America’s
therapists are worried about Trump’s effect on your mental health
His
candidacy is sowing fear, distress and anger across the country, they
say. Here’s what one psychologist is doing to try to stop it.
By GAIL SHEEHY
10/11/16, 6:03 AM CET
What is Donald Trump
doing to Americans’ mental health? It came up in the debate Sunday
night, when Hillary Clinton pointed to a “Trump effect,” an
uptick in bullying and distress that teachers are noticing in
classrooms as their students are exposed to a candidate who regularly
attacks his opponents in bombastic, even threatening terms. The new
revelation of Trump’s crude boasts in 2005 about being able to kiss
and grope women and “move on” a married woman “like a bitch”
gave new fuel to the charge that his candidacy might be normalizing
aggressive, disparaging talk and behavior.
This all might be
another political attack, just stacked up on top of the familiar
charges that Trump is a danger to national security, an impulsive and
erratic personality, and indifferent to the Constitution. But
thousands of therapists are worried that it’s something more—and
they’ve been saying so for months.
Over the summer,
some 3,000 therapists signed a self-described manifesto declaring
Trump’s proclivity for scapegoating, intolerance and blatant sexism
a “threat to the well-being of the people we care for” and urging
others in the profession to speak out against him. Written and
circulated online by University of Minnesota psychologist William J.
Doherty, the manifesto enumerated a variety of effects therapists
report seeing in their patients: that Trump’s combative and chaotic
campaign has stoked feelings of anxiety, fear, shame and
helplessness, especially in women, gay people, minority groups and
nonwhite immigrants, who feel not just alienated but personally
targeted by the candidate’s message.
The manifesto also
made a subtler point: that all the attention heaped on Trump is
actually making it harder for therapists to do their jobs. Trump’s
campaign is legitimizing, even celebrating, a set of personal
behaviors that psychotherapists work to reverse every day in their
offices: “The tendency to blame ‘others’ in our lives for our
personal fears and insecurities, and then battle these ‘others,’
instead of taking the healthier, more difficult path, of
self-awareness and self-responsibility,” as Doherty wrote. Trump
also “normalizes a kind of hyper-masculinity that is antithetical
to the healthy relationships that psychotherapy helps people
achieve.” Not to mention that his comments in the 2005 tape,
Doherty says, are consistent with the behavior of a “sexual
predator.”
To some, the
therapists’ campaign might sound a little touchy-feely, a worried
cry from a group whose job is to be sensitive. But their effort is
also an attempt to understand something bigger about what’s
happening to the country. There’s good reason to believe that
demagogic, authoritarian leadership has a profound effect on
citizens’ mental health—yet we know very little about what that
effect is, Doherty says, because such repressive regimes tend to
punish those who would dare to publicize findings of psychological
damage. Doherty sees this moment in American politics as an important
test case.
In fact, it was a
recent trip to Austria, where a neo–fascist is leading in the
presidential election, that inspired Doherty’s interest in Trump.
He first thought to study what psychiatrists had done in 1930s
Austria and Germany—some had collaborated with the Nazis, others
remained silent—and then turned his attention to the present-day
United States. Doherty sees in Trump echoes of the cults of
personality wielded by strongmen throughout history—and amplified
by Trump’s use of social media for self-propagandizing: appeals to
fear and anger, blaming people seen as “other,” humiliating
opponents, fomenting distrust of the media and the political system,
projecting an image of exaggerated masculinity, and ridiculing women
while claiming to idealize them. For that reason, Doherty sees Trump
as a threat not just to the American people but to the democratic
tradition, which he believes fosters the kind of openness that is
essential to the work that therapists do.
Last month, tTo put
some research heft behind his concerns, Doherty commissioned a
national poll of 1,000 voting-age Americans and found that 43 percent
of the respondents—not limited to people in therapy—reported
experiencing emotional distress related to Trump and his campaign.
Twenty-eight percent reported experiencing emotional distress related
to Hillary Clinton’s campaign. Ninety percent of those feeling
emotional distress say it’s worse compared with any previous
election. But Trump has drawn the bulk of Doherty’s attention, both
because of the GOP nominee’s overt aggression and because his name
comes up more often in therapy sessions, Doherty says.
