Psychopathology And World Politics

Ralph Pettman

• Publisher: WSPC
• Year: 2011
• Print ISBN: 9789814338691
• eBook ISBN: 9789814397018
• Topic: Biological Sciences
• Subtopic: Science General
• Index: Biological Sciences

This unique work looks at the relationship between psychopathology and world politics. What happens when the brain/mind ceases to function properly? How does this impinge on world affairs? What is to be done, for example, when a leader ceases to act in a seemingly sane fashion and yet still commands the loyalty of those who maintain him or her in office? What is to be done when a leader's advisers seem rational but are clearly not? Indeed, what is to be done when a whole society goes insane? This is to raise more questions than a single work can adequately answer.

In lieu of a comprehensive account, which would be beyond the scope of one study, what this book does is first describe psychopathology in general terms and its relationship to world affairs. It then looks at denial in particular and at “speaking the truth” as a potentially therapeutic antidote, especially in relation to nuclear weapons. It follows this by looking at delusion in general and at what being “in touch” with reality might entail with regard to a so-called “failed state”.

With topics ranging from Hitler's mental health to the continuing threat of nuclear Armageddon, this book is a valuable contribution to the field of international politics and modern psychology, and will hopefully lead to a better understanding of contemporary world affairs and the global issue of conflict resolution.

Contents:

• What is Psychopathology?
• Psychopathology and World Politics
• Denial
• Truth
• Delusion
• Reality

Readership: Students, researchers and academics in international relations and psychology/psychiatry; general readers interested in the relationship between psychopathology and world politics.

Chapter What is Psychopathology?
1

Psychopathology refers to forms of behavior that seem so dysfunctional that they denote ill-health. It refers to those “morbid” mental phenomena that some people must deal with some of the time and other people must endure all of the time. It is, in short, the “systematic study of abnormal experience, cognition and behavior — the study of the products of the disordered mind” (Oyebode, 2008, p. 3).

As such, it is one of those concepts that is easier to recognize than it is to define (Davis, 1984, p. 1; Page, 1975, pp. 3, 49). The problem is that psychopathology is concerned with “every psychic reality which we can render intelligible…”. It is concerned, that is, with the way the self endlessly attempts to comprehend the world. This makes it necessary to know what people experience in general before it is possible to say what might be wrong with them in particular. It makes it necessary to know the full nature of their psychic reality. This reality can only be known by objectifying the human psyche and then compensating for the limits and distortions of detachment by the use of empathy and understanding (Oyebode, 2008, p. 3). Only after such a comprehensive appraisal is it possible to determine what the conscious as opposed to the unconscious means and what the inner as opposed to the outer world entails. Only then can it be said what might mentally be the matter (Jaspers, 1972 [1913]).

It should also be noted that psychopathology is used to refer to various techniques that are currently believed to provide people who behave in a mentally unwell way with some kind of help. It has a prescriptive as well as a descriptive and an explanatory dimension.

In other words, psychopathology is supposed to provide a rational basis for identifying those who suffer mentally as opposed to those who suffer physically. It is also supposed to allow for the identification of those who suffer psychosomatically, that is, those who suffer physically because of their state of mind (for instance, those who develop an ulcer because they worry too much), as well as those who suffer psychologically because of the state of their brain or some other part of their body (for instance, those who lose their memory because of Alzheimer’s disease). Psychopathology is supposed in all such cases to provide a rational basis for restorative or at very least palliative care.

This approach to psychopathology was directly contested, a generation ago, by those who believed that changing the definition of disease from one highlighting the “physicochemical derangement of the body” to one highlighting the “disability and suffering of the person” would be potentially disastrous (Szasz, 1974, p. 40). Critics like Szasz argued that such a change could only result in many more people being considered ill than ought to be the case. Such a change, he said, could only end in “abuse” since it would do no more than provide “professional assent” to the “popular rationalization” that life-issues are like bodily diseases. This would rob individuals of their personal responsibility, he said. It would make them powerless patients who would require medical prescriptions. It would cease making them self-reflexive individuals capable of self-help (Szasz, 1974, p. 262). It would put them in an intolerable situation where they would have to accept rules that they did not make and play roles they did not construct for the benefit of those who had imposed a bargain they did not strike. From this perspective, people did not “go mad” so much as get “driven mad” because they could not escape the “social pressures” obliging them to act in this way (Cooper, 2001 [1961], pp. viii–ix). Goffman called the outcome “self-alienating moral servitude” since those who wanted to escape such servitude had first to submit to it. Those who wanted to fight such a regime had first to admit defeat. They had to accept the outlook of those whose job it was to enforce the way the world was defined (Goffman, 1962, p. 386). More generally, it relegated the “wildly charismatic or inspirational area of our experience” to the “desparate region of pseudo-medical categorization” from which critics saw clinical psychiatry as having sprung (Cooper, 2001 [1961], p. ix). Or to put the same point in less rhetorical terms, it meant having a profession intimately allied with the “alienated needs” of the societies it functioned within (Cooper, 1970, p. 10).

