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What makes obsessive political preoccupation distinct is its collective reinforcement: Social media, partisan news outlets and aspects of modern therapy have turned emotional validation into moral virtue. Each act of outrage delivers short-term relief that reinforces the cycle, maintaining the compulsion rather than resolving it. At its core, it isn’t much different from other OCD-like presentations I see in my practice.
The term “Trump derangement syndrome” emerged as a tongue-in-cheek partisan label. The joke obscured the psychological reality in which a political figure becomes a symbolic stand-in for threat and loss of control.
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For many Americans, what began as a stress response has become a chronic state of hyperarousal and vigilance. In 2016 the reaction was acute: disbelief, anger, panic. By 2020 it had hardened into identity. Now it has become a way of life. During the 2024 campaign and into 2025, many patients have spoken with fatalistic dread about Mr. Trump’s continuing presence at the center of national life. Even hearing his name can trigger a physiological response. They aren’t reacting to Mr. Trump the man but to Trump the symbol—the embodiment of chaos, threat and loss of control.
He touches on therapeutic treatment but in this case it may not be sufficient to do 