On the Medicalization of Normality: ‘Saving Normal’ by Allen Frances

Tags

DSM-5, normality, psychiatry, psychology

The following review first appeared in New York Journal of Books on May 16.

The medicalization of ordinary life has been a slow process in the making and the sad result of a combination of factors. Diagnostic manuals like the DSM have contributed to this process and so have the reimbursement procedures of health and social insurances. Careless science reporting, advertising excesses and the lowering of scientific standards in clinical and field trials are other contributing factors.

Having chaired the task force that prepared DSM-IV, Allen Frances knows what he is talking about. Some of the criticisms he fares against DSM-5 also apply to his own work and he is sincere enough to admit these. But DSM-5 displays several new and more serious problems, besides accentuating those of the past. This is the subject of the book Saving Normal: An Insider’s Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma and the Medicalization of Ordinary Life (William Morrow, 2013).

Diagnostic inflation is number one problem on the list. This occurs “when we confuse the typical perturbations that are part of everyone’s life with true psychiatric disorder.” Trouble is, this ‘confusion’ often takes place willfully in order to maximize profits: “The much fuzzier distinction between the mildly ill and the probably well is easily and frequently manipulated.”

The chapters that focus on the fads of the past, present and future are the strongest part of the book. Fads of the present include attention deficit disorder (ADD) and autism. Insofar as adults are concerned, depression is the big cash-cow. In actual fact, many of the diagnosed depressions would pass on their own given some time and attention. “Sadness should not be synonymous with sickness … Our capacity to feel emotional pain has great adaptive value equivalent in its purpose to physical pain – a signal that something has gone wrong. We can’t convert all emotional pain into mental disorder without radically changing who we are, dulling the palette of our experience.”

DSM-5 takes even a step further and proposes to consider tantrums as ‘disruptive mood dysregulation disorder; normal aging as ‘mild neurocognitive disorder’ and gluttony as ‘binge eating disorder’. According to Frances, this is pointing in the wrong direction. Tantrums may sometimes be difficult for parents to bear and cope with, but they are part of child development; forgetfulness in older age occurs without necessarily leading to Alzheimer’s; and excessive eating is unhealthy but not a mental disorder. Other problems with DSM-5 include the introduction of an ‘adult attention deficit disorder’ category and a loose definition of ‘somatic symptom disorder’ for tapping on psychosomatic medical problems.

Taming diagnostic inflation, thus “getting back to normal” will require a number of reforms in public policy (such as barring direct-to-consumer advertising) but also changes in the medical practices away from fast diagnoses based on few consultations towards “stepped diagnosis,” defined as follows: “Definite diagnosis should be made in the first session only in clear or urgent cases. For everyone else, the first several visits would be for fact finding, education and let nature take its course. Diagnosis would be made only after the dust has settled. This is the most direct and efficient way to stop diagnostic inflation in its tracks.”

Additionally, patients are advised to adopt a more self-critical approach: “The key to psychiatric diagnosis is self-report, and this is impossible without careful and persistent self-observation” – a useful piece of advice that does not always work in practice since it takes for granted that patients know what constitutes a symptom and how symptoms tend to cluster together. However, most patients do not have this knowledge and do not wish to obtain it, especially not when in a situation of psychical stress.

It is in this connection that Saving Normal—otherwise a good guide through the intricacies of psychiatric diagnosis—falls short of expectations. What goes missing in the book is what is missing in psychiatric diagnosis more generally, namely a deep understanding of mental disorder as a state of psychical strain resulting from inner conflicts. Such inner conflicts tend to be debilitating, often affecting precisely those cognitive and emotional skills that make a patient a “smart consumer.”

The core problem of all diagnostic manuals is that they operate with manifest symptoms. These are counted together and assessed in terms of their intensity and duration. Such an approach is inherently prone to unreliability besides confounding different analytical levels. More importantly, it completely ignores the hidden psychodynamics driving symptom formation. In the end, that we must today fear the medicalization of ordinary life has something to do with our having excessively medicalized mental disorder.

In Search of the Holy Grail of Consciousness: ‘Consciousness; Confessions of a Romantic Reductionist’ by Christof Koch

Tags

brain sciences, Christof Koch, consciousness, Giulio Tononi, mind sciences, psychoanalysis, unconscious

The advances of neuroscience during the last years have given fresh impetus to the search for the material base of consciousness besides fuelling the debate as to what reigns supreme: the brain or the mind, the body or the soul – or are the two mere reflections of each other or, perhaps, one and the same thing?

