Consider: “What you’ll count as causes of mental illness depends on your politics”. Perhaps we’ll make of this an obvious but uninteresting truth: “Your politics can blind, or instead sensitise, you to value-independent facts about mental illness’s real causes”. Well, sure, that happens! In what follows, though, I want to offer an alternative, and hopefully more interesting, suggestion: that our political values affect what we’ll even count as bona fide causes.
In what follows I want to offer an alternative, and hopefully more interesting, suggestion: that our political values affect what we’ll even count as bona fide causes.
Take such causal candidates as unemployment; social isolation; childhood trauma and neglect; the atomising and alienating effects of life under neoliberalism; systemic prejudice; genetics; drug use; emotional coddling and a resilience-depleting culture; insecurity- and narcissism-engendering social media; the demise of religion, marriage, and stable family life; the cultural loss of virtue concepts such as dignity and probity.
Perhaps you’re more inclined to focus on that which impairs our development of the backbone required to face life’s inevitable hardships, or erodes that traditional social fabric which scaffolds our identity and purpose? If so, maybe you’re of a conservative disposition. Or perhaps you’re less persuaded by the idea of life’s inevitable hardships, and instead inclined to stress the causal significance of such socio-economic challenges as unjustly make life far more painful than it need be? If so it’s possible your politics has a progressive stamp.
That’s all well and good. But let’s bring into view the deeper relation between politics and causation I mentioned above by first considering an analogy:
You’re in the lab, examining tiny critters under the microscope. Some of them are struggling. How to explain this? Will you look to their nature or instead to their environment?
On this occasion you find the agar medium in their petri dish has become unusually acidic. You put it right; the microorganisms recover.
But consider: if you knew that they normally coped well with this higher level of acidity then, even though they recovered because you reduced the acidity, appealing to it wouldn’t count as explaining their sickness. You’d instead be interested in what internal factors prevented them coping normally with the acidity. Our assessment of what counts as relevant for causal explanations depends, that is, on our background sense of what’s normal.
Our assessment of what counts as relevant for causal explanations depends on our background sense of what’s normal.
Something like this is true for humans too. Do we account for someone’s PTSD, say, in terms of the shocks they’ve suffered - or must we instead look to what in their constitution, or in their present environment, prevented them from coping as others do? Is it sufficient, for explaining someone’s depression, to point to the bullying they suffered - or should we instead look at why they couldn’t stand up to it? What shall count as enough bullying to explain a depressive response?
Perhaps we’ll try to answer this by comparing our patient’s resilience with that of their peers. Here, however, a difference emerges between microbial and human life. In both cases we may talk about what the species members should be able to cope with. With the microbes, however, our ‘should’ is understood solely by references to what conspecifics normally do cope with. With the humans, by contrast, we import a range of different ideas about what a good human life is, what level of resilience should be expected from adult humans, what degree of support it’s reasonable and good to offer, what degree of support it’s dignified to accept, when compassionate empathy instantiates a virtue and when it instead becomes a sentimental vice, when courage should and shouldn’t be expected, and so on. And our different ideas about these matters reflect our different politics. And our politics differ not only in what we rightly or wrongly take to lead to the kind of flourishing we’d all recognise as good. We also differ in what we think constitutes a worthwhile, flourishing life.
Our sense of what is a bona fide cause depends not only on our sense of what people typically can, but also on what they ought to be able to, cope with. Such ‘oughts’ must be constantly negotiated in our political discussions.
Take George, who suffers unemployment and becomes depressed. A couple of months later he gets another job; the depression lifts. What explanation shall we give? Surveys suggest that 30% of those men who suffer redundancy in the west of England in 2023 become depressed - but so what? Should we be surprised that 70% of his peers don’t become depressed, or that 30% of them do? What ought a man be able to cope with? What really caused George’s depression: his lack of work or his lack of inner resource?
Perhaps we’ll appeal to one, or the other, or both. But we can’t appeal to any lack whatsoever and arrive at a cogent causal explanation. If George had won the lottery or been visited by angels his depression might have lifted. A loving godfather steeped in stoic philosophy, or living in a culture which finds no dignity in work, might have prevented it. But it’s not reasonable to appeal to the lack of these to explain George’s depression. Our sense of what is a bona fide cause depends not only on our sense of what people typically can, but also on what they ought to be able to, cope with. Such ‘oughts’ must be constantly negotiated in our political discussions. We can’t validate them by reference to value-free facts of human psychology - but that doesn’t mean there’s no moral or political facts to be had. What it means is that you can’t investigate mental illness’s causes in abstraction from such considerations of value.
Dr Richard Gipps is a Chartered Clinical Psychologist, Associate of Faculty of Philosophy and Fellow of Blackfriars Hall, University of Oxford. He is author of On Madness: Understanding the Psychotic Mind published by Bloomsbury (2022). https://oxford.academia.edu/RichardGipps