The Reflective Eclectic
Will Your Therapist Even Notice If You Drink the Kool Aid?
Mental Health’s blindness to mass delusions
Recently, a group of Trump supporters stormed the US Capitol in hopes of stopping what they regarded as the stealing of the 2020 election, something they were certain of, despite the lack of evidence. This was just one of many examples of groups of people who have drunk the Kool Aid and come to believe a dangerous and erroneous idea. Therapists like me could have insight into this phenomenon and may be able to help, if only we’d allow ourselves to do so.
I saw a man for an evaluation a few years ago, sent by a judge after he applied for a pistol permit. The judge wanted to know if he was mentally stable after having had a DWI ten years before. I sometimes do these evaluations because the people of New York State don’t want handguns in the possession of crazed or drunken lunatics. If only they knew how imperfect is our means of detecting lunacy.
After talking with him and checking with people who knew him, I found he had quit drinking shortly after his DWI. He had a family, friends, and a stable job. He had never graced the inside of a psych ward or had reason to see a counselor. We went through an extensive list of symptoms and did not check off a single one. Then I asked him why he wanted a pistol permit.
“I want to get a gun before Obama takes them away from us.”
This was when Obama was still in office. He had more things to say about the President, that he was a Muslim, a socialist, and hadn’t even been born in this country. He wanted to get a pistol while he still could and would not give it up, even if the government forced him to. “They’d have to take it from my cold, dead hands,” he said. He clearly enjoyed quoting NRA President, Charlton Heston.
The question I was hired for and was expected to answer was, is this man insane?
To my mind, he had unsubstantiated beliefs about Barack Obama. He was uneducated in the way the government functions. He didn’t seem to know about how the powerful gun lobby had stymied all moderate attempts at gun reform. He had uncritically swallowed the things right-wing media have told him. He wanted a firearm for no other reason than because others might not want him to have it and was apparently willing to die to keep it. I could have called him delusional, except for one thing. In making a diagnosis, I must do so according to the standards of the American Psychiatric Association (APA). According to them, you are not delusional if your beliefs are ordinarily accepted by other members of your culture or subculture. Therefore, I wrote to the judge, stating the man was of sound mind according to the standards of the APA. I’ve been watching for his name in the papers ever since.
The APA recognizes some shared delusions. There is a condition called Folie au Deux, or madness for two, when a psychosis is transmitted from one person to some susceptible others. Folie au Deux is not supposed to be used for when a large number of people come to believe falsehoods based on hearsay. It, and all delusional disorders are meant to be labels of personal pathologies, not those you share with millions. The APA has in mind a person who is so convinced of an untrue belief, he is willing to go against the opinion of his social circle, not along with it. In other words, you can believe in little green men from Mars if you want, as long as Rush Limbaugh, Alex Jones, Fox News, and the entire Republican Party agree with you.
There’s also mass hysteria, like what occurred in Le Roy High School, down the road from me in 2012 when eighteen students came down with what resembled Tourette’s disorder. However, hysteria, as the term is properly used, refers to a physical manifestation that has a psychological cause. My gun enthusiast got a little excited when talking about Obama, but it would be a stretch to call him hysterical.
So, this one man was able to escape my head shrinking machine and get his pistol permit. He was certifiably, if astonishingly, sane. But had anyone done an examination of our country? Can whole countries go mad?
If the country is mad, who is the therapist that can treat it? I don’t see it as my job as a counselor to disabuse my clients of their political opinions, to undermine their religions, or even to boost science, or urge them to welcome people different from themselves. I am there for the problems they bring me, whether it be depression, anxiety, trauma, substance abuse, or trouble with their loved ones. However, I have found at the core of every problem is an uncomfortable relationship with life on life’s terms. Everyone, to one degree or another has trouble accepting the way things are and would rather believe it’s different. This resistance to reality leads to all the depression, anxiety, trauma, substance abuse, or trouble with their loved ones I’ve ever seen. Then it obstructs healing.
An anxious or a depressed person tunes into all the fearsome, hopeless, and pessimistic parts of her life as much as a Trump enthusiast watches Fox News. I’m always directing their attention to the strengths they possess and the real things they can be grateful for. The traumatized get stuck in the past, which, while it may have been real once, is not real now. Addicts have their well-known denial. Many a violent man believes his abuse is justified and many a battered wife ridiculously trusts that her abuser will treat her differently when he says he’s sorry. They all cling to the very falsehoods that keep them stuck.
It is well within my scope of practice to gently debunk those folks of their illusions, but what about the ones deep into QAnon, or people convinced that Trump won the 2020 election, or that COVID is a Chinese plot, or that vaccinations make you sick? Like the APA, I’ve always steered clear of mass delusions, but, maybe I shouldn’t.
