January 10, 2018
Parts of this article appeared in the book The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President (St. Martin's Press, 2017). This material is reprinted with permission from the author and publisher.
<p>I’m a trauma therapist in New York City. I work with adult survivors of sexual assault, domestic violence and childhood sexual abuse, and I see in my patients’ struggles with PTSD (post-traumatic stress disorder) the impact of living in a period when the social media era has met the apotheosis of Donald Trump. For those who have been previously subjugated, the volatility and chaos coming from the White House via the internet are particularly overstimulating. With their already high anxiety levels and vulnerable senses of security, my patients can be particularly destabilized by the present social and political climate, which can prevent them from cultivating the mental stability essential for healing from trauma. From worries about what will happen to their health care coverage to concerns about race relations and the fears of nuclear war, survivors of trauma—who desperately need to rebuild an internal and external sense of safety—can lose ground the moment their newsfeeds buzz.</p><p>This is a problem, not only for my patients, but for many of us. It manifests as a kind of deep-seated fear, anxiety and/or preoccupation with the news online. Recognizing a common thread between this and how all kinds of media impact my patients, I see trauma survivors as canaries in the coal mine of the internet, their sensitivities markers of the potential toxicity of such exposure. Whether we are previously traumatized or feel newly so, the internet era—which now feeds the age of Trump—can spur us to engage in a series of subtle, if significantly destabilizing, behaviors. We would be well served to raise our awareness about such provocations and how they can stir us, so that we can do our best to control them rather than having them control us.</p><p><strong>Media</strong><strong>'s Impact on t</strong><strong>he Traumatized</strong></p><p>"I almost didn't come today," my patient told me. She was agitated, and fear flickered in her eyes. Her fingers picked at her cuticles, like a distressed animal in a cage. This was a habit she exhibited in the first months of treatment, and a sign of high stress. I was surprised; I had not seen her this destabilized in months. A talented athlete, my patient had worked hard on owning her quiet strengths in a world of extroverts, one of whom was her charming and abusive ex-partner. Her progress was such that we talked about a time for her to "graduate" from our victims' services program. I wondered what had happened.</p><p>"The attacks on London Bridge—I read about how the terrorists chased people in their van...." She trailed off, unable to finish. I recognized the trigger. Her ex, in their last and worst fight, had driven his car at her, jumping the curb and hitting her. Early on in her treatment, even brief flashes of car chases in movie trailers or commercials would cause significant panic. While extensive physical therapy had allowed her to make a full physical recovery, her emotional trauma was deep.</p><p>Although she had since developed a tolerance for seeing such footage, the news that London pedestrians were chased in a van and killed by perpetrators during the June 2017 attacks was too much. "It seemed like I kept seeing news reports about London Bridge, online and even passing restaurants with televisions. Every alert I got on my phone was about the attacks. Then my feed buzzed about a shooting in Florida. I was suddenly afraid every alert was going to bring more bad news, but I still kept checking my phone. I've had troubles sleeping and I couldn't leave my house for a couple days. It was hard for me to even come here."</p><p>This example, which is an amalgamation of a number of my patients' experiences, illuminates how distressing events in the news are amplified and made continuous by frequent online updates and social media commentary, and how seriously this impacts the traumatized. Triggered by the attacks, my patient could not regain mental balance as she was thrown by the too-frequent news alerts. Paradoxically, she kept checking for updates. As she explained, "I wanted to make sure nothing else bad had happened."</p><p>In her heightened state of fear, she became hypervigilant, believing she needed to monitor all world events to ensure her own safety. Thus agitated, she self-isolated. While my patient was frustrated with herself for this, neurobiologically, it made sense. Overstimulated as she was, leaving home would only expose her to a multitude of sensory stimuli and uncontrollable variables that her overwhelmed body and mind could not navigate. In such an anxious state, my patient could only see the world outside her door as chaotic and unsafe.