Category Archives: Mental Health

Capitalism, Empire, and the Infernal Gloom Machine

Depression is built into this machine and the evidence is plastered on the morose faces of people caught in the clutches of its business as usual activities. Depression is found in the insurmountable debts we owe for spending a lifetime of preparation and labor to serve the machine. In addition to debt, the machine awards us for our servitude with trinkets, gadgets, doodads and gizmos that provide a moment of hollow amusement and then sit on shelves in garages and decay. They represent the planned obsolescence of the human heart. The sacrifice paid for our fetish with materialism is the actual quality of our lives.

The gloom machine tells us the quality of our lives is defined by the machine in the driveway, and the machine that flushes away our excrement, and the machine that chills the tortured slaughtered animal flesh for later consumption, and the machine that flashes pornographic images and supplies numbers detailing how much we are liked by our so called friends. But to us humans it seems that quality of life is more appropriately measured in the amount of disposable time we have to pursue that which we want, and the quality of the community around us, and living without being chronically stressed with threats of being displaced from the land upon which we live for not working hard enough for the machine.

Depression is waking up at 6 in the morning in darkness to sit in traffic for an hour to arrive at a job that we don’t want to be at, only to serve the machinations of people with nothing but greed in their overstuffed bellies. And we go to these jobs so that we can pay rents that are unaffordable, and to service debt we’ll never escape, and we go home in darkness to our lonely lives in places where community is absent with a view of an equally lonely tree or a man-made retention pond which is an upgrade over the view of staring directly at your neighbor’s domicile. Depression is the realization there is no vacation on the horizon, no respite, just more of the same. Depression is knowing that such a life is better than many others have it.

Depression is recognizing the cynics were right about this society, that Cohen spoke truth when he sullenly moaned:

Everybody knows that the dice are loaded
Everybody rolls with their fingers crossed
Everybody knows the war is over
Everybody knows the good guys lost
Everybody knows the fight was fixed
The poor stay poor, the rich get rich
That’s how it goes
Everybody knows

Depression is watching art die. The surrealist, the bohemian, the rock ’n roll, and the anti-authoritarian soul has lain down and pledged fealty to the dollar. For money, they’re now all willing to become ready made predictable cubes to be packaged and sold in plastic wrap placed in cleverly designed boxes which deliver to the depressed public what they want, more of something that’s pretty on the outside and vacant within. We are left with monthly subscriptions of more tales of self aggrandizement for the throngs of temporarily embarrassed millionaires.

Depression is watching the worst of us rise to legitimacy and awarded iniquitous riches for it. The popular is depressive, musical hack Cardi B sings about her money money money and she is loved. Jordan Peterson sells cheap self help stolen from better written material decades ago amalgamated with misogyny and dictates of hierarchal subjugation and becomes wildly popular. Trump purveys hatred of people of color and a love of authoritarianism and the depressive people, oh do they eat it up. This is sickness, depressive sickness.

Depression is acceptance of the violent now. The grossly unhappy men with their armaments spread their gloom and horror across the planet and claim righteousness for doing so. Depression is watching society applaud murderous hearts for their crimes who don badges and camouflage and have holidays to celebrate their violent history, while villains are made of those who simply don’t want to stand up for songs of oppression. Thank you for your service to the machine.

Depression is watching notions of resistance and revolution take form in slightly altered subservience. The great reformation desired now is for a “green new deal” that doesn’t come close to mitigating the impending culling of humanity from soon to be ecological catastrophes. Their plans offer only more endless work at the behest of the gloom machine while promising healthcare that will never happen, less debt it will also never deliver, and affordable housing that still won’t solve homelessness. They don’t want to break the machine, just tweak it, and they lack the ability to do that even. Never have I borne witness to such eager slaves and such depressive aspirations. The people seem to adore their cubicle lives, their environmental destruction, their corporations, their debts, their corrupt leaders, their prisons, their banks, and their taxes.

They want to continue to be put to work under the thumb of the status quo western civilization authoritarian mind and this is all the depressed mentally dominated masses can think of as a possible improvement. Instead of wanting to taste real liberty and be actual equals, their dreams are limited to being better treated servants. The gloom machine chugs along fueled with dimwitted ideas sold by boxed-in thinkers without any possibility of escaping the darkness, rather simply offering a more cushy seat for viewing the end of everything.

The machine bellows out demanding more, more, you owe me more, and somehow those wearing red, white, and blue agree and celebrate the demands of the machine. These debts we owe are servitude. The numbers held in digital machines are immoral which demand one must wake up to a dreary existence to do more of what is killing our souls along with the flora and fauna around us.

Depression is the downtrodden plebs who celebrate their corrupt democracy, which is in reality a thinly veiled oligarchy that should be obvious to all. They prop up a system of voting that allows the election of the presidency, a position that shouldn’t exist in the first place in an egalitarian society, to be awarded to candidates who don’t capture the most votes. What little democracy there is in a representative system is lost in totality when the winner of elections need not win the majority of votes. The gloom machine is straight up tyranny.

A non-depressed society would reject being served faux democracy. They’d reject a system absent of reason or compassion and disdain would be for ideas of continuing to support such a destructive way of being. But instead, within the gloom machine shame is reserved for those who don’t want to take part in the busted system, and it venerates those who cast votes for imperialist conquerers and planet destroyers, and those voters are lauded as doing their civic duty for taking part in open public corruption.

Depression is the insincere know it all crowd who are incapable of honest debate and have rarely endeavored to open a book of substance or engage in critical thought, but they know trivialities which they mistake as facts and wisdom. They know arrogance well and emanate it with aplomb. They know how to believe all they see in the corporatized media, but thinking without boundaries or limitations is beyond their capacity. This is not even depression, this is tragedy.

Depression is watching the trees be plowed down for more tract housing, a portion of which will sit empty for years because no one can afford to move there, and even if they could it’s a heinous boring life that awaits which is only significantly better compared to being homeless. Depression is knowing this is the reason why we are rapidly destroying our habitable environment and commencing a 6th mass extinction event which is now accelerating.

Depression is to know there is nothing we can do to stop the country we live in from mercilessly killing innocent people all over the world for no reason other than more economic expansion and our sadistic ideas of exceptionalism that entail spreading pain and hardship so a few elites can have more of what they already have more than enough of.

Depression is the powerlessness to change anything of significance. There is no other way they say other than the desolate gloom machine, they say this is how it must be. And so we remain here waiting for the horror that is soon to approach us all as the gloom descends in ever quickening waves.

A zombified indoctrinated populace can see no other way than capitalism and beating each other over the heads to satiate egos in needless competition that is unnecessary for survival and deleterious to the common good. Capitalism is the primary tool of empire, and a word that should be synonymous with depression. It’s the accumulation of resources in an effort to gain more power in man-made markets to leverage that power over other people and get them to do what the person with the most power desires. Capitalism’s depressing ideology is defined by the lecherous desire for more for the sake of it so the winner can pound their simian chest in victorious celebration of the devastation they’ve created.

Capitalism is inherently unsustainable due the way it allows power to coalesce via the leveraging abilities given to money to buy land, the means of production, elections, and advertising. It allows the whims of the few to overrun the needs of the many where those with the worst intentions aspire to gain more than others because they will attempt to fill the void in their hearts with self importance expressed via power over others. This is why it cannot be used.

If there is no central currency or advantage to collecting huge amounts of resources then the motivation to hoard would evaporate, as those resources would simply rot or become a burden to maintain. There’s no fun in that kind of hoarding. The “fun” comes to the simpleton power seeker when they acquire power to make others do what they want and thus gain the ephemeral validation they so desperately seek.

If one runs the math on players competing for money at different rates of gain over a certain amount of time, there will be a doubling effect which becomes exponential. And this effect will accelerate as it plunders along due to gains in leverage which allows for ever greater amounts of money to be made at faster rates. Eventually it always ends the way a game of monopoly ends, someone has all the power and everyone else is subservient to that entity/person.

These dour thoughts manifest from the recognition of the stranglehold empire has over our lives. The depression is the result of the myriad of expectations I can’t let go of that wants to see a kinder more egalitarian and sustainable world emerge while knowing how unlikely it is. Our collective depression is rooted in the foundations of social hierarchy and its economic tools of control, and understanding what a perfect trap it is, and so it goes, and everyone doesn’t know, but they feel it, though.

Liar, Liar

The dictatorship’s mistake was to torture but not kill.
— Jair Bolsonaro, Radio interview, 2016

I won’t get voted out of office.
— Bill Gates, Bill Moyer Interviews Bill Gates

I hate the indifferent. I believe that living means taking sides. Those who really live cannot help being a citizen and a partisan. Indifference and apathy are parasitism, perversion, not life.
— Antonio Gramsci, Prison Notebooks, International Publishers Co; Reprint, 1989 edition (November 24, 1971)

The sadist needs the person over whom he rules, he needs him very badly, since his own feeling of strength is rooted in the fact that he is the master over someone.
— Erich Fromm, Escape from Freedom, Holt Paperbacks; Owl Book ed edition, September 15, 1994

Years ago Robert Bly talked about Ronald Reagan’s capacity for lying. He said Reagan grew up lying about his father, an alcoholic, and his dysfunctional childhood which he routinely described as happy. How the enormity of that lie, and all the attendant pressures of such intimate dishonesty made lying about the Iran/Contra deal much easier. And I recently heard Gabor Mate say the same sort of thing about Donald Trump. How Trump grew up with an abusive authoritarian father, one who humiliated and belittled the boy Trump, and the world of that boy was one of cruelty and abuse. And if that is the only world you know growing up, that is the world you will see everywhere around you later. And the only way to navigate a world of abasement and lying was to be better at it than those who had abused you. The grandiose aggressiveness and paranoia of Trump is the product, in part, and probably in large part, of a family that operated on strict hierarchies of power, a punitive and sadistic family dynamic. Trump’s brother, of course, drank himself to death.

Countless Presidents came out of dysfunctional families, ones often with authoritarian and alcoholic fathers. Gerald Ford, or Bill Clinton with his stepfather. The list is quite long. British Prime Ministers are also disproportionately the product of similar childhoods. But the point is really about a system that rewards men and women who have developed pathological coping mechanisms that include an ability to lie, an inability to feel empathy or remorse, and who are adept at cheating and taking credit for the accomplishments of others. The deformed character that comes out of such dynamics is, it seems, perfectly suited for the public spectacle of political life. Perfectly suited for a career as a carny barker, too.

All hierarchical systems are to some degree systems that encourage winning and punish losing.

Before the last Presidential election I wrote this about the two leading candidates…

For that is it, a rich white anti intellectual with openly self embraced bad taste, Trump valorizes half the white men in America for their seeming failures. He is saying, ok, you are not rich like me, but the rest, yeah we are one. But Trump has no role without his co-star, Hillary Clinton. Hillary is the cliche woman who is overbearing, petty, resentful and spiteful, but also functions as a female destroyer. And that role is complex, here. Hillary is not the purifying force of Kali, she is not the forest fire that brings regeneration. No she is simply the electric chair with a short, a sadistic contraption of flawed construction that terrorizes and disseminates suffering and cruelty. And while I have thought it impossible that Hillary doesn’t win this dog and pony show, it is now becoming apparent that Trump is the candidate of masculine revenge. Every misogynist looks to Mr Orange Hair to get even. And that misogyny is interlaced with race and colonial memory. And this is where the importance of Heidegger and Schmitt looms. And it is where the rising tide of left liberal antisemitism appears alongside peak Islamaphobia. It is all of a piece, in a sense.

— “Cunning of Unreason“, May 8, 2016 John-Steppling.com

Hillary, too, came from a dysfunctional family environment.

The message here is, I think, most of America is made up of dysfunctional families. Perhaps all families under capitalism are dysfunctional. Most learn to lie about their families. Only today, one form of lying to confess about it and advertise one’s own self improvement program as a response. The therapeutic often, it seems in my experience anyway, to simply be another form of lying. Or self delusion. Americans love to “work on themselves”. It’s a bit like working on your car, or those DIY projects to convert the garage into a ‘rec room’. Of course, fewer and fewer people own their own homes anymore. Maybe they need a show for those living out of their cars. DIY for building portable sidewalk showers without risking police persecution.

Dysfunction is the cost of Capitalism. ‘Wrong life cannot be lived rightly’, as Adorno put it. So one part of the fall-out from this prolonged exposure to the irrationality of life in neoliberal America has been to normalize lying. When Alexandria Ocasio Cortez praises Nancy Pelosi…I have found many people, maybe the majority, expressing something along the lines of, well ‘she has to say that sort of thing’. Or she is only kissing the ring so she can later create possibilities for real change. The fact she was lying is excused. It is excused because America itself lies. And deep down those saying this stuff know full well Ocasio Cortez will become Nancy Pelosi, not fight against her.

In Brazil, the new fascist in power praised his father for the beatings his dad gave him. Young Jair Boslonaro said it helped make him a man. Jair is now out to destroy the rain forest of the Amazon basin. Which might well kill off the planet. We can all partly thank dad for that.

Capitalism is an emotional plague on the planet. Wilhelm Reich said that. Bertell Ollman wrote of Reich’s ideas…

If the desire to accumulate property lies at the origins of sexual repression, its chief function today is to produce submissive beings of both sexes. In our treatment of character structure, the diminution of critical faculties, general passivity, resignation, and other negative effects of repression were identified. The work of sexual suppression is carried on primarily by the family. In his Marxist period Reich believed the suppression that was most decisive in determining character occurred between the ages of four to six in the ways parents respond to sexual play and questions. So important is the role of the family in these early years that Reich refers to it as the “factory of submissive beings.” To him, it is no coincidence that “the lack of victorious spirit, the outlawry of protest, the absence of personal opinions characterizes the relations of faithful children to their parents just as they do the relations of devoted bureaucrats to the state authorities and that of non-class conscious workers to the owner of the factory.
— Bertell Ollman, Social and Sexual Revolution: Essays on Marx and Reich, 1979

For the first time (last census) more Americans are living alone than in families. The loss of jobs, the onerous economic burden of child rearing, and gender inequality were all tied into an impossible model for any but the most affluent classes.

