An insightful look at modern healthcare that making the profitable assumption that the social context in which we suffer our illnesses is irrelevant to their cause and treatment. This way, society itself is never questioned.
Our authorized sanities are so many Nembutals. "Normal" citizens with store-dummy smiles stand apart from each other like cotton-packed capsules in a bottle. Perpetual mental out-patients. Maddeningly sterile jobs for strait-jackets, love scrubbed into an insipid "functional personal relationship" and Art as a fantasy pacifier... And we all know this… Slowly, very slowly we are led nowhere.
— San Francidsco Digger Papers, 1965
HOPKINS VILLAGE, BELIZE — Sitting down here in Central America happily abusing my health, occasionally, between the hangovers and the bouts with sand fleas and mosquitoes comes an insight or two, or at least what passes for insight in my lowbrow take on life. One of these is just how damned lucky the Third World is that it cannot afford a sophisticated mental health system. By that I mean the kind in the "developed countries," where murder and suicide rates are quintuple what they are here in this village. Not that we are without own village resources. My Garifuna buddy Eljay, was in what we would call a depressed state a few months ago, and went to a local "spirit doctor." The wizened old spirit mojo man cured Eljay with a single utterance: "Quit smokin' da ganja for one month." It worked. Total cost: About $2.50 and a pound of red beans. They say the old spirit doctor also treats such things as sexual dysfunction, though I sure as hell cannot detect much evidence of dysfunction, judging from the noises in the village cabanas and under beachside palms at night.
In any case, it causes me to wonder why is there enough pain and alienation to sustain America's umpteen billion dollar mental health business and its 400-plus specialties, not to mention the inner self-help industry and Deepak Chopra's royal court. Why is it that during the months I spend in America I meet so many obviously sick fuckers, some successfully practicing law or politics, others homeless and schizophrenic?
You need not be Marcus or R.D. Lang to feel the stress, depression, boredom and loneliness permeating everyday life up there in Gringolia. But to get an overview it does help to be a couple thousand miles outside the place. Kind of like being high in the stands at the racetrack with binoculars rather than down at the rail next to the paddock. Matters seem especially acute of late, with the entire American anthill in turmoil as its common god, the almighty economy, waves bye-bye while being noisily sucked down the global gurgler. Hell, twenty years ago mental health problems were already being described as "epidemic," despite the joys of Facebook, iPod, and the consumption of some 25 million pounds of hot wings on Superbowl Sunday. A place where "normal" life includes Viagra, all the fried chicken you can stuff, round the clock televised crotch shots and HDTV as national mandate.
I used to think it was just some melancholic germ of my own that made me see a slowly increasing American alienation, anxiety and inner sadness over the span of my 62 years. Now however, I'm pretty convinced there is a national pathology at work, one which author Arthur Barsky called the "pathology of American normalcy." Sounds accurate to me. In fact, this psychic poverty has been around so long it has become something of a norm. Despite that we have not resorted to cannibalism, single payer health care, or god forbid, socialism, we long ago passed into the realm of what we like to call an "unhealthy society." Might not America's psychological malaise be the result of knowing deep inside that life can hold more meaning — be more joyful? More emotionally rewarding and fulfilling? In a word, healthier?
Americans who can afford to be, are obsessed with health of any kind. The rest of us chain smoke in despair. All of which makes tosses fresh red meat to the politicians, who offer "plans," all of which come down to the same thing — we pay for corporate expansion of both the insurance and "medical industry," but through insignificantly different methods. Interestingly, despite our pursuit of constant medical attention and the construction of the planet's largest, and most profitable health machinery, treatment factories for every real and imagined or industry manufactured ailment, surveys show, Americans do not trust doctors. They feel physicians are primarily businessmen or businesswomen who happen to practice medicine because that's where the real grease, the big bucks are. This may or may not be true, but we see little evidence to counter their suspicions. Even the closest physician friend I have in the States insists on a $125 office visit — cash at the front desk on the way out, please — before he will refill a blood pressure prescription I've been taking for 15 years. He knows I do not have health insurance, but hey, what's a bill and a quarter between friends? Well, it's a month's grub for some of us, or dinner and drinks for two at the country club for others.
By comparison, my doctor in Jalisco, Mexico, Jim Jaramillo, who practiced in Albuquerque for 30 years, invites me to ride into the surrounding ranch country and have a dawn drink with the Mexican cowboys, simply because he regards all his patients as friends. And "Nurse Judy," who runs the main clinic here in Hopkins, whoops it up with the rest of her patients on Friday oldies night down by the beach. The village's Dr. Anya, a Mayan-mestizo lady trained in Mister Castro's famous Cuban institution, dropped by my cabana to examine the local kids on my front porch. For free. Then we played guitar together. I asked her if she could teach me any local folk songs. "No," she said, "I'm into Iris Dementh." Go figure. Anyway, none of these doctors require appointments.
