• Bill

Will the November Election Be Too Late to Prevent Fascism in the United States?

I understand how many things that Donald Trump says and does are hilarious in their stupidity and ineptitude. At a certain point, though, those in opposition to him (i.e., "The Resistance") need to understand that slapstick levity is not his intention. What seems ridiculous to many who oppose Trump is for him an effective way to play to the wants and fears of his base of supporters and, increasingly, to manipulate those Republicans in the House and Senate who support him.

Although he boasts of being a "stable genius," Trump is neither. His instability is the result of a severe personality disorder informally known as malignant narcissism, a psychoanalytic diagnosis well established by the work of Otto F. Kernberg, M.D. In DSM terms, it is a combination of narcissistic personality disorder with features of antisocial (i.e., psychopathic) personality disorder. The most dangerous malignant narcissists are those who are highly intelligent, followed by those who have intellectual impairments. While Trump is not as intelligent as he believes, he is smart enough to be a serious threat. Still, there are some indications that he has some form of progressive cognitive impairment, possibly a harbinger of dementia, which would increase his capacity for dangerousness in combination with his personality pathology. Finally, he has what is a malignant narcissist's dream job, the American presidency, which is arguably the most powerful political position in the world.

Many prominent psychiatrists, psychologists, and other mental health professionals have voiced serious concern about Trump's malignant narcissism. However, this diagnosis in and of itself does not accomplish anything in terms of managing Trump's behavior and its deleterious effects. Moreover, Trump's words and deeds have been playing out on the American and world political stages, not on a ward in a psychiatric hospital, for the past three years. Since impeachment has failed and it appears unlikely that the Twenty-fifth Amendment to the U.S. Constitution will be invoked, the only legal solution that remains is electoral. Trump must be defeated at the ballot box.

The need to prevent Trump's reelection to the presidency is clear and obvious to his opponents. Still, there is still just under half a year left until the November general election. And it is also clear and obvious that Trump and his political team have been moving to dismantle any checks on his administration's use of power. For example, Trump has just fired yet another inspector general, this time one who was investigating Secretary of State Mike Pompeo's use of an emergency declaration to evade a congressional hold on the sale of arms to Saudi Arabia and the United Arab Emirates. How many Saturday Night Massacres is Trump allowed to carry out? President Nixon got only one, an action that was seen as a corrupt attempt to prevent his impeachment for the Watergate scandal. How long will Congress tolerate the current president's repeated acts of obstruction of justice? Trump's actions are more egregious than Nixon's, as Trump is doing the (likely illegal) firings himself, not ordering others to do so like Nixon. Will he be allowed to continue this quest for absolute power?

Another dangerous situation is Trump's combination of arrogance and ignorance when it comes to medicine and public health. His latest audacious action is his mention today that he has been taking hydroxychloroquine (update 5/19/20: according to economist Paul Krugman, Trump could be lying due to "infallibilitis"). There are at least three problems with this. First, hydroxychloroquine, an antimalarial drug, has never been suggested for the prevention of COVID-19. As far as the public knows, Trump has not tested positive for infection with the novel coronavirus. Second, evidence continues to accumulate that hydroxychloroquine (and its cousin chloroquine) are not effective for the treatment of COVID-19, even if Trump had it. Third, both medications can cause severe toxic adverse effects. Yet by claiming to be taking hydroxychloroquine, Trump is encouraging others (particularly his cult-like base of supporters) to imitate him. Moreover, he appears to delight in contradicting and defying the opinions of his expert advisers. For example, Anthony Fauci, M.D., the longtime head of the National Institute of Allergy and Infectious Diseases and the lead virologist on Trump's coronavirus task force, has advised against the use of chloroquine and hydroxychloroquine in the treatment of COVID-19.

What do these two incidents have in common? They fit into Trump's overall behavior while in office, the message of which is that he believes that he is not accountable to anyone. So, while some of Trump's antics are laughable, they should be taken seriously as evidence of the threat to democracy that Trump has always been. Trump clearly wants to be a dictator. Republicans in office just as clearly intend to support him in this ambition. And a white nationalist mob, his "base," follows his every whim. In sum, all of this sounds like incipient fascism to me.

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