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Roland S. Martin / YouTube

The recording (below) of Trump’s saying he wanted Marie Yovanovitch fired is making the news (it is at 42 mins. on the 80-minute recording) but not for the reason which stood out when I listened to it.


I am a psychotherapist and not an expert in neurological disease.  I have read what other mental health professionals like Bandy Lee, a forensic psychiatrist, most recently (scroll down for excerpt)  have said about him needing a psychiatric examination because he is mentally compromised in three ways: emotional, cognitive and neurological, not only to be president but to but to stand trial.  I think the later is politically impossible because they don’t meet the constitutional grounds for impeachment. She is qualified to assess his emotional state as am I. Although she has a medical degree I do not know how much of a background she has in assessing a patient’s cognitive state in-depth (the way clinical psychologists do with IQ and other tests) or neurological conditions the way neurologists do with various tests. See: Cognitive Tests and Performance Validity Tests

For therapists and others who are interested in diagnosis (by whatever term you want to use) of Trump, it is very important to understand this presents only an unfiltered view of him in a setting where he feels safe and admired. With this in mind…

when the recording was made a private dinner by Igor Furman who was there with his partner Lev Parnas in April of 2018 there were no signs of cognitive impairment that I could discern.

You may be surprised at my conclusion since I have written frequently about his being a malignant narcissistic who is a danger to our democracy. I have not changed my opinion.

I doubt many readers will take the hour and 23 minutes to listen to the entire recording though I’d recommend that you at least sample 10-15 minutes of it even if you fast forward through different portions.
Here are some of the points that stood out to me.
  • Obviously it showed Trump knew Lev Parnas.
  • It showed how easily he was influenced to demand Yovanovitch should be fired, i.e. because he was told she was going around saying not to pay attention to him because he was going to be impeached.
  • There’s an implication that when he says “take her out, okay” he might have thought that Parnas and Furman actually could assassinate her.
  • Everyone in the group expressed admiration for him. A cynic would say they were sucking up but the admiration seemed genuine.
  • Nobody provoked his ire, so there’s no way to assess his volatility and tolerance for being challenged.
  • In this recording, Trump’s narcissism is front and center but if you try to be objective (I know this is hard) I don’t think it could be considered particularly obnoxious. The sociopathy which I still presume is there is masked. He’s not manipulating these people because he doesn’t have to. They already worship him.
  • Trump speaks in full sentences. He doesn’t slur or garble his words. There aren’t any mispronunciations. He doesn’t refer to anyone by insulting nicknames.
  • He makes what he thinks are jokes. I didn’t think they were remotely amusing but his companions guffawed loudly in response. When the king farts you smell roses, I mean, you don’t pretend to smell them, you really do smell them.
  • I found it interesting that when they talked about marijuana he said he is in favor of legalization, and talked rationally about it.
  • He asked for the opinions of others and seemed to understand their responses about subjects he didn’t know about.
  • They talked about the relative merits of electric and hybrid cars as compared to gasoline and diesel.  He seemed to want to learn more about them.
  • I didn’t see the lack of intellectual curiosity that has been reported. On the contrary I thought he was curious to learn more about some subjects he wasn’t familiar with. Of course, these weren’t the complex geopolitical subjects we expect presidents to know about or at least understand when they are explained. This is the ignorance that led Rex Tillerson to call him a fucken moron.
  • When I listened to the recording I could actually see why some people find him to be engaging and likable, as long as they don’t cross him. You don’t see the dark side that has been reported in books like “Fire and Fury” and “A Very Stable Genius.”
While not I am a neurologist and would hardly venture an assessment of early dementia although some of my mental health associates without a background in neurology have done so or urged an evaluation for this, I do live is a senior facility where, in the six years I’ve been here, I have observed a few dozen residents in various stages of cognitive decline. I have seen it come on slowly over the course of years, and rapidly over the course of months like some cases of Lewy body dementia (which Robin Williams had).
Some of the articles speculating about Trump showing signs of dementia.
It is quite possible Trump has developed dementia more recently, some time after the recording was made in April 2018. 
A couple of days ago this story was published in Salon:


