Journal Opinion Science

Authoritarianism in Mental Health Settings

When I began this journey in Forensic Psychology, I did not expect to learn as much as I have. The main tenet of this career consists in understanding psychopathy, and psychopathology.

It does make me question authoritarianism and the ways in which it can manifest. For instance, Milgram and Adorno et al. studied the psychology of obedience under pressure, and how following orders led to the holocaust. An aspect that has been questioned little is how scarcity or the fear of scarcity has led to similar phenomena due to how people have been conditioned to see money as an enabler of everyday behaviour. For instance, when Milgram conducted his obedience experiments during the 60s, he monetarily rewarded his participants for taking part in the studies. Modern psychologists have attempted to re-examine the dynamics at Yale’s laboratory and what might have led the participants to show that they were capable of being sadistic under such conditions. An example is Gibson’s (2013) work which meticulously examines the prods given by the experimenter. In a way, Gibson seeked to understand how the orders and requests given by the authority figure contributed to the decision-making processes of the participants. However, I have not come across much research highlighting the role of the monetary incentive in everyday behaviour; or how being given a monetary incentive places a subconscious obligation on individuals to comply with requests, even if such requests at times make them feel uncomfortable.

The c/s/x movement, also known as ‘the psychiatric survivors movement‘ (Wikipedia, n.d.) explores how a large number of individuals report feeling or having felt dehumanised by the mental health system. For the unstigmatised person, it is often more common to assume that all these people expressing dissatisfaction with the system are crazy, than to understand the nature of what it means to respect a person’s dignity and human rights. It is quite a complex situation, because it is unclear what reinforces and keeps some mental health settings from actively listening to their patients’ concerns.

According to Turner (2015), signal detection theory (SDT) “describes processes whereby information that is important to the perceiver (known as the ‘signal’) is distinguished from other information that is unimportant and potentially distracting (known as the ‘noise’)”. It is my hypothesis that some of the inherently dehumanising behaviours occurring in the mental health system happen as a result of the hyper-normalisation of object-relations with patients. As I mentioned on my post Investigating the neuropsychopathology of prejudice‘, people can at times perceive those with stereotyped and stigmatised characteristics as non-human objects. This would of course increase the chance of mental health settings staff processing signals coming from clients as background noise, rather than as worth-listening-to human signals. Such established conscious and unconscious behaviours leading to the dehumanisation of many clients are reinforced through monetary incentives, and through an intragroup, mob-like co-validation of such unconscious biases. Like Eichmann, many live their lives constantly affirming to themselves that they were just following procedures and orders, or just doing their job; and therefore they believe it is not their responsibility to reflect on how clients are impacted by this. But the signals coming from mental health patients often stand in stark contrast to the common belief that these dehumanising, and at times non-empathic methods are appropriate, or even de facto acceptable.

I do think everyone deserves to be paid for their labour, and that having access to a basic form of income is an important foundation in any society; and I also think that mental health settings need to be encouraged or trained appropriately to detect clients’ signals as more than just background noise (i.e. as more than non-human objects signals) in order to reduce risk outcomes. The situation is problematic, persistent, and pervasive with these manifestations of authoritarianism in mental health settings. It would indeed be arrogant to assume that all the patients/clients expressing dissatisfaction with the service are wrong, or to culturally pathologise reasonable dissent. It would also be irresponsible and de jure unacceptable to fail to take steps towards alleviating feelings of ‘being dehumanised’ in civil society, especially if such feelings of dehumanisation have the potential to lead to never events, such as suicide.


Gibson, S. (2013) ‘Milgram’s obedience experiments: A rhetorical analysis’, British Journal of Social Psychology, vol. 52, York, The British Psychological Society/York University, pp. 290-309 [Online]. Available at (accessed 11 October 2020).

Turner, J. (2015) ‘Making sense of the world’, in Turner, J. and Barker, M. J. (eds) Living Psychology: From the Everyday to the Extraordinary, Milton Keynes, The Open University, pp. 7-45.

