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The notion that it is better to address the root causes of any problem or ailment than merely treat the symptoms may seem obvious to most of us, but it is often neglected and rarely unpackaged. It is relevant in multiple ways on multiple levels to multiple issues. And it forms a pathway toward continuing refinement of both our understandings and our actions.
In my new capacity on the Board of Directors of ClearMinds, Inc., a recently established non-profit dedicated to a more holistic, root-cause oriented approach to mental health care, this distinction is front and center. ClearMinds is the brain child of my friend Dr. Mark Foster and Amy Smith, a mental health services consumer who had testified to Congress several years ago on behalf of legislation favoring the status quo, only later to discover by accident how truly dysfunctional the status quo really is.
Amy’s experience involved an accident which prevented her from taking her medications for several days. She describes the effect as that of having woken up after a long stupor, fully alive again for the first time in many years. Mark’s experience comes from what he has seen in his practice as a family physician, and then discovered through research on his own, a discovery which paralleled that of science writer Robert Whitaker, who wrote Mad in America and Anatomy of an Epidemic, detailing how America’s reliance on antipsychotic, antidepressant, and antianxiety drugs has, far from being the miracle solution to the supposed chemical imbalances at the heart of various psychoses and neuroses, fueled an explosion in the rate and severity of mental health problems in America.
This leads to one interesting thing to note about the search for root causes: If not done honestly, it leads us astray. The conventional wisdom, echoed by many in the mental health care industry, is that we are addressing root causes with these various psychotropic drugs, when in fact we are merely addressing symptoms, and doing so in the most counterproductive of ways. The historical lauding of such drugs as “chemical lobotomies,” supposedly more humane and less intrusive than physical lobotomies, captures the truth perfectly: These drugs dull the mind and reduce the lucidity and vitality of their users.
It may be the case that for certain people, at certain times, such dulling of the mind, such a “chemical lobotomy,” is preferable to the alternative, when one’s mental health problems inflict so much damage on one’s ability to function that even being half-dead is a superior alternative. But story after story emerges of someone who describes the experience of finally getting off their meds, rarely on the advice of their doctor, as that of waking up after a long stupor, discovering a quality of life they had been told was unavailable to them, and enjoying that quality of life thereafter, treating their mental health problems in more balanced and restrained ways. This suggests that, while the judicious use of psychotropic drugs still has a role in a complete mental health care portfolio, we need to be more alert to the preference of not using them when not necessary, and striving to make them in almost all instances a mere temporary foot-in-the-door on the way to establishing a healthier and more life-affirming mental health regime.
Despite the rising awareness of the influence of genetics on personality, it increasingly appears to be the case that mental health is more deeply rooted in social context than in biological interventions after all. The citizens of those countries with strong families and communities but little access to psychotropic pharmaceuticals enjoy far better mental health than we do. While biological factors are undoubtedly in play, the environmental factors are the ones that have the greatest impact on how they affect one’s life.
There are many other areas of life in which this distinction between symptoms and root causes, and the quest for working our way ever deeper into the latter, form a critical challenge for us to meet. This is perhaps most evident in the political sphere, where those most passionate and engaged tend to be most focused on the symptoms of our political deficiencies, and least focused on root causes. Two examples illustrate my point:
The first example is that of eruptions of violence, whether in the form of ordinary violent crime, domestic terrorism, or international terrorism. The latter two are easily understood as a form of political action gone awry, with fanatical organizations or unbalanced individuals pursuing some political end through a misguided and violent means. But all of these forms of violence, I believe, are symptoms of deeper causes, and should be addressed by increased attention to those deeper causes.
After every such violent act, there is always a chorus of voices decrying the act in vengeful tones. Ironically, I consider this reaction to be as much a part of the problem as the act itself, because it forms the sea of anger and hatred from which those cresting waves of violence emerge. The anger and hatred in which so many participate, to so many various degrees and in so many various ways, is, I think, a deeper root cause of the violence than the mere malice or political agendas of the perpetrators of the violence.
There are many, of course, who dig a little deeper, and cite mental instability as a root cause, and even go a bit deeper than that and cite our failure to adequately address mental health issues as a root cause. This points to something I will talk about below: Digging deeper, and recognizing a root cause of a symptom that itself is a symptom of deeper root causes. Because, while recognizing the salience of mental health issues, and of our mental health care policies, as root causes of eruptions of violence are steps in the right direction, I think we can go deeper still, and recognize that our easy recourse to anger and hatred, often treated as harmless and normal in many contexts in which they are non-violently expressed, combined with our ideological tendency toward extreme individualism, is at the heart of both this aspect of our mental health deficiencies, and our failure to address those deficiencies with adequate public policies.
The second example from the political sphere is the distinction between electoral politics and public attitudes. Enormous amounts of energy and passion are devoted to affecting electoral outcomes, and, in the course of doing so, specific public attitudes on specific issues have come to be seen as an important battlefield on which this political struggle is waged. But we address those attitudes as means to an end, seeking the most effective marketing campaigns to affect perceptions on a very superficial and transcient level, mostly ignoring the underlying attitudes that would make people more or less inclined to favor this or that public policy or candidate.
