My Speech at Sigmund Freud University

I was Invited to Give a Keynote Speech at the ‘Truth and Lies in Politics’ Conference

A few weeks ago on March 30, 2023, I was invited to give a keynote address at Sigmund Freud University in Vienna. The three-day conference was on the theme of “Truth and Lies in Politics.”

In 2021, the late Dr. Hans Werbik, professor at Universität Erlangen-Nürnberg, made it his dying wish and political will that I give a speech addressing the dangers of Donald Trump. He, like many honest mental health experts, presciently predicted that Trump’s candidacy and repeat U.S. presidency would become too possible a reality in 2024.

Below is my full speech:

I am extremely honored to be here.  I am also very honored to have been invited by Dr. Hans Werbik himself, in his last days, to be included in his last political will.  I had told Dr. Allolio-Näcke how much I admired him and felt for him, given that these perilous times weigh especially terribly on the kindest people.  Unfortunately, he departed before he could hear these words, and so I am repeating them here, in appreciation for his organizing this conference and joining together like minds.

Six years ago, as soon as Donald Trump took the U.S. presidency, I urgently organized a conference at Yale School of Medicine that brought together a distinguished group of psychiatrists to discuss the unprecedented dangers of a man with a dangerous psychology assuming the authority and influence of the highest office in the land.  We determined that we as psychological doctors had both a professional and a civic responsibility to share our special knowledge as a service to society.

This led to our public-service book, The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President, later that year, in 2017.  It became an unprecedented New York Times bestseller of its kind, and we donated all revenues to remove any conflict of interest.

Then, in 2019, in the main ballroom at the National Press Club of Washington, DC, I and thousands of mental health professionals who had joined me held our most significant public event, “The Dangerous State of the World and the Need for Fit Leadership.”

We had gathered together as never before the country’s leading scholars from history and political science to climate science and nuclear science, as well as the former chief White House ethics lawyer of the Bush/Cheney Administration, Mr. Richard Painter; the psychiatrist who established the department of psychological profiling for the U.S. Central Intelligence Agency, Dr. Jerrold Post; and representative from the U.S. Congress, the Honorable Jamie Raskin.  The main Public Affairs Network television deemed it important enough to broadcast it for the full three hours.  We collectively warned that uncontained psychological dangers in the presidency would have the effect of “contagion”, spreading to social, cultural, geopolitical, and civic dangers.

At the onset of the Covid pandemic, we, having formed the World Mental Health Coalition, started calling this psychic contagion a “mental health pandemic” and issued our first “Prescription for Survival,” immediately following the announcement of the pandemic in the United States in March 2020.  Had our “Prescription” been followed, we may have saved more than a million lives in the U.S. alone.

That summer, I wrote Profile of a Nation: Trump’s Mind, America’s Soul, and in it I stated that Donald Trump “will likely refuse to concede the results, call the election a fraud, and refuse to leave office.”  Indeed, five months later, that is what happened.  In the book I warned that, as a result, the Trump presidency would not end with an election and had the danger to continue to menace the world until there was commensurate intervention for the real problems, which were his psychopathology and his criminality.  I made this assertion because of the psychic contagion Donald Trump had spread—conditioning the minds of his followers not to accept anything other than his “reality”—which I came to describe in 2021, after the January 6 attack of the U.S. Capitol, as “shared psychosis.”

“Shared psychosis”—unlike “shared psychotic disorder”—is not a diagnosis but a psychosocial phenomenon that has been researched since the mid-nineteenth century, then called “folie communiqué,” or “contagious madness.”  And of course, Goustave Le Bon took it further in his The Crowd, Carl Jung in his The Symbolic Life, and some of Sigmund Freud in Civilization and Its Discontents, before Erich Fromm coined the phrase, “folie à million.”

My talk will revolve mostly around this topic of psychic contagion and “shared psychosis.”

The phenomenon of contagion is what mental health experts have warned against since our monograph, The Dangerous Case of Donald Trump.  As we saw the Trump presidency as a public health and a societal problem from the start, we stated that, if his presidency were not intervened with swiftly and properly, his symptoms—his paranoia, his delusions, and his violence-proneness— would spread from his influential office and become uncontainable.  We noted with the onset of the Covid pandemic that the more important, underlying pandemic in need of control was what we called “the mental health pandemic,” or his compromise of the nation’s collective mental health.  The latter was the more infectious, since it did not require physical exposure but only emotional bonds, to take hold and was responsible for vastly exacerbating the former.

Poor mental health also contributes to denial, and therefore those who are the most affected are the least likely to admit that anything is wrong.  Psychological violence at large scale—and I would call lying, disinformation, and mental manipulation psychological violence—is more dangerous than physical violence, for it hijacks the very mind that is capable of protecting oneself.  After almost 7 million deaths around the world, we have failed to hold the primary culprit for these deaths accountable, or even to speak about it: Donald Trump was the source of almost half the world's disinformation on Covid-19, as well as the one responsible for gutting the U.S. Centers for Disease Control and Prevention, which the World Health Organization historically relies on the most to contain global epidemics.