Millions of men who have been denied their family wages find refuge for male domination in right-wing anti-woman politics and fundamentalist and Catholic religions with their emphasis on denying women’s independence through anti-abortion and anti-birth control movements, opposing equal wages for women and denying support for raped and battered women. Other men seek to take back their male power through guns. (None of the explosion of mass killings have been committed by women.) Millions more seek power in heterosexual pornography in which women are portrayed as inviting sexual degradation.
— Harriet Fraad, “Living Alone:  The Rise of Capitalism and the Decline of Families“, Truthout, October 3, 2012)

Families propagate violence. Sons of violent parents are 1,000 times more likely to batter their adult partners, and daughters of violent parents are 600 times more likely to batter their partners. Children who are bullied at home are more likely to bully and to be bullied at school. Child abuse is rampant in the capitalist family system. We cannot know how rampant, because it goes on behind closed doors, most is never reported, and adults tend to normalise what they experienced as children. When neglected, they conclude that they did not deserve better. When physically terrorised, they will rationalise: “Sure, I was hit. But I deserved it.” According to the Adverse Childhood Experiences study, more than one in four American adults lived with alcohol or drug addiction in their childhood homes, 28 percent were physically abused as children and 21 percent suffered sexual abuse. ( ) Capitalism promotes sympathy for child victims and prosecutes adult perpetrators. But today’s perpetrators are yesterday’s victims. While only a small minority of child victims become adult perpetrators, studies of those who do perpetrate reveal that almost all were traumatised as children. Capitalism cannot acknowledge that most perpetrators are former victims, because it cannot admit that families transmit trauma from one generation to the next.
— Susan Rosenthal, Capitalism, alienation and the family, Socialist Review, 2015

Rosenthal notes something else, and that is that Capitalism in the transition from agricultural production to industrial removed labor from the family. It created this amorphous social sphere of leisure time or free time. But as Adorno noted sixty years ago, there is nothing free about it and leisure had already begun to resemble alienated work.

Rosenthal also adds….

Impossible gender expectations create crushing disappointment. The woman is raised to see the man as a champion and a prince who will make her dreams come true. When she discovers that he cannot do this, she expresses her disapproval or withdraws in despair. The man gets the message that he is not measuring up. How could he? The man is raised to expect a warm attentive partner who is always ready for sex. What he gets is an overworked, exhausted and frequently irritated partner. Both of them blame themselves, and both of them blame each other.

The American political drama, or electoral theatre, is reinforced so aggressively because it is the most basic and effective distraction people have for their social malaise and misery. Voting is a reflection of binary models. It is really just exchange value. And voting makes everyone equal. And Americans have even taken to wearing little stickers that proclaim they voted. So electoral theatre as a shaming device. But voting becomes even more than just a threadbare symbol of equality, it takes on almost occult significance for many. It is one of the few rituals in bourgeois society that seems to encompass something almost magical. Voting is an affirmation of one’s existence, of one’s autonomy and even freedom. I can vote for whoever I choose. Well, off a menu of two.

But I have seen leftist writers proclaim lesser evilism is not to be debated. This is, apparently, because Trump is some sort of special category of evil. This is a hugely regressive and politically immature position. Firstly, voting is not going to solve shit. Full stop. No, the entire apparatus of elections and voting machines and voter suppression or corrupt counts is part of this grand theatre. And this emphasis also promotes a popular idea with the ruling class, that of individualism.

I wrote this several years back…

Voting is the constant reinforcement of the idea of equality. Everyone has a vote, therefore everyone is equal. This is of course not true, however. But the expanding of campaign season ( a bit like the expanding of Christmas shopping season) is serving to keep this illusion foremost in the minds of citizens. The act of voting is then a sort of magic elixir for conveying a sense of equality, and it is coupled with the idea of ‘responsibility.

Dentistry as Art, John-Steppling.com, September 2015.

It is no doubt true that America is a full blown open fascist society today. But it was already. It’s hard to decide what was the starting point, but it certainly could be Bill Clinton’s second term. Or after 9/11. By Obama it was most certainly fascistic in operation. Gabor Mate noted that the ruling class was not fooled by Obama and all that hope and change stuff. Wall Street backed and funded his candidacy. They knew he was one of them. He rewarded them the second he was elected. No, only the mass public believes ANYTHING of what the political class tells them.

The Democratic Party has taken positions actually to the right of Trump on many issues (here is an issue Democrats fell in line with…) And does anyone believe real action would take place if Dems controlled the government? I mean they have, and not that long ago, and what happened? But none of these things are as significant as the wholesale swath of destruction that US and NATO military action has caused in Africa and west Asia. And nobody asks this during election season. Unless I missed something, no candidate or news talking head brought up why NATO even exists anymore. Nobody asked why the US needed to upgrade its nuclear arsenal, or why it occupies a third of Syria. Or why there are military bases in almost every country in Africa. Why there are 900 worldwide.

But more hidden, in a sense, and therefore more insidious is the role of giant foundations and non-military uses of coercion and control. Jacob Levich writes:

For the ruling classes do not rule by guns and laws alone. Rather, they need to be able to do so without the constant resort to force. So, [Joan Roelofs] argues, they manufacture the consent of the ruled through the activities of a broad range of institutions, activities and persons (not necessarily themselves members of the ruling class) who disseminate the ideology of the ruling class as if it were merely common sense. While dissent from ruling class ideas is labeled ‘extremism’ and is isolated, individual dissenters may be welcomed and transformed. Indeed, ruling class hegemony is more durable if it is not rigid and narrow, but is able dynamically to incorporate emergent trends.
— Jacob Levich, “The Real Goal of the Gates Foundation“, Aspects of India’s Economy, May 2014

The role of foundations is, to most Americans, opaque and almost inexplicable. Nobody in political/Electoral theatre mentions this ‘third sector’. Neither business nor government, these foundations operate with budgets in the multi billions of dollars. This is the stuff discussed at Bilderberg Meetings, and other summits of the world’s richest people.

The fall of the Soviet Union ushered in the present phase of public health philanthropy, characterized by the Western demand for “global health governance” – purportedly as a response to the spread of communicable diseases accelerated by globalization. Health has been redefined as a security concern; the developing world is portrayed as a teeming petri dish of SARS, AIDS, and tropical infections, spreading “disease and death” across the globe and requiring Western powers to establish centralized health systems designed to “overcome the constraints of state sovereignty.” Imperial interventions in the health field are justified in the same terms as recent “humanitarian” military interventions: “[N]ational interests now mandate that countries engage internationally as a responsibility to protect against imported health threats or to help stabilize conflicts abroad so that they do not disrupt global security or commerce.
— Jacob Levich, “The Real Goal of the Gates Foundation“, Aspects of India’s Economy, May 2014

I mention this only as a sort of corrective to these naive notions about voting. Voting is not the issue. Not in an absolutely controlled system of perception management. Back in 2014 Gates warned about overpopulation in places “we don’t want it” (sic) and he mentioned Pakistan and Yemen. Huh. Yemen, you say? Yeah, well, I guess that’s not an issue anymore. The U.S. Imperialist agenda is about control. It is adaptive and flexible.

Malthus’s heirs continue to wish us to believe that people are responsible for their own misery; that there is simply not enough to go around; and to ameliorate that state of wretchedness we must not attempt to alter the ownership of social wealth and redistribute the social product, but instead focus on reducing the number of people.

— Manali Chakrabarti, “Are There Just Too Many of Us?”, Aspects of India’s Economy, No. 55, March, 2014

I digress a moment to add on here that the overpopulation mythology has taken on a green cover of late. Suddenly the same old Malthusian eugenics is sprinkled with Gaia jargon and sensitivity to global ecologies. But the thrust and engine driving the idea remains the same.

Most non-profits do the dirty work of what a society is looking more and more to not provide for – mental health care for a bigger and bigger share of the USA population; disability services for a larger and larger swath of Americans mentally, psychologically, intellectually, socially, physically, and spiritually broken or disabled; financial, employment, education, housing assistance for an ever-growing population of humans who are not able to work and live and transport and find health care for themselves in this New Gilded Age.

The non-profits I have worked for are top-heavy, have very little money put aside or earmarked or grant-provided for the workers; many of the non-profits hire development associates, upper management shills, PR folk, marketing and events coordinators; many are in shining and remodeled digs while casting shadows on the street people they supposedly care about.
— Paul Haeder, “The Punditry of Shithole Thinking“, Dissident Voice, January 15th, 2018

In the 1950s came the development of the first psychiatric drug, the antipsychotic drug Chlorpromazine. This marked the beginning of what has come to be a mammoth and powerful industry in chemical warehousing of an unwanted population.

This industry was founded on a single ideology—the “mental illness” theory, or “medical model” (which I’ll refer to simply as the medical model)—an ideology that gave this industry
tremendous power and influence. The medical model essentially states that distressing states of mind can, for the most part, be categorized into discrete “mental illnesses,” and that although these mental illnesses continue to the present day to be rampant and even growing within our society, we must rest assured that the great medical advances of this industry have already developed powerful drugs that can generally contain them, and that it is just a matter of time before our medical technology will eliminate these illnesses altogether.

— Paris Williams, “Madness and the Family: Exploring the Links between Family Dynamics and Psychosis”

As Williams has pointed out, the very term mental illness is something of a self fulfilling prophecy. The profits from all psychotropic drugs is almost incalculable — Xanax (alprazolam), Zoloft (sertraline), Celexa (citalopram), Prozac (fluoxetine), Ativan (lorazepam), Desyrel (trazodone HCL), Lexapro (escitalopram). Exact numbers are hard to know but the best guess by the government itself is that over 35 million people took psychotropics between 2013 and 2014.

A common side effect of psychotropic medication is difficulty feeling certain emotions once the drug accumulates in a person’s system. For example, many people complain of losing the feelings they used to have, report a reduction in their ability to laugh or cry, or experience a decrease in libido. Side effects of SSRIs that might affect one’s sexuality and love relationships, such as diminished sexual interest, are discussed in a chapter from Evolutionary Cognitive Neuroscience.

GoodTherapy.org

Psychiatrists claim their drugs save lives, but according to their own studies, psychotropic drugs can double the risk of suicide. And long-term use has been proven to create a lifetime of physical and mental damage, a fact ignored by psychiatrists. Common and well-documented side effects of psychiatric drugs include mania, psychosis, hallucinations, depersonalization, suicidal ideation, heart attack, stroke and sudden death. Not only that, but The US Food and Drug Administration admits that probably one to ten percent of all the adverse drug effects are actually reported by patients or physicians.

— The Citizen’s Commission on Human Rights

It is no different in the U.K. The Council for Evidence Based Psychiatry states…

The latest prescription figures from the Health and Social Care Information Centre show that the UK is in the midst of a psychiatric drug epidemic. Over 57m prescriptions for antidepressants were issued in England in 2014, enough for one for every man, woman and child. This represents a 7.5% increase since 2013, and over 500% since 1992.

Now there is a kind of psychological blindness affecting Americans, today. A perhaps banal example, but still useful, is the popularity of American football. Since the incontrovertible proof that collisions on the field cause brain damage, acute irreversible damage, the sports popularity has actually increased. Never mind the jingoism attached to this sports-tainment empire, the fact that players are literally risking their lives and mental health to play is one thing, and there is an economic coercion involved, but how is it people want to watch this? Hollywood even made a film about the man who researched the phenomenon of Chronic Traumatic Encephalopathy (CTE). A very popular film starring Will Smith. But more and more people tune in each week. Nobody talks about it. Sitting on the couch, a slice in one hand, Bud light in the other, the question is, I’m guessing, never broached…’Hey bro, so, these guys, you think they’re aware their brains are turning to mush?’ But then the league is 70% black, so, for many it’s a kind of unconscious de-facto solution. Racism in America is indelible and deep. Even animal shelters acknowledge black dogs are harder to place than white. (This is a fact, not the Onion).

This blindness is the product of decades, now, of electronic media indoctrination. People even admit this, accept that it’s true. But they still remain habituated to their various screens. They still wear buttons saying ‘I voted’. They still become shrill and near hysterical at the idea YOU voted for a third party candidate, or worse, didn’t vote at all. How does that work? The presidency of Obama is revealing, both as it happened, and now as an object of near history. If you tell people Obama was the president who signed off on (and presumably helped design) the joint US/Saudi assault on Yemen, you will get denial or blank stares. If you say, well, ICE deported people under Obama, and at a record clip. You get denial. Or that Obama was notorious for persecuting whistle blowers and for narrowing press freedoms as much as possible. Denial. Blankness. Obama was the fulcrum for a very late onset of amnesia. Collectively speaking. He has taken the role of mental black hole. History began and stopped with Obama. (I actually think Michelle might run for President in 2020).

Americans collectively cannot grasp their own family relations. They are not sure, most of them I would wager, on even how to define *family*. But, the idea is past its sell by date I suspect. People are living alone, they have no choice. Often alone and on the street. A recent typhus outbreak on the mean streets of skid row Los Angeles suggests the U.S. is inching or hurtling toward 3rd world status.

