Hochschild Gives Psychiatrists a View of Bridging the Political Chasm

People in the South are quite aware of how they are portrayed in the media, and they are having none of it. They’re tired of ridicule for their accents, their faith, or their belief systems—including that women should not put careers ahead of husbands and children.

Back in 2011, the sociologist Arlie Hochschild, PhD, of the University of California at Berkeley sought to understand the red state paradox: why voters in the poorest states, especially those in the Deep South, seemed to vote against their own self-interest. These states had higher than average levels of federal support alongside low rankings in education and health, yet white voters railed against the federal government.

It didn’t make sense. But as Hochschild explained to the well-attended session Sunday at the 175^th Annual Meeting of the American Psychiatric Association (APA), she came to understand over 5 years of traveling to south Louisiana why it all made sense.

“There’s a great deal of distress and discomfort,” he said. “That’s part of what we need to keep our focus on.”

Hochschild began her project in the early days of the Tea Party movement, after Republicans had taken control of the Congress. “There was this angry group of people living in another bubble, and I didn’t know any of them,” she said. “I realized that I was in a bubble, that we were all in political and moral bubbles, and I had to get out of that bubble.”

The “bubbles” where Americans live and vote, a phenomenon called sorting, are becoming increasingly distinct, making it challenging not only for governance, but also for conversations among extended relatives and even for psychiatrists who may treat patients who do not share their values. Hochschild, citing a 2018 article in the Atlantic Monthly, said it’s actually the far left that is less tolerant of hearing and learning world views that differ from their own.

Kenneth Thompson, MD, the past president of the American Association for Social Psychiatry, guided Hochschild through questions about her resulting book, Strangers in Their Own Land: Anger and Mourning on the American Right. Thompson said the lessons of Hochschild’s research, and the purpose of the session, “Psychiatry’s Role in Understanding Current US Political Polarization,” show that social psychiatry—which focuses on the role of culture in understanding behavior and well-being—has an important role in bridging the current divide.Thompson asked about the process of “scaling the empathy wall,” in which Hochschild sought to not only understand why her Louisiana subjects thought certain things, but also why they felt them. She described an exchange with a gospel singer, a wife of a pastor, who explained her love of radio host Rush Limbaugh. The woman said Limbaugh was defending her against the “feminazis,” which she defined as a woman “who hates children and puts herself first, doesn’t let men hold the door for her, and doesn’t fix her husband’s plate.”

Cultural changes that call for equality in the workplace, advancement of racial minorities or the LGBT community threaten to upend an order that was defined by rules and religion. And when these white voters ask, “What happened to the rules?” they are told the old rules are racist and sexist.

“So, they feel diffident and put down,” Hochschild said, “as having the wrong attitude, being Bible-thumping, and having the wrong faith.”

To the people she met in Louisiana, it amounts to a loss of honor, one that explains why people look past the ravaging of their environment. Hochschild identified 3 psychological obstacles to embracing the facts:

Hochschild came to see that the white voters who put up with Louisiana’s horrific pollution are concerned about holding on to a job today, because they see people like themselves falling down the economic ladder even if they are faring well. She called this group, which she estimates is about 40% of the population, “the elite of the left behind.” (Polls consistently find President Donald Trump has a base support of about 40% of the electorate.)

• The cowboy displays a stoicism that comes from a belief that Mother Nature will bounce back.
• The worshipper shows renunciation; Mother Nature’s gifts come from God, but here on Earth we don’t always get what we want.
• The team player accepts a lack of regulation because it has become part of the Republican mantra, and “I am loyal to my team.”

Why Trump Resonates

The appeal of Trump, Hochschild said, is his ability to tap into what she called the “deep story” of these voters and convert the shame and resentment they feel over the portrayal of their values by the mass media into political action. Similar movements among the “elite of the left behind” are taking place in Hungary, Italy, and Australia as globalization is sorting winners and losers, she said.

“How does a person like Donald Trump speak to them? He takes shame to pride, depression to elation, detachment to attachment,” Hochschild said. Later, she said that there is definitely a generational divide; younger people in Louisiana or Appalachia—the scene of her next project—are more progressive. They don’t vote, but if they did, it would be for Bernie Sanders.

Trump uses the media’s criticism of him to seal himself with this group, because they are so accustomed to being criticized by the media themselves. Hochschild described a 3-part “deshaming ritual,” that the president uses to inoculate himself almost daily:

• He says something transgressive
• The mass media rails against the statement or tweet
• Trump “rails against the shamer,” and “doubles down and says something worse.”

The “catharsis” that Trump supporters feel from this process is comparable to a “secular rapture,” and is key to the reason these evangelical Christians overlook his treatment of women, including his spouses. Americans remember Trump as the person with the last word from his days on “The Apprentice,” Hochschild said.

“You don’t have to wait to die to go to hell,” she said. “At some time, a moment will occur when God will come down and make a judgment—you go to heaven or you go to Hell.”

The language of social psychiatry is extremely important in helping explain what is occurring, because this field seeks explanations and interventions that occur within the framework of a social context.

A Moment for Bridge Builders

“Bridge builders have an unusual set of skills to mediate,” Hochschild said. “They know how to listen, and how to deal with emotions when you feel threatened or challenged. They do something that I call symbol stretching.”

She used an example of the retired Lt. Gen. Russel Honore, a Louisiana native of Creole ancestry who gained attention for his role in the aftermath of Hurricane Katrina. Honore now works on environmental issues, and he taps into the symbol of freedom when he evokes the symbol of a man having the freedom to fish, but not the freedom to lift an uncontaminated fish from Lake Charles.

Hochschild said the nuances in attitudes and beliefs continue to surprise her as she has moved to her work in Appalachia. “There’s quite a lot of empathic reach,” she said. “There are bridge builders I didn’t know were there.”