I saw a post on social media recently that read 'If you think you’re an “anarchist” but have no interest in participating in public health precautions, you’re just a libertarian who’s trying to hide.' (We'll come back to the modern poisoning of the term 'libertarian'.) This thought about public health and anarchism reignited something in my brain that I've wanted to dig into: how do we square a principle of non-coercion with caring for each other's health? I want to focus especially here on mental health, but I think there are tough, generative questions on all sides of imagining true non-heirarchal health care.
In the general case, I believe most societies that are "more anarchist" are, just by default, going to be better for people's mental and physical health. One way I think about anarchism (by way of Daniel Baryon) is: to support a horizontal power structure, you need two main ingredients. You need (left) libertarianism: decisions about social power get evenly socially distributed, and mechanisms are in place to keep them that way. You also need mutuality, where the power structure is built on cooperation and centered on care and maximizing mutual flourishing. Late stage capitalism ain't doing us any favors on either front there. and I'd even go so far as saying that if someone is "well-adjusted" by our capitalist society's mores, they probably are not actually healthy. Relevant example: if you are like the majority of folks, and you're going around without a mask indoors as COVID is in its second biggest spike of all time, you may be "well-adjusted" and not "sticking out", but you're also not caring about the people around you.
So, it's clear that most folks are not thinking from a mutuality lens in America. Those ingredients of a social structure are not well defined, but they do exist and we can point in their general direction. I'd like to dig in and examine an edge case… maybe you can read this as a kind of the "what about the murderers??" question. But from a different angle. What do we (as anarchists and abolitionists who want to build a world without oppression) do about people who (for whatever sad reason that is not their fault) struggle with mental issues that make them dangerous to themselves or others? Addiction comes to mind, as does schizophrenia. (That's a diagnosis which would certainly change after capitalism dies, and I hope its name and stigma would change too, but that's a whole other rabbit hole.) Let's take a seemingly simple example: assuming we have built a utopia with way less hierarchy and oppression, how do we help someone with addiction? Someone in the throes of it, who does not want to be helped? How can we conceive of a mutualist system of care that can balance their needs with society's needs?
There are anarchists who can't think about that. We've all been poisoned by our current society's individualism and extreme atomization. You can find that poison in the replies to that post, getting mad about masks. They seem to believe in a Crowley-ish flavor of their perfect society, one where everything is permitted to the individual who just grabs for it. To me, that's not anarchism. That's more like modern tech-bro flavor "libertarianism". That's not thinking through the consequences of your actions. These people would likely say that the answer to this tricky question of coercion is to let the person suffering with addiction choose their own path.
I gotta be honest. That seems like the answer of someone who's never attempted to actually help a real human with real addiction. It feels like an answer without enough empathy in it. It sounds like an answer that leaves suffering humans to suffer. And I'm sorry, fuck all that. An anarchist society should have way more empathy for those people than our shitty current timeline. And can't they see? Addiction damages more than the person; its cycles can cause real harm to others around them, so thinking in holistic, mutual ways is important. I think we can do better.
Now. Obviously I'm not going to argue for "just a little prison in our utopia, as a treat". But I also think that there can be different, pluralistic ways that an anarchic society bends around the principle of non-coercion in the process of helping people to flourish. I haven't studied them, but I bet you some folks have! And I should be clear here: some of the mental states capitalist society brands as "mental health issues" would be permissible and normal and supported and loved for their diverse contributions, in a half-decent society.
I hope we can agree that there are harmful mental patterns; patterns a person does not have control over by themselves. Patterns which oppress the person from inside themselves, you might say. Where if they could get help to get to the other side of (for example) addiction, they would be happier and the total flourishing in society would increase. They have a meta-desire to want that change: they want to want to change, but addiction stops them from taking steps. How do we help them without coercion? I think there will always be a blurry line; different parts of our utopian society will argue to draw the line differently, and it will never be settled. Because humans are complex, solutions to help us flourish will never be simple.
If you think about the "state of the art" in addiction care in our current capitalist society, it's the intervention, where a circle of close friends talks to the sufferer, with the help of an expert facilitator. I don't have the brain power to research it, but it feels likely that pattern came from indigenous wisdom originally, with our modern assumptions about rehab now piled on top.
Communities under anarchist principles would build multiple ground-up, woven-into-the-fabric-of-society methods to support each other that don't rely on hierarchy. David Graeber always talked about the many ways non-capitalist societies supported each other, like the example where everyone in town has two links in the circular "river of care", upstream and downstream. If your upstream needs help, you can pull from downstream. And so on down the chain.
Hopefully less people would be pulled into harmful patterns than under authoritarian capitalism, too. But life in an anarchic society won't be easy. You'll be more loved, hopefully, and you'll feel more connected. But you'll have to do things that are difficult: in community with people, striving for solutions, and working in menial tasks that… quite frankly if you're reading this, you're probably like me, and you don't have to think too hard about where your garbage goes or your food comes from. It's easy to imagine us all becoming addicted to an easy out.
Another bonus of anarchism would be that we won't have corporations like Purdue Pharma intentionally creating demand for drugs. But demand for escape from everyday life will still exist. How will we build better health care? It's an interesting question, right? I can point in a few directions I'll be exploring, and maybe people can light up the comments with some other paths.
Common Ground Relief: scott crow, Black Flags and Windmills: Hope, Anarchy, and the Common Ground Collective (Oakland, CA: PM Press, 2014).
How anarchist spaces like Christiana and Exarcheia have integrated with the dominant system's health care crud