A Mental Health Expert on How To Reach Those Who Believe in QAnon

What to know to reach loved ones who have gotten lost in the fog of unhealthy conspiracy theories
Illustration: IStock

America has always been riven by partisanship, but the events of recent years show that a new and radicalized strain of politically motivated, internet-fueled conspiracy theorists are gripping large swaths of those who view themselves as conservatives. Specifically, the rise of QAnon, a cult of misinformation in which Hillary Clinton is operating a child sex-trafficking ring out of a D.C. pizza parlor and Donald Trump is still secretly president of the United States, is a reflection of just how detached from reality some have become.

How does the nation heal the wounds inflicted by events such as the Capitol riots on Jan. 6 when we can’t even agree on what’s true? How do rational people contend with and help QAnon-enthralled friends and relatives see the light?

Dr. Mark Smaller, a Douglas, Michigan-based therapist and a former president of the American Psychoanalytic Association, has some thoughts. He has focused much of his career on how to deprogram members of street gangs and cults, and he sees QAnon as of a piece with those entities. He’s part of a group of experts who have been pushing the U.S. House to pass the Threat Assessment, Prevention and Safety Act, which would create a task force to study and develop protocols to deal with people who show signs of being radicalized by various alternative worldviews. 

Smaller, who sees the potential for that work to include the likes of people so animated by wild conspiracies that they might become violent, offered his thoughts to Hour Detroit on how to deal with the QAnoner in your orbit.

Health Guide: Who is most susceptible to believing fantastical ideas such as those promulgated by QAnon?

Dr. Mark Smaller: Usually on the surface, it looks like there’s an ideological reason to join or you join to belong to something that’s beyond you. In most instances, people might join or consider joining a cult or a gang or become a devotee to QAnon or a particular terrorist group because at some point, this individual was particularly troubled and maybe, for example, experienced a particular crisis in his or her life and that crisis or that injury or those psychological difficulties don’t ever get addressed. And then a cult, a group, a gang, or a political group may come along and provide a home for somebody who’s troubled and because of those troubles has become particularly isolated. Joining a group such as these can provide a sense of feeling cared about, understood, connected to like-minded people or people who you become more like-minded the more you get involved in the group.

So with QAnon, these are people who believe crazy stuff and don’t actually do anything about it. Yes, there were instances of actual violence such as the Capitol riot, but mostly it’s just people believing things that don’t make any rational sense. What do you do about those people? What is their psychological injury?

It could be as simple as losing their job. For some people losing their job may mean they’re losing their self-esteem, their self-worth, but even more significantly, they begin to experience a kind of helplessness. Helplessness, of all of our human feelings, is the worst and hardest of human feelings to deal with. You’re dealing with people who may be experiencing a traumatic level of helplessness, and that can easily lead to isolation. As the way not to feel helpless, people will create ideas or get support for some ideas or fantasies that have little to do with the truth but provide a set of answers to questions in order not to feel so helpless. So, for example, why are so many people in denial of the pandemic? Why do so many people ignore what science is telling them? Well, when people experience a certain amount of helplessness, they can only tolerate so much. Then you create a way of organizing your thinking in order not to feel helpless. It’s better to be in denial than to feel so utterly helpless. So you decide, maybe this is just the flu, and then, then you get reinforced online. 

So what do we do about that, especially if it’s a family member, say?

Well, let’s talk about what you don’t do, OK? The assumption that many of us on the other side make is that these people are just not very smart, and if they would just listen to reason and if they just had correct information, they won’t be holding on in a desperate way to these conspiracy ideas and theories. But people who are in the grips of this are made to feel like they’re stupid and looked down upon, and that only raises somebody’s defensiveness and their allegiance to the group, no matter how unrealistic the group’s point of view may be.

OK. But how do you respond any other way when people spout off nonsense?

You try to find out what is going on. You ask them, “Can you tell me what was going on with you that made you start to feel like this group and their ideas make sense? Can we talk about it?” It’s the first step to interfering with somebody’s sense of isolation. That’s the first step. If you start by trying to get them to be contrite or admit they’re wrong, you’re not going to get anywhere. We first have to acknowledge the other person’s position and fear and pain before you can get to contrition. That last part is essential to move forward, but you’re not going to get to that last part until you first acknowledge somebody’s fear, helplessness, and pain. 

Then what?

Well, that can do a lot. You can find out, say, that not only did this person lose a job, but he’s convinced he lost the job because an immigrant came and took his job. That may or may not be true, but you want to respond by saying, “Yeah, the fact that you lost your job is very upsetting. What might we be able to do to start addressing how you might find another job or how this has affected you and your family?” It’s trying to have a reasonable conversation without attacking somebody, because they’re holding on to this point of view for an important reason and we want to try to find out what that reason is. It’s not an easy thing, and even if a family can convince someone to come and see somebody like me, that’s where at least I start. And that’s just the very beginning of what may be a long process to undo what’s going on.

