Psychopathology at the Limits to Economic Growth: Part Two

The Management of Everyday life goes into crisis – mental health consequences

As we will show later in this article, this has enormous knock-on implications for the provision of essential goods and services as well as in the management of everyday life. The mental health implications then arise out of the way this undermines routine arrangements for living, as well as preventing the realisation of what people have chosen as their life purposes. These are the things that motivate them and what they aspire to. The resulting emotions include frustration, anger, fear and confusion too. The limits to economic growth, including the energy-related economic problems, do not just make it difficult to make ends meet – they lead directly to stress and distress.

Stress and distress also feeds anger and creates the conditions for social conflict and social breakdown – with accompanying political implications. In 2008, Syria suffered an unprecedented drought that climate scientists say had become much more likely because of climate change. It devastated agriculture and led to villages being abandoned and people moving into the cities. But the ability of the Syrian state to respond was severely constrained because after 1996 Syrian oil production and exports had been in decline leading to a serious reduction in government revenues.

Into this powder keg many countries intervened – including the US and UK sponsoring foreign proxy fighters in order to overthrow Assad’s government. Millions have been killed and displaced. When people from this crisis and the crises elsewhere in the Middle East and North Africa sought refuge in Europe, there was a wave of xenophobia promoted by right wing populist politicians. That and the chronic impoverishment that had already started for many countries in Europe, as well as in the US, has created the conditions for a destabilisation of politics with Brexit being one example. Nothing works in the same way anymore – because we have reached the limits of economic growth.

Different ways of understanding mental health problems

There are several different ways of understanding mental health problems. The dominant approach is still that theorised by medically-trained doctors who regard mental health problems as problems of the brain and brain chemistry caused supposedly by inherited genetic conditions that make some people particularly vulnerable to stress. This neatly transfers the “main problem” from the deteriorating life circumstances creating the stress itself to the “dysfunctional responses” to the stress – which are then interpreted as symptons to be treated by medication.

This way the medical profession has captured a group of “customers” who have difficulties in living and created a profitable captive market for the drugs industry. “Patients” are often legally obliged to take the drug or other treatments – even though there is strong evidence that so called “medication” does more harm than good, is toxic to the brain and creates a large number of long term conditions like dyskinesias (movement disorders) akin to parkinsonism.

As we will argue, this kind of approach is not going to be very helpful in the crisis that is currently developing. As the saying goes – if your only tool is a hammer all your problems look like nails. For many medically trained doctors their only tool is medication – so we now have an opiod epidemic.

Apart from medical understandings and treatments, there are “talking treatments” based upon psychological and psycho-analytical models of distress. Very often these focus on exploring life histories as well as childhood experiences and relationships, to identify how people have come to think and react emotionally in the way that they do – ways that are sometimes self defeating and dysfunctional, cutting them off from more fulfilling and socially adapted lives. Efforts are then put into training people to counter the self defeating thoughts and reactions that they have.

This will work in some individual circumstances. It can help some individuals to understand themselves and their reactions better. However it is not going to address many practical problems in everyday life that are already beginning to happen because of the limits to growth – eg, the problems of homeless people. People do make their own destinies through their own choices – but not in conditions of their own choosing. For many people in the world those conditions are highly constrained and chaotic and the limits of economic growth are going to make those circumstances worse. In these changing circumstances, approaches that imply that people will be able to pull themselves up by their own bootstraps by changing their thinking are more than misleading.

Life management “packages”… and their breakdown

What are needed instead are models where mental health problems are the result of the breakdown of “life management packages”. Some things are so obvious that we do not think about them – including how every independent person manages their lives. Unless they are dependents, most people must manage age-appropriate arrangements for habitat, relationships, occupation and income. These must be mutually consistent over time to be sustainable – for example, a place to live must be big enough for everyone in a family and this size, in turn, will require financial costs which imply a certain level of income and purchasing power. The requirement for an adequate level of income for the family group means the right kind of job and the right kind of hours. Loss of your habitat, or loss of relationships or loss of occupation and income, are likely to undermine the other parts of the “package”. This will bring about a distressing “life management crisis.”

