The Daily Beast Podcast

Episode: This is What Proves Trump’s Dementia: Psychologist

Date: September 21, 2025

Host: Joanna Coles
Guest: Dr. John Gartner (Psychologist, Professor, Podcast host "Shrinking Trump")

Overview

In this episode, Joanna Coles converses with Dr. John Gartner, a clinical psychologist and former professor at Johns Hopkins University, who discusses his professional assessment that Donald Trump is exhibiting clear symptoms of dementia, specifically frontotemporal dementia. The discussion explores the evidence for cognitive and behavioral decline, examines how Trump’s longstanding personality pathology interacts with dementia, considers the ripple effects on those around him, and compares these phenomena to other leaders.

Key Discussion Points & Insights

1. How Dementia Is Diagnosed in a Public Figure

• Baseline Comparison:
  Dr. Gartner stresses that dementia diagnosis is about “a major deterioration in functioning” compared to a person's own prior baseline (04:21).

  • Trump was once "very articulate… Now what we see is not only has his vocabulary gone down, but his ability to put together thoughts and sometimes even words" (04:21).

• Linguistic & Cognitive Decline:

  • Episodes of “phonemic paraphasia” (mispronounced, non-English words, e.g., “mishes” for “missiles”).
  • “Tangential speech”—jumping randomly between unrelated topics, as with Trump’s “Hannibal Lecter” rant (04:21–07:10).

  Quote:

  "This is something that only people who have an organic brain disease do. It's not something people just do when they're tired or when they get old."
  — Dr. John Gartner (04:46)

• Not Old Age:

  • The decline is not simple aging.
  • "This is really a breakdown in all of the mental functions…" (08:06).

2. Trump’s Malignant Narcissism & Its Interaction with Dementia

• Personality Baseline:

  • Trump has long exhibited “malignant narcissism”—a dangerous and untreatable personality disorder.

  Quote:

  “He’s been a malignant narcissist his whole life... That’s core to who he is, and that’s what makes him so dangerous and untreatable.”
  — Dr. John Gartner (08:37)

• Difference from Other ‘Narcissists’:

  • “Malignant” narcissism combines narcissism, psychopathy (no conscience or empathy), paranoia, and sadism (12:53).

• Historical Context:

  • The concept was coined to explain dictators like Hitler (09:39).

3. Physical and Neurological Symptoms

• Chronic Falling Asleep:

  • Not normal: “He fell asleep most of the days during his criminal trial... It never happens.” (16:04)

• Motor Impairment—Frontotemporal Dementia:

  • “Wide based gait”—noted as pathognomonic (“you don’t see this in anyone unless they have frontotemporal dementia”) (17:26).

  Quote:

  "If you look at his right leg, sometimes he just swings it like a dead weight in a semicircle..."
  — Dr. John Gartner (17:05)

• Strokes/Facial Droop:

  • Public signs at the 9/11 memorial: “half of his face was drooping”; suggestive of mini-strokes (18:20).

4. Danger of Power Combined with Decline

• Worst-Case Scenario:

  • “The person holding the nuclear codes is incompetent, but nobody can rein him in. He won't listen to anybody and no one dares to oppose him.” (21:36)

  Quote:

  “Imagine that that person has sort of omnipotent power...and is paranoid about anyone trying to control them and will attack anyone who contradicts them. It's really kind of like a worst case scenario.”
  — Dr. John Gartner (21:21)

• Cabinet & Staff Enablement:

  • “He’s now got a cabinet of enablers… even in terms of his confusion…” (09:03)

5. Handling & Managing the Decline

• Unpredictability:
  • Paranoia and volatility make him frightening even for close colleagues: “...people want to be out of the room, because if you’re in the room, Donald Trump's gaze may suddenly settle on you and it will trigger him to either go off on you...” (19:17)

6. Public and Media Response

• Emperor’s New Clothes Dynamic:
  • Dr. Gartner argues the press is mostly not confronting the dementia issue directly, with most coverage limited and reliant on a few outspoken professionals: “I don't think you're going to find it. And when you do, unfortunately, it'll be them quoting me and my co host, Harry Siegel” (30:41).
• Trump’s Appeal:
  • The “authoritarian personality” continues to attract disempowered followers seeking strength or dominance (23:16–24:45).

7. Comparisons to Other Leaders

• King Charles:
  • Distinguished from Trump; not “relentlessly evil,” not a malignant narcissist (15:25).
• Joe Biden:
  • Comparison of cognitive decline: Biden’s deficits were hidden from public view, and only became clear in the debate (32:15). The media was harder on Biden than Trump regarding cognitive decline, a double standard Dr. Gartner finds frustrating.

