The Daily Beast Podcast: "Why Ailing Trump Is Paranoid About Mental Decline"
Host: Joanna Coles
Guest: Dr. John Gartner (Clinical Psychologist)
Date: January 5, 2026
Overview
In this episode, Joanna Coles welcomes Dr. John Gartner, renowned clinical psychologist, to dissect Donald Trump’s mental and physical deterioration as he heads into the 2026 midterms. The conversation centers around mounting public evidence of Trump’s cognitive issues, his documented paranoia, media coverage regarding his health, and the implications for governance. Dr. Gartner draws on decades of clinical experience to analyze Trump’s behavior, with particular focus on dementia symptoms layered atop longstanding malignant narcissism.
Key Discussion Points & Insights
The Goldwater Rule and Diagnosing from Afar (03:02–04:33)
- Joanna Coles brings up the ethical dilemma: Can professionals “diagnose” a public figure like Trump without direct examination?
- Dr. Gartner explains the Goldwater Rule's origins and asserts:
- Clinicians routinely make diagnoses based on observable behavior, not just interviews.
- The DSM system requires observable behavioral criteria.
Quote: "We can diagnose patients without interviewing, and we do quite all the time in clinical practice...The other thing is we've had a shift in our diagnostic nomenclature."
—Dr. John Gartner [03:49]
Trump’s Public Strategy: Flooding the Zone (04:34–05:24)
- Unlike Biden (whose team limited public appearances), Trump “floods the zone” with visible, erratic behavior, almost normalizing cognitive decline amidst supporters.
- Trump’s public displays become a kind of desensitization tactic.
Quote: "He is basically filling the zone with so much flagrant manifestations of dementia and psychopathology that we're essentially getting used to it."
—Dr. John Gartner [04:59]
Analysis of Trump’s Response to Media Inquiries (05:24–07:10)
- The Wall Street Journal’s recent article prompted Trump to call the paper himself, notably griping about recurring focus on his health.
- Dr. Gartner analyzes Trump’s “25th time” comment as a Freudian slip, suggesting deep paranoia about the 25th Amendment being invoked.
Quote: "We’re talking about it for the 25th time, because people keep saying it’s 25th Amendment time."
—Dr. John Gartner [06:42]
Paranoia and Malignant Narcissism (10:52–15:40)
- Gartner revisits Trump’s history of paranoia, referencing his 1980s rhetoric up to his current, more incoherent suspicions.
- Paranoia in dementia patients often becomes grotesque and primitive.
- Illustrative anecdote: Trump’s bizarre comments to children about “bad Santa” infiltrating the US [12:31].
- Paranoia is both about fearing outside threats and projecting internal aggression outward.
Quote: “Now, as he’s starting to deteriorate, one of the signs of dementia is people becoming more paranoid. The paranoia is becoming more grotesque, more primitive.”
—Dr. John Gartner [11:21]
Memorable moment:
On Trump’s Santa paranoia:
"How crazy to be paranoid about Santa...I didn't know that was a thing. Santa phobia…"
—Joanna Coles & Dr. Gartner [13:01]
Declining Physical and Cognitive Health: Observable Symptoms (07:56–10:52)
- Trump’s self-medicating with excessive aspirin, visible bruising, and worsening right-side weakness are discussed.
- Clear evidence of stroke/microstrokes: trouble with saluting, walking, drooping face.
- Mobility and psychomotor decline have become increasingly visible.
Quote: "This man is not well. I mean, he's basically melting in front of us cognitively and physically."
—Dr. John Gartner [10:52]
The Nature and Progression of Trump’s Dementia (16:29–19:35)
- Gartner discusses “good days and bad days” phenomenon among dementia patients; Trump’s symptoms are variable but unmistakable.
- Assigns frontotemporal dementia as the likely diagnosis, characterized by behavioral disinhibition as opposed to memory loss.
- Incidents of not recognizing familiar faces (e.g., Hakeem Jeffries) are cited as signs of severe decline.
- Stroke events accelerate existing cognitive deterioration.
Quote: “The type of dementia he probably has is frontotemporal dementia...which actually more front and center is the behavioral disinhibition and the behavioral acting out. So it’s even worse.”
—Dr. John Gartner [17:12]
Hypomania & Sleep Disorders: Old Traits Worsening (19:35–22:33)
- Trump’s lifelong hypomania (high energy, little need for sleep) now mixed with dementia, manifesting as passing out during the day and excessive hate-posting at night.
- This sleep disorder is both a symptom and accelerant of mental decline.
Quote: "Now he's passing out during the day, you see. And that's a whole other level of symptomatology."
—Dr. John Gartner [19:35]
Cognitive Testing & The MOCA (23:15–28:25)
- Trump’s frequent cognitive tests (MOCA) are, by analogy, major red flags: "You don't take it repeatedly unless you're being specifically monitored for decline."
- Trump brags about “acing” tests meant as basic screens—indicative of serious underlying issues.
Quote: “Nobody takes the MOCA repeatedly unless they're being monitored for dementia… He did badly enough on the screening test that they felt they had to give him a battery.”
—Dr. John Gartner [24:35, 27:24]
Alarming Moments and Media’s Tepid Coverage (31:30–36:47)
- Dr. Gartner expresses dismay that major outlets (e.g., WSJ) still minimize Trump’s decline.
