By ELTON CORBANEZI*
Mental suffering is a global catastrophe, possibly as important as the ecological one, but attention is focused mainly on the individual, disregarding the structural aspect of society.
Introduction
Both in common sense and in public opinion, it is commonplace to observe that the way of life in contemporary society compromises the mental health of individuals. Despite this social perception, it is these same individuals who are urged to manage their own mental health through various forms of self-care. In light of this double observation, two questions arise: how can we sociologically understand the implication and reflexivity between the concept of life and mental health in the present day? And how can sociology, in its clinical contribution, think about the lines of escape in the face of psychic catastrophe?
Recently, historian Jérôme Baschet (2021) stated that the 19st century began with the advent of the COVID-2020 pandemic in 1914, in the same way that, for many historians, the 19th century began in XNUMX, with the cycle of world wars. As is known, the COVID-XNUMX pandemic was, in fact, a significant global event for humanity as a whole and, in particular, for so-called “civilized” or “advanced” societies.[I], among which capitalism, in its current neoliberal form, appears as the hegemonic social organization.
Understood as a total social fact[ii], the pandemic both intensified social trends – social, mental and digital acceleration, remote work and education, precariousness of the world of work, wage decomposition, individualization, socioeconomic, racial, ethnic, geographic and gender inequalities and violence – and was perceived as an antechamber to ecological catastrophe (Castro, 2021; Danowski, 2021; Descola, 2021; Latour, 2020), since it had in common with the latter the threat to the human experience on the planet.[iii]
But another crisis was already underway and was exacerbated by the COVID-19 pandemic. This is the psychic crisis (Corbanezi, 2023), to which cultural critic Mark Fisher (2020) drew attention in his famous Capitalist realism [2009], by relating his depressive experience and widespread psychological suffering to the operating mode of contemporary capitalism. In effect, we are witnessing a global catastrophe that is possibly as important as the ecological one, but which, however, focuses mainly on the individual, disregarding the structural aspect of society.
Despite public attention (medical, governmental, media) to the crisis of psychological suffering, there is still no global treaty with visibility similar to the Paris Agreement to mitigate the problems of mental health that is being depleted like natural resources, based on an equally predatory and extractive conception of subjective human resources that are essential to the current phase of capitalism.[iv]
Em the sociological imagination, Wright Mills (1969) emphasizes the basic sociological principle that when a personal disturbance affects a significant proportion of individuals in a given society, it is no longer an individual problem.[v] Now, we live in a world that is globally based on the capitalist social order and in which it is estimated that 970 million people suffer from mental disorders. Of these, 301 million live with anxiety disorders – Brazil is considered the world “leader” in this category with around 19 million people with pathological anxiety, which is equivalent to 9% of the national population – and 280 million with depressive disorders (WHO, 2022, p. 41). Why insist on addressing psychological suffering as an individual problem?
It is true that, in theoretical terms, the phenomenon of mental health is defined by its biopsychosocial complexity. In Brazil, for example, devices such as the Psychosocial Care Network (RAPS) and its Psychosocial Care Centers (CAPS) attempt to put this postulate into practice.[vi] However, for hegemonic psychiatry, which still plays a central role in these institutions and which seeks to control the epidemic of mental disorders through the medicalization of suffering, mental disorders are fundamentally understood as neurochemical dysfunctions, which are ultimately reduced to individual organic functioning.
For the neoliberal social imaginary, in turn, psychological suffering can come from unsuccessful choices and poor management of subjective capital – emotional, relational, cognitive, intellectual capacities – of the individual himself, who would enjoy freedom and autonomy to do so.[vii]
Although mental health is addressed as a public issue, there is no official and global statement that psychological suffering – including the paradigmatic diagnoses of our time, such as depression, anxiety, Attention Deficit Hyperactivity Disorder (ADHD) and Down syndrome – is a disease that affects the general population. burnout – is also the effect of the structural dimension of the society in which individuals live, after all such a statement could imply the need for a radical social transformation[viii]. Everything happens as if the deviation from the norm were limited to the individual as homo clausus.[ix]
Em The Anti-Oedipus, whose subtitle is precisely Capitalism and Schizophrenia, Deleuze and Guattari (2010) turned against the representation of the unconscious carried out by Freudian psychoanalysis, in order to maintain that mental pathology does not derive exclusively from the individual's relationship with himself and with the family. For the authors, the unconscious functions above all as a factory, in terms of production (and not representation) of reality. According to this reasoning, delirium would not be an expression of the individual-family relationship, but, above all, historical-social: people, economy, history, culture, geography, politics are delirious[X]. Similarly, Antonin Artaud (2017) – a fundamental reference for authors of A thousand plateaus – argued that Van Gogh's silencing was not reduced to an individual act. For the French artist, Van Gogh had been, above all, “suicided by society”.[xi]
Our contemporary, Mark Fisher, also committed suicide and left behind a perceptive diagnosis regarding the relationship between psychological suffering and society, evoking the urgency of sociologizing and politicizing mental health today. Sociologizing – a term we have adopted here – means initially understanding in which society psychological suffering appears in an epidemic form.[xii].
This is what we aim to achieve in the first two sections of the article, by addressing neoliberal culture and the institution of subjective precariousness, in which the latter appears not only as an effect of the former, but as a social norm. Politicizing mental health, in turn, implies both demonstrating the individual-society link with regard to the production of psychological suffering and indicating studies, therapeutic forms and experiences of sociability that can collectively produce other modes of subjectivation not based on the principles of neoliberal culture. This is what we seek to achieve in the last section of the article, so that sociology can contribute by considering the structural aspect of the social dimension that involves the complexity of mental health as a biopsychosocial phenomenon.