8. Copycat Behavior and Institutional Effects

• Contagion:

  • Trump’s “psychological DNA” has spread, leading to more aggressive, conscience-less behavior in his circle (“kakistocracy”) (42:59).

  Quote:

  “I sometimes think of Trump as being a malignant narcissist, as being similar to a malignant tumor in the body politic... cells reproduce with that DNA...”
  — Dr. John Gartner (42:59)

• Purging the Restraint:

  • Those with some moral restraint (e.g., Bill Barr) have been purged from Trump’s orbit and the GOP.

9. Prevalence and Extremity of Psychopathy

• Rarity and Extremity:
  • Only “1 in about 150 people meet strict criteria for psychopathy… Donald Trump was the most extreme example” (46:38–48:07).
  • “In that small group, he would be in, like, 99th percentile” (48:07).

10. Family Isolation and Inability to Love

• Isolation:
  • Melania and Ivanka’s withdrawal is presented as further evidence of Trump’s profound inability to maintain close, loving relationships (28:12).
  • “One of the things about malignant narcissists is they are literally incapable of love. They're incapable of love. And so nobody really loves Donald Trump. He doesn’t really have any figures that really love him.” (28:12)

Notable Quotes & Memorable Moments

• On language breakdown and confusion:

  “His ability to actually put together sometimes… is really unable to complete a thought. Actually, sometimes is unable to complete a word. It's called a phonemic paraphasia.”
  — Dr. John Gartner (04:21)

• On the dangerous intersection of personality and organic decline:

  “We have, in a sense, the worst of both worlds...his judgment was always bad... Now he really is losing his ability to think clearly, to plan, to understand things.”
  — Dr. John Gartner (09:39)

• On Trump’s physical symptoms as unique proof of a specific dementia:

  “If you look at his right leg, sometimes he just swings it like a dead weight in a semicircle... The expert I consulted with said this is pathognomonic—you don’t see this in anyone unless they have frontotemporal dementia.”
  — Dr. John Gartner (17:05)

• On the challenges of managing a powerful individual with dementia:

  "Imagine that that person has sort of omnipotent power... and is paranoid about anyone trying to control them and will attack anyone who contradicts them."
  — Dr. John Gartner (21:21)

• On media reluctance:

  "The press was a lot harder on [Biden] in terms of his mental competence than they were on Trump. And that's what really upset us, is the double standard..."
  — Dr. John Gartner (32:15)

• On why Trump’s followers remain loyal:

  “There is a kind of psychological appeal...someone who feels disempowered and who feels re-empowered by someone who in a punitive way is attacking their shared enemies and making them feel powerful…”
  — Dr. John Gartner (23:16)

• On the spread of Trump’s pathology:

  “Trump’s sort of psychological DNA has now seeped into the people in his administration...you have the true believers, the true psychopaths, the true wingnuts, the people who are all in with no inhibitions, no conscience, no soul.”
  — Dr. John Gartner (42:59)

Timestamps for Important Segments

• Signs of Dementia in Trump (Language, Tangential Thinking): 04:21–07:15
• Explanation of Phonemic and Semantic Paraphasia: 07:33–07:47
• Personality Disorder vs. Dementia: 08:06–09:39
• Physical Evidence—Gait, Falling Asleep, Possible Strokes: 16:04–19:17
• Danger of Leadership with Cognitive Decline: 21:21–22:20
• Family Isolation, Lack of Love & Confabulation: 28:12–31:27
• Media & Public Response: 30:41–33:40
• Comparison to Biden’s Decline and Debate Impact: 32:15–33:56
• Contagion in Trump’s Circle ("Kakistocracy"): 42:59–44:52
• Prevalence and Severity of Psychopathy: 46:38–48:20

Conclusion

This episode presents a comprehensive, evidence-based portrait of Donald Trump as a figure suffering from a rare and severe form of dementia, compounded by a pre-existing malignant personality disorder. Dr. Gartner argues that the combination of deep psychological pathology and observable neurological decline in such a powerful individual is unprecedented and dangerous not only for those in Trump’s immediate orbit but for the functioning of American democracy.

Listeners are left with both a clinical understanding of these phenomena and a sense of urgency about the consequences of unchecked, deteriorating leadership at the highest levels.

Recommended resources from the episode:

• Shrinking Trump Podcast
• Follow-up and audience questions are encouraged for future episodes.