Government of national madness
Without democracy there is no mental health
Eran Rolnik, MD, PhD.
The mental health professionals in Israel are known for their selective approach to
political and social stressors. It’s easier for them to cry out when Israeli children are
compelled to shelter in secure rooms than to express an ethical and professional position
about the incomprehensible cruelty of the Jewish state toward Palestinian children and
the children of asylum seekers, or about the long-term implications of the occupation on
the psyche of Palestinians and Jews alike.
This time the therapists are identifying the danger in time and are not willing to shut their
eyes to the hand that is being raised against the heart of Israeli democracy. Under the
slogan “There is no mental health without democracy,” thousands of therapists have
joined the revolt against the regime coup that is being fomented by Benjamin
Netanyahu’s ultra-right wing government. Critical voices about this mobilization are also
being heard, and some are already demanding the return of the old order in the name of
“therapeutic neutrality,” which is ostensibly meant to protect patients from exposure to
therapists’ personal political views.
Justice, liberty, human dignity, separation of branches, freedom of expression and
minority rights are basic values of substantive democracy. The affinity between these
concepts and “mental health” – an elusive and controversial concept in itself – is not self-
evident. Important rulings by the courts on issues such as sexual exploitation of patients
by therapists, the degree of therapeutic confidentiality in mental-health treatment, or even
High Court of Justice rulings that intervene in governmental decisions that infringed on
the rights of psychiatric patients, do not necessarily reflect how dependent mental health
is on a functioning liberal democracy.
Although scientific studies indicate a direct connection between psychiatric illness and
human rights violations, they too do not offer an adequate reply to the question: Can
mental therapy that is worthy of the name exist in every place and in every period? Can
therapists in the realm of mental care work freely as long as Freud’s writings aren’t being burned in the town square or dissidents are not being confined in closed psychiatric
wards?
In Nazi Germany the law defining “treason” was extended even before the persecution of
the Jews became official policy. The revised law stipulated that reading a communist
journal was also an act of treason. The result was that therapists stopped keeping a record
of their sessions. The psychoanalyst Edith Jacobson was suspected of collaboration with
a communist group and arrested by the Gestapo, once a search of her clinic turned up an
invitation to a lecture of the Berlin Psychoanalytic Society that was signed “Regards” and
not “Hitlerite regards” as the law stipulated. In other words, the corrupting influence of
the totalitarian state on medical practice and ethics begins at earlier stages than might be
thought and arrives from unexpected directions.
Accordingly, the therapists’ struggle for democracy must not be confined to formal
aspects of therapeutic practice and ethics, such as maintaining patients’ freedom of
expression and protecting their privacy. It’s more important to position the struggle in the
broad context of the reciprocal relations between political and social structures – such as
an independent court, a free press, functioning institutions of government, workers
committees and diverse civil organizations – and the inner world and mental health of the
citizenry. The politics of the mind and the politics of society are interconnected. Proper
mental treatment needs more than two people who are ready to tell each other whatever
comes into their head.
About 120 years ago, Freud explained to everyone who was willing to hear him out why
the denial by society and by his medical colleagues of the central place of sexuality in
human life is harmful to mental health as well as to the right of women and children to a
good life. It is our duty today to remind everyone who is ready to listen that no one is
immune to the insanity and the death impulses of the insane state official Israel has
become. Even those who possess full civil rights, own an apartment and hold a tenured
job, even those who enjoy good mental health, or light Sabbath candles – everyone for
whom Israel is part of their interiority – can expect to feel far less normal in the Israel of
the Netanyahu-Ben Gvir government than they felt until now. Entire libraries attest to the
fact that even emigration from a homeland that has lost its sanity does not make parting
with it easier.
A bit more history. Already at the turn of the nineteenth century, Jewish psychiatrists
pointed out the connection between the wretched living conditions and shaky civil status
of their Jewish patients and the physical and mental ailments from which they suffered.
Some drew a connection between the psychological distinctness of East European Jews
and their harsh living conditions, others attributed the high rate of depression and suicide
among Jews in the West to their efforts to integrate into the Christian society, which
forced them to forgo their singular identity. What both sets of explanations had in
common was a broad sociological, political and cultural point of view, which sought to
account for “the Jews’ psychic illnesses” outside the genetic, biological and racial pool of
causes that mental health practitioners commonly drew on at the turn of the nineteenth
century.
With the aid of physicians and psychiatrists, Zionism realized its self-perception as a
national movement possessing a spiritual-therapeutic mission. This “therapeutic”
perception of the Zionist revolution was shared by intellectuals on the right and on the
left and even by several of Freud’s followers, though he himself tended to see Zionism
more as a type of illusion than as a sustainable solution for the problem of the Jewish
people.
The murderous totalitarian regimes that shaped the face of the twentieth century and the
fate of the Jews, were the primary incentive for the investigation of the reciprocal
relations between the individual’s anxieties and passions, and the insanity of the modern
group and state abetted by an unrestrained leadership and rampant capitalism. A plethora
of archaic unconscious phantasies drive individuals to submit to autocratic leadership.
One of the connecting points between the private mental space and the public political
space is the attitude toward truth, ambivalence and knowledge. Unlike a formal
democracy, a liberal democracy also embodies universal values which can be termed
“therapeutic.”
