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Psychiatric Times
Column: Second Thoughts
Link: https://www.psychiatrictimes.com/view/against-the-myth-of-independence-for-a-more-
convivial-and-interdependent-society
Against “The Myth of Independence” –
For a More Convivial and Interdependent Society
March 27, 2024
Vincenzo Di Nicola, MPhil, MD, PhD, FCAHS, DLFAPA, DFCPA
No more fiendish punishment could be devised … than that one should be turned loose in
society and remain absolutely unnoticed by the members thereof.
– William James1
In my first column in this series, “Social Psychiatry Comes of Age,” I promised to take up the
contributions of the three branches of social psychiatry. Stay tuned.
First, some groundwork is necessary for us to establish a social psychiatric framework in which
to define and test our contributions. A leader in cultural psychiatry asked me why I dismissed the
biopsychosocial (BPS) model in my first column. Another leading social psychiatrist pointed out
that a spiritual dimension should be added to BPS. Why not add developmental or relational
dimensions, as I understand there were discussions to add them to the multiaxial system of DSM-
III and IV? And why not epigenetics or exposomics which cut across and integrate “bio” and
“social”? And most compelling for me, the socio-economic dimension which is at the heart of the
Social Determinants of Health and Mental Health. It risks ballooning into an endless regress.
Many problems arose with the BPS model. First, it was constructed as a rejection of the
“formulation” of psychodynamic psychiatry and it became a cover for biological psychiatry to
2
claim it was comprehensive. More important than BPS’s flawed starting point and reductive
finale, in any eclectic or multiaxial approach, the social context is bound to be just another add-
on, icing on the cake. This is upside down: in psychiatry, we should start with social context and
add everything else to that framework (the task and hence the starting point would be different in
neuroscience, but I’m talking about psychiatry). Social context is baked into the cake. As the
pioneering neuropsychologist Donald Hebb at McGill demonstrated with his sensory deprivation
experiments, the brain can only function in a rich bath of internal and external stimuli.2
The neurophysiological nature of the brain is relational. Hebb’s cell assemblies are little
communities of neurons working through a rich interplay of messengers. This gave rise to
Hebb’s Law: “Neurons that fire together wire together.” And the discovery of “mirror neurons”
by neuroscientist Vittorio Gallese at the University of Parma has provided the link between
events in the external environment and their mirroring in the brain as the basis for “embodied
simulation theory” (a theory of social cognition) with implications for everything from empathy
to autism.3
Now, I want to do some gardening in the palace of psychiatry. As I walk around the untended
gardens of the “psy disciplines” – the palace of psychiatry, the psychology campus, and
psychotherapy’s big circus tent – I see an awful lot of buzz words and viral memes crowding out
the carefully cultivated plants like weeds. Some of them risk killing the plants around them
altogether like bougainvillea encroaching a tree. The flowering bougainvillea is beautiful but it
chokes the tree of life!
Plastic Words
I will name these buzz words and put them in quotes to signal that I want to examine them and
come to terms with them. Uwe Poerksen, a German scholar, called them “plastic words” because
of their malleability and uncanny capacity to fit any circumstance.4
Plastic words start as
scientific words with specialized meanings but then migrate into everyday usage, stripped of
their specialized meanings. If we are to have an encompassing theory of persons – my definition
of psychology – we have to sort out these plastic words like so many weeds in the garden.
3
As a child and adolescent psychiatrist, family therapist, and social and cultural psychiatrist,
I toil in exactly those areas of the garden that are filled with plastic words – “development,
family, culture, and society” – and of course, everything relating to “mind” and “mental states.”
All of these are notoriously difficult to nail down. And sometimes we don’t want to. In legal
philosophy, for example, there is the notion of the “fuzzy concept” – you want a principle
expressed that is “fuzzy” or elastic enough to anticipate future possibilities.5
In our field, if we
define “family” too narrowly, we will not only offend sensibilities (What about same-sex
parents? What about polyamory, polygamy or polyandry? What about communes?) but leave out
all kinds of actually lived family forms. As to “child development,” I have a simple remedy to
the conundrum of defining it – instead of referring to this slippery construct about growth, just
think of real children. As I have written, we think too much of the concept of development and
too little of actual children.6
And I am critical of the notion of development across the board,
from developmental psychology to economics and politics (see my Slow Thought Manifesto7
and
my socio-political essay on the Global South8
). More about that in later columns.
