Reflections on the Privatisation of Mental Health

Allen Ginsberg’s (1984) poem, Howl, famously begins with the line:

‘I saw the best minds of my generation destroyed by madness.’

allen ginsberg
A young Allen Ginsberg (photo: youtube)

What we should glean from Ginsberg is that mental health is not simply an interior, it’s not an affliction of the deeper, inner, soul as much as a symptom of the society we live in. Suffering from bouts of mental illness himself as well as witnessing it being visited upon friends, Ginsberg deals with the issue with constant reference to 1950s American society. This is an important insight as Mental Health Awareness Week draws to a close. To concentrate wholly on the interior obscures the material and ideological structures that can initiate mental illness.

In stark contrast to Ginsberg, the contemporary debate on mental health seems to want to ignore or dismiss society entirely. It all becomes an issue for the private individual who must deal with it in ‘their own way’. It’s as if, to borrow Eagleton’s phrase (1991: 241), mental illness simply ‘drops from the skies’. The common view that notion that mental health is something that ‘can affect everyone’ (the presumption being it affects everyone equally) seems to somehow absolve the unequal, oppressive and stressful character of modern society. Mental illness can affect everyone but some are more at risk than others. Some are more able to access treatment than others.

The role of racism, poverty, sexuality or just the anxious, weird, cyber-fucked-world we inhabit cannot be ignored. Part of ending the stigma is the recognition that poorer sufferers, apart from the added stress of financial precarity, are unable to access treatment quickly and without financial cost. Go and see how long the local NHS waiting list for mental health treatment is in your area. The recognition that people of colour and LGBTQ+ people are more at risk is also required. Furthermore, there must also be a recognition that neoliberal economics requires a credit market which inflicts the mental distress of astronomical debts onto the general population (Harvey 2010: 17). Household debts are a record high in the UK right now. As Dawn Foster wrote in the Guardian, interventions from Royals and the like obscure the fact that the austerity policies of the Conservative Party have hollowed out the welfare state and the health service and exacerbated the conditions in which mental illness can fester. Warnings from mental health professionals have been ignored, even as the situation has worsened and suicides increased throughout the coalition government’s tenure.  The headline of a well-argued piece put it nicely:

‘Making efforts to break down the stigma around mental health means fuck all if there’s no funding’.

Similarly, research conducted by the homeless charity Shelter emphasise the disastrous impact housing pressures have had on mental health.

shelter
Infographic belongs to Shelter: http://england.shelter.org.uk/professional_resources/housing_and_mental_health?utm_source=twitter&utm_medium=referral&utm_campaign=MentalHealthEnter a caption

These housing pressures have been unaddressed by Tory governments keen to keep property prices high for the benefit of their property-owning members and voters. Even social media apps like Instagram, with its emphasis on ideal body types, have been shown to be harmful to young minds. Without the recognition of these societal factors, the issue becomes depoliticizes or ‘privatised’. Racism, poor housing, cuts to healthcare and welfare, toxic societal conceptions of gender roles and astronomical (student) debts have created a climate in which people can see no way out. Material and social circumstance cannot be ignored. As Megan Nolan wrote in Vice:

‘According to the symptom checklist, I suffer depression and anxiety. But even so, I couldn’t stop myself from saying to my doctor: I don’t think this is because I’m depressed. I think it’s because I’m poor. My anxiety about being poor makes it impossible to work, which makes me poorer, and the cycle continues.’

Mental health, in other words, is a political issue, not a private one we simply need to ‘destigmatize’. More needs to be done.

Before proceeding it’s worth noting the following: this piece simply wants to convey some reflections on mental health with a historical and literary perspective. It’s intent is to revaluate and politicize discourses of mental health, to illuminate historical perspectives that may have otherwise been in left the dark. Walter Benjamin (1973: 57) wrote that: ‘For every image of the past that is not recognized by the present as one of its own concerns threatens to disappear irretrievably.’ It is in this spirit that the piece proceeds.

