What is recuperation?
From Occupy Wall Street to Standing Rock, the past decade has shown more than ever that the capitalist-colonialist system depends not only on the subjugation of its people through violent suppression of uprisings, but also through insidious repression of alternative ways of being in the world that challenge its hegemony. In 1958, Guy Debord published the Situationist Manifesto, calling “official culture” a “rigged game.” He defined “recuperation” as the process by which conservative forces sterilize subversive ideas before integrating them back into culture in a non-subversive form. In the world of ideas, those which are fit for capitalism will survive and those that are not will continue to be diluted and warped until they fit snugly within that system. Psychiatry, as an institution maintained by capitalism, is subject to these same forces, but we have the potential to reframe the conversation and transform psychiatry towards working with alternative understandings of “mental health.”
The modern belief in the importance of the independent, rational self is the most important cultural value upholding capitalism and, by extension, the medical model of psychiatry.1 Joanna Moncrieff,2 Bruce Cohen,3 and many others have illustrated the tight entanglement of psychiatric, biomedical, and capitalist ideologies. Moncrieff in particular describes how psychiatry “polices behaviour that is troublesome, unpredictable and sometimes dangerous but not obviously criminal.”4 Critically, the medical model’s inherent de-emphasis on the social and spiritual context of our lives allows dominant voices to shift the conversation away from the inhumanity of capitalism towards claims that patients’ lack of rational thinking patterns or diseased brains are the reason for their distress.
Recuperation is so successful because it co-opts some valid critiques of our society, while removing what is threatening. Many have already written about how the mental health industry recuperated the socially-oriented, compassionate, self-disintegrating tradition of Buddhist meditation into the modern, consumer-oriented, individualist exercise of wrangling your stressed-out brain into “mindfulness.” Most people genuinely benefit from mindfulness because it addresses part of a genuine problem in our inattentive culture, but the threat of a collective struggle against the root causes of this suffering are no longer part of the discourse. The fate of mindfulness is not an unfortunate, isolated incident. It is part of a long history of the recuperation of Magical ideas — ideas that are naturally “troublesome,” “unpredictable,” and “irrational” — which dates back to the origins of capitalism.
Magical cultures, capitalism, and biopsychiatry
Silvia Federici in her book Caliban and the Witch (2004) argues that the witch hunts in Europe and emerging colonies in the New World were essential to the construction of early capitalism. “Witches,” typically rural, peasant women practicing spells, foreseeing the future, and pre-scientific medicine, were murdered in the tens of thousands in part because witchcraft “gave confidence to the poor in their ability to manipulate the natural and social environment and possibly subvert the constituted order.” Federici explains that “magic is premised on the belief that the world is animated, unpredictable, and there is a force in all things” — forces outside our typical perception. Magic creates something tangible out of “thin air.” Magic does not concern itself with how things work; it thrives in ambiguity and deference to unseen forces. Cultures where magic thrives are incompatible with capitalist values of the primacy of individual responsibility and rationalization of all aspects of life that the constant pursuit of efficiency demands. In order for the peasantry to accept the domination of the new social order, the world had to be disenchanted.
Once the process of disenchanting culture was finished, “magic” was no longer a threat and was reintegrated. Now, we view witchcraft as a silly quirk of a less scientific, less enlightened time. However, far from being an artifact of the past, witch hunts continue around the world in places still in the process of state building. In the West, the story of witchcraft has since been retold in many forms to sell everything from colonialism to teen fiction. The witches of history are portrayed as “wretched fools afflicted by hallucinations.” Their purging, though regrettably brutal, was nonetheless justified according to Thomas Hobbes: “…as for witches I think not that their witchcraft is any real power, but yet that they are justly punished for the false belief that they have that they can do such mischief… their trade being nearer to a new religion than to a craft or science.” Dealing with the “epidemic” of witchcraft was a form of “social therapy,” a sentiment not unlike Trump’s recent calls to mobilize state power to increase involuntary treatment of those diagnosed with mental illness: “At the same time, we need to keep very dangerous people off our streets. And we want to take care of the mental illness, but we have a lot of very dangerous people on our streets.”
The witch hunt climaxed during the uprisings against land privatization of the early 16th and 17th centuries, when proto-capitalists felt most threatened by independent peasant power. Just the same, the American War on Drugs was declared by Nixon at the peak of the psychedelic renaissance. Mushrooms, cannabis, peyote, and ayahuasca had been consumed by indigenous cultures on the fringes of the “Western” world for millennia, viewed as evidence of their witchcraft and “devil worship,” but mostly ignored. It wasn’t until a rapidly growing 60s counterculture emerged, embracing many of the same premises which witchcraft and magic flourish under, that the mainstream of society would see how capitalism deals with such ideas.
