I     Materialistic development of the contradictions in the concept of illness

To resolve a problem firstly depends on being correctly aware of it. It is in no way sufficient to mention only the one or the other particular side of it, because all depends on comprehending [Begreifen] all moments of the problem, all its moments in their interaction. There exists no other way to make sure that comprehending and resolving a problem will be an inseparable unity [Einheit, identity]. If we want to understand why a stone drops down to earth, it is not enough to find out that there are also other things which fall to earth; but what we have to do is to comprehend the essential of the phenomenon (of falling down to earth), which is the gravitation as a common law of matter, if considered under its determination of being mass.

Just the same with regard to illness. From the beginning it was quite clear for us that it is insufficient to seek out for definite physical causes, as the natural-scientific medicine does. But also we soon got it quite clear that it is also insufficient to just speak of the social causation of illness; that it is a too simple manner to make "capitalism" "responsible" for illness and suffering; and we got it clear that it is totally abstract and without any effect to assure (each other) only that society was ill.

Empirically we started from only three facts:

  1. There exists the capitalist society, there exists wage-work (labour) and capitalism.

  2. There exists illness and there exist unsatisfied needs, i.e. the real need and the suffering of the single persons.

  3. There exists the category of historicity [Geschichtlichkeit], the category production; or in a yet more common way there exist the categories of time, alteration [Veraenderung] and of becoming [Werden].

Reducing it to a most simple formula, the SPK was during the years of 1970/71 the greatest possible concretization of the contradictions in the concept of illness in its greatest possible generalization. In general, in dialectics, last not least, one has to climb to a high level of theoretical generalization in order to resolve concrete problems; and at the same time theoretical generalization is both the prerequisite and the result of practical work. From the outset, therefore, we were concerned with comprehending the symptoms as being phenomena of the essence of illness (Note 1).

What is this essence, the essence of illness? According to Marx, the history of mankind is the history of its alienation and of the abolition [Aufhebung] of this alienation. Illness is neither a part nor merely the form of alienation, but illness is alienation, but it is that in a subjective sense, as the somatically and psychically lived need of the single persons.

Illness was conceived by us as life broken in itself, as being contradictory in itself. This, our determination of illness, is the result of historical investigations as they were done by us in the study groups [Arbeitskreise] in the SPK by means of dialectic materialism.

In the primeval societies, mankind is exposed to the forces of nature, which it experiences as an overwhelming and blind violence. In order to survive against those powers, it has to organize social communities; but this means that the violence of nature is penetrating into the inner of the social unity, becoming by that a social power. Since Herder mankind is defined by defectiveness [Maengelwesen], while modern anthropology explains the beginning of mankind's history as an effect of lacking sureness by instinct [Instinktsicherheit, cf. Nietzsche], common in animals. This lack of being protected by instinct thus determines mankind in an antagonistic relation to nature [als das Andere der Natur]. If there shall be human history at all, life as a natural one, as a biologic one has to be broken.

In "National Economy and Philosophy" Marx has pointed out the aim of history very emphatically: "Communism as the positive abolition [Aufhebung] of private property as human self-alienation, and therefore as the real appropriation of the human essence [Aneignung des menschlichen Wesens] by and for man; communism therefore as the complete return of man to himself as a social i.e. human being, according to the measure of mankind a return accomplished consciously and embracing the entire wealth of previous development. This communism, as fully accomplished naturalism = humanism, and as a fully developed humanism = naturalism; it is the true resolution [Aufloesung] of the antagonism between man and nature and between man and man the true resolution of the strife between existence and essence [Existenz und Wesen], between objectivation [Vergegenstaendlichung] and self-confirmation [Selbstbestaetigung], between freedom and necessity, between single human being and species [Individuum und Gattung]. This is the riddle of history solved, and it knows itself to be this solution." (Note 2).

Through the development of the forces of production and the increasing domination of nature all the necessary means able to assure mankind a life free of need and repression have been achieved; but the anarchic capitalist relations of production maintained by violence until now make it impossible to further develop those means, available through the high level of development of the forces of production and at our disposal for the liberation of man with respect to the coercions of nature and society, in a progressive way.

The single and lonely one*, exposed to capitalist society, is confronted with social violence that appears to him as blind and primitive [naturwuechsig], just as the immediate restraints of nature. And it is because of this that I use the term natural violence of capitalism in this book.

