By David Matthews
Originally published at Monthly Review.
A mental-health crisis is sweeping the globe. Recent estimates by the World Health Organization suggest that more than three hundred million people suffer from depression worldwide. Furthermore, twenty-three million are said to experience symptoms of schizophrenia, while approximately eight hundred thousand individuals commit suicide each year.1 Within the monopoly-capitalist nations, mental-health disorders are the leading cause of life expectancy decline behind cardiovascular disease and cancer.2 In the European Union, 27.0 percent of the adult population between the ages of eighteen and sixty-five are said to have experienced mental-health complications.3 Moreover, in England alone, the predominance of poor mental health has gradually increased over the last two decades. The most recent National Health Service Adult Psychiatric Morbidity Survey illustrates that in 2014, 17.5 percent of the population over the age of sixteen suffered from varying forms of depression or anxiety, compared to 14.1 percent in 1993. Additionally, the number of individuals whose experiences were severe enough to warrant intervention rose from 6.9 percent to 9.3 percent.4
In capitalist society, biological explanations dominate understandings of mental health, infusing professional practice and public awareness. Emblematic of this is the theory of chemical imbalances in the brain—focusing on the operation of neurotransmitters such as serotonin and dopamine—which has gripped popular and academic consciousness despite remaining largely unsupported.5 Moreover, reflecting the popularity of genetic reductionism within the biological sciences, there has been an effort to identify genetic abnormalities as another cause of mental-health disorders.6 Nonetheless, explanations based on genomics have also failed to generate conclusive evidence.7 While potentially offering illuminating insights into poor mental well-being in specific cases, biological interpretations are far from sufficient on their own. What is abundantly clear is the existence of significant social patterns that elucidate the impossibility of reducing poor mental health to biological determinism.8
The intimate relationship between mental health and social conditions has largely been obscured, with societal causes interpreted within a bio-medical framework and shrouded with scientific terminology. Diagnoses frequently begin and end with the individual, identifying bioessentialist causes at the expense of examining social factors. However, the social, political, and economic organization of society must be recognized as a significant contributor to people’s mental health, with certain social structures being more advantageous to the emergence of mental well-being than others. As the basis on which society’s superstructural formation is erected, capitalism is a major determinant of poor mental health. As the Marxist professor of social work and social policy Iain Ferguson has argued, “it is the economic and political system under which we live—capitalism—which is responsible for the enormously high levels of mental-health problems which we see in the world today.” The alleviation of mental distress is only possible “in a society without exploitation and oppression.”9
In what follows, I briefly sketch the state of mental health in advanced capitalism, using Britain as an example and utilizing the psychoanalytical framework of Marxist Erich Fromm, which emphasizes that all humans have certain needs that must be fulfilled in order to ensure optimal mental health. Supporting Ferguson’s assertion, I argue that capitalism is crucial to determining the experience and prevalence of mental well-being, as its operations are incompatible with true human need. This sketch will include a depiction of the politically conscious movement of users of mental-health services that has emerged in Britain in recent years to challenge biological explanations of poor mental health and to call for locating inequality and capitalism at the heart of the problem.
Mental Health and Monopoly Capitalism
In the final chapters of Monopoly Capital, Paul Baran and Paul Sweezy made explicit the consequences of monopoly capitalism for psychological well-being, arguing that the system fails “to provide the foundations of a society capable of promoting the healthy and happy development of its members.”10 Exemplifying the widespread irrationality of monopoly capitalism, they illustrated its degrading nature. It is only for a fortunate minority that work can be considered pleasurable, while for the majority it is a thoroughly unsatisfactory experience. Attempting to avoid work at all costs, leisure frequently fails to offer any consolation, as it is also rendered meaningless. Rather than being an opportunity to fulfill passions, Baran and Sweezy argued that leisure has become largely synonymous with idleness. The desire to do nothing is reflected in popular culture, with books, television, and films inducing a state of passive enjoyment rather than demanding intellectual energies.11 The purpose of both work and leisure, they claimed, largely coalesces around increasing consumption. No longer consumed for their use, consumer goods have become established markers of social prestige, with consumption as a means to express an individual’s social position. Consumerism, however, ultimately breeds dissatisfaction as the desire to substitute old products for new ones turns maintaining one’s position in society into a relentless pursuit of an unobtainable standard. “While fulfilling the basic needs of survival,” Baran and Sweezy argued, both work and consumption “increasingly lose their inner content and meaning.”12 The result is a society characterized by emptiness and degradation. With little likelihood of the working class instigating revolutionary action, the potential reality is a continuation of the “present process of decay, with the contradictions between the compulsions of the system and the elementary needs of human nature becoming ever more insupportable,” resulting in “the spread of increasingly severe psychic disorders.”13 In the current era of monopoly capitalism, this contradiction remains as salient as ever. Modern monopoly-capitalist society continues to be characterized by an incompatibility between, on the one hand, capitalism’s ruthless pursuit of profit and, on the other, the essential needs of people. As a result, the conditions required for optimum mental health are violently undermined, with monopoly-capitalist society plagued by neuroses and more severe mental-health problems.
