The names and identities of the patients described in the following have been changed to protect their anonymity. In addition, signed consents to use their material have been obtained.

James arrives at his session, bleary-eyed, having stayed up very late to hear the results of the 2016 presidential election. He doesn’t speak, but instead begins playing a recording of Judy Collins singing. As the song ends, he quietly repeats the refrain:

The weight of the world, too heavy to lift

So much to lose, so much to miss

It doesn’t seem fair that an innocent boy

Should have to carry the weight of the world

He says, “I am a seventy-year-old man, and feel like an innocent boy totally unprepared to handle the weight that the world now thrusts on my shoulders.” After a very long pause he continues, “Trump has said that he would demand that all Muslims be registered, citing as precedent the internment of Japanese Americans, both citizens and aliens, for national security, or rather” — James scoffs — “because of national hysteria and prejudice.”

His words take on the haunting rhythm of the song he has just played, as he yearns for a time when there can be room for diversity. James has begun to define a new anxiety. It has penetrated his heart and now penetrates the therapeutic space. He has the renewed sense that who he is (who anyone is) no longer has value.

Annick, another patient who is a writer, also feels a new kind of anxiety. She reports that Trump has penetrated her dream life, and therefore infiltrated her psyche and her creativity. This “master of surprises,” and “internal terrorist” appears in her dream as an “evil magician, sly and catalytic.” In one dream, she is working on the final stages of writing an essay, and waiting for an important “package of words” to arrive. Rather than getting the package via FedEx, as she was expecting, Trump intervenes — arrayed in a colorful robe like a modern-day Merlin. He holds her package hostage and transforms it from a catalyst for her imagination into a briefcase of burdensome and tedious paper work that will keep her from completing her essay, consigning her to years of endless and “dogged slogging.”

Both James and Annick’s experiences of despair reflect their deepest terrors — especially their fear of losing their capacity to express themselves fully and realize their aspirations. But their stories — along with those of many more of my patients — stand out because they reflect the devastating and profound impact of our new political context. They show us not only the fault lines of their individual lives, but also how the new political environment in which we live has torn the fabric of our collective psychology. Their ability to speak of their suffering enlarges my understanding of what psychotherapy and psychoanalysis must now consider one of its most important tasks. Something new has nudged its way into the center of their psyches, and — for those who identify with a diverse and democratic America —  something elemental and seemingly uncontrollable is making itself felt inside the inner sanctum of the therapy office.

The president-elect’s overt racism and sexism, his homophobic and xenophobic comments and his grand cry to “make America great again,” have unleashed enormous fear in those who don’t support him. Donald Trump has demonstrated the capacity to invade the private world of each and every one of my patients, making inroads into the inner recesses of their lives. Many are able to resist the intrusion, but almost all experience his political style as an assault on their personal agency, their connection to their creative unconscious, and their ability to enjoy the generative and free interaction of emotions and ideas — all of which have previously informed their work and relationships.

Above all, news coverage of Trump’s incessant tweets constantly interrupts our thoughts. Never before have we had a political figure with so much need to make himself the center of all conversation. I think of this style as “manipulative power speak;” he bombards us every day in order to re-configure our version of reality and align it more closely with his. He brands everything he touches with his name, he disregards social and political norms, and he insists that nothing can stand in his way.

Many of my patients connect these intrusions with feelings of personal abuse. The ones who are most deeply affected reassure themselves by touching their stomachs or their hearts, or wrapping their arms around themselves as if to protect against assault. And like an intimate abuser, Trump keeps us hooked by occasionally giving us hope that he might respect our identity and dignity, or behave in “normal” ways. Then he resumes his rampage and rains down insult and threat without regard to consequences. His behavior is thus unpredictable and menacing. Even when we think he is wrong, he is still “right.”

The impact of the Trump phenomenon forces psychological professionals to think again about how our analytic work rests within the larger vessel that is society at large. Severe disruptions and transitions of values and emphasis in socio-political processes call attention to a force outside the analytic dyad that nonetheless has the power to alter the work done between analyst and patient within it. This force cries out to be defined and understood as having an impact that interacts explosively with other realms of analytic concepts. The necessity of articulating our changed context casts patient and analyst out of the safe space of the “analytic container” and into the larger world, where both are unprotected by the carefully constructed analytic logos that has traditionally provided security and clear guidance.

It is now up to us as psychoanalysts and psychotherapists to admit to the same vulnerability and loss of security that many of our patients are sharing with us during therapy. We must try to understand the powerful impact of the new political-social context on our work, and on the individuals in our practices. This involves a willingness to admit that the world in which we live has irrevocably changed for patient and analyst alike.

At the same time, the analyst must not get lost in the quicksand of the changing context, but always hold a stance — and a space — that allows for reflection. We must ensure that our patients do not unwittingly become absorbed in and “adjusted” to this intrusive and destructive social environment, but instead encourage them to grapple consciously with the “Trump within,” unseating his influence on internal psychological processes. Helping our patient’s reflect on the socio-political context in relation to their internal context will ensure that they don’t unconsciously succumb to this new kind of terrorism, one that works seditiously by negating their creative power and undermining their ability to think, live and act autonomously.