These questions have occupied philosophers since time immemorial. They underlie the human quest for meaning, which is closely interlinked with that of life and death. Insofar as consciousness is about having an internal perspective, it is unsurprising that we should occasionally wonder how that comes to be and whether it goes on existing, in some or another form, after the body disintegrates.

But before that question is answered – and that might take some time – it is first important to explore how our body, in this case our brain, enables consciousness.

The biggest part of Christof Koch’s book Consciousness; Confessions of a Romantic Reductionist is devoted to the brain sciences and what they reveal about the nature, location, degree and scope of consciousness. Below a summary of the most interesting research findings he reports about:

• Brain science uses the term ‘quale’ to refer to the feeling of experience that is elicited by consciousness. For years, research had focused on mapping experiences to specific brain regions. This turned out to be a dead end. Experiences cannot be clearly mapped to brain regions. Rather, they appear to be network specific.

• At the same time our brains display extreme capability at specialization. Thus we apparently use different parts for capturing the gist of a scene, i.e. its overall character, as opposed to its details. Then again we have concept cells which are extremely particular or concrete in their approach – for instance, we have brain cells for recognizing our favorite film stars.

• Parts of our brains are in charge of integrating information. In doing so, they fulfill an enabling function. This is the case of the thalamus and hypothalamus and possibly of other regions as well. When such regions are lost through brain damage consciousness may be impaired to a significant degree.

• Attention-demanding tasks are performed by the pre-frontal cortex, which also plays a role with respect to learning. Once we have internalized knowledge our brain tends to shift processing to the cerebellum. This applies to automatic sensor-motor activities like moving our hands; but possibly also to social biases or set psychological mechanisms or re-actions.

• For such actions experiments have shown that our brain precedes our sense (or quale) of agency. This is called ‘readiness potential’ and implies that our brain ‘knows’ our intentions before we do – a finding that could also mean there is no free will, and a source of both fascination and exasperation for a romantic reductionist like Christof Koch.

• This said, the ability of our brain to transform what it considers fixed knowledge into routine, automated, and, seemingly unconscious, procedures is also what explains virtuoso performances in sport, the arts and, even, in science.

Christof Koch is of the opinion that the theory that best explains these findings is Giulio Tononi’s integrated information theory, according to which consciousness is a measure of our brain’s combined ability to both integrate and differentiate information. The integrated information theory also implies that all sentient beings possess consciousness to a certain degree; and likewise computers and the World Wide Web. What the integrated information theory does not explain as of yet is the unconscious – since unconscious processes, like automated behaviors or feelings, are quite complex without necessarily being synergistic.

It is in this latter respect that Christof Koch and his colleagues would stand to gain from paying more attention to the mind sciences (as opposed to the brain sciences), namely psychology and psychoanalysis. The mind sciences, as well as psychiatry that operates at the interface between brain and mind, have produced a wealth of knowledge on the mechanisms of both conscious and unconscious processes and about how these are more diverse than they are uniform. Combining the knowledge of these different disciplines, or to use Tononi’s terms, integrating their information, will bring science further, not least by providing a reference framework for formulating hypotheses.

Ultimately – who knows? – it might even turn out that the holy grail of consciousness is, in fact, the unconscious.

On the Past and Future of Psychoanalysis: ‘Shrink: A Cultural History of Psychoanalysis in America’ by Lawrence P. Samuel

Tags

popular culture, psychoanalysis

The following review first appeared in New York Journal of Books on April 2, 2013

If you are interested in the unconscious, like interpreting your dreams, enjoy literature but the movies even more so, Hitchcock and Woody Allen in particular, like watching The Sopranos and In Treatment, fantasize about the couch or are currently experimenting with it – above all, find psychoanalysis intriguing, maybe brilliant yet also amusing in a way, then you will probably enjoy Lawrence Samuel’s book Shrink: A Cultural History of Psychoanalysis in America.

Many books have already been written about Freud and psychoanalysis. Indeed, the elderly Viennese gentleman represents one of the major inspiration figures of the twentieth century and, as Mr. Samuel’s book proves, the interest in him does not look like subsiding. On the contrary, that it has survived this long despite crazed idolization and even crazier censure suggests that the science he invented is more than just a fad.

