Joanna Moncrieff and the new symptom

by Arran James

How is it possible that society has reached a situation in which ‘compulsive buying disorder’ does not seem an absurdity and academic papers can discuss its biochemical basis (Bullock & Koran, 2003)? The answer may lie in the convergence of the efforts of the pharmaceutical industry with wider political interests.

Neoliberal policies, which date from the late 1970s, are designed to facilitate the expansion of activities of private corporations through deregulation and privatisation. Deregulation refers to reduced state restrictions on trade, capital flows and business practices. A massive transfer of wealth from the public sector to the private sector has occurred worldwide since the 1980s and with it there has been a ‘historic transfer of political authority from the state to the private market’ (Hamilton, 2003: p. 17). In addition, the principles of the market have been imported into the remaining public enterprises, such as the National Health Service, to foster competition and shape them in readiness for sale to private providers (Price et al, 1999).

Increased commercial activity demands increased consumer spending and deregulation allows industry to increase the levels of exploitation of its workforce. If people are to cooperate with this situation, they must be persuaded that the system is morally good, or at least that it is morally neutral. To this end neoliberalist thought portrays ‘market forces’ as natural, inevitable and unrestrainable, and as exempt from normal consideration with regard to the exploitation of people or the environment. Therefore the guilt that would normally arise from excessive consumption or profiteering is suppressed (Richards, 1989). In this context the values of individualism, competition and consumerism can be praised and policies justified by appealing to ‘efficiency’ and ‘consumer choice’.

The deregulation of business and the decline in state welfare provision have led to growing inequality throughout the world, both within and between countries. This polarisation between rich and poor has occurred rapidly and very visibly, thanks to the increasing spread of different forms of media. For example, in the USA in the 1980s the top 10% of the population increased their income by 16%, and the top 1% increased their income by 50%. In contrast, the bottom 10% lost 15% of their income (Phillips, 1990). Alongside this growing polarisation of wealth most people are working more intensely for longer hours, and have poorer working conditions and little job security. Unemployment and low wages are endemic, and health inequalities are growing.

Neoliberal economic policies have been accompanied by increasingly authoritarian social policies. Rates of imprisonment have increased steadily in many Western countries. In the USA, 1.3% of the male population and almost 5% of the Black male population are now in prison (Bureau of Justice, 2005). In the UK, legislation in recent years has introduced child curfews, parenting orders and the Anti-Social Behaviour Order (ASBO), and looks set to increase the use of compulsion in the community for psychiatric patients. These measures can be seen as attempts to police the consequences of economic policies by controlling and excluding the minority of Western populations that are the victims of the dismantling of the welfare state and the low-wage economy.

The propagation of the chemical imbalance theory provides a more subtle means of social control, and supports the neoliberal values of competitiveness and consumerism. Hamilton (2003) has pointed out that the system works by encouraging people always to be dissatisfied and to want more. He describes modern consumers as being in a ‘permanent state of unfulfilled desire’ (Hamilton, 2003: p. 87). The chemical imbalance theory implies that there is a normal or ideal neurochemical state against which everyone can be measured. As the boundaries of disease are pushed out, a large proportion of the population are encouraged to be dissatisfied with themselves and to ‘rectify’ the state of their brain chemistry. People are encouraged to aspire to be something different from themselves, in their emotional lives as well as in their material lives. Individual consumption – in this case of pharmaceuticals – is presented as the means of achieving this.

Joanna Moncrieff. 2006. Psychiatric drug promotion and the politics of neoliberalism. Here.

Moncrieff is a practicing psychiatrist and the author of numerous texts critical of psychiatry and pharmaceutical companies. She is among the closest to the spirit ‘anti-psychiatry’ working and writing from within the field today. Her book is also well worth reading. I have been (re)reading everything she has produced voraciously for a paper on schizophrenia that may be published in the near future.