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ALIENATION:
THE IMPOSSIBLE
CLINICAL
ELABORATION

 
 

 

 

Liviu Poenaru

Since Marx (1867), we have had an immense body of knowledge (Fromm, 1955; Haber, 2007; Rosa, 2010; Saha, 2021) suggesting that alienation could be at the root of numerous individual, societal, economic, and philosophical issues. Rosa's approach of alienation, for example, emphasizes both subjective experiences of estrangement and broader structural factors that contribute to feelings of disconnection in contemporary life. When grasped correctly, proposes Haber (2007), alienation enables us to directly apprehend the core of a life that drifts past itself, encountering this deprivation through suffering and self-imposed constraints. From this perspective, alienation emerges as the tangible encounter with a loss of our personal agency, reflecting and manifesting, in its unique manner and through diverse manifestations, some of the various societal afflictions. As long as these ailments continue to spread, there remains cause to contemplate under the age-old moniker of "alienation".

 

Despite the potential omnipresence of (economic) alienation in contemporary cyber-capitalist societies, the concept is still repressed within the disciplines of psychology, psychiatry, and psychopathological theorizing. Two interpretations could shed light on this massive political and ideological repression, potentially harmful to the mental health of populations. The first would start from the assumption that Western propaganda, culture, and politics have been working tirelessly for decades to obliterate Marxist ideas associated with the red peril (communism), academic stigmatization, and intellectual obsolescence. The ideology of progress, innovation, and the well-being of Western societies has contributed to the minimization of history and critique. Thus, intellectuals and clinicians have themselves succumbed, consciously or unconsciously, to this ideology.  

The second interpretation could rely on the inherently unconscious and implicit nature of alienation, which could only be subjected to repression on both the patient's and the therapist's side. Alienation often touches on profound existential issues, such as meaning, purpose, and identity. Confronting these issues can evoke existential anxiety, which is the fear and uncertainty associated with contemplating one's existence and the broader meaning of life. Patients may resist exploring these themes because they are inherently unsettling and can lead to a sense of existential crisis. Exploring deep-seated feelings of alienation may thus uncover repressed or unconscious material that can be threatening to one's self-concept. This material might include unresolved conflicts, economic neurosis (Poenaru, 2023), traumatic experiences, or unacceptable desires (themselves potentially interconnected with economic conditions). Identity is often intertwined with socio-cultural norms and expectations. Therapeutic exploration that challenges these norms can be experienced as a threat, especially if it leads to questioning long-held beliefs or values. This can result in a fear of social rejection or isolation if one's evolving identity deviates from societal expectations. 

The philosophical, scientific, and epidemiological literature encourages us to propose in the following an investigation of the clinical relevance of the concept of alienation according to 2 axes:  

1) its role in psychopathology;  

2) its impossible clinical elaboration. 

ECONOMIC & UNCONSCIOUS ALIENATION

The worker becomes all the poorer the more wealth he produces, the more his production increases in power and range. The worker becomes an ever cheaper commodity the more commodities he creates. With the increasing value of the world of things proceeds in direct proportion the devaluation of the world of men. Labour produces not only commodities; it produces itself and the worker as a commodity – and does so in the proportion in which it produces commodities generally (Marx, 1844/1964, p. 120-133). 

 

In his critical theory of economics and capital, Marx identifies alienation from the product of labor and from the process of labor, alienation from others, and alienation from self. He lays substantial groundwork for the theorization of a major concept in industrial and contemporary society. According to Marx, workers are alienated from the goods they produce because these goods are owned and controlled by capitalists. They have little or no control over the production process, which is often monotonous and dehumanized, dictated by the needs of the capitalist system. Capitalism fosters competition rather than cooperation, leading to estranged relationships among workers. Instead of forming a community, workers are pitted against each other. In this context, workers are alienated from their own human potential and creativity because their labor is reduced to a mere means of survival, rather than an expression of their individuality and creativity. 

From Marx's perspective, alienation is of an economic essence and can only be understood as a concept associated with unconscious economic mechanisms and dynamics. Furthermore, it presupposes the mobilization of neuro-cognitive-behavioral and emotional mechanisms that are widely known by current sciences (Poenaru, 2023). The Marxist unconscious, as depicted in Marx's writings, remains relatively obscure within the realm of psychology, save for Marxist psychology, which regrettably finds itself consistently marginalized within academic spheres. It is Marx himself who propounds this fundamental principle: "The thoughts of the ruling class are, in every epoch, the ruling thoughts." In essence, this signifies that the cognitions, intentions, disjunctions, and ideals of the ruling class inevitably prevail as the dominant ones across epochs, heavily contingent upon historical materialism—that is, the influence of the means of production on mentalities and social relations. 

