Elevating Empathy

In February 2025, I began reading the book "Hillbilly Elegy" from 2016. The autobiography of the current U.S. Vice President seemed to me a suitable entry point to search for reasons that reveal more about J.D. Vance's stance, away from the usual litany of decrees, Oval Office dramatizations, and crude social network outbursts.

What worldview underpins actions that seem unfamiliar to us?

Initially, I follow the Cultural Foresight approach I developed. Here, we combine a causal layered analysis with the formulation of scenarios to later reconstruct the layers in a reverse process. Readers can learn more about this method on this page. →

I start with a note to understand why we currently feel the world has never been so crazy. In the second step, I explain why the intertwining of health and power politics causes problems. After that, we delve into the analysis to better understand the world with the insights of J.D. Vance. That's already a crazy idea. However, his neuropolitical fallacies are likely to occupy us for a long time.

Media representation intensifies the discourse

Much has already been said about this. Therefore, I would like to briefly focus on the communicative actions of those in power who are assumed to be at the top of an editorial society due to their questionable reputation. Pörksen, 2018

The degree of media representation of the psychological inner life of state leaders has never been so high in human history. Power-conscious people themselves most often ensure an increased level of attention. This cry for love on social networks like X (formerly Twitter), Truth Social, and every other known platform is the starting point for the critical dissemination of statements. Usually, immediately after the appearance of such an ideological tweet, it is circulated further. The powerful emotionally storm our screens with their outbursts, which are sometimes incontinent, and into our realities right away. Both followers and media ensure that something goes viral. Most of the time, the content points to the emotional state of the sender and not to actual statements. Nevertheless, they are often interpreted as such.

US President Donald J. Trump is long regarded as a prototype of a new kind of troll, who one might not even accuse of opportunism, but only the KGB-tested tactic of maximum public confusion, whose potential sometimes leads the public discourse into toxicity. This makes Donald Trump a role model for his supporters. Their voters and fans, from my point of view, share an interesting characteristic that I don't want to declare as stereotypical superficiality. That's why I thought of trying to first understand Donald Trump's number one voter better. Nine years ago, Vice President J.D. Vance published a book titled "Hillbilly Elegy." The film adaptation was picked up by Netflix → and received two Oscar nominations.

In his lamentation, the US vice president describes along his family history the discoveries about his own mental states. He attributes them on one hand to his origins and a related socialization within the successor generation of so-called Ulster-Scots. They are considered the largest voluntary immigrant group to the British North American colonies, from which the USA later emerged. On the other hand — and this will be discussed — he suspects structural neglect by the state and an overwhelming wokeness among other Americans, which increasingly makes life difficult for the style of the hillbillies.

The Republicans' outrage is due to the fact that many — primarily rural Americans — follow this thought. The ongoing reconstruction of the Republican Party is somewhat counterintuitive. Presumably, we are dealing with a political response to neoliberalism, which as an economic doctrine was based on deregulation, free markets, reduced state intervention, and globalization. After all, one of its co-founders was a Republican; namely, Ronald Reagan. Neoliberalism and postmodernism bring with them numerous difficulties that need to be overcome. That is indisputable. However, the ideology that the second Trump administration now imposes on us suffers, in my opinion, from neuropolitical fallacies, which we will address specifically as a result of the analysis.

The intertwining of health and power politics

We still need to clarify the term "neuropolitical" in order to arrive at a common perspective. Allow me first to speak about the relevance of the text. A tectonic power shift towards political liberalism with sometimes right-wing populist understanding is currently taking place worldwide, which here and there threatens to slip into right-wing extremism. Whether this also applies to the USA is not yet recognizable. We plunge into familiar interpretation patterns. Possibly, we are dealing with a cultural revolution that seeks to subject what we understand as a state to a capitalist doctrine. We have long recognized the desire to run the USA as a major corporation in the language of "dealmaking."

To this end, state presidents like Donald J. Trump surround themselves with chief ideologists and are making use of myths believed to be long overcome, which spread not only in America but also here in Europe. All this influences how societies engage with state welfare. So the mandate of the state, which should not be a business, but in most countries leads to a lot of money being earned.

Only through the synthesis of realpolitical conflict analysis and visionary cooperation architecture can it be prevented that the next global health crisis, like the COVID-19 pandemic behind us, again becomes the collateral damage of geopolitical power games. The alternative would be a world in which health degenerates into the privilege of the geopolitics winners.

I have compiled a chapter in the compendium that shows geopolitical dynamics as a determinant of future health architectures with facts. In terms of a New Moral Health Economy. → Compendium

Where would one begin to engage with the complex connections?

