During the turbulent 20th century social theory perspectives developed that helped us to understand the way people behave and respond to the situations in which they find themselves. I have found them useful when looking at dysfunctional systems. There will be newer theories that build on these but I think the general thrust will be much the same. On this page I have snatched some broad ideas from works that explored in depth. I have taken from them what is of interest and relevance for understanding what I have called culturopathic ideologies, cultures and behaviour.

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The nature of the world we live in

In the 1960s sociologist Peter Berger built on insights from Philosophers and wrote a thesis and later a book The Social Construction of Reality. He and his co-author indicated that the world was a pretty complicated place which we could only know through our senses. We could then think about what we experienced using words and ideas. This enabled us to understand what was there and then discuss this among ourselves.

Constructing our world and the tensions this creates

Berger argued that we construct the world we live in as a web of ideas that represents the real world out there and we do this in discourse with others. So while each of us experiences life differently and has an individual point of view we build shared views and ideas in our written or spoken contact with others.

Others challenge the way we have understood things in the past and help us to understand what we experience in new and hopefully better ways. One generation passes understandings to the next who are then challenged by a changing world. They will build on that if valid for their situation, or else adopt new understandings that allow them to succeed in whatever situation they find themselves – sometimes this is beneficial for society but at other times the new beliefs may benefit them at the expense of society and some of its citizens.

Depending on the context of their lives different groups and nations develop different perspectives and understandings – cultures. Berger developed these ideas further over the years and several academic disciplines have developed within the same general framework. These have influenced sociology, psychology, education and social movements. In sociology these insights gave rise to the discipline “Sociology of Knowledge”.

Meaning and angst: In building our world we each create meaning in our lives. This meaning enables us to make decisions and do things. It becomes part of our identity. Our confidence and security depend on it. Because the world we experience can be very confusing we may struggle to do this and our representations may not be an accurate reflection and may differ from others who have different experiences. When our world is threatened or challenged we experience discomfort.  A number of words are used to express this in different contexts and in different disciplines. So we get terms like existential angst, anxiety and dissonance.

Complexity, doubt and uncertainty cause angst and put pressure on us. We struggle to handle multiple points of view particularly if they conflict. Our gut response to a conflicted world is to cling on to and protect the tried and true ideas that have been successful in the past – creating a stable world by denial. When doubt gets stronger our angst increases and we are likely to adopt any alternative attractive and emotionally satisfying pattern of thinking on offer, whether it fits the facts or not – provided it gives us a simple way of understanding that is more stable and comforting.

A stable world is characterised by trust in the ideas that give our lives meaning, and trust in others – being able to believe what others tell us. When that stability is based on ideas that are illusionary and don’t represent the real world it will ultimately be challenged by its consequences in the real world. The things we believe in may be illusionary but their consequences are real – sometimes devastating.

Our vulnerability: . I wrote about the difficulty we have in handling complexity and conflicting perspectives and how we respond in The Cultural Perspective section. When our worlds break up and become chaotic we become particularly vulnerable to snake oil. Politicians can play on this by trotting out illogical nonsense. This is why the Post-truth era is so problematic. People who realise they have been deceived by those they once trusted now doubt everything they hear. The risk is that they will grab at the lifeline of simplistic emotive nonsense when it is presented as obvious.

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Our weakness to ideology

The Canadian author John Ralston Saul writes extensively about our weakness for ideologies and our difficulty in confronting these. In his Massey lectures published as “The Unconscious Civilisation” he argues that western society has become so lost in a maze of illusionary beliefs that it no longer has a grasp of and is unconscious of the real world.

Combatting ideology

In his next book “On Equilibrium” Saul argues that as individuals we have a number of qualities and if we use them together in a balanced way we can learn to tolerate complexity and resist our weakness for ideology.

I like to apply that concept of balance to society’s attributes as well. Ideology often takes sensible social attributes and exaggerates them. It then applies them without the normal social constraints that constrain their excesses. This distorts society and causes harm.

Good useful social attributes like competition and efficiency are normally constrained by other social insights and concerns. When unleashed and uncontrolled in society, and particularly in vulnerable sectors like aged care they are very harmful. The impact of these ‘one eyed’ or closed minded distortions of social balance plays out in our communities. It can only be imposed and maintained by neutralising those in the community who are adversely affected or who see differently – or by excluding the community’s voice from the discourse altogether through censorship.

