Twilight of American Sanity: A Psychiatrist Analyzes the Age of Trump – A Landmark Psychiatric Diagnosis of Our Democracy in Crisis

by Allen Frances

“Unravel[s] the national psyche that brought our politics to this moment.” — Evan Osnos, The New Yorker A landmark book, from “one of the world’s most prominent psychiatrists” ( The Atlantic ): Allen Frances analyzes the nation, viewing the rise of Donald J. Trump as darkly symptomatic of a deeper societal distress that must be understood if we are to move forward. Equally challenging and profound, Twilight of American Sanity “joins a small shelf of essential titles—Arlie Hochschild’s Strangers in Their Own Land is another—that help explain why and how the Trump presidency happened” ( Kirkus ). It is comforting to see President Donald Trump as a crazy man, a one-off, an exception—not a reflection on us or our democracy. But in ways I never anticipated, his rise was absolutely predictable and a mirror on our soul. … What does it say about us, that we elected someone so manifestly unfit and unprepared to determine mankind’s future? Trump is a symptom of a world in distress, not its sole cause. Blaming him for all our troubles misses the deeper, underlying societal sickness that made possible his unlikely ascent. Calling Trump crazy allows us to avoid confronting the craziness in our society—if we want to get sane, we must first gain insight about ourselves. Simply put: Trump isn’t crazy, but our society is. — from TWILIGHT OF AMERICAN SANITY More than three years in the making: the world's leading expert on psychiatric diagnosis, past leader of the American Psychiatric Association’s DSM (“the bible of psychology”), and author of the influential international bestseller on the medicalization of ordinary life, Saving Normal, draws upon his vast experience to deliver a powerful critique of modern American society’s collective slide away from sanity and offers an urgently needed prescription for reclaiming our bearings. Widely cited in recent months as the man who quite literally wrote the diagnostic criteria for narcissism, Allen Frances, M.D., has been at the center of the debate surrounding President Trump’s mental state—quoted in Evan Osnos’s May 2017 New Yorker article (“How Trump Could Get Fired”) and publishing a much-shared opinion letter in the New York Times (“An Eminent Psychiatrist Demurs on Trump’s Mental State”). Frances argues that Trump is "bad, not mad"--and that the real question to wrestle with is how we as a country could have chosen him as our leader. Twilight of American Sanity is an essential work for understanding our national crisis.

Genres: Nonfiction, Politics, History, Psychology, Sociology, Society, Science

336 pages, Paperback

First published June 7, 2016

About the author

Allen J. Frances (born 1942) is an American psychiatrist.
He is currently Professor and Chairman Emeritus of the Department of Psychiatry and Behavioral Sciences at Duke University School of Medicine.
He is best known for serving as chair of the American Psychiatric Association task force overseeing the development and revision of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).
Frances is the founding editor of two well-known psychiatric journals: the Journal of Personality Disorders and the Journal of Psychiatric Practice.

Reviews

[Mike · Rating 4 out of 5]

3.5 stars. The subtitle of this book (“A Psychiatrist Analyzes the Age of Trump”) undersells the author: Frances oversaw the compilation of the DSM-IV and literally wrote the textbook definition for “Narcissistic Personality Disorder.” But this book isn’t about diagnosing Trump; it’s about diagnosing the societal delusions in the United States that led to his election. According to Frances, Trump doesn’t have Narcissistic Personality Disorder. While he certainly has all the traits, so do many celebrities. But the disorder is characterized by a breakdown of a person’s life and personal connections. Trump, if anything, thrives on his narcissistic traits. They are the very reason for his success. This just makes him, quite simply, a major asshole. Neither does Frances believe that Trump is delusional. If 40% of the population buys into it, these are no longer personal delusions, but societal flaws. Trump is not mentally ill (according to Frances), but a large segment of the United States suffers from communal delusions that gave rise to Trump (and which he continues to dangerously stoke).

Frances goes on to list certain social delusions in the U.S. in an attempt to understand why we reached this stage and how we might break free. He remains optimistic, thinking that we are only in a temporary moment of mass delusion -- a spell that will soon break.

Frances’ perspective is rational, well informed, and liberal. The problem I had with the book (a problem that Frances even brings up in passing as a criticism that his wife had) is that he appears to be preaching to the converted. I agreed wholeheartedly with just about every observation, critique, and solution he offered. While you might think that would lead me to give this a five-star review, I had been hoping for a new perspective or greater insight. (In other words, tell me something I don't already know!) Beyond the first few pages about his non-diagnosis of Trump, I found myself just reading what I already understood to be a true and accurate depiction of America in 2017 (although, admittedly, even that is something to be celebrated in an era of "alternative facts").

In short, the audience for this book already understands everything Frances writes. Everyone else (i.e. Trump supporters) wouldn’t be convinced of Frances’ solutions precisely because of their distorted ideology. And so this book stands as a clear, insightful, easy-to-follow breakdown of the Trump Age, but adds nothing new for those of us who already understood the delusions that lead to Trump’s election, and likely will not convert or convince the Trump acolytes, assuming they would even read it (Frances has the rather idealistic hope that his book might just have the power to convince them).

I think, more than anything, this is a book for future generations to understand the collective psyche of the nation in 2017. Unfortunately, for readers in 2017, it feels like the work of another goodhearted, idealistic liberal (of which I count myself) speaking rationally into the void. I wish I had Frances' optimism to think otherwise.

