attempts at living

to make a system out of delusions

Tag: psychiatry

Diplomatic psychiatry?

The idea of psychotherapeutic ‘peace settlements’ (see here) seem close to the anarchist idea of arbitration and resemble something that might operate as a counter or autonomous psychotherapy. The problem for me comes if these settlement procedures were applied to orthodox psychotherapy and/or psychiatry where the patient is receiving treatment via legal detention or social coercion. Their proximity to Latourian diplomacy precisely puts them too close to agonistic procedures in which actual antagonism is obscured or naturalised as something to be negotiated.

The power differential, and the way psychiatric sovereignty operates via constantly displacing itself, mean that many patients have to seek advocates (esp. where the therapist or nurses fail in their often claimed advocacy position). The advocate, as in the peace settlement procedures, is a third who is introduced to the two-person adversarial situation of the institutional therapeutic space. Such spaces need not be hospitals, prisons, therapist offices or schools- the mobility of the clinic via community treatment means your the patients home can be a temporary meta-institutional space, wavering between being a clinical and extra-clinical space (and thus ambiguously importing and disturbing the situational norms regulating the behaviour of all parties).

In such cases the advocate is not a third brought in to reach a position of compromise, negotiated peace or other neutrality. The advocate is a partisan third who actively takes the side of the patient against the therapeutic agency. I say “therapeutic agency” because the patient will rarely come into contact with just one person, even at an initial assessment. By the time an advocate is even a possibility the patient will be firmly confirmed in their “patient” role from the perspective of the therapeutic agency, either as a good patient or a bad one.

The idea of a cultural translator might be a good idea in pragmatic terms however, given that we now understand (via transcultural psychiatry), that immigrant populations are often considered psychotic when formulating their (nonpsychotic) experience in terms, metaphors, structures of belief that would be considered perfectly appropriate in the context of their “home” culture.

So when looking at the idea of the peace settlement we have to consider where it is being deployed, and whether it is being deployed on a the basis of a spuriously  neutral pragmatism or one that begins from partisan fidelity to the distressed. Finally, a question that might scramble this in terms of psychotherapy is why the 2-person “consulting room model” (as David Smail calls it) needs to be retained. Except under exceptional circumstances where it was really too traumatic, we could ask why not prefer some form of group-work. And then, if group-work is too traumatic for the distressed person what makes us think they will tolerate even a third? Especially if the third were someone they knew (friends and family are often not really friends), or if they were appointed by the institutions themselves.

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brief note on ‘the asylum state’

Scanning through a paper on Foucault, Baudrillard and the history of madness, I came across the following:

 

The asylum has been absorbed into the core of the social field, because normality has reached the point of perfection and assumed the characteristics of the asylum, because the virus of confinement has worked its way into every fibre of ‘normal’ existence (Jean Baudrillard, Symbolic exchange and death. p.127).

 

 

In this (hyperbolic) claim Baudrillard sounds a lot like the Foucault he commanded his audience to forget. The asylum, supposedly a place of refuge from the conditions that triggered periods of distress, functioned to carve up the sane and the insane by physically isolating those that early psychiatry deemed mad. In so doing, procedures of confinement could allow the production of a normalised sanity: behaviour and belief- conduct– could be regulated efficiently. Of course the uses of the asylum far exceeded even this aim; they were routinely used to house socially undesirable people who would be subjected to the same inhumane treatment as those suffering from distress. WAF Browne, a Victorian physician, stated that “the lunatic” was

 

‘left to linger out a lifetime of misery, without any rational attempt at treatment, without employment, without a glimpse of happiness, or a hope of liberation.

 

 

Conceal, confine, torture, neglect: these were common hallmarks in the early days of psychiatry, hallmarks that remained in many – if more refined- ways until the closure of the asylums. The deinstitutionalisation movement was and continues to be heralded as a great liberation. Baudrillard’s counter-assertion, really a provocation in the style of Foucault’s method of fabrication, puts forward that when the walls came down and the heavy iron doors were locked for the final time it was the asylum itself that was liberated. It seems that for Baudrillard this is a way to speak about deinstitutionalisation and community care, and the author of the paper suggests- in a highly uncritical manner- that attempts to integrate psychiatric patients into collective life are only an intensification of psychiatric power.

I think this style of argument has a lot of truth to it, especially considering the way community mental health teams operate in conjunction with mental health legislation (esp. CTOs) in making sure that the clinic follows the patient from hospital to home (or “the community”). I also think that it misses the importance of having community treatment options for those who need them and that it also fundamentally fails to grasp the potential radicalism of taking seriously the idea of social integration; that is, full social integration would be participation in struggle against capital and the state and would therefore be disruptive of their functioning. Full integration might imply the potential autonomisation of mental health services so that psychiatric workers became administrators beholden to those for whom they are supposed to care. Full integration might also imply the radicalisation of peer-support networks into solidarity unions for survivors of psychiatric mistreatment (not to imply that mistreatment is the only treatment people receive).

However, with rising dependence on psychopharmacology and the spread of the therapeutic model to problems with living minor as well as large, and the increasingly aggressive pathologisation of everyday life, it seems impossible not to conclude that the there is something of the asylum spread through the social field. What would it mean to take this claim seriously? To take up the specificity of the asylum as a functioning metaphor of society? Practices peculiar to asylums include non-remunerated labour designed to foster “moral integrity”- don’t we see this mirrored in workfare practices? They also include intense surveillance. In contemporary psychiatric hospitals, they might also include “rapid tranquillisation”- the practice of forcibly injecting someone deemed dangerous (often with justification) with antipsychotics in order to call them down. Is such a response mirrored in police actions that are justified by reference to “anti-social behaviour”?

In the end this image of an asylum state might not be particularly helpful, and Baudrillard’s treatment of “the mad” may be more intoxicated with images from psychiatry’s history than it is with any actually living subject. Still, we can hardly disagree that WAF Browne’s summation applies all to readily to our own societies.

 

 

Pharmaco-centric capitalism: a reply to Will Self.

Psychiatry is undoubtedly experiencing something of a crisis. It is a clean and currently self-contained crisis, one that rarely troubles national headlines or makes it into the everyday conversations of workers in the office or the clothes shop floor, but it is a crisis nonetheless. Whilst the so-called anti-psychiatry movement of the 60s had a libertarian and experimental edge to it that courted controversy and political radicals, the “rational anti-psychiatry” or “critical psychiatry” of today is a lot less exuberant, more level headed and nuanced but, perhaps because of that, grips the imagination of the mass of people much less. This is weird. Its weird because when mental health issues do hit the headlines it is to warn us of epidemics of depression, anxiety and dementia; or to warn us of the terrible lunatics that roam the streets whenever “a schizophrenic” kills someone in the street or “psychopath” stalks playgrounds, gunning down children and teachers alike. Even with the publication of the new DSM-V it has only been the readerly classes and the commentariat who have raised furrowed brows and waded into the murky waters of psychiatry’s history. The quiet crisis of psychiatry is weird because 1 in 4 people are supposed to be affected by “psychiatric illness”, although this must be a conservative figure when we include the toll taken on carers, families and friends.

One member of the commentariat, the author and self proclaimed psychogeographer Will Self, has waded in to try to ask the question of whether the current epidemic of depression and hyperactivity has been caused by psychiatry and big pharma themselves. In an online column  published last Saturday, Self recounts an anecdote of his own time being treated for heroin addiction under the supervision of an unnamed psychiatrist, before going on to provide a brief synopsis of the noxious collaboration between psychiatry and big pharma. On first read, Self’s is a decent survey of this potent combination of science and industry.

In his view, psychiatry has increasingly tended to attempt to colonise everyday misery and suffering in order to expand its influence and power. As he puts it, the problem lies with ‘psychiatry’s search for new worlds to conquer, an expedition that has been financed at every step by big pharma’. This partakes of at least two types of narrative that have become incredibly popular. On the one hand, we have the narrative of the pathologisation of everyday life, and on the other hand, clasping the first tightly, is the narrative of imperialism. This story is one that should be familiar to anyone concerned with psychiatry and the experience of mental distress but will be especially familiar to those of us who have trained and work within the psy-disciplines, no less than for those of us who engage with critical theory and radical politics. There is nothing wrong with these stories in and of themselves, but presenting them in such a way as to suppose that this is an inevitable or teleological development of psychiatry would be misleading.