As is obvious, if, for example, you are trapped in a dysfunctional relationship, escaping has all sorts of implications – money, finding a new home, re-managing relationships with dependents. Ending the relationship involves ending a great deal more than ending the relationship alone. Life styles must therefore be considered as “packages” which are unique to each individual. Transitioning to another “sustainable package” will typically involve a great deal of uncertainty, stress and worry.

Vulnerability to life management crises tends to be greater at typical periods of transition – e.g. leaving the parental home, mid life crisis, retirement – when a number of elements of the “package” are changed together. As society heads into the limits of growth, the approaching crisis first of all shows up among vulnerable groups – for example among young people who may not have the resources, the skills and the supportive relationships to set up their own homes, find a job and a find a partner. In later life the transitions are easier where older people have accumulated resources – like larger residential arrangements, relationships and money. However, this will change as retirement ages rise and pensions arrangements disintegrate because of crises in the financial system.

Eventually the limits to growth is likely to lead to more problems across a bigger proportion of the population – not just those in the “transition vulnerable” age groups. At the time of writing, the covid 19 epidemic has created widespread problems for people in paying rent and mortgages, servicing debts and finding employment.

The Limits to Growth are already beginning to disrupt and disintegrate life style packages of the consumer growth economy, and requires transition to new kinds of life style packages. Many jobs are likely to become unviable and many existing skills redundant. Many needs may become unaffordable. Transport arrangements will break down. The break down side of the transition will show up in redundancies, in extreme weather events with drought, floods, crop failures and rising food prices, in currency and financial system turmoil, in relationship break ups, in homelessness and the exacerbation of an already serious public health crisis. There is much potential to lose access to the basics of life – an ability to wash regularly, to prepare and eat regular meals, to have somewhere safe, warm and dry to sleep. Even before covid 19, in places like California, homeless people experienced the re-appearance of “medieval diseases” like typhus. Any society that fails to protect their vulnerable population with minimal support will find that the crisis of life management for the vulnerable groups will feed back into disrupting the life management of people whose lives are, for now, more secure. There will be more people with contagious diseases and other health problems, more people in public places who are seriously disturbed, volatile and behaving unpredictably, more “losers running wild”, more people engaged in opportunistic crime to survive and more social conflict and violence generally.

Turning cause and effect upside down

The confusion and emotions associated with destitution, homelessness and displacement are likely to be interpreted as “mental health problems” and then to be used as explanations as to why people have become destitute, homeless and displaced. Yet for those who are open minded, fear, anger, depression and lethargy appear as understandable emotions in the context of what happens to people when they are down and out. So too is confused thinking, distractedness and an inability to focus. Often enough these mind states are understandable in the lived circumstances of victims of social breakdown. It does not help to instead reference genetics and faux arguments about malfunctioning brain chemistry.

When a life style package is falling apart, or threatens to collapse, the situation a person faces is likely to be extremely complex. For example, leaving a failed relationship may involve making oneself homeless, may make continuing a job difficult, has to take into account how to continue to care for dependents. Or losing a job may make paying a mortgage impossible, threaten homelessness, disrupt relationships in a variety of ways. With disrupted relationships it is impossible to know how others are going to react.

Mental Health “symptoms” are the result of unsustainable life styles, as much as the other way round

Very often the life circumstances where individuals end up highly vulnerable leaves them totally isolated. As living arrangements break down without support arrangements to turn to it is almost too easy to end up on one’s own. The possibility for reciprocal relationships withers – because a person in chaos often has little or nothing to give back – no money, no useful skills, no tools, no place of their own to act as host. Instead they can come to be seen by others as being a source of long-term and severe problems and therefore as a burden and a drain….As the song goes, “No body knows you when you are down and out”.

