Psychological Health in the Expansive Welfare State

Freedom is crucially important for mental health, as well as the other things psychotherapists and psychiatrists “treat.”

For example, consider a person who’s depressed. Depression is a state of learned helplessness. In a free country with a booming economy, and where the standard of living keeps rising from one generation to the next, a therapist can tell his client with credibility: “You have choices. You don’t have to believe your false generalizations that everything is doomed.” It’s a lot harder to overcome depression when the facts of reality make the depressed thoughts more credible.

The same applies to anxiety, something else therapists and psychiatrists help their patients/clients confront. Irrational anxiety refers to living life with a constant sense of panic and impending disaster. If the standard of living is declining, there’s good reason to feel anxiety. Choices are limited and to a large extent there’s nothing you can do. You can’t find a job, you might be forced to live off the government — not a lot of money, plus a loss of independence — and then you’re supposed to somehow feel better?

When I first began graduate school for mental health and therapy, I was taught that the person must be “diagnosed” or evaluated in the context of his or her situation. “Situation” referred to family and personal circumstances, but it also applied to the larger society, especially economics. A therapist is not expected to do anything about the larger social situation, of course; but it was expected to be recognized. This is a recognition that the larger society in which we’re all trying to thrive and operate has something to do with — in fact, quite a lot to do with — the state of our psychological health.

Of course, the political bent of my clinical social work and psychology programs was unflinchingly leftist. We were taught to favor the expansion of the welfare state and Big Government control of the economy as in the best interest of the individual’s mental and personal condition. I was always troubled by this attitude, and eventually came to understand it was precisely the opposite of the truth. I studied economics, individual rights and the deeper philosophy on which these rest — reason as means of knowledge and cognition, objective self-interest as ethics — and I learned that most of what I was learning in the field was on the wrong track. However, the goal was the right one: A mentally healthy person in the context of a rational society.

I don’t know how to say it any clearer than this: The welfare state and psychological well-being simply do not mix. People who take welfare — and I talk to many of them all the time — do not feel empowered. Most of the time, they feel stuck. On the one hand they’re relieved to have the benefits, but on the other hand they perpetually wonder: What might have been? And: What can I do without risking the loss of my benefits? The government makes it easy to stay on welfare, or even unemployment or premature Social Security, essentially forever. As a therapist, I’m expected to help such people feel empowered, robust and in charge of their lives. Yet they’re faced with the very real dilemma of not wanting to give up their government benefits.

This is where I start to think of the person-in-situation model to which I was exposed back in graduate school. If this unhappy person lived in an economically free society, we would have much more of a robust economy, more job opportunities, and countless things we cannot even imagine existing. Life would not be effortless, and without a welfare state one would have to rely much more on family and charity — but also on oneself. Why is that such a crime? Why is it such a social and psychological sin to even suggest such a thing? Nobody dares say it any more, but it’s a fair and reasonable question to ask, and I refuse to stop asking it. I can’t stop asking it, because I have a real live person in my office, or on the telephone, who’s asking for ways to feel less depressed while not being permitted the freedom to do it.

The welfare state was always based on a false notion of psychology. Most of the engineers of the welfare state are people who worked hard for their doctoral degrees and all the rest. They subconsciously project these values and this self-discipline onto everyone. “Well, everyone wants to do this. They just want a hand up, that’s all.” But even if that’s what the recipient of the welfare state benefits wants in the first place, this psychological theory overlooks what the presence of the financial “benefit” in the person’s life actually does to him or her once he or she has it. The government basically says, “You can have this forever — so long as you don’t get your life on track.” With this message coming from the government — more and more all the time, especially as government spends and grows the benefits to heights never before seen in the United States — how in the world is a person supposed to feel less depressed or less anxious?

Therapists also spend a lot of time helping people better understand and function in their marriages, families and personal relationships. If you spend your time practicing as a therapist, as I have for many years now, you’ll start to see just how important economics is. Most people, I find, really do want to be independent. But in order to hold themselves to that high standard, they need a thriving and growing private economy — the kind only unfettered capitalism can deliver — to embrace and live out the choices available to them. The fewer choices they have, the more frightened or despondent they will become. This provides power-seeking politicians with an excuse for growing the welfare and entitlement state, and putting more people on the permanent “dole” of unemployment, Social Security, Medicaid, Obamacare or whatever comes next. But it does not do a thing to enhance the inner spirit and drive of the people increasingly “taken care of.”

People don’t exist in a vacuum. Their psychological states and personal relationships do not either. For the mental well-being of people to improve, they’re of course going to need to improve themselves. At the same time, they will have to live in a society that grows and flourishes, not stagnates or regresses economically (as we’re starting to do in America, sadly). Happy individuals and functioning minds require a free society. The less we see of one, the less we’ll see of the other.


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