Psychiatry has had a number of minoritatian aspects in its history which have been more or less radical and which could have led to the establishment of a different psychiatry. To list all such missed opportunities would take too long but we could briefly include on such an account RD Laing’s attempt to create new therapies at Kingsley Hall, Felix Guattari’s work at the highly experimental La Borde clinic in France, and Loren Mosher’s similarly radical Soteria Project, the latter of which has demonstrated better efficacy than standard psychiatry in a number of studies in the treatment of psychosis (for instance, see here). We could also include the current work of Romme and Escher with Intervoice and its growth into the Hearing Voices Network, based on the psychiatrist and journalist team’s seminal findings that far more people experience voice hearing than ever receive psychiatric treatment. All of these projects were initiated, led and analysed by psychiatrists and psychiatric survivors against the tendency of biopsychiatry to pathologise distressing or divergent experience and to treat it with neuroleptic medications via coercion or legal compulsion. These projects either failed or remain in suppressed as “alternative” not because psychiatry has some immanent imperialistic drive toward the colonisation of our minds but for historical and material reasons. Some elements of these projects have been filtered into the current trend for person-centred care and use of the recovery model, but people involved in the founding of the recovery model (such as Ron Coleman), and some of those involved in its incorporation into mental health services (like Philip Barker and Poppy Buchanan- Barker, whose essay on “pharmaco-centrism” can be found here) see nothing tokenism destroying a potentially liberatory approach to working with people experiencing distress.

In fairness, Self doesn’t actually ascribe to a narrative of psychiatric imperialism for its own sake but suggests that the drive towards transforming everyday human misery into pathological disorders comes from biopsychiatry’s failure to cure the psychoses. As he puts it

unable to effect anything like a cure in the severe mental pathologies, at an entirely unconscious and weirdly collective level psychiatry turned its attention to less marked psychic distress as a means of continuing to secure what sociologists term “professional closure”.

As an explanation for why a group of people who ascribe to the hegemonic “medical model” of psychiatric research and practice would attempt to make the sorrow of grief or the tantrums of a toddler into morbid biochemical or behavioural dysfunctions the invocation of a professional collective unconscious does indeed seem weird. It seems weird because it imports an unnecessary combination of Freudian psychological and ontological presupposition onto a turn that can be much more easily explained. To suggest that psychiatrists are attempting to make the misery of unemployment into a brain disorder treatable with antidepressants because it failed to find a cure for psychotic illness is a stretch at the very least. At most it implies the existence of a symbolic order that only a subset of psychiatrists exist inside of that has structured their desire in such a way as to force them to treat all problems in living as if they were the same a severe and enduring psychotic disorder. While at first it might seem fair to say that feeling wounded by their failure biopsychiatrists expanded their attention to include more “conditions”, it is ludicrous to suppose that this was because the psychiatric unconscious made them do it. Even if Self doesn’t intend to invoke a psychiatric unconscious it remains remarkable that the unconscious drives of the majority of psychiatric researchers and practitioners (recall the two don’t always overlap) across the globe were effected in such a way as to synchronise them into coalescing around a singular trajectory.

Self does note that psychiatry may have wanted to secure its ‘professional closure‘ after it’s legitimacy as a medical science had been called into question by the failure of its curative ambitions. This seems a reasonable suggestion and is probably closer to the truth, but it does not require an invocation of Freudian psychoanalytic concepts to explain. If psychiatry’s legitimacy as a science was challenged this would also obviously constitute a threat to the status of psychiatry as a medical profession awarded with high status and high salaries. It is thus more likely that psychiatry’s desire to maintain the demarcation of its professional boundaries was driven by directly material and cultural capital concerns. In short, if psychiatry wasn’t a medical profession, if it was nothing but pseudo-science, then consultant psychiatrists would lose their money, their gravitas, their status (recall, in the 1950s psychiatrists were glamorous) and their power as agents of the state. As Self also notes, in the United States insurance companies require that a medical condition be present in order to payout on psychiatric treatment. It is commonly asserted that the DSM-III, published in 1980, was largely produced because of the increase in insurance companies refusing to payout  for such claims during the 1970s. In that same period the American NIMH slashed its funding for psychiatric services by 5% in 1976 on the assertion that such funding could not be afforded when mental illness was so vaguely defined and unmeasurable (largely a response to the prior dominance of psychoanalysis in American psychiatry). In the same moment, clinical psychology was just beginning to find its feet and was looking to launch an offensive on the hegemony of psychiatry in the care and treatment of the “mentally ill”, whilst survivor groups were launching offensives on the inclusion of homosexuality in a diagnostic manual of mental diseases. Threatened from all corners, psychiatry renounced psychoanalysis and renewed its original basis as a biomedical enterprise. There was nothing unconscious about this move, and the collective movement towards rekindling biopsychiarty was far from unanimous. Simply, threatened with the accusation of being a “pseudo-science” that lacked diagnostic validity and reliability, lacking evidence of outcomes for treatment and accountability, psychiatrists had to take measures to protect their relationship with medical cognitive authority and ensure its practitioners private wealth.

Simultaneously with all this, psychiatry also had to be defended as the sole means of dealing with “the mad” because it proved to proved itself as a powerful means of social control. The techniques and drugs employed by biopsychiatry in its past, resurgence and in the present day remain attached to the processes of discipline and normalisation that Michel Foucault elaborated on in a number of texts. As a series of dispotifs aligned to the management of bodies and their conduct psychiatry plays a pivotal role in regulating the distribution of the sensible. What can and can’t be said, what can and can’t be done, what can and can’t be seen or heard, on what is and isn’t to be considered “normal” are part of the preserve of psychiatric institutions. This role is especially important when life under late capital proves itself to be anxiogenic and depressing.

It is on the role that psychiatry plays in the medicalisation of everyday misery as the medicalisation of the destructive effects of post-Fordist capitalism that Will Self’s article veers firmly away from. In the analysis of psychologists like David Smail and political theorists like Mark Fisher, the production of distress is seen to be accelerated by the effects of capitalist recomposition. As the psychiatrist Joanna Moncrieff puts it giving someone a psychiatric diagnosis ‘allows behavioural control to be presented as treatment and it sanctions the release of state funds for support that may not be desirable’. Since Richard Warner’s Recovery from schizophrenia: psychiatry and political economy, psychiatry has been aware that long term unemployment and a precarious/casualised labour market produces all the signs and symptoms of depression, and I have written time and again on how life under capitalism produces anxiety, panic, and other “new symptoms”, such as self-harm and eating disorders. I have no doubt that depression and anxiety are on the increase, and that hyperactivity is increasingly being diagnosed, but to suggest that this is the fault of psychiatry and the pharmaceutical industry is to confuse a cause with a symptom and means of managing disastrous psychological effects. That people work shit jobs at low pay, that are increasingly precarious, and that there appears on the temporal horizon a choice between more of the same or some catastrophic moment (ecological, industrial, whatever) within austerity conditions, the corrosion of public services and support networks such as the NHS, unemployment and disability welfare, under increasingly totalitarian state power means that everyday life is increasingly leading to mental distress. People feel impotent and unable to control their lives. They are taunted with empty consumerist visions of a happiness that is denied to them. As Self points out, their traditional coping networks are fragmented and, as Smail and Fisher both point out, their suffering is rendered as a personal failure or a biological disorder.

Why would psychiatry need to pathologise depression and hyperactivity? Its obvious why dubious diagnoses like borderline or anti-social personality disorder exist, but less so why unhappiness should become depression? Self openly states that ‘I don’t think it helps anyone to see the current imbroglio as simply a function of late capitalism’, and yet this would help immensely. The pharmaceutical industry (not “big pharma”) is an industry, which is to say no more or less than that it is a section of capital. For pharmaceutical capitalism to continue accumulating profit it must have an audience to sell its products to and it has that in the form of psychiatry, itself a wing of state power that has a captive market who can be legally compelled to take their medication. Psychopharmacology and psychiatry have been entwined since psychiatry’s birth, and even in the heydays of psychoanalytic psychiatry in the USA benzodiazapines were still regularly prescribed.

What is new in recent years is the transition from a Fordist to a post-Fordist economy, and to the revolution in social life that this has entailed. David Healey, a psychiatrist and psychopharmacologist, has discusses how SSRIs were marketed through pathologisation (ie. transforming unhappiness into a market). Its worth noting that Selective Serotonin Reuptake Inhibitors have nothing “selective” about them, and that the RCTs that prove their effectiveness are- as Self notes- funded by pharmaceutical companies. SSRIs were marketed precisely at the time when the possibility of collective response to capitalism broke down and when capitalism entered a faze in which everything was submitted to economic reason, including human emotions and affectivity. Thus, capital effects a double stroke: a new market and a chemically constrained population. This chemically constrained labour force, who might otherwise slide into despair given the new reality in which real subsumption appears to have swallowed everyone and everything whole, individualises the causes of its distress, never looking to the conditions of its subjectification, and never being capable of summoning the energy to fight back. Of course, this is capitalism’s dream, rather than an accomplished fact. Yet even those people who riot or refuse to work, those who enact a kind of psychic withdrawal from the harshness, uncertainty and emptiness of the work-consume world, can now be medically treated to ensure no further loss of working hours. Economically, the biopower of psychiatry ensures that labour-power can be regulated more or less efficiently whilst as Moncrieff suggests,

concealing the political nature of the responses to the situations that are labelled as ‘mental illness’, psychiatric diagnosis prevents these responses from being questioned and scrutinized. It allows the state to delegate a difficult area of social policy to supposed technical experts, and thus to remove it from the political and democratic arena.

