Building a Future in the Postcapitalism Era

What do you think will characterize our future?

It Didn’t Work Out As Hoped

Not long ago we had the Arab Spring and the hope that there would be a graceful resolution for a troubled Middle East. There were other hopes and the world and America seemed to have drawn back from an abyss following the Great Recession.

Yes, the United States has made a good recovery but we seem to have unsettled footing which very much includes a rather surprising and frightening race for the presidency. There are multiple signs suggesting our country and the world is entering a very unstable period.

Present Reality Addressing the Future

And then I picked up a book called Postcapitalism – A Guide to Our Future by Paul Mason. It is dense and fraught with discussions of failed economic theories and conflicts. It was so difficult I had to read it twice but I couldn’t put it away. He suggests that we are at the end of a long economic wave and that capitalism is collapsing. The book can be dismissed as both overly pessimistic and utopian all at the same time. I found it to be neither because in so many instances I could see what he was warning about was already occurring whether it is what happened to Greece, Brexit, a failing Italian banking system, American college debt, a stagnant American Middle Class etc.

Data at our Fingertips

He points out a series of endeavors and policies which could help us head off catastrophe in climate change, demographic devastation in elderly populations and the need for extensive financial system reforms. One thing he points out that is markedly different in this environment is the information revolution. Among other things there is an extraordinary pool of data out there. It could be employed to shape our future and to create new systems both economic and social. Part of the process is no cost systems such as Wikipedia. He points to such endeavors where costs are going to zero.

Fifty Years Too Soon

And then I was struck by something. I wrote a book entitled Whatever Happened to Community Mental Health.  In the 1960s a public health model was applied to mental health services. It was supposed to bring affordable and effective services to all the people of our country. It failed. I wrote the book about my experiences in the movement because I thought our experiences were worth being in the record.

It occurred to me that in some ways the movement had been created fifty years too soon. At the time it failed because of lack of vision on the part of senior mental health professionals, a focus on status, interest only in grant money, failure to look beyond existing systems. In fact, if the young professionals had been in an era of information technology we could have documented the essence of an impoverished community, the flaws which caused such pain and suffering, the essential points of intervention and the planning needed to build ameliorative services. In fact, the nature of the communities was the major problem and we worked on economic and social issues rather than mental pathology. It all could have been documented, organized and systems designed. But narrow and selfish perceptions caused it to fail.

Breathtaking Potential

Mason’s Postcapitalism points the way to a promising kind of process and I could feel how what our young staff did in the 1960s could be used in the here and now in cost effective and productive ways to build diverse and social movements within such a community, through peer systems and economic system focus. Of course it would involve designing markedly more efficient physical health care systems as well. It was all there in the minds of young professionals but the time was wrong. This revelation alone told me that we have a huge opportunity as capitalism reaches its final wave. Will we have the wisdom or will we be inundated by climate failure, demographic chaos, economic mismanagement, Political naivete,   and social failure? We will see.

What systems for the future would you design?

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt

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Our New Age Blossoming – 2

 

 

Looking Back

It is now over 50 years later than when I went to work in Baltimore. For me time offers not perspective as much as confirmation. The only perspective I find is that I can now clearly see the roots of my deep mistrust of the truth and wisdom of older white men. In fairness there is diversity among them but in our present age the fact of their rule is distressing in so many regards.

Designing a Delivery System

The community mental health movement came with a multi-part design. I was stationed in an outpatient facility which meant I was to consult with the community and deliver services. That seems simple enough. Go out and get acquainted so you get referrals and then give therapy with the psychiatrists giving medication as necessary. What fools we mortals be!

What we found immediately was that we had a lot of learning to do. The community was challenging to put it mildly. They were in serious need and mental health services were not at the top of their list.

The Existing System

There already was a mental health system in place. At the hospital nearby people could come for service. Since it was a medical school there were medical students who often were giving service in six week rotations—with little prior experience. Then there were residents. I’ll save you the agony of all the details but they were not acquainted with the needs of the community either and so could not respond effectively.

At the time psychiatric residents were committed to giving intensive psychotherapy. The local residents were not exactly candidates so they often simply got medication. We immediately found a fundamental truth. The biggest enemy of mental health in the area was the stress of poverty. So they suffered from depression and anxiety. Duh!!!

The System We Designed

Each of us took a morning walk-in clinic. We assessed the person’s problems and then spent the afternoon on the phone arranging appropriate services and getting information about availability among a lot of other things. For example, if they had a physically ill child who was not getting service or inappropriate service we sought appropriate help. Every center had a Vocational Rehabilitation Counselor who got a lot of referrals. Very many of these people needed training and/or education. A job or a better job had a very beneficial effect on their mental health along with the experience of hope.

