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The Trump Effect: This Election Is Bad for Our Brains


October 11, 2016
John Boghosian Arden / The San Francisco Chronicle & The Southern Poverty Law Center & Gail Sheehy / Politico

Donald Trump's public behavior, amplified by the media, has contaminated America's mental landscape and has changed the behavior of many of the nation's children. In schools across the country, teachers are reporting that minority students are being bullied, insulted, and attacked by other students yelling "Trump, Trump, Trump." Latino and Muslim students are being singled out for special intimidation by fellow students chanting "Build a wall" or "Kill the terrorists." The triggers are installed deep in our brains.

http://www.sfchronicle.com/opinion/openforum/article/This-election-is-bad-for-our-brains-9958301.php

This Election Is Bad for Our Brains
John Boghosian Arden / The San Francisco Chronicle

(October 9, 2016) -- As a psychologist with decades of experience helping people change their brains for the better, I feel compelled to comment on how the brain can change for the worse. This presidential election is making things worse. Much worse.

Why is this? Because this is the most uncivil election in decades. Each instance of cruelty and racism, and each offensive or sexist accusation we've witnessed, is making us more and more immune to such uncivil social discourse.

To put this into psychological perspective, there are two opposing forces at work in our brains: the prefrontal cortex and the amygdala. The prefrontal cortex is the most evolutionarily advanced part of the brain. It is responsible for complex thinking: It plans ahead, fact-checks data, and weighs options, slowly. The amygdala, on the other hand, does not. It sees in black and white -- incoming data either represent "threat" or "no-threat," providing knee-jerk reactions that activate our fight-or-flight mechanisms.

Unfortunately, with this election we're seeing our amygdalas run overtime, bypassing our prefrontal cortexes, making us vulnerable to incivility and false information. Here's how:

We have two routes to the amygdala, the fast track and the slow track. Through the fast track, information goes directly to the amygdala before the prefrontal cortex can think it over and fact-check, frequently creating false positives and overreactions.

There's an evolutionary reason for this: Our ancestors on the plains of Africa didn't last very long standing around waiting to decide whether that shadow is a lion. The slow track to the amygdala routes information to the prefrontal cortex before the amygdala, so that complex assessment of the data occurs, helping decide whether that shadow is just a shadow.

In the modern world, we're seldom faced with lions. However, the fast track still serves a purpose, helping pedestrians jump out of the way of vehicles, or aiding a soldier in identifying threats. The fast track has a downside, though: People who use their fast tracks too often are susceptible to anxiety disorders, or even post-traumatic stress disorder in the case of soldiers.

Unfortunately, today we are training our brains to use the fast track instead of the slow track when it comes to politics.

That's because of neuroplasticity -- the ability of our brains to constantly rewire themselves depending on stimuli and our responses. Anything we do more than once, whether thinking, feeling, listening to a speech, or otherwise, becomes easier over time. This is the principle behind practice, studying and repetition.

But where this becomes dangerous is when uncivil words are repeated. Every time you hear a politician call another "anti-American" or hear a slur hurled at one group, it becomes more familiar and even normal. That's tragic.

Politicians have been using the politics of fear and anger for centuries to drive our votes. Our brains recognize harsh rhetoric, uncivil comments and angry diatribes as threats, routing them past our prefrontal cortex, where facts are sorted out from nonsense. We saw these knee-jerk votes in the election leading up to the Civil War, in anticommunist zealotry in the 1950s, and we're seeing it now.

That's why I'm happy that organizations like the National Institute for Civil Discourse are encouraging us to stop using our fast tracks and think before we react -- or vote. Check out www.nicd.arizona.edu/revivecivility for more information.

We're on a fast track to incivility. We need to slow down -- our democracy depends on it.

John Boghosian Arden, Ph.D., formerly directed training for mental health for Kaiser Permanente in Northern California. He is the author of 14 books and lives in Sebastopol.



The Trump Effect: The Impact of the
Presidential Campaign on Our Nation's Schools

The Southern Poverty Law Center

(April 2016) -- Our report found that the campaign is producing an alarming level of fear and anxiety among children of color and inflaming racial and ethnic tensions in the classroom. Many students worry about being deported.

