What Impact Can Adverse Childhood Experiences Have? A Historical Case Study
Key Takeaways
- Counterfactual analysis is framed as useful only if it improves understanding and prevention of destructive leaders and movements, not as commemorative recognition.
- A sequence of “missed intervention points” is proposed, spanning early family abuse, social isolation, major failures, ambient antisemitism, combat trauma, and postwar sociopolitical destabilization.
Authoritarian governments are detrimental to mental health. Let's explore a historic case.
PSYCHIATRIC VIEWS ON THE DAILY NEWS
“I tried to put myself as far as I could into Hitler’s shoes, to study him as a psychiatrist would study a forensic patient, to understand what makes him tick. Empathy is not the same as sympathy.” - Fritz Redlich, MD
Happy birthday, Hitler?!
From an obscure mental health email, I found out that yesterday, April 20, was Hitler’s birthday. I then wondered: Is it better to not recognize his birthday, that is, the beginning of his destructive life, or does the date provide some useful mental health function?
To be helpful, recognizing Hitler’s birthday year by year needs to provide understanding and potential prevention of such an individual and his movement. At its essence, it makes one wonder what would have happened in Germany if he was not even born? Or, if he died early from some accident? How much was him naturally and how much of the causation was events in Germany at the time to make such a cultish coalition?
More psychiatrically relevant is what might have been different if he received a different kind of upbringing and possibly treatment instead of incarceration.1,2 But there are problems with this approach. From over a century ago, accurate and relevant information may be limited. It may also seem traumatic to investigate his life. It felt to me that it might be mentally better to forget about this quest. I gave suffered enough secondary trauma from my extensive clinical work with patients with posttraumatic stress disorders.
What is left of some possible tentative usefulness are these possible missed intervention points, in order of occurrence:
- An abusive father who some even thought was half-Jewish
- An isolated childhood
- Two rejections from Vienna’s leading art school
- Increasing anti-Semitism in his hometown of Vienna prior to World War I
- Major trauma from World War I service
- A less-than-generous treaty for Germany
- Multiple medical illnesses
A case could therefore be made about an unresolved Oedipal conflict and artistic rejections causing a displaced revenge in a social context of rising anti-Semitism. During this time period, modern psychiatry and psychoanalysis was just developing, so treatment was scarce. Psychopharmacology was also in its infancy, but stimulants were commonly available, including from general physicians. Even so, the psychiatrist Fritz Redlich, of Jewish ancestry who fled Vienna and Hitler in 1938, and who was dean of Yale Medical School while I was a medical student there, felt that Hitler did not have a mental illness.3 Redlich, though, did recognize certain personality problems, including undue narcissism. That scenario of various personality problems without enough criteria for a DSM diagnosis is not unusual in clinical practice. So no fancy new analysis of Hitler from me.
Although it generally does not take long for Hitler to come up when anybody wants to emphasize a future of political destructiveness and blame the leaders, and Hitler has come up by critics of our current government, the most helpful aspect of noting Hitler’s birthday is to remind us to be on the lookout for the risk of authoritarian governments and dictatorships even when times may be calm and peaceful.
Right now, one noted historian is concluding that a global axis of authoritarian leaders is coming out stronger.4 Authoritarian governments are not good for mental health. This column and Hitler’s birthday may thereby be a cautionary social psychiatric tale worth telling.
Dr Moffic is an award-winning psychiatrist who specializes in the social, cultural, ethical, spiritual, and religious aspects of psychiatry, and since 2012 is in retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekdays column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He has been an advocate and activist for mental health issues related to climate instability, physical burnout, and xenophobia, among other social justice causes, serving on many related local and national community and professional Boards. He serves on the Editorial Board of Psychiatric Times.
References
1. Langer W. A Psychological Analysis of Adolf Hitler. CreateSpace Independent Publishing Platform; 2012.
2. Redlich F. Hitler: Diagnosis of a Destructive Prophet. Oxford University Press; 2000.
3. Goode E. Insane or just evil? A psychiatrist takes a new look at Hitler. New York Times Books. November 17, 1998. Accessed April 21, 2026.
4. Ferguson N. The gap between Truth (Social) and reality in Iran. The Free Press. April 20, 2026. Accessed April 21, 2026.
