One of the more compelling themes that punctuates Fisher’s Capitalist Realism is the linkage between the rise of certain mental illnesses and post-Fordist capitalist modes of production, identifying it as a key site of the political (at least virtually). Now, for readers familiar with French inflected social theory, this thesis will not, in and of itself, appear new. In An Introduction to Marcel Mauss Levi-Strauss had argued something similar with respect to schizophrenia and psychosis, going so far as to suggest that in certain “primitive societies” this phenomena doesn’t exist. Canguilhem suggested something similar, as did Foucault. But in each of these instances the emphasis was put on the social and discursive production of mental illness. If one adopted these accounts of mental illness, then it became necessary to reject materialist or neurological accounts of mental illness. The story goes that either one adopts the neurological account and is thus subject to an ideological illusion that de-politicizes something that is in fact social (mental illness), or you adopt the social account of mental illness and reject anything having to do with the neurological or psychotropics as ideological mystifications. Fisher’s analysis, by contrast, is far more subtle. As Fisher writes,
The current ruling ontology denies any possibility of a social causation of mental illness. The chemico-biologization of mental illness is of course strictly commensurate with its de-politicization. Considering mental illness an individual chemico-biological problem has enormous benefits for capitalism. First, it reinforces Capital’s drive towards atomistic individualization (you are sick because of your brain chemistry). Second, it provides an enormously lucrative market in which multinational pharmaceutical companies can peddle their pharmaceuticals (we can cure you with our SSRIs). It goes without saying that all mental illnesses are neurologically instantiated, but this says nothing about their causation. If it is true, for instance, that depression is constituted by low serotonin levels, what still needs to be explained is why particular individuals have low seratonin. This requires social and political explanation; and the task of repoliticizing mental illness is an urgent one if the left wants to challenge capitalist realism. (37)
In many respects, Fisher’s analysis of affectivity here mirrors Marx’s critique of commodity fetishism. Just as commodity fetishism treats relations that are truly between person’s as if they were relations between or to things (when I buy a diamond I think I’m just relating to that commodity and not enmeshed in a set of social relationships), “affectivity fetishism” could be construed as treating relations that are, in fact, social and political, as relations to mere neurons. The instantiation of certain neuronal structures and relations is here confused with the cause of these instantiations. Here I would express what I take to be Fisher’s point a bit differently by referring to Aristotle’s four causes. The problem with neurological accounts of mental illness is that they confuse what Aristotle referred to as the material and formal cause of a thing with its efficient cause. Depression, anxiety disorders, and schizophrenia are all certain structures of mentality (formal cause) that are embodied in a certain stuff (material cause), but this in and of itself does not account for why these particular embodied structures come to exist as they do (efficient cause).
read on!
Now, if there’s some legitimate dispute as to whether the brain is the efficient cause of depression or anxiety disorders or whether or not these mentalities should be traced back to social structure, then this has to do with the skyrocketing instances of autism, depression, anxiety disorders, dyslexia, etc., etc., etc., in our world today. Why is it that these mentalities have grown exponentially in the way they have during the last century? The standard line of argument is that these mentalities have always existed in these numbers and it was only during the last century that we came to name them and therefore notice them. This glosses the fact that names and etiologies for many of these mentalities have existed for centuries. What changed in the last century was not so much the emergence of a new set of categories that didn’t exist before (though certainly these taxonomies have grown), but rather the emergence of a set of hypotheses as to the causes of these mentalities. The fact that these mentalities have become ubiquitous suggests that something has changed in our relation to the world to produce a rise in instances of these mentalities. Moreover, we’ve seen other mentalities simultaneously decline and all but disappear such as hysteria and obsession which today are the equivalent of endangered species where mentalities are concerned. Given that genetically we’re largely identical to those that preceded us, it follows that causation must be sought elsewhere.
