health

Case Study — the Psychopathic Manipulation of Medical Authority

~ Chuck Pezeshki ~ 1 Comment

The Dynamic Duo, demanding that I take them to the dog park

Gotta confess — I was raised a doctor’s brat (an actual colloquial term) and as such, have been on the inside of a medical community for my young life, at least.

But times have changed relationally. And the downstream of this is what we are seeing now, which is a collapse of authority of the medical community across the public health debates of the age. But why?

Some background — my father was an obstetrician in a medium-sized town in the Ohio river valley. Portsmouth, OH, was an interesting place, psychosocially, to be raised. It was a collapsing steel town, straight out of a Bruce Springsteen song, with ties to other resource extraction efforts. Empire Detroit Steel was one of the first big integrated steel mills to be shut down, in 1976. And since I got to watch it happen (I graduated from high school in 1979) from a ringside seat, I got to watch the literal formulation of a new, darker age in America’s heartland. Which still reverberates — especially in the medical community — to this day.

My father was an obstetrician/gynecologist in the community for almost all of his career. And as a doctor, I enjoyed the benefits of health care in what is literally a bygone age. When any of us kids were sick, outside a cold, my father would take us to the hospital when he did rounds. Along the way, he would encounter other doctors doing the same thing. He’d have them check me, and give their diagnosis. Then he’d take that aggregate opinion, and treat us as he saw fit. I knew most of the doctors in the community because of that.

But his socialization was not uncommon. Back then, doctors actually circulated in the community, with the various social organizations and fraternal groups. Knights of Columbus, the Shriners and such. Doctors were not an isolated class — they didn’t run for political office, but outside of that, they were everywhere. Doctors definitely ran the hospitals in town, one of which was owned by the Catholic Church. And their wives showed up in PTAs. They were scarce — there’s only so much time any practicing physician has. But you KNEW your doctor.

My father thoroughly enjoyed all of this. By the time his career ended, he had delivered something north of 4000 babies in Portsmouth. He was constantly running into patients at the grocery store and around town, and loved to hear the stories about everyone’s progeny. He was honored, called ‘Doc’.

And he was far from perfect. As he aged, his alcoholism got the better of him, and that’s a story I’ve told elsewhere. But even in the community, when he got busted by the physicians at the hospital for being a drunk, he still commanded respect. After he dried out, he attended his Alcoholics Anonymous meetings regularly, where he was known as ‘Manny’ (his first name was Manoochehr). In one meeting, a member had a literal heart attack. My father dropped to the floor, and started administering CPR, while someone else called an ambulance. He saved that person’s life that day. And immediately afterwards, everyone in the group gathered to shake his hand, saying “Thanks, Doc!” They all knew. Anonymity simply did not exist in that town.

It’s against that backdrop of relational development that we now have modern medicine. No one knows their doctors outside the hastily scheduled, over-managed but underperforming care that we have now. Hospitals are really not run by doctors any more — they’re run by administrators. Physicians are hired for specific roles and specialties. According to some quick ChatGPT noodling, over 80% of all doctors are now guns for hire with the hospitals they work at. Private practice is scarce or nonexistent. And those are subject to the vicissitudes of administrators working to maximize profits and minimize costs, as well as the concerns of private equity investors. In the for-profit sector, private equity owns somewhere between 22-30% of all hospitals. That means money is the only interest, outside of regulatory pressure.

The memetic shift in such a system is profound. My father, even with his alcohol problems, was known as an extremely competent doctor and surgeon. Through his circulation around town, before the town started depopulating from the steel mill collapse, he maintained relationships with all his former patients. This combination of externally defined relationships (he was an OB/GYN physician) and his friendship gave him powerful ties inside the community. But I also think it defined most of small town practice at the time. He saw his women patients for literally everything. There were no complex systems of referral or care, where insurance got to decide what happened. And as such, he had a strong relational base for all his interactions. He really KNEW people. And people KNEW him. And especially with an OB/GYN practice, there was a historical tradition of lifetime care. A woman would have a baby with him, and later on might get her tubes tied, which then led to a hysterectomy in later life. She maintained a changing, but lifelong relationship with her physician.

