A Yale psychiatrist who has sounded the alarm on President Donald Trump’s mental health for years says that Mary Trump’s book warning that her uncle is too unstable to lead the country corroborates what mental health professionals have been saying since before the president took office.

Mary Trump, a clinical psychologist, wrote in her new book “Too Much and Never Enough: How My Family Created the World’s Most Dangerous Man,” that she believes her uncle suffers from multiple personality disorders.

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“I have no problem calling Donald a narcissist — he meets all nine criteria. But the label gets us only so far,” she wrote. “A case could be made that he also meets the criteria for antisocial personality disorder, which in its most severe forms is generally considered sociopathy but can also refer to chronic criminality, arrogance, and disregard for the rights of others…. Donald may also meet some of the criteria for dependent personality disorder, the hallmarks of which include an inability to make decisions or take responsibility, discomfort with being alone, and going to excessive lengths to obtain support from others.”

She went on to suggest that Trump has a “long-undiagnosed learning disability that for decades interfered with his ability to process information.”

Bandy X. Lee, a forensic psychiatrist at Yale School of Medicine and a former research fellow at the National Institute of Mental Health, told Salon that she has been warning about exactly this since Trump’s election. Lee suggested that Trump’s recent deployment of federal forces to cities like Portland and Chicago was intended to distract from questions over his mental fitness.

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“We know what Donald Trump is doing in dispatching federal forces into cities by what he did at the last election when he sent 5,600 active military troops to the southern border because of an ‘invasion’ by a migrant caravan: he is turning a non-concern into a campaign issue in order to distract from the real issues,” she said in an interview. “What are the real issues? That his expert niece just exposed that he is mentally incapable of leading and is committing mass murder — what we independently said since a year ago, based on a standardized assessment, and since a month ago, because of his mishandling of the coronavirus pandemic.”

Despite guidelines precluding mental health professionals from diagnosing patients they have not personally examined, Lee and others have sought to warn about the dangers of Trump’s mental health since the 2016 election.

Lee, the author of the textbook “Violence,” is the president of the World Mental Health Coalition, which issued a “Prescription for Survival” during Trump’s presidency earlier this year and is launching a podcast series with radio host and former California Democratic Party chair Bill Press that features many of the authors included in the book “The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President,” which Lee edited.

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Lee spoke with Salon about Mary Trump’s book, the president’s enablers, and the American Psychiatric Association’s guidelines against discussing the president’s mental health.

Mary Trump’s new book highlights many of the same concerns about Trump’s mental health that you’ve warned about for years. What did you think of her conclusions? Did anything surprise you? Is there anything you disagree with? 

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Yes, I was delighted to see this. But then she is a professional who is highly proficient at what she does, as evidenced in the scholarship and clinical soundness she applies to her reasoning. Any honest and competent mental health professional has come to the same conclusion, which is why there was an astonishing consensus from the start. 

Yet, like history repeating itself, no amount of professionalism — expertise, evidence and facts — seems to matter. We are literally dying for our inability to understand expertise. I started an interview series with my colleagues just because there has been little concept of what she was bringing, or somehow the media cannot go there. Three and a half years ago, I would not have believed this was possible, but after the biggest newspapers and cable and network stations deleted only my quotes or killed entire articles, and broadcasts canceled at the last minute almost 70 times, it would rather surprise me if public discussion were ever allowed to reach critical mass. 

Mary Trump describes her uncle as the “world’s most dangerous man.” You and other psychiatrists have made similar arguments. Why do you think these warnings have gotten so little traction among lawmakers, particularly members of the Republican Party? 

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People will not like this, but it is an indication of the poor state of mental health in our society. We would rather resort to all manner of extreme conspiracy theories, such as QAnon, to justify the unjustifiable — the continuation of a presidency that should never have been for a day — and to deny the undeniable — that a president who is supposed to protect us is killing us. Ironically, the American Psychiatric Association played a central role in enabling denial and in creating stigma around even mentioning the topic, causing us to miss a crucial opportunity before the problem spun out of control. 

In January 2018, the public and the media were listening, to the point where the president’s mental health had grown to the No. 1 topic of national conversation. Many of us were interviewing several hours a day, every day. But then the APA stepped in, grinding the discussion to a complete stop. Its influence was decisive, since I and my colleagues had met with over 50 members of Congress, and they were counting on us to educate the public so that they could act. Instead, the APA has effectively conditioned our culture into expecting not to hear from mental health experts about the mental health of the president, the most consequential public servant on whom our lives depend. 

Mental health itself had been gaining more respect as a result of decades of education, but through an aggressive misinformation campaign by the APA, on which I blew a whistle, we have been thrown back into a dark age. We are suffering the same with the novel coronavirus: what distinguished our time from the Middle Ages was science and knowledge. Removing these, we have the plagues again. 

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Do you think that the book will lead to more discussion about the president’s mental health in mainstream political circles that have largely avoided the topic? 

I hope so, and the public dearly hopes so, judging from the incessant requests that pour in for us to speak more. But the more people clamor for us, the more tightly we are censored out of the major media. For 15 years I taught students at Yale Law School representing political asylum seekers escaping autocracies, so I recognize the pattern of suppression, primarily of expertise and facts. Madeleine Albright recently repeated a phrase I often use: “Fascism is not a political ideology.” I usually add: “It is mental pathology writ large.” 

The actions of the American Psychiatric Association, the Department of Justice and the Republican Party make no sense from a scientific, legal or rational point of view. But they make perfect sense from a power-alignment perspective. The regressed psychology of the president demands this, just as any other autocrat. The next phase is, literally or figuratively, elimination of portions of the population that do not comply or remind the autocrat of reality. We have seen Donald Trump remove scientists from their positions or cut their funding, because science challenges his fantastical thinking. 

Trump has repeatedly cited his “acing” of a mental cognitive test as proof of his mental fitness. Why do you think he keeps bringing this up, particularly in the context of his attempts to paint Joe Biden as unfit? 

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He is likely frantically trying to convince himself that he is mentally fit. This is because the now-removed White House doctor, Ronny Jackson, falsely used the 10-minute cognitive screen — which has nothing to do with fitness and which researchers have found full-blown Alzheimer and hospitalized schizophrenia patients to “ace”, by the way — to declare the president “fit.” The president is resurrecting it to try to use it to the same effect, but of course he only gives himself away. We know what he thinks of himself by what he says of Joe Biden. Projection is a way of disowning what you cannot tolerate in yourself by attaching it to others, and since his case is severe, what he says almost has nothing to do with Biden but is a very accurate portrayal of himself. 

Top officials like Bill Barr and Chad Wolf have deployed federal officers to cities like Portland in response to protests. What does it mean for someone whose danger has been described by numerous mental health professionals to lead what Oregon officials have described as an invading force, particularly ahead of an election? 

Well, this is exactly what we anticipated he would do. In February, I warned that the very delayed impeachment and subsequent acquittal would powerfully inflate his delusions of grandeur and impunity, such that he was now likely to thwart the electoral process and use force to remain in office. The pandemic has accelerated this process. For this reason, I have been advising activist groups not to wait until after the election — and so there should be notices about nonviolent action sooner. If he succeeds in forcing a second term, he will likely use it purely for revenge, and I agree with Dr. Trump that our democracy and our nation as we know it will not survive.   

This interview has been lightly edited for length and clarity.