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Politics of the Mind: Marxism and Mental Distress

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Mental ill health has become one of the key 'public issues' of the 21st century. According to the World Health Organization, depression currently affects 350 million people. Politics of the Marxism and Mental Distress looks at the link between the economic and political system under which we live - capitalism - and the enormously high levels of mental ill-health which we see in the world today. The book ends by looking ahead to a world driven not by the demands of profit but on based on meeting human needs - a world which the Marxist psychoanalyst Erich Fromm called 'a sane society'.

160 pages, Paperback

First published December 14, 2017

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About the author

Iain Ferguson

30 books4 followers
Iain Ferguson is Honorary Professor of Social Work and Social Policy at the University of the West of Scotland. His main areas of interest are neoliberalism and social work, critical and radical perspectives in social work and also social perspectives in mental health. He is the Advisory Editor of Critical and Radical Social Work.

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5 stars
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19 (16%)
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Displaying 1 - 19 of 19 reviews
Profile Image for Daniel Bickle-Lazarow.
32 reviews1 follower
October 25, 2018
Just finished reading this book and I can confidently say it was the best book I have read this year and definitely one of the best non fiction books I’ve read of all time. If you work in social work, psychology, biology or have experienced I the mental health treatment system I’d love to hear what you think of it if you have the chance to read it.

Mental illness (or as Iain Ferguson calls it, mental distress) is prolific amongst people of all walks of life at an ever rising rate and this gave me insight into the shortcomings of our understanding of, but more importantly our services of help for people with mental illness which in my opinion is one of the most egregious unacknowledged killers of our time. 73% of people in the lowest economic bracket (under $2400 p/m) report experiencing a mental health problem in their life time as well as 59% in the highest economic bracket (over $7000 p/m). Suicide is often the second highest killer of people between the ages of 15-25 second only to car crashes.

I found the book especially moving due to losing one of my close friends when we were 17 to mental illness and from reading this book it invigorates me to believe in the fight for a better world more than ever. While I acknowledge that my friend suffered particularly badly from mental illness and that’s unavoidable for some people, I believe that in a better world - a world where schooling wouldn’t be competition based so when my friend couldn’t understand a concept she wouldn’t think it was a failure of herself, a world where schools had the appropriate and adequate health services to give support to the disturbingly large amount of mentally unwell students, a world where when she attempted suicide the first time and went to hospital, she would’ve been given real treatment and not just held until someone at a higher risk than her came along to take her spot - ...I believe in a better world Connal would still be here.

I still miss Connal as I’m sure all the people that knew her do and I will never stop blaming the barbarity of capitalism’s profit motive for the lack of help she should’ve received.
Profile Image for Zoe.
79 reviews17 followers
January 30, 2025
An absolutely indispensable analysis of mental distress from a Marxist framework. Anti-Psychiatry is a field I am very knowledgeable about and reading his critique of that field has helped shape my perspective.

I only wish this book was available to other people in the United States, as I had to transport this book back from London with me when I was there in order to get a copy of it.
Profile Image for poetic interludes.
49 reviews
June 13, 2024
***3.5 rounded up to a 4***

This book provides a concise analysis of mental distress from a Marxist perspective. It critically examines the psycho-pharmaceutical motivations behind the DSM (The Diagnostic and Statistical Manual of Mental Disorders), discusses Freud and his ideological pitfalls/incompatibility with Marxism, and briefly summarizes historical approaches and perspectives on psychotherapy, psychiatry, and anti-psychiatry.

My favourite part of this book was the critical examination of how the DSM was largely influenced and curated with the interests of psycho-pharmaceutical companies in mind. At the same time, the DSM deliberately ignores the socio-cultural causes of mental distress, essentially denying capitalism's influence on worsening mental health. Moreover, I enjoyed the conversation on how depression and anxiety shouldn't be strictly viewed as an individual biomedical/genetic deviation, but rather a sane/typical reaction to the ever worsening conditions under neoliberal capitalism.

