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The lines between the couch and the campaign trail are increasingly blurred, as political anxieties dominate therapy sessions across the country. From anxieties surrounding specific candidates like Trump, Mamdani, and Cuomo, to broader concerns about the state of society, patients are bringing the weight of the political world into their personal lives, and therapists are grappling with how to respond.
The Rise of Political Doomscrolling and its Impact on Mental Health
Therapists report a significant increase in patients exhibiting behaviors linked to constant political engagement, often described as doomscrolling. Patients are arriving at sessions already primed with anxieties fueled by news headlines and social media posts. One therapist noted a particularly striking example: patients becoming deeply fixated on YouTube videos of Mamdani’s early rap career, finding content within them “very upsetting.” “They’ll say, ‘Have you heard about this? Did you see this? This rap video where he’s saying that he’s in alignment with Hamas?’ ”
This trend isn’t limited to specific moments; it intensifies dramatically around election cycles. “It’s a rough week of work for us,” explained a licensed psychologist based in New York City. “It’s, like, ‘Oh, God, I’m about to sit through four days of eight hours of everybody talking about the election.’” The aftermath of elections also sees a surge in appointment requests, with patients often seeking additional support in the days and weeks following a vote.
The Challenges of One-Sided Conversations and Patient Expectations
The nature of therapy itself contributes to the complexity of these political discussions. “It’s not really a conversation, right?” one therapist observed. “You’re in a different position as a therapist.” This often leads to a “whiplash of projections,” where patients assume their therapists share their political views. Increasingly, patients are even seeking therapists who explicitly align with their own worldview. Requests circulating on therapist listservs reveal this trend: “Ideally therapist is Palestinian, but someone aligned with anti-Zionist values could also be a good fit.” Another request specifically sought a therapist who identifies as Republican and is willing to openly discuss their political beliefs.
Most therapists strive to maintain neutrality, even when disagreeing with their clients. However, some, like Jonathan Alpert, a psychotherapist practicing in New York and Washington, D.C., take a more direct approach. “I always push back,” Alpert stated. “My job isn’t to agree with patients; it’s to hold up a mirror.” He believes therapy should be a safe space to confront differing viewpoints.
When Politics Becomes Personal: A Case Study and Broader Concerns
The impact of political anxieties extends beyond abstract debates. Alpert recounted a case where a patient, after witnessing an assault, attributed the incident to the need for policies championed by Mamdani. He subsequently wrote an op-ed arguing against this connection, suggesting that Mamdani’s proposed public-safety plan could exacerbate urban decline. Alpert likened this approach to that of a “bad therapist”—one who offers comfort instead of effective solutions.
Beyond specific policy debates, therapists are witnessing a surge in rage across the political spectrum. “Some of it borders on homicidal,” Alpert noted, recounting instances of patients expressing violent wishes towards political figures, including openly wishing for Trump’s death. Alpert, who has appeared as a commentator on Fox News, has even lost patients for challenging their political beliefs. “Some people don’t want therapy,” he explained. “They want affirmation of their politics.”
This desire for validation often manifests in questions about personal choices. Patients are seeking reassurance, asking, “Should I vote for Mamdani even though his policies scare me?” or “Would voting for Sliwa make me a bad person?” Ultimately, they are seeking confirmation that their anxieties signify moral righteousness.
