I love it when I discover that someone who is clearly very intelligent believes something that I wouldn't have thought anyone intelligent could possibly believe. A wonderful opportunity to explore something with new curiosity.
Usage of the term "capitalism" and "neoliberalism" have moved beyond critiques of economic systems and policies for some people. In a lot of left-leaning circles, these terms serve the same purpose that "Marxism" or "Socialism" do in right-wing ones. They're synonymous with "thing I don't like" (and little more) while signaling which team you're on.
Some of us are at least vaguely conversant with von Mises and Rand, you know. The irony is that I don't actually have much of a problem with von Mises' ideology on the face of it.
The problem is not so much that contemporary corporations are Capitalist, as written by people like von Mises, as that they are actually not. They could be called Objectivist, in the sense that their only real constant is self-interest, but beyond that, there is no set ideology as such. They just try and do whatever they think is in their short term best interests, while generally disregarding the longer term completely, both for themselves and everyone else.
Another irony is that while I agree with almost everything Freddie writes, (although I'm a long way from referring to myself as a Marxist, formal or otherwise) I am also someone who the idpol morons have frequently condemned as an evil cryptofascist, simply because I dare to disagree with their opinions.
I actually view Marxism as having enormous value as a diagnostic tool for understanding why societies collapse, (primarily because one of my major interests is archaeology, and the archaeological record is full of civilisations which ended because of class warfare; I consider the Mayans probably the most obvious example, but it also had a lot to do with the end of the Roman Republic and Caesar's rise to power) but I don't believe that Marx' proposed solution has any hope of working, because the majority are far too stupid, and the elite are too good at manipulating them.
My feline take is that most systems can be made to work tolerably well, to the extent that they are run by non-sociopaths.
The problem is that power of any sort, political, economic, religious, cultural, is to sociopaths what catnip is to cats.
This is why, after some 5,000 years more or less of recorded history, people are still arguing about what system is ideal and can point to examples and counter-examples of why their preferred paradise does or doesn't suck.
Fact is, no system is better than the people running it.
People seem to be conflating mental illness with the idea that "capitalism causes alienation that makes people sad." The second argument is found in Mark Fisher, and I find it persuasive. It's illogical to reduce mental illness—a much larger thing—to a symptom of alienation, but the pressure to compete is depressing.
Possible social arrangements aren't a binary between capitalism and the Soviet Union. In the history of human societies, “capitalistic” (waged) arrangements have existed for a long time, but most were undertaken by people who had the legal status of slaves.
Also, you don't think that *any* advances in technology and social relations could allow more people to engage in meaningful work (or more leisure)?
Keynes thought technological progress would make clinical depression more common, not less. And he seems to have been right.
In 1930, when he wrote "Economic Possibilities for our Grandchildren", it was a relatively rare condition and mainly seen in upper-class women. But he didn't think that would last:
"If the economic problem is solved, mankind will be deprived of its traditional purpose.
Will this be a benefit? If one believes at all in the real values of life, the prospect at least opens up the possibility of benefit. Yet I think with dread of the readjustment of the habits and instincts of the ordinary man, bred into him for countless generations, which he may be asked to discard within a few decades.
To use the language of to-day – must we not expect a general “nervous breakdown“? We already have a little experience of what I mean – a nervous breakdown of the sort which is already common enough in England and the United States amongst the wives of the well-to-do classes, unfortunate women, many of them, who have been deprived by their wealth of their traditional tasks and occupations – who cannot find it sufficiently amusing, when deprived of the spur of economic necessity, to cook and clean and mend, yet are quite unable to find anything more amusing.
To those who sweat for their daily bread leisure is a longed-for sweet – until they get it."
The correlation you posit, between leisure and technological progress, is actually the reverse of what’s been the case since at least the 70s. Keynes famously hypothesized we’d have 15-hour workweeks by now, but instead actual work performed has gone up in many industrialized societies: just consider the entrée of women into the workforce; the prominence of multi-job employment and “side hustles;” the dissolution of the propertied, jobless elite into the Trump and Bill Gates-esque “overworked CEOs,” and so on. What has broken down is not work itself but the traditional bonds of an older capitalism — between “company men” and companies who take care of them — and the depressed idle women Keynes complained about are now, largely, busy and depressed female “professionals.”
So, yes, we have developed more technology and become more depressed, but this no more suggests technology and leisure as the causal mechanism than it suggests “capitalism causes mental illness.” Technology doesn’t have guaranteed social effects: societies make technologies and not the other way around.
I dunno. I think you could make the argument that many white-collar jobs nowadays contribute less meaning to workers' lives than they did a hundred years ago. So being employed rather than unemployed no longer protects people against depression in the way it used to.
David Graeber put it very well in "Bullshit Jobs":
"Automation did, in fact, lead to mass unemployment. We have simply stopped the gap by adding dummy jobs that are effectively made up"
Fair, and I agree! However, who does what (and when and how) are social questions, imo. The only thing I wanted to emphasize, again, is that humans decide what to do with technology, not the other way around. Technology does not *decide* anything, ultimately
It’s funny that alienation is so tied to capitalism though. I speak from a position of high economic/productive power and low social power. Dating apps feel alienating because everyone is reduced to a social commodity in an infinitely crowded market, and I am not well-suited to that market. I’m not usually alienated at work at all, if I’m bored of something then I have the flexibility to change.
