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Psychiatrist Farid Sabet-Sharghi discusses his article, “The psychological trauma of polarization.” Farid explains how the human psyche is evolutionarily wired for connection, making the current climate of hostility and division deeply traumatic. He connects the panic and anxiety seen in his clinic to the reactivation of childhood wounds, where global discord mimics the volatility of a troubled family system. The discussion highlights the visceral impact of the 24-hour news cycle and offers clinical strategies for reclaiming agency through setting boundaries. Learn why unity is not just a social ideal but a fundamental psychological necessity for mental health.

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Transcript

Kevin Pho: Hi. Welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome Farid Sabet-Sharghi. He is a psychiatrist, and today’s KevinMD article is “The psychological trauma of polarization.” Farid, welcome to the show.

Farid Sabet-Sharghi: Thank you very much. It is nice to be here.

Kevin Pho: All right. Let’s start by briefly sharing your story. Then we will jump right into your KevinMD article.

Farid Sabet-Sharghi: In psychiatry and in medicine in general, we focus on the patient. In psychiatry, all the push and movement and my excitement has been around understanding brain functioning and neurochemistry. But it seems like we cannot do that exclusively. We are physicians because we have to see the interaction between the individual biology and also psychology and the existential issues that people are facing.

We are living in a time where there is a lot of disunity and cultural harshness going on, and I have seen how that affects my patients. I feel like that is something that we haven’t been talking about enough. I have had some observations that I find fascinating, interesting, and eventually helpful to the patients.

Kevin Pho: Let’s talk more about that because I am a primary care physician and I see that too. Just with the different world events and the political climate, I do see that affecting patients from a behavioral health standpoint. So tell us more about what you are seeing. Tell us about the KevinMD article.

Farid Sabet-Sharghi: Thank you for that. I was always raised with this mindset. I am one of those few strange people who switched in my residency from radiation oncology, a very technical field, to psychiatry because I was always interested in the meta-narratives in medicine. I wondered what other things are going on in health and healing beyond the bench science that we have studied.

Since childhood, I was raised within the Bahá’í community. One of the standards that I always held very dear to my heart was one of the teachings from the luminary in the Bahá’í Faith, Baháʼu’lláh. It talks about how the well-being of a human being is unattainable unless and until the unity, the sense of unity that the person feels with the rest of humanity and with the universe, is established and is firmly established.

I believed that, but that was sort of a strange thing. As I got older and I have been in practice in psychiatry for about 30-plus years, I have noticed that that is really true. The things that we are witnessing are affecting our health. Disunity is literally making us sick.

The article in KevinMD that I was moved to write is a brief version of some of the observations I have had throughout the years. We are seeing the inner world of our patients being affected by the outer world that they see. Sometimes there is a reactivation and re-wounding of the psychological traumas that they have had. This is not limited just to psychiatry only. I think we are seeing it in all areas. I get consultations from colleagues, like a cardiologist calling me saying: “Why is everybody so angry, so mad, so argumentative, so distrusting?” I think it really goes back to what we see.

Kevin Pho: In your exam room or office, how do these patients typically present, and what kind of signs and symptoms are they coming in with?

Farid Sabet-Sharghi: I have seen a general sense. It is not one particular patient, but we have seen a reactivation of trauma. Many patients show up with new manifestations of panic attacks, chest pains, breathing problems, and sort of visceral feelings. We know trauma leaves this mark on the body. This Cartesian dichotomy between mind and body we know in medicine is not valid at any level because all of us are really treating the whole patient.

I have seen patients like that. When you take a life history and go over all the things they do, such as a lot of exposure to social media, a lot of polarized attitudes, and a lot of catastrophizing, it reflects the argumentativeness, anger, hostility, and sometimes even the violence of what they have witnessed in their family of origin that they had forgotten long ago. It is being reactivated, and it is affecting people. They think they just need more treatments, more aggressive therapies, and more medications. But by just exploring that, I think the knowledge of that really sheds a lot of light. That led to the article that you kindly published.

Kevin Pho: In your article, you talk about that 24-hour news cycle. You mentioned things like social media and the fact that news is constant. There are always updates. Also, social media itself tends to promote the most polarizing article in order to generate clicks. Tell us how this whole 24-hour news cycle and constant exposure to news affect someone’s resilience and psyche.