Regardless of what such critics said then and continue to say, however, abnormal and dysfunctional conditions are found in every human community and in every historical epoch. They are recognizable features of all eras and of all the societies found therein. In other words, in the major cultures of the world, psychopathological phenomena are similar or the same despite individual differences (Jaspers, 1972 [1913]).

Therefore, psychopathology is not just a contemporary phenomenon, nor is it confined to those societies that currently use the concept. Indeed, “every known language includes at least one word that specifically refers to seemingly irrational disturbances in psychosocial functioning”, thereby distinguishing such disturbances from “crime, immoral conduct, and other types of deviance…” (Page, 1975, p. 5).

To reiterate: there are particular psychopathological disorders that are identifiable as such regardless of when and where they occur (Mezzich and Berganza, 1984; Schumaker and Ward, 2001). They may not be as numerous as current classification systems suggest they may be, since close scrutiny of these systems results in few conditions that have unambiguous physiological and/or psychological causes (Poland, Von Eckardt and Spaulding, 1994). They are also described differently in different cultural contexts. Nonetheless, they are recognizable in every culture and in every era, and though this is not a conclusion beyond dispute, they result in similar concerns (Millon, 2004).

It is these concerns that are most reminiscent of Lasswell’s image, cited previously in the Introduction, of a car stuck in one gear. When people or peoples exhibit a lack of “voluntary control” and manifest a “troubled and troublesome” state of mind; when there are notable “disturbances” in their thinking, their emotions, their ability to communicate or their ability to act purposefully regardless of the cultural context; when these disturbances are serious enough to impede “effective and satisfying” conduct; when they result in behavior that is “more persistent, less appropriate…less controlled, more severe, more incapacitating, and more disturbing” than should otherwise obtain (Page, 1975, pp. 5, 15); then a prima facie case exists for talking in terms of mental abnormality or dysfunctionality — whether individual, collective, or communal.

In other words, all societies in every era have found ways to identify and deal with mental disorders. They differ in what they think brings them about and how they should be treated. The members of a premodernist community, for example, might see madness as resulting from a curse or as possession by evil spirits or as the effects of the moon. The members of a modernist society, by contrast, might see madness as biologically or socially induced, that is, as a consequence of a personality disorder or of unconscious drives or the side-effect of some organic disease. What in the first instance might be treated by shamanistic exorcism or bloodletting is more likely to be treated in the second instance with drugs or a form of psychotherapy (Davis, 1984, pp. 142–164). The main point is that both pre-modernist and modernist societies label particular mind-states as abnormal or dysfunctional, regardless of how misguided their understanding might be, and that they actively intervene to deal with these mind-states in the light of their understanding (Draguns and Tanaka-Matsumi, 2003).

This suggests that it is far too radical to argue, as Szasz did, that “[t]here is no medical, moral, or legal justification for involuntary psychiatric interventions. They are crimes against humanity” (Szasz, 1974, p. 268). This might be so in most places most of the time. It is not, however, the case in all places all of the time. There are cases of chronic reactive depression, for example, where the person who is suffering is self-evidently ill. In these cases, only the most radical and decisive intervention is likely to help. Nor is it enough to suggest to those affected that they think about what they should do — they no longer can. Meanwhile, there is ample non-anecdotal evidence to suggest that psychotherapy of various kinds is more effective than no psychotherapy at all (Bloch and Harari, 2006, pp. 14–16).

Who is Normal and Who is Not?

This still begs the question of who is normal and who is not, that is, what is dysfunctional and what is not. Several contemporary disciplines address this issue, each one of which has its own perspective on what is involved. Psychiatrists, psychologists and psychoanalysts, for example, tend to articulate different ideas about cause and prescription. This makes normality and functionality into portmanteau concepts that allow for diverse definitions. This, in turn, makes them difficult to specify with any degree of precision. It leaves considerable scope for psychiatrists, psychologists and psychoanalysts to invent diseases in lieu of discovering them (Szasz, 1974, p. 13) and to seem to know more than is really the case. It is one thing, for example, to learn “formulae and technical terms” and to seem to have the “answer to everything”; it is quite another to adopt an approach that acknowledges the limits of what one is trying to do (Jaspers, 1972 [1913], p. 50).

As noted earlier, normality can be seen in terms of an average or an ideal. As an average, it is a mean that individuals may briefly correspond to, though not usually for long. As an ideal, it is a preferred state in terms of functioning, in accord with an inherent design that, again, individuals may briefly approximate but usually not for long. The former is a statistical concept while the latter is an optimal one (Robins, 1977, pp. 2–3).