Unfortunately it is already clear that societies with a highly individualistic neoliberal ideology, in which people are blamed for their own misfortunes because of a personal failure to compete, are likely to react to this crisis with more and more draconian punitive measures, exacerbated by racism and prejudice. In such societies, the emotions of frustration, anger and fear generated by the economic and social turmoil are not channelled into energies motivating social change and/or against a failing elite, but against those with no power to resist – in a process of scapegoating which will make the crisis worse. This allows the elite to channel negative emotions away from themselves and to motivate and promote disaster capitalist “solutions” – making money out of producing opioids, out of policing, surveillance and security, out of building prisons and weapons. In these kinds of situations, little or no effort is put into understanding why “losers” think, behave and feel as they do. The analytical framework of medical psychiatry, that locates the behaviour and problems of individuals inside themselves, in their genetics and faulty brain chemistry, does not help in the slightest but reinforces the prevalent attitude of condemnation.

In a life crisis, people are faced with extraordinary complex situations and great uncertainty at the same time. In conditions of uncertainty and unknowing it is not surprising that people resort to wishful or fearful guesses about the situation that they face – which psychiatrists and psychologists then call “delusions” or “illusions”. Yet distractedness, fantasies, illusions and delusions in extremely insecure life conditions is a product more than a cause of what is happening. If people resort to poetic metaphor, that is not surprising too. How else to express the drama of extreme insecurity than use the techniques used by poets and artists? The conditions they are in feel very dramatic and people may evoke that with imagery and by emotionally associative thinking (rather like what is sometimes found in the associations used by advertisers or the messages read into ink blot tests or the vague messages written by astrologers). The fearful novelty of their life conditions – of great insecurity, uncertainty and dependency on help by others can also knock their minds back into earlier periods of their life where they felt lost and vulnerable – including to the mind-states of infancy in a process called “regression” by psychotherapists.

To others, the language and expressed thoughts of people like this may seem bizarre. Their actions may also be impulsive, erratic and unpredictable – without a gap for reflection between the emotionally charged thoughts that occur in their minds and their flustered, frightened or angry actions. To be sure, erratic thoughts and impulsive actions, this lack of self control, does not help with coping – but it is too simplistic to see the root problem as resting solely or even mainly in the lack of composure of each patient. The mental turmoil has its roots in a larger context – life packages that are unsustainable and in turmoil.

In the conventional approach of the mental health services, the chaos in life arrangements is thought of as the result of the mental health problems of individuals. An upside down interpretation often takes place as if mental confusion and powerful emotional reactions is the reason that people cannot manage their lives. The breakdown of a life style package is often not visible to mental health services on first coming into contact with the people who become their patients. They see a person whose behaviour is bizarre and treat the person. They do not see the circumstances that has brought the person to them. This initial invisibility to the mental health services creates a focus of interpretation that blames the victim for life circumstances that psychiatrists, pychiatric nurses do not see.

Blaming Victims

In the context of the limits to growth generalising life package breakdowns, the focus on the brain chemistry of people in crisis will be a distraction from the need for community and society wide responses to a developing emergency by blaming victims for their own misfortune. Since the 19th century, medical places of asylum for people whose life arrangements are unsustainable have also been places whose inmates are socially devalued, degraded and humiliated. When the elite stole the common lands from ordinary people which were their sources of security, when industrialisation radically changed economic conditions without a safety net, large numbers of people resorted to crime to survive and were punished or transported. Others found themselves in asylums or, if they were old, in the workhouse.

For centuries elite ideology has been about blaming the poor for their own destitute state – and then punishing them or, in the case of psychiatry, “treating them” – which amounts to much the same thing given the damage done by psychiatric drugs and treatment. I speak from personal experience – being forced to take psychiatric drugs is to be forced into a zombie-like mental state. Depending on the drug one may find one’s muscles tied up in rigid knots and suffer agonising dyskinesias – involuntary, painful and ugly movements of one’s body. What others take to be the symptoms of insanity are often instead the effects of psychiatric medication. (This is detailed in the writings of Dr Peter Breggin: Psychiatric Drugs – Hazards to the Brain )

All this happens, at root, so that the elite and their hangers-on can avoid looking critically at the society which they are governing, their failure to understand why it is going wrong and why it is falling apart. Anything so that they can avoid recognising the violence and cruelty inherent in their policies. Anything so that they can avoid acknowledging that, in the context of profound changes, long standing practices are not working anymore – if they ever did.

