The State of the Nation- Breakdown or Happiness?

Dr Tanveer Ahmed is a Sydney based psychiatrist working in private practice and the author of Fragile Nation – Vulnerability, Resilience and Victimhood. At a time of increasing unease across Western nations while citizens simultaneously enjoy unprecedented wealth and stability, on Wednesday 22 February 2017, Tanveer Ahmed joined social researcher Rebecca Huntley to discuss the many conflicting symptoms currently affecting Australians and their lives.

THE STATE OF THE NATION – BREAKDOWN OR HAPPINESS?

 TANVEER AHMED

Let me start by defining what we mean by the term mental health. It’s become a synonym for emotional distress. This has its roots in the grey nature of mental illness, but also encompasses a host of cultural trends beyond the academic or clinical nature of the discipline.

Mental heath encompasses three different disciplines – neuroscience, behaviourism and psychoanalysis. Neuroscience refers to the most biological aspect of mental illness and the emotions, that what we feel and think has a chemical signature delineated by neurotransmitters and hormones.

Behaviourism underpins what the vast majority of psychologists engage in. Some of you might remember reading or studying Pavlov’s dogs where a canine starts drooling at the sound of the bell associating it with food. This is the science of reward and punishment as well as the idea that how we feel is a direct response to what we think. The basis of cognitive behavioural therapy is if we change the way we think, we can change the way we feel.

Finally, psychoanalysis overlaps most closely to the popular idea of psychiatry…to couches and bearded, teutonic elders. Psychoanalysis is about how our primitive selves, how our instincts and desires must be tamed to live in what we call society. But our primitive self is always playing out in the background in what we say, do or how we behave.

This notion of mental health then plays out at a time when Western societies have become largely post religious. The majority of our population no longer structure their lives around organised religion. However, and this is why I often joke that I am like a secular priest, they make sense of their lives through the language of psychology and mental health.

As a result instead of having characters with their moral connotations, we now have personalities. The notion of personality has a stronger connotation of self-presentation. Moral questions often come through the lens of mental health – for example, anti-social personality disorder, intermittent explosive disorder, impulse control disorders etc

As part of being post-religious life’s project has shifted from one of seeking salvation to one of seeking individual self-fulfilment. The rise of mental health is closely related to this trend because as more of us become pre-occupied with fine tuning our psychological well being this can then leave us somewhat fragile.

My book is partly about groups from other cultures, from traditional societal structures of clan and tradition, who are suddenly thrust into the outer suburbs and asked to make sense of their lives through these new idioms, particularly if they become unusually distressed. Most of them come from backgrounds where there was no great significance of the private, personal realm.

Another contributor is the decline of collective institutions, be they political parties, unions or churches. There may have been a time when the political battleground was between labour and capital. This remains paramount, underlined by our two leaders at the moment, but for many people in terms of how they deal with political questions, the tension lived day to day is that of the individual versus society or the spectrum of private distress and public politics.

This goes to the heart of so many of our resentment based political movements at the moment, be they Islamic extremism to white nationalism, radical feminism or the men’s rights movements. All of them have some basis of truth or fact behind them, but they are then heavily laced with personal resentments or failures projected on to the outside world. I contend that our measures of so many kinds of psychological harm such as abuse, prejudice or trauma have been steadily diluted in recent decades. As a result we have become very sensitive to perceiving psychological harm but also more likely to attribute the cause of that harm being from external sources and not our innate coping vulnerabilities.

A key example I relate in one of my chapters is that of post-traumatic stress disorder which began as an unpredictable, objectively life threatening event but is now treated as a subjective, difficult event. PTSD is actually a very interesting, important analogy for how we view the human being. Just as we’re going through disruptive times in all manner of areas, we are also going through a time when our views around human nature are in a degree of flux.

Prior to the Vietnam war PTSD or shellshock was understood to be rare and occurred mainly in people who already had some kind of pre-existing vulnerability. Now, we view war as innately traumatic in the longer term and in Victoria legislation is being considered for the work of paramedics and police to be categorised as innately traumatic.

It encapsulates a change in the way we view people in Western societies – and it is limited to Western societies – in that we have shifted from framing the human as innately vulnerable and not fundamentally resilient. This then strays into our politics, particularly around free speech where we have deemed certain groups as too sensitive – gays and Muslims for example – to cope with robust debate. The potential for psychological harm has become a more common reason to hamper freedoms.

I want to return to the idea of changing notions of human nature. I profile several patients of mine who joined white nationalist or men’s rights groups. Some of the themes that come out are their feelings of being discarded, that their local areas were no longer recognisable and that they were unfairly labelled privileged for being white and male, when that was far from their own experience.  They were also often from fatherless families and the rise in authoritarianism, certainly for psychiatrists, can be interpreted as a yearning for the primeval father figure.

Almost all had their own considerable psychological frailties and were prone to projecting it all outwards – be it their partners, their work or ethnic groups. My job was often to recognise their distress had significant internal origins, that there was something of an autonomous self. Many of the movements on the left do not believe in such a concept. Marx certainly did not. As a result distressed people of any kind of group not considered privileged is automatically believed to be caused by some aspect of external power structure, be it patriarchy or capitalism.

Now back to the working class white male. Arguably, much of the past half century of progressivism is rooted psychologically in attempting to tame traditional masculinity, which was referred to as toxic masculinity. This is where Hilary came across as the overbearing headmistress telling the boys at the back how naughty they were and to sit in the corner. Trump was that naughty boy and symbolises a kind of blow back of our primitive urges, probably over suppressed by an era of political correctness. Trump is the Freudian id of Western civilisation and his election is, in part, a vote for a traditional view of man and his nature, away from the trends of psychology and authenticity.

Some further points about authenticity. This is a big trend I see in patients where people are searching for some authentic version of themselves in their quest for self-fulfilment. This comes across in quite different types of people. For example, the modern Muslim growing up in the West is searching for some kind of a pure version of Islam not stained by what he/she might consider local cultural practices. We saw this recently in what Yassmin Abdel Magied said on ABC’s Q & A program where she asserted that, “For me, Islam is the most feminist religion.”

While there was more than a little press about the questionable feminist assertion, what is perhaps more interesting is the “for me” bit. It shows the way modern Muslims, particularly those living in the West, self-formulate their religious expression, which is why they often have outer markers of expressing their identity, be it beards or hijabs. A patient I profile is a Pakistani teenager who arrived socially anxious and the way he expressed it was through a long beard. It signalled his religiosity but also his sense of exclusion and anger. As he improved, finished his studies, gained meaningful work and a stronger social circle he remained religious but his beard became progressively thinner communicating his experience of feeling more integrated.

I’d add here that what often Muslims consider as their enlightened view of Islam is what they have absorbed of Western values and culture but they convince themselves that these ideas were always “Islamic”. The vast majority of public Muslims tend to see Islam as they would like it to be and not how it is…at least in my view.

Back to the notion of authenticity. It’s something I see in other kinds of patients such as one I profile who reverts to eating raw food and using only alternative medicine until he becomes so unwell he was sent to me by an insurance company. The reversion to notions of “purity” in our culture are taking place in the forms of food choices as well as the rise in alternative medicine, which marries the authority of science with New Age spiritual themes. Its success is that it is able to marry the two whereas traditional medicine can feel too dry and technical to give any satisfaction to the metaphysical elements that can overlap with the vague aches, pains and anxiety of modern angst.

To summarise, the broad upheaval we are currently enduring also extends to views of human nature. People make sense of their lives through the language of psychology and a great deal of people’s relationship to society and their politics also happens through the interface of private distress and public politics.