THE PSYCHOHISTORICAL ORIGINS OF AIDS
An Interview with Casper Schmidt
By Ian Young
The AIDS Cult 1997
"What is disease? It is false reasoning.... I
will say to the patient, 'You have built the
disease yourself, in your sleep of ignorance.'
... I know that the bottom of these phenomena
is a lie in the beginning and started by a
liar till it was received as true; then the
phenomenon is called disease."
-- Phineas P. Quimby, c. 1860
I first heard of Casper Schmidt in the late
Eighties, when I was compiling the bibliography of
alternative approaches to AIDS that became The AIDS
Dissidents. My friend and fellow researcher John
Lauritsen sent me an article entitled "The Group-Fantasy
Origins of AIDS", which The Journal of Psychohistory had
published a few years earlier in its Summer 1984 issue.
That paper, published in the year the official line on
AIDS was pronounced, represented one of the earliest --
and most intriguing -- dissenting views about the
epidemic. There, Dr. Casper Schmidt, a gay psychoanalyst,
considered AIDS in the light of certain unconscious
American group-fantasies, and compared it to a number of
"hysterical epidemics" in recent history.
Schmidt was one of the first to explore the
psychosocial background to the health crisis, maintaining
that the strident political attacks on gays that
persisted throughout the Seventies had contributed to a
shame-based, sacrificial group psychology among gay men,
which in turn led to "an epidemic of depression with
psychogenically-reduced cell-mediated immunity".
Authorities and the media participated in the general trance
A medical doctor with a psychoanalytic practice in
New York, Schmidt also served as Associate Director of
The Institute of Psychohistory. Born in South Africa,
where he had published several books of poetry in
Afrikaans, he spent two years working as a physician in
the Black township of Soweto before moving to the U.S. in
1975 to train as a psychiatrist, specializing in adoles-
cent, child and infant psychology. In New York, he was
also known as an enthusiastic member of the AIDS activist
group ACT UP.
I arranged to meet Casper Schmidt on a sunny,
blustery morning in November of 1992, in a diner on
Broadway. He struck me as a good-natured man in his
forties, with a penetrating intelligence that was based
on keen powers of observation. After breakfast, we walked
a few blocks to his psychiatric consulting rooms
overlooking Riverside Park on Manhattan's Upper West
I began our interview by asking about psychohistory.
Referring to Lloyd deMause's definition of psychohistory
as "the science of historical motivation", Casper went on
to distinguish three types of psychohistory:
psychobiography (mostly of leaders and other prominent
individuals); the history of childhood -- the different
ways children have been treated historically, and the
results; and group psychology in its political context.
He noted that ninety percent of current psychohistory is
psychobiography, which he said he regarded as being to
some degree a defense against childhood and group
psychohistory. I asked him why.
CS: "Because the fantasies that come together in
political life reach to such a profound level of the
unconscious and are so disturbing and upsetting that most
people find them extremely difficult to deal with. For
example, if you say, 'We want to sacrifice the leader',
that simple sentence -- for which we have such ample
evidence -- provokes immoderate amounts of anxiety
because it confronts them with the deepest levels of
IY: "So the whole fantasy of the sacrifice of a Sacred
King like Kennedy throws them into a tizzy and they posit
the idea of a lone, crazy person who has nothing to do
with the rest of us and is cut off from us by mental
disturbance and so on."
CS: "The one thing that people can tolerate is to enact
the fantasies on the historical stage -- if they can
project the blame onto somebody or other. Looking at this
in a rational, scientific way seems to most people like
the most difficult thing on earth."
Six years after Schmidt's arrival in America, the
AIDS crisis began. Schmidt began to investigate the
syndrome after one of his patients had a lover who had
CS: "The more I read, the more puzzling and the more
profoundly disturbing it became. Because it made no sense.
At that point, everybody was conceptualizing AIDS as an
infectious disease which was spread by sexual contact.
And as I was looking through the evidence, it became more
and more clear to me that this epidemic was not behaving
like an infectious disease at all."