This social morality, anchored in all individuals and reproducing itself permanently, has in this manner a reciprocal effect on the economic base in a conservative direction. The exploited person affirms the economic order which guarantees his exploitation; the sexually repressed person affirms even the sexual order which restricts his gratification and makes him ill, and he wards off any system that might correspond to his need. In this manner morality carries out its socio-economic assignment.
— Wilhelm Reich, Mass Psychology of Fascism, Farrar, Straus and Giroux; 3 edition (November 1, 1980)

The drastic increase in economic inequality has also generated the need for official explanations and justifications. I am reminded of Otto Fenichel, that most neglected of early psychoanalysts who complained in his 1938 book The Drive to Amass Wealth (and quoted by the worthy Russell Jacoby, whose own work Social Amnesia should be required reading today) of what he saw as Ferenczi’s psychologism:

The instincts represent the general tendency, while matters of money and the desire to become wealthy represent a specific form which the general tendency can assume only in the presence of certain definite social conditions.  The existence of the erogenous pleasure in collection causes Ferenczi to overlook the fact that when the capitalist strives to increase his capital he does this on very rational grounds: he is forced to it by competitors who produce on a larger scale …. A social system of this kind makes use of and strengthens erogenous drives that serve the necessity for accumulating. Of this there can be no doubt. There is considerable doubt, however, as to whether the existing economic conditions of production were created by the biological instinct.

At the end Fenichel suggested sometime in the future such conditions would no longer exist. And perhaps somewhere in the distant past they also did not. Capitalism is not inevitable nor is it some kind of natural law. It’s a fact that Google and Facebook censor socialist sites. Why would they do that if they were not afraid? The authority structure, the proprietor class, they want you asleep. That’s the idea.

We are at the tail end of a kind of Ayn Randian period of simplistic one dimensional and crude capitalist cheerleading — and it began in its current form under Reagan. He of the happy childhood. The president who no doubt suffered from Alzheimers even BEFORE he became the commander in chief. And this has led to the marketing industry to double down on certain tropes of American happiness. We are still within a Norman Rockwell cocoon in terms of propaganda. Each holiday season Hollywood churns out one after another fairy tale of the American family — Thanksgiving fables or Christmas. Oh heck, families can be complex, but gull darn it, we always overcome and celebrate together. But a fairy tale is all it is. And a pernicious one. Most families I know struggle through the Holidays, buffeted by guilt and resentment. And depression. It is the cruelest season.

Anti-depressants, and all those millions and millions of prescriptions written in the U.S. and U.K. may (!) alleviate symptoms in some or even many patients, but even at their most effective (and I reserve acceptance they actually do any real good for anyone) they do nothing to change the conditions that created this depression. When mass shooters appear, especially white ones, they are *mentally ill*. If non-white they are likely terrorists. The system is not indicted either way. Only the victims of that system. The U.S. is a remarkably unwell place and it has created a political system that rewards the most pathological people in this unwell place. Donald Trump is the perfect man to be President of this asylum. He is ignorant, and proud of it, a narcissist and pathological liar. A racist and misogynist. He often seems he to be made up of the worst qualities of his predecessors. Bush, Clinton and Obama were all in various ways pathological. But who is President really is not the point. The point is class hierarchies. Until Americans learn to talk politics in terms of class, nothing will change.

The U.S. is reaching an economic/social singularity; there are no jobs, there is no health care, and no education. There is a throughly debased culture and much of the country is in the hands of Evangelical Christians. And Evangelicals, especially Dominionists like Pence and Pompeo and Kudlow and DeVos would have, in an earlier time, been shipped off by their family to some discreet asylum or hospital. We are sort of living a Marat/Sade nightmare. The American fairy tale isn’t working anymore. People may cling to its remnants but at their most lucid I suspect most people know it’s all bullshit. The cultural landscape is so depressing most can only intermittently engage with it. The ruling elite are further distanced from the rest of the populace. The educated liberal bourgeoisie is in crises. All the myriad identity-based systems of belief are less and less convincing. The violence of the military complex finds expression domestically in a militarized sadistic and racist police apparatus. A nation where mass shootings are now routine is a kind of movable hell. Mass incarceration is growing still. It is my experience that people can no longer easily read facial expressions or hear the pitch or intonation of speech — they mimic autistic symptoms in fact. And sociopathy is everywhere. From the wholesale killing of wildlife, to bald faced lies about food ingredients, contaminants in factory farmed meats. But drinking water might be the worst. Across the rust belt and through the southwest, mostly from abandoned mining sites. In Arizona, New Mexico, Oklahoma and on across to Georgia. Detergents, solvents, pesticides, and things such as vinyl chloride and PCEs, paint sludge and boron. A recent report detailed by the Center for Public Integrity noted….

Across the country, in Albany, Georgia, three separate areas of groundwater are polluted with cyanide and chloroform from various industries. One of the contaminated areas came from a landfill on the Marine Corps’ Logistics Base. The U.S. Navy has taken responsibility for the base and is providing residents in the majority African-American town with an alternative water supply due to the health risks associated with the pollution. Politicians and researchers say industrial sites are more likely to be located near low-income and minority communities.’More heavily polluting industries were located near communities of color or minority communities or poor communities because they didn’t have the political clout to fight back.

The EPA estimates, now, that since 1987, various industries have dumped about 600 million pounds of toxic substances, including ammonia and nitrates into the Ohio river. Six hundred MILLION pounds of poisonous crap into the once pristine Ohio River. Cue Doc Watson singing On the Banks of the Ohio.

No, don’t.

In 2015, the top 1% of Americans made almost thirty times as much income as the bottom 99 percent — an increase from 2013, when they earned twenty five times as much. This from the Economic Policy Institute in DC. There is a racial divide, too. The billionaires who make up the Forbes 400 list of richest Americans now have as much wealth as ALL African-American households, plus one-third of America’s Latino population, combined. In other words, just 400 extremely wealthy individuals have as much wealth as 16 million African-American households and 5 million Latino households. (from Forbes own statistics)

That is America today. And everyone knows it. But they can’t say it. They can’t look at it soberly and honestly. It is too much to bear.

And America is exporting its misery at an accelerated clip. The far right fascist sensibility is growing across Europe. There are few NATO countries without a powerful fascist party participating in government, and in several places — Hungary, Italy, Poland, they ARE the government. And now Brazil. One might think the recent summer of apocalyptic fires in the U.S. would be a wake up call, but it’s not. The horror cannot be faced by most. Lying, family or household dysfunction, and chemical numbing are the ground floor reality today. When the ruling class own everything, people must find ways to cope. Once you have mastered lying to yourself, lying to others is easy.

I almost do not exist now and I know it; God knows what lives in me in place of me.
— Fyodor Dostoevsky, The Idiot, 1868–1869; separate edition 1874

Capitalism Is Killing Patients… And Their Physicians

Photo Greanville Post

Physician burnout, depression, and suicide increasingly invade discussions within the medical field. Depression and suicide are more common among male and female physicians, with suicide rates 1.41 and 2.27 times greater than that of the general male and female populations, respectively. Though, the insults to the mental health of physicians begins much earlier in their career.

While the numbers may vary from study to study, some 28 percent of medical residents experience a major depressive episode during their training compared to 6 to 8 percent of the general population. These numbers are important, not only because suffering physicians are suffering humans in their own right, but also because this epidemic leads to poor patient care.

As a recent study out of the Stanford School of Medicine suggests, burnout and depression in physicians can lead to medical error and death. Many have tried to explain the causes of the epidemic, referencing everything from unmanageable workloads and work inefficiency, to lack of meaning in work and lack of work-life balance. Films are now being produced to shine light on the issue. In her TED talk “Why Doctors Kill Themselves,” Pamela Wible points to a medical school culture of hazing and bullying that continues into residency, along with a professional culture that hinders physicians from obtaining mental health treatment.

These factors certainly contribute to the epidemic, but when discussing physician suicide, we ignore the elephant in the room: capitalism. We are unable to recognize how the exploitation and alienation of physicians is integrally connected to this dominant economic system, but nothing could be more poignant, given in the state of the world today.

Ironically, the same destructive system that is driving physicians to extremes is also the main driver of the deterioration of health of the patients and populations, requiring patients to see physicians in the first place. The sooner we realize and confront our own exploitation, the sooner we can join in the fight to address the real driver of disease that is plaguing physicians and patients.

The System Outlined

Busy physicians may not have time to study how the world’s prevailing economic system functions, but doing so could benefit both our profession and the patients with whom we work. To briefly discuss, inside this system the working class that does not own the means of production is forced to sell its labor to an employer to survive.

A few corporations control most of the market for each of the commodities they produce. In these corporations, a very small sector of a board of directors and majority shareholders makes essentially all of the decisions on what to produce, where to produce and how to distribute profits. This puts the working class in a vulnerable position.  With the ultimate goal of profit maximization, decisions are often made by the corporate class which are not in the best interest of workers and negatively affect the health of entire communities.

Outsourcing work, closing factories, creating poor working conditions to cut costs, polluting waterways and the environment–decision after decision may initially increase profits, but in the long term harms health. This harm to health can be more obvious, as when air and water are polluted, or more subtle, for example, when families are put under chronic stress–which eventually leads to various forms of illness– from poor workplace conditions or income insecurity secondary to factory closure and outsourcing.

In this system, certain “costs”–the health of families, and entire communities being destroyed–are “externalized.” This means the business itself does not pay for these costs of poor societal health, which are created secondary to decisions made by business executives to increase profits. Such decisions are made by a small number of wealthy, powerful individuals pursuing their interests for greater wealth and power accumulation at expense of all else.

As economists such as Thomas Piketty have shown by combing through economic records from as far back as the 18th century, capitalism inherently generates inequality, concentrating wealth into the hands of the few at expense of everyone else. Study after study shows us that socioeconomic inequality itself is detrimental to patient health and actually increases morbidity and mortality.

Despite the negative effects, the working class today is more productive than ever, while wages remain flat (or are sometimes even lower) and work hours continue to increase. Workers struggle to put food on the table and meet basic needs, while the ownership class continues to become richer. Workers are exploited and reduced to tools for industry, many times forced to do mundane tasks or assignments over and over. They are alienated, or separated from the control and the product of their labor, each day they go to work. Inside this system workers are ultimately reduced to mechanistic cogs producing profit for large corporations.

This combination of being overworked and lacking true meaning and fulfillment in the work being done, drives more and more throughout both the white and blue collar sectors into despair. As Johan Hari, shows in his recent work Lost Connections: Uncovering the Real Causes of Depression and Unexpected Solutions, workers become separated from loved ones and from things that bring them joy as they work multiple jobs for longer hours as they struggle to make ends meet.

This constant stress leads to anxiety, depression, and various other forms of disease. Meanwhile, all medicine has to offer for them are at best poor attempts–many times with questionable supporting data demonstrating efficacy– to numb the pain that much larger systemic structures continue to create.

Unfortunately, the corporate elite know no limits in this system. They continue to exploit the masses and drive more and more into poverty and desperation while concentrating wealth in ever fewer hands. In America today, the three wealthiest individuals own the same wealth as the entire bottom half of the population, more than 160 million individuals. In order to maintain this system, the elite must ensure that the members of the working class fight amongst themselves rather than direct their rage toward those who are benefiting off of the oppression of the masses.

The capitalist system, born from racism and white supremacy as highlighted in studies such as Edward Baptist’s The Half That Has Never Been Told: Slavery and the Making of American Capitalism, continues to separate members of the working class based on social constructs such as race. At the same time, through a multitude of mechanisms, the system creates a self-loathing, insecure public, driven to constant consumption, leading to the pollution of the earth and poisoning of community after community.

These various forms of structural violence are the true drivers of disease and suffering, of which the health care system sees the results, but has little to no ability to truly address. The health of the majority of the population deteriorates and the elites benefit. Capitalism’s need to endlessly expand and its effect on the earth, has literally lead some scientists to call for the designation of a new geologic era called the anthropocene to describe the effect humans have had on the earth.

Scientists now warn we have moved into the sixth great mass extinction of species seen in our world’s history. A new report by the World Wildlife Fund (WWF) suggests, “Humanity has wiped out 60% of mammals, birds, fish and reptiles since 1970, leading the world’s foremost experts to warn that the annihilation of wildlife is now an emergency that threatens civilisation.” Meanwhile, a new U.N. Intergovernmental Panel on Climate Change (IPCC) report warns us that humanity has only a dozen years to address global warming to avoid increasing droughts, floods, etc., which will inevitably lead to more poverty and illness.

Capitalism does not just threaten the health and well being of every human, but life on this earth as we know it. Capitalism operates as a terminal cancer, knowing no limits to its endless growth and consumption, destroying systems necessary to survival and threatening the continued existence of its host.

Medicine Has Not Escaped

What is outlined above are the underlying causes of the majority of disease and suffering. The prevailing economic system in the world today commodifies every aspect of life including health care. As a result, the health of the public, especially the US public, is subjected to a barrage of market mechanisms.

US medical professionals, while often paid more than the typical member of the working class, are still forced to operate inside of this system that places profits above patient health. We see how this system harms our patients, limiting availability of the care they need, but we tend to miss that we also are damaged by this same system.

As Howard Waitzkin and the “Working Group on Health Beyond Capitalism” state in the book, Health Care Under the Knife: Moving Beyond Capitalism for Our Health,” until the 1980s, doctors, for the most part, owned and/or controlled their means of production and conditions of practice.” This allowed them to have control over things such as their work hours and how much time to spend with patients. As the Working Group references, “loss of control over the conditions of work has caused much unhappiness and burnout in the profession”.

As other members of the proletariat, or working class, have experienced for years, doctors now no longer have control over their labor. Now corporations or other large institutions control such decisions. Physicians have become “proletarianized” and while not members of the traditional working class, they have become tools in the corporate wheel of profit production. This has left us with a health system parasitized by the capitalism that cares more about profit production than it does the care of human beings.