I found this book to be a great intro to this topic, however, it came across as a bit dull at times. As a Psychology major, I didn't mind the deep dives into different thinkers/concepts. However, you'd need to have an interest in the topic since the book is largely focused on summarizing theoretical concepts, which can make it a bit slow.
Profile Image for riddhi.
26 reviews
May 18, 2024
finished reading this book at 2 am on a random sunday and started crying.
Profile Image for سیاووش.
239 reviews4 followers
November 26, 2025
mental distress, the way that it is today, with how widespread it is and how severe its symptoms are, is not something that just happens to happen to people and it is, like many other struggles in our daily life, a product of capitalism. Also pharmaceutical companies gain profit from our suffering. These are all facts, but facts I think we were all already aware of. This book does a very good job of explaining these issues, also expanding on the anti-psychiatry movement and the mental health user movement (which I find very interesting in its own right and will be reading a book about at some point). But at the end of the day, I didn't get the straight forward answer that I wanted to my questions: why do some people get fucked in the head and some others don't, in a way that doesn't seem to be related to how we relate to the system, and what the fuck should we do about it if medication and hospitalisation are subject to oh so much criticism.
overall I think it is a good starting place for someone who has read nothing about the entanglement of the mental and the social. it proves many an interesting point and weaves thinkers like Marx and Freud into it pretty naturally.
Profile Image for Caio Maximino.
72 reviews1 follower
May 16, 2024
Um texto breve sobre política e saúde mental, a partir de um viés marxista e de uma crítica da "captura neoliberal" de conceitos da antipsiquiatria e da psiquiatria crítica. Provê uma análise interessante da relação entre alienação e loucura, bem como uma análise crítica da psicanálise. Apresenta uma defesa da expansão do financiamento dos serviços de saúde mental, bem como de um aprofundamento do "jogo de contradições" que subjaz o que, no Brasil, chamamos de "luta antimanicomial". Para quem vê no Estado a única via para sustentar a saúde mental, é um texto indispensável, ainda que outras alternativas menos reativas precisam também ser pensadas.
Profile Image for J.
290 reviews26 followers
February 2, 2021
Almost excellent ....
Profile Image for Faaiz.
238 reviews2 followers
February 10, 2021
This book succinctly encapsulates my views regarding the staggering extent to which mental health issues today are treated through a framework that roots their causes mostly on biology and the workings of the brain. Of course, lip-service is paid to sociological causes and life events but they are subservient to that of biology in that "genetic precursors of" or "underlying susceptibility to" developing mental illness is said to be triggered by certain life events in particular individuals causing "chemical imbalances" in the brain that result in mental distress. The rise of this phenomena has also meant that medication along with certain types of "band-aid" therapies are prescribed to an alarmingly high number of people in an effort to treat mental illness.

In a way, that the mental health service providers arrived at this approach towards mental health is not surprising. Whatever radical undercurrents in psychiatry existed in the 60's and 70's have been exhausted and wiped out under the current regime of neoliberal capitalism. Psychiatry having abandoned any hope of even imagining let alone working towards a society without the brutal demands that neoliberalism and capitalism place on the majority of people, the fallback option is to just put a band-aid on it, patch up the worker and get them out being a "productive" member of society.

This book serves as a good introduction to the critique of the current paradigm in psychiatry and mental health services as it currently exists and sketches out an outline of some of the history of the stages that psychiatry underwent with a particular focus on the works of Freud, R D Laing, Sedgwick, and a little bit of Zsasz, Fromm and Reich. The significantly short length of the book means that this overview is largely cursory and summary. The book is also largely based on the conditions in the UK with some references made to those of the US.

The book argues for a dialectical historical materialist framework for placing mental illnesses, seeing them as brought on largely by people's life experiences, events, and conditions rather than on a biological deterministic model or one that pays lip-service to sociological factors but largely privileges the biological ones. The book argues for a paradigm shift in our understanding of mental illnesses, their etiology, and their treatment models by advocating for:
services based on the premise that the origins of mental distress are largely social—in other words, a social model of mental distress; services based on people’s own descriptions of their problems rather than on psychiatric diagnoses; greatly reduced, and more pragmatic, use of medication; services individualised to people’s needs; and much less use of coercion
Of course, the length of the book prevents the author from more elaboration on and specificity regarding what this will entail.

Some interesting things to note:
- The appropriation of the language of progressive buzzwords such as "community", "recovery" etc to mask the growing depletion of public services and resources that cater to the mentally ill. This is of particular note in the context of the UK where the NHS has weathered several successive governments advocating for and implementing budget cuts and hollowing out of the NHS.
- A sizeable chunk of this book delves into schizophrenia along with depression and anxiety. My understanding of schizophrenia largely comes from what the DSM-V has to say and I did not really know the contentions that the conception of schizophrenia as an illness generated historically. I still can't say that I have understood the crux of the issue (politically and philosophically) from this book but it is a topic that may be worth exploring.
27 reviews
February 16, 2025
Ferguson surveys the different ways in which mental illness have been conceptualised and explained throughout history, focussing in on the medical model of mental illness and various critiques of it: psychoanalysis, anti-psychiatry and the unnamed "new paradigm" which combines trauma, dissociation, attachment theory and neuroscience. Ferguson is no fan of the mental institutions which housed those who faced mental illness in prison-like conditions before the 1950s, but the declining rate of profit in more recent decades has produced solutions which are no less faulty and can place the burden of caring for the mentally ill on families. The medical model is savaged as failing to provide much proof either that mental illness is biologically/genetically determined or that drugs help, and accused of servicing the incredibly profitable pharmaceutical industry. Psychoanalysis marks an important break in locating the root of mental illness in social relations and the Oedipal complex, but particularly in its more conservative forms can overvalue the "rational" ego and the role of repression in complex social phenomena. Anti-psychiatry provides an important corrective in showcasing how insanity comes from an insane world, but can valorise and mysticise often painful mental illnesses. The new paradigm is social and provides important analyses of the mental health issues facing minority groups due to oppression, but a social paradigm can still lay the blame for mental illness on individuals rather than systems and can justify neoliberalism, child abductions etc. Finally, Ferguson outlines a Marxist model for mental illness, rooted in alienation, and uses it to argue that patient control (importantly distinct from self-reliance) must be at the heart of responses to mental health.

