I see more and more the importance of the late Mark Fisher's book Capitalist Realism: Is There No Alternative?
It is a complex book that a I read a few years ago and need to reread. Nine chapters and 81 pages, the slim volume argues that one of the most promising points of resistance against capitalism is the proliferation of mental illness. So many of us are unhappy, seeking out therapeutic help in the form of psychotherapy and pharmaceuticals. I work in the world of mental health and think and believe that good work is taking place.
I also think that much disturbing work is going on in mental health. There is an important 2014 article by H Hansen titled 'Pathologizing Poverty: New Forms of Diagnosis, Disability, and structural Stigma under Welfare reform." The article demonstrates how the Clinton era welfare reforms introduced unique psychiatric and pharmaceutical dimensions to the distribution of social services. If individuals want to receive government support they often must submit to psychiatric diagnoses, medication regimens, and ongoing observation by government licensed institutions. I have seen the insides of institutions that serve precisely this function. The reality of poverty, trauma, and their combination, is chocked up to mental illness. As if the actions of the 'mentally ill' were not understandable responses to distress and injustice. The medicalization of human growth permits these social-political problems to be explained in individualistic medical terms. In this way the language of 'mental illness' reinforces the oppression and suffering of the most marginalized and vulnerable members of society. Robert Whitaker's book Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill ( which I am slowly reading) has convinced me that medicine and mental health have often contributed to the mistreatment of the poor and vulnerable.
The middle classes are also rife with issues surrounding mental illness. Depression and anxiety are widespread phenomenon, and there is increasing awareness and acceptance (even championing) of psychotherapy in most liberal circles. I have benefited tremendously from therapy, and am delighted to be at the beginning of a career as a therapist. A former therapist once referred to it as 'beautiful work'. I was then only doing the work as a client. I now am beginning to understand that statement from the other side.
I also applaud and am excited about the proliferation of trauma research, and the growing public awareness of the implications trauma research. All of my work is informed at the deepest levels by my reading on trauma and polyvagal theory. It is essential to a full of account of what it means to be human, and how healing is possible.
Fisher's book is so important because it can serve as a load bearing point in the basic features of my project: A politicized form of psychology and psychotherapy that is both effective at producing practical and clinical insights, and theoretically coherent from the level of practice to metaphysics (or ontology, pick your word). I am emphasizing that this politicized vision of psychotherapy must be coherent practically and theoretically. Theory is far more practical than we sometimes think.
This emphasis on the relationship between theory and practice is significant in light of Fisher's argument that capitalism, fused as it is with medicine and the medicalization of human distress, relies on materialist or physicalist ontology:
“The current ruling ontology denies any possibility of a social causation of mental illness. The chemico-biologization of mental illness is of course strictly commensurate with its depoliticization. Considering mental illness an individual chemico-biological problem has enormous benefits for capitalism. First, it reinforces Capital’s drive towards atomistic individualism (you are sick because of your brain chemistry). Second, it provides an enormously lucrative market in which multinational pharmaceutical companies can peddle their pharmaceuticals (we can cure you with our SSRIs). It goes without saying that all mental illnesses are neurologically instantiated, but this says nothing about their causation.” (37).
The discussion of mental illness as an individual medical problem, in other words, prevents it from being understood as social and political issue. The medicalization of mental illness say their is something in your brain/mind/machine-body that is wrong and that needs to be 'fixed'. A politicized account of mental illness, on the other hand, would assert: your feelings of pain and distress can be explained by an unjust and exploitative society that has denied you the time and means for actualizing the potentials that are unique to you. A politicized image of mental illness says: there is a group of people that want you to be unhappy so you buy things.
The truth is somewhere in between the medical and political perspectives. There are genuinely organic or chemical causes of mental illness, and medication is an important and sometimes necessary tool in someone becoming well. The claim is only that the medical-physicalist ontology lends itself more to a politics of mastery or domination, and that we would do well to recenter politics in our understanding of human distress and well being.
Clearly an alternative understanding of mental illness is needed. This means, in part, that a new ontology is required. We need an account of nature and human beings that can account for two things:
1. That mental illness needs to be understood primarily in terms of social-political injustice rather than individual medical causes.
