The Managerial-Therapeutic State and the End of an Empire
Our society is dying. Here, take these pills.
If someone were to ask you, "why do doctors exist," you'd probably look at them like they spouted a second head. Doctors exist to treat illnesses and make us healthy. "Duh!" Doctors are generally well-respected because we trust them to have our best interests at heart; to do us no harm; to treat us well and do good for the world.
Of course, we have a problem: what is "treatment," really? What does "do no harm" really mean? What happens when an institution that you trust isn't actually all that trustworthy? Or, perhaps, there are untrustworthy elements hiding within the trustworthy whole? Before I delve further into this, I'd like to share a personal story for some context in this discussion. I discussed this on twitter about a month ago, but I will recreate part of the story here:
When I was 10/11, I was diagnosed with anxiety. I was always a nervous kid. Maybe I was born that way. Maybe I missed my parents who were rarely home. Maybe I was dropped on my head. Who knows. As time went on, my life seemed to split. On the surface, I was doing great. I was coming out of my shell, meeting friends I'm still close with, talking to girls, etc. But underneath, a cold gnawing hole was opening deep in my heart. I was a "high achiever". Top 5% of the class, poised to go to a top uni. Gifted/High IQ and all that stuff. But I burnt out. Early. Like sophomore year of high school early. I quit the hockey team I was being groomed to captain. Passions were fleeting, fading into a dull grey. Tiger parents didn't help. Uni was more intense. My chronically disorganized self wasn't ready. And so, come December 2016, I slept through my final in the only class I was doing well in. I cant explain to you how I felt that night. I spent the night in the psych ER and I took a year off from school. And I started therapy (school mandated, "ironically").
What I want to emphasize here is the dissatisfaction with the world that I felt, and that I believe a large number of other people feel. A response of "what's the point" whenever we are requested to go through 15+ years of mind-numbing "education" and then work a job that there's a 50/50 chance we won't even care about. The world kind of sucks, and it doesn't appear that our governments care much (if at all) about fixing it. So it should come as no surprise that calls for "therapy" have intensified.
Now, don't get me wrong: I understand the importance of therapy (and later in this piece I will discuss what good/proper therapy looks like) and mental health treatment. But what I am trying to get at is that our modern notions of "treatment" appear to be perverted in a profound sense. I want to discuss the "Managerial-Therapeutic State": as our society has gradually lost its ability to legitimize itself, it has built more powerful apparatuses to quash dissent, and these apparatuses do not have to be physically coercive. Instead, we have apparatuses that aim to soothe and placate our discontent with a hostile and uncaring regime and society.
Our living conditions strangle any attempt to form community. Our worship of autonomy (even in so-called "anticapitalist" spheres) demands governing every relationship by the laws of market logic, eliminating any ability to form "thicker", more meaningful relationships, and establishing a hypercapitalistic society. Our blanket acceptance of "capitalism" leads to corporations exploiting us, stealing away the victories of limited working hours and decent wages, and preventing parents from spending sufficient time with their children and friends from spending sufficient time with each other.
And in the face of all of this, our corporations do not care, our government appears not only incompetent, but hostile as well, and our society is lost. It is clear that the ideologies that legitimized our society, the American Dream/Bootstraps/"You can have it all" belief, has largely collapsed (if it was ever anything more than a delusion in the first place).
But, of course, we aren't an "authoritarian regime." No! We are a "liberal democracy!" Which means we can't just point guns at people and tell them to "work, or else." So how does a society ensure that the populace remains sufficiently "motivated" when it can't use (on at least large segments of the populace) or threaten to use explicit physical violence? Well, you have to build a society in which the main institutions that control the processes of socialization and producing and propagating narratives work to instill the "correct" values. Make no mistake, the American education system and media are very much propaganda machines. They are not "neutral," or any other such nonsense. Since there are limits to how they can coerce you physically, they aim to dominate your mind.
But these systems don't always work, do they? The education system, the media, etc. There are still lots of people dissatisfied with the system. "You can have it all" ideology attempts to transform systemic failures into personal failures, but this doesn't take hold with many (and for good reason). The failure isn't personal: the system genuinely sucks.
So the system has emphasized a new apparatus for these persistent dissidents: therapy. And of course, considering the widespread oversocialization of the day, calls for therapy are increasing from these people fully submerged in the narratives. In their minds, therapy is a way to bring you back in line with the system. It is why we see people talk about how "alt-right" individuals need to be "treated." Everything is framed in the lens of a disorder that needs treatment.
