Bill Press: Trump’s mental health: worse than you thought

Bill Press, Tribune Content Agency on Oct 1, 2026

Since he first came down the golden escalator in June 2015, there have been questions raised about Donald Trump’s mental health. Many psychologists and psychiatrists have suggested that his behavior is consistent with signs of narcissistic personality disorder, anti-social personality disorder, and paranoia.

While these mental health professionals acknowledge they’ve not personally interviewed Trump, they all point out it’s not necessary for Trump, who’s a constant, unfiltered presence on television and social media. Not only that. As professionals, they argue, given the risk of someone mentally unbalanced in a position of great power, they have a “duty to warn.”

Latest to sound the alarm is licensed clinical psychologist Dr. Vincent Greenwood, founder of the Washington Center for Cognitive Therapy in Washington, D.C., who – in his newly-published book “Puppet on a String” – makes the case that Donald Trump’s mental health issues are, in fact, worse than we thought.

Dr. Greenwood’s book opens with this chilling first sentence: “This book is about a puppeteer, his puppet, and their prey.” As Greenwood explains, the “puppeteer” is a mental health disease called“clinical psychopathy.” The “puppet” is Donald Trump, whose wild behavior and speech traits are largely controlled by his condition – like a puppet on a string. And, unfortunately, the “prey” is us.

Dr. Greenwood bases his study on a highly-respected clinical psychopathy checklist (PCL) first published by Dr. Robert D. Hare in 1980 and revised in 1991, and applied in more than 80,000 case studies. He lists 20 behavior patterns that indicate some level of the disease. The list is long, but worth repeating.

According to Dr. Hare and Dr. Greenwood, there are 20 traits at play in someone with clinical psychopathy: 1. Glibness/superficial charm. 2. Egocentricity/grandiose sense of self-worth. 3. Proneness to boredom/low frustration tolerance. 4. Pathological lying and deception/gaslighting. 5. Conning/lack of sincerity. 6. Lack of remorse or guilt. 7. Shallow affect. 8. Callousness/lack of empathy. 9. Parasitic lifestyle. 10. Poor behavioral controls.

The list continues: 11. Promiscuous sexual behavior. 12. Early behavioral problems. 13. Lack of realistic long-term goals. 14. Impulsivity. 15. Irresponsibility. 16. Failure to accept responsibility for one’s own actions. 17. Many short-term marital relationships. 18. Juvenile delinquency. 19. Revocation of conditional release. 20. Criminal versatility.

Bingo! If that doesn’t paint an accurate picture of the Donald Trump we’ve been afflicted with for the last 10 years, I don’t know what does.

“Pathological lying” would definitely prompt a person to claim he got more popular votes than Hillary Clinton in 2016, deny he lost the 2020 election to Joe Biden, and insist he created the strongest economy in history, when facts show the opposite.

“Grandiose sense of self-worth” describes someone who insists on plastering his name on everything, putting his mug on passports and coins, and building a monumental arch to himself.

“Callousness and lack of empathy” would explain a failure to mourn the loss of Renee Good and Alex Pretti, two innocent Americans gunned down by ICE agents in the streets of Minneapolis – or any of the law-abiding American residents routinely rounded up and deported to countries they didn’t come from.

“Promiscuous sexual abuse” fits a man whom more than 28 women have publicly accused of some form of sexual misconduct, ranging from unwanted kissing and groping to sexual assault and rape and who was forced to pay E. Jean Carroll $5 million for sexually abusing and defaming her.

How bad a case of clinical psychopathy is Donald Trump? Dr. Greenwood explains that, using the O’Hare checklist, patients are diagnosed according to how they rate on a scale of zero to two. For each trait, a person could be a 0, a .5, a 1.2, or higher. Anyone with a 40, the highest possible score, would already be in a mental institution. Less than one percent of the population would even cross the threshold to be considered for clinical psychopathy. And the average rating for patients with this condition is 4.

Now here’s the punchline. According to Dr. Greenwood, Donald Trump rates a 32!

On the “Bill Press Pod,” I asked Dr. Greenwood if it was fair to say that Donald Trump is “mentally ill.” “Yes, it is fair to say that he deserves to be linked with the condition of clinical psychopathy, which is considered a serious mental condition,” he told me.

According to Dr. Greenwood and other mental health professionals, the President of the United States is a psychopath. That’s frightening for someone with his finger on the nuclear power button.

(Bill Press is host of The BillPressPod, and author of 10 books, including: “From the Left: My Life in the Crossfire.” His email address is: bill@billpress.com. Readers may also follow him on Twitter @billpresspod and on BlueSky @BillPress.bsky.social.)