Individualism and Collectivism: Schismogenesis and #occupywallstreet

Most social systems require a balance between symmetrical and complementary relationships or patterns.

A symmetrical pattern is characterised by ‘tit for tat’.  You hit me, I’ll hit you back. Obviously, this pattern has its uses, but unchecked would lead to the destruction of one of the parties in the relationship, and thus end the relationship too.

A complementary relationship is characterised, crudely, by a sadist and masochist, where the behaviour of one party complements that of the other. Again, this type of relationship can be useful, but unchecked, this pattern can lead to destruction as the sadist becomes increasingly sadistic and the masochist becomes increasingly masochistic.

Gregory Bateson (1972) referred to these runaway patterns that lead to destruction as ‘schismogenesis’ and argued that most relationships need to have a balance between complementarity and symmetry patterns. This balance could be thought of as a form of homeostasis. For example if a relationship is tending towards more ‘tit for tat’ (symmetrical) patterns, for example both partners becoming more violent, if one party becomes submissive (complementary), this would disrupt the runaway pattern and lead to a balance. Of course this new complementary pattern will, in time, need to be balanced by more symmetrical behaviour and so on.

In an earlier post (I seem to have deleted by accident) I wrote about how privileging personal gain over co-operation can ultimately become self-defeating, and I wonder if there are parallels in the current political context where we might think of balancing patterns of behaviour on a societal level.

Short term, personal gain seems to be the raison d'être of the individualist culture; characterised by politicians whose policies are influenced by terms of office, popularity and benefitting themselves and where corporations are motivated by keeping profits up and shareholders happy. It has become increasingly evident with recent revelations regarding News International and the scandal involving Liam Fox and his friend Adam Werritty that politics and corporate desires are intimately connected, adding more weight to suspicions that there is small elite of people who conspire to serve their own needs.

The benefits of this culture are of course, competition (although sometimes this is faux), comparatively cheap prices and a reasonable standard of living for many people (in the developed world).

The downside to this type of culture is that the addiction to short term gains for the few is leading to future consequences that are self-defeating and destructive.

Cheap, unhealthy processed food has led to phenomenal numbers of people becoming obese, and diabetes is likely to be a massive burden on future health care services.

The environment is exploited without regard to the long term consequences of pollution and deforestation. The fact that global corporations sponsor climate change deniers is significant. Their addiction to short term profits over-rides any responsibility for future generations.  Automobile manufacturers and oil companies have a vested interest in lobbying governments to keep citizens dependant on cars rather than other forms of mass transit.

The developed world’s addiction to oil is almost certainly the reason for US intervention in the Middle East, with countless dead and injured. The concept of transgenerational trauma (Shevlin & McGuigan, 2003) indicates that relatives of people affected by trauma, including those born after traumatic events, have symptoms of post traumatic stress. This does not bode well for the future health of states so significantly impacted upon by conflict.  A dominant narrative of the developed world’s rapacity is likely to feed the emergence of more dissent and violence from poorer states.

A balance is required to counter what I believe is a runaway pattern of individualism, where a more collectivist, long term approach might privilege and prioritise differently, considering more closely the long term ethical and environmental consequences of behaviour. I hope that the #occupywallstreet movement is the beginning of this counter-balance. It is, so far, a peaceful and determined protest and it is to be hoped that it remains so.

I’d like to close with these words from Gregory Bateson’s daughter, Nora; words which I believe offer a wider understanding of the situation:

“When you peel back all of the lovely accomplishments of the great revolutionaries what do you find? At the center there is this: They did the impossible. They risked everything, and changed the unchangeable. Occupy Wall St...This is the exhale we have been waiting for. This movement is the release of all we have held back, and all we have deferred: the fatal complications of poverty, ecological disaster, and political injustice against. Until now, we have been betting away our futures to keep this monster from tipping over; we have been covering for it, nursing it, convincing ourselves we were even proud of it. Like children of abusive alcoholic parents-- we have been silenced for so long. Finally the unsayable is being said, giving the unmovable boulders of this illusion of subservience to economic structures an opportunity to crumble. We were as my father said, “double binded” by the loop of needing the corporate body to both employ us and then relieve us of our earnings for what we thought was survival, but is actually destroying our real survival in our environment and with each other. Now, the thing that has kept us rapt and bound is grotesque: oozing greed, eating its young, poisoning us, the earth and even itself. If we can remember, that these structures are constructs of our imagination, not forged in nature, we can begin to re-imagine the system. Ideas... are what we are working with, and they can grow, change, evolve. We can live better, but first, we occupy. Don’t be distracted by the deeds of the change-makers, the “what” in what they changed, really, the key is THAT they did not wrap themselves in the practicalities of reason. Of course it’s impossible, that is why we have to do it.”  Nora Bateson