And so was the mental model of physician choice, and the importance of a primary care physician was established. As well as the concept of medical authority — the mental model of it sprung from a lifetime of care that a patient might receive from one person, who they developed a profound trust relationship with. This mix of formal and independent assessment implies solid scaffolding. You might pick a physician for a given need or specialty — that’s the title-based, externally defined relationship thing. But you wouldn’t persist with that person if you thought they were incompetent, or didn’t heal you. That’s the trust-based, independently generated relationship part. And that developed a much more complex psychosocial profile inside the community. These relationships were literally wiring the way the community thought about things.

What happened along the way that destroyed this, and turned this model into a psychopathic weapon used against the American public? The first thing that likely triggered this was fundamental labor mobility. Numbers are hard to come by, but only approximately 20% of all people persisted in their hometown from school years to death. There has been some reverse migration (another 20%) but the notion of a primary care physician giving you cradle-to-grave care simply doesn’t exist.

And the minute that happens you now liberate a powerful mental model from its independently generated roots. Now the BELIEF-BASED part becomes the only part of the relationship — what is the physician’s title — as opposed to the DATA-DRIVEN part — the independent relationship you generate with the physician based on whether they heal you or not.

Portsmouth, because of economic collapse, suffered the brain drain across the board that happens in that circumstance. It was so bad, Portsmouth turned into the epicenter of the opioid epidemic, which could be directly attributed to collapse of the medical community. When your smart, complexity-driven thinkers move away, the memetic deficit inside your community to handle complex problems also hits the skids. And who replaced them? In Portsmouth, one of the people was a woman I grew up with — the daughter of a doctor. She drove enormous amounts of opioid use across the region.

It’s not just the immediate effect of losing a competent medical community. That belief-based sense of competency is even further put through the wringer, through the machinations of the managed health care system. When you start adding the effects of economic dislocation, as happened throughout the Midwest from the ’70s-’90s, you have a medical community completely unmoored from personal friendships. Doctors are guns for hire, often not even living in the community where they practice. Instead, they take gigs based on intervals of time in residence in a community — 2 weeks on, 4 weeks off — and live somewhere else. In my most recent health crisis, involving a mesenteric thrombosis, all the physicians that took care of me, AND did my eventual surgery, lived outside of Pullman. One even commuted from Maine. In my case, I was lucky. One of the physicians that managed my care was a former Dean of a medical school, and my surgeon (also from 85 miles away) was top-notch. But there was no way for me to evaluate nor have any meaningful selection authority in my care. No agency.

Once a given memetic structure gets severed from his scaffolding, bad things are destined to happen. People are told “listen to your doctor!” or some such nonsense. But nowadays, people overwhelmingly have no data-driven relationship with that individual. So what happens is that meme is untethered, to be captured by the psychopaths running Big Pharma, to be used to sell drugs. In place of that relationship, we are served up an endless round of ads, telling us to ask for these from that doctor with our non-existent relationship. Only the most diligent of us, doing research, would even find the names of these drugs if we didn’t have the ads. So we are bombarded with odd names, with Woke representations of what the potential patients might look like. These representations are designed to be psychopathically manipulative — for example, most AIDS patients are overwhelmingly homosexual, African-American and male. But the ads themselves display a whole palette of sexes and skin types. The result is paranoia, with the appropriate backside covering when the medical community is actually approached. You didn’t trust them, and for good reason — but the mental model that is played is that if you DON’T trust them, something is wrong with YOU.

This then plays out in all sorts of perverse ways. Consider the vaccination wars. You either BELIEVE in vaccines, or you don’t. And your doctor damn well better believe in vaccines as well, or he’s a quack/crank/whatever. But vaccination as an issue has changed dramatically in the past 20 years. The number of tried-and-true vaccines I gave my kids (they’re now 25 and 27) has at least doubled. And the pressure to increase early vaccines has grown exponentially. Consider the recent fight over the Hepatitis B vaccine for infants. There’s no risk for a child being born with Hep B if the mother doesn’t have it. But it’s one more needle lined up for that infant arm, at the earliest possible moment of life. Does not wanting your infant to get a Hep B vaccine make you an anti-vaxxer? Hardly. But the psychopathic voice behind Pharma-aligned interests, as well as psychopathic voices wanting to establish control over what government is allowed to force on you is never-ending and relentless.

