Celia has suggested that instead of my ranting about Donald Trump and attributing a clinical diagnosis of my own invention (psychopathic narcissist) I should do the research and find out if anyone has actually made a professional psychiatric analysis of Mr Trump’s behaviour. So I have put the question out on the net. The replies are various and quite a few people has made assessments of the situation. Some of the results: (I have corrected the American spelling of some words)
“A number of psychiatrists and psychologists have publicly assessed Donald Trump’s behaviour, with many arguing he meets criteria for extreme narcissism or related disorders and others warning about antisocial or paranoid traits, while a separate cohort criticises such remote diagnosis on ethical grounds under the Goldwater Rule. The debate coalesces around a handful of prominent voices—Bandy X. Lee and contributors to The Dangerous Case of Donald Trump, John Gartner, Justin A. Frank, Allen Frances, Dan McAdams and groups behind open letters—whose conclusions range from “malignant narcissism” to cognitive decline, even as professional ethics and methodological limits are repeatedly invoked.
1. Bandy X. Lee and The Dangerous Case contributors: duty to warn and diagnoses
Forensic psychiatrist Bandy X. Lee edited The Dangerous Case of Donald Trump, a collection in which 27 psychiatrists and mental health experts argued that Trump’s public behaviour constitutes a “clear and present danger” and advanced diagnoses including malignant narcissism, narcissistic and antisocial personality traits, and paranoid features—framing their public commentary as a “duty to warn” despite prevailing norms discouraging off-site diagnosis. Lee and co-authors explicitly challenged the American Psychiatric Association’s restraint, arguing that observable, prolonged public behaviour justifies professional alarm and public statements about fitness for office
2. John Gartner, Duty to Warn, and the petitioners
Psychologist John Gartner organised petitions and advocacy arguing that Trump exhibited a “serious mental illness” rendering him unfit for office, forming groups like Duty to Warn to press for removal or at least public scrutiny; his position typifies clinicians who say sustained observation of public conduct meets DSM behavioural criteria even without direct examination. Gartner and allied clinicians have used terms such as “malignant narcissism” to describe a combination of grandiosity, deceit, and lack of empathy that they judge dangerous for a leader.
3. Large open letters and consensus claims: antisocial and malignant narcissism
In 2024 more than 200 health professionals signed an open letter declaring that Trump meets behavioural criteria consistent with antisocial personality disorder and “malignant narcissism,” citing repeated lying, recklessness, impulsivity, and lack of remorse as DSM-observable behaviours and arguing the Goldwater Rule is outdated when a public figure’s conduct is so highly documented [3]. That letter explicitly used DSM-V behavioural criteria to justify public diagnosis and positioned the signatories against the APA’s ethical prohibition on remote diagnosis.
4. Individual clinicians with deep applied analyses: Justin Frank and others
Clinicians such as Justin A. Frank and others who conducted extended applied psychoanalytic assessments concluded that Trump is psychologically unsuited for the presidency, describing him as a menace based on hundreds of hours of analysis and clinical interpretation of public material; these efforts aimed less at formal diagnostic labels than at explaining personality structure and functional danger. Psychoanalytic and clinical writers often highlight grandiosity, impulsivity, and minimal capacity for reflection as core elements of their conclusions.
5. Alternative views and ethical cautions: Allen Frances and mainstream scepticism
Prominent sceptics within psychiatry, notably Allen Frances—who chaired the DSM-IV task force—have criticised fevered public speculation, arguing that remote diagnosis is unethical, stigmatising, and methodologically unsound; Frances framed media-driven diagnoses as a misuse of psychiatric authority and urged restraint. This institutional and methodological counterpoint undergirds the APA’s longstanding Goldwater Rule and has been repeatedly cited to push back against clinicians who publicly label Trump without a personal exam.