 Shevlin, M. & McGuigan, K. (2003) The long-term psychological impact of Bloody Sunday on families of the victims as measured by The Revised Impact of Event Scale.

British Journal of Clinical Psychology, 42: 4, 427–432.

Fixing a 'broken society'

 

“Something is profoundly wrong with the way we live today. For 30 years we have made a virtue out of the pursuit of material self-interest: indeed, this very pursuit now constitutes whatever remains of our sense of collective purpose”. Tony Judt; Ill fares the Land

Salvador Minuchin, the originator of structural family therapy, considered that, in order to function healthily, a family needs structures, boundaries and rules.

Within the wider family system, sub-systems work together, and complement each others roles.  The boundaries of a subsystem are the rules defining who participates, and how. For example, the boundary of a parental subsystem is defined when a parent tells an older child, “You are not your brother’s parent. If he is watching something on TV he shouldn’t, tell me and I will take care of it”.

For proper family functioning, the boundaries of subsystems must be clear and defined well enough to allow subsystem members to carry out their functions without undue interference, but they must allow contact between the members of the subsystem and others.

In addition to clarity of boundaries, most families can be conceived of as falling somewhere along a continuum of whose poles are the two extremes of diffuse boundaries and overly rigid boundaries. These two extremes of boundary functioning are typically called enmeshment and disengagement.

Members of enmeshed subsystems or families may be handicapped in that the heightened sense of belonging requires a major yielding of autonomy.  In contrast, members of disengaged subsystems or families may function autonomously but have a skewed sense of independence and lack feelings of loyalty and belonging and the capacity for interdependence and for requesting support when needed.

The clarity and range of boundaries within a family are useful parameters for the evaluation of family functioning, but is this the case in a broader society?

Where does a society begin and end?  What sort of boundaries delineate any given society and its sub-systems and are they permeable or rigid?

If our society was a family, my sense is that we have an extremely small subsystem that is very much disengaged from the remaining subsystems. The extreme level of disengagement, along with the disparity in size and wealth between this subsystem and the remaining societal sub-systems is toxic.

This toxicity leads to what David Cameron described as a 'broken society'; lack of social cohesion, poor health, increased dependency on drugs and alcohol and crime. In contrast, societies that have more equality seem to do better.Richard Wilkinson   a researcher in social inequalities in health and the social determinants of health in a 1997 paper published in the British Medical Journal suggested that “one reason why greater income equality is associated with better health seems to be that it tends to improve social cohesion and reduce the social divisions”.

He later went on to suggest that “the psychosocial effects of relative deprivation are unlikely to be confined to health… where death rates from accidents, violence, and alcohol related causes seem to be particularly closely related to wider income inequalities, the predominance of behavioural causes may reflect changes in social cohesion”.

From a structural therapy point of view, a family that has serious problems needs to be restructured. If we think at a societal level, this would involve changing the structure of the society, making it more functional by altering the existing hierarchy and interaction patterns.In a recent TED lecture, Wilkinson argues for a fairer, progressive tax system to address inequalities.

However, a more comprehensive solution to the problem of restructuring our society has been addressed by Tony Judt, who argued that the whittled-down Left squandered a huge opportunity to show the mainstream that new ways of seeing and thinking are desirable. In the aftermath of recent financial crises, it’s pretty much impossible to argue that financial markets properly regulate themselves.

Judt advocates a revival of the central values of American liberalism or European social democracy. He calls for the beneficent authority of a welfare state (in one form or another) to redress the excesses of unregulated market forces; a course that emphatically rejects both dogmatic socialism and unrestrained capitalism.