There’s a continuous optimizing process that wants to increase ”flow”, commoditize “objects” including people, and make all characteristics of all system components visible to the optimizer (if necessary by eliminating characteristics it can’t see). If this is the thing socialists call “capitalism”, then it’s also the thing Scott Alexander called Moloch. And I think that process drives alienation, particularly trying to eliminate characteristics of people that can’t be made visible to the optimizer. When those characteristics are productive, you get old school factory capitalism and people used as interchangeable parts. When those characteristics are social I think you get arranged marriages and dating apps depending on what century it is.
This strikes me as similar to Max Weber's idea of the iron cage of scientific capitalism. The constant impetus to improve efficiency leads to increasing distorted economic and social circumstances that come with focusing on ever-increasingly-small and specific measurements, and efforts to improve performance against them. That distortion results in significant alienation as we horribly miss the forest for the trees...and the leaves, and the bark, and the insects, and the insect wastes, and the mold spores that are the true KPIs that let us understand the forest.
While I think there's a lot of value in all 10 points, I feel like the only one that should need to be made is the tenth: "it's the capitalism" doesn't offer us some kind of material path to improve mental health, and is thus not useful.
I'm generally more capitalist than socialist / communist, but it's not hard to see the benefit of a more effective, ubiquitous social safety net, including to the many who suffer from mental illnesses.
Also, I was under the impression that men are more successful at committing suicide because they use more dramatic methods. They are more likely to say, shoot themselves in the head.
Yeah, that goes somewhat to the point of "attempting suicide as a cry for help" vs "serious plan to off yourself". It's a something of a cline with a bunch of bumpy peaks in the distribution. AFAIK, and it's been at least 30 years since I looked at the data in detail, that's a pretty consistent result across the developed world, with the completed/attempted ratio being more male-biased in the more developed countries. However, taking a quick look at some moderately recent WHO data, and being appropriately wary of all sorts of potential reporting bias, it seems that the higher the aggregate suicide rate (the leaders there mostly being in subSaharan Africa), the higher the male/female bias in completed suicides. I have a bunch of spitballing theories about that.
One interesting data point there, contra an oft-mentioned US-centric explanation for the higher completion ratio in men being access to guns: the drive to the Golden Gate Bridge (back before the barriers were put up) is the same length, but the male/female ratio was (from memory, I'm not going back to find it) something like 4:1 or 5:1. OTOH the drive takes time: picking up the gun is fast. Also (and I *think the data I studied way back when bore this out, but I would not bet on it), women in the developed world anyway (esp US) are far more likely to be relatively strong/easy to OD with pychotropics, which tend to mostly take a fairly long time to kill (and are also much harder to calibrate a lethal dose).
Guns are a part of the explanation for sure, and the best indication of that is that female combat veterans and police officers have a suicide rate roughly equal to men. Familiarity with guns seems like a pretty good explanation of this.
It is largely an issue of means. Women do tend to choose poisoning more, while men choose guns but also hanging, both higher lethality methods. In places with more access to very toxic pesticides, like rural India, we once again see something closer to equal suicide rates. The difference in choice of means is often explained in terms of greater fear of disfigurement in women and a generally higher propensity to violence, self or other directed, in men, but that is far from ironclad.
Thanks, I was not aware of that data re combat veterans and police. Do you happen to know if it applies in countries where police are mostly not armed with guns (the UK and Japan being the two that come to mind)?
I don't have any data pertinent to that, sorry. Quick attempts to search for the UK case at least run into a lot of papers examining training UK police as mental health first responders for suicide prevention. I suspect the relevant Japanese papers if they exist are not going to be in English for the most part.
I don't know if there's any definitive studies on this, but at least some things I've read suggest that the primary reason is that men are more likely to use methods that are less susceptible to medical intervention (jumping from fatal altitude, firearm, suffocation). Women are more likely to use poison (e.g., overdose) or exsanguination.
I feel like the argument that women are “crying for help” is somehow meant to discredit their suffering? I’ve been having an ongoing argument with my mom about this—she is a psychologist. The older I get the more I’m coming around to the idea that…if someone is attempting suicide…there is something deeply wrong. Perhaps it’s a cry for help and/or attention—but why is this person in desperate need of attention? Why is the necessary love and support lacking from their life?
Of the approximately dozen times i tried, they were all while I was alone and not expecting to be found. I just am apparently unkillable by any combination of alcohol and narcotics / sleeping pills.
I haven't tried in nearly a decade, mainly bc i got tired of failing and figured id have to deal with living out the rest of my life. Im also a Christian, and i get the feeling God is telling me im stuck here so deal.
I hate to say it because I love alcohol, but from what I've seen among my friends, quitting alcohol is the best thing you can do for your mental health. I have two friends who are severely bipolar (which is way different than borderline) and they are both doing much better now that they quit. I don't know your specific circumstance, but I am so happy it's working for you too.