But we started out talking about the psychic pathology of Americaness, didn't we? So without going too far over ground well enough covered by better and more authoritative writers than I, the pathology of Americaness is entirely about human consciousness, a taboo subject in our declining industrial super state. The subject has been officially smothered, or even demonized by authority since it was first openly broached in the Sixties. However, those running the industrial government complex learned a few things too in the process. Particularly about the efficacy of dope. Being authoritarian and capitalist, they of course preferred downers over the mind expanding drugs. And ever since then corporately produced biochemicals, tranqs, mind numbing anti-depressants and the like, have been successfully used privately on individuals to squelch the psychic anguish produced in the Darwinian workhouse America has become. Not that I'm entirely opposed. As I've said before, if this officially sanctioned dope were a bit more ecstatic and colorful, I'd be right there in line for my share. Hell, I'm an American — instant gratification works for me too. But an anesthetic to workhouse burnout just ain't enough incentive. Beyond that, the street drugs are crap these days. So to our King Kong pharmaceutical industry, I say: "Work with me here guys!"
Seriously though, back in the Sixties, along with LSD, nature and Buddhism, I looked to psychology for answers. Sure, psychology was very much a bourgeois affectation and fad at the time. But it looked damned promising to many of us, including a redneck hippie with tons of cultural and family baggage to unload and an allergy to mindless toil — especially those aspects of psychology that dealt with social realization.
But who'd have guessed it would become a massive and officially sanctioned ideological control arm of the state? A form of social control and containment of the citizenry through a governmental and corporately sponsored "mental heath system? And the way it does so is this: It refuses to acknowledge that our aggregate society holds any responsibility for the conditions it produces in our fellow individual members. Now collective societal responsibility is common sense for, say, a Dane or a Frenchman. Most of them anyway.
For Americans though, it's an explosive issue. Because if we acknowledged collective responsibilities to the individual members of our society, then we would have to deal with the issue of class in this country. Some gestures are now being made in that direction, thanks to Obama, but it's still America's longest standing hot tater I doubt even he will hold very long. Every successful, well-off American, or even so called middle class Americans — we seem to be unable to truly define them; even uninsured households earning under $25,000 most often define themselves as middle class, thanks to our national denial of our class system — succeeds at the expense of some other American. Or more accurately at the expense of an entire unacknowledged underclass of them. Consequently, we get the "self-determination" and "individual initiative" stuff as an excuse and cover-up. An attractive one too, given that it implies some sort of superiority of effort or talent. And there's no denying that life requires some of both from everyone. But that does not reconcile our larger than ever class discrepancies, much less the alienation one feels when he or she cannot trust that his or her society is operating on their behalf.
Whatever else can be said of capitalism, it is miraculous stuff, pure alchemy. It can privatize and corporatize any damned thing under the sun, turn a profit on it, and then make it a bulwark of corporate state control to boot. Even human misery and oppression of soul and mind. Psychological practice and its institutions benefit greatly from this. After all, they are in the alienation business. It is entirely in the profession's best interests that it treat us as if our lives are lived in a vacuum, our loneliness and despair are entirely our own, as if there were no such thing as context, much less American society's corrosive and toxic environment in which so many of us live out our lives. Put another way, it acknowledges our misery, then privatizes it, then administers lonely alienated "treatment" for our emptiness in a private void, one among tens of millions of like emptinesses in similar voids that are in no way supposed to be societal. No matter that there are enough sufferers to constitute an entire society in themselves. The result, whether or not by design, is to perpetuate the most venerable of American myths, that of the completely autonomous self. Which denies us the power and beauty, not to mention the healing and efficacy, of human unity. In the big picture, much of the U.S. mental health industry, and its associated systems, perpetuate and even propagate mental sickness perhaps as much as it alleviates, through its paradigms. In any case, for the most part, psychology as an institution has hardened into part of the national ideology, thanks to the catalyst of gobs of dough from the state. The American Psychological Association's initial refusal to condemn member participation in the Bush regime's torture told me all I needed to know about U.S. psych-officialdom.