Farid Sabet-Sharghi: It is more than just constant exposure to news. It is the news of conflict amongst human beings. Anyone with a heart is affected by all the troubles and problems that we see around us in the world today. The news media seems to actively play people with rhetoric going at each other instead of just reflecting the news.

Some of the patients were saying that this reminded them of their past. For example, someone who grew up in an alcoholic dynamic family said they never paid attention to why all of a sudden they felt panicky, but it reactivated some of the childhood traumas or experiences they had.

All of us are built for unity. That era of saying that we are just espousing social Darwinism, that all of us are in need of war and conflict, is really not validated by science. My experience as a clinician, and I think in every field from anthropology to psychology to neurosciences, shows that the human world actually has evolved for cooperation, for unity, for understanding, for assistance, for helping, and for mirroring each other.

In fact, the whole purpose of the mirror neurons that everyone talks about in social circles is to be attuned to each other’s needs. Unfortunately, social media and our news cycle don’t reflect that. People are not even agreeing or disagreeing in an appropriate way. One of the quotes that I always remember and use in personal life is that if you and I are discussing something, you and I are not going at each other. We are having our ideas clash. One of the Bahá’í passages says: “From the clash of opinions, the spark of truth comes forth.” That is how we have to approach anything in the scientific world. We have done a good job in the past that way. Unfortunately, that is even being questioned these days because you can’t really agree or disagree on something without it becoming a personal matter.

Kevin Pho: And it doesn’t just affect that person individually. It affects them outside of just themselves. It affects their families as well, right?

Farid Sabet-Sharghi: Exactly. Yes. These systems begin to expand to not only families but social circles and the communities they live in. I practice in two different states, and it is amazing how the external reality of where we live is different according to the zip codes. Some people have one perspective or another perspective.

I remember in even the most contentious times, I would just tickle because two patients that I really cared about (both of them, of course, would pass each other in the hallway) would be amazing if they knew how different their views are on a topic. But both of them were wonderful human beings. They had the best of humanity in mind. Again, unfortunately, sometimes the media projects it as if these people are from different planets and different worlds and should never be together. That is the central damaging message.

Kevin Pho: So when patients like these come into your office and they talk to you about some of the things that we just talked about, how do you approach a situation like this?

Farid Sabet-Sharghi: That is such a good question. As you know, in another article I wrote, the job of a physician, and especially in the field of psychiatry, is that the self itself is a tool. I think a lot of times as physicians, we are not aware that we bring a lot of our inner conflicts, issues, and concerns. Psychiatrists have different terms for these like transference or countertransference. These are views that we project onto our patients from ourselves.

I think it is really important to have that posture of a kindly tongue being a magnet that attracts people. We really need to rise above these things. Again, another aspect of psychiatry is that we have always been in the middle of the stigmatization of the field. So you have to work with people around what feels more calming and healing to them. That is a very important first step: to see what are the forces that are going beyond.

Like any physician, our job is to make sure that a nice history and physical and all the other issues that might be worsening their symptoms are ruled out and looked at. But then beyond that, just having a dialogue about what their lifestyles are. Are they exercising enough? Are they going for walks? Are they listening to the KevinMD podcast as opposed to a conflicting report to learn something new or to be informed of the world around them? That is a good start. Then we sort of be in alliance with patients to alleviate what might be going on. None of the overpromising of calming effects, but sort of realizing that we are all in it together.

Kevin Pho: Now, is there a story or a case study that you could share with us where someone who came to you with some type of psychological trauma from reading the news or something polarizing came to you with a situation like that? What would that look like on a practical basis so we could see it in action?

Farid Sabet-Sharghi: In the middle of the elections, I saw a young lady who was having an escalation of her panic symptoms to the daily point. She couldn’t function anymore. She herself was a highly accomplished, intelligent therapist and professional. Again, I am doing an amalgamation of a few patients, so we are not giving anyone’s particular information.

The fear was that she was having panic attacks because she was going to get together for family gatherings with in-laws who had a very opposing view of hers. In fact, she considered that view out of this world and so toxic that she couldn’t tolerate it. By exploring that a little bit, and of course I reassured her that we are going to manage her symptoms, address her problems, address her concerns, make her functional, and be available, several things came up.