It's only one weapon in an arsenal...but a good one.
It certainly doesn't mean their suffering isn't horrible or deserving of sympathy, but the suicide literature indicates the importance of distinguishing between suicide attempts with the intent to die and what are generally referred to as 'parasuicidal behaviors.' the later often occur in certain personality disorders and serve a number of functions, but they are not infrequently very maladaptive bids for the affection and support of others carried out by people who generally lack healthier skills for securing this reliably.
This especially happens in Borderline Personality Disorder, which tends to happen more or at least be diagnosed more in women. Thus the disparity. Men with who might qualify for the diagnosis often get an antisocial personality disorder diagnosis instead. Frequent bouts of disproportionate rage is another cardinal experience of BPD, and women who experience this tend to end up in treatment while men who do tend to wind up in jail.
I mean…boarderline is the worst. It’s true that people use the threat of suicide to manipulate. I'll concede that point.
But look at it this way…the suffering that they are experiencing in themselves feels bad enough to them that they are willing to go to extreme measures. They are suffering a lot even if they are dealing with it in a “maladaptive” way. The cause of that suffering could be internal, external, or a mix. But the suffering is real and extreme.
The purpose of FDB mentioning the disparity between men and women was to discount capitalism as the sole cause of mental illness. While I agree it is not the sole cause of mental illness, it doesn't make sense as an argument. Suicide is presented as evidence of mental illness, so the conclusion is that women suffer less mental illness than men even though they both suffer equally under capitalism. (Whether all genders/sexes suffer equally under capitalism is not an argument I'm in the mood to have right now, so I'll just concede that point.)
What I am saying is that the number of successful suicides isn't a good metric for suffering. A lot of people are suffering deeply and do not succeed at killing themselves, while others—I presume—try to "cry for help" and take it a little too far. Since success at suicide isn't a good metric, the disparity doesn't tell us anything about whether women suffer more or less mental illness than men. It is totally possible—within the world of this argument—that capitalism is the sole cause of mental illness and that it is distributed equally among all genders/sexes but that women are less successful at suicide for some other reason. (Not wanting to disfigure themselves is a good guess.)
Anyway, I don't think capitalism is the root cause of all mental illness, even though it can be a huge bummer.
I think you are both making some compelling points. I will just add one observation that may be useful. It looks as though JD (and your mom) is using language that people in the mental health field use to discern between different kinds of risk levels, not different degrees of suffering. It’s not asking “is this person really in pain or are they just looking for attention?” it’s “does this person need to be in the hospital right now or can they stay safe with supports at home?”
Just FWIW, I certainly don't think the "attempting suicide via a means that is somewhat less like to be fatal all things considered" is meant to discredit the suffering of those who do that. Rather if we want to view it terribly simplistically (if we must), that men are, to their detriment, rather more resistant to asking for help.
My wealthy aunt suffered from bi-polar disease, and when she did stuff like leave one of her babies on the neighbor's porch, she would end up being treated in a somewhat nice private facility until she got better. She still had a struggle, and died from kidney failure eventually. My dad, who worked selling luggage and crap at flea markets in later life, and who also suffered from bi-polar disease, ended up running from the cops down a California highway, throwing stolen tools from the window. He served two years in a high security facility (prison) for the mentally ill (because he threatened a cop), then a year or so in a low security facility where it actually seemed like he was doing better, then on to a couple shitty nursing homes before he died. They absolutely did not care that he was totally out of it and halucinating when arrested. All the mentally ill wandering the streets I see, they have something in common, and it's poverty.
“ All the mentally ill wandering the streets I see, they have something in common, and it's poverty.”
That’s simply false. It’s very common for a kid from an affluent family to go off to college and at 20ish begin to show signs of schizophrenia. He will in many cases end up on the street. His family is willing and able to help but he won’t agree to treatment and there is nothing anyone can do since we don’t commit people anymore.
Some of those young people end up on the street. Others get parental help and do ok. It’s not “simply false.” My mom set up and ran day treatment centers for the chronically mentally ill in the 70’s through the 90’s, bringing people in from the streets. I am very familiar with the class make-up of the mentally forced to live on the streets. Do some people from wealthy families still end up homeless? Of course. But options matter on average, and the wealthy have more options.
I have a friend who has a kid (young adult) with mental illness, repeatedly hospitalized. They managed to get her an apartment in another city, and are taking turns staying with her. So 24/7 care from middle class parents. It’s super hard but it’s working.
I also have a family history of mental illness. My family member had intractable psychosis and was not able to live independently. Her parents had means, yes, but I think that these two factors played a larger role in why she was never in jail or on the streets: 1. Her parents had the will and ability to care for her, well into their 80’s. 2. Her particular brand of psychosis did not lead her to run away, distrust her family, commit harms to others, or burn relationship bridges. She did not become addicted, and did not tend towards paranoia. The family’s relative financial comfort definitely had an impact on Factor 1, though other circumstances also helped. Factor 2 does not really discriminate. If your family member thinks you want to kill them, won’t take their meds or stop drinking. and can’t attend to their basic needs, they may end up homeless, no matter how much money they come from.
