Marxism, Anarchy, Psychiatry as art and/or science

josh
February 28, 2018 0 Comment

Marxism is, by far, the most complex philosophy I have ever tried to teach.  I believe some of the best philosophies are very easily summarized, so this is not necessarily a compliment.  That being said, my first question is this:

For anyone who knows a lot about Marxism, and/or feels that I have not done it justice, what did I get wrong?  Which principles would you choose to summarize and why?  

What might be some examples of communism being successful, either for a short time or in a specific circumstance?  Do you think that communist theory, perhaps rejecting Marx’s take on the idea, might make a comeback?

Some would claim that communist theory is, in some form, inevitable, given the fact that capitalism, if taken as a full-blown ideology, results in pure horror.  Thoughts?  What is wrong with communism is pretty obvious at this point, but what’s wrong with capitalism, theoretically?

In Nicaragua in the early 1980’s, the Sandinista party made the following appeal to peasants: “Most of our best land is owned by foreign corporations, and we could work like slaves for generations and never buy it back.  If you elect my rival, the have promised to barter with the American and European companies and maybe raise your wages by 10 cents a day.  If you elect us, consider the following: we are not so densely populated a country!  We could simply take back our own land, farm it ourselves, and live very well!  Nothing is truly stopping us from doing this.”  And so the Sandinista’s cemented control, at least for about a decade.  They are in power again now, but no longer seek communism in any Marxist form.

I tell this story to challenge those who would challenge communism appeal; can you not understand the plight of the Nicaraguan peasants?  Capitalism is not even slightly fair with how it doles out opportunities; if you can go to school and choose your degree, by world standards, you have been dealt a very, very good hand.  In many countries, you would have to go to work full-time in your early teens, as would your parents and your children.  Breaking this cycle is difficult, to put it mildly, and communist revolutionaries offered what was frequently seen as the only solution.

What are other solutions?  In places where people have lived in dire poverty for generations, how are they supposed to seize upon the dreams that we all have, that they share with us, for a better life?  I once heard a priest say, “Marxism represents the unpaid debts of the Church,” referring to how Catholicism has failed to address systemic poverty.  I would argue that Marxism, in its most extreme forms, represents the unpaid debts of all of us.  You might find Marxist communism evil or stupid, but mark my words: if we, as a world community, do not find a way to give the poorest laborers in the world some opportunity to advance their careers, some opportunity to perhaps even own the business they work for or own some land of their own, Marxism or something like it will make a comeback.  More people died fighting for or against Marxist revolutions than in all of WWI and WWII combined, and if the poor cannot work their way to some slightly better life, some lunatic preaching, “kill the rich!  NO PRIVATE PROPERTY!” will rule the day.

Last but not least: are they lunatics?  Is no ‘private property’ really such a horrifying thought?  So many times in discussing this topic, I feel like capitalism takes on a moral edge; people talk about the right to own things and accumulate vast amounts of capital as if this legal right is connected to a basic moral view of what it means to be a good citizen, indeed to simply be a good human.  Thoughts?  Marxism was frequently called ‘evil’ during the cold war because it was seen to promote a degraded view of human beings.

Obviously, Marxists would claim that it is capitalism that promotes the degraded view.  One of my the most intriguing ideas within Marxist theory is alienation from labor.  By putting a dollar sign on every labor we do, we are alienated from the true value of our labor.  A few obvious examples: Trisha used to frequently give a massage to her family members and friends, because she’s strong and is good at it; she studies massage therapy and eventually opens her own studio, charging high rates and making a good living.  She now finds that she resents it when friends and even family expect her to give them a massage for free.  John likes to paint.  His wife does not appreciate what he does, tells him that he must focus on developing a real career.  Then his paintings start to sell well, and his wife now supports him, and John feels vindicated that his paintings are, “actually good.”

