Talking to Your Therapist About Election Anxiety

http://www.nytimes.com/2016/10/20/well/mind/talking-to-your-therapist-about-election-anxiety.html

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It has been described as one of the most contentious, tawdry and angry presidential elections in history. And it’s taking a toll on our mental health.

“I’ve been in private practice for 30 years, and I have never seen patients have such strong reactions to an election,” said Sue Elias, a licensed clinical social worker in Manhattan.

The American Psychological Association says that 52 percent of American adults are coping with high levels of stress brought on by the election, according to national Harris Poll survey data released last week. Therapists around the country said in interviews that patients are coming to appointments citing their fears, anger and anxiety about the election.

Both poll data and anecdotal reports show that the high levels of election anxiety are affecting both Republicans and Democrats equally.

“We’re seeing that it doesn’t matter whether you’re registered as a Democrat or Republican — U.S. adults say they are experiencing significant stress from the current election,” Lynn Bufka, the association’s associate executive director for practice research and policy, said in a statement.

According to the American Psychological Association, 55 percent of Democrats and 59 percent of Republicans — a statistical tie — say the election is a major source of stress. “People seem to be getting more worried every day,” said Elaine Ducharme, a licensed clinical psychologist in Glastonbury, Conn.

While every election provokes some level of anxiety as we watch our preferred candidate move up or down in the polls, the battle between Hillary Clinton and Donald J. Trump appears to be taking a greater toll. After speaking with mental health experts across the country about what they are hearing from their patients, a common theme has emerged: This election has made people feel less safe.

Therapists say that some of the issues that have emerged in this election — national security, terrorism, hacking threats, gun rights and sexual assault — play into some of our deepest fears and anxieties. Issues of secrecy — Mrs. Clinton’s emails and Mr. Trump’s tax returns — and allegations of conspiracies and a rigged election, have compounded some patients’ feelings of distrust.

“People are wondering, how can I feel safe? Who will take care of us?” said Dr. Robert Bright, a psychiatrist at the Mayo Clinic in Phoenix. “Everyone I talk to is very concerned about this election.”

What’s striking, say therapists, is how deep the fears go on both sides.

“About one-third of my patients talk about the election — and both the conservatives and the progressives are affected,” said David Rogers, a clinical psychologist in Hershey, Pa. “The campaign is arousing fears about the unknown. Both sides are aroused, because the results feel so consequential. It’s like when Lincoln was running against Douglas and Jefferson was up against Adams.”

Conservative voters are concerned about gun rights, and fear that Mrs. Clinton will appoint Supreme Court justices who will chip away at the Second Amendment. And in a world that feels increasingly unsafe, guns give some Americans a sense of security and control. On the other side, with Mr. Trump questioning the fairness of the election, and one Milwaukee sheriff calling for “pitchforks and torches,” some fear that the aftermath of the election could bring violence.

And the unusual nature of the election, with Mr. Trump pushing the limits of acceptable behavior in politics, is creating problems for people who struggle with mental health issues.

“Boundaries are an important part of mental health,” said Dr. Ducharme. “In order to feel safe, people need to have a sense that there are rules and norms. In this election our leaders appear to be out of control.”

Strong feelings about the candidates are causing not only rifts between Democrats and Republicans, but also among families and friends. Ms. Elias has patients who are avoiding friends and family members with whom they disagree.

“It’s like the Civil War,” said Ms. Elias. “I have never seen an election cause this level of conflict.”

“People are having a hard time seeing the perspectives of the opposite side,” said David Palmiter, a clinical psychologist in Clarks Summit, Pa.

For women, particularly those who have been victims of sexual assault, the election has triggered painful memories. Ms. Elias said that after the second debate, “many of my female patients came in and wanted to talk about Trump.” She said patients felt that Mr. Trump seemed to stalk Mrs. Clinton and invade her space. Some patients needed to process incidents in which they had felt belittled or harassed by men in their lives.

“Women said their hearts were racing during the debate, they were that triggered,” Ms. Elias said. “Some came in complaining of having had nightmares.”

It doesn’t help any of us that the news is relentless. According to the A.P.A. poll, stress was highest among those Americans who use social media.

“I see a lot of hypervigilance,” Dr. Bright said. “I hear of people checking fivethirtyeight.com three and four times a day to see if the numbers have shifted,” he said. “It’s exhausting to live with that level of constant anxiety. You carry that tension in your body and it wears you out.”

Therapists say they offer their patients coping techniques. Rather than tell yourself to stop worrying, which rarely works, Dr. Bright suggests setting aside time to worry, like when you get home from work or during your lunch break. “This is a behavioral technique called thought stopping, and it can be very effective,” he said.

The A.P.A. tells patients to “read just enough to stay informed.” Take breaks from social media to go for a walk, spend time with friends or do other things you enjoy. Be aware of how much election talk is dominating conversations with friends and family, and change the subject. Avoid politics altogether if a conversation is likely to escalate to conflict.

Dr. Ducharme said she tells her patients to limit exposure to the news and to find distractions.

“I tell my patients to catch up on the news for 20 minutes, then turn to something more satisfying,” she said. “My husband and I have watched more comedies on Netflix than ever.”