How Structural Violence Leads to Life or Death

Structural Violence is Not Only the Most Potent Cause of Behavioral Violence, It is the Cause of Ultimate Violence

Someone forwarded me a video of Columbia University economist Jeffrey Sachs describing Donald Trump’s war against Iran as, “vicious,… psychopathic, and delusional,” saying:

[People like Sachs] are now using language to describe Trump that was considered extreme not that long ago.... Sachs brilliantly describes the psychopathy of Trump and what it portends. [It is indeed bitterly ironic] that political pundits can now freely describe the psychopathy of Trump with psychiatric terms without any opposition—but [you] who described and predicted the extremes of what has unfolded were lambasted for doing so.

Of course, in the case of Sachs, he has read my books and has consulted with me even recently. The question is why, when it comes to mental health, the media never consult actual experts, even after it has now become undeniable that the president is non compos mentis. For example, his recent incoherent speech made dangerous threats against Iran: “We’re going to bring them back to the stone ages where they belong.”

Others have left messages:

I am trying to reach Dr. Bandy Lee. Our country is in trouble. We need her help…. Our country is dying, and she knows.

Many members of the public know that, for nine years in a row, our warnings have been not only correct but uncannily precise, in terms of both severity and schedule. Our sidelining is not because of stigma, but we were artificially silenced in order to generate stigma. This aligns with research: the most common cause of stigma surrounding medical matters is a lack of discussion. Before we were abruptly blacklisted, we were invited onto all major news programs, and every broadcast, appearance, or article was so popular, we became the number one topic of national conversation—just as our book was an unprecedented, instant New York Times bestseller.

Why was it so necessary for the establishment to push out the voice of the most relevant experts, in perhaps the most consequential situation we face in history? I mentioned before that our era marks the first to use mental pathology as a political strategy. Exposure to interventionists, healers, and problem solvers—as are mental health experts—would have neutralized that effect.

I have also stated elsewhere how structural violence gives rise to unfit leaders, who in turn further entrench structural violence. Structural violence is what Norwegian sociologist Johan Galtung defined as the “avoidable impairment of fundamental human needs” through unjust social structures. In this context, educating the populace about the root source of unfit leadership breaks the reinforcing cycle between inequality and relative deprivation on the one hand, and the mentally-unfit leaders who exploit and exacerbate those conditions on the other.

Here is how it works: severe structural violence disrupts and fragments societies, first by creating distinctions of “superior” and “inferior”. Then, this inequality increases the need to convince the majority to accept the unacceptable—that is, their own subordination—and our era has figured out how to do this not through force, but through advertising, propaganda, and media manipulation. Finally, when even this can no longer fully justify injustice, mentally-impaired “leaders” become compelling conduits of distraction, distortion, and ultimately detachment from our shared social reality.

Furthermore, social and political structures that maximize structural violence disproportionately attract psychologically-unfit leaders in this symbiotic relationship. Gradually, the quality of leadership deteriorates, not so much as the moral failure of isolated individuals but as a structural consequence. Positions of power are seen as a compensatory entitlement, for the purpose of fulfilling personal ambitions or assuaging feelings of powerlessness and inadequacy, rather than a duty. This excessively appeals to unfit leaders who are incompetent but ruthless, predatory, and hungry for power.

Unfit leaders by definition lack the qualities necessary for good governance—such as empathy, problem-solving abilities, or a genuine commitment to the public—but may excel at exploiting the existing power structures and defeating political opponents. The concentration of wealth and power, driven by insatiable entitlement and penchant for megalomania, turns power into a means for consolidating more power. Driven by emotional compulsion, the populist rhetoric of unfit leaders can be powerfully persuasive, despite having little to back up their claims or promises. In the absence of mechanisms for screening or accountability, their mental symptomatology provides them with an “unbeatable” edge.

Once in power, unfit heads of state typically undermine and erode the rule of law, creating environments where inefficiency, corruption, and abuse of power reign, portending societal dysfunction and decline. Economic mismanagement, violations of human rights, and social unrest contribute to vast suffering. Psychological consequences of these injuries include violence, cycles of abuse, intergenerational trauma, and the veneration of power as a means of self-protection. Taken together, these dynamics undermine the psychological, social, and institutional preconditions for democratic governance.

The deprivation of basic needs, such as education, health care, food, shelter, and security, generates disillusionment and discontent, which may erupt in interpersonal violence or collective insurgencies. The consequences of poor governance may not be limited to the local or national level. The same dynamics reinforce fears, divisions, and strife between countries, complicating efforts to foster the global cohesion necessary for countering some of the most urgent challenges of our time: nuclear dangers, climate devastation, and escalating structural violence.

Furthermore, in the context of U.S. hegemony, the failure of governance in one nation can have ripple effects throughout the globe. Rising tensions among nations have taken on a belligerent rather than cooperative tone. Conflict-ridden, incompetent governance creates weak states, in which more unfit leaders are likely to rise to power. As grievance grows, individuals become increasingly vulnerable to authoritarian promises of stability, only to lead to further coercion and control. This cycle of poor governance, unfit leadership, and fragmentation of the global community has led to our current “Death Spiral,” in which our collective survival is imperiled.

The only recourse to this spiraling structural violence lies in better understanding and addressing the psychological consequences of structural violence: what they are, how they manifest, and how they give rise to unfit leaders. Dysfunctional leadership does not arise by accident; it emerges within structures that concentrate extraordinary power—including the power to destroy all human life on earth—while eliminating accountability. When authority is sustained less through trust, collaboration, and actual improvement of conditions, and more through threats, deception, and traumatic bonding, our trajectory will continue to grow ever more destructive. I have stated before that humanity’s next evolutionary task of survival rests in our ability to master our own minds. Until then, structural violence will continue to produce, reward, and protect leadership pathology—even as we risk species extinction.

Announcement:

Dr. Bandy X. Lee is in the process of establishing SURVIVAL UNIVERSITY. Please use the contact form to join and to help make this unprecedented effort successful. She is also leading a public course series with Preventing Violence Now, about which you can find out more and register here. Our next course begins on Saturday, April 4, 2026 at 1:00 p.m.

Dr. Lee is a forensic and social psychiatrist, president of the World Mental Health Coalition, cofounder of Preventing Violence Now, and a long-term consultant to the World Health Organization and other United Nations bodies on scientific approaches to violence prevention. She became known to the public through her 2017 Yale conference and book that alerted against dangerous leadership. In 2019, she organized a major National Press Club Conference on the theme of, “The Dangerous State of the World and the Need for Fit Leadership.” In 2024, she followed up with another major Conference, “The More Dangerous State of the World and the Need for Fit Leadership.” She published another book on dangerous leadership that has recently been expanded, in addition to a volume on how dangerous signs in a leader spreads and two critical statements on dangerous leadership. As many of the dangers she warned against unfolded—including millions of unnecessary pandemic deaths, the propagation of political violence, the exacerbation of economic inequality, the destruction of democracy, the devastation of the climate, the replacement of international collaboration with hostile confrontation, a renewed and accelerated nuclear arms race, a global emboldening of dictators leading to brutal warfare and genocide, and growing state-sanctioned cruelty and human rights violations—she has advocated for another way. Now, the author of the internationally-acclaimed textbook, Violence; over 100 peer-reviewed articles and chapters; 17 scholarly books and journal special issues; and over 300 opinion editorials, introduces her curriculum on rising above the current destructive course to embrace an awareness of, “One World or None.”