This idea that capitalism causes MI was explored in Europe by the psychiatrically inclined members of Baader Meinhoff in the late '60s. So they threw open the asylums, "freed" the patients, and trained them as terrorists. Within a year, most were dead, either by suicide or killed by police at one of their ill-fated attack operations. About ten years ago, the LA Times put a picture of a US psychiatrist on the cover of its Sunday magazine, touting the same deadly theory, like he was some sort of innovative thinker. I was so infuriated I canceled my sub, never to return.
Very little to add except this: any take about what causes “mental illness” is about as useful as a sweeping generalization about what causes “physical illness.” Both terms encompass so many different kinds of situations. Is it generics? Is it diet? Is it trauma? Behavioral choices? Bacteria or virus? Is it temporary or permanent? It is terminal? Do people with mental illness commit crimes or are they mostly a danger to themselves? Is it exacerbated by capitalism or or some other policy? Yes! No! Maybe! Sometimes! “Mental illness” refers to a million different things, and nothing. One thing cannot cause “it.”
My understanding is there are 2.5 types of mental illness. Chemical is your brain chemistry is fucked. Situational is where something bad / traumatic happened and you'll be fine with time and grieving.
The .5 is ptsd related which is technically situational, but also may be the result of brain rewiring, so you're probably not ever going to be cured even if you can improve.
I have to take exception to the last part of this. PTSD is absolutely curable if the right approaches (an exposure-based therapy like Prolonged Exposure or Cognitive Processing Therapy) are used and you get enough buy-in from folks to actually engage with them. These therapies do have in common that they are rather unpleasant to go through and are not always widely available. these approaches require deliberately making people uncomfortable (with their consent and in a systematic way) and making sure they don't distract themselves or engage in safety behaviors. Needless to say most people who want to be therapists aren't really eager to have this effect in people.
PTSD certainly has important individual factors in play though. The vast majority of people who undergo an experience qualifying for PTSD under Criterion A don't experience PTSD symptoms for any real length of time.
I definitely disagree with the last part; many folks with PTSD have episodic symptoms or symptoms that resolve in time, or with treatment. Of course, some people struggle with chronic PTSD, but not all. Also, people in other cultures relate to trauma much differently. The idea that you’ll never be cured/always be damaged is an unfortunate myth that social media has amplified. The book The End of Trauma by George A Bonnano is a good resource to check out if you’re interested in this topic!
My familiarity with ptsd is through people in the military who are typically told, and not incorrectly imho, they will deal with it the rest of thier life. I suppose the type of damage and repeated exposure matters.
There is a distinction between telling people that they will have traumatic memories all of their lives (true), and that they will have PTSD symptoms all of their lives (not necessarily true). I don’t think it’s ethical for a mental health professionals to tell anyone “you will have PTSD symptoms all of your life.” There is simply not data to know that, and framing it that way can create a self fulfilling prophecy.
It is! Trauma Focused CBT and Prolonged Exposure Therapy are also helpful. Sometimes plain old time and perspective are helpful as well---a percentage of those who develop PTSD symptoms after a trauma find find they resolve over the next months or years. “There are good treatments, and your brain is not broken” is not minimizing, it’s just true.
I guess it's theoretically possible, but from what studies have shown, military vets with ptsd have it until the end of thier life. It's not a social media thing, it's based on actual irl research.
FWIW that line probably has roots in the theories of Thomas Szasz. ( Full disclosure: had to edit my origunal attrubution to a different psychiatriatric theorist, Reich, so maybe my input is questionable in any case.)
But w/public discourse being what it is now the prevailing mentality of all those who have an opinion to share is ( topic/problem of the moment) = (fave boogeyman did it). Your continuing testimony is worth far more than the overshared opionizing so common now. Please continue. But maybe for your own sake remember how inherently lightweight that all is.
I came to the US at age 9 about 50 years ago. By the time I entered high school, I could sense that American society seemed distant....that Americans seemed distant among each other, including among family members.
I've come to see that it's not just the United States, but a property of industrial societies. But even more, I think it may be the secular and irreligious nature of industrial societies.
I don't have the numbers, but it would be interesting to compare suicide and mental illness rates from industrialized societies to African, certain Asian, South American societies not considered industrialized.
But keep in mind that mental illness is not "just a social construction". It does have biological origins.
lol wut
No, I'm quite sure there's genetic influences too.
I am once again wowed by your dedication to appearing jaundiced
Good observation. Yes.
It’s like how a lot of people who get called TERFs clearly aren’t radical feminists.
Yeah, terf becoming a catch-all both ends up both blaming too much on, and giving too little credit to, radical feminism
You sound way too smart to be a socialist.
not you -- I meant deboer
I love it when I discover that someone who is clearly very intelligent believes something that I wouldn't have thought anyone intelligent could possibly believe. A wonderful opportunity to explore something with new curiosity.
What, *learn* from people with viewpoints different from your own?
What are you, some kinda commie, huh?
It’s really fascinating. Similar to talking to brilliant people who you find out are very religious.