Wikipedia (n.d.) ‘Psychiatric survivors movement’ [Online]. Available at (accessed 11 October 2020).


The Psychology of Obedience to Authority: Lessons Learned from the Holocaust

Nazi Germany was a true source of critical inquiry for academics worldwide. The work of Adorno et al. about authoritarianism through psychoanalytic theory,  and the work of Stanley Milgram about obedience influenced by situational factors are at the core of modern forensic psychology practice. Authoritarianism can be described as an attitude spectrum encompassing all types of prejudices, that is, xenophobia; as well as extreme ideologies in regards to discipline and traditions, that is, conventionalism (McAvoy, 2012). This essay seeks to explore the studies conducted by the mentioned above pioneers of forensic psychology during the post-war period in relation to the holocaust events. 

Xenophobic conventionalism was the main motivation driving the mass assassination of innocent people during WWII. This inspired Sanford to invite Adorno, Frenkel-Brunswik and Levinson to join his psychological investigation project in the US, and they became a team often cited as “Adorno et al.” due to Harvard alphabetical referencing rules. They were interested in uncovering the unconscious psychopathology of war criminals, and this led them to create the F-scale (McAvoy, 2012). Based on psychoanalytic theory, they administered questionnaires and interviews to the masses in order to validate their hypotheses which drew a  correlation between extreme childhood trauma and overboard adult attitudes to authority (McAvoy, 2012). The trials being held at Nuremberg, Germany, were a powerful motivator behind social psychology research after the war (Bayard, 2012). Stanley Milgram studied Adorno et al.’s work meticulously and was interested in understanding authoritarian obedience and how it related to irresponsible cruelty. After watching the globally broadcasted trial of Adolf Eichmann in television during 1961, Milgram realised that ordinary people were capable of committing great acts of violence when following orders (Banyard, 2012).  Through systematic procedures and pressure from authoritarian figures, a death toll that today approximates seventeen million minority individuals was achieved. Homosexuals, dissenters, jews, activists, disabled people, and foreigners; all brutally discriminated against and murdered (Holocaust Encyclopedia, 2019). Milgram designed a social experiment in order to better understand the link between conscience, executive obedience, and authority in organised war crimes.  

Adorno et al. (1950, p. V) saw prejudice as a mental health virus: “Even a social disease has its periods of quiescence during which the social scientists […] can study it […] to prevent or reduce the virulence of the next outbreak”. They devised the F-scale with its subscales of ethnocentrism, politico-conservatism, and antisemitism (McAvoy, 2012). They used both, quantitative and qualitative methods: “Individuals were studied by means of interviews and special clinical techniques for revealing underlying wishes, fears, and defenses; groups were studied by means of questionnaires” (Adorno et al., 1950, p. 12). Tests had statements with predetermined scores that individuals could agree or disagree with. The interviews allowed the researchers to double-check whether a participant’s general demeanor matched the anti-democratic scores. Nevertheless, the overall study was not enough to determine the direction of the effect of authoritarianism, nor could this predict whether someone with the potential for fascism would actually act on their attitudes and join a fascist movement (McAvoy, 2012). “The modification of the potentially fascist structure cannot be achieved by psychological means alone. The task is comparable to that of eliminating neurosis, or delinquency, or nationalism from the world” (Adorno et al., 1950, p. 975). 

Social psychologist Stanley Milgram was impacted by such results. He modified the F-scale that Adorno et al. had created (Milgram, n.d.).  After witnessing the trial of ordinary-looking Adolf Eichmann, Milgram (1962) wanted to understand the difference between free and forced obedience in everyday life. He (Milgram, 1965, p. 57) reported: “In its more general form the problem may be defined thus: If X tells Y to hurt Z, under what conditions will Y carry out the command of X and under what conditions will he refuse [?]”. Questions like these had led him to design the base condition to test 40 normal-looking young males in 1962. They each would arrive at Yale University and would be greeted by an experimenter wearing a white coat. An actor played the role of fellow participant.  Everything was standardised, from the laboratory, to the confederates, and the apparatus (Banyard, 2012). Participants were asked to administer potentially lethal electric shocks to the actor playing learner. The electric shock machine looked realistic, but was only a prop. Milgram found that indeed normal people had the potential to harm with some pressure from an authority figure. Milgram (1963, p. 371) called this phenomena “destructive obedience in the laboratory”. He then administered the questionnaires to ratify the participants’ valence. 