Before his recent and tragic suicide, Mark Fisher wrote about the important task of politicizing mental health. He wrote (2009: 21) that capitalist societies sought to ‘privatise’ mental illness:

‘as if [it] were caused only by chemical imbalances in the individual’s neurology and/or by their family background – any question of social systemic causation is ruled out.’ [my emphasis]

Mental illness and its proliferation among the younger generation and the treatments have been ‘medicalised’ as a ‘chemical imbalance’, yet it’s easy to see the benefits of this for capital. Individuals automatically blame themselves, thinking: ‘it’s all in your head’. It’s as if the external world the society we live in is completely irrelevant to the workings of your own mind. As Fisher acknowledges (2009: 21), depression is caused by a lack of serotonin but is it a stretch to imagine the society we live in might have something to do with that? Or, to take the point further, is it a stretch to wonder whether society’s response to mental health can often tell us more about society than it does about our own brains?

Foucault argues (1971), for instance that even the rational, scientific study of mental health as a phenomenon was a result of the contingent social and economic circumstances of modernity. His Madness and Civilisation (1988) elucidates the extent to which mental illness has been interpreted through various ideological frames throughout history. In the Renaissance, the mentally ill were afforded knowledge beyond the sane’s comprehension. In many cases, they were revered as an expression of the limits of human reason. In the modern era, the mentally ill have been rationalized, hospitalized or taken out of society all together. Many found themselves entrapped in what Foucault (1988: 38) called ‘the Great Confinement’ including ‘one out of every hundred inhabitants of the city of Paris’ who were forced to endure ‘arbitrary measures of imprisonment’. Foucault (1988: 45-46) explains how across Europe, workhouses, ‘hospitals, prisons and jails’ could ‘contain those condemned by common law, young men who disturbed their families’ peace or who squandered their goods, people without profession, and the insane.’ This continued into the 20th century. Opened in 1904, Storthes Hall near Kirkburton in Huddersfield had women who’d had children out of wedlock also confined within its walls. In many cases, the poor were conflated with mentally ill as ‘pauper lunatics’ they were treated as one and the same. Storthes’s Hall’s records are rather cryptic and antiquated but they give you a flavour for what could land you inside:

‘Domestic trouble 14

Mental anxiety and worry 27

Intemperance in drink 14

Adverse circumstances 5

Religious excitement 2

Fright and nervous shock 1

Self abuse (sexual) 3’ (Littlewood 2003: 29)

What this illuminates is how political and historically contingent the position of the mentally ill is. Apart from this, it also attests to the shaky foundations that uphold the relationship between the ‘mad’ and the ‘civilised’.

Another mentally ill contemporary of Ginsberg and Foucault was Sylvia Plath. As a woman, Plath offers us another avenue through which we can study mental illness and the societal response to it. The patriarchal character of 1960s society was also a key factor in triggering Plath’s mental illness and her eventual suicide. The Bell Jar’s (1966) political message may be far subtler than Ginsberg, Fisher or Foucault but its existence cannot be denied. She recalls how her university required nude photos from its female students and was more like a finishing school which tried to turn into students into nice ladies than critical and thoughtful creators and innovators (Plath 1966). Another particularly repugnant, all too real passage recounts a case of rape (Plath 1966). Recent revelations also reveal her entrapment in an abusive relationship with fellow poet Ted Hughes, inspiring such classic poems as ‘The Jailor’ which compared the husband to a prison guard (Plath 1965). Hughes and Plath separating after the former’s infidelity was revealed and Plath’s mental health worsened. The pills Plath was proscribed in winter 1963 – monoamine oxidase inhibitor – would never be given dished out to anyone with suicidal tendencies now since they can cause hyperactivity. This contributed to her eventual and infamous suicide in the gas oven of her London abode. Thus, once again Plath’s mental illness cannot be separated from the society in which it manifested itself.