The important feature of Fisher’s distinction between instantiation and causation is that it allows us to maintain both domains (the neurological and the social). However in Fisher’s proposal we still have an ontological question as to what the world must be like in order for what he claims to be possible. And this requires a theory of objects and relations between objects. The autopoietic theorists provide the beginnings of just such an account under the title of “structural coupling”. As articulated by the Encyclopedia Autopoietica,
Structural coupling is the term for structure-determined (and structure- determining) engagement of a given unity with either its environment or another unity. The process of engagement which effects a “…history or recurrent interactions leading to the structural congruence between two (or more) systems” (Maturana & Varela, 1987, p. 75). It is ‘…a historical process leading to the spatio-temporal coincidence between the changes of state..’ (Maturana, 1975, p. 321) in the participants. As such, structural coupling has connotations of both coordination and co-evolution.
During the course of structural coupling, each participating system is, with respect to the other(s), a source (and a target) of perturbations. Phrased in a slightly different way, the participating systems reciprocally serve as sources of compensable perturbations for each other. These are ‘compensable’ in the senses that (a) there is a range of ‘compensation’ bounded by the limit beyond which each system ceases to be a functional whole and (b) each iteration of the reciprocal interaction is affected by the one(s) before. The structurally-coupled systems ‘will have an interlocked history of structural transformations, selecting each other’s trajectories.’ (varela, 1979, pp. 48-49)
Structural coupling, then, is the process through which structurally-determined transformations in each of two or more systemic unities induces (for each) a trajectory of reciprocally-triggered change.
Structural coupling is thus a relation between two systems in which one or both system enters into a relation with another system such that perturbations from the one system come to preside over the trajectory of states in the second system. These relations can be either asymmetrical or symmetrical. Thus, for example, the relation between a plant in the sun is asymmetrical in the sense that the plant comes to be locked into the rhythms of the sun (it’s rising and setting), but the sun does not itself modify its behavior in response to the flower. The sun provides certain “perturbations” that the plant becomes responsive to over time, leading to actualizations of particular sort. This behavior can be modified under certain conditions (i.e., it’s not programmed into the DNA of the plant) through the use of artificial lighting. Here the manner in which the plant actualizes itself becomes very different. By contrast, symmetrical structural coupling can be seen in the instance of two cells in the body that come to coordinate their ongoing movement as a response to hormones released by one another. All cells begin by being pluripotent such that they can become any type of cell in the body (nerve cells, blood cells, muscle cells, liver cells, bone cells, etc). In this respect, cells begin a virtualities with the possibility for many local manifestations. One of the ways in which the actualization of cells becomes “fixed” in a particular way is through hormonal interactions with other cells. One cell produces a particular hormone leading another cell to actualize itself in a particular way and that other cell, in return, produces another hormone leading the initiating cell to actualize itself in a particular way. What you thus get over time is a sort of symbiotic system where the two cells perpetually produce perturbations that lead to rhythmic coordination of activity between the two cells.
All of this initially seems remote from Fisher’s meditations about the difference between instantiation and causation in the case of mentalities. However, the point here is that to make sense of Fisher’s thesis we need to begin with a conception of human bodies as “pluripotent”, capable of actualizing many different actualities, or characterized by a virtual dimension of attractors that can take on very different trajectories or local manifestations. In other words, absent this we risk confusing the human body with any of its local manifestations in history (reducing the human body to its actualization within any particular currently existing network of social relations) such that the thesis loses its critical edge. We end up confusing the proper being of this object, the human body, with its actualization or local manifestation. However, the mapping of the virtual dimension of human bodies is important for another reason as well. Through the mapping of the virtualities or attractors that characterize this sort of object it now becomes possible to examine structural couplings between human bodies and social systems that are pathological in character. What sorts of structural couplings generate sad structural couplings where, by virtue of the impossibility of navigating the perturbations generated by the other object, the social system, the neurological system effectively breaks down and withdraws? The mapping of virtuality and structural couplings between different strata of objects thus allows 1) a plotting of pathological social structures that lead to the effective collapse of one type of structure, the body (as typified in anxiety disorders, schizophrenias, and depressive disorders), but also 2) the suggestion of other alternative forms of mentality that might be produced through other structural couplings to the social system and other ways of organizing the social system. However, while the politicization of affectivity and mentality should be a key terrain in struggles against post-Fordist, neo-liberal systems of capital (and here the work of Massumi, Protevi, and DeLanda are especially important), what should be avoided is the blaming of those who suffer (as we’ve sometimes seen here in the blogosphere) for simultaneously treating their malady as social and political and highly individual and in need of relief.