* Let us remember: everyone in this system is a single one, separated, encapsulated and isolated [Einzelner / Vereinzelter]. Until today, the in-dividual as such does not really exist yet. Creating living conditions so that in-dividuals can really exist is indeed one of the revolutionary tasks.

In a capitalist society in which the forces of production are developed in a progressing way, while the relations of production are to be maintained, there results for the capitalist society the necessity to create non-reproductive values [nicht-reproduktive Werte], the creating of which is not intended for the reproduction but only for the destruction of social life (Note 3). (Weapon arsenals on the one hand, wear and tear built into the products (commodities), into their value of "use" on the other hand). A simple example can illustrate this. As everybody knows, the car industry is one of the most powerful industries. To protect their profits from danger, there has to be guaranteed smooth marketing. In order to prevent demand from faltering, a part of the technical intelligence has to be occupied with producing commodities in such a manner that the products wear out as quickly as possible (often defined as "basic research"). The state, representing the interests of the whole of the capitalists (a sales crisis concerning car industry would automatically also throw steel-, electric- and rubber industry into crisis), is thus forced to build streets. This has the result that cities are broken up with traffic veins, that dreary satellite towns grow up; in further consequence of all this crisis there are no financial means available, which should be important to satisfy most urgent needs in communities (schools, hospitals, children corners etc).

As a consequence of all these factors there results a desolation of all social life, and the overcrowded metropolitan areas soon become an investment field for other industries. The entertainment industry fills this desert establishing slot machines, jukeboxes, night bars etc., and thereby produces: prostitution, violent crime, rocker gangs and all those manifestations of "dissociability", which the apologists of the system of course want to be taken not to be consequences of the capitalist way of production but resulting merely from industrialization.

Thus, the lonely and single one in the capitalist society becomes the object of double exploitation, both in the area of production and in the area of consumption. You may compare him with the man in Greek mythology to whom the Gods granted one certain wish that everything he touched turned instantly to gold, and who died of hunger and thirst. Not only the work in the work place, but also the activity in the "free" time, the hit with the tennis racket, the drive with the car, throwing the penny into the music box, all this is turned into gold for the capitalist system.

Needs: We started from the fact that all our needs are produced by capitalism. This means that all needs are nothing but manifestations of the basic need of capital for surplus value. "Therefore production produces not only an object for the subject, but also a subject for the object" (Note 4). Capitalism is the subject of all of history up to now, and by no means human beings are the masters of the forces of production. But the need of capitalism to produce surplus value is antagonistic to the needs of the single persons to live their lives; a symptom is nothing but the immediate unity of this contradiction which is sensorily perceivable.

The symptom is the elementary unity of the contradiction life - death. And the capitalist manner of production is always directed towards the destruction of labour forces. The concept [Begriff] of this contradiction are those forms of symptoms that are classified as schizophrenias and psychoses. The development (unfolding) of the contradictions of this concept consists in the resistance as it was organized and practiced by the SPK.

It must be clearly seen that those things which are commonly defined as schizophrenias or psychoses are only the simple result in which the antagonism between violence and life is carried to the extremes, while being in the form of a peaceful unity; each authentic human impulse is answered by violence potentials. This peaceful unity of the antagonism of violence - life becomes manifest in "peaceful times" in a "schizophrenic person" (or in all other kinds of illness) and the bourgeois society knows well enough why it suppresses each of these antagonisms, as soon as they become evident and explicit, by the means of the walls of mental and all the other hospitals, straitjackets, psychopharmaceuticals and electric shocks a suppression that, in the state of emergency takes on the form of the annihilation camp. The annihilation camp is mediated through institutions like care homes, correctional centers, prisons and psychiatric institutions the highest realization of the concept of the bourgeois family, means: capitalist class (flowers in the inner courtyards of the prisons and of psychiatric institutions, and flowers (geraniums) in front of the windows of the barracks of Auschwitz; and which prison director and psychiatry professor has not yet announced on "festive" occasions: "We are one great family!" and on Christmas Eve they played pious songs in the annihilation camps amplified by loud-speakers, did they not?).

