Social Biases and the Follies of Science

By EW Wilder

Sometimes, science is simply looking in the wrong place.

If we accept the notion that scientific inquiry itself is a social phenomenon, then it becomes easy to see why certain things are studied while others are not. The male gender bias in studies of heart disease are legendary, so I won't go deeply into them here, but they should have been cautionary: any time research money flows, the question that should be asked is “What cultural biases are inherent to the request?”

In mental health, one of those biases is in favor of a strictly biological model; that is, if your woes are experiential, they are necessarily a problem with your brain.

If you reel at what seems to be such a broad-sweeping generalization on my part, witness a recent report on NPR on some current efforts to use biomarkers to determine if a person is mentally ill. (Listen to this one, as the written synopsis does not give the full report.) The part about PTSD is the most illustrative, with researchers pouring millions into brain scans and computer programs that are supposed to “detect” PTSD. That the military is a large part of this research isn't surprising, but it should be: the people they're studying were in combat after all.

Which goes back to my point: if you have a combat veteran who is complaining about being unable to sleep, feeling constantly sad, being unable to concentrate, and flying into sudden rages, you could spend millions trying to figure out what was wrong. Or you could just ask him.

Our culture somehow discounts the idea that somebody's story of trauma and that the disruption to their lives that this can lead to are “real” (even though we frequently see the effects directly) unless and until there is some “objective” measure: a biomarker, a study, a brain scan.

There are two phenomena at work, and they represent the major streams of American life. One is the rationalist tradition that hies from the Age of Reason. This movement, in many ways, created our nation; the so-called “Founding Fathers” were rationalists, many of them deists, and even such notions as the idea that free people ought to be governed by bodies in which occurred reasoned debate (instead of by the caprices of a king) is a testament to this fact.

Rationalism is great; it has brought us the computers you're reading this on. It brought us modern sanitation and antibiotics and refrigeration. It made sense out of a seeable universe that just seemed to be jacking with us heretofore. But it also has a bad habit of blinding us to the more obvious cultural constants that create our lives: maybe the people who “have PTSD” have simply learned to adapt to an impossibly violent and stressful environment, and maybe those adaptations are ill-matched to a life of cheeseburgers and traffic lights. Maybe those who are labeled “bipolar” have lost their sense of balance because they have had to adapt to unbalanced lives. Maybe depressed people have damn good reasons to be very, very sad.

But the fact that these adaptations have profound effects on the lives of those who experience them and that those effects impact the abilities of people to meet the expectations of our society mean that they have a moral component, not just a medical one. This is where the other major stream of American life comes into play: Puritanism.

No matter what our official religious affiliation may be, even if we have none, American culture still is Puritan in the sense that it associates productivity with value; if you don't work, you're still stigmatized, particularly if your ailment isn't readily visible. That many employers view being unemployed as, itself, a strike against a job applicant shows how deep this cultural assumption is. Further, your engagement with work must always be a happy one: management books are all about how to reinforce upon the workforce how wonderful it is to be at work, even if your entire life seems to be crumbling around you. The reason managers insist that their employees all read Who Moved My Cheese? and The 7 Habits of Highly Effective People is that they believe that employees have an obligation, as an expectation of their employment, to always adapt and always produce. There is no room for (and considerable opprobrium in) merely being human.

This also helps explain why, despite the protestations of psychiatrists, including a prominent one in the NPR report, the disease model of mental illness actually increases stigma, rather than reducing it. If your problems have to do with your life, that's something you can change, but if your problems have to do with your brain, you are, for the moral purposes of a nation that associates productivity with being a good person, damaged goods.

My main problem with the search for biomarkers when it comes to those who go through extreme psychological states is not that it's a waste of money and time. If they are doing basic research, it's well worth doing. The brain's job is to adapt to and learn from the environment, and I'm sure they could find all sorts of interesting things about how the brain does that.

