Throughout my years of clinical work in Appalachia, there has been a consistent pattern of shame correlated with the belief that personal suffering can only be explained by personal failure. Clients like Joe, shamed for being a hillbilly, or Charlie, paying a tragic personal price for structural failure. Marcy truly believed that if she were patient and understanding, her boyfriend would keep his promises.
The shame doesn’t come from the circumstances. It comes from believing they are suffering because they made bad choices; therefore, their pain is their own fault. The coal miners, so bleary-eyed from overwork they are charged with driving under the influence. The teachers are blamed for failing students who rarely attend class. Everyone who takes psychotropic medication to work a job they hate because they need it to survive. Everyone who stays in an abusive relationship does so because they need a place to live.
This relates to the belief that poverty is a moral failing and systemic inequalities are everyday things we should be able to overcome. If we cannot overcome this, it means we deserve to suffer. When a belief is this pervasive, it isn’t an individual problem, but a structural design. What’s happened here is not separate from the nation’s values but a concentrated expression of them.
The shame is not an anomaly within American identity. It is an intentional weapon. Shame silences victims. Those who benefit from our subjugation control the narrative about being Appalachian and American, while isolating us from the rest of the country. This triangulation is evidence of narcissistic abuse scaled to a nation.
We grow up with patriotic songs, stories of American ingenuity, and the concept of the American Dream. The belief that if we work hard and have talent and skills, we can achieve our dreams of success is so integral to American identity that questioning it feels like blasphemy.
Stories of American mythology surround us, instilling the belief that anyone can become rich, famous, or influential by working hard and making good choices. They’re wrapped in the stories of the American frontier and the self-made man. In America, anyone can become anything they desire by working hard and not expecting life to be easy.
We root for underdog players and characters in sports and movies because I feel like an unconscious rebellion against the status quo when the underdog wins. It’s easy to identify with what it would mean to us if we were up against the odds and made that winning shot at the buzzer. Thriving under pressure is what it takes to achieve the Dream, and training starts before we can walk. It’s reasonable to expect our efforts will pay off once they let us off the bench and into the game. We don’t have the coping skills for how it feels when we realize we are not getting called up off the bench.
These core beliefs from childhood can be challenging to let go of. What we have been training for our entire lives doesn’t exist. Even when we logically know many things in life are beyond our control, it doesn’t help that the world reinforces the myth of meritocracy at every opportunity. Many of the beliefs we carry about ourselves and the world come from lies and manipulation.
When the story people have lived inside their entire lives in stops working, it does not arrive as an argument; it comes as a feeling. Exhaustion that persists, a constricted chest when someone says “work harder,” and muted grief behind every “that’s just the way it is.” This feeling arises with the realization that if the rules we follow to stay safe don’t prevent punishment, our safety is conditional, and we are not in control of our fate.
For people raised on the mythology of the American Dream, this disappointing, disorienting realization functions as a psychological anchor, telling us who we are, why we belong and what our suffering means. When that disappears, people do not immediately feel liberated; they feel unmoored.
There is also fear in seeing clearly. If hard work does not guarantee safety, then safety is not something we can earn our way into. That realization threatens the very coping strategies people have relied on to survive. For many, overwork, self-denial, and endurance were not personality traits—they were protective adaptations. They were how people tried to stay safe in a world that offered no guarantees.
Such insecurities are why so many people cling to the belief that poverty is a moral failure even when the evidence contradicts it. That belief, painful as it is, preserves the illusion of control. If people deserve to suffer, then they can still earn safety. If the system is abusive, then it can never guarantee safety. We are vulnerable.
Coming to terms with this vulnerability requires grieving not only lost opportunities but lost certainty. Lost innocence. Lost faith in a story that once made endurance feel meaningful. For people in Appalachia, humiliation compounded this grief. Not only were we promised something that never came and never would, but we also face the blame for believing it would.
The emotional cost of seeing clearly is sorrow, anger, and the slow, painful work of disentangling self-worth from productivity and survival from virtue. Learning to sit with the knowledge that the suffering was real, the effort was genuine, and the failure was not personal. It was inevitable.
Once this grief has a space, a different clarity becomes possible. It isn’t one of certainty but of the clarity that comes from noticing patterns that were previously too threatening to name. When people stop asking what is wrong with them, they often ask a more dangerous question: what kind of system requires so many people to feel this broken?
A narcissistic family system is not defined by vanity or grandiosity alone but by a specific relational structure. The system exists to protect the parents’ emotional needs at all costs. Care is conditional, and love is transactional. Reality becomes distorted to preserve the fantasy that the parent is good, generous, and deserving of admiration. When harm occurs, they deny, minimize, or blame the abuse on the most vulnerable family members.
These systems do not view children as separate people with inherent worth. They are extensions of the parent image. Their value lies in what they produce. When children succeed, the parents take credit. When they struggled, the child became the problem. This framework offers a disturbing but clarifying lens through which to understand the American system.
The myth of American exceptionalism aligns seamlessly with narcissistic abuse. From a young age, citizens are told that they are exceptional by being born Americans. This love-bombing stage is intoxicating. It instills pride, identity, and a sense of destiny before we have the developmental capacity to question it.
