PTSD expert: Americans are being 'psychologically abused' by Trump and will face health crisis for years

Woodward's newspaper, the Washington Post, reported on the aftermath of these revelations, including Trump's acknowledgment "that he intentionally played down the deadly nature of the rapidly spreading coronavirus last winter as an attempt to avoid a 'frenzy' ....":

"So the fact is, I'm a cheerleader for this country. I love our country. And I don't want people to be frightened," Trump told reporters at the White House after announcing his potential Supreme Court nominees if he wins reelection. "I don't want to create panic, as you say. And certainly, I'm not going to drive this country or the world into a frenzy. We want to show confidence. We want to show strength."

None of this should be a surprise given Donald Trump's character, evident mental pathologies and overall pattern of behavior.

Trump's admission is contrary to his public protestations that the pandemic is a "hoax" perpetrated or exaggerated by Democrats to damage him in the election, as well as his claims the virus is not that dangerous and will go away on its own, people should not wear masks, and that public health experts and medical researchers are sharing "fake news" about the lethal nature of the coronavirus.

As psychologist John Gartner cautioned in a recent conversation here at Salon: "Donald Trump is the most successful bio-terrorist in human history. This is not an accident."

Ultimately, Trump's sabotage and willful negligence — to which he has now effectively confessed — is a crime against humanity. At worst, it approaches de facto genocide; at best, it could be called negligent homicide on a mass scale.

On Twitter, former CIA Director John Brennan described Donald Trump as a human "abomination," writing, "If he had a conscience or a soul, he would resign. Tragically for us, he has neither."

The American people should know by now that Donald Trump does not care about their safety, health or well-being. Yet again, Donald Trump has betrayed his presidential oath of office. From his coronavirus pandemic to a democracy under siege from his authoritarian movement, a failed economy, an increase in right-wing violence and terrorism, and a public embrace of white supremacy, Trump and his regime are emotionally and physically abusing the American people.

But Trump's lies about the coronavirus pandemic and his personal responsibility for the hundreds of thousands of deaths that have followed will not force his followers to abandon him. Trumpism is a death cult. Human sacrifice is one of its central rites and rituals. Unfortunately, many of Trump's disciples are willing to both die and kill for him.

Dr. Seth Norrholm is a translational neuroscientist and one of the world's leading experts on post-traumatic stress disorder (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.

In this conversation, Dr. Norrholm explains how Donald Trump's behavior towards the American people resembles that of a domestic abuser. He also details how Donald Trump and his regime are causing the American people to experience symptoms and behaviors similar to PTSD — and that post-Trump PTSD will impact the country's public health for many years into the future. Norrholm also offers advice on how the American people can handle the increase in stress and anxiety as Election Day 2020 approaches in the midst of a deadly pandemic and Trump's escalating threats and violence.

There are people on Twitter and social media all day long discussing Donald Trump and this moment. Trump's administration is actively traumatizing the American people to the point where public opinion polls show that Donald Trump makes them feel unsafe. Other research shows a large increase in emotional and mental health problems which are correlated with Trump's time in office.

What are Trump and his regime doing to the emotional health of the American people? The long-term impact is going to be great.

From 2015 forward, it is a constant timeline of one risk or threat or breaking of norms after another from the Trump administration. There has been no real respite.

Looking at this through social media, it is very much like an addiction where some people will log into Twitter in the morning and then you will see them log off at night and they will actually say, "See you in the morning, folks." Twitter and other social media is almost like a running commentary of their day.

The Age of Trump is the story of authoritarianism and how it can damage the mental health of an entire society. Why has there been such reluctance by most of the mainstream American news media to discuss emotional life as connected to politics in this moment?

Part of the problem with emotions is vagueness. Therefore, the news media and analysts tend to shy away from discussing emotions. I also think that part of the challenge is that American society tends to be forgiving. For example, if the president were to go public and say that, "Look, I've battled an addiction to painkillers or alcohol," or that he has early stage Alzheimer's or Parkinson's, the news media and public would accept it. Why? Because it is a hard diagnosis. It is something tangible. But because with Donald Trump we are talking about behavior which is open to interpretation and involves concepts from psychology that deal with emotions and personality, it is very difficult for the average person to understand. This is true of the news media as well. Therefore, emotions in general are much less discussed by the American news media.

This has meant that the American news media has for the most part covered Donald Trump using the existing heuristics which are, "Here is the president's schedule. Here's what he did today. Here's what he said." Donald Trump should not have been covered that way. The assumption that he is somehow "presidential" and acts in a normal way should have been discarded.

