To the catalogue of anxieties her patients explore during therapy - marriage, children, and careers - psychologist Alison Howard is now listening to a new source of stress: the political rise of Donald Trump.
In recent days, at least two patients have invoked the Republican front-runner, including one who talked at length about being disturbed that Trump can be so divisive and popular at the same time, said Howard, who practices in the District.
What had happened to Trump during his childhood, the patient wanted to know, to make him such a "bad person?"
"He has stirred people up," Howard said. "We've been told our whole lives not to say bad things about people, to not be bullies, to not ostracize people based on their skin color. We have these social mores and he breaks all of them and he's successful. And people are wondering how he gets away with it."
Hand-wringing over Trump's rapid climb, once confined to Washington's political establishment, is now palpable among everyday Americans who are growing ever more anxious over the prospect of the billionaire reaching the White House.
With each new Trump victory in the GOP primaries, Democrats and Republicans alike are sharing their alarm with friends over dinner, with strangers over social media and, in some cases, with their therapists. A recent Washington Post/ABC News poll showed that 69 percent of Americans said the idea of "President Trump" made them anxious.
For some, Trump's diatribes against undocumented immigrants, Mexicans and Muslims evoke unpleasant flashbacks of dictators. For others, his raw-toned insults conjure memories of high school bullies.
Type "Trump" and phrases such as "scaring me" or "freaking me out" into Twitter's search engine, and a litany of tweets unfurl, including one posted two weeks ago by Emma Taylor as she lay in bed in Los Angeles: "I literally can't sleep because I just thought about how Trump may actually win the Presidency and now I'm having a panic attack."
"It's like a hurricane is coming at us, and I don't have any way of knowing which way to go or how to combat it," Taylor, 27, a Democrat, said in a phone interview. "He's extremely reactionary and that's what scares me the most. I feel totally powerless and it's horrible."
Democrats aren't alone in their Trump anxiety.
Whitney Royston, 30, a Republican who works as an event coordinator in Littleton, Colo., said the prospect of a Trump presidency scares her because "he's a side show. He doesn't have anything to say. All he does is tell other people to shut up. If he were to become president, I fear that our world would come tumbling down."
To divert herself, Royston said she fantasizes that "someone will pop out of left field" to become the Republican nominee.
"Divine intervention, a hail Mary," Royston said. She acknowledged that she's not overly optimistic, considering that she hoped for the same kind of miracle to stop Barack Obama in 2008.
Alarmed by another wave of news coverage about Trump's growing strength, Nancy Lauro, 52, a Brooklyn art teacher, sat at her computer last Saturday and searched Google for information about acquiring Italian citizenship. She also inquired about Ireland, where she has family roots.
"As phobias and fears ago," Lauro said later of her query, "this is not a pathological response to a normal situation, but a normal response to a pathological situation. Picking up one's life feels impossible, but I keep flashing on those people who fled Germany when the writing was on the wall and those who didn't. When do you take action to get out?"
Trump-inspired angst is apparently sufficient that on Super Tuesday, as he was piling up victories, Google recorded a 350 percent increase in users submitting the question, "How can I move to Canada?"
A radio disc jockey in Cape Breton, Nova Scotia, last month launched a website inviting Americans to relocate if Trump wins. Over several weeks, some 400,000 visitors have checked out Cape Breton's official web site - 100,000 more than all of last year.
"I call it the basket of golden eggs!" Mary Tulle, the head of Destination Cape Breton, said of Trump's effect, the delight in her voice betraying not an iota of anxiety. "Our doors are open to everybody!"
Amanda Long, an Arlington, Va., massage therapist, is not among those fantasizing about escape. But she has grown accustomed in recent weeks to clients laying down on her table and bellowing, "Can you believe this guy?"
Long allows her clients to vent for a few minutes before she tries to quiet them, if only so they can relax and she can attend to their aches.
"It stresses me out to listen to it," she said. "I can't give you a good massage if I'm grabbing your shoulders like Donald Trump's orange face."
If there is an unofficial capital of psychotherapy, it's New York's Upper West Side, where it's easier to find a therapist than a parking space.
Judith Schweiger Levy, a psychologist in the neighborhood, has noticed a recent uptick in Trump references among her patients, including a middle-aged businesswoman who blurted out this week that her sister is supporting the billionaire.
"She was so upset and worried that she could have a sister - someone so close to her - who would have zero problem with Trump," Levy said. "Another patient - also a woman - all she could talk about was Trump and how he's crazy and frightening."
Ruminating on Trump's effect, Levy said, "Part of the reason he makes people so anxious is that he has no anxiety himself. It's frightening. I'm starting to feel anxious just talking about him."
Another psychologist, Paul Saks, who practices in Greenwich Village, said Trump's recent refusal to immediately disavow David Duke, the Ku Klux Klan's former Grand Wizard, has riled one of his patients who is the grandson of Holocaust survivors.
"This is really resonating with him, and troubling him," Saks said. "Just that Trump has survived and that there's such a cataclysmic shift in the Republican Party - an institution that's part of our way of life even if you're not a Republican - is going to disturb a lot of people."
Mary Libbey, a psychologist on Central Park West, isn't hearing about Trump from her patients. But she finds herself expressing her own anxiety about him to friends and colleagues.
"It helps me to talk about it," she said. "I'm terrified that he could win. His impulsivity, his incomplete sentences, his strange, squinty eyes - to my mind, he's a loosely held together person."
The assassination of Abraham Lincoln. Pearl Harbor. The rise of Joe McCarthy in the 1950s. The Cuban Missile Crisis. The slaying of John Kennedy. Richard Nixon's resignation. The Sept. 11, 2001, terrorist attacks.
Americans are not unacquainted with anxious moments.
What makes Trump distinct now is that he's "a demagogue who has become a vessel for peoples' anxiety and anger," said Michael Kazin, a Georgetown University history professor. But Kazin likes to remind anxious friends that Trump's slice of the Republican pie is 35 to 40 percent, and Republicans in general account for perhaps a third of the population.
"Half of his own party is against him," Kazin said. "And even if he is elected, he's not a hardened right-wing ideologue. Above all, he's a great entertainer. He's a con man who cons himself."
In 1964, Republican Sen. Barry Goldwater's presidential campaign inspired anxiety among voters who feared that he would start a nuclear war. But President Lyndon Johnson crushed Goldwater in a landslide.
Dan Seely, 86, who lives in New Hampshire, was a Republican in those days. He voted for Johnson because he feared Goldwater.
Seely, now a Democrat, is more afraid of Trump because he believes the billionaire has captivated the public in a way that Goldwater never did. "I see his signs on their front lawns," he said. "It makes me wonder who these people are that they think he can be a suitable leader of the free world."
Ken Goldstein, a Los Angeles-based author and businessman who is a Democrat, recalled meeting with a business associate recently and feeling astounded when the man said he thought Trump would "be great for America."
"You just realize you have nothing more to say to that person," he said.
Goldstein finds small comfort imagining Trump's defeat, if only because his followers "are still there."
"Who are these people?" he asked. "Are they at the grocery store, are they sitting next to me at Dodger Stadium? That makes me nervous."