IY: "This would be before the pronouncement of the
official HIV idea."
CS: "Yes, this was in 1983, about a year before HIV [was
publicized]. But already, people were speaking about a
virus in our bloodstream, which was a phrase Reagan would
use throughout his term in office. Yet even at that
stage, the idea was that this was something spread
sexually and through drug use."
The ideas about "safe sex" that were evolving even
then in the gay community Schmidt described as "an
apotropaic ritual" designed to ward off the dangers of
CS: "The further I read about this, the less sense it
made. Infectious epidemics do not follow fault lines that
are cultural or sociological, which is what we find in
this epidemic. You do not find any infectious epidemic in
history that selectively infects a group designated on a
basis of cultural factors."
I asked about the European diseases (like smallpox)
that devastated the Native peoples of the Americas:
CS: "There you have quite a different situation.
Europeans had, through centuries of contact with certain
diseases, built up what is called herd immunity. All
those people who were susceptible to these diseases died
out through the centuries. Everyone who remained had
immunity. When these same diseases were transferred to a
new population, you had an abbreviated replay of what had
happened in Europe -- all over the place, all at once,
with devastating results. This is typical of infectious
"Hepatitis B is an infectious disease spread through
a virus, through sexual contact, contact with blood and
other intimate contact. Hepatitis B is somewhat
restricted to certain groups, particularly gay men,
because of the upsurge of sexual contacts during the
Seventies, in bathhouses and so on. However, it was not
totally restricted to those people, so that any
physician, for example, who came into contact with the
virus was at risk. And it spreads whenever there is
sexual contact -- regardless of sexual orientation.
"That's the difference between an infectious disease
and what you have in AIDS, where the spread is virtually
entirely according to cultural parameters. In the
beginning, it was with gay men, and as the Reagan
administration [established itself in] power, with drug
addicts. And those were the two main scapegoat groups,
and a few smaller groups that may have had unconscious
identifications with us when you had unconscious
fantasies of poisoned blood, which were rampant during
the Reagan/Bush years."
I asked about hemophiliacs, and Schmidt pointed out
that hemophiliacs have incredible numbers of blood
transfusions, causing a phenomenon called tolerance,
which is very similar to AIDS.
IY: "Hemophiliacs have always died at a great rate."
CS: "Even more importantly, there is an enormous
literature on the psychology of hemophilia. All the male
children with hemophilia are subjected to the most
restrictive regimen, which inhibits their ability to
express aggression -- something which I think is
necessary for this kind of syndrome to develop. This is
a factor which they share with drug addicts and gay men.
All these groups of people had in earlier life a
curtailment of their right to express their aggression in
an unfettered way. That is one of the risk factors for
IY: "How does this aggression factor pertain to gay men?"
CS: "A drive seeks to be expressed. It has no concern
whether outwards or inwards. When the expression of this
drive is curtailed for whatever reason, the drive is
often turned inwards and expressed against the self,
giving rise to psychosomatic disorders, actual physio-
logical disturbances. That is what happens in AIDS. For
example, it has become obvious that the people with AIDS
who are least inhibited in their expression of
aggression, and who pursue their own well-being with the
least amount of curtailment, do best. They survive the
longest -- regardless of where they are in the syndrome.
Those who do not express their aggression, their
assertiveness, their right to exist, to the same extent,
seem to come down with the syndrome in a rapid, usually
IY: "You're talking here about characteristics of
long-term survivors -- what Michael Callen was looking at
in his book Surviving AIDS?"
CS: "Yes. These are the people who are not afraid to get
angry and to express their anger. These are people who
demand and are not afraid of expressing their demands."
IY: "Bernie Siegel, in Love, Medicine and Miracles, says
the same about cancer patients."
CS: "One hundred percent identical. When people do not
express these basic drives, they are expressed instead as
stress. Both AIDS and cancer patients feel abnormal
stressors and feelings of helplessness. As a result,
their bodies secrete a substance known as cortisol.
