THE PSYCHOHISTORICAL ORIGINS OF AIDS

An Interview with Casper Schmidt

By Ian Young

The AIDS Cult 1997



"What is disease? It is false reasoning.... I will say to the patient, 'You have built the disease yourself, in your sleep of ignorance.' ... I know that the bottom of these phenomena is a lie in the beginning and started by a liar till it was received as true; then the phenomenon is called disease."

-- Phineas P. Quimby, c. 1860

I first heard of Casper Schmidt in the late Eighties, when I was compiling the bibliography of alternative approaches to AIDS that became The AIDS Dissidents. My friend and fellow researcher John Lauritsen sent me an article entitled "The Group-Fantasy Origins of AIDS", which The Journal of Psychohistory had published a few years earlier in its Summer 1984 issue. That paper, published in the year the official line on AIDS was pronounced, represented one of the earliest -- and most intriguing -- dissenting views about the epidemic. There, Dr. Casper Schmidt, a gay psychoanalyst, considered AIDS in the light of certain unconscious American group-fantasies, and compared it to a number of "hysterical epidemics" in recent history.

Schmidt was one of the first to explore the psychosocial background to the health crisis, maintaining that the strident political attacks on gays that persisted throughout the Seventies had contributed to a shame-based, sacrificial group psychology among gay men, which in turn led to "an epidemic of depression with psychogenically-reduced cell-mediated immunity". Authorities and the media participated in the general trance state.

A medical doctor with a psychoanalytic practice in New York, Schmidt also served as Associate Director of The Institute of Psychohistory. Born in South Africa, where he had published several books of poetry in Afrikaans, he spent two years working as a physician in the Black township of Soweto before moving to the U.S. in 1975 to train as a psychiatrist, specializing in adoles- cent, child and infant psychology. In New York, he was also known as an enthusiastic member of the AIDS activist group ACT UP.

I arranged to meet Casper Schmidt on a sunny, blustery morning in November of 1992, in a diner on Broadway. He struck me as a good-natured man in his forties, with a penetrating intelligence that was based on keen powers of observation. After breakfast, we walked a few blocks to his psychiatric consulting rooms overlooking Riverside Park on Manhattan's Upper West Side.

I began our interview by asking about psychohistory. Referring to Lloyd deMause's definition of psychohistory as "the science of historical motivation", Casper went on to distinguish three types of psychohistory: psychobiography (mostly of leaders and other prominent individuals); the history of childhood -- the different ways children have been treated historically, and the results; and group psychology in its political context. He noted that ninety percent of current psychohistory is psychobiography, which he said he regarded as being to some degree a defense against childhood and group psychohistory. I asked him why.

CS: "Because the fantasies that come together in political life reach to such a profound level of the unconscious and are so disturbing and upsetting that most people find them extremely difficult to deal with. For example, if you say, 'We want to sacrifice the leader', that simple sentence -- for which we have such ample evidence -- provokes immoderate amounts of anxiety because it confronts them with the deepest levels of unconscious motivation."

IY: "So the whole fantasy of the sacrifice of a Sacred King like Kennedy throws them into a tizzy and they posit the idea of a lone, crazy person who has nothing to do with the rest of us and is cut off from us by mental disturbance and so on."

CS: "The one thing that people can tolerate is to enact the fantasies on the historical stage -- if they can project the blame onto somebody or other. Looking at this in a rational, scientific way seems to most people like the most difficult thing on earth."

Six years after Schmidt's arrival in America, the AIDS crisis began. Schmidt began to investigate the syndrome after one of his patients had a lover who had fallen ill:

CS: "The more I read, the more puzzling and the more profoundly disturbing it became. Because it made no sense. At that point, everybody was conceptualizing AIDS as an infectious disease which was spread by sexual contact. And as I was looking through the evidence, it became more and more clear to me that this epidemic was not behaving like an infectious disease at all."

IY: "This would be before the pronouncement of the official HIV idea."

CS: "Yes, this was in 1983, about a year before HIV [was publicized]. But already, people were speaking about a virus in our bloodstream, which was a phrase Reagan would use throughout his term in office. Yet even at that stage, the idea was that this was something spread sexually and through drug use."

The ideas about "safe sex" that were evolving even then in the gay community Schmidt described as "an apotropaic ritual" designed to ward off the dangers of sexual contamination:

CS: "The further I read about this, the less sense it made. Infectious epidemics do not follow fault lines that are cultural or sociological, which is what we find in this epidemic. You do not find any infectious epidemic in history that selectively infects a group designated on a basis of cultural factors."

