How can good people make terrible decisions? To fully understand brainwashing, more formally known as “coercive persuasion,” mental health clinicians must dive into the potentially dangerous outcomes that can result from a mix of factors such as high stress situations, sleep deprivation and isolation.
On this episode of The Menninger Clinic’s Mind Dive podcast, Dr. Joel Dimsdale joins hosts Dr. Bob Boland and Dr. Kerry Horrell for a discussion on the history of brainwashing, the ease of slipping into Stockholm Syndrome and modern tools of persuasion—like social media—and the effects that clinicians need to be mindful of in patient care.
Bringing a unique perspective to the conversation, Joel Dimsdale, MD, began his exploration of brainwashing and its pervasive role in the 20th century after living next door to the Heaven’s Gate religious group, led by Marshall Applewhite until the group’s highly publicized mass suicide in 1997. He is also the author of “Dark Persuasion: A History of Brainwashing from Pavlov to Social Media.”
Dr. Dimsdale is a distinguished professor emeritus and research professor in the department of psychiatry at UC San Diego. He is also an active investigator and past president of the Academy of Behavioral Medicine Research, the American Psychosomatic Society and the Society of Behavioral Medicine.
“Much of my work reflects that I feel coercive persuasion—brainwashing—is not an old wives tale,” said Dr. Dimsdale. “It still exists in the modern day, and we have to be on the lookout for it.”
Visit www.menningerclinic.org to learn more about The Menninger Clinic’s research and leadership role in mental health.
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Welcome to the Mind Dive Podcast brought to you by the Menninger Clinic, a national leader in mental health care where your host, Dr. Bob Boland,
and Dr. Kerry Horrell. Twice monthly, we dive into mental health topics that fascinate us as clinical professionals, and we explore those unexpected dilemmas that arise while treating patients. Join us for all of this, plus the latest research and perspectives from the minds of distinguished colleagues near and far. Let's dive in.
Today, we're very lucky to have Dr. Joel Dimsdale. He's a distinguished professor emeritus and research professor in the Department of Psychiatry at UC San Diego. He has a subspecialty in (CL) consultation-liaison psychiatry is active investigator and Vice President at the Academy of Behavioral Medicine Research and the American Psychosomatic Society among many other things, that's just a real thumbnail. But welcome, Dr. Dimsdale.
thank you. It's good to be here.
Great. So I mean, we could talk about like so many things. I know you've had quite the expertise in Psychosomatic Medicine, and you've done really great research on stress and physiology. And of course, you've had you contributed greatly to DSM-5 and I'm there's probably a lot of people would love to talk about the psychosomatic symptom disorders. And maybe another time because really, what we wanted to focus on was the book he wrote relatively recently Dark Persuasion, which is about brainwashing. And I think we just start with the usual question, I just like how on the roll, and you get interested in this, and what possessed you to write it?
Many things. First off, I've always been interested in history. And we've physicians are passionately interested in history, we seek histories all the time, we swim in a sea of history, or our own personal history, and things that go on around us. When I retired a few years ago, I decided to indulge myself in studying history, and did some work studying the Nazi cabinet ministers. at Nuremberg, I fell into some archives that had basically been buried and lost. And the question I had then was, how could government ministers make such terrible decisions? I've been interested in that for a long time, how do people make horrible decisions? And, you know, with, with cabinet ministers, I guess they were orchestrators of malice, but that doesn't really address the question of how they persuade a populace to pursue horrible ideas, you know, and basically, there are three different views about this. One might say, well, some people's are inherently more murderous. I don't think that's particularly a useful way of viewing things. A second is, well, it's propaganda, perhaps, and a third is brainwashing. And I realized I had no idea what brainwashing was, where it came from. But probably I would never have gotten into this except for my neighbors. i As you know, I live in San Diego and my neighbors, had themselves castrated and then committed the largest mass suicide in American history. As took place roughly 25 years ago. They were in a small religious commune.
Are you saying your, like, actual neighbors? Yes. Oh, my goodness.