Every four years, teachers in the United States use the presidential election to impart valuable lessons to students about the electoral process, democracy, government and the responsibilities of citizenship.

But, for students and teachers alike, this year's primary season is starkly different from any in recent memory. The results of an online survey conducted by Teaching Tolerance suggest that the campaign is having a profoundly negative effect on children and classrooms.

It's producing an alarming level of fear and anxiety among children of color and inflaming racial and ethnic tensions in the classroom. Many students worry about being deported.

Other students have been emboldened by the divisive, often juvenile rhetoric in the campaign. Teachers have noted an increase in bullying, harassment and intimidation of students whose races, religions or nationalities have been the verbal targets of candidates on the campaign trail.

Educators are perplexed and conflicted about what to do. They report being stymied by the need to remain nonpartisan but disturbed by the anxiety in their classrooms and the lessons that children may be absorbing from this campaign.

Two responses from teachers illustrate their dilemma. A teacher in Arlington, Virginia, says, "I try to not bring it up since it is so stressful for my students." Another, in Indianapolis, Indiana, says, "I am at a point where I'm going to take a stand even if it costs me my position."

Our survey of approximately 2,000 K-12 teachers was not scientific. Our email subscribers and those who visit our website are not a random sample of teachers nationally, and those who chose to respond to our survey are likely to be those who are most concerned about the impact of the presidential campaign on their students and schools.

But the data we collected is the richest source of information that we know of about the effect of the presidential campaign on education in our country. And there is nothing counterintuitive about the results. They show a disturbing nationwide problem, one that is particularly acute in schools with high concentrations of minority children.

Here are the highlights:

* More than two-thirds of the teachers reported that students -- mainly immigrants, children of immigrants and Muslims -- have expressed concerns or fears about what might happen to them or their families after the election.

* More than half have seen an increase in uncivil political discourse.

* More than one-third have observed an increase in anti-Muslim or anti-immigrant sentiment.

* More than 40 percent are hesitant to teach about the election.

The comments are particularly revealing.

The survey did not identify any candidates. But out of 5,000 total comments, more than 1,000 mentioned Donald Trump. In contrast, a total of fewer than 200 contained the names Ted Cruz, Bernie Sanders or Hillary Clinton. During the campaign, Trump has spoken of deporting millions of Latino immigrants, building a wall between the United States and Mexico, banning Muslim immigrants and even killing the families of Islamist terrorists. He has also called Mexican immigrants "rapists" and drug dealers.

"My students are terrified of Donald Trump," says one teacher from a middle school with a large population of African-American Muslims. "They think that if he's elected, all black people will get sent back to Africa."

In state after state, teachers report similar fears among minority children.

In Virginia, an elementary school teacher says students are "crying in the classroom and having meltdowns at home."

In Oregon, a K-3 teacher says her black students are "concerned for their safety because of what they see on TV at Trump rallies."

In North Carolina, a high school teacher says she has "Latino students who carry their birth certificates and Social Security cards to school because they are afraid they will be deported."

Some of the stories are heartbreaking. In Tennessee, a kindergarten teacher says a Latino child -- told by classmates that he will be deported and trapped behind a wall -- asks every day, "Is the wall here yet?"

Many children, however, are not afraid at all. Rather, some are using the word Trump as a taunt or as a chant as they gang up on others. Muslim children are being called terrorist or ISIS or bomber.

"Students are hearing more hate language than I have ever heard at our school before," says a high school teacher in Helena, Montana. Another teacher reports that a fifth-grader told a Muslim student "that he was supporting Donald Trump because he was going to kill all of the Muslims if he became president!"

The long-term impact on children's well-being, their behavior or their civic education is impossible to gauge. Some teachers report that their students are highly engaged and interested in the political process this year. Others worry that the election is making them "less trusting of government" or "hostile to opposing points of view," or that children are "losing respect for the political process."