Neoliberal culture
The term “neoliberalism” is often considered generic, broad, imprecise, and even controversial. According to critics of the terminology, it is an overly broad concept to empirically circumscribe complex and singular capitalist societies. However, the concept is relatively established in the field of human and social sciences and significantly mobilized as a category of analysis by critics of this formation and stage of Western capitalist societies (Andrade, 2019; Corbanezi; Rasia, 2020). We are interested here in outlining what we understand by neoliberal culture, a notion that sociological literature addresses more or less explicitly, although the idea is unequivocal in a variety of authors such as Foucault, Bourdieu, Bauman, Sennett, David Harvey, Naomi Klein, Wendy Brown, among others.
For our purposes, the concept of culture is not related to the capitalist sense of cultural production as a commodity, as examined by Adorno and Horkheimer (1985) through the concept of cultural industry, nor to culture as the cultivation of the spirit, according to Norbert Elias' (2011) analysis on the role of intelligentsia ascendant in the formation of modern civilization. The concept of culture that we use refers to the production of global values that guide ways of life and produce specific subjectivities. Félix Guattari (1996) named this conception of culture, originating from anthropology, as “collective soul-culture”, insofar as it involves a given civilization as a whole.
Unlike the other two meanings, it is a form of culture in which everyone participates and which produces common modes of subjectivation. Thus, capitalistic culture, according to the terminology used by the French philosopher and psychoanalyst, produces a capitalistic subjectivity, which, in turn, prevents the development of other subjectivities – singular, minor, non-hegemonic, deviant from social normality –, despite the contemporary incitement to difference and multiculturalism based on neoliberal principles (Boccara, 2013). It is in this sense, as a set of values that we all share to some extent, that we use the concept of neoliberal culture here.
It is not our purpose, therefore, to analyze a specific empirical singularity of neoliberalism, but to present the general features of the neoliberal culture that has taken shape over the last 50 years in Western capitalist countries.[xiii] As Margaret Thatcher (1981) prophesied in an interview with the newspaper Sunday Times in 1981, “economics is the method, the goal is to change the heart and soul.” What, after all, is this change in the collective culture-soul that effectively implies the current and dominant conception of life?
An axiom of capitalism is the need for unlimited growth. To this end, exploitation (of nature, of labor) has always been the means of achieving it.[xiv]. However, if in the disciplinary-Fordist period the objective was sought to be achieved by maintaining order and social stability (in the family, at school, at work), in contemporary post-disciplinary society it is sought to achieve this through the promotion of social values such as freedom and autonomy, from which feelings and experiences of instability, uncertainty, insecurity, and risk arise (Bauman, 2001; Castel, 1995; Sennett, 2019).
In fact, different sociological diagnoses have addressed this fundamental transformation in contemporary capitalist societies since the 1970s and 1980s, when neoliberalism as a form of government rose. For example, for Ehrenberg (1998, 2012), such social transformation, which the author situates in the domain of collective representations that contemporary societies make of themselves, implies the transition from the obedient and guilty individual to the autonomous and insufficient individual: if, previously, mental pathology was inscribed in the problem of disciplinary interdiction (conflictual model of Freudian neurosis), currently, considering the rise of autonomy as a social norm, pathologies gravitate around the incapacity of individual action.[xv]
As is known, the transformation of the Fordist productive paradigm to the current flexible model also results from the appropriation that the status quo capitalist critique of the work model of disciplinary modernity (Boltanski; Chiapello, 2011). In other words, this means that the disintegration of stable work patterns occurred through the workers' own desire, who did not want to spend their entire lives employed in the same factory. Fisher (2020) argues that critical thinking was not reestablished from this capitalist appropriation of desire (for autonomy, freedom, emancipation).[xvi]
It can be said that the transition from the obedient individual to the supposedly autonomous individual also means the transformation of the disciplined individual into an indebted individual (Deleuze, 1992; Fisher, 2020). In this new regime, internal control succeeds external surveillance. Theoretically free and autonomous, it is the individuals themselves who must manage and optimize their capacities, abilities and potential to the maximum according to the demands of contemporary capitalist societies.
This is a new form of injunction according to which it is also necessary to adequately manage subjective human capital (López-Ruiz, 2007). By mobilizing the desires of individuals, contemporary capitalist culture aims to converge personal and business interests, which language management operates explicitly.[xvii] It is clear that this transformation did not occur “naturally”, but rather as a result of the incorporation of neoliberal culture by social actors themselves to evaluate institutional, business and individual performances in a regime of absolute competition.[xviii]
Meet and exceed goals set by a new bureaucracy managers in the private and public sectors has become the supreme objective – hence the ongoing debt. The merely “satisfactory” evaluation of a service or a “delivery”, according to the corporate language disseminated in the social fabric, may be insufficient in the context of the neoliberal imaginary of limitlessness (Laval, 2020), in which the cult of performance, excellence and excess prevails.
Therefore, beyond the macrostructural aspects of neoliberalism (privatization, deregulation, reduction of public social spending and supposedly state intervention[xx]), the values of neoliberal culture – such as competition, isolation, fragmentation, speed, change and exacerbated individualization – directly affect the conception and conduct of individuals' lives.
This is a “business ontology” (Deleuze, 1992; Dardot; Laval, 2016; Fisher, 2020; Foucault, 2008) that involves everything from the State and public policies – forms and metrics for evaluating performance in schools, universities, hospitals, courts of justice – to individuals in their relationships with themselves and with others.[xx]. Understood in this way, neoliberalism is not really just an economic policy, nor is it exclusively an ideology that would mask effective reality according to dominant interests. It is, above all, a form of power that produces social reality (discourses, knowledge, practices) and specific subjects (see, for example, the emergence and place of coaching as discourse and practice in today's society).