The medical industrial complex, made of a multitude of different institutions–hospital corporations, large insurance companies, or pharmaceutical and device corporations and, more specifically the corporate elite who control these corporations–ultimately governs a majority of the large scale, structural decisions that affect patient care. The elite in these institutions, just like other capitalist organizations, make decisions that affect the lives of the majority with little to no input from those who are affected by these decisions.

They govern the prices of drugs–often leading to the obscene drug prices–and how long a physician should be spending with his or her patients in the clinic. These organizations have the primary goal of maximizing profit (regardless of whether they bear the title of “for profit” or “non-profit”) above all else. Consequently, patient health really becomes secondary in this system.

The metastasis of capitalism’s perverse incentives to even the sector that claims to care for the health of human beings, has given us the ineffective, damaging system we have today. Since profit production is of prime importance, physicians–and really health care providers in general–must be trained to be efficient tools for profit, seeing more patients more quickly, knowing how to bill appropriately, etc.

These incentives limit a physician’s ability to do what he or she actually went into medicine (or should have) for: to help people. Physicians want to help their patients, but are simply not able to truly address patient suffering because addressing the causes, as highlighted above, are outside the scope of a profit based medical system.

To understand how exactly this system creates human tools for health care profit while in the process leaving them physically and mentally broken, we must delve into the medical education and training structure and analyze how medical providers are conditioned to accept their own exploitation.

Training in the Art of Being Exploited

Step 1: Medical School

Medical trainees in the US enter medical school at least generally claiming they have some interest in caring for other human beings. Unfortunately, little do they know they are entering a system designed to prime them for their own exploitation from the second their training begins—one could argue even well before that point–and subsequently throughout their residency training.

During medical school, students are forced to study innumerable hours while being told they have to “lay a good foundation” of knowledge for their future practice. The first 2 years in most medical schools are classroom based, where insurmountable amounts of information are thrown at students as they are told “this is just the way medicine is, get used to it.”

Unfortunately though, much of the information students spend their time studying–or more often mindlessly memorizing–will never be used when caring for patients. This information is absorbed, regurgitated on an exam, and then often forgotten. One thing students do begin to learn–if they hadn’t already through their undergraduate education or their grade school education prior–is to listen to authority figures’ demands if they would like to succeed.

Students have little influence on what they are being taught. Instead, they must accept what they are being told or they may not pass their next exam. Students who entered medicine eager and idealistic, hoping to help others, begin to slowly withdraw from their individual passions and interests simply because tests, rotation evaluations determined by the opinions of supervising providers students must impress, and board exams are deemed more important. They are taught that listening to authority figures at the expense of their own interests and passions, comes first and then they can try to pursue their interests if they have time. This obviously can affect the mood and morale of a training physician.

During their third year, medical students are forced to spend numerous hours in the hospital. They are also required to take “shelf exams” at the end of each rotation, which can often have a large impact on their overall rotation grade. Because slight differences in grades can affect residency opportunities, students spend free-time studying for these exams instead of participating in activities to maintain their own mental and physical well being. While the exam scores offer little insight into the type of a physician the student will become, they serve to add extra pressure on students and ensure that they spend little time actually thinking for themselves while they are out of the hospital.

During fourth year many students are expected to complete sub-internships in the fields they are are interested in going into for residency training. These sub-internships normally require students to work near their 80 hour work limit, congruous to work limits of residents (more on that shortly). Medical students often carry their own patient panels, write notes that can be co-signed, and can even pend medication orders to be approved. The main difference between them and an actual paid intern is that they do not get paid. Instead they must work to “impress” their superiors in hopes of obtaining a positive evaluation. Once again, students are taught that listening to and striving to impress authority is their ultimate goal.

After four years of indoctrination, in addition to a medical degree, most medical students are given one final parting gift on their way into residency: hundreds of thousands of dollars of debt. This debt serves as a convenient way of pushing newly minted doctors into financial constriction when entering their residency.

No matter how they view their new employer or the field they have chosen, they know that they now have hundreds of thousands of dollars that they must find some way to pay back. This makes them much less likely to question or challenge authority in their new positions because doing so could impede completion of their training, sabotaging their career and only chance to escape debt. Along, with the inherent emotional stress of caring for sick patients, these financial difficulties can lead to depression, anxiety and a host of mental health issues in the newly minted physician.

Step 2: Residency

Once medical school graduates enter residency, they have already been primed for their inevitable exploitation, understanding that they need to take direction from authority, curtail their passions to make them more palatable to superiors, and most importantly, suppress any depression or anxiety they feel secondary to an ineffective, exploitative system. They now have few options–or are at least told so–other than to continue through residency. They know that to find themselves at this stage, they have made significant financial and emotional sacrifices, often losing connection with the people and things they love in order to fulfill education requirements.

Unfortunately, the exploitation of these newly minted doctors is just beginning.  During training, residents are forced to work often 80 hours per week doing a large portion of the patient care in hospitals (not to mention the additional hours of preparation outside of hospital or clinic, which are not counted toward this 80 hour limit). Residents are salaried, so they provide a cheap, efficient source of labor for hospitals and clinics. Residents become physically and emotionally exhausted trying to care for maxed out patient loads effectively in understaffed hospitals. Work hours become normalized over time and residents simply expect to be working an unhealthy amount of time in the hospital or at least convince themselves that it is normal to maintain their own sanity. It is no wonder this situation plunges many, who are already at risk, into burnout and depression.

Throughout residency, residents do, admittedly, grow exponentially in their ability to care for patients and become independently functioning physicians. Though, there is another type of growth that occurs during these years, which is seldom discussed.

Residents are groomed to be efficient, effective profit producers once they enter the workforce. For example, over their time in residency, a large degree of emphasis is placed on residents meeting particular “quality measures” for the clinic or hospital settings. Training after training is spent ensuring residents understand how to properly bill and submit insurance claims. Residents learn how to see patients extremely quickly and complete entire patient visits within 15 minutes. As anyone who has even interacted with a health care provider can attest, this is not enough time to actually make any significant interpersonal connection with a patient.

Either during this visit or after, residents must also learn to input information into whichever electronic medical record their training center uses. As Matt Anderson notes in Health Care Under the Knife commenting on EMRs, “most were designed to capture billing and quality information, not facilitate clinical care.” Residents end up spending more time looking at a computer than they do connecting with a patient. In the inpatient setting, a hospitalized patient might only see their doctor for a few minutes each day. This is partially because the rest of the day is spent documenting a coordinating care inside of a completely nonsensical system to ensure hospitals will be able to cash in on patient hospital stays.

This puts individuals, who went into medicine to care for and make connections with patients, torn between still trying to achieve this goal and meeting designated “quality measures.” If they are not able to see patients fast enough in the clinic or inpatient hospital setting they may not be seen as “marketable” to employers. This is clearly an environment that can breed physical, mental, and emotional suffering in the exploited trainee.

Even while studies have shown these grueling hours put both patients and residents at risk, when it comes to actually addressing the problems highlighted above, the onus is consistently put on the provider to maintain “self care.” From the beginning of residency, different “mental health departments” speak with residents about the importance of maintaining self care and “balance,” while at the same time maintaining an exploitative system that overworks its employees and drives suffering. Residents are a cheap form of labor for hospitals or clinics, and actually addressing this problem at a systemic level would be too threatening to the profitable status quo.

How the system’s leaders speak about these work conditions is very telling. For example, in 2016 Dr. Janice Orlowski, the Chief Health Care Officer with the Association of American Medical Colleges (AAMC), stated:

The individual is going to go into a profession where their profession calls on them to work extended hours and to be available at unusual hours […] We need to train individuals who can learn to pace themselves, who can recognize when they have sleep deprivation or when they are stressed.

This is an interesting statement, coming from someone who should know the demands put on residents drastically limits their capacity to “pace themselves.” It is clear that there is much more concern for protecting a public image of medicine and hospital programs than there is for addressing the crisis of physician depression and suicide.

Step 3: Practicing Physicians

Finally, if not already burned out, the physician has escaped residency and now believes that he or she will be able to practice “however one wants.” Unfortunately, any overburdened physician–either fresh out of residency or seasoned–who has worked inside a busy hospital or clinic, can attest to feeling tired, overworked, and often unfulfilled, in part due to their lack of patient connection as they are rushed from patient to patient and progress note to progress note.

Again, citing Matt Anderson in the Health Care Under the Knife’s section “Becoming Employees: The Deprofessionalization and Emerging Social Class Position of Health Professionals,” concepts typically lauded again and again in the health sector–”value, efficiency, quality, and market discipline–are part of an ideology to justify corporate control over the work of physicians and other works providing health services.” He references Marx’s concept of alienation–the separation of worker’s control over his or her labor– and describes how more and more health care providers are separated from what they once truly loved about their work, and now must fill the primary role of profit producer and secondary role of health care provider. If this separation did not occur during residency, there is a good chance it will when outside of training working for an employer.

While practicing, providers are still attempting to treat patients who present with illnesses created by the much larger system of capitalist exploitation referenced above, but their training prior to starting independent practice in no way, shape, or form has actually prepared them to join the communities they serve in combating these larger oppressive systems. On the contrary, what they were taught was to keep their head down, survive, and make it through exploitative residency programs. They are in regular practice and know how to put in a billing code and attempt the near impossible task of making a true connection with someone in a 15 minute clinic visit, but have not remotely learned how to begin to resist a parasitic capitalist system damaging both their colleagues and their patients.

At the same time, even if a physician did want to step outside of traditional boundaries to help challenge the true socioeconomic and structural causes of disease highlighted above, the provider still has a massive amount of student loans constricting their decisions. They may also have started a family or accumulated other financial constraints during residency. This leaves them with few options and many find it easier to get back in the clinic, put their heads down, and tell themselves they are really helping to address patient health. When in reality, they have been indoctrinated into a system based on profit maximization and blunting of patient suffering at best.

This endless process of day after day in clinic, seeing little to no progress at a systemic level, can become frustrating and make one’s work seem futile. Imagine spending over 10 years in training–from college, through medical school, through residency–to find yourself in this position. It is no surprise that more and more physicians are burning out, and feeling so desperate, that harming oneself becomes a viable option to escape.

Recognizing One’s Exploitation and Fighting Back

Capitalism’s parasitic economic structure has infiltrated all aspects of our society, and medicine has not been spared. This results in physicians being trained and conditioned to be obedient profit producers above all else. It leads them to be alienated from their loved ones and from their true passions. Inside our healthcare system, physicians are separated from the things that truly brought them joy and fulfillment. Yet we still continue to question why physicians are killing themselves?

Some maintain hope that there will be action around these issues from residency administrations, hospital working groups, or any number of hierarchical bodies that govern medical education, graduate medical education, or our healthcare system in general. The reality is that these issues will never be solved by any large committees or “task forces” we currently have in place, which continually put the onus onto medical students, residents, and practicing physicians to develop more “resilience” inside of a system that is built to do the exact opposite.

Those who have made it to the top positions of organizations such as the Accreditation Council for Graduate Medical Education (ACGME) or the Association of American Medical Colleges (AAMC) are there because they will continue to support the status quo. As political dissident and linguist Noam Chomsky discusses in reference to elite control of institutions, “an unstated but crucial premise is that the ‘responsible men’ achieve that exalted status by their service to authentic power, a fact of life that they will discover soon enough if they try to pursue an independent path.” These institutions will never consider the best interests of physicians or the patients they serve. Their leaders have been groomed to support the status quo. It is up to us to realize our exploitation and begin to fight against it.

Realizing this fact is easier said than done, as most physicians, due to the filtering mechanisms throughout our educational system, which typically lead to those from the upper classes securing seats in medical school, come from the exploitive classes themselves. Physicians are also paid more than a majority of other employees within our healthcare system such as nurses, technicians etc. They are conditioned to believe that they are somehow different or more important than the rest of the working staff when in reality all members are important in caring for the patient and all members are overworked and exploited by the same system.

Giving one member of an exploited group–in this case the physician–more benefits than others, helps to keep the fighting going between all groups as opposed to collaboration and organizing. We will be able to begin addressing the crisis of physician suicide once we, as physicians, accept that just as this capitalist system exploits our patients and coworkers, it is also exploiting us. And then we organize against it.

Whether it is consciously recognized or not, physicians specifically are also often boosted up with a false sense of elitism from the second they step into the field. This creates a blind spot for them being able to recognize their own suffering and exploitation and organize against it. They are given special white coats, which–besides becoming completely filthy after 80 hour work weeks–distinguish them from other hospital staff and distinguish themselves by the title of “doctor.”

While other staff members, such as nurses, actually have the collectivist mindset to organize against the damage the health care industrial complex causes to the patients they care for and even strike when necessary, physicians–especially those in the US–have been conditioned to believe they are too important to the system to do the same, even while that system is actively damaging them. Their administrators and peers say, “If we aren’t caring for patients, our patients will die.”

Those with a vested interest in maintaining the business as usual hold patients as hostages inside this system, guilting providers into accepting the status quo (inadequate care, inadequate access to care, medical errors, and crushing debt) with this rhetoric. It is despite the fact that physicians around the world have been able to organize and strike effectively while also continuing to provide absolutely necessary care.

Referencing Mark Ames’s 2005 book, Going Postal: Rage, Murder, and Rebellion: From Reagan’s Workplaces to Clinton’s Columbine and Beyond is useful for understanding this current phenomenon. In the book, Ames evaluates the mental anguish caused by Reagan era policies and analyzes how our capitalist system degrades and humiliates workers until they are pushed to harm themselves and others. In the following passage he speaks of how people can often deny their own exploitation until it is too late. He notes:

The middle class persistently denies its own unique pathos, irrationally clinging to an irrational way of measuring it, perhaps because if they did validate their own pain and injustice, it would be too unsettling–it would throw the entire world order into doubt. It is more comforting to believe they aren’t really suffering, to allocate all official pathos to the misery of other socioeconomic groups, and its more comforting to accuse those who disagree of being psychologically weak whiners. Despite its several hundred million strong demographic, the white bourgeoisie’s pain doesn’t officially count–it is too ashamed of itself to sympathize with its own suffering.