The distinctiveness of Shrink lies in its focus on popular culture.

Mr. Samuel is not so much interested in the academic discourse on psychoanalysis and the various theoretical contributions to Freud’s work. The fact, however, that he does not ignore these completely lends credibility to his analysis. The question driving his book is how psychoanalysis became so “deeply embedded” in American popular and consumer culture.

The media, later also the movies, played a significant role in this process and, therefore, Mr. Samuel’s decision to systematically rely on print sources was a good one. His sources include serious journalism and science writing but also entertainment literature like women’s magazines. By tracing what has been reported in the media about psychoanalysis over more than a century, a pretty good picture emerges about the field’s fascination but also the main contestation areas.

The hype days were the 1920s and it felt like love at first sight. The reason was a three-letter word, namely sex, “against the background of changing mores and women’s emancipation.” People were keen to have sex uninhibited and talk about it, and psychoanalysis appeared to make both possible. As Lawrence Samuels notes, that was a rather “too basic” understanding, under which psychoanalysis as a science subsequently suffered.

Thus demand for psychoanalysis grew faster than the supply of psychoanalysts, and this led to the unfortunate situation of self-assigned analysts popping up everywhere, charging some 30 USD per hour, then a huge amount, for the provision of “talking cure” that was more talking (about sex) than cure.

The medical profession reacted first to this state of affairs and began in the 1930s to provide training. That was important in terms of professionalization. The downside was that for the next sixty years it became impossible to divorce psychoanalysis from psychiatry, and that despite Freud’s own views on the subject.

Psychoanalysis continued to gather momentum in popular culture throughout the twentieth century, and, gradually, it also achieved high status within the humanities in academia. But otherwise, namely as a science in its own right and as a form of therapy, it has been an uphill struggle.

There are four main reasons for this. The first was the afore-mentioned subjugation of psychoanalysis by psychiatry, which was removed only in the late 1980s when the American Psychoanalytic Association began admitting non-medical candidates. (A few years later, gay candidates also became eligible for training.) The second was the constant challenging of its scientific status in conjunction with epistemological and normative attacks from the strangest of bedfellows, namely the Vatican and second-wave feminism. The third constraining factor had to do with competition as new cheaper and shorter forms of therapy emerged, taking advantage of some of the horror stories about psychoanalysis floating around since the 1960s. Finally, the biggest blow came from advances within pharmacology.

And yet, psychoanalysis has survived and is again on the ascent. There have been internal reforms. One has already been mentioned, namely the admittance to the profession of non-medics. Equally important has been research on the effectiveness of psychoanalysis, alone or in combination with other treatments and in comparative perspective. Finally, there is now available the so-called psychoanalytic or psychodynamic therapy, which is based on psychoanalysis but requires less sessions (per week and over time).

By far the biggest boost has come from neuroscience. The rapprochement between the two fields began in the 1980s when known neuroscientists came forward in favor of Freud arguing that they expected his theories to be confirmed by their research on the brain and the workings of the mind. The predictions have been largely confirmed and more is under way. Another potentially useful alliance has been that between behavioral therapy and psychoanalysis for the treatment of specific disorders.

So much for the serious stuff, which Lawrence Samuel’s book describes very well. But an American book on America and psychoanalysis would not be complete without the extras: the re-telling of horror and wonder stories that made news in the nineteen-fifties, sixties and seventies; the review of the popular terms that emerged to capture the psychoanalytic moment – from getting ‘psyched’ in the 1920s to ‘hitting the couch’ in mid-century; the discussion of films dealing with psychoanalysis; the treatment of the topic in women’s magazines, etc. etc.

Last but not least, since ‘to sofa is to suffer,’ what couch an analyst buys is also of importance and that story is also among the many Shrink has to offer, perhaps an additional incentive to read this book.

“We are a Civilized Nation … ”

Tags

Cyprus bailout, EU

“I’ve been queuing since 11 am and it has been very calm because people just want to do their business and go home … We want to keep our dignity and show all of the foreign media filming us that we are a civilized nation.” (Yioryos Theodorou, queuing outside a Laiki Bank branch on the first day of opening of Cypriot banks; reported by Cyprus Mail).