For a proper grasp of the Marxist unconscious, it's crucial to highlight the inseparable link between the economic and the social realms. This entails the operation of unconscious mechanisms transmitted through social interactions, politics, cultures, and more. According to Marx, the social sphere is fundamentally rooted in the economic domain, with the economic holding a logical precedence over the social—a fundamental principle elucidated by Marxism. This perspective may seem simplistic when compared to propaganda and certain psychological and psychoanalytic perspectives, which depict individuals as "autonomous" entities detached from their surroundings, independent, individualistic, and self-directed. 

For Kaës (2014), the collective negative pact (leading to symptoms, denials, and common bizarre objects) also implies pacts of rejection (collective rejection of representations attached to alienation), perverse alliances, and collective alienations signified by shared madness, with the complicity of peers further contributing to the reinforcement and stabilization of the delusion. 

Alienation, unlike psychosis, involves and preserves a state of total ignorance on the part of the alienated person regarding the accident that has occurred to their thinking. (...) The psychotic may ignore the term 'psychosis' but remains capable of thinking about the state of dependency, exclusion, conflict, or mutilation imposed on their thinking activity. Alienation presupposes a lived experience that is unnamable and imperceptible by the person experiencing it (Castoriadis-Aulagnier, 1979, p. 38). 

These contemporary views of alienation demonstrate once again the fundamentally unconscious nature of alienation, which can nevertheless take various forms: psychological (feelings of isolation, powerlessness, and meaninglessness), social (estrangement individuals feel from their social surroundings and communities), cultural (when individuals feel disconnected from their cultural heritage in conflict with the dominant digital culture), marxist (estrangement of workers from the products of their labor, the labor process, their fellow workers, and their own human potential), philosophical (arising from the individual's confrontation with the absurdity of life, the inevitability of death, and the inherent isolation of the self), among others.

The economic dimension of alienation, particularly in Marxist thought, provides a robust framework for understanding its causes and effects within capitalist systems. However, this is only one aspect of a more complex and multifaceted concept. Alienation transcends economics, encompassing psychological, sociological, cultural, and philosophical dimensions. Nevertheless, it is challenging to isolate these dimensions from their interactions with the pervasive influence of economic codes, as these codes permeate various layers of human experience, making it difficult to separate one dimension from another. Understanding alienation in its full complexity requires recognizing how economic factors shape and are shaped by psychological states, social relations, cultural environment, and philosophical concerns. This holistic view acknowledges the profound interconnectedness of human experiences and the pervasive influence of economic systems. 

For example, economic instability and insecurity can lead to stress, anxiety, and depression (Guan et al., 2022; Guerra et al., 2021; Ridley et al., 2020). The precarity of gig economies or the threat of unemployment can undermine an individual's sense of stability and self-worth. Capitalist economies promote consumerism, which can shape individual identities and values. Economic systems create and reinforce class distinctions, influencing social interactions and relationships. The division between capital owners and workers, for example, fosters a sense of alienation between different social groups. Philosophically, the quest for meaning and purpose is often overshadowed by economic demands. The focus on economic success and material wealth can lead individuals to neglect deeper existential questions, exacerbating a sense of philosophical alienation. Economic systems influence ethical and moral considerations (Wight, 2015; Banks et al., 2022). The prioritization of profit over human well-being can lead to ethical dilemmas and moral alienation, where individuals feel disconnected from their own ethical standards.  

Moreover, economic codes influence cultural norms, shaping what is valued and how success is defined. Economic systems shape cultural norms, values, and practices in significant ways, affecting everything from individual identities and social interactions to public policies and global cultural trends (Kostis, 2021). This cultural penetration makes it challenging to separate economic influences from other dimensions of alienation. Economic priorities often drive public policies and governance structures, affecting social welfare, education, and healthcare systems1 (Kentikelenis, Rochford, 2019). The global economy and rapid technological changes driven by economic imperatives further complicate the landscape. These interconnected dimensions demonstrate the impossibility of defending the existence of psychological, sociological, political, cultural or philosophical aspects of human life isolated from economic codes. 

