PTSD expert Seth Norrholm: To heal from Trump's abuse, we must end "catastrophic thinking"

Leading PTSD expert on Trump and America: It's "like an abused person now at least seeing the start of the breakup"

By Chauncey DeVega
November 18, 2020 12:00PM (UTC)
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Donald Trump (Jabin Botsford/The Washington Post via Getty Images)

For more than four years Donald Trump, his Republican Party and their agents have been physically, psychologically, emotionally and economically abusing the American people. In total, Trump's behavior has caused a type of collective PTSD — certainly in the United States and quite likely the world.

Trump's authoritarian campaign of terror against nonwhite people has included unrepentant police thuggery; the brutal practice of "family separation" directed at migrants, refugees, and immigrants; the destruction of civil rights and human rights protections; and empowering white supremacists and other right-wing extremists.

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Trump's administration has sabotaged coronavirus relief efforts. This has included persistent public lies about the threat posed by the virus as well as a refusal to provide relief and other assistance to parts of the country deemed to be "disloyal" to Donald Trump. Trump and his corrupt inner circle have also viewed the pandemic as an opportunity to enrich themselves at the expense of the public. Trump and the Republican Party's response to the coronavirus pandemic now killed hundreds of thousands of people in the United States and caused widespread economic ruin.

That devastation is part of a larger pattern: Trump administration policies have worsened social inequality in the United States, an outcome that inevitably shortens lifespans for many Americans.

Donald Trump has lied at least 25,000 times (the fact checkers at the Washington Post have stopped counting — there are simply too many to track). Trump's campaign of lies exemplifies the way authoritarian leaders create a state of malignant reality where objective truth no longer exists. In all, TrumpWorld is a mad house that has damaged the minds of tens of millions of people.

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Donald Trump leads a political personality cult where he gives permission to his followers to engage in antisocial and other harmful behavior against their shared "enemies." Trumpism is also a type of political religion, whose adherents are literally willing to sacrifice their lives in a show of love and loyalty for their prophet and Great Leader.

Trump's death-cult rallies have been particularly effective in that regard: public health experts have concluded that such rallies have directly and indirectly led to the deaths of hundreds of people, and quite possibly thousands.

The Trump administration's policies in response to the coronavirus pandemic and other issues have created lasting harm and will cause an increase in deaths and illness far into the future. Ultimately, as with abuse within families, Trump's abuse will have an intergenerational impact on the American people.

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Like other abusers, Donald Trump is holding the American people hostage by refusing to concede the 2020 presidential election and engaging in violent and other destructive acts in retaliation for the public's decision to "break up" with him.

Now that Trump has been decisively defeated by Joe Biden in the 2020 presidential election, how can the American people begin to heal from Trump-caused PTSD and other emotional and psychological injuries? How should the American people balance their momentary joy and excitement about Trump's defeat with a healthy and balanced understanding of the present and future of the country? What does healthy vigilance for the American people look like so that another authoritarian fascist such as Donald Trump does not take power in the future?

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In an effort answer these questions, I recently spoke with Dr. Seth Norrholm. He is a translational neuroscientist and one of the world's leading experts on PTSD and fear. He is currently the scientific director at the Neuroscience Center for Anxiety, Stress, and Trauma (NeuroCAST) in the Department of Psychiatry and Behavioral Neurosciences at the Wayne State University School of Medicine in Detroit.

This is the second of our conversations about the Age of Trump, post-traumatic stress disorder, and the emotional health of the American people.

At the end of this conversation, Norrholm counsels that for the American people to truly heal there must be a proper public accounting of the Trump administration's many crimes, which must then result in punishment or other consequences for the perpetrators.

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As usual, this interview has been edited for clarity and length.

How are you feeling now that the election is over, and Joe Biden is president-elect?

Guarded. Cautious. Trump brought out the worst in all of us. This is a feeling most people do not like to have. Such emotions take a toll on a person emotionally.

