Do you remember Pizzagate, the conspiracy theory that resulted in Frazzledrip and QAnon? It went viral during the 2016 US presidential campaign, when rightwing news outlets and influencers promoted the idea that a pizza restaurant located in Washington DC (mentioned in stolen emails of Hillary Clinton’s campaign manager John Podesta) was actually a secret code for a child trafficking ring.

If you do remember it, then you’re probably not one of the many TikTokers who have now decided to tweak Pizzagate’s background story in order to match it better to the popular culture they grew up with. Although the conspiracy theory pretty much died on the day it influenced a man to drive, armed, to the pizza restaurant and ‘rescue the children’, only to realise that nothing dodgy was going on there and get arrested, Pizzagate is “catching on again with younger people on TikTok and other online hangouts,” as The New York Times reported. Why exactly is that?

In the years after the pizzeria incident (and shooting), Facebook, Twitter and YouTube all managed to largely suppress Pizzagate—at least, as well as they could. But in July 2020, just months before the next presidential election, the conspiracy theory started making a comeback on these platforms, along with new ones such as TikTok.

This time, the conspiracy theory’s revival is being fueled by a younger generation that is active on TikTok, Instagram, as well as on other social media platforms. According to The New York Times, “The conspiracy group QAnon is also promoting Pizzagate in private Facebook groups and creating easy-to-share memes on it.” Due to the nature and novelty of these platforms, the theory has now been morphed.

Gen Zers don’t actually care about Hillary Clinton, and instead are now targeting powerful businesspeople, politicians and celebrities, including Justin Bieber, Ellen DeGeneres, Bill Gates, Oprah Winfrey and Chrissy Teigen. Additionally, the theory has also gone global, when it initially took place in the US mainly. Now, videos and posts about it have racked up millions of views in Italy, Brazil and Turkey.

According to The New York Times, in July 2020, TikTok posts using the #Pizzagate hashtag had been viewed more than 82 million times. If you try looking up the hashtag today, you’ll see that the app has since then banned it. Meanwhile, Google searches for Pizzagate have skyrocketed. After scrolling down to see Google’s related topics, keywords such as “Ellen DeGeneres – American comedian” and “Chrissy Teigen – American model” come up.

In the first week of June 2020, comments, likes and shares of Pizzagate also spiked to more than 800,000 on Facebook and nearly 600,000 on Instagram, according to data from CrowdTangle, a Facebook-owned tool for analysing social interactions. That compares with 512,000 interactions on Facebook and 93,000 on Instagram during the first week of December 2016.

Gen Zers, many of whom are just forming political beliefs, are particularly susceptible to Pizzagate—they are drawn to celebrity photos on tabloids and platforms where users are supposedly analysing secret symbols and clues. Even a triangle, which can signify a slice of pizza, can be taken as proof that a celebrity is part of a secret elite cabal.

In Bieber’s case, many believe that he has been a victim of the child-trafficking ring known as Pizzagate. Four minutes into a video that was posted on Instagram in May 2020, Bieber leaned into the camera and adjusted the front of his black knit beanie. For some of his 130 million followers, it was a signal.

In the video’s comments, someone had asked Bieber to touch his hat if he had been a victim of Pizzagate. Thousands of comments were flooding in, and there was no evidence that the singer had seen that message. But soon enough, the pop star slightly touched his beanie, setting off a flurry of online activity, which highlighted the resurgence of one of social media’s early conspiracy theories.

By tweaking the original theory behind Pizzagate, younger people on TikTok have managed to make the initial conspiracy theory more relatable for them. Although social media giants have become better at stopping false conspiracies like this one, it has also become clear that people who want to spread conspiracies are figuring out workarounds.

Meanwhile, tech companies’ algorithms keep on sucking people further into these false ideas, and TikTok is not proactively moderating its content either—only removing content after journalists reach and point it out. After all, as professor of psychiatry Joe Pierre, MD previously wrote for Screen Shot, “So long as we come to hold beliefs based on intuition, subjective experience, and faith in trusted sources of transmitted information, independent of veracity, conspiracy theories will continue to flourish.”

It’s been said that QAnon is the mother of all conspiracy theories. Since its modest beginnings with Pizzagate in 2016, QAnon has grown from a fringe movement to a seemingly all-inclusive convergence of multiple right-wing conspiracy theories related to COVID-19, vaccines, 5G networks, Bill Gates, Donald Trump, and a “Deep State” cabal that harvests adrenochrome from children. Some have gone so far as to claim that QAnon has become a new American religion.

