Latest revision as of 20:57, 17 July 2025

CURRICULUM OF
THE BASIC PRINCIPLES OF MARXISM-LENINISM
PART 1

THE WORLDVIEW AND PHILOSOPHICAL METHODOLOGY OF MARXISM-LENINISM

For University and College Students

Not Specializing in Marxism-Leninism and Ho Chi Minh Thought

FIRST ENGLISH EDITION

Translated and Annotated by Luna Nguyen

Foreword by Dr. Vijay Prashad

Introduction by Dr. Taimur Rahman

Edited, Annotated, and Illustrated by Emerican Johnson

Proofread by David Peat

Additional Contributions and Editorial Support by Iskra Books

Published in association with The International Magazine

File:T-w-the-worldview-and-philosophical-methodology-of-2.png

1 License
2 Support for This Work
3 Dedication and Gratitude
4 Foreword
5 Preface to the First English Edition
6 Introduction
7 Editor’s Note
8 A Message From The International Magazine
9 Notes on Translation
10 Guide to Annotations
11 Original Vietnamese Publisher’s Note
12 Original Vietnamese Preface
13 Table of Contents
14 Introduction to the Basic Principles of Marxism-Leninism
- 14.1 I. Brief History of Marxism-Leninism
  - 14.1.1 1. Marxism and the Three Constituent Parts
    - 14.1.1.1 Annotation 1
  - 14.1.2 2. Summary of the Birth and Development of Marxism-Leninism
- 14.2 II. Objects, Purposes, and Requirements for Studying the Basic Principles of Marxism-Leninism
15 Chapter 1: Dialectical Materialism
- 15.1 I. Materialism and Dialectical Materialism
  - 15.1.1 1. The Opposition of Materialism and Idealism in Solving Basic Philosophical Issues
  - 15.1.2 2. Dialectical Materialism — the Most Advanced Form of Materialism
    - 15.1.2.1 Annotation 55
    - 15.1.2.2 Annotation 56
- 15.2 II. Dialectical Materialist Opinions About Matter, Consciousness, and the Relationship Between Matter and Consciousness
16 Chapter 2: Materialist Dialectics
- 16.1 I. Dialectics and Materialist Dialectics
  - 16.1.1 1. Dialectics and Basic Forms of Dialectics
  - 16.1.2 2. Materialist Dialectics
- 16.2 II. Basic Principles of Materialist Dialectics
- 16.3 III. Basic Pairs of Categories of Materialist Dialectics
- 16.4 IV. Basic Laws of Materialist Dialectics
17 Chapter 3: Cognitive Theory of Dialectical Materialism
- 17.1 Annotation 210
- 17.2 1. Praxis, Consciousness, and the Role of Praxis in Consciousness
- 17.3 2. Dialectical Path of Consciousness to Truth
  - 17.3.1 a. Opinions of Vladimir Ilyich Lenin about the Dialectical Path of Consciousness to Truth
  - 17.3.2 b. Truth, and the Relationship Between Truth and Reality
18 Afterword
- 18.1 Part 2: Historical Materialism
- 18.2 Part 3: Political Economy
- 18.3 Part 4: Scientific Socialism
- 18.4 Moving Forward
- 18.5 Advice on Further Study
- 18.6 Creative Application of Dialectical Materialism and Materialist Dialectics
- 18.7 In Closing
- 18.8 In Solidarity,
19 [Appendices]
- 19.1 Appendix A: Basic Pairs of Categories Used in Materialist Dialectics
- 19.2 Appendix B: the Two Basic Principles of Dialectical Materialism
- 19.3 Appendix C: the Three Universal Laws of Materialist Dialectics
- 19.4 Appendix D: Forms of Consciousness and Knowledge
- 19.5 Appendix E: Properties of Truth
- 19.6 Appendix F: Common Deviations From Dialectical Materialism
20 [Back Matter]
- 20.1 Glossary & Index

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“Step by step, along the struggle, by studying Marxism-Leninism parallel with participation in practical activities, I gradually came upon the fact that only socialism and communism can liberate the oppressed nations and the working people throughout the world from slavery.”
- Ho Chi Minh

Support for This Work

Translating, annotating, and typesetting this book has taken three years, which would not have been possible without the support of our supporters on GoFundMe. GoFundMe is also the reason we are able to make the digital version of this entire text available for free online. We would therefore like to recognize all of our supporters:

Zach L.	Jake B.	Katia S.	Jimi C.
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There is still plenty of work to be done to complete the translation of this entire curriculum. If you would like to financially support our efforts, you can support us at:

BanyanHouse.org

Dedication and Gratitude

This book is dedicated to all the backers of the GoFundMe campaign that raised the funds to allow me to translate this text. What I initially believed would be a straightforward three-month process of translating ended up taking over three years of not just translation but also research, study, review, annotation, editing, proofreading, peer review, and more — with the incredible support of a full team of talented comrades — in order to make sure that everything would be digestible and intelligible for audiences outside of Vietnam. So, sincerely, thank you to everyone who backed this project for your patience, support, and encouragement.

Thank you to my husband and comrade, Emerican Johnson, who helped me throughout the translation process, and who did such a fantastic job editing, annotating, and illustrating this text. He was my constant dialectical companion as we grappled together with the spirit and meaning of the writings of Marx, Lenin, and Engels that are the bedrock of this text.

Thank you, also, to Iskra Books for the absolutely vital work they have done in helping us to edit this book and hold it to a high standard. We literally could not have done it without you. In particular, thank you to Ben Stahnke for organizing and cheerleading us through to the end, and to David Peat, for the painstaking, meticulous, and no-doubt frustrating work of proofreading our very, very, very imperfect writing!

Thanks also to The International Magazine, who have provided guidance and suggestions throughout the process of developing this translation. I have had the opportunity to work with The International Magazine on various projects and I can recommend no better monthly periodical for internationalist communists to learn about socialist movements around the world.

We owe a great deal of gratitude to Dr. Vijay Prashad and Dr. Taimur Rahman for taking the time to read through our translation and, in addition to providing their feedback and encouragement, also taking the time to write the foreword and introduction to the text. I know that you are both extremely busy with your own important literary, academic, and political work, so this assistance is so very much appreciated.

Finally, I would like to thank the Vietnamese intellectuals and experts who have done such an amazing job at taking hundreds of texts and distilling them down into the original volume which I have translated here. The elegance and precision with which they have been able to capture the essence of Marxism-Leninism is a monumental contribution to the workers of the world, and I only hope my translation does their work justice.

March, 2023
Luna Nguyen

Foreword

In December 1998, Fidel Castro addressed the Young Communist League’s 7^th Congress in Havana, Cuba. The Soviet Union and the Communist state system in Eastern Europe had collapsed, which greatly weakened the cause of socialism. Not only was Cuba hit hard by the loss of its major trading partners and political ally, but socialists in general were penalised by the lethal argument made by the imperialist sections that “socialism had been defeated.” After 1991, Fidel revived the phrase “Battle of Ideas,” which was had been used in The German Ideology by Marx and Engels. To the Young Communists, Fidel said:

We must meet, in the heat of the battle, with the leading cadres to discuss, analyse, expand on, and draft plans and strategies to take up issues and elaborate ideas, as when an army’s general staff meets. We must use solid arguments to talk to members and non-members, to speak to those who may be confused or even to discuss and debate with those holding positions contrary to those of the Revolution or who are influenced by imperialist ideology in this great battle of ideas we have been waging for years now, precisely in order to carry out the heroic deed of resisting against the most politically, militarily, economically, technologically and culturally powerful empire that has ever existed. Young cadres must be well prepared for this task.

Bourgeois ideology had tried to sweep aside its most fundamental critique – namely Marxism – by saying that “socialism had been defeated” and that Marxism was now obsolete. Marxist criticisms of the “casino of capitalism” – as Fidel called it – were being set aside both inside and outside the academy, with neoliberal policy confident enough to ignore each and every criticism. Fidel argued that young communists must learn the fundamentals of Marxism – including both dialectical and historical materialism – and must learn this in a way that was not religious thinking but would allow them to become “new intellectuals” of the movement, not those who repeat dogma but who learn to understand the conjuncture and become “permanent persuaders” for socialism (the two phrases in quotations are from Gramsci’s prison notebooks). The general ideological confidence of the cadre was not clear, and that confidence and their clarity needed to be developed in a project that Fidel called the Battle of Ideas.

During this period, communists around the world conceded that the demise of the Soviet Union had created a serious dilemma for the left. Not only were we penalised by the argument that “socialism has been defeated,” but our own arguments to explain the turbo-charged drive toward globalisation and neoliberalism and to make the case for a socialist alternative were not strong enough. One indication of that weakness was the 2001 World Social Forum meeting held in Brazil, which promoted the slogan – Another World is Possible, a weak slogan in comparison to a more precise slogan, such as – Socialism is Necessary. Young people drifted into our ranks in this decade, angered by the wretched social conditions created by the permanent austerity of neoliberalism, but bewildered about how to transform the political environment. The lack of Marxist political education was felt by socialist forces across the world, which is why many parties around the world began to revive a conversation about internal political education for cadre and active engagement with other social forces regarding the pressing issues of our time. Fidel called these two processes – internal education for the Party and external engagement on the dilemmas of humanity – the Battle of Ideas.

In line with this broad direction, the government of Vietnam worked with the national publishing house Sự Thật (The Truth) to develop a curriculum for universities and colleges in the country. They developed this order of study along five subject areas: Marxist-Leninist Philosophy, Marxist-Leninist Political Economy, Scientific Socialism, Vietnamese Communist Party History, and Ho Chi Minh Thought. This project worked to educate an entire population that would be able to understand the world in a rational and factual manner, outside the illusions of bourgeois ideology. Four years later, Communist Party of Vietnam adopted a resolution to take this work forward, and – under the leadership of Professor Nguyễn Viết Thông – produced this textbook that brought together the many themes of Marxism into focus for the introductory student and cadre. A book such as this is never easy to create, since it must introduce a form of thought that is critical of the foundations of bourgeois ideology – so it is a critique – but at the same time it provides a worldview to understand the actual world in which we live – so it is a science. The text must, therefore, show how bourgeois thought is partial and at the same time how socialist thought, creatively applied, will allow one to have a firmer grip of reality and be able to participate in fighting to transcend the obstinate facts of human indignity that are reproduced by capitalism. No manual such as this is without its flaws and without its limitations, but no education can start without a manual such as this one. The Vietnamese comrades have done a great service to the left movement by producing a text such as this, which can be used for study and then used as a model to develop similar texts in different parts of the world.

Ho Chi Minh, whose interpretation of Marxism and whose ideas about the Vietnamese Revolution, are all over this text once said: “Study and practice must always go together. Study without practice is useless. Practice without study leads to folly.” There can be no better injunction to get to work, to study and develop one’s theoretical armour and to use that theory as the guide to one’s work in the Battle of Ideas and in the battle for the streets, because this unity between theory and action is indeed praxis (thực tiễn), not just practice, but conscious human activity. That is what Fidel encouraged in his lectures on the Battle of Ideas.

Dr. Vijay Prashad.
5 March 2023
Caracas, Venezuela.

Preface to the First English Edition

The text of this book constitutes part one of a four-part curriculum on Marxism-Leninism developed and published by the Ministry of Education and Training of Vietnam. This curriculum is intended for students who are not specializing in the study of Marxism-Leninism, and is intended to give every Vietnamese student a firm grounding in the political philosophy of scientific socialism.

The entire curriculum consists of:

Part 1: Dialectical Materialism (this text)

Part 2: Historical Materialism

Part 3: Political Economy

Part 4: Scientific Socialism

In Vietnam, each part of the curriculum encompasses one full semester of mandatory study for all college students. Each part builds upon the previous, meaning that this text is the foundation for all political theory education for most college students in Vietnam.

However, it is important to note that this is not the first encounter with dialectical materialism which Vietnamese students wil have had with these ideas, because Vietnamese students also study dialectical materialism, historical materialism, political economy, and scientific socialism from primary school all the way through high school.

As such, the text of this book — in and of itself — would probably seem overwhelmingly condensed to most foreign readers who are new to studying dialectical materialism. Therefore, we have decided to extensively annotate and illustrate this text with the information which would have been previously obtained in a basic Vietnamese high school education and/or provided by college lecturers in the classroom.

It is our desire that these annotations will be helpful for students who hope to learn these principles for application in political activity, but we should also make it clear to academic researchers and the like that our annotations and illustrations are not present in the original Vietnamese work.

We hope that this book will be useful in at least three ways:

As a comprehensive introductory textbook on dialectical materialism and for selfstudy, group study, classroom use, cadre training, etc.
As a quick and easy to reference handbook for reviewing the basic concepts of dialectical materialism for students of theory who are already familiar with dialectical materialism.
As a companion book for further reading of theory and political texts rooted in dialectical materialist philosophy.

Also, please note: because this book is intended to be used as a quick reference and handbook for further study, there are many instances where we duplicate references, quotations, and other such information. We hope that this repetition may be an aid for study by reinforcing important concepts and quotations.

This book — Part 1 of the curriculum, which focuses on the universal philosophical system of dialectical materialism — serves as the foundation of all political theory and practice in the Vietnamese educational system as well as in the Communist Party of Vietnam and other organizations such as the Ho Chi Minh Communist Youth Union, the Women’s Union, the Farmer’s Union, the Worker’s Union, etc. Dialectical materialism is the framework for theory and practice as well as the common lens through which Vietnamese socialists relate, communicate, and work together.

This book focuses almost exclusively on the written works of three historical figures:

Karl Marx and Friedrich Engels... who initially developed the universal philosophy of dialectical materialism by synthesizing various pre-existing philosophical, political, economic, and historical tendencies including the idealist dialectical system of Georg Wilhelm Friedrich Hegel, the political economics of Adam Smith and David Ricardo, the materialist positions of Ludwig Feuerbach, and countless others.

...and Vladimir Illyich Lenin, who further developed and defended dialectical materialism, expanded the analysis of imperialism, demonstrated how to apply dialectical materialism to local material conditions specific to Russia at the turn of the 20^th century, and made many other important contributions to dialectical materialist theory and practice.

Obviously, there are countless other writers, revolutionaries, philosophers, and scientists who have contributed to dialectical materialism and scientific socialism. This book focuses primarily on Marx, Engels, and Lenin, because these figures laid the foundations and formulated the basic principles of the philosophy of dialectical materialism and the methodology of materialist dialectics which are most universally applicable in all endeavors.

It is our desire that translating this important work into English will lead to further study, understanding, and appreciation of dialectical materialism as an applied philosophy which socialists can find value in returning to periodically. At the end of the book, we offer a glossary of terms which doubles as an index, appendices with summaries of important concepts and principles, and an afterword, in which we offer advice for further study and application of dialectical materialism.

At the time of publication, we are already in the process of translating and annotating Part 2 of this curriculum, which focuses on historical materialism, with the hopes of eventually releasing the full curriculum. Once it is complete, it will also be made available at BanyanHouse.org — where we also invite questions, constructive feedback, and suggestions.