Cancer patients show an enormous increase in cortisol and
a lowering of their DHEAS levels, the same as in AIDS.
Until two years ago, nobody had been able to figure out
the function of the DHEAS, which is by far the most
voluminous of all the steroid hormones in the body. The
key factor in terms of both cancer patients and PWAs is
that they feel great stress and helplessness. And instead
of expressing their needs outwardly, they turn inward and
over-secrete cortisol, which paralyzes their immune
IY: "You see a sequence of events in the body that leads
to the drop in T-cells that accompanies AIDS."
CS: "That's right. Pneumocystis carinii, for example (a
serious illness of PWAs) is fought by T-cells producing
gamma-interferon. If you have normal T-cells, the chance
of developing pneumocystis is extremely low."
IY: "What part do you think venereal diseases play in the
development of AIDS?"
CS: "Very little actually. I think they're mostly a
marker for something else. The penumbral syndrome
surrounding AIDS started in the mid-Seventies and showed
itself in the enormous increase of venereal diseases and
what was then called Gay Bowel Syndrome.... Everybody
thinks that amoebiasis was driven by these wicked
amoebas. In fact, I think a more accurate interpretation
would be that the reduction in cellular immunity
permitted amoebas to grow. The enormous incidence of
venereal disease during the Seventies was a marker for
people with a psychological vulnerability to the group
psychology, and who responded to it with numerous
anonymous sexual contacts, which increased the
transmission of genuine venereal diseases -- including
syphilis, which is not so easy to treat as people think!"
Schmidt said he regarded the binge of anonymous gay
sex that began in the Seventies as intimately related to
the psychology of ostensibly heterosexual men, and also
as deeply enmeshed with gay men's guilt feelings, tension
and anger, which, deprived of any other outlet, tended to
be repressed into the body. This somatization caused
blocked emotions and profound biophysical changes. One of
the most important of these has been the continuous
simulation of a "fight or flight" syndrome.
The "fight or flight" syndrome occurs at times of
increased stress and is accompanied by, among other
things, temporary immune suppression and raised levels of
adrenalin, endorphins and cortisol. Ordinarily, this
syndrome should occur in humans only occasionally, in
instances of danger. If it becomes, instead, a condition
of life, cortisol levels become perpetually elevated. I
asked Schmidt about the role of cortisol levels in AIDS.
CS: "All the work on cortisol levels in AIDS was done in
1988 but not published until 1992 because the researcher,
Joseph Malone of the U.S. Marine Corps, working at the
San Diego Naval Hospital, thought it was so far out of
whack with the mainstream that there was no point in
trying to publish it. Only in 1992 did he publish it.
Malone was the pioneer who first looked at cortisol
levels in AIDS. Since then, it's been confirmed that from
day one in the spectrum of AIDS diseases, you have an
overproduction of cortisol. That becomes consistently
higher as the syndrome progresses and by the end of the
syndrome, people overproduce cortisol in enormous
amounts, like cancer patients."
Schmidt explained that the balance of cortisol and
DHEAS affect interleukin-2 and gamma-interferon levels in
the body. Interleukin-2 is the T-cell growth factor,
which all T-helper lymphocytes need in order to exist.
Research has shown that if they are deprived of
Interleukin-2 for six to twelve hours, they undergo
changes, called apoptosis, which result in T-cell
destruction. So overproduction of cortisol, and a lack of
Interleukin-2, can result in the killing of lymphocytes -
- both indirectly (by depriving them of growth factor)
and directly (through the toxic effects of cortisol
CS: "Everyone who proceeds to AIDS has lowered levels of
DHEAS. That's the key pathogenetic mechanism, I think, in
the entire syndrome. This is corroborated by the fact
that PWAs have an overactivity of B-cells. A message goes
out to the B-cells, 'Produce antibodies! Produce
antibodies!' And they produce antibodies to everything
they've been exposed to in the past, regardless of
whether it's a current problem. And the B-cells go
haywire, producing enormous amounts of antibodies.
