Elevating Empathy

A few days ago, I started reading the book "Hillbilly Elegy" from 2016. The autobiography of the current US Vice President seemed to me an appropriate entry point, far from the usual litany of decrees, Oval Office scandals, and crude comments on social networking platforms, to search for reasons that might reveal more to me about J.D. Vance's attitudes. What worldview underlies the actions that seem so unfamiliar to us?

I initially 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 reverse. More information on the method is available to interested readers on this page. →

I begin first 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 presents problems. After that, we delve into the analysis to better understand the world with insights from J.D. Vance. His neuropolitical fallacies will likely occupy us for a long time.

Media Representation Intensifies the Discourse

A lot has already been said about this. Therefore, I want to briefly touch on the communicative actions of powerful individuals suspected at the head of an editorial society due to their questionable reputation. Pörksen, 2018

The degree of media representation of the psychological inner lifes of state leaders has never been so high in human history. Most often, power-conscious individuals themselves 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 a critical spread of declarations. Most often, shortly after the appearance of such an ideological short message, it is further disseminated. The powerful often bluster affectively and sometimes incontinent their intellectual outpourings initially on our screens and promptly into our realities. Followers and media alike ensure that something goes viral. Mostly, the content reflects the emotional state of the sender and not actual statements. Nevertheless, they are often interpreted as such.

US President Donald J. Trump has long been considered a prototype of a new type of troll, not even blamed for opportunism, but only the KGB-proven tactic of maximum public confusion, whose potential occasionally allows public discourse to drift toxically. This makes Donald Trump a role model for his followers. His voters and fans share an interesting trait from my point of view, which I do not want to declare as stereotypical superficiality. Therefore, I decided to try to understand Donald Trump's voter number 1 better. Vice President J.D. Vance published a book titled "Hillbilly Elegy" nine years ago. The movie adaptation was added to the Netflix program → and received two Oscar nominations.

In his elegy, the US Vice President describes, along the lines of his family history, the discoveries about his own mental states. On the one hand, he attributes this to his origin and the associated socialization within the subsequent 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 need to be discussed – he suspects structural neglect by the state and an overwhelming wokeness among other Americans, which increasingly makes life difficult for the hillbillies.

The Republicans' fury is due to the fact that many – primarily rural Americans – follow these thoughts. The ongoing transformation of the Republican Party is somewhat counterintuitive. Allegedly, we are dealing with a political response to neoliberalism, which was an economic doctrine based on deregulation, free markets, reduced state intervention, and globalization. One of its co-founders was a Republican, Ronald Reagan. Neoliberalism and postmodernism bring with them numerous difficulties that need to be overcome. That is undisputed. However, the ideology that the second Trump administration now imposes on us suffers, in my opinion, from neuropolitical fallacies, which we will then specifically address as a result of the analysis.

The Intertwining of Health and Power Politics

We will clarify the term "neuropolitical" to arrive at a common perspective. Allow me first to say something about the relevance of the text. Currently, a tectonic shift in power is taking place worldwide in favor of a political liberalism with partly right-wing populist understanding, which threatens to tip into right-wing extremism here and there. Whether this also applies to the USA is not yet apparent. We plunge into familiar interpretive patterns. Perhaps 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 attempt to run the USA as a corporation in the language of "deal-making."

To this end, heads of state like Donald J. Trump surround themselves with chief ideologues and employ long-overcome myths that are spreading not only in America but also here in Europe. All of this influences how societies confront the state's raison d'être. Thus, the state's mission should not be a business, yet in most countries, it leads to significant money being made.

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, becomes a collateral damage of geopolitical power plays again. The alternative would be a world in which health degenerates into a privilege of the winners of geopolitics.

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

Where would one begin to deal with the complex interrelationships?

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

Armoring empathy into this contradiction is a prerequisite for searching for alternative scenarios that we can then prefer.

The Birth of Prejudice: Vance's Origin as a Social Blind Spot

Vance's descriptions of his childhood in Middletown, Ohio, paint a panorama of neglect. His mother, torn between heroin addiction and religious fervor, causes Vance to initially see himself as the third generation of losers. The father leaves the family before the son's third birthday. The grandparents, whose love manifests in corporal punishment and alcohol excesses, provide long-lasting guidance to the growing James David Vance.

For more stable middle-class milieus, an image of a unbounded subculture emerges that undermines all value standards of the enlightened West – an effect Vance deliberately amplifies through 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" inevitably evokes associations with clan structures among European readers – a framing that Vance caters to in parts until about chapter 14. I almost thought I was on the wrong track. However, his personal turn, which unfolds during his study period, finally turns to a special interpretation of the systemic interconnections of US society.