Do you usually see people who are adherents of QAnon as suffering a psychological problem? Is there an actual diagnosis for this? 

There may be an individual diagnosis, and especially the individuals who become the most violent, have psychological issues. There’s no question. The problem is when you get a group of people together like this. People will behave in a group in ways that they would not necessarily behave individually. And now you’re dealing with a troubled group psychology, and that’s where things can get really dangerous. So you’ve got to respond to the individual and you have to respond to the concerns of the larger group.

Can you give me an example you’ve encountered in your practice?

Yes. I have a patient whose parents get all their information from Fox News. These are upper middle class, very successful people, people in positions of privilege, and they really believed for the longest time that the 2020 election was fraudulent. And my patient and his sister finally began to have an ongoing conversation about this. And after a fair amount of conversation, the parents who were very successful, both self-made, who grew up one in poverty and the other one close to poverty, said, “Because I feel like I’ve worked so hard for what I have, and these liberals and CNN or on MSNBC hate me and they’re trying to take away what I worked so hard to earn.” You want to try to identify just like you would do with an individual in treatment, you want to try to identify where did this injury, where did this rage and anger start? And as soon as you get to that, then you’re going to be able to have much more of a possibility of a productive conversation. That family was on the verge of literally not speaking to one another, they’d gotten so estranged. That dramatically changed once the parents felt like their point of view was listened to, acknowledged, and understood. 

Is QAnon really a cult or just a world of fantastical, ridiculous lies? The old-fashioned cult like the Branch Davidians or something would be a group of geographically marginalized people, holed up in a house together or on a farm or a physical place where even talking to them was impossible. In this case, they’re not isolated in that sense and you have legitimate people, news anchors, elected officials, the president of the United States, validating some of this stuff. Is this just a different problem? 

It’s a great question. We have gone from the cults of old where you can belong to one of these groups and you’re not out in the country somewhere completely isolated and disconnected. However, we now have virtual places where we can isolate ourselves as groups. For example, when you sign on to social media, you start following a certain group and then there’s an algorithm that shows you or suggests feeds of people from your particular groups. Now you’re in a group and you’re only getting a certain amount and quality of information that some algorithm has figured out is what you want to hear. So people who start out curious about some of these very crazy conspiracy ideas and theories, read about this on Facebook or on Twitter. And then they’re only going to hear and see other people who feel the same way. This is going to continue to be a real challenge.

So does QAnon require a different level of deprogramming when there’s constant misinformation going on in the culture? 

Well, you know, it’s very interesting. I gave a workshop the other day to a group of mental health professionals and we were discussing how there is a sense of calm because there’s been a new administration and we’re not inundated by tweets from the White House that support these kinds of conspiracy theories. That may be a first step. If we have leadership that’s aware of how provoked people can get, and that the leadership is saying, let’s have a reasonable conversation, people may be willing to at least listen to one another and bring some rationality to so much of the irrationality being broadcast on social media.

With QAnon, these people were led to believe that there was a secret plan to keep Donald Trump as president. That didn’t happen. Why don’t real-world contradictions force people to question the rest of what they think they know?

What we have learned is that if somebody has what seems to be a paranoid view of the world, the last thing you want to do first is to try to contradict with reality their point of view of the world. It may be that at some point, you need to do that. That really crazy conspiracy theory functions for large groups of people in some particular way and you have to try to understand and address that first before you can then go back to what is genuine information.  

You’ve said we’re not supposed to tell a QAnon relative that what they believe is crazy. So how does a family like this even get through dinner?

You need to be counterintuitive. Your impulse is to not talk about these areas of disagreement to avoid yelling and being upset. But the most important thing is to be counterintuitive and to try to begin to have a conversation. It’s not going to be addressed in one conversation. It may take 10 conversations or 20 conversations or more for family members to talk about what this means to them on both sides and to say, “Make me understand why believing this is so important to you.” The best antidote for what’s going on in the world or within families right now that are divided by these political issues and conspiracy issues that I have been able to come up with is connection, connection, and connection. The only way you get connection is by talking.

When I’ve tried discussing these issues with people, usually it’s on Facebook and I’ve done it by presenting a link to a story that shows that whatever the person is saying isn’t true. You know, I’ve tried to present facts. That’s not a good idea?

No, no, it isn’t. It isn’t. You think, “Oh, if I just provide the right information or if I just present the reality, that’s going to do it.” It’s not going to. And it’s a mistake to try to do any of this in a social media forum. If you have to do it virtually, then at least do it on Zoom. You cannot do it through social media because just sending messages or posting things misses the human cues and nuances. It has to be where you can actually respond to somebody else’s humanness.