To further explore mid-to-late twentieth century’s conceptions of mental illness, it’s worth retuning to Ginsberg. ‘Howl’ (1984) has themes of repressed sexual identities, particularly homosexuality. There’s references to men with ‘big pacifist eyes sexy in their dark skin’ and those ‘who let themselves be fucked in the ass by saintly motorcyclists, and screamed with joy’. Howl is to Ginsberg in many ways a stream of consciousness. A consciousness that society, refused to let him have: it was still illegal to have or even talk about homosexual sex in public in the UK and the United States. The poem was banned in many places and Ginsberg was taken to court for writing it. Foucault was a contemporary of Ginsberg, a homosexual with a preference for sado-masochism. Much like Ginsberg, Foucault repressed his sexuality during his adolescence and in turn developed mental health problems which would come and go throughout his life. Much like Ginsberg, Foucault would often self-medicate hard drugs as a way of dealing with his condition. Having grown up in a nice bourgeois household, his family could afford to send him to one of the best psychiatrists in France, Jean Delay at the Hopital Saint-Anne in Paris. At the root of his mental illness though, which was ‘medicalized’ and ‘biologized’ by his visit to a medical professional, was French society’s less than tolerant approach toward his own homosexuality. In a later debate with Chomsky, Foucault said (1971):

‘Psychiatry, for instance, is also apparently meant to improve mankind and the knowledge of the psychiatrists. Psychiatry is also a way to implement a political power to a particular social group.’

Like Ginsberg, for Foucault, society’s homophobia was a major motor in the acceleration of his depressive states. For both figures, binaries of sanity and madness, gay and straight was compounded by their self-medicated drug abuse. Put another way, the society they lived in basically treated homosexuality as if it was a mental illness. Statistics show that LGBTQ+ people today still disproportionately abuse drugs as a self-medication mechanism. The solution, for both Foucault and Ginsberg, was a politicization of mental health which is undoubtedly task of both ‘Howl’ and Madness and Civilisation. As Foucault explained (1971):

‘It seems to me that the real political task in our contemporary society is to criticise the workings of institutions, particular the ones that appear neutral and independent, and to attack them in such a way that the political violence will finally be unmasked so that one can fight against them.’

Political violence for Foucault is surely broadly defined. Violence is undoubtedly inherent in; refusing to sufficiently fund mental health services, cutting welfare payments to disabled people, denying financial assistance to the mentally ill, straddling swathes of population with vast amounts of debt and allowing discriminative attitudes to perpetuate and reproduce themselves etc. These policies show that the government is not simply a ‘neutral’ arbiter. Fisher also saw that emancipatory politics could illuminate the inadequacies in our approach towards mental health. Foucault, Ginsberg, Fisher, even Plath, recognised there was a false neutrality to debates surrounding mental health. This neutrality absolved society of the blame for its causation. Fisher writes (2009: 17), almost paraphrasing Foucault:

‘… emancipatory politics must always destroy the appearance of a ‘natural order’, must reveal what is presented as necessary and inevitable to be a mere contingency…’

Understanding mental health as a political issue can therefore emancipate us from the inadequacies of the status quo.

  • Benjamin, W (1973) ‘Theses on the Philosophy of History’. in: Illuminations. Edited by Arendt. Trans. Zohn. New York: Fontana Collins.
  • Eagleton, T (1991) Ideology: An Introduction. London: Verso
  • Fisher, M (2009) Capitalist Realism: Is There No Alternative? London: Zero Books.
  • Foucault, M (1971) ‘Human Nature: Justice versus Power – Noam Chomsky debates with Michel Foucault.’ Available – https://chomsky.info/1971xxxx/
  • Foucault, M (1988) Madness and Civilisation: A History of Insanity in the Age of Reason. New York: Vintage Books
  • Ginsberg, A (1984) ‘Howl’ in Collected Poems, 1947-1980. New York: Available –

https://www.youtube.com/watch?v=WkNp56UZax4

  • Harvey, D (2010) The Enigma of Capitalism and the Crises of Capitalism. Oxford: Oxford Books
  • Littlewood, Ann (2003) Storthes Hall Remembered. Huddersfield: University of Huddersfield
  • Plath, S (1966) The Bell Jar. London: Faber and Faber
  • Plath, S (1965) London: Faber and Faber

Review: Simon Armitage at the Brontë Parsonage Museum

The Unaccompanied

Simon Armitage (2017) The Unaccompanied. London: Faber and Faber

Simon Armitage (2017) Mansions in the Sky. Branwell Brontë Exhibit.Bronte Parsonage Museum. Haworth, West Yorkshire.