And then there is the never ending pressure from elites for Elite Risk Minimization. Vaccines are supposed to protect you from getting a given disease. What that means is that if YOU get a given vaccine, you’re supposed to be safe from contracting a given disease. But in the context of Elite Risk Minimization, that’s not good enough for them. Everyone else has to get vaccinated, so that there is no chance of even potential exposure. Regardless of the given statistics. What this leads to is a classic psychopathic Double Bind — you must get vaccinated even if others around you are vaccinated and shouldn’t be able to get the given disease. This obvious logical conflict then promotes more craziness in a society already under attack by psychopaths attempting to spread fear on other fronts.

The subtext for all of this is the deep fear of all humans of social ostracism. Not only do you not get to exercise your agency on what gets injected into your body. If you don’t, you suffer social catastrophe, especially in liberal communities. Jimmy Kimmel, during the COVID episode, was very clear about how the elites were going to function. If you were vaccinated for COVID, you could receive medical care for OTHER conditions. If not, tough luck. Worse, you lose your job and livelihood.

And then propagated by psychopathic forces was even more diabolical messaging. One was the gasping COVID patient with Neo-Nazi tattoos, who had refused the shot (which turned out to be a colossal bust) and was now gasping at the black nurse attempting to save his racist life.

As with all things, people figure out the bullshit. But it takes time. And then what happens is fascinating. After living through a couple rounds of this crisis, which REPLACES the formerly healthy, data-driven relational construction that people used to have with their original primary care physician, the people become memetically inoculated from the messaging. The problem is that this, downstream, doesn’t help the society when a real threat comes up. Fool me once, fool me twice, as the old adage goes.

Here’s the point of all this. Modern society, through multiple modes (Pharma, private equity, etc.) psychopathically destroyed the appropriately scaffolded, rational relationship people have with medicine. And attempted to replace it with a monetized model whose beneficiaries were not the people receiving care, but those making money off that care — which weren’t even the physicians. And then that institutional psychopathy reached out to other areas, like the COVID vaccine, and naturally, memetically took up the cause of the elites, with Elite Risk Minimization.

Some notable people are fighting back, like my friend Dr. Jay Bhattacharya, who now heads both the NIH and the CDC (at least temporarily.). But there are enormous institutional forces more than happy to pull out the mental models of the past, to ensure their own short-term gains. As with all psychopaths, they have no ‘bottom’ regarding accusations against actors attempting to stem the tide — look at the endless, relentless attacks against Robert F. Kennedy, Jr. And NOTE — all the attacks will be on the top, superficial level. No nuance given — that’s the knowledge structures piece.

The potential for reform is, quite honestly, bleak. As doctors overall have, more and more, been disenfranchised from administering these systems, there is only a modest amount they CAN do. They do have patients to care for, after all. But I believe it is only people inside the system that have enough detailed scaffolding to make a difference. Hopefully this piece serves as a crudely written road map of how we got there. And where we have to get back out of. Memetic evolution is always the answer. But it’s a very rough road.

And we’re not going to get there without some realization about the relational decline that got us here in the first place.

P.S. For a primer on the difference between rational, independently generated relationships, vs. externally defined, belief-based relationships, do read this piece. Trust vs. Loyalty, folks. Both have their place, so don’t go in with a pre-bias.

Psychopathic Manipulation — A Case Study

~ Chuck Pezeshki ~ 3 Comments

Sunset, along US 95 in the Owyhee Mountains, Idaho

As I write this, a huge breaking wave is coming on to politics across blue states in the US. Nick Shirley, a 23 year old Youtube Influencer, posted a 42 minute video profiling nonexistent day care centers ostensibly run by Somali immigrants in Minneapolis, MN. The video is great in that it is so facile — Nick and an activist named David merely matched disbursement records with visits to the actual day care sites, and witnessed no activity. The link is below.

https://www.youtube.com/watch?v=r8AulCA1aOQ

Estimates of the fraud run into the tens of billions of dollars. But how does this happen? We’ll talk about a different, deep historic timeline — food and clean water charities around both the US and the world. And nope — this is not some “fact finding” kind of piece. My goal is to describe the dynamics of how people get taken in by psychopaths.

Consider the controversy around the current SNAP program in the United States. SNAP, hooked with an Electronic Benefits Transfer card, is how people enrolled in government food aid, can buy food from all sorts of food providers, and is just a renaming of the food stamp program. Eligibility is not hard to prove — almost anyone with a little bit of determination can get food aid. When I have students in financial distress, I often send them to sign up for the program.