You're living there at the time? Yes. Listen, some like
I thought you were talking about, like our neighbors to the south are your neighbors. These are legitimate neighbors.
Wow. And you know, when something like this happens long ago, and far away, you can dismiss it. But when it happens close, it calls out for attention. We're not when I tell people that I'm interested in brainwashing the, the typical response is Oh, Joel, you know, isn't that old, kind of old, musty old war bad science communist,
I think, like the Manchurian Candidate because there was so black and white,
that one probably skipped it at the theaters.
I mean, I guess as I started reading, more and more, it's not yes, it's it has old long roots, but it's continuing today. Uh, yes, there were some, some of this was was deeply embedded in Cold War struggles, but not all of it. Some of the people were sloppy scientists who were morally challenged. But there were Nobel laureates, and there were leaders in our field, for that matter, involved in this as well. So it's a, it's an intriguing question that that I think has haunted the last 100 years. Yeah.
And it feels so relevant to today as well, like this question of how do people develop the beliefs that they do? And how did they end up behaving and doing some of the things that they do?
Oh, yeah, but let's, let's not jump too far ahead. Let's
just say that you didn't know anything about brainwashing. That's where I currently lie. I don't know much about this.
Storm, like could give a definition for us, or something we can use is just what that means and how it differs from like, I don't know, like just persuasion or other things, you know, ways to convince people of things.
Yeah, that's helpful.
I think of things as a conceptual word cloud. And maybe there's a, there are a bunch of things that are subtly different, but they all share some common ground. There's persuasion, there is education. There is coercion, you know, brainwashing is a sloppy term that was introduced in the 50s, during the Korean War by an OSS propaganda veteran. And it was such an appealing concept and still is, you know, a few, I think, the better way of regarding it as coercive persuasion. I think that is the essence of it. But if you look at if you do a Google search on brainwashing, and then do a Google search on coercive persuasion, brainwashing, it's like 500 to one. So as far as as far as the cultural culture at large is concerned, brainwashing is the the dominant term. You know, it has some curious roots, it has roots in torture, in psychopharmacology, in religion, and psychotherapy. It just spreads out in so many odd, odd areas, but but to be to try to focus on the most important aspect, you've got to look at coercive persuasion. So I resist, I resist using the term just when people espouse nutty views. Now, I think it's kind of dangerous to do that. conceptually.
Yeah. And it has that kind of a thing of people who just kind of convinced your kids and stuff that you don't believe in their brain layout schools are brainwashing and stuff like that. Well, you can you define a little more so clear course of procedure. Okay, now, of course, is I Oh, I think I know what persuasion is. Maybe I don't, how can you coercively persuade some of anything? Yeah.
Sounds okay. Yeah.
This has some very curious roots. You know, we all think of Pavlov and when when most people think of Pavlov all they think is dogs drooling, right. But Pavlov was very interested in human behavior, and trauma, and how trauma could shake up people so much that they would start to think differently. The setting for this happened in really extraordinary circumstances. Pavlov's labs. Were all alongside the Neva River in St. Petersburg in the basement of a building. In the nether periodically floods one year at flooded and there was nobody there in the labs and where the dogs there. The dogs were in the basement in their crates, and they were all alone in the crates were floating on the water was climbing up and little dogs. No. Muzzles were just sniffing anciently at the air, and at the last minute the animal handlers rescue the dogs but in order to get the dogs free, they had to dunk the dog's heads under an hour. Have the crate to rescue them. I said what what the people observed is that dogs were never the same after this. They had forgotten what they learned. They changed their dispositions that timid ones became aggressive, and vice versa. Pavlov fill that massive stress is a key constituent for coercive persuasion. He was also curiously, very interested in sleep and sleep deprivation and persuasion. His human work actually attracted Lenin's attention. Lenin came and visited, did a site visit and it was more than just a photo op, he stayed for hours talking to Pavlov and finally said, I'd like your help to remake the communist man and woman. And can you do that? And Pavlov, like any researcher, sift sniffing of funding opportunity? said Why, yes, Lenin was very enthusiastic, as was Stalin. Keep in mind the early days of the Soviet Union was when there was famine and economic hardship. The communists built Pavlov an institute and staffed it with like 357 assistants and postdocs, mind you think about this in a time of poverty. So, Pavlov worked closely with the communists on studies of behavior change. So what he said was that massive stress, sleep deprivation, and although he didn't talk about it directly, he was intrigued about the power of isolation. And of course, tortures have known this for millennia, have known about stress and sleep deprivation and isolation, that these things can shake up a person so that he or she gets more malleable. Some of the brainwashing also involves a fair amount of surreptitious influence as well, massive group pressures that come to bear. And certainly in the show trials and purge trials of Stalin, people could be persuaded to make just nutty, unbelievable confessions that led to their execution. And that point, the west was very preoccupied worried that the Soviets had come upon some powerful grain weaponry. We started studying this as well.