The Invisible Man – 21st Century Versions
For now, walking around my garden, I stumble over “loneliness,” “happiness,” “burn-out” and
“trauma.” To follow media accounts, it would seem that the world is either filled with the search
for happiness or people are walking around like emotional zombies struggling to express
themselves and to be seen. The 2024 World Happiness Report shows that Finland stayed at the
top of country rankings for the seventh year, the USA fell out of the top 20 while Canada’s
steady in 15th
place, and Israel dropped only one place to 5th
place from last year despite being at
war – go figure!9
Meanwhile, “loneliness” and “burn-out” are seen to be stalking young and old alike, creating 21st
century versions of The Invisible Man (I am referring both to H.G. Wells’ 1897 science fiction
version and Ralph Ellison’s more disturbing racial version from 1952), presciently described by
William James in my opening epigraph from his Principles of Psychology.1
4
A worrisome social phenomenon concerns young men who identify as “incels” – or involuntary
celibates – an online support community of young males who are unable to have the heterosexual
relationships they desire.10
Incels, ironically first named by an anonymous Canadian female
calling herself Alana, are estimated to number in the tens to hundreds of thousands and are
perceived as an extremist, supremacist group of men imbued with a sense of predestined
personal failure and nihilism. Such attitudes and beliefs may lead to suicide and various forms of
sexual violence, from “catfishing” (creating a fake online identity in order to deceive) to
femicide. The case of Marc Lépine here in Montreal of the École Polytechnique massacre of 14
women in 1989 has been linked to this movement. As with repressed faith, society eventually
pays a big price for invisibility in the form of repressed sexuality. And “trauma,” which is
“everywhere” in our “toxic culture,” according to Canada’s trauma guru Gabor Maté,11
is
nonetheless somehow unspoken and unheeded. What does all of this actually mean? To cite
Facebook’s ambivalent option about relationships, “It’s complicated”!
So I will be spiraling around these themes repeatedly in this column, taking up definitions,
controversies, trying theories on for size, and discarding them when better ones come along.
That’s the real spirit of science – constant experimentation, questioning and innovation –
not certainty or convictions. Belief, certitude, even fidelity are the stuff of faith, not of science.
That said, faith may be the most repressed and neglected aspect of contemporary social and
political life. And to evoke Freud’s most poetic phrase, the US is now experiencing “the return of
the repressed” with Evangelical Christians and other religious groups demanding their say. A
future column will celebrate Dr. H. Steven Moffic’s remarkable series of volumes on religion,
spirituality and psychiatry, from Christianity to anti-Semitism and from Islam to Eastern
religious and spiritual traditions.
The I’s of Western Psychotherapy
Now, let me take on some of the most divisive notions in the Western world and the Global
North: individualism and independence. (I harbor the comforting hope – maybe an illusion? –
that this isn’t true everywhere.) Raymond Prince, MD, my mentor in social and transcultural
psychiatry at McGill, elaborated the notion that psychotherapy in the West revolves around
5
several “I” words: the individual as the focus of therapy, personal independence as a therapeutic
goal, and introspection and insight as a therapeutic method. Therapy with individuals is
undergirded by Murray Bowen’s “differentiation theory,” implying that the goal of personal
development and hence of therapy should be independence. Meanwhile, two of the most
successful versions of family therapy in the hands of people like Salvador Minuchin, MD
(structural family therapy which is the application of differentiation theory) or Jay Haley, MA
(strategic family therapy) was to put parents in charge of rebellious children and teens. And they
went so far as to minimize their suffering by calling them “identified patients” who were merely
manifesting conflicts of the family system. So much for independence, so much for respecting
each child’s developmental pathway. The ironies abound.
When I constructed my model of cultural family therapy, my motivation was to challenge what I
called “the myth of independence.”12
In this myth, the goals of therapy are to work on
individuals, isolated from their family, communal and social contexts. As Minuchin once
complained, psychoanalysis deals with “man out of context.”
