Dr. John Gartner on a tale of two brains: "Biden's brain is aging. Trump's brain is dementing"

Donald Trump has demonstrated, in repeated and dangerous ways, that he appears to be profoundly unwell mentally and emotionally. Some of the country’s and world’s leading mental health professionals have concluded that based on his behavior, Trump is likely a sociopath if not a psychopath.  

Whatever one may think about the specifics of his policies, President Joe Biden, on the other hand, is a responsible leader and an institutionalist who believes in America and the democratic experiment. By comparison, Donald Trump hates democracy, attempted a coup on Jan. 6, and is a megalomaniac who believes that he is some type of god or messiah. Whatever a fence sitter, undecided, or disgruntled Democrat or other member of Biden’s 2020 electoral coalition who is angry at him over a specific policy may think and feel, there is no issue where Donald Trump will be a real improvement. Moreover, Trump and his MAGA movement will punish those people who they view as being members of the Democratic Party's base of support. Ultimately, a “principled” vote against President Biden (or deciding to abstain in protest) is a vote for Trump and American neofascism.

“President Biden is old” is an easy, lazy, familiar, and comfortable narrative for the mainstream news media. It is sensational and gossipy (which means more ad revenue and attention), and maintains false balance, “fairness," bothsidesism and “objectivity” in their coverage. This maneuvering also allows the mainstream news media as an institution, or so its leaders incorrectly believe, some measure of protection against retaliation by Trump and his regime, if he takes power in 2025. In all, a focus on Biden’s mental health and age is but another way of normalizing Donald Trump and the neofascist movement and a continuation of the years of failure(s) by the American news media that helped to birth the vile Trumpocene.

The claim that President Biden is old and therefore so diminished mentally and physically that he is incapable of being an effective leader has taken on a life of its own. In many ways, this narrative is immune to the facts and evidence and may be a deciding factor in the outcome of the 2024 election and the future of the United States.

Dr. John Gartner is a psychologist and former professor at the Johns Hopkins University Medical School. Gartner was a contributor to the 2017 bestseller "The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President."

In this conversation, Gartner argues that it is actually Donald Trump and not President Biden who is showing diminished mental acuity and dangerous behavior related to aging. Gartner explains that Donald Trump’s escalating dangerousness is connected to what he believes is a diseased mind that will only get worse. Gartner warns that given Trump’s dangerous personality and emotional state, (Gartner describes this as “hypomanic” behavior) he is almost certainly plotting revenge and how to make his “enemies” suffer as revenge for finally being held accountable by the courts and the rule of law. At the end of this conversation, Gartner explains how even on his worst day as an older person, President Biden is a far superior leader and decision-maker (and human being) than Donald Trump.  

This interview has been lightly edited for clarity and length: 

For several years, you have not been commenting publicly about Donald Trump. You shared with me how you are tired and exhausted from being in the fight against him and the MAGA movement and decided to step back. I have talked to other members of “the resistance” and they too have told me similar things. They’re exhausted; they’re tired; they’re spent. You were recently quoted in an article at US News and World Report about Biden and Trump’s mental health and age. Why have you decided to retake your public platform?

I'm not quite coming back to discussing politics publicly as I did before. I went through a similar process like some of the other people you have spoken to who have decided to step away from being active members of "the resistance." For five years I did that work with total energy and commitment. I was sounding the alarm about Trump basically every day. I did hundreds of interviews. I made it my full-time job like I was at war. But after five years, when Biden was inaugurated, I thought, okay, the war's over, I can take off my metaphorical uniform. So, not only are many members of the resistance exhausted, but we disbanded when Biden won in 2020. We had a duty to warn the public about Trump and the MAGA movement and all that danger. We were basically saying, "The British are coming! The British are coming!" At this point the American people must know that the British are here.

I had to speak out now because the 2024 election might turn on this issue of who is cognitively capable: Biden or Trump? It's a major issue that will affect some people's votes. Not enough people are sounding the alarm, that based on his behavior, and in my opinion, Donald Trump is dangerously demented. In fact, we are seeing the opposite among too many in the news media, the political leaders and among the public. There is also this focus on Biden's gaffes or other things that are well within the normal limits of aging. By comparison, Trump appears to be showing gross signs of dementia. This is a tale of two brains. Biden's brain is aging. Trump's brain is dementing.

What evidence do you have for that conclusion?