I asked about the European diseases (like smallpox) that devastated the Native peoples of the Americas:

CS: "There you have quite a different situation. Europeans had, through centuries of contact with certain diseases, built up what is called herd immunity. All those people who were susceptible to these diseases died out through the centuries. Everyone who remained had immunity. When these same diseases were transferred to a new population, you had an abbreviated replay of what had happened in Europe -- all over the place, all at once, with devastating results. This is typical of infectious epidemics.

"Hepatitis B is an infectious disease spread through a virus, through sexual contact, contact with blood and other intimate contact. Hepatitis B is somewhat restricted to certain groups, particularly gay men, because of the upsurge of sexual contacts during the Seventies, in bathhouses and so on. However, it was not totally restricted to those people, so that any physician, for example, who came into contact with the virus was at risk. And it spreads whenever there is sexual contact -- regardless of sexual orientation.

"That's the difference between an infectious disease and what you have in AIDS, where the spread is virtually entirely according to cultural parameters. In the beginning, it was with gay men, and as the Reagan administration [established itself in] power, with drug addicts. And those were the two main scapegoat groups, and a few smaller groups that may have had unconscious identifications with us when you had unconscious fantasies of poisoned blood, which were rampant during the Reagan/Bush years."

I asked about hemophiliacs, and Schmidt pointed out that hemophiliacs have incredible numbers of blood transfusions, causing a phenomenon called tolerance, which is very similar to AIDS.

IY: "Hemophiliacs have always died at a great rate."

CS: "Even more importantly, there is an enormous literature on the psychology of hemophilia. All the male children with hemophilia are subjected to the most restrictive regimen, which inhibits their ability to express aggression -- something which I think is necessary for this kind of syndrome to develop. This is a factor which they share with drug addicts and gay men. All these groups of people had in earlier life a curtailment of their right to express their aggression in an unfettered way. That is one of the risk factors for this syndrome."

IY: "How does this aggression factor pertain to gay men?"

CS: "A drive seeks to be expressed. It has no concern whether outwards or inwards. When the expression of this drive is curtailed for whatever reason, the drive is often turned inwards and expressed against the self, giving rise to psychosomatic disorders, actual physio- logical disturbances. That is what happens in AIDS. For example, it has become obvious that the people with AIDS who are least inhibited in their expression of aggression, and who pursue their own well-being with the least amount of curtailment, do best. They survive the longest -- regardless of where they are in the syndrome. Those who do not express their aggression, their assertiveness, their right to exist, to the same extent, seem to come down with the syndrome in a rapid, usually fatal way."

IY: "You're talking here about characteristics of long-term survivors -- what Michael Callen was looking at in his book Surviving AIDS?"

CS: "Yes. These are the people who are not afraid to get angry and to express their anger. These are people who demand and are not afraid of expressing their demands."

IY: "Bernie Siegel, in Love, Medicine and Miracles, says the same about cancer patients."

CS: "One hundred percent identical. When people do not express these basic drives, they are expressed instead as stress. Both AIDS and cancer patients feel abnormal stressors and feelings of helplessness. As a result, their bodies secrete a substance known as cortisol. Cancer patients show an enormous increase in cortisol and a lowering of their DHEAS levels, the same as in AIDS. Until two years ago, nobody had been able to figure out the function of the DHEAS, which is by far the most voluminous of all the steroid hormones in the body. The key factor in terms of both cancer patients and PWAs is that they feel great stress and helplessness. And instead of expressing their needs outwardly, they turn inward and over-secrete cortisol, which paralyzes their immune systems."

IY: "You see a sequence of events in the body that leads to the drop in T-cells that accompanies AIDS."

CS: "That's right. Pneumocystis carinii, for example (a serious illness of PWAs) is fought by T-cells producing gamma-interferon. If you have normal T-cells, the chance of developing pneumocystis is extremely low."

IY: "What part do you think venereal diseases play in the development of AIDS?"

CS: "Very little actually. I think they're mostly a marker for something else. The penumbral syndrome surrounding AIDS started in the mid-Seventies and showed itself in the enormous increase of venereal diseases and what was then called Gay Bowel Syndrome.... Everybody thinks that amoebiasis was driven by these wicked amoebas. In fact, I think a more accurate interpretation would be that the reduction in cellular immunity permitted amoebas to grow. The enormous incidence of venereal disease during the Seventies was a marker for people with a psychological vulnerability to the group psychology, and who responded to it with numerous anonymous sexual contacts, which increased the transmission of genuine venereal diseases -- including syphilis, which is not so easy to treat as people think!"

