A group of mental health professionals led by a trio of pre-eminent psychiatrists is urging the House Judiciary Committee to consider Donald Trump’s “dangerous” mental state arising from his “brittle sense of self-worth” as part of its inquiry into whether to approve articles of impeachment against him.

“We are speaking out at this time because we are convinced that, as the time of possible impeachment approaches, Donald Trump has the real potential to become ever more dangerous, a threat to the safety of our nation,” said Yale Medical School Professor Dr Bandy Lee, George Washington University Professor Dr John Zinner, and former CIA profiler Dr Jerrold Post in a statement which will be sent to House Judiciary Committee members on Thursday.

The statement will be accompanied by a petition with at least 350 signatures from mental health professionals endorsing their conclusions.

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All three psychiatrists have said they are willing to testify as part of the impeachment inquiry.

The statement warns that “[f]ailing to monitor or to understand the psychological aspects [of impeachment on Mr Trump], or discounting them, could lead to catastrophic outcomes.” 

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Trump impeachment: Who’s who in the Ukraine scandal

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Trump impeachment: Who’s who in the Ukraine scandal

1/26 Donald Trump

Accused of abusing his office by pressing the Ukrainian president in a July phone call to help dig up dirt on Joe Biden, who may be his Democratic rival in the 2020 election. He also believes that Hillary Clinton’s deleted emails – a key factor in the 2016 election – may be in Ukraine, although it is not clear why.

2/26 The Whistleblower

Believed to be a CIA agent who spent time at the White House, his complaint was largely based on second and third-hand accounts from worried White House staff. Although this is not unusual for such complaints, Trump and his supporters have seized on it to imply that his information is not reliable.
Expected to give evidence to Congress voluntarily and in secret.

3/26 The Second Whistleblower

The lawyer for the first intelligence whistleblower is also representing a second whistleblower regarding the President’s actions. Attorney Mark Zaid said that he and other lawyers on his team are now representing the second person, who is said to work in the intelligence community and has first-hand knowledge that supports claims made by the first whistleblower and has spoken to the intelligence community’s inspector general. The second whistleblower has not yet filed their own complaint, but does not need to to be considered an official whistleblower.

4/26 Rudy Giuliani

Former mayor of New York, whose management of the aftermath of the September 11 attacks in 2001 won him worldwide praise. As Trump’s personal attorney he has been trying to find compromising material about the president’s enemies in Ukraine in what some have termed a “shadow” foreign policy.
In a series of eccentric TV appearances he has claimed that the US state department asked him to get involved. Giuliani insists that he is fighting corruption on Trump’s behalf and has called himself a “hero”.

5/26 Volodymyr Zelensky

The newly elected Ukrainian president – a former comic actor best known for playing a man who becomes president by accident – is seen frantically agreeing with Trump in the partial transcript of their July phone call released by the White House.
With a Russian-backed insurgency in the east of his country, and the Crimea region seized by Vladimir Putin in 2014, Zelensky will have been eager to please his American counterpart, who had suspended vital military aid before their phone conversation.
He says there was no pressure on him from Trump to do him the “favour” he was asked for.
Zelensky appeared at an awkward press conference with Trump in New York during the United Nations general assembly, looking particularly uncomfortable when the American suggested he take part in talks with Putin.

6/26 Mike Pence

The vice-president was not on the controversial July call to the Ukrainian president but did get a read-out later.
However, Trump announced that Pence had had “one or two” phone conversations of a similar nature, dragging him into the crisis. Pence himself denies any knowledge of any wrongdoing and has insisted that there is no issue with Trump’s actions.
It has been speculated that Trump involved Pence as an insurance policy – if both are removed from power the presidency would go to Democratic House Speaker Nancy Pelosi, something no Republican would allow.

7/26 Rick Perry

Trump reportedly told a meeting of Republicans that he made the controversial call to the Ukrainian president at the urging of his own energy secretary, Rick Perry, and that he didn’t even want to.
The president apparently said that Perry wanted him to talk about liquefied natural gas – although there is no mention of it in the partial transcript of the phone call released by the White House. It is thought that Perry will step down from his role at the end of the year.