Until physicians are willing to accept the fact they they are being exploited by the same system that harms their patients, there will be no progress made in addressing physician depression and suicide. At that same time, until health care providers generally accept that it is our current capitalist system which puts profit production above the well being of every living thing on this planet–including themselves–we will not be able to effectively address true social and structural causes of disease and suffering.

Capitalism exploits, damages, and destroys us all. History shows us, large scale systemic change has never come from the beneficence of those in power and, frankly, it never will. As historian Howard Zinn writes speaking about public activism, the rights of the citizenry only come when “citizens organize, protest, demonstrate, strike, boycott, rebel, and violate the law in order to uphold justice.”

As physicians, if we truly care about the well being of our coworkers and of our patients, we must begin to organize, unionize, and rebel inside our practices, residency programs, etc, resisting business as usual, and finding ways to threaten the profits of capitalists if we want to see systemic change. We must begin to organize with communities and populations resisting oppression from a parasitic capitalist system as physicians in the past have done with groups such as the Black Panthers and Young Lords.

Once physicians can begin to view the dynamics of our capitalist system more clearly–and view the dynamics of our healthcare system as just one microcosm of how capitalism harms us all–it will become clear what needs to be done. We must put down our fancy white coats and begin to organize with our fellow healthcare staff–and, more importantly, with our patients–against a system that exploits and damages us all. Only then will we be able to begin developing a new system that actually cares about both people and the planet.

• First published in Popular Resistance

Evacuating Nauru: Médecins Sans Frontières and Australia’s Refugee Dilemma

It is an organisation not without its problems. Conceived in the heat of idealism, and promoted as the vanguard of medical rescue and human rights advocacy, Médecins Sans Frontières has had its faults.  Its co-founder Bernard Kouchner went a bit awry when he turned such advocacy into full blown interventionism.  As Nicolas Sarkozy’s foreign minister, his conversion to politicised interventionism in places of crisis went full circle.  He notably split from MSF to create Doctors of the World, where he felt imbued by the spirit of droit d’ingerence, subsequently given the gloss of “humanitarian intervention”. With its mischief making properties, such interventions have manifested, usually in the guise of wealthy Western states, from the Balkans to Africa.

MSF, at least in its operating protocols, is meant to be solidly neutral and diligently impartial.  But neutrality tends to be compromised before the spectacle of suffering.  Bearing witness disturbs the mood and narrows objective distance.  On June 17, 2016, by way of example, the organisation stated that it could not “accept funding from the EU or the Member States while at the same time treating the victims of their policies! It’s that simple.”  Central to this, as Katharine Weatherhead explained in an analysis of the organisation’s stance, is the “ethic of refusal” and témoignage, “the idea of being a witness to suffering.”

Australia’s gulag mimicry – a prison first, justice second mentality that governs boat arrivals – has done wonders to challenge any stance of distance humanitarian organisations might purport to have.  To see the suffering such policies cause is to make converts of the stony hearted.  What matters in this instance – the MSF condemnation of Australia’s innately brutal anti-refugee policy on Nauru – is its certitude.

The Australian government has taken the high, icy road and left the UN Refugee Convention in shambolic ruin; it insists, repeatedly, that refugees are to be discriminated against on the basis of how they arrive to the country; it also suggests, with a hypnotically disabling insistence that keeping people in open air prisons indefinitely is far better than letting them drown.  (We, the message goes, stopped the boats and saved lives!)

MSF, which had been working on the island since November 2017 primarily providing free psychological and psychiatric services, was given its marching orders by Nauru’s authorities last week.  Visas for the organisation’s workers were cancelled “to make it clear there was no intention of inviting us back,” explained MSF Australia director Paul McPhun.

A disagreement about what MSF was charged with doing developed.  The original memorandum of understanding with the Nauru government tends to put cold water on the suggestion by Australia’s Home Affairs Minister that MSF had not been involved in supplying medical services to the detainees on the island.  In dull wording, the agreement stated who the intended recipients of the project would be: “People suffering from various mental health issues, from moderate to severe, members of the various communities living in the Republic of Nauru, including Nauruan residents, expatriates, asylum seekers and refugees with no discrimination.”

It was obvious that the revelations would eventually become too much for either the authorities of Australia or Nauru to tolerate.  Having been entrusted with the task of healing the wounds of the mind, MSF’s brief was withdrawn after the organisation’s findings on the state of mental health of those in detention. “Five years of indefinite limbo has led to a radical deterioration of their medical health and wellbeing,” claimed McPhun in stark fashion to reporters in Sydney on Thursday.  “Separating families, holding men, women and children on a remote island indefinitely with no hope of protection except in the case of a medical emergency, is cruel and inhumane.”

Undertaking a journey from war torn environs and famine stricken lands might well inflict its own elements of emotional distortion and disturbance, but Australia’s policy of keeping people isolated, distant and grounded took it further.  It was penal vindictiveness, a form of needless brutal application.

In McPhun’s sharp assessment, “While many asylum seekers and refugees on Nauru experienced trauma in their countries of origin or during their journey, it is the Australian government’s policy of indefinite offshore detention that has destroyed their resilience, shattered all hope, and ultimately impacted their mental health.”

The organisation has made it clear that Canberra’s insistence that “offshore detention” remains somehow humanitarian is barely credible, there being “nothing humanitarian saving people from the sea only to leave them in an open air prison on Nauru.”

Such a cruel joke has turned the members of MSF into a decidedly militant outfit.  “Over the past 11 months on Nauru,” states psychiatrist Beth O’Connor, “I have seen an alarming number of suicide attempts and incidents of self-harm among the refugee and asylum seeker men, women and children we treat.”  Particularly shocking were the number of children enduring the effects of traumatic withdrawal syndrome “where their status deteriorated to the extent they were unable to eat, drink, or even to walk to the toilet.”

With such observations, there is little surprise that Nauru’s government, which was evidently seeking to find an ally and an alibi, felt slighted.  The doctors had to go.  “Although MSF claimed to be a partner to Nauru and the Nauruan people instead of working with us,” came the government justification, “they conspired against us.”  The government was no longer inclined “to accept the concocted lies told about us purely to advance political agendas.”

What the government statement also insisted upon was the comparative advantage the hosted refugees and asylum seekers had.  They had their own tissue of mendacity to proffer.  “The facilities, care, welfare and homely environment offered to refugees and asylum seekers are comparable or better than what other refugees and asylum seekers across the globe receive.”  For that to make any sense, a comparative study on suicides, psychological corrosion and trauma would have to be done across the world’s refugee camps.  In those terms, Nauru’s performance, aided and abetted by their Australian sponsors, has been ghoulishly stellar.

Alcohol: Why do we drink?

I had known John for 40 years on and off; just over a year ago he died. He was 62 and homeless, an alcoholic who over the course of four years or so had drunk himself to death. He died alone in a tiny basement room of a dreary hostel in London, where the local authority had placed him. A cocktail of alcohol and anti-depressants took him through the gates of death. It was a tragic, ugly end to a life that had once held such promise.

Along with millions of others around the world, John drank to escape the pain of his life; the emotional agony of living was unbearable and, desperate for relief, he turned to alcohol. Habit quickly became addiction, and addicts, as those who have known one will testify, are desperately difficult to help. Behavior changes, moral boundaries dissolve, self-respect and honesty are eroded, relationships destroyed.

Startling statistics

Like recreational drugs, alcohol fuels a range of social ills, including crime, depression, anxiety and suicide. It can cause long-term health conditions, many of which are fatal, and in 2016 (latest figures) “led to 2·8 million deaths and was the leading risk factor for premature death and disability among people aged 15–49 years,” according to a new report published in the Lancet magazine. This is consistent with figures collated by the World Health Organization (WHO), which show that in 2012 alcohol was responsible “for 5.9% [around 3 million] of all deaths and 5.1% of the global burden of disease and injury.” This is far more than the percentage of deaths from HIV/Aids (2.8%), tuberculosis (1.7%) or violence (0.9%).

In addition to the individual drinker, alcohol consumption leads to a range of harmful consequences for “the drinker’s immediate environment and society as a whole.” The drinker’s family, partner or friends are often the first to be affected. Relationships sometimes break down, and abuse, leading in some cases to domestic violence, which is often inflicted by an alcoholic partner, can erupt.

Violent crimes of all kinds are closely linked to alcohol consumption. In America half of all homicides and 40% of all other violent crimes (including rape, assault, child and spousal abuse), are committed when the offender, victim, or both have been drinking. The National Council on Alcohol and Drug Dependency reports that, “according to the Department of Justice, 37% of almost 2 million convicted offenders currently in jail, state that they were drinking at the time of their arrest.”

These are startling statistics, and are more or less representative of levels of alcohol-related crime throughout industrialized countries. In Britain, where overall consumption has fallen by around 18% in the last 14 years, the Office of National Statistics relates that in 2013/14 “70% of violent incidents which took place in a public space were alcohol-related” and that, “70% of violent incidents occurring at the weekend, and 70% of violent incidents occurring in the evening or night, were alcohol-related.” A 2012 government paper stated that, “alcohol is one of the three biggest lifestyle risk factors for disease and death in the United Kingdom after smoking and obesity. It has become acceptable to use alcohol for stress relief, putting many people at real risk of chronic diseases. Society is paying the costs – alcohol-related harm is now estimated to cost society £21 billion annually.”

The richer a society is the more people drink, the greater the quantity consumed and the smaller the “number of abstainers.” And whilst, as the UK shows, there are exceptions, the worldwide tendency is towards increased levels of consumption, with China and India, where the economy has been growing in recent years, energetically joining the party. A trend that WHO believes to be “linked to active marketing by the alcohol industry and increased income in these countries.”

Why drink?

 There are, of course, varying levels of alcohol consumption and many types of drinker, but why do people drink at all and why do governments allow alcohol to be commercially sold and energetically promoted?

Like many problems of contemporary life the reasons are complex, interconnected and woven into the worldwide mode of living, the values it promotes and the conditioned social behavior produced. Individual success, competition and conformity to a certain lifestyle are some of the prominent ideological characteristics of the time; all are divisive in varying degrees and contribute to an atmosphere of anxiety. Like John, large numbers of people cannot cope with the stress and drink to escape, they find life overwhelming, and suffocating under the weight of expectation and self-doubt, loneliness and despair, use alcohol to soften the agony. Widely available and inexpensive, it offers immediate relief, but whilst a drink or two may initially quieten the nervous system the effects soon wear off, appetite grows, dependency develops, and, alcohol being both addictive and a depressant, adds to the suffering and quickly becomes part of the problem.

Young people (under 25), who in many parts of the developed world drink less than their predecessors, may drink out of curiosity, because it’s available and (in supermarkets) comparatively cheap, and to belong to the group, to conform to the image of what it means to be a strong young man, or an open, exciting woman. A few drinks may loosen inhibitions, facilitating a fun night out. In some countries, France Italy, Spain; e.g., alcohol is part of the culture, usually taken with food; in others, like India, it is a new phenomenon, and, consistent with a range of unhealthy western imports, is regarded as an unwelcome development by many Indians. With national economic growth (such as has occurred in India) as well as personal success, typically come increased levels of alcohol consumption as well as other types of indulgence.

Happiness, not Pleasure

Like all types of consumerism, at the heart of alcohol use sits desire, the desire to escape unhappiness and to be happy, and the desire for comfort, for freedom from distress. This desire is promoted by a distorted understanding of life that identifies the self with the body and the constructs of thought, and proclaims the principle purpose of life to be maximizing pleasure and avoiding (psychological) pain. This notion is rooted in a materialistic approach to life that focuses on the form, the body, instead of investigating into the nature of one’s being. Within such a reductive paradigm, happiness has been replaced by pleasure, love exchanged for desire, and freedom for choice. The result is fragmentation and conflict, individually and collectively.

The emphasis on pleasure maintains the desire for stimulation and consumption of all kinds. Pleasurable experiences flowing through the senses may well provide distraction and a momentary sense of happiness, or fleeting relief from unhappiness; however, far from filling the inner void, it reinforces it, leaving the person wanting more. Pleasure is external, hollow and transient; what we might call ‘true’ happiness is permanent, it is part of who and what we are. As the great Indian sage Raman Maharshi said, “Happiness is your nature. It is not wrong to desire it. What is wrong is seeking it outside when it is inside.”

The pattern of desire, indulgence and discontent, followed by desire and further indulgence is perpetuated by the apparatus of the Neo-liberal economic system, which is dependent on such habitually destructive behavior. And, because Corporate State Governments are so heavily focused on the economy and the requirements of business, government policy is designed in line with the demands of the market, and not the needs of the people. Responsible governments would reject the poisonous values of the Neo-liberal project, and work ceaselessly to inculcate values of goodness thereby changing the atmosphere in which people live. Sadly the world is saddled with inadequate politicians without vision, who, far from facilitating the badly needed changes, consistently add to the chaos.

Alcohol consumption is one damaging effect among many that flow from this dominant socio-economic system. Consistent with other polluting patterns of behaviour, it will continue until a kinder, more just paradigm is inculcated, values change and a shift in attitudes takes place. To some degree this reorientation is underway, people everywhere recognize the destructive nature of the current order and long for a different, simpler way of living. When the constant movement outward into the sensory world begins to be arrested and the mind is allowed to be quiet, desire for external stimulation and the focus on pleasure will begin to fall away, allowing happiness to naturally and spontaneously flower.