But the program goes way back — to the Great Depression. Originally, food aid was founded in 1934 as a tool to help farmers get rid of agricultural surplus, but then evolved into the Food Stamp program that reached some form of functional maturity during the Great Society years of Lyndon Baines Johnson. The Food Stamp Act of 1964 shifted from surplus reduction to hunger prevention. And though that shift did occur, it still leaned into agricultural surplus. My grandmother, who had been poor most of her life (she was a character) would always be first in line when the semi truck of excess “government cheese” showed up in town. It was actually really good.

In 2008, food stamps were rebranded through the SNAP act, and the paper stamps were replaced with electronic debit cards. The program was expanded once again during the COVID years of 2020-2022, and included emergency allotments, as well as online grocery purchases.

The point of these programs was to eradicate hunger — and now one gets into the arena of manipulation. We are still bombarded constantly with charities talking about hunger relief. At some level, one can at least believe the story of hunger overseas — we aren’t there, though studies have shown that the majority force of hunger around the world is war. But in the United States, we still hold food drives and such. How does hunger still occur?

Or does it?

If you are advocating for any program, clearly one of the easiest is hunger eradication. Hunger, and especially, the IDEA of hunger has been a standard memetic cudgel as long as authoritarian governments have been in existence. And as the history shows, it is one of the oldest government programs in continuous existence. If someone confronts you on your charity, no one wants to be the one arguing FOR hunger. In fact, the strength of the virtue of the mental model associated with hunger is so powerful, there’s few humans in the United States who will argue for any reduction in these programs.

And the minute you have that level of mental model solidity, you have a tool for program growth — as well as an attractant for psychopaths looking to run a grift using hunger as the primary issue. Recent attempts by HHS Secretary Robert Kennedy Jr. to even reduce the items allowable to be purchased using EBT cards – namely soda pop and candy- have caused a firestorm. As of January 1, 2026, only 18 states will eliminate purchases of these items with SNAP benefits.

Further, in our day of decentralized media, the reduction in purchase range by SNAP has spawned hundreds of videos of people complaining about the changes. Obese people are on social media, complaining how their reduction of benefits will mean they can no longer get their nails done, or buy other luxuries. Reduction in SNAP benefits and the effects on other items purchased have not been formally studied — but dips in the luxury tennis shoe market indicate potential linkages.

And grocers are concerned — these are the legitimate ones — that reductions in SNAP benefits will cut into their profits. None of them want to comment on any of this — Walmart’s SNAP sales are around 1/4 of its grocery sales. But individuals abusing SNAP benefits as a crime is hard to prove.

More easy to look at another program in the current spotlight for fraud associated with food aid programs — the Feeding our Future program in Minnesota. Same memetic structure.

Federal prosecutors allege that between 2020–2022, FOF and affiliated operators:

  • Claimed to serve tens of thousands of children per day at hundreds of sites that did not exist or barely operated.
  • Submitted fabricated meal counts, invoices, and attendance logs.
  • Used shell companies to launder reimbursement money.
  • Spent funds on luxury homes, cars, jewelry, travel, and overseas transfers.

The thing that is interesting about this is how poorly covered by the media AND government it is. Psychopathic manipulation of taboos — in this case, anything with helping ostensibly alleviating hunger– is off-limits. There’s a record of scant media coverage on all of these going back decades. Yet only in the current political turmoil do we actually get a sense that these types of things that spawn massive corruption are in play. And in the case of Feeding our Future, it’s chock-a-block full of Somali operators on the front end. Who, of course, happen to be Black. So now you have both the immigrant AND racial angle. Hunger, immigrants, Blacks. A psychopathic model trifecta.

How can we understand this from a systems perspective? Psychopaths co-opt a mental model about a societal problem (often one buried deep within the human psyche) , launch a dollar harvesting/diversion scheme around that scheme, and then, if the scheme is discovered, use both the dominant mechanism as a “narcissistic shield” or “moral racket” (if we’re not allowed to continue doing this, children will starve!) as well as a rear-guard action (You are all racists because the people perpetrating the scheme are black!)