8/26 Joe Biden

The former vice-president is one of the frontrunners to win the Democratic nomination, which would make him Trump’s opponent in the 2020 election.
Trump says that Biden pressured Ukraine to sack a prosecutor who was investigating an energy company that Biden’s son Hunter was on the board of, refusing to release US aid until this was done.
However, pressure to fire the prosecutor came on a wide front from western countries. It is also believed that the investigation into the company, Burisma, had long been dormant.

9/26 Hunter Biden

Joe Biden’s son has been accused of corruption by the president because of his business dealings in Ukraine and China. However, Trump has yet to produce any evidence of corruption and Biden’s lawyer insists he has done nothing wrong.

10/26 William Barr

The attorney-general, who proved his loyalty to Trump with his handling of the Mueller report, was mentioned in the Ukraine call as someone president Volodymyr Zelensky should talk to about following up Trump’s preoccupations with the Biden’s and the Clinton emails.
Nancy Pelosi has accused Barr of being part of a “cover-up of a cover-up”.

11/26 Mike Pompeo

The secretary of state initially implied he knew little about the Ukraine phone call – but it later emerged that he was listening in at the time.
He has since suggested that asking foreign leaders for favours is simply how international politics works.
Gordon Sondland testified that Pompeo was “in the loop” and knew what was happening in Ukraine. Pompeo has been criticised for not standing up for diplomats under his command when they were publicly criticised by the president.

12/26 Nancy Pelosi

The Democratic Speaker of the House had long resisted calls from within her own party to back a formal impeachment process against the president, apparently fearing a backlash from voters. On September 24, amid reports of the Ukraine call and the day before the White House released a partial transcript of it, she relented and announced an inquiry, saying: “The president must be held accountable. No one is above the law.”

13/26 Adam Schiff

Democratic chairman of the House intelligence committee, one of the three committees leading the inquiry.
He was criticized by Republicans for giving what he called a “parody” of the Ukraine phone call during a hearing, with Trump and others saying he had been pretending that his damning characterisation was a verbatim reading of the phone call.
He has also been criticised for claiming that his committee had had no contact with the whistleblower, only for it to emerge that the intelligence agent had contacted a staff member on the committee for guidance before filing the complaint.
The Washington Post awarded Schiff a “four Pinocchios” rating, its worst rating for a dishonest statement.

14/26 Lev Parnas and Igor Fruman

Florida-based businessmen and Republican donors Lev Parnas (pictured with Rudy Giuliani) and Igor Fruman were arrested on suspicion of campaign finance violations at Dulles International Airport near Washington DC on 9 October.
Separately the Associated Press has reported that they were both involved in efforts to replace the management of Ukraine’s gas company, Naftogaz, with new bosses who would steer lucrative contracts towards companies controlled by Trump allies. There is no suggestion of any criminal activity in these efforts.

15/26 William Taylor

The most senior US diplomat in Ukraine and the former ambassador there. As one of the first two witnesses in the public impeachment hearings, Taylor dropped an early bombshell by revealing that one of his staff – later identified as diplomat David Holmes – overheard a phone conversation in which Donald Trump could be heard asking about “investigations” the very day after asking the Ukrainian president to investigate his political enemies. Taylor expressed his concern at reported plans to withhold US aid in return for political smears against Trump’s opponents, saying: “It’s one thing to try to leverage a meeting in the White House. It’s another thing, I thought, to leverage security assistance — security assistance to a country at war, dependent on both the security assistance and the demonstration of support.”

16/26 George Kent

A state department official who appeared alongside William Taylor wearing a bow tie that was later mocked by the president. He accused Rudy Giuliani, Mr Trump’s personal lawyer, of leading a “campaign of lies” against Marie Yovanovitch, who was forced out of her job as US ambassador to Ukraine for apparently standing in the way of efforts to smear Democrats.

17/26 Marie Yovanovitch

One of the most striking witnesses to give evidence at the public hearings, the former US ambassador to Ukraine received a rare round of applause as she left the committee room after testifying. Canadian-born Yovanovitch was attacked on Twitter by Donald Trump while she was actually testifying, giving Democrats the chance to ask her to respond. She said she found the attack “very intimidating”. Trump had already threatened her in his 25 July phone call to the Ukrainian president saying: “She’s going to go through some things.”
Yovanovitch said she was “shocked, appalled and devastated” by the threat and by the way she was forced out of her job without explanation.

