Is Trump mentally fit to be commander-in-chief?




Los Angeles Times
Is Trump mentally fit to be president? Let's consult the U.S. Army's field manual on leadership
Prudence L. Gourguechon
Since President Trump’s inauguration, an unusual amount of attention has been paid to the 25th Amendment to the Constitution. That's the measure, ratified in 1967, that allows for removal of the president in the event that he is "unable to discharge the powers and duties" of the office. What does that mean, exactly? Lawyers surely have some ideas. But as a psychiatrist, I believe we need a rational, thorough and coherent definition of the mental capacities required to carry out “the powers and duties” of the presidency.
Although there are volumes devoted to outlining criteria for psychiatric disorders, there is surprisingly little psychiatric literature defining mental capacity, even less on the particular abilities required for serving in positions of great responsibility. Despite the thousands of articles and books written on leadership, primarily in the business arena, I have found only one source where the capacities necessary for strategic leadership are clearly and comprehensively laid out: the U.S. Army’s “Field Manual 6-22 Leader Development.”

The Army’s field manual on leadership is an extraordinarily sophisticated document, founded in sound psychological research and psychiatric theory, as well as military practice. It articulates the core faculties that officers, including commanders, need in order to fulfill their jobs. From the manual’s 135 dense pages, I have distilled five crucial qualities:
According to the Army, trust is fundamental to the functioning of a team or alliance in any setting: “Leaders shape the ethical climate of their organization while developing the trust and relationships that enable proper leadership.” A leader who is deficient in the capacity for trust makes little effort to support others, may be isolated and aloof, may be apathetic about discrimination, allows distrustful behaviors to persist among team members, makes unrealistic promises and focuses on self-promotion.
A good leader 'demonstrates an understanding of another person’s point of view' and 'identifies with others’ feelings and emotions.'
Discipline and self-control
The manual requires that a leader demonstrate control over his behavior and align his behavior with core Army values: “Loyalty, duty, respect, selfless service, honor, integrity, and personal courage.” The disciplined leader does not have emotional outbursts or act impulsively, and he maintains composure in stressful or adverse situations. Without discipline and self-control, a leader may not be able to resist temptation, to stay focused despite distractions, to avoid impulsive action or to think before jumping to a conclusion. The leader who fails to demonstrate discipline reacts “viscerally or angrily when receiving bad news or conflicting information,” and he “allows personal emotions to drive decisions or guide responses to emotionally charged situations.”
In psychiatry, we talk about “filters” — neurologic braking systems that enable us to appropriately inhibit our speech and actions even when disturbing thoughts or powerful emotions are present. Discipline and self-control require that an individual has a robust working filter, so that he doesn’t say or do everything that comes to mind.
Judgment and critical thinking
These are complex, high-level mental functions that include the abilities to discriminate, assess, plan, decide, anticipate, prioritize and compare. A leader with the capacity for critical thinking “seeks to obtain the most thorough and accurate understanding possible,” the manual says, and he anticipates “first, second and third consequences of multiple courses of action.” A leader deficient in judgment and strategic thinking demonstrates rigid and inflexible thinking.
Self-awareness requires the capacity to reflect and an interest in doing so. “Self-aware leaders know themselves, including their traits, feelings, and behaviors,” the manual says. “They employ self-understanding and recognize their effect on others.” When a leader lacks self-awareness, the manual notes, he “unfairly blames subordinates when failures are experienced” and “rejects or lacks interest in feedback.”
Perhaps surprisingly, the field manual repeatedly stresses the importance of empathy as an essential attribute for Army leadership. A good leader “demonstrates an understanding of another person’s point of view” and “identifies with others’ feelings and emotions.” The manual’s description of inadequacy in this area: “Shows a lack of concern for others’ emotional distress” and “displays an inability to take another’s perspective.”
The Army field manual amounts to a guide for the 25th Amendment. Whether a president’s Cabinet would ever actually invoke that amendment is another matter. There is, however, at least one historical precedent. The journalists Jane Mayer and Doyle McManus tell the dramatic story in their 1988 book, “Landslide: The Unmaking of the President 1984-1988.”
Before he started his job as President Reagan’s third chief of staff, in early 1987, Howard Baker asked an aide, James Cannon, to put together a report on the state of the White House. Cannon then interviewed White House staff, including top aides working for the outgoing chief of staff, Donald Regan. On March 1, the day before Baker took over, Cannon presented him with a memo expressing grave concern that Reagan might not be sufficiently competent to perform his duties. Reagan was inattentive and disinterested, the outgoing staff had said, staying home to watch movies and television instead of going to work. “Consider the possibility that section four of the 25th Amendment might be applied,” Cannon wrote.
After reading the memo, Baker arranged a group observation of Reagan for the following day. On March 2, Baker, Cannon and two others — Reagan’s chief counsel, Arthur B. Culvahouse Jr., and his communications director, Tom Griscom — scrutinized the president, first at a Cabinet meeting, then at a luncheon. They found nothing amiss. The president seemed to be his usual genial, engaged self. Baker decided, presumably with relief, that Reagan was not incapacitated or disabled and they could all go on with their business.
Much has changed since the Reagan era, of course. Because of Trump’s Twitter habits and other features of the contemporary media landscape, far more data about his behavior are available to everyone — to citizens, journalists and members of Congress. And we are all free to compare that observable behavior to the list of traits deemed critical for leadership by the U.S. Army.
Prudence L. Gourguechon, M.D., is a psychiatrist and psychoanalyst in Chicago.





