mainstream public media, government leaders
United States of America

We are experienced mental health clinicians whose expertise spans various disciplines: psychoanalysis, psychology, marriage and family therapy, social work and psychiatry. As psychotherapists we have privileged access to people’s inner worlds, including anxieties and other forms of distress they may keep hidden from others. We are deeply concerned by our observations that the erratic, negative and threatening tenor and actions of President Trump and his Administration are adversely impacting the psychological and emotional well-being of US residents.

Our purpose in this statement is to alert the public to clinically significant negative mental health consequences of ongoing behaviors by the Executive as well as the Legislative Branches of our government. We call on these leaders to desist in seeding fear and divisiveness in the public. Below, we identify specific harmful actions by government leaders and the psychological consequences that we observe resulting from them:

1) Confusing, misleading and deceiving the public [1]
The magnitude of contradiction,[2] deceit [3,4] and concealment [5,6] in the President’s actions, as well as his apparent indifference to their effects disrupts not just people’s sense of reality, but their faith in their ability to differentiate reality from fiction. For example, the President’s attacks on the Press,[7] asserting “alternative facts” about voter fraud[8] and inaugural crowd size,[9] making unsupported conspiracy claims,[10,11] and appointing environmental officials who deny common scientific evidence of climate change[12] impair people’s ability to assess facts and rely on their own sense of “knowing”. The negative effects we observe on our patients’ thought processes manifest in confusion, indecision, hopelessness and/or despair. The heedless duplicity conveyed by the President’s ongoing obfuscations damages his credibility worldwide.[13,14] More importantly, it poses a serious threat to the psychological health of our nation’s citizens and the integrity of our democracy. As historian Simon Schama recently noted, “Indifference about the distinction between truth and lies is the precondition of fascism. When truth perishes so does freedom.”[15]

2) Attacks on the integrity and transparency of democratic institutions [16]
The mental well-being of all members of our society rests on a sense of trust in the fundamental fairness and integrity of our government’s Executive, Judicial and Legislative branches. When the foundation of confidence and trust in our democratic institutions is threatened, people become anxious, fearful, even paranoid about national security and personal safety.[17,18] The repeated attacks the President has made on vital democratic institutions – namely the Judiciary, the Constitution and the Press – have created a climate of chaos and uncertainty that undermines confidence in the rule of law and due process, both here in the United States and in global diplomatic relations. We are observing negative effects from these attacks in our practices: otherwise stable, functioning people are now suffering from panic, depression, dread, vulnerability to unfair abuses of power, preoccupation with the erosion of our society’s moral compass, paralyzing uncertainty about the future and/or feelings of impending doom.

3) Hateful speech toward vulnerable populations
The hostile, degrading speech wielded by President Trump toward minority groups[19,20,21,22,23] arguably meets the criteria for hate speech.[24] Clinically, we observe that his and his staff’s discriminatory references to women, immigrants, people of color, Muslims, people with disabilities and the LGBTQ community have triggered a resurgence of Post Traumatic Stress and other symptoms in persons from each of these groups.[25] These include persecutory anxiety, humiliation, terror, helplessness, nightmares, despair and/or rage. Likewise, in our patients in general we are observing fear, outrage and/or disgust over the rise in hate crimes resulting from the President’s discriminatory language and policies.[26,27,28,29,30,31] According to a study,[32] “when a politician can create a sense of moral outrage, truth ceases to matter. People will go along with the emotion, support the cause and entrench into their own core group. The actual substance stops being of any relevance.”[33] We are especially concerned for our child and adolescent patients, who are in the early stages of identity development and learning to distinguish socially appropriate, respectful conduct from inappropriate, demeaning speech and behaviors. For them, witnessing verbal aggression is demonstrably detrimental.[34]

[The authors claim sole copyright to the text and signature list of this petition; the authors’ copyright is invoked with regard to any and all commercial, political or other uses not consistent with the spirit and intent of the petition text, as stated above. The authors further assert sole and exclusive rights in determining the ‘spirit’ and ‘intent’ of their own text.]

We are mental health practitioners who attest to the following:

Our daily psychotherapeutic work with a wide range of people provides evidence that numerous behaviors and actions on the part of the Trump Administration are causing serious distress in large numbers of US residents. The President’s rash, aggressive and contradictory style disregards basic rules and ethics expected of executive power-holders of either political party. This is an unprecedented departure from the assumption that our country’s leaders will act with transparency and fundamental respectfulness. For the protection of all:

- We strongly urge the President, our legislators, and the public to seriously consider our clinical observations and the costs they portend for the health of our society and our planet.
- We encourage people experiencing negative effects like those identified here to seek therapeutic and/or community support.[35]
- We assert in the strongest possible terms that the current Administration bears a primary, essential responsibility for protecting the present and future well-being, including the mental well-being, of all citizens and residents of the United States. [36]
- We strongly urge our Judiciary and Legislature to hold the Executive branch to the same ethical and legal standards applied to previous administrations. This includes obliging the President and his staff to act with prudence, integrity and consistency, and to adhere to established chains of government authority. Otherwise, we foresee the rise of an authoritarian government dedicated to undermining our constitutional democracy.