[Bettie · Rating 5 out of 5]

Description: More than three years in the making: the world's leading expert on psychiatric diagnosis, past leader of the American Psychiatric Association’s DSM (“the bible of psychology”), and author of the influential international bestseller on the medicalization of ordinary life, Saving Normal, draws upon his vast experience to deliver a powerful critique of modern American society’s collective slide away from sanity and offers an urgently needed prescription for reclaiming our bearings. Widely cited in recent months as the man who quite literally wrote the diagnostic criteria for narcissism, Allen Frances, M.D., has been at the center of the debate surrounding President Trump’s mental state—quoted in Evan Osnos’s May 2017 New Yorker article (“How Trump Could Get Fired”) and publishing a much-shared opinion letter in the New York Times (“An Eminent Psychiatrist Demurs on Trump’s Mental State”). Frances argues that Trump is "bad, not mad"--and that the real question to wrestle with is how we as a country could have chosen him as our leader. Twilight of American Sanity is an essential work for understanding our national crisis.

Read by Christopher Grove, who has one of the most boring voices ever to read an audio...

This sucked me in, the dopamine sparked and firing neurons urged a choccie infusion to up calorific stores. Mainly Darwinian and Freudian, the scariest bit was where it is posited that we will not find any biological aliens out there in spaaaaace, just AI/robots who have destroyed the folk who invented them. Gulp.

The trick about this book which makes for an eye-scorcher (or in my case, ear-scorcher) is that it is about our era and how certain things are a symptom of a malaise, not the cause per se. Do not bother with this if you are only looking to see if, in a self-affirming theory way, he is mad, for the fact of the matter is way more complicated than that black or white answer. This is a philosophical gob-stopper that at times will have drool escaping from the side of your mouth whilst you feel yourself gagging at the size of it all.

My take is that malignant narcissism is a personality disorder, (the worst?), and as such he could not use an insanity plea to get off the hook. I'm sure that a medic could be bought to say the opposite, hasn't a lying doctor been used twice already!? But the staunch followers are in sore need of psychiatric help, and the future/right now needs a solid, secular well-rounded, fully funded education system that will ensure such lunacy doesn't happen again.

Fully recommended for philosophical readers, not so much for anti-trump vindicators, and definitely a no-no for those who do not believe they could possibly be a part of the problem.

Anthropoceners - yuck.

[Kevin · Rating 5 out of 5]

"When it comes to finding commonsense solutions to concrete problems, we the people are better, wiser, and more united than the politicians who represent us. The platforms of the political parties are drawn up to satisfy the entrenched self-interests of their most rabid members and therefore emphasize differences, rather than commonalities."

Allen Frances is not only philosophical and analytical, he's fantastic! This is pull-no-punches straight talk that won't sit well with far-right, pseudo-religious extremists. Dr. Frances lays out the schematics of how we got to "here" and offers both dystopian and utopian views of where we're headed next. I have yet to encounter anyone who so closely parallels my own opinions and perspectives. This is a thoughtful dissertation on what should be blatantly obvious; the emperor has no clothes.

[Kathryn Bashaar · Rating 3 out of 5]

Trump's not crazy; we are. That's the premise of this book, and the best part of it was when this psychiatrist explains all the cognitive errors and delusional thinking that got us to the point where the world's greatest democracy elected Donald Trump president.
This would be a good book to read if you're just starting to try to figure out how we ended up with Trump as president. But I've been pondering, and reading up on, that for a year, and there was little new insight in this book for me.
Since the book was written by a psychiatrist, I hoped that there would be more about how to change the minds of persuadable Trump supporters, but the book was pretty thin on that. It was mostly just an anti-Trump jeremiad. This guy REALLY hates Trump.
The book seemed to lack a little focus, too. At the end, he swerves off into all the things that are wrong in the world and how they could be fixed. He tries to cover too much, and covers it too thinly.
I think the book was rushed into print. There wasn't really much meat to it.
Like my reviews? Check out my blog at http://www.kathrynbashaar.com/blog/
Author of The Saint's Mistres: http://www.synergebooks.com/ebook_sai...

[Sam Motes · Rating 4 out of 5]

Addresses the issue with trying to paint Trump as having a clinical mental disorder in the first pages of the book to put that argument to bed as a futile effort that does nothing to help the situation and harms the view of those who are truly battling mental disorders. The Author builds the case of a society plagued by societal delusion refusing to address the giant issues facing our world of global warming, racial equality, resource scarcity, imperial ambitions, erosion of privacy, gun control, and on and on. Trump is a symptom of the societal delusion rather than the cause of our dilemma. He is certainly causing untold damage due to being the seriously flawed individual he is but that we as a society thrust him into such a critical role to the future of our society and the world in general is the deeply melancholy concern. The greedy are further served and the needy are further screwed.

"It Is Not the Strongest of the Species that Survives But the Most Adaptable" - Charles Darwin.

Addresses my concern with Trump in that Trump wining isn't my concern but rather the state of our society that Trump was able to be in the position to win and seen as what we need as the POTUS to build our world for tomorrow by a larger portion of our society. If you are looking on a book focusing on how incompetent Trump is, Look to “Trump Revealed” or other such focused reads. If on the other hand you want an uncomfortable unflinching look in the mirror on what is wrong with our society so that action can be taken then read on. It is as powerful as anything from the pen or voice of Chomsky or Zen.

