Dr. John Gartner: The world is watching "a fundamental breakdown in Trump’s ability to use language"

It has become undeniably clear and obvious to any reasonable person that Donald Trump is experiencing increasing challenges with his speech, language, and memory during these last few weeks and months. Such a conclusion does not require a huge team of investigative journalists: a person only has to watch the corrupt ex-president’s speeches, interviews and other public behavior. For example, at a series of rallies and other events last weekend, Trump repeatedly confused one person with another. Like a broken computer in a science fiction movie, Trump appears to have moments where he cannot speak, appears lost in his thinking, and is more generally confused as he spouts nonsense words and non-sequiturs.

MediasTouch editor Ron Filipowski shared a montage online of 32 examples of Trump experiencing severe challenges during his recent speeches in Virginia and North Carolina last Saturday. 32 examples from just two speeches where the ex-president “mispronounced words, got confused, mixed up names, forgot names, and babbled insane nonsense.”

One of Donald Trump’s former advisors, Alyssa Farah Griffin of ABC's "The View", told CNN in an interview on Monday that Trump "is not as sharp as he was in 2016": 

I have said this before, he is not as sharp as he was in 2016 and not even as sharp as he was in 2020….Listen, he's never been a super articulate or eloquent person….But he's consistently missing up — uh, mixing up names of heads of state. He's mixing up names like Nancy Pelosi and Nikki Haley. I mean, this is it's gotten worse, it hasn't gotten better he's not nearly as sharp as he was.

Also on Monday, during an appearance on Morning Joe, MSNBC contributor Jonathan Lemire reported that Trump’s inner circle is aware of his apparent cognitive challenges and are trying to conceal them from the public:

We're seeing with more and more frequency, even as the media — and we talked about it earlier, how the weekend was full of polls and obsession about President Biden's age — it is this, Trump, who day after day is showing the signs of age but also pressure….because he is not getting as much of the share of the Republican vote as he'd like….Nikki Haley posting a win over the weekend. Pressure because of the money he now owes, nearly half a billion dollars in a couple cases in New York City, and pressure that his first criminal case, a case that could theoretically put him in prison, starts in just three weeks. We are seeing it night after night on the rally stage, where he seems to even just lose control of the English language. Mika [Brzezinski] cringes, I can't help it either at the end of that clip. His team knows, but they're just forging forward.”

Whatever one may think of Donald Trump the political leader, and all of the evil and vile things he has done in that capacity, he is a human being who appears to be in crisis. Moreover, that Donald Trump is leading President Biden in the polls and has a real chance of becoming the next president of the United States should be a source of great alarm for anyone who claims to care about the well-being of the country and its future.

In a series of widely-read conversations with me here at Salon, Dr. John Gartner, a prominent psychologist and contributor to the bestselling book "The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President,” has issued the following, almost prophetic warnings, about the ex-president’s behavior:

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.

Continuing with this ongoing conversation, I asked Dr. Gartner, and several other leading mental health and medical professionals via email for their thoughts and insights about Donald Trump’s deeply troubling behavior last weekend (and more generally), what they believe is happening based on the public evidence, and what advice they would give Trump and those who care about him.  

Dr. John Gartner is a psychologist and former professor at the Johns Hopkins University Medical School. 

This is becoming a weekly ritual: A round-up of the latest behaviors evidencing Trump’s apparent dementia. For the eighth time, Trump announced that he was running against Obama. No one believed it when he said he was joking the first seven times, and he keeps saying it, showing just how deeply disoriented he is and how advanced his apparent dementia has become.

Trump is continuing to show more of these phonemic aphasias: “Venezuero” instead of Venezuela. He is also demonstrating semantic aphasias: “steak mountain or steak hill,” instead of “Snake mountain.” Trump is continuing to slur words. What is even more troubling is how Trump sometimes can’t form words at all but just makes sounds. For example, “Saudi Arabia and Russia will…. bluh-ub-bll….”

And finally, there were more examples last week of a fundamental breakdown in Trump’s ability to use language, to think and to communicate. When Trump visited the border, he said: “Nobody [can] explain to me how allowing millions of people from places unknown, from countries unknown, who don’t speak languages — we have languages coming into our country, we have nobody that even speaks those languages. They are truly foreign languages. Nobody speaks them.” In my opinion, Donald Trump is getting worse as his cognitive state continues to degrade. If Trump were your relative, you’d be thinking about assisted care right now.

Harry Segal is a senior lecturer at Cornell University and Weill Cornell Medical School. He holds a Ph.D. in English Literature from Yale University and a Ph.D. in Clinical Psychology from the University of Michigan. He also conducts a part-time practice in Ithaca, New York, and has written extensively on personality disorders.

