Suffering is real

Issue section: 

Susan Rosenthal (Feb SR) lumps together the different psychological sciences — psychiatry and psychoanalysis — failing to recognise that with the founding of psychoanalysis, Freud established a new science, one, of course, that proceeded to develop insights and practices beyond those of its founder.

If Freud rooted mental illness in biology — the sex drive and later on the life drive — his successors adopted a much more socially-oriented approach. Melanie Klein and her school analysed babies as “object-seeking”, ie socially oriented from the moment of birth.
It is ridiculous to attack psychoanalysis because Freud didn’t get everything right. On this view, we should reject physics because Newton didn’t put forward the theory of relativity.

Susan correctly argues that no aspect of human experience is unaffected by society but draws the wrong conclusion. It does not follow that Marxism alone can help us understand and deal with some of its effects. The value of psychoanalysis is precisely that it helps us understand how the external structures of exploitation and oppression are internalised into the mind of the individual. In other words, it helps us understand crucial aspects of alienation. Of course, psychoanalysis might well wither away under socialism but so long as capitalism exists, the mentally ill need it. Of course, she is right to argue against drug-based treatments and, by implication, against conventional psychiatry which uses re-adjustment techniques such as cognitive behaviour therapy.

While it is true that ultimately capitalist society is responsible for mental illness, this does not mean we can ignore individual solutions. After all, it is individuals who are afflicted by such illness, just as they are by physical illness. Capitalism also causes physical ill-health: does this mean we don’t go to the doctor when we fall ill but rather intensify our struggle for revolutionary change? Of course, we should do the latter but also visit our GP. If we are able to alleviate suffering, physical or mental, it is our duty to do so.

Susan is right to argue that homelessness causes mental illness. But it is also true that mental illness causes homelessness. According to the National Coalition for the Homeless: “As a result of…the stresses of living with a mental disorder, people with mental illnesses are much more likely to become homeless than the general population... A study of people with serious mental illnesses seen by California’s public mental health system found that 15 percent were homeless at least once in a one-year period.”

At times Susan seems to deny the reality of mental illness. But as Polly Toynbee reminded us in a recent Guardian article, one in four suffer mental health problems with three quarters getting no help. We can’t simply tell them to wait for the revolution.

Sabby Sagall