After the USA's withdrawal from the WHO became known, USAID had to significantly limit its work, and the US Secretary of Health, Robert F. Kennedy (junior), announced upon his appointment that he would now also take action against health institutions, we return to J.D. Vance as the first Trump voter ever. Reading his already mentioned book "Hillbilly Elegy" seemed important to me to better understand the attitude behind the common MAGA litany of the new American way. His political career — from "hillbilly philosopher" to designated heir to Trump's legacy — seems like an American paradox: A man who relentlessly dissects the vulnerabilities of the white working class in his autobiography Hillbilly Elegy (English) now propagates a policy of social coldness. Yet this very ambivalence makes him a key figure in a global trend.

Uplifting empathy in this contradiction is a prerequisite for seeking alternative scenarios that we can then also prefer.

Ongoing observations can be found under → Health Politics and Geopolitics against the backdrop of a New Moral Health Economy.

The birth of prejudice: Vance's origins as a social blind spot

Vance's descriptions of his childhood in Middletown, Ohio, paint a panorama of neglect. The mother, torn between heroin addiction and religious fervor, causes Vance to initially suspect himself as the third generation of losers. The father leaves the family before the son's third birthday. The grandparents, whose love is expressed in beatings and binges, provide young James David Vance with long-term orientation.

For more stable middle-class milieus, the image of a borderless subculture emerges, that undermines all value standards of the enlightened West — an effect that Vance consciously reinforces with his drastic language (“We scream, we hit, we smash glasses”).

Particularly disturbing is Vance's description of a perverted honor code. While theft or drug dealing within the family is tolerated, any criticism from external authorities (teachers, police officers, social workers) is considered betrayal. This "logic of the closed society" evokes inevitable associations with clan structures among European readers — a framing that Vance himself serves with his descriptions up to about Chapter 14. I almost thought I was on the wrong track. But his personal turnaround during his studies finally turns to the specific interpretation of the systemic connections within American society.

The Anti-Establishment Rhetoric of J.D. Vance

The anti-establishment rhetoric of J.D. Vance appears as a calculated political strategy in this light. His intimate knowledge of hillbilly culture and its traumas he skillfully uses to stage himself as an authentic representative of the white working class. In doing so, he instrumentalizes exactly those social mechanisms and resentments that he once critically dissected in his autobiography.

His transformation from a critical observer to a MAGA activist can be interpreted as a deliberate absorption of the uneducated classes. He speaks their language, knows their wounds, and understands how to mobilize the latent grudge against the "establishment." The hillbilly mentality, shaped by mistrust of authorities and a strong insider-outsider thinking, becomes a political tool in this.

Particularly cynical is that Vance politically exploits the traumatic experiences of his cultural background, which he has mercilessly reflected upon. Instead of addressing the identified systemic problems, he reinforces narratives of exclusion and distrust — a strategy that secures him and the MAGA movement voter shares but further deepens the societal divide.

If we initially trust the book, which certainly does not reflect every facet of J.D. Vance's thinking, we suspect that he falls short regarding the problems waiting for him; and will present extreme problems not just to American society.

The turn to empathy: The US Vice President and the key to understanding trauma

On the pages of Chapter 14, Vance undergoes his very personal ACE revelation, marking his personal system change, which manifests in a new form of liberalism that “The New Institute” calls Neo-Illiberalism. Presumably, the initial boundary that turned Vance into a critic of Trump and subsequently made him the U.S. Vice Presidential candidate ran here. Previously, he represented Ohio as a senator and member of the Republican Party.

The break in Chapter 14 of Hillbilly Elegy does not lie in the mere enumeration of six Adverse Childhood Experiences (ACEs) to which he sees himself exposed, but in the realization of inescapability. This existential insight transforms the text from sociological report to tragedy of ancient dimensions – the hero realizes that his curse is also his identity.

J.D. Vance engages deeply with the concept of Adverse Childhood Experiences (ACEs), a key term in trauma research that shapes his understanding of the socio-cultural dynamics within the white working class of Appalachia. Through his own research, Vance discovers that traumatic childhood experiences not only burden individual biographies but also shape collective patterns within the community he describes as the hillbilly caste. His personal reflection on six of his own ACEs — including parental violence, family drug abuse, and unstable relationships — serves as the starting point to deconstruct the cyclical nature of poverty, lack of education, and emotional dysfunction in his cultural background. This recognition leads to the existential question of how much responsibility individuals bear for their fate and how much cultural legacies limit their scope for action – a tension Vance exemplifies with his drug-addicted mother and the contrasting experiences of his partner Usha.