1 http://www.latimes.com/projects/la-ed-our-dishonest-president/
2 https://www.nytimes.com/2017/04/11/world/middleeast/russia-syria-chemical-weapons-white- house.html?emc=edit_th_20170412&nl=todaysheadlines&nlid=34056115
3 https://www.washingtonpost.com/news/fact-checker/wp/2017/02/24/fact-checking-president-trumps-cpac- speech/?utm_term=.e180f121366a
4 https://www.buzzfeed.com/maryanngeorgantopoulos/president-trump-lie-list?utm_term=.dfmlVqwLpx#.akV3OWZ6X4
5 https://www.nytimes.com/2016/08/21/us/politics/donald-trump-debt.html?_r=0 ; http://www.usatoday.com/story/news/politics/onpolitics/2016/02/26/donald-trump-internalrevenue-service- audits/80996086/
6 http://www.cnn.com/2016/11/10/politics/russia-contact-trump-campaign/index.html
7 http://www.latimes.com/projects/la-ed-trumps-war-on-journalism/
8 https://www.nytimes.com/2017/01/24/us/politics/unauthorized-immigrant-voting-trump-lie.html?_r=0
9 https://www.nytimes.com/2017/01/21/us/politics/trump-white-house-briefing-inauguration-crowd- size.html?action=click&contentCollection=Politics&module=RelatedCoverage®ion=marginalia&pgtype=article
10 https://www.washingtonpost.com/news/the-fix/wp/2017/04/05/trump-just-bet-the-farm-on-his-wiretapping- conspiracy-theory-and-still-provided-no-evidence/?utm_term=.25249c062c8d
11 http://www.latimes.com/projects/la-ed-conspiracy-theorist-in-chief/
12 https://www.washingtonpost.com/news/the-fix/wp/2017/04/03/the-left-and-right-agree-fox-news-destroyed-epa-chief- scott-pruitt-over-climate-change/?utm_term=.f3f80ae9df5a; https://www.epa.gov/climatechange/climate-change-basic- information
13 https://www.nytimes.com/2017/02/17/world/europe/trump- europe.html?emc=edit_th_20170218&nl=todaysheadlines&nlid=34056115&_r=0
14 http://time.com/4739396/trump-syria-russia/
15 R. Cohen, New York Times Op-Ed, 2/10/17: https://www.nytimes.com/2017/02/10/opinion/preserving-the-sanctity-of- all-facts.html?&moduleDetail=section-news- 2&action=click&contentCollection=Opinion®ion=Footer&module=MoreInSection&version=WhatsNext&contentID=Whats Next&pgtype=article
16 http://www.latimes.com/projects/la-ed-trumps-authoritarian-vision/
17 https://www.theatlantic.com/politics/archive/2017/02/trump-is-attacking-any-institution-that-challenges-him/515727/ 18 http://www.huffingtonpost.com/entry/donald-trump-crew-lawsuit_us_588586fee4b070d8cad386b7
19 https://www.washingtonpost.com/opinions/five-myths-donald-trump-tells-about-donald-trump/2016/01/28/b7cead16- c46e-11e5-9693-933a4d31bcc8_story.html?utm_term=.55b6ce6ff78e
20 http://fortune.com/2016/06/07/donald-trump-racism-quotes/
21 http://www.cosmopolitan.com/politics/news/a44629/donald-trump-insults-women/
22 https://www.nytimes.com/2016/05/15/us/politics/donald-trump-women.html
23 https://www.washingtonpost.com/news/the-fix/wp/2017/01/09/meryl-streep-was-right-donald-trump-did-mock-a- disabled-reporter/?utm_term=.4e4156376d95
24 https://definitions.uslegal.com/h/hate-speech/
25 http://www.seattleglobalist.com/2017/03/21/trump-policies-drive-undocumented-families-seek-mental-health- help/63535
26 https://www.dallasnews.com/news/flower-mound/2016/12/06/flower-mound-officials-issue-statement-condemning- hate-speech-calls-equal-treatment
27 https://www.splcenter.org/hatewatch/2016/11/15/update-more-400-incidents-hateful-harassment-and-intimidation- election
28 http://www.cnn.com/2016/11/10/us/post-election-hate-crimes-and-fears-trnd/
29 http://www.vox.com/2017/2/19/14650180/trump-anti-semitism-jews-america-religion
30 http://heavy.com/news/2017/02/jewish-community-center-jcc-bomb-threats-today-full-list-february-27-states- pennsylvania-photos-video-calls-evacuations/
31 http://www.latimes.com/politics/washington/la-na-essential-washington-updates-trump-silence-on-anti-semitic- incidents-1487286542-htmlstory.html
32 http://www.cep.ucsb.edu/papers/GroupsInMind2010.pdf
33 http://www.politico.com/magazine/story/2017/01/donald-trump-lies-liar-effect-brain-214658
34 https://www.dallasnews.com/news/immigration/2017/04/08/dallas-officials-blast-anti-immigrant-signs-found- elementary-school
35 https://www.immigrantjustice.org; https://gaylesta.org/community-resources; http://www.muslimmentalhealth.com; http://www.bazelon.org/News-Publications/Other-Resources/Mental-Health-and-Disability-Advocacy-Resources.aspx; https://www.womenshealth.gov/mental-health/
36 https://www.nytimes.com/2016/12/12/opinion/the-mental-health-crisis-in-trumps-america.html

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