I hate these folks but I also understand them. And, well, uh, I also empathize with them. They share the same psychology as the paranoid patients I treat every day. The only difference is that the paranoid beliefs of the tea-party movement are political while those in my consulting room are of a more personal nature.

The causes and dynamics, however, are the same. And so just as I have empathy for my patients, I have come to have empathy for the tea-party'ers, even as I despise their influence and work hard to defeat their ideology. It's crucial that progressives do likewise because if we don't understand the ways that decent, god-fearing, and victimized people can come to espouse such a dangerous ideology, we won't be able to fight them effectively.

I treat people who are paranoid all the time. Sometimes they're only mildly paranoid. For example, someone I treat can't tolerate blame of any kind, can't take any responsibility for failures, and can't really be optimistic about the potential goodness in others. It's always someone else's fault. Other times, they're more severely paranoid. A patient I saw spun tale after tale of slights, interpreted innocuous events as malignant, saw conspiracies everywhere, and always imputed malevolence to others' motives. The most extreme cases can be found in the delusions of schizophrenics.

There isn't one cause of paranoia. Tomes have been written about it. Individual variations and exceptions abound. A few generalizations, however, can be made. Paranoid people are trying their best to make sense of and mitigate feelings of helplessness and worthlessness. Their beliefs are attempts to solve a profound problem, albeit in ways that distort reality.

People can't tolerate feeling helpless and self-hating for very long. It's too painful. It's too demoralizing, too frightening. They have to find an antidote. They have to make sense of it all in a way that restores their sense of meaning, their feeling of agency, their self-esteem, and their belief in the possibility of redemption. They have to. They have no choice. That's just the way the mind works.

The paranoid strategy is to generate a narrative that finally "explains it all." A narrative-a set of beliefs about the way the world is and is supposed to be--helps make sense of chaos. It reduces guilt and self-blame by projecting it onto someone else. And it restores a sense of agency by offering up an enemy to fight. Finally, it offers hope that if "they"-the enemy, the conspirators--can be avoided or destroyed, the paranoid person's core feelings of helplessness and devaluation will go away.

Take an extreme case. Someone I saw years ago had a paranoid delusion that orbiting satellites were trying to control his mind. He went to great lengths to insulate his apartment so as to repel these psychic assaults. When I got to know him better, I discovered that he developed this delusion as a way to make sense of an on-going but terrifying experience--the genesis of which lay in his childhood--that he wasn't a separate person and didn't have the right to his own thoughts. This terrifying feeling of helpless vulnerability was rendered comprehensible to him by his delusion about orbiting satellites. In a paradoxical way, his delusion reduced his terror even as it generated its own fears and dangers.

Another patient I saw had a daughter who was mentally retarded. When the daughter's disability was discovered, he felt so helpless and guilty (normal feelings that were exaggerated by experiences from his own childhood) that he slowly developed the belief that the daughter had been the unwitting victim of sexual abuse by relatives, that this abuse had led to various cognitive arrests, and that treatment for the abuse could and would restore her to normalcy. In this way, he negated his guilt, and momentarily overcame his helplessness through a heroic search for a therapeutic "cure."

While extreme cases, these vignettes illustrate the core truth about paranoia, namely, that it is an attempt to lessen unbearable feelings of self-blame and powerlessness. In this special sense, psychotherapists understand paranoid beliefs as attempts at adaptation and self-healing, even as these beliefs compromise the ability to test reality and invariably create suffering of their own.

Paranoid beliefs about Obama and the government promulgated by the ultra-right have a similar genesis and meaning. In the Times story about the tea-party movement, the writer describes how most tea-party activists are not loyal Republicans. "They are frequently political neophytes," he writes, "who prize independence and tell strikingly similar stories of having been awakened by the recession. Their families upended by lost jobs, foreclosed homes and depleted retirement funds, they said they wanted to know why it happened and whom to blame."

They began listening to Beck, reading the Federalist Papers, books by Ayn Rand and George Orwell, and started visiting radical right wing websites. The Times writer then makes a crucial observation: "Many describe emerging from their research as if reborn to a new reality." In other words, like my patients, the tea party folks find in their paranoid views about politics a narrative that "explains it all," that reduces their sense of helpless confusion, and that channels their feelings of victimization into ones of self-righteous militancy. They go from passive victim to active agent, from guilty to innocent, but all at the price of distorting reality into one full of malevolent conspiracies.

The payoff is that they are no longer confused. They are reborn and now, thankfully, have the "answer." And that answer is that big forces are hurting and enslaving them.

And while these forces include the banks and large corporations, the main culprit is, of course, the government. People don't have a direct and immediate experience of Goldman Sachs. The do, however, experience government every day, not only on television news shows, but via laws, taxes, public services (or the lack thereof), law enforcement, etc.

Lots of people feel guilty and helpless, of course, and most don't become paranoid. Some become simply depressed or resigned, others turn to strategies of distraction or addictive self-medication. Others might face their feelings more directly, tolerate them, and find alternative solutions, e.g. turn to friends, therapists, or various communities of support. Still others may find relief for painful feelings by projecting all meaning and agency onto God. And some simply fight back against "reality," despite long odds. The psychological reasons that one person turns to paranoia and another seeks a healthier solution are not generally known.

It is also obvious that left wing conspiracy theorists share much of the same pathology as those on the right wing of the spectrum.

For new tea-party members, however, the drift toward paranoia is facilitated by the right-wing media machine that offers several ready-made narratives perfectly designed to help its consumers clear up their confusion, understand their helplessness, absolve them of any blame, and offer a way out. The conspiratorial alliance of business and government, a growing tyranny intended to disenfranchise, disarm, and exploit ordinary citizens, secret pacts to overthrow the constitution, etc. all currently led by an un-American, godless, colored, elitist, contemptuous, foreigner--Barack Hussein Obama. A grim and frightening picture of the world to be sure.