What Donald Trump and anti-vaxxers have in common

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I’ve seen the speculation that Donald Trump is purposely trying to lose the presidential election.

The thinking seems to be that no one would purposely be so contemptuous of the truth, so offensive and so outrageous if they wanted to win. Surely Trump can see that he has reached the ceiling of his support and he has to broaden his message to sway those who are undecided.

For Donald Trump, as for anti-vaxxers, facts take a back seat to ego.

But Trump wants to win. How do I know? His quixotic approach to the election seems remarkably familiar to me. I’ve been battling such tactics for years; they are the same tactics as the anti-vaxxers and for the same reasons. In both cases the fundamental issue is adulation and self-esteem.

Consider:

1. Both have a striking contempt for basic knowledge

You might imagine that Trump would find it needful to educate himself about American history, American government, the Constitution, foreign relations and a myriad of other important topics to make it clear that he is qualified to become president. You would be wrong.

Similarly, you might imagine that anti-vaxxers would find it needful to educate themselves about immunology, virology and statistics to make it clear that they are qualified to opine about vaccines. You would also be wrong.

Why? Because both Trump and anti-vaxxers are walking, talking illustrations of the Dunning-Kruger effect. That’s the paradox that those who know the least actually believe they know the most. They are so lacking in basic knowledge that they are incapable of realizing that they are lacking in basic knowledge.

2. Both are fact resistant

Both Trump and anti-vaxxers aren’t merely evidence resistant; they are fact resistant. However, a good portion of what appears to be blatant lying by Trump or anti-vaxxers is more properly described as “bullshitting.” To lie, one must be aware of the truth; bullshitting, in contrast, is a form of arrogant ignorance. Trump and anti-vaxxers often have no knowledge of a particular issue. Rather than acknowledge that (or correct it), they issue streams of blather meant to dazzle equally ignorant listeners.

3. Both embrace blatant lying when is suits them

They do lie, or course, in addition to bullshitting. Trump is a pathological liar. He proclaims what he wishes were true, even when he knows it isn’t (e.g. the invocation of a non-existent aide with a brand new Twitter account) to blame for Melania’s plagiarism of Michelle Obama’s speech. Anti-vaxxers, particularly professional anti-vaxxers, lie when convenient (e.g. pretending polio was disappearing long before the advent of the polio vaccine).

4. Both give primacy to feelings (gut, intuition) over facts

Though neither Trump nor anti-vaxxers are cognizant of the fact, they are the ultimate post-modernists, believing that reality is radically subjective. For them, reality is what they feel, and has nothing to do with an objective evaluation. It literally does not matter to them what the facts are; they believe that “listening to their gut (or intuition if you prefer) provides better “facts” than any expert or textbook.

5. Both outsource blame

Both Trump and anti-vaxxers are always sure that it is somebody else’s fault. If it’s bad, it’s not their responsibility. It’s always the responsibility of the elites or the despised (sometimes both). For every untoward occurrence (whether that is stagnation of blue collar wages or a child’s autism), neither Trump nor anti-vaxxers ever ask, “What went wrong?” Instead they faithfully resort to a different formulation: “Who did this to us?”

6. Both are desperate for adulation and self-esteem

Trump entered the presidential race for the same reason he does anything; as a narcissist he has a hunger for adulation that can never be assuaged. It is enough for him that he can bask in the glow of carefully vetted crowds of supporters. That is far more immediate and real to him than the majority of people who view him with contempt.

Anti-vax advocacy has precious little to do with vaccines or with children. The combination of self-education and defiance of authority is viewed by anti-vax parents as an empowering form of rugged individualism, marking out their own superiority from the pathetic “sheeple” who aren’t self-educated and who do follow authority. Anti-vaxxers congregate on websites and in Facebook groups that validate this distorted view of themselves.

7. Their isolation is the key to their self-regard

Trump is obsessed with his supporters because they temporarily fill the maw of his narcissistic hunger. He can’t bother to convince anyone who disagrees because he cannot tolerate anyone who does not praise him. Anti-vaxxers carefully curate their online spaces, banning and deleting anyone who dares to present science that does not support them because they can’t tolerate the idea that they aren’t knowledgeable, uniquely insightful and special; they’re simply ignorant and deluded.