Usage of the term "capitalism" and "neoliberalism" have moved beyond critiques of economic systems and policies for some people. In a lot of left-leaning circles, these terms serve the same purpose that "Marxism" or "Socialism" do in right-wing ones. They're synonymous with "thing I don't like" (and little more) while signaling which team you're on.
Some of us are at least vaguely conversant with von Mises and Rand, you know. The irony is that I don't actually have much of a problem with von Mises' ideology on the face of it.
The problem is not so much that contemporary corporations are Capitalist, as written by people like von Mises, as that they are actually not. They could be called Objectivist, in the sense that their only real constant is self-interest, but beyond that, there is no set ideology as such. They just try and do whatever they think is in their short term best interests, while generally disregarding the longer term completely, both for themselves and everyone else.
Another irony is that while I agree with almost everything Freddie writes, (although I'm a long way from referring to myself as a Marxist, formal or otherwise) I am also someone who the idpol morons have frequently condemned as an evil cryptofascist, simply because I dare to disagree with their opinions.
I actually view Marxism as having enormous value as a diagnostic tool for understanding why societies collapse, (primarily because one of my major interests is archaeology, and the archaeological record is full of civilisations which ended because of class warfare; I consider the Mayans probably the most obvious example, but it also had a lot to do with the end of the Roman Republic and Caesar's rise to power) but I don't believe that Marx' proposed solution has any hope of working, because the majority are far too stupid, and the elite are too good at manipulating them.
My feline take is that most systems can be made to work tolerably well, to the extent that they are run by non-sociopaths.
The problem is that power of any sort, political, economic, religious, cultural, is to sociopaths what catnip is to cats.
This is why, after some 5,000 years more or less of recorded history, people are still arguing about what system is ideal and can point to examples and counter-examples of why their preferred paradise does or doesn't suck.
Fact is, no system is better than the people running it.
I have believed for a long time, that the only form of political or economic organisation that really exists, is rule by psychopaths.
This basically recapitulates The Iron Law Of Oligarchy.
People seem to be conflating mental illness with the idea that "capitalism causes alienation that makes people sad." The second argument is found in Mark Fisher, and I find it persuasive. It's illogical to reduce mental illness—a much larger thing—to a symptom of alienation, but the pressure to compete is depressing.
Possible social arrangements aren't a binary between capitalism and the Soviet Union. In the history of human societies, “capitalistic” (waged) arrangements have existed for a long time, but most were undertaken by people who had the legal status of slaves.
Also, you don't think that *any* advances in technology and social relations could allow more people to engage in meaningful work (or more leisure)?
Keynes thought technological progress would make clinical depression more common, not less. And he seems to have been right.
In 1930, when he wrote "Economic Possibilities for our Grandchildren", it was a relatively rare condition and mainly seen in upper-class women. But he didn't think that would last:
"If the economic problem is solved, mankind will be deprived of its traditional purpose.
Will this be a benefit? If one believes at all in the real values of life, the prospect at least opens up the possibility of benefit. Yet I think with dread of the readjustment of the habits and instincts of the ordinary man, bred into him for countless generations, which he may be asked to discard within a few decades.
To use the language of to-day – must we not expect a general “nervous breakdown“? We already have a little experience of what I mean – a nervous breakdown of the sort which is already common enough in England and the United States amongst the wives of the well-to-do classes, unfortunate women, many of them, who have been deprived by their wealth of their traditional tasks and occupations – who cannot find it sufficiently amusing, when deprived of the spur of economic necessity, to cook and clean and mend, yet are quite unable to find anything more amusing.
To those who sweat for their daily bread leisure is a longed-for sweet – until they get it."
The correlation you posit, between leisure and technological progress, is actually the reverse of what’s been the case since at least the 70s. Keynes famously hypothesized we’d have 15-hour workweeks by now, but instead actual work performed has gone up in many industrialized societies: just consider the entrée of women into the workforce; the prominence of multi-job employment and “side hustles;” the dissolution of the propertied, jobless elite into the Trump and Bill Gates-esque “overworked CEOs,” and so on. What has broken down is not work itself but the traditional bonds of an older capitalism — between “company men” and companies who take care of them — and the depressed idle women Keynes complained about are now, largely, busy and depressed female “professionals.”
So, yes, we have developed more technology and become more depressed, but this no more suggests technology and leisure as the causal mechanism than it suggests “capitalism causes mental illness.” Technology doesn’t have guaranteed social effects: societies make technologies and not the other way around.
I dunno. I think you could make the argument that many white-collar jobs nowadays contribute less meaning to workers' lives than they did a hundred years ago. So being employed rather than unemployed no longer protects people against depression in the way it used to.
David Graeber put it very well in "Bullshit Jobs":
"Automation did, in fact, lead to mass unemployment. We have simply stopped the gap by adding dummy jobs that are effectively made up"
Fair, and I agree! However, who does what (and when and how) are social questions, imo. The only thing I wanted to emphasize, again, is that humans decide what to do with technology, not the other way around. Technology does not *decide* anything, ultimately
It's also suggested by Durkheim (he doesn't make the sadness extension, but he recognized a sort of ailment that afflicts us based on alienation).