They say you should never meet your heroes but upon hearing the The Brontë Parsonage Museum was hosting Simon Armitage it was hard to resist. After greedily releasing two collections of poetry this week, his exhibit on Branwell Bronte, the ‘fail son’, opium-addicted, Bronte brother was also opened. His reading dealt with the complexity, speed and inequality of modern life, set against the background of West Yorkshire’s rolling Pennine hills. The eccentricity and telluric quality of Armitage’s writing was juxtaposed with the dizzying experience of the modern metropolis. You came away with a sense that this was a poet who, after translating and playwriting for many years, had come back to his stomping ground with a political point to prove.

Armitage filled the silences between his poems with a more improvised form of the wit we’ve come to expect from his prose works. Gig (2008), All Points North (1998) and Walking Home (2013) were written with what he describes as his ‘bleak sense of humour’. Yet he always manages to somehow keep it serious enough to avoid the trap of gimmick. Armitage typically combines hilarity with the dry and the dismal. ‘The Poets Hosts His Annual Office Christmas Party’, full of innuendo, is the stand out funny one of this collection. However, The Unaccompanied also demonstrates Armitage’s ability for a more systematic social commentary.

Reading in soft Huddersfieldian tones, he juxtaposes the rich with the poor, the rural with the urban and the tragedy with the farce. Armitage himself described the work as a ‘recession collection’, a ‘sociological’ recantation of British society since 2008. Or at least post-crash British society as he saw it through his gritty, Northern Realist lens. You can see where he’s coming from. It’s easy to think that in a decade where wage growth has been at its lowest since the invention of the steam engine, poetry is a self-indulgent piss-around for the moneyed-classes. Yet it remains as vital as ever.

Beginning with ‘Thank You For Waiting’, a satirisation not only of airlines but of the inequality engendered by neoliberal capitalism, he was subtle yet bitingly political. He amusingly portrayed the segregation of air travel by social class in the United States through the medium of substances from ‘Gold’ and ‘Silver’ to ‘Sweat’ and ‘Dust’. ‘Nurse at a Bus Stop’ speaks of a young woman who will always ‘hold the hand of cancer till the line goes flat’ even as the social and the political, indeed history itself, works against her. Risking being a ‘Jilted bridge of public transport’, she slogs every day to counter the ‘humanitarian crisis’ the Red Cross reported in British hospitals. The poem defended those who wear their NHS ‘fob watch’ as ‘a medal to your breast’. It vindicated those still left with the faith to fight for the NHS, even as successive governments have pulled the rug from under it. The audience’s collective murmur of miserable agreement capped off the poem, showing how well Armitage has managed to keep his finger on the public pulse.

In a sense, The Unaccompanied speaks for what has come to be known since Brexit as the communities left behind. That said, he’s not simply representing the Brexiteer. Rather his attention is on those left behind, socially and politically, in general. The clue here is in the title of the collection. We’re taken on a journey through almost anonymous West Yorkshire villages, to Poundland where we meet ‘a duty manager with a face like Doncaster’. Then there’s Wakefield Westgate railway station which recently moved, almost as if it was sick of being neighbours with the murderers and rapists that inhabit Wakefield’s high security prison. Armitage recounts his meeting with serial killer Robert Maudsley, which took place in earshot of the platform announcements, in ‘Solitary’. What comes through is Maudsley’s banality as well as his empty existence ‘in his glass case’. We are left pitying the life of those detained in solidarity confinement, if not Maudsley himself. Here we find that the miserable, macabre and mundane are transmuted by Armitage into the sublime.

His commentary on modernity steps it all up a notch. The Unaccompanied’s enigmatic and ambiguous cover itself is worth thinking about. When asked about it he recounts and explains the numerous and conflicting interpretations of the ‘cosmonaut’ set against the background of ‘embryonic pink’. Kept alive by a mechanic umbilical cord, it’s easy to relate to this anonymous, almost post-human figure, left stranded by the machinery of his own making. ‘The Emergency’s’ enigmatic last line ‘What is it we do now?’ is reminiscent of Marx’s definition of modernity: ‘All that is solid melts into air’. Perhaps the collection should be read as a search for solidity in a world of fluid and flux. ‘To-do-list’, the fastest poem he read, attests to this. A whirlwind of errands where to eat and breathe is ‘optional’, the poem’s theme of speed only seeks to reflect that of contemporary life. Similarly, ‘Old Boy’ reads like a rant from a Dad struggling to keep up with the news of the day, never mind technological advances. Yet we can relate to how the complexitity of modern life can make us feel like ‘a monkey with a jigsaw’. To appreciate the poem’s frustration fully, it’s worth listening to a fast-paced version from Armitage’s band, The Scaremongers, on the track ‘From the Shorelines of Venus’.