Trump’s bombastic
approach, of course, has been intoxicating and persuasive to a
significant portion of the electorate. He has a kind of roguish
charm, and plenty of downtrodden Americans feel energized by his
message that the country needs to be made “great” and “safe”
again. And certainly, not all therapists attribute their clients’
anxiety to Trump or the election. In the conservative bastion of
Newport Beach, California, for instance, psychologist Michelle
Matusoff, a Republican whose practice focuses on children, teens and
parenting, told me she was aware of the pervasive discussion on
social media about misogyny, xenophobia and racism in the
presidential election. She’s not a fan of Trump (especially after
the release of the 2005 tape). But she criticizes him gingerly—“He
doesn’t censor himself well,” she recently told me, meaning he
says what he really believes but he doesn’t disguise it in coded
language—and she calls analyses like Doherty’s letter
“subjective.” “There’s a lot of disapproving and eye-rolling
among my colleagues [about Trump], but we don’t notice a
significant mental health impact on our clients,” she says.
But Doherty is
deadly serious about trying to make psychotherapists across the
country aware of the psychological threat of what he calls
“Trumpism,” and to equip them to counter it in their practice. In
his online manifesto, he urged American psychotherapists to become
“citizen therapists” by actively discussing Trump with their
clients and communities. I spoke to seven of those therapists, who
described the effects of Trumpism they are seeing in their
clients—from fear of being ostracized or stripped of legal
protections they now enjoy, to suffering the terror of a childhood
trauma reawakened by a candidate whose father trained him to think of
himself as a “killer” and a “king.” They also spoke about how
Trump—with his evident lack of self-reflection and frequent
scapegoating—is making it harder for them to do their jobs.
Although it’s fair
to assume that most of Doherty’s therapists skew liberal, not all
of them do. Carrie Hanson-Bradley, a therapist in Lincoln, Nebraska,
says she has voted for Republican presidential candidates her whole
life. These days, she says, when her clients report increased anxiety
and insecurity, they often point not just to personal troubles but to
things they hear about in the news, including the Islamic State and
the presidential election. Most of those clients, white males who
skew low- to middle-income, don’t want to talk specifically about
whom they’re voting for. But they do express concern about “not
having a candidate that represents them and their problems,”
explains Hanson-Bradley, who says she will not be voting for Trump.
“It’s really hard when your conservative values lean one way, and
the candidate”—Trump—“doesn’t represent that.”
Some therapists say
their clients are pinning their worries much more squarely on Trump
himself. Fran Davis, a Boston psychologist with 30 years of
experience, told me that the day after Trump’s stunning primary
victory on Super Tuesday, six of her seven regular clients said they
felt acute anxiety just imagining that Trump could be president.
Parents talked about their distress over eruptions of hateful talk
and taunting in schoolyards. A legal immigrant parent reported her
child asking, “Do we have to get out of the country?” Others had
uglier worries. One of Davis’ patients, David Heimann, told me in
an interview that Trump’s racist threats against Mexicans and
Muslims triggered for him fears of persecution reminiscent of his
family’s experience in the Holocaust.
Hillary Clinton and
Donald Trump during the town hall debate on October 9, 2016 in St
Louis
Women have been a
repeated target of Trump’s, particularly of late, with his crude
hot mic comments, his revived body-shaming attacks against former
Miss Universe Alicia Machado and his not-so-veiled threats on Hillary
Clinton’s life—suggesting that Second Amendment supporters could
take up arms against her, or that Clinton’s bodyguards should
disarm to “see what happens to her.” Those comments have touched
a nerve in many women, sometimes even more alarmingly among those
dealing with the post-traumatic effects of physical or sexual abuse
by husbands, boyfriends or fathers. Michelle Shauf, who works in the
male-dominated high-tech and financial sectors in Atlanta, grew up
with an abusive father and has recently sought therapeutic
counseling. Shauf told me it depresses her to see Clinton’s
experience and qualifications wielded as negatives to keep her from
taking on a job held only by men. Plus, Shauf, who has a 9-year-old
daughter, fears that Trump’s shaming of women for being “fat”
or “flat-chested” can be primal injuries to adolescent girls’
self-esteem.
Trump’s
suggestions that he could roll back civil rights gains for gay
people—by appointing Supreme Court justices who would overturn
same-sex marriage, for instance, and backing North Carolina’s
controversial bathroom law (HB2)—are similarly triggering fears in
some LGBT therapy patients. Susan Blank, Shauf’s therapist in
Atlanta, told me about one gay male client who was married in Vermont
when same-sex marriage was first legalized there and moved back to
Atlanta when Georgia recognized it. He told Blank it was similar to
the movie Jaws: “Just when I thought it was safe to go back in the
water, Trump was nominated.” Margaret Howard, a licensed clinical
social worker in St. Louis, said one of her lesbian clients was
unnerved while traveling for work through what she described as
“Trumpish areas” of the South with her same-sex partner. To
register in a hotel, they hid their relationship and pretended to be
roommates. “Having to go back in the closet has come as a real
shock to my younger clients,” Howard told me. “They are used to
acceptance.”