Cyprus has received a lot of bashing during the last ten days. Many of the criticisms are valid but exaggerated.

The Cypriot banking sector is definitely inflated, but the accusation (advanced by French Finance Minister Pierre Moscovici) that Cyprus is a casino economy is far-fetched. The Cypriot banking sector has for the most part been taking advantage of the same regulatory loopholes regarding capital flows, especially those in transit, that are in use in other financial centers like Frankfurt, Luxembourg, Switzerland, London or New York. The specific problem of Cyprus has been one of size (the country’s economy is very small in comparison to its banking sector and output) in conjunction with the absence of effective controls.

Undoubtedly, many rich people have used Cyprus as a tax-haven. Many of these, but not all, are Russians. There are also several rich Cypriots or Cypriots in high positions who have broken the law at various instances, and this justifies the set up of a criminal investigative committee, as announced by the Cyprus government, to look into these issues. Such measures are long overdue – but better late than never.

It should also be said that the Cypriot victim and trickster mentality, an attitude rooted in the twin collective experience of colonialism and war, has facilitated the consolidation of shadow-economic practices.

And still … there is another side to Cyprus and other narratives than those of rich elites and nouveau riches enjoying cocktails while bathing in the sun.

• T., an older man, past seventy. As a young man he took flight from the Turkish invasion of the North, lost everything, had to start anew. With the help of a low-interest loan for refugees he managed to build a new house for his family. He repaid it timely, and continued to put money aside from his modest salary, and that of his wife, in order to support the education of his children, since he believes education is the only thing ‘one cannot take away from you.’ His pension is far from generous and he fears cuts—the rumors have it these could be as high as twenty to forty percent. The little money he still has in the bank is a security – as he does not wish to become a burden to his children when the time has come to move into an old people’s home.

• M., a young woman from South Asia. She has been working in Cyprus as household help since a couple of years. Her salary is meager according to European or even Cypriot standards, just over three hundred Euros, yet this is a significant amount of money in her country of origin. M. receives her wages in cash at the end of the month, proceeds on the same day to transfer most of it to her family with Western Union. She now worries she might be losing her job. Her employer is a single-mother with two children who also fears for her job.

• I., a Russian woman in her early forties – she has migrated to Cyprus five years ago with her husband who has a middle-level management job at an offshore company. She does not know much about his job other than that he works hard and travels a lot. He earns reasonably well so that she does not have to work and the children can attend a private English school. Nonetheless, she would like to get a job so as not to be fully dependent on her husband. She has begun to learn English and Greek. Last night her husband called to say he is considering migrating back to Russia. The prospect frightens her.

Stories like the above are as real as those that have been circulating in the media during the last days. As with other crisis-stricken nations, this is perhaps something to be kept in mind before passing judgment.

Wicked or Smart? The Proposed Solution to Cyprus’ Financial Troubles

Tags

Cyprus bailout plan, EU

It is difficult to assess the quality of the proposed bailout plan for Cyprus given its suddenness and the lack of background information.

What is known is that the EU, with the agreement of the Cypriot government, are proposing a haircut of bank deposits for the total amount of 5.8 billion Euros, whereby deposits below 100.000 Euros would be taxed by around 7 per cent and those above 100.000 Euros by around 10 per cent. In return, Cyprus would receive a financial aid for its banks of the order of 10 billion Euros.

The list of the unknowns is longer:

• How do small savers compare to big savers in terms of absolute numbers and also in terms of their deposit contributions? This is important in order to establish the deal’s fairness.
• What is the role and contribution of corporate investors as compared to ordinary investors?
• How will the proposed deal impact on future conditions imposed on deposits (including of foreign and corporate investors) in the medium- and long-term?
• How does the deal impact on proposed salary cuts of public sector employees?
• What guarantees have been provided that these measures are non-recurring?

The official story is that the Cyprus government has opted for this solution in order to avoid worse, whereby the details of the worse-case scenario are also fuzzy and not very credible considering that, first, Cyprus is a member of the EU and has Euro as its currency and second, the bailout plan is small as compared to those implemented for Greece, Spain and Ireland.