Anti-vaxxers want to convince everyone that they are correct but since they cannot abide anything or anyone that does not satisfy their desperate need for self-regard, they make little headway with the majority of people who disagree with them because they can’t tolerate engaging with them.

Similarly, Donald Trump wants to be president. But since he cannot suffer anything or anyone who does not satisfy his desperate need for adulation, he can’t make any headway with the majority of people who disagree with him. At this point, he isn’t even trying; he just doubles down on the prevarication, bigotry and outrageousness that so delights his core supporters.

Donald Trump is not trying to lose this election. He would like to be president, but that desire is utterly dwarfed by his desperate need to be praised.

  • TheArtistFormerlyKnownAsYoya

    I only wish it were true that Donald Trump was a Democratic plant intended to throw the election. That would require self-awareness and humility that Trump certainly does not possess.

  • Dr Kitty

    OT:
    Probably only thing worse than believing for years that your loved one died because doctors wrongly withheld treatment from them, is discovering, in the midst of trying to sue doctors for negligence and malpractice, that it was your loved one’s decision not to have treatment, despite the recommendations of their doctors. They requested that their decision be kept confidential, because they knew you wouldn’t support it, and confidentiality persists after death.

    Years of blame and anger directed at the wrong people and all the stress and anxiety and expense of filing a legal case, only to find that all the staff did was respect your relative’s wishes and protect their confidentiality, even when it would have been much easier for them to just tell you the truth.

    If at all possible, please be open and honest with your family about any decisions to stop treatment or seek alternatives against medical advice.
    You really don’t want them to find out the hard way many years and several thousands of dollars down the line.

    • demodocus

      oh, geez…

    • MI Dawn

      Oh, that really sucks. I’m so very happy that my family is open about these things (much to my younger sister’s distress). We’ll sit around at family gatherings and discuss end-of-life treatments/care, cremation, memorial services, body donation. She just gets up and leaves, the idea distresses her so much.

    • Tigger_the_Wing

      I’m so very sorry, that is terrible – and that the confidentiality extends post mortem just makes it harder.

      I’m very open with my family – we have great, and usually hilarious, discussions about end-of-life issues.

      Not so hilarious is the grip the RCC still has on this country; my preferred way to go when the pain becomes unbearable is simply to stop taking my heart meds and die of a heart attack. But they won’t honour DNR requests here.

  • Megan

    Has anyone heard of “no vax until 12 lbs?” That was a new request for me recently. Apparently they were recommended this by a HCP. Where do these things come from? It seems so arbitrary and weird aside from being wrong.

    • guest

      There was a minimum weight my daughter needed to hit before she could get the Hepatitis B shot. I think it was four pounds.

      • Azuran

        But then again, a baby below 4 pounds is clearly premature. So there’s probably some other kind of health reason related to the prematurity and not the actual weight itself. They probably just decided on a weight that corresponded with a baby mature enough to receive the shot because it’s an easy measurement to follow. Either that, or maybe the vaccine was simply not tested to show it was safe in babies smaller than 4 pounds.

        • guest

          The nurse told me that it was the weight that mattered, because there had to be enough flesh on the baby’s leg before they could give the shot. I dunno. She was premature, but healthy. They kept her primarily for weight gain and prophylactic antibiotics.

          • Azuran

            I guess you do need to have some place where you can actually physically give the shot.

          • guest

            The first time I changed my daughter’s diaper, I was kind of shocked – she had skinny little legs that just ended at her torso – she had NO butt to speak of. She’s doing great now – completely average height and weight and all caught up with vaccinations.

    • Gene

      Preemies couldn’t get hep b (given at birth) until 2kg. Micropreemies who were 2mo and due for their 2m vaccines sometimes were delayed until they were officially 2kg. Otherwise, never heard of weight as a reason to delay.

  • guest

    I have a weird, really OT question: Is there any research on the risk of breastfeeding if you have potentially been exposed to to CJD? I am not permitted to donate blood in the US, but when I had my children I didn’t think to ask what that meant as far as breastfeeding goes.

    • demodocus

      Mad cow? Dunno. i do know that blood banks are hyper cautious.