</p><p>This patient's situation illustrates three kinds of stresses stemming from her engagement with news and social media sites that affect so many of the survivors I see. These are <em>Stresses of Exposure, Stresses of Access</em> and <em>Stresses of Hypervigilance</em>. The impact of such media-inspired anxieties exhibits the ways in which media content can stir individuals—particularly those suffering from trauma—mentally, emotionally and even physically. For a while there can be the assumption that "just reading" or "just watching" upsetting material online is harmless because these are passive activities. But when our senses absorb stimuli that is frightening, shocking or extreme, be it online or in reality, our brains have a neurobiological response that sets off a chain reaction of stress hormones. The effect on the body mirrors what would occur if what was read or watched had been real. And because traumatized individuals' brains often remain in a hyperactivated state as a result of the horrors they have survived, they are easily overstimulated. Their sensitivities highlight stresses that can affect us all, if to a more subtle degree.</p><p><em>Stresses of Exposure</em></p><p>Triggered by the London Bridge attacks, my patient suffered from <em>stresses of exposure</em> when she kept seeing footage and news reports of the attacks online and on television. While inherently upsetting, these events caused my patient to relive over and over the means by which her own life was threatened. Subject to constant updates of a crisis that brought to mind her own traumatic experiences, she felt bombarded with terrifying footage and information. The frequent buzzings of news feed alerts on her phone subjected her to even more jolts of fear.</p><p>Overexposed in such a way, her mental "window of tolerance"—or her cognitive space of calm—narrowed significantly, compromising my patient's ability to think. Her anxiety caused insomnia, and in her overtired, hyperactivated state, her fears took over. She genuinely felt the world was again unsafe, and thus could not leave her apartment.</p><p>To stabilize this patient and help her regain a sense of calm, I strongly recommended she turn off her banner notifications to all social media and news sites and, if she could, to check her phone for updates as little as possible in the following week. I explained that neurobiologically, she was overstimulated, and overwhelming fear had harnessed her to her news feed. I noted that while she felt bombarded and out of control in the immediate aftermath of this tragic event, she still possessed the means to control how exposed she was to such extreme stimuli. We discussed how it was no small act to recruit her own strength and awareness to stop the alerts on her phone and turn away from this onslaught of toxic information, so that she could quell her fears by settling her agitated body and mind.</p><p><em>Stresses of Access</em></p><p>Through continuous advances in mobile device technology, we now have unprecedented means of connecting to the internet and to each other at any time. Certainly, having the means to find out any information or to connect to anyone with internet access is a unique 21st-century privilege. This all-access-all-the-time nature of engagement in the internet era is, however, a double-edged sword. The darker edge is revealed by my patient's experience of being completely overwhelmed by her newsfeed alerts. Simply by keeping her cell phone's notifications on, she inadvertently opened herself up to <em>stresses of access</em> unique to our times. Because her mobile phone was always with her, she had constant access to the upsetting news that was triggering her. And, via the phone's alerts, this news also had constant access to <em>her</em>. With the appearance of every banner, my patient's attention was pulled away from her own reality and into fear-inducing information that subjected her to spontaneous jolts of stress. The stresses of such access undermined my patient's ability to think clearly and sunk her into a seemingly inescapable reactive state of fear where she could not turn away from the toxic news but was unable to do much to stop her exposure to it.</p><p>The survivors of intimate partner violence and date rape reveal an even sharper side of the double-edged sword of access when they happen to "bump into" perpetrators and abusive partners online. One of my patients had an abusive ex suddenly appear on a "Friends You Might Know" Facebook section; another patient's perpetrator showed up as a potential suitor on Tinder; yet another saw her attacker appear as a business contact on LinkedIn. Equally, if not more distressing was when a survivor's abusive partner reached out to her through a mutual friend's Facebook page years after she left him. Because social media sites push making connections over protecting privacy, blocked perpetrators can still access their ex-partners via the "neutral" pages of friends, or friends of friends. All these situations bring up the terrifying possibility that a survivor may never be free of her attacker.