As a social psychiatrist, I have worked largely in public hospital and prison settings, where there are high concentrations of severe mental disturbances that go untreated, and therefore psychic contagion.  Severe symptoms can spread among family members, criminal co-conspirators, gangs, and other tight-knit groups, but under the right conditions, throughout a nation.  A colleague and collaborator at the World Health Organization, Dr. Gary Slutkin, knows that violence is better described as an infectious disease whose spread we can interrupt.  Understanding this could perhaps help us to apply the same principles to the spread of mental symptoms.  We know that international terrorism and suicides are contagious.  Effective prevention, therefore, requires population-level interventions and the application of psychological principles to systems, institutions, cultures, and perhaps even politics.  The course I last designed for the students of Yale Law School was of translating law into social policies that further societal health.

Now, three conditions are necessary for the spread of mental symptoms:

The first condition for spread is severe pathology in an influential figure

The transmission of mental symptoms has been alternatively called, induced delusions; shared psychosis; folie à deux, trois, quatre,…, or millions—depending on the number affected—or mass hysteria when affecting a whole population.  All describe the same phenomenon, with slightly different angles.  The latest, induced delusional disorder in ICD-11 and DSM -5, focuses on the most commonly transmitted symptom, delusions, but does not cover other possible symptoms, such as mood.  Shared psychosis captures the syndrome-like severity, but is confusing, since it does not always require psychosis.  Folie à millions, or “madness by the millions,” is perhaps the most preferred.  Finally, “mass hysteria” describes well the frenzied irrationality that captures crowds, but often does not actually involve symptoms of “hysteria”, or the contemporary term, “histrionics”.

The important feature is that mental symptoms are not confined to the person but are psychosocial.  They take hold and spread across interpersonal connections, just as they initially take over one portion, and then eventually the whole mind of an individual; this is how inner, and then outer, conflicts arise.

Severe psychopathology in an influential figure, therefore, transmits to others or a group, until the exposed persons or groups come to feel, think, and behave as if they had the same disorder as the primary person.  Unlike normal social dynamics, where enthusiasm, common purpose, or even outrage can be “infectious” but individuals retain their uniqueness, the spread of pathology is especially efficient and deleterious, taking over the very personalities of those involved.

Transmission happens more readily in vulnerable persons, but those who succumb are not necessarily of unsound mind from the start.  Even bizarre beliefs, such as the primary person being God-ordained, can take hold in ordinarily rational persons under the right conditions.  Delusions are more infectious than conscious lies or simple misinformation, because the primary person truly believes in them and is driven to affirm them through propagating their false beliefs.  For example, when an influential figure must hold the belief that a serious viral pandemic is a “hoax”, orchestrated by enemies to bring down one’s presidency, or that a reelection that one has lost is in fact “stolen”, the underlying emotional process is difficult to correct with “mere” evidence or presentation of facts.

The second condition for the spread of symptoms is having group members with high emotional investment

Another condition for the spread of mental disease is emotional investment.  Folie à deux describes shared madness within a pair, but here the focus is on folie à groupe, or the spread of mental symptoms in a group.  The group can be a household (folie à famille), a prison dormitory or cell-block, a religious or other highly emotionally-bonded group, a community, or a nation.  Members may have high emotional investment in the primary person because of family relations, gang affiliation, cultic programming, or societal identity.  Pathology in the primary individual can create the ideal conditions for transmission: a compulsion to “tweet”, a desire to deny reality and to denigrate the press, intolerance of uncertainty, pressures of conformity, and an insatiable need for adulation finding a “forum” in addiction-inducing, hypnotic rallies.

Induced delusions are like primary delusions, wherein resistance is too great for evidence or truth to gain traction. Those who try to maintain their grounding in reality experience stress, anxiety, ostracism, and exhaustion and may eventually submit.  When it originates in disease, it is no longer a simple culture but a “cultural disorder.”

The third condition for spread of symptoms is an environment that fosters contagion

Conditions of isolation with the primary individual, either physically or through filtered information, especially when they “immunize” against alternative viewpoints through phrases such as “fake news,” combined with constant, high levels of exposure to the compulsions of the primary individual, form the ideal environment for shared delusions.

The cult-like quality of the leader-follower arrangement between Donald Trump and his supporters. alarmed my colleagues in the mental health profession enough to write entire volumes of their own.  Existing arrangements of “viral” social media, profit-driven news programs that rely on ratings, and rallies that reinforce herd mentality and conformity, all contribute to the spread of symptoms.

