Throughout history, a particularly effective rhetorical weapon has been used to attack critics: falsely pathologizing dissent.

Framing criticism as a form of mental illness or irrational obsession, is how powerful figures and their supporters dismiss opposing viewpoints without ever engaging with their substance.

The contemporary use of “Trump Derangement Syndrome” (TDS) to dismiss criticism of Donald Trump is the latest abuse in the historical tradition.

Attack of Pathologizing Dissent

When criticism is labeled as a form of mental instability, several things happen simultaneously:

1. Red Herring – focus shifts from the content of the critique to the supposed psychological state of the critic
2. False Binary – those who “see clearly” versus those who are “deranged”
3. Ad Hominem personal attack – how can one reason with someone who is, by definition, irrational?

This rhetorical triad attack has proven remarkably effective across languages, cultures, political systems, and historical periods.

Let’s examine some key examples, their precedent and parallels to contemporary discourse.

Soviet Union: Punitive Psychiatry

Perhaps the most direct historical parallel comes from the Soviet Union, where psychiatry became weaponized against political dissidents. Critics of the regime were diagnosed with:

• “Sluggish schizophrenia” – a fabricated mental illness characterized by the “symptoms” of questioning Soviet authority or desiring reform
• “Reformist delusions” – the supposedly irrational belief that the Soviet system needed improvement
• “Political paranoia” – the “delusion” that the Soviet government might be oppressive

Soviet citizens who criticized policies or leadership found themselves not in political debates but in psychiatric hospitals, where their “illness” of dissent could be “treated.” The diagnosis itself was circular: the very act of criticizing the system was considered evidence of mental illness.

Nazi Germany: “Negativism”

The Nazi regime similarly pathologized opposition by diagnosing critics with “negativism” – a supposed condition where individuals irrationally opposed the positive transformation of Germany under Hitler. Those expressing concerns about Nazi policies weren’t treated as having legitimate political viewpoints but rather as suffering from psychological dysfunction that prevented them from seeing Hitler’s “greatness.”

Mao’s China: “Rightist Thinking Disease”

During China’s Cultural Revolution, Mao Zedong’s government labeled critics as suffering from “rightist thinking disease.” This “condition” required intensive “thought reform” rather than rational engagement with the critiques being raised. The diagnosis served to isolate critics and frame their concerns as personal psychological failings rather than legitimate political positions.

Pol Pot’s Cambodia: “Memory Sickness”

The Khmer Rouge regime in Cambodia diagnosed those who expressed nostalgia for pre-revolutionary life or questioned current conditions with “memory sickness.” This wasn’t seen as rational comparison but as an ideological disease requiring reeducation. Similarly, intellectuals and critics were dehumanized as “microbes” infecting the revolutionary body, requiring elimination rather than engagement.

Ceaușescu’s Romania: “Hostile Attitude Syndrome”

In Romania under Nicolae Ceaușescu, critics were diagnosed with “hostile attitude syndrome,” a supposed condition that made them irrationally opposed to the Romanian leader’s policies. This diagnosis allowed the regime to medicalize political opposition and treat it as a form of mental illness rather than legitimate dissent.

American McCarthyism: “Comsymp” Label

During the McCarthy era in the United States, critics of anti-communist efforts were labeled “Communist sympathizers” or “comsymps.” While not explicitly framed as a mental disorder, this label functioned similarly by suggesting critics were irrationally sympathetic to communism rather than making legitimate critiques of McCarthy’s methods and excesses.

American Iraq War: “Anti-American Sentiment Disorder”

More recently, during debates over the 2003 Iraq War, some proponents of the war characterized critics as suffering from “Anti-American Sentiment Disorder” – implying their criticisms stemmed from psychological issues rather than reasoned analysis of the war’s justification and execution.

American “Trump Derangement Syndrome”

Against this historical backdrop, the term “Trump Derangement Syndrome” emerges as the latest iteration of a long-established tactic. Originally coined as “Bush Derangement Syndrome” by psychiatrist and political commentator Charles Krauthammer to describe critics of President George W. Bush, the term was repurposed and gained widespread usage during the Trump presidency.

It is typically defined as an irrational hatred of Donald Trump that impairs the sufferer’s judgment and leads them to criticize everything associated with him, regardless of merit. This framing does three things:

1. Preemptively discredits criticism – Any critique, no matter how factual or reasoned, can be dismissed as a symptom of “derangement”
2. Creates a circular logic – The more evidence one presents to support criticism, the more “obsessed” and therefore “deranged” one appears
3. Shifts discussion from policy to psychology – Rather than debating the merits of policies or actions, the discussion becomes about the critic’s mental state

Information Warfare Angle

Pathologizing dissent is studied in information warfare doctrine because it represents a sophisticated tactic of authoritarian threats:

• Creates epistemic closure – When legitimate criticism can be dismissed as derangement, a closed information environment forms where contrary evidence never penetrates
• Reinforces in-group/out-group dynamics – Those who accept the framing see themselves as rational and clear-thinking, while critics are dismissed as irrational and unworthy of engagement
• Inoculates against criticism – Supporters are provided with a ready-made explanation that requires no further consideration of the criticism’s substance

Breaking the Pattern

Understanding this historical pattern is crucial for meaningful democratic discourse. When we recognize “derangement syndrome” accusations for what they are – the latest iteration of a longstanding tactic to pathologize dissent – we can move beyond them to engage with the substance of political disagreements.

Legitimate criticism should be met with counterarguments addressing the substance, not with accusations about the critic’s mental state. History shows us that when societies accept the pathologizing of dissent as normal, the result is not better discourse but rather the silencing of necessary criticism and the reinforcement of unchecked power.

The next time “derangement syndrome” is mentioned, recognize the warfare context of history. Ask whether the accusation addresses the substance of the criticism or merely attempts to delegitimize, and dehumanize, the critic. In a healthy democracy, we need robust debate focused on issues, not ad hominem attacks disguised as psychological diagnosis.

From Stalin’s “sluggish schizophrenia” to “Trump Derangement Syndrome,” the tactic of pathologizing dissent has remained remarkably consistent across time and political contexts. By recognizing this pattern, we can resist its divisive effects and recommit to substantive political dialogue where ideas are engaged on their merits rather than dismissed through psychological labeling. The health of our democracy depends on our ability to critique power without being fraudulently labeled as ill for doing so.