Trump’s fitness to stand trial questioned by professionals: “Serious signs of deterioration”


Here’s how Bandy Lee, MD, again a forensic psychiatrist not a neurologist, put it:

“We must consider Donald Trump’s mental compromise as being threefold: emotional, cognitive and neurological — including potential substance misuse,” Lee said. “While it is not possible to come to a diagnosis from a distance, it is very possible to distinguish many things, such as abnormal symptoms and signs — whether these are patterns of strategic presentation or stereotypical disease over time, trends of decline and dangerousness.”

Lee said Trump’s comments about Edison show a “marked worsening” of Trump’s mental state.

“He is less able to stay with a topic, to find complex words, to form complete sentences. And the content of his words is becoming more impoverished, if not nonsensical,” Lee said. “Connecting the present to a distant past or to history is common in progressive dementia, and while dementia is still not a diagnosis we can make without detailed medical records, these are serious signs of deterioration we should not ignore.”

“Whatever the source of the loose association, he speaks of Thomas Edison as if he were a contemporary of Elon Musk that we should equally protect. And he mentions light bulbs and the wheel as if they were recent inventions like the electric car,” she continued. “His impairment should be very clear to everyone, and I have stated that it is inhumane, either for him or for ourselves, to continue to prop up this man as being normal.”

“As he declines cognitively, his other symptoms are likely to worsen, as well,” Lee added. “He mentions at the end, ‘We help him, so he has to help us,’ as if he were keeping Mr. Musk beholden lest he betray him or leave him without protection — what someone is likely to say when he is paranoid.”

I think there is an alternate explanation to what Bandy Lee, John Gartner, and others describe as cognitive decline or early dementia.
The early signs of dementia are:
  • Memory loss. …
  • Difficulty in planning or solving problems. …
  • Difficulty doing familiar tasks. …
  • Being confused about time or place. …
  • Challenges understanding visual information. …
  • Problems speaking or writing. …
  • Misplacing things. …
  • Poor judgment or decision-making.
  • Reference
Some of what has been alluded to as signs of early dementia in Trump aren’t even on this list. Other signs on the list we don’t know about because we aren’t observing him in unguarded moments.
What we do see could be attributed to a deterioration of the defense mechanisms he previously found successful in warding off of anxiety. While he will never admit it out loud I think he realizes that his impeachment has diminished his stature. I also think he has fewer and few people around him that he believes are loyal and because of his paranoid streak there are few people he trusts. The books like “Stable Genius” report things that he knows are true and therefore he knows people are, to use the language of the mobsters he emulates, ratting him out, and he doesn’t know who they are.
I think one of the reasons he has so many rallies and spends so much time at Mar a Lago is that he is desperate for approbation. I think this distracts him from the growing awareness that if the polls are correct he will suffer a devastating defeat in November and for someone with an intense need to believe he is both a very stable genius and the greatest president ever this could be a shattering experience.
Denial is a primitive defense and when the truth becomes overwhelming it is true as my colleagues warn that someone like Trump is at their most dangerous because the wall of denial he’s built to defend Castle Trump could crumble like it’s made out of bread crumbs. He could lapse into psychosis and even Pence and the Cabinet would have to initiate the 25th Amendment immediately.

The Irony

At the end of the dinner, these admirers presented him with an apparently framed copy of the most famous part of Teddy Roosevelt’s Citizen in a Republic speech usually referred to as “the man in the arena.”

It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.

Trump obviously loved this and basked in their adoration.


What he didn’t know is that this is frequently quoted by politicians and well known by historians. Interestingly and perhaps ironically considering where Trump stands now Richard Nixon quoted it both in his victory speech on November 6, 1968 and in his resignation address to the nation on August 8, 1974.

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