A lot of heavyweight thinkers have offered explanations of the irrationality of modern political behavior--you know, behavior like Medicare recipients at town halls screaming about the evils of government-run health care or otherwise reasonable people likening Obama's plan to Nazi eugenics. George Lakoff theorizes that conservatives interpret reality through metaphors and meta-narratives modeled after authoritarian family structures. Drew Westen argues that they interpret facts according to emotionally based investments in conclusions they already hold, bypassing cortical centers of reason altogether. These and other analyses are powerful and helpful. But they aren't satisfying to me because they aren't specific enough to account for the passionate urgency and self-destructiveness of the right-wing rejection of a program that will obviously benefit them.

In both my consulting room and my writing and teaching about organizational and political change, my focus is on understanding the causes of irrational and self-destructive thinking and behavior. It's much more difficult to be objective, however, if I have a stake in the outcome like I do with the health care debate. In this case I feel an overwhelming impulse to leap through the television and throttle the whole bunch of them-the right-wing fear mongers, the pseudo-neutral mainstream press, the idiotic spittle-spewing town hall demonstrators ranting about communism, and the cowardly Democratic party fat cats who are barely to be seen. Like so many others, I'm sometimes reduced to feeling simple awe, wonder, and despair at how screwed up the world-and people--seem to be.

But when I put my professional hat back on, the behavior out there is still a compelling puzzle crying out for further explanation. I'm not talking about the behavior of people who have a vested interest in the status quo or are shilling for them. I'm talking about ordinary folks who repeatedly vote and act against their best interest. Of course, they don't think that this is what they're doing. When people do or say irrational things, they always think they're being reasonable. I'm saying that it's against their best rational interests to fight against health reform, to vilify government when it helps and protects them every day, and do so in ways that insure that the folks who are screwing them continue to be able to do so. And I'm saying that explanations that rely on notions of brainwashing, racism, or fundamentalist moralism are, while useful, insufficiently specific and psychologically complex.

It is certainly true that liberal attitudes, like conservative ones, can also derive their force from deeply personal, unconscious, and irrational sources. But I'm not a relativist who believes that the "truth" depends on your point of view or cares much about the fact that the Fox News audience would label me the irrational one. In my view, conservative irrationality is much more blatantly self-defeating than is the liberal variety and, thus, of more interest to me in regard to the current debate.

Here's what I think is going on: People in our culture have an inherent resistance to feeling helpless, victimized, and in need of protection, care, and help. This resistance takes many forms, some of which promote hostility toward government in general and toward liberal and humanistic political agendas like health care reform in particular.

Feelings of helplessness and dependency can feel toxic. We all naturally tend to take responsibility for our lot in life. We want to feel that we choose our lives, that we have some inalienable and existential freedom to determine our present and future, that we are actors and agents. While true in some deep and important way, such a belief can and does create problems when our choices are limited or constrained by limited resources, the interests and needs of others, or the demands of institutions, when, in other words, we are actually helpless and in need of help. Helplessness is an extremely painful state, one that the human psyche will do almost anything to escape.

But if our over-investment in being free agents leads us to refuse to face feelings of helplessness, then our suffering has to be fault. If we always have choices, then we're also always accountable for their outcomes, and if these outcomes are negative then we have no one to blame but ourselves. What do we do, then, about all the areas of life that we don't control, never controlled, never will control? What about our relative helplessness and dependence as children on our families? What about the profound influence of our culture that shapes our opportunities, crafts our values, and defines our sense of what's possible and what's not? What about our on-going need for collective responses from entities much bigger than the self to such things as the excesses of the market, the protection of the environment, public safety, international conflict?

Our responses to this conflict are complicated. On a personal level, we usually insist on maintaining the illusion of freedom and autonomy, but only at the cost of becoming self-blaming and guilty. For example, in my clinical practice I hear patients frequently describe abusive conditions of childhood in terms that regularly forgive parents and blame themselves. Children who are neglected grow up feeling guilty about their need for caretaking. Kids who were hit a lot tell me that they were "hard to handle." It's said that children would rather be "sinners in heaven than saints in hell," that they would rather exonerate their caregivers and feel guilty than hold their caregivers accountable and feel innocent.

Culturally, we enshrine ideals of free choice and personal responsibility in the notion of meritocracy-the belief that people rise or fall to the level of their essential ability and value. Therefore, if we're ultimately responsible for our social position, then its limitations must reflect something essentially limited about us. Despite the obvious barriers and constraints on social mobility, people still secretly blame themselves for their lot in life.