In political debates about political outcomes, the focus is always on political strategies and tactics, but almost never on how we as a society, acting in organized ways, affect how we as a society, diffusely, fundamentally understand the world we live in. I have often said that the real political battlefield is the human mind, and that the greatest long-term investment political activists can make is to nurture an understanding of the world compatible with the policies that they favor.
This distinction between symptoms and root causes is less a dichotomy than a continuum, from the more superficial to the more profound, with the most easily identified root causes of particular symptoms being themselves symptoms of deeper root causes. Therefore, we should never be complacent that we have found the ultimate underlying answer to any question, or the ultimate treatment regime for any disease or social problem. Just as the fictional character Algono found that every solution to every puzzle was itself a part of a subtler puzzle to be solved (see The Wizards’ Eye), we are forever on a path into increasing subtlety of understanding, tracking a world far more complex than any of our models or conceptualizations.
That is why the starting point of all wisdom is the recognition of not knowing. More than any other habit of thought, more than any other virtue, this skepticism, this humility, is at the heart of our ability to grow and improve and do better. With it forever front and center in our consciousness, we can continue to dig ever deeper through the layers of symptoms and root causes, increasing both the subtlety of our understandings and the effectiveness of our practices, increasing our mental health as individuals and our social and economic and cultural and political health as a state, nation, and world. This is the real challenge, and glorious endeavor, of human existence.
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The following is a brief email exchange with a leader of a local Move On chapter to whom I offered to present PRG (“the politics of reason and goodwill”):
Q: since the GOP appears to be working on building the politics of RESENTMENT… that would be a good place to start. A think tank that would work on changing the discussion to politics of community goodwill. How would you go about doing that?
A: There are no panaceas. The Republican strategy of cultivating resentments and fears and hatreds -basically, of appealing to our basal ganglia (“the reptilian brain”)- is one that has a comparative advantage in the short run. When we invest our resources in confronting it (as we must), we have to recognize that we are fighting in their arena. But, as has been noted by John Maynard Keynes (“People will do the rational thing, but only after exploring all other alternatives”) and Martin Luther King Jr. (“The arc of the moral universe is long, but it bends toward justice”), respectively, Reason and Universal Goodwill (i.e., social justice) enjoy a comparative advantage in the long-run. One of the biggest mistakes that the Progressive Movement has made over the past few decades is to keep getting drawn into a brawl in a conservative arena, letting conservatives frame the narrative. We’ve done this because we, too, are more easily drawn to attending to the short-term urgencies than to the long-term struggle, and, as such, are constantly fighting to win “the reptilian brain” rather than to cultivate what human history has always struggled to cultivate: Human Consciousness. Traditional politics and political activism will continue much as they have, with the conservative ability to appeal to our baser natures always vexing us in the short run, and progressives trapped on a treadmill perpetually fighting against it, rather than engaged in the long-term effort to cultivate Reason and Goodwill. Other institutions, meanwhile, are more focused on those long-term evolutions: Academe, certain religious-philosophical orders and institutions (such as Esalon Institute in Big Sur, California), and so on. But the products of these other institutions are very esoteric, and do not diffuse into the population at large in any highly robust way. So the question is: How do we make a long-term investment in cultivating those human qualities in the population at large, that are not cultivated to any great extent by those esoteric institutions that are focused on them, and are mostly ignored by political activism? In one sense, it’s not a “political” question, because it isn’t at all about winning the immediate struggles over current policy issues and current electoral contests. In a deeper sense, of course, it is quintessentially “political,” since politics is really, at root, about the battle over what people believe (this is somewhat true even in brutal dictatorships, but more true the more democratic a society is). Even the much vaunted corporate power we talk about so much is the power to spend enormous amounts of money on media messages which affect what people believe. When we ask “how can we most effectively affect what people believe in the short run?” the answer, to too great an extent, is “appeal to their fears and hatreds and resentments.” When we ask “how can we most effectively affect what people believe in the long run?” the answer is increasingly “appeal to their dreams and aspirations and imaginations.” But how do you cultivate in people lost, to varying degrees, to their resentments and fears and hatreds, their forgotten or buried human consciousness, full of aspirations and yearning idealism? The answer is, basically, create viable channels of communication, effective messages, and reinforcing behaviors in which you can engage them. That’s what my proposal is designed to do.