The Anti-Establishment Rhetoric of J.D. Vance

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

His transformation from critical observer to MAGA activist can be interpreted as a deliberate appropriation of the less-educated classes. He speaks their language, knows their wounds, and knows how to mobilize latent resentment against the "establishment." The hillbilly mentality, characterized by distrust of authorities and a strong insider-outsider mentality, becomes a political tool.

Particularly cynical is that Vance exploits the traumatic experiences of his cultural origins, which he has ruthlessly reflected on, for political gain. Instead of addressing the recognized systemic problems, he amplifies narratives of exclusion and distrust – a strategy that secures votes for him and the MAGA movement but further deepens social division.

Trusting in the book, which certainly does not mirror every facet of J.D. Vance's thinking, we can anticipate that he falls short regarding the problems that await him; and not only the US society will experience extreme difficulties.

The Turn to Empathy: The US Vice President and the Key to Understanding Trauma

On the pages of chapter 14, Vance undergoes his very private ACE revelation, marking his personal system change, which manifests in a new form of Liberalism, referred to as Neo-Illiberalism by "The New Institute." Initially, this was likely the boundary that made Vance a critic of Trump, later ascending to the US Vice Presidential candidacy following reconciliation between the two. Previously, he represented Ohio as a senator and member of the Republican Party.

The chapter 14 caesura of Hillbilly Elegy does not lie in merely listing six Adverse Childhood Experiences (ACEs) to which he is exposed, but in the realization of inescapability. This existential insight transforms the text from a sociological report into a tragedy of ancient dimensions – the hero realizes that his curse is simultaneously his identity.

J.D. Vance delves deeply into 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 personal research, Vance discovers that traumatic childhood experiences burden not only individual biographies but also form collective patterns within the hillbilly caste community he has identified. His personal reflection on six own ACEs – including parental violence, family drug abuse, and unstable relationship structures – serves as a starting point to deconstruct the cyclical nature of poverty, lack of education, and emotional dysfunction in his cultural origin. This insight leads to the existential question of how much responsibility individuals bear for their destiny and how strongly cultural legacies limit action spaces – a tension Vance exemplifies through the contrasting experiences of his drug-addicted mother and his partner Usha.

Vance's attitude towards his mother is particularly ambivalent. On the one hand, he acknowledges that their drug addiction and violent outbursts result from their own seven ACEs →. On the other hand, he condemns her decision to keep turning to heroin despite rehabilitation phases as moral failure →. This tension between empathy and reproach runs throughout the chapter and reflects the societal debate about the causes of poverty – a theme Vance will later address in his political career as US Vice President. →

The term Adverse Childhood Experiences comes from a groundbreaking study by the Centers for Disease Control and Prevention (CDC) from the 1990s, which Vance discovers 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 the 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 firsthand as he traces his impulsive anger and relationship difficulties back to six ACEs →.

The Neuropolitics of Vulnerability

It seems absurd that J.D. Vance defers to the MAGA doctrine. The increasingly apparent focus on national concerns under the banner "Make America great again" underlines what we will soon better understand as Neo-Illiberalism.

Neuropolitical herein refers to the interdisciplinary approach of neuropolitics, which deals with the intersection between neuroscience and political science. Neuropolitics examines how neurobiological processes influence political behavior, decisions, and attitudes, and conversely, how political and social factors shape the brain and its functions → → →.

This field combines methods from cognitive neuroscience to answer classic political science questions, 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 includes considering the political impacts of neurotechnological developments and the ethical questions arising from them →. If fallacies are neuropolitical, as I label it in the subtitle to this essay, then I mean that we need to acknowledge a reality we can no longer meet with hope, worry, and repetitive appeals to reason when dealing with politicians who, due to a deeply internalized heroic journey based on their identity, believe they are legitimately acting in the role of a state ruler. Possibly, these very individuals manage to have their thinking and associated mental states democratically legitimated. The sometimes superhuman effort now required to be and remain a successful politician is unimaginable for 99% of people.

Neuropolitics no longer follows the litany of a political operation that placates and delays. Neuropolitics compels a society and dismantles the deliberative virtues of democracies based on the psychological constitution of a new, positioned power elite. Consequently, speculations about transforming the USA into a dictatorship are simplistic. A neuropolitically motivated Neo-Illiberalism begins earlier.