For example, she remembered the arguments, hostility, and harshness of her own childhood and how the parents’ arguments reminded her of all the stuff that goes on on TV and then in this family gathering that would go on. So we had to work with some of her psychological trauma regarding reducing her exposure to the corrosive effects of this reactivation of trauma. She was receiving appropriate pharmacological therapies. I gave her some sort of as-needed breakthrough management of her symptoms before she managed a family gathering.

Beyond that, we did some exploration as far as looking at these people. How would she approach, for example in our own practice, if she saw a delusional patient? Would she be mad at them because of some of their delusions? We really have some of our false beliefs, or what I think in an existential spiritual dimension could be called “vain imaginations” of people. By seeing people beyond those thoughts, realizing that people really are not coming up with their own thoughts, she was able to develop a higher sense of empathy. As you well know when you interview people, very few people have original thoughts. They are just parroting somebody else’s thoughts. She was able to develop a higher sense of empathy and begin to see that.

We stepped into it. I also treated exposure to any kind of conflict-based relationship like a medicine that should be dosed properly. So we timed her. Maybe after half an hour she would remove herself from the situation. Thank God it really went well for her. She was able to see their humanity. She was able to see that people have reached those areas because they were also in their own echo chamber. We explored some of her own catastrophizing mindsets that she was having.

Kevin Pho: What kind of advice do you have for people who just come across a political post (it could be just reading a newspaper or on their Facebook feed) and it makes them anxious? What kind of advice do you have in that situation?

Farid Sabet-Sharghi: I would say that there are things that we all should be anxious about. I always tell patients about a quote from Miles Davis, the jazz musician. He said: “If you’re not anxious, you’re not paying attention.” So I don’t want to come across as if I am not anxious about things happening in the world. Who isn’t? We want a unified world, but we are not there yet. We think that there are a lot of wonderful forces in the world that will bring that about. Many groups are working towards removing this.

First and foremost is: What is the content that they just saw? What if they are seeing children suffering somewhere? It is OK. It is a natural human response to feel those emotions. We shouldn’t be burying them. Then I would look into whether or not the source that they received that information from was valid, or was it just to sell them something and it just got their system up? I go over a little bit of the neurobiology of getting people excited about events.

Beyond that, if they can shine some sort of a perspective and also balance their news of that information with other wonderful activities that go on in their communities, that helps. In every community in the world, there is something good going on. People are working on the education of children or on helping each other in times of need. We can see that and focus on that part of the news too. In a very non-judgmental, explorative way, giving time and not immediately jumping into giving quick advice to people, I think that is also important to validate their concerns.

Kevin Pho: In fact, in your article it said that unity is a psychological necessity. Sometimes it is very challenging to foster unity in the own lives of patients when everything outside or the outside world is so divided. Right?

Farid Sabet-Sharghi: Yes, that’s correct. Part of it is that we talk about being in the present and being aware of the power of our current moment. I know it has become very much invoked. But I also see and try to convey, in a way that is universally accepted and not with one form of language or the other, that the evolution of humanity collectively is moving in the right directions even though sometimes the immediate future appears dark.

Yes, we can’t deny the fact that there are a lot of horrible atrocities, verbally and physically, and wars going on. But collectively, there are things that are happening in the human world. That unity that I first mentioned is on its way in our future. Of course, our personal experiences and childhood experiences differ and vary. I think there are always going to be some problem areas that we deal with. But the thing is that we acknowledge that we are not alone and we are not judged.

That whole sense of shame (I know a lot of people emphasize it, but I think that is a very important concept) that makes us feel like we are inherently bad as opposed to “something happened to me and that is my experience.” Many immigrants I see in my practice have that sense of “Am I inherently bad that there are just certain things that have happened to me that other people won’t be able to understand?” I can’t even explain it. Just exploring that and opening that up itself is very healing.

Kevin Pho: We are talking to Farid Sabet-Sharghi. He is a psychiatrist. Today’s KevinMD article is “The psychological trauma of polarization.” Farid, let’s end with some take-home messages that you want to leave with the KevinMD audience.

Farid Sabet-Sharghi: I just think that for all the physician and health practitioner audience, your role is a lot more important than you think in bringing about positive change, not only in individual lives but also in your families and society. Always be aware of your own self-care because there is a big price that we pay as physicians in this field because we are privileged to have the front-row seat into human struggle.

Kevin Pho: Thank you so much for sharing your perspective and insight. Thanks again for coming on the show.

Farid Sabet-Sharghi: Thank you kindly.