Andrew Garman reviews two books that explore the different ways in which the modern world impacts mental health.
Sedated: How Modern Capitalism Created our Mental Health Crisis, by James Davies (Atlantic, 2022)
As an anthropologist and a psychotherapist, Davies is well-placed to see both the detail and the big picture behind the still-burgeoning mental health crisis in the UK and much of the western world. The thinking behind the title “Sedated” is insightful. Why, he asks, if there is so much misery around, are people not rising up to take collective action to improve their lot? The answer, Davies thinks, is that the population has been “sedated” – both literally, with drugs – and metaphorically, because they are told that they are the problem, not their situation. Behind all of this is the drug industry, keen to turn suffering into profits, and governments, keen to get workers back to work.
Davies describes in detail the reasons behind the crisis – linked to modern capitalism – which have to do with managerialism, precarious employment, debt and a general individualist culture where blame is deflected downwards rather than towards those in charge. His analysis is thorough, well-argued and highly readable. And it provides a good foundation for thinking through where society needs to change.
The Inner Level: How More Equal Societies Reduce Stress, Restore Sanity and Improve Everyone’s Well-being, by Richard Wilkinson and Kate Pickett (Allen Lane / Penguin, 2018)
Wilkinson and Picket rose to prominence in 2010 with their book, The Spirit Level, which demonstrated a strong correlation between a range of societal ills and the level of income equality across a range of Western societies: this triggered a wave of inequality research around the world. The Inner Level digs deeper. By bringing together this research, a picture is painted of inequality permeating every aspect of society – health, well-being, social cohesion, children’s life chances and respect for the natural environment – with negative impacts. For example, for children, equality in society correlates positively with child well-being and educational attainment but negatively with bullying, child maltreatment, dropping out of school, social mobility and teenage pregnancy.
But the real value of the book lies in its exploration of the complex causal web underpinning these phenomena. This might be seen as a combination of two broad categories. The first is political, pointing the finger at those politicians that have promoted individualism and competition, together with the myths that meritocratic societies are better (and that we in the UK live in one). The second is biological. There is good evidence that humans are wired for co-operative behaviour, but can also naturally switch to competitive behaviour. Then, our natural biochemistry prepares us (as if) to fight in a hierarchical society: trust decreases, cortisol-mediated status anxiety increases and blood chemistry prepares for the possible wounds that need blot clots to form more easily. This paradigm even explains why women in more unequal societies prefer men with more masculine faces.
There is much fascinating detail in this book which is a must-read for anyone interested in understanding the root causes behind the current mental health epidemic.