Erich Fromm: Mental Health and Human Nature
Baran and Sweezy’s understanding of the relationship between monopoly capitalism and the individual was significantly influenced by psychoanalysis. For one, they made references to the centrality of latent energies such as libidinous drives and the need for their gratification. Moreover, they accepted the Freudian notion that social order requires the repression of libidinal energies and their sublimation for socially acceptable purposes.14 Baran himself wrote on psychoanalysis. He had been associated with the Institute for Social Research in Frankfurt in the early 1930s and was directly influenced by the work of Eric Fromm and Herbert Marcuse.15 It is within this broad framework that a theory of mental health can be identified in Baran and Sweezy’s analysis, with the contradictions between capitalism and human need expressing themselves chiefly through the repression of human energies. It was Fromm, most notably, who was to develop a unique Marxist psychoanalytical position that remains relevant to understanding mental health in the current era of monopoly capitalism. And it was from this that Baran, in particular, was to draw.16
While making explicit the importance of Sigmund Freud, Fromm acknowledged his greater debt to Karl Marx, considering him the preeminent intellectual.17 Accepting the Freudian premise of the unconscious and the repression and modification of unconscious drives, Fromm nonetheless recognized the failure of orthodox Freudianism to integrate a deeper sociological understanding of the individual into its analysis. Turning to Marxism, he constructed a theory of the individual whose consciousness is shaped by the organization of capitalism, with unconscious drives repressed or directed toward acceptable social behavior. While Marx never produced a formal psychology, Fromm considered that the foundations of one resided in the concept of alienation.18 For Marx, alienation was an illustration of capitalism’s mortifying physical and mental impact on humans.19 At its heart, it demonstrates the estrangement people feel from both themselves and the world around them, including fellow humans. Alienation’s specific value for understanding mental health lies in illustrating the distinction that emerges under capitalism between human existence and essence. For Marx, capitalism separates individuals from their essence as a consequence of their existence. This principle permeated Fromm’s psychoanalytic framework, which maintained that, under capitalism, humans become divorced from their own nature.
Human nature, Marx argued, consists of dual qualities and we “must first deal with human nature in general, and then with human nature as modified in each historical epoch.”20 There are needs that are fixed, such as hunger and sexual desires, and then there are relative desires that originate from the historical and cultural organization of society.21 Inspired by Marx, Fromm argued that human nature is inherent in all individuals, but that its visible manifestation is largely dependent on the social context. It is untenable to assume “man’s mental constitution is a blank piece of paper, on which society and culture write their text, and which has no intrinsic quality of its own.… The real problem is to infer the core common to the whole human race from the innumerable manifestations of human nature.”22 Fromm recognized the importance of basic biological needs, such as hunger, sleep, and sexual desires, as constituting aspects of human nature that must be satisfied before all else.23 Nonetheless, as humans evolved, they eventually reached a point of transcendence, from the animal to the uniquely human.24 As humans found it increasingly easier to satisfy their basic biological needs, largely as a result of their mastery over nature, the urgency of their satisfaction gradually became less important, with the evolutionary process allowing for the development of more complex intellectual and emotional capacities.25 As such, an individual’s most significant drives were no longer rooted in biology, but in the human condition.26
Considering it imperative to construct an understanding of human nature against which mental health could be evaluated, Fromm identified five central characteristics of the human condition. The first is relatedness. Aware of being alone in the world, humans strenuously endeavor to establish ties of unity. Without this, it is intolerable to exist as an individual.27 Second, the dominance of humans over nature allows for an easier satisfaction of biological needs and for the emergence of human aptitudes, contributing to the development of creativity. Humans developed the ability to express a creative intelligence, transforming this into a core human characteristic that requires fulfillment.28 Third, humans, psychologically, require rootedness and a sense of belonging. With birth severing ties of natural belonging, individuals constantly pursue rootedness to feel at one with the world. For Fromm, a genuine sense of belonging could only be achieved in a society built on solidarity.29 Fourth, humans crucially desire and develop a sense of identity. All individuals must establish a sense of self and an awareness of being a specific person.30 Fifth, it is psychologically necessary for humans to develop a framework through which to make sense of the world and their own experiences.31