Civil society and ideology

Ideologists seek power and take control. They maintain a barrier between their ideas and the challenges of the real world. They take control of information about the world and persuade the community of the validity of their ideas by molding this information to their point of view.

But our communities (civil society) are at the coalface and experience and see the consequences of policies. When organized and involved communities develop an independent discourse that will analyse in a more realistic way and draw its own conclusions.

When civil society is in control of information and has power it sets the limits of acceptable discourse and so conduct. Ideology is constrained. Culturopathic ideologies therefore seek to undermine civil society, control the information it gets and disempower it. They threaten democracy. Ideologies take control of knowledge and try to influence the way in which community’s interpret their adverse experiences so that they come to accept the ideological explanations.

Neoliberalism has been particularly successful at building consumer ideas (eg consumerism), at limiting adverse interpretations, and at emasculating civil society by hollowing out its structures. It has used the media very effectively but is now struggling to maintain this in the face of rising disillusionment. It is more difficult to control the new social media.

Much of the information we have been given is skewed or deceptive and society has now realised this – hence the post-truth era. In aged care the community has been marginalised and excluded. With less involvement citizens lose interest. Knowledge and skills are lost.

When failures in aged care cause the community to become restive, this is mollified by a series of tokenistic ‘reforms’ that re-affirm the merits of the ideology but do not address the underlying problems.

As the tide of criticism rises we see regulators in the wider marketplace and in aged care simultaneously accused of protecting government and industry. It reinforces the argument that the failures in aged care are part of a wider problem.

Banks: Reports about the way ASIC protected and sanctified the information it released about the confronting scandals in which banks defrauded vulnerable customers. It even sent “draft press releases to the banks for feedback before issuing them to the media and the public”. FOI documents show that the Commonwealth bank values their “relationship with regulators and we engage with them every day on a range of topics”.

ASIC modified releases to "placate Westpac” including “the timing of the media release”. A strategy “that resulted in ‘minimal’ media coverage and public reaction”. It seems that a supposedly independent Ernst and Young review of Macquarie was considered to be a sham by ASIC, but even the word “superficial’ was edited out of the press release.

Aged Care: Extensive information about the way in which the dysfunctional Oakden aged care psychiatric facility continued to abuse and mismanage residents over a period of at least 15 years in spite of numerous complaints and extensive information. During this period the accreditation process protected the facility rather than its inmates and gave comfort to the South Australian managers. It was an independent psychiatric report that exposed the whole sorry saga and finally forced Oakden’s closure.

Incredibly in the face of a damning report and intense criticism of the way the accreditation process failed and gave comfort to managers, the industry, in this case ACSA trotted out the Neoliberals article of faith by claiming that “Aged care is a highly regulated industry and subject to rigorous accreditation standards by the Australian Aged Care Quality Agency (AACQA). This includes both regular scheduled site visits and unscheduled “spot-checks” to ensure that providers are meeting high standards”. It’s like one of those old cracked vinyl records repeating the dogma of the 20th century over and over again long after it has lost its credibility. The agency itself is in damage control as they can no longer deny what happened.

There are signs that in the post-truth era civil society is finally stirring and forcing some changes. Shareholders are members of society and are becoming more aware of the issues created by this marketplace.

Global warming: Strong reaction from investors threatening to withdraw investment coupled with community protesting at bank celebrations has put pressure on banks investing in Adani’s planned Queensland coal mines. The majority of banks are refusing to fund the project, so placing it in jeopardy. Westpac has decided that it will no longer invest in anything except the highest quality coal. . The response of the minister and the industry was to denigrate the citizens who exerted responsible pressure, the citizens who spoke out then stigmatize and attack Westpac publicly calling it a wimp for behaving responsibly.

Exploiting labour: Investor angst about the social and financial consequences of exploitative, poor and often illegal labour practices has caused them to back away from private equity and franchising businesses because of their poor records in increasing profits at the expense of staff. Investors are avoiding those sectors where there is “a 'grey area' when it comes to labour practices.". First Super “which manages $2.5 billion of members' retirement savings” is considering “winding up of its private equity program”.

