I am being interviewed tomorrow for the “Bill Press Pod” with Jennifer Panning, PsyD, one of my co-authors in The Dangerous Case of Donald Trump. The topic is the effect of Donald Trump on the mental health of all of us. So I might as well blog about it, too! 

It is well known that when an unstable personality takes charge of a group of people or organization, the emotional wellbeing of his or her followers is negatively affected. This is supported by considerable research on the ease at which humans can be manipulated into following cult figures and can quickly fall under the sway of peer pressure or “groupthink”. 

But even when people disagree with a leader, that leader’s emotional state can affect everyone in the country, and we witnessed that occur with Trump. In my psychotherapy practice I began seeing this immediately after the 2016 election, with patients reporting concerns and distress about the effect Trump would have on the country. I felt it myself, having spent election night disgusted and literally nauseated at the prospect of Trump in the White House, with existential fear about the harms he would do to the climate, specifically. Dr. Panning coined the term Trump Anxiety Disorder in Dangerous Case to describe this experience.

Throughout Trump’s term, patients with experience of relational or narcissistic abuse have reported that his voice, mannerisms and actions are triggering for them. Just hearing his voice, makes the hair on my neck stand up. My primal warning system knows Trump is a predatory, sociopathic type of person and I instinctively want to distance myself. For those of us who can spot dangerous personalities, Trump is a constant source of destabilizing anxiety and dread. Four years of witnessing Trump get away with repeated violations of laws and social norms is triggering to a healthy person’s sense of unfairness and injustice. To those who experienced childhood or attachment/family trauma, this can reactivate traumatic memories of the helplessness and repressed rage they experienced early in their life. 

Since the COVID pandemic and economic collapse, then spiking after George Floyd’s murder, I have seen a dramatic increase in people voluntarily mentioning that their pre-existing issues with anxiety and depression have worsened. Their distress, difficult to describe, is a combination of worry, disgust, grief, hopelessness and indignation about the state of the world— with most people identifying Trump as the source of the problem. They recognize that America has a leader who chose not to act and protect citizens, and instead choose to ignore the coronavirus pandemic in a grossly self-interested effort to try to keep the economy strong and ensure his re-election. Trump now seems to be actively, sadistically trying to make things worse by, for example, working to restrict voting by mail by destroying the U.S. Postal Service.

Trump’s behavior triggers in most people a sense of moral outrage or indignation, which I consider a healthy response. Indignation is a drive or emotion that falls on the prosocial end of a spectrum. Prosocial drives work to build human connection and community and include “caring and sharing” traits such as generosity, kindness, empathy, fairness, and reciprocity. 

The opposite end of that spectrum includes antisocial traits, such as self-interested individualism and selfishness, cheating, lying, domination, violence, and violation of laws and the rights of others. (Antisocial is used as a descriptor, not a diagnostic label.)

When antisocial and abusive people engage in indignities against others and violate their rights, this triggers a primal response of indignation in those of us with more prosocial tendencies. In a recent special edition of the Journal of Humanistic Psychology that I co-edited, I wrote an article entitled “In Praise of Indignation,” about this prosocial primal reaction to our rights and dignities being taken away. When we feel a violation of our values and morals, we usually have a sense of unfairness.

Trump and his enablers in the GOP have gleefully peeled back this country’s thin veneer of civility to reveal that millions of our fellow citizens are happy to exhibit hatred, immorality, corruption, hypocrisy, selfishness, and even sadistic traits. The act of refusing to wear a face mask has visibly exposed the antisocial pathology of our neighbors and friends as selfish, individualistic, and having no desire to work toward the common good. 

My patients are disgusted, disheartened, hopeless and angry about what they see. They are experiencing a moral injury when they recognize the reality of the antisocial behaviors among their fellow citizens and the GOP leadership. All this primal distress, disgust, and anger leads to fear and anxiety.

As I mentioned above, many patients also express grief — some, of course, with specific specific losses of family members and jobs, weddings postponed and graduations cancelled.

They struggle to express an amorphous grief at watching their beloved country slide into fascism, watching citizens turn against each other, watching our prosocial morals evaporate, and witnessing our sense of community and patriotism disappear. 

As humans, we feel and function best when we are part of a tribe, a team, or a community with a common goal of caring for each other. Our natural instinct is to look to others for mutual support in times of crisis, then to band together and have each other’s backs. When we recognize that this does not actually exist in our nation or state, we become disheartened at the sense of isolation and abandonment we feel. For some people it may even be fear-provoking to know we may be on our own in a fundamental way.  

Helplessness then triggers fear, worry andexistential angst. For those mired in helplessness, it is natural to feel more anxious at their inability to protect themselves or the future of their world.

Violations of rights and social norms are why I have regularly described Trump as abusive. Merely listening to his lies and gaslighting during press conferences or on Twitter, creates a distortion of reality that is abusive. 

People want calm, mature leadership and instinctively feel the disruption and chaos of an immature, impulsive person like Trump. By creating an environment where people do not know whom to trust or what to believe, Trump created a baseline of anxiety for the past four years that is now compounded by the current health, economic and social crises. 

We will continue to see increases in mental health concerns among a wide range of people in this country until these crises are resolved. But if Trump wins in November, expect more people to struggle with emotional functioning. There may be increases in anxiety, but I believe many people will collapse into depression or the “fold” response, having lived too long in “fight-or-flight.” They will transition from indignation into the hopelessness and helplessness of depression after fully realizing that we are on our own, abandoned by our leaders who are merely working in their own self-interest and to protect the needs of the rich, white and Evangelical Christian base voters. 

If Trump wins I know that it will be difficult to maintain a sense of moral outrage for another four years or longer. 

For some of us who have spoken out directly and publicly about Trump, the anxiety may become be more immediate and real. What will a newly empowered dictator-wannabe do to his enemies when constitutional restraints are not enforced by Congress and with unlimited power? 

We must reject Trump’s reality and reclaim the reality that most of us recognize — the prosocial drives of healthy, moral, good people must triumph over the antisocial evil that is Trump and the GOP. 

If you value the mental health of our country, vote for Biden and Harris and for Democrats who support working toward the good of all of us in this country. 

Share this post!