The invisible assumptions of charity driven development: reading Bill and Melinda Gates’s 2014 letter

The Bill and Melinda Gates Foundation released their annual letter for 2014 a few months ago. It was devoted to dispelling three common myths, which they argue, block progress for the poor.

1. Poor countries are doomed to stay poor.
2. Foreign aid is a waste.
3. Saving lives leads to overpopulation.

These myths are indeed myths, and the Gateses are right to try to dispel them. It is also nice to see the Gateses sharing to their audience some important facts that they would have otherwise had to turn to some more radical scholars, to find. Myths #1 and #2, for example, was nicely addressed in 2002 by economist Ha-Joon Chang in Kicking Away the Ladder (although reading any number of the Asian, African, and Latin American nationalists from the 1940s to the 1960s or so might also have done the trick). For Myth #3, we could go back to Betsy Hartmann’s 1987 book, Reproductive Rights and Wrongs (I picked it up after reading an article by Hartmann in 2000 called Cross-Dressing Malthus).

But the main point I wanted to make in this blog is one I made a few years ago here about philanthrocapitalism. That is, that the solutions for the world’s problems aren’t going to come from billionaires, and the billionaires know it. Bill and Melinda admit it, in a low-key way, in their letter, with an extended discussion of government aid:

“When pollsters ask Americans what share of the budget goes to aid, the average response is “25 percent.” When asked how much the government should spend, people tend to say “10 percent.” I suspect you would get similar results in the United Kingdom, Germany, and elsewhere…Here are the actual numbers. For Norway, the most generous nation in the world, it’s less than 3 percent. For the United States, it’s less than 1 percent.”

What billionaires can do is tiny compared to what governments can do. In their letter, Bill and Melinda are trying to do what anyone can: try to convince others of their arguments in favour of policies they think would help. That is clear from the content of their letter and the nature of their arguments. Why would they do that, if governments didn’t matter?

But their organizations follow a different model. Gates made his billions on one side of a debate. What he argued and practiced was that the software programmers created could be cut up and sold for massive profits. On the other side of that debate, about knowledge, information, computers, and society, were those who argued that information should be free, that innovation occurred when people could share, that software should be under the control of its users. Gates, like the other software billionaires, benefited from collaborative innovations – then privatized them to make his billions, and then used the power that came from those billions to try to stop the innovation and freedom that he benefited from (Linda McQuaig and Neil Brooks tell this story in their 2010 book The Trouble With Billionaires).

Like most corporations, Microsoft does its best to reduce its tax burden, to avoid taxes wherever possible, and to be part of a long-term trend of corporations paying less and less in taxes. Some of the billions in taxes Gates didn’t pay are now part of his foundation’s endowment. But if it’s governments that do the real work of development, then starving those governments of revenue can’t be good for development. Even as they try to lobby governments about the value of foreign aid, the Gateses practice a model where the wealthy keep money away from governments, and distribute it as they see fit, through charities of their choice, and where foreign NGOs, rather than local, sovereign governments, control the money and the power. Perhaps there are other myths that block progress for the poor, like:

4. Private aid is significant compared to government aid.
5. Rich people can’t be expected to pay taxes like everyone else.
6. Priorities decided by individual, wealthy donors, yield better development outcomes than priorities decided by democratic processes.

Maybe we can watch for these in the 2015 letter…

Reading the Manifesto for Social Materialist Psychology

A little while after my Ossington Circle interview with author Paul Moloney, I was sent (by Paul) the Midlands Psychology Group Manifesto for a Social-Materialist Psychology of Distress. It’s an unadorned, long, well-written text that is full of important insights. I appreciate it as someone who is trying to understand “the system” and how it impacts people, and how we could help one another first to survive in the unequal and often violent society we live in, and how we could try to make change. I am going to go through the manifesto a bit here.

The manifesto is arguing against “most psychology”, which it describes as “individual and idealist”. By contrast, the manifesto is “social materialist”. To the manifesto, “individuals exist, but their experiences are thoroughly social, at the very same time as they are singular and personal. And cognitions occur, but their relation to the material world is neither determinate nor arbitrary.”

An important consequence of the social materialist approach is that it argues “distress arises from the outside inwards”, it is “not the consequence of inner flaws or weaknesses”. While “all mainstream approaches to ‘therapy’ locate the origin of psychological difficulty within the individual, usually as some kind of idiosyncracy of past experience.” The explanation of why some individuals succumb to distress while others can withstand it is, in the social materialist school of thought, quite simple. It is due to the “embodied advantages someone has acquired over time from the social/material environment”. Understanding distress, like understanding survival, is done best by looking from the outside in – at what happened to the individual in society. Hence, trauma, inequality, and other social realities are causes of distress.

The manifesto attacks psychiatric diagnosis as a “quaint notion that distress can be neatly partitioned into robust categories”, which “reflects the mistaken belief that it is caused by organic diseases or impairments.” Understand distress as social and material, and the categories fall apart, as in diagnostic failure:

“This may be why psychiatric diagnosis is notoriously both unreliable and invalid. Evidence of unreliability is provided by the lives of service recipients, who frequently receive different diagnoses during their contact with services. Further evidence comes from studies showing that, even in reliability trials where normal variation is artificially constrained (by video presentations, special training and broad categories) psychiatrists frequently disagree about the ‘correct’ diagnosis (e.g. Bentall, 2003, 2009; Pilgrim & Rogers, 2010; van Os et al., 1999). Evidence that diagnosis is invalid comes from studies of comorbidity which show that patients who meet the criteria for one diagnosis most likely meet the criteria for at least one other (e.g. Boyle, 2002; Brady & Kendall, 1992; Dunner, 1998; Maier & Falkai, 1999; Sartorious, Ustun, Lecrubier, & Wittchen, 1996; Timimi, 2011). Other evidence comes from studies of symptom profiles which show (for example) that the symptoms of people given a diagnosis of bipolar disorder do not cluster separately from those of people given a diagnosis of schizophrenia (Bentall, 2003). Because psychiatric diagnosis is neither reliable nor valid, all of its claimed benefits – in respect of aetiology, treatment, prognosis, service planning, inter-professional communication, reassurance to service users and their families – are compromised.”

