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  • Tim Mathis

Why do people accept authoritarians? Lessons from the psych unit

Updated: Feb 16, 2022

adjective: authoritarian


favoring or enforcing strict obedience to authority, especially that of the government, at the expense of personal freedom.

From one authoritarian to another...

Full disclosure: I'm an authoritarian.

Not usually, but every once in awhile.

I'm a nurse on a psychiatric unit, and it makes you that way. The psychiatric unit is a microcosmic culture where freedoms are given and taken away on a daily basis, and when I work as a charge nurse, I (along with my professional peers), am the authority that sometimes chooses to take away personal freedom, and demand obedience.

A different way to put it is that, on a regular basis, I have to make the choice to force people to do things against their will. It is both the nature of my job and the most morally challenging aspect of it.

When a patient comes into the emergency department in psychiatric crisis, it's been my role to decide whether they need to be admitted for inpatient hospitalization. At times, they disagree with my assessment. I currently work in pediatrics, so sometimes this means we get parents' consent and admit forcefully that way. Other times, when the parents disagree as well, we pursue legal force through the Involuntary Treatment Act.

Once patients are on our unit, there are a variety of ways that we take away personal freedoms, from disallowing personal electronics use, to physically moving patients from one area to another, to placing feeding tubes for eating disordered patients, to injecting legally compelled medications for patients who are psychotic and unwilling to take medication on their own.

When do you feel okay about being an authoritarian?

Instinctively, I'm not an authoritarian, so I never feel good about doing anything against someones will. But I can tell you that the way a morally conscious person can continue to do this kind of work is to recognize that at times, authoritarian action is the least bad option.

For example, you can only pursue an involuntary admission if you feel that the patient will not be safe if discharged from the hospital. And you can only feel justified in forcefully placing a feeding tube in the nose of a crying young girl if you believe that they are actually killing themselves with their eating disorder. Or to hold down a psychotic patient and inject them with a medication with real side effects: you have to believe that their life is at risk, either in the short or long term, if their symptoms aren't addressed.

In other words, in order to feel that it is morally acceptable to take away another person's freedom, most of us have be feel at least a little bit of fear. For our own safety, or for another person's safety.

As a nurse, it is my responsibility, in fact, to only use force when I believe it is the least bad option, to question doctors and peers when I disagree with their decisions to use force, and to stop using force when it is no longer essential - to release an aggressive patient from restraints as early as possible, and to remove the feeding tube as early as is safely possible.

And there are types of force that are never seen as acceptable. It's never okay to lie to a patient to get them to do what I want, for instance, because it is counter productive. Believe it or not, a person will be less likely to trust you in the future if you lie to them in order to get them to take a medication than if you force them to physically, and less likely to work with you in the future.

Lying is an authoritarian act because it takes away an individual's honest choice, while also undermining their sense of security in their environment - their ability to trust what they hear and see as reliable.

We also don't use force for our own convenience. We don't physically move patients because they are being annoying, or because they're being insulting towards staff. We only do it when it becomes a risk to staff, or other patients.

Most people have to feel that there is strong moral justification in order to use authoritarian force. And on the flip side, people who have force used against them will only be able to learn from it if they too come to understand it as justified: that it was better than what would have happened otherwise.

Society and Authoritarianism

You might see where I'm going with this. There are some important social lessons in all of this. Working on the psychiatric unit has taught me that:

1) Most people who generally feel that it is not okay to take away individual freedom will agree that it is acceptable when they feel safety is at risk. That is, when they are afraid.

2) Lying is never an acceptable way to persuade because it undermines trust in relationships where power is varied and cooperation is essential.

3) Most people will come to conclude that authoritarian action is unjustified when they believe that less forceful options exist.

We can extrapolate these principles out, and recognize that they're the foundation of the rule of government in society: we trust government to the extent that we feel it only removes freedom to an extent that is necessary. We stop trusting government when we feel we are being lied to. We resist forceful action by government when we believe better options exist.

Authoritarianism as a leadership strategy

We can also recognize that these principles are manipulated by leaders whose instinct is towards Authoritarianism with a capital 'A' - the bullies and mean girls and bad bosses and dictators that exist, in relatively small percentage, at all levels of society. People whose instinct is to demand obedience and use force to get what they want, even when it harms the general public.

