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“Well, Doctor, what have we got—a Republic or a Monarchy?” asked a lady. “A Republic, if you can keep it,” responded Benjamin Franklin.

Few people make the connection between the breakdown of a democracy, and the Republic that supports it, and the state of collective psychological health of a society. Yet, the link is fundamental. Just as a proper functioning of a person, whatever one’s choices in life, depends on a healthy, functioning body and mind, and we need to take good care of these things, so is the case for a body politic. This is because a would-be tyrant is not someone with a certain style of but a that will eventually destroy politics, and the body it governs, if allowed to continue (Adorno, 1950). Tyranny, therefore, is a form of disease, which by definition leads to destruction and demise. Mental health professionals rarely speak out about the affairs of the political domain: they do not have to. Only when things are entering the realm of pathology, and the nation is facing a collective crisis of a psychological nature, does it become critical.

A tyrant cannot take hold of power on his own, just as more than one condition needs to exist for disease to set in: take the example of tuberculosis. If we asked, what causes tuberculosis? One might say the pathogen, or the tubercle bacillus, causes it. The fact is, however, the tubercle bacillus is a necessary but insufficient cause of tuberculosis, for most people who are exposed to the bacillus, and who even have it in their bodies, do not become sick with the illness. Their bodies have an immune system that is capable of walling it off, and it just stays there and does no harm, just like the other numerous microorganisms that inhabit our bodies. Therefore, most people do not get sick when they are exposed to tuberculosis, but it is when they have an immune system that is impaired for one reason or another, incapable of fighting it off, that they get ill from it.

There is yet another factor: tuberculosis occurs more frequently, lasts longer, and is less frequently cured, causing a greater number of deaths, among those who are deprived. If one has poor housing, poor , poor , and poor access to medical care, all of which are associated with deprivation, one is more likely to become ill with tuberculosis, not to receive proper treatment, and to die from it. In other words, all these conditions—the pathogen, poor immune functioning, and deprivation—have to exist simultaneously to cause or to sustain what we usually think of as a purely physical disease.

Similarly, a malignancy in society does not develop because of single individuals. Would-be tyrants have always been a part of human society, but they are usually walled off in jails and prisons. More enlightened societies prevent the dysfunction that gives rise to them in the first place. We know that even cancer cells are necessary but insufficient causes of cancer, since they occur in the body all the time. It is only when the immune cells, or the body’s resistance, fail to detect them and defend the body against them that they come to spread and determine the fate of the entire body.

If the tyrant is the pathogen, the healthy element of the population is the resistance. We sometimes live happily among hundreds of thousands of would-be tyrants, since such personalities in a strong democracy are just “comical figures on soapboxes when they have no following” (Altemeyer, 1998, p. 85). A healthy body rejects malignant cells, but an unhealthy one succumbs, embraces, and may even actively promote their spread, no matter the threat posed, gaining endless momentum, hurtling towards the ultimate goal of any disease: destruction and death. In the same sense, tyranny is a tumor, a disorder afflicting the polity. A tyrant is just another tumor cell that metastasizes and proliferates throughout the body politic.

Would-be tyrants exploit the public’s existing weaknesses—such as the lingering of war, the that follows a state’s disintegration, or the fragmented of a nation grappling with . When these vulnerabilities reach a breaking point, they sweep a tyrant into power. Some rise to being heads of state, and others to leading corporations. They institute policies and social conditions that worsen public health, spawning more would-be tyrants. A tyrant must feed on vulnerabilities in order to ascend to a high position, but once in power, her malignancy infects the public sphere and worsens the spiral into pathology.

Human history offers endless examples of such descents into tyranny. The disintegration is seldom caused by a single individual, but revealed through him. In our culture, it has progressed alongside decades of exploitation, corporate greed, reduction of the middle class, and growing tensions between the rich and the poor. Heavily investing in a war machine while allowing the general state of health and education to decline, the populace became ripe for manipulation to political ends. Seizing the rising and desperation by appealing to the more primitive human impulses—spinning further and further untruths in order to lure, only to worsen the conditions that gave rise to the discontent in the first place—has been a psychological tactic for amassing power. Now that the political structure giving rise to these pathological conditions has reached its logical conclusion, the nation was attracted enough to elect an impaired who would then accelerate the descent into darkness.

However, as David Hume noted in On the First Principles of Government, power is on the side of the governed. To help facilitate this power (for true power is always healthy), it is important that mental health professionals speak the truth. They can serve as a preventive through the early detection of a “malignant normality” issuing from a disordered personality, as witnessing professionals (Lifton, 2017). They can promote public safety through alerting communities about signs of danger (Gilligan, 2017). They can offer their expertise to different branches of government that might serve as checks or balances (U.S. Const. arts. I-III), or for the judicial system in ways that can mitigate adverse directives (Pub. L. 93–595, §1). Finally, they can offer solutions (Gartrell and Mosbacher, 2017).

While Heraclitus of fifth-century BCE Greece said, “Character is destiny,” the destiny of the nation is not dependent on the tyrant’s character alone. While the collusion of corrupt or otherwise compromised structures may support her, we know that diseases do not always end in death. This is because the body responds, and even if the body politic was caught off-guard because it was not used to tyrants, once exposed to the pathogen, the immune system can build its ability to fight back. This requires that it correctly understand and face what is happening, individually and collectively, and change accordingly.