And this plays out in society and in politics as well. Conservative British Prime Minister
Margaret Thatcher infamously declared that, “There is no such thing as society,”13
while
conservative critics argued that in socialist societies like the Soviet Union, there was no such
thing as the individual. Like most binary oppositions, these extremes do not describe lived
reality. Not only is society real but the very British tradition of “the commons,” defined as the
“social practice” of governing a resource not by the state or the market but by a community of
users that self-governs that resource through institutions that it creates, was the basis for
democracy and progressive movements. Economists have analyzed the “tragedy of the
commons” in economic and social theory which describes what happens when people struggle
for their individual demands against the common good.14, 15, 16
And not only is the individual real but it takes almost totalitarian coercion to disabuse people of
the sense of their own individual consciousness and need for agency (control of their own lives)
and the search for meaning (which is the subtext of the humanistic and positive psychology and
psychiatry movements). And we must consider the possibility that the nature of this coercion has
6
become subtler and more pervasive through social media. Critical theory in philosophy and
sociology with thinkers like Theodor Adorno of the Frankfurt School is one long interrogation of
these subtle and almost invisible coercive tools available to convince people that they are free
when in fact their choices are highly constrained and predetermined.17
Ultimately, independence is a myth because we are all richly interdependent upon each other.
In his class-busting play, Pygmalion, George Bernard Shaw wrote: “Independence? That’s
middle class blasphemy. We are all dependent on one another, every soul of us on Earth.”18
Some
of us can live the illusion of being independent because the people, systems and structures
around us serve our interests (as we serve theirs). Children, the elderly, and the infirm are more
obviously dependent, but so is anyone who has a team and a series of institutions, rules and
regulations in place to support what appear to be professional and personal choices. In fact, I am
more interdependent as a child psychiatrist than most of the children I see because I am
reciprocally acting in accordance with the child’s needs and wishes, her parents, school and other
communities, as well as all the other systems we are embedded in – my clinical team, hospital,
health care system, university department, various professional orders and associations, and so
on.
As a consequence, the comforting construction of an individual “self” has as many facets as the
social roles we have and is only as stable as the social structures and systems allow: “Properly
speaking,” William James wrote, “a man has as many social selves as there are individuals who
recognize him and carry an image of him in their mind (emphasis in original).”1
Just as we have as many “social selves” as the number of people we interact with, human social
life requires a recognition of our mutual interdependence in the spirit of what social critic Ivan
Illich defined as conviviality – “individual freedom realized in personal interdependence.”19
And
as usual, William James, the pioneering American psychologist and pre-eminent philosopher of
pragmatism, said it best:
Thus social evolution is a resultant of the interaction of two wholly distinct factors, –
7
the individual, deriving his peculiar gifts from the play of physiological and infra-social
forces, but bearing all the power of initiative and origination in his hands; and, second,
the social environment, with its power of adopting or rejecting both him and his gifts.
Both factors are essential to change. The community stagnates without the impulse of the
individual. The impulse dies away without the sympathy of the community (emphasis
added).20
Resources:
Here is a descending spiral staircase into how to deconstruct words in our time:
 Start with Uwe Poerksen, Plastic Words4
You want to go deeper?
 Raymond Williams, Keywords21
More time on your hands, like Dr. Arthur Conan Doyle writing detective tales about Sherlock
Holmes while waiting for patients to show up at his practice?
 Barbara Cassin, et al., Dictionary of Untranslatables: A Philosophy Lexicon22
Deeper than that and you are into the ultimate rabbit hole – the rhizomatic rabbit warren called
philosophy. What’s a rhizome you will ask? That’s a philosophical question that will take us on a
tour of Gilles Deleuze’s and Félix Guattari’s work, A Thousand Plateaus,23
a work of philosophy
bordering on psychiatry, where they invoke the rhizome as a metaphor for processes that do not
arise from a single origin, like Chomsky’s generative grammar or the Freudian unconscious, all
implying interconnectedness, like fungi sprouting everywhere above ground and connected by
their rhizomatic structure underground.