But what is therapy, really? "It is a place you go to talk about your feelings and get prescribed pills or soothing words to feel better." Yeah, sure, but that doesn't really get at what therapy is deep down. Therapy is, in 90% of cases, a degenerated mentor-mentee relationship. A mentor is someone you can go to for advice, help, guidance, and a kick in the pants when you need it. Therapy, done properly, seems to mirror this mentor-mentee relationship. You have serious issues in your life and you're not sure where to turn, so a therapist steps in and helps you figure it out.
Of course, you will notice a problem: mentor-mentee relationships usually arise "organically". You meet them within a pre-existing network, and many times these aren't paid/commercial. In other words, the way we find and relate to therapists (through the market) is directly opposed to how we need to relate to mentors. That doesn't mean all therapists will end up being bad; but it does mean there are perverse incentives at play here.
So how do you build good therapy? Obviously there are people who need to seek out mentors/therapists and are unable to find them organically. So how do we build a society wherein mentorship is more common?
The first way is, of course, to build genuine communities. And it is critical to distinguish between an actual organic community not subject to the laws of the market, and therapy branded as "community" to sell a commodified version of it to you:
The next is to seek out the good therapists and build our education system for therapists around them (more on this in a moment). Good therapy exists, and while it isn't particularly easy to find, it is out there. To return to my personal story, I'd like to relay how it took time for me to find a good therapist, and what an impact that had on my life:
There are those of us who will not be fixed by a swift kick in the pants to get us eating properly, working out, sleeping well, etc. All those are important of course, but depression is a different animal. It's like an elephant sitting on your chest. Many of us, myself included, are broken in some way. We struggle to relate properly to the world and to others. To build meaningful connections. Yeah, "Tumblr depression" exists. But art hoes do not delegitimize the entire history of art.
Getting a proper diagnosis and not just "depression. Take these pills" is life-changing. It is as if someone has brought out the inner core of your very being and showed it to you. I can't really describe what those moments were like.
The problem, of course, is that very few therapists are truly qualified to help people like me in those struggles to relate. I'm lucky. After 10 therapists, I found one who legitimately changed (saved?) my life. We still talk. I will be inviting him and his family to my wedding.
Of course, what I am saying is that there is, in fact, a proper way (ways?) to relate to other people and to the World. Ex: My therapist said my search for a "transcendental twin" was misguided and would only cause me pain.
And the problem is that in a world where we have abandoned any notion of what a proper relationship (intimate or otherwise) is supposed to look like besides consent, harm, and hedonic fulfillment (or commercial benefit), what model individuals can therapy point to?
I'm lucky my therapist is happily married with kids. I'm lucky he had an independent mind (I didn't even know R.D. Laing was political when my therapist gave me a book by him). I'm lucky he let me borrow his copy of the Bhagavad Gita. In other words, I am lucky my therapist knew what a healthy relationship (to others and the World) looks like, and affirmed that knowledge by living it. "Skin in the Game" or something.
The goal must be to have therapists who are genuinely qualified to help people relate to the world properly. And that means recovering more substantive notions of healthy relationships, beyond "harm", "consent", and "fulfillment".
I don't mean to sound like a broken record, but much of the issue with therapy comes back to our society's obsession with individual autonomy/"freedom". It is present on all sides, and is deeply corrosive to any kind of meaningful existence. Our therapists are not only subject to perverse incentives, not only unlikely to have the kind of connection needed for proper mentorship, but also are immersed in an ideology that actively opposes any kind of real mentorship. It is time we recover those substantive notions of healthy relationships, both to others and to the world at large. Our ideology must change for our communities to recover. And our communities must recover if we are to make life worth living once again.
Funny enough, I have been thinking about this too. My experiences are similar, but no mandatory therapy required so there was that flexibility in the process. The whole "find a therapist" task was arduous so I have to wonder if people genuinely realize what they are engaging when they "seek therapy" or suggest to others to do the same.
Good therapy (and least in my experience and the kind I received) has been about tapping into a subconscious realm that interfere with your day to day. A proper therapist pokes and prods with the right questions to help you engage with that inaccessible part of the self, but the ability to come out of your malaise entirely depends on you. Invariably, this is the part of therapy that no one talks about because it is driven by personal responsibility.
I get it. No one wants to feel blamed in these spaces, but at the same time, how do you talk about substantive issues that interfere with your existence when you've extracted yourself entirely from them? I have a sense a lot of therapy out there is simply reaffirming your existence and I like the way that you have explained it (degenerated mentor-mentee relationship).
Therapy and good mental healthcare is something I have always advocated for but all I see lately are its perversions. It's upsetting but i'm glad I am not alone in this matter.