[Friscomama · Rating 4 out of 5]

In the prologue, the author explains that the book was started before Trump's election was expected. It covers the mistaken ways in which we Americans seek happiness. I suspect the subtitle about President Trump was put on by the publisher to increase sales, and it probably will.
It's mostly a dense scholarly approach, covering the parts of the human brain that includes fast reflective thinking, that has the advantage of being able to get us away from danger without delay, and the slower logical thinking that helps us analyze whether or not we are really in danger. It goes on with the materialism that has us consuming more and more without any increase in happiness, philosophy from the ancient Greeks, the history of the "united States are" transition to "the United States is," the origins and evolution of the U.S. government, and the historical context of fearing the "others" who are not like us, and so on. I had enough prior knowledge to slog through it, but it won't be everyone's idea of a fun read.
Trump supporters will probably not agree with the author's portrayal of the President, but they might want to see what the "others" on this have to say. For one thing, the author, a psychiatrist, does not think Trump is mentally ill.

I received this book in a Goodreads giveaway. My review was not affected by that.

[Buchdoktor · Rating 5 out of 5]

Allen Frances wurde nach der Wahl von Ronald Trump zum amerikanischen Präsidenten gebeten, in einer Fernsehsendung Trumps Psyche zu analysieren. Die Berufsethik der Fachärzte für Psychiatrie verbietet allerding Ferndiagnosen an Politikern. Frances wurde vom Wahlsieg Trumps kalt erwischt, weil er zum Zeitpunkt der Wahl bereits an seiner Analyse der USA arbeitete und bis dahin den Kandidaten für keinen ernstzunehmenden politischen Gegner gehalten hatte. Hier schreibt nun der Sohn von Emigranten über einen Nachkommen von Emigranten, beide Männer sind in Queens aufgewachsen.

Frances beschreibt zunächst den Ist-Zustand der USA und erläutert dabei, was die Wahl Trumps über das Land und seine Wähler aussagt. Auch ein ungehobelter Narzisst ersten Grades müsse an keiner psychischem Krankheit aus dem DSM-5 leiden (dem Diagnostischen und statistischen Leitfaden psychischer Störungen), gibt Frances seinen Lesern gleich zu Beginn mit auf den Weg. Wenn man rücksichtsloses Benehmen zur psychischen Erkrankung erklären wollte, müssten fast alle Politiker und Prominenten als psychisch gestört bezeichnet werden. Wirklich psychisch Kranke würden durch dieses Vorgehen stigmatisiert.

Frances eloquent vorgetragene Charakterisierung Trumps hat mir in ihrem reinen Umfang die Sprache verschlagen, ebenso die Liste der fatalen Irrtümer des Präsidenten zu existenziellen Problemen, die komplett zu widerlegen sind. Der Autor blickt zurück in die Weltgeschichte und die amerikanische Geschichte, um drängende Probleme der Gegenwart zu beurteilen. Muss wirklich jede Nation und jede Generation fatale Fehler unserer Vorfahren wiederholen, fragt man sich in diesem Kapitel. Die Liste der Trump-Fails reicht von der Klimaerwärmung, über Überbevölkerung, Resourcen-Verschwendung, den Irrglauben, man bräuchte nur den Reichen zu geben, damit die gesamte Nation profitieren werde, das amerikanische Gesundheitssystem als Spielwiese von Lobbyisten und Pharmakonzernen, den unangreifbaren Wahn, die USA seien in allem die Erfolgreichsten und deshalb zur Weltpolizei legitimiert, die Illusion, auch nur ein einzelner Krieg könnte wirtschaftlich profitabel sein, die rücksichtslose Durchsetzen von Interessen der Menschen gegenüber dem Lebensrecht anderer Spezies, die weltfremde Vorstellung, ein Staat könnte sich in der globalisierten Welt durch Mauern oder Strafzölle abschotten, das blinde Vertrauen in Big Brother und in den technischen Fortschritt, der schon von selbst alle Probleme lösen werde, bis zum ebenso blinden Glauben, private Waffen würden der Sicherheit dienen. Aus Sicht des Psychiaters analysiert Frances eloquent, welch explosive Grundlage in den USA aus Puritanismus, religiösem Extremismus, Kulturlosigkeit, mangelndem Geschichtsbewusstsein und Geldgier entstanden ist. Europäischen Lesern wird hier ernüchternd ein Spiegel vorgehalten; denn Wahlergebnisse in Europa bilden exakt die beschriebene Struktur ab, in der Bürger fordern „meine Stadt first“ und nach einer starken Vaterfigur suchen, der sie blind zu folgen bereit sind. Wie fatal sich die Szenarien in Europa und den USA ähneln, ist Grund genug, Frances USA-Analyse und seine To-Do-Liste für die unmittelbare Zukunft zu lesen.

Die Trump-Wahl sei nur das Tüpfelchen auf einer offen rassistischen, gespaltenen Gesellschaft, die die arbeitende Bevölkerung seit 1970 wirtschaftlich abgehängt hat. Die amerikanische Verfassung habe offenbar mit „man“ nicht „den Menschen“ gemeint, sondern den weißen Mann. Frauen, Farbige und die Arbeiterklasse wären als Staatsbürger nicht gleichgestellt; Frauenfeindlichkeit sei in der amerikanischen Gesellschaft tief verwurzelt. Frances blickt bis zum Peleponnesischen Krieg zurück, um aufzuzeigen, warum Menschen immer wieder falsche Entscheidungen treffen und inkompetenten Führern folgen, und was Psychologie und Verhaltensforschung über diese Prozesse zu sagen haben. Unsere Gehirne seien einfach noch nicht an die Moderne angepasst, so Frances. In einer Überflussgesellschaft seien primitive, impulsive Handlungen jedoch ineffizient (iss sofort die ganze Pizza, ehe es ein anderer tut). Über seine eloquente Analyse könnte ich noch seitenweise berichten.

