One of the most ubiquitous products of advanced capitalism is mental illness. Despite our relative comfort, our god-like technology and our unprecedented freedom, something about the world we live in makes us miserable and anxious.
Depression, anxiety, addiction and psychotic disorders are on the rise at an alarming rate. The most comprehensive survey from the USA found that 46% of 18-75 year olds report a history of mental illness. World Health Organisation research puts the figure at 55%. Suicide is now the most common way to die for men aged 18-30. Depression is the leading cause of disability in the world today.
Until now we have lacked both an explanation for this mental illness epidemic and any substantial solutions. This lack of understanding in itself further compounds the despair. Wilkinson and Pickett’s The Inner Level draws on vast datasets and diverse areas of scientific enquiry to describe an extraordinarily elegant and provocative theory of mental illness in the 21st century.
Unlike many books on the human mind, it is very easy reading and makes accessible large scale statistical analysis. Their argument is constructed by mixing these hard scientific facts with a miscellany of trivia such as the toiletting habits of the French aristocracy, the antisemitic origins of plastic surgery and the history of the rituals surrounding classical music.
They show that rates of depression, anxiety, narcissistic personality traits, addiction and psychosis are higher (across the whole income range) in societies where there is higher income inequality, and those in the lowest income brackets experience the highest rates of mental distress. Their work combines insights from epidemiology, animal behavioural science, evolutionary psychology and anthropology to explain why unequal societies are so psychologically toxic. Drawing on the best scientific research their theory speaks directly to our lived experience. They give us the peer reviewed science to smash some of capitalism’s big myths, such as social Darwinism and meritocracy.
The central argument in the book draws on evolutionary psychology to argue that steep hierarchies of income inequality trigger powerful and primal status anxiety, as observed in pack animals. The greater the income inequality, the more we worry about how we are perceived by others. The human response to this status anxiety is various forms of social awkwardness ranging from shyness and overly flamboyant behaviour through to depression and mania.
Pack animals, like the great apes that were our pre-human ancestors, organise themselves in dominance ranking systems or pecking orders. Dominant animals eat first and have first preference for mates. It is survival of the fittest. Knowing your place in the pecking order and having a capacity for judging rank is essential for survival. The most intense rivalries exist between those closest to each other within the pecking order. There are complex social codes involved in showing appropriate levels of submission to more dominant animals, and appropriate levels of dominance to more submissive animals.
A breach of the code, such as subordinate animals making eye contact with dominants or misjudged aggression, could lead to conflict and defeat. Human beings stopped living in this way about 200,000 years ago, around the time we became anatomically human. Wilkinson and Pickett are at pains to stress that for 90-95% of the time we have been anatomically human, we have organised ourselves in aggressively egalitarian societies, where wealth and power were shared and weaker members were cared for by the whole. Within these hunter-gatherer societies, any individuals exhibiting antisocial or domineering tendencies were dealt with by “counter-dominance strategies”.
These ranged from ridicule and humiliation through to exile and murder. Humans differed from our pack animal ancestors in that we had developed hunting technology such as spears, bows and arrows, knives that meant muscular strength no longer conveyed any special advantage in the pecking order. Even relatively weak members could use this these weapons against their rivals. Furthermore, big game hunting required cooperation and sharing to be effective.
The authors argue that this long period in our history has left an evolutionary legacy with a strong selection bias against more the most aggressive, selfish and manipulative behaviour. It accounts for the fact that our celebrations involve sharing food and the exchange of gifts. This theory is supported by a variety of behavioural science experiments have demonstrated that people have an innate preference for sharing and fair play. The development of settled agriculture brings a return of status hierarchies. Grain and other agricultural produce could be amassed as private property. Class society emerges as some individuals amass more than others.
The dominance-submission structures of our primal psychology that had been all but extinguished for 200,000 years resurface. However pre-capitalist agrarian societies were fairly static. The life of one generation was much the same as the next, and people mostly did not move around very much. People were known within their communities and felt secure within their identities. Modern capitalism contrasts starkly. People are very mobile and most day to day interactions are with strangers or with near strangers. “Without the stabilising effect of an identity held in the minds of a community of people, it is as if each encounter demands that we try to implant a positive version of ourselves in others’ minds.”