Schmidt said he regarded the binge of anonymous gay sex that began in the Seventies as intimately related to the psychology of ostensibly heterosexual men, and also as deeply enmeshed with gay men's guilt feelings, tension and anger, which, deprived of any other outlet, tended to be repressed into the body. This somatization caused blocked emotions and profound biophysical changes. One of the most important of these has been the continuous simulation of a "fight or flight" syndrome.

The "fight or flight" syndrome occurs at times of increased stress and is accompanied by, among other things, temporary immune suppression and raised levels of adrenalin, endorphins and cortisol. Ordinarily, this syndrome should occur in humans only occasionally, in instances of danger. If it becomes, instead, a condition of life, cortisol levels become perpetually elevated. I asked Schmidt about the role of cortisol levels in AIDS.

CS: "All the work on cortisol levels in AIDS was done in 1988 but not published until 1992 because the researcher, Joseph Malone of the U.S. Marine Corps, working at the San Diego Naval Hospital, thought it was so far out of whack with the mainstream that there was no point in trying to publish it. Only in 1992 did he publish it. Malone was the pioneer who first looked at cortisol levels in AIDS. Since then, it's been confirmed that from day one in the spectrum of AIDS diseases, you have an overproduction of cortisol. That becomes consistently higher as the syndrome progresses and by the end of the syndrome, people overproduce cortisol in enormous amounts, like cancer patients."

Schmidt explained that the balance of cortisol and DHEAS affect interleukin-2 and gamma-interferon levels in the body. Interleukin-2 is the T-cell growth factor, which all T-helper lymphocytes need in order to exist. Research has shown that if they are deprived of Interleukin-2 for six to twelve hours, they undergo changes, called apoptosis, which result in T-cell destruction. So overproduction of cortisol, and a lack of Interleukin-2, can result in the killing of lymphocytes - - both indirectly (by depriving them of growth factor) and directly (through the toxic effects of cortisol itself).

CS: "Everyone who proceeds to AIDS has lowered levels of DHEAS. That's the key pathogenetic mechanism, I think, in the entire syndrome. This is corroborated by the fact that PWAs have an overactivity of B-cells. A message goes out to the B-cells, 'Produce antibodies! Produce antibodies!' And they produce antibodies to everything they've been exposed to in the past, regardless of whether it's a current problem. And the B-cells go haywire, producing enormous amounts of antibodies.

"All of this dovetails with the work done with DHEAS. The guy who is most intimately connected with this and who discovered how this works is Raymond A. Daynes at the University of Utah."

IY: "This mechanism is a result of what kind of stresses?"

CS: "All the details haven't been worked out, but we do know several things. In Philadelphia in the Sixties, they found that if you put animals in a situation they can't escape from, and give them electric shocks, they try to escape for a certain time, but when they realize they can't escape, they lie down and tolerate the shocks, whimpering and moaning. If you open the gates of their cage, they behave as if they're still prisoners. They develop learned helplessness.

"All you need to do is to drag them out of the cage, and then they learn very quickly. Stephen Maier at the University of Colorado has worked out the physiology of this; there are biochemical reactions in the endorphin system which affect lymphocytes directly. Also, there are changes in the hypothalamus which cause the secretion of cortisol. Any kind of restraint, learned helplessness, or belief that people can have no impact on their situation, causes these changes.

"When individuals don't feel they can influence political life, if you have a conservative swing, with Reagan coming the White House, promulgating the fantasies of the far Right, saying that homosexuals are bad because they are destroying the family life of America and they should die, that is the kind of thing which creates inescapable stress, giving rise to feelings of helplessness. People don't know what to do, they don't have anything they can do. With the exception of ACT UP. That's where ACT UP comes in, because there, people are not helpless! They can release their feelings and express them. Which is why most of the people in ACT UP don't easily die from AIDS. We have an enormous and beautiful track record of people surviving much better. Expressing their rage is what saves them!"

I asked about HIV, the retrovirus that has been pronounced the official "cause" of AIDS.

CS: "I was never impressed with HIV as the cause of the syndrome, for various reasons. Most important, a virus like this does not remain confined to cultural categories. I thought there must be some other explanation for this. Indeed there is: epidemic hysteria. When you have people low down on the totem pole of power: women, prisoners, children, homeless people, people who feel powerless, those are the people who do not have an avenue to express their rage, they turn this inward and become ill with epidemic hysteria. AIDS is a clear case of epidemic hysteria.