18/26 Alexander Vindman

A decorated Iraq War veteran and an immigrant from the former Soviet Union, Lt Col Vindman began his evidence with an eye-catching statement about the freedoms America afforded him and his family to speak truth to power without fear of punishment.
One of the few witnesses to have actually listened to Trump’s 25 July call with the Ukrainian president, he said he found the conversation so inappropriate that he was compelled to report it to the White House counsel. Trump later mocked him for wearing his military uniform and insisting on being addressed by his rank.

19/26 Jennifer Williams

A state department official acting as a Russia expert for vice-president Mike Pence, Ms Williams also listened in on the 25 July phone call. She testified that she found it “unusual” because it focused on domestic politics in terms of Trump asking a foreign leader to investigate his political opponents.

20/26 Kurt Volker

The former special envoy to Ukraine was one of the few people giving evidence who was on the Republican witness list although what he had to say may not have been too helpful to their cause. He dismissed the idea that Joe Biden had done anything corrupt, a theory spun without evidence by the president and his allies. He said that he thought the US should be supporting Ukraine’s reforms and that the scheme to find dirt on Democrats did not serve the national interest.

21/26 Tim Morrison

An expert on the National Security Council and another witness on the Republican list. He testified that he did not think the president had done anything illegal but admitted that he feared it would create a political storm if it became public. He said he believed the moving the record of the controversial 25 July phone call to a top security server had been an innocent mistake.

22/26 Gordon Sondland

In explosive testimony, one of the men at the centre of the scandal got right to the point in his opening testimony: “Was there a quid pro quo? Yes,” said the US ambassador to the EU who was a prime mover in efforts in Ukraine to link the release of military aid with investigations into the president’s political opponents. He said that everyone knew what was going on, implicating vice-president Mike Pence and secretary of state Mike Pompeo. The effect of his evidence is perhaps best illustrated by the reaction of Mr Trump who went from calling Sondland a “great American” a few weeks earlier to claiming that he barely knew him.

23/26 Laura Cooper

A Pentagon official, Cooper said Ukrainian officials knew that US aid was being withheld before it became public knowledge in August – undermining a Republican argument that there can’t have been a quid pro quo between aid and investigations if the Ukrainians didn’t know that aid was being withheld.

24/26 David Hale

The third most senior official at the state department. Hale testified about the treatment of Marie Yovanovitch and the smear campaign that culminated in her being recalled from her posting as US ambassador to Ukraine. He said: “I believe that she should have been able to stay at post and continue to do the outstanding work.”

25/26 Fiona Hill

Arguably the most confident and self-possessed of the witnesses in the public hearings phase, the Durham-born former NSC Russia expert began by warning Republicans not to keep repeating Kremlin-backed conspiracy theories. In a distinctive northeastern English accent, Dr Hill went on to describe how she had argued with Gordon Sondland about his interference in Ukraine matters until she realised that while she and her colleagues were focused on national security, Sondland was “being involved in a domestic political errand”.
She said: “I did say to him, ‘Ambassador Sondland, Gordon, this is going to blow up’. And here we are.”

26/26 David Holmes

The Ukraine-based diplomat described being in a restaurant in Kiev with Gordon Sondland while the latter phoned Donald Trump. Holmes said he could hear the president on the other end of the line – because his voice was so “loud and distinctive” and because Sondland had to hold the phone away from his ear – asking about the “investigations” and whether the Ukrainian president would cooperate.
Accused of abusing his office by pressing the Ukrainian president in a July phone call to help dig up dirt on Joe Biden, who may be his Democratic rival in the 2020 election. He also believes that Hillary Clinton’s deleted emails – a key factor in the 2016 election – may be in Ukraine, although it is not clear why.

2/26 The Whistleblower

Believed to be a CIA agent who spent time at the White House, his complaint was largely based on second and third-hand accounts from worried White House staff. Although this is not unusual for such complaints, Trump and his supporters have seized on it to imply that his information is not reliable.
Expected to give evidence to Congress voluntarily and in secret.