Individual and idealistic psychology leads not only to diagnostic, but to treatment failures, because by aiming at relief through “insight” it fails to recognize that “much of our experience, including emotional arousal, is not necessarily available to conscious introspection”. Social materialist psychology offers a more “multiple, complex, and open-ended” view of the causes and the possible treatments of distress.

The bad news is that social-materialist psychology does not provide any easy cures – neither, though, does mainstream psychology. The manifesto is very direct about this: “Distress cannot be cured by medication or therapy.” The notion of a “cure” is harmful – “the majority of psychoactive drugs cause mental and physical harm, especially with long-term use,” and “whilst the talking therapies appear more benign, too often they are just a more insidious form of control, fostering the illusion that misery is an internal failure or breakdown, awaiting correction from an expert.”

On the other hand, both medication and therapy can help. Medication “can usefully anaesthetize the distressed to their woes, yielding brief bubbles of respite or clarity. During these short, chemically induced holidays from their misery, those with the resources may initiate life changes that alleviate their problems and establish positive future trajectories,” while therapy “provides comfort (you are not alone with your woes), clarification (there are sound reasons why you feel the way you do) and support (I will help you deal with your predicament),” which, “in an atomised, fragmented, time-poor society, where solidarity and collectivity are derided, time limited, and relationships consistently infected with a toxic instrumentalism, these are valuable, compassionate functions.”

In social-materialist psychology, success in treatment is predicted by compassion, understanding, and resources – not technique. If the therapist is compassionate and understanding, and the patient has resources to act on the new insights, the chances of success are high. Technique, on the other hand, doesn’t matter. Discarding the idea that specific techniques matter might be difficult, but it would be helpful:

“In a thoroughly commodified society it is perhaps understandable that some practitioners will want to have branded, marketable products, just as in a professionalised culture some will want to identify themselves as bearers of highly specialised knowledge and skills. Like everyone else, therapists must earn a living, so it is only to be expected that interest should influence how they present themselves and their work. Nevertheless, doing so distracts attention from the actual causes of distress by bolstering the belief that it is a mysterious state amenable only to professional help; it disables friends and family, who may feel that they could not possibly understand; and it negates the contribution of community, solidarity and trust. The presentation of therapy as specialised technique cheapens and oversells psychology itself; leads to resources being wasted comparing the marginal differences between this brand and that; and deflects effort and attention from the very real opportunities for psychological research and insight that are supplied by the highly privileged situation of the therapeutic encounter.”

The manifesto, like Paul Moloney’s book, provides a compassionate and nuanced take on psychology and therapy. If you want to help others, take a look at it.

Ali Mustafa

I met Ali Mustafa a long time ago, when he was one of the younger activists in Students Against Israeli Apartheid (SAIA). I was not so old as I am now but Ali’s energy and anger made me feel my age then.

Ali was no single-issue activist. He spent a summer working (as an intern I think) with the Movimento Sem Terra (MST) in Brazil, a movement of landless peasants. That was how he did things. He wanted to go, be in it.

He was no hotel journalist. When he went to Palestine and Egypt and to Syria, he lived with the people, shared their risks, faced whatever they faced.

I didn’t always get to meet him after his tours when he’d come back to Toronto, but I did quite a few times. We would talk and argue over details, facts, doctrine (“Is what’s happening in Egypt really a *revolution*?” – Ali thought yes, and so did I, for the record).

He was a journalist in the sense that he went there, wherever there was, and wrote and documented, and photographed. But he was not a journalist in any of the bad ways. There was nothing careerist about him. He never pretended at any false objectivity – he was a people’s journalist and he believed in their struggles. Pretty much everything I ever saw him do, he did with this motivation. He never put himself above the people he was writing about. He put himself with them, instead.

When I was Ali’s age, I think I had a lot more help and support doing the kinds of things I did than he had doing what he did. I really wish more people could have seen his work, and I wish he could have been around some more decades to do more of it.

Ali Mustafa (twitter handle @_fbtm blog was a Canadian freelance journalist and activist. He died with 7 Syrians in an airstrike by the Assad government in the Hadariya neighbourhood of Aleppo on March 9, 2014.

Ali was pretty prolific. Here’s a small sample of Ali’s writing from his blog:

Oct 31, 2013: Reporting from the Inside – Ali interviewed by Stefan Christoff, a very nuanced and well-informed example of Ali’s type of people’s journalism, about Syria.

March 3, 2013: The Ultras and the Eegyptian Revolution – Ali interviewed by Left Hook. Ali’s take on the Egyptian Revolution.

January 20, 2013: Kafka in the Courts Ali’s reporting on the case of Mohammad Majoub.

March 24, 2011: Where Athenian Democracy Went Wrong – Ali showing off a bit with some deep historical thinking about ancient democracy and what it means for today…