How the 1/6 Anniversary Reminded Me of Clinical Psychiatry

How can we examine the distress of 1/6/21 through a lens of clinical psychiatry?

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As I watched some of the 1/6/21 anniversary events unwind in Washington DC yesterday, I wondered how I could reconcile whatever empathy and compassion I have for those who were in so much emotional distress or brainwashed that they could storm and desecrate our Capitol, some with homicidal intent, with the anguish I feel for the trauma and damage they did to the country and all those directly and indirectly traumatized by their behavior? I may have found the answer, as is often the case, in my clinical work as a psychiatrist. Indeed, I even felt some resonance with the time when I worked with the inmates at a medium security men’s prison.

In clinical psychiatry, there seems to be 2 general ways to help patients. One, which is much preferable, is to form a positive therapeutic alliance with a patient so that we are working together for the common goal of recovery and mental health.

The second way, which I think most of us want to avoid, is forcing a patient into some sort of treatment via inpatient or outpatient commitment. More often than not, when I reluctantly had to go that route after judging that there was significant suicidal or homicidal risk, later on the patient was often thankful for what I did, and we moved onto that positive therapeutic alliance—an alliance which most research suggests is the key ingredient for beneficial outcomes. Sometimes the same sort of force needs to be done to rescue someone from a destructive cult and, actually, there does seem to be much cultish thinking, processes, and behavior involved in the Capitol event and all its supporters.

Perhaps cultism psychologically justifies the second path chosen by the Biden administration anniversary program, that the opposition that led the 1/6/21 Capitol need to be reduced, if not subdued and conquered, with justice and the truth. If this analysis has some veracity, my hope is that as sometimes happens in clinical psychiatry, that more of the Capitol opposition will eventually conclude that repentance was needed for recovery from 1/6/21. Much more time will be required to see if that happens.

Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues relate to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric TimesTM.