A clinical psychologist who specializes in treating adults with personality disorders suggested that President Donald Trump has major, untreated mental health problems that could put the nation in danger.
Leanne Watt, Ph.D., and former President George W. Bush's former chief ethics lawyer, Richard Painter, teamed up and wrote an Oct. 18 NBC News opinion article, saying that those who see telltale signs of personality disorders in the president have a duty to come forward.
"Waiting for unfitness to manifest beyond the types of observable and highly predictive behavior patterns studied by psychiatrists and psychologists is, we believe, naive," they wrote. "A president in a downward mental health spiral could destroy important global partnerships, alter centuries-old alliances and leave the United States vulnerable to terror attacks or war."
Although Watt stopped short of unofficially diagnosing Trump, the article specifically discusses the potentially dangerous combination of antisocial personality disorder and narcissistic personality disorder, which together create "impulsive, dramatic and unpredictable behavior" that "could ... compromise a president's leadership ability," explained Watt and Painter.
Watt notes that "garden-variety" narcissism is not in itself cause for concern.
"It's crucial to note that having a mental illness does not automatically disqualify a person from serving successfully as president," states the op-ed. "Indeed, as a Duke University Medical Center study estimates, up to half of the first 37 U.S. presidents displayed clinical features consistent with mental illness at some point in their lives," including Abraham Lincoln and Thomas Jefferson, who reportedly had depression and anxiety.
But Watt and Painter viewed the combination differently, noting that it can cause people to "struggle to keep calm and think clearly in high-pressure situations."
Narcissism often manifests as "an exaggerated self-importance, sensitivity to criticism, lack of empathy, a need for admiration and attention, entitlement and exploitation with a need for personal gain," said Watt, adding that antisocial symptoms include "a disregard for the rights of others," law-breaking, lying, "failure to honor financial obligations" and tendencies to seek revenge, take risks and exploit people.
Should their assessment prove correct, Painter and Watt floated the idea of invoking the 25th Amendment, which would allow Vice President Mike Pence, if backed by most Cabinet members, to temporarily or permanently take power if Trump is "unfit to govern."
But this unprecedented move is wildly unlikely, not only because it requires Trump's closest allies to side against him, but also because the Constitution forbids officials from using the rule for partisan political purposes.
As psychiatry experts Peter D. Kramer and Sally L. Satel noted in an August New York Times op-ed, the 25th Amendment, which covers temporarily debilitating events as well as more long-term ones, such as Alzheimer's disease, also allows the president the opportunity to declare recovery pending a congressional vote.
"The traits that might earn Mr. Trump a diagnosis of personality disorder were on display during the election campaign," wrote Kramer and Satel, noting that "he is governing as he campaigned" and has not since demonstrated any noticeable mental health changes.