Representing what Fromm argued to be a universal human nature, the satisfaction of these drives is essential for optimum mental well-being. As he contended, “mental health is achieved if man develops into full maturity according to the characteristics and laws of human nature. Mental illness consists in the failure of such development.”32 Rejecting a psychoanalytical understanding that emphasizes the satisfaction of the libido and other biological drives, mental health, he claimed, is inherently associated with the satisfaction of needs considered uniquely human. Under capitalism, however, the full satisfaction of the human psyche is thwarted. For Fromm, the origins of poor mental health are located in the mode of production and the corresponding political and social structures, whose organization impedes the full satisfaction of innate human desires.33 The effects of this on mental health, Fromm argued, are that “if one of the basic necessities has found no fulfillment, insanity is the result; if it is satisfied but in an unsatisfactory way…neurosis…is the consequence.”34
Work and Creative Repression
Like Marx, Fromm asserted that the instinctual desire to be creative had the greatest chance of satisfaction through work. In the Economic and Philosophic Manuscripts of 1844, Marx strenuously argued that labor should be a fulfilling experience, allowing individuals to be freely expressive, both physically and intellectually. Workers should be able to relate to the products of their labor as meaningful expressions of their essence and inner creativity. Labor under capitalism, however, is an alienating experience that estranges individuals from its process. Alienated labor, Marx contended, is when “labour is external to the worker, i.e., it does not belong to his essential being…therefore, he does not affirm himself but denies himself, does not feel content but unhappy, does not develop freely his physical and mental energy but mortifies his body and ruins his mind.”35 Under capitalism, great efforts are made to ensure human energy is channeled into labor, even though it is often miserable and tedious.36 Rather than satisfying the need to express creativity, it frequently represses it through the monotonous and grueling obligation of wage labor.37
In Britain, there is widespread dissatisfaction with work. One recent survey of employees conducted in early 2018 estimated that 47 percent would consider looking for a new job during the coming year. Of the reasons given, a paucity of opportunities for career advancement was prominent, along with not enjoying work and employees feeling like they do not make a difference.38 These reasons begin to illustrate an entrenched alienation from the labor process. Many people experience work as having little meaning and little opportunity for personal fulfillment and expression.
From such evidence, a claim can be made that in Britain—as in many monopoly-capitalist nations—a substantial portion of the labor force feels disconnected from their work and does not consider it a creative experience. For Fromm, the realization of creative needs are essential to being mentally healthy. Having been endowed with reason and imagination, humans cannot exist as passive beings, but must act as creators.39 Nevertheless, it is clear that work under capitalism does not achieve this. Considerable evidence suggests that far from being beneficial to mental health, work is actually detrimental to it. Although the exact figures are likely to remain unknown due to the intangibility of such experiences, it can be inferred that, for many members of the labor force, it is commonplace for work to provoke general unhappiness, dissatisfaction, and despondency. Moreover, more severe mental-health conditions, such as stress, depression, and anxiety, are increasingly emerging as the consequences of discontentment at work. In 2017–18, such conditions constituted 44 percent of all work-related ill health in Britain, and 57 percent of all workdays lost to ill health.40 An additional study in 2017 estimated that 60 percent of British employees had suffered work-related poor mental health in the past year, with depression and anxiety being some of the most common manifestations.41
Rather than a source of enjoyment, the nature and organization of work under capitalism clearly does not act as a satisfactory means to fulfill an individual’s creativity. As Baran and Sweezy argued, “the worker can find no satisfaction in what his efforts accomplish.”42 Instead, work alienates individuals from a fundamental aspect of their nature and, in so doing, stimulates the emergence of varying negative states of mental health. With around half of the labor force in Britain having experienced work-related mental-health issues, and many more likely feeling a general sense of despondency, there exists what Fromm termed a socially patterned defect.43 It is no exaggeration to argue that the deterioration of mental well-being is a standard response to wage labor in monopoly-capitalist societies. Negative feelings become commonplace and, to varying degrees, are acknowledged as normal reactions to work. With the exception of severe mental-health disorders, many forms of mental distress that develop in response are taken for granted and not considered legitimate problems. As such, the degradation of mental well-being is normalized.
