This paper was originally written to satisfy the requirements of Zoe Martell’s Controversies in Psychology Writing Course at San Francisco State University. A special thanks to Professor Zoe Martell, who taught me how to write on controversial and contemporaneous issues with conviction, has routinely made the well being and understanding of her students a personal priority, and who has undoubtedly had the largest impact on my scholarly development thus far.
Disproportionate and extreme reactions to events and perceived offenses are considered hallmarks of mental pathology. Extreme reactions, emotional outbursts, and depressive episodes are all associated with mental disease, we do after all define pathology along those terms, and those symptoms are perceived to be a product of internal mental illness. However mental illness is not always the cause of such actions and thoughts, in short, extreme reactions and disabling distress can be waranted. Increasingly the root and progenitor of a patients mental anguish is the very condition of the patient within their society and the condition of their society at large. The ability of societal events to generate mental anguish has been made all the more obvious during the COVID-19 outbreak and the subsequent response thereto.
I argue; That anger, depression, and exasperation among other emotions can and do represent a rational response to contemporaneous events for a significant subset of patients. That certain frameworks and approaches are grossly inadequate to address the needs of this growing subset of patients. That patients who constitute that subset should be directed towards direct political actions and activities as a matter of course, and finally, that any intervention which does not include some aspect of the proposed intervention is not only inherently and disastrously inadequate, but clearly and unethically detrimental to the immediate and long term well-being of the patient.
I propose that for a specific subset of patients, who we will call Lucid-Dysphoric (LD), a multitude of emotions and behaviours such as, exasperation, anger, depression, and anxiety are not evidence of pathology but instead constitute a normal and rational response to the environment and system that they experience. For an ever-growing percentage of the populace, their condition and status within their economic and societal system constitutes a clear and pervasive detriment to their daily lives. As the American and World economies begin to constrict and large entities ensure their safety at the cost of the general population, it will become obvious to an ever-growing subset of people that they are unequivocally doomed to exploitation and deprivation both now and in the future.
I will argue that global climate change, governmental actions, and wealth inequality have created a situation where any reaction other than hopelessness, anger, frustration, depression, and anxiety is near pathological, and that since these situations are not liable to change in any meaningful way in the near future, mental health professionals should help direct those emotions into meaningful and purposeful actions.
I recognize that there has been a long-standing separation between politics and psychology. I am aware of the reasons that many mental health professionals steer clear of mixing the two. However, a multiplicity of occurrences has made it and will continue to make it impossible to help people if we refuse to acknowledge and address the root causes of their despair. I hope to demonstrate that given the extant and foreseeable state of affairs, these sorts of patients will become more prevalent, and that without addressing the root of our patients problems we are either pacifying patients to their objectively abhorent conditions, or increasing the probability that they will find detrimental amd possibly violent outlets for their emotions.
In short, patients live in a political world. We should too.
There are currently more than 40 million unemployed people due to the COVID-19 pandemic (Kelly, 2020), 36.5 million of which filed within the last 7 weeks (Vo, 2020), and millions more are likely to follow (Egan, 2020). It is important to note that those numbers are coming from a country with an estimated population of 330 million. Thousands of families in San Antonio (Higgins, 2020), Alameda County (Anthony, 2020), and New York City (Bufkin, 2020) found themselves needing to resort to food banks this month, with many more to follow (Barbiroglio, 2020). In order to cope those foodbanks have had to create their own supply chains (Coppola & Baker, 2020). For those who have maintained their employment and have been deemed necessary by our government, conditions are or remain dangerous and unhygienic (Haedicke, 2020), presenting risk of infection for them and their families. Such people are, in most states, ineligible for unemployment benefits if they quit (Conley, 2020) and have little legal recourse (Wiessner, 2020), so in order to feed and house themselves and their families they must work under increasingly dangerous conditions. Workers who protest and attempt to gain hazard pay or personal protective equipment can be and have been fired en masse. Trash workers who protested their conditions found themselves fired and replaced with prison labor (Monteverde, 2020). To be brief, if you were hurting before you’re dying now, figuratively and literally. And if you attempt to do anything other than what your employer or your government asks of you, you’re screwed.