"All of this dovetails with the work done with
DHEAS. The guy who is most intimately connected with this
and who discovered how this works is Raymond A. Daynes at
the University of Utah."
IY: "This mechanism is a result of what kind of
CS: "All the details haven't been worked out, but we do
know several things. In Philadelphia in the Sixties, they
found that if you put animals in a situation they can't
escape from, and give them electric shocks, they try to
escape for a certain time, but when they realize they
can't escape, they lie down and tolerate the shocks,
whimpering and moaning. If you open the gates of their
cage, they behave as if they're still prisoners. They
develop learned helplessness.
"All you need to do is to drag them out of the cage,
and then they learn very quickly. Stephen Maier at the
University of Colorado has worked out the physiology of
this; there are biochemical reactions in the endorphin
system which affect lymphocytes directly. Also, there are
changes in the hypothalamus which cause the secretion of
cortisol. Any kind of restraint, learned helplessness, or
belief that people can have no impact on their situation,
causes these changes.
"When individuals don't feel they can influence
political life, if you have a conservative swing, with
Reagan coming the White House, promulgating the fantasies
of the far Right, saying that homosexuals are bad because
they are destroying the family life of America and they
should die, that is the kind of thing which creates
inescapable stress, giving rise to feelings of
helplessness. People don't know what to do, they don't
have anything they can do. With the exception of ACT UP.
That's where ACT UP comes in, because there, people are
not helpless! They can release their feelings and express
them. Which is why most of the people in ACT UP don't
easily die from AIDS. We have an enormous and beautiful
track record of people surviving much better. Expressing
their rage is what saves them!"
I asked about HIV, the retrovirus that has been
pronounced the official "cause" of AIDS.
CS: "I was never impressed with HIV as the cause of the
syndrome, for various reasons. Most important, a virus
like this does not remain confined to cultural
categories. I thought there must be some other
explanation for this. Indeed there is: epidemic hysteria.
When you have people low down on the totem pole of power:
women, prisoners, children, homeless people, people who
feel powerless, those are the people who do not have an
avenue to express their rage, they turn this inward and
become ill with epidemic hysteria. AIDS is a clear case
of epidemic hysteria.
"HIV, a relatively weak virus, belongs to the family
of retroviruses. Characteristically, the retroviruses do
not kill cells, they cause them to proliferate. So from
the word go, when people said this weak virus kills the
T-cells, it didn't make sense to me. All the evidence was
against it. Plus -- and this is where the theoretical
sine qua non arises, that most people are trying to
ignore, because they are all in a trance -- there are
many people who have the syndrome without any evidence
for the virus."
Though Casper Schmidt was one of the first to
question the role of HIV, he pointed out that the first
to publish his skepticism was a French scientist by the
name of Georges Matté. But it is Dr. Peter Duesberg, he
said, who has made the most cogent arguments.
CS: "A man in Montreal called Hugo Soudeyns discovered
that HIV has two receptors for cortisol. This makes a lot
of sense because these receptors allow cortisol to have
an effect on the virus; cortisol may be necessary for its
growth. This was discovered by people in Robert Gallo's
lab in 1986! They showed that cortisol stimulates the
growth of HIV in the test-tube. So this explains the fit
between incidence of the virus and the syndrome."
IY: "Yet there are people with HIV antibodies who are not
CS: "Yes. If you don't have all the psychological factors
that go into making the syndrome, you can have the virus
and it will have little effect -- similar to
cytomegalovirus or some of the herpes viruses. You can
have these viruses floating around in your body all your
life without ever becoming sick from them. Ninety percent
of gay men have cytomegalovirus. But only when your
immune system is drastically disempowered do you get
We talked about the role of the AIDS crisis in
changing the status of gays in America.