Meaningful Association and Loneliness
For Fromm, there existed an inherent relationship between positive mental health, meaningful personal relationships in the form of both love and friendship, and expressions of solidarity. Acutely aware of their “aloneness” in the world, individuals attempt to escape the psychological prison of isolation.44 Nonetheless, the operation of capitalism is such that it frequently prevents the satisfactory fulfillment of this need. The inadequacy of social relationships within monopoly-capitalist societies was identified by Baran and Sweezy. They argued a frivolity had descended over much social interaction, as it became typified by superficial conversation and a falsity of pleasantness. The emotional commitments required for friendship and the intellectual efforts needed for conversation were made largely absent as social interaction became increasingly about acquaintances and small talk.45 Contemporary monopoly capitalism is no exception. While difficulties in measuring its existence and nature abound, arguably one the most widespread neuroses to plague present-day capitalism is loneliness. It is increasingly considered a major public-health concern, perhaps most symbolically evident with the establishment of a Minister for Loneliness in 2018 by the British government.
As a neurosis, loneliness has debilitating consequences. Individuals may resort to alcohol and drug abuse to numb their misery, while persistent experience increases blood pressure and stress, as well as negatively impacts cardiovascular and immune-system functioning.46 A mental-health condition in its own right, loneliness exacerbates additional mental-health problems and is often the root cause of depression.47 In 2017, it was estimated that 13 percent of individuals in Britain had no close friends, with a further 17 percent having average- to poor-quality friendships. Moreover, 45 percent claimed to have felt lonely at least once in the previous two weeks, with 18 percent frequently feeling lonely. Although a close, loving relationship acts as a barrier to loneliness, 47 percent of people living with a partner reported feeling lonely at least some of the time and 16 percent often.48 Reflecting the dominant scientific constructs of mental health, recent efforts have been made to identify genetic causes of loneliness, with environmental conditions said to exacerbate an individual’s predisposition to it.49 However, even the most biologically deterministic analyses concede that social circumstances are important to its development. Nonetheless, few studies attempt to seriously illustrate the extent to which capitalism is a contributing factor.
Individualism has always reigned supreme as a principle upon which the ideal capitalist society is constructed. Individual effort, self-reliance, and independence are endorsed as the hallmarks of capitalism. As understood today, the notion of the individual has its origins in the feudal mode of production, and its emphasis on greater collectivist methods of labor—such as within the family or village—being surrendered to the compulsion of individuals, who have to be free to sell their labor power on the market. Prior to capitalism, life was conducted more as part of a wider social group, while the transition to capitalism developed and allowed for the emergence of the isolated, private individual and the nuclear, increasingly privatized family.50 Fromm contended that the promotion and celebration of the virtues of the individual means that members of society feel more alone under capitalism than under previous modes of production.51 Capitalism’s exaltation of the individual is made further apparent by its potent opposition to the ideals of collectivism and solidarity, and preference and incentive for competition. Individuals, it is said, must compete with each other on a general basis to enhance their personal development. More specifically, competition is, economically, one of the bases on which the market operates and, ideologically, corresponds to the widespread belief that, to be successful, one must compete with others for scarce resources. The consequence of competition is that it divides and isolates individuals. Other members of society are not considered as sources of support, but rather obstacles to personal advancement. Ties of social unity are therefore greatly weakened. Thus, loneliness is embedded within the structure of any capitalist society as an inevitable outcome of its value system.
Not only is loneliness integral to capitalist ideology, it is also exacerbated by the very functioning of capitalism as a system. As a result of capitalism’s inexorable drive for self-expansion, the growth of production is one of its elementary characteristics. Having become an axiomatic notion, rarely is the idea of expanded production challenged. The human cost of this is crippling as work takes precedence over investing in social relationships. Furthermore, neoliberal reforms have left many workers with progressively more precarious jobs and less protections, guaranteed benefits, and hours of employment—all of which have only aggravated loneliness. Amplifying the proletarianization of the labor force, with ever-more workers existing in a state of insecurity and experiencing increased exploitation, the centrality of work has become greater as the threat of not having a job, or being unable to secure an adequate standard of living, has become a reality for many in a “flexible” labor market.52 Individuals have no choice but to devote more time to work at the expense of establishing meaningful relationships.
The growing attention given to work can be illustrated in relation to working practices. Despite the fact that the average length of the working week increased in Britain following the financial crisis of 2007–09, the broader picture over the last two decades has officially been one of decline. Part-time workers, however, have witnessed the number of hours they work increase, along with the number of part-time jobs. Additionally, between 2010 and 2015, there was a 15 percent rise in the number of full-time members of the labor force working more than forty-eight hours per week (the legal limit; additional hours must be agreed upon by employer and employee).53 Furthermore, in 2016, one employee survey illustrated that 27 percent worked longer than they would like, negatively impacting their physical and mental health, and 31 percent felt that their work interfered with their personal life.54 Significantly, loneliness is not just a feature of life outside of work, but a common experience during work. In 2014, it was estimated that 42 percent of British employees did not consider any coworker to be a close friend, and many felt isolated in the workplace.
