Abstract
On the surface, an innocent enough piece of gossip journalism about one of the world's richest men. However, at the end of the 20th century, it appears we are returning to a situation where Empires are dominating the world. Now it is the multinational companies and their owners that have replaced the Kings and Emperors of the last century. The owners and their families have become the new ‘Royal’ families, and we are mesmerised and entertained with reports of their various romantic and other shenanigans, usually by newspapers or TV stations owned by their competitor moguls.
‘For richer. For poorer … what Wendi means for Murdoch Inc’ [1].
Although there are supposedly democratic governments in the major Western countries, in reality they are in the thrall of these new Emperors and their power. This was illustrated in Australia when the Labor Government of Bob Hawke (and subsequent governments) energetically wooed the moguls—now the democratically elected governments really rule almost at the behest of Wall Street.
We are, on the surface, not in the same situation as 100 years ago when there was hardly a middle-class and the majority of the population were poor and poorly educated, with a small ruling elite. Now most people in the Western world are middle class, and have some possibility of education or ownership of some form of wealth.
The Reagan and Thatcher economic revolutions of the 1980's have ostensibly rendered possible a share in the capitalist cake for all the population. Anyone with a little cash to spare could theoretically become a billionaire via the stock exchanges of the world.
So is there anything for psychiatrists to be concerned about? Of course there is. The majority of the population is now subjected to the output of media run by a few people but with the possibility of reaching millions. In effect, then, we are once again becoming like the serfs of the past, where the information served up to us through our TV and computer screens is influenced by very few extremely wealthy people.
Independent government-funded media organizations such as the ABC and the Canadian Broadcasting Corporation are under severe pressure through major funding cuts which influence some their executives to censor themselves in terms of how much critical information they allow to be broadcast concerning politicians of the day (who in turn are manipulated by these media Empires).
The general effect of these societal changes may be that a concern for the have-nots will be something which is gradually eliminated from the mind of society in general. There will be, and already is, a feeling that as long as one is a member of the ‘haves’ there is no need to worry about the ‘have-nots’. This group of course includes the poor and mentally ill and minority groups such as Aborigines.
The recent ‘compromise’ between the Australian Democrats and the Federal Government on the issue of the Goods and Services Tax may be an example of a trend in this direction—as long as one can have a share in power, the concerns of those who cannot are forgotten.
Although the deal takes the GST off so-called essential food items, the tax itself is acknowledged to be regressive, so where the Democrats could have stopped the tax altogether, the majority in their party opted for pragmatism and power over principle (the Democrats in the past opposed regressive taxation).
Those in the Democrats who opposed this GST bill did so partially on the grounds of the tax on books. This is symbolic perhaps of the whole social change I am referring to.
The majority of senators in that party felt as long as the poor could get ‘essential’ food items free of GST it did not matter if they had reduced access to knowledge through books and education. This is little different from the situation that existed under the Tsars and Emperors. The main difference is that now, since most people are middle-class, poverty has been exported to developing and third world countries and small relatively invisible segments in developed countries.
Meanwhile the middle classes retreat to their TV and computer screens and send their children to private schools where they are taught to be good free-marketeers. Occasionally and increasingly frequently, the bliss is shattered when delinquents kill their class-mates in ghastly tragedies. Then the media agonise for a few weeks over why these tragedies are happening, usually reaching the conclusion that there was something amiss in the family of the delinquents, without much reference to the roles and responsibility of society and government in the prevention or alleviation of these situations. Then we all return to our anaesthetised complacency, courtesy of the multinational media emperors.
Should psychiatrists comment on political and social change, or maintain some sort of medical neutrality? If this means providing psychiatric care to General Pinochet or P.W. Botha should they become mentally ill, then clearly the answer is to maintain neutrality.
However doctors also have a responsibility to prevent harm to our patients. The ‘new’ society may offer increasing affluence for a minority, but the social effects of isolation from others and exposure to the offerings of the internet and television may be as profound as the industrial revolution was 150 years ago.
A couple of clinical examples from a psychotherapy practice serve to illustrate the subtle effects of the new economics on our patients.
Example 1
A young man, 22, highly intelligent, with a borderline personality disorder, attempts to study at university. He also has intermittent ulcerative colitis. He requires regular psychotherapy. Over a number of years he shows significant improvement, ceasing his promiscuous sexual behaviour, entering a stable relationship and obtaining high distinctions at times in his university essays. He longs however to be independent of his enmeshed family in which there is high expressed emotion. The current government however requires him to have earned around $13,000 dollars in the past 18 months in order to qualify for student assistance of around $170 per fortnight. As he has fallen $80 short of this amount, he is forced to remain in the highly charged atmosphere of his parental home, sometimes with detrimental effects to his developing academic career and recurrent bouts of colitis.
Example 2
A woman aged 40, single mother of a 17 year old autistic son who has lived in a group home for the past three years, wishes to commence a TAFE course. However she is forced to attend a job agency and apply for positions she has little skill for, otherwise she will lose the pension she lives on. As I listen to her rage about the disjunction between her needs and what she is compelled to do, I am reminded of a type of forced labour such as one might have imagined in the former Eastern bloc or indeed in Tsarist Russia.
Both these apparently banal situations arise under social policies devised by a government which claims to espouse family values. Although superficially the new economics appear to encourage individual responsibility within a supportive family, they fail to acknowledge the most important family of all—the nation state within a family of nations.
The collapse of the nation state has been accompanied by the virulent rise of ethno-nationalism such as seen recently in Yugoslavia. As Kecmanovic points out, ethno-nationalism may provide the individual with an identity through various psychological mechanisms [2].
Ignacio Ramonet, writing of the replacement of states with the power of the United States and Wall Street [3] asks: “After the nation-state, will we witness the emergence of the sovereign individual, endowed with all the attributes and prerogatives vested in the state? Globalisation and its ultra-liberal ideology would doubtless accommodate, and even welcome, a transformation of this kind, which the new communication and information technologies make technically feasible.”
The examples of my patients demonstrate the alienation of individuals from a state in which they used to feel included, through state assistance, to develop their individuality. When the young man I mentioned first came for therapy he was regularly involved in the ‘sport’ of shooting wild pigs and other animals. Now this is hard to believe as he talks of his love of mediaeval history which he studies at university.
However how many others like him are there who have not been so fortunate and are exposed to the on-line food of violence and pornography provided by the new emperors? These people may be attracted to new modes of ‘association’ to confirm their identities.
Danny Ben-Moshe [4] calls for government to regulate the internet, to prevent the dissemination of racial hatred. It may well be that the internet which is already dissolving national borders, could be the forum where the nation state is once again forced to assert itself in order to limit the potentially dangerous effects of alienation which force vulnerable individuals to seek identity through ethno-nationalism and other forms of racial hatred.
Historically nationalism has had horrendous effects. Western countries may feel isolated from places like Kosovo, but school massacres such as those experienced in the USA recently, will become increasingly common, bringing the effects of the new imperialism into the homes of those in the comfortable West.
Psychiatrists have a duty to speak out against the destruction of the nation state and the welfare system and its replacement with a sort of Victorian strict-nanny state determined by stockbrokers and magnates on Wall Street.