At the limits to growth, what the governing elite will want is to avoid the idea getting around that completely new policies, institutions and social arrangements are going to be needed so that society as a whole can transition onto a different path – a path more appropriate to radically reduced resource availability with much greater risks for everyone.

Such a different path will be necessary for each individual and for society as a whole. The crisis will be a breakdown in the present, but it will also be a breakdown in what people expect from the future. If individuals and society are to transition to something more sustainable and resilience then they will need what a critic of psychiatry, Thomas Szasz, called “life games” which are more in tune with the times.

“Life games” – a structure of motivations

Something that you get up in the morning for and that provides purpose, meaning, direction, organisation and structure in your life can be described as a personal “life game”. Examples are not just employed jobs – though they may be – but things like becoming a successful business manager; becoming rich; parenting; “saving the world” – with different variants; becoming famous as performer – as an academic – or becoming a politician.

At root, motivations are either extrinsic or intrinsic. Motives are extrinsic where they come from the outside. They may, for example, involve punishment and reward by others, leaving individuals motivated to please others so they do not get punished. Or they may seek to impress other people with their “brilliance”. Seeking fame, celebrity, wealth are all extrinsic because there is a dependence on others for pumped-up self esteem.

Intrinsic motivations are different – an individual who is intrinsically motivated pursues interests for their own sake, not in order to impress or please others. If people are mainly intrinsically motivated they will be more self-sufficient and the reaction of other people is less important for them to maintain psychological equilibrium.

According to Szasz, to be mentally healthy one needs “a game to play in life”. In this view, mental health crises can be seen not just as the kind of breakdown described here as disrupted life-style packages. Mental Health crises may also be because of breakdowns of motivations and purposes focused on the future. This happens when individuals come to see that what they aspired to achieve is no longer achievable and/or believable. People may be knocked back psychologically at this and despair – indeed, one way of interpreting depression is that it is an emotion in which one is robbed of the energy to any longer think about or pursue a path that is futile and unachievable.

The transition to a post growth economy, to more appropriate life style packages, will require different motivations – aims, objectives and life games. People will need to leave non-viable life style packages behind and adopt new ones viable in the new, more unstable and constrained circumstances.

In a period of crisis, people motivated by extrinsic values will feel insecure unless told what to do. This is dangerous if they end up being recruited by gangs led by strong willed and authoritarian characters who themselves focus on simple purposes – like accumulating money and power by spreading fear (fascism).

In a period of crisis, people motivated by intrinsic motivation will need to improvise alternative co-operative and self help responses to the extent that their chosen motivations are relevant responses in their community.

Poverty and Sensory Deprivation – Living in Day Dreams as a Substitute for a life

One of the features of chronic long term mental health problems is that a person often ends up with no “life game” to play, no motivations and chronically impoverished. This impoverishment is more than an absence of purchasing power, it is a chronic absence of any meaningful experience. At its worst, this state may come close to sensory deprivation.

Extreme poverty which leads to an absence of meaningful experience to the point of sensory deprivation can lead to hallucination and paralysing day dreaming. When very few or no other external stimuli occur in one’s life, when one is chronically isolated, what goes on in the mind is a pre-occupation, not with external events, but an awareness of one’s own mental contents. “Cut off from external sensory stimuli there are only internal mental contents in the mind. ‘During waking hours, the brain only functions efficiently if perceptual stimuli from the external world is being received. Our relationship to the environment and our understanding of it depend on the information we gain through our senses. When asleep, our perceptions of the external world are greatly reduced, although significant sounds, like those of a child, may still arouse us. We enter the fantastic world of dreams; an hallucinatory, subjective world which is not dependent on memory in the here and now, but which is governed by our previous experience, by our wishes, our fears and our hopes.’ ”.

