Alienation: Diagnosis and Prognosis

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One of the earliest usages of alienation in the English language is found in Wycliffe’s Bible. It is used in the sense of an individual estrangement from God. Over the years, the term came to be used in the medical field and legal arena. In the 19th century England, the term alienist refers to a psychiatric doctor. Alienation is still used in legalese with reference to the loss of the right of ownership over a property. The term has an extended and unique meaning in philosophy. It was Jean-Jacques Rousseau (1712- 1778) who first used this term in a philosophical tract. Stanford encyclopedia of philosophy defines alienation as a “…problematic separation between the self and the other that properly belong together”. In philosophy, the focus is on the problematic separation. Both the Hegelian school and the Marxist school have made use of the term alienation in their philosophical discussion. The term has a cornerstone presence in both existentialism and Marxism. However, both the denotations and the connotations of the term is different from one school to another. Hegel’s (1772-1831) entaiusserfng i.e estrangement or alienation has profound significance in existentialism. Alienation in existentialism refers to the estrangement of an individual who finds the social institutions, the social values, and the society itself meaningless and empty.

In Marxism, alienation has a different meaning. Karl Marx seems to have first used this term in 1844. It is found in his Economic and philosophical manuscripts of 1844 (published in 1932). He makes use of the German term entfremdung (estrangement) to explain the implication/effect of the capitalist production system on a worker. Usually, any person would experience two levels of pleasure or enjoyment when he/she does something or produces something. Marx says that primarily, a person “…would have the direct enjoyment of both being conscious of a satisfied human need by his work… [and he/she] would have the executive pleasure of knowing that his personality to be objective, visible to the senses and hence a power beyond all doubt.” Deriving pleasure is possible only when an individual independently pursues his/her desired line of work.

On contrary, when an individual is put in a capitalist institution, like a factory, he or she does not have the freedom to choose a specific path or the freedom to choose the specific need of the society. He/She becomes a minor unidentifiable near non-existent cog in a gigantic wheel. This crosses estrangement or alienation in the worker. Marx was actually influenced by the usage of this term in the ‘Essence of Christianity’ (1841) written by Ludwig Sen (1804-1872). Marx improvised this idea to suit his critique on existing modes of production. He lists four levels of alienation experienced by a worker. To begin with, the workers alienated from the product. Then, the workers alienated from the art of production. Thirdly, a worker alienated from the gattungswesen (species-essence) and finally from other workers. Since this piece of writing intends to focus on alienation as used by Karl Marx, it would be better to explain this idea with an illustration.

Let us take the case of a blue-collar worker who works in an automobile factory. From morning to evening, he may have to do a specific task again and again in the production line. For example, he may have to just fix the right rear end wheel of a car. The idea of alienation says that this monotonous work will manifest as alienation in the worker on four levels. To begin with, such a worker cannot have any sort of emotional identification with the product i.e an automobile as he/she has not contributed to the overall production of it. Secondly, such a worker is alienated from the very art of production. He/She will not have an overall idea or knowledge about producing an automobile. Instead, he or she will be encouraged to rapidly and precisely a small task like fixing a wheel or such. Thirdly, the worker gets alienated from the species essence. He/She cannot have the satisfaction of doing something to fulfill the need of others. Finally, a worker working in such an institution is alienated from other workers. In such circumstances, a worker might see his fellow workers not as collaborators but as competitors.

Marx would not have thought that his theory would be very suitable even to professionals. In the late 20th century, and 21st century, with the advent of corporate companies, the woes of the alienation is not limited to the assembly line worker. Even medical professionals and teachers are affected by alienation. Although there is no difference in labor, professions like teaching and medicine are considered to be far more sophisticated with enough space for individualism. However, things have changed in the past decade and now in one way, there has come strange equality between all types of workers. A blue-collar worker and a neurosurgeon are affected by the same pangs of alienation. In this piece, I plan to use examples from the medical field and educational sector to argue my case.

Once upon a time, doctors were considered to be walking gods on earth. Necessarily, most of the families had a family doctor. People who did not have the means to have a family doctor had another option. They could rely on the doctor who practices in their area in a ‘polyclinic’. Polyclinics have become a near-extinct institution. I do not know how many people under the age of 30 would understand the term polyclinic. Polyclinic refers to one room or two-room clinics that were rented and maintained by three or four doctors. Throughout the day, the doctors would use the space according to the slots. They were affordable both to the doctor and the patients. The doctors knew not only their patients by their name but also familiar with the illness and lifestyle of the patients. With the boom in real estate and entry of corporate entities into healthcare, most of the polyclinic has met a slow ignoble death.

Now, one can see the multi-storied building with flashing lights and a marketing team offering you a healthcare solution. Everything is sophisticated and you get follow-up calls if you miss an appointment. The marketing team is ready to negotiate the cost of the surgery with you. Upon entry, one is provided with the smart card and after each visit, someone calls to get the feedback. In the midst of such sophistication and flashiness what is missed is the bond of an individual whom you trust to heal you and solace you get from a medical professional’s commitment. One may visit a corporate hospital umpteen number of times but there is no guarantee that he or she will be able to visit the same doctor. Over the Course of the treatment, one may have to see the faces of new doctors on each follow-up visit. “Everything is there in your file and hence there is no need to insist upon the same doctor” is the explanation provided by the hospital.

