That is the image that comes to mind while reading Ronald W. Dworkin’s “The Rise of the Caring Industry.” The caring industry consists of the “77,000 clinical psychologists, 192,000 clinical social workers, 105,000, mental health counselors, 50,000 marriage and family therapists, 17,000 nurse psychotherapists, and 30,000 life coaches” at work in the US today and the additional “400,000 nonclinical social workers and 220,000 substance abuse counselors working outside the official mental health system yet offering clients informal psychological advice nonetheless” According to Dworkin this represents “more than a 100-fold increase in the number of professional caregivers over the last 60 years, although the general population has only doubled.”
Most conversations about what Dworkin has neatly labeled the caring industry eventually come around to Christopher Lasch’s The Culture of Narcissism (1979) and Philip Rieff’s The Triumph of the Therapeutic (1965). Both make the obligatory appearance, but in Dworkin’s view both are inadequate. Regarding Lasch he writes,
Many people who go to counselors share nothing with the stereotypical self-absorbed neurotic. On the contrary, they are average people with conventional values who face real-life problems but have no one to talk to. Fully a third of the American population has undergone some form of psychotherapy. It strains the imagination to think that the majority of them are narcissists.
Rieff was simply writing too soon to know the full import of the unfolding sea change in Western culture:
What Rieff had observed were the first stirrings of a new social order, one that would rest on a nation-spanning network of caring professionals. Today, countless institutions and millions of people are dependent to one degree or another on the caring industry. Therapy is no longer just a “culture.” In the form of professional caring, it has become our way of life.
Now we might question whether Dworkin’s take on Lasch and Rieff is itself adequate, but the main point he makes in bringing them up seems sound: the profound transition in American life that gave rise to the caring industry predates the 1960’s and 1970’s. The caring industry is rooted in the “seemingly placid 1950’s, when mass unhappiness and mass loneliness began.” Dworkin goes on to remind us that
So great was people’s unhappiness during the 1950’s, and so suddenly did it emerge, that both the political and medical authorities called it a “mental health crisis.” Rates of alcoholism and juvenile delinquency skyrocketed during the decade, which popular magazines dubbed the “Age of Anxiety.”
If you’re familiar with Mad Men, and just now it seems few are not, you’re probably taking exception to my title since Mad Men is set in the early 1960’s, not the 1950’s. But keep in mind that the early sixties were much closer to the 1950’s than they were to “The Sixties” which really start up mid-decade and spill over into the 1970’s. In a fascinating essay titled “The Other Sixties,” Bruce Bawer argued that the early sixties as a period had a certain integrity of its own, but it was still a period when “men wearing ties and neatly pressed suits on all occasions” was the norm.
And so the image of Draper on Prozac, or perhaps Draper on the couch, to imaginatively capture the period in which far-reaching transformations in American life gave rise to the caring industry. This is, in fact, a connection made explicit in the first few episodes of the first season in which Betty, not Don, Draper ends up going to a psychiatrist for her “nerves.” Part of Mad Men’s brilliance derives from its poignant, and sometimes painful, explorations of the growing unhappiness and loneliness of the era that Dworkin identifies with the birth of the caring industry. If this were all Dworkin was intending to drive home, that the caring industries roots go back to the 1950’s, then it would be merely an interesting and compelling historical narrative. But there is more, Dworkin argues that the rise of the caring class was necessitated by the breakdown of peer groups which had previously provided the resources and support ordinary people relied upon to navigate the difficulties and hardships of life.
Today’s caring professionals offer the same service to lonely, unhappy people that friends and relatives once did . . . People want to be able to go about their daily lives with the knowledge that someone is there for them. This basic truth led to the rise of the caring industry. Millions of unhappy people use professional counselors to compensate for having no one to talk to about their everyday problems.
Dworkin details a number of factors contributing to this sad state of affairs: Americans were increasingly moving to new towns alone, “urban renewal projects that tore down impoverished but vibrant inner city neighborhoods,” decreasing attendance at church or synagogue, longer work hours, a loosening of family ties, and more. The end result: “many people found themselves with neither the time nor the energy to listen sympathetically to a friend’s problems.”
We were becoming, as a classic work of sociology from the 1950’s put it, The Lonely Crowd.
Dworkin concludes his essay by arguing that the rise of the caring industry is most significant because it marks the end of a civilization based on an ideology of love. This is Dworkin’s most expansive and sweeping argument and, consequently, the most controversial and debatable; but there is a certain plausibility to it. In his view,
Many people today meet their basic psychological needs, including self-esteem, fulfillment, and identity, not through a social system of friends, intimates, and communities, as people did in the age of love, but by working directly with a caring professional. Although lonely, they are psychological stable, and society is spared the tumult of an earlier era when people satisfied these needs through loving communities.
Dworkin’s thesis possesses a certain explanatory elegance, but it also raises a number of questions. I wonder, for example, what difference the rise of social media might make to his analysis. Nonetheless, there is one claim Dworkin makes that strikes me as being quite right. The chief problem with the ideology of love, as Dworkin describes it, is that it finally encouraged people to love humanity. “But it is impossible to know humanity in the concrete; humanity is a fiction, it cannot be loved.”
We cannot love an abstraction. But we can love and befriend the particular people that are our families, friends, and neighbors. It is a messy business, loving real people; but apart from it, we become faceless members of the lonely crowd.