In summary, the three conditions, (a) a primary symptomatic "leader"; (b) emotionally-invested followers, and (c) an environment that filters information, together allow for the spread of mental symptoms.  As a result, we have a public health crisis arising from the unmitigated psychic contagion that is the product of allowing a mentally-impaired individual not only to spend four years in an influential office but also to continue to use that influence to try to regain his bully pulpit—mainly through lies.  Because psychic contagion does not spread by microbes but by psychic drives, via the vector of emotional bonds in an age of “viral” social media, it is far more contagious than what we ordinarily think of as infectious disease.

The actual observed effects are staggering.  For example, before Donald Trump, could we have imagined a mediascape of the level of lying that we see today?  Could we have conceived of a U.S. Congress being taken over by those who planned and participated in the January 6 attempted coup d'état?  Could we have fathomed a health crisis so mismanaged, as to incur over 1.1 million American deaths, not to mention multifold that number worldwide?  Could we have foreseen the current collapse of industries and institutions, as well as democracy itself?  

Viewing the lack of accountability as success, furthermore, has spread the “contagion” not just in the United States but abroad: countries in Asia, the Middle East, South America, and even Canada and Europe have seen not only imitative mass shootings in the name of racism or sexism, but Fox News-like propaganda so-called “news” programs and the election of Trump-like personalities in multiple countries.  Having spread beyond politics to include most visibly cable “Talk TV” and social media, the very nature of public discourse has changed.  Having dangerous and troubled personalities in national and international leadership positions has the effect of proliferating themselves: through imitators, surrogates, protégés, and novel institutional and media creations such as Newsmax and One America Network in the United States.  The recent, so-called Conservative Political Action Committee meeting was international: Jair Bolsonaro, who orchestrated an exact replica of the January 6 attempted coup in Brazil, spoke right before Trump, which is illustrative of the cross-fertilization that occurs, as once did among Stalin, Hitler, and Mussolini.  Donald Trump’s Political Action Committee now has affiliates in Mexico, Brazil, Hungary, Australia, and Japan.

Certainly, Trump is not the only cause, but we can be certain that many global crises—including the climate crisis and renewed nuclear arms race—would not be nearly as bad without the cultural shift he enabled.

Solutions

What do we do with a psychic contagion that has turned into a psychic pandemic?  We know from the scientific literature that, when contact with the inducing individual is removed, the shared symptoms usually subside just as dramatically as they have appeared.  We can prevent epidemics from occurring in the first place by screening candidates for mental impairment before they take influential positions.  Once they are in power, there must be an effective means of removing them if they are found to be unfit.  Further, we can armor ourselves by promoting public mental health and education about mental disease.  Additionally, we must remove environmental “toxins” that include propaganda, brainwashing, and the social engineering that social media generate.

In terms of removing the primary offending agent, it was only a few months ago that we learned that White House Chief of Staff John Kelly had secretly purchased and consulted our book, The Dangerous Case of Donald Trump, when it was first published.  He used it as a guide and what he called an “owner’s manual” for how to control and contain a man he, too, realized was far more dangerous than he initially assumed.  He even used some of the key concepts in our book possibly when he intervened to stop from ordering the use of nuclear weapons against North Korea.  Around the same time as this news, the Magazine Mother Jones stated about my warnings: “The psychiatrist who warned us that Donald Trump would unleash violence was absolutely right.”

But we cannot wait.  Donald Trump underestimated when he said he could “shoot someone on Fifth Avenue” and not face any consequences.  He may have even said he could “kill a million people” and still not face consequences.

In the current situation in the United States, for the current mental health pandemic we face, there is one thing to do: to indict Donald Trump.  To take him into custody, to remove him from exposure to the public, and to indict his co-conspirators, too.

Doing so carries dangers—indeed, grave dangers—but only by the measure that we have waited to intervene.  Psychic epidemics, like viral epidemics, are exponential in growth, and by not intervening, we have allowed an entire culture to become engulfed in criminality and pathology.  While difficult, we must stem the Trump epidemic before it grows even worse, and we must act now.

And this is only the beginning.  The U.S., unfortunately, has great influence around the world, and the fascist tendencies—which are in truth signs of mental pathology in politics—have also replicated and spread globally.

Given the growing dangers, Dr. Werbik was absolutely right about the need to congregate among ourselves ahead of next year's election cycle, for America’s election is the world’s election in a globalized world.

We need a reset that includes psychological discourse and education about what is happening in larger society.  I had no experience participating in politics when I began, but I recognized that my quarter-century clinical experience of treating violent offenders in jails and prisons, as well as my public-health work in preventing violence, gave me insights that I needed to share.

We each have our gifts and resources that, as members of society, we need to contribute to the betterment of society.  Psychological and psychoanalytic knowledge is especially valuable at this time, and we would do well to bring our voices to the public forum because, as far as I am concerned, what our present, most pressing world emergency is a collective mental health crisis.