His version of social democracy (or, for Americans, liberalism) envisages a society less materialistic, less individualistic and more community-minded than the present one, based on an economy in which capitalism, while by no means abolished, is on the other hand firmly tamed and regulated.

In light of these great upward shifts of wealth, Judt (who died in 2010) felt that, at that time, no civic movement had gained mainstream influence. Perhaps the #occupy protests are the beginning of this very movement?

Judt. T. (2010). Ill fares the land. London; Penguin.

Minuchin, S. & Fishman, H. C. (2004). Family Therapy Techniques. Harvard: Harvard University Press

Wilkinson, R. G. (1997). Socioeconomic determinants of health: Health inequalities: relative or absolute material standards? BMJ 314: 591

Robbing from the vulnerable

The above video is from recent events in London. It shows a young Malaysian being simultaneously helped and robbed by a group of youths. The video was shown on the BBC news and understandably provoked quite a lot of reaction.

I felt this is quite an interesting motif to reflect upon from a broader perspective, thinking about how what was perpetrated in the video above models behaviour at other levels of society; from politics, corporate business and finance, healthcare, education and of course, the media.

Most corporations want our money, usually in exchange for junk.

Junk food that is full of additives, junk equipment that has obsolescence built in, junk insurance that is full of small print to minimise pay-outs and junk clothes, with a limited life and manufactured by people living in poverty.

Meanwhile, on a larger stage, the same deceits continue...

Children blown to pieces by  cluster bombs as democracy is forced upon populaces.

Troops killed in the name of war on an abstract concept - terror - which is in reality serving the interests of oil companies.



The muggers in the above video are simply replicating what happens routinely to us all. That young man being mugged is you. He is all of us who are being robbed under the pretext of being helped.

All the time, the rich get richer  -  last year, according to Mary Ridell writing in the Telegraph, the combined fortunes of the 1,000 richest people in Britain rose by 30 per cent to £333.5 billion.

Wikileaks: Dominant and subjugated narratives

There seems to be international condemnation of Wikileaks. The founder, Julian Assange, is at the centre of intense media speculation and a hate campaign against him in, particularly in the US, following the leak of 250,000 US diplomatic cables.

It is clear that most governments, particularly those closely involved with the US, are acutely embarrassed by the leaks. The leaks reveal the duplicitous nature of many governments and the lies and deceptions that characterise governments’ relationships with each other and their own populaces.

Of course, the dominant story from any government is that they are as transparent as possible and that politicians are honest people trying to do the best for their countries.

But the populations of these counties are, to a greater or lesser degree, aware of a subjugated story; this is a story where corruption is rife in many parts of the world, including wherever we happen to live. This story is where politicians routinely lie.  This is the story of our leaders thinking of themselves, not the greater good. This is the story where business deals and politics are blurred, where giant corporations lurk behind decisions to send troops to war. This is the story of atrocities commited in the name of democracy and freedom.

Julian Assange and Wikileaks have thickened this alternative story, and at the same time, thinned the dominant narrative of ‘honest government’.

As the Wikileaks cables are being revealed, there has been a general cynicism evident regarding the process used by FIFA to select the host nations for the 2018 World Cup. Whilst this might be regarded as a joke, it nevertheless casts light on the dubious activities and horse-trading that seems commonplace in international relations.

It is going to be interesting to see how this pans out.  What will the implications be if Assange is silenced?  I think the context is rapidly changing; people are becoming surer of their cynicism of governments, and if Assange is arrested or murdered, this will only serve to thicken the subjugated story and cast even more doubt on the dominant story. It may even prove to be the tipping point and the stories will flip; and this will have serious consequences. People are going to demand something better.

Evidence based medicine: Selective use of evidence and the role of drug companies

Recently I was talking to my daughter Hannah about the work she was doing for one of her modules. Although her degree is in Marine Biology, for some reason she was looking at National Institute for Clinical Excellence (NICE) guidelines, and how they work.