What is the actual value of Trisha or John’s respective labors (massage, painting)?  Who knows; we put a dollar amount on everything now.  There are some feminists who have put a great deal of effort into quantifying how much money an average mother would make if she were paid fairly for the care she gives her own children.  The idea that a mother caring for her child has any intrinsic monetary value at all is rather disturbing, perhaps.  And something has died inside of Trisha if she no longer wants to so something comforting and healing for a friend simply because other people now pay her for it.  Capitalism rates the labor of a top hospital administrator at approximately 5 times the amount of a top surgeon, and the labor of a mediocre professional baseball player at 20 times that of a public defender.  Most of us would say that we don’t only think of money when it comes to what to value in terms of our time and energy, we clearly do think of money is of paramount import.  Because we must.  In a communist society, the athlete would not get paid more than the school teacher, and we would think rather differently about the labor of both.  Thoughts?  Do any of you you feel alienated somewhat from your labor, in terms of the process of making money for something that you might do for free, or perhaps doing something you would never do if it wasn’t making you money?

· Graded Discussion Forum: Anarchy now!! (maybe…)

Do any of you relate to the idea that more interdependence on your neighbors and your community would make you better people?  What about the idea that central planning (of the economy, of the social safety net) always fails, not because it’s frequently poorly done, but because central planning (ie, the federal gov) simply doesn’t work.

At least one claim by anarchists is very hard to dispute: large-scale, modern war couldn’t happen without large-scale, modern governments.  What do you think of where they would go with this: If we were instead a loosely interconnected system of towns and tribes, and no one person had power over anyone that they did not actually know personally, then there would be less conflict…?

Do any of you have moments when you’ve felt the vast impersonal nature of your government?  I offer the following examples from my own life:

The IRS audits an older friend of mine, the same year that her mother dies and her husband is in the hospital.  She fails to do her part in the audit so the IRS puts a lean on her teaching salary.  She explains that her husband is in a coma and that therefore she cannot comply; the IRS representative tries to show compassion over the phone, but explains that there is nothing to be done.

I approach a large intersection and a man jay-walks right as I enter on a green light.  I brake to a stop and he walks in front of me just as the light turns yellow; I cannot go back, and cannot accelerate quickly enough to not get caught on the camera for running a red light.  A cop witnesses the whole thing, cites the jaywalker, but he cannot have the camera ticket expunged; I am told that I have to go to court; the cop says that he will do his best to show up and testify.  He doesn’t show; I pay a $500 ticket because the camera shows what it shows.  The judge says that I, “very well may be telling the truth,” but again, there is simply nothing she can do.

One of the most famous examples from literature, from John Steinbeck’s The Grapes of Wrath.

A family that owns their farm free and clear falls on hard times, is unable to pay their taxes.  The federal government seizes their land, and bulldozers come out to destroy their home.  The father takes his rifle, stands in front of the house, says that he will shoot whomever is in charge.  The bulldozer drivers explain that they are just doing their job, that they are following orders from the sheriff.  The sheriff eventually shows up, and he explains that he is only following orders from the mayor’s office.  The mayor gets wind of the stand-off, and explains that the bank is to blame.  The father says that he wants to know who at the bank to talk to or shoot, and is told that no-one at the bank even knows about their farm, because the bank deals with vast numbers of properties all at once.  The father backs down; his family is about to be homeless in the middle of the Great Depression.  People around them are dying of starvation, but there is apparently not a single individual willing to take responsibility for destroying their lives.  Their lives are being destroyed by systems made up of individuals, not a single one of which is willing to take a stand for the actions of the system.  The system thus takes on its own sense of moral agency.

Do any of you every feel that way about the system?  The strangest moments come when you meet a compassionate, empathetic government employee who really does want to help you, but they do not have the authority to do so, and the person who does have authority probably would never hear your case.

Bureaucracies, be they a bank or a government–inevitably become impersonal, and thus morally bad, once they reach a certain size.  You cannot have power over people you do not know and actually deal out that power justly; it is morally impossible.  Thoughts?