This alone can explain projects like DOGE or the exchange of school literature as a measure to reinterpret historical events in the USA. Efforts exist to revise the curriculum of American history to focus more on the nation's achievements and less on its historical errors. This reflects in debates about Critical Race Theory and the portrayal of slavery and colonialism in textbooks. For years, many curricula and textbooks have avoided addressing the connection between white supremacism and slavery. This leads to an incomplete representation of American history and its impact on today's social structures. →

Anyone who has seen the movie "Interstellar" may recall the conversation with his daughter's teachers, where the former NASA pilot Cooper learns that the school teaches the conspiracy of a moon mission that supposedly never happened, as technical activities such as spaceflight are considered harmful and too expensive. In the movie, humanity presumes itself at its end, preferring to produce food rather than allowing people to grow beyond themselves.

With the help of modern trauma research, Vance explains that political radicalization may be a neurobiological consequence. He expresses himself somewhat differently and constantly oscillates between personal experiences, which he repeatedly incorporates, and an eroded American dream he believed he was living far too early. He owes his wife Usha the access to continue confronting his own domains. With her, he learns about the harmonious culture of an Indian-American family and, with it, how a supportive environment fosters conflict resolution skills.

Vance cites data showing that 40% of working-class children experience 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 an environment where violence and instability become the norm. Particularly impressively, he illustrates this with an international comparison: While in France, only 0.5% of children go through three or more stepfathers, this rate is 8.2% in the USA – for him an indicator of fragile family structures in marginalized groups.

In individuals with trauma per the insight regarding the ACE concept, the hyperactive amygdala system prefers a black-and-white thinking. This has to do with the enormous mental effort to which traumatized people succumb, causing them to slide into a strange economy of their sensations. Reduced connectivity in the prefrontal cortex also makes long-term strategies difficult in favor of impulsive solutions. Suspected are epigenetic imprints from trauma of previous generations (mining accidents, economic crises, war experiences). This manifests in intergenerational fear patterns.

By exposing these mechanisms in his biography, the “angry hillbilly” becomes the symptom bearer of collective failure – a diagnosis that establishes empathy not as an excuse but as an analytical tool. However, his empathy leans towards a worldview that is not humanistically shaped in the broadest sense but fundamentally religious.

The Pitfall of False Compassion: Vance's Political Fallacies

Vance's solutions obsessively revolve around the reconstruction of familial bonds – an approach that reductionistically relativizes the complexity of social vulnerability. The concept of filial obligation, he transfers to the state. MAGA is an expression of this ideology. Thus, in the book, he accuses the Democratic Obama administration of consciously causing the manifestation of educationally disadvantaged milieus.

Neo-Illiberalism

The paper from The New Institute in Hamburg titled "Beyond Neoliberalism and Neo-Illiberalism: Economic Policies and Performance for Sustainable Democracy" provides a valuable conceptual framework for analyzing novel 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 introduced in this comprehensive essay collection.

Neoliberalism was not just an economic program but a political agenda involving rewriting rules in a way that favored some groups and disadvantaged others. This economic model is associated to this day with increasing inequality, financial instability, and wage stagnation.

Neo-Illiberalism now refers to that political response characterized by authoritarian tendencies, ethno-nationalism, and clientelism, while paradoxically, certain market-oriented economic policies are to be retained. Jessica Pisano aptly defines the phenomenon in the mentioned paper:

While Illiberalism produces something that looks like 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. The book Hillbilly Elegy illuminates the political development of today’s Vice President. Thus, the tensions between traditional conservatism, populism, and what the paper terms "Neo-Illiberalism" become visible.

Vance’s political identity has several key components.

First, 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 notion that the post-neoliberal economy should include more domestic space and freedom for the reconstruction of national social contracts. The daily reports on the USA's tariff policy since the official takeover are a clear indication that the USA is seeking a path to partially disengage from globalized supply chains through neo-illiberal protectionism.

Second, the new US policy combines cultural traditionalism with selective economic interventionism. The sometimes-disturbing rhetoric often emphasizes the demonization of certain groups, identified by Rosana Pinheiro-Machado as a hallmark of neo-illiberal politics. Nevertheless, he maintains a fundamentally market-oriented worldview, consistent with the observation that Neo-Illiberals simultaneously advocate for strong governmental authority and weak state intervention.

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

Thus combines economic nationalism, cultural traditionalism, selective state intervention in the economy, criticism of elites combined with transactional politics, and pronounced skepticism towards a progressive welfare state as a new worldview. An ideology describable as neo-illiberal economic pragmatism currently remains elusive. It is being implemented at high speed in government actions relative to the rest of the world. Deliberative democracies are confronted with this, appearing weak. A plan apparently also shared by Viktor Orbán. Those who understand democracy as a process of balancing various needs like freedom, security, and regulation recognize in the actions of the Hungarian Prime Minister a pattern intended to keep the European Union on similar toes as a deliberative institution. Possibly due to experiences made somewhere between Russia as a former hegemon and a previous aspiration for western alignment of the former Eastern bloc state.

