim that our opposition to him is just us not liking that we lost. But this level of alarm and despair at the outcome goes beyond that. Yes, I voted for Hillary Clinton, but my vote was more about not wanting Trump than it was about wanting Clinton. Following the election, there was a wave of hate crimes as bigots and bullies (even school children) felt empowered to publicly insult and threaten those "others" they didn't like, immigrant communities were seized with fear and alt-right propagandists ramped up their anti-minority rhetoric. It felt like an attack on our country, a country of diversity held together by shared American values. At least it was, until we elected Donald Trump President of the United States.
I was left full of anger, at the unexpected result and at all those people who voted for Trump. And I actually knew some people who DID vote for him. They seemed to have bought into some of what Trump said and that, combined with their not liking Clinton, accounts for their vote. Some Trump votes were reluctant votes (they would have liked a better choice of candidates) and no doubt some who voted for him must have regrets. But I think the reason he won is complicated and cannot be reduced to the standard "a bunch of disaffected old white men who lost their factory or coal mine jobs voted for him." That is too simple an explanation and goes against the actual findings of who his voters were. Many were employed at good jobs with above-average income. We have to admit that Trump's despicable qualities actually look good to some people. Maybe some people would like to be as rich and powerful as he is and don't mind that he is contemptuous of our system of government and threatens anyone who disagrees with him. Perhaps they would be ok with an authoritarian government led by a tyrant who can issue orders that go unquestioned. Have we created a lot of citizens with vapid materialistic goals, no conscience and a lack of understanding of basic American values as expressed in the Bill of Rights and inherent in our three-branch government system (judicial, legislative, executive) ?
One essayist comments:
. . . ." Is Trump the end product of our culture of narcissism? Is he what we get and deserve because he epitomizes the god or gods we currently worship in our mindless, consumerist, hyperindulgent cult of continuous stimulation and entertainment? "
The same essayist compares the Trump victory to words from George Orwell's futurist book, 1984, which says the people in Orwell's frightening vision of an authoritarian takeover could be "made to accept the most flagrant violations of reality..." That is what Donald Trump is intent on doing to all of us.
In my own case, as the year moved forward and I tried to adjust, I found myself getting physically ill. I spent most of the month of June in the hospital with a life-threatening condition. I came to believe that my anger at having to live in a world where Donald Trump is President of the United States had caused my illness. If I wanted to go on with my life, I had to get my anger under control and begin to believe that this too shall pass. History is cyclical and we have had bad times before (how would it have been to live during the Civil War, for example?) and have come through them. The outpouring of resistance to the Trump agenda (the Women's March happened right after the election, an immediate incredibly strong reaction) is encouraging and the inability he has shown to actually accomplish anything has limited the damage. Our democratic processes have worked, as the judicial branches have shot down his more outrageous executive orders and, even as I write this, Special Prosecutor Robert Mueller is turning up evidence of ties between people in Trump's orbit and Russian oligarchs tied to Vladimir Putin. There is a real possibility that Trump will not be able to finish out his term of office.
The statements of the professionals in this book are another helpful development. While they were slow and cautious about speaking out, their voices matter and we the public should heed their warnings.
I'll end this too-long review with these words from essayist Howard Covitz:
. . . ." He (Trump) displays all the signs of a seriously personality-disordered person and has repeatedly spoken of using violence. And the outcome? The outcome, if he is indeed as ill as some sizable portion of the mental health community suspects, could well be potentially devastating to a significant percentage of humanity. "
- Reviewed in the United States on July 21, 2025Format: PaperbackVerified PurchaseDue to a special interest in the mental health field, I was particularly interested once I learned of this book, which was timed for Donald Trump's first term. Reading it during his second, what becomes apparent is how much it still applies and even more so now.
The book is a series of articles or essays by prominent psychiatry and mental health professionals, each of whom takes a well-considered and detailed stand on whether the Goldwater Rule is doing more harm than good in the age of Trump.
What especially got my attention was the chilling chapter on nuclear weaponry under this administration.
Bill Moyers observed a few years ago that "There could not be a book more urgent, important, or controversial" ... for me there's no question as to the urgency or importance.
- Reviewed in the United States on October 20, 2024Format: KindleVerified PurchaseIn reading this book I expected that the focus would be on former President Trump. But that’s not the whole story. While Trump is the main subject of a lot of the essays, this book goes beyond that.
On the negative side I will admit that the first part of the book was a labor to read. Very dry.
Once I got past the early section of the book I found a lot of both interesting and educational material on psychiatry in general.
+There was a plethora of material and diverse opinions on the “Goldwater Rule”. It was both a history lesson and really sensible arguments against it.
+Another topic that I found valuable was the 25th Amendment, what it is, its origin, potential “almost” use in the past, and possible future modifications.
My two favorite essays were:
“Cognitive Impairment, Dementia, And The POTUS” and “The Charismatic Leader - Follower Relationship And Trump’s Base.”
To sum it up, this book was written during Trump’s presidency but it has a lot of psychiatric information that is understandable and is beneficial to know in general. I suggest that any curious voter read the book before the upcoming presidential election. It is as relevant and important today as when it was originally published.
Top reviews from other countries
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JohnReviewed in Italy on January 9, 20185.0 out of 5 stars Necessario
Una lettura molto interessante, scorrevole pur per i "comuni mortali" che di psicologia non ne sapevano un'H. Ottima rilegatura, consegna rapida come sempre.
GGreaderReviewed in the United Kingdom on September 22, 20245.0 out of 5 stars Well worth a read, even if you are a Trump fan
Format: KindleVerified PurchasePsychology is interesting, read it with an open mind
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KarinReviewed in Germany on April 23, 20185.0 out of 5 stars Dringend müssten jetzt Maßnahmen ergriffen werden, sonst gibt es in Kürze den nächsten Irren-Krieg
Es ist natürlich etwas ganz anderes, ob man als Küchenpsychologe ein mehr als ungutes Gefühl hat, was die psychische Verfassung dieses Präsidenten angeht oder ob eine Anzahl angesehener Fachleute ihre Ansichten und Berwertungen dazu formulieren. Die Autoren beleuchten das Thema aus jeweils unterschiedlichem Blickwinkel und ich muss sagen, ich habe diese Essaysammlung mit großem Interesse verschlungen. Ich finde das Buch liefert hoschspannende Gedanken zu Weltpolitik und Machtstrukturen auf der einen Seite wie auch ganz allgemeine Erklärungen zu psychischen Prozessen auf der anderen. Sehr lesenswert.
Alain LeclercReviewed in Canada on December 27, 20235.0 out of 5 stars consciousness
a great book with truth by great writers
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Amazon CustomerReviewed in France on October 13, 20223.0 out of 5 stars Moyen, très moyen !
Format: HardcoverVerified PurchaseHistoire totalement irréaliste... Pour ne pas dire abracadabrante. Cher et en plus truffé de fautes d'orthographe. Effarant. Les correcteurs de métier (dont je fais partie) n'existent donc pas pour l'auteur ? Quant à la mise en forme, elle est des plus bizarres...
Tout est à revoir... Ou alors il vaudrait peut-être mieux que l'auteur abandonne l'écriture ?