Even if anarchism is insightful in some of its criticism, what are its pitfalls in its positive vision of the world?  What are some things that might not be able to develop in society if the U.S. was a loosely knit group of collectives instead of a vast, modern country?

Debates on a theory such as anarchism usually fall along the following lines: if you’re ‘pro’ anarchist, your burden is trying to prove that it’s possible that the theory might actually work, and/or that it still is valuable even if it’s impractical.  If you’re ‘anti’ anarchist you have to argue that the theory has no value, usually by arguing that it could never be practical in the real world.  How might these arguments proceed?

· Graded Discussion Forum : Psychiatry as art and/or science

There are those of us who are clearly judged as completely, 100% mentally normal; every extreme feeling we have has a clear cause and a healthy resolution back to equilibrium.  We are realistic, happy, and stable our entire lives.

There are those of us who clearly are mentally not normal.  One of my relatives couldn’t go to school because she was afraid of people.  All people.  The physicist John Nash saw people who weren’t there and had elaborate conversations and relationships with them.

Most of us are somewhere in the middle.  This is where an ethical dilemma can come in.  This is mostly a dilemma regarding how we take care of ourselves, how we view ourselves and our feelings, but also in how we respond to others.  This is a topic that, if it isn’t deeply personal for you, it undoubtedly someday will be; especially given how rapidly the DSM is expanding, it seems safe to say that most people will receive a diagnosis at some point, or will know someone who has. 

You’ve suffered a loss, or life has taken some of your dreams into a dark alley (those dreams you all have now.  You know what they are) and beaten them up pretty badly.  You feel sad most of the time, and have almost no motivation to try to make things better.  Many days, you feel no motivation to do anything, even things you enjoy, perhaps the most classic category for the diagnosis of depression.  You go see a psychiatrist, and she tells you that you have depression.  

(1) Take the diagnosis very, very seriously, decide that your sadness and failures for your entire life have been attributed mostly to this diagnosis.  There is no way of proving that this is true, but there is, of course, no way of proving that it is NOT true; many go this route.  

(2) Take the medication prescribed.  Take the diagnosis and treatment seriously, but go forward assuming that it is only one way of looking at your life, and that you may be completely better someday.

(3) Not take the medication prescribed, and insist that you want to try talk therapy.

(4) Back-pack across Europe.  Join a Bikram yoga collective and go vegan.  etc.

In other words, it’s a choice to some extent, and as the polemic against mainstream psychiatry becomes more widely known, it is a choice that more and more people are becoming aware of.  Is there something categorically limiting to agency, something wrong, with taking a pill to feel better, instead of some other route?  Some would say, “my friend and I were both diagnosed, and she takes Prozac, but I just do a lot more yoga and forced myself to be more proactive.”  Why is the yogini assumed to be “better” than the one who takes pills?  I would argue that there is nothing wrong with doing anything that helps you, that it does not limit our freedom and our agency to depend on medication, provided that that medication is readily available.  And yet there is still a stigma associated with medication.  Where does this stigma come from?  Thoughts?

There are two basic problems in how modern psychiatry is practiced and experienced in America, (1) A stigma against people who suffer from mental illness and personality disorders, a stigma against taking medication; the problems with this stigma are, appropriately, often talked about.  Numerous prominent people who have been diagnosed with anxiety, depression, etc. have helped lower this stigma.  Simply put, there is nothing wrong with needing help, seeking help, and feeling better with the help of treatment.  (2) A less talked about problem, the problem with buying into diagnosis too much, of attributing broad life narratives to it (“I suppose I’ve never had a good relationship because”…”I suppose I always push away my friends because”) that are simply not part of the diagnosis, of taking the diagnosis on as a full-blown personal identity.  I’m not sure which problem is worse, but with the bifurcated left vs. right alarmist media bull@#$# that pervades the internet in which extreme views form communities as never before, it’s easy to see how both problems could be getting a lot worse. 