Clean Water Around the World

One of the most vexing problems I’ve struggled with in deciding to help various student groups over the years is the ‘clean water’ problem. And inevitably, requests for donations also show up in my mailbox — arguing for this scheme or that for bringing drinking water to the unwashed masses. Often these schemes are in esoteric locations, often in Africa to places I’ve never been. I’ve spent significant time in 40+ countries, and not just in conference hotels. So I have some reasonable perspective on what life is like in the various parts of the Third World and Fourth World that most people would never go in their lifetimes.

What I’ve seen is that people all over the world, even in the poorest places, always seem to be able to afford three things — cell phone minutes (I have yet to visit a place where cell phones are not ubiquitous, and I’ve been to some crazy places) , sugary or savory snacks in small packages, and bottled water. I have a modest reluctance to pronounce this, but I’m increasingly skeptical that there is a drinking water problem anywhere outside a war zone. I have yet to visit a true Stone Age venue, where there are no small kiosks selling these things.

And if you focus in on water, this is, like it or not, the de facto solution for drinking water around the world. No mother is going to take water out of some sand trap contraption that engineers specializing in Third World development and give it to her baby. It just ain’t happening, unless there is some major crisis.

And once again, outside of war zones, various NGOs have swarmed over all those sub-Saharan countries, with various well-drilling and water production schemes. Nothing is new under the sun. My own university had a revolving door with Malawi and a series of classic dysfunctional development schemes there. My favorite was drilling a well for a cabbage grower. Various development agents came in, and drilled a well. Initially, the cabbage grower was elated. Instead of growing 10 cabbages a year, he could now grow 100! The development folks left, and came back the next year.

How had he fared? He was weeping. “Last year, I had 10 cabbages, but all got sold. Now I have 100 cabbages. But I have no way to get them market, and most of them are now rotting. And I did make a little more money, but I started drinking. My two wives told me that they would not live with an alcoholic, so they left me.”

There was a similar story about people in Malawi growing rice. Except people in Malawi don’t grow rice. Rice requires flooded paddies. But flooded paddies then create mosquitoes. And mosquitoes create malaria. And so on.

The point of all this is now we have another perfect psychopathic mental model that can be used by outside forces to run yet another Long Con. You have an issue everyone is familiar with, that has been around forever. You are asked for money — who could refuse money for clean water for kids? You cannot protest — you will be condemned for a lack of virtue. Meanwhile, maybe no wells get drilled. Mothers are still feeding their kids bottled water. And you are threatened with a moral racket, or narcissistic shield if you even question.

The pattern is clear.

Alternatives

Give locally, and know the people you live with. Grounding validity is always the answer. I give no more to organizations with fungible accounting categories.

Mental Illness and its Weaponization Against Society by Psychopaths

~ Chuck Pezeshki ~ Leave a comment

Blanket Chest — Khaya and Sapele

One of the radical changes in the structure of our society in the USA is the dramatic shift in how generalized populations are supposed to not only address mental illness, through care modalities, but how mental illness is supposed to be mainstreamed into the various operations of our corporations and institutions. No longer is mental illness a condition to be treated and overcome. Rather, now, it must be accommodated in your normative social environment. And if you, as an individual cannot accommodate a given neurodivergent condition, then you face punishment or loss of employment.

Worse, if you are trapped with a severely mentally ill person in your immediate family, the “mainstreaming rehabilitation” mindset is so powerful that if you are dealing with a violent version from a protected class who ALSO has a mental illness, the current systems and institutions supposedly set up to protect society as well as family units collapse. YOU are the bad person for refusing to accept aberrant behavior, and not go along with disordered social service agencies who offer little, if any help.

There can be no more terrible example that the recent arbitrary murder of Iryna Zarutska by DeCarlos Brown on the commuter train in Charlotte, NC. Brown had been convicted and released 14 times for violent crimes, including armed robbery, and his own mother had attempted to have him involuntarily committed. But despite violent schizophrenic outbreaks, this failed, even in light of his extensive criminal history. My suspicion is that had Brown not been African-American, he would have been committed. But our social institutions are so contaminated with the notion that racism must be the root of all evil, even Brown’s own mother’s concerns — she had taken him to a homeless shelter because she could not control his behavior — landed on a tin ear in the justice system. She didn’t persist — and Iryna Zarutzka, a person honestly seeking refuge in this country paid with a violent death, and her life.