For the Authoritarian in government:

1) Fear is an important quality to cultivate in a population when government wants to remove rights or reduce freedom, because it leads the majority of the population to feel that such actions are morally justifiable.

2) Lying is an authoritarian action. It can be used as a shortcut to manipulate some situations, but will ultimately result in widespread distrust of government. (See WMD in Iraq.)

3) Resistance is driven by the principle that authoritarian action is unjustified: either the fears driving the actions are baseless, or there is a less authoritarian way to meet the same goals.

And to introduce another lesson from the psych unit:

4) The more power given to an authoritarian, the more dangerous they become, because their followers also are pressured to become authoritarian. Another time when I, as a nurse, use authoritarian action? When the boss says so. When the courts order a patient to receive compelled anti-psychotics, for instance, my decision becomes "give the med or potentially lose my job and license." Resistance comes with a higher cost than when I was making the call on my own. Government employees under a person who is willing to use force unjustifiably for convenience or personal gain are forced to choose between their livelihood and the correct moral decision.

Bringing this into focus.

Authoritarians can exist on the right or left - socialism has had its dictators as has fascism.

I write mostly for an American audience, and America tends not to think of itself as an authoritarian state, but this is clearly a mistake. For readers on the left, America's authoritarian instincts were drawn into focus during the Trump presidency, when the society experienced, for instance:

1) The exaggeration of crimes committed by immigrants, and the risk posed by refugees from Muslim countries, while simultaneously trying to institute forceful bans and crackdowns on these immigrants and refugees.

2) A pattern of lying overtly, and by omission, publicly on Twitter and TV, and under oath during legal hearings, to achieve political ends.

3) A sowing of distrust of media that critiques leadership as an 'enemy of the state', while simultaneously barring that media from previous points of access to government.

4) A pattern of sowing distrust in political enemies by the propagation of conspiracy theories - such as the accusation that Barack Obama was not born in the United States, and that he was responsible for stirring up the political dissent that arose against the administration.

5) The pitting of police against (particularly the black) population in "law and order" rhetoric.

6) Direct public attack and threats of legal action against private citizens, political rivals, and government employees that criticized the administration, and on judges that held them legally accountable.

Readers on the right are more acutely attuned to the possibility of authoritarian acts from the left (or middle), and while personally I feel that the genuine threat of authoritarianism in America is strongest from the right at this stage in history, I think most people like myself, who fall on the progressive end of the political spectrum, can recognize the impulse to just force conservatives to behave how we'd like. In a situation where we feel like they are acting like authoritarians, we'll be more likely to feel that the right thing will be to resort to force ourselves.

In America, it continues to be the case that fear and distrust are being actively promoted. Authoritarian action is being pushed by government leaders. the population is being lied to. A huge percentage of the population is willing to go along, either by active support, tacit support, or denial. A huge percentage of the population believes that liberals, blacks, Muslims, immigrants, the mainstream media, and the GLBTQI community, are enemies of the state. On the other side of the equation, of course, an equally large percentage of the population sees Republicans as the enemy of the communities listed in the last sentence. (Which, let's be honest, is not an unjustified belief in many ways.)

The cycle of authoritarianism

My colleagues know that one reason you don't resort to authoritarian measures unless you absolutely have to is that it creates a cycle. When someone forces something on you, you lose at least a little bit of trust. Or you get a little bit more willing to push back. On our unit, you know that going 'hands on' means that you're at a pretty high risk of getting kicked or punched. And you know that you're cementing a conflict with a patient that might not be easily resolved.

Which is, I believe, what's happening in the US, and around the world. The right didn't invent government overreach, and I'm not sure who started the fire. Lies by omission and 'spin' have been the standard operating procedure of government for years, for instance. We just call it politics, and it doesn't immediately infuriate people as much as overt lying, but it has contributed to the slow creep of fear, anger and disillusionment that got us here. The war in Iraq was sold to the general public in unjustifiable ways by both parties. The nature of American intervention internationally is consistently hidden from the general public by leadership on both the right and left under the guise of security. Executive action has been increasingly accepted as a legitimate means to make governmental change, and particularly authorize military intervention. Etc. etc. ad nauseum.

