Six years and one month ago, on April 20, 2017, I convened a conference at Yale School of Medicine that unexpectedly changed my life. It was also a conference that, many tell me, helped introduce the public to terms that included “dangerous”, “Trump Contagion,” and “mental health pandemic,” in relation to Donald Trump in ways that has helped the nation understand and protect itself against the serious threats we face. Some have even suggested that, had we not spoken up at that time, Trump’s far-too-close defeat in the 2020 election may not have been realized. Whether or not this is true, it is clear that voices in mental health are critical to a correct understanding of this historical moment.
Out of the conference came a rushed proposal for the book, The Dangerous Case of Donald Trump. I and my colleagues wrote and put together that book in a record four weeks, and Macmillan published it just five months later in October 2017. When the book came out, it was to our amazement an instant New York Times bestseller, so much so that one of the Big Five publishers had not printed nearly enough books! It took them five weeks to replenish stocks in ways that they would not run out within the hour, and there were anecdotes of people driving across their states to get to the one bookstore that still had a copy. Had there been enough books at the time, we were told, we might have sold two or three times as many! A second, updated and expanded edition of this book was published in 2019.
There have been many requests for a new book, The More Dangerous Case of Donald Trump, and I have pondered over writing about the Trump Contagion, which goes far beyond Trump. What is commonly overlooked, especially in psychiatry’s rush for the next new medication, is that mental health is psychosocial. This means that psychological phenomena are not confined to individuals. Serious mental symptoms—not simply yawns or laughter—can spread even more rapidly because of the emotional drive behind them.
This is the reason I warned since the beginning that Donald Trump’s mental impairments were a public health issue, not a personal problem, and that his occupation of the U.S. presidency would be dangerous to politics, democracy, public safety, and even geopolitical stability.
Shortly following Donald Trump’s election, the American Psychological Association and then the American Psychiatric Association did studies that showed unprecedented levels and rises in stress and anxiety. And since my lifelong work has been devoted to intervening with violent perpetrators and preventing violence for society, the future course, in the absence of intervention, was predictable (and preventable).
Here is what I wrote for the instantly-accepted book proposal six years ago:
On November 8, 2016, an unprecedented psychological phenomenon happened in American history. As the result of a presidential election, millions of Americans contracted a clinically significant anxiety disorder, simultaneously. More so than about their favored candidate losing, it was about now having in control, someone who appeared to be out of control—and they were right. Among those who cheered, a significant number turned violent, and a crime surge was recorded since the morning after election. “There’s something wrong with him,” many columnists, reporters, and members of the public said of Donald Trump….
The state-corporate programs of the past thirty-five years or so have had devastating effects on the majority of the population, with stagnation, decline, and sharply enhanced inequality being the most direct outcomes. This has created insecurity and fear and has left people feeling deprived, isolated, and helpless—and thus vulnerable to powerful forces they can neither understand nor influence. The breakdown does not result in just by economic laws but by policies, the kind that serve only the rich and powerful but weaken the rest not only materially, but psychologically and spiritually.
Donald Trump is a predatory “seismograph”, sensing and appealing to those who experience the breakdown of American society—not to heal, but to exploit for the “benefit” of his own dysfunction. If allowed to remain in power, we can anticipate that he will fuel feelings of anger, fear, frustration, and despair through feigned understanding, only to create more reasons and conditions for discontent. Structural violence—or inequality—of which Trump is a product, will also give rise to behavioral violence, and we may see future rises in mortality, civil conflict, and war.
This is what my book proposal said six years ago. I followed up on many of the same themes in my book titled, Profile of a Nation: Trump’s Mind, America’s Soul, published in 2020 as the next presidential election approached. I specifically predicted that, in view of Donald Trump’s psychological impairments, he “will likely refuse to concede the results, call the election a fraud, and refuse to leave office.” Indeed, that is what came to pass, leading to his claim of electoral fraud, seeking to overturn the vote results in a number of key states, and instigating the attempted coup of January 6, 2021.
Whereas mental health experts do not predict the future, we are trained to consider patterns and evaluate the probability of harm, which is why courts, prisons, and governments regularly consult us for “dangerousness” assessments. This is a task quite apart from “diagnosing” and should not be confused with individual patient care, as the American Psychiatric Association (APA) misled the public, in an attempt to protect its federal funding. Indeed, the APA’s own code of ethics emphasizes our “responsibility to patients … as well as society.”
Whether Donald Trump will again be the Republican candidate for President, whether or not he will be elected, and what actions he will take to try to bring that about or what he will do if he does not prevail, are major questions now of considerable concern. Whatever happens, what I have come to call, “Trump Contagion,” has seriously affected the United States and beyond.
That is why I feel the imperative to write this new book. The public must better understand how societal vulnerabilities give rise to mentally-impaired leaders; how they spread their pathology, criminality, and violence when in positions of power; and—most importantly—how we can intervene. We are at a critical juncture in our species’ evolution, where our continued survival without extinction may depend on whether we can successfully examine ourselves and apply the principles that mental health professionals use first to contain danger, at societal scale.
Note to Subscribers: I invite any suggestions and ideas you may have in the “Comments” section. Thank you!
You asked for suggestions. . .
I would love to see you interviewed more widely. Here are some podcast suggestions:
The Mary Trump Show
Meidas Touch
Pod Save America
The Bulwark
Each of these reach a very large audience. I think your work is not only important, but critical, at the time. For one thing, I don't think the majority of people have read your books, heard you speak or heard of Trump contagion and your ideas of how to work with the major pickle we are currently in.
What about DeSantis? Please write about him. I think he's also a danger.