Last month, when I published a column asking “Is ‘Trump Derangement Syndrome’ Real?” in The Wall Street Journal, I expected it to spark lively debate.
I didn’t anticipate a live demonstration of the very pathology I’d described.
My column outlined a pattern I see in my psychotherapy practice every week.
I call it “obsessive political preoccupation,” a presentation that resembles an obsessive-compulsive pattern in which one political figure becomes the center of intrusive thoughts, heightened arousal, and compulsive monitoring that takes over a person’s mental bandwidth.
TDS is not an actual diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, and I made that clear in my article.
But patients tell me about political thoughts that hijack their day, sleepless nights, irritability, anger and anxiety that spills into work and relationships.
One woman said she couldn’t enjoy a family vacation because “it felt wrong to relax while Trump was still out there.”
I see marriages strained, friendships fractured and daily functioning disrupted by the mere mention of “Donald Trump.”
For many, their anxiety has outgrown politics and become a way of operating in the world, shaping every reaction before they even realize it.
As soon as my column was posted online, the response illustrated my point with almost clinical precision.
Many of the loudest critics merely reacted to my use of the term “TDS,” not to my explanation.
Their retorts, immediate and emotional, displayed the very pattern I described: impulsive, catastrophic thinking driven by feeling rather than reflection.
In trying to disprove the phenomenon, they demonstrated it dramatically.
Two days later I discussed the piece live on Fox News, and the reaction intensified.
The segment was calm and clinical.
But once the clips hit social media, they were stripped of context, paired with heated captions, and fed into outrage feeds.
The surge of emotional messages I received was immediate and relentless.
Some accused me of defending a fascist.
Others called me a “pedophile protector,” and one self-identified therapist suggested I must be a pedophile myself.
Several messages, including voicemails, wished me dead.
These weren’t fringe accounts, but people who publicly describe themselves as compassionate, trauma-informed, or dedicated to mental-health work.
Their reaction is exactly what concerns me as a clinician.
My op-ed warned that emotional reasoning dominates much of our political culture.
Disagreement is treated as cruelty.
Discomfort is treated as danger.
When people fuse their identity to their political emotions, challenging those emotions feels like an attack on the self.
And this pattern appears across the political spectrum.
The critics who condemned the piece reenacted the pattern in real time.
Their outrage became their evidence.
Their feelings became their argument.
They proved my point more clearly than anything I could have written — and that’s why we need to talk about these symptoms openly.
Our society encourages people to “trust their truth,” to follow every impulse and to label ordinary discomfort as harm.
Too many in my profession have encouraged this view.
They now celebrate it — when directed at the “right” targets.
I see the consequences daily, as a patient tells me she’s stopped speaking to her father because he “voted the wrong way,” or a couple avoids family gatherings because a relative supports Trump.
These are educated adults who have adopted the idea that emotional discomfort equals danger.
The backlash I experienced clarified the consequences.
When people show hostility to the point of threatening death the moment their feelings are activated, we’re no longer dealing with political disagreement, but with a profound emotional problem that affects far more than elections.
We need to relearn how to tolerate emotional discomfort.
Feeling challenged doesn’t mean you’re in danger — and never gives you permission to threaten or defame people who see the world differently.
We also need to separate people from their politics.
Your uncle is not a villain because he supports Trump’s policies, and your cousin is not immoral because she votes Democrat.
Finally, we need to restore resilience.
Therapy is supposed to help people regulate their emotions and challenge distorted thinking.
Instead, the language of therapy has drifted into political life and is being used to justify emotional overreactions and excuse impulsive behavior.
These last few weeks made it obvious: TDS isn’t a niche reaction, but part of a national pattern that’s changing how people think, behave and relate to their own families.
If we can’t separate emotion from interpretation, the chaos will continue.
The real emergency isn’t in Washington.
It’s in the way Americans are thinking.
Jonathan Alpert, a psychotherapist practicing in New York City and Washington, DC, is author of the forthcoming book “Therapy Nation.”