8
Image taken from: https://literariness.org/2017/04/26/the-philosophical-concept-of-rhizome/#jp-
carousel-9445
Dr Di Nicola is a child psychiatrist, family psychotherapist and philosopher in Montreal,
Quebec, Canada, where he is Professor of Psychiatry & Addiction Medicine at the University of
Montreal and President of the World Association of Social Psychiatry (WASP). He has been
recognized with numerous national and international awards, honorary professorships and
fellowships, and was recently elected a Fellow of the Canadian Academy of Health Sciences and
given the Distinguished Service Award of the American Psychiatric Association. Dr Di Nicola’s
work straddles psychiatry and psychotherapy on one side and philosophy and poetry on the
other. Dr Di Nicola’s writing includes: A Stranger in the Family: Culture, Families and Therapy
(WW Norton, 1997), Letters to a Young Therapist (Atropos Press, 2011, winner of the Camille
Prize Prize of the Quebec Psychiatric Association), and Psychiatry in Crisis: At the Crossroads
of Social Sciences, the Humanities, and Neuroscience (with D. Stoyanov; Springer Nature,
2021); and, in the arts, his “Slow Thought Manifesto” (Aeon Magazine, 2018) and Two Kinds of
People: Poems from Mile End (Delere Press, 2023, nominated for The Pushcart Prize).
9
References
1. James W. Principles of Psychology. Holt; 1890.
2. Hebb DO. Essay on Mind. Psychological Press; 1980.
3. Gallese V. Bodily selves in relation: embodied simulation as second-person perspective on
intersubjectivity. Phil. Trans. R. Soc. B. 369 (1644): 20130177 doi:10.1098/rstb.2013.0177
4. Poerksen U. Plastic Words: The Tyranny of a Modular Language. Trans. Mason J, Cayley D.
Pennsylvania State University Press; 1995.
5. Posche R. “Ambiguity And Vagueness In Legal Interpretation,” in: Solan LM & Tiersma PM
(eds.), The Oxford Handbook of Language and Law. Oxford University Press; 2012: 128-
144.
6. Di Nicola VF. Review-essay: On the rights and philosophy of children. Transcultural
Psychiatric Research Review, 1995, 32(2): 157-165.
7. Di Nicola V. “Take your time: Seven pillars of a slow thought manifesto.” Aeon (online
magazine). February 27, 2018. https://aeon.co/essays/take-your-time-the-seven-pillars-of-a-
slow-thought-manifesto.
8. Di Nicola V. Review article—The Global South: An emergent epistemology for social
psychiatry. World Social Psychiatry, 2020, 2(1): 20-26.
9. Helliwell JF, Layard R, Sachs JD, et al., eds. World Happiness Report 2024. University of
Oxford: Wellbeing Research Centre; 2024. ISBN 978-1-7348080-7-0
10. Wikipedia contributors. (2024, March 20). Incel. In Wikipedia, The Free Encyclopedia.
Retrieved 04:52, March 24, 2024, from
https://en.wikipedia.org/w/index.php?title=Incel&oldid=1214636070
11. Maté G, Maté D. The Myth of Normal: Trauma, Illness & Healing in a Toxic Culture. Alfred
A. Knopf Canada; 2022.
12. Di Nicola V. “Stones and Bridges: The Myth of Independence,” in: A Stranger in the Family:
Culture, Families, and Therapy. W.W. Norton & Co.; 1997: 194-211.
13. Di Nicola V. Perspective—“There is no such thing as society”: The pervasive myth of the
atomistic individual in psychology and psychiatry. Follow-up and reply to commentaries on
“A social psychiatry manifesto for the 21st
century.” World Social Psychiatry, 2021, 3(2): 60-
64.
10
14. Ostrom E. Governing the Commons: The Evolution of Institutions for Collective Action.
Cambridge University Press; 1990.
15. Forsyth T, Johnson C. (2014), Elinor Ostrom's legacy: Governing the commons and the
rational choice controversy. Development and Change. 2014;45:1093-110.
https://doi.org/10.1111/dech.12110
16. Della Porta D. Progressive social movements and the creation of European public spheres.
Theory, Culture & Society. July 2022. doi:10.1177/02632764221103510
17. Tyson L. Critical Theory Today: A User-Friendly Guide. 4th
ed. Routledge; 2023.
18. Shaw GB. Pygmalion. Dodd, Mead & Company; 1916.
19. Illich I. Tools for Conviviality. Fontana/Collins; 1975
20. James W. “Great Men, Great Thoughts and the Environment.” Atlantic Monthly 46 (October
1880): 441-459.
21. Williams R. Keywords: A Vocabulary of Culture and Society. Flamingo/Fontana; 1984.
22. Cassin B, Apter E, Lezra J, Wood M. Dictionary of Untranslatables: A Philosophy Lexicon.
Princeton University Press; 2014.
