Verified by 
Key points
- After the election, some high-risk youth are in significant emotional distress.
- There may be an increased risk of self-harm in the most vulnerable.
- The therapists' office is an important source of comfort during uncertain times.
In my office, the clinical need skyrocketed last week. It reminded me of the other moments in my career when a nationwide event caused significant distress for many people: 9/11, the 2016 election, the Muslim ban, COVID, and the Dobbs decision. In response to the results of the 2024 election, I am again asking myself: How can I be most helpful to those who are in deep distress during a time of great uncertainty?
The closer one is to a traumatic event, either emotionally or physically, the more intense the hit. If you lived close to the Twin Towers or if you lost a loved one on 9/11, the shock, fear, loss and grief were intense. If you lived far away from the East Coast or didn’t have any direct connection to New York, the cities where the planes lifted off, or the people lost, the event still felt horrible, but the effect was much less personal.
This construct applies to the 2024 election as well. You may feel fine post-election. But, there is a broad swath of Americans in significant emotional pain after 11/5. Some young people are at much higher risk of self-harm and suicide now than they were just last week. In my office, young survivors of sexual assault report feeling betrayed and unsafe in a country that just voted for an adjudicated sexual abuser. Calls to the Trevor Project, a national suicide and crisis phone and text line for LGBTQ+ youth, increased 700% on Nov 6, compared to October. Conversations about the election increased by nearly 5,200%.
My approach in the office after November 5th
Sometimes patients share their concerns about the election results freely but others don’t know if my office is a safe space to talk openly. They don’t know if I will understand their heightened sense of vulnerability.
For patients entering the office with an uptick in distress, I ask them how they are feeling after the election. If they say “fine” I move on to a topic of their choice. It’s possible they may have concerns about the election but don’t feel comfortable sharing them with me. If so, they now know that I welcome a discussion of this subject if they wish to bring it up in the future.
For those who are impacted, my question provides permission to share how they are doing. I am interested in their perspective; it is okay to talk to me about this topic.
If they are upset about the election, I ask for more details. Then, if appropriate, we talk about how they have sustained an emotional hit, directed at them, and that is why they feel so vulnerable, scared and alone.
As they express grief, anxiety, or fear, I affirm their feelings that the results are deeply upsetting, and the future is uncertain, which is frightening. Anything else would be gaslighting.
I don’t follow up with the details of my political leanings, but I affirm the reality of this moment for marginalized groups. If the patient is happy about the current election results, my job is to lean into the concerns that my patients have—not to impose my own.
Some patients have shared a rise in suicidal thoughts with intent and a plan. As therapists, we are facing a specific type of wounded, and we need our words at the ready; they are our salves and our medicines.
What I am saying to patients at increased self-harm risk after the election
If you hurt yourself, you are aligning yourself with the group that has already hurt you deeply.
At this moment, the act of greatest resistance is to provide yourself with unwavering self-care and compassion and to connect with your community.
This is a time we need to reach out to each other—and be with one another. We are more vulnerable alone. Who can you be with that will help with this sense of isolation?
We don’t know what is going to happen in the next days, months or years, but I promise you will not be facing by yourself. We will keep working together and this office will remain a safe place for you. I don’t have loads of power, but I have some. I promise to use the power I have to advocate for your healthcare needs and to make school a safe place for you.
***
Some patients have asked me how I am doing—and the true answer is that I feel our conversations are deeply meaningful and this work has been grounding for me during a highly turbulent time. While the therapeutic relationship is a professional one, the connection is real. I feel privileged when patients trust me to discuss these most sensitive of topics. I feel less helpless personally if I can provide comfort and connection, one conversation at a time. It seems to me this is always the first step forward for all of us during tumultuous times.
***
If you or someone you love is contemplating suicide, seek help immediately. For help 24/7 dial 988 for the National Suicide Prevention Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.
References