Introduction

Just a generation ago, Vietnam was the site of the most brutal war of the 20^th century. More tonnage of bombs were dropped on the Vietnamese people than were dropped by all sides combined throughout the Second World War. In addition, countless acts of cruelty were used to scorch the very soil of the nation. By the end of Vietnam’s Resistance War Against Imperialist USA (known to the world as “the Vietnam War”), Agent Orange, napalm, and unexploded munitions had left a land deeply scarred and a people traumatised by decades of death and murder. The impression one had was that although Vietnam had won the war, it was so badly devastated that it could not hope to win the peace. But, miraculously, Vietnam is winning this war today, as the Vietnamese economy has become one of the fastest growing in the world and quality of life for the people is improving at a pace which could scarcely have been predicted in 1975.

No one could have imagined that Vietnam would turn around so dynamically and rapidly. How did they achieve this economic miracle? How could this nation — so recently devastated by imperialism and war — possibly be able to reconstruct, revive, rejuvenate, and rebuild? That story is now unfolding before our eyes.

Vietnam’s development has not come without hardship, struggle, setbacks, and mistakes. The people of Vietnam have had to learn hard lessons through struggle and practice to develop and strengthen ideological and theoretical positions. In this manner, the philosophical development of Vietnam deserves study and attention from socialists around the world. To outsiders, Vietnam can appear to be rife with contradictions. As depicted by Western journalists, Vietnam is simultaneously a success story driven by capitalist markets and a failing socialist state. Every victory is chalked up to private enterprise, while every setback is attributed to socialism. In this sense, the media has failed to understand the essential character of the core contradictions which drive the development of Vietnam politically, socially, and economically.

Luna Nguyen has used social media and played an incredibly important role in helping the English speaking world understand the complexities of such contradictions that beguile so many academics and experts. She has helped to give an insider’s perspective on her own country’s path of development towards socialism.

Nguyen’s translation of Part 1 of this influential work, Introduction to the Basic Principles of Marxism-Leninism, a textbook studied by university and college students across Vietnam, is yet another big step in the direction of making Vietnam’s understanding of their own country’s development available to the English reading world.

For me, as an outsider, it is fascinating not only to see how deeply Vietnamese society takes an interest in European philosophical development (referencing Hume, Hegel, Descartes, Marx, Engels, and so many other Europeans, almost as if they are figures seated in some ancient monastery in Fansipan), but, even more importantly, how they have assimilated that knowledge into the wider context of their own history, society, and culture. The textbook truly comes alive in all the parts where these ideas are shown to be relevant to Vietnam itself. For instance, the textbook stands out with discussions of Ho Chi Minh’s concept of “proletarian piety,” which artfully blends elements of Vietnamese culture with Marxist concepts of class consciousness, or the story of Chi Pheo, who stands as a sympathetic stand-in for the interpretation of the unique characteristics of the Vietnamese Lumpenproletariat. The book itself is an instance of the dialectic of the universal and the particular, the abstract and the concrete.

Just as importantly, it shows that, in Vietnam, Marxism-Leninism and Ho Chi Minh Thought are not mere perfunctory rituals that are repeated like a learnt formula for this or that exam; but that although the Vietnamese political economy in its current form certainly contains contradictions which must be negated in the process of building the lower stage of socialism, the government remains seriously committed to the goals, theory, and practice of Marxism-Leninism and Ho Chi Minh Thought.

Hence, I highly recommend this book, not merely because it is a well-illustrated and easy-to-read book on the principles of dialectical materialism, but more importantly because it offers an insight into how the Vietnamese government collects and synthesises the philosophical developments that are, on the one hand, the collective legacy of all of humanity, and, on the other hand, the concrete manifestations of a revolutionary theory of (and for the oppressed yearning for) freedom in every corner of the world.

March, 2023

Dr. Taimur Rahman

Editor’s Note

Working on this project has been one of the most illuminating experiences of my life. In translating this work, Luna has opened a door for English speakers into the wide world of Vietnamese scholarship and pedagogy as it relates to socialist theory and philosophy.

Luna and I have done our best to capture the original meaning and spirit of the text. Furthermore, as we have mentioned elsewhere, our annotations and illustrations are intended only to contextualize and expand on the core information of the original text similarly to the class/lecture setting for which the curriculum is intended.

In their lives, Karl Marx and Friedrich Engels were never able to finish clarifying and systematically describing the philosophy of dialectical materialism which their work was built upon. Engels attempted to structurally define the philosophy in Dialectics of Nature, but unfortunately that work was never completed since he decided to prioritize publishing the unfinished works of Marx after his untimely death.

I believe that this text is a great step forward in that work of systematically describing the philosophical system of dialectical materialism and the methodological system of materialist dialectics. I also believe it’s worth noting how the Vietnamese scholars who crafted this curriculum have embedded the urgent necessity of action — of creative application of these ideas — throughout the text in a way that I find refreshing and reflective of the works of Marx and Engels themselves.

As the text will explain, dialectical materialism is a universal system of philosophy which can be utilized to grapple with any and every conceivable problem which we humans might encounter in this universe. In Vietnam, dialectical materialism has been used to delve into matters of art, ethics, military science, and countless other fields of inquiry and endeavor. It is my hope that this book will, likewise, lead to a wider and fuller understanding and (more importantly) application of dialectical materialism in the Western world.

March, 2023

Emerican Johnson

A Message From The International Magazine

The International Magazine began in 2020 to connect international socialist movements and to strengthen the voice of oppressed people across the globe. We have been following the work of Vietnamese communists in their unique path towards peace, prosperity, and the construction of socialist values with a keen eye and much interest. It is with this spirit of international solidarity and a deep desire to learn from and share wisdom from our comrades around the world that we celebrate the release of this First English Edition of The Worldview and Philosophical Methodology of Marxism-Leninism Part 1: The Worldview and Philosophical Methodology of Marxism-Leninism.

Ho Chi Minh once said: “In order to build socialism, first and foremost, we need to have socialist people who understand socialist ideology and have socialist values.”

To this end, Vietnamese communists have expended tremendous resources building a curriculum on Marxist-Leninist philosophy and analysis which includes dialectical materialism, materialist dialectics, scientific socialism, historical materialism, and political economy. These topics are taught in primary and secondary schools and are mandatory subjects for all students attending public universities in Vietnam. Beyond that, Vietnam offers free degrees to students who wish to study Marxist theory and philosophy and Ho Chi Minh Thought (defined as the application of Marxist philosophy to the unique material conditions of Vietnam). In this manner, Vietnam has demonstrated a steadfast commitment to developing “socialist people” “with socialist values.”

We are, therefore, extremely excited to have worked with Luna Nguyen on the translation and annotation of Part 1 of the Vietnamese university curriculum on the worldview and philosophical methodology of Marxism-Leninism into English, which will make this unique perspective of socialist theory available to comrades around the world for the first time.

After having read through this volume, which outlines the fundamentals of dialectical materialism and materialist dialectics, we find the most important lesson to be the relationship between theory and practice. According to the Vietnamese scholars who authored the original text, Marxist-Leninist philosophy must be considered a living, breathing philosophy which requires application in the real world — through practice — in order to be made fully manifest.

We hope that readers of this volume will carry forward this guidance through practice which suits your material conditions, wherever you are in the world.

If you would like to learn the perspective of socialists from other nations around the world, we invite you to visit our website at InternationalMagz.com — the home of The International Magazine online. There, you will find articles written by comrades from a wide variety of backgrounds and nationalities with a clear bias towards anti-capitalism, anti-fascism, and anti-imperialism!

In solidarity,

The Editorial Team of The International Magazine

Notes on Translation

Vietnamese is a very different language from English, which has presented many challenges in translating this book. Whenever possible, I have tried to let the “spirit” of the language guide me, without altering the structure, tone, and formatting of the book.

One thing you will likely notice right away: this book is highly condensed! This is because most Vietnamese students are already familiar with these concepts. We have added annotations to try to make the book more digestible for those of you who are new to Marxism-Leninism, and these annotations are explained on the next page.

I have worked hard to try to make the language in this book consistent with the language used in popular translations of works from Marx, Lenin, etc., that would be familiar to English-language students of Marxism-Leninism. That said, different translators have been translating these texts into English for over a century, such that different word choices have been used to relate the same concepts, and even Marx, Engels, and Lenin used different terms to describe the same concepts in many instances (not to mention the fact that Marx and Engels wrote primarily in German, whereas Lenin wrote primarily in Russian).

As such, I have made it my first priority to keep the language of this translation internally consistent to avoid confusion and, again, to match the spirit of the original text as much as possible. As a result, you may find differences between the translation choices made in this text and other translations, but it is my hope that the underlying meaning of each translation is properly conveyed.

March, 2023

Luna Nguyen

Guide to Annotations

This book was written as a textbook for Vietnamese students who are not specializing in Marxism-Leninism, and so it is meant to be a simple and condensed survey of the most fundamental principles of dialectical materialism to be used in a classroom environment with the guide of an experienced lecturer. That said, a typical Vietnamese college student will already have been exposed to many of the concepts presented herein throughout twelve years of primary and secondary education. As such, in translating and preparing this book for a foreign audience who are likely to be reading it without the benefit of a lecturer’s in-person instruction, we realized that we would need to add a significant amount of annotations to the text.

These annotations will take the following forms:

Short annotations which we insert into the text itself [will be included in square brackets like these].

Longer annotations which add further context and background information will be included in boxes like this.

We have also added diagrams to our annotations, as well as a detailed glossary/index and appendices, which are located in the back of the book. We hope these will resources will also be of use in studying other texts which are rooted in dialectical materialist philosophy.

Original Vietnamese Publisher’s Note

In 2004, under the direction of the Central Government, the Ministry of Education and Training, in collaboration with Sự Thật [Vietnamese for “The Truth,” the name of a National Political Publishing House], published a [political science and philosophy] curriculum for universities and colleges in Vietnam. This curriculum includes 5 subjects: Marxist-Leninist Philosophy, Marxist-Leninist Political Economy, Scientific Socialism, Vietnamese Communist Party History, and Ho Chi Minh Thought. This curriculum has been an important contribution towards educating our students — the young intellectuals of the country — in political reasoning, so that the next generation will be able to successfully conduct national innovation.

With the new practice of education and training, in order to thoroughly grasp the reform of the Party’s ideological work and theory, and to advocate for reform in both teaching and learning at universities and colleges in general, on September 18^th, 2008, the Minister of Education and Training, in collaboration with Sự Thật, have issued a new program and published a textbook of political theory subjects for university and college students who are not specialized in Marxism — Leninism with Associate Professor and Doctor of Philosophy Nguyen Viet Thong as chief editor. There are three subjects:

Curriculum of the Basic Principles of Marxism-Leninism

Curriculum of Ho Chi Minh Thought

Curriculum of the Revolutionary Path of the Communist Party of Vietnam.

Curriculum of the Basic Principles of Marxism-Leninism was compiled by a collective of scientists and experienced lecturers from a number of universities, with Pham Van Sinh, Ph.D and Pham Quang Phan, Ph.D as co-editors. This curriculum has been designed to meet the practical educational requirements of students.

We hope this book will be of use to you.

April, 2016

NATIONAL POLITICAL PUBLISHING HOUSE — SỰ THẬT

Original Vietnamese Preface

To implement the resolutions of the Communist Party of Vietnam, especially the 5^th

Central Resolution on ideological work, theory, and press, on September 18^th, 2008, The Ministry of Education and Training has issued Decision Number 52/2008/QD-BGDDT, issuing the subject program: The Basic Principles of Marxism-Leninism for Students Non-Specialised in Marxism-Leninism and Ho Chi Minh Thought. In collaboration with Truth — the National Political Publishing House — we published the Curriculum of the basic principles of Marxism-Leninism for Students Non-Specialised in MarxismLeninism and Ho Chi Minh Thought.

The authors of this text have drawn from the contents of the Central Council’s previous programs (Marxist-Leninist Philosophy, Marxist-Leninist Political Economy, and Scientific Socialism) and compiled them into national textbooks for Marxist-Leninist science subjects and Ho Chi Minh Thought, as well as other curriculums for the Ministry of Education and Training. The authors have received comments from many collectives, such as the Ho Chi Minh National Academy of Politics and Administration, the Central Propaganda Department, as well as individual scientists and lecturers at universities and colleges throughout the country. Notably:

Associate Professor To Huy Rua, Ph.D, Professor Phung Huu Phu, Ph.D, Professor Nguyen Duc Binh, Professor Le Huu Nghia, Ph.D, Professor Le Huu Tang, Ph.D,

Professor Vo Dai Luoc, Ph.D, Professor Tran Phuc Thang, Ph.D, Professor Hoang

Chi Bao, Ph.D, Professor Tran Ngoc Hien, Ph.D, Professor Ho Van Thong, Associate

Professor Duong Van Thinh, Ph.D, Associate Professor Nguyen Van Oanh, Ph.D,

Associate Professor Nguyen Van Hao, Ph.D, Associate Professor Nguyen Duc Bach, PhD. Pham Van Chin, Phung Thanh Thuy, M.A., and Nghiem Thi Chau Giang, M.A.

After a period of implementation, the contents of the textbooks have been supplemented and corrected on the basis of receiving appropriate suggestions from universities, colleges, the contingent of lecturers of political theory, and scientists. However, due to objective and subjective limitations, there are still contents that need to be added and modified, and we would love to receive more comments to make the next edition of the curriculum more complete.

MINISTRY OF EDUCATION AND TRAINING

Introduction to the Basic Principles of Marxism-Leninism

I. Brief History of Marxism-Leninism

1. Marxism and the Three Constituent Parts

Marxism-Leninism is a system of scientific opinions and theories which were built by Karl Marx^[1] and Friedrich Engels^[2], and defended and developed by Vladimir Ilyich Lenin^[3]. Marxism-Leninism was formed and developed by interpreting reality as well as building on preceding ideas. It provides the fundamental worldview* and methodology of scientific awareness and revolutionary practice. It is a science that concerns the work of liberating the proletariat from all exploitative regimes with the ambition of liberating all of humanity from all forms of oppression.

Marxism-Leninism is made up of three basic theories which have strong relationships with each other. They are: Philosophy of Marxism-Leninism, Marxist-Leninist Political Economics, and Scientific Socialism.

Philosophy of Marxism-Leninism studies the basic principles of the movement and development of nature, society and human thought. It provides the fundamental worldview and methodology of scientific awareness and revolutionary practice.

Based on this philosophical worldview and methodology, Marxist-Leninist Political Economics studies the economic rules of society, especially the economic rules of the birth, development, and decay of the capitalist mode of production, as well as the birth and development of a new mode of production: the communist mode of production.

Scientific Socialism** is the inevitable result of applying the philosophical worldview and methodology of Marxism-Leninism, as well as Marxist-Leninist Political Economics, to reveal the objective rules of the socialist revolution process: the historical step from capitalism into socialism, and then communism.

