Bert Olivier
Bert Olivier

Why it’s important for our health to get rid of the neoliberal regime

In his riveting study, What about me? The Struggle for Identity in a Market-Based Society (trans. Hedley-Prôle, J. London: Scribe Publications, Kindle edition, 2014), the Belgian psychoanalyst, Paul Verhaeghe, gives a resoundingly affirmative answer to the question: “Is there a demonstrable connection between today’s [neoliberal capitalist] society and the huge rise in mental disorders?” Many of us already knew this but Verhaeghe’s new book supplies one with incontrovertible, documented evidence.

It is impossible to do more in a blog post than provide a kind of overview of the book’s central thesis. In the introduction, after stating that since an earlier book (in which he investigated the connection between social change and mental disorders), he has become convinced that the effect of such change is far more significant than previously realised, he remarks: “The neo-liberal organisation of our society is determining how we relate to our bodies, our partners, our colleagues, and our children – in short – to our identities. And you can’t get much more disordered than that”.

What does the neoliberal “organisation” of society amount to? As the title of the book indicates, it is market-based, in the tacit belief that the abstract entity called the “market” is better suited than human beings themselves to provide a (supposedly) humane structure to the communities in which we live. But because neoliberal capitalism stands or falls by the question, whether profit is generated or not, it means that human economic activities in such a society have to generate optimal profit.

Predictably, according to the profit-driven dictates of the market, workers/employees in every organisation, from small companies to large corporations and even what used to be regarded as public institutions such as schools and universities, have been increasingly subjected to a regime of relentless competition, linked to rewards (such as promotion and bonuses) for productivity and punitive measures (no promotion, no bonuses, being fired) for lack of it. This has gone hand-in-hand with quasi-legal measures to ensure the productivity of employees and the identification of those who are not productive, such as the imposition of production-deadlines, self-assessment and company audits. Not even schools and universities have been exempted from this. It was not difficult to guess what effect these transformations in working conditions would have on people’s health.

Among those focused on by Verhaeghe are psychiatric conditions (the incidence of which has multiplied) like depression, eating and personality disorders and depression. Nor is it difficult to guess why this should be the case – if one feels that, no matter how hard you try, it is just not possible to be as productive, or as innovative regarding product-design as some of your colleagues, depression and anxiety are likely to assert themselves sooner or later.

It is, therefore, not surprising to find that the most commonly occurring personality disorders among working people today (and even executives are not exempted from this) are social phobia and performance anxiety. Why would this be the case, the less perspicacious among us might wonder. The answer should be obvious: in a society where those around you in the workplace either fall into the category of competitors (including your best friends at work) or those who have the task of evaluating your own performance (sometimes they are both), it is difficult not to experience anxiety intermittently, which could easily develop into a pathology. Social phobia has the same origin – involuntarily, you start fearing people’s motives when they talk to you about your work, and again this could burgeon into a pathological condition.

As an aside I should mention that, in my own judgment, these findings on Verhaeghe’s part are compatible with something I argued in a previous post (see: http://www.thoughtleader.co.za/bertolivier/2013/08/30/capitalism-andas-suffering/), namely that capitalist work displays an “obsessional neurotic structure” – even on the part of those who are not clinically “ill” – insofar as, for reasons outlined above, it demands of workers (executives included) a painfully repetitive, conscientious commitment to productive work, on the tacit assumption or belief that “something terrible” would happen to them if they should fail to do so. And anxiety or fear and depression are always waiting in the wings, lest one should feel, as one invariably does, sooner or later, that one is not meeting expectations (which have by then been internalised).

What is the connection of Verhaeghe’s work with neoliberal capitalism? Again, it should be obvious: in what has become a society dominated by – let’s be honest about it – nothing less than market fundamentalism, competition and reciprocal (in terms of company structures, horizontal as well as vertical) evaluation are virtually the only functions that are allowed, or at least, valorised. But how does one “know” that you are not adequately competitive, that is, that you are not “successfully competing” with your peers?

Again I have to condense brutally. First Verhaeghe shows that the dominant medical view (the “illness model”), that mental disorders are the manifestation of “underlying bodily processes”, and therefore have nothing to do with the state of society in which patients live, is losing support. This is evinced by the recent criticism on the part of the British Psychological Society and the World Health Organisation, of the newly published Bible of psychiatry, or the DSM. In both cases these organisations pointed out explicitly that the diagnoses enshrined in the DSM ignore the fact that such diagnoses are largely based on social norms (something Foucault argued ages ago).

