“The Paranoid Style in American Politics,” historian Richard Hofstadter’s 1964 essay, is as relevant as ever. “American politics has often been an arena for angry minds,” the essay begins. We have certainly seen this, particularly during the Trump years in which grievance, chaos, and division have reigned. At times it has felt crazy (and crazy-making), but Hofstadter is at pains to state that he is borrowing the clinical term “paranoid” to describe “the heated exaggeration, suspiciousness, and conspiratorial fantasy” among more-or-less normal people that’s existed from the country’s founding through the present day.

Hofstadter’s essay was published in tumultuous times, with the anti-communist fervor of McCarthyism serving as his contemporary exhibit of the paranoid style and its capacity for wreaking havoc.

Hofstadter notes the phenomenon’s “apocalyptic and absolutistic framework”:

Since what is at stake is always a conflict between absolute good and absolute evil, what is necessary is not compromise but the will to fight things out to a finish. Since the enemy is thought of as being totally evil and totally unappeasable, he must be totally eliminated.

Hofstadter notes a key phenomenon of the modern right wing–feeling dispossessed (or at least knowing how to manipulate others experiencing or frightened of dispossession):

America has been largely taken away from them and their kind, though they are determined to try to repossess it and to prevent the final destructive act of subversion.

Hofstadter then brings his socio-political commentary into the psychological realm: “It is hard to resist the conclusion that this enemy is on many counts the projection of the self; both the ideal and the unacceptable aspects of the self are attributed to him.”

This dovetails with the hallmark feature of clinical paranoia, as described by Nancy McWilliams in Psychoanalytic Diagnosis (1994,The Guilford Press): “The essence of paranoid personality organization is the habit of dealing with one’s felt negative qualities by projecting them; the disowned attributes then feel like external threats.” (p. 205). McWilliams also notes the reliance on denial and high levels of innate aggression among those who skew paranoid. They struggle with anger, resentment, envy, vindictiveness, and—most of all—fear:

The paranoid stance is a combination of fear and shame. . . Paranoid people use denial and projection so powerfully that no sense of shame remains accessible within the self. The energies of the paranoid person are therefore spent on foiling the efforts of those who are seen as bent on shaming and humiliating them. (p. 208)

Paranoia, whether clinical or socio-political, is difficult to treat. It remains to be seen how much the passions of the moment will dissipate if not constantly stoked, or if a dangerous fringe that has made it into the mainstream has metastasized beyond control.