The reason that the story is complicated, however, is that it doesn't stop here. If it were, there wouldn't be so many people out there blaming everyone and everything in sight for their stress and suffering. Self-blame and guilt-the unfortunate byproducts of our American belief in freedom and choice-are also difficult to tolerate because they're painful. On an unconscious level, the mind tries to get rid of these secret toxins in various ways, even though most of these strategies invariably fail to offer permanent relief. Sometimes we blame others: "I'd be happy if you (fill in the blank-liberals, government, etc.) would just stop getting in my way, stop trying to hold me down with (fill in the blank---regulations, taxes, laws, etc)." Such complaints seek to proclaim innocence, to blame government so as not to surrender to self-blame. They are attempts to reverse and deny troubling private feelings of responsibility. Conscious claims of innocence and victimization seek to counteract private feeling of guilt.

Blaming others may be a time-honored strategy to alleviate feelings of guilt and helplessness, but because it's defensive, it doesn't last very long. It has to be stoked over and over with new accusations, new grievances, and thus the creation of new and powerful "others" posing a threat to us. At the end of the day, however, the self-blaming resulting from the illusion of individual free choice comes back to haunt us.

Other folks get consumed with envy of people that they imagine are being taken care of, in effect complaining: "We're sacrificing and enduring deprivation and those people over there are getting away with something, getting a free pass. We're responsible for our own lot in life but they seem content to get handouts." This was the psychology behind Reagan's demonization of the mythic "welfare queen" that so stirred up the envy and resentment of white working class men in the 1980s. And it lies behind the equally vitriolic resentment of the imaginary others who will be taken care of by the Obama administration-the uninsured or the poor-while "we" pay the bill through our sacrifice and higher taxes.

Unconscious longings and conflicts such as these are especially apparent in the bizarre claims about "death panels." The sheer irrationality of the claims suggests that something psychically powerful and conflictual is at work. The fantasy behind these claims is that the handicapped, the elderly, and the demented, will be killed. What these groups have in common is that they're innocent and helpless. Those raising the specter of government ordered euthanasia are defending the innocence of others because they are so terribly conflicted about giving voice to their own. They feel terribly guilty and ashamed of their own legitimate dependency needs. Unable to accept them, they project them onto others, locating them-in a sense, the vulnerable and innocent parts of themselves--in others who are indisputably dependent to whose defense they can safely come. My view is that they can't experience fully that dimension of their own lives in which they are innocent and helpless, for example, in their families, communities, school systems, workplaces, and health care system. Their militancy on behalf of grandma is a disguised once-removed militancy on behalf of themselves.

We all have a longing to be cared for, a longing that unfortunately comes to feel inherently in conflict with autonomy and freedom. The conflicts that we all have about being deserving of such care thus get distorted and appear as anti-government paranoia. Our own internal sense of being undeserving of care becomes, then, a rejection of the need for care which becomes an external distrust of the care that is actually being offered. Government-as-caretaker becomes a threat rather than a gratification. If you see government as providing help, you are forced to accept that you need help, and that position is what ultimately is intolerable.

This dynamic process in which need becomes fear becomes anger is well known to clinicians who treat paranoid patients. The threat feels external to these patients, but the source of it is really internal, a fear of their own dependency needs being manipulated and used as a means to control them. The only way that they can feel safe and innocent is if they locate the problem outside them in some larger malevolent power and then aggressively defend themselves against that power. If they join with others in the process, all the better, since such imaginary communities provide a further sense of safety and connection. In the end, though, the paranoid system has to be continually replenished with new enemies, new threats, and, therefore, new dangers to battle. For the hard-core Right, egged on by their media and political patrons, the government provides an endless source of new enemies.

The answer to this type of dynamic in which feelings of helplessness, dependency, and innocence are so dangerous isn't through reason. In my experience, there are two options. The first is to give up on attempts to reach them, an approach that I think is perfectly appropriate for many of the hard-line paranoid anti-government types. I am generally a therapeutic optimist except in cases where there is significant paranoia. Since everything I do or say is seen through a paranoid filter, there is little chance for me to reach the person. Politically, we shouldn't try. We should outvote them, outfight them, and defeat them. The other option, appropriate with other less rigid and brittle members of this psychic class is take a longer view. In these cases, while defeating them politically we have to also disprove or disconfirm their experience in practice, to provide over time experiences in which they can feel some control but also get helped. It's almost as if you have to take care of them in spite of themselves, in ways that allow them the maximum amount of freedom and the maximum autonomy to say No. Only then will you stand a chance of them hearing your arguments.

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