CS: "Whenever people have become part of the group
psychology of the mainstream, they have always entered
through a period of sacrifice. The Jews in Europe went
through an extended period of sacrifice before they were
accepted. My reading of the AIDS crisis is that it is
really part of the assimilation of gays into the
political life of the country as a whole. And I think all
of this started in the late Forties with the end of
Isolationism and the assumption of America as the
dominating power of the world. This gave Americans
incredible amounts of hubris!
"Then, I think Kinsey was extremely important.
Kinsey published [his first report on human sexuality] in
the late Forties and caused an upheaval in this country.
For the first time in the history of the world you had an
accurate, statistical representation of what people
actually did sexually. Everybody was driven insane
because their cherished group-fantasies were completely
demolished in two volumes! So immediately you had a
reaction, which was McCarthyism. The cover was blown off
the defenses. Those people who had strong homoerotic
fantasies and couldn't deal with them were driven totally
insane by Kinsey."
IY: "Like Hoover and McCarthy!"
CS: "Of course! People who were deepest in the closet and
were most repressed. We were suddenly a great power 'on
the world stage' and all our secrets were being published
in books! This gave rise on the one hand to McCarthyism
and all the paranoia it entailed. But on the other hand,
you have the feeling that we can tolerate much more than
before. So Frank Kameny and the Mattachine Society and
the Daughters of Bilitis were all more advanced people,
more in touch with the group fantasy of tolerance and
openness. By the late Fifties came Women's Liberation,
the Men's Movement, the Gay Movement. Then came the
conservative clampdown of the late Seventies.
"I think that the end result of all of this will be
that you will have virtually no overt homophobia or
severe discrimination against gays in the future. But
there will always be pockets of homophobia because abused
children need to project their bad feelings somewhere.
There will always be fag-bashers among boys who have been
severely treated -- and despised -- by their fathers. In
time, this too will change. Because America has become
the first society to say that child abuse is
unacceptable! I foresee a society which is relatively
peaceful ... after the epidemic is over.
"Most epidemics are symmetrical. They rise and fall
in a curve. Since the AIDS epidemic peaked for gay men in
1988, we can expect the epidemic to be over for gay men
by 1996-7. What the Centers for Disease Control and the
American group psychology did to confuse this is to keep
changing the definition! In 1989 and 1990, the CDC
published the statistics with old and new definitions
separately, so you could quite clearly see how according
to the old definition, the incidence of AIDS went up
until 1988 and then started coming down. The new
definition is a lump added on top. As soon as they
noticed people would realize this, they conflated the two
definitions. They now give them as if they're the same."
IY: "Why do you think they did this?"
CS: "In order to ensure that people are still
sufficiently frightened and that the sacrifice does not
stop. We do not want people to understand the dynamics of
this illness because that will subvert the sacrifice.
Anything that threatens to resolve the situation is
fought bitterly as if it is the enemy.
"If you go to a primitive tribe where they are about
to sacrifice fourteen babies, and tell them that this
will only make them feel good for a day or a week, and
then they'll have to sacrifice more, that there are ways
to feel better without this sacrifice -- you know what
they do? They kill you on the spot! Because you are
interfering with their sacrificial ritual. Nobody
criticizes the sacrificial ritual.
"Every bit of AIDS research that underwrites the
group fantasy and continues the sacrifice is approved
IY: "Now how do the people participating in the group
fantasy know when the fourteen babies have been killed?
How do we know when enough is enough?"
CS: "It's really interesting. The only answer we have is
based on work done with other cultures. When, during the
Aztec Empire, the priests performed their ritual
sacrifice -- which they did a lot! -- they would take the
skulls of the victims, make holes in the temples and fix
them onto long poles which they would string up in front
of the big pyramid in such a way that whoever stood on
top of the pyramid could look down as they imagined the
gods would, and could count the skulls on a device called
a tzompantli. They literally imagined the gods counting
the sacrifices. When the people felt sufficient relief
from their bad feelings, this would be conveyed to the
High Priest who would then go up on the pyramid, commune
with the gods, and declare that the gods have said
IY: "So this is literally a Golgotha, a hill of skulls."