The book is not just a good summary of the Marxist view of mental health but also an overview of the most important debates in modern psychology and psychiatry, full of inspiration for further reading. The area covered which I know most about would have to be psychoanalysis, and while the overview of psychoanalysis was of necessity simplistic, some of Ferguson's evaluation, such as that Freud's theories were usefully materialist while Lacan's irredemably idealist, strike me as basically correct. I only wish it were longer. I wish also that the book explored the way in which the new model of mental illness has morphed into a kind of identity politics, particularly on university campuses, where anything uncomfortable or challenging is labelled potentially traumatic in a way which serves to further atomise and fragment the student body. But this may well be a very recent development, and not common in Ferguson's line of work.
Profile Image for Drew.
Author 3 books12 followers
November 25, 2020
3.5
This is a good, approachable summary of the medicalization and social attitudes towards madness and mental distress in the 20th and 21st century. It’s strongest point is this clear summary. While there is a definite critical edge that derives from a Marxist angle, actual critique on the basis of Marxism takes up very little of the text. This is not a book with strong analysis. I agree with it generally, but would have liked to see the sections connecting concepts in Marxist terms expanded, since there is more there that is left unexplored.
Profile Image for Laura Barnes.
79 reviews
September 21, 2023
Fantastically nuanced take on the pathologisation of human behaviour during the background of capitalism. Really, it's a lot more balanced than you might expect and has definitely altered the way I look at mental health. Like, should grief really be classed as a mental illness? Should we really put so much stock in attachment theory when its own creator has distanced himself from it? Really eye-opening to see the domino effect of psychological theories that were created to help people turning into tools with which to discriminate against people.
Profile Image for Emma .
100 reviews
February 15, 2021
Great overview of psychopolitics and also overviews of the big names (Laing, Freud, etc) but I wish there was more Marxist critique on mental health provision and what this might look like
This books a gateway drug to lots of others.
31 reviews
Read
February 23, 2021
More historical and less analytical than I was expecting
162 reviews
February 27, 2023
Psychology, psychiatry and related issues aren't a personal strength but this was a good intro to a number of debates, and presented a nuanced Marxist approach.
579 reviews
June 3, 2024
A good analysis of mental health and distress under capitalism using a Marxist lens
3 reviews2 followers
December 16, 2024
This analysis will have fresh insight for those familiar with Marxist theory and/or anti/critical psychiatry, while remaining accessible for those with neither.
Profile Image for Durakov.
157 reviews65 followers
October 14, 2021
This is a nice little volume. Unlike Peter Sedgwick's Psychopolitics, which is a lengthy polemic disguised as a summary (important to read, don't get me wrong), it actually offers a solid overview of the critique of psychiatry from the left from Freud to present-day peer organizations. I would absolutely recommend this to someone who wants a rundown of leftist social psychiatry. Ferguson is fair to everyone he treats, though one could argue he falls into the common trap of using the major figureheads as a stand-in for whole movements (so Freud is invoked as an avatar for psychoanalysis, Laing for antipsychiatry). There's benefits to this (helps trace developments more easily, can embed concepts in specific social contexts), but what's lost are all the deviations of those movements, especially because these figureheads are often among the more well-situated and comfy in such movements. It probably couldn't really be avoided in a text like this, but, all the same, I am tired of reading about Laing all the time.

My main issue is that it is lighter than I wanted on delving into the Marxist concepts that was promised by the title. Still, Ferguson illuminates very promising paths for such a critique, and, unlike Bruce Cohen's Psychiatric Hegemony, which Ferguson rightly notes appears more indebted to the popular mixture of labeling theory and Foucault, Ferguson does base his critique in Marx's understanding of capitalist alienation and our social capacity to transform the world.
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