In May, Donald Trump announced he had received a perfect score of 30 out of 30 for the fourth time on the Montreal Cognitive Assessment test, a cognitive screening tool used by doctors.
The President called this proof of his “extreme intelligence”, but the announcement rang alarm bells among clinicians. The chance of a perfect score on the MoCA test for a healthy adult is about 10 per cent, according to its creator. The odds lengthen to one in 10,000 for four consecutive perfect scores.
But the more concerning aspect was the frequency of the test, with Trump taking three in little more than a year, says Dr Henry David Abraham, professor of psychiatry emeritus at Tufts University School of Medicine in the US.
“You give a MoCA for a rapid screen. Is the person functioning in a cognitive sense or not?” he said. “If you are doing two, three, four, you’re not doing a rapid screen. You’re looking for a trend.”
Abraham is convinced there is a trend towards a decline in Trump’s mental state, and that it could threaten disaster for humanity. “He’s certainly our most impulsive president in my lifetime,” said Abraham, noting the sudden attacks on Iran and Venezuela, and Trump’s conduct during them. “He is an unstable individual with absolute control over the American nuclear arsenal.”
Some of the President’s threats towards Iran, such as “a whole civilisation will die tonight”, were widely taken as a veiled reference to nuclear weapons. The clinician also pointed to disturbing images Trump has posted on social media, including an AI-generated image of him pressing a red button while surrounded by explosions and mushroom clouds.
There are concerns about the US President’s mental health judging from his social media posts, such as this AI-generated image showing him pressing a purported nuclear button (Photo: Donald Trump/Truth Social)Earlier this year, Abraham signed a letter with 36 leading psychiatrists and neurologists arguing that Trump’s condition rendered him unfit for office.
The letter, which was entered into the congressional record with the support of several senators, alleged “marked deterioration in cognitive functioning, evidenced by disorganised and tangential speech, rambling digressions, factual confusions, unexplained sudden changes of course in strategic matters”, as well as “grandiose and delusional beliefs” and “severely impaired judgement and impulse control”.
The scientists also cited the “escalating violence” initiated by Trump, including the Iran war, as a reason to question the President’s near-total authority over America’s nuclear weapons. “More than 5,000 nuclear warheads in inter-continental missile silos, on submarines, and in bombers around the world, are ready for launch solely upon his order,” the letter read.
Dr Henry Abraham is a psychiatrist and Nobel Peace Prize recipient for the prevention of nuclear war. He believes Trump’s outbursts reveal he has ‘attacks of rage that he can’t control’ (Screengrab: YouTube)Abraham, who was among the recipients of the 1985 Nobel Peace Prize for his work with International Physicians for the Prevention of Nuclear War (INPPW), believes the effects of ageing are worsening pre-existing tendencies in Trump such as delusion and confabulation – the invention of fictional memories and narratives.
Abraham further suggests the President’s outbursts reveal he has “attacks of rage that he can’t control”, and believes this could worsen as the war drags on without the victory he promised.
“He can’t get out of it. He’s embarrassed every day about it, or at least attacked every day about it,” the psychiatrist said. “What prevents him one night from saying, ‘Oh, I can solve this Iran problem in 10 seconds’ – which would essentially be the use of nuclear weapons.”Abraham further fears that the lack of seriousness with which Trump has treated war – he referred to the raid on Venezuela as “like a television show” – could extend to nuclear weapons.
Abraham (centre, with medal) receives the 1985 Nobel Peace Prize with International Physicians for the Prevention of Nuclear War colleagues (Photo: Henry David Abraham/Wiki Commons)Other US presidents have presided over potential nuclear crises, said Abraham, adding that a lack of checks on presidential authority over nuclear weapons is a long-standing issue. A president can order a nuclear strike without consulting anyone else, and the order cannot be blocked by any official or body, according to US protocols (though military officers have a duty to refuse an illegal order).
Richard Nixon reportedly made drunken threats to use nuclear weapons in US wars in Asia during the troubled end of his term in office, while John F Kennedy was forced to navigate the Cuban Missile Crisis.
But those administrations had responsible staff to guide them, said Abraham. Nixon’s top aides were said to have introduced an informal vetting process around nuclear issues. Kennedy had experienced diplomats to negotiate with the Soviet Union.
“Trump has none of that,” said Abraham, referring to “sycophants” surrounding the President. “He has no one around him serving as a guard-rail. He has no diplomatic structure to support him and guide him through an extremely difficult war of choice.”
The President appears to have little interest in or understanding of diplomacy, he suggests. “A realist would say, ‘I made a mistake [in Iran]. I’ll have to negotiate. We’re going to embark on a long-term diplomatic solution to the problem.’ But he doesn’t understand diplomatic solutions.”
Trump’s erratic behaviour is among several factors that make this a “scarier time” for nuclear threats than any Cold War crisis, Abraham believes, pointing to the breakdown of nuclear control treaties, the rise of China and North Korea as nuclear powers, and threats from Russia.
Intervention over Trump’s mental state is controversial, the psychiatrist concedes. There is opposition within his field over the violation of the Goldwater Rule, which prohibits giving a diagnosis without directly assessing a patient.
Abraham supports the rule, but believes that in this case it clashes with another professional obligation: the duty to warn. He cites the 1976 Tarasoff case, in which it was established that a therapist must take preventative measures if they believe a subject is a danger to others.
A memorial for the more than 100 schoolchildren killed in a suspected US strike on an Iranian girls school in Minab at the start of the war (Photo: Fatemeh Bahrami/Getty)Abraham and his colleagues are campaigning to draw attention to Trump’s mental state and the threat they believe it poses. He encourages whistleblowers to volunteer unreleased information from Trump’s medical records, pointing to a recent check-up that involved a record 22 medical specialists.
“Those 22 doctors, they had better figure it out, and they better come forward,” he said.
Clinicians are also encouraging members of Congress to stage an intervention, possibly through the 25th amendment, which allows for the removal of a president if they are unfit to serve. Abraham supports efforts to introduce limits on presidential power to use nuclear weapons. Democrats in Congress have tabled bills for new checks and balances.
The White House dismissed the concerns of Abraham and his colleagues. “President Trump is the sharpest, most accessible, and energetic president in American history,” spokesperson Davis Ingle told The i Paper. “Henry David Abraham is a Trump Deranged loser engaging in armchair diagnosis for political purposes. He is defiling the medical profession.”
But Abraham has the support of the IPPNW, which represents thousands of scientists across the world.
“IPPNW shares and fully supports his concerns about the risk of President Trump’s psychopathology in regards to his control over the US nuclear arsenal,” said its executive director, Michael Christ. “IPPNW believes that no one person, particularly the current US President, should have sole authority to launch a nuclear war.”
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