Regardless of whether normality is an average or an ideal, the question then becomes: when does an eccentric pattern of behavior (with regard to culturally accepted means or preferred states) become pathological? When do people manifest an inability to cope that is so notable and deviates so far from the social mean or preferred ideal that they seem to need treatment of some kind?

When, for example, does repressing an unpleasant memory so that it no longer directly impinges become pathological rather than a means of seeking mental comfort? When does rationalizing what is being done so that it seems to be beneficial become evidence of unwellness rather than of a desire for self-justification?

And when should those who seem to have chosen delusions be deemed so ill that they should no longer be treated as self-indulgent? When does projecting feelings of inadequacy onto seemingly malevolent others become persecution and paranoia rather than a desire to escape feelings of self-blame or a lack of self-confidence? When, that is, does compensating for inadequacy become a neurotic wish to succeed rather than vaulting ambition? When does the eschewal of personal or social traits that are deemed undesirable become a “reaction formation” rather than a need not to parade those traits in the public domain? When does retreating from adversity become “regression” rather than a process of renegotiating a radical change in the environment? When does imitating a significant role-model become “identification” rather than adopting the ideas and practices of someone who is admired? When does imitation of this kind become so intense that it becomes “introjection” rather than extreme identification with another self or culture (Page, 1975, pp. 14–15)? When should someone who is weak or oppressed, who speaks softy but is not heard, who then speaks more loudly and is deemed anti-social, be categorized as insane for deciding finally to shout out loud (Szasz, 1974, p. 119)?

It is clear from the above that determining where the line should be drawn between normality and abnormality, or functionality and dysfunctionality, is, in all but a few cases, far from self-evident. This is not to say that no such line exists. The fact that at the turn of the last millennium a major hospital in Jerusalem had several patients, each one of whom claimed to be Jesus Christ, and all of whom denounced the others as false prophets, suggests that there are delusions that are evidence of illness rather than self-indulgence (Morris and Hill, 2000; Rokeach, 1981 [1964]). Instances of this specific form of insanity are relatively rare, however. Most of what is called mental illness is a more or less moderate case of a syndrome deemed recognizable as such in the everyday world. It is usually within the range that is recognized as necessary to allow for effective functioning there.

The Political Implications of Defining Normality

It is also clear from the above that, except for those concerns that are recognizable as such in every place and time, conditions like these are closely related to the cultural context in which they are found and that this has important political implications. For example, normality and abnormality and functionality and dysfunctionality are labels that are used to create in-groups and out-groups. They are used against those out-groups that an in-group wants to label as undesirable. Diagnosis under these conditions is not neutral. It does not transcend the interests of the in-group as it would in the case of a physical disease. It promotes those interests in a culturally specific and politically self-aggrandizing way (Goffman, 1962, pp. 364–365).

The incarceration of political enemies in mental asylums is clear evidence of such an implication. This occurs particularly under conditions of authoritarian rule, though it is not unknown under democratic ones either. Again, these issues were thoroughly aired a generation ago by critical analysts concerned with the medicalization of mental illness. “There is no doubt”, as one such critic said, “that psychiatrists [for example] may be called on to help ‘adapt’ individuals to a status quo that is itself brutalizing for those whose social role makes them an integral part of a pathological social system” (Devos, 1976, p. 279). Goffman called this process “mortification”. He described it as placing a barrier between the person or persons who were labeled abnormal or dysfunctional and the wider world. He said this involved destroying the former’s previous identity and imposing one more relevant to the role they were expected to play as someone abnormal or dysfunctional. This included depriving them not only of their property but also of their name, their dignity and even their personal or social integrity. At the same time, it included the provision of substitute possessions deemed more suitable to the cultural context they now found themselves in. It also included the imposition of “forced deference” so that those who were mortified had to live lives that were completely alien to them. More subtly, it included taking the defensive responses of those being mortified and making them part of the process. Goffman called this “looping”. In society at large, for example, wherever people have to conform to an environment that radically insults their sense of self, they are usually given some leeway with regard to expressing their discontent. By the time they are grown-up they have usually learned what is necessary to function in the world, so that the matter of appropriate or inappropriate behavior only tends to arise when they are assessed as productive or not. In institutions like mental hospitals, however, “didactic feedback” can be erected into a “basic therapeutic doctrine” (Goffman, 1962, pp. 14–48).

Less obvious is the way every culture sets terms of reference that make some kinds of politics legitimate and other kinds illegitimate and the way concepts of normality and abnormality are germane to setting these terms. The modernist project, for example, emphasizes knowing as a matter of using reason as an end in itself. It places a related emphasis on the appropriate form of being, that is, socially-alienated individualism. This makes the active promotion of a politics of personal autonomy almost automatic. The success of modernist science has made it possible for modernists to globalize their culture to a historically unprecedented degree. It has made it possible for modernists to globalize their preferred ways of ordering the world’s strategic, market and social affairs as well. This has had profound political consequences for the global order. Those who accept these consequences are deemed to be functional. Those who do not are deemed dysfunctional.