This is how neoliberalism constitutes a rationality (Dardot; Laval, 2016; Foucault, 2008) and, by extension, a culture whose values guide life conduct (ways of thinking, feeling and acting) and produce capitalist subjectivation in its neoliberal form. In other words, neoliberal culture transforms the capitalist axiom of unlimited growth via (self)exploitation and competition into a “way of life”. This mode of production of subjectivity and subjection not only engenders an unstable and fragile subjectivity but also establishes it as a social norm.
From a sociological point of view, this subjective precariousness can lead to the current paradigmatic forms of psychological suffering: anxiety (anguish arising from the ever-present risk), depression (a feeling of failure in relation to current social values), burnout (work burnout), attention deficit and hyperactivity (restlessness resulting from overstimulation combined with the demand for productivity).
Subjective precariousness
Neoliberal culture, as a set of values that establishes the hegemonic conception of life and guides individual conduct, produces precariousness in a generalized sense. In concrete terms, it can be said that precariousness is a modern institution that accompanies the development of capitalism in its different phases: liberalism, Taylorism-Fordism, the welfare state, and neoliberalism.
In neoliberalism, the process of precariousness is taken to the extreme, not only due to political-economic aspects, such as various deregulations – financial, environmental, labor market –, labor subcontracting, salary degradation and the deconstruction of essential public services.[xxx]. In addition to objective precariousness, neoliberal culture establishes subjective precariousness based on the principles that govern a certain conception and conduct of life.
In addition to the autonomy, freedom of choice and power to act that characterize contemporary individualism, certain characteristics such as mobility, speed, adaptation, risk-taking and change establish subjective precariousness as a condition for social success. This statement is not restricted to workers, the middle and lower classes: it is a dominant lifestyle and way of life, disseminated throughout the social fabric by discourses and practices in the media, business and psychological counseling. Understanding this condition can contribute to the sociological understanding and problematization of mental health problems today.
The concept of subjective precariousness is not fully established in the field of human and social sciences, although it can be inferred from modern and contemporary sociological literature. In this respect, it differs from studies on the notion of precariousness, which has been widely examined in the field of labor sociology. Les metamorphoses de la question sociale, by Robert Castel (1995), is an important milestone regarding the concept of precariousness and also addresses its subjective dimension.
In his work, the French sociologist argues that the centrality of the category “work” in contemporary society is not only economic, but also symbolic and psychological. Thus, beyond the technical relationship of production, work constitutes the privileged support for inscription in the social structure and, through it, it would be possible to analyze what the author calls “zones of social cohesion”, namely, integration (stable salaried work), vulnerability (an intermediate range that combines job insecurity and fragility of support) and social disaffiliation (lack of participation in productive activity and isolation).
Given this classification, it is possible to state that the feeling of uncertainty and vulnerability resulting from the lack of social integration through work impacts individuals not only in objective terms (material conditions), but also subjective terms (identity, self-esteem, social relationships, well-being, expectations regarding the future).
An important step forward in establishing the concept of “subjective precariousness” comes, however, from the research of Danièle Linhart. The French sociologist effectively develops the concept to broaden the perspective of precariousness in the field of labor sociology itself. As Danièle Linhart (2008, 2009a, 2009b, 2015) argues in several studies[xxiii], subjective precariousness does not only concern workers who find themselves in precarious jobs, with temporary contracts, low wages, irregular hours, lack of social benefits and legal protection.
It is extended to stable salaried workers, subjected to the domination strategies of the management contemporary, which attributes centrality to the subjectivity of individuals. According to Danièle Linhart (2008, p. 322), subjective precariousness constitutes the “new ills at work”. This is because the new business management not only fully mobilizes the subjectivity of individuals (relational, cognitive, affective, emotional aspects) but also requires them to constantly prove – often at the expense of their coworkers – that they are up to the demands of excellence and the position they occupy[xxiii]. Subjective precariousness therefore arises from the centrality and mobilization of the subjectivity of wage earners.
Aligned with Christophe Dejours' (1998) perspective on the psychodynamics of work, Danièle Linhart (2008, p. 322; 2009, p. 212) argues that the extreme form of subjective precariousness can lead even “well-integrated” employees to suicide, which represents the ultimate sign of restlessness and the unacceptable in the contemporary world of work.[xxv] As can be seen, although explicit in her research, Danièle Linhart’s concept of “subjective precariousness” is limited to the category of work. It is true that work is an indisputable central category in contemporary society, especially if we consider the capture of subjectivity in its entirety and the practically complete decline of the division between free time and work time in cognitive, immaterial and informational capitalism. But the concept of subjective precariousness can be even more diffuse in society and even be part of the ethos contemporary.
Beyond the field of labor sociology, an important extension of the idea of precariousness in its existential and subjective dimension appears in Judith Butler (2011, 2015) and, especially, in Isabell Lorey (2015). Based on the ontological discussion about what a life is, Judith Butler (2015) argues, in general terms, that precariousness is a common human condition and, therefore, shared by all. However, when related to organizations, normativities and social and political frameworks that develop historically, the degrees of “existential precariousness” vary according to the “condition of precariousness”.
The central argument is that all life is precarious, in the sense that it is fragile and requires political, economic and social support for its maintenance. However, associated with this existential conception of precariousness, the political notion of “precarious condition” highlights its radically unequal distribution among diverse populations, which also occurs around mourning, recognition and violence, maximized for some and minimized for others.[xxiv].
Following Judith Butler, Isabell Lorey (2015) also argues that the processes of neoliberalization of contemporary societies further intensify the unequal distribution of precariousness. However, the author goes a step further by arguing that precariousness is not only an effect of social, political and economic structures but is itself a structuring factor in contemporary capitalist societies. In other words, based on Foucault's notion of governmentality, the German political scientist argues that precariousness is a political strategy of government incorporated by the governed themselves.[xxv].