23. Deleuze G, Guattari F. A Thousand Plateaus: Capitalism and Schizophrenia. Trans. Massumi
B. Minneapolis: University of Minnesota Press; 1987.

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Against “The Myth of Independence” – For a More Convivial and Interdependent Society

  • 1. 1 Psychiatric Times Column: Second Thoughts Link: https://www.psychiatrictimes.com/view/against-the-myth-of-independence-for-a-more- convivial-and-interdependent-society Against “The Myth of Independence” – For a More Convivial and Interdependent Society March 27, 2024 Vincenzo Di Nicola, MPhil, MD, PhD, FCAHS, DLFAPA, DFCPA No more fiendish punishment could be devised … than that one should be turned loose in society and remain absolutely unnoticed by the members thereof. – William James1 In my first column in this series, “Social Psychiatry Comes of Age,” I promised to take up the contributions of the three branches of social psychiatry. Stay tuned. First, some groundwork is necessary for us to establish a social psychiatric framework in which to define and test our contributions. A leader in cultural psychiatry asked me why I dismissed the biopsychosocial (BPS) model in my first column. Another leading social psychiatrist pointed out that a spiritual dimension should be added to BPS. Why not add developmental or relational dimensions, as I understand there were discussions to add them to the multiaxial system of DSM- III and IV? And why not epigenetics or exposomics which cut across and integrate “bio” and “social”? And most compelling for me, the socio-economic dimension which is at the heart of the Social Determinants of Health and Mental Health. It risks ballooning into an endless regress. Many problems arose with the BPS model. First, it was constructed as a rejection of the “formulation” of psychodynamic psychiatry and it became a cover for biological psychiatry to
  • 2. 2 claim it was comprehensive. More important than BPS’s flawed starting point and reductive finale, in any eclectic or multiaxial approach, the social context is bound to be just another add- on, icing on the cake. This is upside down: in psychiatry, we should start with social context and add everything else to that framework (the task and hence the starting point would be different in neuroscience, but I’m talking about psychiatry). Social context is baked into the cake. As the pioneering neuropsychologist Donald Hebb at McGill demonstrated with his sensory deprivation experiments, the brain can only function in a rich bath of internal and external stimuli.2 The neurophysiological nature of the brain is relational. Hebb’s cell assemblies are little communities of neurons working through a rich interplay of messengers. This gave rise to Hebb’s Law: “Neurons that fire together wire together.” And the discovery of “mirror neurons” by neuroscientist Vittorio Gallese at the University of Parma has provided the link between events in the external environment and their mirroring in the brain as the basis for “embodied simulation theory” (a theory of social cognition) with implications for everything from empathy to autism.3 Now, I want to do some gardening in the palace of psychiatry. As I walk around the untended gardens of the “psy disciplines” – the palace of psychiatry, the psychology campus, and psychotherapy’s big circus tent – I see an awful lot of buzz words and viral memes crowding out the carefully cultivated plants like weeds. Some of them risk killing the plants around them altogether like bougainvillea encroaching a tree. The flowering bougainvillea is beautiful but it chokes the tree of life! Plastic Words I will name these buzz words and put them in quotes to signal that I want to examine them and come to terms with them. Uwe Poerksen, a German scholar, called them “plastic words” because of their malleability and uncanny capacity to fit any circumstance.4 Plastic words start as scientific words with specialized meanings but then migrate into everyday usage, stripped of their specialized meanings. If we are to have an encompassing theory of persons – my definition of psychology – we have to sort out these plastic words like so many weeds in the garden.