To celebrate the 200th anniversary of the birth of Branwell Brontë, Armitage curated an exhibit at the Bronte Parsonage Museum where we adjourned after the reading. Even in these poems he wrote for Branwell Brontë, Armitage can’t escape the 21st century frame. This would seem anachronistic if it wasn’t so plain funny. In one fail swoop Armitage bounces from Wordsworth and the Brontës, to The Smiths and Premier League football. ‘William, It Was Really Nothing’ recounts a letter Branwell sent to William Wordsmith, who was more than uninterested in writing back. Armitage can’t resist mixing the low and highbrow and he seems to work to cultivate an ‘everyman’ reading voice. Contemplating his self-worth, a 21st century version of the Bronte brother pontificates about Manchester United shelling out £85million for Paul Pogba. ‘Wallet’ continues the theme, empty but for a condom and coke-covered credit card, Branwell’s character is brought to life through the prism of 21st century.

Armitage’s modesty and humble beginnings in provincial West Yorkshire can disguise the intellectualism that lays behind his poetry. His translations of poems from Ancient Greece and the Middle Ages show how well-read his. No doubt he would deny this. He is keen to create space for interpretation of his work that is safe from academic literary theory. While it garnered a few laughs, his joking cry of ‘help’ at the prospect of giving a lecture at Oxford can’t help but seem insincere. Indeed, his lectures at Oxford reveal him to be an avid and wide-ranging reader. The beauty and hilarity of Armitage lies in his ability to talk about the Odyssey and Poundland, Brontë and Pogba as if they were one and the same. His subtle yet germane social commentary in this new collection shows he’s still got a few aces up his sleeve.

Armitage sits on the bed in Branwell’s Studio© at the Brontë Parsonage Museum, Haworth. Photographer: Simon Warner.

Armitage at the Bronte Parsonage

 

 

Trump: the final death-knell of the Palestinian state?

religion-diplomacy-politics
Trump speaking at AIPAC (American-Israel Public Affairs Committee), the largest pro-Israel lobby.

The election of Donald Trump has had worldwide repercussions. Not least on the Palestinian question. Palestine, though not a state in practice, has been recognised as such at the UN with an overwhelming majority: 138 in favour, 9 against and 41 abstensions. Trump said in the primaries that solving the conflict would be a top foreign policy priority. He said it was:

‘… something I’d really like to do… As a single achievement, that would be a really great achievement… I’m going to be probably going over there pretty soon and I want to see him [Netanyahu], I want to see other people, I want to get some ideas on it.’

As with every issue Trump wades in on, there was a lot of confusion about his position on the Palestinian question. This was made worse by a blatant lack of knowledge on the topic, not knowing the difference between two of Israel’s Islamist enemies, Hezbollah and Hamas being one example. Hezbollah is a Lebanese political party and mostly-Shiite militia, Hamas is a Palestinian political party and militia.

Surprising in the primaries Trump balked at the question of recognising Jerusalem as Israel’s undivided capital which is standard practice for both Democratic and Republican party candidates. Even to question Israel’s entitlement to all of Jerusalem is enough to render you an extremist to the American political establishment. This is despite the fact that no other country in the world recognises Jerusalem as the capital of Israel, since half of Jerusalem is occupied Palestinian land that Israel has deliberately and illegally built on.  In contrast, as stated, most countries, including the the UK, recognise Palestine. Trump was skeptical of Israel’s commitment to peace. This is perfectly rational given that settlement construction is a colossal obstacle to peace, all you need to do is look at a picture of the West Bank. If you do, you will see that Israel illegally occupies vast swathes of Palestinian land and has continued to build on it, evicting and demolishing houses in the processs. This contravenes international law, effectively colonising Palestinian land. His position of cutting a more neutral line, was understandable, suprising but ultimately opportunistic.

israel-palestine
This map from The Funambalist shows that Palestinian land has been dissected by the illegal growth of Israeli settlements which include roads and facilities Palestinians may not use.

