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Austerity, psychological help and challenging neoliberalism

 

Huge cuts to benefits and services are about to hit millions of Britons which will exacerbate the troubled and troubling times we are living in.  In the UK in the last 35 years the social fabric has dramatically changed,  the Bevanite settlement and welfare state has been profoundly (possibly irreversibly) pulled apart. Since the end of the cold war we have seen the seemingly relentless march of neoliberalism and untamed capitalism, the spread of  globalisation, and of  rising inequality. The world many grew up in and expected to continue is on the retreat and many in the helping professions such as psychotherapists feel the need to find a response which articulates our core beliefs and hopes. This is maybe all the more urgent as attempts are made to co-opt psychotherapy into neoliberal agendas with worrying implications. We have seen a spate of protests about the ways in which the government treats  those who need to claim what we used to call social security and is now derisorily called ‘welfare’  Mental health workers have staged protests against attempts to integrate mental health clinics with jobcentres,  and groups such as the alliance for psychotherapy and counselling are increasingly making their opposition  heard.

 

Psychotherapy, and psychology have a potentially important role to play and profound points to make, to challenge a range of preconceptions that have gained weight in society at large.  In order for this to happen though we do need to distance ourselves from versions of human nature that play into the hands of neoliberal individualism, and we also must resist the uses that are made of psychotherapy  to support an overly individualistic and ‘blame the victim’ ideology.

A starting point is the rise of a dominant view of human nature as competitive, individualistic, and aggressive, a view all too close to Freud’s of course. This echoes age-old debates about human nature whether  in philosophy (e.g. Rousseau v Hobbes) or in psychoanalysis (Freud/Klein v Winnicoot/Kohut for example).Research that I have become interested in has shown clearly that even very young infants have prosocial and proto-moral capacities [1], [2], showing overt preference for  characters who act well and kindly as early as three months.  Toddlers by 14 to 16 months are genuinely altruistic and helpful [3], and in experimental situations pick up cues about others needs and respond helpfully when that is needed.  Children who have had good care tend to be cooperative, capable of reciprocity and generosity. This gets turned off in the face of stress, fear and anxiety [4].

What research shows and  therapists know from the consulting room of is that trauma, stress and anxiety undermine empathy, altruism and compassion. Having worked with maltreated kids and adults for decades, and now working with forensic patients at the Portman clinic in London, it is clearly no coincidence that those who can act in the nastiest, most selfish and scary ways are the very people who have often suffered the most terrible abuse and trauma. We have known for decades  that abuse turns off prosocial tendencies as early as toddlerhood [5], and that secure attachment is profoundly linked with kindness, generosity, empathy and cooperation [6]. Indeed the very brain areas central to empathy and cooperation tend to be more offline following trauma and abuse [7] whereas more primitive brain regions such as the amygdala become more dominant. This research fits well what psychoanalytic describes in terms of how  persecutory or paranoid-schizoid states can dominate in fear, stress and anxiety.

Why does this matter? Increasingly we are peddled a view of human beings as naturally selfish and individualistic and that a moral and social sense can only be installed by society and the adult world. Dawkins was as guilty of this as anyone, writing  in the Selfish Gene [8] ‘If you wish, as I do, to build a society in which individuals cooperate generously and unselfishly towards a common good, you can expect little help from biological nature. Let us try to teach generosity and altruism, because we are born selfish’. Since Thatcher this has become a dominant strand in neoliberal ideology. Yet of course a very competitive dog-eat-dog world is one which breeds these very selfish individualistic traits. As social psychology has long shown us, when stressed, anxious or in a crazy rush we become less nice and helpful [9], whereas when the world feels good or beneficent we tend to act more generously and benignly [10]. It might be that the current economic world is creating the dominance of this version of human nature and giving less space for more humane altruistic ways of being to thrive and flourish.