Larval Subjects . 
February 9, 2010 at 8:09 am
A study was recently published by two researchers at Northwestern University that claimed that communal cultures may have evolved as a protection mechanism for populations with a high genetic predisposition to mood disorders. They cite evidence that individualistic cultures have much higher rates of diagnosis compared to communal cultures, but communal cultures have much higher incidence of the genetic markers for mood disorders in their populations.
I’ve also read articles that discuss the differences between somatizing (experiencing as bodily symptoms) vs. psychologizing (experiencing as mental phenomena) depression, and how that differs across cultures.
My point relates to Fisher’s claim that “The current ruling ontology denies any possibility of a social causation of mental illness.” I think this is simply not true, and social causation of mental illness is in fact a hotly debated topic. Whether it is the dominant paradigm is a different question, but my impression is that it is well-represented and has gained a lot of ground recently.
A second point relates to this claim: “Considering mental illness an individual chemico-biological problem… reinforces Capital’s drive towards atomistic individualization…” But where do we see the most productive forms of capitalism today? Isn’t it in countries who adopt “capitalism with Asian values”, i.e. authoritarian capitalism that rejects the atomistic individualism of the West?
I think there are reasons to doubt Fisher’s thesis on mental illness challenges the status quo in any meaningful way.
February 9, 2010 at 5:47 pm
Mike,
Your first example actually supports Fisher’s thesis, while I think, given the relative newness of capitalist dynamics in China it is simply too early to tell whether it will generate social atomism and similar regimes of affectivity. If these mentalities are potential sites of the political, then this is because the de-individualization of psychic maladies, coupled with a recognition of the collective nature of affects, opens a space where it becomes possible to contest certain forms of social organization.
February 9, 2010 at 10:19 pm
First-time commenter…
And my comments will be very subjective. In December 2009, I was told that my diagnosis for schizophrenia, got in December 2002 was unwarranted at the time; so my seven years’ bad luck was over.
It was “simple schizophrenia”. And it’s pretty much apparent to me now that I got it at the time because I was lonely. I liked literature a lot, and that didn’t find much validation hereabouts. I’d have got a bit further if I’d found people who weren’t solely interested in having the laughs.
I must say though that I found doing English in university tremendously unsolacing, and it was mainly because of all the leftist, post-colonialist stuff we were supposed to care about. Of course, nobody, did, but people, especially foreigners from very rich backgrounds, again found it easier to have the laughs and get the 2.1.
All those things are inherently unmotivating, especially when treated as objective data of knowledge. (It would at least induce a lot less cynicism if at the end of a lecture, the lecturer said, “So get out there and fight, etc”.)
So that was literary studies in leftist academia – zero-acknowledgement of the problems one might face where one was. And zero-acknowledgement that the stuff studied might actually do you real good. It seems bloody weird to me.
And there was also a girl who with her coven was taunting me in the way girls have been known to do – though again that might have been contentious where I was. (The exact representation of my situation is in Shakespeare’s Twelfth Night, in which I would have been Malvolio; although money was far from my mind – I was interested in her wit.)
Apart from all these things that have just made me weary with hearing many things from the left, I do wholeheartedly agree with the article! We are, many of us, ridiculously isolated. That’s what must be fought.