It’s funny that alienation is so tied to capitalism though. I speak from a position of high economic/productive power and low social power. Dating apps feel alienating because everyone is reduced to a social commodity in an infinitely crowded market, and I am not well-suited to that market. I’m not usually alienated at work at all, if I’m bored of something then I have the flexibility to change.
There’s a continuous optimizing process that wants to increase ”flow”, commoditize “objects” including people, and make all characteristics of all system components visible to the optimizer (if necessary by eliminating characteristics it can’t see). If this is the thing socialists call “capitalism”, then it’s also the thing Scott Alexander called Moloch. And I think that process drives alienation, particularly trying to eliminate characteristics of people that can’t be made visible to the optimizer. When those characteristics are productive, you get old school factory capitalism and people used as interchangeable parts. When those characteristics are social I think you get arranged marriages and dating apps depending on what century it is.
This strikes me as similar to Max Weber's idea of the iron cage of scientific capitalism. The constant impetus to improve efficiency leads to increasing distorted economic and social circumstances that come with focusing on ever-increasingly-small and specific measurements, and efforts to improve performance against them. That distortion results in significant alienation as we horribly miss the forest for the trees...and the leaves, and the bark, and the insects, and the insect wastes, and the mold spores that are the true KPIs that let us understand the forest.
I just listened to the SSC podcast reading of the Moloch meditations. Holy crap. Brilliant and depressing.
While I think there's a lot of value in all 10 points, I feel like the only one that should need to be made is the tenth: "it's the capitalism" doesn't offer us some kind of material path to improve mental health, and is thus not useful.
I'm generally more capitalist than socialist / communist, but it's not hard to see the benefit of a more effective, ubiquitous social safety net, including to the many who suffer from mental illnesses.
This post was as convincing and eloquent and powerful as anything I have read in a long time.
Breathtakingly brilliant.
Thank you for writing it.
Also, I was under the impression that men are more successful at committing suicide because they use more dramatic methods. They are more likely to say, shoot themselves in the head.
Yeah, that goes somewhat to the point of "attempting suicide as a cry for help" vs "serious plan to off yourself". It's a something of a cline with a bunch of bumpy peaks in the distribution. AFAIK, and it's been at least 30 years since I looked at the data in detail, that's a pretty consistent result across the developed world, with the completed/attempted ratio being more male-biased in the more developed countries. However, taking a quick look at some moderately recent WHO data, and being appropriately wary of all sorts of potential reporting bias, it seems that the higher the aggregate suicide rate (the leaders there mostly being in subSaharan Africa), the higher the male/female bias in completed suicides. I have a bunch of spitballing theories about that.
One interesting data point there, contra an oft-mentioned US-centric explanation for the higher completion ratio in men being access to guns: the drive to the Golden Gate Bridge (back before the barriers were put up) is the same length, but the male/female ratio was (from memory, I'm not going back to find it) something like 4:1 or 5:1. OTOH the drive takes time: picking up the gun is fast. Also (and I *think the data I studied way back when bore this out, but I would not bet on it), women in the developed world anyway (esp US) are far more likely to be relatively strong/easy to OD with pychotropics, which tend to mostly take a fairly long time to kill (and are also much harder to calibrate a lethal dose).
Guns are a part of the explanation for sure, and the best indication of that is that female combat veterans and police officers have a suicide rate roughly equal to men. Familiarity with guns seems like a pretty good explanation of this.
It is largely an issue of means. Women do tend to choose poisoning more, while men choose guns but also hanging, both higher lethality methods. In places with more access to very toxic pesticides, like rural India, we once again see something closer to equal suicide rates. The difference in choice of means is often explained in terms of greater fear of disfigurement in women and a generally higher propensity to violence, self or other directed, in men, but that is far from ironclad.
Thanks, I was not aware of that data re combat veterans and police. Do you happen to know if it applies in countries where police are mostly not armed with guns (the UK and Japan being the two that come to mind)?
I don't have any data pertinent to that, sorry. Quick attempts to search for the UK case at least run into a lot of papers examining training UK police as mental health first responders for suicide prevention. I suspect the relevant Japanese papers if they exist are not going to be in English for the most part.
Thanks for looking.
I don't know if there's any definitive studies on this, but at least some things I've read suggest that the primary reason is that men are more likely to use methods that are less susceptible to medical intervention (jumping from fatal altitude, firearm, suffocation). Women are more likely to use poison (e.g., overdose) or exsanguination.
I feel like the argument that women are “crying for help” is somehow meant to discredit their suffering? I’ve been having an ongoing argument with my mom about this—she is a psychologist. The older I get the more I’m coming around to the idea that…if someone is attempting suicide…there is something deeply wrong. Perhaps it’s a cry for help and/or attention—but why is this person in desperate need of attention? Why is the necessary love and support lacking from their life?
Of the approximately dozen times i tried, they were all while I was alone and not expecting to be found. I just am apparently unkillable by any combination of alcohol and narcotics / sleeping pills.
I haven't tried in nearly a decade, mainly bc i got tired of failing and figured id have to deal with living out the rest of my life. Im also a Christian, and i get the feeling God is telling me im stuck here so deal.