</p><p>Such stresses of media access are of a higher order of magnitude than being overexposed to triggering news in terms of the havoc it wreaks on a survivor's sense of freedom and self-efficacy. The all-access-all-the-time nature of the internet means that harmful, abusive individuals have the same access to a survivor as she has to a trusted colleague, or a dear friend or relative. Moreover, the "virtual" nature of such online contact causes many of my patients to question their own panic upon seeing their attacker's face, or to critique their own natural fear that this will lead to further contact. Such self-doubt slows the process of healing from trauma, as it depends on individuals recognizing their own feelings so that they can recruit them to reestablish a new sense of safety.</p><p>For better and worse, the openness of our access to information and individuals—and <em>their</em> access to <em>us</em>—is the new reality of the internet era. While it is a hard truth that this all-access nature of the internet means that survivors are less likely to avoid future contact with their abusive ex-partners or sexual assailants, what then becomes crucial is that they have the support, skills and mental space to meet such intrusions with as much internal and external protection as possible. Perhaps the single most important guideline I recommend is for a survivor to not withstand these upsets alone. Shame and isolation co-arise with subjugating traumas. If a survivor can tell a therapist or someone who is safe about the impact of a triggering news event or a threatening social media connection, she can more easily bear the burden of fear and shame rather than ignore or push such feelings away. This basic act of seeking a witness to one's trauma is a means of valuing one's own experience and vulnerabilities and it is essential for a survivor to know that while future triggers may be inevitable, she does not have to face them alone.</p><p><em>Stresses of Hypervigilance</em></p><p>Stresses of access can quickly create <em>stresses of hypervigilance</em>, or an obsessive involvement with news or social media in reaction to feeling overexposure to traumatic content or triggering individuals. Caught up in the onslaught of alerts following the London Bridge attacks, my patient was drawn into a spiral of overstimulation. As she was continuously provoked by "breaking news" updates, she found herself anticipating the next jolt and so checked the headlines between alerts herself to gain some sense of control over what was destabilizing her. Because our devices make all news accessible to us all the time, the illusion that my patient had of keeping tabs on it seemed possible from within her desperate need to feel safe. Yet while hypervigilance—a state of heightened awareness about one's surroundings—can deliver a sense of safety when applied to a finite environment, when such effort is applied to keeping track of the limitless news on the internet, it is exhausting and self-defeating. Instead of feeling empowered by accessing information about the London Bridge attacks and other traumatic events, my patient became overwhelmed and fell into crisis. Her fears ratcheted to an intolerable high, and she could only isolate herself in order to feel safe.</p><p><strong>Trauma + the Internet + Trump</strong></p><p>The ramifications of my patients' experiences point to the fact that our growing attachment to updating and being updated could be traumatogentic. This is particularly meaningful in the age of Trump. When the U.S. presidency, a position that already draws the focus of global attention, is held by an extreme individual like Trump, his erratic and dangerous behavior captures all media focus. As with my patient, such constant coverage becomes a compulsive fixation for many of us. Like her, we might be so focused in a mistaken attempt to keep ourselves safe.</p><p>While the internet holds out the possibility for us to tirelessly monitor the extremes emanating from the White House, this promise is ultimately empty. This is marked by the exhaustion many of us feel even as we’re unable to put our devices down, in spite of knowing we have spent too much time online. It is important to remember that our smartphones are powerful pocket-sized multimedia advertisement machines that seduce us with sensory stimuli in the form of alerts, videos, texts, posts, likes, tweets, Snapchats, emails, and so on each time we use them. The companies who create the applications we use employ neuroscience to keep us checking our devices—and staying on them—so that we can see more ads.</p><p>For the insomnia-stricken among my patients, I generally recommend all screens be put away at least an hour before bedtime, because it scatters attention and overstimulates the brain. Moreover, backlit screens have been proven to block the production of melatonin, a natural sleep-promoting hormone. And because sufferers of PTSD are easily overwhelmed by too many sensory stimuli, I advise all my patients to turn off their newsfeed alerts and social media notifications when they feel particularly anxious. For the traumatized, whose neurobiological systems are already in state of hyperarousal, anything that disturbs sleep or heightens anxiety narrows their "windows of tolerance"—cognitive states of balance and calm that allow for logical, measured thought. This makes finding stability even more challenging, and hinders healing significantly.