Advanced capitalism is psychologically toxic because it combines steep hierarchies of class society with the unstable, fragile identities of individuals in a crowd of strangers. “It is hard to imagine a more effective way of telling a large swathe of the population they are worthless than to pay them a quarter of 1 percent of [their boss]”. At the same time we live in a society where we are strangers to almost everyone we meet, and consequently a “social evaluative threat” haunts most interactions.
Studies have found that anxiety about how we are perceived by others generates more stress hormones than threats to the physical body. Living with this stress changes our biology. The authors quote a study of low grade civil servants which found they had increased levels of blood clotting agent. They conclude “the blood of subordinate civil servants appeared to be prepared for the kind of attacks which, for example, a subordinate baboon might risk from dominants”. There are a number of responses to status anxiety. The most obvious is depression. If social encounters are so anxiety inducing, one answer is to avoid social encounters and withdraw.
There is a growing body of evidence to support the idea that depression is linked to “an inability to stop, or escape from, a submissive situation or defeat”. Psychologist Paul Gilbert has made the comparison between depression and “behavioural deactivation” in infants. “Behavioural deactivation” is the widely observed phenomenon whereby ignored babies learn to stop crying to communicate their distress.
Research shows that this is not because they have become less distressed, but because they have learned that it is safer to suffer in silence. Gilbert argues that despair is “a form of behavioural deactivation when protest does not work. Positive emotions and feelings of confidence and the desire to explore, search and seek out must be toned down”. The lack of freedom to escape the subordinate ranks of class society must account for the fact that men in the lowest quintile for income are 35 times more likely to have depression than men in the top quintile. “Greater inequality heightens social threat and status anxiety, evoking feelings of shame which feed into our instincts for withdrawal, submission and subordination.”
The second response to status anxiety is narcissism. Wilkinson and Pickett quote a study linking “self-enhancement bias” to income inequality. “Self-enhancement bias” or “illusory superiority” is the tendency for people to over exaggerate their desirable qualities relative to others. A well known example is that almost everyone believes they are a better-than-average driver. “Narcissism is the sharp end of the struggle for social survival against self-doubt and a sense of inferiority.”
Wilkinson and Pickett have many fascinating insights into the history of privacy and etiquette which develop with capitalism. The public self is adorned with status symbols and conveys class rank by a subtle and elaborate repertoire of gesture, accent, vocabulary, and behaviour. The private self is a mysterious entity which we obsessively guard from the public gaze. The obsessive self-love of the public persona that is at the root of narcissism.
The tendency to attempt to present a successful front is a driving force of conspicuous consumption, where people go without basics or become indebted in order to drive a flash car or wear a designer label. Widespread anxiety is good for business, not only because it drives up conspicuous consumption, but also because depressed and anxious people tend to seek out what small pleasures they can get.
The third response to status anxiety is addiction. Addiction broadly defined is compulsive pleasureseeking, which could involve drugs and alcohol but also might involve anything that triggers our dopamine-based pleasure reward centres.
Nowadays addiction services consider that we might become addicted to gambling, shopping, video games, even cupcakes. Wilkinson and Pickett describe the Rat Park experiments, where opioid-addicted rats were released into a purpose built rat paradise where rats were free to associate with other rats in a high stimulus environment. Within weeks of this experiment most of the rats had kicked their opioid habit. Psychotherapist Craig Nakken argues, in words that will be familiar to Marxists, that addictive and compulsive behaviours involve “replacing people with things”. The scientist behind the Rat Park experiments, Bruce Alexander, argues: “free market society can no more be free of addiction than it can be free of intense competition.”
Having outlined the mechanisms whereby income inequality promotes mental illness and addiction, Wilkinson and Pickett begin to explore other trends. Perversely the more unequal the society, the more strongly people believe that they live in a “meritocracy” and that class status reflects innate ability. In fact the complete opposite is the case. Social mobility declines with increased income inequality. There is also less social mixing and real obstacles to crossclass communication.