Particularly ambivalent is Vance's attitude towards his mother. On one hand, he acknowledges that her drug addiction and violent outbursts are consequences of her own seven ACEs →. On the other hand, he condemns her decision to revert to heroin despite phases of rehabilitation as a moral failure →. This tension between empathy and accusation runs through the entire chapter and reflects the societal debate about the causes of poverty – a topic that Vance will later take up in his political career as US Vice President. →

The term Adverse Childhood Experiences originates from a groundbreaking study by the Centers for Disease Control and Prevention (CDC) from the 1990s, discovered by Vance in his library research →. ACEs include ten categories of traumatic experiences before the age of 18, including physical/emotional abuse, neglect, domestic violence, parental divorce, or incarceration of a family member →. According to the study, each ACE exponentially increases the risk of later health problems such as depression, heart disease, and substance abuse — a connection Vance experiences himself as he traces his impulsive anger and relationship difficulties back to six ACEs →.

Neuropolitics of Vulnerability

Absurdly, J.D. Vance subjects himself to the MAGA doctrine. The increasingly evident focus on national sensitivities under the banner "Make America great again" underscores what we will better understand as Neo-Illiberalism.

Neuropolitically refers here to the interdisciplinary approach of neuropolitics, which deals with the intersection between neurosciences and political science. Neuropolitics examines how neurobiological processes influence political behavior, decisions, and attitudes and vice versa, how political and social factors shape the brain and its functions → → →.

This field combines methods from cognitive neuroscience to answer classical questions of political science, such as the formation of political attitudes →. Neuropolitics aims to illuminate the complexity of political phenomena through a deeper understanding of the underlying neurocognitive mechanisms → →. In a broader sense, the neuropolitical approach also encompasses the consideration of the political implications of neurotechnological developments and the ethical questions arising from them →. If fallacies are neuropolitical as I mention in the.subtitle of this essay, it means we need to recognize a reality that we can no longer face with mere hope, fear, and repetitive appeals to reason when dealing with politicians who, based on a deeply internalized hero's journey rooted in their identity, believe they are rightly acting in the role of state leaders. These individuals may succeed in democratizing their thoughts and associated mental states. The sometimes superhuman effort now required to be and remain successful as a politician is unimaginable for 99% of people.

Neuropolitics no longer aligns with the litanies of a political operation that reassures and postpones. Neuropolitics compels a society and demolishes the deliberative virtues of democracies due to the psychological constitution of a newly poised power elite. Speculations about turning the USA into a dictatorship are therefore rather under-complex. A neuropolitically motivated Neo-Illiberalism starts earlier.

Only then can projects like DOGE or the exchange of school literature as a measure to retell historical events in the USA be explained. There are efforts to revise the American history curriculum to focus more on the nation's achievements and less on its historical missteps. This mirrors debates around Critical Race Theory and the depiction of slavery and colonialism in textbooks. Many curricula and textbooks have avoided for years addressing the connection between white suprematism and slavery. This leads to an incomplete portrayal of American history and its impact on today's social structures. →

Anyone who has seen the film "Interstellar" likely recalls the conversation with the daughter's teachers, where former NASA pilot Cooper learns that the school teaches the conspiracy of a moon mission that supposedly never took place, as technical activities like space travel are deemed harmful and too expensive. In the film, humanity believes itself to be at an end and prefers the production of food over allowing people to transcend their limits.

Through modern trauma research, Vance explains that political radicalization can be a neurobiological consequence. He expresses this slightly differently and constantly oscillates between personal experiences that he repeatedly incorporates and an eroded American dream he believed he was living much too soon. He owes his access to confronting his own domains until today to his wife, Usha. Through her, he learns about the harmonious culture of an Indian-American family and how a supportive environment fosters conflict resolution skills.

Vance cites data showing that 40% of working-class children suffer multiple ACEs – compared to 29% in higher strata →. He explains this discrepancy with the "toxic stress spiral" of poor communities: unemployment, lack of education, and intergenerational trauma create a milieu where violence and instability become the norm. He illustrates this particularly vividly by means of an international comparison: while in France only 0.5% of children experience three or more stepfathers, this rate in the USA is 8.2% – to him, an indicator of the fragile family structures in marginalized groups.

For individuals with trauma modeled after the concept of ACEs, the hyperactive amygdala system leads to a preference for black-and-white thinking. This has something to do with the enormous mental effort that traumatized individuals slide into a strange economy of their sensations. Reduced connectivity in the prefrontal cortex also makes it difficult to create long-term strategies in favor of impulsive solutions. Epigenetic imprinting is suspected due to trauma experienced by previous generations (mining accidents, economic crises, war experiences). This is how intergenerational fear patterns manifest.