Climate Change, Extreme Weather, Destructive Lifestyles

Throughout the world heat waves, flooding and uncontrollable wildfires have caused widespread havoc, lives have been lost, homes destroyed, livelihoods ruined.

Unprecedented levels of heat have been recorded in North America, Europe and Asia, as well as the Atlantic, Pacific and Indian Oceans. According to The UN Framework Convention on Climate Change (UNFCC) record cold May temperatures were registered in “northeastern Canada and the northern Atlantic Ocean, off the southern coast of Greenland.” Global temperatures for the first five months of the year were the highest on record for a La Niña year; higher temperatures, “lead to more frequent and long-lasting heat waves causing adverse environmental impacts.”

These extreme weather patterns are the ferocious signs and sights of climate change in 2018, and, because so little is being done to tackle the causes, year on year they become more and more intense. Planet Earth is becoming a world in which the extreme becomes the expected, the disastrous the everyday.

How bad must it get?

The year began with the coldest first week of January on record for numerous cities in eastern America; freezing temperatures and heavy snowfall swept across Europe in March as the “Beast From the East” hit. Britain was severely affected, with up to three feet of snow in some areas and temperatures down to minus 10ºC.

Floods have affected East Africa killing dozens of people, tropical cyclones hit Somalia, Djibouti, Yemen and Oman, dust storms killed hundreds in India, and Pakistan had an intense heat wave with temperatures exceeding 40ºC. Heavy rains and 70 mph winds in Bangladesh caused landslides, deaths and injuries. California had the largest wild fires ever recorded, and down under, Australia is becoming the ‘Land of Drought’ according to the Prime Minister, Malcolm Turnbull.

A heat wave of unprecedented temperatures scorched Europe and Japan, where 40ºC (104ºF) temperatures were recorded, 30 people died and thousands needed medical treatment for heat related conditions. A month earlier Japan had some of the worst floods in its history, more than 200 people lost their lives and almost 2 million people were evacuated; the Caribbean is bracing itself for this year’s hurricane season, while “still recovering from last year’s devastation,” which, the UNFCC say, was “the costliest on record”.

The list of extreme weather events across the word is endless; extremes that are increasingly normal as the impact of man-made climate change become more and more apparent, and yet little is being done to address the primary causes. How bad does it have to become before substantive action is taken to reverse the terrible damage we are doing to the natural world?

The mechanics of climate change

Climate change is being triggered by global warming; Global warming, described by NASA as “the unusually rapid increase in Earth’s average surface temperature…primarily due to the greenhouse gases released as people burn fossil fuels” occurs, “when the atmosphere traps heat radiating from Earth toward space.” This happens when so-called greenhouse gases (Carbon Dioxide (CO2), Methane (CH4) and Nitrous Oxide (N2O), being the three main culprits) clog the lower levels of Earth’s atmosphere. This leads to a range of effects: The planet overall becomes warmer (average ground temperature rises), causing “extreme weather events and other severe natural and societal impacts” to become more frequent; glaciers in the Arctic region melt sending huge quantities of water into the ocean, which raises the sea level, oceans are made warmer and expand, further contributing to rising levels. As the sea level rises land is flooded, cities, towns and villages are threatened, lives lost, homes destroyed, communities ripped apart, people displaced.

Man-made greenhouse gases (GGE) are produced by a range of sectors and activities: Animal agriculture produces the largest amount (18% of the total according to the UN, other sources put the figure much higher), followed by electricity and heat production, transportation and industry – all through burning fossil fuels – oil, coal and gas. GGEs have been increasing since the industrial revolution, leading to a rise in global ground temperatures, which to date has reached about 1ºC above pre-industrial levels. Temperatures continue to increase at around 0.17ºC per decade.

One degree doesn’t sound like much but, as the extreme weather events show, the effect of this modest rise on the climate is huge, the consequences far reaching, potentially catastrophic.

In 2015 the Paris Agreement on Climate Change was reached and signed by every country in the world; under President Trump America has since pulled out. Hailed as historic, its central aim is to keep global rises in temperature “well below 2 degrees Celsius above pre-industrial levels and to pursue efforts to limit the temperature increase even further to 1.5 degrees Celsius.” Even if these rather optimistic targets are met, a recent study by an international team of scientists writing in the journal, Proceedings of the National Academy of Sciences suggests, “there is a risk of Earth entering what the scientists call “Hothouse Earth” conditions.” The BBC report that the group believe 2ºC of warming “could turn some of the Earth’s natural forces [forests, oceans and land] – that currently protect us – into our enemies…As the world experiences warming, these carbon sinks could become sources of carbon and make the problems of climate change significantly worse.”

If this occurs they forecast the climate stabilizing at “a global average of 4-5°C higher than pre-industrial temperatures with sea level 10-60 m higher than today.” This would mean that some parts of the Earth would become uninhabitable. In order to avoid this nightmare scenario the authors make clear that “a total re-orientation of human values, equity, behavior and technologies is required. We must all become stewards of the Earth.” This requires a major shift in human attitudes.

Unhealthy destructive lifestyle

Climate Change and the environmental disaster in its various colors is the result of human activity and complacency; we have poisoned the oceans, rivers and streams, cleared 85% of the world’s tropical rainforests, mainly for livestock, and are turning healthy land into desert; we are filling the air we breathe with toxins, creating dead zones in the oceans and causing the eradication of species at an unprecedented rate. Collectively we seem to have no respect or love for the natural environment and whilst some people are acting responsibly, the majority fails to see the connection between lifestyle and disaster and appear content to treat the planet like a giant rubbish tip.

The natural order has been thrown into disarray by the widespread adoption of a selfish, destructive way of life: A particular lifestyle, or collection of related ‘lifestyle choices’, are responsible for the production of man-made greenhouse gases that are triggering the extreme weather patterns we are seeing all around the world.

Hedonism and consumerism sit at the heart of the unhealthy mode of living that is driving the catastrophe and making us ill; mankind’s relentless consumption of stuff, the vast majority of which is not needed, combined with an animal-based diet (common to 97% of the global population), has created a cocktail of chaos within the natural world, bringing about the greatest crisis in the history of mankind. It is a materialistic lifestyle that the global economy, and by extension the corporate state depends on and ceaselessly promotes. This is why, despite the intense urgency of the environmental issue, we hear little on mainstream media and virtually nothing from governments, who are more concerned with economic growth and petty domestic politics than the stability and health of the planet.

The harmony of the natural world has been thrown into chaos by the same approach to life that has separated us one from another, and fuelled internal conflict resulting in a global mental health epidemic. In all areas, where there should be unity and right relationship we see enmity, discord and disease. Restoring the planet to health and creating a world in which human beings can live healthy peaceful lives are inextricably linked. Both require a fundamental change in values, a shift away from divisive modes of living built on competition and greed to inclusive ways in which social/environmental responsibility is cultivated and embraced.

Such ideas are not new and are frequently championed, but the prevailing socio-economic ideology actively works to suppress such principles, and powerfully promotes values of division and selfishness. Despite this widespread conditioning, an unstoppable current of change can be seen sweeping the world; social responsibility is growing apace, and perennial values of goodness – cooperation, tolerance and sharing – are increasingly influencing the minds of men and women everywhere.

To galvanize this global movement a major public education program should be undertaken by governments and schools to increase awareness of climate change and lifestyle and create a sense of urgency and engagement. Change can be slow, but these are extraordinary times, and there is a growing recognition that if we unite all things are possible. If not, if we continue in the selfish, greedy, divisive ways of the past, the weather patterns will become more extreme and unpredictable, the air and waterways will become more toxic, loss of life will increase and the associated environmental ills will deepen. The choice is ours.

When an Alien is Our Brother, Son, Friend

I think that most of us instinctively avoid people with mental illness.

I think in many ways what my films are about is that search for my grandpa’s dentures: for that humanizing narrative that bridges the gap between “us” and “them” to arrive at a “we.”
—Brian Lindstrom, documentarian

I first had my real run-in’s with “the law,” in Tucson, Arizona. Pima County Sheriff’s deputies in three vehicles were chasing me on my Bultaco 360cc, as I was cutting through dirt roads and gullies as a 15-year-old unlicensed motocrosser. The mayhem those deputies created, going after me as if I was a mass murderer.

It took six months and probably a few snitches at my high school before the knock on the classroom door of my physics class when the vice principal and two deputies greeted me. The two weaponized cops, in the hallway, handcuffed me and walked me away.

I was charged with driving a motorcycle without a license, along with 18 moving violations.

All of the charges were dropped, as my mother was well-connected to both Tucson Police Department captains and the chief of police, as well as a senator in the Arizona legislature.

Bottom line was the deputies were humiliated, over a one-year period, by my smart-ass ripping up the desert and eluding them. Without evidence that I was actually the one on the Bultaco each time I eluded them, the judge threw the cases out the window while admonishing me to wear a helmet and get a license.

It didn’t take much longer in my life to have more interfaces with cops, as I became the police reporter for both the college daily in Tucson and eventually several dailies and weeklies in Southern Arizona along the US-Mexico border.

My first real live reporter’s story on a cop shooting was when I had to cover a killing of a person with bipolar effective disorder who was in distress near Ajo, Arizona. A mother calls 911 about her son, a Vietnam veteran, drinking a lot and standing in their fenced yard talking to and yelling at ghosts. He had a six-inch Buck knife, and a tall boy PBR in the other hand. Deputy skids to a stop, comes out of the patrol car, pulls his gun, and while in a shoot-to-kill stance, mind you, on the other side of the clear demarcation of the property line to the son and mother’s double-wide trailer and shed set up, he shouts at the man to put the knife down and lay on the 120 degree desert ground with fingers laced and around his head.

The mother pleads to the cop to just back off, to not yell; her son yells back, cussing out this dude, telling him, “Don’t you come onto our property or I’ll stick you.” One thing leads to another, the distressed man charges, while still in his yard, the four-foot high fence between the police official and him. The deputy yells stop, and the Vietnam veteran tells him to fuck off and get away.

At the property line, on his family’s side of the line, the veteran waves his beer and his knife. Fifteen seconds later, the cop fires three rounds, pumping metal into the 42-year-old’s chest.

That was my first foray into investigating police policies around distressed and mentally deranged and emotionally flagging citizens.

One way to end the mental health crisis is to “shoot them out of existence” said one asshole El Paso deputy to me off the record.

Jump cut almost four decades later: Portland, Oregon. Pearl District. Daytime. Man who is deathly afraid of police is confronted by cops, runs away, is subdued, and in less than 120 minutes from the point of confrontation and while in police custody, said perpetrator is dead.

Watching Brian Lindstrom’s Alien Boy: The Life and Death of James Chasse, I am reminded of my forty plus years in and around cops, with mentally distressed clients, as a social worker with homeless and re-entry and veteran clients, and as a teacher in many alternative high school programs, community college, prisons, with military students, and with adults living with developmental disabilities.

I viewed the five year old film with homeless veterans and their family members in Beaverton, Oregon. Three in the audience (including me) had heard of the James Chasse case of Portland Police slamming to the pavement a skinny 42-year-old while also kicking him, applying a Taser, and hogtying the man with schizophrenia and letting him turn ashen gray while standing around sipping Starbucks.

Lindstrom’s film is powerful on many levels, notwithstanding the filmmaker’s ability to ply through the historical record to humanize this interesting and buoyant son who was known around Portland for many years. The quintessential peeling back of the biographical onion peel is what’s compelling about the filmmaker’s approach.

Here, a quote Lindstrom, lifted from a 2013 Portland Mercury interview:

With Alien Boy, our main goal was to honor Jim and really to kind of restore the depth and dimension to Jim’s life. We wanted to restore his humanity and depth. When he died his whole existence was reduced to this headline, 42 Year Old Man with Schizophrenia Dies in Police Custody, and that’s just such a desolate interpretation of his life. Actually, it’s really just an interpretation of his death not of his life. So we painstakingly researched his life, and found friends, family, his old girlfriend, his neighbors, all these people that could talk about him and give him the kind of fullness he deserved. He lived a life of hardship. He was dealt a hard hand but he played it well. He had a lot of integrity and drive. He built a meaningful life and we really wanted to show that in the film.

Mr. Chasse was living in an SRO (subsidized single room occupancy apartment) in downtown Portland, with his own little space from where he positioned his life to survive the voices and the hardships a schizophrenic lives through attempting to be accepted and left alone as an atypical in a neuro-normal and highly judgmental world.

The promontory idea my audience participants who viewed the film expressed was how a person who lives their life disheveled and as a loner with obvious atypical clothing and demeanor can end up at the blunt end of the macho and violent world of a police force. What is really compelling are the eyewitnesses to the event – people who did not know James at the time of the brutal and misanthropic and cavalier way he was meted out injustice – and the stake they had in reviving the 42-year-old’s humanity.

As is the case in all these incidents of police brutality, overreach, and killing, the victims are rarely treated as sons and daughters, fathers and mothers, uncle and aunts, friends and neighbors. They are un-people, aliens, reduced to their prior run-ins with the law, their rap sheets, their mental states, and their resistance.

Lindstrom takes this case, and builds a life, and in the process of reportage, he is able to elicit the emotive power of those of us bearing witness to injustice, a crime against humanity, and any warped expression of the human condition vis-à-vis a cliquish and many times felonious police force. Bearing witness, we as the documentary’s viewers are compelled to see a man, Jim, whose origins are a boy, a child, a son, a boyfriend, a character in the community, and a citizen of not only Portland, Oregon, but of the world.