Timothy Leary — “the most dangerous man in America” — told a crowd of 30,000 hippies at the Human Be-In in San Francisco to “Turn on, tune in, and drop out” with psychedelics. “Turning on,” Leary explains in his autobiography Flashbacks, meant to “become sensitive to the many and various levels of consciousness and the specific triggers engaging them.” Psychedelics were interpreted as experiencing the world from perspectives outside the mundane, blasé, and mechanical. Not uncoincidentally, the 60s were a powerful era in the anti-psychiatry movement, when the lines between popular conceptions of “madness” and “sanity” were blurring. As with witchcraft, the state would suppress through violence and propaganda this culture of non-rationality and guidance from untamable and unseen forces. The 1960s view of psychedelics is much closer to the traditional understanding of these substances by indigenous communities compared to the emerging scientific discourse today.
Ayahuasca provides a convenient example of psychedelic use given its long, well-studied history within indigenous cultures, as well as recent interest by the field of mental health. Luis Luna writes that it is impossible to understand indigenous ayahuasca use without understanding indigenous spirituality, and vice-versa.5 Their worldview includes “an underlying spiritual aspect to everything that exists, an intimate relationship and even dependency between the seen and the unseen, between the world of nature and human creation on one side, and normally invisible and intelligent forces…Sacred plants, such as ayahuasca, facilitate the perception of such complexity.” The Shuar group of the Ecuadorian Amazon believe that “the main function of ayahuasca is to enter into contact with the unseen side of reality…the true forces behind daily life are in the supernatural realm.”6 One common narrative is transformation of the consciousness into an animal, such as the jaguar, harpy eagle, or anaconda, or that we may communicate with ancestors through ingesting ayahuasca.
The idea that we may experience the world from the point of view of a non-human animal has no place in our culture of individualism. The idea that we may gain healing through speaking with our ancestors has no place in a biopsychiatric model. If we wish to appreciate the full power of psychedelics, we must go further than dismissing these worldviews as a curious anthropological quirk of a remote tribal past to accepting that fundamentally different understandings of the human experience are possible, and in fact, are probably far more “normal” in a historical sense than our modern worldview.
How will psychedelics be recuperated?
A recent opinion paper in JAMA Psychiatry called psychedelics “disruptive psychopharmacology” while detailing a plan to bring these substances into the fold of the mainstream of medicine.7 They emphasized meeting these “disruptive” medicines with traditional biological methods, even proposing to test whether the therapeutic effect of psilocybin could still be achieved with the patient unconscious under general anesthesia. This says enough about the emerging story we will tell about what these substances are and how they function.
To the credit of the mental health world, some attention has been placed on incorporating features of indigenous practices into models of how ayahuasca might be used in a clinical setting:8 guidance through the experience (the shaman roughly approximated by a psychotherapist) and some discussion on the importance of a non-passive engagement with the experience. However, for a psychiatrist trained to conceptualize within the medical model, psychedelics will at worst be a novel pharmacotherapy altering broken neural pathways, and at best remain an intervention targeting a multidimensional “mental illness” rather than a communion with the magical yet essential dimension of the human experience.
To be clear, I am making no claim on how this narrative of psychedelics relates to their “effectiveness” in relieving any particular cause of diagnosed mental illness. To do so already presumes a medical model of dealing with distress. Nor am I am saying that psychedelics have no role in psychiatry. I am saying that “set and setting” includes the way these substances are framed in our imagination. How we imagine these substances as “plant medicines,” “drugs,” or as “a doorway to the divine” is just as important as their neurochemical effects. Their magic and their power to transform our insight and the sources of our suffering will be limited if we allow psychedelics to be recuperated into capitalist and biomedical frameworks.
- U’Ren, R. (1997). Psychiatry and capitalism. The Journal of Mind and Behavior, 1-11. ↩
- Moncrieff, J. (2008). Neoliberalism and Biopsychiatry: A Marriage of Convenience. Liberatory Psychiatry: Philosophy, Politics, and Mental Health, 235-255. ↩
- Cohen, B. M. (2016). Psychiatric hegemony: A Marxist theory of mental illness. Springer. ↩
- Moncrieff, J. (2018). Capitalism and psychiatry: applying Marxist critical theory to the mental health industry. ↩
- Luna, L. E. (2011). Indigenous and Mestizo Use of Ayahuasca: An Overview. The Ethnopharmacology of Ayahuasca, 2, 01-21. ↩
- Harner, M.J. 1972, The Jívaro: People of the Sacred Waterfalls, University of California Press, Berkeley. ↩
- Heifets, B. D., & Malenka, R. C. (2019). Disruptive Psychopharmacology. JAMA Psychiatry. ↩
- Sloshower, J. (2018). Integrating Psychedelic Medicines and Psychiatry: Theory and Methods of a Model Clinic. In Plant Medicines, Healing and Psychedelic Science (pp. 113-132). Springer, Cham. ↩
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.