Chapter 19: From Society to Cell: Uncertainty, Conflict, and Loss of Control

Stress affects everyone, but the worst affected are the politically and economically marginalized. The commonest emotional triggers for stress are uncertainty, conflict, and lack of information or control, all of which are caused or exacerbated by capitalism. Capitalism, as Yuval Noah Harari observes, is not just an economic doctrine but an ethical worldview which sees economic growth as the supreme good on which all others depend.

In a culture dominated by this worldview, it is only natural that most health problems should be seen as the results of individual decisions. However, it is clear that the capitalist stressors the author has already mentioned cannot be so described. The increasing economic uncertainty which has created widespread stress and financial insecurity cannot, for instance, be due to the choices made by individuals. Studies such as one which compared the stress levels of young Swedes and Greeks during the Greek economic crisis have shown the effect of macroeconomics on health. On a more personal level, studies in the United States have shown that the risk of suffering from a heart attack or stroke for people aged fifty-one to sixty-one more than doubles after they have lost their job and endured prolonged unemployment.

Warren Buffett has remarked that class warfare exists, in the sense that the rich are making war on the poor and winning. The Nobel laureate Joseph Stiglitz agrees and laments the cost of inequality. However, Maté suggests that capitalism is in fact succeeding magnificently, since it is intended to concentrate wealth and power in the hands of a few billionaires. This is an arrangement which leaves the vast majority of people in a state of alienation from society.

Chapter 20: Robbing the Human Spirit: Disconnection and Its Discontents

Contemporary society is inherently pathological because it teaches people to prize acquisition of material goods rather than human connection. The author says that this is “not a moral assertion but an objective assessment” of where disease comes from. If a virus caused the same effects as disconnection, it would be front-page news. Most psychologists agree that people have certain core needs, including connectedness, autonomy, competence, self-esteem, trust and meaning.

The author has named authenticity and attachment as the two most basic human needs and says that in a sane world, the two would not be in conflict. The psychologist Bruce Alexander speaks of “dislocation” as a loss of both, a sense of disconnection from oneself and others. This dislocation is abnormal for humans in the sense that it starves them of their core needs but has been normalized by a toxic society. One common form of dislocation is the feeling that one’s work is boring and meaningless. A survey of employees across 142 countries found that only thirteen percent of them felt engaged at work. This is true even of high-status professionals such as doctors and lawyers and others who command high salaries.

Meaning in life is an inherent expectation, and lack of it takes a heavy toll on both mental and physical health. Capitalism exploits the desire for meaning without satisfying it, as people who yearn for something larger than themselves buy into lifestyle brands. The resulting loneliness is a public health crisis. The percentage of Americans who say they are lonely has doubled from twenty to forty percent since 1980, and the lonely are at increased risk of illness and early death. Sadly, the author concludes, loneliness and other forms of disconnection are “becoming our culture’s most plentiful product.”

Chapter 21: They Just Don’t Care If It Kills You: Sociopathy as Strategy

Neuroscience is used in the field of neuromarketing by corporations who want people to become addicted to their products. These products, from soft drinks to cell phones, promise happiness, which is accompanied by a sense of completeness, and deliver pleasure, which leaves one always craving more. In his book, Salt Sugar Fat: How the Food Giants Hooked Us, Michael Moss documents a deliberate conspiracy to create mass addiction to junk food, neurochemically undermining free will. However, such conspiracies are so common in the corporate world that they seldom spark popular outrage, let alone long-term change.

A report in the Lancet found that eleven million deaths in 2017 were attributable to diets high in salt, sugar, and fat. Rates of obesity are increasing throughout the world, particularly in North America. Researchers at Durham University in England have pointed out that countries with the highest rates of and increases in neoliberalism have correspondingly high levels of obesity. The obesity epidemic is, at least in part, the product of an epidemic of stress caused by the challenges of modernity.

Big Food is only following Big Pharma and the tobacco companies in promoting profitable products known—and indeed designed—to be addictive. Over seven million people die every year from tobacco use and “for every person who dies, thirty live with chronic illness.” In his book The Corporation: The Pathological Pursuit of Profit and Power, Joel Bakan points out that a limited company is a legal person under American law. If it were a natural person, that person would be a sociopath. He originally thought that corporations were pathogens in essentially healthy democratic systems, but now believes that “the pathogen has infected the host.” The author ends by discussing the sociopathology of oil companies which are prepared to sacrifice the survival of all life on earth to their greed.