The proliferation of so-called mental disorders today have to be seen in this light. The neoliberal practice of salary differentiation, linked to performance, and the resulting income inequality (characteristic of neoliberal societies) is where to look. Verhaeghe – no doubt anticipating accusations of not being sufficiently “scientific” in his writing – therefore turns to the work of two eminent, widely respected social epidemiologists, Richard Wilkinson and Kate Pickett, under the headings, “Mental disorders as social problems” and “Too much inequality is bad for your health”.

Pickett and Wikinson’s findings were unambiguous (Verhaeghe 2014: location 2365): “… an increase of this kind [income inequality] has far-reaching consequences for nearly all health criteria. Its impact on mental health (and consequently also mental disorders) is by no means an isolated phenomenon.” The key factor in their study proved to be stress, which has been shown to have an impact on human cardiovascular systems as well as immune systems. And stress (indirectly it seems to me anxiety and social phobia too) is directly linked to income inequality. A salient conclusion of Wilkinson’s first book The Impact of Inequality: How to make sick Societies Better was already that in a city or a country where there is high income inequality (need I say like South Africa) “the quality of social relationships is noticeably diminished: there is more aggression, less trust, more fear, and less participation in the life of the community” (2014: location 2375). It seems to me that these findings are not unrelated to what happened at Marikana two years ago.

One should keep in mind that income inequality is directly linked to differences in social status. And not surprisingly, Verhaeghe points out that low social status has a “determining effect on health” (2014: location 2375). He therefore arrives at the startling conclusion, that even in “prosperous … Western Europe, it isn’t the quality of health care … that determines the health of the population, but the nature of social and economic life. The better social relationships are, the better the level of health” (location 2375). And health has been deteriorating steadily under the neoliberal regime. Need I say more?

  • Although familiar with Verhaeghe’s earlier work, I was kindly alerted to the publication of this new book by Devin Purvis, who sent me this link: http://www.theguardian.com/commentisfree/2014/aug/05/neoliberalism-mental-health-rich-poverty-economy
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    • http://roryshort.blogspot.com/ Rory Short

      @Bert you are absolutely on the ball with this. In my view neo-liberals have turned the market into the equivalent of God. They put everything to do with human life into the hands of the market, a totally in-human construct if we with draw from consciously shaping it. Different sporting codes are all based on competition but competition according to rules otherwise the codes would implode. Why should the competition in commercial markets not be subject to rules consciously applied by us the players in the market?

    • Bert

      Oops! The second “depression” should not be there in this sentence: “…like depression, eating and personality disorders and depression.” The sentence should stop after “personality disorders”. That’s what happens when one is in too much of a hurry to finish something.

      The two links supplied above can be directly accessed here:

      http://www.theguardian.com/commentisfree/2014/aug/05/neoliberalism-mental-health-rich-poverty-economy

      http://www.thoughtleader.co.za/bertolivier/2013/08/30/capitalism-andas-suffering/

    • http://www.bolobolo.co.za Lin

      Here’s a link to a related short piece by anarchists you could like.
      We Are All Very Anxious – Six Theses On Anxiety And Why It Is Effectively Preventing Militancy, And One Possible Strategy For Overcoming It
      http://cloudfront.crimethinc.com/pdfs/We-Are-All-Very-Anxious.pdf

    • http://www.aspo.org.za Yaj

      Excellent article. An American psychiatrist Kenneth Lux also wrote about this 12 years ago entitled “Adam Smith’s Mistake” when he realised that all or most of his patient’s mental problems emanated or were exacerbated by financial stressors.

      In a debt-based money system of fractional reserve banking and compound interest , money , the very means of our survival, is systemically made scarce because our money supply is created out of thin air as interest-bearing debt whenever loans are issued by banks.However there is never enough money in circulation at any one time for everybody to be able to pay pack both the principal AnD the interest, hence the scarcity of money, competition and the stress in society.
      So what we need is monetary and banking reform to a full reserve system and public credit whereby all new money is created debt-free and interest-free only in sufficient quantities by a public body.