      • guest

        Yeah, but it occurred to me that I would probably be rejected from screened milk banks for the same reason, and yet none of my health providers brought it up as something I should consider, so I was wondering. Not that it makes any difference now – what’s done is done. But periodically I remember that I have this restriction and wonder if suddenly one day I’ll start deteriorating.

        • Dr Kitty

          Everyone in the UK born before 1996 is *technically* at increased risk from vCJD. We’re all still encouraged to breast feed here, so I wouldn’t worry about it.

          There are fewer than 250 cases of vCJD worldwide, with 170-odd in the UK, and the incidence has been declining since 1999.

          There have been cases of vCJD transferred by organs and blood, so it makes sense for tissue, blood and milk banks to decline donations from groups felt to be at higher risk, but “higher risk” is still, big picture, very, very, very low risk of actually developing a prion disease.

          http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/BloodSafety/ucm095107.htm

          • Mattie

            Are you at risk if you were born outside the UK and moved there in 1996? My mum is English but I was born in Italy, just interested in where the risk ‘stops’. I heard all about mad cow disease growing up lol

          • guest

            Thanks, that does put it in perspective. I lived in the UK for nine months shorty before the outbreak. The Red Cross should do as it sees fit as far as me donating blood goes, but there’s so little information available to me. Should I remove the organ donor designation from my drivers license, just in case? I always disclose when asked in medical contexts, but most doctors don’t ask.

      • Nick Sanders

        Can you blame them? Prions are horrifying.

        • guest

          Except they don’t seem to know much about them, or even be 100% certain they’re responsible for the CJDs.

    • Mel

      Well, the CDC had zip on breast-feeding and CJD.

      The WHO has a downloadable PDF on the assorted transmittable spongiform encephalopathies at http://www.who.int/csr/resources/publications/bse/WHO_CDS_CSR_APH_2000_3/en/

      On my quick read-through:
      -None of the TSE’s have been found in bodily secretions including breast milk (pg. 4) placing it in the “no infectivity” category
      – No known cases of transmittance between mother and infant outside of genetic mutations (pg. 9)
      – No special precautions needed during pregnancy for a patient infected with CJD prior to delivery. During delivery, protection against body fluid splattering should be used. (pg. 9)

      • guest

        Thanks! I don’t think my surgical team knew about my status and took any extra precautions, but they should be taking precautions anyway.

  • demodocus

    Isn’t Trump also an antivaxxer?

    • Nick Sanders

      Yes, or at least courting their votes.

    • Emma

      Technically, no. He said quite a few times that he IS in favour of vaccines, but his issue is with the timing – he thinks children are getting too many injections in too short of a time period. He wants them spread out. He said if he were president he would push for proper vaccines but not allow “massive injections” to be given at one time. Not the worst position to have, or at least a lot better than those who don’t believe in vaccinations and refuse to vaccinate at all, ever. My biggest problem is that Trump’s reasoning for why he wants to see a delayed or spread-out vaccination schedule is because he believes these massive injections cause autism. He claims he’s seen it happen to his workers’ children – apparently they went in for injections as healthy children and came back autistic (apparently from receiving too many at once).
      Some of his tweets:
      “Massive shots that a small child cannot take – AUTISM.”
      “Healthy young child goes to doctor, gets pumped with massive shot of many vaccines, doesn’t feel good and changes – AUTISM.”
      “Spread them out over a period of time & autism will drop!”
      LOL

      • Sue

        So many anti-vaxers repeat this “too many too fast” mythology. What is it they think they know about babies’ and toddlers’ immune systems that pediatricians, immunologists and Neonatal ICU specialists don’t know?

        • Dr Kitty

          My son’s favourite “toy”, that he crawls towards at top speed and has managed to have in his mouth on at least one occasion when I wasn’t fast enough is…the toilet plunger.
          He also enjoys chewing the handle of the supermarket trolley, which is touched by dozens of hands daily.

          He’s suffered no ill effects.

          It’s like these people haven’t met babies…you know the ones who will put any damn thing, no matter how disgusting, in their mouths.

          5 inactivated viruses at once is nothing compared to what they can be exposed to on an average day exploring their environment.

          • Gene

            My kids consider floor noms to be the fifth food group.

          • MI Dawn

            One kid thought sand was an ideal food group. Changing her diapers was always interesting.

