Friday, March 31, 2023

Pathfinders: Shut up and take the pill (2023)

The Pathfinders Column from the March 2023 issue of the Socialist Standard

Sometimes, instead of trying to chase down the causes of a particular medical problem through extensive (and expensive) lab research, it’s easier to change the environment the problem flourishes in. This is especially true of environments like the human gut biome, in which very little of the bacterial load has been studied or is even known to science. Nobody really knows what’s in there or what any of it does. Following the much-publicised success of faecal microbiome transplants (FMTs), which have proved to be often stunningly effective against sometimes fatal Clostridium difficile and other conditions previously thought untreatable, vaginal microbiome transplants are now being proposed as a holistic approach to certain poorly understood but common vaginal disorders, by effecting a wholesale change to the vaginal environment (New Scientist, 13 February –

From a socialist perspective there is a certain irresistible analogy to be drawn here, human society as a macrobiome, containing a complex ecosystem of unique and discrete agents whose interactions work in concert to make the whole thing function. In common parlance we talk about ‘good’ and ‘bad’ bacteria, although we understand that this is not some moral verdict on the bacterium itself, which is neither good nor bad, but merely a handy way to describe individual bacterial behaviours that are either helpful or at least neutral, or deleterious for the whole macro-organism. Thus, in a healthy and balanced macrobiome, one would expect a preponderance of good bacteria, displaying socially advantageous behaviours that help the various functions work in harmony to create a stable and disease-free environment for the whole community.

Most people would probably agree that what we see in capitalist society is not healthy and balanced, by any stretch of the imagination. Instead we see a toxic load of bad bacteria that result in a dysfunctional, polluting environment, a sick and convulsive macrobiome that is frequently at war with itself and therefore has a poor general survival prognosis. No surprise that such a hostile environment generates a wide array of severe clinical symptoms that are dangerous and even deadly for the individuals who experience them.

The prevailing medical model, darling of the profit-driven pharmaceutical industry, usually treats these symptoms in isolation via some form of targeted medical therapy or intervention. It may be added that the capitalist state, the darling and administrative apparatus of wealthy elites, actively promotes certain bad behaviours it likes, ie, ones that made the elite rich, while weaponising the medical model into its dark twin, the criminal model, to target extreme antisocial individual behaviours it doesn’t like, using a range of ‘interventions’ including sequestration (and in some countries, execution) to try to curb them.

Whether any of these therapies or controls actually work depends on a large number of factors, but in no case is anything done about the environment which, in all likelihood, produced this symptom or behaviour in the first place. Of course not. The ruling elites owe their position to the prevailing social ecosystem. They would be mad to consider any social model of change that threatened their power base.

A good illustration of all this is in the treatment of mental illness. Ongoing clinical research into depression has tended to raise as many questions as it solves, for instance debunking long-standing generalist assumptions about neurotransmitters like dopamine and serotonin to explain why, in studies, Prozac-like drugs only seem to work for some people and not others, yet this only succeeds in adding further layers of mystery to the picture (New Scientist, 18 January – Meanwhile a seeming epidemic in the popularity of conspiracy theories is prompting new research into paranoia, once thought to have been the sole province of people with schizophrenia-like conditions but now seen as more of a gradient affecting up to 1 in 6 people (New Scientist, 6 February –

There will certainly be some genetic factors at work, perhaps even some remote evolutionary legacies, so this type of coal-face research is always worthwhile, but only up to a point. Given that around 1 in 4 adults over 18 suffer from some diagnosable form of mental disorder in any given year (, it’s tempting to say: let’s cut the techno-crap and look at the real common denominator, which is not chemicals but your class position. Being in the working class, and thus poor, powerless and oppressed, is more likely to make you ill than any genetic or evolutionary influence.

The link between financial and mental health is so strong as to be axiomatic. 44 percent of respondents in US surveys report that money is the main stressor in their lives. 70 percent have ‘cried about money at some point’ while 56 percent have done so in the past year ( Not surprisingly, clinical psychologists say ‘money is a top cause of stress for many Americans’ ( Meanwhile the Mind UK charity ( has a helpful page of advice on money troubles that lists ways that lack of money can impact your mental health, like for example not being able to afford housing, food, water, heating or medication. To which it’s tempting to respond, Oh really, no shit?

This is not to draw some simplistic conclusion that the more money you’ve got, the happier you’ll be. A study published in Nature suggests that there is a sweet spot at around $95,000 a year (£79,000), at which point your general happiness hits a plateau, and above which new stressors enter the picture which adversely affect your life satisfaction and sense of wellbeing ( But the vast majority of those having mental health problems are unlikely to be earning anywhere near that golden plateau. Instead they experience life as a perpetual fight for survival in the face of debts, deprivation, damaged relationships, bullying bosses and institutions, and feelings of futility and personal inadequacy.

There isn’t a pill for any of that. Instead, capitalist society performs its own bowdlerised version of FMTs, by supplanting one shit government by another, one set of micro-policies by another, in the pretence that these might achieve something for a change, but very likely in the full knowledge that nothing but a wholesale system change would ever really work.
Paddy Shannon

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