</p><p>We are, as humans, organic creatures whose brains cannot sustain over-exposure to mechanistic devices, nor can they process news and information at the volume and speed at which digital media outlets produce it. We are not machines; feeding our quest for knowledge and defining our existences online deliver a synthetic fulfillment that is fleeting and unsustainable. Seeking such satisfaction via the internet is like trying to quench thirst by sipping water from a firehose. The current digital media information climate renders us feeling perpetually parched, ever-seeking new information and ever-eager to broadcast ourselves through social media channels and newsfeeds. But by drinking from the internet's firehose, we not only end up still thirsty, but we also may get seriously hurt in the process, as my patients' experiences reveal. Because this onslaught of ever-available information disallows us to take the time to truly consider any of it, we open ourselves to flooding our brains and to believing dangerous and unchecked falsehoods.</p><p>There is a maladaptive match between Trump, a spectacle-driven reality TV persona, and our current technological age. The pairing of online media sites that rely on page views to maximize advertising dollars and Trump's factually thin but impossible-to-ignore ravings has resulted in him effortlessly infecting media outlets primed to spread his viral-ready broadcasts. As Evan Williams, the co-founder of Twitter, has commented, the internet “<a href="https://www.nytimes.com/2017/05/20/technology/evan-williams-medium-twitter-internet.html?smprod=nytcore-iphone&smid=nytcore-iphone-share">rewards extremes</a>” and social media sites are designed to highlight whatever gets the most attention. (“Say you’re driving down the road and see a car crash. Of course you look. Everyone looks. The internet interprets behavior like this to mean everyone is asking for car crashes, so it tries to supply them,” Williams notes.) Donald Trump's success at capitalizing on the mass market use and influence of social media is something that social and political scientists, digital media scholars, campaign experts, journalists and government officials are still scrambling to understand. As Stanford election law scholar Nathaniel Persily observes:</p><blockquote><p>[T]he story of Trump's social-media dominance is one that reflects a candidate <a href="https://www.journalofdemocracy.org/sites/default/files/07_28.2_Persily%20%28web%29.pdf">with qualities uniquely tailored to the digital age</a>. Every candidate has assets and liabilities. For Trump, his assets included his fame, following, and skill in navigating the new media landscape. He also figured out that incendiary language could command media attention or shift the narrative. These combined strategies allowed him to garner roughly $2 billion worth of free media during the primaries, and probably a comparable amount during the general-election campaign.”</p></blockquote><p>Mass media's ability to turn attention into money is a fundamental tenet of advertisement and marketing. Trump's immense talent for grabbing attention and turning it into material wealth and power makes him, first and foremost, a master of marketing. He is innately attuned to what Tristan Harris, a former product manager at Google, calls a “<a href="http://www.cbsnews.com/videos/brain-hacking-2/">race to the bottom of the brain stem</a>” in citing how mass market internet media companies manipulate our primitive emotions of anxiety, fear and loneliness to create dependency and “get attention at all costs.” As with the internet, we fixate on Trump and his outrageous behavior, not necessarily because we want to, but because our brains are evolutionarily attuned to fixate on what we fear.</p><p><strong>Trauma, Truth and Trump</strong></p><p>Looking through the lens of trauma treatment, it’s of particular concern that we find ourselves in a perfect storm where we have a narcissist president, fixed on broadcasting his own unilateral and inconsistent versions of reality in a climate driven by internet media channels that produce information so quickly that falsehoods are privileged over truth. It is a tenet of trauma therapy to validate our patients' truths, which is to say their experiences of subjugation. Without it, the work of healing cannot progress. Being believed and not having one's experience denied is crucial to anyone who has seen unspeakable horrors or who has been subjugated by another through torture, rape, or physical or sexual abuse. Such events turn one's world upside down, and a cornerstone of our work is to help a patient stabilize by affirming the truth of their experience. Only then can we build, with words, a narrative of the event, so that the patient can make sense of and communicate to herself and others what happened. She is thus able to able to move out of her isolation and shame to recruit witnesses to help her bear such a painful burden. This allows the patient to move her experience from crisis—a wordless reactivity; to trauma—a narrative of pain; to history—a story about the past. With time to validate truths and make meaning out of chaos, a patient can reduce her panic attacks, flashbacks and dissociation. Rather than being caught in a cycle of meaningless crisis, she can regain stability, increase her sense of calm and move on with her life. As trauma expert Bessel van der Kolk put it, "<a href="http://seeing-her-ghosts.com/Bessel-van-der-Kolk">Communicating fully is the opposite of being traumatized</a>."