The dominant ideology increasingly has shown a disdain for much that we value in psychoanalysis, particularly dependency, vulnerability and softness, the qualities that often have (somewhat sexistly) come under the umbrella of being ‘maternal’.  Much contemporary thinking is in thrall to a particular version of phallic machismo, a state of mind  which the psychoanalyst  Rosenfeld’s described in terms of harsh internal mafia gangs [11]. In this the poor are despised and blamed as ‘scroungers’ and lazy,  the wealthy are feted for their justly rewarded endeavour and the weak are exhorted  to ‘man up’ and stand on their own two feet.

In this individualistic weltanschauung any proper social analysis disappears.  Poverty is the responsibility of the poor, individuals need to look after themselves, the strongest survive and thrive in a Spencerian perversion of Darwin’s in fact  much more socially aware ideas.  One of the worst sequelae of this is the idea that so-called ‘job-seekers’ will be made to undertake a course of CBT or mindfulness to make them ‘fit for work’, with the implication being that somehow it is their unfitness that is the problem, rather than the way society is currently configured, with fewer jobs, foreshortened career structures, rising inequality, internships,  zero-hours contracts etc.

A central aim of psychotherapy is to help people to feel more hopeful, to develop capacities to mentalize, empathise, to take back projections and see others more as they are.  Many of us have noted how in psychotherapy over time, as people feel more at ease, they also become more generous, prosocial and even, to use a non-psychoanalytic word, kind [12], [13]. Indeed just being empathised and attuned with has been shown to make people more prosocial and altruistic, not only in adults but  even in babies [14]. Yet these systems in our brains, and in our autonomic nervous systems, go offline under stress, or in fear and anxiety, and our social engagement systems turn off as we prepare to meet threat [15]. Thus much that we are aspire to in psychotherapy works against the dominant ideology.

Indeed it might even be argued that capitalism and materialism has a vested interest in poor mental health. People who have more extrinsic motivation, as defined by Kasser [16] tend to value consumer goods, status, and how they are seen. They also tend to have poorer mental health and much more likelihood of a psychiatric diagnosis. They are much more likely to believe that purchasing material goods is the road to happiness and the way out of despair, depression or emotional pain. In other words they make far better consumers than those with intrinsic motivation who value relationships, good experiences,  or having a sense of vocation or community, for example.  It is no coincidence I think that we have seen a marked rise in narcissism, at least in US [17], in recent years, as well as a decline in empathy [18]. We also know that as inequality rises, not only do health [19] and mental health outcomes get worse  [20], but we see a decline in altruism and empathy, and the worst culprits being those with the most privilege [21]. Indeed just being primed to think about money and financial words makes people less caring and more selfish, indeed more likely to become the Dawkins version of human nature [22].

Of course altruism, at least that kind motivated by empathy [23] i.e. intrinsically motivated altruism, is threatened both by stress, fear and anxiety, and is also turned off by the offer of extrinsic rewards. Indeed even Tomasello’s altruistic toddlers stopped being motivated to help once they were offered concrete rewards for helping [24]. Maybe the new breed of public sector managers and commissioners should take note. Most of us want to work because our hearts are in it, not for the extrinsic rewards, which might even turn us away from the tasks

We as psychotherapists can have a voice to combat these arguments and also to resist the individualising and blaming agendas that are rife. We know that inequality, poverty and poor early experiences all massively increase the likelihood of later mental and indeed physical health issues [25]. We need to help individuals of course, and not blame them, but we also cannot lose sight of the fact  that social change is needed.

Allied to this worry about individualising, we also need to resist the process of commodification of wellbeing, into which psychotherapy can be dragged alongside the self-help industry, wellbeing, cbt and mindfulness apps and other forms of commodification. While these can all genuinely be extremely  helpful, this also smacks of the kind of fetishism that Marx  [26]writes about (one that disguises the social relations behind the processes) as well as the fetishism that Freud wrote about, in which something important becomes perverted.  Neoliberalism has this capacity to encapsulate, hide and make shiny the radical edge of therapeutic thinking. Its genius is to hoover everything up in its path, ingest it and convert (pervert)  it for its own uses.

