B X Lee -- ‘Madman Theory’ to Conceal Actual Madness
‘Madman Theory’ to Conceal Actual Madness
It Only Works to a Certain Point; Sooner or Later, Madness Requires Proper Intervention
A superbly-written article has appeared in the New Yorker by Fintan O’Toole, explaining how “Trump’s strategy of feigning madness [has no] border between pretense and actual irrationality.” I pull a few quotes, but the thesis (poetry) should be drawn from the full article:
[When asked] whether there were any limits on his global powers, he replied, “Yeah, there is one thing. My own morality. My own mind.” Since whatever morality he ever possessed has long since departed, the remaining question is whether he has also lost his mind….
there’s no doubt that in Trump’s chaotic mind there lurks the Madman Theory, a belief that acting crazy is a rational strategy…. Yet it raises a further question: Is it possible for someone to act the lunatic while actually being one?
To the truly psychotic person, there is no greater yearning than to convince oneself and others that one is sane. Hence, the more likely scenario is that he is pretending to pretend—just as he once described his word salad (another sign of psychosis) as “the weave”—to avoid facing a painful reality. And according to the Madman Theory, if the U.S. president spews genocidal ravings against Iran, it is only proof of a brilliant strategy from a “very stable genius.”
Yet:
Shakespeare gives us more than Lear or Hamlet, real or feigned mental derangement. There is a third possibility. Titus Andronicus begins by pretending to be mad and then becomes so in reality.
O’Toole adds:
Just because you’ve invented and acted on the Madman Theory doesn’t mean you can’t go mad: Nixon’s paranoia, enemies lists, conspiracy theories, and seemingly drunken order to nuke North Korea do not speak of robust mental health. The Madman Theory, it seems, can be a self-fulfilling prophecy.
The truth is that there are few things as dangerous as giving unfit persons power: Adolf Hitler may have remained obscure, had he been kept from power and allowed to continue his peddling of postcards. Donald Trump may have remained a petty businessman. I have treated more than a thousand similar individuals in my career, and society keeps most of the havoc they wreak in check. Even Barry Goldwater mellowed into a fine senator, once he was kept out of the presidency. The ballooning of pathology is a product of our giving power to those least equipped to handle it.
One can tell the degree of pathology by the end result of destruction—in other words, self-sabotage. Insisting that one knows better than all the experts and threatening and terrorizing all those who would suggest otherwise only works so far. Indeed, the longer it “works”, the greater the destruction—and the United States would do well finally to contain him, rather than allow him to write its epitaph, which he is getting close to doing.
We know that as soon as Trump was elected in 2016, [his] frantic lashing out has been described over and over by those who worked with Trump in the White House…. John Kelly and “other top officials … came to believe that Trump was mentally ill, unable or unwilling to process basic information necessary to do his job”…. The chairman of the joint chiefs of staff Mark Milley “was certain Trump had gone into a serious mental decline in the aftermath of the [2020] election,… manic, screaming at officials and constructing his own alternate reality.”
For these reasons, in assessing dangerousness or unfitness, collateral reports are far more valuable than a personal interview. This is why we assembled a panel of independent top mental health experts to perform a standard mental fitness evaluation, when we had the correct, highest-quality collateral information we could ask for, through the Mueller report. We thus predicted Donald Trump’s behavior in Iran—violence, war, civilizational destruction, international enmity, and inability to stay with a decision, even for a few hours—back in 2019.
We can also project that, regardless of the circumstances handed to him, he will eventually be unable to negotiate, continue to escalate, and potentially bring about World War III.
We did not require a personal interview to determine this, even though we made a “reasonable attempt” to obtain one. A personal interview is not even needed for most diagnoses since 1980, according to the Diagnostic and Statistical Manual of Mental Disorders—and certainly not for evaluating danger or unfitness (some studies show that interview of the most dangerous individuals actually diminishes accuracy, because of their facility with lying and charming).
I was most impressed when O’Toole said: “The madness, after all, is not just personal. It is structural.”
Our task was to educate the public on the structural possibilities of applying psychiatric knowledge. This is why, in 2017, I introduced “the Dangerous Case of Donald Trump” as a public health problem. Structures can facilitate mental pathology—as socioeconomic inequality has—and mental pathology can debilitate structures—as Trump Contagion has. And understanding these principles gives us vast possibilities for intervention, which is why Congress members were mainly relying on us before our silencing.
We came forward in unprecedented ways, as the most relevant experts for the situation, to warn that prevention was critical—because the spread of derangement would eventually make its primary source unstoppable. I have dubbed the 2024 election, “the first U.S. presidential election to be won by mental contagion”—that is, the spread of a leader’s mental derangement. This is also why I raised the alarm against the American Psychiatric Association’s silencing of experts, perhaps even more than warning against Donald Trump‘s actual derangement.
Even with the most severe symptoms, prognosis can improve if there is insight—or awareness that something is wrong, a precursor to seeking appropriate help. Here, as masterfully as the article is written, there is scarcely mention that mental derangement is a mental health issue, for which there is an entire science.
Therefore, merely “diagnosing” and keeping the public “entertained” with this or that symptom was not our role. The profound tragedy is that, we did not have to live through everything to come to the realizations in O’Toole’s article. We had 250 years of psychiatric knowledge, the greatest concentration of renowned expertise in the world—not to mention lessons learned on fascism during World War II, and countless heroic deeds performed to safeguard our democracy. Yet, in the same manner we became the global epicenter of the Covid pandemic, we could not keep from becoming the greatest “Banana Republic” the world has seen, with one of the most incompetent and corrupt regimes in history, which rivals if not surpasses Nazi Germany in collective psychosis.
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Discussion about this post
https://bandyxlee.substack.com/p/madman-theory-to-conceal-actual-madness
Dr. Lee,
Thank you. This was a very helpful post. I appreciated the extra details you added this time about how you evaluate the president's situation from different angles. Every little bit of context helps us non-professionals.
This may illustrate how much I need to learn: Is a person's madness a separate thing from Frontotemporal Dementia and malignant narcissm and sadism? Or is it just a manifestation of what those conditions do to the brain? If you could expand on this in a future post, many of us would appreciate it. Take care.
Brilliant analysis. Now do the same for the lethargy, powerlessness, and ineffectiveness of the American people.