In separating actually existing psychiatry from “big pharma”, and in separating “big pharma” from capitalism and the interests of a particular class protected by state power, Will Self’s analysis effectively decouples his critique from any economic or political implications. What we are left with is a weak moralism that he himself even calls ‘ lily-livered liberal’, that also misrepresents certain aspects of the history of the two disciplines. This moralism is born out in Self’s comparison of psychiatrists as “drug-pushers” where it is clear that we’re supposed to read “drug-pusher” as a good go-to caricature of a bad person. This moralism of the psychiatrist as unscrupulous bastard getting kids hooked on downers is conjoined to the weak assertion that ‘we are all to blame’. Our responsibility, according to Self, comes from the fact that we are

‘absolutely bloody miserable, we can’t get up in the morning, we are dirty and unkempt, and we go along to our GP and are prescribed an antidepressant and lo and behold we recover.

For Self, the bad dealer-man gives us misery guts a pill and we feel better and therefore “we” are to blame for having been miserable and/or for the ‘chemical repression of the psychotic’ (it isn’t clear which). This complete obliteration of a perspective willing to recognise, analyse and critique the structural causes and consequences of psychopharmacological psychiatric treatment completely mirrors the prevailing ideology under which that structure justified itself (the same problem is found in the second half of Soderbergh’s recent film, Side Effects). Presumably this morality also extends to the parents of children, or the children themselves, who are desperate to find some way to ameliorate the incredibly stressful situation that hyperactivity can cause. It is also telling that people who experience psychotic phenomena are given only fleeting mentions in the article, as if concern over psychiatric power is really only important when it concerns the middle class readership of the Guardian. People diagnosed with psychotic illness tend to be either live in poverty at onset or to drift into poverty as a result and Self only real reflection on economic position seems is his correct reference to ‘socio-medical discrimination: no sick note – and no social benefits’, although he leaves out any reference to the fact that today many people who should not be working are having their welfare revoked and forced back to work.
Self does include reference to ‘autonomously organised self-help groups’, suggesting that these might provide adequate compensation for the loss of traditional family networks. While this might be true, Self’s example is the 12 step program that is used in alcohol and substance misuse, groups that require members swap a pathological identity (“ill”) for a deviant one (“addict”). While 12 step programs might prove useful to some people they do not challenge the causes of people’s problems but further privatise them as individual failures- “My name is Arran and I am an alcoholic”, as the well-known admission of responsibility goes. I have no qualms with self-help groups. They are shown to be efficacious, to foster recovery, to aid in the production of destigmatising communities of support, and may even lead to the ability for people to become politically active. I don’t want to suggest that the answer for all mental distress- as one insurrectionary anarchist text has it- is ‘revolt, not therapy’, but therapy without an understanding of the material conditions in which distress develops often does more harm than good. Examples like the Hearing Voices Network and the Soteria Project are far closer to how I understand the term ‘autonomously organised  self-help groups’. In time, members of such groups might even drop the “self-help” reference, and engage in the organisation of autonomy.

I like Will Self’s novels and short-stories. They are full of a dark humour and Ballardian insights. If I am critiquing his understanding of psychiatry, psychopharmacology and the pharmaceutical industry it is not because he is part some nefarious cabal attempting to mystify us but because his view is symptomatic of a mystification that is already in place. Self’s brief overview partakes of a fiction that he didn’t write, but when he write that ‘I don’t think it helps anyone to see the current imbroglio as simply a function of late capitalism’ he becomes a supporting character inside of it. After all, what else but capitalism is helped by refusing to see capitalism’s role in the production of “mental illness”, and accusations that psychiatry is a pseudo.science is precisely what lead to resurgent bio psychiatry.

Postpsychiatry: reaching beyond the technological paradigm in mental health

Mark Fisher on the need for a leftist psychotherapy

Mark Fisher seems to have called for what I’m calling a “political therapeutics”:

R: In a talk you gave about ‘Capitalist Realism’ earlier this year you called for the
development of a ‘leftist psychotherapy’. Could you explain what you mean by this?

M: This is really serious, I think. Since there are so many people who are depressed – and I
maintain that the cause for much of this depression is social and political – then converting that
depression into a political anger is an urgent political project. Of course it’s not only about that. It’s
also about levels of real distress and suffering in society, which can not be handled or dealt with by
the individualising, privatised assumptions of the dominant forms of treatment in mental illness,
which are, in this country, cognitive behavioural therapy – which is a kind of combination of positive
thinking and kind of psychoanalysis light: the focus on family background of the sufferer, and on
then of converting thought patterns from these negative into positive ones. There’s that. And on the
other hand, brain chemistry focus – the horrible loop whereby massive multinational pharmaceutical
companies sell people drugs in order to cure them from the stresses brought about by working in
late capitalism. Neither of these things are very effective – all they do is largely contain people’s
depression rather than actually deal with the actual cause of depression.

One can apply Marx’s arguments about religion very directly to this – that religion was the opium of
the masses. Anti-depressants and therapy are the opium of the masses now, in lots of ways. That
isn’t to say that they don’t do anything at all. They do in many cases relieve intense suffering, which
people are undergoing. But it’s just the same as religion. As Marx said, it’ll make people better in a
kind of savage and pitiless world – religion wants real comfort to people in the same way, in a world
of relentless competition, of digital hyper-stress, etc. Being able to talk to someone for an hour in
cognitive behavioural therapy or having something which will take the edge of things via antidepressants – that will make people feel better, but just as with religion, it doesn’t get to the sources
of that sort of misery in the first place. It in fact obfuscates it.

If you want to look at the rise of capitalist realism, one can also look at the decline of anti-psychiatry.

As anti-psychiatry declined, then capitalist realism grew. I think there’s a relation there between the
two. That normalization of misery as part of the privatization of stress has been absolutely central to
the rise of capitalist realism.

How do we get beyond that? Some kind of return to the issues that were raised by anti-psychiatry.
I’m not saying necessarily that everything anti-psychiatry said was right. With anti-psychiatry, as
with many other anti-authoritarian strands of leftism that emerged in the 60s – that kind of rhetoric
became diverted and captured by the neoliberal right. When did anti-psychiatry cash-out? Well in
some ways, Care in the Community, etc. But of course that wasn’t the only way it could have gone.
Thinking about ways of reforming, changing institutional care, of looking at a shift beyond this
narrow kind of focus either on family background or the kind of chemical make-up of people’s brains
– this could have a very high impact, I think, if we could articulate this.

A reader of ‘Capitalist Realism’ actually drew my attention to the work of someone called David
Smail, who’s himself a kind of therapist – though I don’t think he’d like the term ‘therapist’. He, in a
number of books, has sort of argued for the development of a leftist psychotherapy. Smail claims
that feelings of well-being fundamentally arise from a public world – against the background of a
public world. And in a society in which the concept of the public has been so kind of viciously and
systematically attacked – it’s no surprise, Smail argues, that distress has increased. He argues that
– as I would – that the dominant forms of treatment in mental illness have reinforced that rather than
challenged it. I think developing Smail’s ideas could be extremely powerful.

Read the full interview here.

From what I recall, this is a slightly more nuanced position than appears in Capitalist Realism, although its been a been a few years since I read the book so I could be wrong.

This post originally appeared as a response to Steven Hickman at noirrealism.

On this pure semiopath that : this is, once again, played out in Virilio as a kind of prophetic theory-fiction around his idea of cocooning. Houellebecq’s novel is the future (the future without futurity) that emerges out of Virilio’s ideas. In this regard it is interesting that the (awful) cinema version The possibility of an island is not the story of this film but tries to mash together elements of Atomised and Lanzarote in order to present a kind of inverted image of technognostic/Singularity ecstatic thought, hope, utopia. With both men I share the fear that PoI might sketch a possible future, not a literal one but one that is already emergent, already with us, in the production of what you are calling the “semiopath” but which I have always (and incorrectly) thought of as a post-traumatic subject…increasingly I prefer to think of it as the dis-embodied subject.