Love in a narcissistic system is never unconditional. As children grow, the expectations shift. Worth becomes contingent on performance. Productivity, visibility, and success are rewarded with praise and a sense of belonging. Failure, illness or dependence are met with shame and withdrawal. Support that should be offered because we are human beings with human needs is withheld, so we continually need to earn and re-earn our deservingness of care.
The Dream does not simply motivate work. It also moralizes the outcome. In narcissistic systems, shame is the primary tool of control. It keeps people quiet, compliant, and focused inward as they search for personal defects rather than questioning the structure that produced their pain. When citizens believe their suffering is self-inflicted, the system is absolved of responsibility.
America, similar to a narcissistic parent, focuses heavily on projecting fairness and protecting its benevolent image rather than providing genuine care. She celebrates stories of exceptional success while ignoring the structural conditions that make those stories statistically rare. She elevates outliers as evidence that the system works, while dismissing widespread suffering as individual failure. This selective attention allows the fantasy to persist even as evidence accumulates against it.
When people question the Dream, the system responds not with curiosity or a desire to repair, but with punishment. The system frames dissent as ingratitude and critique as moral failure. Naming structural harm often invites accusations of laziness, bitterness, or entitlement, which is not the behavior of a rational political system that values truth and justice for all. It is the behavior of an abusive system protecting its self-image.
In narcissistic families, the family often designates one child to carry the shame of the entire system. This scapegoated child absorbs blame, so the parent does not have to confront their own failures. They label the scapegoat as difficult, defective, or hopeless. Their suffering becomes proof that the problem is personal, not systemic. The American system of white supremacy assigned this role to Appalachia.
Appalachia’s function is not merely economic, though extraction has been central. It is also psychological. America positioned the region as backward, lazy, and culturally inferior so it could point to it as evidence that poverty results from character flaws rather than design. As long as people frame Appalachia as a moral failure, the broader system remains unchallenged.
This framing is why the hillbilly caricature matters. It is not an insult, but a narrative weapon. Stripping people of complexity and dignity and rendering their suffering unserious and self-inflicted allows exploitation to be reframed as inevitability. After all, why invest in people who are supposedly incapable of progress?
This dynamic serves multiple functions at once. It preserves capitalism by obscuring class warfare. It preserves white supremacy by deflecting attention from extraction, and it preserves the American self-image by locating failure somewhere else. In narcissistic systems, the scapegoat often senses the truth first. Their lived experience contradicts the official story and threatens the system. They must be silenced, ridiculed, or dismissed. Appalachia’s humiliation is not collateral damage; it is necessary to the system’s emotional regulation.
America cannot admit to abusing Appalachia without losing the fantasy of being good. Therefore, they must maintain the narrative that we deserve our suffering even as bodies accumulate.
Understanding America as a narcissistic system does not require abandoning patriotism or complexity. It requires abandoning denial. It asks us to recognize that a system built on conditional worth will always produce widespread shame, that a system obsessed with image will always sacrifice care, and that a system dependent on scapegoats will never run out of people to blame.
Once this pattern becomes visible, it cannot be unseen. The question is no longer whether the system is fair, but whether it is capable of the care it promises. And that realization, while destabilizing, opens the door to a different loyalty—not to the fantasy of the Dream, but to the people who have been carrying its cost.
Once the system’s structure is visible, Appalachia’s position within it becomes easier to understand. Often, people see the region’s suffering as unfortunate, accidental, or inevitable—a consequence of geography, culture, or poor decision-making. When examined historically and functionally, Appalachia does not resemble a neglected region so much as a deliberately positioned one. It functions as an internal colony.
Colonies exist to be extracted from, not nurtured. Their value is in what others can take: resources, labor, and land, instead of the well-being of the people there. Infrastructure is built only where it facilitates extraction. When the resources are depleted or no longer profitable, investment recedes. What remains is environmental damage, economic precarity, and a population blamed for the consequences of abandonment.
This pattern has repeated itself in Appalachia for generations. Explicit cooperation of political and corporate power outside the region extracted timber, coal, gas, and labor on an immense scale. Wealth and decision-making authority flowed outward. Risk and harm remained local. When industries collapsed or moved on, the narrative shifted. What had once been framed as progress became framed as pathology. The region was no longer useful as a partner, only as a cautionary tale.
The story Americans are told about Appalachia relies on caricature. The hillbilly figure is lazy, ignorant, and backward because it serves a crucial ideological function. It transforms the predictable outcomes of extraction into evidence of personal and cultural deficiency. It answers the uncomfortable question of why poverty exists by locating the problem within the people rather than the system that exploits them.
Appalachia’s role as an internal colony is not only economic but psychological. The region absorbs a disproportionate amount of national shame. It serves as an example of what happens when people fail to embody the American values of self-reliance, ambition, and optimism. In this way, Appalachia functions as a warning. Work hard, assimilate, stay productive, or you will end up like us.
Excerpted from Money in the Mountains: The Cultural Trauma of Appalachia by Rayelle Davis. Copyright © 2026 by Rayelle Davis. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