  • 3. 3 As a child and adolescent psychiatrist, family therapist, and social and cultural psychiatrist, I toil in exactly those areas of the garden that are filled with plastic words – “development, family, culture, and society” – and of course, everything relating to “mind” and “mental states.” All of these are notoriously difficult to nail down. And sometimes we don’t want to. In legal philosophy, for example, there is the notion of the “fuzzy concept” – you want a principle expressed that is “fuzzy” or elastic enough to anticipate future possibilities.5 In our field, if we define “family” too narrowly, we will not only offend sensibilities (What about same-sex parents? What about polyamory, polygamy or polyandry? What about communes?) but leave out all kinds of actually lived family forms. As to “child development,” I have a simple remedy to the conundrum of defining it – instead of referring to this slippery construct about growth, just think of real children. As I have written, we think too much of the concept of development and too little of actual children.6 And I am critical of the notion of development across the board, from developmental psychology to economics and politics (see my Slow Thought Manifesto7 and my socio-political essay on the Global South8 ). More about that in later columns. The Invisible Man – 21st Century Versions For now, walking around my garden, I stumble over “loneliness,” “happiness,” “burn-out” and “trauma.” To follow media accounts, it would seem that the world is either filled with the search for happiness or people are walking around like emotional zombies struggling to express themselves and to be seen. The 2024 World Happiness Report shows that Finland stayed at the top of country rankings for the seventh year, the USA fell out of the top 20 while Canada’s steady in 15th place, and Israel dropped only one place to 5th place from last year despite being at war – go figure!9 Meanwhile, “loneliness” and “burn-out” are seen to be stalking young and old alike, creating 21st century versions of The Invisible Man (I am referring both to H.G. Wells’ 1897 science fiction version and Ralph Ellison’s more disturbing racial version from 1952), presciently described by William James in my opening epigraph from his Principles of Psychology.1
  • 4. 4 A worrisome social phenomenon concerns young men who identify as “incels” – or involuntary celibates – an online support community of young males who are unable to have the heterosexual relationships they desire.10 Incels, ironically first named by an anonymous Canadian female calling herself Alana, are estimated to number in the tens to hundreds of thousands and are perceived as an extremist, supremacist group of men imbued with a sense of predestined personal failure and nihilism. Such attitudes and beliefs may lead to suicide and various forms of sexual violence, from “catfishing” (creating a fake online identity in order to deceive) to femicide. The case of Marc Lépine here in Montreal of the École Polytechnique massacre of 14 women in 1989 has been linked to this movement. As with repressed faith, society eventually pays a big price for invisibility in the form of repressed sexuality. And “trauma,” which is “everywhere” in our “toxic culture,” according to Canada’s trauma guru Gabor Maté,11 is nonetheless somehow unspoken and unheeded. What does all of this actually mean? To cite Facebook’s ambivalent option about relationships, “It’s complicated”! So I will be spiraling around these themes repeatedly in this column, taking up definitions, controversies, trying theories on for size, and discarding them when better ones come along. That’s the real spirit of science – constant experimentation, questioning and innovation – not certainty or convictions. Belief, certitude, even fidelity are the stuff of faith, not of science. That said, faith may be the most repressed and neglected aspect of contemporary social and political life. And to evoke Freud’s most poetic phrase, the US is now experiencing “the return of the repressed” with Evangelical Christians and other religious groups demanding their say. A future column will celebrate Dr. H. Steven Moffic’s remarkable series of volumes on religion, spirituality and psychiatry, from Christianity to anti-Semitism and from Islam to Eastern religious and spiritual traditions. The I’s of Western Psychotherapy Now, let me take on some of the most divisive notions in the Western world and the Global North: individualism and independence. (I harbor the comforting hope – maybe an illusion? – that this isn’t true everywhere.) Raymond Prince, MD, my mentor in social and transcultural psychiatry at McGill, elaborated the notion that psychotherapy in the West revolves around
  • 5. 5 several “I” words: the individual as the focus of therapy, personal independence as a therapeutic goal, and introspection and insight as a therapeutic method. Therapy with individuals is undergirded by Murray Bowen’s “differentiation theory,” implying that the goal of personal development and hence of therapy should be independence. Meanwhile, two of the most successful versions of family therapy in the hands of people like Salvador Minuchin, MD (structural family therapy which is the application of differentiation theory) or Jay Haley, MA (strategic family therapy) was to put parents in charge of rebellious children and teens. And they went so far as to minimize their suffering by calling them “identified patients” who were merely manifesting conflicts of the family system. So much for independence, so much for respecting each child’s developmental pathway. The ironies abound. When I constructed my model of cultural family therapy, my motivation was to challenge what I called “the myth of independence.”12 In this myth, the goals of therapy are to work on individuals, isolated from their family, communal and social contexts. As Minuchin once complained, psychoanalysis deals with “man out of context.” And this plays out in society and in politics as well. Conservative British Prime Minister Margaret Thatcher infamously declared that, “There is no such thing as society,”13 