We are American psychiatrists, psychologists, and other mental health professionals who have come together at this critical time in our nation’s history.  We are petitioning the House of Representatives Judiciary Committee to include the attached statement in the official record of its proceedings with regard to the impeachment of President Donald J. Trump.

We believe there are important mental health issues that need to be understood and addressed with regard to the president, who we believe poses unique dangers to the country and the world.  Our concerns transcend politics and are brought forward in accordance with the American Psychiatric Association’s ethical guidelines for our profession “to serve society by advising and consulting with the executive, legislative, and judiciary branches of the government” (Section 7.1), as we “recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health” (Section 7).

A group of us first outlined our concerns at a conference at Yale School of Medicine in April 2017, when the majority of the public believed the president was “settling in.”  This was followed by a public-service book, The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President, which many say predicted the course of this presidency.  Thousands of others joined us to form a professional association known as the World Mental Health Coalition.

In March of this year, top experts from 13 different fields joined us at the National Press Club with the unanimous conclusion that the president was unfit from each of their perspectives.  Our mental capacity evaluation, based on a standard procedure using extensive coworkers’ and associates’ reports in Special Counsel Robert Mueller’s report, showed that the president lacked the ability to make rational decisions.  These are some of the reasons why we believe our perspective is important for the impeachment proceedings.

Attached you will find our brief statement for inclusion in your records.  A video recording as well as a transcript of their full statements can be transmitted to you upon request.  We and others are available for further consultation.

Respectfully submitted,

Bandy X. Lee, MD, MDiv

John Zinner, MD

+ 800+ mental health professional co-signatories

STATEMENT

We are among several mental health experts making ourselves available for consultation with Congress in accordance with our ethics guideline, which states: “Psychiatrists are encouraged to serve society by advising and consulting with the executive, legislative, and judiciary branches of the government.”  We are also in keeping with the Goldwater principle that encourages psychiatrists to educate the public when asked about a public figure, so that we may improve the community and better public health.  We appreciate the momentous task Congress has with the impeachment proceedings and present ourselves as recognized experts who can answer critical questions relating to mental health.  We are among thousands of mental health professionals who have felt obligated to speak up because of the exceptional psychological dangers of this presidency.  In medicine, safety supersedes all other concerns, and we are acting in accordance with our professional responsibility to society and the humanitarian goals of medicine.

We are speaking out at this time because we are convinced that, as the time of possible impeachment approaches, Donald Trump has the real potential to become ever more dangerous, a threat to the safety of our nation.  We bear in mind that Donald Trump, as President, has the unfettered authority to launch nuclear weapons at any time for any reason.  There is no formalized way of preventing this unless his order is disobeyed by the Commander of the U.S. Strategic Command, who has been given the order to launch.  Short of this calamity, there are many other dangers he can pose by the use, fueled by rage, of his assumed absolute executive authority, and by the loyalists who serve him.

There are many things we can say about the psychology of Donald Trump.  He is remarkably transparent through his Twitter stream of comments, real-time video displays and newspaper accounts, past and present, as well as testimonies of persons who know or have known him.  He has shown that his sense of worth is entirely dependent on the admiration from others, such as at the rallies of his base.  Without this external affirmation, President Trump has revealed that he feels, deep down, like a loser, a failure, weak, dumb, fat, ugly, fake, “crooked”.  We know this because these self-denigrating pictures of himself, President Trump projects onto others, whom he transforms into enemies, and compensates consciously by creating a grandiose image of himself as unique, a stable genius, entitled to special treatment, and better at everything than everyone else.

What makes Donald Trump so dangerous is the brittleness of his sense of worth.  Any slight or criticism is experienced as a humiliation and degradation.  To cope with the resultant hollow and empty feeling, he reacts with what is referred to as narcissistic rage.  He is unable to take responsibility for any error, mistake, or failing.  His default in that situation is to blame others and to attack the perceived source of his humiliation.  These attacks of narcissistic rage can be brutal and destructive.  A striking but not unusual example of his lack of caring and empathy is his policy of separating children from their parents at the Southern border.  Additionally, he has made the reckless decision to allow an attack of our Kurdish allies, against all advice, shortly after announcement of the impeachment inquiry.  These events are closely related and betray his extreme inability to tolerate any challenges against him.

We have come to the conclusion that there is an ethical obligation to warn of the danger that President Trump poses.  We believe that there is a possibility of our stumbling into a war, should, for example, the adventurous Kim Jong-un have further flights of missiles over Japan or another nuclear test.  President Trump’s need to demonstrate his strength as commander-in-chief and the praise that would come from taking strong actions could lead to a very unfortunate situation.

Impeachment is the ultimate rebuke of a president, which President Trump has intensely feared, at least since the appointment of the special counsel.  Failing to monitor or to understand the psychological aspects, or discounting them, could lead to catastrophic outcomes.  For these reasons, we implore Congress to take these danger signs seriously and to constrain his destructive impulses.  We and many others are available to give important relevant recommendations as well as to educate the public so that we can maximize our collective safety.