Least obvious of all is how, when modernists began objectifying what seemed to them to be the very seat of reason, they began to objectify the brain and the mind and to see abnormality and dysfunctionality as the consequence of two sets of causes, one brain-based and physical and the other mind-based and psychological. The physical causes they saw as the more metabolic and organic ones. This was to posit a “disease” model of psychopathology (Davis, 1984, pp. 1–8). The psychological causes they saw as the more mental and emergent ones. This was to posit an “adaptation” model of psychopathology (Davis, 1984, p. 8).

The Modernist Conception of Consciousness

In promoting this dichotomy, modernists were promoting a difference between the brain and its awareness. This was an idea that was first advanced in the early days of the modernist project. It was one that construed the mind and the brain as separate and discrete. It also construed a similar difference between what is acquired naturally and what is learned growing up (Descartes, 2006 [1637]; Taylor, 1966, p. 11). These distinctions became part of the history of psychopathology as a modern-day science (Jaspers, 1972 [1913]).

While objectifying reason resulted in a clearer conception of the brain and the mind, the process did not stop there. It was taken a step further and used to question this conception itself.

The dichotomies that the brain/mind and nature/nurture alternatives represent were redefined as a consequence — they were turned into continua. The clear-cut differences that brain/mind and nature/nurture highlight became complex, unitary, non-additive concerns that are not fully understood.

Further reflexivity undermined the assumptions of modernity itself. Modernity was set up in opposition to knowing-by-believing. Consequently, though many modernists still subscribed to a spiritualist perspective, modernity as a doctrine promoted secularity. Secularism in turn promoted secular coping strategies, secular counseling, or scientific treatments, like those that involve psychotropic drugs. Modernists themselves who suffered mentally chose to self-medicate using alcohol, narcotics and other such substances. Non-modernists, meanwhile, like those who belonged to communities still relatively untouched by modernist mores, were more likely to eschew the secularity of modernity and to see psychopathology in terms of spirituality. Thus, they tended to see healing in terms of rituals and ceremonies that emphasized the relationship between the people and the land. They tended to want to restore harmony, not just in organic and physical or mental and psychological terms, but in sacral ones as well. This was pre-scientific rather than scientific language, but in psychopathological terms it was not inappropriate. It was not necessary to return to demon possession and shamanistic exorcism or witchcraft and bloodletting to find a meaningful role for non-modernist knowing in this regard.

Despite all the reflexivity that modernity ultimately encouraged, the notion that there was a dichotomy between the organic or physical and the mental or psychological persisted. More particularly, modernists continued to see the causes and consequences of psychopathology in dichotomous terms. They admitted that the brain and the mind, for example, were not the dichotomous alternatives they were initially seen to be when the modernist perspective was brought to bear psychopathologically. They acknowledged that closer analysis revealed that the brain was the mind and the mind was the brain in mixed ways that the attempt to objectify both did little to describe and explain. This said, we still have those who want to alleviate the suffering that psychopathology causes by seeing it primarily in terms of organic or physical causes. Analysts like these tend to prescribe treatment regimes that deal with the brain. They cleave pre-eminently, though not exclusively, to a psychiatric approach. By contrast, we still have those who want to highlight environmental causes. Analysts like these tend to prescribe treatment regimes that deal with the mind. They cleave pre-eminently, but not exclusively, to mental and psychological or psychoanalytic approaches.

Organic or Physical Causes

Those who highlight the importance of an organic or physical approach tend to argue, as Jaspers did, that psychopathology finds in neurology, internal medicine and physiology its “most valuable auxiliary sciences”. As our knowledge of such causes advances, he says, the need to posit psychological causes becomes less acute.

As knowledge of the limits of human awareness expands, however, psychopathologists find no organic cause capable of accounting for those limits. Jaspers himself posited a dichotomy between the brain/mind as a somatic/psychic entity, likening the current research situation to exploring a foreign land from opposing directions and one, moreover, where the explorers fail to meet because of the terrain that separates them (Jaspers, 1972 [1913]).

This said, the fact that psychopathology and the main psychopathological syndromes are found in every culture is evidence in itself for assuming the universality of organic causes. How these syndromes are manifest may depend on what is learned locally. What they are called may have highly specific linguistic referents. However, human beings do respond to “intolerable stress situations” in similar ways, for example. They also react to life’s problems with...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Contents
• Preface
• About the Author
• Acknowledgements
• Introduction
• Chapter 1:What is Psychopathology?
• Chapter 2:Psychopathology and World Politics
• Chapter 3:Denial
• Chapter 4:Truth
• Chapter 5:Delusion
• Chapter 6:Reality
• Conclusion
• References
• Index