Seemingly every day now, US President Donald Trump escalates his policy and personal attacks against other countries and their heads of state, the poor and the weak, and migrant families. Most recently, Trump has championed the heartless separation of migrant children from their parents. Though public outrage may have forced him to retreat, his disposition to attack will soon make itself felt elsewhere.
 Most pundits interpret Trump’s outbursts as playing to his political base, or preening for the cameras, or blustering for the sake of striking future deals. We take a different view. In line with many of America’s renowned mental-health experts, we believe that Trump suffers from several psychological pathologies that render him a clear and present danger to the world.

Trump shows signs of at least three dangerous traits: paranoia, lack of empathy, and sadism. Paranoia is a form of detachment from reality in which an individual perceives threats that do not exist. The paranoid individual can create dangers for others in the course of fighting against imaginary threats. Lack of empathy can derive from an individual’s preoccupation with the self and a view of others as mere tools. Harming others causes no remorse when it serves one’s own purposes. Sadism means finding pleasure in inflicting pain or humiliating others, especially those who represent a perceived threat or a reminder of one’s weaknesses.

We believe that Trump has these traits. We base our conclusion on observations of his actions, his known life history, and many reports by others, rather than as the finding of an independent psychiatric examination, which we have previously called for, and call for again. But we do not need a complete picture to recognize that Trump is already a growing danger to the world. Psychological expertise tells us that such traits tend to worsen in individuals who gain power over others.

To justify his belligerent actions, Trump lies relentlessly and remorselessly. In fact, according to a Washington Post analysis, Trump has made over 3,000 false or misleading claims since taking office. And, the Post notes, his lying seems to have escalated in recent weeks. Moreover, Trump’s confidants describe him as increasingly likely to ignore any moderating advice offered by those around him. There are no “grownups in the room” who can stop him as he surrounds himself with corrupt and bellicose cronies prepared to do his bidding -- all of which is entirely predictable from his psychology.

Trump’s wild exaggerations in recent weeks reveal the increasing severity of his symptoms. Consider, for example, his repeated claims that the vague outcome of his meeting with North Korean leader Kim Jong-un constitutes an end to the nuclear threat posed by Kim’s regime, or his blatant lie that Democrats, rather than his own policies, caused the forced separation of migrant children from their parents at the southern border with Mexico. The Post recently counted 29 false or misleading statements in a mere one-hour rally. Whether intentional or delusional, this level of persistent lying is pathological.

Since Trump actually lacks the ability to impose his will on others, his approach guarantees an endless cycle of threats, counter-threats, and escalation. He follows any tactical retreat with renewed aggression. Such is the case with the spiraling tit-for-tat trade war now underway between Trump and a widening circle of countries and economies, including Canada, Mexico, China and the European Union. The same is true of Trump’s unilateral withdrawal from a growing number of international agreements and bodies, including the Paris climate agreement, the Iran nuclear deal, and, most recently, the United Nations Human Rights Council, after it criticized US policies toward the poor.

Trump’s paranoia is translating into heightened geopolitical tensions. Traditional allies, not accustomed to dealing with US leaders with severe mental defects, are clearly shaken, while adversaries appear to be taking advantage. Many of Trump’s supporters seem to interpret his shameless lying as bold truth-telling, and pundits and foreign leaders tend to believe that his bizarre lashing out reflects a political strategy. Yet this is a misunderstanding. Trump’s actions are being “explained” as rational and even bold, whereas they more likely are manifestations of severe psychological problems.

History abounds with mentally impaired individuals who have gained vast power as would-be saviors, only to become despots who gravely damage their societies and others. Their strength of will and promises of national greatness entice a public following; but if there is one lesson of this kind of pathology in power, it is that the long-term results are inescapably catastrophic for all.

We should not remain immobilized by fear of a future disaster. A leader with dangerous signs of paranoia, lack of empathy, and sadism should not remain in the presidency, lest he commit devastating damage. Any appropriate measure to remove the danger -- the ballot box, impeachment, or invocation of the US Constitution’s 25th Amendment -- would help restore our safety.


Jeffrey D. Sachs and Bandy X. Lee
Jeffrey Sachs is Director of Columbia University’s Center for Sustainable Development. Bandy X. Lee is a forensic psychiatrist at Yale School of Medicine and a project leader for the World Health Organization.


(Project Syndicate)