Much therapeutic work is aiming to develop capacities that  we sometimes describe as ‘containment’[27], emotional holding [28], ‘mentalizing’ [29], mindsight [30], mindfulness [31], mind–mindedness [32]. These all describe versions of how we can be in touch with our own and other’s thoughts and feelings, without which emotional wealth/capital (as opposed to poverty), altruism and genuine mutual care and cooperation are not possible. Many children and adults never develop such abilities. When in a near constant state of heightened arousal, anxiety or fear and their capacities remain off-line. Consumerism, high levels of competition, of distrust, and the quest for status and money also turn these off.

This argues for a model of human development assuming an inbuilt human propensity for relationships from birth onwards, what Trevarthen [33] called being born with a ‘‘companion in meaning making’. Bråten  [34] described infants as born ‘alterocentric’ as opposed to the ‘egocentric’ Piaget , Emde  [35]‘we-go’ not ego’. Of course selfishness vies with cooperativeness and indeed is adaptive in certain situations, and for good reason can become exaggerated at times of stress and tension.

To finish with a quote from carol Gilligan ‘more than ever, we need psychoanalysis with its method of free association to undo the dissociations that currently threaten not only our happiness but also our survival. But we need a psychoanalysis freed from its truncated Oedipus story, a psychoanalysis that recognizes trauma, not nature, as the force that turns love incestuous and anger murderous; a psychoanalysis that is at once psychological and political—that …. encourages us to take the risk of opting for love and freedom’ [36]

 

[1]          J. K. Hamlin, K. Wynn, and P. Bloom, ‘Social evaluation by preverbal infants’, Nature, vol. 450, no. 7169, pp. 557–559, Nov. 2007.

[2]          P. Bloom, ‘The moral life of babies’, The New York Times, 09-May-2010.

[3]          M. Tomasello, Why We Cooperate. Cambridge, Mass: MIT Press, 2009.

[4]          G. Music, The Good Life:  Wellbeing and the new Science of Altruism, Selfishness and Immorality. London: Routledge, 2014.

[5]          M. Main and C. George, ‘Responses of abused and disadvantaged toddlers to distress in agemates: A study in the day care setting’, Developmental psychology, vol. 21, no. 3, pp. 407–412, 1985.

[6]          M. Mikulincer, P. R. Shaver, O. Gillath, and R. A. Nitzberg, ‘Attachment, caregiving, and altruism: Boosting attachment security increases compassion and helping’, Journal of Personality and Social Psychology, vol. 89, no. 5, pp. 817–839, 2005.

[7]          E. McCrory, S. A. De Brito, and E. Viding, ‘The impact of childhood maltreatment: a review of neurobiological and genetic factors’, Frontiers in Psychiatry, vol. 2, 2011.

[8]          R. Dawkins, The selfish gene. Oxford University Press, USA, 2006.

[9]          J. M. Darley and C. D. Batson, ‘“ From Jerusalem to Jericho”: A study of situational and dispositional variables in helping behavior.’, Journal of Personality and Social Psychology, vol. 27, no. 1, pp. 100–108, 1973.

[10]        A. M. Isen and P. F. Levin, ‘Effect of feeling good on helping: Cookies and kindness.’, Journal of Personality and Social Psychology, vol. 21, no. 3, pp. 384–388, 1972.

[11]        H. A. Rosenfeld, Impasse and interpretation: therapeutic and anti-therapeutic factors in the psycho-analytic treatment of psychotic, borderline, and neurotic patients. Oxford: Routledge, 1987.

[12]        G. Music, ‘Trauma, helpfulness and selfishness: the effect of abuse and neglect on altruistic, moral and pro-social capacities’, Journal of Child Psychotherapy, vol. 37, no. 2, pp. 113–128, 2011.

[13]        G. Music, ‘Selfless genes, altruism and trauma: research and clinical implications’, British Journal of Psychotherapy, vol. 28, no. 2, pp. 154–171, 2012.