Then there is the other side, with Fox News and other right-wing news media which Trump's followers listen to. That side is proceeding with, "This is how we have to defend our position." That is when we see cult psychology, a shared psychosis where the members have to radically defend their positions because the alternative is admitting that they were wrong. It is as if American society has lost the ability to admit wrong and apologize where whole groups of partisans and Trumpists can't simply say, "Look, I read the situation wrong and I made a mistake."

There is a cycle of ups and downs, highs and lows, hopes and disappointments in the Age of Trump where at one moment it seems like he will be stopped and then he somehow survives and becomes more powerful. How does that roller coaster of emotions impact the American people?

This fits the model of an abusive relationship. If you think about an abusive relationship, the victim often tells themselves, "Tomorrow it'll be better because family's coming to town." Or they have filed a police report or taken other steps to change the abusive situation. But what happens when those steps do not work to stop the abuse? That cycle has a compounding negative cumulative impact.

The American people are being psychologically abused by Donald Trump. Consider all the reports about his criminality from the Russia scandal onward, the whistleblowers, all the cumulative evidence.

The American people, the abuse victim says, "OK, I've got some hope. The authorities are looking into it." Then [Bill] Barr is brought on and the Mueller report is diluted and misrepresented, and nothing happens in terms of consequences. So the American people, who are the abuse victim, then says, "OK, that didn't work." Then there is a period of mourning, dejection and sadness. Then the American people say, "OK, what's the next step I can take?" Then they see Trump being impeached. Now the conclusion is, "OK, this is going to be the mechanism by which I could end this abusive relationship." Now we go through the process from December to January, and there is a parade of witnesses with all this damning information. Trump looked like he was done for. And again, Trump gets away with it all.

Trump's bellicosity and the reminders that he has access to a vast nuclear arsenal is akin to an abuser saying to a partner, "Remember, I sleep with my revolver." So the bottom line is that we as mental health professionals were already looking at a post-Trump era of exacerbated mental illness that has now been compounded with an unchecked pandemic that has killed nearly 200,000 and altered millions of lives.

The American people, as Trump's abuse victims, then say, "Damn it, this is another instance where nothing happened." Now the hope is that on Election Day something will change, and Trump will be gone.

What does that cycle of emotions do to the human brain?

There is research on Hurricane Katrina survivors, mass shooting survivors and other examples where the trauma was a distinct event. With Trump and this national calamity, it is an ongoing event which involves repeated exposure to chronic stress.

From an evolutionary perspective, the human stress response system only knows one way to function, which is essentially the fight or flight response. So, you recognize that threat, there's a physiological response, your autonomic nervous system kicks in, your heart rate accelerates, cortisol is released. That is an evolutionary response to acute threats in the environment.

When a person is repeatedly stressed, the human body continues to release cortisol. The heart rate stays elevated. This can have long-term effects.

There are a number of studies which show that excessive cortisol can have a number of neuropsychiatric effects. This includes changing the neuronal structure, which can reduce the number of synaptic contacts that neurons have with one another. Excessive cortisol can damage different areas of the brain. That too has a range of consequences, whether it is learning and memory deficits and emotional dysregulation. Anger and mood disorders can become much more pronounced.

There is definitely going to be post-Trump syndrome — especially for those people who have been more engaged with current events. They are obviously at much more risk than a person who says, "You know what? This is just politics."

If you are someone who is genetically more predisposed to be an anxious person, that can be buffered if you are placed in a situation where you have got resources such as a job and a home. Even with the genetics involved, if those buffers are in place such a person may not ever experience anxiety. When people start losing their jobs and health care in massive numbers, that is a tipping point for overcoming learned helplessness and resisting.

In total, there are going to be a host of post-Trump biological and psychological consequences that as a society we are going to be dealing with for a long time.

Stress also impacts people's individual dreams and also the collective subconscious of a society. There has been research on the dreams the German people experienced under the Nazis. Likewise, there are mental health professionals who are compiling lists of the types of dreams people are experiencing under the Trump regime. What do we know about stress and dreams?

Conflicts can bleed into dreams. This is especially true of unresolved conflicts. Viewing the Trump presidency as a type of unresolved conflict reveals quite a few things. The Trump administration is the daily stressor. It has all these tentacles and there seems to be no resolution in sight. The stress from the Trump administration is filling in gaps in our dream state.