This belief in meritocracy also translates into more antisocial attitudes. Wilkinson and Pickett point to a variety of studies that show the best paid individuals usually harbour the most antisocial attitudes. People in posher cars are more likely to cut up other road users. Top bosses score highly on the psychopathy scale. They argue that this tendency is rooted in the disregard that primitive animals show their subordinates. They point to research that proves antisocial tendencies are a product of rank and social position (rather than the other way round, where being antisocial would be the key to success and social climbing). In more equal societies, where there is greater social mobility and thus greater competition for the top jobs, the rich tend to be more pro-social. “It is inequality itself that creates the climate in which richer, high status people behave badly, rather than some inbuilt characteristic”.
It is not just the rich who are antisocial. More unequal societies experience the highest rates of antisocial behaviour across all sections of society. Living in an unequal society means you are more likely to be a victim of violence (as measured by homicide rates) and childhood bullying. Conversely civic involvement and traditional labour movement values such as solidarity are more common in more equal societies. There are also other tendencies they uncover which militate against the development of strong workingclass movements within unequal societies. Inequality makes communication across social rank fraught with social awkwardness.
Wilkinson and Pickett point to data that shows cross-class marriages decline with increased income inequality. As rivalries tend to be greatest among people of similar rank, this obstacle to communication could be a real difficulty in building working-class organisation. Across history, left activists have usually been better-off workers and young people from posher backgrounds. Socialist agitation and education may be more difficult in more unequal societies due to this increase in social awkwardness. Solidarity within the working-class movement may also be more difficult. An example of this might be how the wider working class responded to the recent junior doctors’ strike.
The tendency of income inequality to promote individualistic attitudes and differentiation and social awkwardness within the working-class goes some way to explain the explosiveness and unevenness of class struggle. The relatively equal times of the 1970s generated much more trade union struggle and labour movement militancy than today. The difficulty for today’s leftists is that we are fighting not only against a background of defeats and setbacks for the labour movement but also against a culture, generated by inequality, that is highly individualistic and antisocial where people slightly higher up (or lower down) the pecking order are treated with a degree of suspicion that would be absent in a more equal society.
Socialist transformation is not simply a matter of getting a political party to power with the right programme. Rather it is a process of transformation in working-class attitudes and culture. Against the hegemony of capitalist values of individualism, passive consumerism, nihilism and philistinism we pose the values of solidarity, militancy, democracy and critical thought. Equality begets a stronger movement to win more equality. Inequality makes the raising of such a movement much more difficult.
Towards the end of the book, the authors begin to sound a little like Marx and Engels: “The complexity of modern industrial production has... returned us to an inherently interdependent, and so potentially cooperative, way of life.
“We now make almost nothing for our own use but work instead in highly co-ordinated groups to produce goods and services almost entirely for the benefit of others. When such highly integrated and co-ordinated behaviour is essential, building it on systematic inequality looks like an irrational hangover from a past era”.
In the final chapter, however, we get a kind of left social reformism from above. The authors are far more radical than any mainstream politician in advocating “economic democracy” and ideas to make irreversible structural changes in economic life, but they end up positioning themselves as mere helpful advisers to government and promoting some NGOs.
The great power of their book is that it shows how class society is deeply ingrained in how we think and feel about the world. It shows how status anxiety pervades every aspect of social life within modern capitalism. The science that they present points not to deus ex machina left social democratic reform but to bottomup, revolutionary class struggle.
Socialists reading this book will get a sense of how Marx and Engels must have felt when they read Darwin’s Origin of Species. It is a work of natural science that confirms our view of the historic class struggle. It is the first convincing theory of mental illness in the 21st century and provides us with a powerful ideological weapon against psychologically toxic capitalism. It not only speaks directly to our lived experience but the book is peppered with suggestions of how our lives might be radically different if we won the equality that it advocates. It allows us to imagine the immense human potential that could be unleashed by winning equality. It shows how much of today’s depression, social awkwardness, compulsive pleasure-seeking, conspicuous consumption and narcissism could be consigned to the dustbin of history.