Im Gegensatz zu seinem „Klienten“ Trump, den er hier auf die Psychiater-Couch legt, weiß Frances sich angemessen auszudrücken, ohne dabei ein Blatt vor den Mund zu nehmen, und verfügt über ein für einen Berufsfremden beachtliches volkswirtschaftliches Wissen. Frances schreibt altersweise und mit spürbar schlechtem Gewissen, welche Welt seine Generation Kindern und Enkeln hinterlässt. Er persönlich z. B. habe sich zu spät für amerikanische Politik interessiert. Nun sei es höchste Zeit, die Macht des Geldes und den zügellosen Vetternwirtschafts-Kapitalismus mit der Macht des Volkes zu bekämpfen. In den letzten Kapiteln bringt Frances schließlich ermunternde Beispiele, wie Menschen alte Gewohnheiten abwerfen und überraschende Veränderungen bewirken konnten.

Im Ausdruck und mit seinen Lösungsvorschlägen überschreitet Frances in einigen Fragen die Grenze zum Populismus. Er personalisiert z. B. „die Konzerne“ und, „die Computer“, ein Indiz dafür, dass er komplexe Zusammenhänge nicht sehen kann oder will. Allerdings ist er sich der Gefahren sehr bewusst, die in der Schwächung der Gewaltenteilung liegen, wenn Justiz und freie Presse ihrer Aufgabe nicht mehr nachkommen können. Eines von Frances Herzensthemen ist die Überbevölkerung mit dem daraus folgenden Kampf um Resourcen, die er speziell in den Krisenherden Afrikas und des Mittleren Ostens kritisiert. Um hier wirksame Lösungsvorschläge vorbringen zu können, fehlen dem Autor allerdings interkulturelle Kompetenzen und die Wahrnehmung aller Variablen. Die Grenzen des eigenen Wissens kann er offenbar nicht erkennen. Selbst amerikanischen Zeitungslesern sollte nach 60 Jahren Entwicklungshilfe-Kritik klar sein, dass das heikle Thema Familienplanung ohne grundlegende Reformen von Bildungs- und Gesundheitssystemen nicht umzusetzen ist. Frances‘ Vorschläge würden im Ausland vermutlich bereitwilliger angenommen, wenn die USA zuvor eigenen Kindern und Müttern ein allen zugängliches menschenwürdiges Leben verschafft hätten, unabhängig vom Vermögen der Eltern.

Frances Analyse hat mich positiv überrascht durch seine für einen US-Amerikaner erstaunliche Bildung und seine ausgiebige Recherche. Sein Buch ist sorgfältig in flüssiges Deutsch übersetzt, so dass ich die Namen der Übersetzer gern auch auf dem Titelblatt lesen möchte. Wer sich von langen Satzgebilden nicht abschrecken lässt, findet bei Allen Frances Parallelen zu Entwicklungen in Europa, die niemandem gleichgültig sein sollten.

[Cgallozzi · Rating 4 out of 5]

The book, written by a Psychiatrist - opens with a statement that Donald J. Trump is not "crazy or insane" - but rather speaks about a larger U.S.-wide "Social Delusion" which Trump capitalized upon in his election victory. The Social Delusion includes - denial of the major topics of the day - income inequality, climate change population growth and other items.

You need to be careful here - to broadly interpret all the author asserts - still some thread of the politics of "Social Delusion" - deficits don't matter; there isn't any climate change; stopping Planned Parenthood funding (and support for birth control in the developing world) - are or appear to be the current policies of this administration and are thought to be short sighted at best.

Closing with ideas on how to organize (the word "resist" isn't used) - has some good ideas.

My bottom line: interesting - but unfocused book - some great parts concerning "Social Delusion" across the U.S., and the very large and negative impact some of the current administration's policies have or may have. No commentary on what the Democratic party's responsibilities were in augmenting these "Social Delusions" - or how the Democratic party could help "heal" the country - an opportunity missed.

Carl Gallozzi
cgallozzi@comcast.net

[Owlseyes]

"Trump is not mad, but our society is"
(my translation)

Interview in Portuguese:

https://www.dn.pt/edicao-do-dia/28-se...

My view: Allen Frances should have stated his present political affiliation; midterm elections are just around the corner. He should have been asked about the work Mad Politics: Keeping Your Sanity in a World Gone Crazy by Gina Loudon. And, as he uses the expression "Democracy dies in apathy"..., it sounds like WaPo terminology/slogan. Ah, he should have elaborated a bit on the "Goldwater Rule".




UPDATE

Now Allen Frances suggests Trump is a monster, well worse than Mao, Hitler and Stalin. Gee!
https://www.breitbart.com/clips/2019/...