In neoliberalism, argues Isabell Lorey (2015), precariousness would be in a process of normalization, which means that it becomes democratized and becomes a common condition – which does not imply, under any circumstances, leveling and homogeneity of the forms of precariousness that affect individuals, groups and social classes.[xxviii]. Institutionalized and normalized, precariousness would not be episodic, but a form of regulation and social control that characterizes contemporary capitalist societies, in which insecurity constitutes the central concern of subjects, as also pointed out by Butler (Lorey, 2015, p. VIII) in the preface to the work.[xxviii]
By mobilizing the individual desire that demands freedom and refuses to obey the Fordist-disciplinary paradigm, the technology of neoliberal government was able to transform precariousness into a form of (self)government, in which the condition of insecurity becomes generalized. Hence the ambivalent meaning of precariousness in the social imaginary: on the one hand, unrestricted exploitation; on the other, liberation from old forms of domination. The governmental issue would then be to manage and balance the acceptable limit – although not precisely calculable – between maximum precariousness and minimum safeguards, in order to avoid insurrections under the permanent Thatcherite claim that “there is no alternative” (Lorey, 2015, p. 65).[xxix]. For the author, therefore, neoliberalism normalizes and institutionalizes uncertainty and destabilization, which is why precariousness is socially diffuse, not being restricted, as for Linhart, to the margins of society.
But we can also say that precariousness, if understood not exclusively as scarcity and insecurity, but also – as the etymology and meanings of the term allow[xxx] – as ephemerality and transience, it constitutes a part of the very ethos dominant form of contemporary neoliberal capitalism. It is a way of life (way of thinking, feeling and acting) and, therefore, a hegemonic subjective constitution, around which key notions of contemporary capitalist society gravitate. In the brief text “Precarity as a 'lifestyle' in the neoliberal era”, Christian Laval (2017) formulates the expressions “culture of precarity” and “luxury precarity”.
Fruitful, they show the appreciation and promotion of a way of life that comes from the highest social stratification. It is about the exaltation of attributes such as risk-taking, speed, mobility, flexibility, dynamism, uncertainty and change. It is as if the volatility of the stock market should be incorporated and managed by humans. In short, it is about the institutionalization – in terms of social practice – of uncertainty in the name of the supposed individual freedom and autonomy that characterize the contemporary neoliberal era.
Among others, sociologists Bauman (2001) and Sennett (2019) have each shown in their own way the shift from the modern paradigm of disciplinary stability to the contemporary paradigm of post-disciplinary instability. Their widely known notions of liquidity and character erosion express this social transformation. What these notions fundamentally designate is the absence of solidity and the excessive praise of ephemerality and change.
Similar sociological diagnoses of contemporary capitalist societies show that fragmentation, displacement, disorder, risk and instability are not only not a problem for individual and social life, but are the golden rule for success. The “winners” attract them, while the “losers” repel them.[xxxii]. It is in this sense that we want to say that subjective precariousness constitutes not only the effect of neoliberal culture but is itself a part of ethos dominant; it participates in the socially hegemonic way and conception of life; it is an aspect that the spirit of contemporary capitalism requires of “successful” individuals.
To present the origin of the term “flexibility” in the English language, Sennett (2019, p. 53) reports that its meaning derives “from the simple observation that, although the tree bent in the wind, its branches always returned to their normal position”. Flexibility would therefore mean “this capacity of the tree to yield and recover, the testing and [the] restoration of its form”. Barbara Stiegler (2019), in her detailed study on the genealogy of neoliberalism based on evolutionary sources, argues that the fundamental issue of neoliberalism – and of industrial society, in general – has always been adaptation (to acceleration, competition, productivity, optimization and to an environment that requires the unlimitedness of human capacities).
Sociologically, the high incidence of paradigmatic mental disorders of our time (anxiety, depression, burnout, ADHD), which are strictly related to the logic and current social conception of life, may be an index of the transposition of the original meaning of the term “flexibility” as a first-order concept in neoliberal culture, since the restoration of normality (that is, adaptation) is no longer safe[xxxi]. Taking the image offered by Sennett further, we can say that deforestation – the effect of the exploitation of natural resources – is not, in this sense, exclusively environmental. Violence based on the same principle also affects human psychological life. This is what Mark Fisher sought to show when he affirmed the existence of a psychic crisis, whose advance was intensifying together with the ecological crisis in contemporary capitalist societies, without, however, the same political and structural attention.
Politicizing mental health
We are currently facing a notable contradiction. On the one hand, the sociocultural imaginary – based on official, scientific and media discourses and practices – seeks to promote mental health. What is at stake is not only preventing and treating psychological suffering, but also improving well-being (better than well), according to the well-known formula of cosmetic psychopharmacology by Peter Kramer (1993).
Indeed, the contemporary concept of mental health encompasses both health and illness in all their variations and extremes (Corbanezi, 2021b; Ehrenberg, 2004a; 2004b). On the other hand, the same imaginary that aims to promote mental health is based on subjective self-exploration,[xxxii] from which the condition of subjective precariousness also arises. In this sense, the culture of private discomfort and the medicine of well-being and improvement are part of the same dynamic (Ehrenberg; Lovell, 2001, p. 18).
Now, how can we have effective mental health – for which the individual would be exclusively responsible – in a context in which the social injunction lies in competition, performance, acceleration, change, ephemerality and unlimited individualism? In other words, how can we promote individual mental health while socially inciting subjective precariousness?[xxxv]
By addressing mental health from both its positive perspective of producing well-being and its negative perspective of producing psychological suffering, sociology can contribute to understanding and politicizing the issue. First, because sociologizing here already implies submitting the problem to a political dimension, in the broad sense of producing subjectivities and governing behaviors: what types of subjects are produced in a society based on neoliberal culture and how are they (self)governed? Second, by sociologizing the problem, we can perceive it as a social experience, unlike what is proposed by the predominant explanations of psychiatry and neoliberal culture, which tend to reduce suffering to the individual dimension.