I see. Wow. It makes
me curious how, because thinking about torture, and thinking about some of those more physical based, like isolation and things like that, how those can be based in courts of persuasion. But if we move more to kind of modern day, I imagine there's a lot of, quote unquote, brainwashing, coercive persuasion going on that doesn't include as much of torture and isolation and sleep deprivation. And so I wonder how it's evolved, how it sort of moved from, and perhaps hasn't totally moved from maybe, unfortunately, some of this still exists, but how it's gone from torture and more religion to perhaps more other kinds of modern psychological methods of coercive persuasion.
Oh, keep in mind that coercive persuasion or brainwashing is usually viewed as a zero sum game. I do something and get benefit even though I know you're not getting a benefit. But sometimes that gets a little confused if, if I am misled in thinking I'm actually helping you. psychiatry has a an amazing history with this. I'm a kind of Jason Bourne nut. I love the I love the the books and the films. And you may remember the plot. Matt Damon, who plays Jason Bourne, is this nice young man who's kind of unhappy in his life and he goes and sees this avuncular psychiatrist or psychologist who makes a deal with him, wipes out his memory, and teaches him wonderful new skills to be the best assassin in the world. Well, all of that happened except for the last business about being the best assassin So in the world, we had head of the American Psychiatric Association, head of the World Psychiatry Association, working out of McGill, what he did with therapeutic intent was to take patients and subject them to sleep deprivation, every possible drug under the sun. He believed in not leaving a single receptor Unbound, and massive doses of ECT, hundreds of treatments of electro convulsive treatment, supplemented with insulin coma therapy. And it as if that's not enough, He was a he was a gadget enthusiast and believed that sleep learning was, was a real possibility. So he had his patients wear a helmet. And he played distillations of the messages of psychotherapy, repeatedly, a quarter of a million times, Jeanine, you love your husband, you, you're a good wife, you're a good mother, you're not depressed quarter of a million times. And what he, when all was said and done, he was quite successful in doing on a brain wipe, people would forget, but all this he couldn't necessarily persuade them to change their attitudes and beliefs. And that's the interesting nugget about brainwashing.
Because I'm thinking I mean, everything you just named My God, even with, gonna be thoughtful. I say this, but I mean, with my patients who are going through ECT, especially when they're in their therapeutic phase of ECT, they can't remember anything. Like session to session, there's very low, I can only imagine with all of that memory would be just toast. But the fact that they wouldn't change their beliefs. Yeah, I'm still I still just found myself on the edge of my seat of like, how does that part happen? How do we, how could one, maybe not even just one, but how does groups of people how do people change their belief systems? It's
right, because you take the movie version, right? You take the mild mannered person and turn them into a killer.