"Phonemic paraphasias" —the substitution of non-words for words that sound similar—are not normally seen until a patient enters the moderate to severe stages of Alzheimer’s.

Some examples of Trump’s non-words: Beneficiaries becomes “benefishes.” Renovations become “renoversh.” Pivotal became “pivobal." Obama became “obamna.” Missiles became “mishiz.” Christmas became “Crissus.” Bipartisan became “bipars.”

This is a fundamental breakdown in the ability to use language. If you were talking to your father on the phone and he did this you would think he is having a stroke. There is no healthy older person who speaks that way.

Trump also engages in what we call "tangential speech." He just becomes incomprehensible when he engages in free association word salad speech that is all over the place. Again, that's a sign of real brain damage, not being old, not being slow, not losing a step not being, but of severe cognitive deterioration. What I don’t understand is why those clips aren’t replayed over and over in the mainstream media. Isn’t Trump babbling incoherently the most newsworthy part of his rally? You can be sure it would be if it were Biden.

Biden has been excoriated for forgetting names, which can be a normal part of aging. But Trump isn’t just forgetting names, he’s forgetting and combining people. Trump believes Nikki Haley is Nancy Pelosi. He has said repeatedly that Obama is still president. He said his father was born in Germany when that was his grandfather.

There is also a person's baseline. This is an essential tool for evaluating a person's mental decline. If you look at Trump's interviews and speeches from the 1980s for example, he may have always been a bit of a jerk, but he was articulate and polished. Now if you look at Trump there is great deterioration. By comparison, Biden has never been the most articulate person; he always had a stutter. He always made gaffes. But Biden has a good heart and good judgment. Over the decades we have not seen much evidence of deterioration in Biden's speaking.

The mainstream news media is now advancing a narrative that President Biden is old, too tired, and needs to retire. By comparison, Trump, who is only a few years younger than the president, is being depicted, inaccurately, like he is some type of Immortal or human fountain of youth and vitality. I have made the intervention that Trump looks to some like he is full of energy and life because he is clearly so unwell and out of control and dangerous. President Biden is deliberate and measured. 

Trump is what we would clinically describe as "hypomanic." Trump is a man who is sending out messages on what used to be Twitter and also on his Truth Social platform at three in the morning, sometimes dozens of them in a row. A hypomanic personality has certain strengths and weaknesses. But a lot of it is like a vector of force that depends on where you direct it. Trump has directed his energy in purely destructive and hateful ways. What appears to be endless reserves of energy feeds the incorrect impression that somehow Trump is stronger because he has the vitality of someone who is in a crazed state, who's running amok. There's energy in that apparent crazy behavior. But in the end that is not the type of person who we want as a leader. Such a person will not keep us safe. Trump and people who act like him are not going to have good judgment.

What distinguishes “hypomania" from a high energy personality?

Bipolarity exists on a spectrum. On the lower end of the spectrum, at the high end of normal limits, it manifests as an exuberant, confident person and energetic person. At the other end of the scale are people with bipolar type 1 who have psychotic delusions of grandeur.

As I’ve written about, Trump has a hypomanic temperament as his baseline, but it can become inflamed to the point where he does appear to bear psychotic delusions of grandeur. With Trump, in my opinion, we are seeing this second, very unhealthy and dangerous manifestation of hypomania. There is also a sense of entitlement. Oftentimes arrogance goes with temperament. Charisma as well and a high sex drive. There is also a high drive for dominance. There is also something else very concerning and potentially quite dangerous about hypomania. Those who have that type of personality are also prone to severe hypomanic episodes which escalate in a crisis or when they fixate on something they find exciting. Then they can become even more reckless, impulsive and irritable. Such personalities like Trump show even worse judgment in such moments.

How is Donald Trump responding to the pressure from his criminal and civil trials? Last week, he was fined more than 350 million dollars. He now owes almost 500 million dollars in fines and penalties from his two civil cases.

Donald Trump is making a list of all the people he's going to punish and get revenge on. He is thinking about all the institutions in our society he is going to destroy. There's nothing more dangerous than a wounded animal. To my eyes, Donald Trump was always an animal — but now he's a wounded animal. Too many Americans — including people in the news media and in politics who should know better — are not comprehending the scale of Trump's revenge. If Trump gets back in power heads are going to roll. There are so many people who are going to be in harm's way. People better wake up and stop being in denial.