As we have already stated, for the hegemonic psychiatric conception, mental disorders are, in general, the effect of neurochemical dysfunctions (Corbanezi, 2021b). For neoliberal culture, it is a dimension of life whose responsibility and management are the responsibility of the individual. It is worth emphasizing that the two explanations seem contradictory to each other, since neurochemical imbalance could not be reduced to individual responsibility.
Stricken with depression, Fisher (2020) set out to politicize psychological suffering. It is as if depression were not his. The author thus advances Deleuze and Guattari's (2010) thesis that delirium is always world-historical.[xxxiv]. In dialogue with the anti-psychiatric theoretical tradition of the 1960s and 1970s, whose pathological model of analysis par excellence was schizophrenia, the cultural critic warns of the need to politicize the common and everyday disorders of our current times. Instead of accepting the “privatization of stress,” we should ask ourselves: “when did it become acceptable for such a large number of people, and a particularly large number of young people, to be ill?”
The question refers, it is worth insisting, to Mills' (1969) basic sociological principle regarding the relationship between private disturbances and public issues.[xxxiv], which currently constitutes the specific and global language of mental health (Ehrenberg, 2012, p. 425). Problematizing the forms of “magical voluntarism” – this “unofficial religion of contemporary capitalism” according to which individuals would be able to escape their own conditions, including pathological ones –, Fisher (2020, p. 140, 137) argues that various forms of depression would be better understood and combated “through impersonal and political analytical frameworks, rather than individual and 'psychological' ones”[xxxviii]. The biomedicalization of suffering and the reduction of neoliberal culture to the individual dimension would, therefore, be proportional to the depoliticization of mental health conditions and consistent with the individualistic configuration of contemporary Western societies.
In fact, as a rule, the resources currently mobilized to combat psychological suffering or promote mental health are individual and/or corporate (medication, therapies, physical exercises, motivational speeches, meditation and coaching practices); they are strategies to integrate and conform the individual, since mental health is defined, broadly speaking, by adjustment and adaptation to social norms.[xxxviii]. The current paradigmatic forms of psychological suffering are not, however, transgressions of social norms: they result, above all, from the individual search to fulfill them. However, beyond individual and corporate strategies to confront psychological suffering, whose proposals tend to be based on the maintenance of order, what collective and therapeutic experiences could confront subjective precariousness as a social effect and norm?
An empirical case study presents a relevant experience in this regard. In a master's degree research at the Institute of Psychiatry of the University of São Paulo (USP), Guilherme Boulos (2016) empirically demonstrates the remission of depressive symptoms in individuals through collective participation and diverse sociability in homeless occupations in São Paulo. The group studied using qualitative and quantitative methods is relatively homogeneous: lives in conditions of absolute precariousness, whose predominant characteristic is the situation of deprivation.
From a longitudinal perspective, the data show the remission of depressive symptoms after joining the social movement. The testimonies indicate that shattered lives are reintegrated, at least subjectively, by participating in a popular collective movement. The reasons for the remission of symptoms are the bonds of solidarity, acceptance, recognition, recovery of self-esteem, a sense of belonging, overcoming feelings of invisibility and uselessness, the qualitative expansion of social relations, and so on. A form of sociability diametrically opposed to the principles of neoliberal culture (competition, performance, individualism, isolation) can appear in such an experience as a collective alternative to subjective precariousness and the psychological suffering that results from it.
This is obviously not an isolated case. There are many others in progress and have already been experienced historically. In the book History of popular psychoanalysis, Gabarron-Garcia (2023) undertakes a politicization of psychoanalysis. To combat the apolitical and bourgeois meaning attributed to the discipline, the author goes through a series of historical experiences to show its political and revolutionary dimension.[xxxix] All of them seek, to some extent, to subvert hierarchical social relations based on individualizing and competitive capitalist sociability.[xl]. The author concludes the work by evoking a series of experiences taking place worldwide, highlighting, in the Brazilian case, the establishment of CAPS in the public health system and psychoanalytic collectives for free reception and listening in public spaces.
Deivison Faustino (2022, p. 276-278) also brings to light a series of studies and research and intervention groups based on the influence of Franz Fanon and the recent exponential increase in interest in the work of the Martinican psychiatrist, also in the so-called psi field, with emphasis on the psychology of racial relations and the relationship with schizoanalysis. In the same direction of a new politicization of psychiatry and mental health today, it is worth noting the renewed interest in institutional psychotherapy, which aims to treat institutions and subvert the hierarchy and established roles of social relations through institutional processes of collectivization.[xi]
More broadly, we should also highlight the current interest in the theme of the “common,” of which the homonymous work by Dardot and Laval (2015) is exemplary. For the authors, “common” designates an alternative political rationality to neoliberal rationality and implies a radical transformation of the system of norms that threaten humanity and nature. As a general political principle, “common” would result from what the authors call “instituent praxis,” which are dispersed, diverse, and even marginal collective practices, of which the examples of sociability, therapeutic practices, studies, and interventions that we have mentioned may be part.[xliii]
Although not exhaustive, the experiences and studies highlighted here can contribute to the politicization of psychological suffering by highlighting how neoliberal capitalist subjectivation and the social relations of domination and competition that arise from it are part of the explanation for the high incidence of psychological suffering today.
As far as consistent ecological policy is concerned, the way out of the epidemic crisis of psychological suffering also seems to lie in a collective (and not simply individual) transformation of our ways of life and sociability.[xiii]. A reality that the status quo, represented by government agencies, multilateral agencies, the media, companies and elites, cannot effectively enunciate. Understood here as politicization, such a perspective constitutes, in our view, yet another way of taking seriously the “social” particle (beyond “socioeconomic factors”) of the phenomenon officially defined as “biopsychosocial”.
