Will Bernie Sanders expand the use of medicine as policing?

One thing has troubled me about Bernie Sanders. I think what I read that raised my eyebrows of concern was written hastily. I don’t think we democratic socialists and supporters of his campaign (and the related ones of some local candidates, including in New York where I live) should want to expand the most corrupt and exploitative industry in America, the one most centrally involved in the project of social control, or policing in the broad sense of the term. That is the “mental health” system. In one of his books, Sanders discusses the need for more “mental health care” mainly in terms of defending “society” against crime. Repeating the canard that most of the worst crimes are due to “mentally ill” people being allowed to live in freedom, and that “mental illness” is essentially a potentiality for crime. (This problem has recently been brought to some greater public attention by the movie “Joker,” which I have criticized for these reasons separately on this site).

In the 60s and 70s, many on the left supported a cause called, in this country, “anti-psychiatry.” Its leading figures were French philosophers Michel Foucault and Gilles Deleuze, both still household names in France (Foucault was Professor at the Collège de France, the nation's most prestigious institution of learning, and was given a state funeral following his death by AIDS in 1984) and among intellectuals and artists on the left in this country. Does Sanders, and do most of his supporters, see nothing important in this trend, now largely forgotten? Indeed, the left as such easily tends in this country in particular to forget much of itself and its own history.

Social democrats will call us libertarians because we share some of our criticisms with them. The correct position here must draw a page from that political desire, marked as it may be by a constitutive impossibility, that is anarchism. Anarchists of the left (on the right, it is a contradiction) oppose capital as well as the state, and believe both that states police societies and peoples on behalf of capital, and that the dream of a capitalism without states is an idiocy since all it would mean is a society of paranoid property-defenders and companies that hire Pinkerton private police (which have a long history in America and one of being used primarily against workers, especially if the strikers are disobedient, as they are by definition). Freedom lies outside regimes of property and domination. (On this, see my essay on this site on socialism as the path to greater liberty). Short of that, we should have a state of minimal coercion. This can allow social benefits. I have asked people from Sweden if their big social welfare state makes them feel less free, and they always say no, and in fact much evidence is that people all over Europe are more free than Americans.

However, the old argument between liberty and social security is a relic of the Cold War. Liberty does not entail capitalism; it does entail democracy. There is no reason why we cannot have universal health care (and better yet, a universal basic income) without the massive social control and policing ours is based on. It is based on policing and oppression for the same reasons that it is based on profit. A Sanders government could go some ways to changing this if it wanted to.

That will probably depend on the continued vitality of the new left wing of the Democratic Party that he re-inaugurated and represents to place some pressure on the federal government and, though media attention achieved in various ways, to our society as a whole, which will encourage a sympathetic administration to be more bold and not more compromising, and will also place pressure on more centrist political forces that can help keep the government’s effective weight more on the ship of state’s left side. The Sanders campaign only makes sense as a part of a movement, which it certainly is, and we who support it must have the will to resist the complacent passivity of over-relying on our leaders. We need them to need us.

Politics is not government, representation, and leaders because it is more than that. That is the only reason it can be driven by various people wanting things to be some other way than how they are. This is not a spurious idea: government by pure administration, bureaucracies with their own logic, where everything that is said is true by authority or declaration, problems are solved by describing them nicely, with every possible action justified a priori in terms of statements serving as principles. In this country, the executive branch has expanded its powers over the last hundred years, and of course the bureaucracies whose professional and managerial employees do the hard work of governing the society and its people, whether they are corporate or government employees. The so-called state of emergency is the rule of pure administration and power, a government not so much of persons rather than laws but of force and not law, in which the rights of persons that require limitations on the powers of governments, corporations, and powerful individuals are ignored by virtue of an actual or virtual declaration that the crisis situation, as an emergency, calls for action rather than further thought, — this is the reality of governance today, and the authoritarianism promoted by Trump as well as the now almost 20 year old “war on terror,” are certainly forms of that. This is also what makes possible the many abuses and uses of personal domination in contexts that may be intimate or familial as well as oriented towards managing efforts at success.

For those of us on the left in any sense that could consider itself proper, the problem with Democratic Party liberalism or progressivism as we know it is that social democratic policies can normally only be put into effect by marshaling the powers of a professionalocracy that manages the services provided to citizens and residence through procedures of social control. Instead of remembering or returning to and learning from this forgotten history on the left, perhaps just because there was a partial liberation of de-institutionalization that the heavy-handed-state social-democrats mourn in part because it fed like so many other things (including all the New Age and therapeutic spiritual ideologies) into neoliberalism, — instead these liberals just want more treatments, whether voluntary or involuntary. They would effectively deprive people like me of our citizenship.

The de facto monarchical state does not, like that which is effectively still a republic, have citizens, in a practical sense, but only subjects. They are affected, and must conform to common sense and obey authorities, but they are not supposed to participate in governance through properly political or democratic processes, though we are allowed to speak somewhat freely, depending on the situation, as well as to cast a vote in a manner that, highly improbable as it is that anyone’s vote will in itself make a difference, beyond the Kantian principle that one should do it because it would be bad if people in generally didn’t, is more ritual than actual as a way of affecting what those in power will do. People who think in the terms of the mental health system could (and have threatened to) destroy the lives of persons like me by making us prisoners for an indefinite period of time (and without having been judged worthy of confinement in any process to which we can participate in and so argue against).