We had some interesting discussions about what evidence is accessed by NICE, about randomised controlled trials (RCT’s) and the consultation process. What emerged from her review confirmed my suspicions regarding the use of evidence, particularly by drug companies who have a vested interest in their products being recommended in guidelines.

In 2003, the Department of Health agency responsible for ensuring that medicines meet appropriate standards of safety and effectiveness (the Medicines and Healthcare products Regulatory Agency—MHRA), released data regarding the risks and benefits of newer antidepressants used to treat depression in children and young people.

The information published on the MHRA's website included both previously published and never before published data obtained directly from the manufacturers of the SSRIs ("selective serotonin reuptake inhibitors") and other newer atypical antidepressant drugs. These data were collected after earlier work had raised concerns about the safety of paroxetine (Seroxat) and venlafaxine (Efexor, Efexor XL) in children and young people with depression.

Based on their review of the data, the MHRA concluded that all of the newer antidepressant drugs, other than fluoxetine (Prozac), carried serious risks that outweighed any benefits. The MHRA, therefore gave warning of the potential that these drugs could increase the risk of suicide-related behaviour (rather than decreasing it—as would be expected of an antidepressant) when using these drugs in the treatment of depression in childhood and adolescence.

The National Collaborating Centre for Mental Health (NCCMH) had been commissioned by NICE to produce national guidelines for the whole of the NHS on the treatment of depression in children and young people. NCCMH is an evidence-based guideline development unit jointly run by the Royal College of Psychiatrists and the British Psychological Society and funded by NICE.

However, the NCCMH only had access to published data, so, when the MHRA verdict on the SSRIs became public, it became evident that the MHRA had access to information about a total of 11 trials, of which the NCCMH had only seen 5.

Because of the inconsistency between the MHRA's findings and the published literature, several members of the NCCMH committee (Whittington et. al. 2004), decided to compare and contrast the published data with the unpublished data. This work was designed as an experiment to test out what the difference might (or might not) be if, in producing a guideline, the committee had access to the unpublished as well as the published literature.

They concluded that the published evidence was more favourable than the unpublished evidence, and most importantly that it was only when all evidence was examined that it was clear that the risks (particularly the increased risk of suicidal behaviour and thinking) outweighed the benefits.

They also found evidence to suggest that at least one of the drug companies who had undertaken trials of an SSRI in the treatment of childhood and adolescent depression had withheld publication of trial data on the grounds that it contained evidence that the drug was unlikely to be effective in treating depression in this age group.

A UK psychiatrist, David Healy, has been raising similar concerns for a while. He has general concerns about influence of pharmaceutical companies and the way that they don't mention the problems in the way that academics are expected to do so. He has evidence of one paper being written by a pharmaceutical company, but where academics appear to be the main authors. He has a particular concern about this influence on bipolar disorders, particularly since NICE guidelines quote one of the articles in which very young children are given the diagnosis of bipolar disorder and prescribed medication as part of a 'trial'.
You can access one of Healy’s papers here: http://www.furiousseasons.com/documents/healybp.pdf

In June this year, the New York Times published an article identifying that a world-renowned Harvard child psychiatrist, Dr. Joseph Biederman, whose work has helped ‘fuel an explosion in the use of powerful antipsychotic medicines in children’ earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007 but for years did not report much of this income to university officials, according to information given Congressional investigators.

In my earlier article about Champix I didn’t mention that the manufacturers did not trial the drug with patients who have a history of mental health problems at all, and the drug was released on evidence that was derived from an ungeneralisable sample of the population.

Drug companies can afford to fund trials into their newly developed products. They may, as seen above, be selective in the evidence that they see fit to publish. The vast resources to fund for research into other therapies, for example talking therapies, are simply not available. Funding this type of research is down to practitioners on a local level, or perhaps interested University faculties. This means there is a huge disparity in what evidence is available for NICE (or those advising NICE) to base their decisions upon.

And the evidence is skewed.

Reference
Whittington C, Kendall T, Fonagy P, Cottrell D, Cotgrove A, Boddington E. Selective serotonin reuptake inhibitors in childhood depression: systematic review of published versus unpublished data. The Lancet, 24 April 2004; Volume 363: Number 9418, 1341-45.