This somehow reminds me of the old Soviet Union's psychiatric handling of dissidents. If you did not display state defined norms, then you were deemed nuts, and needed medication, behavior modification or institutionalization. It was deemed impossible that those very norms may have been driving your condition. The similarities are there, particularly when you consider the massive growth of the U.S. prison industry and its reliance on pharmaceutical and behavior modification control. The entire machinery of education, social work, psychology, and medicine are meshed (though the practitioners would stoutly deny it) and help hold firm the class line in this country. Many of them do so unknowingly, of course, and are dedicated to helping fellow beings through the methods they have been taught — and and are accredited through state sanctioned institutions of course. But the overwhelming majority seem to draw their paychecks and health insurance happily enough, Ever spend much time with the average mid-American social services psychologist? The kind who make recommendations in our juvenile courts, etc? On the whole they're a sorry assed bunch if ever there was one, bureaucrats wrapped in the smug piety of social work. Others are far more aware, but fearful of calling bullshit on the system that pays the mortgage and sends the kids to college.
Given the economic and societal breakdown now underway and accelerating toward completion, Obama or no Obama (What is this thing of ours, this national obsession with saviors, elected or otherwise?), it's bound to be interesting to see if they can indoctrinate, dope, counsel, and lock up or medicate the dissidence, and perhaps outright resistance that will occur. Whether the final American collapse takes four years or forty years is anybody's guess. But it's gonna take a passel of behavioral management experts, whether in psychological institutions, university research centers, or on Madison Avenue, to keep the lid on this puppy when she blows. However, I'm not ruling out the possibility that they just might help do that — keep the lid on — because they are state authorized and accredited to do so. The infrastructure of industrial strength administration of psychology is there. And has been ever since sheepskins were issued to "industrial psychologists." Nobody in the Western World seems to see the irony and conflict in that term. But the fact is that even if 50 million Americans exploded tomorrow, they would have "snapped" alone, particulated and atomized in a very large and spread out country, and ultimately be administered treatment or institutionalized as "individuals." Of course if they if they were more concentrated, which would put them in a situation to act in unison, then god help 'em because they would then be a national security problem, the last thing you want to be in a security state.
Obviously, I'm no psychiatrist, and am sure to get plenty of email offering certain proof of that, plus proof that I am a paranoid nutcase with authority problems (I'll gladly admit to the latter), though in more polite professional jargon. To which I say less politely, "Fuck 'em all!" I see what I see.
And what I see, based upon my own experience and watching that of others, is that alienation and the pain of utter aloneness, is in the rootstock of nearly all psychic malady, excepting the clearly organic. If when we look around us in the world, we do not see ourselves in society, nor does society see itself in us, we eventually come to feel the sustained, unutterable pain of aloneness. This would seem the appropriate response for a member of our highly social species of flesh, and does not necessarily deem us ill, but often rather more human.
Unfortunately, Americans get laughed off the map for being overly human these days, dubbed emotional pussies, part of the Kumbaya crowd, unrealistic utopians …and if you are sincerely human enough, get your ass kicked by the system. To be so makes us the bane of the super rational, technological production driven society we have come to be. We got there partly through our weakness, shallow greed and mindless consent, but more so by the orchestrated world machinery benefiting powerful elites, both corporate, governmental and financial (is there a difference?) which have always been among us, though never in such strength.
Many years ago as a much younger man, I went through a couple of major depressions, the second of which brought me to the brink of suicide. In the first instance I was somewhat helped, through medication and "talk therapy," by a psychologist who eventually killed himself. They found him in a tree in his back yard with his beeper going off. This is not to disparage the man in any way. Dr. John Farley was a man of good will, good intent and great compassion.
The second time though, I walked out of the abyss by myself. And along the way I encountered, sought out really, others on the same path. And I saw that together, in open sharing of our personal truths, most of not all of us were nowhere near mentally ill. Just sick. Sick even to the point of death in some cases, of our spiritual imprisonment within the Great Machine, but strong enough to refuse under any circumstances to dwell under its spiritual humiliation.
Contrary to what one might think, in the many years since I've not much thought about those experiences. Just moved on. But in this new and strange era in which we find ourselves, they've returned as subjects of contemplation. And — judge me as you will — like many others these days, I smell the breath of Thanos in that machinery of the system unto which we supplicate in our fear, denial or intentional obliviousness.
Still, it is only a system. Systems can be changed. In any case they inevitably crash entirely of their own entropies. Doubtlessly, ours will take down with it the hardening privatization and institutional control of the human spirit. I won't be around to see it.
But I would be damned pleased to see such a once noble attempt at elimination of suffering as the American psychological profession rise to the choices before us — liberation from our collective societal darkness, and psychic death within the machine.
Meanwhile, here in Hopkins Village, darkness has come and brought with it good old Eljay, ready to split a bottle of the local bitters on my porch. The night winds are rising and with them comforting assurance that The Machine is not everything... indeed, not anything by the light of these indifferent stars.
Copyright © 2009 Joe Bageant