‘Civil War’ in America?

Who is Instigating a Climate of Chaos and Fear?

“What the heck?  Do you want us to be in civil war?  Because that’s what’s going to happen….  We’re not going to keep putting up with this.  We need to get angry.  We do need to rise up and take our country back.” - Sarah Palin

“The next stage is violence….  Are you worried they’re going to try to kill you?  Why wouldn’t they try to kill you?...  Do you think we’re moving toward civil war?  Do you think it’s possible that there’s open conflict?” - Tucker Carlson, questioning Donald Trump

“I can say this: there’s a level of passion that I’ve never seen.  There’s a level of hatred that I’ve never seen.  And that’s probably a bad combination.” - Trump, responding to Carlson

Many have asked me what is going on with all this talk about “civil war”?  First, it is very dangerous.  Sticks and stones may break your bones, but words can kill—and coming from powerful political figures, they can even cause massacres, as we have seen through history, and briefly tasted on January 6, 2021.

Millions have heard, repeated, and amplified the above recent statements in many forums.  So, indeed, something is going on with all this “civil war” talk, as it shapes and directs the mood of the country.

Why is this ominous phrase being thrown about at all?  Who are they setting the stage for?  Dangerous individuals with nefarious intent intuitively understand crowd psychology and the influence that their words will have.  Are they trying to warn the public or influence opinion for political purposes?  Or are they purposely trying to circumvent rational responses by instigating a climate of chaos and fear?  Are they trying to undermine the criminal prosecutions now under way of their cherished leader, Donald Trump?

And what about Trump himself?  Is he himself engaged in an all-encompassing replay of when, during a debate leading up to the 2020 election, he told the Proud Boys to “stand by,” which they understood to mean “prepare”, which is exactly what they did, leading to the January 6, 2021, assault on the U.S. Capitol, marching in military dress and formation with helmets and make-shift weapons?  

Many commentators and analysts are filling the news pages and television screens with repetitions and alarm at this “civil war” talk.  From my perspective, I am trying to understand what is going on not in rhetorical or political terms but in psychological terms, and the mere repetition without detailed understanding feels as worrisome as the mere airing of Donald Trump in the early days, without fully appreciating the implications—that symptoms spread far more quickly than rational persuasion, for example.

What is taking place, at least in large part, is related to what I have been for some time calling, “Trump Contagion.”  We know from individuals who succumb to psychopathology that, as time passes, they stop making healthy and life-affirming choices but are fervently attracted to the very things that harm or might even destroy them.  This tendency has manifested collectively to contribute to what I have called a “Death Spiral.”

“Trump Contagion” continues unabated, augmenting itself as it propagates fear and endangerment throughout society.  Those engaged in the spread of this psychological pandemic, with Donald Trump clearly at the center, are aware of what is happening.  This was already apparent when Trump marveled at his own following and said: “I could stand in the middle of Fifth Avenue and shoot somebody, and I wouldn't lose any voters….  It’s, like, incredible!”

Now, they see that this was an understatement: he could kill more than a million Americans through Covid mismanagement and still not lose his loyal followers—indeed, the more he kills, the more fervently they cling.  Is it any wonder, then, that others, with their obsequious “follower psychology,” are on board with the spreading as well?  Tucker Carlson, purposely broadcasting the above interview at the same time as the first Republican Debate was on Fox News, spewed forth this statement:

”If you begin with criticism, then you go to protest.  Then you go to impeachment.  Now you go to indictment, and none of them work.  What’s next?...  We’re speeding toward assassination, obviously, and no one will say that!” 

American society is now like a metaphorical dry forest awaiting a spark.

However, this “Trump Contagion” of which I speak is actually a more nuanced and complicated subject that pushes the boundaries of the psychological disciplines.  There are many psychiatrists who themselves spend their time further restricting their field to the individual, then the brain, and then chemicals in the brain.  They have even been attracted to the idea of eliminating personality disorders from their diagnostic repertoire, let alone admit that there is a psychosocial phenomenon of spread that psychiatrists have observed and documented since the nineteenth century.  Look at how much the Trump administration rewarded the American Psychiatric Association for making dangerous public figures an area of absolute non-involvement, not just for its members but for the entire mental health profession.

If anything, our current predicament—which I would say is metaphorically and literally existential—reveals that, when a situation reaches a point where basic social cohesion is threatened, where systematic violence and death may result, when the collective public health is seriously endangered, then we have an obligation to add our expertise.

There is indeed a complicated connection between what is happening in America today at the political and societal level and the magnitude of social dysfunction, the epidemic of mental health disorders, and the growing threats and incidents of violence.  As doctors of psychiatry, we should contribute what we can both to an understanding of what is happening and to suggestions on how to ameliorate the situation to minimize the dangers and to protect societal well-being.  Our Hippocratic Oath and the Declaration of Geneva require of us nothing less.