When such a crazy, violent event happens, one needs to reflect on what principles are our society structured around. It’s easy to go through some litany of the usual list of the various v-Memes, laying out safety and security at the bottom, moving up to rules to regulate such areas as commerce, or even traffic, and then ending up in the space of opportunity to create new economies, or protect the environment. The list would certainly go on.

But if we were to look at things from a more generalized relational substrate, we might come up with profoundly different answers. From a guiding principles perspective, a society is supposed to lay the groundwork for fundamental coherence of action among its residents. Dependent on the overall psychosocial development of its members, societies should create structured environments that allow members to participate, within reason, in an environment that allows enough predictability for people to join some group action, and have some set of expectations about what the outcomes will be.

The short version is coherence, within the context of development and values of a given society, must be the desired end state. It is one of the hallmarks of Collapse Narratives that they promote other, decidedly more disordered, egocentric outcomes.

When people read that word “coherence” it is very easy, without an understanding of v-Memes, which code how people change and grow over a lifetime, to assume that somehow it means that everyone should be a goose-stepping minion. This is ridiculous. A simple example is in order. In contemporary society, the guiding principle of coherence implies that you ought to be able to get in your car, drive to the local supermarket, and provided you have cash or credit cards in your wallet, buy yourself a six-pack of beer. All those activities rely on a much larger stable system to instantiate this simple action.

And psychopaths know this. So if they want to relationally disrupt the coherence of the system, they have several pathways available to them. One is the obvious, conscious mode of throwing a brick through the grocery store’s window. While that is dramatic, it’s also highly unlikely that brick throwing is going to be mainstreamed as a stated societal value any time soon.

Better to co-opt mental models of virtue that a society might hold dear, that inherently are unstable, and arm different cohorts of society, with these as attack modes to the foundations of a society — which inherently includes coherence — and get people inside the system, functioning on different temporal and spatial scales — to fight. Then the psychopath gets to sit back and quite literally watch the world burn.

Much of this has manifested in the last 30 years. My own mother had a relatively profound personality disorder — she was likely Avoidant/Borderline. She was an absolute fire starter when it came to manipulating people into a constellation where people believed they were justified in starting a fight, especially as she aged. But her demeanor, projected as someone who was introverted, gained her allies across the community, especially in the face of my father’s alcoholism, which was also real. It took me to about 48 years of age to realize that at least part of the reason my father drank was because he was married to my mom.

Yet at the same time, my mother functioned relatively well in society. It was because society had imposed constraints on her behavior. As a doctor’s wife (my father was an obstetrician in good standing in the community) she had a role to play, and she knew it. We were Catholic, and she befriended the local sisterhood, who played no small part in our social lives. They also had problems, but once again, they were constrained by social expectations. There were particular situations where it became obvious my mother had problems. But here’s the key — for the most part, because her role was scripted, and she did have a couple of bright kids, she had little latitude for finding or displaying any deep, disordered feelings.

The key element in her progression through life in the ’60s and ’70s was that she was supposed to be an upstanding citizen, PTA leader, and mother. Any activities straying out of that would have been considered aberrant and anti-social. Her focus of her identity, which was madly scrambled inside her own head, was EXTERNAL to her true self. It is also true she had a brutal childhood, full of poverty and uncertainty, and my own grandmother had multiple husbands that she had. to navigate. But her path was set. And that was a GOOD thing.

Contrast this to any young woman emerging into modern society. As part of the bedrock belief structure of any version of late stage feminism, you get to be, ostensibly, whatever you want. But that means very little if you have a combination of disorders, as well as a lack of family structure. Young men, even though they are an aggrieved and attacked group in modern society, have far more. Bedrock ‘Protect and Provide’, though diluted, still exists. Focusing on the egocentric needs of some women does benefit some — I have some outstanding female colleagues that I wouldn’t trade for anything. But most people have little integral sense of self until they are north of 26. Couple this with the very natural drive to have children, which is then wildly confounded by extant societal messaging, and it’s no wonder we’re in some version of societal crisis. Short version — like every society, we have some percentage of crazy people. We then strip away boundaries for normative behavior, and then additionally arm young women in particular with powerful legal tools to lash out, and we end up with a lethal stew for relational disruption.

The people that suffer most from this are, not surprisingly, healthy young women, who then inherit a hostile relational environment that they are poorly equipped to navigate.