Annotation 1

* A worldview encompasses the whole of an individual’s or society’s opinions and conceptions about the world, about ourselves as human beings, and about life and the position of human beings in the world.

** The word “science,” and, by extension, “scientific” in Marxism-Leninism has specific meaning. Friedrich Engels was the first to describe the philosophy which he developed with Marx as “Scientific Socialism” in his book Socialism: Utopian and Scientific.

However, it should be noted that the English phrase “scientific socialism” comes from

Engels’ use of the German phrase “wissenschaftlich sozialismus.”

“Wissenschaft” is a word which can be directly translated as “knowledge craft” in German, and this word encompasses a much more broad and general concept than the word “science” as it’s usually used in English.

In common usage, the word “science” in English has a relatively narrow definition, referring to systematically acquired, objective knowledge pertaining to a particular subject. But “wissenschaft” refers to a systematic pursuit of knowledge, research, theory, and understanding. “Wissenschaft” is used in any study that involves systematic investigation. And so, “scientific socialism” is only an approximate translation of “wissenschaftlich sozialismus.” So, “scientific socialism” can be understood as a body of theory which analyzes and interprets the natural world to develop a body of knowledge, which must be constantly tested against reality, with the pursuit of changing the world to bring about socialism through the leadership of the proletariat.

Even though these three basic theories of Marxism-Leninism deal with different subjects, they are all parts of a unified scientific theory system: the science of liberating the proletariat from exploitative regimes and moving toward human liberation.

2. Summary of the Birth and Development of Marxism-Leninism

There have been two main stages of the birth and development of Marxism-Leninism:

1. Stage of formation and development of Marxism, as developed by Karl Marx and Friedrich Engels.

2. Stage of defense and developing Marxism into Marxism-Leninism, as developed by Vladimir Ilyich Lenin.

a. Conditions and Premises of the Birth of Marxism

Annotation 2

The following sections will explain the conditions which led to the birth of Marxism. First, we will examine the Social-Economic conditions which lead to the birth of Marxism, and then we will examine the theoretical premises upon which Marxism was built. Later, we will also discuss the impact which 18^th and 19^th century advances in natural science had on the development of Marxism.

- Social-Economical Conditions

Marxism was born in the 1840s. This was a time when the capitalist mode of production was developing strongly in Western Europe on the foundation of the industrial revolution which succeeded first in England at the end of the 18^th century. Not only did this industrial revolution mark an important step forward in changing from handicraft cottage industry capitalism into a more greatly mechanized and industrialized capitalism, it also deeply changed society, and, above all, it caused the birth and development of the proletariat.

Annotation 3

Marx saw human society under capitalism divided into classes based on their relation to the means of production.

Means of production are physical inputs and systems used in the production of goods and services, including machinery, factory buildings, tools, and anything else used in producing goods and services. Capitalism is a political economy defined by private ownership of the means of production.

Within the framework of Dialectical Materialism, all classes are defined by internal and external relationships [see The Principle of General Relationships, p. 107]; chiefly, classes are defined by their relations to the means of production and to one another.

The proletariat are the working class — the people who provide labor under capitalism, but who do not own their own means of production, and must therefore sell their labor to those who do own means of production: the bourgeoisie. As the owners of the means of production, the bourgeoisie are the ruling class under capitalism.

According to Marx and Engels, there are other classes within the capitalist political economy. Specifically, Marx named the petty bourgeoisie and the lumpenproletariat. Marx defined the petty bourgeoisie as including semi-autonomous merchants, farmers, and so on who are self-employed, own small and limited means of production, or otherwise fall in between the proletariat and the bourgeoisie.

In the Manifesto of the Communist Party, Marx described the petty bourgeoisie as:

... fluctuating between proletariat and bourgeoisie, and ever renewing itself as a supplementary part of bourgeois society... The individual members of this class, however, are being constantly hurled down into the proletariat by the action of competition, and, as modern industry develops, they even see the moment approaching when they will completely disappear as an independent section of modern society, to be replaced in manufactures, agriculture and commerce, by overlookers, bailiffs and shopmen.

Vietnam’s Textbook of History for High School Students gives this definition of the petty bourgeoisie in the specific context of Vietnamese history:

The petty bourgeois class includes: intellectuals, scientists, and small business owners, handicraftsmen, doctors, lawyers, and civil servants. The vast majority of contemporary intellectuals before the August Revolution of 1945, including students, belonged to the petty bourgeoisie. In general, they were also oppressed by imperialism and feudalism, often unemployed and uneducated.
The petty bourgeoisie were intellectually and politically sensitive. They did not directly exploit labor. Therefore, they easily absorbed revolutionary education and went along with the workers and peasants.
However, the intelligentsia and students often suffer from great weaknesses, such as: theory not being coupled with practice, contempt for labor, vague ideas, unstable stances, and erratic behavior in political action.
Some other petty bourgeoisie (scientists and small businessmen, freelancers, etc.) were also exploited by imperialism and feudalism. Their economic circumstances were precarious, and they often found themselves unemployed and bankrupt. Therefore, the majority also participated in and supported the resistance war and revolution. They are also important allies of the working class.
In general, these members of the petty bourgeoisie had a number of weaknesses: self-interest, fragmentation, and a lack of determination. Therefore, the working class has a duty to agitate and spread propaganda to such members of the petty bourgeoisie, organize them, and help them to develop their strong points while correcting their weaknesses. It is necessary to skillfully lead them, make them determined to serve the people, reform their ideology, and unite with the workers and peasants in order to become one cohesive movement. Then, they will become a great asset for the public in resistance war and revolution.

Marx defined the “lumpenproletariat” as another class which includes the segments of society with the least privilege — most exploited by capitalism — such as thieves, houseless people, etc.

In the Manifesto of the Communist Party, Marx defined the lumpenproletariat as: “The ‘dangerous class’ (lumpenproletariat), the social scum, that passively rotting mass thrown off by the lowest layers of the old society.” Marx did not have much hope for the revolutionary potential of the lumpenproletariat, writing that they “may, here and there, be swept into the movement by a proletarian revolution; its conditions of life, however, prepare it far more for the part of a bribed tool of reactionary intrigue.”

Political Theories, an official journal of the Ho Chi Minh National Institute of Politics, discussed the lumpenproletariat in the specific context of Vietnamese revolutionary history:

It should be noted that Marxism-Leninism has never held that the historical mission of the working class is rooted in poverty and impoverishment. Poverty and low standards of living make workers hate the regime of capitalism, and causes disaster for workers, but the basic driving force behind the revolutionary struggle of the working class lies in the very nature of capitalist production and from the irreconcilable contradiction between the working class and the bourgeoisie.
Moreover, it should not be conceived that a class is capable of leading the revolution because it is the poorest class. In the old societies, there were classes that were extremely poor and had to go through many struggles against the ruling class, but they could never win and keep power, and did not become the ruling class of society.
History has proven that the class that represents newly emerging productive forces which are able to build a more advanced mode of production than the old ones can lead the revolution and organize society into the regime they represent. Fetishizing poverty and misery is a corruption of Marxism-Leninism...
The very existence of the lumpenproletariat is strong evidence of the inhumane nature of capitalist society, which regularly recreates a large class of outcasts at the bottom of society.

In the late 19^th and early 20^th centuries, millions of Vietnamese people were forced to leave their homes in rural farmlands to work for plantations and factories which were owned by French colonialists. These workers were functionally enslaved, being regularly physically abused by colonial masters, barred from any education whatsoever, and receiving only the bare minimum to survive. As a result, under French colonial rule, about 90% of Vietnamese were illiterate and the French aimed to indoctrinate Vietnamese people into believing that they were inferior to the French.

The French colonialists also worked with Vietnamese landlords to exploit peasants in rural areas. Those peasants received barely enough to survive and, like the plantation slaves, were prohibited from receiving education. Because Vietnamese peasants and colonial slaves composed the majority of workers while being so severely oppressed and living in conditions of such abject poverty, it was difficult to fully distinguish between the proletariat and the lumpenproletariat in Vietnam during the colonial era.

During this time, Ho Chi Minh and other Vietnamese communists developed the philosophy of “Proletarian Piety.” The word “piety,” here, is a translation of the Vietnamese word hiếu, which originally comes from the Confucianist philosophy of “filial piety.” Filial piety demanded children to deeply respect, honor, and obey their parents. Through the concept of Proletarian Piety, Ho Chi Minh adapted this concept to proletarian revolution, calling for communists to deeply love, respect, and tirelessly serve the oppressed masses. This philosophical concept sought to unite the proletariat, lumpenproletariat, and petty bourgeoisie into one united revolutionary class. Even some feudal landlords and capitalists — who were, themselves, oppressed by the colonizing French — were willing to fight for communist revolution and were welcomed into the revolutionary movement if they were willing to adhere to the principle of proletarian piety. The working class and peasantry would lead the revolution, the more privileged classes would follow, and all communist revolutionists would serve the oppressed masses through sacrifice and struggle.

During this period, many novels were written and circulated widely which featured main characters who were members of the lumpenproletariat or enslaved by the French, such as Bỉ Vỏ, a story about a beautiful peasant girl who was forced to become a thief in the city, and Chí Phèo, the story of a peasant who worked as a servant in a feudal landlord’s house who was sent to prison and became a destitute alcoholic after being released. The purpose of these stories was to show the cruelty of the colonialist-capitalist society of Vietnam in the 1930’s and to inspire proletarian piety, including empathy and respect for the extreme suffering and oppression of the lumpenproletariat, peasantry, and colonial slaves. These stories also presented sympathetic views of intellectuals and members of the petty bourgeoisie: for instance, in the novel Lão Hạc, the son of a peasant leaves to work for a French plantation and the father never sees him again. The aged peasant becomes extremely poor and sick without the support of his son, and the only person in the village who helps him is a teacher, representing the intellectual segment of the petty bourgeoisie.

The writers of these novels were communists who wanted to promote the principles of proletarian piety. Rather than looking down on the most oppressed members of society, and rather than sewing distrust and contempt for the petty bourgeoisie, Vietnamese communists inspired solidarity and collaboration between all of the oppressed peoples of Vietnam to overthrow French colonialism, feudalism, and capitalism. Proletarian piety was crucial for uniting the divided and conquered masses of Vietnam and successfully overthrowing colonialism. Note that these strategies were developed specifically for colonial Vietnam. Every revolutionary struggle will take place in unique material conditions^[4], and the composition and characteristics of each class will vary over time and from one place to another. It is important for revolutionists to carefully apply the principles of dialectical materialism and materialist dialectics to accurately analyze class conditions in order to develop strategies and plans which will most suitably and efficiently lead to successful revolution.

The deep contradictions* between the socialized production force** and the capitalist relations of production*** were first revealed by the economic depression of 1825 and the series of struggles between workers and the capitalist class which followed.

Annotation 4

* See: Definition of Contradiction and Common Characteristics of Contradiction, p. 175.

** In Marxism, “socialization” is simply the idea that human society transforms labor and production from a solitary, individual act into a collective, social act. In other words, as human society progresses, people “socialize” labor into increasingly complex networks of social relations: from individuals making their own tools, to agricultural societies engaged in collective farming, to modern industrial societies with factories, logistical networks, etc.

The production force is the combination of the means of production and workers within any society. The “Socialized Production Force,” therefore, is a production force which has been socialized — that is to say, a production force which has been organized into collective social activity. Under capitalism, the “Socialized Production Force” consists of the proletariat, or the working class, as well as means of production which are owned by capitalists.

*** Marx and Engels defined “relations of production” as the social relationships that human beings must accept in order to survive. Relations of production are, by definition, not voluntary, because human beings must enter into them in order to receive material needs in order to survive within a given society. Under capitalism, the relations of production require the working class to rent their labor to capitalists to receive wages which they need to procure material needs like food and shelter. This is an inherent contradiction because a small minority of society (the capitalist class) own the means of production while the vast majority of society (the working class) must submit to exploitation through wage servitude in order to survive.

Examples of such early struggles include: the resistance of workers in Lyon, France in 1831 and 1834; the Chartist movement in Britain from 1835 to 1848; the workers’ movement in Silesia (Germany) in 1844, etc. These events prove as historical evidence that the proletariat had become an independent political force which pioneered the fight for a democratic, equal, and progressive society.

Annotation 5

Here are some brief descriptions of the early working class movements mentioned above:

Resistance of Workers in Lyon, France:

In 1831 in France, due to heavy exploitation and hardship, textile workers in Lyon revolted to demand higher wages and shorter working hours. The rebels took control of the city for ten days. Their determination to fight is reflected in the slogan: “Live working or die fighting!”

This resistance was brutally crushed by the government, which supported the factory owners. In 1834, silk mill workers in Lyon revolted again to demand the establishment of a republic. The fierce struggle went on for four days, but was extinguished in a bloody battle against the French army. About 10,000 insurgents were imprisoned or deported.

The Chartist Movement in Britain:

Chartism was a working class movement in the United Kingdom which rose up in response to anti-worker laws such as the Poor Law Amendment of 1834, which drove poor people into workhouses and removed other social programs for the working poor. Legislative failure to address the demands of the working poor led to a broadly popular mass movement which would go on to organize around the People’s Charter of 1838, which was a list of six demands which included extension of the vote and granting the working class the right to hold office in the House of Commons.

In 1845, Karl Marx visited Britain for the first time, along with Friedrich Engels, to meet with the leaders of the Chartist movement (with whom Engels had already established a close relationship). After various conflicts and struggles, Chartism ultimately began to decline in 1848 as more socialist-oriented movements rose up in prominence.

Workers’ Movement in Silesia, Germany:

In June, 1844, disturbances and riots occurred in the Prussian province of Silesia, a major center of textile manufacturing. In response, the Prussian army was called upon to restore order in the region. In a confrontation between the weavers and troops, shots were fired into the crowd, killing 11 protesters and wounding many others. The leaders of the disturbances were arrested, flogged, and imprisoned. This event has gained enormous significance in the history of the German labor movement.

In particular, Karl Marx regarded the uprising as evidence of the birth of a German workers’ movement. The weavers’ rebellion served as an important symbol for later generations concerned with poverty and oppression of the working class in German society.

It quickly became apparent that the revolutionary practice of the proletariat needed the guidance of scientific theories. The birth of Marxism was to meet that objective requirement; in the meantime, the revolutionary practice itself became the practical premise for Marxism to continuously develop.

- Theoretical Premises

The birth of Marxism not only resulted from the objective requirement of history, it was also the result of inheriting the quintessence* of various previously established frameworks of human philosophical theory such as German classical philosophy, British classical political economics, and utopianism in France and Britain.

Annotation 6

* In the original Vietnamese, the word tinh hoa is used, which we roughly translate to the word quintessence throughout this book. Literally, it means “the best, highest, most beautiful, defining characteristics” of a concept, and, unlike the English word quintessence, it has an exclusively positive connotation. Quintessence should not be confused with the universal category of Essence, which is discussed on p. 156.