I’m so sorry to hear that you are struggling with this.
Im a million times better than i was a few years ago. Sober for 4 years and meds that have things way more under control.
I hate to say it because I love alcohol, but from what I've seen among my friends, quitting alcohol is the best thing you can do for your mental health. I have two friends who are severely bipolar (which is way different than borderline) and they are both doing much better now that they quit. I don't know your specific circumstance, but I am so happy it's working for you too.
It's only one weapon in an arsenal...but a good one.
It certainly doesn't mean their suffering isn't horrible or deserving of sympathy, but the suicide literature indicates the importance of distinguishing between suicide attempts with the intent to die and what are generally referred to as 'parasuicidal behaviors.' the later often occur in certain personality disorders and serve a number of functions, but they are not infrequently very maladaptive bids for the affection and support of others carried out by people who generally lack healthier skills for securing this reliably.
This especially happens in Borderline Personality Disorder, which tends to happen more or at least be diagnosed more in women. Thus the disparity. Men with who might qualify for the diagnosis often get an antisocial personality disorder diagnosis instead. Frequent bouts of disproportionate rage is another cardinal experience of BPD, and women who experience this tend to end up in treatment while men who do tend to wind up in jail.
I mean…boarderline is the worst. It’s true that people use the threat of suicide to manipulate. I'll concede that point.
But look at it this way…the suffering that they are experiencing in themselves feels bad enough to them that they are willing to go to extreme measures. They are suffering a lot even if they are dealing with it in a “maladaptive” way. The cause of that suffering could be internal, external, or a mix. But the suffering is real and extreme.
The purpose of FDB mentioning the disparity between men and women was to discount capitalism as the sole cause of mental illness. While I agree it is not the sole cause of mental illness, it doesn't make sense as an argument. Suicide is presented as evidence of mental illness, so the conclusion is that women suffer less mental illness than men even though they both suffer equally under capitalism. (Whether all genders/sexes suffer equally under capitalism is not an argument I'm in the mood to have right now, so I'll just concede that point.)
What I am saying is that the number of successful suicides isn't a good metric for suffering. A lot of people are suffering deeply and do not succeed at killing themselves, while others—I presume—try to "cry for help" and take it a little too far. Since success at suicide isn't a good metric, the disparity doesn't tell us anything about whether women suffer more or less mental illness than men. It is totally possible—within the world of this argument—that capitalism is the sole cause of mental illness and that it is distributed equally among all genders/sexes but that women are less successful at suicide for some other reason. (Not wanting to disfigure themselves is a good guess.)
Anyway, I don't think capitalism is the root cause of all mental illness, even though it can be a huge bummer.
I think you are both making some compelling points. I will just add one observation that may be useful. It looks as though JD (and your mom) is using language that people in the mental health field use to discern between different kinds of risk levels, not different degrees of suffering. It’s not asking “is this person really in pain or are they just looking for attention?” it’s “does this person need to be in the hospital right now or can they stay safe with supports at home?”
(I get that that doesn’t really change your argument re FDB’s piece)
Just FWIW, I certainly don't think the "attempting suicide via a means that is somewhat less like to be fatal all things considered" is meant to discredit the suffering of those who do that. Rather if we want to view it terribly simplistically (if we must), that men are, to their detriment, rather more resistant to asking for help.
My wealthy aunt suffered from bi-polar disease, and when she did stuff like leave one of her babies on the neighbor's porch, she would end up being treated in a somewhat nice private facility until she got better. She still had a struggle, and died from kidney failure eventually. My dad, who worked selling luggage and crap at flea markets in later life, and who also suffered from bi-polar disease, ended up running from the cops down a California highway, throwing stolen tools from the window. He served two years in a high security facility (prison) for the mentally ill (because he threatened a cop), then a year or so in a low security facility where it actually seemed like he was doing better, then on to a couple shitty nursing homes before he died. They absolutely did not care that he was totally out of it and halucinating when arrested. All the mentally ill wandering the streets I see, they have something in common, and it's poverty.
“ All the mentally ill wandering the streets I see, they have something in common, and it's poverty.”
That’s simply false. It’s very common for a kid from an affluent family to go off to college and at 20ish begin to show signs of schizophrenia. He will in many cases end up on the street. His family is willing and able to help but he won’t agree to treatment and there is nothing anyone can do since we don’t commit people anymore.
Some of those young people end up on the street. Others get parental help and do ok. It’s not “simply false.” My mom set up and ran day treatment centers for the chronically mentally ill in the 70’s through the 90’s, bringing people in from the streets. I am very familiar with the class make-up of the mentally forced to live on the streets. Do some people from wealthy families still end up homeless? Of course. But options matter on average, and the wealthy have more options.
I have a friend who has a kid (young adult) with mental illness, repeatedly hospitalized. They managed to get her an apartment in another city, and are taking turns staying with her. So 24/7 care from middle class parents. It’s super hard but it’s working.