By the end of 2020, an NPR/Ipsos poll confirmed broad support for some of the beliefs falling underneath the wide QAnon umbrella. Nearly 40 per cent of Americans endorsed belief that the “Deep State” was working to undermine President Trump and as many as 1 in 3 believed that voter fraud helped Joe Biden win the presidential election. The claim that “a group of Satan-worshipping elites who run a child sex ring are trying to control our politics and media” was rated as false by a mere 47 per cent of respondents. But ironically, 83 per cent voiced concern about the spread of false information.

How can we explain why so many people believe in things not supported by empirical evidence? How did people come to believe in Pizzagate, the conspiracy theory that Hilary Clinton was running a child pornography ring out of the basement of a pizzeria that actually had no basement? How did people believe something as obscure and lacking in evidence as “Frazzledrip,” another conspiracy theory claim that Clinton was filmed tearing off the face of a child, wearing it as a mask, and then drinking the child’s blood?

Although a common temptation is to invoke mental illness or delusional thinking as an explanation, such accounts mostly fall flat. For one thing, surveys have consistently shown that about half of the population believes in at least one conspiracy theory. So conspiracy theory beliefs, like religious beliefs, are normal, unless we want to start proposing that half the population has a psychotic disorder.

Although psychology research has found some support for a kind of subclinical paranoia being related to conspiracy theory belief, most findings indicate that it is a matter of more quantitative differences in certain subtle ‘cognitive quirks’ that we all tend to have to some degree. For example, greater needs for closure, certainty, and control could explain why some tend to embrace conspiracy theories during times of crisis and chaos.

Psychological needs for uniqueness can explain how belief in conspiracy theories are often rewarding, based on believers’ fantasy of “seeing the light” in a way that “uncritical sheep” do not. Lack of analytical thinking and ‘bullshit receptivity’ have also been implicated in conspiracy theory belief, but these are also widespread liabilities of normal human brains and results of poor education, not deficits of psychopathology per se.

A more convincing account of QAnon conspiracy theories like Pizzagate and Frazzledrip lies at the level of social interaction and information science as opposed to psychiatric disorder. Conspiracy theories involve a negation of conventional explanations in favour of an alternative account featuring shadowy forces with malevolent intent. Therefore, mistrust—not clinical paranoia—is often the central feature of conspiracy theory belief.

QAnon conspiracy theories that, at their core, demonise left-wing liberals and “globalists” were born out of an emerging right-wing American populism and have come to be widely adopted within the Republican party. Appearing around the time of Clinton’s campaign against Donald Trump during the 2016 Presidential race, conspiracy theories like Pizzagate and Frazzledrip that maligned her were embraced because many viewed her as a literal enemy, just as the so-called “birthers” endorsed conspiracy theories about Barack Obama’s citizenship 8 years before. While mistrust can be earned, when it underlies conspiracy theory belief, it’s often fueled by prejudices of “othering” in the form of hyper-partisanship, racism, or misogyny.

Mistrust of others, and especially of authoritative sources of information, results in a vulnerability to misinformation that is widely available within today’s media landscape. When Edgar Maddison Welch decided to “self-investigate” Pizzagate armed with a rifle, he was misinformed by sources like Reddit and InfoWars that had presented the supposed “evidence” of Clinton’s guilt. Only later, when Welch was arrested, did he concede that “the intel on this wasn’t 100%.” Likewise, the purported “evidence” for Frazzledrip was widely claimed within YouTube videos back in 2018, despite the fact that no actual video of Clinton cutting off a child’s face ever existed.

The democratisation of knowledge in the modern era of online media has resulted in a ‘post-truth’ world in which ‘fake news’ has become a household word, but no one can agree on which information sources are to be trusted. Consequently, trust has largely become a matter of confirmation bias and motivated reasoning aligned with partisan identities, with little agreement about what constitutes objective evidence anymore.

Human beings are fond of myths that revere our heroes and demonise our enemies. We’re also fond of the self-deception that we think rationally and are always right. The reality is that we come to hold beliefs based on intuition, subjective experience, and faith in trusted sources of transmitted information, independent of veracity. It’s no coincidence that Pizzagate, Frazzledrip, and QAnon have been largely online phenomena that have flourished in an era of hyper-partisanship where the other side is regarded as a mortal enemy and existential threat. So long as that continues, conspiracy theories will continue to flourish.

Joseph Pierre, MD is a Health Sciences Clinical Professor in the Department of Psychiatry and Biobehavioural Sciences, David Geffen School of Medicine at UCLA and the Acting Chief of Mental Health Community Care Systems at the VA Greater Los Angeles Healthcare System. His column titled Psych Unseen and published in Psychology Today draws from the perspectives of psychiatry, neuroscience, psychology, and evidence-based medicine to address timely topics related to mental illness, human behaviour, and how we come to hold popular and not-so-popular beliefs.