while conservative critics argued that in socialist societies like the Soviet Union, there was no such thing as the individual. Like most binary oppositions, these extremes do not describe lived reality. Not only is society real but the very British tradition of “the commons,” defined as the “social practice” of governing a resource not by the state or the market but by a community of users that self-governs that resource through institutions that it creates, was the basis for democracy and progressive movements. Economists have analyzed the “tragedy of the commons” in economic and social theory which describes what happens when people struggle for their individual demands against the common good.14, 15, 16 And not only is the individual real but it takes almost totalitarian coercion to disabuse people of the sense of their own individual consciousness and need for agency (control of their own lives) and the search for meaning (which is the subtext of the humanistic and positive psychology and psychiatry movements). And we must consider the possibility that the nature of this coercion has
  • 6. 6 become subtler and more pervasive through social media. Critical theory in philosophy and sociology with thinkers like Theodor Adorno of the Frankfurt School is one long interrogation of these subtle and almost invisible coercive tools available to convince people that they are free when in fact their choices are highly constrained and predetermined.17 Ultimately, independence is a myth because we are all richly interdependent upon each other. In his class-busting play, Pygmalion, George Bernard Shaw wrote: “Independence? That’s middle class blasphemy. We are all dependent on one another, every soul of us on Earth.”18 Some of us can live the illusion of being independent because the people, systems and structures around us serve our interests (as we serve theirs). Children, the elderly, and the infirm are more obviously dependent, but so is anyone who has a team and a series of institutions, rules and regulations in place to support what appear to be professional and personal choices. In fact, I am more interdependent as a child psychiatrist than most of the children I see because I am reciprocally acting in accordance with the child’s needs and wishes, her parents, school and other communities, as well as all the other systems we are embedded in – my clinical team, hospital, health care system, university department, various professional orders and associations, and so on. As a consequence, the comforting construction of an individual “self” has as many facets as the social roles we have and is only as stable as the social structures and systems allow: “Properly speaking,” William James wrote, “a man has as many social selves as there are individuals who recognize him and carry an image of him in their mind (emphasis in original).”1 Just as we have as many “social selves” as the number of people we interact with, human social life requires a recognition of our mutual interdependence in the spirit of what social critic Ivan Illich defined as conviviality – “individual freedom realized in personal interdependence.”19 And as usual, William James, the pioneering American psychologist and pre-eminent philosopher of pragmatism, said it best: Thus social evolution is a resultant of the interaction of two wholly distinct factors, –
  • 7. 7 the individual, deriving his peculiar gifts from the play of physiological and infra-social forces, but bearing all the power of initiative and origination in his hands; and, second, the social environment, with its power of adopting or rejecting both him and his gifts. Both factors are essential to change. The community stagnates without the impulse of the individual. The impulse dies away without the sympathy of the community (emphasis added).20 Resources: Here is a descending spiral staircase into how to deconstruct words in our time:  Start with Uwe Poerksen, Plastic Words4 You want to go deeper?  Raymond Williams, Keywords21 More time on your hands, like Dr. Arthur Conan Doyle writing detective tales about Sherlock Holmes while waiting for patients to show up at his practice?  Barbara Cassin, et al., Dictionary of Untranslatables: A Philosophy Lexicon22 Deeper than that and you are into the ultimate rabbit hole – the rhizomatic rabbit warren called philosophy. What’s a rhizome you will ask? That’s a philosophical question that will take us on a tour of Gilles Deleuze’s and Félix Guattari’s work, A Thousand Plateaus,23 a work of philosophy bordering on psychiatry, where they invoke the rhizome as a metaphor for processes that do not arise from a single origin, like Chomsky’s generative grammar or the Freudian unconscious, all implying interconnectedness, like fungi sprouting everywhere above ground and connected by their rhizomatic structure underground.
  • 8. 8 Image taken from: https://literariness.org/2017/04/26/the-philosophical-concept-of-rhizome/#jp- carousel-9445 Dr Di Nicola is a child psychiatrist, family psychotherapist and philosopher in Montreal, Quebec, Canada, where he is Professor of Psychiatry & Addiction Medicine at the University of Montreal and President of the World Association of Social Psychiatry (WASP). He has been recognized with numerous national and international awards, honorary professorships and fellowships, and was recently elected a Fellow of the Canadian Academy of Health Sciences and given the Distinguished Service Award of the American Psychiatric Association. Dr Di Nicola’s work straddles psychiatry and psychotherapy on one side and philosophy and poetry on the other. Dr Di Nicola’s writing includes: A Stranger in the Family: Culture, Families and Therapy (WW Norton, 1997), Letters to a Young Therapist (Atropos Press, 2011, winner of the Camille Prize Prize of the Quebec Psychiatric Association), and Psychiatry in Crisis: At the Crossroads of Social Sciences, the Humanities, and Neuroscience (with D. Stoyanov; Springer Nature, 2021); and, in the arts, his “Slow Thought Manifesto” (Aeon Magazine, 2018) and Two Kinds of People: Poems from Mile End (Delere Press, 2023, nominated for The Pushcart Prize).