"HIV, a relatively weak virus, belongs to the family of retroviruses. Characteristically, the retroviruses do not kill cells, they cause them to proliferate. So from the word go, when people said this weak virus kills the T-cells, it didn't make sense to me. All the evidence was against it. Plus -- and this is where the theoretical sine qua non arises, that most people are trying to ignore, because they are all in a trance -- there are many people who have the syndrome without any evidence for the virus."

Though Casper Schmidt was one of the first to question the role of HIV, he pointed out that the first to publish his skepticism was a French scientist by the name of Georges Matt. But it is Dr. Peter Duesberg, he said, who has made the most cogent arguments.

CS: "A man in Montreal called Hugo Soudeyns discovered that HIV has two receptors for cortisol. This makes a lot of sense because these receptors allow cortisol to have an effect on the virus; cortisol may be necessary for its growth. This was discovered by people in Robert Gallo's lab in 1986! They showed that cortisol stimulates the growth of HIV in the test-tube. So this explains the fit between incidence of the virus and the syndrome."

IY: "Yet there are people with HIV antibodies who are not sick."

CS: "Yes. If you don't have all the psychological factors that go into making the syndrome, you can have the virus and it will have little effect -- similar to cytomegalovirus or some of the herpes viruses. You can have these viruses floating around in your body all your life without ever becoming sick from them. Ninety percent of gay men have cytomegalovirus. But only when your immune system is drastically disempowered do you get sick."

We talked about the role of the AIDS crisis in changing the status of gays in America.

CS: "Whenever people have become part of the group psychology of the mainstream, they have always entered through a period of sacrifice. The Jews in Europe went through an extended period of sacrifice before they were accepted. My reading of the AIDS crisis is that it is really part of the assimilation of gays into the political life of the country as a whole. And I think all of this started in the late Forties with the end of Isolationism and the assumption of America as the dominating power of the world. This gave Americans incredible amounts of hubris!

"Then, I think Kinsey was extremely important. Kinsey published [his first report on human sexuality] in the late Forties and caused an upheaval in this country. For the first time in the history of the world you had an accurate, statistical representation of what people actually did sexually. Everybody was driven insane because their cherished group-fantasies were completely demolished in two volumes! So immediately you had a reaction, which was McCarthyism. The cover was blown off the defenses. Those people who had strong homoerotic fantasies and couldn't deal with them were driven totally insane by Kinsey."

IY: "Like Hoover and McCarthy!"

CS: "Of course! People who were deepest in the closet and were most repressed. We were suddenly a great power 'on the world stage' and all our secrets were being published in books! This gave rise on the one hand to McCarthyism and all the paranoia it entailed. But on the other hand, you have the feeling that we can tolerate much more than before. So Frank Kameny and the Mattachine Society and the Daughters of Bilitis were all more advanced people, more in touch with the group fantasy of tolerance and openness. By the late Fifties came Women's Liberation, the Men's Movement, the Gay Movement. Then came the conservative clampdown of the late Seventies.

"I think that the end result of all of this will be that you will have virtually no overt homophobia or severe discrimination against gays in the future. But there will always be pockets of homophobia because abused children need to project their bad feelings somewhere. There will always be fag-bashers among boys who have been severely treated -- and despised -- by their fathers. In time, this too will change. Because America has become the first society to say that child abuse is unacceptable! I foresee a society which is relatively peaceful ... after the epidemic is over.

"Most epidemics are symmetrical. They rise and fall in a curve. Since the AIDS epidemic peaked for gay men in 1988, we can expect the epidemic to be over for gay men by 1996-7. What the Centers for Disease Control and the American group psychology did to confuse this is to keep changing the definition! In 1989 and 1990, the CDC published the statistics with old and new definitions separately, so you could quite clearly see how according to the old definition, the incidence of AIDS went up until 1988 and then started coming down. The new definition is a lump added on top. As soon as they noticed people would realize this, they conflated the two definitions. They now give them as if they're the same."

IY: "Why do you think they did this?"

CS: "In order to ensure that people are still sufficiently frightened and that the sacrifice does not stop. We do not want people to understand the dynamics of this illness because that will subvert the sacrifice. Anything that threatens to resolve the situation is fought bitterly as if it is the enemy.

"If you go to a primitive tribe where they are about to sacrifice fourteen babies, and tell them that this will only make them feel good for a day or a week, and then they'll have to sacrifice more, that there are ways to feel better without this sacrifice -- you know what they do? They kill you on the spot! Because you are interfering with their sacrificial ritual. Nobody criticizes the sacrificial ritual.

"Every bit of AIDS research that underwrites the group fantasy and continues the sacrifice is approved of."