German classical philosophy, especially the philosophies of Georg Wilhelm Friedrich Hegel^[5] and Ludwig Feuerbach^[6], had deeply influenced the formation of the Marxist worldview and philosophical methodology.

Annotation 7

German classical philosophy was a movement of idealist philosophers of the 18^th and 19^th centuries. Idealism is a philosophical position that holds that the only reliable experience of reality occurs within the human consciousness. Idealists believe that human reason is the best way to seek truth, and that consciousness is thus the only reliable source of knowledge and information.

One of Hegel’s important achievements was his critique of the metaphysical method.

Annotation 8

Metaphysics is a branch of philosophy that attempts to explain the fundamental nature of reality by classifying things, phenomena, and ideas into various categories. Metaphysical philosophy has taken many forms through the centuries, but one common shortcoming of metaphysical thought is a tendency to view things and ideas in a static, abstract manner. Metaphysical positions view nature as a collection of objects and phenomena which are isolated from one another and fundamentally unchanging. Engels explained the problems of metaphysics in Socialism: Utopian and Scientific:

The analysis of Nature into its individual parts, the grouping of the different natural processes and objects in definite classes, the study of the internal anatomy of organized bodies in their manifold forms — hese were the fundamental conditions of the gigantic strides in our knowledge of Nature that have been made during the last 400 years.

But this method of work has also left us as legacy the habit of observing natural objects and processes in isolation, apart from their connection with the vast whole; of observing them in repose, not in motion; as constraints, not as essentially variables; in their death, not in their life. And when this way of looking at things was transferred by Bacon and Locke from natural science to philosophy, it begot the narrow, metaphysical mode of thought peculiar to the last century.

Francis Bacon (1561 — 1626) is considered the father of empiricism, which is the belief that knowledge can only be derived from human sensory experience [see Annotation 10, p. 10]. Bacon argued that scientific knowledge could only be derived through inductive reasoning in which specific observations are used to form general conclusions. John Locke (1632 — 1704) was another early empiricist, who was heavily influenced by Francis Bacon. Locke, too, was an empiricist, and is considered to be the “father of liberalism.”

Engels was highly critical of the application of metaphysical philosophy to natural science. As Engels continues in Socialism: Utopian and Scientific:

To the metaphysician, things and their mental reflexes — ideas — are isolated, are to be considered one after the other and apart from each other, are objects of investigation fixed, rigid, given once for all. He thinks in absolutely irreconcilable antitheses... For him a thing either exists or does not exist; a thing cannot at the same time be itself and something else. Positive and negative absolutely exclude one another; cause and effect stand in a rigid antithesis one to the other.
At first sight this mode of thinking seems to us very luminous, because it is that of so-called sound common sense. Only sound common sense, respectable fellow that he is, in the homely realm of his own four walls, has very wonderful adventures directly he ventures out into the wide world of research. And the metaphysical mode of thought, justifiable and necessary as it is in a number of domains whose extent varies according to the nature of the particular object of investigation, sooner or later reaches a limit, beyond which it becomes one-sided, restricted, abstract, lost in insoluble contradictions. In the contemplation of individual things, it forgets the connection between them; in the contemplation of their existence, it forgets the beginning and end of that existence; of their repose, it forgets their motion. It cannot see the wood for the trees.

Dialectical Materialism stands in contrast to metaphysics in many ways. Rather than splitting the world into distinct, isolated categories, Dialectical Materialist philosophy seeks to view the world in terms of relationships, motion, and change. Dialectical Materialism also refutes the hard empiricism of Bacon and Locke by describing a dialectical relationship between the material world and consciousness [see: The Relationship Between Matter and Consciousness, p. 88].

For the first time in the history of human philosophy, Hegel expressed the content of dialectics in strict arguments with a system of rules and categories.

Annotation 9

Dialectics is a philosophical methodology which searches for truth by examining contradictions and relationships between things, objects, and ideas. Ancient dialecticians such as Aristotle and Socrates explored dialectics primarily through rhetorical discourse between two or more different points of view about a subject with the intention of finding truth.

In this classical form of dialectics, a thesis is presented. This thesis is an opening argument about the subject at hand. An antithesis, or counter-argument, is then presented. Finally, the thesis and antithesis are combined into a synthesis, which is an improvement on both the thesis and antithesis which brings us closer to truth.

Hegel resurrected dialectics to the forefront of philosophical inquiry for the German Idealists. As Engels wrote in Socialism: Utopian and Scientific:

Hegel’s work’s greatest merit was the taking up again of dialectics as the highest form of reasoning. The old Greek philosophers were all born natural dialecticians, and Aristotle, the most encyclopaedic of them, had already analyzed the most essential forms of dialectic thought.

Hegel’s great contribution to dialectics was to develop dialectics from a simple method of examining truth based on discourse into an organized, systematic model of nature and of history. Unfortunately, Hegel’s dialectics were idealist in nature. Hegel believed that the ideal served as the primary basis of reality. Karl Marx and Friedrich Engels strongly rejected Hegel’s idealism, as well as the strong influences of Christian theology on Hegel’s work, but they also saw great potential in his system of dialectics, as Marx explained in Capital (Volume 1):

The mystification which dialectic suffers in Hegel’s hands, by no means prevents him from being the first to present its general form of working in a comprehensive and conscious manner. With him it is standing on its head. It must be turned right side up again, if you would discover the rational kernel within the mystical shell.

Starting with a critique of the mysterious idealism of Hegel’s philosophy, Marx and Engels inherited the “rational kernel” of Hegelian dialectics and successfully built materialist dialectics.

Annotation 10

In order to understand the ways in which the critique of Hegel’s philosophy by Marx and Engels led to the development of dialectical materialism, some background information on materialism — and the conflicts between idealist and materialist philosophy in the era of Marx and Engels — is needed.

Materialism is a philosophical position that holds that the material world exists outside of the mind, and that human ideas and thoughts stem from observation and sensory experience of this external world. Materialism rejects the idealist notion that truth can only be sought through reasoning and human consciousness. The history and development of both idealism and materialism are discussed more in the section The Opposition of Materialism and Idealism in Solving Basic Philosophical Issues on page 48.

In the era of Marx and Engels, the leading philosophical school of materialism was known as empiricism. Empiricism holds that we can only obtain knowledge through human sense perception. Marx and Engels were materialists, but they rejected empiricism (see Engels’ critique of empiricism in Annotation 8, p. 8).

One reason Marx and Engels opposed the strict empiricist view was that it made materialism vulnerable to attack from idealists, because it ignored objective relations and knowledge that went beyond sense data. The empiricist point of view also provided the basis for the subjective idealism of George Berkeley [see Annotation 32, p. 27] and the skepticism of David Hume. Berkeley’s Subjective Idealism is empiricist in that it supports the idea that humans can only discover knowledge through direct sense experience. Therefore, Berkeley argues, individuals are unable to obtain any real knowledge about abstract concepts such as “matter.”

Similarly, David Hume’s radical skepticism, which Engels called “agnosticism,” denied the possibility of possessing any concrete knowledge. As Hume wrote in A Treatise on Human Nature: “I am ready to reject all belief and reasoning, and can look upon no opinion even as more probable or likely than another.” Hume’s radical skepticism lay in his empiricist belief that the only source of knowledge is sense experience; but Hume went a step further, doubting that even sense experience could be reliable, adding: “The essence and composition of external bodies are so obscure, that we mustnecessarily, in our reasonings, or rather conjectures concerning them, involveourselves in contradictions and absurdities.”

Later, in the appendix of the same text, Hume argues that conscious reasoning suffers from the same unreliability: “I had entertained some hopes (that) the intellectual world ... would be free from those contradictions, and absurdities, whichseem to attend every explication, that human reason can give of the material world.”

Engels dismissed radical skepticism as “scientifically a regression and practically merely a shamefaced way of surreptitiously accepting materialism, while denying it before the world.” Engels directly refutes radical skepticism in Socialism: Utopian and Scientific:

... how do we know that our senses give us correct representations of the objects we perceive through them? ... whenever we speak of objects, or their qualities, of which (we) cannot know anything for certain, but merely the impressions which they have produced on (our) senses. Now, this line of reasoning seems undoubtedly hard to beat by mere argumentation. But before there was argumentation, there was action... And human action had solved the difficulty long before human ingenuity invented it. The proof of the pudding is in the eating. From the moment we turn to our own use these objects, according to the qualities we perceive in them, we put to an infallible test the correctness or otherwise of our sense-perception.

This concept of determining the truth of knowledge and perception through practical experience is fundamental to dialectical materialist philosophy and the methodology of materialist dialectics, and is discussed in further detail in Chapter 3, p. 204.

Another weakness of empiricism is that it denies the objectiveness of social relations, which cannot be fully and properly analyzed through sensory experience and observation alone. Marx saw that social relations are, indeed, objective in nature and can be understood despite their lack of sensory observability, and that doing so is vital in comprehending subjects such as political economy, as he observes in Capital Volume I:

(The true) reality of the value of commodities contrasts with the gross material reality of these same commodities (the reality of which is perceived by our bodily senses) in that not an atom of matter enters into the reality of value. We may twist and turn a commodity this way and that — as a thing of value it still remains unappreciable by our bodily senses.

In other words, Marx pointed out that no amount of sense data about a commodity will fully explain its value. One can know the size, weight, hardness, etc., of a commodity, but without analyzing the social relations and other aspects of the commodity which can’t be directly observed with the senses, one can never know or understand the true value of the commodity. The materialism of Marx and Engels acknowledges the physical, material world as the first basis for reality, but Marx and Engels also understood that it was vital to account for other aspects of rational knowledge (such as social relations). Marx and Engels believed that empiricist materialism had roughly the same flaw as idealism: a lack of a connection between the material and consciousness. While the idealists completely dismissed sense data and relied exclusively on reasoning and consciousness, the empiricists dismissed conscious thought to focus solely on what could be sensed.

It is important to note that, while Marx and Engels rejected empiricism, they did not reject empirical knowledge nor empirical data which is collected from scientific observation [see Annotation 216, p. 210]. On the contrary, empirical data was key to the works of Marx and Engels in developing dialectical materialism. As Lenin explained: “(Marx) took one of the economic formations of society – the system of commodity production – and on the basis of a vast mass of data which he studied for not less than twenty-five years gave a most detailed analysis of the laws governing this formation and its development.” And so, the dialectical materialism of Marx and Engels served to bridge the gap between idealism and materialism. They believed that our conscious thoughts are derived from material processes, but that consciousness can also influence the material world. This is discussed in more detail in the section “Materialism and Dialectical Materialism” on page 48.

Marx and Engels also criticized many limitations of Feuerbach’s methodology and viewpoint* — especially Feuerbach’s prescriptions for how to deal with social problems — but they also highly appreciated the role of Feuerbach’s thought in the fight against idealism and religion to assert that nature comes first, and that nature is permanent and independent from human willpower.

Annotation 11

* Viewpoint, point of view, or perspective, is the starting point of analysis which determines the direction of thinking from which problems are considered. Marx and Engels were critical of Feurbach’s hyper-focused humanist viewpoint.

Feuerbach’s atheism and materialism offered an important foundation for Marx and Engels to develop from an idealist worldview into a materialist worldview, which led them directly to developing the philosophical foundation of communism.

Annotation 12

Ludwig Feuerbach was one of the “Young Hegelians” who adapted and developed the ideals of Hegel and other German Idealists. Feuerbach was a humanist materialist: he focused on humans and human nature and the role of humans in the material world. Like Marx and Engels, Feuerbach dismissed the religious mysticism of Hegel. Importantly, Feuerbach broke from Hegel’s religious-mystical belief that humans descended from supernatural origins, instead describing humans as originating from the natural, material world.

Feuerbach also distinguished between the objectivity of the material external world and the subjectivity of human conscious thought, and he drew a distinction between external reality as it really exists and external reality as humans perceive it. Feuerbach believed that human nature was rooted in specific, intrinsic human attributes and activities. As Feuerbach explains in The Essence of Christianity: “What, then, is the nature of man, of which he is conscious, or what constitutes the specific distinction, the proper humanity of man? Reason, Will, Affection.”

Feuerbach explained that the actions of “thinking, willing, and loving,” which correspond to the essential characteristics of “reason, will, and love,” are what define humanity, continuing: “Reason, Will, Love, are not powers which man possesses, for he is nothing without them, he is what he is only by them; they are the constituent elements of his nature, which he neither has nor makes, the animating, determining, governing powers — divine, absolute powers — to which he can oppose no resistance.”

In his Collected Works, Feuerbach further explains that materialism is supported by the fact that nature predates human consciousness:

Natural science, at least in its present state, necessarily leads us back to a point when the conditions for human existence were still absent, when nature, i.e., the earth, was not yet an object of the human eye and mind, when, consequently, nature was an absolutely non-human entity (absolut unmenschliches Wesen). Idealism may retort: but nature also is something thought of by you (von dir gedachte). Certainly, but from this it does not follow that this nature did not at one time actually exist, just as from the fact that Socrates and Plato do not exist for me if I do not think of them, it does not follow that Socrates and Plato did not actually at one time exist without me.

Marx and Engels were heavily influenced by Feuerbach’s materialism, but they took issue with Feuerbach’s sharp focus on human attributes and activities in isolation from the external material world. As Marx wrote in Theses on Feuerbach: “The chief defect of all hitherto existing materialism – that of Feuerbach included – is that... reality... is conceived only in the form of the object... but not as sensuous human activity.”

“Sensuous human activity” has a very specific meaning to Marx; it grew from two conflicting schools of thought:

The idealists believed the external world can only be understood through the active subjective thought processes of human beings, while the empiricist materialists believed that human beings are passive subjects of the material world. Marx synthesized these contradicting ideas into what he called “sensuous activity,” which balanced idealist and materialist philosophical concepts.

According to Marx, humans are simultaneously active in the world in the sense that our conscious activity can transform the world, and passive in the sense that all human thoughts fundamentally derive from observation and sense experience of the material world (see Chapter 2, p. 53). So, Marx and Engels believed that Feuerbach was misguided in defining human nature by our traits alone, portraying “the essence of man” as isolated from the material world and from social relations. In addition, Feuerbach’s humanism was based on an abstract, ideal version of human beings, whereas the humanism of Marx and Engels is firmly rooted in the reality of “real men living real lives.” As Engels wrote in Ludwig Feuerbach and the End of Classical German Philosophy:

He (Feuerbach) clings fiercely to nature and man; but nature and man remain mere words with him. He is incapable of telling us anything definite either about real nature or real men. But from the abstract man of Feuerbach, one arrives at real living men only when one considers them as participants in history... The cult of abstract man, which formed the kernel of Feuerbach’s new religion, had to be replaced by the science of real men and of their historical development. This further development of Feuerbach’s standpoint beyond Feuerbach was inaugurated by Marx in 1845 in The Holy Family.^[7]

Marx and Engels believed that human nature could only be understood by examining the reality of actual humans in the real world through our relationships with each other, with nature, and with the external material world. Importantly, it was Marx’s critique of Feuerbach which led him to define political action as the key pursuit of philosophy with these immortal words from Theses on Feuerbach: “Philosophers have hitherto only interpreted the world in various ways; the point is to change it.”

