8 Psychiatric Perspectives on Political Participation

AucArtStudio/AdobeStock

PSYCHIATRIC VIEWS ON THE DAILY NEWS

Remember that popular song from the 1970s by the jazz poet Gil Scott Heron, “The Revolution Will Not Be Televised”? Well, it just was. On Tuesday night, President Trump’s Address to Congress was a made for TV program summarizing the current revolution in the Republican Party and its avalanche of executive orders and policy changes from the new administration.

These admittedly “swift and unrelenting” changes have caught many by surprise with their onslaught. That has led to uncertainly and disagreements about how to respond, including within psychiatry. Right now, I am left with some tentative and possibly confusing aphorisms to share, aphorisms that might also fit our clinical care.

1. Do Not Settle for Just Doing Something

Doing something, anything, will usually make one feel better in a worrisome and uncertain situation. Often, that means repeating whatever was done in some previous crises. However, this current political situation seems unique and fast-moving, likely requiring some innovative responses.

I suppose that sometimes this takes place in our clinical work, too, that we feel pressed to do something when it is not quite clear what is best to do.

2. Understand Your Enemy

This admonition obviously applies to both political sides, but may be currently more important for those with less power—that is, the Democrats. That is why I was impressed with what I have heard about Gavin Newsom, the Governor of California, in the article by Allysia Finley on March 2, 2025 titled: “Gavin Newsom Tips His Hat to the ‘MAGA Movement.’”¹ Apparently, he is planning a podcast to interview the opposition leaders to “understand what the motivations are, the legitimacy of those motivations, and just really where people are coming from.”

Doesn’t sound too different from a psychiatric interview, does it?

3. Use a Carrot as Well as a Stick

A carrot is some kind of positive reinforcement, and intermittent positive reinforcement usually changes the behavior of the other more than the negative reinforcement of a stick that punishes in some way. This approach is relevant both for allies and the opposition.

In clinical care, such behavioral intervention is common in trying to shape adverse child behavior.

4. Humiliation Leads to Revenge

Public humiliation of the more sensitive and narcissistic usually backfires because it causes a psychological wound that elicits a desire for revenge sooner or later. A kind of humiliation likely took place during the televised conflict between Presidents Zelenskyy and Trump. Given that Trump has the power, someone in Zelenskyy’s position might do well by conveying an effusive public apology and gratitude, not just the regrets as he has done so far.

Although humiliation is unlikely in the private clinical interaction, it can occur as part of the expressed stigma toward the mentally ill that still exists with the public.

5. Scapegoat Yourself

It is all too easy to blame others after a loss. Perhaps that is what Democrats are doing now. Better to soul search first for one’s own contribution than be thrown out or leave a Congressional session early.

In clinical situations, scapegoating is probably most likely to emerge if there is unrecognized diversity, equity, and inclusion implicit bias in the clinician which distorts appreciation of the obstacles the patient faces in their everyday life.

6. Look Both With a Close-up Lens and Far-Away Lens

Close-up can refer to one’s own tribe as well as immediate needs. Far-away refers to the future and outcomes of endeavors. Both are important politically and, at best, connect with each other.

In some ways, these visions parallel how we work with patients, establishing a therapeutic alliance and addressing immediate needs, along with a view to the future.

7. The Tried and True Will Not Work Well Enough with the New and False

With the acceptance of alternative facts, cultish thinking, and lies in some political quarters, trying to correct each falsity seems practically impossible. We can start with the phrase “Americans” or “the American people” when it is used politically to suggest all Americans, when it is really only some Americans who believe such and such. Perhaps instead, it is values and perceptions that need the most discussion and processing to bridge differences. Surely, some of the live moving human stories told at the Congressional address, even if set up for PR effect, could have been cheered by all.

In trauma-informed care, the original facts of the trauma may be obscured, but the treatment can succeed anyways.

8. Causing Chaos to Produce Peace

As the new governmental orders and policies disrupt their targets, and the Department of Education is said to be targeted today, feelings of uncertainty and chaos emerge. The question is whether the chaos is intended to justify more order, which at its extreme is military law and order, or whether it is intended to enhance creativity.

In psychiatry, we are escalating our study of psychedelics, which seem to act by rearranging established pathways in the brain. The goal is finding the right disrupting procedure to produce healing trips and not “bad” trips.

Concluding Thoughts

There is probably little surprise that such aphorisms can apply both to politics and clinical psychiatry. After all, both have to do with relationships, and relationships are always subject to some confusion and conflict, but also to healing cooperation.

Dr Moffic is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry and is now in retirement and retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He presented the third Rabbi Jeffrey B. Stiffman lecture at Congregation Shaare Emeth in St. Louis on Sunday, May 19, 2024. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now The Eastern Religions, and Spirituality. He serves on the Editorial Board of Psychiatric Times.

Reference

1. Finley A. Gavin Newsom tips his hat to the ‘MAGA Movement’. Wall Street Journal. March 2, 2025. Accessed March 6, 2025. https://www.wsj.com/opinion/gavin-newsom-tips-his-hat-to-the-maga-movement-california-politics-80b89b41