Greater engagement in productive activities at the expense of personal relationships has been labeled the “cult of busyness” by psychiatrists Jacqueline Olds and Richard Schwartz.55 While they accurately identify this trend, they nonetheless evaluate it in terms of workers freely choosing such a life. This elides any serious criticisms of capitalism and the reality that the cult of busyness has largely been an outcome of the economic system’s inherent need for self-expansion. Furthermore, Olds and Schwartz fail to accept the trend as a reflection of the structural organization of the labor market, which makes more work a necessity instead of a choice. The avoidance of loneliness and the search for meaningful relationships are fundamental human desires, but capitalism suppresses their satisfactory fulfillment, along with the opportunities to form common bonds of love and friendship, and to work and live in solidarity. In response, as Baran and Sweezy argued, the fear of being alone drives people to seek some of the least fulfilling social relationships, which ultimately result in feelings of greater dissatisfaction.56
Materialism and the Search for Identity and Creativity
For monopoly capitalism, consumption is a vital method of surplus absorption. In the era of competitive capitalism, Marx could not foresee how the sales effort would evolve both quantitatively and qualitatively to become as important for economic growth as it has.57 Advertising, product differentiation, planned obsolescence, and consumer credit are all essential means of stimulating consumer demand. At the same time, there is no shortage of individuals willing to consume. Alongside the acceptance of work, Fromm identified the desire to consume as an integral characteristic of life under capitalism, arguing it was a significant example of the uses to which human energies are directed to support the economy.58
With consumer goods valued for their conspicuity rather than their intended function, people have gone from consuming use values to symbolic values. The decision to engage in popular culture and purchase a type of automobile, brand of clothing, or technological equipment, among other goods, is frequently based on what the product is supposed to convey about the consumer. Frequently, consumerism constitutes the principal method through which individuals can construct a personal identity. People are emotionally invested in the meanings associated with consumer goods, in the hope that whatever intangible qualities items are said to possess will be passed on to them through ownership. Under monopoly capitalism, consumerism is more about consuming ideas and less about satisfying inherent biological and psychological needs. Fromm contended that “consumption should be a concrete human act in which our senses, bodily needs, our aesthetic taste…are involved: the act of consumption should be a meaningful…experience. In our culture, there is little of that. Consuming is essentially the satisfaction of artificially stimulated phantasies.”59
The need for identity and creative fulfillment encourages an insatiable appetite to consume. Each purchase, however, regularly fails to live up to its promise. Rarely is satisfaction truly achieved through consumption, because what is being consumed is an artificial idea rather than a product that imbues our existence with meaning. In this process, consumerism as a form of alienation becomes evident. Instead of consuming a product designed to satisfy inherent needs, consumer goods exemplify their synthetic nature via their manufactured meanings and symbolisms, which are designed to stimulate and satisfy a preplanned response and need.60 Any identity a person may desire, or feel they have obtained, from consuming a product, as well as any form of creativity invoked by a consumer good or item of popular culture, is false.
Rather than cultivating joy, the affluence of the monopoly-capitalist nations has bred a general widespread dissatisfaction as high value is placed on amassing possessions. While consumerism as a value exists in all capitalist societies, in those of greater inequality—with Britain displaying wider wealth disparities than most—the desire to consume and acquire greatly contributes to the emergence of neuroses, as the effort to maintain social status and emulate those at the top of society becomes an immense strain. The impact of this has been demonstrated within British families in recent years. In 2007, UNICEF identified Britain as having the lowest level of child well-being out of twenty-one of the most affluent Organisation for Economic Co-operation and Development nations. In response, an analysis of British families was conducted in 2011 comparing them to those in Spain and Sweden, countries that ranked in the top five for child well-being.61
Of the three nations, the culture of consumerism was greatest in Britain, as it was prevalent among all families regardless of affluence. British parents were considered more materialistic than their Spanish and Swedish counterparts and behaved accordingly toward their children. They purchased the most up-to-date, branded consumer goods, largely because they thought it would ensure their child’s status among their peers. This was a value shared by the children themselves, with many accepting that social prestige was based on ownership of branded consumer goods, which, evidence suggests, contributed to arising worry and anxiety, especially for children from poorer households who recognized their disadvantage. While a compulsion to purchase new goods continuously for themselves and their children was identified among British parents, many nonetheless also felt the psychological strain of attempting to maintain a materialistic lifestyle and caved to such pressures. Across all three countries, children identified the needs for their own well-being as consisting of quality time spent with parents and friends, and opportunities to indulge their creativity, especially through outdoor activities. Despite this, the research showed that, in Britain, many were not having such needs satisfied. Parents struggled to spend enough time with their children due to work commitments and often prevented them from participating in outdoor activities due to safety concerns. Subsequently, parents compensated for this with consumer goods, which largely failed to meet their children’s needs. As such, the needs of British children to form and partake in meaningful relationships and act creatively were repressed, and efforts to satisfy these needs through consumerism failed to bring them happiness.
