Donald Trump gives the impression that he would like to govern by decree. He has that impulse in him and he wants to be a savior, so he says, in his famous phrase, "Only I can fix it!" That's a strange and weird statement for anybody to make, but it's central to Trump's sense of self and self-presentation. And I think that has a lot to do with his identification with dictators. No matter how many they kill and no matter what else they do, they have this capacity to rule by decree without any interference by legislators or courts.

Donald Trump both disbelieves and believes in falsehoods, so that when he did thrive on his longstanding - the claim that Obama was not born in the United States - he's crazy like a fox in manipulating it because it gave him his political entrée onto the national stage. In order to make your falsehoods powerful, you have to believe in them in some extent. And that's why we simplify things if we say that Trump either believes nothing in his falsehoods and is just manipulating us like a fox or he completely believes them.

The language of the totalist environment is characterized by the thought-terminating cliché. The most far-reaching and complex of human problems are compressed into brief, highly reductive, definitive-sounding phrases, easily memorized and easily expressed. These become the start and finish of any ideological analysis.

For anyone with the traits - of feeling himself victimized, of seeking to be the strongman who resolves everything, yet sees truth only through his own self and negates all other truth outside of it - is bound to become more malignant when he has power. Power then breeds an intensification of all this because the power can never be absolute power - to some extent it's stymied - but the isolation while in power becomes even more dangerous. Think of it as a vicious circle. The power intensifies these tendencies and the tendencies become more dangerous because of the power.

But I spent just two calendar years at Cornell University, though it was covering more than three years of work, and then went to medical school and did become interested in psychiatry, and even helped form a kind of psychiatry club in medical school.

There's an all-enveloping destructiveness in Donald Trump's character and in his psychological tendencies. But I've focused on what professionally I call solipsistic reality. Solipsistic reality means that the only reality he's capable of embracing has to do with his own self and the perception by and protection of his own self. And for a president to be so bound in this isolated solipsistic reality could not be more dangerous for the country and for the world. He's not psychotic, but I think ultimately this solipsistic reality will be the source of his removal from the presidency.

Donald Trump doesn't have clear contact with reality, though I'm not sure it qualifies as a bona fide delusion. He needs things to be a certain way even though they aren't, and that's one reason he lies. There can also be a conscious manipulative element to it. When he put forward, and politically thrived on, the falsehood of President Obama's birth in Kenya, outside the United States, he was manipulating that lie as well as undoubtedly believing it in part, at least in a segment of his personality.