Donald Trump’s behavior is wholly predictable. Yet, the mainstream news media, the political class, and the American people as a whole continue to act surprised by his escalating dangerousness, promises of becoming a dictator, violent threats and other pathological behavior. At this point, after at least 8 years of Trump and the MAGA movement and all the horrible things he and they have wrought, one would think the American people and their leaders would be experts on mental pathology.

At this point, anybody with an IQ over 90, who isn't brainwashed by Fox News can see that Trump is unwell, dangerously unfit, malignant personality who has reaped massive destruction (have we just forgotten the hundreds of thousands of Covid deaths?) but even "mainstream" news sources have been normalizing Trump's dangerous and aberrant behavior because the corporate owners of the media want the ad money and don’t want to alienate their potential public by telling too much of the truth about the situation. Instead, they waste precious time talking about if President Biden is too old.

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Given Trump’s personality type and behavior and now his mountain of debts from the civil cases, there must be real anxiety among the United States government and the national security state and allies about the ex-president having access to top secret and other highly classified information. As others have pointed out, Trump could potentially give away the country’s secrets to hostile foreign governments for money. 

Donald Trump has absolutely no loyalty to the country. In fact, there's a perverse way in which I think he takes pleasure in destroying America. That is a function of his malignant narcissism. I have no doubt Trump would sell America's secrets and likely already has given his psychopathic behavior. Malignant narcissists take joy in destruction. An emotionally and psychologically healthy person can't understand it.

Trump is now proclaiming that he is basically the Chosen One, a type of emissary and messiah from “god” and “Jesus Christ." As a clinician who has studied Trump’s behavior, how are you making sense of such claims and what they reveal about his mind?

It's the grandiosity; Trump has delusions of grandeur. That fits both the malignant narcissism and the hypomania. It fits both. Trump is practically declaring that he is God. If someone else was doing such a thing they would likely be hospitalized. Trump's sense of reality testing is very fluid. Yes, Trump is performing for his MAGA followers, but I also am convinced that he actually believes that he has some type of God-like powers.

What about Trump’s followers who see in him some type of god or superhero?

At some level their worship of Trump is cartoonish. They idolize him beyond anything that is reasonable. If you get sucked into a cult, there is this psychology of worshipping the Dear Leader, he or she is omniscient, the Messiah. Some people's personalities are also more vulnerable to joining cults. People who have more primitive personality disorders or other such conditions split the world into idealized figures and devalued figures. Such people also tend to have unstable emotional lives and relationships. On a mass movement scale, Trump is able to mobilize many such people. I would also suggest that many of Trump's most die-hard followers are organized psychologically on this more primitive level. Some have the authoritarian personality described by Adorno after World War II in their attempt to understand who was attracted to the Nazis. Charismatic leaders like Donald Trump excite in their followers a kind of frenzy. But because the MAGA movement, like other fascist and authoritarian movements, is a death cult, what Trump is inciting in them is a kind of a dark frenzy and dangerous excitement. We have seen such energies summoned in some of the worst moments of modern history, most notably in Germany.

Returning to my earlier point. Donald Trump is utterly predictable. You have predicted almost everything that Trump would do given his personality type and mind, sometimes years in advance. What are some of your specific predictions that have come true?

I predicted over a year before the 2020 election that Trump wouldn't surrender power willingly. Trump's threats to put immigrants and other "undesirables" in camps is also predictable and not at all surprising. I was warning the public years ago that Trump should be compared to Hitler. The media and other people told me I was exaggerating, and that Trump wouldn't have concentration camps. He did it. He is now promising an even bigger concentration camp system and the largest deportation program in history. When a person tells you who they are, believe them. Trump is now quoting Hitler and Mein Kampf and talking about "vermin" and "poison" in "the blood" of the country. It's not a dog whistle anymore. It's a foghorn. Trump has really beaten us down. We've become so desensitized.

Let’s assume that both Biden's and Trump’s behavior and personalities continue in the same direction. With that assumption, on their worst day, which of these two men would you rather have as President of the United States?

Even if he was demented, I would rather have Biden than Trump as President of the United States. Dementia brings out the worst in people's character. They become 10 times worse. If Biden really were to mentally decline — and I'm not saying he has or will or is — but he's basically a benign person with good judgment. Biden cares about his fellow human beings. Biden is patriotic, and he actually believes in defending the Constitution and the United States of America. So even if Biden were to become diminished in his cognitive abilities, he's still not going to do something evil or crazy. He just might need more help. By comparison, Donald Trump unleashed would be like Satan unbound.