In aged care too: It is alleged that aged care providers have been looking the other way when it comes to exploiting staff. “A cleaning company that provides services to aged care facilities - - has been accused of underpaying and exploiting its staff by the Health Services Union (HSU)”. The pressures of competition are blamed for what is happening. Those who pay fair wages cannot compete.

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Berger looked at the stability of the world of ideas. At one end he had a stable well-ordered comfortable world which he called Nomos. At the other was a wildly disorganised world – a state of anomy or chaos. He used this to look at the function of religion in society. He was not challenging any religion although clearly they cannot all be totally true but simply looking at their social role using his insights.

Nomos, Anomy and belief

He argued that religion functioned as a protection from anomy. By believing in something outside ourselves and unknowable we are able to explain the complexity of our world in simple ways that cannot be challenged. Religious belief creates a state on nomos which he described in his title as The Sacred Canopy – a shield protecting us.

Escaping into belief: The way stress causes people to grasp at and embrace ideas that relieve that stress is illustrated in an even earlier book, Battle for the Mind, by a rather controversial psychiatrist. This explored the sometimes deliberate use of angst and stress in securing religious conversion and its similar use in brain washing. In both adopting new beliefs allows us to escape angst by adopting a belief that relieves the stress. The book was influential at the time. One psychiatrist I knew saw religious conversion as the only way any of us could manage the anomy of impending death. He saw religious conversion, even by deliberately increasing stress as the way to manage the angst of dying.

The power of belief: Ideology can serve the same nomos creating social function as religion, but usually in a more damaging way for others. It too provides certainty in an uncertain world. It allows us to counter anything that challenges that belief by using a whole army of psychological strategies. People have believed in fascism, communism, apartheid and any number more.

Strictly speaking the term can be used for democracy and capitalism when they are believed in rather than adopted as the most sensible option available. Most of us realise that both can go very wrong and be undermined. When controlled by evidence, logic, common sense and a reflective society that sees with many different eyes, both are helpful rather than harmful. For many neoliberalism seems to have breached that line and believers have no doubts.

People will hold belief so tightly that they will kill others or die for it themselves. We can look back to the inquisition and the burning of witches in Medieval Christianity. In Islam we currently have Isis and Al-Qaeda where people kill others and themselves. The Japanese Samurai warrior tradition and culture became the driving force for the Kamikaze pilots who flew their explosive loaded planes into US warships in World War 2 killing themselves in the warrior tradition. Japanese soldiers fought to the death and rarely disgraced themselves by surrendering.

Traditionally belief was good: Belief is enormously powerful. It readily leads us into an illusionary world and this prevents us from coming to grips with the complexities of the real world. It frequently threatens others. So Blind belief is potentially harmful and is something we might condemn.

But in our historically inherited Christian and Islamic worlds belief is the ultimate virtue and we have been urged to be true believers and not have doubts. Unbelievers and doubters become evil heretics. They have been shunned and persecuted.

The problem of belief: Today we expect believers to accept some doubt and tolerate other believers rather than kill them. We want people to examine evidence and use logic rather than uncritically believe. But we have no simple word for this. We can talk about “on balance”, in my opinion, on the basis of evidence, most likely, or that the evidence clearly shows.

There is no simple word that encapsulates this so most of us still say “I believe that” even when we are talking about the balance of probability that makes us decide to base our actions on a particular set of ideas over others until it is disproven – the scientific stance. But we need to remember that for many belief becomes an essential mode of survival and we must accept that as beneficial even essential for them – displaying tolerance.

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Concepts that are opposites

For our purposes it is useful to look at ideas that represent the opposite ends of a spectrum and to have a continuum between them. We can look at what makes situations or people move towards one or other end of that spectrum. This can lead us to policies that change things by encourage us to move towards the desirable end of the spectrum.

Analysing apposing ideas

The structure of knowledge: As illustrated above Berger used the concepts of nomos and anomy as two ends of a dimension about the world we build for ourselves. While we might consider nomos as the desirable normal end this would lead to a static unchanging world that makes little progress. It is the challenge created by a move towards anomy that stimulates thought and so positive change. It is necessary and we do need to embrace it too. In planning we need to focus on ways of handling anomy and the discomfort it causes beneficially and without escaping into belief and ideology.

Constructive versus responsive behaviour: There are times in our lives when instead of angst, we find challenging established ideas including our own stimulating and exciting. We engage constructively and reflect with evidence and logic and in doing so build and enlarge our world. We can see this as constructive behaviour.