So um, yeah, I want to return to eect for just a moment because I'm, I'm not criticizing ECT and neither, I'm criticizing the way it was used these, all of these things are tools and how they are used, how much they're used, and with what intent is, is crucially important, I think, the around the same time that you and camera and that's the name of the psychiatrist in Montreal, was doing this. There were basically many other investigators throughout the country who were doing these studies about persuasion. surreptitious persuasion. surreptitiously drugging people with LSD. And seeing what the response was, was, was this something that could be used as an offensive weapon against the enemy? I don't know whether you've ever encountered it in your California days. But on the peninsula near Stanford is the Pulgas Water Temple. It's a it's a couple of beautiful ionic columns. And it's where the, the, the aqueduct that comes from the Sierras bubbles up, and they built this beautiful water temple in the WPA days and inscribed it with words from Isaiah and there will be rivers in the desert for my people Israel will. So it was an open, open aqueduct that fed all of Northern California and during the 60s there was concern that an enemy could drop LSD into the aqueduct and poison the city. There have been a lot of concerns about the use of psycho psychedelics, particularly for with surreptitious intent. And in the me remember the the Chicago Democratic Convention years ago, Mayor Daley was out there. He was guard he had the National Guard out, guarding the city's water supply. Less the hippies poison the city, right?
Is this only made that a movie about this recently? Oh, no.
But this is the 60s
right the trial of the Uh oh, yes.
Something like that. You're
talking about the Democratic National Convention? I thought that was the same thing. Oh, yeah. Because you gotta watch it.
That's a good movie. I did watch that movie.
Right? I mean, well, and we keep coming back to religion and cleaning the temples and stuff. I mean, it does get back to like, your neighbors. I mean, so how do you get from what your talks? Yeah. To hear more about the neighbor? We're talking about? How do you think you get from having said that, like, yes, you can, you know, you can wipe people's memories, you can do things but how do you get them things that seem uncharacteristic like to commit suicide that probably isn't. Right, or castrate things
that aren't an easy leap? So first off, people say, okay, a cult is any religion crazier than your own? There's a lot of strange things involved in every, every religion, and even even castration and suicide has been part of, of, of Christian teaching, early church, teaching, suicide, heroic suicide, has been part of Jewish tradition. So it's not just crazy new cults that have indulged in such behavior. What's different about this is that you wonder, what's the attraction? How does somebody get sucked into this? I think the key issue is that they can't get out. Now that's, that's a subtle point. People were all questers, we're looking for things we're searching. There's a lot of churning in religious affiliation. People are constantly affiliating, dis, affiliating, and not just from Presbyterian, to Methodist, but But big, big churning. But when you look at the data, the interesting thing is that it's a temporary affiliation, so that 5-25%, of recent converts, will quit and return to their prior religion, if they can get out. And that's the big difference with Heaven's Gate and Jonestown. And a number of these other cults in Jonestown, the people were geographically isolated. In the middle of the jungle, there was barbed wire fence, there were guards patrolling the premises with with machine guns, Heaven's Gate was a little different. Those were my neighbors, Heaven's Gate, you had the situation where the people had been members of this religious commune. For decades, they had been separated from their friends, their family, they were instructed not to have contacts outside the group. So that although there was no barbed wire fence, they had nowhere to go, other than their own group.
It makes me wonder about, and maybe I'm off base, because this is really just a hunch. But I wonder too, if there's a part about our human psychology, and perhaps craving a purpose, a group and identity that like something in that again, very normal human wish or desire, can get used in this way. You know, I like, like being a part of a group and believing in a particular ideology might give you a sense of purpose. Again, doing something like castrating yourself, if it's for a purpose, something bigger than yourself something to hold on to, I could imagine people can people are willing to do all sorts of things to have that experience.