In that respect, if there is a tradition of taking a psycopathy and rendering it as the metaphorical lens for the age, then I think I could suggest that these men are tracing out the contours of this disembodiment… schizophrenia begins with disembodiment, but undoubtedly the most obvious (and lethal) form of the disorder is anorexia nervosa. It is the eating disorders that are the psychiatric metaphor for our age, just as they are among the most widespread symptoms of our perversely post-scarcity, post-affluent society. One can even think of Houellebecq’s ideas on the sexual economy that followed sexual liberation (I think he speechifies on this in Whatever but it may be Platform) and how the anorexic symptomology relates directly to this deregulation of bodies, pleasures and desires.

Funnily enough, I was reading The Map and the Territory while on a clinical placement with a CBT therapist in an eating disorders unit (a job I would love, btw) and could see the return of the organic at the end of that novel as an acute correlate to so many of those women’s (I didn’t work with any men) disavowal of their own bodies. The complexified auto-affection that comes undone through intensification; the rigidity of thought; the alexythimia and hedonic dysphoria; the obsessiveness of the mundane; the possible rejection or inability to cope with adulthood, majority, reason; the use of psychostimulants. I will need to return to these theme, central to my way of thinking about and orienting my clinical practice. Ballard may have left psychiatry, and in ‘To Stay Alive’ Houellebecq may only have seen in it a tool of survival (indeed, an institutionalisation of coping mechanisms), both of these men have equal right to claim to understand the psychopathology of our age…as much as any contemporary Freud or Kreaplin might.

Psychiatry and post-traumatic subjectivity

Today at 2pm (GMT) Novara Media will be broadcasting on contemporary psychiatry and the post-traumatic subject. This is a subject the importance of which for me I can’t express. I think I have said before that my own experiences of panic and the rising anxiety, disassociation, and dis-empathic conditions that I saw so many friends falling into had three profound influences on me. First, it compounded my desire to leave London. Second, it lead me to the desire to work in the psychiatric world (eventually as a nurse). Third, it led me to start thinking and reading about just this post-traumatic subject.

Meanwhile, Novara Media is a fantastic project hosted by the brilliant Resonance FM. If you don’t have the time to listen to today’s stream live (I probably won’t either) I will be embedding it once it is available.

Update: (Quasi-)relatedly, Foucault News has also just put up a link to a new paper. From abstract:

By exploring the complex co-existence and intertwinements of discipline and biopolitics in preventive practices, this study eschews an interpretation that views the powers of the professional health system as invasive and one-directional. Perhaps surprisingly, the study demonstrates how patients in various ways defy a ‘patient-centered’ and empowering approach and demand to be treated medically and disciplined in a more traditional sense.

Communism in recovery

In spite of the association of violence with political will, however, I would argue, as did Arendt, that the new glorification of violence of the late 1960s was caused by a severe frustration of the faculty of action in the modern world. That is, it expressed an underlying despair with regard to the real efficacy of political will, of political agency. In a historical situation of heightened helplessness, violence both expressed the rage of helplessness and helped suppress such feelings of helplessness. It became an act of self-constitution as outsider, as other, rather than an instrument of transformation. -Moishe Postone, History and helplessness: mass mobilisation and contemporary forms of anticapitalism.

As a psychiatric worker this absolutely appeals to me intuitively and theoretically. The violence in the riots of 2011 and the violence that is fetishised by certain left factions are born out of helplessness. Indeed, one could see the current historical moment, the movement of the left from its position of despair to optimism is also analogous to the psychiatric patient dragging themselves out of a kind of learned helplessness. The rejection of electoral politics by the majority of people could be seen as a symptom of learned helplessness: do they refuse to vote because they don’t care, or because “it won’t make any difference”; whenever you hear someone saying that they wish that there could be a world without classes, without a state, without injustice, without violence against women and so but that can never be because “that’s just the way things are” they are also talking the language of learned helplessness. In a similar respect, I wonder if the Zizekian call for a Master is a symptom of such learned helpness (the need for a savior; an externalisation of the locus of agency), or if it is instead a return to being able to think in terms of heroism, and therefore evidence of a recovery of agency and imagination?

In the 1960 and 1970, American psychologist EP Seligman was carrying out research on dogs to investigate the phenomena of classical condition (Pavlov’s dogs; the formation of an association between a stimulus and a resultant that influences behaviour). In the course of his research Seligman noticed that those dogs that received unavoidable electric shocks would fail to take evasive action in situations where avoidance-escape behaviour would have removed them from an aversive stimulus. The control animals, those dogs that did not receive such electric shocks, were able to flee the threatening situation with no difficulty. Repeating the experiment with human participants (and noise rather than electricity), Seligman found his dog results were reproduced. Seligman proposed that there was a structure of expectation that expected the uncontrollability of outcomes through intervention, and therefore the belief that intervention and action would be futile. He named this expectational-behavioural feedback loop learned helplessness. Essentially, repeated failed attempts to perturb a situation and produce a change inculcate in the attempters that it is pointless to even really try. Isn’t this the structure of the experience of the left?

Since assembling the idea, learned helplessness has become positively viral, being applied to pretty much all psychiatric conditions, to prison populations, to older people in care homes and so on. The authors of the website You are not so smart have even extended the application of the theory of learned helplessness to everyday life:

Every day – your job, the government, your addiction, your depression, your money – you feel like you can’t control the forces affecting your fate. So, you stage microrevolts. You customize your ringtone, you paint your room, you collect stamps. You choose.

This is the social psychology of capitalism. I have seen this first hand in patients of long-stay psychiatric wards and I have lived it during a period of long term unemployment (studies of both of which in relation to learned helplessness have proliferated since Seligman’s day). Isn’t this also the economy of the false choice that infects every aspect of contemporary life (coke/pepsi etc.)? You get to choose, but just enough to make sure you don’t make a real choice. This is precisely the trap that has broken apart and out of which the anti-cuts protests and the anti-Austerity movements have sprung. For Seligman, learned helplessness was to be understood as a form of depression, but it is clear that this has been a depression of what Franco Berardi calls “the social brain”. It is not that you or I have been depressed, although we might very well have been, but that we have all been subjected to depressive processes of subjectivation; the entire field of the production of subjectivity has been depressed. In discussin such a depression I want to make it clear that I reject the false dichotomy that presents itself as a political antagonism. On the one hand, depression is often portrayed a neurochemical condition, a “brain disease”. I argue that even when it is not theorised in this way the casual pharmacological treatment of it as such displays a kind of political faith (in a phrase designed to modify Santayana’s “animal faith”) that it is. The first half of Steven Soderbergh’s last film, Side Effects, does a wonderful job of exploring this faith and the complex relationship of psychiatry, the pharmaceutical industry, professional patients (people who have the knowledge about this brain disorder and the “fact” that prozac will make it better), family, and capitalism- and its affects- before losing its way. On the other side of this debate is the position that says depression is a social and political problem. The latter position is passionately argued by Mark Fisher in his excellent Capitalist Realism and in a good deal of interviews. I support Fisher’s calls for a politicisation of depression and, following psychiatrist Joanna Moncrieff, I would also claim that diagnoseslike “depression” often serve to produce markets for psychiatric drugs and

allows the state to delegate a difficult area of social policy to supposed technical experts, and thus to remove it from the political and democratic arena. (Here).

I agree with this critique but I do think it is important to realise that neurobiology does play a demonstrable role in depression. There does seem to be a distinction to be made between biological dysphorias and situational dysphorias, and there is a job to be done to disentangle these phenomena from one another in specific cases. At the least, medication can and does have a role to play in the treatment of severe cases of clinical depression regardless of whether or not they are over-prescribed (the overprescription of morphine would not detract from its observable and subjectively reported ability to alleviate symptoms). Medications and other treatments should be viewed as tools rather than as totems to be revered or destroyed. Spend some time with someone who is so depressed that they are refusing to eat, to move, or to do anything but sleep. Now watch them in that state for months on end. It is unlikely that they would be capable of joining in any effort to politicise depression or to express it as what it often, but not always, is: political rage that has learned to view the situation of expressing itself as hopeless.