[Todd Martin · Rating 3 out of 5]

“The American fascists are most easily recognized by their deliberate perversion of truth and fact. Their newspapers and propaganda carefully cultivate every fissure of disunity… They claim to be super-patriots, but they would destroy every liberty guaranteed by the Constitution. They demand free enterprise, but are the spokesmen for monopoly and vested interest. Their final objective toward which all their deceit is directed is to capture political power so that, using the power of the state and the power of the market simultaneously, they may keep the common man in eternal subjection.”
- April 9, 1944, speech by Vice-President Henry Wallace

“Nationalism is an infantile disease. It is the measles of mankind.”
- Albert Einstein

Imagine a world where:
- Public policy was made using the best available data, and that politicians relied on research to guide decisions at all stages of the policy process.
- Systems existed to monitor ongoing governmental program performance and the information used to implement continuous improvements.
- Evidence was used to eliminate ineffective government programs, freeing up public funds for better uses.
- The public ignored, or better yet, stopped electing politicians who’s rhetorical claims were contraindicated by the facts.
- Knowledge already in our possession was used to make sound policy decisions and additional data was gathered to better inform future decisions.
- Evidence and critical thinking were valued over dogma.
- Scientific theories were valued over conspiracy theories.
- Citizens were disgusted rather than swayed by emotional appeals to their most hateful instincts.

Now wake up … because you’re definitely dreaming.

Twilight of American Sanity, by psychiatrist Allen Frances, discusses the myriad ways that the U.S. is off the rails in terms of its public policy, not because of the ‘stable genius’ in charge, but because of the citizens who elected him.
Frances is a smart guy and he does a good job articulating the problems the U.S. currently faces, though I would characterize the book as overly long and overly broad in scope. The picture he paints is not a pretty.

There’s a word for those who believe their lives and the lives of their children will be improved by:
- Redistributing wealth upwards.
- Shrinking national monuments.
- Allowing corporations and the wealthy to re-write laws in their favor.
- Expanding corporate control of the internet.
- Inciting racial hatreds.
- Ignoring global warming.
- Disenfranchising voters.
- Waging a war against the free press.
- Waging a war on science.
- Abolishing safety, health, consumer and environmental protections.

That word is … delusional.

When I was a child, I spoke and thought and reasoned as a child. But when I grew up, I put away childish things.
- 1 Corinthians 13:11

Becoming an adult requires that we give up the comforts of childhood. Naively accepting everything we are told, blind trust in authority and the belief that everything is always going to be ok, give way to the harsher realities of adulthood. But these unpleasantries are offset by the reality that through our initiative, hard work, creativity and curiosity we can exert control over our fate and steer a successful course for our lives.

Well … it’s long past time we grew the f*ck up as a society. Magical thinking is counterproductive to our understanding of the world. We need to put away childish things, face reality and take a thoughtful, rational and evidence-based approach to our problems and our methods of governance … for a change.

[Peter Geyer · Rating 4 out of 5]

This book intrigued me, as I had read Allen Frances' Saving Normal and found it interesting and well-written, although circumscribed by intellectual boundaries to do with his profession. By that, I mean an acceptance of particular ideas considered scientific, that are nonetheless challengable.

The presidency of Donald Trump, from how it came about to what's happened since, has engaged all sorts of minds, some of which have indulged in clinical assessments that have been both predictably negative and ethically controversial. Frances begins by dealing with this issue, identifying himself as the person who wrote the criteria for Narcissistic Personality Disorder, the label usually attached to Trump, pointing out that, while Trump meets the criteria, he's not crazy because he doesn't appear to be under any distress or difficulty.

This makes sense to me, particularly as it can be convenient to say someone ostensibly abusing a position of power or a committer of appalling acts have a mental illness, rather than address what's going on. Excluding people from "normality" in this way means we don't get to see that human beings are capable of all sorts of things, good, bad, mundane and to label someone as crazy avoids dealing with that.

Although the book constantly refers to Trump and the actions of those associated with him, a process I found unhelpful, for reasons i'll explain later, Frances tells the reader that he started work on this book before Trump's candidacy or presidency with an aim of looking at social insanity. By that he means the avoidance of the obvious (to him, and me) in areas like climate change, education, gun control, health, wealth and power etc. He provides a list of these issues early in the book, and proceeds to examine them, regularly injecting negative comments about Trump and his allies, which are essentially factual.

I'm uncomfortable with him doing this because I dislike that kind of writing, no matter who it's about. A person loses an argument with ad hominem statements (they don't, actually, just with me). It may be, too that the book is possibly for Americans, and not others, as Frances wants to galvanise resistance to Trump, by means of what he inaccurately calls "populist" groups. What he means is that these groups arise out of the people.

His call for this kind of thing links in with his view of American culture and history, particularly as the son of an immigrant. There's an obvious pride for him in being American even when he's describing various events and depredations from the past. The prevailing myths about the founding of what became the United States are accepted, more or less, although this is from an outsider's point of view, liable to be more critical.

What this means is that the book's narrative is positively oriented to Americans solving this particular problem, multifaceted though it is, and diverse though Americans might be in what they want from life.

The book is studded with interesting information about human evolution, genetics, behaviour etc., and here I thought that he was too accepting of the standard model, particularly with regard to selection and the lives of human ancestors. There are too many presumptions that can be contested by authoritative evidence, and I think he lacks nuance in this area. However , this perspective appears essential for how he thinks the current invidious position can be changed.

Frances provides a reasonable amount of personal information, and you find that the call to arms which is contained within this book is in contrast to his student life in the years of protest about the Vietnam War and even well after that. So this is a late entry into politics, and what that means is that he's sometimes a little too simplistic in his assessment, although what he says is pretty accurate.