  • 9. 9 References 1. James W. Principles of Psychology. Holt; 1890. 2. Hebb DO. Essay on Mind. Psychological Press; 1980. 3. Gallese V. Bodily selves in relation: embodied simulation as second-person perspective on intersubjectivity. Phil. Trans. R. Soc. B. 369 (1644): 20130177 doi:10.1098/rstb.2013.0177 4. Poerksen U. Plastic Words: The Tyranny of a Modular Language. Trans. Mason J, Cayley D. Pennsylvania State University Press; 1995. 5. Posche R. “Ambiguity And Vagueness In Legal Interpretation,” in: Solan LM & Tiersma PM (eds.), The Oxford Handbook of Language and Law. Oxford University Press; 2012: 128- 144. 6. Di Nicola VF. Review-essay: On the rights and philosophy of children. Transcultural Psychiatric Research Review, 1995, 32(2): 157-165. 7. Di Nicola V. “Take your time: Seven pillars of a slow thought manifesto.” Aeon (online magazine). February 27, 2018. https://aeon.co/essays/take-your-time-the-seven-pillars-of-a- slow-thought-manifesto. 8. Di Nicola V. Review article—The Global South: An emergent epistemology for social psychiatry. World Social Psychiatry, 2020, 2(1): 20-26. 9. Helliwell JF, Layard R, Sachs JD, et al., eds. World Happiness Report 2024. University of Oxford: Wellbeing Research Centre; 2024. ISBN 978-1-7348080-7-0 10. Wikipedia contributors. (2024, March 20). Incel. In Wikipedia, The Free Encyclopedia. Retrieved 04:52, March 24, 2024, from https://en.wikipedia.org/w/index.php?title=Incel&oldid=1214636070 11. Maté G, Maté D. The Myth of Normal: Trauma, Illness & Healing in a Toxic Culture. Alfred A. Knopf Canada; 2022. 12. Di Nicola V. “Stones and Bridges: The Myth of Independence,” in: A Stranger in the Family: Culture, Families, and Therapy. W.W. Norton & Co.; 1997: 194-211. 13. Di Nicola V. Perspective—“There is no such thing as society”: The pervasive myth of the atomistic individual in psychology and psychiatry. Follow-up and reply to commentaries on “A social psychiatry manifesto for the 21st century.” World Social Psychiatry, 2021, 3(2): 60- 64.
  • 10. 10 14. Ostrom E. Governing the Commons: The Evolution of Institutions for Collective Action. Cambridge University Press; 1990. 15. Forsyth T, Johnson C. (2014), Elinor Ostrom's legacy: Governing the commons and the rational choice controversy. Development and Change. 2014;45:1093-110. https://doi.org/10.1111/dech.12110 16. Della Porta D. Progressive social movements and the creation of European public spheres. Theory, Culture & Society. July 2022. doi:10.1177/02632764221103510 17. Tyson L. Critical Theory Today: A User-Friendly Guide. 4th ed. Routledge; 2023. 18. Shaw GB. Pygmalion. Dodd, Mead & Company; 1916. 19. Illich I. Tools for Conviviality. Fontana/Collins; 1975 20. James W. “Great Men, Great Thoughts and the Environment.” Atlantic Monthly 46 (October 1880): 441-459. 21. Williams R. Keywords: A Vocabulary of Culture and Society. Flamingo/Fontana; 1984. 22. Cassin B, Apter E, Lezra J, Wood M. Dictionary of Untranslatables: A Philosophy Lexicon. Princeton University Press; 2014. 23. Deleuze G, Guattari F. A Thousand Plateaus: Capitalism and Schizophrenia. Trans. Massumi B. Minneapolis: University of Minnesota Press; 1987.