Theologian in Residence

Newsletter #2 Article: When Care and Capitalism Collide

When Care and Capitalism Collide

by Dr. David Deane

 Health, according to the World Health Organization is, “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”  In this the W.H.O stays true to its realization that we will understand health and wellbeing differently and that we are free to decide, for ourselves, what it should look like. Sound good? 20 Chaplains that I interviewed in three different locations agreed that it does. Furthermore they agreed that this definition of health shaped their understanding of care. For example, all agreed that their care must be reactive rather than active, that is, they must assist the client/patient in achieving the client’s notion of well being, rather than try to foist their (the Chaplain’s) notion of well-being onto them. As one interviewee remarked, “I’m not here to proselytize, I’m here to help people and this means helping them get where they want to go, not where I want to take them”. Another summed up a universal opinion among the 20 when he said, “Chaplaincy used to be about speaking but now it’s about listening”. An experienced Chaplain in her late 50’s noted, “I can’t say that my idea about how they (those receiving spiritual care) should be imagining well being is right and theirs is wrong. We can’t put God in a box (a phrase that many interviewees repeated) and so we can’t put what God wants of us in a box either, that’s for every individual to work out for themselves”.     

     The W.H.O. model of health, brings with it a corollary model of care and not a single interviewee was even remotely critical of this, after all, who could be against the individual’s freedom of choose for themselves how they will understand well-being? Who could argue that the role of the chaplain is to proselytize? Who could have the arrogance to claim that their understanding of wellbeing is right and other people’s are wrong? Well, to some extent, me.        

At a recent conference in Orlando (yes, Disney World) I argued in front of 1800 attendees that the W.H.O’s model of wellbeing and the concomitant model of health care advanced by my 20 interviewees is wrong. Worse than being wrong, I argued that it actively surrenders to global capitalism the responsibility to creatively imagine what wellbeing and care might look like. The conference paper (which can be heard online at (http://web.me.com/davidwcdeane/Site_2/Podcast/Podcast.html) was 12,000 words long and as the first section of the book I’m currently writing is now sitting at closer to 20,000. I hope, however, in the 1500 words left to me here to convey something of that argument. 

Why the W.H.O.’s model is wrong    

The W.H.O.’s model only makes sense if individuals are free to decide for themselves what wellbeing looks like. The idea that humans are so free is modern, in that it occurs very infrequently before the philosophical enlightenment in the 18th century. A number of shifts in how we understand ourselves and the nature of knowledge makes this possible. For example, the idea of an “individual”. Strange as it may seem to us, very few pre-moderns thought of human persons as “individuals”. Christian pre-moderns for example understood us as being made in the image and likeness of a God who while being One was not singular. God was a Trinity and the Trinitarian persons flowed through one another. They were who they were only in relationship, not in isolation. The Council of Toledo in 675 makes clear that, “The Father is Father not with respect to himself but to the Son.”. The council was clear that God is not Father in Godself, but rather this designation was descriptive, not of the first person, but, of the relationship between the first person (the “Father”) and Jesus the Christ. As we are in the image and likeness of this God, so too we are who we are in relationship. For pre-modern Christians, we are not individuals.

      There is a downside to this however, as the pre-moderns were all too aware, in that if we are who we are in relationship then our relational context will shape and even decide who we are. 

          Let me use an example. When I was a doctoral student I did some work with youth on both sides of the divide in Northern Ireland. We showed Catholic youths and Protestant youths (separately) slides of parades. Parades in Northern Ireland are opportunities for the nationalist and unionist communities to celebrate their identity, the nationalists on March 17th (St. Patrick’s Day) and the Unionists on July 12th (the anniversary of the battle of the Boyne when the Protestant King, William of Orange, was victorious). Then we asked each group to describe the faces of the people marching. The Catholic youths described the faces on March 17th as “joyous”, “celebratory” and “happy” while the faces on July 12th were described as being “triumphalist” and “threatening”. The Protestant youths described the faces from the July 12th parade as “happy” and “partying” while the faces of the marchers on St Patrick’s day were “enraged”, “angry” and “mad”. What neither group knew was that we had photo-shopped the images so that it was the same faces in each parade.     What does this tell us? It tells us that our basic experience of the world, the way we process the sensory data from our eyes is filtered through our contexts. In terms of my argument it surely will allow me to posit that our understanding of well-being will be shaped, perhaps even determined by our context? Surely we can agree that we are not simply free to decide for ourselves what well being and health is? Surely our context will shape how we understand it? If so then, I would argue, the model of health offered by the W.H.O. and the corollary model of care faithfully observed by our Chaplains is, at best, naïve. In what follows I want to argue that what the W.H.O. is doing, and what our Chaplains are doing, is surrendering to the context the responsibility to imagine what wellbeing is.

      Of course, this may not be a bad thing. After all, if our context is good then we will be shaped by this good context and Chaplains who acquiesce with this will be acquiescing with a good thing. But what is our context?