By exposing these mechanisms in his biography, the "angry hillbilly" becomes a symptom carrier of a collective failure – a diagnosis that establishes empathy not as an excuse, but as an analytical tool. However, his empathy is oriented toward a worldview that is not in the broadest sense humanistic but appears fundamentally religious.

The trap of false compassion: Vance's political fallacies

Vance's solution proposals obsessively circle around the reconstruction of familial bonds – an approach that reductionistically relativizes the complexity of social vulnerability. He transfers the concept of filial obligation to the state. MAGA is an expression of this ideology. In the book, he accuses the Democratic Obama administration of deliberately causing the formation of educationally disadvantaged milieus.

Neo-Illiberalism

The paper by The New Institute in Hamburg titled "Beyond Neoliberalism and Neo-Illiberalism: Economic Policies and Performance for Sustainable Democracy" offers a valuable conceptual framework for analyzing new political-economic positions, including those of J.D. Vance. Before examining Vance's specific form of liberalism (or illiberalism), it is important to understand the key concepts and distinctions presented in this comprehensive essay collection.

Neoliberalism was not only an economic program but a political agenda that involved rewriting the rules in a way that benefited some groups and disadvantaged others. This economic model continues to be associated with growing inequality, financial instability, and wage stagnation to this day.

Neo-Illiberalism now refers to the political response characterized by authoritarian tendencies, ethno-nationalism, and clientelism, while paradoxically aiming to retain some market-oriented economic policies. Jessica Pisano aptly defines the phenomenon in the paper:

While illiberalism produces something that resembles ethno-nationalism, it often begins with an economic pact, a transactional politics.

She describes a distinct political economy of illiberalism, where central power maintains relationships with local clientelist networks. Through the book Hillbilly Elegy, the political development of today's Vice President can be illuminated. This reveals the tensions between traditional conservatism, populism, and what the paper describes as "Neo-Illiberalism."

Vance's political identity has several key components.

Firstly, Vance's economic positions reflect what Dani Rodrik describes in his contribution as "a step back from hyper-globalization." Vance has criticized free trade agreements and advocated for economic nationalism and protectionism. This reflects the aspiration that a post-neoliberal economy should include more domestic space and freedom for the reconstruction of national social contracts. The daily reports on US tariff policy since the official takeover of office provide a clear indication that the USA is seeking a path to partially withdraw, at least partially, from globalized supply chains through neo-illiberal protectionism.

Secondly, the new US politics combines cultural traditionalism with selective economic interventionism. The often disturbing rhetoric frequently emphasizes demonization of certain groups, which Rosana Pinheiro-Machado identifies as a characteristic of neo-illiberal politics. Yet he retains a fundamentally market-oriented worldview, which corresponds with the observation that neo-illiberals simultaneously demand strong government authority and weak state intervention.

The Trump administration and particularly Vance build their political identity on representing those who feel economically and culturally alienated, particularly in regions of deindustrialization. Until his appointment as Vice President, Vance represented the state of Ohio as a senator. A state heavily affected by deindustrialization fits perfectly into this analysis.

Thus, economic nationalism, cultural traditionalism, selective state intervention in the economy, criticism of elites combined with transactional politics, and a pronounced skepticism towards a progressive welfare state combine to form a new worldview. An ideology that can be termed as neo-illiberal economic pragmatism and is currently barely tangible. It is being implemented towards the rest of the world with high speed in governmental actions. Deliberative democracies are confronted with this and appear weak. A plan that Viktor Orbán obviously also supports. Those who understand democracy as a process of balancing different needs such as freedom, security, and regulation recognize in the actions of the Hungarian Prime Minister a pattern intended to keep the European Union active as a deliberative institution in a similar way. Possibly due to experiences made, emerging somewhere between Russia as a former hegemon and a previous desire for Western integration of the former Eastern Bloc state.

The Concrete Liberalism of “The Sanctified Family”

The above-mentioned cultural traditionalism is reflected in the family policy advocated by Vance.

The possibility of enabling consensual divorce of marriages is to be abolished. The dissolution of a marriage without having to prove fault by either party is considered obsolete today. Marriages have become a sort of disposable item. The cancellation of social safety nets in favor of church aid networks underscores the fundamentalist tendencies of his return to Christian faith that Vance hints at at the beginning of Chapter 15. The militarization of national US borders is described as a necessity to create a refuge for American family values. In a way, more noble exclusion can hardly be declared. We recall J.D. Vance's speech at the Munich Security Conference, which did not revolve around traditional security aspects, but around values that he did not even subtly deny to European nations, but underlined with critiques involving examples from Scotland and Romania.