3/26 The Second Whistleblower

The lawyer for the first intelligence whistleblower is also representing a second whistleblower regarding the President’s actions. Attorney Mark Zaid said that he and other lawyers on his team are now representing the second person, who is said to work in the intelligence community and has first-hand knowledge that supports claims made by the first whistleblower and has spoken to the intelligence community’s inspector general. The second whistleblower has not yet filed their own complaint, but does not need to to be considered an official whistleblower.

4/26 Rudy Giuliani

Former mayor of New York, whose management of the aftermath of the September 11 attacks in 2001 won him worldwide praise. As Trump’s personal attorney he has been trying to find compromising material about the president’s enemies in Ukraine in what some have termed a “shadow” foreign policy.
In a series of eccentric TV appearances he has claimed that the US state department asked him to get involved. Giuliani insists that he is fighting corruption on Trump’s behalf and has called himself a “hero”.

5/26 Volodymyr Zelensky

The newly elected Ukrainian president – a former comic actor best known for playing a man who becomes president by accident – is seen frantically agreeing with Trump in the partial transcript of their July phone call released by the White House.
With a Russian-backed insurgency in the east of his country, and the Crimea region seized by Vladimir Putin in 2014, Zelensky will have been eager to please his American counterpart, who had suspended vital military aid before their phone conversation.
He says there was no pressure on him from Trump to do him the “favour” he was asked for.
Zelensky appeared at an awkward press conference with Trump in New York during the United Nations general assembly, looking particularly uncomfortable when the American suggested he take part in talks with Putin.

6/26 Mike Pence

The vice-president was not on the controversial July call to the Ukrainian president but did get a read-out later.
However, Trump announced that Pence had had “one or two” phone conversations of a similar nature, dragging him into the crisis. Pence himself denies any knowledge of any wrongdoing and has insisted that there is no issue with Trump’s actions.
It has been speculated that Trump involved Pence as an insurance policy – if both are removed from power the presidency would go to Democratic House Speaker Nancy Pelosi, something no Republican would allow.

7/26 Rick Perry

Trump reportedly told a meeting of Republicans that he made the controversial call to the Ukrainian president at the urging of his own energy secretary, Rick Perry, and that he didn’t even want to.
The president apparently said that Perry wanted him to talk about liquefied natural gas – although there is no mention of it in the partial transcript of the phone call released by the White House. It is thought that Perry will step down from his role at the end of the year.

8/26 Joe Biden

The former vice-president is one of the frontrunners to win the Democratic nomination, which would make him Trump’s opponent in the 2020 election.
Trump says that Biden pressured Ukraine to sack a prosecutor who was investigating an energy company that Biden’s son Hunter was on the board of, refusing to release US aid until this was done.
However, pressure to fire the prosecutor came on a wide front from western countries. It is also believed that the investigation into the company, Burisma, had long been dormant.

9/26 Hunter Biden

Joe Biden’s son has been accused of corruption by the president because of his business dealings in Ukraine and China. However, Trump has yet to produce any evidence of corruption and Biden’s lawyer insists he has done nothing wrong.

10/26 William Barr

The attorney-general, who proved his loyalty to Trump with his handling of the Mueller report, was mentioned in the Ukraine call as someone president Volodymyr Zelensky should talk to about following up Trump’s preoccupations with the Biden’s and the Clinton emails.
Nancy Pelosi has accused Barr of being part of a “cover-up of a cover-up”.

11/26 Mike Pompeo

The secretary of state initially implied he knew little about the Ukraine phone call – but it later emerged that he was listening in at the time.
He has since suggested that asking foreign leaders for favours is simply how international politics works.
Gordon Sondland testified that Pompeo was “in the loop” and knew what was happening in Ukraine. Pompeo has been criticised for not standing up for diplomats under his command when they were publicly criticised by the president.

12/26 Nancy Pelosi

The Democratic Speaker of the House had long resisted calls from within her own party to back a formal impeachment process against the president, apparently fearing a backlash from voters. On September 24, amid reports of the Ukraine call and the day before the White House released a partial transcript of it, she relented and announced an inquiry, saying: “The president must be held accountable. No one is above the law.”