My general point is that it is just as ludicrous to reduce the problem of depression to the social field just as much as it reduce it to the neurochemical. The brain and the social field are not distinct from one another in some absolute way but are part of a circularity that operates via the body as korper and as leib. I don’t think Mark Fisher believes that the body and the social world are fundamentally distinct in this way, so it is strange that he should treat neurochemical and the social field in this way. If it is carried out for tactical reasons in a polemic against psychiatry, then I can’t follow him in that work. Psychiatry is neither monolithic in theory, disciplinary composition, or practices. As someone on the “inside” as it were, and with a history of close relationships with people who have undergone treatment, and having been assessed myself for panic in my adolescence (doctor: “you’re a student of philosophy? well, don’t worry…it;s not an existential crisis!” chuckle chuckle, indeed) I am aware of the problems. I have spent most of my training to enter the profession being critical of it and am a member of the Soteria Network, which offers a candidate model for a new psychiatry. The embodiment of mental disorders is striking- and is something I am writing about. The embodiment of depression is especially striking: the is an abandonment of voluntary motility-mobility, the alteration of gait (which at least one physiotherapeutic study suggests can be something that is treated with positive results), which psychiatric researchers Fuchs and Schlimme see as a result of a process whereby

the body loses the fluidity and transparency of a medium and becomes conspicuous, turning into a heavy, solid body, which puts up resistance to the individual’s intentions and impulses. (Here)

The depressive body is the body that is all korper and not enough lieb; in refusing to recede into the background it makes itself too evident and doesn’t allow for the enaction of world through meaningful comportment; it remains an heavy obstacle that must be taken into account in such a way that “intuitive attunement” to affordances in the environment through sensorimotor intentionality fails. As Fuchs and Schlimme further argue

The open horizon of possible experiences shrinks into a locked atmosphere, in which everything becomes permeated by a sense of lost possibilities.



The depressive subjectivation processes are once that operate on bodies in order to produce bodies that are exhausted and, as Deleuze put it, ‘the exhausted don’t possibilitate’. Depression is not the mood of the melancholic that introjects some lost object in order to angst over it, but it is the very real loss of the capacity of affection and to experience a world. At its excessive side, depression can take on a psychotic edge that indulges in mood-congruent delusions such as Cotard’s disorder or those of excessive guilt, the sense that one has committed some terrible crime and must/will be punished for it.

Returning to Fisher, I absolutely agree with him on the question of the ‘affective consequences of the kind of cyberspace-matrix that the yound especially are embedded in’ (Here). This is why I think that the rejection of Paul Virilio has been far too fast and that e has, at least in part (and I’d say in the useful part) been mischaracterised.

I don’t know what Virilio’s relationship to Althusser might be, but he can certainly be positioned among the post-Althusserians. It is possible to think of Virilio as a profoundly reactionary thinker- he does himself no favours here, we might attribute it to a combination of his Catholicism and his agora-phobia (his fear of the public)- yet he is not exactly alien or hostile to Marxian thinking. First of all, Virilio is consistently traced back to Benjamin; if there is any thinker that Virilio is claimed to be a disciple of it is Benjamin, with all his fragmentary thinking, his love of discontinuity and his catastrophic thinking. For my own part, it is resolutely the catastrophic thought that I am attracted to- obviously this is relatable to what I call catastrophia.

In Virilio there are a few elements worth considering: speed, information overload, “the democracy of emotions” (massification-synchronisation and the destruction of the time of deliberation”, which taken together form what I call “acceleration“. At the same time there is also his denunciation of the myth of progress, and the idea of the accident. These two elements can be called Virilio’s “catastrophism”. Taken together these two interactive moments form part of the thought of Franco Berardi and Bernard Stiegler, although it is a moment that both of these thinkers either underplay or ignore and which we don’t see many treatments of. This is undoubtedly due to Virilio’s reactionary comments but, much more likely, also his designation as a postmodernist. Heidegger’s Nazism is more deserving of forgivenness than is Virilio’s percieved sin of postmodernism, and Zizek’s adoration of Christology and the whole turn to St. Paul is worth more attention than a man who genuinely has faith. At any rate, Virilio’s alleged postmodernism is as false an allegation as is that against Marx that thinks he figures the social revolution as the end of history. In Virilio’s own words:

I believe that technical modernity, modernity taken as the outcome of technical inventions over the past two centuries, can only be stopped by an integral ecological accident, which, in a certain way, I am forecasting. Each and every invention of a technical object has also been the innovation of a particular accident. From the sum total of the technosciences does arise, and will arise a „generalized accident”. And this will be modernism’s end. (John Armitage (Ed.), Paul Virilio:from modernism to hypermodernism and beyond, Sage, 2000, p. 26)

So, only an ecological accident that is a generalised accident- here I think Virilio is talking about something like ecological collapse brought on by industrial processes that is yet to occur, but nonetheless is certainly with as a latent possibility (or if you prefer sf speculations, the nanotech paranoia surronding cancerous “grey goo”)- only this endangering of the world itself will end modernity; a planetary accident, climatological-geological, something involving extinctions. This is a dark vision, although it escapes pessimism because it is atemporal; this is a possibility right now (“does arise” and “will arise”; the future is already here). The relation of modernity to this technical modernity is interesting because Virilio is often taken as a techno-determinist, although he denies this. At any rate, or rather at full speed, for Virilio modernity as technical modernity- modernity as the ability of our hominid species to intervene technologically “for technical intervention’s sake” in its factical conditions- is far from over (shale gas drilling and the 3D printer are the latest forms of this obsessive thrust). Indeed, Virilio appears as a kind of technomoralist in the sense Ballard gave to this position; standing at the blind curve on the clifftop road with the sign reading “for god sake slow down”.

In Virilio’s hands the one form of the ‘absent causality’ that capitalism denies is the body. This actually places him closer to feminism than most of the post-Althusserians. Specifically, it puts him in proximity to the feminist theory of Silvia Federici. In Federici’s Caliban and the witch, the central claim is that the original version of primitive accumulation- the first violent expropriation- was that of the enclosure of the female body (for Federici historical accusations that feminism is a “splitter” movement or sectarian faction misses the point that capitalism is capitalist-patriarchy— this is another good reason to criticise the blindness of the SWPs central committee and Alex Callinicos). This is not the full story though. For Virilio the absent causality is also the dark side of technology. In Virilio’s eyes capitalism must always make technology as a system appear as if it was always a neutral development, when it is actually one that has catastrophic structurally integral consequences. This is the meaning of the oft-quoted phrase that the invention of the train is also the invention of the train crash and this is what Virilio terms “accident” (it is also why, back in 2008-2009, Virilio spoke of the financial collapse as “an accident”).

In a fairly crap interview with hipster central magazine Vice magazine, we find this exchange

Q.Do you mean “accident” in the same way that some say “event” in modern-day philosophy?

PV: Yes, except that for me, an accident is the event of speed. Our accidents are linked to the acceleration of history and of reality. The French were occupied by the Nazis by surprise. They didn’t react well because they didn’t understand the speed of it all. They were taken by speed. Today’s events, like the stock-market crash, are speed accidents. I call these “integral accidents” because they trigger other accidents. There is an amplification of pure events in history. Today, history is entirely accidental. Look at 9/11. It’s not an event, it’s an accident. But we consider it to be as important as yesterday’s events. It’s like a declaration of war without a war.

The outside that Virilio wants to highlight as being folded into the interiority of capitalism is the integral accident. At the same time, in this interview, we also see Virilio anticipating Timothy Morton on the burial of plutonium:



‘Imagine placing nuclear waste in a hole. How do you tell people in 200,000 years that there are dangerous substances there? It’s not science fiction anymore. How do you communicate with those people? What language will they speak? The length of the threat isn’t considered here. And it’s the same for stocking nuclear weapons. They are everywhere.)

What we see then is that in Virilio’s “accidentology”, his phenomenology of the accident, that there is precisely a diagnosis of times when ‘the structure internally cannot control its own excesses’. (Bruno Bosteels, Here).


Elsewhere Virilio speak of the need for a ‘a university founded on the disaster we’re discussing, the progress that turns to catastrophe…’ and isn’t this precisely a call for a place of thought for thinking capitalism? For Zizek, the problem is that Virilio remains a figure of

the conservative-leftist Kulturkritik (from Adorno to Virilio), which bemoans the stupidity of the manipulated masses, and the eclipse of the autonomous individual capable of critical reflection. (Here).

This is a quick rejection, with Adorno and Virilio serving as a kind of abecedarian gesture at a multiplicity of sad and, the implication is, elitist theorists. Yet if revolutionary theory is going to speak to anybody, if it is to be made applicable to people’s concerns, if it is to address itself to and allow itself to be heard by the workers then it Virilio offers a language and terrain that is familiar to so many people simply because they actually live it!