I also have a family history of mental illness. My family member had intractable psychosis and was not able to live independently. Her parents had means, yes, but I think that these two factors played a larger role in why she was never in jail or on the streets: 1. Her parents had the will and ability to care for her, well into their 80’s. 2. Her particular brand of psychosis did not lead her to run away, distrust her family, commit harms to others, or burn relationship bridges. She did not become addicted, and did not tend towards paranoia. The family’s relative financial comfort definitely had an impact on Factor 1, though other circumstances also helped. Factor 2 does not really discriminate. If your family member thinks you want to kill them, won’t take their meds or stop drinking. and can’t attend to their basic needs, they may end up homeless, no matter how much money they come from.
This idea that capitalism causes MI was explored in Europe by the psychiatrically inclined members of Baader Meinhoff in the late '60s. So they threw open the asylums, "freed" the patients, and trained them as terrorists. Within a year, most were dead, either by suicide or killed by police at one of their ill-fated attack operations. About ten years ago, the LA Times put a picture of a US psychiatrist on the cover of its Sunday magazine, touting the same deadly theory, like he was some sort of innovative thinker. I was so infuriated I canceled my sub, never to return.
This is terribly sad.
Very little to add except this: any take about what causes “mental illness” is about as useful as a sweeping generalization about what causes “physical illness.” Both terms encompass so many different kinds of situations. Is it generics? Is it diet? Is it trauma? Behavioral choices? Bacteria or virus? Is it temporary or permanent? It is terminal? Do people with mental illness commit crimes or are they mostly a danger to themselves? Is it exacerbated by capitalism or or some other policy? Yes! No! Maybe! Sometimes! “Mental illness” refers to a million different things, and nothing. One thing cannot cause “it.”
My understanding is there are 2.5 types of mental illness. Chemical is your brain chemistry is fucked. Situational is where something bad / traumatic happened and you'll be fine with time and grieving.
The .5 is ptsd related which is technically situational, but also may be the result of brain rewiring, so you're probably not ever going to be cured even if you can improve.
I have to take exception to the last part of this. PTSD is absolutely curable if the right approaches (an exposure-based therapy like Prolonged Exposure or Cognitive Processing Therapy) are used and you get enough buy-in from folks to actually engage with them. These therapies do have in common that they are rather unpleasant to go through and are not always widely available. these approaches require deliberately making people uncomfortable (with their consent and in a systematic way) and making sure they don't distract themselves or engage in safety behaviors. Needless to say most people who want to be therapists aren't really eager to have this effect in people.
PTSD certainly has important individual factors in play though. The vast majority of people who undergo an experience qualifying for PTSD under Criterion A don't experience PTSD symptoms for any real length of time.
I definitely disagree with the last part; many folks with PTSD have episodic symptoms or symptoms that resolve in time, or with treatment. Of course, some people struggle with chronic PTSD, but not all. Also, people in other cultures relate to trauma much differently. The idea that you’ll never be cured/always be damaged is an unfortunate myth that social media has amplified. The book The End of Trauma by George A Bonnano is a good resource to check out if you’re interested in this topic!
My familiarity with ptsd is through people in the military who are typically told, and not incorrectly imho, they will deal with it the rest of thier life. I suppose the type of damage and repeated exposure matters.
There is a distinction between telling people that they will have traumatic memories all of their lives (true), and that they will have PTSD symptoms all of their lives (not necessarily true). I don’t think it’s ethical for a mental health professionals to tell anyone “you will have PTSD symptoms all of your life.” There is simply not data to know that, and framing it that way can create a self fulfilling prophecy.
I don't want to be a minimizing pollyanna candyass, but EMDR therapy is allegedly helpful for PTSD.
It is! Trauma Focused CBT and Prolonged Exposure Therapy are also helpful. Sometimes plain old time and perspective are helpful as well---a percentage of those who develop PTSD symptoms after a trauma find find they resolve over the next months or years. “There are good treatments, and your brain is not broken” is not minimizing, it’s just true.
I guess it's theoretically possible, but from what studies have shown, military vets with ptsd have it until the end of thier life. It's not a social media thing, it's based on actual irl research.
I’d be interested to see those studies! That is different than what I learned in my own education.
FWIW that line probably has roots in the theories of Thomas Szasz. ( Full disclosure: had to edit my origunal attrubution to a different psychiatriatric theorist, Reich, so maybe my input is questionable in any case.)
But w/public discourse being what it is now the prevailing mentality of all those who have an opinion to share is ( topic/problem of the moment) = (fave boogeyman did it). Your continuing testimony is worth far more than the overshared opionizing so common now. Please continue. But maybe for your own sake remember how inherently lightweight that all is.
Of all my substack subscriptions this is far and away the best.
I came to the US at age 9 about 50 years ago. By the time I entered high school, I could sense that American society seemed distant....that Americans seemed distant among each other, including among family members.
I've come to see that it's not just the United States, but a property of industrial societies. But even more, I think it may be the secular and irreligious nature of industrial societies.
I don't have the numbers, but it would be interesting to compare suicide and mental illness rates from industrialized societies to African, certain Asian, South American societies not considered industrialized.
But keep in mind that mental illness is not "just a social construction". It does have biological origins.