Trump is a public health crisis – and 'stress management' isn't enough: Noted neurologist

Donald Trump's presidency has caused a large increase in self-reported levels of stress among the American people. This will impact their health for generations. A similar dynamic is taking place in Europe and other parts of the world where authoritarian and other forma of extremist or reactionary politics have taken hold. Authoritarianism is not just a political and moral crisis — it is a public health crisis as well.

This is another example of how politics is both a function of nature and nurture. There is the biological component of how the human brain is hardwired to respond to the environment. Nurture also influences how the brain develops and therefore processes information — and this in turn helps to shape political values and behavior.

Ultimately, the truism that "the personal is political" remains correct in many ways that are both obvious as well as subtle and unexpected.

How is the stress caused by Donald Trump and his right-wing movement negatively impacting the health and decision-making of the American people? In what ways has fear been weaponized by Trump and other authoritarians? If biology is connected to political behavior, where did all of these "new" authoritarians in America and elsewhere come from? How can we use our increasing knowledge about the human brain and stress to craft better public policy? How has research drawn from sociobiology and evolutionary psychology been abused and distorted by public figures such as Jordan Peterson and others who want to make grand claims about human behavior? How can science help us to understand the relationship between brain structure and sociopolitical behavior?

In an effort an answer these questions I recently spoke with Dr. Robert Sapolsky, a professor of biological sciences and neurology at Stanford University. Sapolsky is one of the world's leading authorities on the connection between stress and  disease, and was awarded a MacArthur Fellowship in 1987. He is the author of numerous books, including "Why Zebras Don't Get Ulcers," "A Primate's Memoir: A Neuroscientist's Unconventional Life Among the Baboons," and most recently "Behave: The Biology of Humans at Our Best and Worst." His writing has  appeared in many publications, including Scientific American, Harper's and The New Yorker.

This conversation has been edited for clarity and length.

Broadly, I would say it is generating a huge amount of stress and of the type that is of the worst sort. This is the stress that pushes people towards parochialism and banding together with comfortingly similar faces. This type of stress pushes people towards being less empathetic. It pushes towards the worst kinds of stress management, which is scapegoating.

Recent surveys show that stress levels among the American people are at record levels. What explains this?

Nobody in their right mind would say that it's more stressful today than what it was like for someone whose farm in Oklahoma was blowing away in 1930. But what I think has changed — and is at the root of an awful lot of these levels of stress skyrocketing — is that the most effective sources of communal support have been withering away. Social support is declining. This is the stability of communities and families. Stability has gotten jettisoned in part because social capital as a whole is crashing in many different communities. This is driven by income inequality and other problems, but also because we as individuals have needs and desires now that are exactly of the type that harms a sense of community.

We like being mobile. We want to be able to be anonymous. We want to be able to reboot ourselves. We're willing to move to whatever isolated corner of the country for a good job or two years of great schooling or another opportunity. In having those opportunities, we have lost some really traditional sources of comfort and stress reduction.

Trumpism and other types of right-wing populism in the United States and elsewhere are a symptom of deep feelings of loneliness and social atomization. Right-wing authoritarianism is also a story of a loss of social capital. Trump's followers and other authoritarians are desperate for a feeling of community. It is not surprising that some observers have described Trump's rallies as being like church revivals.

That is a reflection of how after and during Trump's election the American pundit class discovered the marginalized white male, the undereducated working-class white male, and how they've been made to seem peripheral and left behind culturally. It is exactly such a circumstance that pushes a person towards one's in-group values, and that dynamic is certainly on display at Trump's rallies.

There is research that suggests that the brains of in-group or higher social status group members in a given society do not behave in the same way when said person encounters someone they deem to be of "lower" social status. 

There is research which examined whether or not cars slowed down and stopped for people in crosswalks. The expensiveness of the car was taken as a proxy for socioeconomic status. This research shows that the wealthier the person, the less likely they were to stop for someone at a crosswalk.

What's most interesting here is that people on top have every reason to be falling for system justification. This all makes wonderful sense. What's vastly more interesting is people on the bottom having a social dominance orientation and supporting the status quo.