Final considerations
We have seen the values that underpin neoliberal culture and that constitute both a conception of life and the current reference from which individuals conduct it. In this scenario, subjective precariousness appears not only as an effect of neoliberal capitalist subjectivation, but also as a social norm, since individuals are urged to incorporate the values of neoliberal culture in order to achieve social success. We believe that such ways of life and social values must inevitably participate in the explanation of the high incidence of psychological suffering today, with emphasis on the paradigmatic disorders related to neoliberal capitalist subjectivation (anxiety, depression, burnout, ADHD).
We seek to argue that mental exhaustion occurs according to the same logic as the exhaustion of natural resources, of which the current ecological crisis is emblematic, which is why only a collective transformation of the conception of the world and of life can contribute to the deceleration of both forms of crisis. In this way, without disregarding the existence of biological and psychological elements, we aim to show the relevance of politicizing mental health problems as a social and collective experience in which contemporary social values play a fundamental role.
*Elton Corbanezi is a professor at the Department of Sociology and Political Science at the Federal University of Mato Grosso (UFMT). author of Mental health, depression and capitalism (Unesp). [https://amzn.to/3EfESTk]
Originally published on CRH notebook, December 2024.
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Notes
[I] As a witness the fall of the sky, indigenous peoples deal with epidemics (xawara) mortals since contact with the “commodity people,” as Davi Kopenawa refers to the whites of Western civilization. “I am always dismayed when I look at the emptiness in the forest where my relatives were so numerous. The epidemic xawara never left our land and, since then, our people have continued to die in the same way” (Kopenawa; Albert, 2015, p. 245-246). During the COVID-19 pandemic, everything was as if we had all become indigenous, according to Lévi-Strauss’ famous formulation that we would be doing to ourselves what we did to them (Albert, 2020; Castro, 2021).
[ii] For Philippe Descola (2021), the COVID-19 pandemic can be understood based on Marcel Mauss's concept of “total social fact”, that is, as a phenomenon that reveals the profound nature of a society. It is in this sense that, according to the anthropologist, the COVID-19 pandemic made it possible to exacerbate the traits of post-industrial capitalism that governs the current world.
[iii] It is known that the Covid-19 pandemic exclusively threatened the human experience, unlike the ecological crisis – which is both climatic and environmental –, which entirely puts nature at risk. As sociologist Anthony Giddens (1991) pointed out in the 1990s, the ecological crisis is among the consequences of modernity, that is, an unexpected effect of the development of modern capitalism and equally not foreseen by the founding classics of sociology who analyzed it.
[iv] In her analysis of World Health Organization (WHO) documents on global mental health policies, Sônia Maluf presents, in this dossier, the outlines of the WHO's global action plans and goals for mental health. The researcher also shows how the WHO's official discourse on mental health is a contested field: on the one hand, it emphasizes the recognition of the role of social, cultural and economic factors in understanding mental health problems; on the other, the strategies for implementing plans and goals tend to be reduced to an individualistic configuration, in which both neoliberal rationality and psychiatric explanation participate. Ultimately, the author argues, the individualistic configuration remains hegemonic in the WHO's official discourse.
[v] In the 1950s, the American sociologist criticized the reduction – carried out by psychiatry and psychoanalysis – of mental pathologies to an individual problem, thus delivering a scathing criticism of Ernest Jones (Mills, 1969, p. 19-20). On the conservative role played by Jones in promoting Freud and psychoanalysis, see Gabarron-Garcia (2023).
[vi] An example of the difficulties in implementing such devices can be seen in the case study by Barros (2023).
[vii] It is worth noting that the radical transformation of the psychiatric paradigm with the publication of the DSM-III (APA, 1980) in 1980 occurred concomitantly with the processes of neoliberalization of Western capitalist societies. This is a subject that we address in Corbanezi (2018; 2021b).
[viii] Let us take as a basis the radical logical reasoning of socio-ecological demonstrations regarding the climate crisis, which is also personified in the figure of the young environmentalist Greta Thumberg: let us change the system, not the climate (Löwy, 2023). In criticizing the socially alienated form of production of scientific knowledge, the mathematician Alexander Grothendieck (2014) also stated that it was not enough to change the mode of production of knowledge, but the industrial model of civilization in which it is inserted.
[ix] In a theoretical-methodological discussion on the individual-society relationship, Norbert Elias (2011, p. 230) defines it as follows: homo clausus: “The conception of the individual as homo clausus, a small world in itself which ultimately exists entirely independently of the great external world, determines the image of man in general.”
[X] Focused on psychic reality, it is the same general sociological postulate as Mills (1969, p. 10): “The history that affects every man is world history”.
[xi] Much of the intellectual production draws attention to the causal correlation between psychological distress and society. In contemporary times, we can highlight Fanon (2020), who showed, in the 1950s and 1960s, the effects of colonialism on the psyche, passing through different anti-psychiatric perspectives (Basaglia, Laing, Cooper, Szasz), until more recently Han (2017), who argues that the production of psychological distress results from the society of performance. According to Ehrenberg (2012), this normative approach, from which the author distances himself, is predominant in sociological, anthropological, philosophical and psychoanalytic studies on the subject and is also frequently demanded by mental health professionals.
[xii] We know that the epidemic of mental disorders is also a social construction, which means that it is produced as an idea by different discourses, such as medical, scientific, economic and social. In this regard, see Corbanezi (2021b), in which we seek to show the production of the idea of a depressive epidemic based on the affinity between the development of the psychiatric nosology of depressive disorders and the social values of contemporary capitalism.
[xiii] We limit ourselves here to indicating the following studies on the origins and theoretical and historical variations of neoliberalism: Foucault (2008), Dardot and Laval (2016), Harvey (2008) and Stiegler (2019). We analyze the subject in detail in Corbanezi and Rasia (2020).
