SATURDAY: "He has a story in his head!"

SATURDAY, AUGUST 1, 2026

Is he mentally ill? Is something wrong with President Trump? Once again, we started the current week with that same old question. 

On Monday night, Lawrence O'Donnell repeatedly called the president a madman. At one point, he referred to the president's "insanity."

In our view, O'Donnell did excellent work all week. But at one point on Monday night, he made a deeply peculiar remark:   

O'DONNELL (7/27/26): Everyone knows how crazy the president of the United States is. And no one is calling for the use of the 25th amendment to remove the madman in that image from the office of the presidency because the entire professional Republican Party in Washington has accepted fully the madness of Donald Trump. 

The American news media has understandably run out of words to describe the horror of the madness of Donald Trump.

Our journalists have done all they could? They've "understandably run out of words?"

Lawrence O'Donnell is deeply experienced, but that was a strange assertion.

As we noted yesterday, for perhaps the ten millionth time, our major news orgs have agreed that they must never discuss an obvious possibility—the possibility that the president is (severely) mentally ill. 

Over the course of the past ten years, many medical specialists have said that the president does seem to be mentally ill. In the old days, several ranking medical specialists discussed that possibility with O'Donnell himself, right there on The Last Word. 

Below, we want to remind you, once again, about the basic conceptual frameworks surrounding the concept of "mental illness." First, though, consider what happened, yesterday afternoon and yesterday evening, on two major news broadcasts.   

We start with last night's PBS NewsHour. Brooks and Capehart were on hand, as always, to be interviewed by Geoff Bennett. 

Is something wrong with President Trump? Right at the start of their weekly segment, David Brooks said this:

BENNETT (7/31/26): David, what does it say that the president is apparently willing to sacrifice his attorney general's confirmation, rather than make concessions on this settlement fund?

BROOKS: All hail the king! The government is there to serve the president, not to serve the government. And so he wants that $1.8 million [sic] slush fund—

Billion! Sorry. I was only counting my share.

(Laughter)

But he also wants immunity from prosecution from the IRS, and that's the key. Because he's made boatloads of money...

So he wants that. And he's got this story in his head, which is like the core of his identity these days: He was robbed of the 2020 election, the January 6 people were perfectly nice people, and the prosecutions that he endured in his years out of power were the deep state going after him. 

And that's central to his identity, and that's going to always be the priority.   

The president "has a story in his head," and it's "like the core of his identity." As Brooks describes it, the story in the president's head seems to conflict with basic reality, but it sounds like that story's not going to change. 

He's got a story in his head, It's central to his identity! We're inclined to agree with what Brooks said, although what he said is quite fuzzy. Earlier, on MS NOW's Deadline: White House, one-time Trump aide Sarah Matthews seemed to say something similar.

Matthews resigned as a Trump aide on January 6. She spoke with Nicolle Wallace:  

WALLACE: (7/31/26): There are lots of public-facing proof points of his decline, performatively, perhaps cognitively—I don't know. 

This feels like the inability to stop talking about an event where it was his supporters who were beating the cops...Why do you think he can't stop talking about it?  

MATTHEWS: You know, I think that Donald Trump has always been a broken man. But I do think that losing the 2020 election fair and square to Joe Biden permanently broke his brain.  

WALLACE: [Laughter]

MATTHEWS: I don't think he's ever been able to recover from that, because he looked at someone like Joe Biden and he thought, "How could I lose to this guy?" I mean he called him, you know, "Sleepy Joe." And then obviously it affected him because he's a narcissist. His ego won't allow him to see the facts for what they are—that there was no election fraud and that it was Joe Biden who was the winner of the 2020 election, and so he's been fixated on this topic and talking about the election...   

Matthews continued from there—and she isn't a medical specialist. Like almost everyone else, she hasn't had professional experience with people who are (significantly) mentally ill.