For the sake of children and their education, presidential candidates should begin modeling the kind of civil behavior and civic values that we all want children to learn in school. Barring such a change in tone, however, teachers and school administrators will face an uphill battle. Remaining impartial will be difficult when the students' conversation revolves largely around Trump.

But we urge educators not to abandon their teaching about the election, to use instances of incivility as teaching moments, and to support the children who are hurt, confused and frightened by what they're hearing from the candidates. Our specific findings from the survey follow.


Impact on Students
Every student, from preschoolers up through high school, is aware of the tone, rhetoric and catchphrases of this particular campaign season. Students are hearing conversations at home. They're chatting, posting and joking on social media. Whether teachers decide to bring it into the classroom or not, kids are talking about it, modeling their behavior on that of political candidates and bringing heightened emotion to school along with their backpacks.

One California teacher noted, "YouTube, Instagram and Twitter make everything 'live' and interactive." Some students attend candidates' rallies. And then there is the endless cycle of talk radio, 24-hour news and cable comedy shows. "The explosive headlines and conversations have caught their attention," a middle school teacher in Providence, Rhode Island, wrote about her students. "They want to talk about a cartoon/headline/video they saw."

The 2016 campaign and the antics of its contestants are omnipresent. As one Bloomfield Hills, Michigan, elementary school teacher told us, "Shying away from difficult conversations doesn't mean the conversations aren't taking place." A Portland, Oregon, middle school teacher reported that her principal had imposed a "gag order" on teachers, prohibiting them from talking about the election.

But the order didn't stop one of her students from telling an immigrant classmate, "When Trump wins, you and your family will get sent back." On the survey she posed the question, "What does a teacher do? I can assure you that if a student says that loudly and brazenly in class, far worse is happening in the hallway."

For almost all students, the campaign is personal and their support or opposition to candidates -- actually to one candidate mainly -- is intense. But the effect of the campaign on students depends very much on where they stand in the school pecking order. Those who have been marginalized in the past are bearing the brunt of behavior and comments that often cross over into abuse.

Marginalized Students Are "Terrified"
Over two-thirds (67 percent) of educators reported that young people in their schools -- most often immigrants, children of immigrants, Muslims, African Americans and other students of color -- had expressed concern about what might happen to them or their families after the election. Close to one-third of the students in American classrooms are children of foreign-born parents.

This year, they are scared, stressed and in need of reassurance and support from teachers. Muslim children are harassed and worried. Even native-born African-American children, whose families arrived here before the American Revolution, ask about being sent back to Africa.

Others, especially younger students, have worries that are the stuff of nightmares, like a return to slavery or being rounded up and put into camps. Overall, these vulnerable students are disillusioned and depressed at the hatred they're hearing from candidates, in the news, from classmates and even, sometimes, from trusted adults. They're discouraged to find out what people really think. Teachers struggle to help them feel safe.

Undocumented students or students with undocumented family members are especially vulnerable. These students have a legal right to a public school education, but many of them come to school every day fearful that their families will be separated. Teachers, in general, are very protective of students and sensitive to their pain.

Fears are pervasive. Students tell teachers they are worried about deportation, having their families split, being put in jail or attacked by police, losing their homes, seeing their places of worship closed, going into hiding and being sent to detention camps. Some Muslim students think that, if Trump becomes president, they will have microchips implanted under their skin.

Students are stressed and anxious in a way that is threatening their health, emotional well-being and their schoolwork. We heard from dozens of educators about young students who expressed daily worries about "being sent back" or having their parents sent back.

In many cases, the students are American citizens or come from families that are here legally. It doesn't matter: Regardless of immigration status, they feel under attack. We heard about students from second grade to high school crying in class.

A Tennessee kindergarten teacher reported that she has a student who asks her every day if the wall has been built yet. "Imagine the fear in my students' eyes when they look to me for the truth," she said.

In Massachusetts, an elementary school social worker described what was happening to her 8-year-old son, who was adopted from Korea. "He came home from school and recounted a conversation he'd had with his friends on the playground. Many … come from immigrant families and/or are black or brown.