Resistance as Class Struggle
While not denying the existence of biological causes, the structural organization of society must be recognized as having serious repercussions on people’s mental health. Monopoly capitalism functions to prevent many from experiencing mental well-being. Yet, despite this, the medical model continues to dominate, reinforcing an individualistic conception of mental health and obscuring the detrimental effects of the present mode of production. This oppresses users of mental-health services by subordinating them to the judgment of medical professionals. The medical model also encourages the suspension and curtailment of individuals’ civil rights if they experience mental distress, including by legitimizing the infringement of their voluntary action and excluding them from decision-making. For those who suffer mental distress, life under capitalism is frequently characterized by oppression and discrimination.
Aware of their oppressed status, users and survivors of mental-health services are now challenging the ideological dominance of the medical model and its obfuscation of capitalism’s psychological impact. Furthermore, they are increasingly coalescing around and putting forward as an alternative the need to accept the Marxist-inspired social model of mental health. The social model of disability identifies capitalism as instrumental to the construction of the category of disability, defined as impairments that exclude people from the labor market. Adopting a broadly materialist perspective, a social model of mental health addresses material disadvantage, oppression, and political exclusion as significant causes of mental illness.
In 2017 in Britain, the mental-health action group National Survivor User Network unequivocally rejected the medical model and planted social justice at the heart of its campaign. As part of its call for a social approach to mental health, the group explicitly denounces neoliberalism, arguing that austerity and cuts to social security have contributed to the increasing prevalence of individuals who suffer from poor mental health as well as to the exacerbation of existing mental-health issues among the population. Recognizing social inequality as a contributor to the emergence of poor mental health, National Survivor User Network proposes that the challenge posed by mental-health service users should be part of a wider indictment of the general inequality in society, arguing that “austerity measures, damaging economic policies, social discrimination and structural inequalities are causing harm to people. We need to challenge this as part of a broader social justice agenda.”62 Furthermore, the action group Recovery in the Bin positions itself and the wider mental-health movement within the class struggle, pushing for a social model that recognizes capitalism as a significant determinant of poor mental health. Moreover, representing ethnic minorities, Kindred Minds vigorously campaigns on an understanding that mental distress is less a result of biological characteristics and more a consequence of social problems such as racism, sexism, and economic inequality “pathologised as mental illness.”63 For Kindred Minds, the catalyst for deteriorating mental health is oppression and discrimination, with ethnic minorities having to suffer greater levels of social and economic inequality and prejudice.
Capitalism can never offer the conditions most conducive to achieving mental health. Oppression, exploitation, and inequality greatly repress the true realization of what it means to be human. Opposing the brutality of capitalism’s impact on mental well-being must be central to the class struggle as the fight for socialism is never just one for increased material equality, but also for humanity and a society in which all human needs, including psychological ones, are satisfied. All members of society are affected by the inhumane nature of capitalism, but, slowly and determinedly, the fight is being led most explicitly by the most oppressed and exploited. The challenge posed must be viewed as part of the wider class struggle, as being one front of many in the fight for social justice, economic equality, dignity, and respect.
David Matthews is a lecturer in sociology and social policy at Coleg Llandrillo, Wales, and the leader of its degree program in health and social care.
Notes
↩ World Health Organization, Fact Sheets on Mental Health (Geneva: World Health Organization, 2017), http://who.int.
↩ World Health Organization, Data and Resources (Geneva: World Health Organization, 2017), http://euro.who.int/en.
↩ World Health Organization, Data and Resources.
↩ Sally McManus, Paul Bebbington, Rachel Jenkins, and Traolach Brugha, Mental Health and Wellbeing in England: Adult Psychiatric Morbidity Survey 2014 (Leeds: NHS Digital, 2016).
↩ Brett J. Deacon and Dean McKay, “The Biomedical Model of Psychological Problems: A Call for Critical Dialogue,” Behavior Therapist 38, no. 7 (2015): 231–35. Pharmaceutical companies who have identified it as a market opportunity have been the primary beneficiaries of this approach, exemplified by the proliferation of anti-depressants as illustrated by Brett J. Deacon and Grayson L. Baird, “The Chemical Imbalance Explanation of Depression: Reducing Blame at what Cost?,” Journal of Social and Clinical Psychology 28, no. 4 (2009): 415–35.
