Psychiatrists’ letter warning Congress of Trump’s mental unfitness for office.

The Goldwater Rule about restrictions on writing about and diagnosing public personalities has loosened considerably. The American Psychoanalytic Association does not find it unethical for its members to do so.

Two dozen members of Congress support the establishment of an 11-member Commission to assess the mental physical capacity of any president to perform his or her duties, Iff the president is deemed unfit, the individual would be removed from the Oval Office. The 25th Amendment to the Constitution adopted in 1967 provided for the establishment of such a Commission but it was never acted upon.

This is the letter warning about Trump and urging the creation of the commission. We are sending this statement to every member of the House of Representatives and every Senator because we know of your deep concern about the dangers we face, and your constitutional commitment to act upon them.

August 11, 2017

To Members of the U.S. Senate and House of Representatives:

Since Mr. Trump’s election to the presidency, a growing number of mental health professionals have come forth to warn about the dangers he poses to the United States and the world. Far from being a partisan issue, the severe emotional impediments that Mr. Trump exhibits, we believe, present a grave threat to international security. It no longer takes a psychiatrist to recognize the alarming patterns of impulsive, reckless, and narcissistic behavior – regardless of diagnosis – that, in the person of President Trump, put the world at risk. Furthermore, when imminent danger emerges, our professions’ ethical principles obligate us to place human safety above all other concerns, through our “duty to warn” and “duty to protect.” We now find ourselves in a clear and present danger, especially concerning North Korea and the president’s command of the U.S. nuclear arsenal.

We have reason to believe that Mr. Trump’s propensity for violence and war is beyond the usual of U.S. presidents. Unlike his predecessors, Mr. Trump was quick to use deadly attacks within days of his inauguration, which led to multiple civilian deaths, including women, children, and a Navy SEAL in Yemen. His widely praised strike on the Syrian military airfield allegedly resulted from an impulsive reversal of policy upon seeing a photograph of a chemical weapons attack. Mr.
Trump delighted at dropping the so-called “Mother of All Bombs” in Afghanistan. Even the important victory over ISIS in Iraq came with great controversy over the disproportionate use of brutality and disregard for civilian lives. These actions occurred alongside a broad, clear, and well-documented pattern of abusive and threatening behavior that have escalated, from verbal assaults on opponents or those who have simply offended him, to now posturing against volatile
North Korea. His heightened paranoia and isolation, recklessness and impulsivity, distortions of reality, rage reactions, and ever-present desire to show strength – burnishing his own sense of worth – are consistent with both an incapacity to make rational decisions and a potentially lethal proclivity to make dangerous ones.

History has shown that repeatedly forgoing diplomatic solutions with North Korea has accelerated its weapons programs, and accordingly, the U.S. pressure of South Korea into carrying out a joint ballistic missile drill in the neighboring sea, soon after North Korea tested its first intercontinental missile, proved to be ineffective. As mental health professionals, we know the importance of using de-escalation when individuals become belligerent or threatening. Contrary to intuition, a raft of research shows that de-escalating lessens violence, as it reduces instances of meeting threat with more threat. Meanwhile, we know that individuals who are violent are often willing go to their own deaths, or to sacrifice the lives of others, for a distorted need for respect, such that threats are ineffective. Governments and countries are not individual personalities, but these are human affairs, and similar dynamics can play out in more or less
predictable ways. The role of honor or, rather, perceived humiliation is often overlooked as a powerful stimulant of international violence, and those of us with global and cross-cultural training can attest to its particular importance in the East Asian setting.

We fear that the president may not have the capacity to consider an array of possible choices, due to his own emotional needs. The provocative threat he made, that North Korea will be “met with fire, fury, and … power the likes of which this world has never seen” is the very type of behavior we have long predicted and feared. We are deeply concerned that these responses will accelerate our course toward a devastating war.

We urge you to take our warning seriously; our knowledge and clinical experience tell us that those who should be alarmed often fail to recognize the threats confronting them. In clinical practice, there are steps that professionals take in these circumstances: we remove access to weapons and, if necessary, hospitalize the person. The equivalent for Mr. Trump involves the Constitution’s provisions for removing a president who is unable to discharge his duties. For the sake of our country and the world, we ask that the U.S. Congress take immediate steps to form a commission to determine his fitness for office.

Bandy X. Lee, M.D., M.Div.
Assistant Clinical Professor in Law and Psychiatry, Yale School of Medicine
Dee Mosbacher, M.D., Ph.D.
Assistant Clinical Professor, Department of Community Health Systems
University of California, San Francisco (2005-2013)
Nanette Gartrell, M.D.
Associate Clinical Professor of Psychiatry, University of California, San Francisco (1988-2011)
Edwin B. Fisher, Ph.D.
Professor of Health Behavior, Gillings School of Global Public Health
University of North Carolina-Chapel Hill
Lance Dodes, M.D.
Assistant Clinical Professor of Psychiatry, Harvard Medical School (retired)
Contributors to forthcoming book, The Dangerous Case of Donald Trump

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