He told me they know that if Donald Trumpet [sic] was elected that we would have to move to another continent to be safe and that there would be a big war. He is very nervous about being sent away with my husband who is also Korean American."

Stressed students have a harder time learning, and we saw many reports that anxiety was having an impact on grades and ability to concentrate. In Washington state, a teacher told us about a 10-year-old boy who can't sleep at night because he is worried his immigrant parents will be sent away.

A California art teacher described a fifth-grader who had begun having "full-blown panic attacks." After fellow students in Washington State had repeatedly shouted slurs from their cars at one Muslim teenager, her teacher reported, the girl expressed suicidal thoughts.

For immigrants whose home countries are unsafe places to which they can't return, the fear is "tremendous and profound." One teacher observed that the campaign season is particularly traumatizing for students who have "suffered through exile, migration and even asylum." Others reported that their Iraqi and Syrian students are terrified of being sent back to their war-torn countries.

They're not just scared. Teachers used words like "hurt" and "dejected" to describe the impact on their charges. The ideas and language coming from the presidential candidates are bad enough, but many students -- Muslim, Hispanic and African-American -- are far more upset by the number of people, including classmates and even teachers, who seem to agree with Trump. They are struggling with the belief that "everyone hates them."

An elementary school administrator in Vancouver, Washington, wrote, "Students who had undocumented family members and relatives are afraid of what other kids will think of them if they find out. One [fourth-grade] student reported that she thought everyone hated her because her mother was illegal and she didn't want to come to school. Over 35 percent of our students are Mexican. I've never had this … before this year."

African-American students aren't exempt from the fears. Many teachers reported an increase in use of the n-word as a slur, even among very young children. And black children are burdened with a particularly awful fear that has been reported from teachers in many states -- that they will "be deported to Africa" or that slavery will be reinstated. As an Oklahoma elementary teacher explains, "My kids are terrified of Trump becoming [p]resident. They believe he can/will deport them -- and NONE of them are Hispanic. They are all African American."

Even in schools where a majority of students are African American and don't face racial taunts on the playground, students feel uneasy. A teacher in Ferguson, Missouri, where nearly nine out of 10 students are African American, says, "We do not have the language and hate of any candidates repeated at the high school where I teach. … However, I do hear students wonder if they are being let in on what all white people truly think and feel. This is so disappointing and hard to combat."

According to their teachers, these vulnerable students feel that Trump is a "rich racist who hates them." Young children can't understand why people hate them without even knowing them. One teacher's comment, "It breaks my heart," was echoed by dozens of others.

Another wrote simply that, in her diverse school, "My students have one thing in common. Apparently America hates them."

Students are confused. Their teachers have worked hard -- and often successfully -- to teach them about American ideals. They are, according to one Boston high school teacher, "confused as to how a person who has no respect for American ideals can be so popular." On one hand, they are taught that the United States is a nation of immigrants, but their current experience doesn't match the lesson. Many immigrant students feel that "they don't belong here" and they have "no value" to the country.

All students, regardless of whether they are members of targeted groups, are vulnerable to the stress. Kids are worried about their friends and want to protect them. A Minnesota teacher wrote about her own middle school daughter who felt terribly guilty after a "dear Muslim friend was called a 'terrorist' by another classmate." The teacher reported, "We had a lengthy conversation about what to do if there was a 'next time.'"

Teachers struggle to provide safety in their classrooms and reassurance to their students. Often that means breaking their usual rule against discussing their own politics and assuring children who "beg [them] not to vote for Trump because he will send their parents out of the country" that, indeed, they will not.

Others try to explain how our system actually works, underscoring the point that the president alone doesn't make laws, or that it's unlikely Mr. Trump will actually be elected. But, as one California teacher explained, "I have tried to reassure my students that no matter the outcome, they will be okay. I don't even know if that's true, but I can't have them worry and stress about it."

Teachers work to keep their classrooms respectful. Often that means constant reminders that the rules for classroom discussion aren't the same as the rules on the debate stage. Sometimes it means declaring some things off limits. "I really don't want to have his [Trump's] name invoked in my classroom," said a teacher from Pennsylvania. "It feels like it makes it an unsafe place for my students of color."