2. That human beings do not need to be fixed, but need to heal and grow. The body, in other words, is more like a plant than a machine: it is a wild, organic, growing thing. A full account of mental illness thus requires an ontology of life.
Fisher thought that the left was particularly ill suited to articulating such alternatives because of the proliferation of 'postmodernism' and the suspicion of 'metanarratives'. He thought that it was time to reclaim the capacity for metanarrative: "Against the postmodernist suspicion of grand narratives, we need to reassert that, far from being isolated, contingent problems, these are all the effects of a single systemic cause: Capital. We need to begin, as if for the first time, to develop strategies against a Capital which presents itself as ontologically as well as geographically, ubiquitous." (77) Fisher is thus, in part, calling for a theoretically or ontologically consistent form of resistence against Capitalism. I think that the contemporary use of trauma research by political, queer, POC, or indigenous therapists/healers is precisely an ontologically consistent form of resistance to capitalism.
Does the full ontology or metaphysics matter? I'm not sure. Part of me thinks that going so far with the ideas is... self-indulgent? Crude? Insensitive? I have concerns about becoming a disengaged academic some day. I have been doing political adjacent mental health work. I felt good about it. I will continue to be engaged with it, despite that I'm leaving my current job.
Surely ideas mean something? And surely the consistency of the ideas down to the metaphysical level has some significance? This is precisely the question of science and politics. I am not sure.
Regardless, I ask: What would such a fleshed out ontology and metanarrative of mental illness as a political problem rather than an individual medical issue look like?
Metaphysically, it would require a teleological account of nature as opposed to a mechanistic or physicalist account of nature. It would require us to understand nature as something that we belong to, and that is naturally a world of growing beings that are driven by their desire to pursue what is good for them. It means that goodness or 'value' is real and out there in nature. Trauma, and all that we are learning about the intelligence of the body, moreover, imply a teleological ontology of life, and a politics not of mastery, but of sacrifice and equity.
This stands in contrast to many modern accounts of knowledge, the most popular being physicalism, followed by forms of postmodernism in which language is said to be projected or imposed onto a silent world.
Fisher points out the fundamental compatibility of postmodernism with capitalist-medical-physical ontology. I think this is not incidental, as Stanley Rosen argues in Hermeneutics as Politics that postmodernism and physicalism are the two branches of enlightenment philosophy.
The dilemma, then, is this: both physicalism and postmodernism either reinforce, or are powerless to combat, capital's logic. A new ontology of trauma, the body, and Life are necessary.
Metanarratively, it would require in part what Fisher describes: a historical narrative that can account for Capital as the cause of contemporary despair and unhappiness.
Capitalism, as I view it, however, needs to be understood as part of a larger shifting that takes place in the relation between science and politics. This shift in the relation between science and politics is referred to as 'modernity' and saw itself flourish in the 'enlightenment'.
I believe the most striking way of analyzing this shift in the relation between science and politics is through a peculiar tradition of writing known as 'esoteric writing'. Esotericism I've written about here so much and I feel like I write the same sentences over and over. Esotericism is a form of writing in which someone is potentially obscure or misleading for a variety of reasons: to avoid political persecution; to avoid disseminating dangerous ideas; to agitate for political change; or to help other philosophers learn by providing them with challenging texts. People wrote this way up until sometime in the mid nineteenth century.
How did such a thing disappear from our view?
The issue highlighted by esotericism is precisely the uneasy and often contentious relation between science and politics. Science and politics, in other words, have generally been radically divided from one another. Our situation in which science and politics are so intimately fused is highly novel, and clearly highly volatile. To perceive this one need only reflect on the fact that a wildly irresponsible president has access to the most sophisticated and powerful weapons ever created.
Esotericism, its forms, and its disappearance, can offer a metanarrative that fleshes out the explanation of capitalism. Capitalism is a unique form of this attempt to bring about a fusion of science and politics. The changing relationship between science and politics can be traced in the way that philosophical and scientific writers relate to politics and society as a whole. 'How esoteric did they have to be?' is a crucial question for self-knowledge.
Developing an understanding of esotericism means coming to terms with the fundamental conflict between science and politics that is at the heart of our current political moment, in which there is an absurd and horrific amount of resistance against the basic measures to prevent the spread of the coronavirus.
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