Bandy X. Lee M.D., M.Div.

Psychiatry in Society

Our Nation’s Danger from Within

Presidents influence how we think, feel, and behave.

Posted Dec 03, 2018

In the lead-up to the midterm elections, the nation watched in horror as reports came in of yet another mass shooting in America. In Pittsburgh, an individual with an anti-Semitic history reportedly carrying an AR-15 semi-automatic rifle and multiple handguns, shouted, “All Jews must die,” as he entered the Tree of Life synagogue, killing 11 worshippers and injuring six others. The direct blame lies with the gunman, to be sure. However, there is also a clear relationship between the gunman’s online rants and the anti-Semitic rhetoric that has moved from the political fringes into the White House.

The president possesses one of the most influential positions for telling people how to think, feel, and behave. When he states that a Jewish billionaire is funding a caravan of “criminals and unknown Middle Easterners,” implying that terrorists were among them, he is telling Americans they should be very, very afraid. It does not matter that the caravan was a thousand miles away, mostly consisting of parents and children who are seeking asylum from violence, and less than half the number the president stated.

What is important are the effects of those misleading statements: the synagogue shooter suspect told a SWAT officer while in custody that Jews “were committing genocide to his people.” On social media, he had also said that a Jewish humanitarian organization “likes to bring invaders in that kill our people. I can’t sit by and watch my people get slaughtered. Screw your optics, I’m going in,” moments before the shooting.

Psychoanalyst Phyllis Greenacre observed that paranoid conviction can be a powerful force in the charismatic leader-follower relationship (Robins, 1984). Mr. Trump understands this well and intuitively makes use of fear as a means of strengthening the psychological dependence of his followers on him. Since fear is often a fuel for violence, it is unsurprising that a small but significant percentage of his followers then spill over into physical violence. Statistics over the past year confirm this phenomenon, including the increase by almost 60 percent of anti-Semitic incidents alone (Anti-Defamation League, 2018).

A childhood friend of the gunman said, “He was in his own little world,” until they drifted apart and he disappeared. His next-door neighbor described him as “pretty much a ghost” and barely there. Yet he loudly spewed anti-immigrant and anti-Jewish invectives and conspiracy theories online, finding a like-minded audience on a white nationalist-favored social media network, Gab. Of course, it is difficult to prove causation between a president’s incendiary speech and violent acts by members of the population, but it is also not difficult to see that stirring up hate, anger, fear, and terror will goad unstable individuals to action. It is all the more powerful when individuals see the action as an avenue for turning their situation of alienation and failure into one of belonging and pride.

The pipe bomber suspect, who recently sent sixteen explosive devices in a mass assassination attempt on prominent Democrats, journalists, and other Trump critics, lived in a van that was covered with pro-Trump stickers, as well as one that read, “CNN Sucks,” and another that had a picture of Hillary Clinton in the crosshairs of a gun. While all the potentially lethal packages were intercepted before they reached their targets, Mr. Trump’s framing of the press as “the enemy of the people” or consistent chants of “Lock her up!” clearly seem to have had an influence on the 56-year-old who revered Mr. Trump in the midst of a troubled life, whereby he was unable to hold a job, unlikely to maintain friendships, and unable to maintain a roof over his head.

When the president uses angry rhetoric and presents himself as a spokesperson for disaffected and aggrieved individuals, he not only incites them but gives them a false outlet for their grievances. His ad-libbed prompts encourage supporters to physically harm protesters at his rallies, such as: “Knock the crap out of them, would you? Seriously, okay? Just knock the hell ... I promise you I will pay for the legal fees” or, “I'd like to punch him in the face,” and, “Part of the problem and part of the reason it takes so long … is nobody wants to hurt each other anymore.” Recently he said of a Congressman who assaulted a journalist, “Any guy who can do a body slam is my kind of guy.”

Mr. Trump needs his supporters as much as they need Mr. Trump—it is the “lock and key” relationship political psychiatrist Jerrold Post (2004) has identified. In this model, the “narcissistically wounded” leader is “mirror hungry,” seeking adulation in his followers, while the followers are “ideal hungry,” seeking the unrealizable promises. Since the promises are false to start, scapegoating and violence often ensues, with aggressive, violence-inciting rhetoric often inspiring the followers to act. 

The president invokes words that play directly to the fears, deep-seated resentments, and gullibility of his “base”, and the extraordinary characterization of a humanitarian crisis such as the caravan of migrants fleeing violence and poverty—largely as a result of U.S. policies—as a national security threat to be met with thousands of troops shows the psychological maneuvering that underlies this relationship. Sanctioning, creating, and celebrating violence elevates his position at the same time as it distracts his following through an avenue for the expression of grievances as well as finding meaning. Public safety is thus at risk in the short-term as well as the longer term. 

Throughout history, we have seen the fueling of divisions and similar prompts to violence lead to the destruction of democratic nations. A president’s language must be held to higher standards precisely because of his position of power and the profound ramifications. The full consequences remain unknown, but we likely have not seen the end, and mental health professionals must abide by ethical guidelines to employ our skill, training, and expertise to warn, protect, and educate the public about the dangers.

Co-authored with Claire Silverman, Ph.D.

Claire Silverman, Ph.D., is a licensed clinical psychologist in New York City who has taught at the City University of New York, the State University of New York, and worked as a senior psychologist for inpatient services before retiring to part-time practice.


Post, J. M. (2004). Leaders and Their Followers in a Dangerous World: The Psychology of Political Behavior. Ithaca, NY: Cornell University Press.

Robins, R. (1984). Paranoia and Charisma. Paper presented to annual meeting of International Society of Political Psychology, Toronto, Canada.

Anti-Defamation League (2018). Anti-Semitic incidents surged nearly 60% in 2017, according to new ADL report. New York, NY: Anti-Defamation League. Retrievable at:

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