↩ As exemplified by Jordan W. Smoller et al., “Identification of Risk Loci with Shared Effects on Five Major Psychiatric Disorders: A Genome-Wide Analysis,” Lancet 381, no. 9875 (2013): 1371–79. In this study, five of the most common mental-health disorders, including schizophrenia, bipolar disorder, and depression, were associated with genetic variations.
↩ Deacon and McKay, “The Biomedical Model of Psychological Problems,” 233.
↩ Social class is one of the most significant indicators of mental health, as evidenced by research within the social sciences dating back to the earlier part of the twentieth century. The first most notable study of this kind is Robert E. L. Farris and Henry W. Dunham, Mental Disorders in Urban Areas (Chicago: Chicago University Press, 1939), which identified higher rates of mental disorders in the poorest districts of Chicago. This was followed by, among others in both Britain and the United States, August B. Hollingshead and Frederick C. Redlich, Social Class and Mental Illness (New York: John Wiley, 1958); Leo Srole, Thomas S. Langer, Stanley T. Michael, Marvin K. Opler, and Thomas A. C. Rennie, Mental Health in the Metropolis: The Midtown Manhattan Study (New York: McGraw-Hill, 1962); and John J. Schwab, Roger A. Bell, George J. Warheit, and Ruby B. Schwab, Social Order and Mental Health: The Florida Health Study (New York: Brunner-Mazel, 1979).
↩ Iain Ferguson, Politics of the Mind: Marxism and Mental Distress (London: Bookmarks, 2017), 15–16.
↩ Paul Baran and Paul Sweezy, Monopoly Capital (New York: Monthly Review Press, 1966), 285.
↩ Baran and Sweezy, Monopoly Capital, 346–47.
↩ Baran and Sweezy, Monopoly Capital, 346.
↩ Baran and Sweezy, Monopoly Capital, 364.
↩ Baran and Sweezy, Monopoly Capital, 354–55.
↩ Paul A. Baran, The Longer View (New York: Monthly Review Press, 1969), 92–111; Paul M. Sweezy, “Paul A. Baran: A Personal Memoir,” in Paul A. Baran: A Collective Portrait (New York: Monthly Review Press, 32–33. The unpublished chapter of Baran and Sweezy’s Monopoly Capital, entitled “The Quality of Monopoly Capitalist Society II,” drafted by Baran, had included an extensive section on mental health. That chapter, however, was not included in the book because it was still unfinished at the time of Baran’s death. Nevertheless, some elements of the mental-health argument were interspersed in other parts of the book. When “The Quality of Monopoly Capitalism II” was finally published in Monthly Review in 2013, almost sixty years after it was drafted by Baran, the section on mental health was excluded due to its incomplete character. See Paul A. Baran and Paul M. Sweezy, “The Quality of Monopoly Capitalist Society: Culture and Communications” Monthly Review 65, no. 3 (July–August 2013): 43–64. It is worth noting that the treatment of mental health in Monopoly Capital did not go unnoticed and was subject to criticism by Robert Heilbroner in a review in the New York Review of Books, to which Sweezy responded in a letter, defending their analysis in this regard. See Robert Heilbroner, Between Capitalism and Socialism (New York: Vintage, 1970), 237–46; Paul M. Sweezy, “Monopoly Capital” (letter), New York Review of Books, July 7, 1966, 26.
↩ The influence of Fromm is evident in Baran’s work and correspondence. He studied Fromm’s The Sane Society, together with Marcuse’s Eros and Civilization and One Dimensional Man (in manuscript form). He was undoubtedly familiar with the wider body of work by both thinkers. While Baran was not in complete agreement with the details of Marcuse’s analyses, he openly acknowledged the importance and significance of his work, identifying Eros and Civilization as having great relevance to U.S. society and recognizing a psychoanalytical analysis as vital to understanding monopoly-capitalist society. See Nicholas Baran and John Bellamy Foster, The Age of Monopoly Capital: Selected Correspondence of Paul A. Baran and Paul M. Sweezy, 1949–1964 (New York: Monthly Review Press, 2017), 127, 131. See also the “Baran-Marcuse Correspondence,” Monthly Review Foundation, https://monthlyreview.org.
↩ Erich Fromm, Beyond the Chains of Illusion: My Encounter with Freud and Marx (London: Continuum, 2009), 7.
↩ Fromm, Beyond the Chains of Illusion, 35.
↩ Bertell Ollman, Alienation: Marx’s Conception of Man in a Capitalist Society (Cambridge: Cambridge University Press, 1977), 131.
↩ Karl Marx, Capital, vol. 1 (1867; repr. London: Lawrence and Wishart, 1977), 571.