    • Stephen Browne

      Thanks Bert, this fits so well with where I am in my life. I’m sick of being told what I need to be/accomplish to be successful/happy. Time is not money; hours spent not working your butt off do not equal an actual loss of substance.

    • Bert

      Rory, that is the $64000-question – why the market is not rigorously subjected to human judgment and control. Joel Kovel, for one, despairs of this ever happening, because, as he says, it is impossible to give the abstract process that capital embodies, “a heart”.

      Lin, thanks for that link – those six theses and the context in which they are inscribed make me think of Hardt and Negri’s way of writing. Nice coincidence that you should send me this link; Verhaeghe, too, emphasizes the anxiety accompanying capitalist work-competition.

    • Trevor

      A further aggravation to neo-libralism’s detrimental influence is the sense of pride and self-importance one senses in those who proudly relate what betrays their complete capitulation and subsumation into the market system. “I have to keep competitive. I’m not available. It’s such a burden. Sigh!” (Read: :”But I love every minute of it and enjoy the kudo’s.”)
      In spite of the devastation to one’s health, it has millions of convinced takers. They have my pity, but clearly expect admiration. Moreover, ‘mere’ health damage or devastation (depression, and worse) scarcely seems to capture the whole of it. The loss is complete; viz. “What shall it profit a man (sic)…”?

      (Admittedly I do not speak as a complete outsider, of course.)

    • Richard

      I think the issue is much more complex than what is stated here, and some issue that are immediately brought to mind are (1) why do we expect to live in stress-free environments; (2) to what extent is chaos in the world in general a cause of stress and anxiety; (3) have we not been flattening society since the days of Thomas Paine, leaving individual performance (measured in money) as the only way hierarchically to measure people one against the other; (4) have we not made man the measure of man, removing religion or any other set of criteria as ways to measure achievement?

      Here is one train of thought: in many ways, the weakening of group-think has brought the Darwinian struggle to each person individually. With the weakening of the influence of the West on the world (and this could be any hegemonic power) we are reduced to individuals struggling for survival, one against the other. Imagine a pre neo-liberal world, say South Africa. All inhabitants are subject to an imperial power holding hegemony. Self-government is permitted, and suddenly people within the colony are competing against each other for political and economic power, with a language (Dutch/Afrikaans versus English) element at play. Complete independence arrives, and this competition becomes an ethnic one, black-and-white. As that fades, the only remaining avenue for competition is economic. This is broadly what has happened, to my mind. We are now atoms, fighting each other for dominance.

    • http://roryshort.blogspot.com/ Rory Short

      In my view the problem has its roots in the money system. The true purpose of money it is to serve as facilitator of voluntary exchanges of goods and services. But because, money has been 1) falsely elevated to being the ‘means of exchange’ rather than the’ facilitator of exchange’ and 2) turned into an object that exists in its own right separate from any exchange, it can be accumulated thus leading to the development of capitalism. We need a money system that enables money to carry out its proper role of facilitating exchanges. Because of the internet and information technology such a money system could be built.

    • http://paulwhelanwriting.blogspot.com Paul Whelan

      The idea that the ‘pre-capitalist’ world – whatever that means except to those who maintain there was one or could again be one now – was a world in which there was no injustice, inequality and resulting ‘stress’ for ‘individuals’ is too far-fetched to entertain.
      Are we seriously to believe that the medieval European peasant, for many centuries sweating out his short life in virtual slavery, was immune to all these things; that Asians and Africans for twice the number of generations living under the arbitrary whim of their chief or headman had no worries that kept him asleep at night?

    • Bert

      Paul, neither Verhaeghe nor Ian Buchanan (see my post on living in a schizo world), nor Ian Parker (all of whom explore the pathologies peculiar to living under capitalism), argues that there was no stress or anxiety in earlier eras. Freud’s remark, that obsessive neurosis is a ‘caricature’ of religion, gives you a clue to understanding this. In a thoroughly ‘religious’ society (that is, dominated by religion as structuring principle), guilt was systematically inculcated in people, and led to similar pathologies. The point is that suffering under capitalism, which is what structures contemporary societies, is different, and Verhaeghe has nicely captured these forms of suffering. Parker does, too, in Lacanian Psychoanalysis – Revolutions in Subjectivity. I write about this because the champions of capitalism would have us believe that it is heaven on earth for everyone. They could not be further from the truth.