Good mental treatment releases psychic forces, love and creativity by developing the
sense of truth, justice and the patient’s responsibility about what occurs within him. The
political realm has a large influence on people’s readiness and ability, as individuals and
as a society, to seek the good, the right and the beautiful; to contain the pain and the
anxiety that this search entails, and to bear the consequences of recognizing the truth.Meaningful mental treatment is aimed at self-recognition and not at allaying anxiety. It
lies on the same plane as the democratic project, because the ability to think and to feel,
and the connection between thought and feeling and between rationality and passion, are
highly fragile mental achievements, which humanity arrived at with much toil.
We cannot be indifferent to the political world, because in order to grow and develop as
human beings we need not only good parents, an education system, effective social
welfare and health, but also a beneficent political environment which will not undermine
our efforts to constitute ourselves as subjects who strive for the truth and try to live
according to its lights, even when this does not serve our immediate desires and interests.
Politics is also what will make it possible for us – or act as a barrier – to accept the
simultaneous existence of multiple truths and viewpoints in society without recourse to
physical violence and mass psychosis.
Liberal democracy spurs the readiness of individuals and groups to integrate more than
one point of view into their mental and interpersonal world. It is conducive to processes
of inclusion, mourning and reparation that are required for mental growth. Dynamic
therapists who take an interest in the dreams of their patients can already now see how
their inner world is deciphering the government’s assault on the courts as a perverted
attack on the individual mental space.
People are not born as democrats. The inner world is an arena of clashes between needs,
wishes, frustrations, anxieties and conflicting impulses. The human mind often resorts to
fairly authoritarian ways in warding off its internal conflicts and anxieties. Along with the
desire for independence and separateness, people also have a tendency to sell their soul,
to merge and to coalesce with whatever will allay their anxieties. Together with the
curiosity and the desire to know about the world, in situations of pain, anxiety and
uncertainty we develop fear of the new and the foreign, and a readiness to hate, to
exclude and to disavow whole segments of inner and outer reality. An autocratic and
narcissistic leadership, of the sort that is becoming ever more frequent in politics, is adept
at heightening the inherent tendency of people to see the world in black-and-white. A
suspicious and ostracizing political climate, of the sort that populist leaders specialize in
creating, intensifies the fear not only of the other and the different, but also of the
encounter with our own psychical reality. The result is a type of dullness of the senses, narrow-mindedness and indifference that is vividly remembered by everyone who has
ever lived in a dictatorship.
A populist leadership and press use the truth in order to lie. They will see to showering
the public with half-truths that have been wrenched out of their context and with
“alternative facts” under the guise of “pluralism” with the aim of generating chaos and
confusion about every “fact of life,” indeed about the very possibility of knowing
anything about the world. In an intellectual and media climate in which it is, ostensibly,
impossible to know anything about anything, and in which everything is amenable to
subjective interpretation, there is a concomitant decline of interest in research, thought
and exchange of opinions. Most of one’s inner resources are aimed at easily attainable
pleasures and at getting rid of tension and anxiety. In nondemocratic regimes, preference
will always be given to excitation and sentimentality over emotion; to rapid, violent
action over thought. In a nondemocratic society there is no place for shame, for regret, for
pangs of conscience.
Meaningful mental therapy assists a person to become aware of unconscious wishes,
anxieties and fantasies, of the type that nourish nondemocratic longings which are
ingrained in the psyche. To do battle for democracy and against tyranny from the
viewpoint of “mental health” means resisting the temptation to self-deception, to
idealization, to uniformity of opinion, to complacency and to the “inner tranquility” that
undemocratic forms of government offer us, as do certain frames of mind in science, in
culture and in religions. In the hands of a fascist regime, even a work of art loses its
symbolic and subverting value, and becomes empty and addictive prattle.
It also follows from all these reasons why democracy is a frustrating, never-ending
project that stands in total contradiction to every pretense to arrive at a “final solution” to
complex political and social problems. In a nondemocratic regime the pressure to
participate in the collective tyrannical experience and to adopt a strategy that rests on
splitting, projections and denials, renders it difficult even for people who are sane and
healthy of mind to distinguish between inner and outer reality.
The mistrust of the press and of open sources of information transforms even simple
actions of learning and of collecting data into acts that are experienced as subversive. The
place of compassion, caring and accepting our incompleteness and dependence as human beings is supplanted by wickedness, omnipotence, contempt and narrow-mindedness,
which become a “cultural code” – through which the ruling authority offers the citizens
an alternative social pact which overcomes the “letter of the law.” The state and its
corrupt institutions signal to the public that real life takes place outside the law. It permits
people to hate, covet, usurp and grab whatever comes to hand in order to repulse
anxieties of dependence and dearth, incompleteness, ignorance, uncertainty and
loneliness.
The regime coup must not be allowed to curb the political energy that has been flowing in
the Israeli community of therapists in recent weeks. Modern history teaches that without
democracy there is no mental health. And also that those who work in this field play an
important role in the amelioration and healing of society, when it succeeds in liberating
itself from the grip of the death impulses of fascism and seeks to repair and revivify
democratic aspirations.
*Dr. Rolnik is a psychiatrist, historian and training and supervising psychoanalyst at the
Israel Psychoanalytic Society (IPA). He is the author of Freud in Zion: Psychoanalysis
and the Making of Modern Jewish Identity (Karnac/Routledge 2012). He edited, co-
edited and wrote chapters for 20 more books. His latest book, Talking Cure – 13 Talks on
Psychoanalysis, is published by Resling (in Hebrew 2022) and in German Redekur-
Psychoanalyse verstehen (Brandes & Apsel 2023).