According to Moody’s, as reported in the New York Times, European Union officials are pursuing other policy goals. But what might these be? Is this their way of forcing Cyprus to reform its banking sector—or perhaps the way to avoid insisting on this? Could this be meant to scare bigger countries such as Italy and Spain into accepting reforms so as to avoid the ‘Cyprus fate?’

Under certain circumstances the proposed bailout plan may represent a good way forward, at least for Cyprus. But at this point this is impossible to say. EU and Cypriot politicians are well-advised to reconsider both their conceptual and communication strategies.

The Middle-East Peace Process that Is Not or Never Was

Tags

Ben Birnbaum, ethnic conflict resolution, Israel, Middle-East, Palestine, politics, Tony Judt, two-state solution

In an article published today in The New Republic, Ben Birnbaum warns that the prospects for a two-state solution in the Middle East for settling the conflict between Israel and Palestine are rapidly fading away. He bases this conclusion on the following observations:

• Israelis are comfortably living in cognitive dissonance: in surveys, two thirds report being in favor of a peace deal that envisages a Palestinian state with a capital in East Jerusalem and extending over areas of the West Bank and Gaza; yet, on election day, the majority voted for right-wing and extremist parties that oppose one of the key requirements for such a solution, namely the reversal of the settlement process.

• The trend is negative with extremist nationalist views on the rise among young people. Thus, for instance, the electoral base for the pro-settler Jewish Home Party is the age group between eighteen and thirty-five. This is the reverse from what can be observed among young Jews of the Diaspora who are increasingly alienated by Israeli politics.

• Palestinians do not fare much better with their concurrent support for Fatah and Hamas; moreover, the support for Fatah is waning and will probably expire with Mahmoud Abbas’ anticipated departure from politics because of ill health. According to Birnbaum, Abbas is still the ‘better partner’ for a two-state solution. Unfortunately, like many politicians of his generation, ‘he has not only failed to groom a successor, he has at times actively undermined potential heirs.’

One central mistake of the Middle-East peace process has been the failure of political elites to first, think outside their narrow narratives and reference frameworks, and second, communicate to their citizens the real-life implications of compromises. This is no specificity of the Israel/Palestine conflict but a typical occurrence in all ethnic and community conflicts.

The main reason such conflicts remain unresolved, as if ‘frozen’, for extensive periods of time has to do with the manipulation of public opinion with the help of nationalist ideologies and for the mere purpose of winning elections. Peace processes require long-term strategic thinking. Few politicians display this—and if and when they finally do they usually are too old to follow the solution through (see Ariel Sharon).

Ben Birnbaum’s analysis is not new. Ten years ago, the late Tony Judt was widely condemned for raising similar doubts and concerns in an article published in The New York Review of Books and entitled ‘Israel: The Alternative’.

Judt saw, already in 2003, that the two-state solution was doomed to fail. But he did not stop there. He dared confront the alternative, namely, the choice between ‘an ethnically cleansed Greater Israel’ [which Israel cannot afford if it wants to remain a democracy] and ‘a single, integrated, binational state of Jews and Arabs, Israelis and Palestinians.’ The creation of such a state would not be easy, not least because ‘it would require the emergence, among Jews and Arabs alike, of a new political class’–an idea representing ‘an unpromising mix of realism and utopia.’ But, he concluded, ‘the alternatives are far, far worse.’

Alas, the idea of a binational state of Israelis and Palestinians remains as much a taboo today as it was ten, twenty or thirty years ago. Therefore, it is time to think of alternatives to both the two-state and one-state solutions.

What may these be?

According to the theory of ‘complex power sharing’ developed, among else, by Stefan Wolff, one common mental blockade in ethnic conflict resolution is precisely the said tendency to think in terms of alternatives in conjunction with thinking in terms of end points, i.e. a valid solution to a conflict is that which covers all open questions and is final and conclusive. But the actual practice suggests that it is also possible to resolve ethnic conflicts mid-way by combining mechanisms and tools from different models.

If this too were not to work, then, as Tony Judt said in an interview in 2010, Israel, while no doubt surviving, perhaps even as a Jewish state, risks losing its relevance for Jews and non-Jews around the world ‘as people forget the original impulse and historical circumstances surrounding its foundation.’

Italian Goodbyes, Comebacks and Déjà-Vu

Tags

Beppo Grillo, Berlusconi, Italian elections

Italy is currently at the centre of public attention.