↩ Erich Fromm, Marx’s Concept of Man (London: Bloomsbury, 2016), 23–24.
↩ Erich Fromm, The Sane Society (London, Routledge, 2002), 13.
↩ Fromm, The Sane Society, 65.
↩ Fromm, The Sane Society, 22.
↩ Fromm, Beyond the Chains of Illusion, 27.
↩ Fromm, The Sane Society, 27.
↩ Fromm, The Sane Society, 28–35.
↩ Fromm, The Sane Society, 35–36.
↩ Fromm, The Sane Society, 37–59.
↩ Fromm, The Sane Society, 59–61.
↩ Fromm, The Sane Society, 61–64
↩ Fromm, The Sane Society, 14.
↩ Fromm, The Sane Society, 76.
↩ Fromm, The Sane Society, 66.
↩ Karl Marx, Economic and Philosophic Manuscripts of 1844 (1932; repr. Radford, Virginia: Wilder Publications, 2011).
↩ Fromm, Beyond the Chains of Illusion, 63.
↩ Fromm, The Sane Society, 173.
↩ Investors in People, Job Exodus Trends: 2018 Employee Sentiment Poll (London: Investors in People, 2018), http://investorsinpeople.com.
↩ Fromm, The Sane Society, 35.
↩ Health and Safety Executive, Work Related Stress, Depression or Anxiety Statistics in Great Britain, 2018 (Bootle, UK: Health and Safety Executive, 2018), 3, http://hse.gov.uk.
↩ Business in the Community, Mental Health at Work Report 2017 (London: Business in the Community, 2017), http://bitc.org.uk.
↩ Baran and Sweezy, Monopoly Capital, 345.
↩ Fromm, The Sane Society, 15.
↩ Fromm, The Sane Society, 29.
↩ Baran and Sweezy, Monopoly Capital, 347–48.
↩ Jo Griffin, The Lonely Society? (London: Mental Health Foundation, 2010), 6–7.
↩ Griffin, The Lonely Society?, 4
↩ David Marjoribanks and Anna Darnell Bradley, You’re Not Alone: The Quality of the UK’s Social Relationships (Doncaster: Relate, 2017), 17–18.
↩ Luc Goossens, Eeske van Roekel, Maaike Verhagen, John T. Cacioppo, Stephanie Cacioppo, Marlies Maes, and Dorret I. Boomsma, “The Genetics of Loneliness: Linking Evolutionary Theory to Genome-Wide Genetics, Epigenetics, and Social Science,” Perspectives on Psychological Science 10, no 2 (2015): 213–26.
↩ Michael Oliver, The Politics of Disablement (Basingstoke, UK: Macmillan Press, 1990); Eli Zaretsky, Capitalism, the Family, and Personal Life (London: Pluto Press, 1976).
↩ Fromm, The Fear of Freedom, 93.
↩ See Ricardo Antunes, “The New Service Proletariat,” Monthly Review 69, no. 11 (April 2018): 23–29, for an analysis of the evolving insecurity of labor markets within the advanced capitalist nations and the hardening of proletarian divisions.
↩ Trade Union Congress, “15 Per Cent Increase in People Working More than 48 Hours a Week Risks a Return to ‘Burnout Britain’, Warns TUC,” September 9, 2015; Josie Cox, “British Employees are Working More Overtime than Ever Before—Often for No Extra Money,” Independent, March 2, 2017.
↩ David Marjoribanks, A Labour of Love—or Labour Versus Love?: Our Relationships at Work; Relationships and Work (Doncaster: Relate, 2016).
↩ Jacqueline Olds and Richard Schwartz, The Lonely American: Drifting Apart in the Twenty-First Century (Boston: Beacon Press, 2009).
↩ Baran and Sweezy, Monopoly Capital, 347–48.
↩ Baran and Sweezy, Monopoly Capital, 115.
↩ Fromm, Beyond the Chains of Illusion, 63.
↩ Fromm, The Sane Society, 129-130.
↩ Robert Bocock, Consumption (London: Routledge, 2001), 51.
↩ United Nations Children’s Fund, Innocenti Report Card 7: Child Poverty in Perspective: An Overview of Child Well-Being in Rich Countries (Florence: UNICEF Innocenti Research Centre, 2007), http://unicef-irc.org.
↩ National Survivor User Network, NSUN Manifesto 2017: Our Voice, Our Vision, Our Values, (London: National Survivor User Network, 2017), http://nsun.org.uk.
↩ Raza Griffiths, A Call for Social Justice: Creating Fairer Policy and Practice for Mental Health Service Users from Black and Minority Ethnic Communities (London: Kindred Minds, 2018).