And often, it means expressing affection. A teacher at a Virginia Title I (high poverty) school where nearly two-thirds of the students are Hispanic said, "My second-graders are scared. They're scared of being sent back to their home countries. They're scared of losing their education. As their teacher, I hug them each day to let them know they are safe and they are loved."

Students Seem "Emboldened"
The gains made by years of anti-bullying work in schools have been rolled back in a few short months. Teachers report that students have been "emboldened" to use slurs, engage in name-calling and make inflammatory statements toward each other. When confronted, students point to the candidates and claim they are "just saying what everyone is thinking." Kids use the names of candidates as pejoratives to taunt each other.

If marginalized students are fearful and hurting, it's partly because other "students seem emboldened to make bigoted and inflammatory statements about minorities, immigrants, the poor, etc.," wrote a high school teacher in Michigan.

Teachers in New Hampshire -- where the first primary was held -- reported some of the greatest increases in disturbing behavior. One high school teacher from Westmoreland wrote, "A lot of students think we should kill any and all people we do not agree with. They also think that all Muslims are the same and are a threat to our country and way of life. They believe all Muslims want to kill us."

Muslim students -- along with the Sikh and Hindu students who are mistaken for Muslims -- have endured heightened levels of abuse. According to reports from around the nation, Muslim students regularly endure being called ISIS, terrorist or bomber. These opinions are expressed boldly and often. Even in schools where such behavior isn't tolerated, current-events discussions often become uncomfortable for teachers and Muslim students.

The harassment of students who are immigrants or children of immigrants is another particular problem, because nearly one-third of U.S. public school students have foreign-born parents. Teachers in every state reported hostile language aimed at immigrants, mainly Mexicans.

A Wisconsin middle school teacher told us, "Openly racist statements towards Mexican students have increased. Mexican students are worried." A middle school teacher in Anaheim, California, reported, "Kids tell other kids that soon they will be deported." Regardless of their ethnic background or even their immigration or citizenship status, targeted students are taunted with talk of a wall or threats of forcible removal.

Neither are the slurs limited to schools with immigrant populations. "At the all-white school where I teach, 'dirty Mexican' has become a common insult," a Wisconsin middle school educator said. "Before election season it was never heard."

Indeed, what teachers described -- slurs and negative comments repeatedly directed at particular students or groups of students -- is essentially the definition of bullying. In recent years, a large swath of the American public has been alerted to the dangerous effect of bullying on school children. It affects health, academic achievement and, in some cases, leads to self-harm.

As a result of efforts at both the state and federal levels, schools now have comprehensive policies and programs to prevent and address bullying. In many schools, these programs have made a real difference in creating a culture of respect. The educators who reported that the election wasn't having too much of an effect cited their school's values and commitment to civility.

In other places, much of that hard work -- achieved over years -- is being undone. A Michigan middle school teacher described an exchange that followed an anti-bullying assembly: "I had students tell me it [insults, name-calling, trash talk] isn't bullying, they're just 'telling it like it is.'"

Or, as a New Mexico high school teacher lamented, "Any unity developed by Mix It Up at lunchtime has flown out the window."

It's not just that "they seem to talk more smack," as one Sacramento, California, elementary teacher wrote. The campaign has actually become part of the new bullying vocabulary. One New Orleans teacher told us, "Students have used support of candidates as a 'dis.'"

We heard reports that both elementary and middle school students have taken to chanting, "Trump! Trump! Trump!" in a "taunting tone." Others cited an increase in the use of words like loser and deadbeat. The bullying crosses party lines. An Albuquerque, New Mexico, middle school teacher identified "an anti-Trump bias" among her students, "and ridicule for those who might support Trump."

Behavior Is Harder to Manage -- and Explain
Teachers report an increase in anger and "acting out" among students and a decreased ability to engage in civil discourse. Discussions turn into shouting matches, verbal hostility and sometimes even fights.

"Students have become very hostile to opposing points of view, regardless of the topic," a Jefferson, Georgia, high school teacher wrote, adding, "Any division now elicits anger and personal attacks."