After (a) hearing about the misdiagnosis, and thinking on the fact I’d belaboured under it to some extent and (b) figuring out what the girl was up to in December, I was asked was I “depressed,” and whether I should go back to my doctor of 5 years who, it turns out, hadn’t looked at the files! Well I wasn’t very happy with the whole situation, but I didn’t feel by any means “depressed”. I guess that is the power of ideology.
February 10, 2010 at 12:11 am
In what sense is a culture which fosters social alienation, neither favors nor rewards even relative degrees of individual autonomy, though in the guise of doing just that, marginalizes social (and especially) economic non-conformists, abandoning them to their own devices–in what sense can such a culture be claimed to be ‘individualistic?’ I can make sense of the idea of “communal culture;” but to my poor understanding, “individualistic culture” (as one might find it described in context of capitalist and post-capitalist discourse) doesn’t even come up to being an oxymoron. It just don’t make sense!
February 10, 2010 at 7:58 pm
Fisher’s thesis is that “the current ruling ontology denies any possibility of a social causation of mental illness” and I think he’s wrong about this. Here’s an article called Cultural and Ethnic Issues in Psychopharmacology in a mainstream publication by a mainstream psychiatrist. Doesn’t Zizek take the opposite view? The culturalization of antagonism is correlative with de-politicization.
February 10, 2010 at 8:19 pm
Mike,
I think you’re misunderstanding the issue here. The issue isn’t whether there are researchers that recognize the social dimension of various mentalities. The issue is public understanding of these things and how they’re discussed in the public sphere.
February 11, 2010 at 4:39 am
And that public understanding is individualistic (and humanistic) in its view of causation. Human agency is posited as a special force in the universe. The idea that there is any sort of superego relation is unpopular, even as disaffection with the social status quo is on the rise. The public still concentrates on the agency of a few great men in society, and ignores the object-assemblages they act with/in.
February 11, 2010 at 4:50 am
Right AMM, and incidentally, why don’t you email me so I know who the hell you are! :) One of the questions at here is that of the grounds under which political transformation can take place. Collective affects is one of those sites. I simply can’t agree with the “Zizekian thesis” (I’ve never come across it in Zizek myself and would be shocked were he to claim such a thing) that “culturalization” (a term I didn’t use) is contrary to the political. De-naturalization is one of the key gestures of the political. In this connection, one shows that what appears to be natural (essential), is, in fact, a key gesture on the way to genuine politics. Whether we’re talking about the de-naturalization of gender roles, racial identities, or forms of labor and production, this is a step that it is always necessary to pass through in the genesis of the moment of the political. If this is the case, then it is because it opens the domain of freedom where the possibility of alternative forms of life, affectivity, identity, and production become available. If these sad forms of affectivity are potentially such a potent political site then this is because they are deeply intertwined with contemporary modes of production and communication, with systematic social structures, that generate these forms of affectivity. While I don’t begrudge anyone using meds in relation to these mentalities– I use them myself as a way of handling my own depression and anxiety and believe that they can also be emancipatory –the shift from treatment primarily organized around psychotropics (the personal) to the politicization of these mentalities (the demonstration that they are social, economic, and political in character) is a powerful site where concrete critique can take place.
February 11, 2010 at 8:32 am
I may be missing the point, but in Tolerance as an ideological category, Zizek points to culturalization as a new form of naturalization/neutralization. I don’t think that he means only that vulgar multiculturalism (in the form of diversity seminars, etc.) naturalizes culture either. How else can you read his call for the left to return to a universalist egalitarian project?
February 13, 2010 at 4:21 am
First time poster. I greatly enjoyed Fisher`s book and in particular this connection between mental illnesses and post-Fordist production, so am grateful for the further analysis. Thanks!
February 14, 2010 at 7:32 pm
But the same is true of *any* phenotype: nobody is 100% certain exactly when and for what reasons it evolved (although, with recent developments in genome sequencing, this has begun to change.)