[14]        M. Carpenter, J. Uebel, and M. Tomasello, ‘Being Mimicked Increases Prosocial Behavior in 18‐Month‐Old Infants’, Child Development, 2013.

[15]        S. W. Porges, The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. New York: Norton, 2011.

[16]        T. Kasser, The high price of materialism. Cambridge, Mass: The MIT Press, 2003.

[17]        J. M. Twenge and W. K. Campbell, The narcissism epidemic: Living in the age of entitlement. New York: Atria, 2009.

[18]        S. H. Konrath, E. H. O’Brien, and C. Hsing, ‘Changes in dispositional empathy in American college students over time: A meta-analysis’, Personality and Social Psychology Review, vol. 15, no. 2, pp. 180–198, 2011.

[19]        M. Marmot, Status Syndrome: How Your Social Standing Directly Affects Your Health. London: Bloomsbury, 2005.

[20]        R. Wilkinson and K. Pickett, The Spirit Level: Why More Equal Societies Almost Always Do Better. London: Allen Lane, 2009.

[21]        P. K. Piff, D. M. Stancato, S. . Côté, R. Mendoza-Denton, and D. Keltner, ‘Higher social class predicts increased unethical behavior’, PNAS, vol. 109, no. 11, pp. 4086–4091, Feb. 2012.

[22]        K. D. Vohs, N. L. Mead, and M. R. Goode, ‘The psychological consequences of money’, science, vol. 314, no. 5802, pp. 1154–1156, 2006.

[23]        C. D. Batson, Altruism in humans. Oxford: Oxford Univ Pr, 2011.

[24]        F. Warneken and M. Tomasello, ‘Extrinsic rewards undermine altruistic tendencies in 20-month-olds.’, Developmental psychology, vol. 44, no. 6, pp. 1785–1788, 2008.

[25]        V. J. Felitti, ‘The relation between adverse childhood experiences and adult health: Turning gold into lead’, Editor’s Comments, vol. 6, no. 1, p. 44, 2002.

[26]        K. Marx, ‘The fetishism of commodities and the secret thereof’, Capital: A Critique of Political Economy, vol. 1, pp. 71–83, 1867.

[27]        W. R. Bion, Learning from experience. London: Heinemann, 1962.

[28]        D. W. Winnicott, The maturational processes and the facilitating environment: Studies in the theory of emotional development. London: Karnac, 1996.

[29]        P. Fonagy, Affect regulation, mentalization, and the development of the self. New York: Other Press, 2002.

[30]        D. Siegel, Mindsight: Transform Your Brain with the New Science of Kindness. Oneworld Publications, 2010.

[31]        P. M. Williams and D. D. Penman, Mindfulness: A practical guide to finding peace in a frantic world. Piatkus, 2011.

[32]        E. Meins, C. Fernyhough, M. de Rosnay, B. Arnott, S. R. Leekam, and M. Turner, ‘Mind-Mindedness as a Multidimensional Construct: Appropriate and Nonattuned Mind-Related Comments Independently Predict Infant–Mother Attachment in a Socially Diverse Sample’, Infancy, vol. 17, no. 4, pp. 393–415, Jul. 2012.

[33]        C. Trevarthen, ‘Intrinsic motives for companionship in understanding: Their origin, development, and significance for infant mental health’, Infant Mental Health Journal, vol. 22, no. 1–2, pp. 95–131, 2001.

[34]        S. Bråten, Ed., Intersubjective Communication and Emotion in Early Ontogeny, New Ed. Cambridge University Press, 2006.

[35]        R. N. Emde, ‘From ego to “we-go”: Neurobiology and questions for psychoanalysis: Commentary on papers by Trevarthen, Gallese, and Ammaniti & Trentini’, Psychoanalytic Dialogues, vol. 19, no. 5, pp. 556–564, 2009.

[36]        C. Gilligan, Joining the resistance. John Wiley & Sons, 2013.

 

 

 

 

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