Virilio also gives a language and a function to the point of a vanguard- an intellectual vanguard that may or may not be instantiated as a party (I am making no a priori judgements in these notes): to offer a different temporality, to be able to slow down, to take time, to look things over, to understand rather than react. To continue the language of my previous post, the vanguard operates on the physiology of revolution via the activation of the conscious control on the spontaneity of the autonomic system (in Virilio’s analyses of panic, we can continue this language to speak of an overactivation of the sympathetic nervous system…indeed, at this level of analysis this language ceases to be metaphorical).

In this way Virilio isn’t at all ‘bemoan[ing] the stupidity of the manipulated masses’- it is technology that is doing the manipulation, or rather it is the user-technology relationship itself and so it is a kind of auto-manipulation, and so the insinuation that they have been foolishly tricked by some media elite is off the cards. Rather, it is that Virilio is arguing against the various forms of techno-mediatic spontaneity that appeal to the creative impulses of the working classes. Indeed, the way that capitalism subsumes the cognitive-affective capacities of the species (whatever the hell the “general intellect” is) is what Virilio discusses under the term “endocolonisation”.

As to the eclipse of the autonomous individual; actually, Virilio is critical of a what he sees a tendency towards a cocooning of the body inside of a technological shell and of a panic-stricken siege mentality that imprisons the sensuous body behind a thousand screens, with forced feedback technology displacing the erotic sensualities of masturbation and sex. This is the vision painting in Michel Houellebecq’s novel The possibility of an island and it is actually a vision of the apotheosis of the autonomous individual.

In each instance of analysis Virilio is looking at this particular situation and looking for an element that has been excluded at the level capitalist discourse but which is, nonetheless, very much an operational presence, ready to reveal itself at any moment. In this regard, Virilio isn’t so much a pessimist in the philosophic sense as he is a hyper-pessimist in Foucault’s sense, insisting not that x,y or z are good or bad but that they are dangerous.

In other words, Virilio is looking at what can be used with an awareness of the risks, and he is trying to think outside of the temporality of the present in order to properly think that present. In seeking to think the accident, to critique the pseudo-liberations of postmodernism, and to find a time for deliberative thinking that manages to detach itself from the “communism of affects” (spontaneity), Virilio is being far more Leninist than Zizek is willing to tolerate.

The real problem with Virilio as a philosopher is that he remains caught up in human exceptionalism. This is, of course, dictated by his Christianity (his “anarcho-Christianity”, as he puts it in an interview with John Armitage, and links it to anarcho-syndalicalism). Yet for all that, he is one of those thinkers who early on included an analysis of a dimension of nonhuman materiality in the shape of technology and technological objects, and, for those of us dedicated to therapeutics and politics, a degree of pragmatic humanism is essential.

In his analysis of speed and communicative technologies, Virilio is also performing an analysis of the processes that produce the depression of the social field that has produced the learned helplessness of the left (and of the workers in general) and that has compounded clinical depression in individuals. As acceleration accelerates, we get more and more sedentary, more and more (inter)passive and domesticated. The point of this side-step through Virilio hasn’t been to mount a defense or championing of his bleak vision but to note that there is a well established approach to understanding this new mediatic environment that understanding it as explicitly linked to capitalism. The task then, and this is a process already under way, but which needs to be better understood and directed, is to unlearn helplessness and thereby lift hopelessness. It might also be to engage with the new logic of the youth born fully integrated into a post-internet media landscape. This is beginning to happen but it is an unsteady course and there is always the possibility of relapse.

Mark Fisher has made calls recently to hear the end of the left’s Beckettian mantra “fail again, fail better” in favour of a kind of renewed heroism that dared to think it could win. For myself, I think that this means the embrace of a kind of communist pragmatism that is capable of recognising that as hominids adrift in the world we are a being permanently trying to cope. The question then is what allows us to cope? The Leninist question of what is to be done, to repeat myself, becomes the question “what can be done” and, to borrow from the solution-focussed therapies, we can begin by asking “what has worked for us before?” This orientation is my own reason for backing Left Unity and for keeping in contact with anarchist groups as well as keeping abreast of socialists that one wouldn’t consider radical or necessarily communist. It is born out a desire to be faithful to this moment of reinvigoration and confidence. This calls for a strategy of tactical openness, of a willingness to be truly experimental and to not foreclose possibilities while they are flourishing and while they can be made use of and put to work for a better way of coping with being alive. Therapy might well be the opium of people in the hands of the capitalists, but what would a political therapeutics look like that sought to enable resistance to capitalism? If the left is in recovery after a period of depression then let us look bear in mind what Franco Berardi that

When dealing with a depression the problem is not to bring the depressed person back to his/her normality, to reintegrate behavior in the universal standards of normal social language. The goal is to change the focus of his/her depressive attention, to re-focalize, to deterritorialize the mind and the flow of expression. Depression is based on the stiffening of existential refrain, on the obsessive repetition of the stiffened refrain. The depressed person is unable to go out, to leave the repetitive refrain and s/he goes and goes again in the labyrinth. The goal of the schizoanalyst is to give him/her the possibility to see other landscapes, and to change the focus, to open some new ways of imagination. I see a similarity between this schizoanalytic wisdom and the Kuhnian concept of paradigmatic shift when the scientific knowledge is taken inside a conundrum.(Here)

The left should not be seeking to return to its old forms or to abandon its new ones. I seek to begin with the determination of what is in our power and what is not, and acting based on that diagnosis increasing what calls under our agency and enflaming the potency of our efficacy. To speak in plain language: its by thinking and by doing what we can that we can risk building ourselves as a united front and produce a left wing movement that can defend and, why not?, even attack capitalism. But to do this, we can’t just go back to how we were, with our old refrains that we got stuck in; we can’t be statists and antistatists, anarchists and Leninists and so on. For now, at least for a little while, we should risk a degree of wilful naivety in the hope that through experimenting we might make something new. I myself am no hero, and don’t seek to be one; these comments reflect only an attempt to grapple with the situation we find ourselves in. Yet perhaps this aversion to heroism has been part of the problem…



Attention Bombardment: Is there a Lenin for the anxious age?

Terence Blake is currently translating the latest seminar with Bernard Stiegler. In scanning through it I am reminded of the reasons I became a psychiatric nurse (proletarianisation of the mentally ill; pathologisation of the proletariat) and of why I left London (living in a city of panic that was a bunker city was doing my panic disorder no good). Here is a series of quotes on attention and what Berardi calls the possibility of the psychobomb that explodes the (bio)psychosphere of subjectivation:

Do not forget that your brain functions in time, and needs time in order to give attention and understanding. But attention cannot be infinitely accelerated. Marx described a crisis of overproduction in industrial capitalism—when production surpasses demand, an excess workforce is fired, who in turn have less money to buy products, resulting in an overall effect of economic decline. In the sphere of semiocapital, however, overproduction is linked to the relation between the amount of semiotic goods being produced in relation to the amount of attentive time being disposed of. You can accelerate attention by taking amphetamines, for instance, or using other techniques or drugs that give you the possibility of being more attentive, more productive in the field of attention. But you know how it ends.- Franco “Bifo” Berardi.2011. Time, acceleration, and violence. Here.

These infinite demands for the finite neurocognitive resource of attention- which is a form of bodily comportment to the world- provide a ceaseless stream of attentional-demand on the brain that it can’t meet. Navigating the contemporary urban environment, and not necessarily even that of the megapolis, and even sitting in a cafe today presents one with hundred of flashing signs, adverts, audio-transmissions, moving images, and so on and so on, a cacophony of signs and a chaos of noise, accelerating, multiplying, a plethora upon a plethora overlaid and overlapping that are superimposed on the physical environment with its own denizens such that the nervous system had evolved to cope with. The pathogenetic potential of this rests on these moving images, bodies and roaring sounds that activate our hominid survival networks, drawn as they are to sudden movement, to rushes of sound and in full autonomic efficiency our bodies- which are ourselves- carry out how many assessments of threat a day, a week, a month, a lifetime? And the genius of pharmaco-capitalist production is that it produces its own consumers through the techniques of marketing.

The rise of neuromarketing is the latest modality of this particular version of techne and mobilises other features of the medical technologies typically put to work for neurological and psychiatric conditions. The Pepsi Challenge has been undertaken with test participants undergoing fMRI scans. Before continuing, we should remember that there are a number of problems with the neuroimaging processes and the fact that they say nothing outside of the hermeneutics humans perform on them (cf. Richard Bental. 2011. Why psychiatric treatments fail; neuroskeptic. Nonetheless, they provide valuable data; the point is more to recall that the neuroimage is not a the revalation of truth, but is itself a tool in an ever expanding arsenal of neurotechniques. The findings reported in the journal Neuron showed that the semiological relationship to the brand was the main indicator of verbally expressed preference and that knowledge of which drink was being drunk by altered the state of the participants brains. In particular, there were changes to hippocampal regions associated with affectivity and memory. In this study it appears to be the semiological relation to brand that determines preference of drink and therefore the activation of certain consumer behaviours (ie: buying Coke instead of Pepsi) because their is a semio-affectivity that implies an emotional relationship with a set of affective signifiers and images surrounding “Coke”. The authors of the study state that

Coke and Pepsi are special in that, while they have (Figure 3A) similar chemical composition, people maintain strong behavioral preferences for one over the other.