Unfortunately, all this ignores that dysfunctional family structures perpetuate adverse childhood experiences – a vicious cycle that mistakes trauma for tradition.

Morality as Replacement Diplomacy

Recently, Vance called for a "Alliance of Moral Nations" against China and Iran. Thus he tries to elevate the hillbilly principle of “loyalty over reason” to the global stage. The geopolitical danger lies not in the isolationism of the USA itself, but in its sacred exaggeration: When multilateral treaties (climate agreements, NATO assistance) are denounced as "weakling ideology," foreign policy becomes a state and dogmatically mandated trauma coping as politics. In the US, a leader cult around the current POTUS is already emerging.

Empathy as a political duty: A European compass

Europe's recently discredited, liberal values, fought for over several centuries, face a threefold challenge.

Firstly, the instrumentalization of traumas by populist forces threatening to exploit the narrative of "lost greatness". Early signs are evident in the election results on the continent. BREXIT was a harbinger that was not discussed as such. Secondly, geopolitical tensions shake faith in multilateral solutions. Thirdly, socio-economic inequalities foster new dividing lines.

But this crisis dynamic presents the opportunity to rethink European values. Not as a static set of rules, but as a learning system. An evidence-based social policy that takes trauma research seriously could combine empathy and rationality and strengthen the judgment of those who should shape social policy. Democratic processes must consider neurobiological insights into collective fears without succumbing to them through traditional reflexes.

The progressive value compass of Europe must set three orientation points. Fact-based decision-making instead of emotional manipulation, constructive empowerment for social difficulties instead of suppression, and integrative solutions instead of exclusion. Only then will European values remain resilient and future-proof.

The art of differentiated compassion

True empathy neither approves nor demonizes generational states, but acknowledges complex challenges. These cannot be met with anti-establishment rhetoric, but rather intensify the same injuries that prevent the hillbillies from ascending. A cult of toughness, as it was also heard in the Bundestag election campaign of 2025, is an internalized survival mechanism, not a character trait. The America-First policy reflects the mistrust of a boy who never experienced secure bonds. This trait he likely shares with his boss.

Strategic empathy in practice

Concrete maxims of action can be transferred to individual actions just as much as to geopolitical decision-making chains that should address future German foreign policy. It sounds somewhat intrusive, but why not develop trauma-sensitive dialogue formats that anticipate negotiations with the Trump/Vance administration and its ACE-influenced negotiation patterns (black-and-white thinking, short-term deal orientation). A feminist foreign policy was an initial attempt to overcome traditional perspectives.

Let's call it Neurodiplomacy, which addresses cooperation offers not only to the USA but focuses on the targeted limbic system reactions (sense of security, status recognition). Geopolitical diplomacy always involves tough interest politics. The hope that the behavior of such statesmen might adapt rationally out of nowhere is no hope.

The Empathy Gap as a Hotbed of Danger

The open dismissal of Vance as "hillbilly president" on the diplomatic stage would reinforce the vicious circle described in the book Hillbilly Elegy: Exclusion → Trauma → Radicalization → renewed exclusion.

Europe faces the task of developing a third narrative – beyond naive willingness to cooperate and moral arrogance. Because Vance's ACE score is not an American special phenomenon but a symptom of a global crisis. The neoliberal dream left millions stranded in Detroit, Duisburg, and even in East Germany, whose anger now erupts in illiberal revolt. The election results of the Bundestag election in 2025 clearly speak this language. Even the CDU is lagging behind the developments. Europe has a task.

To awaken empathy towards states suffering from neuropolitical crossfire, their doctrines and worldviews must be understood. These statesmen see other hotspots, and we are well advised to progressively anticipate them before they once again set the world order on fire. → Progressive Anticipation

Finally, all that remains is another reminder of the link between geopolitics and health crises. Without an empathetic understanding of the neuropolitical determination of statesmen, we will find no sustainable solutions for global health crises. Strengthening multilateral health organizations and building resilient health systems, therefore, must go hand in hand with a trauma-informed foreign policy that challenges the worldview of the "law of the strongest" and in this way establishes a new rule-based order at a significantly more sensitive level. Whether the new federal government will demonstrate what was demanded now remains to be seen.

Literature Used

• Hillbilly Elegy, details to follow.

• Pörksen, B. (2018). The Great Irritation: Paths out of Collective Agitation. Carl Hanser Verlag GmbH & Co KG.

• The contextual links each directly refer to the source used.