Liberals often ponder the incorrect question which is, "How is it that election after election, so many of the poor vote against their economic interests by putting robber baron Republicans into power?" My explanation is that the benefit these Republican voters are getting is a visceral one, which is that at least it's making for a world that's predictable.

I think the relationship between social-dominance orientation in people and the extent to which they're made uncomfortable by ambiguity and novelty is really important. Better a stable world that's familiar, in which I'm doing pretty poorly, than dealing with all the ambiguity of a changing world.

This also explains why what I have described as "political sadism" by Trump and other conservatives has been so effective. Right-wing leaders abuse their supporters and then those same supporters feel compelled towards the political leaders who are hurting them. 

It is catharsis. You get someone who's good at manipulating those emotions and what they do is to raise every terrifying prospect one could imagine: "We're being invaded by hordes of rapists and drug dealers, etc. The whole world is laughing at us, but here's the solution. The solution is me."

It has to be very cathartic in that sense to generate the terror and then resolve it. In some ways picking up on your concept of a Trump rally as some evangelical religious revival, religion is really good at decreasing anxiety. That sounds great until you consider that religion is mostly good at decreasing the anxieties that it invented in the first place.

If political behavior is informed by biology, how do we explain where these "new" authoritarians have come from?

Authoritarians have always been here. But the features of a given moment make that way of thinking more or less appealing. Germany in the 1920s, when people are starving, suddenly makes "populist" answers and scapegoating different groups as the source of the problem much more appealing.

Today's tumult in America is a much subtler one, where all sorts of folks whose values used to be at the core of society are now made to seem peripheral. Many people who are often not very educated or have occupations and skills that are obsolete and who maybe feel like the dominant culture has passed them by are now imagining themselves surrounded by people who don't look like them. This can be immigrants or refugees. In the face of all that change, easy answers start to seem really appealing.

Let's reflect on the resurgent power of ethnocentrism, racism and nativism in today's politics. Trump won the White House by playing on racist stereotypes and other myths about immigrants from Latin America. But that fear-mongering was most powerful among white racially homogeneous communities. Communities that are more racially integrated did not succumb to these threats. How do we explain that?

Your observation fits perfectly with all the news coverage about how people who live right on the U.S.-Mexico border are saying, "Emergency? What emergency? What are you talking about?" What exposure does is, with any luck, is show you a reality and objective truth that is very different from what the demagogues are saying.

Temperament also matters as well. On the most basic level, is the unknown a scary thing or an exciting thing? Even the temperament of children in terms of novelty at a young age is predictive of anxiety and political orientation later on in life. The notion of humans as inherently rational beings has been not only trashed in economics, but trashed in all the best research on moral decision-making.

Researchers have shown that brain structure influences political behavior. Those who tend to be more authoritarian and conservative are more likely to fixate on unpleasant images and obsess about things that are viewed as pollutants or are "dirty," People who  tend to be more liberal or progressive are not as sensitive to the same stimuli. How can these divergences  be weaponized in politics? 

Disgust is a very powerful tool for bringing about crowd violence. If a group can be dehumanized and made into the Other, the "them," to treat that group horribly is made much easier. Powerful neurobiological processes have assisted in that process and outcome.

What about sociobiology? Has it fallen out of fashion yet? With the popularity of Jordan Peterson and other academic-adjacent types who try to make grand claims about human nature and biology, that area of study seems to still be popular.

The good research typically does not support such narratives in the slightest. That sort of sociobiology research in the 1970s and 1980s has lost most of its steam because the work has gotten more rigorous. This is true not just of human beings. Complex social species violate strict sociobiological models of behavior because individual differences disprove conclusions about such things as nice pseudo-economic models regarding decision-making that optimizes reproductive success for example.

Much of this re-emerged in the 1990s in the form of evolutionary psychology, and that has certainly been appropriately trashed concerning its excesses.

One of the problems with that type of research and theory is a focus on differences without a focus on the reliability of the differences as well as the magnitude of the difference. Another problem is a focus on averages rather than understanding that the most interesting stuff about humans is variability from the mean and the importance of individual difference. Jordan Peterson's simplistic perspective on the universe is not sustained by rigorous science.

Those simple stories are very lucrative. This is especially true regarding claims about how men and women are "naturally" different from one another. When you hear such arguments, do you just dismiss them out of hand? Are such claims even worth engaging?