There is, on the one hand, the Pope, the self-proclaimed representative of God on Earth (for Catholics), who has decided to resign because of old age, thus encouraging the hopeful conclusion that God may possess some common sense after all.

On the other hand, there is Berlusconi, media Czar and main proponent of ‘bunga bunga’ politics, who has managed a comeback in last week’s elections. What’s more, his vulgar and hyperbolic style is setting standards: at the other end of the political spectrum, the comedian and blogger Beppe Grillo has managed to obtain a twenty-five percent of the vote, largely by giving free reign to his anger over politics and politicians.

Berlusconi has scored with the promise to abolish taxation. Grillo has a non-programme (available in German here) comprising a shopping list of some hundred or so propositions ranging from harmless (e.g. free Internet for all or more research on rare diseases) to green (e.g. no more private cars in cities) to reactionary (e.g. yes to austerity, no to Europe).

Together, Berlusconi and Grillo have captured more than fifty percent of the Italian vote.

How to interpret these results?

The conclusion that a large part of the Italian electorate is behaving stupidly appears inevitable, whereby I am here using the term ‘stupid’ not to refer to lack of intelligence but rather its intentional suspension in order to make a point

The point being made by Italian voters who have voted for either Berlusconi or Grillo, is similar to that orchestrated by an old man who crosses the street when the red light/hand is flashing despite his fragility or rather in its denial.

Italians have been told there is no way around reforms in the areas of individual and corporate taxation, the labor market, pensions and health insurance. Many of these reforms are necessary for the long-term sustainability of social infrastructures – and not only, or even primarily, as a result of the financial crisis. Rather the latter has thrown light on the many systemic weaknesses with which our economies, especially in Southern Europe, have been functioning during the last decades.

Still, many Italians think it is possible to go on pretending political institutions are unnecessary whilst treating citizen responsibility as a commodity to be traded for mere diversion.

What is going to happen?

Keeping with the analogy of the old frail man crossing the street with the red light flashing in order to prove he is still young: unless he changes his behavior and does so fast he will be run down by a car.

Italy’s woes are serious but not unmanageable. The reforms the country is facing are long overdue. Delaying them further will only make the transition more painful and increase the country’s dependency on European funds.

New elections are very likely and may help clarify the situation. At least it can be hoped that, given a second chance, some voters will opt to exit from their denial position that renders them dependent on populists.

Horsemeat Sold as Beef – Open Questions

Tags

adulteration, EU, food, food industry, horsemeat, quality tests

The good news is that traceability rules work. Otherwise it would not have been possible in such a short period of time to discover the many food operators engaged in adulteration practices. According to ‘The Guardian’, it was the Irish who first came up with the idea to test for this, very likely after being tipped off. That was back in November. For various reasons, most notably, the fear of doing “huge damage to commercial interests,” the results were kept classified till they were confirmed. The waiting time was perhaps also necessary in order to gauge the geographical scope and dimensions of the scandal.

We now know we are here facing a criminal offence of enormous proportions involving food operators across the whole of the European continent and both in the low- and high-end markets.

Currently attention is focusing on restoring consumer confidence. Full clarification has been promised; new labeling rules are under consideration; and even DNA ‘authenticity’ tests are on the table as part of permanent procedures.

The latter are unlikely to materialize considering the costs involved. Insofar as labeling rules are concerned, these definitely require re-examination, also in relation to the rules for additives and enzymes which are frequently used in processed and frozen food. Agreeing on new rules will, however, take time.

The key issue that has however still to be tackled is that of safety and quality controls – both by food operators and by public authorities. An important question in this connection is how often have controls of frozen products been taking place? My guess is: very rarely, if at all.

I base this hypothesis on three observations:

• first, there is the extensive scale of the adulteration crime, which is indicative of a practice within the food industry of taking advantage of (a) known blind spot(s);
• second, official controls are the weakest link of the EU food safety regime as already shown by research (my own included);
• third, I could only find one international standard for frozen (meat) products dating back to 1976, last modified 2008, but on the whole a lightweight (CAC-RCP 8-1976).

Against the background of rising world-wide demand (and prices) for meat products (fresh or frozen) this was a felony too good and easy not to have happened.

