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  • Writer's pictureDr. Bandy Lee, M.D., M.Div.

Trump’s Mental Unhealth – Chapter 5: Elections Alone Won’t Help if We Do Not Name the Problem

If you haven't already, check out Chapter 1, Chapter 2, Chapter 3, and Chapter 4 of Dr. Bandy Lee's 'Trump's Mental Unhealth' column.


Imagine this, as it could be the stuff of Star Wars: An alien being finds himself among humans, and his special power is to be able to harness the side of human minds to make them willingly, or at least obligingly, collude with him as he takes over the Earth. Not all humans recognize his destructive intents, but those who do, no matter what they try, he uses their systems against them, despite his unfamiliarity with those systems. Humans devise ever ingenious ways to try to drive him out, but, having control of their minds, the alien uses their methods against them….

This is not science fiction, but a common situation where the “alien being” is not a being but a certain kind of sickness, well known to mental health specialists. Neuroscientists estimate that 98 percent of mental activity is unconscious. In healthy individuals, the unconscious part of the mind is aligned with the conscious, high-functioning part. This is the part that people consider their whole mind, which sets goals, makes complex plans, and abides by principle. When that high-functioning part is impaired or damaged, however, the subconscious may take charge in destructive and “primitive” ways. Aware of vastly more than any conscious mind can ever take in, it can be highly efficient, and would take over the world if necessary in its own view, for “self-preservation.”

There are two major steps to solving any problem: (a) naming the problem; and (b) finding a solution that meets the problem. When there is a problem of mental health, because it affects the mind, nine-tenths of the solution is naming of the problem, or “insight”. If a person has insight, it will be the key to the person’s seeking help, following through with treatment, and finding recovery. If the person becomes too compromised to recognize that anything is wrong—indeed, fights every chance at awareness, perhaps going as far as to call oneself an “extremely stable genius”—then insight may need to come from without.

It is said that the definition of insanity is doing the same thing over and over again and expecting a different result. A deeper level of insanity would be doing the same thing over and over again, expecting the same result, and finding nothing wrong with the result. This might include finding nothing wrong after 175,000 deaths, and “changing” only by doubling down on maladaptive ways.

Specialists tell apart disease from healthy choices not by asking the person but through observation of patterns. It presents remarkably similarly across individuals, systems, and societies. To paraphrase Leo Tolstoy, diseased personalities (or cultures) are all alike; every healthy personality (or culture) suffers, rejoices, and ponders in its own way. When a president was presenting himself as a very special personality, experts could have indicated that it was a pathological personality, very common and stereotypical. When everyone mistook him for having brilliant strategies, experts would have been able to warn that it was rather uncontained pathology, taking over not only his mind but those of his followers.

But how has an advanced society such as the United States, with the greatest repository of the world’s most renowned mental health experts, fallen into such a state? It is a condemnation on our society that national emergencies—be it of mental health or of infectious disease—cannot be dealt with through expertise. We have seen how impeachment, a special counsel’s investigations, talks of the 25th Amendment, or any other political process that has excluded mental health expertise has failed, no matter the evidence, facts, and superior argument. As long as we: (a) refuse to name the problem; and (b) refuse to find the right solution that may involve appropriate specialists, we will forever run in circles.

Psycho-terrorism is worse than bioterrorism, for it can be used as a weapon that victims cannot even recognize, if not actually assist it. Chaos, confusion, and collusion result, no matter what one tries, for mental pathology takes over the mind. This is why identifying for the public what it is, what is the usual course, and what are the correct interventions was crucial. Dealing with the feats people go to, not to face the problem afflicting them, is exactly what mental health experts do on a daily basis. We recognize the critical importance of prevention. We also recognize what a serious state we are now in: will Donald Trump prepare several “October surprises,” rather blow up the world, than face the fact that he is a failure, a “loser”? You can almost be certain he would—and I believe, belatedly, people are beginning to recognize this reality.

Mary Trump quotes Victor Hugo in her book: “If the soul is left in darkness, sins will be committed. The guilty one is not he who commits the sin, but the one who causes the darkness.” Dr. Trump may have been referring to literal crimes, or the corruption and enabling that have allowed the president to get away with perhaps an encyclopedia of crimes.

But the greater concern is “collusion” with the president’s mental disturbances. This is why, when the American Psychiatric Association (APA), which should have known better, instituted with the Trump presidency a new interpretation of “the Goldwater rule” to create a gag order, it was an ominous signal to many of us. This was the impetus for my dropping everything and speaking up, for which many have called me a whistleblower. We foresaw that this act would descend the American population into darkness—and by protecting power instead of public health, the APA would play a direct role in the public’s victimization, by depriving society of the one thing that could empower it: insight.

“The Goldwater rule,” whose stated purpose is to improve public health, is not supposed to protect a political figure at the expense of public health. Yet, it was used publicly to attack and intimidate professionals into silence, blocking them from the media and creating a chilling effect on anyone who would dare speak up. That the APA never disciplined any members through its official channels—but rather publicly imposed a voluntary guild rule on the entire mental health profession, 94 percent of which does not belong to the APA—is very telling. Perhaps then its conflict with the First Amendment would have come to light, since no state licensing board is permitted to adopt this “rule”.

Debate is needed for the public to hear the arguments, to have access to important information, and to develop a critical consciousness for itself. With regard to the dangerousness of the president, there has always been a medical consensus. Hence, for there to be a solution, or to name the problem in the first place, perhaps we need to heed the late Supreme Court Justice Louis Brandeis’ advice: “Sunlight is ... the best of disinfectants.”

About the contributor:

Dr. Bandy Lee, M.D., M.Div., is a forensic psychiatrist at Yale School of Medicine for 17 years who taught at Yale Law School 15 of those years, was a research fellow at the National Institute of Mental Health, and a consultant with the World Health Organization since 2002. She is author of the textbook, Violence (Wiley-Blackwell, 2019) and editor of The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President (Macmillan, 2017 and 2019). She is also president of the World Mental Health Coalition, which has issued a “Prescription for Survival: Refill,” and has launched her own web site,, which features an interview with Dr. Mary Trump. For donations to her organization, a tax-deductible 501(c)3, please go here.

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