海角大神

President Trump鈥檚 mental health has burst into public consciousness, following release of the explosive tell-all book 鈥淔ire and Fury鈥� and Mr. Trump鈥檚 eye-popping Twitter response 鈥� in which he called himself a 鈥渧ery stable genius.鈥�

The book, by journalist Michael Wolff, describes a chaotic White House riddled with infighting. In an interview on NBC鈥檚 鈥淭oday,鈥� Mr. Wolff asserted that 鈥�100 percent of the people鈥� around the president 鈥� including senior advisers and family members 鈥� question his intelligence and fitness for office.

But anyone who thinks the Trump presidency is on the ropes or that he鈥檚 about to be removed from office via the 25th Amendment to the Constitution 鈥� a topic Wolff claims White House aides discussed repeatedly 鈥� has another thing coming, analysts say. And, it can be argued, Mr. Trump may in fact come out on top when all is said and done, given the questions surrounding the reporting techniques used by Wolff, and factual errors in the book.

In addition, efforts by mental-health professionals to raise alarm bells about Trump鈥檚 stability may well backfire, as none have formally evaluated Trump. The American Psychiatric Association鈥檚 longstanding code of ethics prohibits drawing conclusions about a person鈥檚 mental state without an in-person examination.

鈥淚 think this all inoculates him,鈥� says Steven Schier, a political scientist at Carleton College in Northfield, Minn., and co-author of a book on the first months of Trump鈥檚 presidency. 鈥淚n other words, the more this stuff is out there, the less impact it probably has.鈥�

鈥淚鈥檓 not defending Trump,鈥� Mr. Schier continues. 鈥淓ven a casual view of his behavior does raise concerns, but it doesn鈥檛 mean he鈥檚 clinically [out of his mind].鈥�

Besides Wolff鈥檚 book, a months-long effort by a Yale University psychiatry professor to sow alarm about Trump鈥檚 mental stability has added to the drumbeat of concern about his ability to function as president. The professor, Bandy Lee, published a book of essays last October by 27 mental-health practitioners who say their 鈥渄uty to warn鈥� the nation about Trump鈥檚 mental health supersedes 鈥減rofessional neutrality.鈥�

But the nation has hardly reached the point where an effort to remove Trump from office via the 25th Amendment is even remotely feasible. The 25th Amendment, enacted in 1967, was a response to the assassination of President John F. Kennedy, which raised questions about the nation鈥檚 governance had Mr. Kennedy survived but in an incapacitated state.

The requirements for removing a president under the 25th Amendment are steep: The vice president and a majority of Cabinet members must make a 鈥渨ritten declaration that the president is unable to discharge the powers and duties of his office.鈥� Then a two-thirds vote by both houses of Congress is required to fulfill the transfer of power to the vice president.

鈥業noculated with his base鈥�

On Monday, that he did not interview Vice President Pence or any Cabinet members for his book. This admission throws cold water on his suggestion that the 25th Amendment is a viable option. Wolff鈥檚 book quotes White House staffers Wolff spent the better part of a year essentially as 鈥渁 fly on the wall鈥� inside the West Wing, at the invitation of now-former Trump aide Steve Bannon and current adviser Kellyanne Conway.

Wolff鈥檚 book, which burst into public view last week, was not what the Trump White House expected. But so far, it doesn鈥檛 seem to be hurting the president鈥檚 job approval ratings,

The flaws in Wolff鈥檚 book 鈥� which the author himself admits was produced hastily 鈥� have played into Trump鈥檚 narrative of a press corps eager to take him down, and that could help him survive this latest maelstrom.

鈥淎t least he鈥檚 going be inoculated with his base,鈥� says Republican strategist Ford O鈥機onnell. 鈥淗e鈥檚 also probably going to get the benefit of the doubt among some right-leaning conservatives and potential independents in key states going forward,鈥� particularly in the midterm elections this November.

Mr. O鈥機onnell also sees a lot of the 鈥渕ainstream media鈥� angry that Wolff beat them to the punch. 鈥淚 think they would have preferred to build the 鈥楾rump is nuts鈥� narrative over time, and now it could undercut their reporting and be a blessing for Trump,鈥� he says.

Dr. Lee of Yale reportedly spent two days on Capitol Hill last month, meeting with more a dozen Democratic senators about Trump鈥檚 mental state.

From Lincoln to LBJ

If anything, one outcome is clear from both the Wolff book and Lee鈥檚 effort to raise alarm bells about Trump鈥檚 behavior: They have busted through the taboo that has kept public discussion of presidential mental health under wraps, at least while a president is still in office.

Throughout history, presidents have faced emotional and mental challenges, either following a family tragedy or under the strain of the job. Experts on the presidency describe the job as isolating; only the president himself knows what he is experiencing.

鈥淲oodrow Wilson was sidelined in August 1914 by the death of his first wife. It took him a while to snap out of it,鈥� says historian David Pietrusza. 鈥淲hen he did, he was seriously lovesick over courting his future second wife, Edith Bolling Galt. I'm not sure which situation was worse.鈥�

President Abraham Lincoln, who lost two of his children, was reported to have suffered from depression. Kennedy was diagnosed with anxiety, and took heavy-duty prescription medication. Presidents Franklin Pierce and Calvin Coolidge both lost children, and dealt with depression.

Aides to Lyndon Johnson and Richard Nixon had to navigate both presidents鈥� serious psychological challenges.

As for Trump, 鈥減laying armchair psychiatrist/psychologist is a dangerous game, even when one knows the individual in question very well,鈥� says Mr. Pietrusza in an email. 鈥淧laying it at a distance is like playing the lottery. Add a substantial dose of political self-interest, and the pastime becomes even less reputable.鈥�

鈥淧reviously, the knock on Trump was that he was fascist," Pietrusza continues. "That proved to be incorrect. He was not a fascist. He was just Trump. Now, he is rumored to be mentally unfit as defined by the 25th Amendment or by some such reasoning process. He is, however, probably still just Trump.鈥�

鈥楪oldwater rule鈥� at stake

On Friday, Trump will go for a physical exam at Walter Reed National Military Center. Typically, presidential physicals don鈥檛 include an examination of mental health. But when spokeswoman Sarah Sanders was asked last week if Trump鈥檚 physical would include mental health, she did not say either way.

In response to an interview request about psychiatrists鈥� comments on Trump, the American Psychiatric Association (APA) responded by providing a link to its web page on with The rule, instituted in the wake of Republican Sen. Barry Goldwater鈥檚 presidential campaign in 1964, was a response to a survey sent by Fact magazine to more than 12,000 psychiatrists, who were asked to assess Senator Goldwater鈥檚 mental health.

The survey elicited some 鈥渉arshly negative responses鈥� by psychiatrists who had never met Goldwater, and in 1973, the APA instituted its rule forbidding members from commenting on the mental health of political candidates. Many of the responses were deemed to be tainted by the political views of the doctors.

Today, some psychiatrists argue that since non-physicians comment publicly on Trump鈥檚 mental state, the Goldwater rule binds medical professionals unfairly. And in the case of Trump, some feel a 鈥渄uty to warn鈥� the public about what they see as danger signs.