How should psychiatrists like Greenberg, Frances, and Insel, and teachers like me, responsibly present the “polemical” argument?  Even if a teacher doesn’t present the argument as, “true,” simply the argument itself, particularly in the extreme form presented by Insel and Greenberg, is probably causing a lot of people to stop taking their medication, to question their diagnoses.  They have no scientific basis for their opinions (they would argue, of course, that their opposition also has no scientific basis).     

Greenberg, the most extreme critic of the ones cited in the reading, would assert that therapy is mostly an art, not a science at all, that until neuroscience becomes as exacting as cellular biology, what we ought to do is learn about a variety of psychiatric theories (including Freud, Lacan, and others that are usually not taught any more), a lot of philosophy, a little world religions, and then sit down and just talk to patients about their lives.  Greenberg calls this “existentialist humanist talk therapy.”  If someone says that they’re depressed about the government, we take them at their word, and we talk about the government.  What do you think of this approach to psychiatry?  

Last but far from least, of grave concern is how we attribute extreme behaviors to diagnoses.  I talk in class in about my work at the Suicide hotline, and about school shootings across the country, because it’s awkward to talk about more personal things.  One reason why I am so interested in this issue is because two close friends of mine have killed themselves, and in both cases, I was appalled by how quickly therapists rushed to convince all the departed’s loved ones that there was nothing we could have done, because the deceased suffered from mental illness.  Acquaintances of my friends, who did not know them well, bought this explanation immediately; in one case, the diagnoses was depression; in the other case, it was bi-polar.  It seemed like therapists involved were determined to convince all of us that they had essentially died due to improper medical treatment, the implication being that they were simply sick, and their sickness simply killed them.  But no, something in my rebels to this completely: they killed themselves.  If you knew them over time, knew of their home life, simply knew them a bit, you knew that their suicidality did not easily correlate neatly with the symptoms involved in their diagnosis.

In the suicide prevention community, we must try to always encourage people to get help, but in the very act of seeking help, you are excercising your free will.  When we treat suicidal depression as solely or primarily a medical condition, we can cripple people’s sense of agency.  

Indeed, one of Greenberg’s pet projects is suicide: he points out that if suicidal depression were in fact a disease, one would think that treating it this way for going on 34 years now would have resulted in either (A) a greater ability to predict when people will kill themselves, and/or (B) fewer suicides.  But neither has taken place; the only thing that is different from 50 years ago is the way we use verbs: now those of us in the field are taught to say, “he lost his life to suicide,” instead of the more active verb, “he killed himself.”  The implications concerns me.  Like Sartre’s response to the horror of WWII Europe, I fear that we are simply frightened of the true freedom and responsibility we have in this world, most of all for ourselves.

Discussions on this topic frequently wind up falling along the lines of saying that you are somehow “for or against” meds/psychiatry, and why.  While this can be quite interesting and dynamic, I hope that the reading that I prepared is not coming across as taking a side against anything.  Instead, I’m trying to explain why many thinkers, including many psychiatrists, are trying to get us to analyze what we’re doing a a culture when we start categorizing certain experiences of sadness, anxiety, violent thoughts, sexual thoughts, etc. as mental disorders.  They present a vision where good psychiatrists are the forefront of the solution to a problem that they helped create, talk more openly about the grey areas in diagnosis.

Last, but certainly not least, a lot has happened in the last few years on this issue.  the National Institute of Mental health is officially abandoning the DSM, on the argument that the categories produced by the checklist approach to diagnosis simply is not scientific.  This could represent a massive philosophical shift in how psychiatrists see their profession.  Three articles on this shift (NOT required reading, but well worth skimming if you’re interested in this):

http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml (Links to an external site.)Links to an external site.

https://www.newscientist.com/article/dn23487-psychiatry-divided-as-mental-health-bible-denounced/

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