I do believe that the international political right has embraced an authoritarian strategy across the last several decades. In US domestic politics see Mitch McConnell, Trump, voter suppression, the Capitol Insurrection and its subsequent whitewashing, police culture, the drug wars, etc. Abroad see Brexit, Bolsonaro, etc. for examples of countries using authoritarian strategies domestically. But particularly in international relations, it would be hard to argue that anyone has utilized authoritarianism more actively than Vladimir Putin in Russia. (The only real competitor is the United States.) A lot of people would call him a moderate on the liberal/conservative spectrum. Russia's motivations seem nationalistic vs. ideological. Authoritarianism is a hydra that rears its many heads in a variety of scenarios where humans are convinced that they are justified in forcing their will on others.

How do we break the authoritarian cycle?

Ha! I knew you'd ask me that, and I wish I knew the answer.

On the unit, the cycle usually stops when one person stops punching the other. When they recognize that they don't get the outcome they want using aggression, they learn other strategies. Sometimes it happens because they get hurt themselves. Sometimes it happens because they start to develop some compassion for the people they're hurting.

And, more broadly, the cycle stops when people agree on the authority structure. A lot of times, if hitting is intentional, kids will be much less likely to hit if they understand that the people in charge are doing their best to keep them safe and help them. Nurses will be much less likely to resort to physical restraint if they are confident that patients can manage to de-escalate safely without it. Trust, cooperation, having fun together, working out a system that works for everyone. All of that helps.

But I have to be honest, there are times when it still doesn't end. Some patients end up in prison because we can't figure out other ways to keep them from being aggressive. Some nurses lose their jobs because they consistently escalate their interactions using force unnecessarily.

So, I'm not sure that utopia exists. I'm not sure we'll ever be able to stop being vigilant against authoritarianism and its potential abuses.

I've had some hopes that, across the long term at least, the Covid-19 pandemic would undermine some of the impulses that lead to authoritarianism domestically and in international relations. But it seems like the pandemic has created more of a butterfly effect. Given that it hit in a cultural context where authoritarian social trends were on the rise, it's hard to predict the long term impacts.

I do think, in the grand scheme, that by and large the pandemic forced people (and countries) to see ways that we are all tied together. In the chaos that is US society, ongoing arguments about vaccination and personal responsibility have undermined that feeling, or at least added some complexity, and the long term damage to the economy and healthcare system may create conditions that lend themselves to an even larger base of people who feel authoritarianism is necessary for the greater good. But to me this still isn't clear. The political playing field, to me, still feels like it's being reshuffled, at least to a degree, and some of that is bound to be positive.

There has also been a significant degree of international cooperation in the vaccine effort and general pandemic response, but it's hard to be entirely optimistic. The pandemic forced countries to self-isolate in ways that may seed further nationalism in the future. Xenophobic impulses have bubbled up as people have flailed around, looking for someone to blame for Covid-19. As soon as the smoke began to clear, Russia began the process of pushing its nationalistic interests in Ukraine.

At an individual level there's only so much that any of us can do. The center might hold in American society if enough voices on the right recognize and condemn the authoritarian strategies that have become mainstream in their party politics. The center might hold if enough people on the left stick to their moral authority, and don't overcompensate for unjust actions with injustice of their own. The left's vested interest is in demonstrating to the right that they're being lied to - that their fears don't merit an authoritarian response. And the right's vested interest is in not letting authoritarianism become synonymous with conservative by accepting it as normal. In both cases though, it seems like breaking the cycle is going to mean dramatic reshaping of leadership and priorities in the political parties. It's not about individuals, it's about systems.

Internationally, history is a big, complicated mess. It seems likely that we're heading into a challenging period. (I mean, in the grand scheme, every period of human history has been challenging, so I don't know why this would come as any surprise.) Now we're confronted with the pandemic aftermath, the impacts of climate change, a shifting of international power which seems like it'll re-calibrate the world economy and political structure in ways that are bound to be disruptive. The US and Russia are both wounded beasts. China is ambitious. Peak oil is coming (and is maybe already here).

In the end, I think, authoritarianism is a natural human instinct in response to situations that will continue to arise in our relationships and politics. It's a hard pill to swallow, but managing it is part of the challenge of being human.

If you liked this, I hope you'll check out my books.

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