Yet later in our lives these ideas become so important to us that we experience stress when we are challenged by new experience, conflicting evidence or new ideas. Our gut response is to defend them in any way we can. So we have a spectrum from being constructive to being responsive. The former is clearly the desirable end of this spectrum. Constructivism has become an important idea in education and every effort is made to foster it and create contexts in which students will learn constructively and not respond to stress with rote learning.

It can also become a way of life. Viktor Frankel, an Austrian psychiatrist was a holocaust survivor. He noted that in the death camps those who were able to respond under stress by being constructive and developing new ways of thinking survived. Those who were responsive did not. He subsequently developed a form of therapy that helped people to become constructivist in response to their problems. He taught people not to bury or run away from their misfortunes and sad experiences but to use them as a vehicle for greater understanding and for rebuilding their lives.

Open and Closed minds - a measure of character: In 1960 Milton Rokeach published a study of dogmatism in a book “The Open and Closed Mind”. In that book he postulated a personality spectrum along which most of us lie and along which we can move at different times in our lives. While he has since changed his ideas and does not accept what he said in 1960 the concept of an open and closed mind can be usefully developed and used because we can see many who fall into these categories. I have found it useful.

An open mind is essentially constructive. It tolerates stress, and is able to accept and manage conflicting ideas and uncertainty. The approach to these situations is investigative and reflective - building new and more appropriate and perhaps more complex insights. It uses intelligence to explore, accept and adapt. Because it embraces doubt it is less dogmatic and less certain in what it says and does it can be seen as less driving and dominating and so less decisive and sometimes less effective.

A closed mind in contrast is essentially responsive but not in a way that acknowledges doubt or uncertainty. It uses its intelligence to justify and rationalize its position rather than challenge it. These people can be very intelligent and display great ingenuity in their rationalisation. They have no doubts, are assertive, persuasive and charismatic. They readily become leaders. Their energy and conviction makes them effective and they can accomplish much when their ideas are soundly based. They deal with ambiguity by rationalization, compartmentalization, willful blindness and if need be by deceiving themselves. When challenged they ignore what they don’t want to acknowledge by attempting to dominate and discredit their critics. When all else fails they can become very aggressive.

As indicated people who tend to be closed minded can be very effective and accomplish much but they need to work in an environment where they are contained and managed by discourse with others. They are particularly successful in the marketplace. Their decisiveness can be an asset but uncontrolled they can go off at a tangent and cause problems.

In handling this there are two issues.

  • Creating a context in which the energy and drive of these people is harnessed but their excesses are constrained.
  • The issue of suitability. I have long argued that in vulnerable markets the system selects for those who are most successful there and puts them in charge. In a competitive market in vulnerable sectors like health or aged care, decisive persuasive closed minded people are often much more successful. They shut out the things they don’t want to know about such as failures in care.

    Human services require leaders that can embrace the complex issues surrounding human suffering, our vulnerability and our relationships with our communities – ie open minded leaders and managers. Instead, in vulnerable markets, a form of perverse social Darwinism selects for the least suitable and drives away the most suitable.

Authenticity and inauthenticity – a spectrum of identity: I have already written about Sartre’s concepts and described the way pressures including angst and anomy can challenge identity. These can drive us into lying to ourselves so that we can embrace an inauthentic identity that enables us to continue to “be” and to ‘become” in the situation in which we find ourselves.  We can do this to varying degrees.

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The argument is that we are looking at an aged care system whose discourse is dominated by the powerful neoliberal market and political agenda – a group whose power and control depends on controlling and rationing the information we get.

Because the neoliberal agenda is inappropriate for the sector it clashes with real life creating uncertainty and anomy. True believers are strongly defensive and employ every strategy in the book to neutralize critics.

So we have a system where decisions are made a long way from where care is provided, that is responsive rather than constructive, where individuals tend to be closed minded, and where people need to abandon authenticity in order to find an identity in the system.

The proposed aged care hub is situated close to the bedside and is directly involved in the collection and evaluation of data. This will rebalance the power in the discourse and bring alternate discourses to the discussion which will be local rather than central. Its intention is a constructive pattern of relationships which foster open mindedness and authenticity. Believers will be able to discuss and challenge their beliefs in a context that is not threatening or destructive of their identity.

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