I see a dramatic change since he announced his candidacy in November 2022. That speech was more typical of Trump during his presidency – he relied on the teleprompter, but his digressions were easy to follow even if they were filled with lies. But over the past year, his appearances have been erratic. Sometimes, as with the CNN Town Hall, he made few gaffes. But in the past six months, Trump's rallies are filled with strange lapses of logic. He has confused Biden with Obama, spoke of World War II, and has lapsed into bewildering digressions that are hard to follow. Only this weekend he said: “We have languages coming into our country that no one can speak,” a strange grasping for meaning, bordering on neologism. At other times, he seems to get lost in the middle of a sentence.

Since this is an intermittent problem, it suggests that when Trump is especially stressed and exhausted, he suffers cognitive slippage that affects the way he associates words or their meaning. Note, though, that Trump’s pathological lying is itself a form of mental illness, so these cognitive lapses are literally sitting atop what appears to be an already compromised psychological functioning.

There seems to be an emerging difficulty maintaining linguistic control that may well be caused by his incapacity to manage the stress caused by his multiple indictments, court appearances, and huge legal fines. In addition, his daughter and son-in-law are no longer supporting him, and his wife hasn’t appeared with him in public at any of his rallies or victory speeches. This lack of support may be contributing to what appears to be his intermittent cognitive disorganization.

First, I would recommend a full neuro-psychological assessment to identify the deficits in his cognitive functioning. Given those results, I would then recommend limiting his daily activity, scheduling tasks that require high-level cognition early in the day to avoid “sun-downing,” and psychotherapy to explore the sources of stress contributing to mental difficulties. I would certainly recommend that he immediately cease running for president.

Vincent Greenwood, Ph.D, is the founder and executive director of the Washington Center For Cognitive Therapy, a mental health program that provides clinical services in the Washington D.C. area. He has worked as a research associate and training leader at Johns Hopkins University and the National Institute of Health. In 2020, he launched DutyToInform.org to disseminate information about the intersection of psychology and our recent political turmoil. He is the author of The Open And Shut Case Of Donald Trump.

In the past week, we have seen Trump say the following things which could indicate a larger problem with speech and cognition: “Putin has so little respect for Obama…we have a fool for a president." This is an example of mixing up people, not just an occasional mix-up of a name. It is similar to his going on and on about Nikki Haley being responsible for security at the Capitol rather than Nancy Pelosi.

Trump has displayed this kind of confusion with increasing regularity over the past few years. It is meaningful because the confusion of people, in contrast to the occasional forgetting of names, is a sign of early dementia, as noted by the Dementia Care Society.

In his speech in North Carolina, Trump said “migrant cime” leaving out the “r”; and was unable to say “Venezuela” which came out sounding like “Venezwheregull.” These are examples of what we call phonemic paraphasia which is associated with underlying brain damage.

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(Aphasia is the term we use for disorders of communication. Aphasia is a symptom of some other underlying condition, such as dementia, stroke or head injury. A phoneme is the smallest unit of speech - often a letter or two - that distinguishes one word from another. For example, the letter “r” in the word “far” separates that word from “fad,” “fan,” and “fat.” Phonemic paraphasia is the inappropriate substitution of one sound for the other).

We all stumble over and mispronounce words occasionally. This is not what is going on with Trump. The incidence of these kinds of mistakes takes him into this realm of phonemic paraphasia, which is a sign of underlying brain damage, not just aging. Even when compared to his speech of a few years ago, you can observe a noticeable difference. When you compare it to his speech as a middle-aged man, the shift is radical and ominous.

Trump has also been displaying another kind of paraphasia, called semantic paraphasia, also associated with cognitive deterioration. (Semantic paraphasia involves choosing incorrect words). Last week in his South Carolina speech, he said, “soup pie cane” when he meant to say “supply chain,” and “lady, lady, lady,” when he meant to say “later.” As a younger man Trump’s linguistic style might be characterized as glib but was not marked by the use of the substitution of incorrect words. Semantic paraphasia is a qualitative marker - not of aging -but of underlying disease.

Trump’s unscripted speech of late has also revealed other signs of likely dementia. These include mid-thought change of subject, repetition of words, the use of fillers (“well,” “um,” “so,”), trouble formulating complete sentences not to mention paragraphs, getting words in the wrong order, and simpler word choice.

Loss of vocabulary is not a correlate of normal aging. If anything, there appears to be a slight increase in vocabulary as one gets into their seventies and eighties. It is noteworthy that Trump exhibits a markedly declining vocabulary with overreliance on superlatives over the years. He has gone from what might be described as possessing a somewhat sophisticated vocabulary to one sorely lacking in suppleness.

The key question at the moment regarding Trump’s fitness is the following one. Is there a significant change in his cognitive baseline and are the changes markers of disease rather than normal decline linked to aging? In my professional opinion, the answer to that two-part question is yes. Trump has shown a noteworthy decline in his linguistic competency from his previous baseline, and the decline exposes clinical signs of disorder, not simply aging.