I want to start with Trump’s lies. It’s now a commonplace that Trump and his underlings tell whoppers. Fact-checkers have never had it so good. But all politicians lie. Bill Clinton could barely go a day without some shading or parsing of the truth. Richard Nixon was famously tricky. But all the traditional political fibbers nonetheless paid some deference to the truth — even as they were dodging it. They acknowledged a shared reality and bowed to it. They acknowledged the need for a common set of facts in order for a liberal democracy to function at all. Trump’s lies are different. They are direct refutations of reality — and their propagation and repetition is about enforcing his power rather than wriggling out of a political conundrum. They are attacks on the very possibility of a reasoned discourse, the kind of bald-faced lies that authoritarians issue as a way to test loyalty and force their subjects into submission. That first press conference when Sean Spicer was sent out to lie and fulminate to the press about the inauguration crowd reminded me of some Soviet apparatchik having his loyalty tested to see if he could repeat in public what he knew to be false. It was comical, but also faintly chilling.

What do I mean by denial of empirical reality? Take one of the most recent. On Wednesday, Senator Richard Blumenthal related the news that Judge Neil Gorsuch, Trump’s nominee for the long-vacant Supreme Court seat, had told him that the president’s unprecedented, personal attacks on federal judges were “disheartening” and “demoralizing.” Within half an hour, this was confirmed by Gorsuch’s White House–appointed spokesman, who was present for the conversation. CNN also reported that Senator Ben Sasse had heard Gorsuch say exactly the same thing, with feeling, as did former senator Kelly Ayotte.

The president nonetheless insisted twice yesterday that Blumenthal had misrepresented his conversation with Gorsuch — first in an early morning tweet and then, once again, yesterday afternoon, in front of the television cameras. To add to the insanity, he also tweeted that in a morning interview, Chris Cuomo had never challenged Blumenthal on his lies about his service in Vietnam — when the tape clearly shows it was the first thing Cuomo brought up.

What are we supposed to do with this? How are we to respond to a president who in the same week declared that the “murder rate in our country is the highest it’s been in 45 to 47 years,” when, of course, despite some recent, troubling spikes in cities, it’s nationally near a low not seen since the late 1960s, and half what it was in 1980. What are we supposed to do when a president says that two people were shot dead in Chicago during President Obama’s farewell address — when this is directly contradicted by the Chicago police? None of this, moreover, is ever corrected. No error is ever admitted. Any lie is usually doubled down by another lie — along with an ad hominem attack.

Here is what we are supposed to do: rebut every single lie. Insist moreover that each lie is retracted — and journalists in press conferences should back up their colleagues with repeated follow-ups if Spicer tries to duck the plain truth. Do not allow them to move on to another question. Interviews with the president himself should not leave a lie alone; the interviewer should press and press and press until the lie is conceded. The press must not be afraid of even calling the president a liar to his face if he persists. This requires no particular courage. I think, in contrast, of those dissidents whose critical insistence on simple truth in plain language kept reality alive in the Kafkaesque world of totalitarianism. As the Polish dissident Adam Michnik once said: “In the life of every honorable man comes a difficult moment … when the simple statement that this is black and that is white requires paying a high price.” The price Michnik paid was years in prison. American journalists cannot risk a little access or a nasty tweet for the same essential civic duty?

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Then there is the obvious question of the president’s mental and psychological health. I know we’re not supposed to bring this up — but it is staring us brutally in the face. I keep asking myself this simple question: If you came across someone in your everyday life who repeatedly said fantastically and demonstrably untrue things, what would you think of him? If you showed up at a neighbor’s, say, and your host showed you his newly painted living room, which was a deep blue, and then insisted repeatedly — manically — that it was a lovely shade of scarlet, what would your reaction be? If he then dragged out a member of his family and insisted she repeat this obvious untruth in front of you, how would you respond? If the next time you dropped by, he was still raving about his gorgeous new red walls, what would you think? Here’s what I’d think: This man is off his rocker. He’s deranged; he’s bizarrely living in an alternative universe; he’s delusional. If he kept this up, at some point you’d excuse yourself and edge slowly out of the room and the house and never return. You’d warn your other neighbors. You’d keep your distance. If you saw him, you’d be polite but keep your distance.

I think this is a fundamental reason why so many of us have been so unsettled, anxious, and near panic these past few months. It is not so much this president’s agenda. That always changes from administration to administration. It is that when the linchpin of an entire country is literally delusional, clinically deceptive, and responds to any attempt to correct the record with rage and vengeance, everyone is always on edge.

There is no anchor any more. At the core of the administration of the most powerful country on earth, there is, instead, madness.

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With someone like this barging into your consciousness every hour of every day, you begin to get a glimpse of what it must be like to live in an autocracy of some kind. Every day in countries unfortunate enough to be ruled by a lone dictator, people are constantly subjected to the Supreme Leader’s presence, in their homes, in their workplaces, as they walk down the street. Big Brother never leaves you alone. His face bears down on you on every flickering screen. He begins to permeate your psyche and soul; he dominates every news cycle and issues pronouncements — each one shocking and destabilizing — round the clock. He delights in constantly provoking and surprising you, so that his monstrous ego can be perennially fed. And because he is also mentally unstable, forever lashing out in manic spasms of pain and anger, you live each day with some measure of trepidation. What will he come out with next? Somehow, he is never in control of himself and yet he is always in control of you.