In the spirit of transparency: I am a licensed social worker and psychotherapist who has decided observations about the mental health of the former president. I take into consideration, The Goldwater Rule, which states:

“The Goldwater rule is Section 7 in the American Psychiatric Association‘s (APA) Principles of Medical Ethics, which states that psychiatrists have a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health, but they should not give a professional opinion about public figures whom they have not examined in person, and from whom they have not obtained consent to discuss their mental health in public statements. It is named after former US Senator and 1964 presidential nominee Barry Goldwater.”

Although I am not attempting to diagnose Donald Trump, as an American and world citizen, I have solid and justifiable concerns about his fitness to have been in office, and his fitness to make a run again for the role that puts him in a position of power again. While he occupied the Oval Office, I read his niece Mary Trump’s book, called Too Much And Never Enough. In it, she sounds the alarm about his behavior and the severely dysfunctional family dynamics that contributed.

I recently dove into a book called American Carnage: An Officer’s Duty to Warn and emerged both terrified and motivated as the facts, as evidenced by Donald Trump’s words were there in stark black and white. This short (83 page) paperback is essential reading for anyone who is alarmed about the impact of the words and actions of the former president, or should be. The author, Steve Nolan, LCSW, worked as a psychotherapist for 25 years and was a career military man for 30 years. One of his roles was Chief of Combat Stress for Paktika Province in Afghanistan. In addition, he ran a clinic for the VA that treated veterans with PTSD. This experience lends credibility and puts him in a position to make authoritative statements without claiming to diagnose the man.

The subtitle alludes to the responsibility that all clinicians have to warn if a person’s behavior presents a clear and present danger to others. An example would be, if in a treatment setting, a patient said that they were going to kill someone, that duty to warn would supersede confidentiality. Nolan takes his roles as a therapist and veteran seriously and this book is a loud and clear red alert.

The cover shows a photo of Donald Trump with his arm around an American flag, leaning into it and planting a smooch on it. Nolan’s take on this performative act, “It’s not an object to be used for grandstanding or self-promotion. You don’t prove allegiance by physical contact, you prove allegiance by selfless service to your country.” Not a coincidence that in the midst of horror of George Floyd’s murder and the protests that occurred in the aftermath, that he used a Bible as a prop while he stood in front of St. John’s Episcopal Church in DC.

Nolan sets the stage with the DSM-V diagnoses for Narcissistic Personality Disorder and Antisocial Personality Disorder. Even if a reader or writer, in his case, is not attempting a diagnosis and regardless of which end of the political spectrum they find themselves, I dare them to go through the list and not check off most, if not all of the criteria as it pertains to Trump.

Throughout the remainder of the book, Nolan takes literal statements made by the former president (documented in writing as his tweets or recorded on radio or television interviews) and adds observations in the form of commentary.

Keep in mind that the book was published in 2020, prior to the election in which Joe Biden was named the winner. The ‘Big Lie,’ while hinted at in anticipation of the possibility that Trump might lose, had not yet been perpetrated. January 6th was waiting in the timeline wings and was unfathomable to most of us, except those who were involved in its planning and execution. The COVID pandemic had just begun and the world shut down for many of us and death was all around. Nolan wrote the book while in social isolation. The two impeachments had not yet occurred. The legal cases that Trump finds himself embroiled in at this writing, had not yet come to fruition. Election officials and anyone courageous enough to stand up to his lies were threatened by his followers.

Had those empowered to take action done so, and invoked the 25th amendment in the face of pushback from legislators from Trump’s own party, those events might have been avoided.

As it stands, three years after American Carnage: An Officer’s Duty to Warn was published, we are still very much on high alert, very much endangered by the words and actions of a man who self aggrandizes every chance he gets, plays the victim card, speaks in the third person, which is called Illeism, demonizes the media and those who disagree with him. Even others who are running for the Republican nomination, with very few exceptions, either hold him in deference or are hesitant to rile his adherents.

The danger is not merely what this self serving (rather than servant) leader has said, but the affect he has on those who take up arms (literally on January 6th) and fight his battles for him. That American flag that Trump kissed was wielded as a weapon that day.

Nolan’s book should be read by our legislators, journalists, community leaders and average citizens. This is not hyperbole. The danger is real.