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Right now, I feel relieved. I will feel more relieved after the inauguration. On social media, people were sharing that they are now able to sleep for the first time in years after the election and Trump being defeated. There are definitely people for who that is true.  

When you saw the American people celebrating in the streets when it was announced that Joe Biden had won the election, as a clinician who studies PTSD how did you make sense of those emotions?

I return to what we see in abusive relationships. There was the watered-down Mueller report. Impeaching Trump failed. Those events are like what happens if the authorities come to the house because they have been alerted to a problem. They see bruises, broken furniture, and then they leave without any consequences. The abused person is left in this state of despair where there was hope — resolution was within his or her grasp and it did not happen.

That weekend when the election was called for Biden was the result of that anxiety being stretched out for several days: The abused person is left there in an ambiguous state of not having resolution. That is why it was so important for the election to be finally decided. Once the election was called, it was like an abused person now at least seeing the start of the breakup with the abuser.

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Clinically, what we would do with a person who is in an abusive relationship is to conduct an "extraction." The relationship is broken off, and then there are law enforcement guardrails put in place, such as a restraining order. There are physical guardrails too, where the abused person can move out of the abusive home and find shelter elsewhere. With Trump the guardrails that are supposed to be in place are still not there. For example, most companies do not fire somebody for cause and then say, "OK, you've got 70 days to get out of here," because obviously that is a great deal of time to wreak havoc and continue to be abusive.

Trump still being president is very much the same thing. A person would not break up with an abusive spouse or partner, and then say, "OK, as of two months from now, we will formally end this." Such a situation would be an emotional mess.

What about Donald Trump's followers?

There are the hardcore loyalists who are going to continue to support Trump no matter what he stands for. They support the efforts to change the results of the election. They are going to continue to align themselves with Donald Trump. Those supporters are not going anywhere. If and when there is another version of Donald Trump and his movement, they are the people who will be there for it. They will stick with their right-wing extreme views.

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There is also another group of Trump supporters who now view him as the loser. Some of his supporters are now taking down their Trump signs. They are accepting that Trump lost the election. The next question then is: Why were they loyal to Trump to begin with? There are of course the active racists who subscribe to Donald Trump's belief system and his overall worldview. There are other Trump supporters who are just opportunists. They had a financial stake in him being president. For them, holding their nose and accepting Trump made sense. There are other Trump supporters where their view of Christianity aligned with Trump's political convictions. For these people, Donald Trump was the person most likely to strike down Roe v. Wade and put judges in power who agree with extreme right-wing Christian belief systems.

Donald Trump is a neofascist and an authoritarian. Leaders of that type do not quit. There is no predicting the type of destruction and chaos that Trump will unleash in the weeks and months before Biden is inaugurated in January. The American people must be vigilant that a future version of Trump does not rise to power. What does healthy vigilance look like in terms of your PTSD model for understanding the impact of Trumpism?

With PTSD, hyper-vigilance manifests as an overwhelming sense of threat and concern that is not proportional to reality. While it is possible that something adverse may happen during the course of a given day, most days it's not likely. For example, defensive driving is healthy vigilance. The prototypical or stereotypical way that we think about hyper-vigilance is the combat veteran who rarely goes out in public, and when he or she does, they sit with their back against the wall so they can see the entire store or a restaurant.  

In hindsight, I believe that the time of Trump's presidency will be understood as one where many Americans were traumatized in the sense of having a daily sense of anxiety, dread and concern. Signaling to that is how people said that once Trump lost the election it was the first time they did not have to look at their phones to see what he did overnight or what he had tweeted.  

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The stress and anxiety of the pandemic is added on top of the stress and anxiety of Trump's presidency.

What counsel would you offer to the American people in terms of managing their emotions about the 2020 election? The Age of Trump is one of extreme emotions and highs and lows, hopes and disappointments.