And while there is more to say here from a gendered perspective, the real point is that the de-centering from some version of societal conformity as an expectation for young people, to a re-centering on the poorly developed needs of the self is a recipe for societal chaos. And chaos goes directly against the need inside a society for coherence. The society simply cannot function effectively at the complexity level that it may have evolved to. And so it begins to decline.

Psychopaths love this circumstance of combining what has been called a “moral racket”, combined with my term, “narcissistic shielding.” The more out of it a given person with alternately neurodivergent issues that might have been more manageable in a more constrained environment, or someone who actually suffers from mental illness, the more they show up on the psychopath’s radar as someone who can be co-opted and manipulated against the relational hierarchy in a social setting. In my clinic program, which is somewhat unique in that I send students out into the real world, I noticed a pattern where a more well-formed psychopath would adopt a functional “child” — and then wait for affront from me. It was relatively unconscious, though the impetus for “splitting” by the personality-disordered ‘parent’ was usually a bad grade for work.

Then the bias towards centering the social situation around the person with mental illness or neurodivergence would come into play. It’s well known, for example, that people on the autism spectrum are often literalists, and have a very difficult time with irony or sarcasm. So the student would misunderstand something I said (I use a lot of humor in the classroom, akin to a football coach goading players to higher performance) and then the psychopath would raise the interests of her narcissistic shield in order to gain power and control.

This has happened on systemic levels across society. Academia is well-known to include more than its fair share of mentally ill people (who could study a particularly obscure, minute area for their entire career without the advantage of OCD?) and it’s not surprising, with its development of complex micro-aggressions, often developed by its own psychology and sociology faculty, that there is a rapid relational collapse into externally defined, low empathy, relational modes. The problem with this is that our brains will only do what they practice, and when you end up with entire modern systems that enshrine siloed thinking, exacerbated by a heavily siloed social system, there is a profound decay in the ability to synergize larger solutions that society needs.

As the society plunges ever deeper into the meaning crisis, it exposes even more avenues for psychopaths to use the narcissistic shields of the mentally impaired to focus on ostensibly empathetic solutions for problems — “let’s focus on making people who are severely disordered feel comfortable everywhere.” This creates a wild level of cognitive burden on the rest of society. If a 50 year old man with lipstick wants in your high school daughter’s locker room, she must be accommodated. If the homeless person refuses being housed, and prefers to sleep in the open-air drug market they’ve established at the local park, they must be accommodated! This re-centering causes everyone else to retreat from public spaces, which causes further social degradation, as well as establishing hyper vigilance as the norm for public interaction. Everyone you meet doesn’t mean you well — because they probably don’t. During the recent Palisades Fire in Los Angeles, I brought up on social media the likelihood that homeless people had helped spread the fires. My ultra-virtuous liberal friends immediately went on the attack. How dare I impugn such an obvious source (homeless people in LA often live at the mouths of canyons, and have burn barrels they gather around)!

And it hardly helps the mentally ill, either. I had a memorable adventure once chasing a bipolar schizophrenic through the streets of Vancouver, BC. I don’t know if that sounds like fun — but it wasn’t. He had actually escaped from an institution, but real mental illness is no joke. Mentally ill people need help because they are not normal. And they are often very low functioning. A lack of understanding that differential actually worsens the societal consequences for them. It does not help to pretend.

But for psychopaths, it’s any manipulative virtue/narcissistic shield in a storm. And when your goal is relational chaos, there are multiple paths to get there. Facilitating the crazy is just another tool in the toolbox.

If you think it’s almost designed to make you crazy, or at a minimum, retreat from society, you’d be correct. That’s the key game in the psychopath’s playbook — relational disruption, or make you nuts. And what could be more delicious than using the helpless against society?

One final note — I was in Vietnam looking for venues for international projects, when I happened to encounter a British psychiatrist. We hit it off famously, and ended up having drinks at the Hotel Metropole with another Vietnamese mental health care provider. He had been working in Laos, and I asked him what they did in the villages there. “They build a set of pole cages outside the villages, and when they have someone go on a manic episode, they lock them in the cage.” He went on to tell me that there were only eight psychiatrists in all of Laos, a country of approximately 7.7 million people.

As always — perspective — use it or lose it.

Hotel Metropole, Hanoi, Vietnam