The British classical political economics, represented by such economists as Adam Smith^[8] and David Ricardo^[9], also contributed to the formation of Marxism’s historical materialist conception [see p. 23].

Smith and Ricardo were some of the first to form theories about labor value in the study of political economics. They made important conclusions about value and the origin of profit, and about the importance of material production and rules that govern economies. However, because there were still many limitations in the study methodology of Smith and Ricardo, these British classical political economists failed to recognise the historical characteristic of value*; the internal contradictions of commodity production**; and the duality of commodity production labor***.

Annotation 13

* Historical Characteristic of Value

Marx generally admired the work of Smith and Ricardo, but saw major flaws which undermined the utility of their classical economic theories. Perhaps chief among these flaws, according to Marx, was a tendency for Smith and Ricardo to uphold an ahistoric view of society and capitalism. In other words, classical economists see capitalism as existing in harmony with the eternal and universal laws of nature, rather than seeing capitalism as a result of historical processes of development [see Annotation 114, p. 116]. Marx did not believe that the economic principles of capitalism resulted from nature, but rather, from historical conflict between different classes. He believed that the principles of political economies changed over time, and would continue to change into the future, whereas Smith and Ricardo saw economic principles as fixed, static concepts that were not subject to change over time. As Marx explains in The Poverty of Philosophy:

Economists express the relations of bourgeois production, the division of labour, credit, money, etc. as fixed, immutable, eternal categories... Economists explain how production takes place in the above mentioned relations, but what they do not explain is how these relations themselves are produced, that is, the historical movement that gave them birth... these categories are as little eternal as the relations they express. They are historical and transitory products.

** Internal Contradictions of Commodity Production

In Marxist terms, a commodity is specifically something that has both a use value and a value-form (see Annotation 14, p. 16), but in simpler terms, a commodity is anything that can be bought or sold. Importantly, capitalism transforms human labor into a commodity, as workers must sell their labor to capitalists in exchange for wages. Marx pointed out that contradictions arise when commodities are produced under capitalism: because capitalists, who own the means of production, decide what to produce based solely on what they believe to be most profitable, the commodities that are being produced do not always meet the actual needs of society. Certain commodities are under-produced while others are over-produced, which leads to crisis and instability.

*** Duality of Commodity Production Labor

In Capital, Marx describes commodity production labor as existing in a duality — that is to say, it exists with two distinct aspects:

First, there is abstract labor, which Marx describes as “labor-power expended without regard to the form of its expenditure.” This is simply the expenditure of human energy in the form of labor, without any regard to production or value of the labor output. Second, there is concrete labor, which is the aspect of labor that refers to the production of a specific commodity with a specific value through labor.

Marx argues that human labor, therefore, is simultaneously, an activity which will produce some specific kind of product, and also an activity that generates value in the abstract. Marx and Engels were the first economists to discuss the duality of labor, and their observations on the duality of labor were closely tied to their theories of the different aspects of value (use value, exchange value, etc.), which was key to their analysis of capitalism.

Smith and Ricardo also failed to distinguish between simple commodity production and capitalist commodity production*, and could not accurately analyse the form of value** in capitalist commodity production.

Annotation 14

* Commodity Production

Simple commodity production (also known as petty commodity production) is the production of commodities under the conditions which Marx called the “Simple Exchange” of commodities. Simple exchange occurs when individual producers trade the products they have made directly, themselves, for other commodities. Under simple exchange, workers directly own their own means of production and sell products which they have made with their own labor.

Simple commodity production and simple exchange use what Marx referred to as “C→M→C mode of circulation” [see Annotation 60, p. 59]. Circulation is simply the way in which commodities and money are exchanged for one another.

C→M→C stands for:

Commodity → Money → Commodity

So, with simple commodity production and simple exchange, workers produce commodities, which they then sell for money, which they use to buy other commodities which they need. For example, a brewer might make beer, which they sell for money, which they use to buy food, housing, and other commodities which they need to live.

In the C→M→C mode of circulation, the producers and consumers of commodities have a direct relationship to the commodities which are being bought and sold. The sellers have produced the commodities sold with their own labor, and they directly consume the commodities which they purchase with the money thus obtained.

Capitalist commodity production and capitalist exchange, on the other hand, are based on the M→C→M’ mode of circulation.

M→C→M’ stands for:

Money → Commodity → More Money

Under this mode of circulation, capitalists spend money to buy commodities (including the commodified labor of workers), with the intention of selling commodities for MORE MONEY than they began with. The capitalist has no direct relationship to the commodity being produced and sold, and the capitalist is solely interested in obtaining more money.

Capitalist commodity production, therefore, uses the M→C→M’ mode of circulation, in which capitalists own the means of production and pay wages to workers in exchange for their labor, which is used to produce commodities. The capitalists then sell these commodities for profits which are not shared with the workers who provided the labor which produced the commodities.

** Value-Form

This is one of the most important, and potentially most confusing, concepts in all of Marx’s analysis of capitalism. Marx explains these principles at length in Appendix of the 1^st German Edition of Capital, Volume 1, but here are some of the fundamentals:

One of Marx’s key breakthroughs was understanding that commodities have many different properties which have different effects in political economies.

Just as Commodity Production Labor exists in a duality of Concrete Labor and Abstract Labor (see Annotation 13, p. 15), commodities themselves also exist in duality according to Marx:

Commodities have both “use-value” and “value.”

Use-Value (which corresponds to Concrete Labor) is the commodity’s tangible form of existence; it is what we can physically sense when we observe a commodity. By extension, use-value encompasses how a commodity can be used in the material world.

Value, or the Value-Form, is the social form of a commodity, which is to say, it represents the stable relationships intrinsic to the commodity [see Content and Form, p. 147].

Note that this relates to the dialectical relationship between the material and the ideal [see The Relationship Between Matter and Consciousness, p. 88].

Value-forms represent relational equivalencies of commodities, i.e.: 20 yards of linen = 10 pounds of tea

These relational equivalencies are tied to the equivalent labor value (see Annotation 15 below, and Annotation 26, p. 23) used to produce these commodities. The value-form of a commodity is the social form because it embodies relational equivalencies:

1. The value-form represents the relationship between the commodity and the labor which was used to produce the commodity.

2. The value-form represents the relationship between a commodity and one or more other commodities.

As Marx explains in Appendix to the 1^st German Edition of Capital: “Hence by virtue of its value-form the (commodity) now stands also in a social relation no longer to only a single other type of commodity, but to the world of commodities. As a commodity it is a citizen of this world.”

Understanding the social form of commodities — the value-form — was crucial for Marx to develop a deeper understanding of money and capitalism. Marx argued that classical economists like Ricardo and Smith conflated economic categories such as “exchange value,” “value,” “price,” “money,” etc., which meant that they could not possibly fully understand or analyze capitalist economies.

British classical political economists like Ricardo and Smith outlined the scientific factors of the theories of labor value* and contributed many progressive thoughts which Marx adapted and further developed.

Annotation 15

* Adam Smith and David Ricardo revolutionized the labor theory of value, which held that the value of a good or service is determined by the amount of human labor required to produce it.

Thus, Marx was able to solve the contradictions that these economists could not solve and he was able to establish the theory of surplus value*, scientific evidence for the exploitative nature of capitalism, and the economic factors which will lead to the eventual fall of capitalism and the birth of socialism.

Annotation 16

* David Ricardo developed the concept of surplus value. Surplus value is the difference between the amount of income made from selling a product and the amount it costs to produce it. Marx would go on to expand on the concept of surplus value considerably.

Utopianism' had been developing for a long time and reached its peak in the late 18^th century with famous thinkers such as Henri de Saint-Simon^[10], François Marie Charles Fourier^[11] and Robert Owen^[12]. Utopianism sought to elevate the humanitarian spirit and strongly criticised capitalism by calling attention to the misery of the working class under capitalism. It also offered many far-ranging opinions and analyses of the development of human history and laid out some basic foundational factors and principles for a new society. However, Utopianism could not scientifically address the nature of capitalism. It failed to detect the Law of Development of Capitalism^[13] and also failed to recognise the roles and missions of the working class as a social force that can eliminate capitalism to build an equal, non-exploitative society.

Annotation 17

The early industrial working class existed in miserable conditions, and the political movement of utopianism was developed by people who believed that a better world could be built. The utopianists believed they could create “a New Moral World” of happiness, enlightenment, and prosperity through education, science, technology, and communal living. For instance, Robert Owen was a wealthy textile manufacturer who tried to build a better society for workers in New Harmony, Indiana, in the USA. Owen purchased the entire town of New Harmony in 1825 as a place to build an ideal society. Owen’s vision failed after two years for a variety of reasons, and many other wealthy capitalists in the early 19^th century drew up similar plans which also failed.

Utopianism was one of the first political and industrial movements that criticized the conditions of capitalism by exposing the miserable situations of poor workers and offering a vision of a better society, and was one of the first movements to attempt to mitigate the faults of capitalism in practice.

Unfortunately, the utopianists were not ideologically prepared to replace capitalism, and all of their attempts to build a better alternative to capitalism failed. Marx and Engels admired the efforts of the utopianist movement, and studied their attempts and failures closely in developing their own political theories, concluding that the utopianists failed in large part because they did not understand how capitalism developed, nor the role of the working class in the revolution against capitalism.

As Engels wrote in Socialism: Utopian and Scientific:

(The) historical situation also dominated the founders of Socialism. To the crude conditions of capitalistic production and the crude class conditions correspond crude theories. The solution of the social problems, which as yet lay hidden in undeveloped economic conditions, the Utopians attempted to evolve out of the human brain. Society presented nothing but wrongs; to remove these was the task of reason. It was necessary, then, to discover a new and more perfect system of social order and to impose this upon society from without by propaganda, and, wherever it was possible, by the example of model experiments. These new social systems were foredoomed as Utopian; the more completely they were worked out in detail, the more they could not avoid drifting off into pure phantasies.

Engels is explaining, here, that — in a sense — the utopian socialists were victims of arriving too early. Capitalism had not yet developed enough for its opponents to formulate plans based on actual material conditions, since capitalism was only just emerging into a stable form. Without a significant objective, material basis, the utopians were forced to rely upon reasoning alone to confront capitalism.

In this sense, the early historical utopianists fell into philosophical utopianism in its broader sense — defined by the mistaken assertion that the ideal can determine the material [see Annotation 95, p. 94]. In believing that they could build a perfect society based on ideals and “pure fantasy” alone without a material basis for development, the utopians were, in essence, idealists. As Engels explained: “from this nothing could come but a kind of eclectic, average Socialism.” Engels concluded that in order to successfully overthrow capitalism, revolution would need to be grounded in materialism: “To make a science of Socialism, it had first to be placed upon a real basis.”

The humanitarian spirit and compassionate analysis which the utopians embodied in their efforts to lay out concrete features of a better future society became important theory premises for the birth of the scientific theory of socialism in Marxism.

- Natural Science Premise:

Along with social-economic conditions and theory premises, the achievements of the natural sciences were also foundational to the development of arguments and evidence which assert the correctness of Marxism’s viewpoints and methodology.

Annotation 18

Natural science is science which deals with the natural world, including chemistry, biology, physics, geology, etc.

Three major scientific breakthroughs which were important to the development of Marxism include:

• The law of conservation and transformation of energy scientifically proved the inseparable relationships and the mutual transformation and conservation of all the forms of motion of matter in nature.

• The theory of evolution offered a scientific basis for the development of diverse forms of life through natural selection.

• Cell theory was a scientific basis proving unity in terms of origins, physical forms and material structures of living creatures. It also explained the development of life through those relationships.

These scientific discoveries led to the rejection of theological and metaphysical viewpoints which centered the role of the “creator” in the pursuit of truth.

Annotation 19

For centuries in Europe, natural science and philosophy had been heavily dominated by theological viewpoints which centered God in the pursuit of truth. Descartes, Kant, Spinoza, and many other metaphysical philosophers who developed the earliest theories of modern natural science centered their religious beliefs in their philosophies. These theological viewpoints varied in many ways, but all shared a characteristic of centering a “creator” in the pursuit of philosophical and scientific inquiry.

Together, the law of conservation and transformation of energy, the theory of evolution, and cell theory provided an alternative viewpoint which allowed scientists to remove the “creator” from the scientific equation. For the first time, natural scientists and philosophers had concrete theoretical explanations for the origin and development of the universe, life, and reality which did not rely on a supernatural creator.

Marx and Engels closely observed and studied the groundbreaking scientific progress of their era. They believed strongly in materialist scientific methods and the data which they produced, and based their analysis and philosophical doctrines on such observations. They recognized the importance and validity of the scientific achievements of their era, and they developed the philosophy of Dialectical Materialism into a system which would help humans study and understand the whole material world.

In Socialism: Utopian and Scientific, Engels explained that ancient Greek dialecticians had correctly realized that the world is “an endless entanglement of relations and reactions, permutations and combinations, in which nothing remains what, where and as it was, but everything moves, changes, comes into being and passes away.”

Engels goes on to explain that it was understandable for early natural scientists to break their inquiries and analysis down into specialized fields and categories of science to focus on precise, specific, narrow subject matters so that they could build up a body of empirical data. However, as data accumulated, it became clear that all of these isolated, individual fields of study must somehow be unified back together coherently and cohesively in order to obtain a deeper and more useful understanding of reality.

As Engels wrote in On Dialectics:

Empirical natural science has accumulated such a tremendous mass of positive material for knowledge that the necessity of classifying it in each separate field of investigation systematically and in accordance with its inner inter-connection has become absolutely imperative. It is becoming equally imperative to bring the individual spheres of knowledge into the correct connection with one another. In doing so, however, natural science enters the field of theory and here the methods of empiricism will not work, here only theoretical thinking can be of assistance.

As science grows increasingly complex, a necessity develops for a philosophical and cognitive framework which can be used to make sense of the influx of information from disparate fields. In Dialectics of Nature, Engels explains how dialectical materialism is the perfect philosophical foundation for unifying scientific fields into one cohesive framework:

Dialectics divested of mysticism becomes an absolute necessity for natural science, which has forsaken the field where rigid categories sufficed, which represent as it were the lower mathematics of logic, its everyday weapons.

So, Marx and Engels developed Dialectical Materialism not in opposition to science, but as a way to make better use of scientific data, and to analyze the complex, dynamic, constantly changing systems of the world in motion. While distinct scientific discoveries and empirical data are invaluable, each data point only provides a small amount of information within a single narrow, specific field of science. Dialectical Materialism allows humans to view reality — as a whole — in motion, and to examine the interconnections and mutual developments between different fields and categories of human knowledge.

These scientific principles confirmed the correctness of the dialectical materialist view of the material world, with such features as: endlessness, self-existence, self-motivation, and self-transformation. They also confirmed the scientific nature of the dialectical materialist viewpoint in both material processes and thought processes.

