I am a psychiatrist and Narrative Therapist with an interest in philosophy and history, especially poststructuralism, social constructionism and hermeneutics. My daily work is in a Family Medicine residency program, where I try to help the residents develop some knowledge and skill at understanding people's problems in the context of the many discourses that pull them toward pills, procedures, and "productivity" and away from listening so as to develop narrative empathy for peoples' predicaments. I hope to use this blog to share interesting info about these things, and to refine my ability to describe what's precious but not widely appreciated in this work.
Following Foucault, I believe that even in the most disempowered of lives, there is always lived experience that is obscured when we measure those lives against abstract, universalized norms. Narrative therapists seek to develop ways of thinking and working that bring forth stories of specific persons in specific contexts so that they can lay claim to their otherwise marginalized stories and live out the possibilities those stories reveal for their lives.
I look to historians for their power to illuminate not just the invisible lineaments of the present, but also that which is not present. What are the roads that were not taken that most shape our own time? Lately, the historian who’s been doing that best is Nelson Lichtenstein, who parlayed a career writing about midcentury capitalism and industrial unionism into extraordinarily penetrating accounts of why the economic regime we live under today is so deeply unsatisfying. One abandoned idea documented in his most recent book, “A Contest of Ideas: Capital, Politics, and Labor,” haunts me. Powerful people in the Democratic Party, like Senator Robert Wagner of New York, used to insist that the job of liberalism was to penetrate the “black box” of the corporation and turn the workplace into a more democratic institution. They believed that to leave decision-making in the great firms that dominate our lives merely to owners (as opposed to, say, the system of “co-determination” between labor and management under which the German economy now thrives) was no less than a violation of the Constitution’s 13th Amendment, which outlawed involuntary servitude. Now that such thinking is rare as a unicorn — and workers all but belong to their bosses during their working day — no wonder it’s hard to win the allegiance of the white working class to the Democrats.
The problem is that white people see racism as conscious hate, when racism is bigger than that. Racism is a complex system of social and political levers and pulleys set up generations ago to continue working on the behalf of whites at other people’s expense, whether whites know/like it or not. Racism is an insidious cultural disease. It is so insidious that it doesn’t care if you are a white person who likes black people; it’s still going to find a way to infect how you deal with people who don’t look like you. Yes, racism looks like hate, but hate is just one manifestation. Privilege is another. Access is another. Ignorance is another. Apathy is another. And so on. So while I agree with people who say no one is born racist, it remains a powerful system that we’re immediately born into. It’s like being born into air: you take it in as soon as you breathe. It’s not a cold that you can get over. There is no anti-racist certification class. It’s a set of socioeconomic traps and cultural values that are fired up every time we interact with the world. It is a thing you have to keep scooping out of the boat of your life to keep from drowning in it. I know it’s hard work, but it’s the price you pay for owning everything.
When I published No Logo a decade and a half ago, readers were shocked to learn of the abusive conditions under which their clothing and gadgets were manufactured. But we have since learned to live with it – not to condone it, exactly, but to be in a state of constant forgetfulness. Ours is an economy of ghosts, of deliberate blindness.
Grief dispels anxiety.
What gets measured gets managed — even when it’s pointless to measure and manage it, and even if it harms the purpose of the organization to do so.
It’s dubious and dangerous, Drucker is saying, to take what’s measurable for what’s important. But he’s also saying something much more radical, even subversive: Some things that can be measured shouldn’t be.
Any group of persons – prisoners, primitives, pilots, or patients – develop a life of their own that becomes meaningful, reasonable and normal once you get close to it.