          • demodocus

            my son still has a fascination with the plunger, then hugs, kisses, and pats his sister

          • Allie

            I once caught my daughter drinking water from the toilet brush holder. Still gives me shudders, though I was more concerned about residual toilet cleaner, which could be very dangerous, than the bacteria/germs. However, she suffered no ill effects whatsoever. She has also licked the bottom of her shoes, and routinely eats food off the floor. That one is a given. I can only assume this predilection is adaptive – exposure does strengthen the immune system, although that in no way protects them from vaccine-preventable illnesses.

    • Sean Jungian

      I don’t for a minute believe that Trump is an antivaxxer. As @disqus_nDbzlLOHy2:disqus says above, he courts the antivax vote. I’m sure all of his children were vaccinated on time, and that he never questioned it once.

      The antivaxx crowd is, to him, just another disaffected group he can target, parrot back what they want to hear, and win that sweet attention and adulation he lives for. It would take a lot to convince me that he gives a crap one way or another about vaccinating, it’s just another “outsider” group he can pander to and exploit, just as he did the “birthers”, and the climate-denialists, and the truthers, and just as he does now with the “alt-right”, the white supremacists, and the disgruntled working class.

      Trump has a gift for seeming sincere, although I really don’t know how anyone can honestly buy into it. He’s a plain talker, and I really think that is the main attraction he has for his supporters – he doesn’t do political doublespeak (he does not have the temperament for being that diplomatic) and he keeps his statements short, with short words and simple ideas. I can see why a lot of people find it refreshing. I support Hillary but I hate her politician-speak, where every word feels disingenuous and over-thought-out and carefully designed to say nothing. That’s basically every politician ever. Obama has been a little less politician-y now that he’s nearing the end of his term, but even he does it. It’s probably required if one wants to be in politics.

    • Amy

      He’s going for the woo vote, but so is Jill Stein. It may be the only demographic in which she’s at all competitive. All but one or two of the Sanders supporters I know, myself included, are supporting Clinton now.

      • The Computer Ate My Nym

        As the meme says, Sanders has my heart, Clinton has my vote.

  • Bugsy

    Wow!!!! This is your best post yet, Dr. Amy.

  • Angela

    “Anti-vax advocacy has precious little to do with vaccines or with
    children. The combination of self-education and defiance of authority is
    viewed by anti-vax parents as an empowering form of rugged
    individualism, marking out their own superiority from the pathetic
    “sheeple” who aren’t self-educated and who do follow authority.”

    That quote from the post perfectly describes anti-vaxxers. It’s about defying authority, first and foremost.

    I really can’t believe that Trump is actually the Republican nominee.

    • Roadstergal

      “I really can’t believe that Trump is actually the Republican nominee.”

      I think it’s the bed they made. They’ve been saying for years that you need to be scared – scared of immigrants, scared of terrorism, scared of the UN, scared that your guns will be taken away, scared that your polluting vehicles will be taken away, scared of the ‘holocaust’ of abortion, etc – and there’s only so long you can use that as an election and fundraising tool before people start to wonder why there is still all the same stuff to be scared of when they’ve been giving their money and votes for so long.

      What do his supporters all say? He’s not “PC,” he’ll DO SOMETHING about the foreigners and the UN and NATO and feminists and abortion-havers and all.

      • demodocus

        there’s “not pc” and then there’s pretending that simple politeness is a bad thing.

        • Kerlyssa

          it’s the same thing. saying you’re not politically correct is the politically correct way of saying you are a rude bigot

          • demodocus

            snicker

    • Sean Jungian

      This is a very good article about how the Republican party prepared the way for a Donald Trump to come along:

      https://www.theguardian.com/news/2016/aug/16/secret-history-trumpism-donald-trump

      Matt Taibbi at Rolling Stone has also had some interesting background commentary about the rise of Trump.

    • Amy

      I can. This goes back almost 50 years to the Southern Strategy and courting angry white blue-collar workers, who were traditionally Democrats, by appealing to their racism and lashing out at “elites” with their good educations. For a long time it was all coded, like Reagan’s appeal to states’ rights and his mentioning the made-up “welfare queen,” and then Pat Buchanan’s populism in the early 90s, Dubya’s folksy charm counting more than his prep school background and Yale degree, and then Palin and the Tea Party.

      The only way Trump is different is how overt he is about it all.