Annotation 20

Endlessness refers to the infinite span of space and time in our universe. Self-existence means that our universe exists irrespective of human consciousness; it existed before human consciousness evolved and it will continue to exist after human consciousness becomes extinct. Self-motivation and Self-transformation refer to the fact that motion and transformation exist within the universe independent of human consciousness.

Engels wrote of the scientific nature of the dialectical materialist viewpoint in Socialism: Utopian and Scientific:

Nature is the proof of dialectics, and it must be said for modern science that it has furnished this proof with very rich materials increasingly daily, and thus has shown that... Nature works dialectically and not metaphysically; that she does not move in the eternal oneness of a perpetually recurring circle, but goes through a real historical evolution.

In conclusion, the birth of Marxism is a phenomenon which is compatible with scientific principles; it is the product of the social-economic conditions of its time of origin, of the human knowledge expressed in science at that time, and it is also the result of its founders’ creative thinking and humanitarian spirit.

b. The Birth and Development Stage of Marxism

Marx and Engels initiated the birth and development stage of Marxism from around 1842~1843 through around 1847~1848. Later, from 1849 to 1895, Marxism was developed to be more thorough and comprehensive, but in this early period of birth and development, Marx and Engels engaged in practical activities [Marx and Engels were not just theorists, but also actively supported and participated with various revolutionary and working class organizations including the Chartists, the League of the Just, the Communist League, the International Workingmen’s Association, etc.] and studied a wide range of human thought from ancient times on through to their contemporaries in order to methodically reinforce, complement and improve their ideas.

Many famous works such as The Economic and Philosophical Manuscripts (Marx, 1844), The Holy Family (Marx and Engels, 1845), Thesis on Feuerbach (Marx, 1845), The German Ideology (Marx and Engels, 1845–1846), and so on, clearly showed that Marx and Engels inherited the quintessence [see Annotation 6, p. 8] of the dialectical and materialist methods which they received from many predecessors. This philosophical heritage led to the development of the dialectical materialist viewpoint and materialist dialectics.

Annotation 21

There is a subtle, but important, distinction between Dialectical Materialism and Materialist Dialectics. This will be explained further in chapters I (p. 48) and II (p. 98).

With works such as The Poverty of Philosophy (Marx, 1847) and The Manifesto of the Communist Party (Marx and Engels, 1848), Marxism was presented as a complete system of fundamental views with three theoretical component parts.

Annotation 22

According to Lenin, the three component parts of Marxism (and, by extension, of Marxism-Leninism) are:

1. The Philosophy of Marxism: Including Dialectical Materialism and Historical Materialism
2. The Political Economy of Marxism: A system of knowledge and laws that define the production process and commodity exchange in human society.
3. Scientific Socialism: The system of thought pertaining to the establishment of the communist social economy form.

These are discussed in more detail in Chapter 2, p. 38.

In the book The Poverty of Philosophy, Marx proposed the basic principles of Dialectical Materialism and Scientific Socialism,* and gave some initial thoughts about surplus value. The Manifesto of the Communist Party laid the first doctrinal foundation of communism. In this book, the philosophical basis was expressed through the organic unity between the economical viewpoint and socio-political viewpoint.

Annotation 23

* Scientific Socialism is a series of socio-political-economic theories intended to build socialism on a foundation of science within society’s current material conditions [see Annotation 79, p. 81]. Scientific Socialism is the topic of Part 3 of the textbook from which this entire text has been translated, which we hope to translate in the future.

The Manifesto of the Communist Party outlined the laws of movement in history,* as well as the basic theory of socio-economic forms.

Annotation 24

* The laws of movement in history are the core principles of historical materialism, which is the topic of Part 2 of the textbook from which this entire text has been translated, which we hope to translate in the future.

The basic theory of socio-economic forms dictates that material production plays a decisive role in the existence and development of a society, and that the material production methods decide both the political and social consciousness of a society.

Annotation 25

Social consciousness refers to the collective experience of consciousness shared by members of a society, including ideological, cultural, spiritual, and legal beliefs and ideas which are shared within that society. This is related to the concept of base and superstructure, which is discussed later in this chapter.

The Manifesto of the Communist Party also showed that for as long as classes have existed, the history of the development of human society is the history of class struggle. Through class struggle, the proletariat can liberate ourselves only if we simultaneously and forever liberate the whole of humanity. With these basic opinions, Marx and Engels founded Historical Materialism.

By applying Historical Materialism to the comprehensive study of the capitalist production method, Marx made an important discovery: separating workers from the ownership of the means of production through violence was the starting point of the establishment of the capitalist production method. Workers do not own the means of production to perform their labor activities for themselves, so, in order to make income and survive, workers have to sell their labor to capitalists. Labor thus becomes a special commodity, and the sellers of labor become workers for labor-buyers [the proletariat and capitalist class respectively]. The value that workers create through their labor is higher than their wage. And this is how surplus value* is formed. Importantly, this means that the surplus value belongs to people who own the means of production — the capitalists — instead of the workers who provide the labor.

Annotation 26

* Surplus value is equal to labor value (the amount of value workers produce through labor) minus wages paid to workers. Under capitalism, this surplus value is appropriated as profit by capitalists after the products which workers created are sold.

So, in discovering the origin of surplus value, Marx pointed out the exploitative nature of capitalism [because capitalists essentially steal surplus labor value from workers which is then transformed into profits], though this exploitative nature is concealed by the money-commodity relationship.

Annotation 27

Under capitalism, a worker’s labor is a commodity which capitalists pay for with money in the form of wages. Workers never know how much of their labor value is being withheld by employers, which conceals the nature of capitalist wage-theft.

The theory of surplus value was deeply and comprehensively researched and presented in Capital^[14] by Marx and Engels. This work not only paves the way to form a new political-economic theory system based on the working class’s viewpoint, it also firmly consolidates and develops the historical-materialist viewpoint through the theory of socio-economic forms.

Annotation 28

Karl Marx explained that the goal of writing Capital was “to lay bare the economic law of motion of modern society.” By “laws of motion,” Marx refers to the origins and motivations for change within human society. Historical materialism holds that human society develops based on internal and external relationships within and between aspects of society. Historical materialism is the topic of Part 2 of the textbook from which this entire text has been translated, which we hope to translate in the future.

According to the theory of socio-economic forms [which is the basis of historical materialism], the movements and developments of human society are natural-historical processes based on dialectical interactions between forces of production and relations of production; between infrastructure basis [commonly referred to as “base” in English] and superstructure.

Annotation 29

The forces of production consist of the combination of means of production and workers within society. Under capitalism, the production force consists of the proletariat (working class) and means of production which are owned by the bourgeoisie (capitalist class).

Marx viewed society as composed of an economic base and a social superstructure. The base of society includes the material relationships between humans and the means of productions and the material processes which humans undertake to survive and transform our environment. The superstructure of society includes all components of society not directly relating to production, such as media institutions, music, and art, as well as other cultural elements like religion, customs, moral standards, and everything else which manifests primarily through conscious activity and social relations.

In the preface to A Contribution to the Critique of Political Economy, Marx explained:

In the social production of their life, men enter into definite relations that are indispensable and independent of their will; these relations of production correspond to a definite stage of development of their material forces of production. The sum total of these relations of production constitutes the economic structure of society — the real foundation, on which rises a legal and political superstructure and to which correspond definite forms of social consciousness. The mode of production of material life determines the social, political and intellectual life process in general. It is not the consciousness of men that determines their being, but, on the contrary, their social being that determines their consciousness.

RELIGION GOVERNMENT EDUCATION

POLITICAL ECONOMY NATURE

The base of society includes material-based elements and relations including political economy, means of production, class relations, etc. The superstructure includes human-consciousness-based elements and relations including government, culture, religion, etc.

In other words, Marx argued that superstructure (which includes social consciousness) is shaped by the infrastructural basis, or base, of society. This reflects the more general dialectical relationship between matter and consciousness, in which the material, as the first basis of reality, determines consciousness, while consciousness mutually impacts the material [see The Relationship Between Matter and Consciousness, p. 88]. So, the base of society — being material in nature — determines the superstructure, while the superstructure impacts the base. It couldn’t possibly be the other way around, according to the dialectical materialist worldview, because the primary driving forces of conscious activity are rooted in material needs.

The theory of socio-economic forms proves that the materialist viewpoint of history is not just a hypothesis, but a scientifically-proven principle.

Annotation 30

As Lenin explains in What the “Friends of the People” Are and How They Fight the Social-Democrats:

Now — since the appearance of Capital — the materialist conception of history is no longer a hypothesis, but a scientifically proven proposition. And until we get some other attempt to give a scientific explanation of the functioning and development of some formation of society — formation of society, mind you, and not the way of life of some country or people, or even class, etc. — another attempt just as capable of introducing order into the “pertinent facts” as materialism is, that is just as capable of presenting a living picture of a definite formation, while giving it a strictly scientific explanation -until then the materialist conception of history will be a synonym for social science. Materialism is not ‘primarily a scientific conception of history’... but the only scientific conception of it.

Capital is Marx’s main work which presents Marxism as a social science by illuminating the inevitable processes of birth, development, and decay of capitalism; the replacement of capitalism with socialism; and the historical mission of the working class — the social force that can implement this replacement. Marx’s materialist conception of history and proletarian revolution continued to be developed in Critique of Gotha Programme (Marx, 1875). This book discusses the dictatorship of the proletariat, the transitional period from capitalism to socialism, and phases of the communism building process, and several other premises. Together, these premises formed the scientific basis for Marx’s theoretical guidance for the future revolutionary activity of the proletariat.

Annotation 31

When Marx refers to a “dictatorship of the proletariat,” he does not mean “dictatorship” to mean “totalitarian” or “authoritarian.” Rather, here “dictatorship” simply refers to a situation in which political power is held by the working class (which constitutes the vast majority of society). “Dictatorship,” here, refers to full control of the means of production and government. This stands in contrast to capitalism, which is a dictatorship of the bourgeoisie, in which capitalists (a small minority of society) have full control of the means of production and government.

c. The Defending and Developing Stage of Marxism

- Historical Background and the Need for Defending and Developing Marxism

In the late 19^th century and early 20^th century, capitalism developed into a new stage, called imperialism. The dominant and exploitative nature of capitalism became increasingly obvious. Contradictions in capitalist societies became increasingly serious — especially the class struggles between the proletariat and capitalists. In many colonised countries, the resistance against imperialism created a unity between national liberation and proletarian revolution, uniting people in colonised countries with the working class in colonial countries. The core of such revolutionary struggles at this time was in Russia. The Russian proletariat and working class under the leadership of the Bolshevik Party became the leader of the whole international revolutionary movement.

During this time, both capitalist industry and natural sciences developed rapidly. Some natural scientists, especially physicists, lacked a grounding in materialist philosophical methodology and therefore fell into a viewpoint crisis. Idealist philosophers used this crisis to directly influence the perspective and activities of many revolutionary movements.

Annotation 32

Imperialism

Lenin defined imperialism as “the monopoly stage of capitalism,” listing its essential characteristics as “finance capital (serving) a few very big monopolist banks, merged with the capital of the monopolist associations of industrialists” and “a colonial policy of monopolist possession of the territory of the world, which has been completely divided up.”

Subjective and Empiricist Idealism

In the late 19^th century, natural scientists were exploring various philosophical bases for scientific inquiry. One Austrian physicist, Ernst Mach, attempted to build a philosophy of natural science based on the works of German-Swiss philosopher Richard Avenarius known as “Empirio-Criticism.” Empirio-Criticism, which also came to be known as Machism, has many parallels with the philosophy of George Berkeley. Berkeley (1685 — 1753) was an Anglo-Irish philosopher whose main philosophical achievement was the formulation of a doctrine which he called “immaterialism,” and which later came to be known as “Subjective Idealism.” This doctrine was summed up by Berkeley’s maxim: “Esse est percipi” — “To be is to be perceived.” Subjective Idealism holds that individuals can only directly perceive and know about physical objects through direct sense experience. Therefore, individuals are unable to obtain any real knowledge about abstract concepts such as “matter”.

The philosophy of Empirio-Criticism, which was developed by Avenarius and Mach, also holds that the only reliable human knowledge we can hold comes from our sensations and experiences. Mach argued that the only source of knowledge is sense data and “experience,” but that we can’t develop any actual knowledge of the actual external world. In other words, Mach’s conception of empirio-criticism holds all knowledge as essentially subjective in nature, and limited to (and by) human sense experience. Mach’s development of Empirio-Criticism (which can also be referred to as empirical idealism or Machism)' was therefore a continuation of Berkeley’s subjective idealism. Both Berkeley’s Immaterialism and Empirio-Criticism are considered to be subjective idealism because these philosophies deny that the external world exists — or otherwise assert that it is unknowable — and, as such, hold that all knowledge stems from experiences which are essentially subjective in nature.

Mach argued that reality can only be defined by our sensual experiences of reality, and that we can never concretely know anything about the objective external world due to the limitations of sense experience. This stands in direct contradiction to dialectical materialism, which holds that we can develop accurate knowledge of the material world through observation and practice. Whereas Berkeley developed subjective idealist theological arguments to defend the Christian faith, Mach employed subjective idealism for purely secular purposes as a basis for scientific inquiry.

Note: all quotations below come from Lenin’s book: Materialism and Empirio-Criticism.

Vladimir Lenin strongly opposed Empirio-Criticism and, by extension, Machism, which was becoming popular among communist revolutionists in the late 19^th century, because it pushed forward idealist principles which directly opposed the core tenets of dialectical materialism.

Lenin believed that revolutionaries should be guided not by idealism, but by dialectical materialism. He believed that Empirio-Criticism and Machism consisted of mysticism which would mislead political revolutionaries.

Lenin outlined Machian arguments against materialism:

The materialists, we are told, recognise something unthinkable and unknowable — ’things-in-themselves’ — matter ‘outside of experience’ and outside of our knowledge [see: Annotation 72, p. 68]. They lapse into genuine mysticism by admitting the existence of something beyond, something transcending the bounds of ‘experience’... When they say that matter, by acting upon our sense-organs, produces sensations, the materialists take as their basis the ‘unknown,’ nothingness; for do they not themselves declare our sensations to be the only source of knowledge?

Lenin argued that this new form of Machist subjective idealism was, in fact, simply a rehashing of “old errors of idealism,” disguised and dressed up with new terminology. As such, Lenin simply reiterated the longstanding, bedrock dialectical materialist arguments against idealism [see Annotation 10, p. 10]. He was especially upset that contemporary Marxists of his era were being swayed by Machist Empirio-Criticism because he found it to be in direct conflict with dialectical materialism, writing: “(These) would-be Marxists… try in every way to assure their readers that Machism is compatible with the historical materialism of Marx and Engels.”