But it may be that his personal bias towards logic makes it difficult for him to grasp why voters etc. don't see the obvious, even though he uses areas of the brain to explain why they might not. Then, too, he wants to make readers see that he's an American patriot.

One of the interesting aspects of this book, although not an unusual approach at all, is the appeal to leaving the world in good shape for future generations, usually in terms of personal children and grandchildren, with the rejoinder that what will our descendants (or the descendants of others if, like me, you don't have children) think of us.

I've never thought this argument was any good, as far as convincing anyone to change their opinion or actions and "save the planet" as it were, or act on other slogans. Personally, I think that acting on climate change and other issues is something good in itself and don't know why there's this kind of blaming and emotional appeal about treating children badly. I've never heard anyone (friends, colleagues etc) mention this as a reason for doing anything, unless the person is an activist of some sort. Maybe it's something picked up from others on the presumption that it works...I don't know.

To be honest, I'm not sure what to make of this book. There isn't anything particularly wrong with it other than what I think sketchiness in various areas, from arguments to research and science. It's personal in a particular way, and clearly written, if somewhat colloquial in its style. What I mean here is there are quite a few places where you have to be an American or have some affinity with American culture in order to understand what he's written. Having said that, it's not unusual at all for American writers of this kind to do that.

It might also be the case that I doubt that what he wants to occur will actually happen, even though I agree with his identification of problem areas. Late in the book he provides examples of change initiated by groups of citizens to give an idea of what he has in mind. Maybe I'm too cynical, but maybe the book is essentially for Americans.

[Robert Narojek · Rating 5 out of 5]

“Each nation has a President/King/Emperor/Prime Minister/Chancellor, that it deserves”

I always keep saying the above, and even more so now after reading one of the best books on delusional American society.

Allen Frances “Twilight of American sanity” is a fantastic read evaluating in-depth current problems and issues facing Trump’s America. He starts with the question how could it be at all possible that such a “persona” could be elected within the most powerful and successful Empire in last 500 years. How is that possible? Is a question that will be haunting Americans for many years to come. And Frances shows clear direction to obtain the answers. However he is not certain that it will be possible to return to the glory and greatness of USA.

Of course it is easy for someone like me to post all kind of opinions on the “American Delusion”, being of European decent and living North of the border with US makes me comfortable to laugh at the strange paradoxes present in this country. However after reading this book it becomes very clear that unless Americans start working out and changing the fabric of the “nation” the world, as we know it will be gone for good.

Thirty years ago US and Canada were objects of envy for anyone from outside, most people wanted to model their lives to achieve a bit of the “American way of life”, and in most cases they were successful and also they surpassed the great “American Dream”, most notably in the EU. Frances shows very clearly that GDH (Gross Domestic Happiness) is what nations should aim for, as is the case with Scandinavian countries and Canada, consistently being the top 5 in the world and US in the mid twenties. To quote the “classic tweet boy” – HOW SAD ☺

Today with US under the rule of democratically elected President it is imperative for the young generation to take into their hands “shaping of New American Dream”, because if they neglect this the future could be very dire. USA decided to exit the world stage as a “Gendarme of the Free Democratic World” and this move in itself understandable, opens opportunity for likes of China, Russia, and Turkey to fill in the vacuum, and it is already happening. As Allen Frances thoughtfully points out the only hope is that US will change to be more in line with modern world, or the hope for the sustainable future of mankind will be only on EU, Canada, Australia and probably few other nations. And then slow decline and sunset of the Empire of US of A.

[G.F. Erichsen · Rating 3 out of 5]

Dr. Frances started writing his book well before any reasonable person was expecting Donald Trump to be elected U.S. president, and then it appears he rewrote much of it after the election. The result is an unfocused approach to politics and the national psyche that, while mostly correct, isn't particularly satisfying nor particularly new. The book is at its best in the final chapters, when Frances mostly gets away from politics, a few digs at Trump aside, and writes about what makes people happy. Hint: It's not the things we have.

As a nationally known psychiatrist, one who played a major role in developing the diagnostic criteria used by medical professionals and insurance companies, Frances is constantly asked whether Trump is mentally ill. Although he suggests the answer is no, he doesn't really answer the question, and not just because Trump isn't one of his patients. One reason is that have a diagnoses of narcissistic personality disorder, and person needs to be distressed or impaired, and Trump's narcissism, while it may cause distress in others, doesn't appear to do that to him. Another reason is because the diagnosis isn't all that relevant: "Trump is a threat ... not because he is clinically mad, but because he is very bad."

Instead of focusing on Trump's possible delusions, Frances focuses on societal delusions, such as one that says technology will bail us out of global warning and depletion of resources.

Frances' agenda is left-leaning, but in some ways his approach to achieving his goals is Trumpian: Let's elect a different populist, perhaps someone in the mold of Bernie Sanders or Bill Clinton. After spending pages decrying the strength of emotions over rationality in attaining political power, Frances seems to shift course in a way that doesn't make much sense.

Frances is at his best once he gets away from Trump, politics and global issues. "[T]he basic ingredients of a good life remain remarkably the same over the ages," he writes near the end of the book, listing "family, friends, finding meaning, feeling gratitude, giving to others, loving nature, staying fit and healthy, and a spiritual appreciation of the implausible wonder of life." On that note, he seems to be a wise man and not just another Trump critic. It's too bad more of the book wasn't written in that vein.