 What is our context?

     While space is not present here to argue this point with the nuance it deserves, I will nonetheless claim that the prevailing shaping context is not good (at least as most of our Religions tend to understand good). As Slavok Zizek has recently argued[1] our context is shaped by the grammar[2] of global capitalism. Global Capitalism, for Zizek, is best understood not, as in traditional economic categories, in terms of modes of production and freedom from state involvement, but in terms of an orienting of desire toward commodities.

      Global capitalism, as a late modern development, functions as a directing of our desire toward commodities in the world that we can pay for - “If I have that car/house/computer/painting, then, then I’ll have happiness”. For this desire to be manufactured the objects must be offered to us as things that bring true meaning, good things such as familial relations or sexual prowess that we see as the epicenter of happiness. Let’s take two very brief examples from advertising. What is MasterCard selling in their “priceless” advertising campaign? They are selling meaning and telling us that for 9.7% (for you), or 19.7% (for me), we can have it. MasterCard is selling us moments of meaning, right relations with our spouse and children, meaningful encounters with art and sport, security in old age; MasterCard is selling us wellbeing. Priceless? No, in fact these “priceless” moments can be yours for only 19.7% apr.

      Again, take anti-cholesterol medication Lipitor, it advertises itself not as anti-cholesterol medication but as a gateway to fishing with our grandchildren (which is depicted in its advertising), it is selling us not an object such as a pill but, rather, it is selling us familial relations, things of “real” value, it is selling us meaning.

      The most significant point, however, is not simply that such companies are trying to sell us meaning. They are also telling us what “meaning” actually is. This is where it gets complicated. Take a rap music video. What role does money and jewelry and big cars and scantily clad women play in such videos? As signifiers of “success”, yes? Well, yes and no. A signifier is something that connotes something in its absence, there is a space between the thing “success or happiness” and the signifiers of it “money, jewelry, sex” but, in fact, this space doesn’t exist. The signifiers of the success have collapsed the space between the success and themselves. The signifiers are the success. The devotees of such videos cannot imagine “success” outside of such material things, which do not connote the success, they are it.

      And this is how capitalism works. It must first shape how we imagine “success” or happiness” or “meaning” before they can sell it to us. It must first become a commodity. It is obvious with rap videos, but the “meaning” being bought in Mastercard advertising is doing the exact same thing. It is telling us first, what meaning is, and then selling it to us.

  The goods of Capitalism and the goods of Early Christianity

     Comparison with a radically alternative perspective will help, I hope, make the point clearer. We will all agree that, for example, early Christianity would not see the “goods” we encounter in rap videos as “goods”. But we should remember that the early Christians we not too big on the goods we encounter in MasterCard ads either. Children, marriage, old age, all these things we never the “goal” or telos of life for early Christians. For early Christians Christ was a physician, healing us from many of the “goods” we are hardwired to seek. A healthy person, from the early Christian perspective, is not a person physically fit, making money and feeling really good about themselves in a world where their peers are going without medical treatment. This, from the early Christian perspective, is a sickness where the seemingly healthy person is, in fact, blind. If we are in the Mayo clinic spending our money on treatment while others are without health care, how would early Christians look at this? If we see ourselves as individuals, isolated, not as persons, interwoven, how would early Christians look at this?  If we decide “for ourselves” shaped by capitalist culture, that we have well-being in a world where our neighbor is in desperate need, what would an early Christian chaplain do?

     My guess is that they would try to help the person. Allowing them to wallow in their sickness is not helping. What should a Muslim chaplain do? My guess is, try to help the person, allowing them to wallow in their sickness is not helping.  

     Yet our goal is something called “interfaith” chaplaincy, which, in effect, too often means “acquiescent with capitalism” chaplaincy. In means that Muslims, Christians and others with coherent understandings of well-being often alien to prevailing ones in our culture must leave such perspectives outside the door and, once inside, act like the good little liberal secularists we are. Inside the door the person must be allowed imagine well-being for themselves, which, if I’m right, means to allow capitalism completely free reign to imagine well-being for them.

     I am not suggesting that we proselytize dying people. I’m suggesting that Chaplains of all faiths must realize that we are all dying. Chaplains must work with people long before their death beds in order to shape our understanding of well-being. I don’t know how to die. My culture tells me to ignore it and take steps to ensure it will never happen. I don’t know how to die, I am floundering and well- intentioned chaplains are abandoning me, hiding from their duty under the guise of “letting me decide for myself”. They can only help us if they refuse the tyranny of the same where all perspectives are subsumed by the capitalist grammar that we find in the W.H.O’s well-intentioned statement. Chaplains must realize the illusion of individual autonomy and be prepared to offer an alternative perspective to prevailing discourses.  Only then, amid the torrent of diverse perspectives, can the individual really begin to imagine what real well-being might be like.

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