My problem is that they will miss the problems that underly the causes of the brain's adaptations to these states: a culture that does not merely countenance, but often reinforces psychological damage, that fails to address the social inequities and poor policies--both foreign and domestic--that perpetuate violence and despair, and that prevents healing by blaming the suffering and keeping in place schools, social spaces, and workplaces that are essentially inhumane.

We would rather spend millions over and over again to keep parsing out the biological details than spend the billions once to solve what we already know in our hearts, but will not admit in our heads, ails us.

The Opposite of What You Know

EW Wilder

The more we see of the world, the more obvious it becomes: power protects itself.

This is evident from the smallest of power differentials—those between teacher and student, doctor and patient, worker and direct supervisor—all the way up to national and international power relationships. Because of this, it becomes the role of those in positions of power to protect that power first and foremost: the actual services or activities institutions with managerial power structures ostensibly exist to support are secondary at best; often they are almost an afterthought.

Supervisory roles, with their performance reviews and managerial expectations, are designed not to serve those directly performing the work nor to help the processes of production, service provision, or exchange. Rather, they exist to hold the worker “accountable” not to the ostensible effort of the organization, but to the managerial structure itself. This shifts responsibility from becoming concentrated up the supervisory train, as remuneration and role would suggest it should do, but away from it and onto the least compensated, least powerful members of the organization.

The protestations of those at the top that they deserve extra pay because they take extra risks and have greater responsibilities simply aren't true: those at the top are more able to manage their own time, more likely to have close relationships with those who supervise them (typically a board of directors for publicly run companies and non-profits), and have the clout to negotiate huge salaries and severance packages. This helps create conditions for them to be irresponsible with impunity, which would be impossible for low-level employees who are subject to many levels of supervision, demeaning if not infantilizing policies and procedures, and performance reviews designed to blame them when anything goes wrong.

Note, also, that the supposedly “free” market backs up existing power structures as well, demanding layoffs first when a company loses money, not that the CEO be fired. This is the opposite of what would be demanded of a college sports team, for example, or even a politician.

Managerial structures that reinforce power at the top create relationships with workers based on the negative: they kick into gear when the worker does wrong; they are punitive of her errors, not supportive of her efforts. Control over her own work, much less initiative and innovation, are a threat to power and therefore must be punished, no matter how useful they may be. And so a worker's role is strictly defined by procedure and policy. Further, the supporting structures that do exist are taken out of the control of the restive worker and insourced to separate “administrative” or “operations” departments, departments subject to punitive power structures of their own.

This concentrates the power of those at the top even more, pitting departments against each other for control over the resources necessary to get the work done and making the worker constantly under threat from that competition: if a department that is also competing for the company's resources keeps those resources from a worker, she will still be blamed for not getting the job done and subsequently punished. The power structure wins by a divide and conquer strategy. Departments, also, have no other recourse than to rely on the managerial power structure to work out the inevitable (and designed-in) problems between each other, reinforcing its power yet again and preventing worker collectivization.

If we see existing managerial power structures for what they really are, ways to protect those in charge and not ways to get work done, we may begin to address problems not only of inequality but also of inefficiency. But because we believe so deeply in these structures and replicate them everywhere from schools to the executive branch of government, change is unlikely to happen. And it's unlikely that those in power would let it happen: already we see the incredible influence of those industrialists and executives who would seek to impose this structure on our representative bodies themselves by electing “free market” politicians, whose stated goals are to bring these principles to the public sphere. Again, the rhetoric is the opposite of the intention, as we have seen how these politicians act when they get into office: in Kansas, and Texas, Wisconsin and Ohio, they have acted like petty dictators, bullying and dominating wherever they can, ignoring both constitutionality and the financial stability, much less best interests of, the states they serve.

The goal of these people is to usurp what little democracy our republic allows and decimate our last, best hope at retaining the popular rule we have so willingly given up in the workplaces that, if we are lucky enough to be employed, already dominate our lives.