When the Former Colonizer Fears Colonization: David Cameron’s EU Speech and the Reversal of British Identity

Tags

Britain, British identity, David Cameron's EU speech, European Union

Britain was once an empire, its colonies extending around the world. Today it is one other country member of a league of nations that strives to become a federal political union. It is not even one of the EU founding members, but rather a reluctant late-comer who has joined because it had no other choice and primarily for economic reasons.

It is a curious reversal of identity – from colonizer to an unstable state of fearing colonization – and as a citizen of a former British colony I am tempted to think, it ‘serves them right’ – but Schadenfreude and joking apart, this has been quite a serious transformation and the British, as a collective, have yet to digest it. This explains their difficult (strange, arrogant … all of the above) relationship to the European Union.

(And if you were to think I am over-psychologizing, then just take a moment to recall the feelings of British pride emerging in the course of the successful organization of the Olympic Games last summer – the ‘glorious rebirth of Britishness,’ or so the ‘Daily Mail’ – and you will know what I am talking about.)

This fear is quite prevalent in David Cameron’s EU speech which builds on six premises and advances the following points:

• Securing peace was the ‘first purpose’ of the European Union. This has been achieved.
• The main challenge today is ‘securing prosperity’ in the face of economic competition or ‘a new global race of nations.’

• Britain is ‘an island nation: independent, forthright, passionate in defense of our sovereignty’ (– a little bit of denial always goes a long way!!).
• This explains why for the British, the European Union is ‘a means to an end … not an end in itself,’ a pragmatic approach (– no offence taken).
• Britain is not just independent, it is also an open nation: ‘I am not a British isolationist.’ (Aha!)

• There are two sides of the European Union: the Single Market (good thing) and the political union and related mechanisms (bad thing) (talk about splitting!)
• Britain wants the Single Market (good thing).
• Britain does not want a political union (bad thing).
• To seek more integration is ‘more of the same’ and ‘more of the same will just produce more of the same: less competitiveness, less growth, fewer jobs.’ (What a sentence!)

• Britain wants flexibility and flexibility is to be understood as follows:
• Despite not agreeing to political integration, Britain wants to have a say in (Treaty) decisions affecting the Eurozone since such decisions will impact on the Single Market, thus on Britain’s competitiveness.

• In the name of democratic accountability, there should be a referendum on whether Britain shall remain a member of the European Union.
• This referendum will, however, not take place now but in three to five years time. This gives Britain’s European partners an opportunity to accommodate Britain’s interests so as not to lose a strong and valuable partner.

• Exiting from the European Union is not a good option for Britain. ‘Of course Britain could make her own way in the world, outside the EU, if we choose to do so. So could any other member state. But the question we will have to ask ourselves is this: is that the very best future of our country?’
• (And some more pragmatic pro-EU discourse for the end): ‘Even if we pulled out completely, decisions made in the EU would continue to have a profound effect on our country. But we would have lost all our remaining vetoes and our voice in those decisions. … The fact is that if you join an organization like the European Union, there are rules. You will not always get what you want. But that does not mean we should leave – not if the benefits of staying and working together are greater.’

Cameron and his advisers are not the best speech writers and this partly explains his convoluted line of argumentation. But at another level the style is quite authentic in revealing both the internal inconsistencies of the British (Conservative) position and the inability to come to terms with it.

David Cameron is correct to highlight that the European Union began as a Single Market and that the removal of barriers to competition does not necessitate a political integration even if requiring the harmonization, at least in part, of standards (social, environmental, safety, etc.). But the European Union ceased to be just a Single Market long before the present crisis – at the latest when it was decided to establish a monetary union back in the early 1990s.

Yet a monetary union cannot function properly without a fiscal union, a central bank, common supervisory bodies in the finance sector, etc. etc. – in brief a political institutional arrangement that makes it possible to balance the interests and needs of the (rich) centre with those of the (poor) periphery, among else through the uncomplicated transfer of funds.

Cameron seems to recognize this when he admits that the Eurozone has a right to proceed with reforms and that such reforms are necessary in order to better deal with future challenges. But he stubbornly maintains the British ‘no play’ position and that for two reasons: first, he is worried about British public opinion, his own party and the next elections (three things he tends to confound); second, the Europe of ‘two speeds,’ which he so laments, is already a reality and – bummer – Britain is stuck on the wrong side. Hence also his wish to see the process of political integration slow down.