It’s getting harder to ignore this kind of madness. Not only is it getting more florid, more extreme, and more dangerous, but it’s disrupting relationships. If you’re so devoted to one billionaire you have never met, who knows nothing about you, than you are willing to alienate your loved ones who aren’t devoted to that billionaire, then we have something to talk about. You have transformed a mass insanity into a personal one. Now, you’re in my wheelhouse and any therapist who ignores what you’re doing is overlooking a major source of your troubles.
The same goes to those engaged in the resistance to the billionaire in the White House. They can become unhinged also, and it’s important that they acknowledge it. Why? Because it’s the willingness to call out your own madness that gives you the authority to call out the madness of others.
Put a spoon in a glass of water and it will appear bent. If someone saw this and started running around, posting on social media that water bends spoons, someone should tell them otherwise. That’s how people look out for each other. Of course, there are effective ways of telling people they have the wrong idea about things, and ineffective ones. Shouting at them, protesting, and calling them deplorable may get out the vote, but it’s not how you change anyone’s mind. If you think it does, then we’ve found your own madness.
There currently exist just a handful of recognized conditions that could make a person profoundly lose touch with reality. It happens in the rare Folie au Deux and mass hysteria I mentioned. We see it in those whose brains are damaged by injury, drug use, or medical conditions. It’s found in some with such severe depression or mania that they confuse what’s real. Anxiety takes some to such extremes they will believe things that aren’t true. There’s schizophrenia, resulting in hallucinations or bizarre delusions; and there’s delusional disorder, non-bizarre type, which I think can be the template for the condition I propose, Kool Aid Intoxication and Dependence Disorder (KAIDD).
A person with delusional disorder typically believes something that could be true, like she’s pregnant, or someone is in love with him, or her husband is cheating on him. What makes it delusional is way they inflexibly cling to the weakest of evidence. It’s the degree of certainty that tips the clinician off that the patient is out of touch with reality. The patient cannot entertain the possibility he could be wrong.
A better name for delusional disorder would be “certainty disorder”, for it is the patent’s assumption of certainty that has gotten out of hand. The only things we can be absolutely certain of are a priori truths like two plus two is four. We know them to be true because four is defined as that which two plus two equals. All other knowledge should be provisional, something you hold until a better theory comes along. If you have a belief, no matter how many people believe it, try to falsify it. If you won’t, then you have then you have consumed the Kool Aid.
There is one notable exception. There are some beliefs that cannot be falsified; or proven for that matter. A belief in the existence of God is one of them; it cannot be proven or disproven, it can only be taken on faith. But faith is uncomfortable for many people, they’d rather have certainty; and so, they claim certainty when all they could have is faith. The consequences of confusing the two are dire.
To have faith means to be willing to live with uncertainty, to take a step into a void when you don’t know what will happen; to be willing to say you don’t know everything, you could be wrong, and could be making a big mistake. When you have faith, you’re willing to entertain doubts, knowing all the time your belief cannot be proved or disproven.
It’s safe to say the people who occupied the Capitol believed they were doing the right thing and could not be talked out of it. They had too much invested after swallowing lies for four years to back down now. It doesn’t matter to them that Trump’s claims of stolen election were presented to a hundred judges and laughed out of the courtroom due to lack of evidence, they were certain. Their certainty made them, and still makes them dangerous.
There is one important feature about making diagnoses of all kinds that should be mentioned. For something to be a problem, it must be a problem. No harm, no foul. A crazy belief, no matter how bizarre, that picks no pocket or breaks no legs should be left alone. For example, when I’m watching a movie, moved to tears or cringing in my seat over something imaginary that appears to be happening, I’m behaving as if it were real; but it hurts no one. In fact, it may be providing me some catharsis or exercising my capacity for empathy. A lot of fantasy is perfectly harmless. Most religious faith is like that. If I believe, for instance, that God loves the world, and take it as an article of faith, it can make me a better or happier person, whether it’s actually true or not. Indeed, since there is so much in life that can neither be proven or disproven, maybe a better way to test for delusions is to look at the consequences of them.
Now that I’ve sketched the outlines of my proposed Kool Aid Intoxication and Dependence Disorder (KAIDD), I’d like to say something about treatment. Good luck. Medication may help, but the people who most need it won’t take it, and the people who think they have it, don’t need it. Furthermore, from what I’ve learned by working with people with any delusion is that it’s impossible to talk them out of it. I’ve learned not to try. They become more entrenched the more opposition they encounter. Sometimes, if I hear them out, they walk away with less compulsion to act on them, but it is just as likely that listening to them will encourage them.
The purpose of identifying something as a delusion is not so you can tell the patient, it’s to tell the people around him, so they don’t catch it. This is how we shrinks, and mainstream media, Facebook, and Twitter have failed; and how we can do better. For too long, we’ve allowed nonsense, lies, and distortions to go unchecked, permitting a pandemic spread of misinformation.
Keith R Wilson is a mental health counselor in private practice and the author of three self-help books, two novels, and innumerable articles.