Lenin goes on to describe the work of philosophers such as Franz Blei, who critiqued Marxism with Machist arguments, as “quasi-scientific tomfoolery decked out in the terminology of Avenarius.” He saw Empirio-Criticism as completely incompatible with communist revolution, since idealism had historically been used by the ruling class to deceive and control the lower classes. In particular, he believed that Machist idealism was being used by the capitalist class to preach bourgeois economics, writing that “the professors of economics are nothing but learned salesmen of the capitalist class.”

Lenin was deeply concerned that prominent Russian socialist philosophers were adopting Machist ideas and claiming them to be compatible with Marxism, writing:

The task of Marxists in both cases is to be able to master and adapt the achievements of these ‘salesmen’... and to be able to lop off their reactionary tendency, to pursue your own line and to combat the whole alignment of forces and classes hostile to us. And this is just what our Machians were unable to do, they slavishly follow the lead of the reactionary professorial philosophy.

Lenin further explains how Empirio-Criticism serves the interests of the capitalist class:

The empirio-criticists as a whole... claim to be non-partisan both in philosophy and in social science. They are neither for socialism nor for liberalism. They make no differentiation between the fundamental and irreconcilable trends of materialism and idealism in philosophy, but endeavor to rise above them. We have traced this tendency of Machism through a long series of problems of epistemology, and we ought not to be surprised when we encounter it in sociology.

In the conclusion of the same text, Lenin explains why communists should reject Empirio-Criticism and Machism with four “standpoints,” summarized here:

1. The theoretical foundations of Empirio-Criticism can’t withstand comparison with those of dialectical materialism. Empirio-Criticism differs little from older forms of idealism, and the tired old errors of idealism clash directly with Marxist dialectical materialism. As Lenin puts it: “only utter ignorance of the nature of philosophical materialism generally and of the nature of Marx’s and Engels’ dialectical method can lead one to speak of ‘combining’ empirio-criticism and Marxism.”

2. The philosophical foundations of Empirio-Criticism are flawed. “Both Mach and Avenarius started with Kant (see: Annotation 72, p. 68) and, leaving him, proceeded not towards materialism, but in the opposite direction, towards Hume and Berkeley (see: Annotation 10, p. 10)... The whole school of Mach and Avenarius is moving more and more definitely towards idealism.”

3. Machism is little more than a relatively obscure trend which has not been adopted by most scientists; a “reactionary (and) transitory infatuation.” As Lenin puts it: “the vast majority of scientists, both generally and in this special branch of science... are invariably on the side of materialism.”

4. Empirio-Criticism and Machism reflect the “tendencies and ideology of the antagonistic classes in modern society.” Idealism represents the interests of the ruling class in modern society, and is used to subjugate the majority of society. Idealist philosophy “stands fully armed, commands vast organizations and steadily continues to exercise influence on the masses, turning the slightest vacillation in philosophical thought to its own advantage.” In other words, idealism is used by the ruling class to manipulate our understanding of the world, as opposed to materialism (and especially dialectical materialism) which illuminates the true nature of reality which would lead to the liberation of the working class.

At this time, Marxism was widely disseminating throughout Russia, which challenged the social positions and benefits of capitalists. In reaction to Marxism, many ideological movements such as empiricism, utilitarianism, revisionism, etc. [see: Appendix F, p. 252] rose up and claimed to renew Marxism, while in fact they misrepresented and denied Marxism.

In this context, new achievements of natural science needed to be analyzed and summarized in order to continue the authentic development of Marxist viewpoints and methodologies. Theoretical principles to fight against the misrepresentation of Marxism needed to be developed in order to bring Marxism into the new era. Vladimir Ilyich Lenin would fulfill this historical requirement with his theoretical developments.

- The Role of Lenin in Defending and Developing Marxism.

Lenin’s process of defending and developing Marxism can be separated into three periods: first, from 1893 to 1907; next, from 1907 to 1917; and finally from the success of the October socialist revolution in 1917 until Lenin’s death in 1924.

From 1893 to 1907, Lenin focused on fighting against populists^[15]. His book What the Friends of the People are and How They Fight Against the Social Democrats (1894) criticized the serious mistakes of this faction in regards to socio-historical issues and also exposed their scheme of distorting Marxism by erasing the boundaries between Marxism’s materialist dialectics and Hegel’s idealist dialectics. In the same book, Lenin also shared many thoughts about the important roles of theory, reality, and the relationship between the two.

Annotation 33

The populist philosophy was born in Russia in the 19^th century with roots going back to the Narodnik agrarian socialist movement of the 1860s and 70s, composed of peasants who rose up in a failed campaign against the Czar. In the late 19^th century, a new political movement emerged rooted in Narodnik ideas and a new party called the Socialist Revolutionary Party was formed. The political philosophy of this movement, now commonly translated into English as “populism,” focused on an agrarian peasant revolution led by intellectuals with the ambition of going directly from a feudal society to a socialist society built from rural communes. This movement overtly opposed Marxism and dialectical materialism and was based on subjective idealist utopianism (see Annotation 95, p. 94).

With the book What is to be Done? (1902), Lenin developed Marxist viewpoints on the methods for the proletariat to take power. He discussed economic, political, and ideological struggles. In particular, he emphasized the ideological formation process of the proletariat.

Annotation 34

In What is to be Done?, Lenin argues that the working class will not spontaneously attain class consciousness and push for political revolution simply due to economic conflict with employers and spontaneous actions like demonstrations and workers’ strikes. He instead insists that a political party of dedicated revolutionaries is needed to educate workers in Marxist principles and to organize and push forward revolutionary activity. He also pushed back strongly against the ideas of what he called “economism,” as typified by the ideas of Eduard Bernstein, a German political theorist who rejected many of Marx’s theories.

Bernstein opposed a working class revolution and instead focused on reform and compromise. He believed that socialism could be achieved within the capitalist economy and the system of bourgeois democracy. Lenin argued that Bernstein and his economist philosophy was opportunistic, and accused economists of seeking positions within bourgeois democracies to further their own personal interests and to quell revolutionary tendencies. As Lenin explained in A Talk With Defenders of Economism:

The Economists limited the tasks of the working class to an economic struggle for higher wages and better working conditions, etc., asserting that the political struggle was the business of the liberal bourgeoisie. They denied the leading role of the party of the working class, considering that the party should merely observe the spontaneous process of the movement and register events. In their deference to spontaneity in the working-class movement, the Economists belittled the significance of revolutionary theory and class-consciousness, asserted that socialist ideology could emerge from the spontaneous movement, denied the need for a Marxist party to instill socialist consciousness into the working-class movement, and thereby cleared the way for bourgeois ideology. The Economists, who opposed the need to create a centralized working-class party, stood for the sporadic and amateurish character of individual circles. Economism threatened to divert the working class from the class revolutionary path and turn it into a political appendage of the bourgeoisie.

The Encyclopedic Dictionary of Vietnam, published by the National Committee of the Communist Party of Vietnam, defines opportunism, in this context, as “a system of political opinions with no direction, no clear path, no coherent viewpoint, leaning on whatever is beneficial for the opportunist in the short term.”

Lenin critiques opportunist socialism — referring to it as a “critical” trend in socialism — in What is to be Done?:

He who does not deliberately close his eyes cannot fail to see that the new “critical” trend in socialism is nothing more nor less than a new variety of opportunism. And if we judge people... by their actions and by what they actually advocate, it will be clear that “freedom of criticism” means “freedom for an opportunist trend in Social-Democracy, freedom to convert Social-Democracy into a democratic party of reform, freedom to introduce bourgeois ideas and bourgeois elements into socialism.”

The first revolution of the Russian working class, from 1905 to 1907, failed. Lenin summarized the reality of this revolution in the book Two Tactics of Social-Democracy in the Democratic Revolution (1905). In this book, Lenin explains that the capitalist class in Russia was actively engaged in its own revolution against Czarist feudalism. In this context of this ongoing bourgeois revolution, Lenin deeply developed Marxist concepts related to revolutionary methodologies, objective and subjective factors that will affect the working class revolution, the role of the people, the role of political parties etc.

Annotation 35

From 1905 to 1907, Russia was beset by political unrest and radical activity including workers’ strikes, military mutinies, and peasant uprisings. Russia had just suffered a humiliating defeat in the Russo-Japanese war which cost tens of thousands of Russian lives without any benefits to the Russian people. In addition, the economic and political systems of Czarist Russia placed a severe burden on industrial workers and peasant farmers.

In response, the Russian proletariat rose up in various uprisings, demonstrations, and clashes against government forces, landlords, and factory owners. In the end, this revolutionary activity failed to overthrow the Czar’s government, and the Czar remained firmly in power until the communist revolution of 1917.

Lenin wrote Two Tactics of Social-Democracy in the Democratic Revolution in 1905 in

Geneva, Switzerland. In it, he argues forcefully against the political faction within the Russian socialist movement that came to be known as the “Mensheviks.” The Mensheviks, as well as the Bolsheviks (Lenin’s contemporary faction) emerged from a dispute within the Russian Social Democratic Labour Party which took place in 1903.

In the same text, Lenin argued that the Mensheviks misunderstood the forces that were driving revolutionary activity in Russia. While the Mensheviks believed that the situation in Russia would develop along similar lines to previous revolutionary activity in Western Europe, Lenin argued that Russia’s situation was unique and that Russian Marxists should therefore adopt different strategies and activities which reflected Russia’s unique circumstances and material conditions.

Specifically, the Mensheviks believed that the working class should ally with the bourgeoisie to overthrow the Czar’s feudalist regime, and then allow the bourgeoisie to build a fully functioning capitalist economy before workers should attempt their own revolution.

Lenin, on the other hand, presented a completely different analysis of class forces in Russia. He believed the bourgeoisie would seek a compromise with the Czar, as both feudal and bourgeois classes in Russia feared a proletarian revolution.

It’s important to note that Russia’s industrial workforce was very small at this time, and most Russians were peasant farmers. The Mensheviks believed Russian peasants would not be useful in a proletarian revolution, which is why they argued for allowing capitalism to be fully established in Russia before pushing for a working class revolution. They believed it was prudent to wait until the working class became larger and more dominant in Russia before attempting to overthrow capitalism. They believed that the peasant class would not be useful in any such revolution.

In contrast, Lenin believed that the peasants and industrial workers would have to work together to have any hope of a successful revolution. He further argued that an uprising of armed peasants and workers, fighting side by side, would be necessary for overthrowing the Czar.

From 1907 to 1917, there was a viewpoint crisis among many physicists. This strongly affected the birth of many idealist ideologies following Mach’s Positivism that attempted to negate Marxism [See: Annotation 32, p. 27]. Lenin summarized the achievements of natural science as well as historical events of the late 19^th century and early 20^th century in his book Materialism and Empirio-Criticism (1909). By giving the classical definitions of matter, proving the relationships between matter and consciousness and between social existence and social consciousness, and pointing out the basic rules of consciousness, etc., Lenin defended Marxism and carried it forward to a new level. Lenin clearly expressed his thoughts on the history, nature, and structure of Marxism in the book The Three Sources and Three Component Parts of Marxism (1913). He also talked about dialectics in Philosophical Notebooks (1914–1916) and expressed his thoughts about the proletarian dictatorship, the role of the Communist Party, and the path to socialism in his book The State and Revolution (1919).

The success of the October revolution in Russia in 1917 brought about a new era: the transitional period from capitalism to socialism on an international scale. This event presented new theoretical requirements that had not existed in the time of Marx and Engels’ time.

In a series of works including: “Left-Wing” Communism: an Infantile Disorder (1920),

Once Again on the Trade Unions, The Current Situation and the Mistakes of Trotsky and Bukharin (1921), The Tax in Kind (1921), etc., Lenin summarized the revolutionary practice of the people, continued defending Marxist dialectics, and uncompromisingly fought against eclecticism and sophistry.

Annotation 36

In Anti-Dühring, Engels identifies the historical missions of the working class as:

1. Becoming the ruling class by establishing a dictatorship of the proletariat.

2. Seizing the means of production from the ruling class to end class society.

Eclecticism is an incoherent approach to philosophical inquiry which attempts to draw from various different theories, frameworks, and ideas to attempt to understand a subject, applying different theories in different situations without any consistency in analysis and thought. Eclectic arguments are typically composed of various pieces of evidence that are cherry picked and pieced together to form a perspective that lacks clarity. By definition, because they draw from different systems of thought without seeking a clear and cohesive understanding of the totality of the subject and its internal and external relations and its development over time, eclectic arguments run counter to the comprehensive and historical viewpoints [see p. 116]. Eclecticism bears superficial resemblance to dialectical materialism in that it attempts to consider a subject from many different perspectives, and analyzes relationships pertaining to a subject, but the major flaw of eclecticism is a lack of clear and coherent systems and principles, which leads to a chaotic viewpoint and an inability to grasp the true nature of the subject at hand.

Sophistry is the use of falsehoods and misleading arguments, usually with the intention of deception, and with a tendency of presenting non-critical aspects of a subject matter as critical, to serve a particular agenda. The word comes from the Sophists, a group of professional teachers in Ancient Greece, who were criticized by Socrates (in Plato’s dialogues) for being shrewd and deceptive rhetoricians. This kind of bad faith argument has no place in materialist dialectics. Materialist dialectics must, instead, be rooted in a true and accurate understanding of the subject, material conditions, and reality in general.

Simultaneously, Lenin also developed his Marxist viewpoint of the factors deciding the victory of a social regime, about class, about the two basic missions of the proletariat, about the strategies and tactics of proletarian parties in new historical conditions, about the transitional period, and about the plans of building socialism following the New Economic Policy (NEP), etc.

Annotation 37

The early 1920s were a period of great internal conflict in revolutionary Russia, with various figures and factions wanting to take the revolution in different directions. As such, Lenin wrote extensively on the direction he believed the revolution should be carried forth to ensure lasting victory against both feudalism and capitalism. He believed that the October, 1917 revolution represented the complete defeat of the Czar, however he believed the proletarian victory over the bourgeoisie would take more time. Russia was a poor, agrarian society. The vast majority of Russians under the Czar were poor peasants. Industry — and thus, the proletariat — was highly undeveloped compared to Western Europe. According to Lenin, a full and lasting proletarian victory over the bourgeoisie could only be won after the means of production were properly developed. In Fourth Anniversary of the October Revolution, Lenin wrote:

This first victory [the October, 1917 revolution] is not yet the final victory, and it was achieved by our October Revolution at the price of incredible difficulties and hardships... We have made the start... The important thing is that the ice has been broken; the road is open, the way has been shown.

So, Lenin knew that the victory over the Czar and feudalism was only a partial victory, and that more work needed to be done to defeat the bourgeoisie entirely. He believed the key to this victory over the capitalist class would be economic development, since Russia was still a largely agrarian society with very little industrial or economic development compared to Western Europe:

Our last, but most important and most difficult task, the one we have done least about, is economic development, the laying of economic foundations for the new, socialist edifice on the site of the demolished feudal edifice and the semi-demolished capitalist edifice.