"However, in contrast to this, in Aufstand gegen die Masse ("Rebellion Against the Crowds") Bruno Bettelheim tells of a girl who, in one of the most terrible situations of alienation of all mankind's history, got aware of this situation in a moment of highest lucidity, and succeeded in breaking out. This girl belonged to a group of Jews and all of them had to wait naked in a queue in front of the gas-chamber. The watching SS-officer was told that she had been a dancer and he ordered her to dance. And dancing she got closer and closer to him. Suddenly she snatched his weapon and shot him down. Her destiny was sealed, and it was equally clear that she had not been able to change the situation in any way, that is the annihilation of the group. But she had given her life in a very personal sense, and by this action also a historical possibility was expressed that was tragically lost during the annihilation of the masses in the extermination camps." (Note 5).

Whoever tackles symptoms in a serious way has to face the violence of capitalist society, and also has to look out to organize counter-violence against this violence. All social relations transfer themselves into the substantial structure of the body [in die Materiatur des Koerpers] and into the consciously performed representation of the body [und in die Koerpervorstellung] = psyche; the single one produces his body and his psyche within the capitalistically organized process of production (Note 6). A symptom is a phenomenon (manifestation) emerging from the essence of illness [eine Erscheinung des Wesens Krankheit], as protest and inhibition of that protest. The aim of the agitation in the SPK was to take up the progressive moment of illness, the protest, and to organize it collectively. How far it was possible for the single person to use the progressive impulse of illness for himself or herself often depended on the economic situation and the social position of the single person in agitation. Those who were privileged in a manner which offered them the possibility of acting out their situation by means of the capitalist consumption-offer (tourism, parties, etc), or for those whom their social position permitted to keep themselves "healthy" at the cost and the expense of others, for those the agitation ended in being "healthy" again and this in a thoroughly bourgeois sense; for such persons it could seem to be enough that the most disturbing symptoms had disappeared, since apart from that they had made use only of the reactionary side of illness (inhibition of the protest, as an organized form of violence against others and, therefore, against themselves), and they left the SPK by their own "free" will; that means that they had become "healthy", but objectively they were again on the side of the capitalism:

"The propertied class and the proletarian class represent the same human self-alienation. But the former class feels at ease and strengthened in this self-alienation, it recognizes alienation as its own power and has in it the semblance of a human existence; while the latter class, however, feels annihilated in this alienation, regarding in alienation its own powerlessness and the reality of an inhuman existence. It is, to use an expression of Hegel, in its depravity [Verworfenheit] the rebellion against that depravity, a rebellion to which it is necessarily driven by the contradiction between human nature and its condition of life, which is the frank [offenherzige], decisive [entschiedene], universal [umfassende] negation [Verneinung] of this nature" (Note 7).

Health is a thoroughly bourgeois concept. Capitalism in its totality establishes an average norm of exploitability concerning the commodity labour force. The health system on the one side has the task of raising this norm and on the other side it has the task of selecting and disposing of the hands (workmen) which do no longer fit into this norm in a most cost-effective way, or respectively as it was done in the Third Reich to liquidate them directly, or as done nowadays to remove them by differential euthanasia (Note 8).

To be healthy thus means to be expropriated and to be exploitable.

Our practice in the SPK brought (last not least) to evidence what massive potentials of violence are ready to be used and deployed against the production of non-destructive needs and against the realization of life. Our practice has made it clear that all the rights, guaranteed by the constitution to everyone equality, physical integrity (the "habeas corpus", conceived as protection against arbitrary detention, whereby one usually forgets that no human body if it were already a real free one could endure any internment), free development of personality are nothing but abstract phantoms, and that even trying to claim these constitutionally guaranteed rights is branded as a crime. The degree in which the constitutionally guaranteed rights can be brought to concretization does not depend, for example, on the judgement of "independent judges", but on the (higher or lower) stage of the rebellion (counter-violence) which the expropriated class is able to set against the life-destroying violence of capitalism. And therefore the claim: "Fight against the dismantling of democratic rights" is nothing but a hollow catch-phrase.

The bourgeoisie doesn't hesitate to annihilate millions of labour forces in order to accumulate profits, if it is not confronted with the material violence of the affected ones.

The realization of the right to life takes place in the people's war. All power must come from the people.

Whoever shudders at the word people's war has not yet got a clear understanding about what the violence of the capitalist system is, what class warfare from above is, taking place in permanence; that each year there are 10 000 people killed by "self"-murder = suicide ; that every day 15 people are killed by so-called industrial accidents, that each year as many people as Offenbach (German town near Frankfurt/M.) has inhabitants are annihilated by traffic accidents.

"There is always war in the cities." Brecht


Chapter II