13/26 Adam Schiff

Democratic chairman of the House intelligence committee, one of the three committees leading the inquiry.
He was criticized by Republicans for giving what he called a “parody” of the Ukraine phone call during a hearing, with Trump and others saying he had been pretending that his damning characterisation was a verbatim reading of the phone call.
He has also been criticised for claiming that his committee had had no contact with the whistleblower, only for it to emerge that the intelligence agent had contacted a staff member on the committee for guidance before filing the complaint.
The Washington Post awarded Schiff a “four Pinocchios” rating, its worst rating for a dishonest statement.

14/26 Lev Parnas and Igor Fruman

Florida-based businessmen and Republican donors Lev Parnas (pictured with Rudy Giuliani) and Igor Fruman were arrested on suspicion of campaign finance violations at Dulles International Airport near Washington DC on 9 October.
Separately the Associated Press has reported that they were both involved in efforts to replace the management of Ukraine’s gas company, Naftogaz, with new bosses who would steer lucrative contracts towards companies controlled by Trump allies. There is no suggestion of any criminal activity in these efforts.

15/26 William Taylor

The most senior US diplomat in Ukraine and the former ambassador there. As one of the first two witnesses in the public impeachment hearings, Taylor dropped an early bombshell by revealing that one of his staff – later identified as diplomat David Holmes – overheard a phone conversation in which Donald Trump could be heard asking about “investigations” the very day after asking the Ukrainian president to investigate his political enemies. Taylor expressed his concern at reported plans to withhold US aid in return for political smears against Trump’s opponents, saying: “It’s one thing to try to leverage a meeting in the White House. It’s another thing, I thought, to leverage security assistance — security assistance to a country at war, dependent on both the security assistance and the demonstration of support.”

16/26 George Kent

A state department official who appeared alongside William Taylor wearing a bow tie that was later mocked by the president. He accused Rudy Giuliani, Mr Trump’s personal lawyer, of leading a “campaign of lies” against Marie Yovanovitch, who was forced out of her job as US ambassador to Ukraine for apparently standing in the way of efforts to smear Democrats.

17/26 Marie Yovanovitch

One of the most striking witnesses to give evidence at the public hearings, the former US ambassador to Ukraine received a rare round of applause as she left the committee room after testifying. Canadian-born Yovanovitch was attacked on Twitter by Donald Trump while she was actually testifying, giving Democrats the chance to ask her to respond. She said she found the attack “very intimidating”. Trump had already threatened her in his 25 July phone call to the Ukrainian president saying: “She’s going to go through some things.”
Yovanovitch said she was “shocked, appalled and devastated” by the threat and by the way she was forced out of her job without explanation.

18/26 Alexander Vindman

A decorated Iraq War veteran and an immigrant from the former Soviet Union, Lt Col Vindman began his evidence with an eye-catching statement about the freedoms America afforded him and his family to speak truth to power without fear of punishment.
One of the few witnesses to have actually listened to Trump’s 25 July call with the Ukrainian president, he said he found the conversation so inappropriate that he was compelled to report it to the White House counsel. Trump later mocked him for wearing his military uniform and insisting on being addressed by his rank.

19/26 Jennifer Williams

A state department official acting as a Russia expert for vice-president Mike Pence, Ms Williams also listened in on the 25 July phone call. She testified that she found it “unusual” because it focused on domestic politics in terms of Trump asking a foreign leader to investigate his political opponents.

20/26 Kurt Volker

The former special envoy to Ukraine was one of the few people giving evidence who was on the Republican witness list although what he had to say may not have been too helpful to their cause. He dismissed the idea that Joe Biden had done anything corrupt, a theory spun without evidence by the president and his allies. He said that he thought the US should be supporting Ukraine’s reforms and that the scheme to find dirt on Democrats did not serve the national interest.

21/26 Tim Morrison

An expert on the National Security Council and another witness on the Republican list. He testified that he did not think the president had done anything illegal but admitted that he feared it would create a political storm if it became public. He said he believed the moving the record of the controversial 25 July phone call to a top security server had been an innocent mistake.