[Christina · Rating 5 out of 5]

Irrefutable analysis in light of today's humanitarian crisis in America where children in detention centers are caged and injected with psychiatric drugs.

As a disclaimer: I've also read books that Conservative / Republican men have written.

Allen Frances, MD has redeemed himself here in my estimation. His analysis is beyond reproach.

Wasn't a fan of Saving Normal yet might go back and read it again in light of having read Twilight.

I was surprised at how bold, honest, and daring Allen Frances, MD is in Twilight.

[Bill S. · Rating 5 out of 5]

Should be mandatory reading for anyone age 15 and up. A primer on what's wrong with American society and how to fix it.

[wickedwitchie · Rating 4 out of 5]

In his book written in 2017, Frances remained optimistic that the Trump era was just a temporary societal delusion and America would, on the whole, finally come to her senses. He offers a psychological and philosophical analysis of how we ended up with that presidency. Presenting acute observations and reasonable solutions, Twilight is a fantastic read. Yet, I must admit I was hoping for something more. It didn't offer any new perspective for me and with the far-right leaders gaining popularity worldwide, I'm not sure if I share the author's optimism. Still, it's worth reading as a kind of Understanding Current Politics 101 textbook.

[DrWJK · Rating 1 out of 5]

The Psychiatrist Who would Rescue Us from Trumpism Should Look at Himself

I read this book after checking it out from my local library. So, fortunately I didn’t lose any money.

The main thesis of the book is that the doc is an “expert,” and he diagnoses Trumpism as a symptom of a sick society – namely, the USA.

The doc says that Trump isn’t crazy, but we Americans are. But this statement is both Dishonest and Sneaky. It’s dishonest because when you read the book you clearly see that he thinks that Trump voters are nuts, but not those who voted for Hillary. (He’s a bad man, and she’s a decent woman.) His statement is sneaky because he only says this as a literary device to attract attention, he doesn’t really mean it. Hence, this guy has a personal problem with intellectual honesty and ethics.

He also has a problem with Delusions of Grandeur: He says he thinks his book is “just in time” to save the US and the World, and he knows exactly what needs to be done.

The doc wants his readers to think his Rx for the USA and the World is something nobody but he has ever thought of. But his “insights” and Rx are pedestrian and commonplace. First, he writes that Trump was able to win the 2016 election because he connected with the emotions of his voters. In their Trumpism, they are full of resentment at having lost jobs, status, and opportunity to Globalization. Trump appears to them as an avenger who will smash the political elites and clean up the swamp. OK. But the doc really hasn’t a clue as to how to make these folks feel whole again. Instead, he worries that Trump may be headed for a second term. So his main Rx is for defeating Trump in 2020, rather than for healing the sufferers of Trumpism.

What the country needs, says the doc, is another Bill Clinton (but with better control of his sex urges). He predicts that a Bill Clinton-like candidate will be the Anti-Trump that all commonsense people are hoping for. A Bill Clinton clone could appeal to the herd emotions of the masses, and shepherd the nation down the middle of the road, were the doc says it should go.

One of the doc's concerns is that Over Population is getting out of hand. The risk is that there might soon be more people than food, and riots, if not wars will result. His Rx is to change the Christian’s, and the Pope’s, attitude about Birth Control. But he doesn’t say how this can be done.

The doc announces that an even greater threat to America and the Planet is pollution and environmental degradation. Gosh, doc, thanks for enlightening us with your novel and brilliant insights. He doesn’t have an exact policy proposal for solving this threat, but maybe the New Bill Clinton will.

Indeed, the doc is more interested in publishing page after page of platitudes rather than proposing practical policies which his Bill Clinton clone and the Democratic Party could implement.

Mostly, the doc says the kind of things a nice ol’ grandpa would say to his grandchildren. For example, money can’t buy happiness; you can be happy w/o a lot of stuff; happiness can be found for the individual and the nation if we all just live in tune with Mother Nature, etc. The cure for Trumpism is to just be happy!

So far from the “political wisdom” the doc thinks he is bestowing upon us, his book is really part of the 1%’s project for Dumbing Down America, for which the doc and his publisher are perpetrators. By offering no concrete proposals, much less insightful analysis, this book would leave its readers to the mercies of the very political establishment that has created Trumpism.

This is an anti-reform book disguised as political wisdom so as to fool the reader and make a profit by doing so.

I agree w/ reviewer J.D.’s comment on the nefarious role of the DSM in our society. The doc tries to get himself some authority because he contributed to it, but the document is really just a billing instrument for insurance and pharmaceutical companies. Presenting it as “scientific” is just another Fraud in which the doc participates.

William J. Kelleher, Ph.D.

[Lauretta Monise · Rating 4 out of 5]

IMPORTANT READ

[Lewis Van Osdel · Rating 2 out of 5]

Twilight of American Sanity covers what Allen Frances thinks are the overall problems with the US society. Basically Dr. Frances's prescriptions for America are the following elect politicians with a progressive/far left agenda, be active in protests and fight against President Trump.

Dr Frances complains about President Trump throughout the whole. Early in the book, Dr. Frances diagnosis Donald Trump with Narcissistic Personality Disorder when he has never interviewed Trump, his family, or his close friends. Most responsible psychologists or psychiatrists typically administer a MMPI, interview their patient, or review their medical records before handing out a diagnosis. Granted Dr. Frances was a major contributor to DSM III and DSM IV and he had major influence for writing the diagnosis criteria for Narcissistic Personality Disorder. The thing most politicians at the national level are narcissists. There is a good chance that Dr. Frances's preferred candidate, Hillary Clinton, is probably a narcissist too.