[xiv] Unlimited growth through exploitation: this is the logical reason why modern and contemporary capitalism cannot be sustainable. This necessary criticism that capitalism is ecologically unsustainable has now become commonplace, as Dardot and Laval (2015, p. 514) state. Here we want to problematize the psychic crisis based on the same principle.
[xv] This is what the French sociologist calls the transition from autonomy-aspiration (desire for emancipation in the context of disciplinary society) to autonomy-condition (post-disciplinary emancipatory society, in which autonomy becomes a social norm) (Ehrenberg, 2012).
[xvi] In Fisher's terms (2020, p. 63): “[…] the left has never recovered from the blow that capital dealt it when it mobilized and metabolized the desire for emancipation from the Fordist routine”. Also inspired by Deleuze and Guattari – who, for Fisher (2020, p. 14), present the “most impressive interpretation of capitalism since Marx” –, the fundamental question for the author of Capitalist realism it is like (re)capturing the desire for the transformation of social reality.
[xvii] See, for example, the euphemism of terms such as “partners” and “collaborators” to replace classic terms such as “worker” and “laborer”, as well as the overvaluation of happiness, the discovery of meaning in work and the spirit of sacrifice and teamwork. On the mobilization of subjectivity by new forms of business management, see Linhart (2015).
[xviii] It is worth noting, for example, the process of implementing neoliberal culture in Brazilian universities, which could be, in principle, the place of resistance par excellence to neoliberal values (Corbanezi, 2021a; Sguissardi; Silva Junior, 2018; Silva, 1999).
[xx] Despite the common terminology of the “minimal state”, it is known that, since its foundation, neoliberalism has been based on the reconstruction of a strong state to defend economic policies favorable to the dominant classes (Bourdieu, 1998; Dardot; Laval, 2016; Foucault, 2008; Wacquant, 2012). As Fisher (2020) repeatedly asserts, for example, it was the state that saved the banks in the 2008 economic crisis.
[xx] Dardot and Laval (2016, p. 356-357) coined the term “ultrasubjectivation” to capture this ethos individual that could be synthesized in the formula “the beyond itself in itself”.
[xxx] As Fábio Franco (2021) shows, neoliberalism is essentially based on the imperative “Make things precarious”.
[xxiii] The concept appears explicitly in Linhart (2009a, 2015). In Linhart's studies (2008, 2015), it arises from the central idea that the exploitation and absolute mobilization of subjectivity subjectively weaken the contemporary worker, who does not have, as the author observes, two subjectivities, one for work and another for life outside of work (Linhart, 2008, p. 209).
[xxiii] Here is how Linhart (2009a, p. 2) defines the concept: “It is the feeling of not being comfortable at work, of not being able to trust professional routines […]; it is the feeling of not mastering one’s work and of having to make uninterrupted efforts to adapt, to achieve the established objectives, to avoid putting oneself at physical and moral risk […]. It is the feeling of not having resources in cases of serious problems at work, neither from the hierarchy (increasingly rare and less available), nor from the work collectives that have become worn out by the systematic individualization of employee management and their placement in competition. It is, therefore, the feeling of isolation and abandonment. It is the loss of self-esteem, related to the feeling of barely mastering one’s work, with the feeling of not being up to it. It is the fear, anxiety, the feeling of insecurity that is conveniently called stress.”
[xxv] The emblematic case is the serial suicides at France Telecom. In the same vein, Standing (2014, p. 29, 85-89) also argues that precariat, whose central characteristics are chronic uncertainty and insecurity, is advancing in the public service, despite the “much-coveted security of employment”. The author argues that functional flexibility, commuting, evaluations and performance demands cause intense personal suffering. Fisher (2020) also shows how managerialism, based on the culture of auditing, performance and flexibility, tends to suppress the classical values of what is understood as public service.
[xxiv] In Butler's terms (2015, p. 38): “Precarity must be understood not only as an aspect of this or that life, but as a generalized condition whose generality can only be denied by denying precarity as such. And the obligation to think of precarity in terms of equality arises precisely from the irrefutable capacity for generalization of this condition. Based on this assumption, the differential allocation of precarity and the condition of being mourned is challenged. Furthermore, the very idea of precarity implies a dependence on social networks and conditions, which suggests that here we are not dealing with 'life as such', but always and only with the conditions of life, with life as something that requires certain conditions to become a livable life and, above all, to become a life capable of being mourned”. The author also discusses the unequal distribution of precarity, mourning and violence based on normative schemes that define the degree of variety of what is human in Butler (2019).
[xxv] Let us remember that Foucault (2008) asserts that the sophistication of neoliberal power technology resides above all in the ability to govern based on the rationality of those governed. This is the key to thinking about neoliberalism as rationality.
[xxviii] The author is categorical in this regard: “The process of normalization [of precariousness] does not imply equality in insecurity” (Lorey, 2015, p. 66).
[xxviii] It is worth noting that Bourdieu (1998) already stated in the 1990s that precariousness would not only be an economic effect, but also a political strategy of decollectivization, which is why collective resistance became increasingly distant in the context of precariousness. Analyzing movements around precarious subjectivities such as EuroMayDay, Lorey (2015) defends the need to develop new political forms of resistance based on the condition of precariousness itself. In this regard, the author especially criticizes Robert Castel, who, unlike Bourdieu, was able to witness the global development of the EuroMayDay movement, but would not have perceived political capacities in precarious subjectivities. For Standing (2014, p. 15-19), in turn, it would be necessary to move from the symbolic and carnivalesque scope of movements that affirm individualities and identities based on the common condition of precariousness to the political program through the constitution of the precariat as a class-for-itself.
[xxix] The idea that there is no alternative is, it is worth saying, the basis of what Fisher (2020) calls “capitalist realism”.