The problem with the idea that post-Fordist modes of production *cause* (rather than contribute to) mental illness is that we already know, with a very high degree of certainty, that this just isn’t the case– most mental illnesses, along with most illnesses in general, have been around in H. sapiens’ gene pool for hundreds of thousands of years, and are possibly an inheritance from our pre-hominid ancestors. They were most likely caused by random mutations that got selected in because for some amount of time they served some important function. The evidence is overwhelming: the genes implicated in many mental illnesses (multifactorial disorders with strong genetic components such as MDD, schizophrenia, bipolar, and OCD) have been around for a very long time.
I understand the value of thinking about humans as capable of all sorts of things– of course. There are a wide range of possibilities for the embryo, reined in by the alleles mommy and daddy passed on, which is an exchange that is in turn reined in by social circumstances. Along the way what happens to the offspring and what it does, how it lives, will make a difference as far as its gene expression is concerned. But the human body, once it’s left the embryonic stage, is no longer “pluripotent” in the same way that a blastocyst is. As time goes on, genes get expressed and potential is slowly limited, all based on the basic blueprint encoded in gametes and passed on to zygote.
You say: “This behavior can be modified under certain conditions (i.e., it’s not programmed into the DNA of the plant) through the use of artificial lighting.” I’m not quite sure what this is getting at. The DNA of the plant *does* program its its biochemical response mechanisms to certain frequences of light. Artificial light is not some other kind of mystically different substance than sunlight: it’s simply light at a different wavelength (not UVA, UVB, etc, unless it’s a sun lamp made to emit those frequencies).
I understand the worries people have about “individualism” with regard to mental illness, and I share most of them, but there isn’t a working psychiatrist or a biomedical researcher alive today who doesn’t understand that phenotypes get expressed with help from environmental cues, and that social situations *do* contribute to the onset and severity of mental illness. As far as what the average person thinks: well, the vast majority of them would agree with Fisher. Most people in the West believe, from a common sense, unscientfic perspective, that “mental illness” is purely social in construction, and if it has a bodily basis, it’s still nowhere near as “physical” as measles or flu or strep throat. Either mommy and daddy made someone “crazy”, or their harsh life did, or their living in a ghetto with no father did, etc. The actual numbers suggest that mental illness is blind to race, ethnicity, religion, and social class. Like addiction, it hits all demographics. Some simply don’t have the resources to effectively fight back.
I suppose my issue boils down to this: if we’re going to talk about how social factors affect illness (and researchers already do), why would we limit that discussion to mental illness and ignore other diseases? After all, these are equally affected by environment. There’s something shadowy lurking in the subtext of Fisher’s argument that bothers me, and it’s the idea that kidney stones and/or malaria and/or AIDS are far more concrete and “real” and “physical” , and therefore less subject to social forces, than mental illness. Along with it there’s the attending notion that the “social” realm is the real operator in the world, and it is even bigger and more important than the laws of physics or the mechanisms of biochemistry, so that everything else merely “mediates” social reality. But this just isn’t so. These may not be the conscious thoughts of those who push the “mental illness is SOCIALLY constructed” line, but it is an unintended ideological consequence of eliding non-mental illnesses from the frame.
As long as the discussion actually includes all illnesses, I’m all for it. It would be fascinating to do a socio-epidemiological study of the rise of AIDS, for example, including the economic undercurrents that carried it across the globe.
One last minor quibble: I would argue that “hysteria” has not disappeared from the arsenal, but that its name has changed: it’s now called “psychogenic” illness or any number of gender-neutral terms. Munchhausen’s. Etc. The same is true of many other mental illnesses- same biochemical mechanism, different name.
February 14, 2010 at 8:03 pm
Ok, just one more thing.
Fisher says: “If it is true, for instance, that depression is constituted by low serotonin levels, what still needs to be explained is why particular individuals have low seratonin.”