CS: "Absolutely. And this is what the Quilt is for AIDS.
You display the Quilt, horizontally, to the gods so they
can see when enough people have been sacrificed and send
the message, 'Stop the sacrifice!' This is exactly the
same as the tzompantli. You are displaying the equivalent
of the skulls to the gods so they can decide when there
"Group fantasies are relayed through indirect means.
Now, since the epidemic is clearly diminishing, they have
displayed the Quilt in its entirety for the last time --
on the week of October 12 (1992)."(1)
Casper Schmidt finished the interview by saying that
he had been treating a number of people with AIDS, and
had shared his preliminary findings with fellow
therapists in a paper entitled "Guidelines for the
Psychoanalytic Treatment of AIDS". In this paper, he
observed that his AIDS patients had all suffered
syndromes of longstanding stress connected with
conflicting feelings about their sexuality and that this
condition involved "activation of the
hypothalamo-pituitary-adrenal axis (the stress axis)",
leading to increased cortisol production and decreased
DHEAS. From these beginnings, he traced the course of the
cellular disturbance that eventually leads to the
gradual, relentless decline in T-cells characteristic of
All of these patients, Schmidt found, suffered from
intense, socially-induced shame, and an extraordinary
capacity to disguise and feign feelings, with negative
feelings being "shunted into their bodies", resulting in
histories of psychosomatic complaints, and a "suicide
syndrome" of "destructive affects ... turned against the
self". He also observed that all these patients had been
severely traumatized in childhood.
Schmidt was hoping that by combining experimental
therapeutic work with a thorough program of nutrition and
vitamin supplementation (such as the Direct AIDS
Alternative Information Resources Protocol), the core
AIDS symptom of continuing T-cell decline might be
arrested, and even reversed. And he was hopeful that the
incoming Clinton administration would effect positive
After I finished the interview and left Casper's
apartment, I walked a few blocks to a friend's place. My
friend had just returned from visiting someone he knew,
another PWA. "Poor Bob", he said, "he has these terrible
lesions here." He pressed his fingers against his temples
and made circular motions against the sides of his head.
I thought immediately of the holes in the temples of
Casper's Aztec skulls -- a sudden synchronicity that gave
me an eerie feeling -- puzzling, and strangely exciting -
- like the first breakthrough in the cracking of a
complex and difficult code.
Casper and I found we had a lot in common, including
our love of poetry and South Africa (where I had lived as
a child), and we soon became friends. We discussed
editing and publishing a book of his short stories, to be
entitled The Barbecue of Madame Nhu, in reference to a
comment by the wife of the President of South Vietnam
when monks began to immolate themselves in protest
against the war: "I hope they invite me to the barbecue!"
Another of his stories was a Borgesian fable about the
forgotten origins of the tango among homosexual gauchos
during the long, cold nights on the pampas!
I arranged for Casper to spend a holiday visiting me
and my partner in Banff during the summer; he was to
bring his stories with him. He never arrived, and my
efforts to reach him were unsuccessful. What he hadn't
told me was that at some point in his researches, he
realized, to his horror, that he was diagnosing himself.
The last year or so of Casper's life remains
something of a mystery. Diagnosed with AIDS, he entered
hospital, and shortly afterwards left, to die at home of
AIDS-related illness in the late Spring of 1994, about
eighteen months after our interview. The long-promised
second part to "The Group-Fantasy Origins of AIDS" was
never completed. All his research papers, manuscripts and
patient case files have disappeared. *
(1) Newspaper articles published around this time pointed
out that the Quilt had become too big to display whole,
in a single location. Since then, new locations have been
found, most recently Washington, DC -- October 1996.
A visitor to the Quilt on 12 October 1996 wrote
anonymously in the guest book: "please god let this be
the last time we have to come to washington to see the
quilt. no more deaths."
This interview is Chapter V of the book, The AIDS Cult,
edited by John Lauritsen and Ian Young. It is reprinted
with the permission of the editors.