There exists ample evidence that poverty in and of itself is a negative factor for health in general (Esposito, 2016) and mental health in particular (Rogers & Pilgrim, 2003). From shorter life spans to increased stress, people in poverty and near it are the most vulnerable and therefore the most exploited subsect of people in this and nearly all nations.
The poor, due to their poverty, cannot be happy or have mental well-being in any meaningful way. Simple as that. Without food, water, and basic needs there is no hope of progressing meaningfully and maintaining one’s mental health (Maslow, 1948). There is no clear “positive” response to the inequality that many people experience as a matter of course through their lives. Depressive symptoms themselves overlap with those of starvation (Streit, 2018), and anxiety is all but guaranteed under the sorts of conditions described above. It is evident that the socioeconomic standing of a person within their society affects and can negate the possibility of good mental health and affect.
Any person regardless of upbringing could not reasonably be expected to exhibit anything other than apparently pathological mental states given such conditions. We conclude this brief section by noting that unemployment numbers will continue to rise and that rises in unemployment have been correlated with increases in suicidality and hospitalizations (Lin & Chen, 2018), and that those who were already impoverished or living day to day (around 78 percent of us (Vivian, 2017)) are the most likely to bear the negative consequences of unemployment. There will be an increase in clinical patients whose primary reason for being in front of a mental health expert will be their job loss, poverty, and their consequences. It is therefore crucially important that we know how to be responsive to their needs.
Immigrants have had a rough go at. During the Trump administration there has been an increase in family deportations and abuses towards immigrants, and undocumented immigrant camps appear to have COVID-19 cases rivaling the numbers of some nations. As that continues, the administration has opened up visa restrictions for temporary workers as there are few people willing to risk their lives in the US for the illicitly low wages being paid. Asian Americans and immigrants in the US and across the world have been killed or attacked as racists have been given permission and premise to attack Asians due to the coronavirus.
The death toll from COVID itself is higher here than any other place in the world and our response has clearly been lacking. On the state level there have been confiscations by FEMA from hospitals and subsequent redistribution to corporations with ties to the administration, with those corporations proceeding to sell the equipment to the highest bidder. States have reacted by smuggling equipment into their borders and protecting them with their state guards. Meanwhile front-line workers are losing wages because hospitals are not making enough money due to the cancellation of elective procedures. This has led to protests by nurses and some strikes which have garnered little to no media attention.
Non-American Cruise lines and American Banks all got trillions of dollars from thin air and compared to the smooth stimulus efforts of other nations, the initial and anemic 1200-dollar one-time stimulus check hasn’t even made it to most of those who were eligible. Our government has, especially in comparison to other governments, failed miserably. There is clear evidence of a myriad of abuses, yet nothing seems to happen.
For immigrants, people of color, and pretty much anyone who is paying attention, these happenings engender anger. The clear abuse from the government has laid bare the fact that the government serves only those who populate it and those who enabled their rise to power.
Even under “normal” conditions, these abuses were evident for many people and naturally caused them some anguish. For those affected by them, “some anguish” is a laughably inadequate term. Imprisoned people had always been exploited and forced into labor; however, the pandemic demonstrated the blatant exploitation of imprisoned people. Let us recall the interaction with poverty outlined above, those without a semblance of power found themselves subjugated and replaced by a more subjugated and exploited set of people. It is evident that for nearly all people, but especially those with lower social standing, that their government does not have their best interests in mind.
We conclude that any person sufficiently exposed to the occurrences of the world will experience some sort of unfairness or wrong, and that to expect any reaction other than anger, indignation and hopelessness from people is absurd. We note that prior to the pandemic many of the same types of events were happening. However, things used to be much less blatant, and to many people those occurrences and injustices were justifiable. However, as more people are affected and more people die or are disenfranchised, this will become less of a possibility to all but the most pliable and ignorant of people. So again, we expect to see more people who in reaction to their government seek mental health treatment. Media, due to their immense bias towards the people who own them and their interests, will continue to advocate for absurd treatments to real problems or as is more likely, ignore those problems altogether and fabricate new ones. As traditionally trusted sources of information begin to lose the confidence of the people, we expect more paranoia and feelings of persecution to arise in the population. For many people, for example immigrants, this is a rational response, as they are indeed being persecuted, and fear and paranoia, while discomforting and painful, are rational responses to their condition.
