In the mid-20th century, the American psychologist Milton Rokeach published what has become both a classic of psychiatric literature and of literature itself. The Three Christs of Ypsilanti, which appeared in 1964, tells the story of three patients in a Michigan state asylum, each of whom believed he was Jesus Christ, and all of whom refused to acknowledge the others’ claims of divinity. The book is admired as a study in the boundaries of madness and identity, and as an exposure of the inhumanity of institutionalised mental health care at the time.

America now has a president who compares himself to Christ. And in that context Rokeach’s book may well shed some light on his condition – and his psychosis. Rokeach’s study appeared just three years after the publication of The Myth of Mental Illness by Thomas Szasz, the founder of what came to be called the anti-psychiatry movement.

Szasz argued that the concept of mental illness was a metaphor that pathologized what he called merely “problems in living.” That school of thought had profound effects on American society. It set in motion the deinstitutionalisation of hundreds of thousands of psychiatric hospital patients, some of whom ended up wandering the streets of American cities, occasionally erupting into violence. That led to figures like Rudy Giuliani and, to a lesser extent, Michael Bloomberg, and to law and order as a prominent and permanent plank of the political right.

The Queens-born, Manhattan-residing Trump would have fully experienced this atmosphere, which lasted from the 1960s well into the 1990s. One wonders whether Szasz’s well-intentioned normalisation of mental illness appalled the law-and-order Trump, or appealed to that part of him that had begun slipping into a break from reality. Although Rokeach was not part of the anti-psychiatry movement, his book is celebrated, in part, as a brief for an understanding of mental illness not as an abomination from nowhere, but as occurring on a continuum of identity caught up in harrowing forms of social power.

But Rokeach wanted to humanise mental institutions, not empty them out. It was not his fault that the anti-psychiatry movement unintentionally turned his humane approach to mental illness into an inhumane tolerance for unspeakable mental pain and the price it exacts from society. With the advent of the anti-psychotic drug Thorazine, vast numbers of patients were released from hospitals into the world numb, dysfunctional and lost.

On some level, anti-social behaviour became tolerated as mental illness was normalised. America is now normalising mental disorder in a different way: tolerating the dysfunction of its leader and his erratic, dangerous behaviour. It’s unlikely that Trump identifies with Christ.

Rather, his identification with criminals, and his pardons of criminals, and his identification with gangster-autocrats give the impression that he believes he is the Anti-Christ. Like Lucifer himself, Trump envies Christlike figures – he released thousands of documents about Martin Luther King’s assassination with the obvious intent of making public the FBI’s smears of King and its revelations about his private life. In fact, Trump wishes to undermine every figure who embodies both virtue and power; he seems to think he is so omnipotent that he can usurp Christ himself if he wishes to.

After all, to dress down the Pope, Christ’s representative on earth, Trump would have had to believe he was positioned, in Trump’s terms, at a higher pay grade. And so, having berated Leo for being “WEAK on Crime” and “terrible for Foreign Policy”, Trump depicts himself as Leo’s boss, as it were, taking on the duties of his idling chief executive. He did declare last year: “I run the country and the world” and he has been moving in a manic hurry around the globe, threatening, insulting, punishing, abducting heads of state, starting wars, toppling the world order and attempting to replace international institutions with his own.

He has tried to supplant the UN, for example, with his “Board of Peace”, a sort of cross between the Napoleonic Code and the Rotary Club. If Trump does not suffer from the delusion that he is the Prince of Peace, he does insist that he deserves the Nobel Prize for peace; if he does not believe that he is the incarnation of love and compassion, he seems to think that he embodies a supernatural spirit of damnation and revenge. The three Christs of Ypsilanti – Clyde Benson, Joseph Cassel and Leon Gaborwere; real patients in Ypsilanti, Michigan – were hurt into their sickness.

One suffered terrible personal tragedies, the other an emotionally and physically abusive father, the third a mother who was herself psychotic. The American psyche has changed since then. “Problems in living”, into which mental illness once became reconceptualised in the hands of the anti-psychiatry movement, have now become pathologised again as mental illness, and with a vengeance. The origins of Trump’s psychotic break