So so the the power of group, you know, all of us remember the social psychology classes we studied years ago. And the conformity pressure is absolutely enormous. It's breathtaking. If you've ever participated in any of those experiments, it's it's just absolutely breathtaking. So if you're able to start imposing group pressures on people, that's enormous religious institutions have done this state institutions have done this, the central role of public and fashion in a group setting. This has been something that has been known As a powerful forever and the the Heaven's Gate people basically for bad each other from having individual thoughts, that was a sin, each person was assigned a group partner to check his thoughts and feelings, they had to discuss their dreams, they, if they had strong opinions, that was a fault, the the passion was a fault. Sex was viewed as a corroding agent that rusts our vehicles they, they regarded a body as as a vehicles, and they became convinced that they were children of space, who had been marooned on Earth. When, when the Hale-Bopp Comet came, I guess you probably had to have been at least 10 years old to remember that it was the biggest comet. And in history, it was totally unannounced unexpected. The Heaven's Gate, people felt that this was a mark, and that there was a spaceship trailing the comet that would rescue them and take them home to space. And they developed this very unshakable belief that if they suicided, at the moment that the comet was closest to Earth, they would be able to teleport onto the spaceship and eternity. So all of their farewell videos, by the way, are available. They are available, you can look at them the they're sitting tranquilly, in this very affluent suburb of San Diego, surrounded by the trees, talking about what I'm going to do. It brings me great joy. Now, by the way, with with Heaven's Gate, you probably are aware that it had its roots in Houston.
I'm sounding really familiar. I must have watched documentary at some point about this. We're not up to date on our cult, our backgrounds. I'm so sorry.
Well, you know, there's no, there's no paucity of cults and the annual we see it all the time. And I guess the question is, how can people be persuaded to believe this stuff? Yes. That that pattern parasites are hiding in the basement of a pizza parlor, in Washington, DC, that is all run surreptitiously by Democratic politicians. This is, well, how do people believe this? Well, it's repeated over and over and over. People stop listening to any, any counterfactuals they only seek their information from people who share the same beliefs. They stay on their social media all night long. They're sleep deprived. They're bullying each other. The conformity pressures are just astonishing.
It is. Yeah. I mean, it's very interesting to me, because like, you know, initially, I'm sure when I thought about this in the past, I would just have a cynical response to it. You know what, people don't really believe this. It's just it's convenient to espouse it's like, going back to your church torture, history. You know, it's like so Jewish people being forced to accept Catholicism in the torture chamber. It's like, yeah, yeah, I agree to whatever you say, just get me out of here. But it sounds from what you're saying it's much more complicated than that.
A certain number of people do believe. And I think if you kind of look down from 30,000 feet, you see that a large, a disappointingly large number of people are malleable and will believe, utter nonsense. and government leaders, religious leaders, have known this a long time. But the interesting thing is, is stress and trauma that underlies so much of the vulnerability and that's part of actually involved in the Stockholm Syndrome. Now, you know, Stockholm, the bank was robbed in Stockholm and four or five bank tellers were held in the vault, were held hostage, and within a day or two, they were taking the bank robbers side as opposed to the police's side. And this is not at all rare. One of the odd things that I discovered that I talked about in the book, there's a database called the hobbits hostage and barricade situation. The FBI maintains a database of all hostage and barricade or Hobbit situations. So there's a database, sadly, with something like 20,000 hostage incidents, and hijackings and all of that. And when you look at that, you find that the sympathy for the captor is actually rather high. That's been troubling. And we in psychiatry and psychology have been repeatedly asked, What does this mean? How does this come about? Well, part of it is that the hostage realizes that he's in danger from the police that basically when the hostage situation ends violently, the hostage if is four times more likely to be shot inadvertently by the police than by the captor. So. So I you know, the wonderful thing about history and reading is that you you delve into all these very interesting databases. But yeah,
it sounds like to me, there are a few important factors. There's the physical factors like stress and, and past experiences and trauma and sleep deprivation and whatnot. And then there's the group mentality piece of conformity pressures. Is there anything in regard to like individual psychological vulnerabilities? And I guess trauma also fits into that one. But that makes someone more likely, I guess, if it's common, I guess it would be more, someone who's more likely to not be brainwashed? Because it sounds like maybe the average Joe, under certain circumstances would be Yeah,
I guess about vulnerabilities. Yes. So I am sorry, to have to tell you that some of your favorite assumptions may be disproved. Nor normally we say, oh, it's intelligence related. A smart person could never be taken in. That is not the case. You know, we sometimes say it particularly when we talk about politics or something heated you will say, Well, he's an idiot. I used to be very active in university politics. And you can readily see that people can be can have numbskull views regardless of their intelligence. There is a little bit of, of data to suggest that people who've been a little more isolated and have less experience in the world, and younger people are a bit more susceptible. If you look at hostage situations, the Stockholm Syndrome appears to afflict these people a little more often. There's been some interest Well, what about a psychiatric history? Does that make a difference? And again, at least from the harvest database know, they've got they've got an ample number of people to study and it's not the case that a person suffering from schizophrenia or a person from with major depression is more vulnerable to coercive persuasion than others. There is some work in religious conversion, which is interesting and this, this dates back 200 years. If the Moonies are the the cult group of love today are 10 or 20 years ago, there. The Methodists were regarded as the cult group a couple of 100 years ago, and the mainstream religions, particularly the Church of England, were quite concerned. And we're studying what's defined these people and they were younger. They were adolescents and people in their 20s. They were people who were ruminative that was actually the word used in the church studies. They were a little depressed. So there's some suggestion that that people are there may be some settings that render people more influenced, but it's not a strong, it's not a strong signal. Wow.