Every year we have record-breaking temperatures reached and extreme weather galore. To many who recall stable weather, this is disconcerting. On a more anecdotal note there are parts of the Russian Tundra that have lost their perma-frost and their year-long snow, becoming muddy wastes, and the people who lived or still live there often express their longing for the frozen tundra they once knew. The effects of climate change are clear to many, but as the rate of change continues to accelerate, there will be more people who begin noticing and understanding its consequences. The California fires in places like paradise are a prelude to larger and more devastating fires, and soon most people will be touched by extreme climate events in some way. While there will inevitably be a subsect of the population unamenable to reality, we suspect that an increasing proportion of people will become educated to the impending adverse effects of climate change.
We have long exceeded the maximum emissions required to stave off the worst effects of climate change. Pockets of humidity and heat which will make parts of the globe uninhabitable have already begun to emerge and are liable to become more prevalent by mid-century. Humans can only withstand certain levels of heat, and when the air becomes too humid and too hot, the humidity ensures that our sweat does not evaporate, and so does not cool us off. Those without access to cooling will die, regardless of their health. (Raymond, Matthews, & Horton, 2020)
Again, we conclude that any reasonable person, once understanding this, will feel a certain negative emotion or combination thereof. Perhaps in the form of anger or hopelessness or anxiety. Furthermore, individuals are not liable to have much of an impact when they decide to make a change on their own (recycling is a myth (Franklin-Wallis, 2019)), so the hopelessness factor is doubly due. It is therefore reasonable and normal for a person to feel intense anxiety due to the impending death or displacement of themselves or their progeny/kin. I myself have family in areas of the world that will, in all likelihood, be uninhabitable by the time I reach 70.
Given the facts presented we believe most people will present with some sort of negative emotion. And we have demonstrated that those negative emotions are rational given the circumstances and the limited ability of the average person to change or remedy them. The question naturally arises, what of the people who manage to live their lives happily? What do we make of them?
We believe that as conditions begin to exceed the “unacceptable” threshold for a growing number of people, people who manage happiness will tend to be a heavily insulated middle and upper class. People of those classes will be able to enjoy life and progress through it without much discomfort or perturbation barring the sort of historical societal unrest of Tsarist Russia. Such people will of course find it necessary to ignore or rationalize the sorrow and pain of the people not within their class, but historical evidence seems to indicate there is no limit to how much we can ignore.
Hopelessness, anger, anxiety, and exasperation can all be turned into positive action. People crave meaning and they react well to having meaningful plans and livelihoods. As we have clearly established, things aren’t looking too hot for the vast majority of people, and certainly look terrible for most Americans. There is however the ability to change the systems which cause people anguish, which has the benefits of both giving people meaningful activities and can lead to the easing of those same pressures which causes them such suffering.
We take for example a man who was on campus at SFSU protesting for an abolition of the income tax. This person was not paid to appear there and make talking points. He had been successfully convinced by some advocacy organization that the root of his problems was not the immense load of debt he was in or the astronomical interest rates that he was paying, but instead the government for taking a portion of his income. This man was hurting economically and was undoubtedly distressed. As he would later disclose, his wife needed money due to cancer treatment and he found himself incapable of paying for her treatment.
That man felt wronged, stressed, and knew that there was someone to blame, however a group with interests far different than his own had managed to convince him and in a way gaslight him into believing that his best interest was not in raising taxes on the upper classes to pay for healthcare or anything of the sort, but instead lowering their tax rates while increasing his own by the imposition of a flat tax rate. This man understood that he was hurting but there had been no means available for him to adequately vent his frustration and alleviate his powerlessness. He was in a quixotic position, incapable of ever making enough to support his wife and yet desperate to do so in order to save her.