Image result for james chasse jr

Image result for james chasse jr

James Chasse, Jr., was a fixture in the early punk rock scene in Portland, and Lindstrom allows a kaleidoscope of memories to enter the milieu of his film. One might expect the fury of the chase, or the fear of a dark alley and known crack dealer’s crib. In the case of James Chasse, Jr., he was minding his business in his grimy state in an upscale part of Portland. That was his crime.

“I think we’re used to viewing a lot of police tragedies that are unfortunate one-time decisions about pulling a trigger,” Lindstrom says. “What’s so disturbing about this [case] is that the film reveals this cascade of deceits, omissions, and lies that lead to this terrible death, which was preventable.”

Alien Boy premiered in February 2013 at the Portland International Film Festival after six years of production. The architectonics of the film peers back into our own souls – many of us have experienced videotaped depositions, court documents, and witness interviews up close. September 17, 2006 police approached Chasse, believing he was behaving suspiciously. Herein lies the universal truth of community police forces – if you run away, you most probably will be maimed or injured by officers.

In the case of Jim, he ended up with two dozen breaks on 16 ribs. The policemen signed a waiver denying the EMT unit authority to send him to a hospital.

I’ve seen this shit in Guatemala, in Mexico, in El Paso and Spokane – a hog-tied and writhing-in-pain screaming suspect thrown in a cell, whereupon the person stops breathing or has a seizure, and then slow-to-respond jailers and deputies load the suspect into a police vehicle headed for a hospital. Jim’s level of pain was captured on video and audio, and the viewer sees the brutality of group think in the jailer-cop mindset as people stand around inside the Multnomah County Detention Center as the dying Jim Jim went white and cyanic.

Jim was dumped in a squad car where the cop who pounded him to the pavement drove him to Providence Medical Center. He died in transit, a few minutes away from the emergency room.

This film does not hearken back to some episode of Law and Order, and instead we get a wonderful and human portrait of not an alien, but a life of a man who was a seeker of art as musician, writer, and cartoonist.

Here’s the rub – men and women can live lives of dignity and worth even with mental illness and the so-called hearing voices effects of schizoid disorders. They have friends, they believe in things, they are many times artists, and they can be creative and have meaningful relationships. Lindstrom calls Jim Jim “an amazing success story … a beautiful, sensitive, fragile-yet-resilient nature.”

As a practitioner in the social services world, I have worked with hundreds of people who are looked upon by mainstream society as broken, damaged, suspect and unworthy of all the rights embedded in a democracy, part and parcel what it means to be a citizen. I’ve had clients who lived in the same subsidized apartment building Chasse lived in. This world of neuro-atypical people living in our communities is a success story when social services and the full suite of programs come in and help people like James Chasse function in the world.

Jim Jim was part of our world, and given that, we have a responsibility to honor and respect the individual. Our versus his, or us versus them, are not paradigms in 21st Century USA, and Brian Lindstrom plays out that criticism through the people he interviewed and the narrative flow of his powerful film. Unfortunately, police departments, jailers and prison authorities, and now ICE against undocumented immigrants believe that the men and women with the weapons, military gear and new super powers to harass citizens are the “us” and we are the “they.” For people with developmental, psychological and intellectual disabilities, they are at the bottom rung of “humanity” in the minds of many street-level cops.

Lindstrom has spent years confronting the stories of people he says “society kind of puts an X through.” When the audience finishes a film like Alien Boy, we come away as better people in that same collective community, many times with a greater sense of empathy.

For some, it’s not a cakewalk as this filmmaker is challenged to “expose some grit and grace, that otherwise you might not know was there, in the people you may walk by every day.”

The filmmaking involved many sealed documents and gag orders since the city and police bureau were being sued by the Chasse family. “It was an exercise in faith,” he says. “We would just show up and do the work and hope that a way would be revealed.” The floodgates of evidence opened in 2010 when the Chasse family settled for $1.6 million from the City of Portland.

The viewers last week in the homeless veteran shelter where I work asked if things had changed, and some in the audience answered:

“Hell, no. The Portland police have gotten worse. They attack protesters against ICE detention camps. They give me no evidence that they know how to deal with people in mental health crises.”

A bit of a Lindstrom’s biographical underpinning points to a Portland kid who was thinking all the time about stories he wanted to tell, and he came to the conclusion that it was film as a medium to express those narratives.

Lindstrom was the first member of his family to attend college, paying for this education at both University of Oregon and then Lewis & Clark University by working summers at a salmon cannery in Cordova, Alaska. A linchpin to Brian’s transformation into believing he would be a filmmaker occurred when communications professor Stuart Kaplan screened Edward R. Murrow’s 1960 documentary, Harvest of Shame, about the hard lives American migrant farmworkers faced producing America’s food.

“Brian was really captivated by that, and thought that that’s the kind of thing he would like to do,” Kaplan says. “Documentaries that could bring about social change.”

After graduating from Lewis & Clark, Lindstrom got into Columbia University’s film directing program, where he produced educational videos for the New York City Department of Transportation. His thesis films included a short drama adapted from a Charles Baxter short story and a five-minute documentary about the famous schoolyard basketball player Earl “The Goat” Manigault.

Brian Lindstrom

He’s connected to the NW Film School, and he’s worked with one of my old stomping grounds, Central City Concern, a Portland nonprofit that provides housing, health care, and addiction-treatment services. The fruit of his labor includes Kicking, a half-hour documentary that follows three drug addicts through the medically supervised detox process at Central City’s Hooper Detox Center, and then Finding Normal, about CCC’s Mentor program, where recovering drug addicts get housing and a peer mentor to bust the cycle of addiction, sobriety, relapse.

Today, Lindstrom works intently on other projects while also spending time with his two children and wife, writer Cheryl Strayed, author of the best-selling memoir, Wild, which was turned into a Hollywood film.

My quick mini-interview of Alien Boy‘s Brian Lindstrom:

Paul Haeder: What’s the lesson you take away in 2018 after making the film Alien Boy, and after the screenings, the interviews, the passage of time from that 2006 killing?

Brian Lindstrom: We need to do more to support and protect people dealing with mental illness. I naively thought, way back in 2013 when we were finishing Alien Boy, that the Justice Dept. would come in and make everything better. That hasn’t happened. I want to think the opening of Unity is a step in the right direction and takes pressure off of PPB in terms of dealing with people in mental health crises, but evidently there are some issues at Unity that need to be worked out. I want to be clear that just because I’m advocating for anything that takes the burden off of PPB dealing with people with mental illness, I am in no way condoning or excusing what the PPB did to James Chasse. What is clear to me is that we have to figure out a way to support and protect people with mental illness so that PPB isn’t the defacto mental health services provider.

PH: You make documentaries. What influence do you want these films to have on audiences? The old conundrum is as artists who cover social/environmental/cultural/community injustices we get both the 35,000 foot perspective and the two inch POV, yet in the back of our minds we say, “Shit nothing has changed … in fact, it’s worse.” Riff with this in terms specifically with how you see not only PPB dealing with people they come in contact with living with mental health diagnoses, but writ large in the USA?

BL: I have a confession to make. If I’m truly honest with myself, I don’t make films for audiences. I make them for the people in the film. It is my small way of honoring them. That doesn’t mean I don’t delve into dark areas or that I ignore that person’s struggles. I’m much more concerned with trying to achieve an honest depiction of that person’s life than I am with any potential audience reaction.

PH: Why do you focus on the subject matter you have thus chosen in your documentarian body of work?

BL: It chooses me. I don’t know how else to explain it.

PH: Which story that hasn’t been told but for which you would like to see be told by anyone, or you yourself?

BL: Hmm… So many. I will go with the first that comes to mind: I’ve always wanted to make a documentary about an adult overcoming illiteracy.

PH: What advice do you give young or nascent filmmakers who want to make a difference and tell those stories that might spark a difference in our world?

BL: Grab a camera and go for it. Learn to get out of the way of the story.

PH: Anything you learned in the making of Alien Boy that you have just come to grips with?

BL: We must keep fighting for those whom life has dealt a hard hand.

PH: Why do you make documentaries?

BL: The camera is a bridge of sorts that allows me to get to know people I otherwise might never get to meet. I’m forever grateful for the brave people who have let me tell their story.

Education and the Mental Health Epidemic

Across the western world June is exam time; in Britain, written tests taken in halls of silence and tension have triggered a mini-epidemic of anxiety rooted conditions. Pupils have reported mental exhaustion, panic attacks, crying, nosebleeds, sleepless nights, hair loss and outbreaks of acne.

Over the past 25 years, depression and anxiety amongst teenagers in the UK has increased by 70%. This pattern is repeated across the developed world, and is the result of a cocktail of pressures, pressures that result in 10% of under 18-year-olds in America being dependent on mental health medication.

In parts of Asia things are just as bad or worse: the pressure to achieve high marks in exams in Hong Kong is driving some students to suicide: “71 students took their lives between 2013 and 2016,” reports The South China Morning Post. In Singapore, which produces children who excel in standardized tests, an 11-year-old jumped to his death from the 17th floor of an apartment building in 2016 because he was afraid to tell his parents his exam results. The inquest heard that the boy’s parents relentlessly pushed him to achieve at school: his mother would cane him for every mark he received under 70%. In 2015 a record 27 suicides were reported amongst children between 10 and 19, which was double the previous year’s total.

Suicide or attempted suicide is a raw scream revealing the internal agony a child is living with; pain that he/she feels suffocated by, and unable to openly acknowledge. In most cases children don’t kill themselves, they just become ill, some, chronically. The World Health Organization (WHO) states that neuropsychiatric conditions are the primary cause of disability in under 25-year-olds worldwide and says that globally between 10% and 20% “of children and adolescents experience mental disorders,” feeding what are often long-term conditions. Research shows that 75% of all mental health issues begin before a person reaches 18, with 50% taking root before age 15.

Engines of conformity

There are various interconnected reasons for this mental health epidemic; the burden to conform and the relentless pressure to succeed are primary causes and are present throughout institutionalized education. For many young people education has become a bi-word for competition and anxiety, school or university a place where uniformity is demanded and individuality denied: a hostile place in which pressure and stress dominate.

Despite the best efforts of teachers, many of whom are doing wonderful work, the goal of academic institutions in many countries has been reduced to passing exams and achieving good-to-high grades. This is anathema to what education ought to be. At the heart of education should be the aim of creating happy human beings free from fear. This requires establishing environments that allow an individual to discover innate talents, to explore him/herself and slowly, perhaps clumsily, give expression to that; a stimulating, nurturing space where mistakes can be made, failure allowed, independent thinking fostered and responsibility for society and the natural environment engendered.

Like all aspects of contemporary life, education has been tainted by the values of a particular approach to life, a materialistic methodology that fosters negative tendencies instead of feeding the good and liberating the spirit. Competition is encouraged instead of cooperation, placing people in opposition to one another, cultivating division instead of unity. Individual success is championed at the expense of group well-being and life is reduced to a battleground ruled by desire and the pursuit of pleasure.

The focus within this paradigm of misery is on material success and the accumulation of status and things. Hedonism is sold as the source of all happiness, feeding perpetual discontent. It is an extremely narrow approach to life that denies mystery and wonder, pours cynicism on the miraculous and attempts to crush self-investigation and silence opposition.

Whilst the majority of humanity suffer and struggle to live healthy fulfilling lives within this mode of living, there are those who, economically at least, profit handsomely. As a result, and failing to recognize that they too are trapped, they do everything to maintain it; they are the wealthy and powerful, the ‘ruling elite’. Money begets power and political influence under the pervading paradigm; such influence is used to shape (and draft) government policies that strengthen systems, which maintain the existing unhealthy order.

To uphold the status quo, freedom of thought and true individuality is curtailed, social conformity insisted upon. The major tools of conditioning are the media, which is commonly owned by corporations or controlled by governments, organized religion, and education. The policies of schools and colleges are set by central government, and, consistent with the pervasive ideology politicians ensure that conformity and competition are built into the working methodology.

Students are set in competition with one another, with established standards and with themselves, and are regularly forced to sit written examinations to evaluate how much they can remember or know, about any particular subject. Taking exams dictates the passage of a child’s education and establishes the benchmark against which young people are judged, and by extension often judge themselves. Using tests as a way of assessing a person’s ability and knowledge is archaic; sitting exams exerts colossal pressure, and although some may be able to cope and ‘do well’ the majority feel suffocated.

In Britain, the National Society for the Prevention of Cruelty to Children (NSPCC) relates that in 2016/17 Childline delivered “3,135 counseling sessions on exam stress – a rise of 11% over the past 2 years.” Children aged between 12 and 18 reported that exam stress was causing “depression and anxiety, panic attacks, low-self-esteem, self harming and suicidal thoughts.” This pattern is common in many developed and developing countries, where ideologically-driven corporate governments obsessed with trade, continue to pursue methods, that are, by design, detrimental to the well being of children.

Instead of policies rooted in competition, cooperation and sharing need to be encouraged in all aspects of education and standardized exams consigned to the past. The educational environment needs to be one in which children are encouraged to support each other, to share their own particular gifts with the group and build a sense of social responsibility. Many teachers naturally employ such inclusive methods, but working within divisive systems, which promote individual success, conformity and competition, their efforts are often frustrated.

An Alternative way

A more enlightened approach to education is found in Finland. Here, children don’t start school until they are seven, there is no streaming or selection in schools, so children of varying abilities work side by side, no homework is set, school holidays are long and there is only one standardized test, administered in the final year of high school. The result is happier children than in countries where testing, homework, selection and competition reign supreme. Not only are children happier (according to the World Happiness Report, Finland is the happiest country in the world), they achieve higher academic marks than students in many other countries; according to The Programme for International Student Assessment (PISA) organized annually by the OECD, Finland ranks fourth for reading and 5th for Math in the world; 93% of students graduate from High School, compared to 78% in Canada and 75% in America.