Washington Post
Trump would slash disaster funding to the very agencies he’s praising for Harvey response
Lisa Rein
As he toured rising floodwater in Texas on Tuesday, President Trump effusively praised his administration’s Hurricane Harvey response, an effort he began touting on Twitter last weekend even before the storm made landfall.
But not too long ago, the president proposed a budget calling for cuts to some of the federal government’s most consequential efforts to prepare states and local communities and help them recover from catastrophic events such as Harvey.
Congress is likely to approve a Harvey recovery bill, as it has after past disasters, to cover the huge cost of storm damages. The cuts proposed by the Trump administration would slice away funding for long-term preparedness efforts, many of them put in place to address the sluggish federal response to Hurricane Katrina in 2005.
The proposed cuts would include programs run by the Federal Emergency Management Agency, whose new administrator was praised by Trump in a tweet last weekend for “doing a great job”; the Department of Housing and Urban Development, which helps rebuild homes, parks, hospitals and community centers; the National Weather Service, which forecasts extreme storms; and the National Oceanic and Atmospheric Administration, whose research and community engagement help coastal residents prepare for disaster.
“The president has definitely sent a signal with his budget that emergency management is not of interest,” said Scott Knowles, a historian at Drexel University who studies risk and disaster.
Some threatened programs, Knowles said, are “small-budget efforts with big national impact” — training programs that coach local officials on natural disaster response and mapping efforts that show ever-changing flood plains created by new development.
Hurricane Katrina, which killed 1,800 people, most of them in Louisiana, led to the creation of federal programs to help governments better predict disasters and deal with their effects. Some were put in place during the Obama administration in response to rising concerns about climate change and its future impact on sea levels.
The budget released by the Trump White House in March cuts roughly 9 percent for disaster-relief programs across the Department of Homeland Security and other agencies. The cuts are in keeping with the president’s goal of creating a leaner, more efficient government that asks more of the private sector and the states, a goal FEMA Administrator William B. “Brock” Long has reiterated in recent days.
The cuts also shift away from Obama-era “resilience” efforts to prepare for climate change.
Trump officials recently struck down an Obama administration rule requiring building projects in line for federal funding to strongly consider climate change risks — for example, by elevating structures in flood zones away from the reach of rising water.
The goal of the Obama rule was to mitigate the costs to taxpayers of damage claims under the federal flood insurance program.
Climate scientists have warned that coming decades will bring rising sea levels, along with more frequent and serious flood risks to housing, offices and infrastructure. But Trump officials say that removing the rule streamlines the approval process..
NOAA would lose about $200 million in a handful of programs that help coastal states brace for future climate change and adverse climate and weather events.
The proposed cuts would withdraw support for research and engagement in coastal communities. The $73 million Sea Grant program, for example, gathers information on areas including fisheries management and storm preparation.
The budget would also eliminate $667 million from FEMA for state and local grant funding. It also would require local and state governments to match 25 percent of the federal dollars they receive.
Money to help homeowners and businesses rebuild after a disaster and cover other needs goes through HUD’s $3 billion Community Development Block Grant Program. Trump is proposing to zero it out, and it is unclear how disaster recovery money would be affected or delivered without the program.
The Weather Service would lose $62 million now used to update its weather models and allow it to predict changing weather further out. The National Flood Insurance Program would lose $190 million for mapping flood-prone areas, information that can affect flood insurance premiums.
And the Agriculture Department would lose $114 million in disaster assistance to help farmers recover livestock, crops and equipment, an impact that would be particularly felt in Texas, where farm areas are flooded.
“The USDA offices serve as primary sources of contact for rural counties,” said Derek Hyra, director of the Metropolitan Policy Center at American University. After a disaster, “they’ll go to the feds and say: ‘Here’s what happened to my farm. How do I get operating again?’ ”
The Department of Health and Human Services preserves spending levels for most preparedness and response programs, including its hundreds of doctors, nurses, pharmacists and other medical professionals who are now deployed to Texas. But a national hospital preparedness fund would be cut by $27 million to $227 million. The program is being redesigned to steer money to parts of the country with the greatest need and withhold dollars from areas that “fail to deliver results.”
Wendy Smith-Reeve, Arizona’s emergency management director and president of the National Emergency Management Association, called the proposed cuts “incredibly impactful.” To push back, she said, states need to do a better job showing the Trump administration “what our investment is” in preparing for disasters.
It is unclear whether the cuts will survive in Congress, which has made little progress toward approving a budget for the next fiscal year. Lawmakers are scheduled to resume negotiations when they return to Capitol Hill next week.
Experts say that an emergency relief measure would not cover the longer-term losses to many disaster programs.
“The consensus is that politicians get rewarded for coming to the aid of disaster victims,” said Patrick Roberts, a public policy professor at Virginia Tech who specializes in emergency management, “but with mitigation, the benefits are harder to see.”
He said that every dollar spent on mitigation projects before a disaster saves four dollars in recovery expenditures.
Amy Goldstein, Chris Mooney and Thomas Gibbons-Neff contributed to this report.