With an assault victim, there may be some way of confronting the perpetrator and exacting revenge. Dreams reflect unresolved conflicts, but they also are a form of "re-experiencing" where the elements of the traumatic event are part of the dream content. This can take several forms.

A soldier who was hit by an IED explosion may have a dream in which they're in the Humvee and the IED does not go off, or it goes off and there is a different consequence. These events can be replayed or played out in different scenarios in the dream state. It can be very vivid, to the point where a trauma victim may re-experience the trauma in a dream to the point where there is some kind of resolution. This may be facing the perpetrator or finding happiness and joy again. But then the person wakes up and has an extreme feeling of being let down because it was all just a dream.

Those types of intrusive re-experiencing thoughts and memories are going to play out in individuals who are particularly susceptible to what is happening today with the Trump administration and what it is doing to the American people.

What are your thoughts about Donald Trump's mind and personality? How does Trump think about his behavior and the harm he is causing?

In the mind of a malignant or severe narcissist, it only takes a small scintilla of possibility that there was some type of "deep state" attack against him. Of course, that is highly unlikely. But even if there is such a remote possibility, that is all that is needed for a severe narcissist like Trump to build upon. That is why he has such an affinity for conspiracy theories, because it gives him a psychological out for his apparent crimes and other wrongdoing.

The malignant narcissist lives in this altered reality where there is a type of idealized self. Trump sees himself as an eternal emperor. He is a king in his mind who is all-knowing and all-powerful. But behind that facade Donald Trump is a vulnerable and in many ways a childlike individual. Trump is fighting so very hard to keep that veneer up in the public.

I was asked some years ago, what is the best course of action when dealing with a severe narcissist? It is repeated confrontation. It's calling out the lies in real time. It's calling out the hypocrisy. It is confronting the public veneer.

I know this won't happen, but I would love for a journalist to say, "Are you wearing makeup, Mr. President? Is that self-tanner, or are you wearing makeup? Why is your face orange and your ears white?" That is how one deals with a narcissist. Confrontation. I wish Hillary Clinton had done that to Donald Trump. She did try, though.

During Hillary Clinton's debates with Trump, she or one of the journalists there should have said to Trump, "You want to take away women's reproductive rights. Have any of your lovers ever had an abortion?" On national TV before the world Trump should have been asked that question. But of course, none of the people there had such courage.

That is exactly what needs to happen. Trump views himself as the most powerful person in the world. There is no linear or logical flow to Donald Trump's responses and thinking. It is all based on emotions. This is why we see so much flip-flopping from Donald Trump, because he says what feels good and feels right at the time for the audience which is in front of him.

He is just chasing one emotion to the next. Trump lives moment to moment because of his emotion-based thinking. That is Trump's way of avoiding any accountability or having to deal with the details of policy and governance. The lies are of course another way of Trump to maintain the public face he likes to present, the illusion of his strength.

Bob Woodward's new book reveals that Donald Trump knew in February that the coronavirus was an especially deadly airborne virus that could potentially kill hundreds of thousands of people. Trump knew this and publicly lied about it, downplaying the danger and interfering with relief efforts for personal and political gain. In essence, Trump lied and many tens of thousands of people are now dead, and more will die. How does that impact the emotions of the American people, to know that their president is actively hurting them?

People are smart, they pay attention. Most rational people recognized that no solutions or pathways out of this pandemic went through the Trump administration. The longstanding guardrails for public safety were torn down or silenced. The CDC was muzzled, the WHO was belittled, the scientific experts were either shouted down, spoken over or misquoted. People knew that the answers they were looking for and the practical solutions that they were seeking lay with their state and local officials. That was our advice in the mental health community early on: Focus on what is being done in your town by your EMTs, by your health care providers, by your mayors and by your governors. We as a people had to accept that we couldn't trust the president and those in his orbit and that trust in the office and in our principles must be regained over a long period of time.

What advice would you have for people in terms of managing their emotions in these final weeks leading up to Election Day?

The best advice in times of high stress and crisis is to maintain routines as best as possible, to keep up with hobbies, maintain friendships and relationships, and take the time to recognize and express your emotions. It's normal to feel afraid, anxious, on edge and angry, and for that to seep into your daily activities. One of our strongest drivers of stress and anxiety is unpredictability and lack of control. This has especially been the case for the past few years, and certainly for the past six months. Do things you can control, like your diet, exercise, time with friends and family (even if at a distance), and — if it helps you rather than adds to your stress — be an activist. Make a plan for voting, encourage others to vote, support your candidates up and down the ticket. Focus on what you can personally do and not too much on what others are doing.