IY: "Now how do the people participating in the group fantasy know when the fourteen babies have been killed? How do we know when enough is enough?"

CS: "It's really interesting. The only answer we have is based on work done with other cultures. When, during the Aztec Empire, the priests performed their ritual sacrifice -- which they did a lot! -- they would take the skulls of the victims, make holes in the temples and fix them onto long poles which they would string up in front of the big pyramid in such a way that whoever stood on top of the pyramid could look down as they imagined the gods would, and could count the skulls on a device called a tzompantli. They literally imagined the gods counting the sacrifices. When the people felt sufficient relief from their bad feelings, this would be conveyed to the High Priest who would then go up on the pyramid, commune with the gods, and declare that the gods have said 'Enough!'"

IY: "So this is literally a Golgotha, a hill of skulls."

CS: "Absolutely. And this is what the Quilt is for AIDS. You display the Quilt, horizontally, to the gods so they can see when enough people have been sacrificed and send the message, 'Stop the sacrifice!' This is exactly the same as the tzompantli. You are displaying the equivalent of the skulls to the gods so they can decide when there are enough.

"Group fantasies are relayed through indirect means. Now, since the epidemic is clearly diminishing, they have displayed the Quilt in its entirety for the last time -- on the week of October 12 (1992)."(1)

Casper Schmidt finished the interview by saying that he had been treating a number of people with AIDS, and had shared his preliminary findings with fellow therapists in a paper entitled "Guidelines for the Psychoanalytic Treatment of AIDS". In this paper, he observed that his AIDS patients had all suffered syndromes of longstanding stress connected with conflicting feelings about their sexuality and that this condition involved "activation of the hypothalamo-pituitary-adrenal axis (the stress axis)", leading to increased cortisol production and decreased DHEAS. From these beginnings, he traced the course of the cellular disturbance that eventually leads to the gradual, relentless decline in T-cells characteristic of AIDS.

All of these patients, Schmidt found, suffered from intense, socially-induced shame, and an extraordinary capacity to disguise and feign feelings, with negative feelings being "shunted into their bodies", resulting in histories of psychosomatic complaints, and a "suicide syndrome" of "destructive affects ... turned against the self". He also observed that all these patients had been severely traumatized in childhood.

Schmidt was hoping that by combining experimental therapeutic work with a thorough program of nutrition and vitamin supplementation (such as the Direct AIDS Alternative Information Resources Protocol), the core AIDS symptom of continuing T-cell decline might be arrested, and even reversed. And he was hopeful that the incoming Clinton administration would effect positive changes.

After I finished the interview and left Casper's apartment, I walked a few blocks to a friend's place. My friend had just returned from visiting someone he knew, another PWA. "Poor Bob", he said, "he has these terrible lesions here." He pressed his fingers against his temples and made circular motions against the sides of his head. I thought immediately of the holes in the temples of Casper's Aztec skulls -- a sudden synchronicity that gave me an eerie feeling -- puzzling, and strangely exciting - - like the first breakthrough in the cracking of a complex and difficult code.

Casper and I found we had a lot in common, including our love of poetry and South Africa (where I had lived as a child), and we soon became friends. We discussed editing and publishing a book of his short stories, to be entitled The Barbecue of Madame Nhu, in reference to a comment by the wife of the President of South Vietnam when monks began to immolate themselves in protest against the war: "I hope they invite me to the barbecue!" Another of his stories was a Borgesian fable about the forgotten origins of the tango among homosexual gauchos during the long, cold nights on the pampas!

I arranged for Casper to spend a holiday visiting me and my partner in Banff during the summer; he was to bring his stories with him. He never arrived, and my efforts to reach him were unsuccessful. What he hadn't told me was that at some point in his researches, he realized, to his horror, that he was diagnosing himself.

The last year or so of Casper's life remains something of a mystery. Diagnosed with AIDS, he entered hospital, and shortly afterwards left, to die at home of AIDS-related illness in the late Spring of 1994, about eighteen months after our interview. The long-promised second part to "The Group-Fantasy Origins of AIDS" was never completed. All his research papers, manuscripts and patient case files have disappeared. *

(1) Newspaper articles published around this time pointed out that the Quilt had become too big to display whole, in a single location. Since then, new locations have been found, most recently Washington, DC -- October 1996. A visitor to the Quilt on 12 October 1996 wrote anonymously in the guest book: "please god let this be the last time we have to come to washington to see the quilt. no more deaths."

This interview is Chapter V of the book, The AIDS Cult, edited by John Lauritsen and Ian Young. It is reprinted with the permission of the editors.