I spoke to this man for a long time and afterwards I was able to convince him that loans had to be capped at a certain rate and that perhaps tax codes should have loopholes closed. However, he remained there, passing out leaflets and carrying the sign someone else had printed for him.
In hindsight I recognize that I made an error. I failed because I did not direct his frustration towards anything meaningful. I convinced him of who the enemy was, but I did not give him a meaningful way to fight back against it, so there he remained. People crave an outlet when they’re in the kinds of situations that man found himself in and I did not provide him with any other outlet than the one he was already engaged in.
We as mental health professionals must ensure that the frustrations of people are meaningfully directed towards acts which are liable to make their situation better. We cannot simply act to alleviate pain through medication or the lessening of the real anger and emotions that people are experiencing. As this sort of scenario becomes more and more prevalent, especially during and after the COVID-19 pandemic, we must create opportunities for our patients to meaningfully express their emotions and act as aggressors to the progenitors of their pain.
In order to do this, we have to ourselves be able to identify the problem and the mechanisms and opportunities required to use them. We must know the avenues and advocacy groups which specialize in or around the areas of pain that people are interested in or are being oppressed by. This will be different in every context and there will not always be a clear resolution. For a Californian in a large city there may be different activities than a Texan in a small town or a Appalachian who’s list their livelihood. However, there are always meaningful ways that a person can interact with and exert pressure on the causes of their oppression.
To do anything less is to be complicit in the gaslighting of our patients and to allow their negative emotions be exploited by outside influences towards causes that will be, in all likelihood, detrimental to their own well being on a personal and institutional level.
As established prior, there is no hiding the fact that people are hurting. We cannot tell a person who’s lost everything or is experiencing persistent anguish to relax and live their life. We can and must direct them instead towards the correct avenues for changing their situation. People who are screwed in the myriad of ways we’ve described above and do not have the ability or knowledge to understand who is harming them run the risk of being manipulated into believing that they’re being harmed by groups and people who are themselves not complicit or party to their harm. Thereby allowing the harming entities to continue as they were and, in the process, use our patient as an agent of oppression towards another group. This must not be allowed. Often it is very evident once explained and examined the reasons and mechanisms by which a person is being exploited. If we adequately and correctly diagnose and elaborate these societal issues to our patients, we can maneuver them so that they do not end up susceptible to extremist propaganda and ideologies.
The disenfranchised are more likely to use violence, as it may be their last option to exert power. Martin Luther King Jr. wrote, “The riot is the language of the unheard”. We must ensure that our patients are not left unheard and that their concerns and actions correspond with the sources of their pain and oppression. As we have demonstrated patients with societally originating mental distress must be shown who to blame as there exist a myriad of political actors who are willing to point the finger in any other direction than themselves.
When things are going as poorly as they are for an entire nation and society, people will experience negative emotional states as they feel the effects of their own condition and lot within their society. Regardless of a person’s understanding of their subjugation or exploitation, they still inherently understand and experience the fact that they are being harmed. And for those who do not know what entities are causing them damage, they will require a scapegoat or some boogieman to make their inner world coherent. For many, immigrants, “the deep state”, and China are to blame for their pain and due to a myriad of reasons those people are disproportionally likely to join hate groups or instigate terrorism themselves. We must ensure that such people do not act upon those beliefs but more importantly we must address the root of their grievances. If we ignore the factors that led to those beliefs and their grievances, then we inevitably allow them to continue in their misplaced emotions. By refocusing who and what those people blame towards the more evident of causes, we can ensure that people who would have otherwise been susceptible to extremist causes are instead funneled towards more productive, healthy, and effective action.
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COVID-19, Coronavirus, Pandemic, Quarantine, Mental, Health, Pathology, Non-Pathological, Oppressed, Disenfranchised, Treatments, Poverty, Direct, Political, Action, Systemically, Repression, Subjugation, Rational, Response, Decline, Inequality, Exploited, Persecuted, Depression, Anger, Hopelessness, Happiness, Contentment, Quixotic, Precarious