Untreated major depression or anxiety are not merely "being sad" or "being nervous." Hatred is not merely "anger" or "dislike." If you or a loved one has ever had serious depression or anxiety, you know why these conditions are considered "major" psychiatric illnesses.
Untreated, major depression and anxiety dominate peoples' lives, and the lives of those around them. They cause unending misery and can cause overt harm, both to the patients and to those close to them. Sometimes that harm is fatal, such as with suicide.
Hatred defined as disease:
Hatred is concentrated and focused ill will, the active desire to see harm come to another person or persons. It is blind to contrary facts, and blind to contrary casual experience. It is not the same thing as "I hate that song!" or "I hate that guy!" or "I hate people who (do whatever)!" Those things are only severe dislike, expressed with a touch of hyperbole.
True hatred is chronic brooding malevolence to the point of an obsession, whether constant or episodic and recurring. Hatred is to dislike, as major depression is to having the blues. Hatred is to anger, as fullblown anxiety disorder is to being nervous.
Hatred is the defining motivator for hate crimes and for a majority of terrorist acts. It's a danger to the public, in a manner similar to the danger of drunk driving or contagious disease. And it's a detriment to the haters themselves, as it can impair their career paths and result in behaviors that put them in prison. It causes harm on an enormous scale, and it can and does kill. But instead of causing suicide, it causes murder.
These defining characteristics of hatred are more than sufficient to qualify it as a major psychiatric disorder. It needs to be so categorized, and then treated as such in medicine and in our culture.
Getting it done:
Pragmatically, this addresses the root cause of hate speech without need of a constitutional amendment or a Supreme Court ruling, and it does not engage the entire controversy over the limits of free speech.
All this will take is the consensus of the committee of the American Psychatric Association (APA) that compiles revisions to the DSM: the Diagnostic and Statistical Manual that is used as the basis for categorizing psychiatric illnesses. That is an easy goal to reach. A few psychiatrists working together, should be sufficient to get the ball rolling.
Preferably they won't be folks who are publicly identified as "political" in the manner of the psychologists who have been warning about Trump's narcissistic behaviors. This, pragmatically, because it would undermine their ability to get the job done. Ideally they'll have track records of peer-reviewed publications on the subject of categorizing psychiatric illnesses, and some of their work will have been accepted into medical canon.
I'm going to guess it would take three such people to get things moving. First they could write a paper for peer-reviewed publication. Next, present their work at an APA conference. Then approach the folks who work on the DSM. It might take a few years but it could be done.
The very first impact of this will be to unleash a flood of research money toward finding means of prevention and treatment.
It may be that some existing medication also works for this, just as SSRIs (selective serotonin-reuptake inhibitors, such as Prozac and Zoloft), first approved for use treating depression, are also used to treat OCD (obsessive/compulsive disorder). Or it may be that some other medication, presently in the pipeline, turns out to work for this as well. Or it may be that some entirely new medication is needed. But even an existing medication, once approved for treating an additional diagnosis, is a boon to its manufacturer: so we can reasonably expect Big Pharma to get onboard and make progress quickly.
Treating hatred as a major psychiatric illness will not eliminate all hate speech, but it will reduce its prevalence through social and health-care mechanisms. In the past, people were reluctant to talk about depression and anxiety, or speak up with those close to them who showed symptoms. All of that changed radically when the first SSRIs and the first new-generation anxiolytics (anti-anxiety meds) went into widespread use.
There was a time when the only treatment for depression was lithium, and it didn't always work. In those days, depression was "a secret." Talking about it first-hand, or confronting others about their own moods and behaviors, was "taboo" (subjected to a superstitious no-talk rule).
Once the SSRIs became available, there was a huge change in the culture. Patients could talk freely, their loved ones could talk freely, and now everyone knows the symptoms and everyone can bring it up: "Dude, you sound like you're seriously depressed, you need to see your doctor about that." Very often that input from others works, and people listen and seek the treatment that changes their lives for the better.
If this is successful, the medical model for hatred as emotional disorder will reduce hate speech to a level (quantity and intensity) that does not produce hate crimes.
Expected benefit:
One of my going hypotheses at the root of the idea of stochastic terrorism (I'm the original author of that), is that exposure to a sufficient quantity of violent speech, will predictably produce an increase in violent acts.
Operationally that means that if an audience of size X is subjected to hate rants focused on target Y, for Z consecutive days, then we can reasonably predict there will be one additional terroristic act against a target in category Y. This is probably scalable, such that further increases in the intensity of the hate speech, or its duration, or its audience size, will produce quantity Q of additional terrorist acts.
If that's true, then there is also a level of hate speech (measured by intensity, duration, and audience size) below which no additional hate crimes are produced.
And if that's true, then reducing the prevalence of hate speech below that threshold, will reduce hate crimes to being rare events rather than weekly headlines.
It will also enable medical intervention where law enforcement can't go, in cases that appear to be heading toward hate crimes. Thus for example, hatred could be treated in the course of workplace wellness and human relations programs, just as depression and anxiety disorders are treated now.
Today: "Your productivity has crashed, so you're on track for being let go. But it might be depression, and it's covered by our health plan. So you should see the doctor about that, and then if your situation and productivity improve, you'll be on track for a raise."
In a few years: "You've been spouting racial epithets in the office. Ordinarily that would put you on track for being let go. But it might be hatred disorder, and it's covered by our health plan. So you should see the doctor..."
Or, "Dad, every time you say [racial epithet], it sounds like you want to kill someone. That's not healthy and it can keep you from getting ahead. You need to see the doctor about that, because it's an illness and it can be treated..."
Seriously. Again, consider how things have changed with regard to depression.
But!, the constituency!:
Yes, there is a constituency for the disease: an identifiable group in society who believe it's their right to spread the disease and inflict it on others, just as anti-vaxers inflict measles and whooping cough on others. That should not stop us.
There have been "constituencies" for other things that today are diagnoses with treatments. Alcoholism, other forms of substance abuse, and pedophilia, come to mind.
There was a time when the "three-martini lunch" was a staple of business culture, and people who objected were considered prudes. Today anyone who has three stiff drinks every day at lunch is considered to have a drinking problem and urged to get treatment. The previous "normalization" of incipient alcoholism in the culture, no longer occurs, and the behavior that produces it is not accepted.
There was a time when popular music was infested with lyrics about grownups having sex with minors, and people who objected were considered prudes. Today that's not acceptable, and to the extent it continues, it doesn't get the kind of mass-media play it once did. The effect it once had, of "normalizing" pedophilia, also a recognized psychatric illness, has receded substantially. Today it's "not OK" to sing or talk about wanting to have sex with a kid.
There was a time when belief-based exemptions to vaccination were also acceptable. Today the spread of anti-vax paranoia, having led to numerous outbreaks of dangerous diseases, has led to laws eliminating those exemptions (such as here in California). Diseases that were once nearly eliminated, and then came roaring back with the anti-vaxers, are once again receding.
Today we have a pandemic of hatred and the murder that it produces. Last week alone, two haters, 14 mail bombs, and 11 people murdered at a synagogue. Had those bombs gone off the toll would have more than doubled. In one week.
If two similar-sized clusters of measles occurred in the US, it would be a major public health emergency, and medical resources would be mobilized to contain the disease.
If we recognize hatred as a psychiatric illness, it becomes clear that we have a psychiatric pandemic and a public health emergency. That's the first step toward prevention and treatment, and stopping the carnage.
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Note: Per the usual rule for my stories, “pounce & poop” (drive-by downers posted early to show up at the top of comments) = “threadjack,” and should be flagged per DBAD. DK is for activists, not for pre-emptive defeatists.