[xxx] From Latin precarious, the term precarious designates, in its etymology, what is “obtained through prayer; taken as a loan; from others; strange; temporary” (Houaiss; Villar; Franco, 2009). In fact, in the French language, in addition to uncertainty and instability, the term precarious it also means ephemerality, fleetingness, passage (Le Petit Robert, 2001). The idea of ephemerality, passage and change is equally central to the classical notion of precarious work.
[xxxii] Characterizing the contemporary global elite formed by “absent masters”, Bauman (2001, p. 22) argues that “moving lightly, and no longer clinging to things seen as attractive for their reliability and solidity […], is today a resource for power”.
[xxxi] See the data presented in the introduction to this article. In the context of the COVID-19 pandemic, in which there was an acceleration of social trends (Corbanezi, 2023), the WHO reported a 25% increase in the prevalence of anxiety and depression worldwide (PAHO, 2022).
[xxxii] Just as capitalism cannot exist without precariousness, we have known since Marx that capital cannot exist without exploitation. If the human becomes capital, exploitation is doubled over the individual himself, despite the verbal subterfuge of the theory of human capital that it is always an “investment”.
[xxxv] Linhart (2015, p. 129) highlights how the discourse and practice of management contemporary society are based on an equally paradoxical logic: on the one hand, employees are increasingly required to excel, take risks, and be fully engaged; on the other, they are driven to a feeling of impotence and fear that can lead to paralysis. It is like requiring individuals to concentrate in order to increase productivity while simultaneously immersing them in the overexcitement of the virtual world. Standing (2014) and Fisher (2020) argue that contemporary hyperconnectivity compromises the intellectual and cognitive development of the precariat and youth, respectively.
[xxxiv] Carmen Silva (2021, p. 287), leader of the Homeless Movement of the Center, in a conversation at Ocupação 9 de Julho, in São Paulo, after stating that the delirium of homeless people in the context of the covid-19 pandemic is based on concrete issues, thus expresses this delusional condition: “When I get home, I carry all the fear in the world, all the delirium of everyone, which is hunger, that my husband is unemployed, that I am going to die, that my son is hungry”.
[xxxiv] On the relationship between private evils and social issues in Mills's public and political sociology, see the erudite essay by Gabriel Cohn (2013).
[xxxviii] In his study of the precariat, Standing (2014) argues that anxiety and personal suffering are a normal condition for this category, which experiences acute and chronic insecurity. The author then problematizes the individualization of suffering based on the hegemony of cognitive-behavioral therapy, recommended to people after the 2008 economic crisis by the UK government, which, in this way, did not address structural issues that produce personal suffering. As the author says, “there is nothing wrong with therapy per se. What is questionable is its use by the state as an integral part of social policy” (Standing, 2014, p. 216).
[xxxviii] Note, in this sense, the definition of mental disorder (mental disorder) in force since the DSM-III. Due to the lack of definitive laboratory data, the suffering and impairment in the individual's ability to function in some dimension of life (personal, school, family, work) define the mental disorder. The Brazilian psychiatrist and psychoanalyst Mario Eduardo Costa Pereira (2013) problematizes the concept of mental disorder from the idea that, to define the disorder, it would be logically necessary to define the order, which the DSM does not do. In a way, that is what we are trying to do here by submitting mental health problems (mental disorder) to a sociological perspective that aims to understand them in relation to the social values of neoliberal culture (social order).
[xxxix] Among the experiences covered in the book are Freud's defense of popular clinics before their cultural pessimism and the appropriation and promotion of Freud's ideas by Ernest Jones, Vera Schimidt's psychoanalysis with children in the Union of Soviet Socialist Republics (USSR), Wilhelm Reich's sexual politicization against fascism, Marie Langer's trajectory and therapeutic experiences in Europe and Latin America, François Tosquelles' institutional psychotherapy, the La Borde clinic with Jean Oury and Félix Guattari, and the radical experience of the German collective Socialist Patients' Collective (SPK) in Heidelberg.
[xl] The experience of Maria Langer and her colleagues, for example, aimed to modify the social relations between their patients in order to establish another subjective and collective basis. “We were able to observe how the therapeutic process of the groups evolved as solidarity emerged and was consolidated among the group members, despite the existing rivalries, tensions and ambivalences. In the groups we contrasted solidarity with the unhealthy competition of the system” (Langer apoud Gabarron-Garcia, 2023, p. 138).
[xi] Proof of the renewal of such interest are, among others, the publication (and translation) of Gabarron-Garcia (2023), the study by Camille Robcis (2024), and the recent publication in Brazil of the collection of texts by François Tosquelles (2024). We also note the collective exhibition “Touché l'insensé”, at the Palais de Tokyo, in Paris, in 2024, focused on the history of institutional psychotherapy and current collective experiences around its therapeutic practice.
[xliii] Political struggles that obey the political rationality of the common are presented, according to the authors, as “collective research into new democratic forms”. The revolutionary project of the “common”, they state, “can only be conceived articulated with practices of a very diverse nature, economic, social, political, cultural. Provided that common lines of force end up emerging sufficiently through the links between the actors of these practices, an ‘imaginary meaning’ can end up crystallizing and giving meaning to what until then seemed to be merely dispersed, diverse and even marginal actions or positions taken” (Dardot; Laval, 2015, p. 19, 582, 578).
[xiii] When the COVID-19 pandemic brought to sharp relief the chronic problems of neoliberal capitalist societies, Descola (2021) argued that the cure could only lie in a radical change in our ways of life, a transformation of thought similar to that brought about by the Enlightenment. Problematizing the ecological issue and the false problem of the notion of sustainability from the indigenous perspective, according to which the idea of sustainability is incompatible with extractive and predatory industrial development, Krenak (2019, p. 12) asks whether we are effectively one humanity. The question applies here, for us, also to psychic ecology.
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