Depression isn’t caused by “low serotonin levels”, it’s caused by the failure of key receptors to properly mediate re-uptake of serotonin that *is* produced. The brain is making plenty of serotonin, the problem is that in some cases too much is being sucked up too quickly be the receptors (MDD), and in other cases not enough is (schizophrenia, some anxiety disorders). What the *cause* of this is has already been looked into, very thoroughly. Turns out that some people are genetically predisposed to shoddy serotonin reuptake mechanisms, and the average age of onset for some illnesses is uncannily similar (schizophrenia: mid 20s, bipolar: late teens) while others aren’t. Just like some people are genetically predisposed to breast cancer (they have the BRCA1 gene), while others aren’t. People with APOE4 can have heart disease, people with APOE5 *will* get Alzheimer’s. This suggests that there is a hardwired genetic basis for these illnesses, that lie dormant and then express themselves when they are programmed to do so.
There’s still room for the environment to worsen these things, but not to cause them.
I’m afraid that the mystery some people see in mental illness and genetics is only an effect of their lack of knowledge about both fields. It’s also strange to me that people make millions off cancer treatments. Cancer rates are much higher in the developed world due to high rates of environmental pollution. But nobody except the alternative medicine homeopathic crowd seems seems too worried about this. Why isn’t Fisher asking about how cancer gets “socially” constructed and determined?
There’s something rather odd about how mental illness is such a focal point over other possible vectors, in the leftist imagination, when it comes to the profits of companies and the evils of individualism. It ultimately belies some unsettling beliefs, imo.
February 25, 2010 at 7:46 am
I’ve been diagnosed as bipolar for about 12 years and the effect of repeated episodes is devastating. Having given this issue a great deal of thought, I am prepared to accept that there may be a genetic component in terms of causation but I also feel that this is amplified by the atomised societies in which we live. Late capitalism thrives on values that put incredible stresses on the individual and some of us find that those pressures make things much, much worse.
I also think that talk of causation is less productive than research into the effectiveness of coping strategies (I run a self-help group) and that we ought to be very cynical about the efficacy of medication.
Interesting article, thanks
March 6, 2010 at 12:55 am
Hi Levi!
It’s a great way to ask about the causes of mental illness. In fact, Mark Fisher is correct when he argues that there is a relation between mental illness and how the social relations happen. A strictly biological perspective is very important to the dominant ideology. If we believe that all our discontents are effects of the individual and biological causes, they are completely out of a relation with their social causes (“the current ruling ontology denies any possibility of a social causation of mental illness”). I agree with you: we don’t blame of those who suffer, but we must treat their malady as a social and political phenomenon (and highly singular and in need of relief).
In this way, the psychoanalytic perspective is very interesting because its therapeutic method needs a reformulation of the patient’s position in his symbolic order. Not to recognise the world as it is, but to recognise the limits of our imaginary formations. Therefore, I think there’s a negative goal in the psychoanalysis. It’s maybe a therapeutic method as well as a critique of ideology. Even when the ideological discourse argue by a human perspective, it doesn’t imply a reformulation of the symptom’s position in the symbolic order or in the social relations.
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April 7, 2010 at 7:49 pm
[…] 7, 2010 at 7:49 pm · Filed under Uncategorized This article is a veritable gold mine! I am interested very broadly in articulating forms of affectivity […]
May 29, 2010 at 5:21 pm
[…] as a socially construed phenomena is precisely the popular image (in comments of a Larval Subjects post on the topic). That is, the go-to explanation of mental illness being boiled down to life-events, I […]
June 2, 2010 at 11:39 am
Nature or nurture…the entire discussion has the pall of cliche and the stench of taxonomic packaging…anodyne lite gets it right….when he/she says there is room for the environment to worsen these things but not to cause them…its the ancient Aristotelian discussion of Free Will opposed to Divine Foreknowledge retold in viological versus sociological narrative…..of course the two are interdependent, as any practising psychiatrist will confirm; and the possibility of a Utopian social order, in and of itself, does not probably preclude mental illness; or as Anodyne correctly notes, any other illness either…..