The interactions mentioned above can only be translated into mechanisms and processes of a neuro-cognitive-behavioral nature, which are by default unconscious due to the automatic nature of many behaviors, the need for cognitive efficiency, the influence of emotions, social and cultural conditioning, and underlying neurological processes. Understanding these unconscious mechanisms provides insight into how economic behaviors are formed and maintained, often without the individual's conscious awareness. 

PSYCHOPATHOLOGIE

 

As previously suggested, alienation (especially its complex and indiscernible network of related factors) can have profound effects on individuals and societies. On a personal level, it can lead to mental health issues such as depression, anxiety, and existential crises. In the majority of cases, the consequences related to multiple dysfunctional contexts do not take the factor of alienation into consideration. Thus, analysts and researchers, especially in medical settings, generally emphasize bio-psycho-social factors that are dissociated from alienation. This concept, while significant, may not always be readily integrated into existing frameworks for understanding human behavior and health. Alienation, rooted more deeply in sociological and philosophical realms, has not received the same level of attention. Without a doubt, the two main reasons mentioned above (economic-political propaganda and the fundamentally unconscious nature of alienation) have contributed to this state of affairs. Some approaches in biomedical and psychological research tend to reduce complex phenomena into simpler, measurable variables. Alienation, with its nuanced and holistic nature, may not easily fit into reductionist frameworks. Many Western societies emphasize individualism and personal responsibility, which may downplay the societal and structural factors that contribute to alienation. Economic systems shaped by neoliberal ideologies often prioritize individual success and competition, potentially marginalizing discussions of alienation rooted in critiques of capitalism and social structures.

Identifying alienation within the implicit and explicit mechanisms and dynamics of human behavior requires a nuanced understanding of its various manifestations and contexts. By paying attention to existential, social, psychological, and cultural dimensions, as well as the impact of labor and work on individuals' experiences, we can begin to recognize the signs of alienation and work towards addressing its underlying causes.

Social exclusion, a form of alienation where individuals or groups are denied the opportunity to participate in societal activities, has been linked to various mental health issues (Durkheim, 1897; Perkins & Repper, 2003). Ali et al. (2019) emphasize the need for conceptual frameworks to better understand and address the stigma associated with mental health conditions, which can lead to profound feelings of alienation. Socially, alienation can result in a breakdown of community cohesion, increased social conflict, aberrant political decisions, and a sense of disenfranchisement among individuals. Social cohesion is often considered the "glue" that holds societies together (Moustakas, 2023), characterized by positive social relations, a sense of belonging, and collective identity. When individuals experience alienation, these bonds weaken, leading to a fragmented society. Research indicates that higher social cohesion is linked to better health, less loneliness, and a community's ability to solve collective problems. Conversely, alienation disrupts these positive outcomes. Alienation can exacerbate social conflicts, particularly in contexts where marginalized groups feel excluded from societal benefits (Ozcurumez, Hoxha, 2020).

The circular causality at play and the plurality of factors potentially responsible for alienation suggest several modalities of expression of alienation: stress, existential discontent (feelings of emptiness, existential anxiety, loss of one's own values and beliefs), social isolation (perception of oneself as foreign or marginal), psychological distress (feelings of abnormality, confusion or conflict regarding identity and self-perception, difficulties in reconciling internal experiences with external expectations), loss of autonomy and control over one's work or life circumstances, etc.

We now have proof that cybercapitalism (much more than previous economic systems, due to the 24/7 injection of economic codes via the Internet and smartphones) leads to multiple psychological and physical pathologies. The increasingly artificial, invasive, and consumerist economic logic of work makes people sick and kills (social murder, Medvedyuk, Govender, Raphael, 2021), and not always for understandable reasons, particularly in the case of the scopophilic society. In all cases, with social murder, we face the most extreme version of capitalism, similar to the version of cybercapitalism that kills young Instagram users by turning their image into a matter of survival.

The economic codes that are constantly injected into our minds and bodies via digital technology seem to jeopardize the bio-psycho-social integrity of individuals, potentially triggering self-destructive behaviors. As Twenge (2020) outlines, after relative stability in the early 2000s, the incidence of mental health issues among adolescents and young adults in the United States began to rise sharply in the early 2010s. This increase is marked by significant upticks in depression, anxiety, loneliness, self-harm, suicidal thoughts, suicide attempts, and completed suicides, with the most notable rises among girls and young women. A growing body of evidence suggests that these trends may be associated with the increasing use of technology. In addition, social media use, as we all have experienced, has been associated with increased anxiety (Moreno et al., 2020). These data are confirmed by Frances Haugen, the Facebook (now Meta) whistleblower, who announced that in 2021 the company (which also owns Instagram) was aware that the use of its applications led to an increase in suicides among young girls: 'We make body image issues worse for one in three teen girls,' stated a slide from an internal presentation by company researchers in 2019. This information was reportedly published on Facebook's internal message board and viewed by The Wall Street Journal (Wells, Horwitz, Seetharaman, 2021).

