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Duty to Warn: Psychiatrists and Mental Health Experts Assess the “Dangerous Case” of President Trump

StoryJanuary 01, 2018
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We revisit our interview with someone who’s led a discussion of mental health professionals who are deeply concerned about President Trump’s psychological instability. Dr. Bandy Lee is a forensic psychiatrist on the faculty of Yale School of Medicine who organized the “Duty to Warn” conference at Yale and edited the best-selling book, “The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President.”

Dr. Bandy Lee declares that she is not representing the views of Yale University, Yale School of Medicine or Yale Department of Psychiatry.

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This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: This is Democracy Now!, democracynow.org, The War and Peace Report. I’m Amy Goodman. We end today’s Democracy Now! special by looking at President Trump’s mental health and a growing movement among mental health professionals called “duty to warn.” Last month, President Trump slurred his speech and mispronounced his words during an address on Israel.

PRESIDENT DONALD TRUMP: Let us rethink old assumptions and open our hearts and minds to possible and possibilities. And finally, I ask the leaders of the region, political and religious, Israeli and Palestinian, Jewish and Christian and Muslim, to join us in the noble quest for lasting peace. Thank you. God bless you. God bless Israel. God bless the Palestinians. And God bless the United States. Thank you very much.

AMY GOODMAN: White House Press Secretary Sarah Huckabee Sanders responded to questions about Trump’s slurred speech by announcing he had scheduled a physical health exam.

PRESS SECRETARY SARAH HUCKABEE SANDERS: The president’s throat was dry. Nothing more than that. He does have a physical scheduled for the first part of next year, the full physical that most presidents go through, that will take place at Walter Reed. And those records will be released by the doctor following that taking place.

AMY GOODMAN: Meanwhile, New York Times’ chief White House reporter Maggie Haberman commented on Trump’s behavior when she was interviewed on CNN last month.

MAGGIE HABERMAN: Something is unleashed with him lately. I don’t know what is causing it. I don’t know how to describe it. It may be pressure from—

ALISYN CAMEROTA: Oh, you see a difference in the past what? Days? Weeks?

MAGGIE HABERMAN: I think the last couple of days’ tweets have been—


MAGGIE HABERMAN: —markedly accelerated in terms of seeming a little unmoored.

AMY GOODMAN: This all comes as Pentagon leaders told a Senate panel they would ignore any unlawful order by the president to launch a nuclear strike. The testimony came as part of the first congressional hearings in more than 40 years on the president’s authority to start a nuclear war.

Well, last month, I sat down with Yale psychiatrist Dr. Bandy Lee to talk with her about President Trump’s mental health and the growing movement of mental health experts called “duty to warn.” Dr. Bandy Lee is a forensic psychiatrist on the faculty of Yale School of Medicine, an internationally recognized expert on violence. She edited the book The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. The book became a best-seller when it was published in October. I began by asking her about her concerns about President Trump’s mental health.

DR. BANDY LEE: It’s actually historically unprecedented that so many mental health professionals have come forth with their concerns, under any president, of any party. So it really is the first time that this many mental health professionals are coming together in a coalition. We even have a website now, DangerousCase.org, where the public and lawmakers can discourse with us. There are thousands of us at this point.

AMY GOODMAN: So talk about—lay out what your concerns are as a psychiatrist.

DR. BANDY LEE: So, our concerns are that someone with this level of mental instability and impairment has this much power, in the office of the presidency—basically, the power to start a devastating war, to launch nuclear missiles, without any inhibition. You saw from the hearings that there is very little inhibition in place right now. Within five minutes of the commander-in-chief’s orders, nuclear missiles could be launched without question. And—

AMY GOODMAN: And how does that relate to his mental fitness?

DR. BANDY LEE: And, of course, his decision-making capacity, having such levels of impulsivity, having a loose grip on reality and being so fragile in his ability to cope with ordinary stresses, such as basic criticisms or unflattering news, will tend to unravel, especially in times of heightened stress, such as under the special counsel’s investigations.

AMY GOODMAN: Just last week, Tony Schwartz, author of—well, co-author of Trump’s book, The Art of the Deal, told MSNBC’s Ari Melber that the president’s inner circle is worried about his mental state.

TONY SCHWARTZ: I know that two different people from the White House, or at least saying they were from the White House, and that turned out to be a White House number, have called somebody I know in the last several weeks to say, “We are deeply concerned about his mental health.” That’s—

ARI MELBER: Wait a minute. You’re saying you have knowledge of people calling from a White House line raising that question. Why would they do that? How do you know that?

TONY SCHWARTZ: I know that because I know the person that they called. And this is a person who I absolutely trust, who has great integrity.

AMY GOODMAN: So, that was Tony Schwartz, who I think ghostwrote the book The Art of the Deal, very close to Trump for a period of time. What are your thoughts about what he said?

DR. BANDY LEE: Well, as you know, he has a chapter in the book, even though he’s not counted among the 27 experts. We do have three others who have been included for their special insight, their special experience with Mr. Trump. And we included him because he has special insight into these matters. And I would agree with his assessment. We speak often. We share our observations. And we’re both deeply concerned.

AMY GOODMAN: The chapter that Tony Schwartz wrote in your book, “I wrote The Art of the Deal with Donald Trump. His self-sabotage is rooted in his past.” Explain his point here.

