Between his defense of domestic abusers, his habit of stoking fears about immigrants, and his support for tax cuts tailor-made for billionaires, it’s sometimes easy to forget about the level of destructive power that President Trump wields every day, as commander-in-chief of the U.S. military, including its nuclear arsenal.

Trump, however, has not forgotten. The president has seized on the opportunity to push an issue on which he has long been disturbingly fixated: last summer, he called for a ten-fold increase in the U.S. nuclear stockpile, a move which reportedly prompted Secretary of State Rex Tillerson to label him a “fucking moron.” Trump’s calls for nuclear escalation were echoed in the recently-released Nuclear Posture Review (NPR), which calls for new types of nuclear weapons and a lower threshold for using them. Meanwhile, tensions between the United States and North Korea have escalated; dozens of experts warn that the United States may be sleepwalking into a war where millions would die.

Trump’s obsession with nuclear weapons, along with his well-documented impulsiveness and erratic behavior, has meant that a growing number of lawmakers are now arguing for a wholesale reform to the nuclear command and control system.

….Actually, throughout my life, my two greatest assets have been mental stability and being, like, really smart. Crooked Hillary Clinton also played these cards very hard and, as everyone knows, went down in flames. I went from VERY successful businessman, to top T.V. Star…..

— Donald J. Trump (@realDonaldTrump) January 6, 2018

Dr. Steven Buser, M.D., is well-placed to talk about Trump’s temperament and its relation to the country’s nuclear stockpile. As a psychiatrist, he spent 12 years in the Air Force, where one of his duties was to evaluate military personnel for their safety to be around nuclear weapons.

“They really lay out the criteria really clearly — you must have the highest level of trustworthiness, responsibility, reliability, conduct and behavior in order to be around nuclear weapons,” Buser told ThinkProgress. “But when you look at President Trump, if you apply those same standards to an airman in a missile silo who wants to be around nuclear weapons, were Trump that airman, would he pass that security requirement? As an Air Force psychiatrist I’d say absolutely not, not without further evaluation. That’s the great irony of the entire nuclear command structure from the missile silo to the chairman — all these high standards, but not for the president.”

Dr. Buser is one of several professionals who are concerned not only by Trump’s temperament and tendency to speak without thinking, but the lack of standards for routinely testing that temperament — which, in turn, leaves the door open for a potentially catastrophic nuclear misstep.

“We have two insecure alpha narcissists basically goading each other into a fight,” Dr. John Gartner, Ph.D., told ThinkProgress, referring to North Korean leader Kim Jong-un. Gartner is the founder of Duty to Warn, an association of mental health professionals who advocate for removing Trump from office, “on the grounds that he is psychologically unfit.”

Citing Trump’s plans to host a military parade in the nation’s capital featuring military hardware and machinery, Gartner added, “This whole thing about a military parade is very symbolic. The type of leaders who want to puff themselves up by celebrating the power of their military these are the type of leaders who always start wars.” 

Dr. Jacqueline J. West, a psychologist and author who recently spoke at the National Press Club’s “Presidential Mental Health & Nuclear Weapons” conference, argues that Trump’s doggedness concerning the nuclear stockpile comes from a “deep identification of dominance.”

“It comes from, developmentally, a very early split between the ideas of predator and prey,” she said. “[Dominance] makes him feel like he’s winning, like he’s more powerful, like he’s bigger.”

Trump’s Nuclear Posture Review aims to make nukes more ‘usable’

Experts say it will make the world less safe.

This obsession with dominance makes it easy to envision a scenario in which, when dealing with an escalating nuclear crisis, Trump’s primary instinct becomes to prove to an opponent how much stronger he is, not realizing that, with potentially millions of lives at stake, cooler heads need to prevail. A recent example of this was Trump’s tweet on January 2, in which he boasted, “North Korean Leader Kim Jong Un just stated that the ‘Nuclear Button is on his desk at all times.’ Will someone from his depleted and food starved regime please inform him that I too have a Nuclear Button, but it is a much bigger & more powerful one than his, and my Button works!”

These concerns have prompted a slew of Democratic lawmakers to introduce legislation that would add checks and balances to the command-and-control structure of the U.S. nuclear arsenal. In January 2017, Rep. Ted Lieu (D-CA) introduced the “Restricting First Use of Nuclear Weapons Act” which prohibits the president from launching a first nuclear strike unless Congress has expressly authorized it. Congressman Jamie Raskin (D-MD), along with 20 co-sponsors, also introduced the “Oversight Commission on Presidential Capacity Act” in May last year, which would allow Congress to call for a psychological examination of the president in emergency situations, to ensure his ability to execute his duty effectively. In November, for the first time since 1976, the Senate Foreign Relations Committee held a hearing examining the extent of the president’s nuclear authority.

“The entire nuclear chain, with one exception, has two people needed to do any action — arm a bomb, launch a bomb, and so on — except [when it comes to] the president,” Buser said. “Why not have a system where the attorney general or secretary of defense, for example, have to confirm to the president that, yes, that action is a reasonable one?”

Democratic lawmakers have also echoed experts’ criticism of Trump’s Nuclear Posture Review, arguing that it sets aside promises of non-proliferation seen during the Obama administration for a much more aggressive stance.

“[The NPR] expands the buildup not only of bombs but of delivery systems, all of which confirms that we have engaged in a new nuclear arms race,” Rep. John Garamendi (D-CA) told ThinkProgress. The difference, Garamendi said, is that the delivery systems now under development by the United States, Russia, and China are much more stealthy — meaning that the realities and strategies of the Cold War aren’t going to apply.

Garamendi added that, in the case of North Korea and South Korea, the pair had a history of tit-for-tat engagements. Following that logic, any sort of “bloody nose” attack by the Trump administration on North Korea would likely results in some form of counter-attack against South Korea as well.

The sheer number of controversies that Trump has generated over the past two years has given pundits, politicians, and psychological experts reason to wonder whether Trump is actually the “very stable genius” he claims to be. And while some have raised legitimate questions about the dangers of assessing Trump’s temperament from afar, the mental health professionals who spoke with ThinkProgress maintain that the signs are there for all to see.

“It’s all from observable behaviors,” said Dr. David Reiss, M.D., a psychiatrist and author who contributed to the book, The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. “We’re not interpreting how his childhood led to this or that, we’re defining observable behaviors the same way a surgeon would say if you’ve got a hot stomach we need to send you to the ER [for further evaluation].”

He added, “We can evaluate danger from a distance just based on history and secondary information. [That] doesn’t mean that we’re providing a diagnosis or prognosis.”

Correction: An earlier version of this article mistook Congressman Garamendi’s first name. His full name is John Garamendi, not Eric Garamendi as originally published.