The context we are examining, therefore, is a significant source of exponential stress and allostatic load (Juster, McEwen, & Lupien, 2010). It's clear: continuous exposure to a fight, flight, and freeze logic—where we simultaneously engage in combat-like struggles, seek escape, and become immobilized by screens that exploit our unconscious attraction to negative stimuli—inevitably leads to heightened stress levels. Psychosocial stress induces changes in cognition, affect, and behavior (Wolf, 2018), while an increasing number of studies highlight its effects on inflammatory reactions and the immune system (Yan, 2016). Pruett (2003) emphasizes that there is now irrefutable evidence that stress responses can cause clinically significant immunosuppression and other immune dysfunctions. The production or action of stress mediators is primarily responsible for these undesirable immunological effects.

Western populations are faced with multiple sources of stress, resulting in health consequences, including autoimmune, psychiatric, cardiovascular, dermatological, neurodegenerative diseases, and cancer (Yan, 2016). Epidemiological data and the increase in medication sales highlight the stress and prevalence of psychological and somatic illnesses in society. Prevalence rates in developed countries show that 27% of children aged 5 to 14 in Australia and 26% in the United States live with some form of long-term chronic illness. Research by Zheng et al. (2020), consistent with findings by Park et al. (2013), indicates that approximately one-third of adolescents in the United States suffer from chronic medical conditions, which are often accompanied by poor mental health. Furthermore, according to Winkler et al. (2020), the prevalence of individuals experiencing symptoms of at least one current mental disorder increased from 20.02% in 2017 to 29.63% in 2020, during the COVID-19 pandemic. According to US Centers for Disease Control and Prevention, the number of people who died from a drug overdose in 2021 was over six times the number in 1999.

Let's take another example. The French High Council for Family, Childhood, and Aging (Haut conseil de la famille, de l’enfance et de l’âge) reported a significant rise in medication use among children and adolescents in 2021. Despite a lack of robust studies on their efficacy in children, and findings suggesting minimal differences between treated and control groups, the consumption rates soared:

  • Hypnotics saw a 224% increase;

  • Antipsychotics rose by 7.5%;

  • Anxiolytics went up by 16%;

  • Antidepressants increased by 23%.

 

These rates are significantly higher, ranging from 2 to 20 times, compared to the general adult population. This raises some questions: Why are young people (and not only them) so vulnerable? Can this immense body of knowledge be understood without taking the concept of alienation into consideration? We argue that without a nuanced approach to alienation, the network of associated factors will remain forever repressed by individuals, society, and health professionals. And yet, this development is encountering a great deal of resistance.

 

THE IMPOSSIBLE ELABORATION

 

In addition to its fundamentally unconscious nature, the concept of alienation is inherently transversal; in other words, it reveals its particularities only at the intersection of various disciplines. It’s conceptual diversity makes it challenging to pin down a single, unified definition that can be easily operationalized for psychological study. The term itself originates from various intellectual traditions, each emphasizing different aspects of the experience, from Marxist notions of worker alienation in capitalist societies to existentialist themes of existential dread and meaninglessness. Alienation is inherently a subjective experience, varying significantly from person to person. This subjectivity complicates attempts to develop standardized psychological measures or interventions. What one individual experiences as alienation might be perceived differently by another, depending on their personal, cultural, and contextual background. Psychological research often seeks to identify patterns and generalizable findings, but the deeply personal nature of alienation resists such generalization.

Throughout this work, we have discussed reasons why alienation (as both an unconscious and socio-economic-political entity) resists therapeutic elaboration. Furthermore, the therapist who attempts to name it may face protest reactions suggesting that they are on the wrong track and should return to the classical concepts of therapeutic understanding, primarily focusing on family traumas. Patients themselves can then act as guardians of the normative framework of psychotherapy. However, if our hypothesis is confirmed, we have many reasons to resist as well and to continue our work of deconstructing alienation to avoid becoming alienated therapists (Parker, 2007). Parker reminds us that psychology is meant to help people cope with the afflictions of modern society. He argues that current psychological practice has become part of the problem, rather than the solution. Mainstream psychology often perpetuates social control by pathologizing individual behaviors and experiences that deviate from normative expectations. He suggests (in line with Fromm) that traditional psychological practices tend to focus on individual pathology without adequately addressing the socio-political contexts that shape human experience.