Another thing Dr Frances is pretty naïve about the whole political process. The thing is there are politicians on both sides that pass legislation to protect their "sacred cows" from their political contributors. Dr. Frances singles out the Koch brothers for the conservative side, but he fails to mention about George Soros or other rich left-wing donors. Plus Donald Trump isn't a conservative; he is more of a pragmatic populist.

Another Dr Frances really doesn't understand Jesus Christ. He thinks Jesus would be okay with abortion, same-sex marriage, and he wanted no rich people. It isn't really clear how common abortion was in ancient Judea. Plus homosexuality was more tolerated in Roman and Greek culture. It was against levitical law given that Dr. Frances came from Jewish background he should be aware of it, and Jesus was referred to as a rabbi.

[Ellison · Rating 2 out of 5]

An absolute blistering RANT against the establishment, Americanism, Capitalism, overpopulation, and the person he feels personifies all Global ills. In a word: TRUMP!

He shares that he attended classes with two people who went on to own pro football teams, he actively cheers against the teams because he did not accomplish as much as his classmate. This to me crystalizes the authors positions, I think he needs a hug.

He explains that humans are basically automatons whose DNA is lucky to have survived. While not a spiritual man he utilizes spiritual quotes whenever they fit his purposes. He does advocate spirituality as it generally appears to cause people that practice their beliefs to be...happy.

If Conservatives partake in this material he will attack every position that they have a position on. That includes but is not limited to fossil fuels, overpopulation, abortion, medicine, Global Warming/Climate Change, and many more.

He shares that he took a complete pass on social issues growing up and that in his advanced age he has decided to enter the fray of public opinion. Occasional insight.

[Emily St. Amant · Rating 2 out of 5]

Couldn’t get into it. I was hoping for more unique insights instead of ideas I’ve heard over and over again.

[Lucas · Rating 1 out of 5]

The topic of "Twlight of American Sanity" seemed quite interesting and had a lot of potential. However, unfortunately the author has taken a different approach to writing than advertised. Rather than objectively "analyzing the Age of Trump", Allen Frances uses this book - particularly the first chapters - to push his progressive agenda. If that's what he wanted to do, all power to him, however don't disguise it as a psychiatrist analyzing the political climate. It had nothing to do with "The Age of Trump", rather it had to do with the author's disdain for conservatism. I feel cheated and ripped off, as I purchased a book who's subject was of great interest to me, yet what I read what something completely different.

[Al Swanson · Rating 1 out of 5]

Absolute liberal hogwash

Morons like this give guys bad raps. He blindly criticizes the president simply because he's a bit off kilter. Guaranteed he'd promote the black guy just for that reason alone. So what if he pans his own country! Who cares if he apologizes for being American! He can cause he's not. But yeah, he's a good lout. Trump is Trump. Has been for a while now. Unlike the previous PC president, he had actually accomplished things first. Not BO.

But who cares. As PC washes us clean of our backstory - and thus our transgressions - we can once again take center stage. We'll just lie and say we aren't.

Now you have an idea what reading this book was like.

[Douglas McClellan · Rating 1 out of 5]

It can be interesting to read differing opinions on President Trump. I find the difference between supporters and detractors thought provoking. However Dr Frances obvious disgust for Trump and anyone who voted for him his really hard to read. He tries to present his case as factual but it comes off as all opinions and biases. The chapters on happiness and the brain function were enjoyable, these chapters seemed to be less about Trump and more about the human mind. My one carry away was that President Trump is not crazy but I am and you are too probably.

[Scott · Rating 4 out of 5]

I agree with just about everything Allen Frances writes in this book. Which is scary, because I thought that my opinions were simply the result of rational research and analysis that other people hadn't done. Yet he wrote the book on it over a year ago. Plus, I'm not normally very positive about psychiatrists. I got this book thinking it would bear on Trump's mental state, and it does, but not directly. I urge Americans who care about avoiding delusion to read this.

[Becky · Rating 4 out of 5]

Premise of the psychological effects of this being rather obvious, I thought this would have more to do with the current situation. Rather this pulled in a great deal of historical reference and a ton of psychological information. It was good but not earth shattering. I am leaving open the thought of reading it again in the future when I'm not in such a fatalistic mindset.

[Stephen Selbst · Rating 1 out of 5]

Twilight is tedious, repetitive, and self-indulgent. With competent editing, this could have been a monograph. But at full-book length, it borders on being unreadable. I suspect that the author's prominence as a psychiatrist bought him a pass on editing . But his political observations are unremarkable and his psychological observations are too few to compensate for the blather.

[Paul · Rating 5 out of 5]

An incredible book about how Donald Trump is a manifestation of the current craziness and bitter partisanship in society. Somewhat frightening, but ultimately encouraging in its suggestions to restore sanity to the United States.

[Luís Medeiros · Rating 1 out of 5]

This book doesn't go further than to state and criticise Trumps craziness. I actually was expecting more than what this book said. I do not need to read a book simply showing that Trump is crazy, I already know that.

[Lisa · Rating 4 out of 5]

I wish delusional Trump supporters would read this - but they'll cling to their short-sighted hatred and foolishness instead