The studies conducted by Adorno et al. (authoritarianism) and Stanley Milgram (obedience) gave forensic psychologists much detail in terms of personality, situational factors/influences, authority, and compliance in the system  (Byford, 2017). Monetary incentives were offered to participants in both studies: “This was the only way to insure that the staff of the Study would not be conscience-stricken” (Adorno et al., 1950, p. 26). WWII was a common theme in both approaches: “Gas chambers were built, death camps were guarded, daily quotas of corpses were produced with the same efficiency as the manufacture of appliances […] Obedience is the psychological mechanism that links individual action to political purpose” (Milgram, 1963, p. 371). Both experiments were carried out in the US, made use of pen and paper questionnaires, and included qualitative assessments; although the conditions, apparatuses, and  procedures were completely different. The results were controversial enough to elicit a lot of attention from the general public in both cases. Adorno et al.’s work was criticised for being based on psychoanalytic theory, and for the risk of acquiescence response bias (McAvoy, 2012). Milgram’s work got him in serious ethical trouble due to what he was able to uncover about his subjects; and how this impacted their real life, identities, and reputations (Banyard, 2012). Both teams reported their findings through writing, although Milgram also created a documentary about his experiment (Obedience, 1962). 

As it can be observed, there are many substantial similarities between Adorno et al.’s and Milgram’s experiments, even if these are different when it comes to structure. One preceded the next, and one added to the other. Authority and its relation to obedience can be better appreciated by drawing a correlation between the two approaches studied above. The results shed light on personality, and how adult behaviour can be a result of individual differences, as well as of contextual circumstances. Adorno et. al studied the master, and Milgram studied the slave. The general conclusion? Both sides are equally dangerous. 


Adorno, T.W., Frenkel-Brunswik, E., Levinson, D.J. and Sanford, R.N. (1950) The Authoritarian Personality, New York, Harper.

Banyard, P. (2012)  ‘Just following orders?’, in Brace, N. and Byford, J. (eds) Investigating Psychology, Oxford, Oxford University Press/Milton Keynes, The Open University, pp. 61-95.

Byford, J. (2017) ‘The importance of replication’, in McAvoy, J. and Brace, N. (eds) Investigating Methods, Milton Keynes, The Open University, pp. 47-82.

Holocaust Encyclopedia (2019) Documenting Number of Victims of the Holocaust and Nazi Persecution [Online]. Available at: (Accessed 2 April 2019)

McAvoy, J. (2012) ‘Exposing the Authoritarian Personality”, in Brace N. and Byford, J. (eds) Investigating Psychology, Oxford, Oxford University Press/Milton Keynes, The Open University, pp. 14-56 

Milgram, S. (n.d.). Modified “F” Scale, Opinion Questionnaire [Online]. Available at:|bibliographic_details|2089868 (Accessed 2 April 2019)

Milgram, S. (1962). ‘Free Obedience vs. Forced Obedience’ in Stanley Milgram Personal Papers [Online]. Available at: (Accessed 2 April 2019)

Milgram, S. (1963). ‘Behavioral Study of Obedience’, in Journal of Abnormal and Social Psychology, pp. 371-372 [Online]. Available at: (Accessed 2 April, 2019)

Milgram, S. (1965). ‘Some Conditions of Obedience and Disobedience to Authority’, in Human Relations, vol. 18, no. 1, pp. 57-76 [Online]. Available at:|bibliographic_details|2082063 (Accessed 2 April, 2019)

Obedience (1962) Directed by Stanley Milgram [Documentary]. New Haven, Yale University. Available at: (Accessed 2 April 2019)