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Let me rephrase the title of the classic book Fear and Loathing on the Campaign Trail ’72, published around the time Nixon won reelection, to label this article Fear and Gloating on the Campaign Trail of ’16 (and please forgive me if I offend anyone; we psychiatrists sometimes say undesired things). 

Fear is our natural, hard-wired, fight-or-flight response to perceived yet deeply embedded Stone-Age risks. This response can be dampened by a parental figure who, in one way or another, reassuringly promises that everything will be better – as in, a new leader.

Nowadays, our perception of danger is also about other risks, sometimes real and sometimes not. Our so-called “post-truth” era makes that distinction harder to make. It often takes pausing for cognitive reflection and understanding to determine the actual risk.

Indeed, how well we process our pre- and post-election fears may be the challenge of our time!

Opening the Pandora’s Box found on this campaign trail, many found out about the fears of one societal group in particular: working-class white Americans who were angry about declining economic success and feeling unneeded. Their health had worsened. Their fears, justified or not, were about trade, immigration, and rights. After some of them were called “deplorables,” their candidate won. Now, some are gloating – even their middle-school children. 

In turn, there is fear on the other side. Will gains in civil rights be compromised? Women tend to sense a newly released misogyny, reminding them of past trauma caused by men, and some are buying more guns. There are reports of increased anxiety not only in psychiatric patients, but also their therapists, who overwhelmingly supported Hillary Clinton.

Consequently, some who have had the tables turned are reacting with the fight-or-flight response of walking outside, screaming aloud, and fighting.

There is also grief, despair, mourning, and even some guilt on the losing side. Lost, at least for the time being, is the deep hope of some for our first woman president. Potentially lost is the continuation of the policies of our first black president, including healthcare reform, which relates to our very own jobs!

Now, did the half of our population who were eligible to vote, but didn’t, fear and/or loathe both candidates?

All of these feelings are neither good nor bad; that depends on their intensity and what is done with them. At one extreme, fear becomes existential angst, a dread indicating that the basic security of our existence is under siege. Then we tend to cling to our tribe and scapegoat other tribes, as in Islamaphobia or anti-semitism, examples of which can be found in the ICD-10 Z codes, “factors influencing health status.”

Although the Goldwater rule ethically prohibits me from speculating on the possible internal fears of our current leaders, I can say that gloating is often a cover for the underlying fear of not being successful.

As a psychiatrist, I have seen some of the worst we are capable of, so I can’t help but ethically speak out about these immense health risks to society: nuclear war, global warming, and assassination, among them. But I have seen the best of humanity, too, and a way to overcome fear and gloating may be to reflect on the anecdote of when a 17-year-old black male recently contacted a white grandma after erroneously receiving her text invite – she overcame any fear she may have had by then inviting him and his whole family to her Thanksgiving dinner. May we all model ourselves after this, both on a small and large scale.


H. Steven Moffic, MD

H. Steven Moffic, MD, is an award-winning author whose fifth book, “The Ethical Way: Challenges & Solutions for Managed Behavioral Health,” is considered a seminal study on healthcare ethics. Always in demand as a writer, Dr. Moffic has attracted a national audience with his three blogs— Psychiatry Times, Behavior Healthcare, and Over 65.H. Dr. Moffic, who is also a popular guest on Talk-Ten-Tuesdays, recently received the Administrative Psychiatry Award from the American Psychiatric Association (APA) and the American Association of Psychiatrist Administrators (AAPA).

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