Quite a while ago, just before the upheavals of the ’60s-shifts that have not ceased, but have been forced in less direct, less public directions — Marcuse in his One-Dimensional Man, described a populace characterized by flattened personality, satisfied and content. With the pervasive anguish of today, who could be so described? Therein lies a deep, if inchoate critique.

Much theorizing has announced the erosion of individuality’s last remnants; but if this were so, if society now consists of the thoroughly homogenized and domesticated, how can there remain the enduring tension which must account for such levels of pain and loss? More and more people I have known have cracked up. It’s going on to a staggering degree, in a context of generalized, severe emotional disease-ease.

Marx predicted, erroneously, that a deepening material immiseration would lead to revolt and to capital’s downfall. Might it not be that an increasing psychic suffering is itself leading to the reopening of revolt — indeed, that this may even be the last hope of resistance?

And yet it is obvious that “mere” suffering is no guarantee of anything. “Desire does not ‘want’ revolution, it is revolutionary in its own right,” as Deleuze and Guattari pointed out, while further on in Anti-Oedipus, remembering fascism, noting that people have desired against their own interests, and that tolerance of humiliation and enslavement remains widespread.

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The mental health system, despite all its complexity, can be described as a drainage hole for human suffering. Mostly, the pain that flows into it seeps into the groundwater, but occasionally it will reverse course and erupt into “normal” life as if from a geyser.

Reducing a wide collection of psycho-social phenomena into one generic mold of “human suffering” without committing a grave injustice to the diversity of voices within the “patient” community, voices that yearn to be differentiated and heard, is extremely difficult. Nevertheless, my experience has shown that a certain pattern or structure does underlie most interactions in the mental health system — often, the pain encountered in its bounds combines a type of Hurt, the conviction that something wrong and unjust has happened to me, with some kind of Silence, indicated by a paucity of language in the interpersonal space and in some cases, the actual inability to put one’s experience into words. These two features — Hurt and Silence — usually merge and become inseparable. Thus, in the interaction with the “consumer,” the mental health “professional” can either reinforce the foundation of Hurt and sentence the “consumer” to continued silence or, alternatively, work toward the disentangling of these two elements.

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