A patient has his own qualms and there are trust issues. He finds it very difficult to survive in a hospital environment without a rapport with at least one healthcare professional but he or she is silenced by the infrastructure and machine-like precision of the corporate healthcare system. Doctors have their own problems. A doctor cannot continuously treat a patient. A doctor is encouraged to keep a relationship with a patient as professional as possible. A doctor cannot exercise his discretion in treating a patient. A doctor instead is expected to follow in-house treatment protocols and any deviation or violation from the treatment protocol even though it’s not against medical ethics will result in some sort of disciplinary action against the professional. Similarly, a doctor working in a corporate entity can seldom experience the satisfaction of healing a patient on his own. A patient is seldom treated by the same doctor over the course of treatment. Finally, a medical professional will be forced to consider his colleagues as competitors rather than compatriots.

In a corporate environment, performance is continuously monitored. In corporate parlance, performance means performing an act that would bring more profit. Hence, a medical professional working in such an environment will always be subjected to the pressure to outperform his colleagues in terms of caseloads, surgeries, etc. In such a circumstance, a healthcare professional may have to often taunt his/her ethical responsibility for survival. A few years ago, an ophthalmologist complained that he was being forced to do dozens of surgery per day by his employers to fulfill his contract. Such an act would be detrimental to the welfare of both patients and healthcare professionals. In a corporate environment, any employee can shrug off the responsibility because no one is specifically responsible for anything. Also the term, ‘corporate’, has its roots on Corpo which means body, which has no actual body or so. It is just a legal person. Hence it cannot be punished in this world or nether world. At the maximum, it will be dissolved but like a hydra, it will come again with another head and name.

The same issue plagues the education sector ever since it was found to be a profitable business. The traditional role of a teacher has been completely redefined in educational institutions that are run with corporate values. A teacher who works in an educational conglomerate is expected to have the policies of an employee in the food chain. Uniformity, similarity, and predictability become very essential. A teacher is not supposed to project any individual traits or teach in accordance with his or her pedagogical discretion. He or she is supposed to act in accordance with the standard pedagogical procedure framed by the institution. Any sort of rapport between students and teachers is discouraged. Recently, one of my friends raised a pertinent question in a social media post. He asked why people who have studied in private institutions seldom fondly remember the teachers. The answer is very simple. In such materialistic institutional settings, both the teachers and students view each other as subjects and not objects. In such institutions, often teachers are turned into troubleshooters and mercenaries of the management.

Teachers are often asked to do tasks such as fees collection and they do not have any chance to exercise any discretion while doing so. Further, in many institutions, teachers have to double up as recruiters and do anything short of kidnapping to ensure that all seats are filled. In such a situation, the only thing that exists between a teacher and student is unfathomable bitterness. They are bound only by hatred for each other. There is little chance for a student in such an institution to make his teacher as his role model. There is no doubt that few students who studied in such institutions would have fond memories about the teachers. It is a miracle if the student does not pathologically hate their teacher. For both the teachers and the students, each other are nameless entities. The teacher has to either suffer from chronic alienation or dehumanize and objectify the student.

Although I have used examples from two fields, this phenomenon is found in almost all the arenas. Lack of an emotional attachment with the job and the lack of job satisfaction drives people to compensate for the void by doing irrational acts such as alcoholism or illicit relationships.

The diagnostic part that attempts to provide a taxonomical analysis is over. The challenge is to provide a prognosis. One can condemn the corporate. On the other hand, one cannot dispute the fact that the corporate have made many cutting edge technologies available to the commoner. Everything comes with a price tag but the availability is equally important. The challenge is to find a solution that ensures the extermination of the alienation on one hand and the availability of facilities on the other hand. Marxist theory was very helpful in diagnosis but historical evidence suggests that the theory may not be of much use when one looks for a solution. Marxism states that in a Marxist utopia, work will be to “…each worker according to the abilities and benefit each worker according to the needs.” However, the so-called Marxist regimes have not put these words into practice.

Any worker from the erstwhile communist regime would prefer to work in the capitalist United States of America than in their Marxist paradises on earth. Hence, it is essential to look for a solution in other avenues. As usual, Gandhian philosophy has a solution to this problem too. Complete decentralization, autonomous villages, and a greed-free life would be a panacea to cure the ills of corporatism. But the problem is, Gandhian philosophy is an extreme idealism that expects men and women to be sages. Interestingly, certain aspects of postmodernism that overlaps Gandhian idea provide some sort of solution to the problem in hand. Postmodern theory is against meta-narratives and it is for mini-narratives. It is against the universal state and promotes the local state. Going in that route, one can say that alienation will be reduced to a great extent if simple clinics are promoted instead of hospital chains.

If one can concur with the intrinsic pessimism present in postmodernism, one can put it to use to solve such issues. It is essential to ensure the removal of alienation for the welfare of society. It is dangerous to have a tribe of professionals who are bound with the profession only by the chains of material benefits. Emotional attachment is essential to ensure integrity. Everything, right from nationalism to professional ethics will become meaningless if they are tempered only by material benefits. This is where religion, literature, and ethics come to use. Although they do not have a direct connection with most of the professions, they ensure that the professional would function with integrity by the values provided through them. In the world where food chains engage in structural competition with each other, there exist age-old shops such as Iruttu Kadai Halwa that do not consider the theory of supply-demand and profit-making but function based on their own value system that has evolved over generations.

In order to successfully contain the way of alienation, it is essential for society to work in tandem with professionals. Forty years back, the teacher was not paid much. In spite of that, he/she was satisfied and derived job satisfaction. This was due to two reasons, primarily he/she was not affected by alienation as the profession was more subjective than objective. Secondarily, his/her conviction was strengthened by the respect that was shown towards him/her by the society irrespective of his material achievement. The society should learn to measure an individual by his/her ethical conviction and not by the automobile driven by him/her.