- Recommends the New Republic’s “Eleven Most Senile Moments of 2025” list—key incidents include:
- Publicly falling asleep,
- Nonsensical rants about “groceries,” “magnets,” “boats, sharks, and electricity,"
- Failing context when discussing a death or ignoring a man passing out (34:24).
Memorable quote: “This is the real Emperor's New Clothes fiasco that we're living here.”
—Dr. John Gartner [31:30]
The Human Side: Recognizable Patterns (36:47–37:36)
- Listeners are reminded that these symptoms are widely recognizable from family and friends’ experiences.
- Many commenter responses echo: “This reminds me of my mother/ex-husband.”
Quote: “One of the most common comments that we've gotten is, this reminds me of my mother. This reminds me of my ex husband.”
—Dr. John Gartner [37:23]
Managing Trump: “The Wire in the White House” (39:34–49:49)
- Illustration of White House staff coping mechanisms—keeping Trump distracted with meaningless tasks (naming rooms, obsessing over decorations).
- Reference to the “25” text chain among staff during his first term to privately note his erratic acts.
- Comparison to managing dementia patients in nursing homes; in this case, the challenge is intensified by Trump's absolute power.
Quote: “They're kind of letting him grandiosely run around naming everything after himself and being obsessed with these little details, while meanwhile other people are actually running the government.”
—Dr. John Gartner [49:53]
Violence, Disinhibition, and Risks to Society (46:45–48:31)
- Dementia often brings aggression, especially when coupled with existing paranoia.
- The real-world danger: a cognitively impaired president could act erratically with immense power, risking catastrophic decisions.
Quote: “He might physically act out by just deciding to kill a few hundred people, you know what I mean? Just blow up a few boats…this is the worst possible formula that I could possibly imagine for any kind of stability.”
—Dr. John Gartner [47:56]
Advice and Reflections: What Should Staff Do? (48:31–51:26)
- Dr. Gartner’s advice: invoke the 25th Amendment.
- In absence of that: staff are left “stroking his ego” and keeping him occupied with low-stakes responsibilities.
Quote: "Part of I think what they do, is stroke his ego... letting him focus on irrelevant things that pump up his ego but don't have much effect."
—Dr. John Gartner [48:58]
Trump, Strongmen, and Geopolitical Grandiosity (51:34–54:14)
- Trump’s affinity for “strongmen” like Putin and Xi is evaluated as grandiosity and identification with autocrats.
- His pursuit of peace prizes, relationship with authoritarians, and open flattery of adversarial leaders is examined.
- Dr. Gartner ties these patterns to decades-old reported Russian interest in Trump as a political asset.
Notable Quotes
-
"He's basically melting in front of us cognitively and physically."
—Dr. John Gartner [10:52] -
"Now, as he's starting to deteriorate, one of the signs of dementia is people becoming more paranoid. The paranoia is becoming more grotesque, more primitive."
—Dr. John Gartner [11:21] -
"Nobody takes the MOCA repeatedly unless they're being monitored for dementia."
—Dr. John Gartner [24:35] -
"This is the real Emperor's New Clothes fiasco that we're living here."
—Dr. John Gartner [31:30] -
"We’re literally watching The Wire in the White House."
—Joanna Coles [15:40]
Key Timestamps
- 03:02 – The Goldwater Rule and ethical debates on public diagnosis
- 05:24 – Analyzing Trump’s defensive phone call to the WSJ
- 07:56 – Physical symptoms: aspirin use, bruises, stroke speculation
- 10:52 – Cognitive and motor decline: right-side weakness, public signs
- 11:21 – The deepening of Trump’s paranoia and its pathological roots
- 16:29 – Frontotemporal dementia: “good days/bad days,” memory lapses
- 19:35 – Hypomania, sleep, and how symptoms have shifted
- 23:15 – MOCA test, public bragging, what multiple tests really imply
- 31:30 – How and why media minimizes Trump’s decline
- 33:16 – The New Republic’s ‘Most Senile Moments of 2025’ rundown
- 36:47 – Shared public recognition of dementia symptoms
- 39:34 – Coping inside the White House; evasion & distraction tactics
- 46:45 – Dangers of disinhibition, aggression, and uncheckable power
- 48:31 – Dr. Gartner’s practical (and urgent) advice to staff
- 51:34 – Trump’s relationship with global strongmen and historical perspective
Podcast Tone
- Informal yet clinical.
- Candid, at times darkly humorous.
- Coles and Gartner use plain language, accessible analogies, and don’t shy from irreverence (sometimes laughter at the absurdity, akin to “coping with elderly relatives”).
- Moments of seriousness when discussing real-world consequences.
For Listeners Who Haven’t Heard the Episode
- This conversation is a forthright examination of Donald Trump’s mental and physical decline, viewed through the lens of professional psychology and bolstered by mainstream media coverage and observed behavior.
- Dr. Gartner argues Trump’s dementia compounds preexisting malignant narcissism, producing a dangerous and unpredictable leader.
- Real-world implications for US governance are discussed, as is the scant action by those closest to the President, who are left to “manage” the decline by distraction and appeasement, rather than intervention.