</p><p>Thus it is traumatizing to have, in the White House, a president and an administration intent on confounding "full communication" by manipulating the truth to serve their own ends. As Columbia University psychoanalyst Joel Whitebook points out, according to Trump and his team, there is only one reality—Donald Trump's:</p><blockquote><p><a href="https://www.nytimes.com/2017/03/20/opinion/trumps-method-our-madness.html?_r=0">Armed with the weaponized resources of social media</a>, Trump has radicalized this strategy in a way that aims to subvert our relation to reality in general. To assert that there are “alternative facts,” as his adviser Kellyanne Conway did, is to assert that there is an alternative, delusional, reality in which those “facts” and opinions most convenient in supporting Trump’s policies and worldview hold sway. Whether we accept the reality that Trump and his supporters seek to impose on us, or reject it, it is an important and ever-present source of the specific confusion and anxiety that Trumpism evokes.</p></blockquote><p>When a world leader as powerful as the president of the United States insists there are "alternative facts" derived from a reality only he knows, it can be alarming and destabilizing for us all. Democracy and rule of law are threatened without an agreement between government and its citizens on the objectivity of truth and reality. A breakdown in this agreement puts the definition of truth and reality into the hands of those with the most social, political and/or economic power. In history, this has supported the severe wrongdoings of institutions more intent on preserving their power than protecting individual rights. The sexual molestation of children by priests in the Catholic Church represents a stark and longstanding example of an institution that insisted on its own truth and reality rather than that of abused innocents. To hold onto power, Catholic Church leaders permitted the ongoing sexual abuse of society's most vulnerable, the very individuals they had a holy mandate to protect.</p><p>In trauma therapy, we see the corrosive long-term effects upon the human spirit when an individual's truth and reality are denied, particularly when they grapple with traumas that take away their sense of subjectivity and self-efficacy. In his constant attempts to redefine the truth against the wrongdoings he has enacted, Donald Trump behaves like an aggressive perpetrator who fundamentally has no respect for the rights and subjectivities of those in American society who disagree with him. He shows this through his insistence on overpowering and shaming individuals who will not bend to his opinion or his will. From my stance as a trauma therapist, it is heartbreaking to see the damage Donald Trump is wreaking upon American society. It is a perpetration creating deep wounds from which I fear it will take us years to heal.</p><p>The unfortunate symbiosis of our president's narcissistic, attention-hungry outrageousness with this internet era's insatiable appetite for spectacle has resulted in a flood of incendiary news and information that few of us have the time or mental space to fully process. Yet we gorge ourselves on such toxic infotainment with a niggling sense of impending doom. As <em>New Yorker</em> editor-in-chief David Remnick said of White House press secretary Sean Spicer's unusually high ratings for his press briefings: "Undoubtedly, some people watch Spicer to be entertained. But there’s another reason his ratings are high: we watch because we’re worried."</p><p>Indeed we are worried. Due to Trump and his administration's constant and volatile shifts in mood, communication, and representations of basic truths, far more Americans now possess narrower "windows of tolerance" in managing stress. As president, Trump has created an epidemic of heightened anxiety.</p><p>It is difficult to predict how tenable this is for us—as individuals or as a society. Uncertain times call for collective strength and stability, and such disempowerment is detrimental to our individual and national mental health. We can, however, use a deeper understanding of how our social media era, combined with the age of Trump, stirs us to habituate to seemingly innocuous behaviors such as reading the news, posting, reposting, tweeting and commenting. While such actions are in and of themselves no problem, when the information trafficked is provocative, aggressive, volatile, and questionably true, this promotes anxiety and reactivity rather than measured thought. We can be aware of the propensity for new media outlets to privilege emotionally stimulating falsehoods over measured and nuanced facts. We can unplug ourselves and take time to simply enjoy the act of thinking freely. It is a privilege we still enjoy in the United States, and it will be the skill we need to prevent us from careening towards crisis, as it seems Donald Trump would have us do.</p>
Keep reading... Show less