We democratic socialists, who believe as we must in articulating disagreements and working from within social conflict considered as a necessary good and not an evil to be suppressed, controlled, or managed, as it were, from above, we must always be vigilant in the will to oppose every new form of barbarism that may accompany the better, because socialist and democratic, mastery of real social problems, when the forces of capitalism and bureaucracy remain the principal tools and means of social action and organization. It would be all too easy to agree with the followers of the absolute liberalism of Friedrich Hayek (which influenced Margaret Thatcher and American libertarians like Milton Friedman) that opposes, in what are at best vain gestures and adolescent posturing that posits an absolute liberty, government as such as antithetical to it, an idea of freedom falsely conceived as social distance and separation from the authority or effects of others, and so based on property, definable as what is mine and not yours, in the absence of any possible “us” and “ours,” including the fabric of a life in common and so all politics, thus rendered in principle impossible or, absurdly, leading only to the Gulags that are the supposed destiny of the pursuit of any ideals or collective goods whatsoever, as the desire to change things that defines politics as an attitude or orientation, a form of will, as itself merely crime.
In fact, absolute liberty is simply the desire invoked as its opposite by the all-too-prevailing and too-little noticed authoritarianism. This is a legacy in part of slavery and a mark of our nation’s continuing immaturity. The conservatives are often right about the liberals in fact, but they have no alternative. We side with the liberal progressives in wanting to change things, but oppose their reliance on a state apparatus whose principal function is in fact to control the populace as labor and consumer/debt-payer power in the name of the interests of capital.

Struggles like this will continue under, and be strengthened by, an administration whose leader proclaims his project (it is a desire, not a set of proposed policies) as democratic socialism. But leftists don’t let liberal-left friends go statist; the political as such is conflict and contestation, and relies on social antagonisms being capable of expression, and of course not only in those occasional presumptive expressions of popular will and sovereignty that are elections, but also in art and thought, as well as in organizing neighborhoods, tenants, workers, the ill- or non-employed, the immigrants, poor, and the wretched of the earth.

The function of the mental health system is directly de-politicizing. Politics is politicization, and reactionary governmentality is depoliticization, through ideologies, such as nationalism, and psychologization. If you think it follows as a matter of course that your personal problems (the ones that are personal because you experience and feel or “have” them) are your own “illness” (in a form of circular reasoning that amounts to observing that some people have problems because they have problems), then you can have no politics and thus too no engaged worldly thinking (but what other kind is there?). Do you suffer from precarious life? Come on in to our new secular church with its ideologies of medicine and spirituality; we’ll help you adjust. Bourgeois society has also functioned on the assumption that social problems are caused by crime and other things that should, like infectious diseases, simply be overcome by managing them, with this to be done by the governing authorities. In short:

The concept of mental illness is an anti-democratic one, and a democratic socialist movement needs new concepts and tools for improving the lives of persons, from the self-inquiries of psychoanalytic thought and practice, to forms of art and education that are available universally and at no cost to individuals. Another way of putting this is that a society that is democratic does not function by excluding abnormal persons from the static and statist ideal of social order, but by means of the very different understanding that the lives of persons are always and necessarily a matter of trauma, incompleteness, unmanageability, disagreement, and social forms and order as constituted by persons as participants in a movement out from a vulnerability and chaos that no order or security measures can abolish nor should oppose. Socialism does more than redistribute who pays and who benefits; when it is genuine and rooted in real social crises that will not disappear and cannot be simply cured, it is revolutionary in its capacity to call into question all kinds of common-sensically taken-for-granted givens. To the figure of the deviant person who is either (at least potentially) criminal, mentally ill, or simply immature, and so to be excluded from the totalizing regime of normality, we oppose the very different figure of the person who lives his or her life by way of a thinking that is active and critical, not just problem-solving. Capitalism wants passive citizens who see or hear the news and react. It is content with social discontents that are merely medicalized, ultimately wished away along with the world’s poor, precariat, and workers, debtors, and others who “lack,” in capital’s fantasy of a world as pure representation with no labor needed to reproduce capital at all. This is (as I argue in my review on this site of the recent Pablo Larrain film “Ema”) the narcissistic fantasy of a full body lacking lack, immune from suffering and counting on not running out of gas; it is the capitalist mastery that wants, to speak like Kurtz in Conrad’s Heart of Darkness, the products of brutes yet willingly exterminates them. The broader category to which the worker as such belongs is that of a constructive thinker, making sense of her or his experience, for the purpose not only of living a successful life within the world, but also working to change that world. The opposite of the figure, tending now towards a very profitable universality, of the mentally ill person is the figure of the artist and creative thinker seeking to make sense of her or his experiences of the very imperfect and troubling world we all share. This figure is, just as much as the one who works and the one who obtains things he needs by buying them, as universal as that proclaimed by the world’s great religions. Among which must be placed the new, yet not so new, American religiosity of self-improvement and the corollary notion of a society ruled in the most undemocratic way imaginable by medical authorities on the basis of their knowledge of the new scientific object that is the brain, and by techniques of management of persons assigned recognizable lack or trauma with the nation’s most exploitative industry, pharmaceuticals, and police officers with medical degrees who as doctors and nurses are being denied the opportunity to practice medicine as medicine, which, along with making generally available psychoanalysis and educational opportunities that are not conformed to job and debt-payment needs, can form a basis of a society that is much less willing to waste so much talent as is now done. That is of course because individual capitalist firms seek nothing but their own financial gain, offloading onto individual workers and consumers all kinds of costs, including coping with precarious or boring work by fixing one’s own presumptive break-down, when what is really broken and failing is something much broader, a society that fails many of its members and offers to most of the others too little for us to call it good enough.