She isn't a medical specialist! But she plainly seemed to be stating the view that something is wrong with the president:

According to Matthews, his ego won't allow him to see the facts for what they are.  

As she continues, Matthews plainly says that, in her opinion, Trump really believes the apparently crazy claims he keeps making about the events of January 6.  

According to Matthews, he isn't lying—he really believes it! That's not unlike what David Brooks said about the story the president carries around in his head, which is like the core to his identity.

Are Brooks and Matthews possibly describing a type of diagnosable "mental disorder/mental illness" For example, could this be a diagnosable version of "delusional disorder?" 

("Delusional disorder?" That's a clinical "mental disorder/mental illness" you can read about simply by clicking here.)

Are Brooks and Matthews clumsily describing some diagnosable mental disorder (mental illness)? Putting it a bit more simply, or perhaps somewhat differently:

Is it possible that the sitting president really believes the unfounded claims he continues to make?

We don't know, and they don't know either—but there are medical specialists in this country who, at least in theory, could shed light on that possibility based on their medical experience. 

That said, for better or worse, people like Wallace have agreed that they will never interview the medical specialists who could offer expert assessments about the possible state of the president's mental health and cognition. They simply aren't going to go there!

For better or worse, Wallace won't interview such medical specialists, and neither will Rachel Maddow or pretty much anyone else. They won't tell you that they're skipping such interviews. Presumably, they're just doing what management tells them they have to do.

On occasion, O'Donnell conducted such interviews in the past, but it looks like those days are gone.  For better or worse, Wallace simply chooses to laugh when a lay person like Matthews launches an honest attempt at describing the president's mental state.   

Does it matter if something is wrong in the way Matthews describes? Below, we'll highlight one key phrase in what Mary Trump recently said:

BURNETT (2/26/26): You've known him your whole life. Do you actually see a decline?

MARY TRUMP: I do, but I think it's important to remember that Donald has never been fit in any capacity. Obviously, what we're dealing with now are age-related cognitive declines. We're dealing with physical issues that the White House tries to cover over.

But this is somebody who for decades now has had serious, undiagnosed and untreated psychiatric disorders, which are only going to worsen, especially given the pressure he's under and given the cognitive and physical declines.   

Her uncle's ongoing psychiatric disorders "are only going to worsen!" Other medical specialists have said the same thing, dating back to 2017. Wallace laughs delightedly and refuses to consider the possibility that this disturbing prediction could be accurate.

Is there some such thing as "mental illness?" Does "mental illness" exist?  

Our primitive discourse is highly unsophisticated when it comes to such basic questions. As a general matter, we Americans struggle along with an extremely unsophisticated public discourse, the results of which are now increasingly obvious.

We Americans! As a general matter, we accept "the germ theory of [physical] disease," but we have a profoundly undeveloped set of understandings about the basic features of mental illness. More generally:

Over here in Blue America, We Blues just aren't amazingly sharp, and our best-known journalists aren't a whole lot better. 

Over there, in Red America, the Fox News Channel airs its clownlike dog-and-pony shows to audiences which dwarf our own, and our news orgs in Blue America don't say a word about the endless clowning.

There's nothing left for the press to say? Our major news orgs have "understandably run out of words to describe the horror of the madness of Donald Trump?" 

We've run out of ways to describe the madness without ever having tried the one most obvious way?

 Why in the world—why on earth—did O'Donnell make such a weird statement? In fairness, we'll close with this:  

Is it possible that President Trump is "mentally ill" in some serious way? (For example, is it possible that he's "delusional" in some clinical way?") Beyond that, is it possible that he's "mentally ill" in a way "which is only going to worsen?"

You'd think our journos would want to know! But if they tried to examine such a possibility, would they know how to do it? 

As with any serious illness, a serious mental illness should be a cause of sympathy, pity, concern. Our discourse doesn't run on such fuel. As Professor Brabender memorably said, midway through the last century:

Where I come from, we only talk so long. After that, we start to hit.