A Brain Without Guardrails, Part II: Trump's Summer of Confusion

Since my last assessment of President Trump’s mental functions on May 17, 2026, A Brain without Guardrails, I thought an update was indicated in light of an apparent flurry of abnormalities he has shown in thinking, behavior, language, and mood occurring in just the last two months. The list below is not comprehensive. To pursue his agenda, insofar as there is one, Donald Trump’s technique has been to “flood the zone” with actions too voluminous for anyone to keep up with. But that cuts both ways since he is also flooding the zone with the signs and symptoms of mental illness. My approach below is to select the most salient.

June 17, 2026, the G-7 Summit: Donald Trump walks into the Group of Seven (G7) summit in France and announces, “I’m the boss” to the leaders of France, Canada, Italy, Japan, the United Kingdom and Germany.

COMMENT: The world leaders laugh. Trump’s demeanor is not described. If he was joking, even in bad taste, the other leaders likely played along diplomatically. If Trump was serious, his declaration would be yet another indication that he suffers from grandiose delusions consistent with psychosis or dementia. A non-pathological possibility is that the president is just ignorant of the dynamics of power among Western democracies. Ignorance can be many things, but it’s not an illness.

July 7, 2026, the NATO Summit: On the runway of the Ankara Esenboğa Airport in Ankara, Turkey, at 2 PM Turkish time (7 AM ET) Donald Trump and Recep Tayyip Erdoğan, the Turkish president, walk slowly from the plane. Trump turns from his host while talking and begins to address the honor guard a dozen or so feet to his left. There is no interpreter. Erdogan then takes Trump by the arm and redirects him towards a microphone eight steps away in plain sight. At the microphone Trump speaks about two more words, Erdogan applauds, and the two men move on.

Aaron Rupar@atrupar

Erdogan clutches a wandering Trump's arm to guide him around

1:47 PM · Jul 7, 2026 · 1.38M Views

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Video of Donald Trump and Recep Tayyip Erdoğan in Ankara at the start of the NATO Summit, 2026. Source, Fox News, July 7, 2026. Fair use.

During the Summit itself, Trump calls Volodymyr Zelensky “President Putin,” refers to Iran as the “Islamic Republic of Japan,” and calls the 2015 Iran agreement the “JPOC” instead of the JPOA. He also refers to TikTok as “TicTac” and Turkey as a “great company.”

COMMENT: The flight to Ankara from Washington on Air Force One takes about ten hours. Arriving in Turkey at 2 PM Ankara time, Trump’s biological clock was set at 7 AM ET, a not unreasonable time to start the day, and so Trump’s drift down the runway in apparent confusion can’t be from jet lag. If he slept on the plane, his confused demeanor would not be explained by exhaustion. Two forms of confusion are present: disorientation while navigating his physical environment; and paraphasia, i.e., confusions while speaking. Causes of these kinds of confusion are worrisome. They include a number of disorders that can affect brain function including stroke, mood disorders, drug effect, dementia, and delirium. Confusion while walking is not the first time for Donald Trump, and is reminiscent of October 28, 2025, when in Japan during a review of an honor guard at the Imperial Palace Prime Minister Sanae Takaichi had to redirect an apparently confused Trump back onto the correct path. Neither are his speaking errors new. But they appear to be increasing in number.

July 19, 2026, the World Cup: As Donald Trump in his role of co-host of the World Cup took to the stage at MetLife Stadium in New Jersey, fans booed. Beaming with pleasure nonetheless, he placed a medallion on each member of the victorious Spanish football team. Lipreading revealed that the president used the same six words to congratulate each player. FIFA President Gianni Infantino went to get the team trophy as Mexico President Claudia Sheinbaum and Canada Prime Minister Mark Carney, the other two co-hosts, filed off the stage. Trump and Infantino then handed the trophy together to Rodri, the team captain. As cameras clicked Trump inserted himself into the team picture by continuing to stand with the players on the podium.

The Spanish victors of the 2026 World Cup championship with Donald Trump standing with the team. Photo credit, the White House. Fair use.

The FIFA president then tried to direct Trump to step out of the frame, but Trump momentarily shook him off.