In Pampa, Texas, where 50 percent of the students are Hispanic, "The word 'Trump' is enough to derail a class," reported a middle school teacher. Especially in middle school, where behavior is notoriously hard to manage, discourse spirals quickly into anger. We heard multiple accounts of students yelling at each other, and "increased hostility in conversations between students." A New York City middle teacher put it succinctly: "Students on both sides are angry."

Angry words can escalate quickly. "My fifth-graders got in a fist fight on the playground yesterday," a Queens, New York, teacher wrote. "It started when one of the boys quoted Donald Trump."

Clearly, educators want to prevent those kinds of fights while encouraging a lively exchange of ideas in healthy debate. One of the goals of education is to teach students how to make persuasive arguments, support opinions with facts and listen to the perspectives of others. Those goals are out the window in many classrooms.

A Biddeford, Maine, middle school teacher observed that, "Students are quick to become accusatory and condemn others for having a different point of view."

Another middle school teacher in Indiana wrote, "Students are more apt to get into shouting matches than to have a discussion about something."

Students in Merrillville, Indiana, found themselves in the news after chanting, "Build a wall!" during a basketball game against a rival team made up of mostly Latino players. Photo credit: AP Images/Jonathan Miano

For some students, this level of conflict is hard to handle. "A student said he'd prefer another Obama term, and it angered another student who has been vocal about her support of Donald Trump," a Texas high school teacher said. "The angry student began yelling, 'What is the matter with you?' and 'This is why I HATE people."

While the increased tension sends some students into tears, other, often older students, are more likely to find the campaign a springboard to adolescent humor. The comments indicated that students in middle and high school, especially boys, seem to have a hard time distinguishing between entertainment and politics. Not only do they see the campaign, the candidates and the debates as a joke, but they're missing the fact that something significant is happening.

"My students seem more interested in the campaign this year, but only in the same way they are interested in circling a couple of kids who are about to fight on the playground," wrote a sixth-grade teacher from Roseville, California. "It is pure entertainment." A Boston high school teacher laments, "Our students see the whole presidential campaign as a game, with the real common people having no real input."

Sometimes a joke just isn't funny, and students are learning that the hard way. A Chicago elementary school teacher reported, "Some of the first-graders were talking about who their parents voted for. One jumped in, apparently as a joke (because the students are old enough to know that Donald Trump is an easy butt of a joke), and said 'What about Donald Trump?' His friends, not realizing he was joking, proceeded to yell at him until he cried."

A consistent theme from teachers across grade levels was that their students understood the behavior on display isn't okay. Middle school students on New York's Long Island "are confused as to how certain campaigns have been allowed to promote racism, violence and hate." And high school students in Lake Worth, Florida, display "lots of negativity about the candidates and the way they speak" and "discuss the immaturity of some of the rhetoric presented by adults."

Or, as a middle school administrator from Omak, Washington, commented, "Students do not understand why this has become such an angry and dishonorable campaign. They are taught better behavior by their teachers, and then they see this mess on TV and are confused."

Note: If you would like a .pdf version of this report, please click here. If you would like to read the full comments from the survey, please click here. For additional information on the impact on teaching and more background on the survey, please read the entire article on the SPLC website.


"The Donald Trump Effect." A Pro-Trump Video Ad
(Subsequently removed from YouTube but reposted for posterity)



This video, a trailer for a fictional film called "The Trump Effect," used music and a voiceover from a trailer for EA/BioWare role-playing game Mass Effect 2 to describe Trump as the "one man who stands between humanity and the greatest threat of our brief existence." The audio accompanying the video, which included the popular song "Heart of Courage," was was published by EA in 2010.
Video game publisher Electronic Arts (EA) filed a successful copyright claim against the after it gained popularity when Trump re-tweeted it. Trump retweeted the video Monday morning, and the video was taken down by mid-afternoon.



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

Gail Sheehy / Politico

(October 10, 2016) -- 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, to 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.

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.

Posted in accordance with Title 17, Section 107, US Code, for noncommercial, educational purposes.

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