Illness or Social Movement?
America First. Make America Great Again. How many times have you heard the first slogan, America First? Probably not very many. It was in common use during the two world wars among those promoting isolationism, nationalism, white supremacy, and opposition to U.S. involvement in the wars (Churchwell, 2018). The second has been turned into a profitable business: MAGA. These are not slogans hatched by Donald Trump or the Republican Party. And they are not issuing from the minds of madmen. Here are just a few of the possible errors we may make in using psychopathology to understand our current political crisis.
Error # 1: these were and are not men with mental illnesses, anymore than other white men in our society suffer with symptoms. The man you see above, Howard Phillips, served in the Reagan Administration, and promoted agendas and espoused views that most would consider odd, paranoid, and reprehensible, along with his associate Pat Buchanan, Reagan’s press secretary. And it’s almost certain these men would not be given psychiatric diagnoses.
We live in a diagnosis culture, a psychopathology culture, where many seek a diagnosis for something, in themselves or others, or turn to professionals for a diagnosis For many a label or diagnosis offers a sense of reassurance or relief: they’re not alone in the world; they belong to something larger than themselves (see the patient’slikemeproject). For some, diagnostic labels may become confused with the self; the self is reduced to the disease: I am my disease, I am the label. For many, a diagnostic label serves an altogether different purpose, especially when applied to others: it’s not me, it’s you. The latter offers a strong defense against anxiety. The former uses identity as a way of living and sometimes surviving.
In totalitarian states, diagnosis is used as a means of controlling, manipulating, or altogether eliminating opposition. In Mao’s China, if you were given a diagnosis of neurasthenia, you were considered weak and lacking strong commitment to the larger state project. However, we’ve seen similar use of diagnostic labels in the United States: see Jonathan Metzl’s book, 2010, Protest Psychosis: How Schizophrenia became a Black Disease. And much has been written about the use of diagnosis and psychiatry in the former Soviet Union and Nazi Germany. We must ask, always: what purposes do diagnostic labels serve and in whose interest are they used?
In 1964, the historian Richard Hofstadter wrote a very important and widely cited book, The Paranoid Style in American Politics. He uses diagnostic and clinical language to explain Barry Goldwater, a Republican Senator and candidate for President, and Joseph McCarthy, a Senator from Wisconsin. In his words,
ALTHOUGH American political life has rarely been touched by the most acute varieties of class conflict, it has served again and again as an arena for uncommonly angry minds. Today this fact is most evident on the extreme right wing, which has shown, particularly in the Goldwater movement. how much political leverage can he got out of the animosities and passions of a small minority. Behind such movements there is a style of mind, not always right-wing in its affiliations, that has a long and varied history. I call it the paranoid style simply because no other word adequately evokes the qualities of heated exaggeration, suspiciousness, and conspiratorial fantasy that I have in mind (1964: 3).
Over and over again we return to diagnostic language to understand our political moment. Justin Frank wrote Bush on the Couch. For Frank, George W. Bush suffered from megalomania, was incapable of true compassion, showed signs of sadism and untreated alcoholism; combined with irritability, judgmentalism, and a rigid, inflexible world view, Frank concluded he was unfit for office. Then there was Frank’s Obama on the Couch with his wild analyses of his character but no conclusion about his fitness for office.
Now in its second edition (2019), The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President-Updated and Expanded with New Essays, psychiatrists and social critics have turned to psychiatry to help us navigate these troubled times. And of course, they find in Donald Trump any number of possible diagnoses (e.g., dementia, cognitive impairment, delusional disorder, malignant narcissism); the latter the most likely among them. Any one among these categories may describe this man but this does not move us closer to understanding the social movement Donald Trump stepped into, a movement with deep roots in America First and racial politics. And Donald Trump’s mind, in our view, is in no way different from the minds of Barry Goldwater, Howard Phillips, or Pat Buchanan. And these men, like Donald Trump, no doubt suffered with many symptoms, including paranoia. And they may have suffered most from what Michael J. Thompson (2013) calls moral atrophy:
This constitutes an extreme case of alienation because of its ability to secure broader forms of compliance to institutional and social goals that are not in the interests of their participants. I see alienation as a pathology of moral cognition, a particular deformation of the capacities for moral judgment shaped by the kind of social relations that occur particularly within modern capitalist economic life; relations characterized by rationalized hierarchical social structures, routinized patterns of everyday life, and the need for secure forms of compliance to institutional authority. Alienation therefore means a weakened ability of the personality system’s capacity to judge, evaluate, and think through the world (2013: 302).
Error # 2: By focusing on the diagnostic categories we fail to understand the social movement dynamics enabling the emergence of certain kinds of political leadership (see Alan Brinkley’s 1994 essay on this topic). And while many leaders, good and bad, may be diagnosed with mental illnesses, even serious ones (and we should listen to our colleagues in psychiatry who’ve described their concerns about Donald Trump) we should not let this concern override the deeper logics of the social movements that produce some leaders and their styles; and others, like Trump, not produced by them (Trump continuously shifted his political alignments and views to suit his immediate objectives) but instrumentally used by them.
Error # 3: If you fail to address the social movement dynamics and focus instead on the psychology of leaders, you’ll never manage to find ways to intervene or strategically engage in counter-movements. In critical social science (social work foremost among them) we must, after we’ve identified the problem and established the cause of the problem, pass a negative judgement. Otherwise, we’ve no rationale for interventions to remove the offending causes (see our post on science,)
HOW TO GET INVOLVED?:
You’ll want to get familiar with the IREHR (The Institute for Research and Education on Human Rights). They do research and strategic organizing to counter racism, anti-Semitism, Islamophobia, nativism, homophobia, and other forms of bigotry. Read their reports, download their anti-biograty app, and DONATE money to support this very important organization. They need our help.
The Southern Poverty Law Center has produced a community organizing manual, Ten Ways to Fight Hate: A Community Response Guide
One important book to read: Blood and Politics, Lenoard Zeskind.
References
Brinkley, A. (1994). The problem of American conservatism. The American Historical Review, 99(2), 409-429.
Churchwell, S. (2018). Behold, America: The Entangled History of" America First" and" the American Dream". New York: Basic Books.
Frank, J. A. (2004). Bush on the Couch: Inside the Mind of the President. New York: Regan Books.
Hofstadter, R. (1964). The paranoid style in American politics. Vintage.
Kleinman, A., & Kleinman, J. (1994). How bodies remember: Social memory and bodily experience of criticism, resistance, and delegitimation following China's cultural revolution. New Literary History, 25(3), 707-723.
Lee, B. X. (2019). The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President-Updated and Expanded with New Essays. New York: Thomas Dunne Books.
Metzl, J. M. (2010). The protest psychosis: How schizophrenia became a black disease. Boston: Beacon Press.
Thompson, M. J. (2013). Alienation as atrophied moral cognition and its implications for political behavior. Journal for the Theory of Social Behaviour, 43(3), 301-321.