22/26 Gordon Sondland

In explosive testimony, one of the men at the centre of the scandal got right to the point in his opening testimony: “Was there a quid pro quo? Yes,” said the US ambassador to the EU who was a prime mover in efforts in Ukraine to link the release of military aid with investigations into the president’s political opponents. He said that everyone knew what was going on, implicating vice-president Mike Pence and secretary of state Mike Pompeo. The effect of his evidence is perhaps best illustrated by the reaction of Mr Trump who went from calling Sondland a “great American” a few weeks earlier to claiming that he barely knew him.

23/26 Laura Cooper

A Pentagon official, Cooper said Ukrainian officials knew that US aid was being withheld before it became public knowledge in August – undermining a Republican argument that there can’t have been a quid pro quo between aid and investigations if the Ukrainians didn’t know that aid was being withheld.

24/26 David Hale

The third most senior official at the state department. Hale testified about the treatment of Marie Yovanovitch and the smear campaign that culminated in her being recalled from her posting as US ambassador to Ukraine. He said: “I believe that she should have been able to stay at post and continue to do the outstanding work.”

25/26 Fiona Hill

Arguably the most confident and self-possessed of the witnesses in the public hearings phase, the Durham-born former NSC Russia expert began by warning Republicans not to keep repeating Kremlin-backed conspiracy theories. In a distinctive northeastern English accent, Dr Hill went on to describe how she had argued with Gordon Sondland about his interference in Ukraine matters until she realised that while she and her colleagues were focused on national security, Sondland was “being involved in a domestic political errand”.
She said: “I did say to him, ‘Ambassador Sondland, Gordon, this is going to blow up’. And here we are.”

26/26 David Holmes

The Ukraine-based diplomat described being in a restaurant in Kiev with Gordon Sondland while the latter phoned Donald Trump. Holmes said he could hear the president on the other end of the line – because his voice was so “loud and distinctive” and because Sondland had to hold the phone away from his ear – asking about the “investigations” and whether the Ukrainian president would cooperate.

“[W]e implore Congress to take these danger signs seriously and to constrain his destructive impulses. We and many others are available to give important relevant recommendations as well as to educate the public so that we can maximise our collective safety,” the psychiatrists write.

While Dr Lee and her colleagues have previously offered themselves to be consulted by impeachment investigators, she told The Independent they felt it necessary to come forward once more because the US president is “is ramping up his conspiracy theories” and “showing a great deal of cruelty and vindictiveness” in his “accelerated, repetitive tweets,” which she explained are signs that he is “doubling and a tripling down on his delusions”.

“I believe that they fit the pattern of delusions rather than just plain lies,” she continued, pointing to the claim he made during a meeting with Jens Stoltenberg, Nato’s secretary-general, that “many legal scholars” were “looking at the transcripts” of his 25 July phone call with Ukrainian president Volodymyr Zelensky and agreeing with his description of the call as “absolutely perfect” as an example of his pathology.

Dr Lee, an expert on violence prevention, acknowledged that members of congress – especially Republicans who are supportive of the president – might dismiss the warning she and her colleagues are delivering as just a product of differences of political opinion, but stressed that the fact that they should be taken seriously because their training enables them to recognise Mr Trump is exhibiting “definitive signs of severe pathology of someone who requires an advanced level of care” and who “meets every criterion of lacking a rational  decision making capacity”.

“The one thing that we are trained to do is to distinguish between what is healthy and what is abnormal, and when the pattern of abnormality fits, then we recognise that it is pathology and not part of the wide variation of which healthy human beings are capable,” she said. “What we recognise is a pattern of disease and that may look like another political ideology or another political style to the everyday person who is unfamiliar with pathology, but to us it is a very recognisable pattern.”

Dr Lee explained that the president’s continued embrace of conspiracy theories was actually a public health issue because of his ability to draw members of the public into a “shared psychosis at the national level”.

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“His detachment from reality… his pathology is actually gaining ground more quickly than the ability of rational actors to bring up the facts,” she said, adding that the House should consider these issues in the same way they are examining the legal and constitutional aspects of impeachment. 