From this perspective, the therapeutic framework must contend with societal norms, professional norms, and the norms internalized by the patient. Therefore, the elaboration of alienation seems impossible. But this is not a reason to give up, as it poses ethical problems as long as it is the source of many pathologies. Furthermore, it appears to be a key element of the pathogenic system we are experiencing with cybercapitalism. Therapists need to integrate an understanding of socio-economic and political factors into their practice before addressing the issue of alienation. This approach requires a shift from viewing the patient solely as an individual with personal pathology to understanding them as part of a broader socio-political context. This holistic approach can help address the root causes of alienation.

In the psychoanalytic approach, this implies interpreting childhood traumas also as consequences of a network of socio-political-economic factors that we have discussed earlier. It seems important to us that the associative and interpretative work within the therapeutic framework takes into account the biological foundation, sexuality (extensively theorized by psychoanalysis), primary relationships, and the way these have consolidated object relation configurations that can repeat in various contexts of the patient's emotional, social, and professional life. Equally important, and requiring in-depth training and the therapist's commitment to critical discourse, is that the associative and interpretative work relies on hypotheses related to the socio-political-economic context in which primary and secondary (childhood and adult) relationships have evolved.

But let us not forget that not everything is a question of trauma, at the risk of falling into one of the dogmas of psychology and society. From birth (and even before), we have been conditioned and imprinted, like Pavlov's dogs and Lorenz's geese, to the economic stimuli that have colonized our reflex circuits. We do not need to be traumatized to be conditioned, and much of alienation resides in this conditioning. Education is enough. Moreover, the dissemination of fear by economic and media propaganda encourages ever-increasing production and consumption, posing risks to physical and mental health, including autoimmune diseases. We live in an era of neuro-cognitive-behavioral and emotional manipulations based on stress, fear, and the ideology of risk, which lead to increased online engagement (the primary aim of cybercapitalism). In terms of the inseparable fear tied to stress, recent research suggests that the deliberate use of fear by political-economic authorities may aim to cultivate sensitivity to specific stimuli (Poenaru, 2023). This sensitivity is sustained at the neuronal level through the reinforcement of synapses that facilitate such responses.

PERSPECTIVES 

 

We now have evidence that alienation is a crucial element for understanding contemporary pathologies. When analyzed from the perspective of unconscious functioning, alienation can be seen as a complex interplay of mechanisms and dynamics rather than a singular entity or static structure. This conceptualization can align with various psychoanalytic, psychological, sociological and critical theories that, taken together, offer the possibility to unpack the intricacies of alienation, first at the theoretical level and then at the clinical level. This entails establishing in-depth research programs to better understand its mechanisms and how we can intervene clinically to overcome the resistances we have highlighted.  

Certainly, psychoanalysis could play a crucial role in this program, given the highly complex unconscious dynamics involved. However, this requires developing new perspectives on the existence, at the unconscious level, of representations and affects stemming not only from early relationships but also from how these relationships (as well as the maturation process and all stages of an individual’s life) are continuously influenced by the codes of consumer society and their alienating potential. 

Although alienation is fundamentally a complex, transversal, and unconscious concept, it seems that we already have many techniques and theoretical models for its deconstruction, which undoubtedly requires the time for insight and the easing of resistances. Psychoanalytic methods uncover unconscious processes, while socio-political, critical, economic, and philosophical perspectives highlight broader systemic factors. For, ultimately, isn't it the mission of psychoanalysis to elaborate repressed representations and go beyond manifest contents while breaking the barriers of the unconscious in order to stimulate mentalization?  

Contemporary models thus offer multiple avenues for intervention that combine these insights to promote individual and collective well-being beyond norms. This holistic approach may ensure a comprehensive understanding and effective deconstruction of alienation, fostering greater psychological and social integration. 

 

REFERENCES 

 

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Notes

Centers for Disease Control and Prevention, Understanding the Opioid Overdose Epidemic.

Available online: https://www.cdc.gov/opioids/basics/epidemic.html

 

Haut conseil de la famille, de l’enfance et de l’âge, Conseil de l’enfance et de l’adolescence (2023). Quand les enfants vont mal : Comment les aider ? Available online : https://www.hcfea.fr/IMG/pdf/hcfea_sme_rapport_13032023.pdf   

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