DR. BANDY LEE: Well, there’s actually a lot that’s outlined. It’s a reprint of an article that he wrote, I believe for The New Yorker. He outlines very much his interactions and experiences with the president. And he describes, most markedly, this emptiness, this—what he calls a black hole level of self-esteem or self-worth that is missing, whereby he can have all the admiration of the world, all of the successes, and he will—his thirst will never be quenched, because of that intense need. And that is what we’re seeing, over and over.

And what is most concerning for us is that his way of coping with this critical sense of need at every moment, so much, to the point where he cannot think of the past or the future or consequences, his main urgency is to quench the need at the moment. And the way he does this is by burnishing his power, by going to belligerent language or affirming conflicts and others’ sense of the world as a threatening place where you have to be violent.

AMY GOODMAN: This is Republican Senator Lindsey Graham of South Carolina speaking about, well, then-candidate Donald Trump. This was back in 2016.

SEN. LINDSEY GRAHAM: I’m not going to try to get into the mind of Donald Trump, because I don’t think there’s a whole lot of space there. I think he’s a kook. I think he’s crazy. I think he’s unfit for office.

AMY GOODMAN: So that was Graham in 2016. But Senator Graham sounded different last month, when he spoke to CNN.

SEN. LINDSEY GRAHAM: You know, what concerns me about the American press is this endless, endless attempt to label the guy as some kind of kook, not fit to be president.

AMY GOODMAN: So, that is Senator Graham now. What about what he’s saying?

DR. BANDY LEE: I think the laypersons, the public or lawmakers, would be prone to underestimating the dangers of this president, because most people are used to seeing individuals who are healthy. It’s only professionals who see those who are impaired, day in and day out. And so, the natural tendency will be to interpret what they’re seeing in terms of a normal range, a normal variation of human choices, decision making and behavior. What we are—what we feel pressed to do is to warn about the situation where someone is not acting within normal range, where one is normalizing what is in fact a malignancy in one’s interpretation of reality.

AMY GOODMAN: On Wednesday, the House voted not to impeach President Trump. The vote failed 364 to 58, with all Republicans voting against the measure. The Democratic leadership also came out against the impeachment vote. The measure was introduced by Congressmember Al Green of Houston, who said on the House floor, “Donald John Trump, by causing such harm to the society of the United States, is unfit to be president and warrants impeachment, trial and removal from office.” And then, in April, Maryland Congressmember Jamie Raskin introduced a bill that would create a commission to determine if the president is mentally or physically unfit for office. This is Congressman Raskin, also professor of constitutional law, explaining how the bill is based on the 25th Amendment.

REP. JAMIE RASKIN: Section 4 of the 25th Amendment says that the vice president of the United States can act with a majority of the Cabinet to determine that there’s a presidential incapacity, or the vice president can act with a majority of any body to be set up—and Congress never set up the body that’s called for in the 25th Amendment. So this is us essentially following through on our constitutional obligation to set up a body in the event of a presidential disability. And that’s something that would be determined by the body, but, of course, only with the vice president of the United States. So, we’re talking about a body that is nonpartisan, that’s independent and that acts with the vice president, who, of course, is reporting directly to the president. So it would be in the most extreme cases where there’s a consensus that’s developed the president is incapable of discharging the duties of office.

AMY GOODMAN: So, that is Congressman Jamie Raskin. You just came from Capitol Hill, where you’re talking to—


AMY GOODMAN: —Democratic and Republican congressmembers. What about this?

DR. BANDY LEE: Senator—or Representative Raskin was one of the members that I got to meet, but, unfortunately, he was called to vote, so we didn’t get to talk much. He definitely wishes to follow up. And we, among ourselves, have also been advocating for an expert panel, that would be separate and independent and appointed by the National Academy of Medicine, so, in fact, we could work on figuring out what the solution might be for us to be able to form an independent panel that can give recommendations that he could receive through a commission.

AMY GOODMAN: Let me ask you about this unusual article I just read that’s sort of going all over the internet, “Could Trump’s Hair Drug Threaten His Physical and Mental Health?” And it said—this is from months ago—”This week, President Trump’s doctor disclosed that the president takes finasteride, a drug marketed as Propecia, to treat male pattern baldness. While it is tempting to make jokes about Trump’s hair, and even the sexual side effects that accompany the drug, it also has many disturbing side effects that neither the president—nor any other man—should risk.

“In the 19 years since Propecia was approved to treat hair loss from male pattern baldness, side effects have been so concerning that the term post-finasteride syndrome (PFS) has been coined and hundreds of lawsuits have been brought. In addition to its sexual side effects, the drug’s effects on cognition, mood and mental states have been documented in the scientific literature.

“A 2013 study in Journal of Sexual Medicine noted 'changes related to the urogenital system in terms of semen quality and decreased ejaculate volume, reduction in penis size, penile curvature or reduced sensation, fewer spontaneous erections, decreased testicular size, testicular pain, and prostatitis.' [unquote] Many subjects also noted a 'disconnection between the mental and physical aspects of sexual function,' and changes in mental abilities, sleeping patterns, and/or depressive symptoms.”

Do you think this is relevant?

DR. BANDY LEE: Most definitely. Mental function is not separate from physical function, and many medications have profound effects on the mind’s capacity. And so, this is one of the reasons why an evaluation would be so critical, because mental impairment can be just as debilitating as physical impairment, and the both are connected. So, to have all the medical records, as well as to be able to get a list of medications and to do a medical exam, would be essential to doing a mental health exam.

AMY GOODMAN: That was Dr. Bandy Lee, on the faculty of the Yale School of Medicine, an internationally recognized expert on violence, a forensic psychiatrist. She edited the book The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. The book became a best-seller when it was published in October.

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