For many people, isolation and sensory deprivation is the stuff of everyday life – they are sensorily deprived because they have no money for consumer purchases; they are sensorily deprived because they have no work, or their work of the most mind numbing and repetitive tedium; they are sensorily deprived because they live stacked in rectangular environments of grey concrete, peeled paint and glass and surrounded by grass; they are sensorily deprived because they are frightened to go out at night lest they get mugged by those who, in order to find at least some excitement and adventure, rob their neighbours at knifepoint.

I recall in 1984 visiting someone who had been an inmate like myself in his new flat. He had just received a grant to paint it. He also had two chairs, a Baby Belling Cooker, one saucepan, a plate and a cassette recorder. He had one tape which he played over and over again. He ate fish and chips (at every meal) and painted his flat white. Not, of course, quite so much sensory deprivation as a sensory deprivation experiment – but then a sensory deprivation experiment lasts at most a few hours. This was what this person had to look forward to for the rest of his life.

Staying Balanced on a Stationary Bicycle

A metaphor that is useful here is the metaphor of the stationary bicycle. It is impossible to stay balanced on it unless it is moving – but to move it must have a direction – you must be going somewhere. You have to have a destination, even if only a provisional one. Without purpose, without going somewhere, you cannot stay balanced in life either. You will have no activity, no learning, no achievement.

If too much activity is externally motivated – eg by parents, teachers and social workers who always tell you what to do – you may lack experience of pursuing your own purposes.

For a young person lacking personal resources ( money, friends, skills ) to find and pursue their own purposes then the future may appear to be very frightening – full of daunting challenges – where to live, how to get a job and what kind of job, where to find trustworthy friends, how to find someone (a partner) who will actually like you when you don’t even like yourself and when you secretly think of yourself as pathetic….

The danger to be highlighted here is that with the global economy contracting, millions of people will lose their previous motivations and purposes, their reasons for living, as the economy goes down and their career choices are rendered meaningless. Alternatively they may launch themselves into career choices that as circumstances deteriorate turn out to be more challenging with every year. Loaded up with student debt it may have originally seemed possible to find a well paying and interesting job that would enable one to find a home, create a family and live a comfortable life – but many young people now find that that is no longer true. They find themselves instead in the “precariat” – people who live from “gig” to “gig”, who depend upon short term sources of meagre income or on zero hours contracts – jobs without security in an economy sliding into a slump.

Addictions

Although people tend to think of addiction as difficulty in withdrawing from the use of particular substances – like heroin or cocaine – another way of thinking about addiction is as a way of life where everything else takes second place to a compulsive kind of behaviour – getting the next fix. The next fix may be of a drug but it can also be something else like gambling.

Poverty and social exclusion lead to empty lives – the life of an addict creates a sort of artificial substitute. An addiction gives a daily purpose, social network and reciprocal implicit “fuck you” rejecting identity against the excluding society and what are felt to be hypocritical agencies whose staff get regular income for their social control role.

As things get even worse many may then be left stranded unable to start again, to recycle their lives, because unable to find new purposes and life games that are in tune with the new times that they find themselves in. If they have grown up in circumstances where parents, school teachers and other authority figures always told them what they should be doing but are now unable to go down the tracks that they were supposed to follow, they could end up in serious psychological difficulties.

Alternatively they may be recruited to cults or gangs or by the police and armed forces and used as cannon fodder in resource wars unleashed by a psychopathic elite who are unable to understand what is happening or provide a positive response.

It will help these people psychologically to have an alternative narrative in which their problems are the result of a broad historic process for which they are not to personally to blame. This narrative needs to be connected to transitional arrangements for re-localised, low energy, ecologically designed lifestyles like permaculture.

Where most people in a society share a common understanding of what is happening and a common understanding of what must be done, then that society has at least a chance of acting appropriately to its circumstances and the threats facing it. Unfortunately, achieving this common understanding is not at all simple. This is for a number of reasons which can be described as the psychopathologies that are specific to the rich and powerful, as well as their professional helpers.

Continue to Part Three
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