How Should We Talk About Donald Trump’s Brain?

How Should We Talk About Donald Trump’s Brain?

How Should We Talk About Donald Trump’s Brain?

The drive to pathologize Trump isn’t going away, and neither, alas, is he.


There’s nothing wrong with the 25th Amendment. It’s a tool intended to handle the orderly transition of power when it’s universally acknowledged that the chief executive of the United States is unable to fulfill his or her duties. There might be all kinds of things wrong with Donald Trump’s mental faculties, but, with apparently unwavering Republican support for the president, the 25th Amendment will not help us respond to the White House’s current occupant. It won’t stave off nuclear hellfire. It won’t even stop Trump from tweeting.

Over the past two years, pundits, politicians, mental health professionals, and countless folks on social media have weighed in with their thoughts about Donald Trump’s brain. While it’s possible that he is experiencing age-related cognitive change (humans, after all, do that as they age), he’s also the same racist, sexist, abusive liar that he’s been throughout his life. When people casually speculate about a pathological basis for his disgusting behaviors, they have zero impact on him or his presidency. They do, however, spread the stigmatizing idea that mental illness causes objectionable behavior. It’s a stigma that people who identify as mentally ill know all too well. It leads to closeting, shame, lack of care, and self-harm.  

Perhaps in response to the pushback to the casual use of mental-health stigma against Trump, even people eager to call Trump crazy are moving away from armchair diagnoses. Most recently, 13 mental-health professionals, all extraordinarily qualified, have joined with Brave New Films to assert the need in a new short film for a formal assessment of Trump’s mental function. The experts calmly state that in the face of the presidential power to start a nuclear war, we need a board of experts to assess whether Trump is fit to perform the duties of the presidency. They do not, of course, explore whether the very existence of a nuclear arsenal capable of destroying all life on Earth is a post-rational fact that no human could competently handle.

The new film picks up on a general shift in our conversations around the president’s brain. In early 2018, Trump reportedly “aced” the Montreal Cognitive Assessment, as reported by his doctor. It’s a fairly simple test that establishes a useful baseline for certain kinds of overt cognitive change—I have close members of my family who can no longer pass it, I’m sad to say. I like to think that a president who couldn’t pass would eventually generate sufficient press coverage and concern among his or her staff to invoke the 25th Amendment as an appropriate intervention. But merely erratic and detestable conduct, even with diminishing vocabulary and incoherent phrasing, won’t shake Trump’s grip on power. The GOP, as evidenced by their support at the State of the Union, has made that clear.

In response to the news about the test, despite Trump’s risible “very stable genius” tweet, the discussions about presidential mental health have taken a new turn. Journalists and mental health professionals are no longer calling Trump crazy; instead, they are calling for non-partisan, formal, and transparent mental-health assessments to become a standard part of presidential vetting. The New York Times editorial board, in a piece that ultimately suggests the best response to Trump is politics (something I’ve argued as well), writes, “In the future, it would be a good idea if presidential candidates voluntarily submitted to a mental health evaluation.” Margaret Sullivan, in The Washington Post, warns about shattering norms (i.e casually diagnosing Trump from afar), writing, “When norms are shattered, they stay that way, like so many Pandora’s boxes with their lids wide open for all time.” In The Atlantic, James Hamblin agrees that identifying mental illness without talking to a person is an exercise fraught with bias and unprofessional conduct. But we need to do something, he argues: “The idea that the president should not be diagnosed from afar only underscores the point that the president needs to be evaluated up close.” He picks up the idea of a “presidential fitness committee,” which first got attention after President Ronald Reagan’s diagnosis of Alzheimer’s went public, writing, “It could regularly assess the president’s neurologic status and give a battery of cognitive tests to assess judgment, recall, decision-making, attention—the sorts of tests that might help a school system assess whether a child is suited to a particular grade level or classroom—and make the results available.” The recent Brave New Film production reaffirms Hamblin’s sense that we must do something about measuring presidential mental fitness.

From a disability rights perspective, this kind of suggestion is a vast improvement on casual stigmatizing, though still concerning. Formal assessments of “fitness” are laden with normative assumptions about how brains work, something which has long disadvantaged people with neurological differences. Still, it would be good to include medical transparency as part of a wide-reaching effort to re-establish norms in a post-Trump era someday. I’m much more concerned about emoluments and corruption than Trump’s mental health, but I’m in favor of mandating certain kinds of disclosures for future presidential candidates. Norms, it seems, no longer hold. We’re going to need rules.

But then what? What happens when someone with bipolar disorder, schizophrenia, depression, anxiety, or any number of other neurological conditions runs for president? We witnessed in 2016 the constant barrage of right-wing attacks on Clinton’s physical and mental health, vicious in both frequency and ableism (and sexist ageism, since Trump, older and in worse shape, was allowed a freer pass). If we’re to push for a mental-fitness examination, we can’t allow “fitness” to consist of “no diagnosable conditions.” Instead, these efforts to assess Trump’s brain should be re-positioned to support the idea that people with disabilities can do everything non-disabled people can, given appropriate supports.

Best of all, the 25th Amendment actually supports the notion that people with psychiatric disabilities can be president (as first pointed out to me by philosopher and writer Elizabeth Picciuto). The document instructs on procedure in cases when the president “is unable to discharge the powers and duties of his office.” That’s a functional description, not a pathological one. It fully allows for a president to require both appropriate supports and reasonable accommodations to do their job. What’s more, it’s in line with what we know about history. Many presidents have, to the best of our powers of retrospective diagnosis, had conditions such as depression, anxiety, and alcoholism. Left unsupported, as is true with non-presidents, these conditions can lead to problems, but that’s a social and cultural problem, not a medical one.

The Brave New Films video shows that the drive to pathologize Donald Trump isn’t going away, but neither, alas, is he. Trump’s vice president, Cabinet, and party are sticking with him until the end. So let’s use this moment as an occasion to talk about mental health and supports. The problem isn’t the 25th Amendment and how it’s written, but us, and how we might put these tools to use. We don’t resist Trump or Trumpism by embracing ableist conceptions of normal.

Dear reader,

I hope you enjoyed the article you just read. It’s just one of the many deeply-reported and boundary-pushing stories we publish everyday at The Nation. In a time of continued erosion of our fundamental rights and urgent global struggles for peace, independent journalism is now more vital than ever.

As a Nation reader, you are likely an engaged progressive who is passionate about bold ideas. I know I can count on you to help sustain our mission-driven journalism.

This month, we’re kicking off an ambitious Summer Fundraising Campaign with the goal of raising $15,000. With your support, we can continue to produce the hard-hitting journalism you rely on to cut through the noise of conservative, corporate media. Please, donate today.

A better world is out there—and we need your support to reach it.


Katrina vanden Heuvel
Editorial Director and Publisher, The Nation

Ad Policy