Trump later backtracked entirely as his speech to AIPAC (American-Israel Public Affairs Committee) in March made clear. The semblance of neutrality vanished. AIPAC is a very strong pro-Israel lobby which has significant influence in Washington. By this time, it is worth noting, he had decided it was ‘appropriate’ to understand the difference between Hezbollah and Hamas. Trump stated: ‘We will move the American embassy to the eternal capital of the Jewish people, Jerusalem.’ Moving the American embassy to Jerusalem would be to virtually deprive the Palestinians of their political and legal right to half of the Holy City. It further set a precedent that would make a Palestinian state nigh on impossible. In an interview with The Daily Mail in May he said that settlement growth should ‘keep going’ and ‘keep moving forward‘.Settlement growth that is likely to consign a Palestinian state to oblivion.

The prospects of a Palestinian state look all the more dim when we take a closer look at the people around Trump. His son-in-law Jared Kushner, whom Trump said could play a key role in negotiations, comes from a family that is friendly with Israeli Prime Minister Netanyahu and who have donated tens of thousands to extremist settlements in the West Bank. His advisor on Israel, David Friedman, would be on the far-right in Israel, he believes in expanding the settlements  and annexing the West Bank entirely. Steve Bannon, Trump’s Chief of Staff and founding member of alt-right news website Breibart, demonstrates beyond all doubt that you can be both pro-Israel, pro-settlement-building and yet antisemitic. Rudy Guiliani, the former mayor of New York tipped to be involved in the Trump administration – potentially as Secretary as State – is openly against the idea of a Palestinian state, suggesting that it would undermine US security and cause terrorism. Newt Gingrich, also tipped for a top position in the Trump administration, called Palestinians ‘terrorists’ and also doesn’t recognise the right of Palestine to exist. 

In Israel, Trump’s victory was welcomed by many Israel. One of Trump’s key backers Sheldon Adelson owns Israeli paper Israel HaYom and the positive coverage it has emitted of him has meant that Israelis are generally supportive and optimistic about a Trump administration, according to polling. His victory was also welcomed by the Israeli goverment, the most extreme far-right government in its history. Trump and Netanyahu are natural friends, maybe Trump stole his idea for a wall on the Mexico border from the ‘seperation barrier’ that Ariel Sharon built deep inside Palestinian territory back in 2003.

nigelwallstory483
The ‘Seperation barrier’ at Qalqiliya where residents are seperated from their own land and travel is blocked off.  Picture credit, Nick Parry at Electronic Intifada

Israeli cabinet ministers who represent pro-settlement parties or who live on settlements themselves couldn’t resist chiming in. Education Minister Naftali Bennet was elated:

‘Trump’s victory is a tremendous opportunity for Israel to immediately announce its intention to renege on the idea of establishing Palestine in the heart of the country – a direct blow to our security and the justice of our cause.

This is the president-elect’s outlook as it appears in his platform, and that definitely should be our way. Salient, simple and clear. The era of the Palestinian state is over.’

This is not simply hot air, extreme-right-wing lawmakers in Israel moved fast to legalise Israeli outposts deep inside Palestinian territories. Emboldened by Trump’s victory, they worked ever-harder to undermine the possibilities of the Palestinian state even as Secretary of State John Kerry arrived for peace talks.Kerry hit back stating:

‘… more than 50 percent of the ministers in the current [Israeli] government have publicly stated they are opposed to a Palestinian state and that there will be no Palestinian state.’

It is worth noting that Obama and Kerry were publicly critical of the settlements, they did veto the condemnation of them at the UN Security Council. Nonetheless, Trump’s open and vocal support for moving the US embassy and settlement expansion would set a new precedent. As his spokesman said: ‘We are going to see a very different relationship between America and Israel in a positive way.’. Perhaps this really is the final death-knell of the Palestinian state.