The level of stress has been excessive. There are people who have now spent four or so years having to deal with Trump's presidency and its consequences. Those people are more at risk for stress-related illnesses such as gastrointestinal problems, cardiac problems and exacerbation of other physical symptoms because of the stress.

The elation that many people are feeling because of the election and Biden winning is a positive and healthy state of mind. It is a response to good news and something positive. This is a relief from a chronic stressor where it is now either temporarily removed or eliminated completely. The 2020 election and Joe Biden beating Donald Trump helped many people reset after years of chronic stress.

Watching Joe Biden and Kamala Harris give their acceptance speeches on that Saturday night reminded me that I forget what an adult leader sounds like. I forgot what it felt like to look at the president of the United States with reverence. I forgot what it felt like to feel normal.

How do Americans get back to some sense of normalcy?

The moments of elation and relief allow a person to reset and to perhaps stop catastrophic thinking. Catastrophic thinking creates connections between stressful things, and that is how a person can fall into hopelessness and despair and depression. Depression can then cascade into substance use.

That is how many of our psychological co-morbidities occur, because there's been a constant state of decreased mood or anxiety that starts to bleed over into other areas of your life.

I believe that some people may be somewhat buoyed by Biden's election. The transition and inauguration of Joe Biden allows people to reset themselves emotionally and mentally. But I worry that the next 10 weeks will be a return to a state of anxiety for many people, more of the same that they experienced during Trump's presidency. The celebrations of Biden and Harris winning may turn out to just be a brief reprieve.

What of the so-called "Resistance" to Donald Trump and his movement? There are people who appear to be on Twitter and other social media all day long, every day, constantly discussing Donald Trump. Of course, there are others who have been engaging in organizing, activism and social change work. What do such people do with their energy now that Biden has won the election?

It is like a marathon. This is true both physically and emotionally. A person training for a marathon is investing themselves in a goal and objective that thoroughly takes over most of their waking hours. The big event comes, the marathon. You run the marathon and then it is over. For some people, the plan is, "When is the next marathon?" That is why there are ultra-marathons. People must change their objectives and have something else to work toward.

In specific terms of your question about Trump and the Resistance, it is a matter of directing those energies somewhere else. Many of the problems are not going anywhere. Trumpism and white supremacy and racism and other social problems are not going anywhere here in America. If a person has spent the last four years as part of the Resistance, fighting back against Donald Trump and his authoritarian movement, such a person can now channel that energy towards related concerns that are far from resolved, such as working with the Black Lives Matter movement, or working against sexism. There are many causes left to struggle for. The energy can be directed there. Find that next objective and channel the energy towards that.

I am an advocate for a truth and reconciliation commission, and if warranted, criminal prosecutions for members of the Trump regime who have committed crimes. What role does the truth play in making sense of the Age of Trump and all that has happened? Will revealing the full truth about the Trump regime somehow re-traumatize people? Will there be closure? What if there are no investigations or punishments for the Trump regime's obvious crimes?

That would not be a good outcome. For the psychological well-being of the American people, there need to be consequences for the horrible things that happened under the Trump presidency. There needs to be a resolution. In terms of the abusive relationship analogy we have been using, there need to be consequences — that courtroom moment where a sentence is handed down to the abuser. Closure is important. If there is no closure, then the abuser and all that trauma can continue to cause emotional, psychological and physical trauma.

There is a hunger and need for some kind of resolution among the American people because of what Donald Trump and his administration have done to them. Such a resolution will provide validation and affirmation. "Yes, this guy really was a bad guy" needs to be publicly acknowledged. The feelings of stress and anxiety were warranted. Ultimately, the American people need their feelings to be validated about Donald Trump and what has happened with him as president.


Chauncey DeVega

Chauncey DeVega is a politics staff writer for Salon. His essays can also be found at Chaunceydevega.com. He also hosts a weekly podcast, The Chauncey DeVega Show. Chauncey can be followed on Twitter and Facebook.

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