When I was still in my psychiatric residency training in New York City, I was subjected to the doctor draft of that time, during the early fifties, at the time of the Korean War.

There are people who believe that there should be a standard psychiatric examination for every presidential candidate and for every president. But these are difficult issues because they can't ever be entirely psychiatric. They're inevitably political as well. I personally believe that ultimately ridding the country of a dangerous president or one who's unfit is ultimately a political matter, but that psychological professionals can contribute in valuable ways to that decision.

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.

While Donald Trump doesn't have any systematic ideology, he does have a narrative, and in that narrative, America was once a great country, it's been weakened by poor leadership, and only he can make it great again by taking over. And that's an image of himself as a strongman, a dictator. It isn't the clear ideology of being a fascist or some other clear-cut ideological figure. Rather, it's a narrative of himself as being unique and all-powerful. He believes it, though I'm sure he's got doubts about it.

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.

I never quite envisioned myself a proper doctor under that white coat, but I was interested in the idea of healing and in the psychological dimension rather early on.

The one-sided exploitation of existential guilt is thought reform's trump card, and perhaps its most important source of emotional influence over its participants. Revolving around it are issues most decisive to thought reform's outcome.