If he succeeds, that is bad news not only for Europe but also for Britain. Britain will always be a proud ‘island nation’ with a celebrated – yet sometimes inglorious – past. That is beyond doubt. The question is rather what shall its future be.

For guidance, the British may like to pay attention to the fourth verse of their national anthem which goes like this: ‘Lord make the nations see / That men should brothers be / And form one family / The wide world over.’

Women and Fiction: Shakespeare’s Sister and Virginia Woolf

Tags

books, feminism, Virginia Woolf, women and fiction, writing

Most writers ask themselves – at some point in their lives, every now and again or all the time – why they write, what or how they (should) write, what they gain but also lose by writing, whether writing is fun or torture, what drives them to write but also what tears them apart, how they are to relate to their ideal and real readers, what is the link between fiction and reality, their real lives and those imagined, for themselves or their characters …

This is one of those lists that can be continued in perpetuum or ad absurdum, take your pick.

It is inescapable and rid with pain, yet important: some of the most interesting literary and philosophical reflections have emerged by confronting it.

A prime example is Virginia Woolf’s essay A Room of One’s Own written in 1929 but still topical today. It deals with the subject of women and fiction by way of the example of Shakespeare’s sister.

Did Shakespeare have a sister?
We don’t know.
We know so very little about Shakespeare – we even do not know whether he was actually his own author.
His wife was supposedly Anne Hathaway, she was older than him, bore him three children, but it is unlikely, or so it is claimed, that the sonnets that celebrate love’s desire and mourn its loss were inspired by her. All we know about Anne Hathaway was that she was bequeathed only the “second-best bed,” what many have read as indication that she was second rate, as a wife, a woman, or an author’s inspiration.

Considering this, if Shakespeare’s sister did exist, it is better she went unnoticed.

Shakespeare’s sister, by the name of Judith, is a fictional creation by Virginia Woolf. This does not mean she never existed in reality. All it says is that she definitely existed in fiction.

Virginia Woolf imagined Shakespeare’s sister while preparing a lecture on women and fiction, an ambiguous subject: “The title women and fiction might mean … women and what they are like; or it might mean women and the fiction that they write; or it might mean women and the fiction that is written about them; or it might mean that somehow all three are inextricably mixed together.” (p.4)

Women have inspired men all through the centuries serving “as looking-glasses possessing the magic and delicious power of reflecting the figure of man at twice its natural size” (p.35) and it is for this reason they also figure so frequently in fiction written by men. But unfortunately, this function of mirroring comes with a price tag, namely that of presumed inferiority, “for if they [women] were not inferior, they would cease to enlarge.” (p.36)

In the Elisabethan age, for several centuries before and for some thereafter, women were indeed inferior since they had no access to education – and that is also why “it would have been impossible, completely and entirely, for any woman to have written the plays of Shakespeare in the age of Shakespeare” (p.46). Therefore, had Shakespeare a sister – and don’t forget her name was Judith – she was for certain doomed to inconsequentiality, much like his wife Anne, regardless of the fact she might have been both beautiful and gifted. In actual fact, it is better to imagine she was not gifted, because had she been a genius, yet been granted no access to the tools for harnessing her gifts, as that was objectionable on grounds of principle and morals, she probably would have ended up “gone crazed, shot herself, or ended her days in some lonely cottage outside the village, half witch, half wizard, feared and mocked at.” (p.49)

The fear to be mocked or be misunderstood runs deep. Even when women did begin to write they had trouble emerging out of anonymity. They were still “at strife against [themselves],” possessed by “the desire to be veiled.” (p.50) This desire hides a deep-seated fear and sense of insecurity, and is still very much alive, which is why women writers are today still not as prolific or imaginative as men. They are still perhaps using writing mainly as a form of self-expression rather than art, and still unable to forget that they are women, that is to say a gender category which is sociologically defined. But, so Woolf, “it is fatal for anyone who writes to think of their sex. It is fatal to be a man or woman pure and simple; one must be woman-manly or man-womanly” (p.103)

Hence, the importance for women of a room of one’s own, over a period of several centuries, on the road to self discovery and beyond mere self expression

Shakespeare’s sister, Judith, was Virginia Woolf’s demon – her creative inspiration and the source of her doubts. Many a times she thought she had ‘gone crazed’ and eventually she ended up killing herself.