Twilight of American Sanity: A Psychiatrist Analyzes the Age of Trump by Allen Frances M.D.

William Morrow, New York 2017. (1st edition; 336 pages)

Reviewed by Barry Blackwell, MA, MD.(Cantab), M.Phil (Lond), F.RC Psych.


Allen Frances is a distinguished internationally known American psychiatrist and Task Force Chairman of its Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, DSM-IV.

His book begins with a Prologue with the thought-provoking title, “Trump Isn’t Crazy, We Are,” supported by a quotation from Friedrich Nietzsche, “Insanity in individuals is somewhat rare. But in groups, parties, nations, and epochs it is the rule.”

Trump’s popularity is surprising but viewed from the author’s perspective it derives from “the failure of our Constitution to live up to its ideals, its inability to respond to the increasingly urgent dangers that threaten human survival.” Frances lists “over- population, global warming, resource depletion, including income disparity, and environmental degradation” as variables that have been obscured by concerns about the candidates’ ages and alleged cognitive impairment.

The Prologue is followed by Chapter One, “Confronting the Facts of Life,” beginning with “ignorance is not bliss. Compelling evidence our world is marching blindly into a perfect storm of irreversible catastrophes.”

The remaining eight Chapters, Epilogue, Notes and References, a total of 336 pages, can be summarized succinctly in the author’s words: “Absent urgent corrective action it will soon be the final straw or a last-minute wake-up call,” an outcome considered unlikely by this reviewer, given a dysfunctional Congress:

“Trump’s personal positions are wrongly and ridiculously retrogressive on every issue crucial to survival. He and his henchmen are making decisions bringing us closer to apocalypse and social breakdown. We risk placing the future of humanity in

the hands of someone indifferent to the facts, proud of scientific ignorance, ready to act deceitfully on whim and spite. It is crazily delusional for our country to follow this clownish Pied Piper unto perdition.”