The underlying idea is this: Most Americans presumably self-identify (accurately or inaccurately) as reasonable people of goodwill. Those who don’t are beyond reach, and can only be marginalized rather than “brought on board.” Many conservatives and moderates place a high value on “community” and “family,” and believe in social solidarity at that level, even if constrained within their own narrow definitions. Media Messages (both traditional and social) with markers that indicate that they are “progressive” or “liberal” or “Democratic” messages hit cognitive confirmation-bias filters and never reach the mind of any but those who are already on board. Reframing those messages, divorced from reference to particular policies or candidates, in non-partisan language, creates a pathway to reaching into at least some of the minds that would otherwise be inaccessible. There are three components to my idea for doing it: 1) a network of non-partisan community organizations committed to doing good works in the community, and creating a forum for civil discourse dedicated to examining issues from all points of view and with as much mutual respect as participants can muster (with guidelines agreed to up-front to reinforce this commitment); 2) something I call “meta-messaging,” which is a project to gather, design, publish, and disseminate narratives which reinforce people’s commitment to social responsibility and compassion (think of “A Christmas Carol,” which is both an example of, and a metaphor for, such “meta-messaging”); and 3) creating a user-friendly internet portal to all arguments, from across the ideological spectrum, that are actually arguments (even if bad ones), rather than just slogans and platitudes and emotional appeals. This third component lends legitimacy to the claim to be a movement committed to “reason” as well as to “goodwill,” and might, to some small degree, over time, increase the role of reasoned argumentation and analysis in the formation of popular political opinions. These three components are mutually reinforcing in a variety of ways. Doing good works in the community reinforces recognition of belonging to a society, of interdependence. The community forums to discuss political issues can encourage drawing on the information made available through the internet portal. The community organizations’ avowed purpose of strengthening our communities provides a conduit for the narratives (the “meta-messages”) reinforcing a sense of social responsibility. It is a movement designed to cultivate what is best in us, to improve how we arrive at our political positions both as individuals and as a society, and to produce a marginal, slight, constant impetus in favor of Reason and Goodwill. Since democratic politics, when all is said and done, is really a battle over what people believe, a long-term strategy which can exert a long-term pressure on what people believe, or the underlying attitude informing their beliefs, can have a bigger pay-off than all of the other more immediate types of political activism than we are typically engaged in. Since virtually all of our political organizational resources currently go toward the latter (the immediate political struggles), and virtually none to the former (the effort to affect underlying attitudes which inform policy positions), it seems to me to be obvious than we need to create a movement that redresses that by investing some small, perhaps even tiny, portion of our resources at affecting underlying attitudes. While it may seem naive to think that anything like this can work, I think it’s almost inconceivable that it wouldn’t, if any significant effort were made, though it wouldn’t yield any dramatic or easily measurable results in the short run (that’s not what it’s designed to do, or can do). The zeitgeist changes, and varies from society to society, mostly according to the cumulative winds of social change. Almost all efforts to affect those winds are focused on the short-term, and do so to the extent that those short-term efforts are successful. But we generally lack the farsightedness to invest in the long-term evolution itself, where we can have the most dramatic effects, and will encounter the least resistence (both from individual cognitive barriers, and organized political movements). When we figure this out, and begin to divert a very tiny stream of resources toward it, we will at last be working toward putting ourselves on a sustainable progressive path into the future.
Q: Specifically where would you start?
A: Do you mean, where would I start with the project I’ve laid out? With the first nodes in a network of non-partisan community organizations dedicated to this vision. That requires virtually no funding, just a sufficient degree of interest. As funding allows, the next step would probably involve developing the meta-messaging paradigm. I have a pretty straightforward human research experiment I’d like to operationalize for testing its efficacy, for those who prefer research-based practices rather than speculative ones. The most labor intensive component is probably the internet portal, which I envision as something similar to the human genome project: A huge cataloguing of information. I know that this is a different kind of idea. It’s not focused on a single issue (in fact, depends on not focusing on specific issues, or, in the context of organizing this movement, taking organizational stands on specific issues), will not yield returns within election cycles, is not inherently combative, does not identify the “good guys” and the “bad guys,” is committed to what I infer to be our underlying values as progressives (and what most certainly are my underlying values) rather than to the political ideology that has (imperfectly) grown out of those values, and aspires to initiate a gradual and sustained movement of the whole political tug-o-war in the direction of Reason and Goodwill rather than just to win a few rounds of that tug-o-war where it is currently located. There’s little doubt in my mind that we’re going to have to start to think more along these lines, and commit more resources to something similar to this, if we are serious in our commitment to get this country onto a better path. What we’re doing now plays right into the hands of those who want to define progressives as mere equal and opposite counterparts of conservatives, pick your flavor, it’s just a matter of taste. That’s because we treat our political struggles as a bunch of issues, on which their is an ideological difference of opinion, rather than as a tension between reason in service to humanity on the one hand, and irrational belligerence on the other, with progressives tending to be more aligned with the former and conservatives more aligned with the latter, but not always, and not in all ways. It is not only an idea about how to improve the efficacy of the progressive movement in the long run, but also about how to improve the quality of the progressive movement in the long run, by focusing more on advocacy of those procedures and methodologies which favor reason and goodwill, and less on the substantive positions that imperfectly track what conclusions those procedures would lead to. Right or wrong, agree or disagree, it’s a dialogue we desperately need to be having.
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