Not So Simple

Did we have the support of higher ups? Sometimes, but often not. The older white men generally wanted to preserve the existing system and were primarily interested in the aura of getting the money for a grant to a new glamorous type of program. They loved the aura and wanted to look good to each other. Daily we were in the position of fending off orientations and demands which did not serve our community well. One of my common responses was “We’ll get back to you” or ”Let me look at alternatives.”

Allies With the Community

We  had to develop relationships with the community so we could respond to their real needs. In that era of the beginning of the civil right movement the community became contentious and interesting. Assertions of community needs and objections to the mistreatment of black men began at that time. There were issues about health services. At one point growing activism led to a difficult public hearing and I found myself sitting next to the state head of the mental health system who was clueless. Other times we were visited by arrogant “consultants” from Washington who we had to endure. 

I’ll leave it there for now. It was rough and tumble and never-ending as we fought for the people of the community. You might think we would have had allies from the professions but they were too often few and far between.

Another Major Wave of Change

In some ways we didn’t understand what we were seeing either. In the end the establishment brought down the community mental health movement. As the young rebels left, the clinics in the community were closed and the old ways resumed. I tell the full story in my book Whatever Happened to Community Mental Health.

But two things came out of the era that proved to have a long wave and import for our future. One was the civil rights movement and in the next post I’ll go into the other one. 

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt

Our New Age Blossoming – 1

 

 

Gaining Perspective

We may miss a moment deserving of wonder. I’m convinced we are entering such a moment. But let me hold it as a mystery for now. And I’ll begin with a hint and some personal history.

Up front I need to make it clear who I am. Often we don’t know how who we are may be meaningful. For me it has a lot to do with history and what is unfolding. I am a 78 year old white man and my perceptions and reservations about white men go back a long way.

The word “perception” references a view, not worship, because I learned deep reservations early in my adult life.

Innocence Challenged

In the early 1960s I went to Duke University to work on a doctorate in clinical psychology. In high school I became deeply interested in nuclear physics but a college instructor destroyed my interest. I then chose psychology because of my mother’s suffering. She could be joyful and full of song but over time fell deeper and deeper into terrible depressions and when she was depressed she was often covered with weeping eczema. I wanted to know why. 

Psychology gave me the opportunity to seek answers and fit with my personality where the search for possibilities was central. In the end that led me to clinical psychology rather than experimental psychology.

Time to Leave Academia

Toward the end of my time at Duke the community mental health movement was starting and at graduation I took a job as one of the first psychologists hired in one of the first programs in the country. The job was in the inner city of Baltimore. I was a neophyte and an innocent. We thought we were to give mental health services.

On my first day I met a young black woman social worker who became my mentor and main ally in an unexpected battle to come. Community mental health was charged to make mental health services more widely available to all Americans. In fact no one knew the nature of services impoverished inner-city residents needed. 

The Core Experience

Now I’ll tell the secret. Well, one of them. The staff was a racially diverse staff which included young and assertive women. At the time the Women’s Liberation Movement was just beginning. The experience became a battle royal regarding the coming of women and the delivery of services which I spell out in my book Whatever Happened to Community Mental Health. Our chief opponents in this battle were the people in charge of the program and its development. The core opposition was older white men. Whatever perspective I was carrying that might have guided my life as a white man was torn to shreds. And today we see the continuing battle with them, their often distorted perspectives and corruption as we approach a new day for our country.

In future posts I deal with these issues in more detail but will also open other themes related to the wonders that might come for America if we were to seize the moment and the opportunity.

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt

Health Care Alternatives and Reality – Series – Pt. 5

 

The Myth of Mental Illness

The above is the title of an important book by Thomas Szasz. Mental illness still dominates a significant portion of our health care system and it still has major conceptual problems. Of course, as a clinical psychologist, I was schooled in it. I actually came to love Carl Jung’s work a lot more than Sigmund Freud’s but his work still dominates.

Alternative Realities

And so we again return to where we live on the cusp. Over the decades I found nonphysical problems related to mental and cognitive issues to be far removed from “illness” and often nuanced. And when we move away from the dominant model, we find suitable alternatives. Unfortunately the insurance industry dominates the field and therefore may dictate treatment or at least what it is called. What it is called will often influence what is done. Substantial reform is needed.

Some of the Issues

When my wife and I personally confronted issues for remarried families (aka stepfamilies) we learned important lessons. An important initial lesson was that the process is a matter of adjustment, not psychopathology. Certainly there were some people with substantial disturbance from other causes but we learned to begin with our model of adjustment. The  couple was focused on initially. Too often the mother or stepmother was put in therapy as if they were the problem although they may have shown the greatest distress initially. And we were resistant to putting children in therapy because adjusting to a new family was not pathological in almost all cases. Because of our approach we could structure an information system and found that generally the family could take over adjustment and handle their own future after very few sessions. See our book Stepfamilies: Professionals and Stepcouples in Partnership by Mala S. Burt, M.S.W. and Roger B. Burt, Ph.D.

