Economic Globalization and Mental Health

Economic globalization is much in the news these days, most recently as Congress debated President Obama’s proposal for a “free trade” agreement with the nations of the Pacific Rim. My impression is that few mental health professionals keep up with the details of economic globalization and its impact on culture and mental health. In this article I will briefly present two ways in which economic globalization has a huge and largely unrecognized impact on the lives and work of psychologists and other psychotherapists in the United States and the rest of the world.

Economic globalization means global free market capitalism. Decades ago, Erich Fromm noted that personality structures reflect the socio-economic system within which people are socialized. At this moment, the supremacy of global capitalism means that individualistic, competitive values increasingly prevail in cultures, not only in the U.S., but also around the world. Pope Francis recently noted how climate change along with its devastating effect on peoples’ lives (now and in the future) results from a one-dimensional concern with personal and corporate profit as opposed to concern with communal welfare in the long term. In our practices, in our personal lives, and in the lives of our patients, we see the consequences of overwork and anxieties about financial success. We organize our lives and the lives of our children, from infancy on, around the frantic search for a place at one of the top colleges as defined by U.S. News and World Report (which, itself, sells a lot of magazines by ranking colleges and universities). People, including children and adolescents, who feel they are not destined for the top, give up, surrendering to a “whatever” ethic or to drugs and alcohol and other forms of self-destructive self-soothing and self-regulation. These are all consequences of the economic inequality that is pervasive and obvious. We see these consequences all the time in our practices and in our communities, yet may overlook the relevant socio-economic context. I do not mean to condemn individualistic and competitive values per se, only to point to the consequences of the one-sided emphasis on these values that has arisen in the wake of the Reagan-Thatcher years.

Global free market capitalism has resulted in the decimation of public sectors around the world, leading to increasingly inaccessible mental health care for all but the most economically privileged. In times of economic downturn, international organizations like the International Monetary Fund and the World Bank will act to bail out struggling economies with strings attached — strings that involve opening up the economy to global free markets (Greece is the most prominent recent example). Keynesian belief that government spending is necessary to jump-start lagging economies has given way to the idea that corporate profits will trickle down and benefit everyone. Government intervention in the economy must be cut back to allow the markets to work their magic. Taxes are cut and social programs, including mental health programs, are reduced or eliminated.

An example: in Portugal last year, one of my hosts told me that the European Community had recently required that all children be enrolled in school. The result was that the Portuguese schools were suddenly flooded with children of all ages who had never been in school. The resulting behavioral and academic challenges for classroom teachers were huge. My host had started a program to support teachers in managing classrooms with children who had widely divergent abilities to read and write and sit still to learn. At the time of my visit, his program had been suddenly shut down due to governmental budget cuts.

Another example: when a company such as Walmart enters a country like India, untold numbers of small shops suddenly go out of business, throwing their owners and employees into unemployment. India has no unemployment insurance. Also in India and other countries, agri-businesses like Monsanto patent seeds for high yielding crops. It becomes illegal, then, for farmers to harvest the seeds of their crops for the next year; they must buy seeds from Monsanto at the market rate. As seeds that were genetically engineered and patented by Monsanto cross-pollinate with crops in the vicinity, these seeds too become subject to patent laws. Millions of farmers are thereby forced into bankruptcy; tens of thousands have committed suicide in recent years in India. In the United States, free market capitalism has evolved gradually with a variety of government regulatory mechanisms to attenuate the impact on those who lose under the system. Unemployment insurance and subsidies for farmers are examples. When free markets are forced on economies that have no such regulatory mechanisms in place, the economic and psychological consequences are devastating for millions of people while corporations, and their shareholders, reap the monetary profit.

Globalization is an abstract concept; few people who concern themselves with the feelings and psychological state of individuals and families take the time to understand how the system works and how it is perpetuated. Failure to take account of the systemic context for people’s distress results, however, in over-pathologization of individuals, by the professionals who diagnose and treat them, and by the individuals themselves who come to blame themselves, in a one-sided way, for their unhappiness.