    • Momma Cyndi

      Is the problem ‘neo-liberal’, capitalist, communist, consumerist or any other social order – or is it just a lot of people in too little space?

    • http://paulwhelanwriting.blogspot.com Paul Whelan

      Bert – I’m sure no thinker worth the name would maintain any longer capitalism is heaven on earth. We have two distinct ideological poles since Herr Marx (they were there before, but took different forms), neither of which has ever been an accurate description of human existence or provided a solution to its permanent problems. Rather the contrary, I fear. Ideology has added much harm.

      As for today, Momma Cyndi seems nearer the truth in her/his comment above and it’s certainly as plausible as any other general explanation of alienation or neurosis. You could say that the fact the ‘system’ manages to work at all, given the circumstances, is more a tribute to human ingenuity and its power of organisation than the opposite.

      The fact is, life is hard – and then you die, as Woody Allen puts it.

    • Maria

      @ Paul: That an obviously intelligent person like yourself can be blind to the truth of Verhaeghe’s commentary on the alienated society in which we live, is testament to the success of neoliberal ideology. Believe it or not, Verhaeghe’s work is validated by many writers, including Silvia Federici. Here is an excerpt from her paper, “With philosophy and terror: Transforming bodies into labor power.” In the book edited by Marvakis, A. et al, “Doing Psychology Under New Conditions”, Captus Press Inc., 2013, p. 2-10. Here she comments on the human health effects of capital’s typical way of organizing labor:

      “Indeed, the abstraction and regimentation of labor has reached today its completion and so has our sense of alienation and de-socialization. What levels of stress this situation is producing in our lives can be measured by the massification of mental diseases – panic, anxiety, fear, attention deficit, the escalating consumption of drugs from Prozac to Viagra…

      “Fear and anxiety are only one aspect of the terror that today is employed to suffocate the growing revolt against the global work machine. Equally important has been the militarization of everyday life, now an international trend, preceding September 11.”

      Do yourself a favor and read something like this in its entirety. Just perhaps you might start seeing the light. There’s bad news for capitalism, though. Federici documents the growing resistance to capitalism. Sooner or later it will reach…

    • http://necrofiles.blogspot.com Garg Unzola

      Suffering under capitalist societies is much different. It’s the kind of suffering people choose if they’re given the choice. Strange.. they must be crazy.

    • http://necrofiles.blogspot.com Garg Unzola

      Criticising Neoliberal Ideology for health care implications would be more sane if most countries did not have a failing public health care service. But that would of course entail cutting the metaphorical crap and being a bit more clinical.

      I guess the impoverished people really do deserve their diet pills and liposuction. We can’t have Neoliberal Ideology clash with their inherent right to dignity or even with their narcissism.

    • http://necrofiles.blogspot.com Garg Unzola

      I guess it’s futile to try and point out that this is not even capitalism when an entire sector is nationalised and run by the government. It’s the exact antithesis of Neoliberal Ideology – which is of course not without its flaws but the very least one would expect of a criticism would be familiarity with anything besides conceited metaphors.

      Liposuction link below:

      http://www.telegraph.co.uk/health/nhs/10947902/NHS-spends-millions-on-cosmetic-surgery.html

    • Bert

      Here is an interesting and even more disturbing piece by Verhaeghe, sent to me by redoubtable ecological feminist, Ariel Salleh:

      http://www.theguardian.com/commentisfree/2014/sep/29/neoliberalism-economic-system-ethics-personality-psychopathicsthic

    • Bert
    • YajChetty

      100% on the money ! That’s why we need a paradigm shift with monetary reform( 100% reserve banking and the public creation of credit), tax reform ( replacing income tax and VAT with a land tax and transaction tax) as well as universal basic income .The current neoliberal regime based on fractional reserve banking by which private banks create 97% of our money supply out of thin air when they issue loans and compound interest is the driving force behind monetary scarcity, competition, economic exclusion and mental illness.

    • hiiq

      Yes, lovely idea. Now go see if Boeing will sell you a 787 in exchange for your new money.

    • NeurenPietersen

      How do you propose that money will become more abundant without fractional reseve banking?