Patrick Dougherty, a
trauma therapist in the Twin Cities who is a longtime colleague of
Doherty’s (no relation), has found that even his mostly white
heterosexual male patients—Trump’s demographic sweet spot—are
experiencing anger and fear as a result of Trump’s campaign. Partly
it’s that many of the men Dougherty treats grew up in dysfunctional
families—a violent or alcoholic parent, or one who was depressed or
negligent. Trump’s aggressiveness is triggering for them personal
childhood traumas, says Dougherty, himself a Marine veteran of the
Vietnam War. For others, Trump is contributing to a sense of
“collective trauma,” a blow that tears at the basic tissue of
social life. The videotaped police killing of Philando Castile in
Minneapolis this summer and the recent stabbing at a mall in St.
Cloud already have parts of Minnesota on edge; Trump’s antagonism
toward minorities and others is only making matters worse, Dougherty
says: “Even here in the upper Midwest, our sense of community is
disappearing.” One client told Dougherty: “I work with
Muslims—what’s going to happen to those people?” The client
added, “I’m afraid some white motherfucker is gonna go down to
the West Bank”—a part of Minneapolis that has a large population
of Somali, mostly Muslim immigrants—“and shoot people up.”
Therapists, of
course, must tread lightly when it comes to discussing politics, and
for some particularly vulnerable patients, the fear that Trump
incites can be attractive. Mary Kelleher, a marriage and family
therapist in Seattle and another signatory of Doherty’s manifesto,
experienced panic attacks herself just thinking about how her
patients—most of whom are legal immigrants of Latin American,
African or Caribbean descent—might respond to Trump’s branding of
immigrants as a danger. But she was shocked to hear some of her
immigrant clients say they were drawn to Trump. On reflection, she
concluded, “His strongman persona represents safety to them, even
if his policies could be personally destructive.” Still, Kelleher
is careful not to engage in a political argument with her patients.
“Their traumatization could go back decades, and that’s where I
would focus,” rather than going directly to the subject of Trump,
she explains. “Their alignment with Trump is a symptom of their
trauma.”
***
Trump’s emergence
in therapy sessions presents a powerful conflict for some therapists
between their professional norms—which include not imposing their
political beliefs on their clients—and what some describe as a
strong, even historic sense of moral obligation to keep this
candidate out of the White House. Kirsten Lind Seal, a therapist who
teaches ethics at Saint Mary’s University of Minnesota and signed
Doherty’s manifesto, assured me, “I am not going to diagnose
Trump from afar, but I have an ethical obligation to make my voice
heard [outside of the consulting room] about how bigotry, xenophobia,
racist and sexist speech is ripping apart the fabric of our social
and political life.”
That’s where
Doherty sees his work coming in. The thousands of signatories to his
open letter have become an online community that shares ideas about
how to counter “Trumpism.” And in August, he invited 14 of his
most committed followers to brainstorm steps they can recommend to
therapists in the trenches. They discussed ideas like easing into a
conversation by first asking what the Trump campaign means to the
client, if the client doesn’t bring up Trump on his or her own. If
the answer suggests acute anxiety, then the therapist can suggest
action steps, like disengaging with non-stop TV coverage of the
campaign and engaging instead with friends and community. Doherty’s
working group also discussed how patients who feel threatened by
Trump can take action as citizens rather than feeling helpless—for
instance, by registering new voters—rather than turning to passive
coping mechanisms, like having another glass (or bottle) of wine.
The Marine veteran
therapist Dougherty, for one, is experimenting with raising the
question of political stress more directly among his regular clients.
“I wrote a letter about the prevalence of hate speech in the
campaign, about terrorism and mass shootings, and left it in my
waiting room. I closed by saying, ‘If these things are troubling
you, I want to invite you to bring it into your therapy session.’”
Out of 30 patients, 20 raised those concerns, and Dougherty is
working to help address them.
It isn’t enough to
defeat Trump the candidate, some signers of Doherty’s manifesto
say, and that’s not really the point. They believe they have to
fight Trumpism—the emotional pain they say he has already caused.
“There is a real and present danger for a national mental health
crisis,” Doherty says. “And regardless of the outcome of the
election, it will continue to need our attention.”
Gail Sheehy is the
author of 17 books, including a biography of Hillary Clinton,
Hillary’s Choice, and a current memoir, DARING: My Passages.
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