It terrifies me. It is very hard to dismiss. It constantly strikes me that, "Oh my God, you should be able to debate these people and show how nonsensical they are," and then realizing any sane person who is coming from my field would be out of their minds to even engage in such a debate or discussion.

Why? Because the undercurrent of their claims is not anything that's solvable by rational arguments and facts. The men's rights types and others who parrot their claims are just trying to appeal to unpleasant emotions. You cannot reason somebody out of a stance they were not reasoned into in the first place.

Jordan Peterson doesn't have followers because his arguments are logically airtight. There are many men who are fed up with feeling that they are somehow marginalized or made peripheral. Peterson is someone who is  telling them what they want to hear on an emotional level.

I am concerned about the implications of "big data" as applied to genetic research. "Sociogenomics" seems like it can be easily twisted to bring back and legitimate old discredited theories about race. In essence, "sociogenomics" could be a 21st century way of giving life to zombie ideas such as "race science" and "eugenics" from a century or more ago. 

To the extent to which we are in the "genomics era," one thing that disturbs me is how broadly most people misinterpret what genes have to do with behavior. One should not ask what a gene does. Instead we should ask what a gene does in a particular environment.

There is no species that provides more diversity of environments than human beings when it comes to generating genes that are subordinate to environmental interactions. "Evolutionarily adapted" is not a moral value. It is not a state of goodness of fit. It is just a statement of how you're dealing with the environment in the present.

And just as evolution is not directional towards ever more wonderfully "supreme beings" until it produces Germanic culture in the 1930s, in the same way evolution is not a force of moral selection or value selection.

We have the tools for getting incredible amounts of data. There are people taking online surveys and instead of 60 subjects in your study, there are 5,000. A researcher is sequencing genomes from 100,000 people. Instead of recording from one neuron at a time, we can record information from thousands.

What results is an amount of data that researchers cannot intuitively make sense of. There is no intuitive way to understand those massive amounts of data. The downside then, as you suggest, is that it is easy to manipulate and subsequently produce whatever result you want with that data.

This leads us to "epigenetics" and how stress impacts different individuals and communities. On one hand it is very powerful to be able to say that environment and stress have measurable negative impacts on individuals and groups, often as demarcated along the color line. But I am also deeply concerned about how this research can be used to advance regressive arguments such as that these problems are genetic and can't be fixed by public policy.

One of the big worries is exactly what you raise. Epigenetics can be used to suggest that things can't change, they are unfixable. Then a few steps later the conclusion can be that these problems should be fixed on a societal level because they are inevitable. But in reality nothing about the biology of this is about inevitability. It is all about propensities, vulnerabilities and potential as related to the environment.

For example there are claims that everything that can go wrong with our health is stress-related. This is certainly not the case. Stress causes very few diseases. What stress does is it makes it harder for your body to withstand the traditional causes of diseases. In the realm of stress management there are these claims about the power of the mind and psychology to buffer people from stressful circumstances.

The danger here is an absurd notion that we all have the power to be free from stress if we only had the right attitude and if we only had the correct internal coping mechanisms.

"Stress management" is mostly for neurotic middle-class or higher-status people working on their "First World problems." Stress management should not be expected to make a dent in your life if you are homeless or if you're a refugee or if you have a terminal disease.

The solutions are then framed as being individual and primarily a function of "self-reliance" and "personal responsibility," as opposed to being communal and public-health-oriented.

Absolutely. Mental health professionals, who are trained to think about one person at a time, often wind up being so stressed out because they realize what they are dealing with are mostly public health problems. Any claim that a person should be able to meditate away their neurochemical imbalances or organic disease states — what are these societal-sized problems on an individual level — is just ridiculous.

Let us imagine that Rep. Alexandria Ocasio-Cortez or another forward-thinking elected official asked you to testify about your research on stress and human biology. What advice would you offer?

Everything that researchers such as myself know about the links between socioeconomic status and stress-related health repeatedly shows that at the end of the day the mediating factor is that poor communities and socially unequal societies create people who do not trust each other and feel like they do not have efficacy.

Social capital crashes in communities that are unequal and/or poor. Do something about that. That's the level where intervention is needed. Medication is not a long-term solution.