Teachers in Finland are well qualified – all have a Master’s Degree – and are highly valued. They are not dictated to by misguided politicians who come and go, but are trusted to do their job independently, and the country has a long-term approach to education policy, which “means plans remain in place for a significant amount of time, giving them a chance to work, ” says Russell Hobby, leader of the National Association of Head Teachers.

An education system is part of a society’s overall approach to living. As well as being a happy place to live and having a relaxed attitude to education, Finland has some of the lowest levels of wealth and income inequality in the world and the highest level of community trust. In contrast, Britain, USA, Singapore and Hong Kong have some of the highest levels of inequality. The Finland education system is inseparable from the culture, which it serves. Saku Tuominen, director of the HundrEd project says that Finland has “a ‘socially cohesive’, equitable and efficient society, and it gets a consistently reliable school system to match.”

Systems of education built around the ideals of the market that use competition, selection and examinations are contributing to a collective atmosphere of division, injustice and anxiety. Such methodologies need to be fundamentally changed, replaced by creative environments in which children and young adults can simply be, without pressure to achieve or become anything in particular. In such an atmosphere, true intelligence, which is beyond the limitations of knowledge, can flower.

The Housing Crisis Is a Feminist Crisis That Democrats Need To Hear

Image via Boston Globe by John Tlumacki

Every election year, Democratic candidates download the latest changes to the Democratic Party platform. They usually make sure to hit refresh on the Wikipedia page for feminism and check for new developments.

It’s a miracle, with an unapologetic sexual assaulter in the White House, that reproductive health and the gender pay gap are getting any airtime at all. For statisticians and pundits, support for these issues is the best way to make a back of the envelope calculation of odds.

If you follow political punditry, you’d think Americans were split on Roe v. Wade. The fact is, only a quarter of Americans support rolling it back. For perspective, the anti-vaxxer movement has about as much support. The truth is that most Americans are in favor of social equity and access to basic social services.

As it stands, women still make 70% of what men do. Women are more often bound with being the sole breadwinner of single-parent households. Women often have more debt and lower credit scores than men. Women are also the fastest growing section of the homeless population.

Every potential obstacle for having a roof over your head is in the way for women.

Given that Democratic political candidates want to show their support for social justice, feminist, and lower-income issues, you’d think they would commit to ending the housing crisis. With a ratio of six-to-one between the number of vacant homes (18 million) and homeless Americans (3 million), you’d think they’d want to close the gap.

Housing, displacement, and gentrification should be stronger feminist issues injected into the Democratic party platform, as they affect the most dependable Democratic voters, women of color, first. This could bring new life and new energy to the platform.

The Wealth Gap Isn’t Closing

So long as women make 70% of what men make, while paying 100% of housing costs, the wealth gap between men and women will persist.

Women are also saddled with two-thirds of the student debt in the U.S. While women make up a few percentage points more of the college population than men, they are far less likely to get a high-paying job without a college degree or to inherit a family business.

Women also pay more in healthcare costs, paying an average of 30% more than men do. Just staying alive is more expensive for women.

Even high earners and entrepreneurs face a obstacles to affordability. With just 16% of business loans being given to women, companies owned by women face a glass ceiling when it comes to growth.

The Parenting Gap Is Real

In New York and California, where the minimum wage is headed toward $15 an hour, women are required to work two jobs to afford adequate housing. The cost of a two-bedroom apartment for a parent and their children in these states is around $26 an hour. The simple dignity of privacy after being a dedicated and productive contributor to the economy is denied to many women.

There are social expectations for women to take responsibility in the event that the family is a single-parent household. When men are tasked with single parenthood, they’re deeply lauded and appreciated in ways that single mothers aren’t.

Single mothers are often perceived as defective and plagued by problems they’ve somehow caused on their own. Single fathers are perceived as strong, emotionally complex, and courageous more often than single mothers are. Meanwhile, single mothers account for over 70% of all single-parent households.

Homelessness Is Increasing For Women

Unemployment numbers don’t tell a complete story. Unemployment is down as people need to take 2-3 part-time jobs just to get by. Single women and families with children form 50% of the homeless population and their numbers are growing, even though many of them have employment.

While elected officials propose small concessions and programs to act as a band-aid, they simply don’t solve the issue.  Homeless advocates are constantly struggling with elected officials who tell citizens to help the homeless by calling police, public safety, 311, 911, or an endless list of 800 numbers.

This reveals how abstract our understanding of housing insecurity is. People will sometimes endure homelessness as a way to escape an abusive parent or partner. If their abusers are in the local shelter system, elected officials are offering a thoughtless solution that fails to address both chronic homelessness and chronic abuse.

Another problem in the relationship elected officials have to housing insecurity is in the scapegoating of the mental health crisis. Plenty of people with mental health issues have homes. However, living with housing insecurity can cause all kinds of untold damage to the psyche.

And Yet Women Are Still Voting

Elected Democrats continue to stand on banal feminist platforms and telegraph their support for the right to choose and closing the gender pay gap. After decades of denying these rights or the visibility for these causes, this feels like progress.

Cynics could say that these changes could be attested to by the fact that more women vote than men. Others could say that Democrats are waking up to the fact that their most dependable demographic is women. However, given that in 2016 an infamous misogynist got the majority of votes from white women, Democrats can’t rely on women as an unspecific monolith.

Democrats are losing voters as you go up the income bracket, with people making more than $50,000 a year dropping off precipitously. This has been hard for Democrats to face, as they’ve enjoyed funding from the real estate and financial services industries. Angling for the people who are voting for them most dependably would win elections but require a disruption to the fundraising that pundits tie to a candidate’s ability to win.

So Where Do The Democrats Turn?

The people who you’d think would be too busy to vote, working single mothers who might have to work two jobs on a Tuesday, are showing up for Democrats. Why aren’t they showing up for women, especially their most loyal voting block, black women?

Just as the DNC ignored the “flyover” states in the 2016 presidential election, just as the assumed conservativism of the south is being turned on its head, the future of the Democratic party can’t survive on the steam built up by the current Democratic establishment. Democratic voters want new issues, an inspiring platform, and something more than just a team to root for.

We should push that our Democratic platform includes intersectional feminist principles that feature housing prominently. We must then demand that Democrats start putting those principles in practices.

As the 2016 presidential election proved, Democrats can’t and shouldn’t count on anyone to turn out. That’s all the more reason to work to earn our trust. So long as they withhold progress on this front, we should withhold our endorsement of their platforms.

Living in an Age of Desire and Anxiety

Overwhelmed by anxiety and image insecurity a friend’s 20-year-old daughter recently quit her university course and withdrew to her bedroom where she took to self-harming. Company and environments in which she felt emotionally secure became harder to find, until she stopped venturing out at all together.

‘Alice’ is one of a growing number of people, young and old, but disproportionately under 30 years of age, who feel unable to meet the expectations and challenges of contemporary life — whether real or imagined.

Precise figures of those suffering from mental health issues around the world are difficult to collect because many people, particularly in developing countries, do not seek treatment. The World Health Organization (WHO) estimates that globally 264 million people suffer from some form of anxiety disorder: around 5% of all women and 2.6% of men (this is probably inaccurate as men are less likely to admit feeling anxious for fear of being labeled ‘weak’).

What is causing this epidemic? Indeed is it possible to talk about ‘common causes’ or is each case unique?

Whilst human beings may all be ‘different’, as anyone who has travelled knows, the human condition is universal, and throughout the world people respond in similar ways to comparable circumstances, influences and conditioning factors. In addition to a shared nature all of us are increasingly subjected to the stimulants, pressures and values that are more or less the same. Individual cultures are being eroded, replaced by a standardized approach to living. This process of Cultural Homogenization is being brought about systematically using various interconnected tools of control:

At the heart of the conformity movement is the global socio-economic system together, hand in hand, with globalization. People everywhere are victims of the values promoted by the Neo-Liberal view of life. The volume of the materialistic mantra depends on where one happens to be living, but the doctrine and conditioning forces remain largely the same. The other primary factor is education; the basic principles of Neo-Liberalism – profit; i.e., success, individual ambition over group well-being and uniformity, have permeated and polluted the classrooms of schools and colleges in countries throughout the world.

Add these pernicious factors together and it becomes evident that the ground has been laid for a particular type of global socio-psychological conditioning to take place, and in a way previously unheard of when societies were more autonomous.

Conformity and Desire

The fact that the human condition is universal, and the socio-economic structures that people are being conditioned by similar, makes it possible not only to discuss common psychological causes of anxiety, but to broadly identify the societal elements that create the circumstances in which anxiety and other mental health issues, flourish. One could go so far as to say that when adopted – remembering that the process takes place unconsciously – much of the conditioning being poured into the minds of humanity make anxiety virtually inevitable.

This is no accident: an anxious, discontented population is the (unspoken) aim of the architects and devotees of the system; contentment, independence and mental equanimity are the enemies of Neo-Liberalism, because they reduce the desire for sensation and stuff, and the whole corrupt paradigm is maintained by limitless consumerism.

Everyone is subjected to the values, methods and dogma of the machine, but the under 30s, are more exposed  and it seems at greater risk from its poisonous impact. They face colossal pressures from various sources including family, the media (including online) and education – where conformity, competition and systems of reward and punishment pervade many institutions. This trinity of control is extremely unhealthy, creating the conditions in which comparison and imitation flourish and notions of superiority, resulting in arrogance and pride, and inferiority — feeding fear and anxiety, self-doubt or in some cases self-loathing — flower.

Anxiety flows from, and is a form of, psychological fear; psychological fear is woven into the fabric of desire and is fed by insecurity, and the current socio-economic systems encourage both. Insecurity of all kinds is fed, from the insecurity of having a roof over one’s head, food to eat and in some cases, access to health care, to insecurity about whether one is good enough, the perfect daughter or son, clever enough, beautiful enough, tall enough, witty enough, etc., etc.

According to WHO statistics young women are particularly at risk of anxiety, and one of the most common types suffered relates to appearance. This flows from a wider stereotype of what a ‘successful’, desirable, complete, woman looks like. A recent report based on research conducted in 13 countries found that almost 70% of women and girls suffer from appearance anxiety as a result of reductive media images of women. Throughout Asia, for example, cosmetic advertising all too often show images not of a healthy Indian or Sri Lankan woman, but of a light skinned model. This highly inappropriate representation is driving many women in such countries to use highly damaging (physically and psychologically) skin lightening or bleaching creams in an attempt to mimic the billboard beauty; in the process their complexion is often irrevocably scarred.

In Britain a report by the All Party Parliamentary Group (APPG) on Body Image found that girls as young as five are worrying about their size and appearance. They state that, ‘body image dissatisfaction’ (BID) can lead to “physical, emotional and societal problems;” children suffering BID “are less likely to engage in learning and participation in school.” They lose confidence and simply give up. The report goes on to say that, “over half of bullying experienced by young people was because of appearance.”

The focus on appearance, on image, on achievement and on being a particular type of human being flows from a view that emphasizes ‘becoming’ as opposed to ‘being’. It is an approach that is tied to desire and functions in relation to psychological time. It is this movement in psychological time that allows the seed of anxiety to be planted and grow. The idea that one ‘becomes’ something – ‘something’ that corresponds to a projected and, because of fear, an embraced ideal; becomes happy, popular, married (preferably with children), becomes richer, more successful, etc., etc., gets the job, the car, the house, the woman, or man. The process of becoming is insatiable and therefore endless; an itch that forever demands to be scratched.

The projected image arises from a narrow idea of how life should be lived, what one’s aspirations and principles should be; it is an image spooned into the mind from childhood (as the APPG study found), directly and indirectly. And whilst independent thinking and creativity are warmly spoken of, the pressure to conform is intense ­– the media in all its forms and education being the principle institutions utilized in maintaining conformity. Far from stimulating creative thinking and cultivating an environment in which fundamental questions may be raised, in many countries education has become a powerful tool for conditioning the minds of young people and a feeding ground for the world of work. As Noam Chomsky has said, “Society simply reduces education to the requirement of the market. Students are trained to be compliant workers.” He goes on to state that “a deep level of indoctrination takes place in our schools.”

In addition to competition, reward and punishment, and conformity the principle coercive element in maintaining the conditioned stereotype and causing anxiety is desire. Desire lies at the very root of the chaos and is the principle factor in the problem of anxiety.

Every aspect of the present system is designed to strengthen desire; desire for pleasure, desire to live a certain lifestyle, to look a certain way, to have whatever or whoever it is that one desires. Desire to be liked, loved even, ‘love’, (so the story goes) that is achieved by conforming to the prescribed pattern and thereby becoming likeable, or worthy of love. Love itself has been replaced by desire, pleasure substituted for happiness and freedom traded in for choice.

The main reason why desire is perpetually inflamed is in order to maintain the current socio-economic model, which depends on limitless consumerism for its survival. Secondly constant desire keeps the mind in a state of unease – of discontent. This suits the beneficiaries of the machine well, for in such an agitated state a population can be more easily controlled, and crucially, made dependent upon various remedial treatments; alcohol, medication — legal and illegal — shopping excursions, holidays and the like, all of which are provided by the architects of the system.

The result of this cocktail of conditioning is an environment of insecurity, suppression and anxiety. If anxiety flows from desire and psychological time, it is equally true that freedom from anxiety comes about when there is the absence of desire and from attachment to the objects of desire. Within the current socio-economic environment this difficult task is made even harder, but as long as desire dominates the system that feeds on it will be perpetuated, anxiety will persist and discontent and conflict, within the individual and society will continue.