6. Psychologists offering dimensional descriptions rather than formal diagnoses
Some psychologists, including narrative personality researchers like Dan McAdams, have stopped short of clinical diagnosis while offering dimensional portraits—stubbornness, aggression, grandiosity, present-focused thinking—that explain behaviourally observable patterns without invoking formal DSM labels, a position that signals caution while still contributing psychological interpretation to the public conversation. Family-sourced commentators such as Mary Trump have provided insider-based psychological narratives that align with clinicians’ descriptions but are not clinical assessments per se
Conclusion
The public psychological commentary about Trump clusters into two camps: clinicians and organised groups who—citing prolonged public behaviour—argue for labels like malignant narcissism, antisocial or paranoid features and warn of danger, and professional sceptics who stress the Goldwater Rule, methodological limits, and ethical restraint; both sides are visible across the sources, and many individual analysts (Bandy X. Lee and contributors, John Gartner, Justin Frank, the 200+ signatories, Allen Frances, Dan McAdams) are repeatedly named in the debate. Reporting shows consensus about certain behavioural descriptions—grandiosity, lying, need for praise, aggression—while disagreement persists about whether those descriptions legitimately constitute clinical diagnoses without direct examination.”
In addition, the very first paragraph defining ‘Narcissistic personality disorder (NPD) states:
Narcissistic personality disorder (NPD) is a complex and heterogeneous personality disorder characterised by patterns of grandiosity, entitlement, low empathy, and interpersonal difficulties, which can manifest as either grandiose ("thick-skinned") or vulnerable ("thin-skinned") forms. Grandiose individuals display arrogance, social dominance, and exploitative behaviours, while vulnerable individuals show shame, inferiority, hypersensitivity, and extreme reactions to criticism. NPD often involves impaired emotional empathy, superficial relationships, and difficulty tolerating disagreement. It is often co-morbid with other mental disorders and associated with significant functional impairment and psychosocial disability.
If ever there was a description of Donald Trump's behaviour, this is it. He is actually both thick-skinned as well as thin skinned. His reactions to any simple criticism or what he perceives as being critical is met with bombast arrogance and insult. In addition he has no sensitivity, knows no shame, eschews any idea of inferiority and does display extreme reactions to criticism. His whole demeanour is, I would suggest, a textbook case of advanced NPD.
There is a caveat imposed by the Goldwater Rule which "is the eponymous rule established by the American Psychiatric Association (APA) in Annotation 7.3 of American Medical Association's (AMA) code of ethics. Section 7 of AMA's Principles of Medical Ethics states that medical doctors have a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health. As a subsection therein, Annotation 7.3 (also known as "Goldwater rule") is addressed to psychiatrists and mandates that, when asked to comment on public figures, they shall refrain from diagnosing, which requires a personal examination and consent."
“A physician shall recognise a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.
On occasion psychiatrists are asked for an opinion about an individual who is in the light of public attention or who has disclosed information about himself/herself through public media. In such circumstances, a psychiatrist may share with the public his or her expertise about psychiatric issues in general. However, it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorisation for such a statement.”
American Psychological Association suggests: “Similar to the psychiatrists' Goldwater Rule, our code of ethics exhorts psychologists to "take precautions" that any statements they make to the media "are based on their professional knowledge, training or experience in accord with appropriate psychological literature and practice" and "do not indicate that a professional relationship has been established" with people in the public eye, including political candidates. When providing opinions of psychological characteristics, psychologists must conduct an examination "adequate to support statements or conclusions". In other words, our ethical code states that psychologists should not offer a diagnosis in the media of a living public figure they have not examined.”
Regardless of what one may think about Mr Trump’s public or private behaviour, he appears to have no filter. I suggest that anyone, with a modicum of education and simple interaction and observation of normal human activity, can see for themselves the deeply disturbing reality of Mr Trump and the reactions of those around him who bolster and feed this personification of NPD. This makes him vulnerable and in effect easy to manipulate. This is clearly indicated by the influence Mr Netanyahu and Mr Putin seem to have over him. That in itself is highly dangerous. So, it is clear in my view that the man should be sectioned. How long will that take? Will it ever happen? What is wrong with the American public to have allowed this to go on for so long?