FIFA President Gianni Infantino attempting to remove Donald Trump from the Spanish team World Cup victory photograph. Credit: Dan Mullan/Getty Images Sport via Getty Images. Fair use.

The headline of the Washington Post reported Trump trying to photobomb the Spanish team, “Trump Loomed over the World Cup.” The Guardian newspaper, not usually given to humor, allegedly wrote a caption for the photo of Trump and the FIFA president, “Gianni Infantino carefully explains to Donald Trump that he is not part of the Spanish national team.” The two men eventually ended up standing in the cannon fodder of fluttering gold confetti. The expression on Trump’s face then became vacant and seemingly confused over what was happening.

Donald Trump and Gianni Infantino caught in a downpour of confetti at the FIFA World Cup celebration. Photo credit, Sports.yahoo.com. Fair use.

COMMENT: Trump’s diminished use of language in congratulating the athletes is telling. Psychologists have observed a decline in the complexity of his sentences and his command of vocabulary in the last decade. This moment is more of the same, commonly seen in many brain disorders such as psychosis, stroke and dementia.

Though the U.S. was one of three host countries, Trump’s role was to award the trophy to the team. Seeking out center stage is part of Trump’s character. But he habitually has trouble respecting boundaries. During a prior victory ceremony when the Chelsea football team defeated Paris Saint-Germain, he lingered on the center of the stage after the medal ceremony, and to the puzzlement of the Chelsea team, he appeared in the middle of the photograph of their trophy lift. Clinically this is nothing to laugh about.

A psychologist friend once designed a questionnaire to differentiate three classes of patients: those with mania, depression, and dementia. A typical question was “Would you like to go to a party?” The manic patients tended to answer, “Yes!” But so did many of the demented patients. (The depressed patients said things like, “I don’t know. What’s the point?”) The manic and demented patients found the idea of a party exciting, agreeing before they thought things through. (A good example is the decision to start the war with Iran). A healthy person might want to know what kind of party was being offered before agreeing to go. But demented patients lack judgement.

A psychological measure of control over one’s impulses is the go/no-go test. One simply pushes a green button when it appears, and avoids pushing a red one when that appears instead. You can try it yourself. Such responses are governed by the brain’s frontal lobes. Demented patients lack impulse control. In the cafeteria of a unit for folks with various forms of dementia I watched with growing apprehension as a woman with Alzheimer’s eyed her neighbor’s cherry pie, slowly walked her hand across the table, and scooped out a cherry with her finger.

Donald Trump has a similar problem. At the World Cup he was swept up in the excitement of the moment, and couldn’t resist posing with the champions, no matter how bizarre or pathetic it appeared to others. One can argue that this is nothing more than Trump’s narcissism, the size of which is worthy of its own world cup. But what harm if he borrowed the adoration intended for a soccer team? But lacking judgment and boundaries, so do patients with dementia. Therein lies the challenge of diagnosing a powerful politician whose medical history is hidden in a shroud of secrecy. What explains his aberrant behavior? Narcissism, dementia, or something else?

July 22, 2026, Sam Stein, Managing Editor of the Bulwark: Stein posted on X. the following, “Trump is telling the story about beating jon ossoff when he first ran for Congress. The issue is, Trump told this story about 15 minutes ago.”

COMMENT: Trump is fond of repeating the same word or phrase in his rallies. This may be for emphasis. “Lock her up!” “Build that wall!” Populating one’s speech with repeating monosyllables, on the other hand, may also be from increasingly impoverished speech. That can be subtle, and so, arguable. But repeating the same story after fifteen minutes is neither subtle nor arguable. Trump clearly forgot what he said fifteen minutes before. This is a major lapse in short term memory, and disturbingly an all too common hallmark of dementia.

Consistent with the syndrome of dementia is when he said after the World Cup boos, cheers, and photobomb. “We have to do this again, and we have to do it while I’m around.” The next available World Cup the U.S. will co-host is in 2038. Donald Trump will be 92, and he certainly won’t be the host. What was he thinking? People with dementia live in their own private worlds. As defenses fall apart, the most raw of feelings emerge. In the case of Donald Trump that will be nothing to look forward to.