Another major issue is what is termed post traumatic distress disorder or PTSD. The military is wrestling with removing the word disorder because it proves to be a bar to veterans getting help with their adjustment. Does anyone really believe that someone should go to war and kill people daily or risk being killed daily while suffering stress and not need to cope with management and an enduring reaction. I shared my perception with some friends who were veterans and found them in tears when I suggested they were not “sick” although there were still issues decades after their war experience. 

Enduring and Broad Issues

Those are just two examples of the reality of a world far more nuanced than what is described as mental illness. We can go on between things like personality diversity, numerous personal management needs as we pass through stages of our life. When I first came into the field the predominant viewpoint was that our development was finished in early adulthood. Absurd.

Management of life experience continues throughout life and it would be best if we approached our lives in that fashion. Take an area of life experience and we see that there is change, stress and adaptation. It would help if we defined a type of insurance that was appropriate and took these issues out of the hands of insurance companies focused exclusively on profit.

Life on the Cusp

Yes, here is that cusp again. Each of us is different with a raft of different experiences. We work for stability and commonality and often success. But it would help if we understood the richness of our diversity in the sense that much of the issues are not pathological and that our views from the cusp feed creativity, diversity and innovation. And life can be difficult, even jarring. From time to time we need to seek expertise and guidance but we generally do not need to cast it all into psychopathology. There are problems out there with profound biological origins where the person needs substantive help but very often management and guidance are what is needed.

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt

A Time of National Reformation

Understanding the Need for Change

 

Do you believe we are facing major change or just major disorder?

It has not yet been described as such, but it would seem we are on the verge of a national reformation. We appear to be suffering conflicts with no solutions immediately on the horizon. It is often dismissed as political but we have to suspect we are dealing with more fundamental issues.

The reaction to recent mass shootings is just one indicator of a national crisis. We are looking at demographic change looming large even as a major party seems to be in the process of collapsing. Now is a time for us to do a multilevel reevaluation on many fronts.

Public Safety and Guns

At the forefront is the issue of needed changes regarding our rules about guns. That means what type of guns should be permissible for possession outside of the military and what rules there need to be related to possession in general.

With all the discussion I have not once heard a meaningful discussion regarding the second amendment. The amendment was about the maintenance of a militia in a newborn country that did not have a standing functional army. Somehow it has become transformed into something else entirely.

In broad strokes we need to address matters of public safety as they relate to gun possession and related restrictions. That means we will also have to address ideological issues as they relate to the wellbeing and the future of our country.

Personal Dysfunction in a Society

But for me as a psychologist, I see another set of issues related to what we call mental health. It is brought up regarding guns and has sets of problems of their own. As noted, we originally applied the disease model as a way to remove issues of personal functioning from the belief in demonic possession. Our emotional and cognitive functionality did not belong in the religious arena but using the medical model has serious problems in its own right.

Many of the shooters in recent massacres were victimized by family history, distorted religious zealotry and probably sexual identity confusion among many other issues. But the question of how we address public safety leads us into a complex arena. And in that regard the disease model offers little clarify. It is supposed to instruct us about the nature of the problem, what procedures to use to deal with it and what medication is indicated if any. In fact, we must separate “mental illness” from the issue of gun management. They are related but there are many other issues involved.

Designing a Helping System

Our health care system is often dysfunctional, especially when corporate profit guides response.  The physical health system and the mental health systems need serious attention and redevelopment.

In the larger picture we need to go back to fundamentals and design the model of how to relate to what are currently called mental health issues. They may be biochemical, stress related, developmental, chemically induced and so forth. Then we need to deal with how to respond and what help to offer. A long overlooked reassessment would take considerable time and even then will prove difficult when it comes to public safety. The issue will always be how to make functional help available and how systems can be designed to serve the sufferer and the public.

Reexamining Fundamentals

It would seem, at this time of what I believe will be national reformation, we should be reexamining fundamentals on many fronts. And my special interest is in reforming and completely revising the use of the outdated model of mental illness. How to respond to dysfunction and distress in human life is complex and that includes our response to drug addiction and abuse. Prevention is related to availability and utilization of services. When we tell people they are “sick” it may turn them away from the guidance and help they need. We attached the D to PTSD and turned it into a disorder when it is, in fact ,a predictable stress reaction among other things. It goes beyond a reaction to the experience of war and now we can see effects on our school children because of the recent shootings. The D proves to be a barrier to help and understanding. We can throw money at these issues but it would seem best to begin by reevaluating our approaches. 

How many of these issues have you experienced personally?

Gaia’s Majesty-Mission Called: Women in Power by Roger B. Burt

Roger B. Burt’s Amazon home page

Creating Characters and Plots by Roger B. Burt

Stepfamilies: Professionals and Stepcouples in Partnership

Whatever Happened to Community Mental Health by Roger B. Burt