The Concrete-Liberalism of the "Sacred Family"

The cultural traditionalism mentioned above manifests in the family policy propagated by Vance.

The possibility of consensual divorce of marriages is to be abolished. Dissolving a marriage where no misconduct by either party must be proven is seen today as obsolete. Marriages are considered to have become a kind of disposable article. The removal of social safety nets in favor of church aid networks underscores the fundamentalist tendencies of his return to the Christian faith, which Vance alludes to at the beginning of chapter 15. The militarization of national US borders is described as a necessity to create a protective space for American family values. Exclusion could hardly be declared more nobly. We recall J.D. Vance's speech at the Munich Security Conference, which didn’t revolve around traditional security aspects, but around values that he didn’t even subtly criticize European nations for lacking, but rather substantiated with criticisms including examples from Scotland and Romania.

Unfortunately, this ignores that dysfunctional family structures perpetuate adverse childhood experiences – a circular argument confusing trauma with tradition.

Morality as Ersatz Diplomacy

Recently, Vance called for a "alliance of moral nations" against China and Iran. Thus, he attempts 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 elevation: when multilateral treaties (climate agreements, NATO guarantees) are denounced as "weakling ideology," foreign policy becomes state-sanctioned and dogmatically decreed trauma management as politics. A cult of leadership around the current POTUS is already growing in the USA.

Empathy as Political Duty: A European Compass

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

Firstly, there is the threat of the instrumentalization of trauma by populist forces exploiting the narrative of "lost greatness." Initial tendencies can be seen in election results across the continent. BREXIT was a precursor not adequately discussed as such. Secondly, geopolitical tensions threaten trust in multilateral solutions. Thirdly, socio-economic inequalities promote new fault lines.

Yet this crisis dynamic opens the chance to rethink European values. Not as a static set of rules but as a learnable system. An evidence-based social policy that takes trauma research seriously could link empathy and rationality and strengthen the judgement of those who should shape social policy. Democratic processes must account for neurobiological insights into collective fears without succumbing to traditional reflexes.

The progressive value compass of Europe must set three orientation points. Fact-based decision-making instead of emotional manipulation, constructive handling of social difficulties instead of repression, and integrative solutions instead of exclusion. Only in this way will European values remain resilient and future-oriented.

The Art of Differentiated Compassion

True empathy means neither accepting nor demonizing generational conditions but acknowledging the complex challenges. These cannot be assuaged with anti-establishment rhetoric but rather intensify the very wounds that prevented the hillbillies' rise. A cult of toughness heard even in the campaign for the 2025 Bundestag election is an internalized survival mechanism, not a character trait. The America-First policy reflects the distrust of a boy who never experienced secure attachment. This trait he likely shares with his boss.

Strategic Empathy in Practice

Concrete action maxims can be applied from individual actions to geopolitical decision-making chains that, for example, face German foreign policy in the future. It sounds somewhat intrusive, but why not develop trauma-sensitive dialogue formats that anticipate negotiations with the Trump/Vance administration and their ACE-influenced negotiation patterns (black-and-white thinking, short-term deal orientation). Feminist foreign policy was an initial attempt to overcome traditional perspectives.

Let us term this Neurodiplomacy, which uses cooperation offers not only for the USA to specifically address limbic system reactions (sense of security, status recognition). Geopolitical diplomacy always entails hard-core interest politics. The hope that the behavior of such heads of state might reasonably adapt out of the blue is none.

The Empathy Gap as a Hazard

The openly displayed rejection of Vance as "Hillbilly President" on the diplomatic stage would intensify the vicious cycle the book Hillbilly Elegy describes: Exclusion → Trauma → Radicalization → renewed exclusion.

Europe faces the task of developing a third narrative – beyond naive cooperative willingness and moral superiority. Because Vance's ACE score is not an American special phenomenon but a symptom of a global crisis. The neoliberal dream has left millions behind in Detroit as in Duisburg and even in eastern Germany, whose anger now unravels in illiberal revolt. The election results for the 2025 Bundestag speak volumes here. Even the CDU is chasing developments. Europe has a task.

Awakening empathy towards states suffering neuropolitical crossfire means understanding their doctrines and worldviews. These state leaders see other flashpoints, and we are well advised to understand them better before they set the world order aflame again.

Finally, it only remains to point out once again the connection between geopolitics and health crises. Without empathetic understanding for the neuropolitical determination of state leaders, we will not find sustainable solutions for global health crises. Strengthening multilateral health organizations and building resilient health systems must therefore go hand in hand with a trauma-informed foreign policy that confronts the worldview of "the right of the stronger" and thereby establishes a new rules-based order on a significantly more sensitive level. Whether the new federal government shows what was demanded here remains to be seen.