“They are having four constitutional scholars testify, but alongside the legal aspects, we must consider the psychological aspects. In fact, the psychological aspects are more basic because the legal process presumes psychological health and equipment and capacity,” she said.

Donald Trump ignores impeachment question as he leaves Downing Street

Dr Zinner, a former National Institutes of Mental Health researcher who has taught about and consulted with intelligence agencies on narcissistic personality disorders, told The Independent that members of congress need to be warned about the danger impeachment poses when the presidency is held by someone of Mr Trump’s pathology, which he described as a textbook case of Narcissistic Personality Disorder.

“Impeachment is the greatest threat to his self esteem that he’s experienced so far, and we’re very worried that his rage will be even more destructive than it’s been in the past,” he said.

He also dismissed Republicans who defend Mr Trump by claiming that his style is that of a blunt-talking New York businessman as “simply ignorant about the whole area of psychology that pertains to him”.

“These aren’t alternative viewpoints,” Dr Zinner explained, calling one “the product of very sound psychology… that comes from mainly from psychoanalytic theory, but is very established and sound and studied,” and the other “just ignorance and dismissiveness”.

Dr Zinner said the goal of the petition is to reach legislators to educate them. “Most people don’t really know this is a coherent, well-studied, well-defined condition,” he said.

“Even those that don’t dismiss [the diagnosis of Narcissistic Personality Disorder] say, ‘well, you know, these are just a lot of random bad, insane behaviours,’ but they don’t see how it coheres around the self esteem issue,” he continued.

“And others, they say, ‘well, he’s a liar and he’s a cheat and he exploits people and all of that stuff,’ but those are just random traits, whereas all of it hangs together around his developmental deficiency of not having an internal stable self-esteem.”

Donald Trump repeatedly refused to believe intelligence briefings, former deputy director says

He rejected the suggestion that the so-called Goldwater rule prohibits him from speaking out on the president’s mental state. The Goldwater rule suggests that it is unethical for psychiatrists to give opinions on the mental health of someone they have not personally examined.

But Dr Zinner said: “It’s not a rule, it’s really a principle or a standard, which is very different because the preamble of the code of ethics of the American Psychiatric Association that establishes the basic guidelines for the ethical canons says that a psychiatrist’s responsibility, first and foremost, is to his or her patients and to society and to his colleagues and himself in that order.

“You know … the people that have written most strongly in favour for the rule themselves have diagnosed Trump. In other words, they’re total hypocrites,” he said, before adding that a  one-on-one interview wasn’t necessary to diagnose the president because of his myriad public statements and public behaviour.

Dr Post, who created psychological profiles of Israel’s former prime minister Menachem Begin and Egypt’s former president Anwar Sadat for former president Jimmy Carter to use when negotiating the Camp David Accords, and who founded the CIA’s Center for the Analysis of Personality and Political Behavior, told The Independent that evidence of Trump’s lack of self-esteem and the danger that impeachment will bring by exacerbating his precarious mental state can be found in the way he pardons convicted war criminals like Navy Chief Petty Officer Eddie Gallagher and labels them heroes.

“He’s identified with these war criminals because he knows that he’s being seen as a criminal. So he’s trying to redefine them as heroes, just like he is. People challenge his intelligence, so he accuses Maxine Walters of being ‘low IQ’ and says, but I’m a stable genius,” said Dr Post, who founded George Washington University’s Political Psychology Center after his retirement from the CIA.

Dr Post warned the strong connection between Mr Trump and his followers means the possibility he would call for violence against his perceived political enemies “cannot be discounted”.

“Watching his rallies, there’s an almost palpable connection between Trump and his followers, who have taken his invitation to externalize and project their problems upon [other groups],” he said. “He’s basically saying he understands where their problems are coming from and he will rescue them, so to hurt their rescuer is very painful [for his followers] indeed.”

Any challenge to Mr Trump’s power, whether impeachment or an election loss next November, could be a significant trauma for him and his supporters, Dr Post said. 

Asked for a prediction of how Mr Trump would react to either, Dr Post invoked the Welsh poet Dylan Thomas: “He will not go gentle into that good night, but will rage, rage at the dying of the light.”

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