You know, we're going to be running out of time. So and we've been skirting around the issue of politics, of course, we just went through a midterm when this is as this is being recorded, but I imagine you see relevance there to a lot of the things you've you've learned and then once you've been talking about our knots you tell us,
I have strong political feelings. I, number one, number two, I feel that history is very difficult to write when you're in the present tense when you're in the midst of it. So I've, I've preferred to talk about brainwashing. In past events where it's clear, I guess, I am struck by the advanced weaponry we have for brainwashing today, largely through social media. You know, propaganda is like advertising. It's, it's actually fairly coarse. You spread it out everywhere. And if it finds a certain fertile ground, maybe it'll take root. Social media is a lot smarter than that. The algorithms that determine what is shown to us what we see what we remember, we are now confronting a weaponry that is far more powerful in coercively persuading people. And I don't think that this weapon is being used by only one political side. It's a tool. We famously in the United States, meddled in propaganda in lots of countries. And we're outraged that other countries are doing that with us now. And we feel how can they do that? This is unfair. But I think the issue is that it's a new contagion. And we, as a species are defenseless against new contagions. With that in
mind, I'm him. I'm gonna kind of revert that a little bit. Are there ways to recognize and and to resist against kind of, you know, quote, unquote, brainwashing or courtship persuasion? Like, are there things to tip? Yeah, like so tip to look out for
sure. So I don't regard that as a rebuttal from you. I I regard that is, please tell us something there's what's the deal? Right, we really ended up
pretty defenseless to it. And I was like, Well,
I think there's one simple thing doesn't go far enough. But I am, I am struck by the mischief that we get ourselves into by anonymous postings. I could imagine that if social media were less anonymous, people might have an an ounce more of thoughtfulness about what they say. But you see, we are struggling with our own views about privacy and human rights and freedom of expression. Other countries don't struggle quite as much along those lines. This is a moving target. Look, the automobile came out what 1900, more or less. And we're still struggling with drunk driving. There are contagions with with new things, and it takes cultures on long time to come to terms with it. So I think this getting back to politics. It'll be interesting. If, if Congress can agree about what to do this is curiously, one of the few things that Republicans and Democrats agree is a problem.
I think we're gonna end on that that's a side note as we can find.
Well, and I get I can tell it's, it's so it's so good. Listening to Duxton. Dell, you clearly think like a historian, and I appreciate that, that we don't know what the mess we're in quite yet. Until maybe we're a little farther down the line. Well, thank you so much for joining us. Dr. Dimsdale. Any last word before we wrap up?
I appreciate your interest. I guess when I when I wrote dark persuasion, I wrote it because I felt and still feel that coercive persuasion is not an old wives tale, that it exists and we have to be on the lookout for it.
Well, the books are fascinating read and I recommend that to anyone. So we've been your host, I'm Bob Boland.
I'm Kerry Horrell.
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