Recently, Levi Bryant has attempted to construct a model of criticism called Borromean Critical Theory that corresponds roughly with psychiatric theory’s repeated calls for a biopsychosocial model of psychpathology. In this Borromean Critial Theory there are three implicated and interoperative layers of reality to be targeted for any problem, with each being according its own unique weighting and expression in a map of a given situation. These layers are the phenomenal, the material, and the semiotic. This tripartite can also be expressed in terms of the epistemic and the corporeal. What is important to note is that in this study we find all three levels in operation: the activation of the gustatory system by the introduction of the cola drink to the mouth (material) and the simultaneous sensory experience- the qualia- of taste (phenomenal), and the relationship to those particular cognitive schematic associations with the consumer brands “Coke” and “Pepsi”. Despite the near total chemical symmetry of the two drinks and the continuousness of all human gustatory systems with one another- although continuity does imply variation, so we must be careful- the overdetermining factor in the relationship to the drink, and therefore to the subjectivations responsible for producing the consumer subject, activating the repertoire of semio-sensorimotor comportment that organises consumer behaviour, and finally couples the consumer to the economy in this particular way, through this particular commodity mediation. To put this otherwise, here is a situation in which the material and phenomenological are trumped by the semiotic; the epistemic obliterates the corporeal. This is why Franco Berardi is able to call contemporary capitalism semiocapitalism. Critics of neuromarketing express concerns over the destruction of informed consent that the abandonment of rational content to advertising and a focus on stimulating affective brain states implies; yet this is already to miss the point that capital always functions on and through the recomposition and reinvestment of attention and desire. This again is summarised by Franco Berardi when he states that ‘the attention economy has become an important subject during the first years of the new century’ [Precarious Rhapsody, p.82]. This reference to an attention economy is at one and the same time a reference to the way that advertising has always attempted to marshal finite organic hominid attentional resources for economic purposes, and to the economy of that finite resource.

Indeed, marketing operates/operated on a model called AIDA: Attention, Interest, Desire, Action [Here]. This was supposed to explain the design for advertising, what it was supposed to target and activate, and in what order, in order to stimulate the consumer to buy this particular product rather than any competitor product. Commodification always begins with the commodification of the nervous system: harnessing the attention activation networks of perception that were evolved as coping mechanisms that aided survival in a threatening world. Without attention there can be no perception; without the pivot of the waist, the turn of the head, the fixing of the gaze there could never be that particular organism-environment coupling that produces the perceptual experience of a world. The marketing industry is thus not simply the manipulator of desires, the educator of how one ought to desire as a subject of capital, it is also itself a particular version of the coupling relation; it is a semiotic coupling with the body mediated through material media (the poster, the billboard, the TV screen, the high street, the shopping mall, the radio, the various internet enabled screens, the ambient advertising of professionals and even those others we find ourselves sharing a space with- through their conversation or the branding on their clothes, phones, whatever). The advertising industry is primarily involved in physiological interventions .

The kind of physiological intervention that is carried out through the activation of attention primarily involves the production of a heightened physiological state; a state of arousal. The eye, the reptilian brain, the autonomic nervous system and the endocrine response produce all those bodily experiences we are all familiar with: the increased heart-rate, blood pressure, light headedness, and a general increase in sensory responsiveness to any and all stimuli- especially motion- and a readiness for action. Arousal of this kind of obviously important for a full range of creaturely behaviours such as seeking food, hunting for that food, and the obvious sense of “arousal” as sexual arousal. Arousal is the condition of metabolic self-differing, the movement of the organism from one state to another state. There is the experience of the rushing of the blood, the emptiness of the visceral, the aggressivity that doesn’t know if it is rage or lust, destructive or erotic. Of course there is also the matter of memory (and I’m sure Steigler will writes about this); that which presents itself to me as particularly emotionally salient will be remembered while that which is not emotionally salient to me will not be so keenly recalled, if it is recalled at all; we all remember having our heart broken, but who remembers what they had for breakfast today 10 years ago? This phenomena is known as selective attention and involves a selectivity of neural encoding that impacts on long-term memory retention. It is why Coca Cola adverts appeal to a sense of family, to a warm feeling, to a feeling of safety, or to a sense that it is youthful, vibrant, culturally hip and so on; in short, it is why neuroadvertising works so well. It is why semiocapitalist consumers don’t have to be convinced of the virtues of consumption but will happily consume the consumption of others in TV shows like Cribs, and it is why the English riots of 2011 had as a component the revenge of the desire of the excluded consumer (cf. Baumann’s analysis of the situation).

What I have described above is called the flight-or-fight response. It is the priming of the body for escape and/or violence and it is what has managed to life just that little step ahead death, at the level of the species and at the level of each organism. The idea that it is perfectly adaptive (even if adaptionism didn’t have its own problems) is misleading because it is also a generic mediation system for a number of psychopathologies; the bodily system of safety is also a bodily system of distress. When we talk about a constant state of physiological arousal the pathologies that immediately spring to mind are the anxiety disorders, especially generalised anxiety disorder. GAD is characterised by a low but persistent state of anxiety, while panic disorder is characterised by extreme, repetitive, transient states of anxiety. These two disorders are common among the psychiatric population, especially those treated in the community who never actually see a psychiatric worker but are prescribed betablockers,benzodiazapines, or so-called “selective” serotonin reuptake inhibitors or breathing exercises by GPs or family doctors. Although we typically think of it as a condition suffered by soldier or rape survivors, post-traumatic stress disorder is an anxiety disorder that is mediated by a traumatic event. I don’t wish to go into the complex debates around what constitutes “trauma” and what constitutes an “event” but for now I want to focus on the empirical record. This record shows that children who undergo bullying or women who live through consistent levels of domestic abuse can develop PTSD. This is important here because I think that it reveals to us that the post-traumatic is less a psychiatric or psychological condition than it is the name for a certain stabilisation of violent and violently pathogenic processes of subjectivation. In this sense we can have a tense agreement with Zizek when he states that there exists

a totally “mediatized” subject, fully immersed into virtual reality: while he “spontaneously” thinks that he is in direct contact with reality, his relation to reality is sustained by a complex digital machinery. Recall Neo,
the hero of The Matrix, who all of a sudden discovers that what he perceives as everyday reality is constructed and manipulated by a mega-computer – is his position not precisely that of the victim of the Cartesian malin génie?[Here]

and completely disagree with him that this mediatised subject is in any sense separable from the

post-traumatic subject – a “living proof” that subject cannot be identified (does not fully overlap) with “stories it is telling itself about itself,” with the narrative symbolic texture of its life…

It is not so much that the mediatised subject’s relation to reality is sustained by digital machinery- as if it wasn’t already relating to reality in relating to itself, but this isn’t the place for a critique of Zizek’s Cartesian exceptionalism (which is beyond me anyway)- it is that this digital machinery, along with the other technologies and techiques that seeks a direct affectation and activation of the organic economy of attention, exceeds what the brain is capable of. This is not the post-traumatism that Zizek and Malabou consider in the figure of the Alzheimer’s patient and the person with autism (one wonders if either of these people have ever actually encountered people with either condition in a clinical setting), but a post-traumatism that is born precisely out of the material-phenomenal demand that one be plugged-in to the Matrix at all times and in all places. The problem with the film The Matrix, that Zizek thinks illustrates our relation to the Cartesian cogito so well, is that it is based on a fundamental misreading of Baudrillard’s theory of simulation that treats it as if it were still of the order of a mere simulacrum. In other words, in a properly Baudrillardian world it would be impossible to disconnect from the Matrix! Luckily for us, we do not live in the world that Baudrillard’s theory-fictions describe but that such worlds are imaginable speaks of our proximity to them; whatever shows up as fictionally possible within a given epistemic order must be considered as part of our semiological horizon. Alzheimer’s does display the confabulations that rest beneath our stories about ourselves perfectly and it also shows that trauma can be considered a slow and agonisingly patient exposure to the pathogenic violence. To go beyond Malabou, who seems to contain the trauma of Alzheimer’s to the brain and thereby reveals an utter ignorance of the work of Tom Kitwood and others, the trauma of Alzheimer’s only makes sense when we consider it as a traumatised enaction of an increasingly cognitively (and later, sensorimotor) impoverished world. If the mediatised subject is like the PTSD child or abused woman, if it is like the Alzheimer’s patient then this is because it is subjected to pathogenic processes of subjectivation that operate epistemically and materially.

This post-traumatism can also result in “desubjectification”, a term that refers to the deprivation of interiority experienced as the emptying of value from one’s existence. This is also the condition that Kristeva refers to as an amputated subjectivity, and that manifests itself so frequently in depression. One shouldn’t understand “desubjectication” as the undoing of subjectivation but the production of impotent subjects that don’t experience themselves as such. It is what motivates Jodi Dean to ask the question

How is it that the subject remains reduced to the individual, as if there were an individual who is subjected rather than a collective, exercising the power of its own self-determination, that becomes fragmented and desubjectified, pacified as it is divided up into ever smaller portions?- Here.

Depression and anxiety often go together; there is a wealth of psych-disciplines literature that even suggest that prising them apart is a misrepresentation of reality. Berardi has suggested that today the word “alienation” is defunct, that instead we should consider the term “psychopathology”.

In 1983 Gray (here) proposed a neurobehavioural account of chronic anxiety. In his research chronic anxiety was linked to the overactivation of septohippocampal and Pepez circuits. Gray called this behavioural inhibition system (BIS). BIS interrupts ongoing behaviour to redirect attention to potential threats that show up in the sensorium. At the cognitive level the current sensory input (the landscape of threat) is compared against future predictions based on that stimuli. Where a mismatch occurs the BIS is activated. In the mismatch criteria is assumed to be too low and therefore constant mismatches are generated resulting in chronic BIS activity. This BIS is mediated by norepinephrine and serotonin and is coupled to sympathetic nervous system via the amygdale and hippothalamus. Thus, high levels of arousal are maintained outwith the suffers ability to easily consciously ameliorate them. While this doesn’t explain panic symptoms or post-traumatic disorder as such, it does provide a general way to think about the problem of the economy of attention. (Cf: review of literature connecting BIS to anxiety).

One can recall a time around the dot-com crash of 2000 when a number of books dealing with the topic of the attention economy appeared in bookstores. Economists suddenly became aware of the simple fact that in a semiocapitalist world, the main commodity becomes attention. The 1990s saw an era of increasing productivity, increasing enthusiasm for production, increasing happiness of intellectual workers, who became entrepreneurs and so forth in the dot-com mania. But the 1990s was also the Prozac decade. You cannot explain what Alan Greenspan called the “irrational exuberance” in the markets without recalling the simple fact that millions of cognitive workers were consuming tons of cocaine, amphetamines, and Prozac throughout the 1990s. Greenspan was not speaking of the economy, but the cocaine effect in the brains of millions of cognitive workers all over the world. And the dot-com crash was the sudden disappearance of this amphetamine from the brains of those workers.- Franco “Bifo” Berardi.2011. Time, acceleration, and violence. Here.

Whether or not this is quote provides a true story it does provide an approach to thinking the attention economy that highlights the corporeal aspect of capitalism in a time when the epistemic semio-aspect seeks to assert hegemony. Resistance to capitalism has to begin from bodies and their passions. Politics politics is not exclusively about contested meanings, and processes of subjectivation that occur in the epistemic sphere alone, resistance is not a discursive enterprise alone. I even have some misgivings about the verbal being raised above all other forms of expression (Habermas vs. Ranciere- there is agreement at least on speech, on the speaking subject). Politics is also, surely, about the arrangement of bodies in space, about what bodies can appear where and when, under or against whose watch and guard, in what combinations; there is a sense in which politics is thus about the question of the relation, about forming or deforming them, and why organisation is so central, so crucial to its operation. Part of this question of organisation is also the organisation of the materiality of the affectivity of bodies in their capacity to be affected. A simple withdrawal from the world of hyperstimulation or the advocacy of a “revolutionary public health” campaign to “consciousness raise” out of the depths of depression through pharmacology or mindfulness techniques alone can’t be all that we advocate- that would make us identical to the existing psychiatric system that is enmeshed in neoliberal governmentality and capital markets. To be even more cutting, it would be to identify with the problem itself.

We live in a ‘dark age of appetites‘ and passions. This “dark age of appetites” is a fantastic way of talking about the contemporary scene. While I am looking at the production of a new left political party, and thereby getting involved (for the first time) in “political politics”, I do so tactically, provisionally and entirely from within a perspective that recognises this dark age, this age in which democracy and the passions can’t communicate except in the sense of the distribution of bodies in (il)legitmate spaces. The passions can be made to speak, indeed the pathological conditions are often seen in those signs and symptoms that are themselves characterised by the sign-use (ie: alogia; pressured speech; disorganised speech of all varities- word-salad, loose associations and non-sense). What is interesting about the democracy of Ranciere and those who follow him (Todd May for instance) is its lack of form and its explosive core of refusal- the identification of a wrong, the contesting of meanings and of material-aesthetic partitions. Of course the riot of 2011 that haunt me- “us”?- were evidence and enaction of the “dark age of passions”…this is a much better formulation than the “sad passions”… yet the problem of Ranciere is his verbosity, his over appreciation- in line with much of the continental tradition, and indeed of the profession of philosophy itself, carried out as it is by paid and sometimes tenured wordsmiths. I am more interested in the demands that bodies in space can make prior to the political demands that they might formulate. In this respect the dark age of passions is an age of inarticulate demands, demands at the level of the body and therefore they are visceral demands, a visceral politics that refuses the level of representation and constitution. If this is the anarchic moment that must be celebrated, an immanent anarchism that can’t be done away with or forgotten, the question nonetheless remains that of organisation. Even dark passions must be organised, must be given form…in the stoic language; must be cultivated! Such a cultivation would be the job of a movement, an affinity group and- why not!- a party!

The minute the party turns on this anarchism, the moment that it establishes an arche or seeks to enshrine the theoretically advanced membership as anything more than an intellectual vanguard, that is when it must be obliterated. The calls within Occupy for democracy shouldn’t follow the mode of consensus-decision making that so large a movement can’t keep to if it wants to continue (and all the Bonana-insurrectionist talk of rejecting the “myth of mass” is itself caught up in a fetishisation of mass, scale and size rather than recognising its practical necessity for “revolution”- the emancipatory recomposition of society that goes beyond class society).

Maybe the point is not to follow Badiou’s pseudo-anarchism, but to ask how someone like Ranciere would go about constructing a party. If we are seeking to “repeat” the party, rather than simply “return” to it, there are questions to be asked. Indeed, should not “party” simply name the name of what results from the principle of the united front, such a front as the Italian left failed to achieve and so gave Mussolini all the space he needed to take the state for fascism.

Whatever else politics is doing, today it must also seek to defend not just those gains made by the working class that are now under threat from socioeconomic austerity, but is must also defend the body and it’s affectivity from its hyperactivite overactivation and/or nervous exhausted collapse that capitalism generates by bombarding the mediatised subject and demanding the double-bind “Pay attention! Don’t burn out!” Political organisation must not just be the organisation of principles, of activists, of demand, but also of the affects; it must be the organisation of rage.

The continual question of the negative passions. The undeniable potency of them, the undeniable force that erupts with anger and rage. I don’t question their value from a Neitzschean perspective but from an ancient one, from the perspective of Seneca. The oft remarked story of Plato who froze in his place for hours after raising his hand to strike a slave: “I am punishing an angry man”, he is said to have remarked to a passing student or friend (did Plato have friends? can a man with such a thought as his be so vulnerable as to be exposed in the production of a friendship?) Seneca says that anger does not attempt to influence the mind, as all the other passions do, but that it seeks to DESTROY it. Maybe such a destruction of the everyday consciousness- full as it is of its own impotence, its own solipisistic perspectival imprisonment (how we yearn to see through the eyes of the other), its own heavy sadnesses- is a goal worth attaining. But then what? Seneca reminds us that an enraged soldier can’t fight to win but only to inflict harm, he flails instead of striking at the weak spots, and he doesn’t notice when he is injured, outmanned, and about to be crushed. The same question returns to me again and again, and I still don’t really know what it means: how do we organise rage? This seems imperative! Crucial! If the negative passions are a weapon then how do we use them collectively and with skill and precision? Is there a way that we can claim the attention economy for ourselves? Such would be to produce a political therapeutics that would not be reducible to mere therapy. This therapeutics would itself be part of a politics, it would be part of our communist praxis, but it would not follow Franco Berardi’s own notion that we relax, slow down, get senile.

Joanna Moncrieff and the new symptom

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.