Lenin’s plan for rapidly developing the means of production was his New Economic Policy, or the NEP. The New Economic Policy was proposed to be a temporary economic system that would allow a market economy and capitalism to exist within Russia, alongside state-owned business ventures, all firmly under the control of the working-class-dominated state. As Lenin explains in Fourth Anniversary of the October Revolution:

At this very moment we are, by our New Economic Policy, correcting a number of our mistakes. We are learning how to continue erecting the socialist edifice in a small-peasant country.

He continues later in the text:

The proletarian state must become a cautious, assiduous and shrewd “businessman,” a punctilious wholesale merchant — otherwise it will never succeed in putting this small-peasant country economically on its feet. Under existing conditions, living as we are side by side with the capitalist (for the time being capitalist) West, there is no other way of progressing to communism. A wholesale merchant seems to be an economic type as remote from communism as heaven from earth. But that is one of the contradictions which, in actual life, lead from a small-peasant economy via state capitalism to socialism. Personal incentive will step up production; we must increase production first and foremost and at all costs. Wholesale trade economically unites millions of small peasants: it gives them a personal incentive, links them up and leads them to the next step, namely, to various forms of association and alliance in the process of production itself. We have already started the necessary changes in our economic policy and already have some successes to our credit; true, they are small and partial, but nonetheless they are successes. In this new field of “tuition” we are already finishing our preparatory class. By persistent and assiduous study, by making practical experience the test of every step we take, by not fearing to alter over and over again what we have already begun, by correcting our mistakes and most carefully analyzing their significance, we shall pass to the higher classes. We shall go through the whole “course,” although the present state of world economics and world politics has made that course much longer and much more difficult than we would have liked. No matter at what cost, no matter how severe the hardships of the transition period may be — despite disaster, famine and ruin — we shall not flinch; we shall triumphantly carry our cause to its goal.

With these great works dedicated to the three component parts of Marxism [see Annotation 42, p. 38], the name Vladimir Ilyich Lenin became an important part of Marxism. It marked a comprehensive developing step from Marxism to Marxism-Leninism.

d. Marxism-Leninism and the Reality of the International Revolutionary Movement

The birth of Marxism greatly affected both the international worker movements and communist movements. The revolution in March 1871 in France could be considered as a great experiment of Marxism in the real world. For the first time in human history, a new kind of state — the dictatorship of the proletariat state (Paris Commune) was established.

Annotation 38

The Paris Commune was an important but short-lived revolutionary victory of the working class which saw a revolutionary socialist government controlling Paris from March 18 to May 28, 1871.

During the brief existence of the Paris Commune, many important policies were set forth, including a separation of church and state, abolishment of rent, an end to child labor, and the right of employees to take over any business which had been abandoned by its owner. Unfortunately, the Paris Commune was brutally toppled by the French army, which killed between 6,000 and 7,000 revolutionaries in battle and by execution. The events of the Paris Commune heavily influenced many revolutionary thinkers and leaders, including Marx, Engels, and Lenin, and was referenced frequently in their works.

In August 1903, the very first Marxist proletariat party was established — the Russian Social Democratic Labor Party. It was a true Marxist party that led the revolution in Russia in 1905. In October 1917, the victory of the socialist revolution of the proletariat in Russia opened a new era for human history.

In 1919, the Communist International* was held; in 1922, the Union of Soviet Socialist Republic was established. It marked the alliance of the proletariat of many countries. With the power of this alliance, the fight against Fascism not only protected the achievements of the proletariat’s revolution, but also spread socialism beyond the borders of Russia. Following the lead of the Soviet Union, a community of socialist countries was built, with revolutions leading to the establishment of socialism in the following countries [and years of establishment]: Mongolia [1921], Vietnam [1945], the Democratic People’s Republic of Korea [1945], Yugoslavia [1945], Albania [1946], Romania [1947], Czechoslovakia [1948], East Germany [1949], China [1949], Hungary [1949], Poland [1956], and Cuba [1959].

Annotation 39

* The First International, also known as the International Workingmen’s Association, was founded in London and lasted from 1864–1876. Karl Marx and Friedrich Engels were key figures in the foundation and operation of this organization, which sought better conditions and the establishment of rights for workers.

The Second International was founded in Paris in 1889 to continue the work of the First International. It fell apart in 1916 because the members from different nations could not maintain solidarity through the outbreak of World War I.

The Third International, also known as the Communist International (or the ComIntern for short), was founded in Moscow in 1919 (though many nations didn’t join until later in the 1920s). Its goals were to overthrow capitalism, build socialism, and establish a dictatorship of the proletariat. It was dissolved in 1943 in the midst of the German invasion of Russia in World War II.

These great historical events strongly enhanced the revolutionary movement of the working class all around the whole world. The people awakened and encouraged the liberation resistance of many colonised countries. The guiding role of Marxism-Leninism brought many great results for a world of peace, independence, democracy, and social progress.

However, because of many internal and external factors, in the late 1980s, the socialist alliance faced a crisis and fell into a recession period. Even though the socialist system fell into crisis and was weakened, the socialist ideology still survived internationally. The determination of successfully building socialism was still very strong in many countries and the desire to follow the socialist path still spread widely in South America.

Nowadays, the main feature of our modern society is fast and varied change in many social aspects caused by technology and scientific revolution. But, no matter how quickly and diversely our society changes, the nature of the capitalist production method never changes. So, in order to protect the socialist achievements earned by the flesh and blood of many previous generations; and in order to have a tremendous development step in the career of liberating human beings, it is very urgent to protect, inherit and develop Marxism-Leninism and also innovate the work of building socialism in both theory and practice.

The Communist Party of Vietnam declared: “Nowadays, capitalism still has potential for development, but in nature, it’s still an unjust, exploitative, and oppressive regime. The basic and inherent contradictions of capitalism, especially the contradictions between the increasing socialization of the production force and the capitalist private ownership regime, will never be solved and will even become increasingly serious. The feature of the current period of our modern society is: countries with different social regimes and different development levels co-exist, co-operate, struggle and compete fiercely for the interests of their own nations. The struggles for peace, independence, democracy, development, and social progress of many countries will still have to cope with hardship and challenges but we will achieve new progress. According to the principles of historical development, human beings will almost certainly go forward to socialism.”^[16]

Annotation 40

Historical materialism is the application of dialectical materialist philosophy and materialist dialectical methodology to the analysis of human history, society, and development. The principles of historical materialism, as developed by Marx, Engels, and Lenin, indicate that human society is moving towards socialism and will almost certainly — in time — develop into socialism, and then proceed towards a stateless, classless form of society (communism). These principles of historical materialism were initially formulated and discussed in several books by Marx, Engels, and Lenin, including:

• The German Ideology, by Marx and Engels

• Socialism: Utopian and Scientific, by Marx and Engels

• Karl Marx, by Lenin

The Communist Party of Vietnam has also declared:

“In the opinion of the Vietnam Communist Party, using Marxism-Leninism and Ho Chi Minh Thought as the foundation for our ideology, the guideline for our actions is an important developmental step in cognition and logical thinking^[17]. Achievements that the Vietnamese people have gained in the war to gain our independence, in peace, and in the renovation era, are all rooted in Marxism-Leninism and Ho Chi Minh Thought. Therefore, we have to ‘creatively apply and develop Marxism-Leninism and Ho Chi Minh Thought in the Party’s activities. We have to regularly summarise reality, complement and develop theory, and soundly solve the problems of our society.’”^[18]

Annotation 41

Ho Chi Minh Thought refers to a system of ideas developed by Ho Chi Minh and other Vietnamese communists which relate to the application of Marxist-Leninist philosophy and methodology to the specific material conditions of Vietnam during the revolutionary period.

There is no universal road map for applying the principles of Marxism-Leninism. How the philosophy of Marxism-Leninism should be applied will vary widely from one time and place to another. This is why Ho Chi Minh and other Vietnamese communists had to develop Ho Chi Minh Thought: so that scientific socialism could be developed within the unique context of Vietnam’s particular historical development and material conditions.

It is the duty of every revolutionary to study Marxism-Leninism as well as specific applied forms of Marxism-Leninism developed by revolutionaries for their own specific times and places, such as: Ho Chi Minh (Vietnam), Mao Zedong (China), Fidel Castro and Che Guevera (Cuba), etc. However, it must be recognized that the ideas, strategies, methodologies, and philosophies developed in such particular circumstances can’t be applied in exactly the same way in other times and places, such as our own contemporary material conditions.

The Renovation Era refers to the period of time in Vietnam from the 1980s until the early 2000s during which the Đổi Mới (renovation) policies were implemented. These policies restructured the Vietnamese economy to end the previous subsidizing model (which was defined by state ownership of the entire economy). The goals of the Renovation Era were to open Vietnam economically and politically and to normalize relations with the rest of the world. The Đổi Mới policies were generally successful and paved the way to the Path to Socialism Era which Vietnam exists in today. The goals of the Path to Socialism Era are to develop Vietnam into a modern, developed country with a strong economy and wealthy people, which will allow us to transition towards the lower stage of communism, which Lenin called “socialism.”

And, finally: “We have to be consistent with Marxism-Leninism and Ho Chi Minh Thought. We have to creatively apply and develop the ideology correspondingly with the reality in Vietnam. We have to firmly aim for national independence and socialism.”

II. Objects, Purposes, and Requirements for Studying the Basic Principles of Marxism-Leninism

1. Objects and Purposes of Study

The objects of study of this book, The Basic Principles of Marxism-Leninism, are the fundamental viewpoints of Marxism-Leninism in its three component parts.

Annotation 42

Remember that a viewpoint is the starting point of analysis which determines the direction of thinking and the perspective from which problems are considered. Also remember that Marxism-Leninism has three component parts:

1. The Philosophy of Marxism:

Including Dialectical Materialism and Historical Materialism

2. The Political Economy of Marxism:

A system of knowledge and laws that define the production process and commodity exchange in human society.

3. Scientific Socialism

The system of thought pertaining to the establishment of the communist social economy form.

These objects of study stand as the viewpoints — the starting points of analysis — of Marxist-Leninist philosophy and the three component parts of which it’s composed.

In the scope of Marxist-Leninist Philosophy [the first component part of Marxism-Leninism], these objects of study are:

Dialectical Materialism — the fundamental and most universal worldview and methodologies which form the theoretical core of a scientific worldview*. [See Part 1, p. 44]
Materialist Dialectics — the science of development, of common relationships, and of the most common rules of motion and development of nature, society and human thought. [See Chapter 2, p. 98]
Historical Materialism — the application and development of Materialism and Dialectics in studying social aspects. [Historical materialism is the topic of Part 2 of the textbook from which this entire text has been translated, which we hope to translate in the future.]

Annotation 43

* Remember that Scientific in Marxism-Leninism refers to a systematic pursuit of knowledge, research, theory, and understanding [see Annotation 1, p. 1]. Note, also, that Worldview refers to the whole of an individual’s or society’s opinions and conceptions about the world, about humans ourselves, and about life and the position of human beings in the world. This is discussed in more detail on page 44.

Thus, a scientific worldview is a worldview that is expressed by a systematic pursuit of knowledge of definitions and categories that generally and correctly reflect the relationships of things, phenomena, and processes in the objective material world, including relationships between humans, as well as relationships between humans and the world.

In the scope of Marxist-Leninist Political Economics [the second component part of Marxism-Leninism], the objects of study are:

The theory of value and the theory of surplus value.
Economic theory about monopolist capitalism and state monopolist capitalism.
General economic rules about capitalist production methods, from the stage of formation, to the stage of development, to the stage of perishing, which will be followed by the birth of a new production method: the communist production method.

Annotation 44

Marxist-Leninist political economics is the topic of Part 3 of the textbook from which this entire text has been translated, which we hope to translate in the future.

In the scope of Scientific Socialism [the third component part of Marxism-Leninism], the objects of study are:

The historical mission of the working class and the progression of a socialist revolution.
Matters related to the future formation and development periods of the communist socio-economic form.
Guidelines for the working class in implementing our historical mission.

The purposes of studying The Basic Principles of Marxism-Leninism are:' to master Marxist-Leninist viewpoints of science, revolution, and humanism*; to thoroughly understand the most important theoretical foundation of Ho Chi Minh Thought, the revolutionary path, and the ideological foundation of the Vietnam Communist Party. Based on that basis, we can build a scientific worldview and methodology and a revolutionary worldview; build our trust in our revolutionary ideals; creatively apply them in our cognitive and practical activities and in practicing and cultivating morality to meet the requirements of Vietnamese people in the cause of building a socialist Vietnam.

Annotation 45

* The humanism of Marxism-Leninism differs greatly from the humanism of Feuerbach discussed in Annotation 12, p. 13. Marxist-Leninist humanism concerns itself with the liberation of all humans. As Marx and Engels wrote in The Communist Manifesto: “the free development of each is the condition for the free development of all.”

2. Some Basic Requirements of the Studying Method

There are some basic requirements for studying the basic principles of Marxism-Leninism:

First, Marxist-Leninist theses were conceptualized under many different circumstances in order to solve different problems, so the expressions of thought of Marxist-Leninists can vary. Therefore, students studying the basic principles of Marxism-Leninism must correctly understand its spirit and essence and avoid theoretical purism and dogmatism.

Annotation 46

Marxism-Leninism should be understood as an applied science, and application of this science will vary based on material conditions. As Engels wrote in a personal letter in 1887, remarking on the socialist movement in the USA: “Our theory is a theory of evolution, not a dogma to be learned by heart and to be repeated mechanically. The less it is drilled into the Americans from outside and the more they test it with their own experience... the deeper will it pass into their flesh and blood.”

As an example, Lenin tailored his actions and ideas specifically to suit the material conditions of Russia under the Czar and in the early revolutionary period. Russia’s material conditions were somewhat unique during the time of Lenin’s revolutionary activity, since Russia was an agrarian monarchy with a large peasant population and a relatively undeveloped industrial sector. As such, Lenin had to develop strategies, tactics, and ideas which suited those specific material conditions, such as determining that the industrial working class and agricultural peasants should work together. As Lenin explained in The Proletariat and the Peasantry:

Thus the red banner of the class-conscious workers means, first, that we support with all our might, the peasants’ struggle for full freedom and all the land; secondly, it means that we do not stop at this, but go on further. We are waging, besides the struggle for freedom and land, a fight for socialism.

Obviously, this statement would not be specifically applicable to a society with highly developed industry and virtually no rural peasants (such as, for instance, the modern-day USA), just as Lenin’s remarks about the Czar would not be specifically applicable to any society that does not have an institution of monarchy.

As another example, take the works of Ho Chi Minh. Ho Chi Minh Thought is defined by the Communist Party of Vietnam as “a complete system of thought about the fundamental issues of the Vietnam revolution.” In other words, Ho Chi Minh Thought is a specific application of the principles of Marxism-Leninism to the material conditions of Vietnam.

One unique aspect of Vietnam’s revolution which Ho Chi Minh focused on was colonization. As a colonized country, Ho Chi Minh realized that Vietnam had unique challenges and circumstances that would need to be properly addressed through revolutionary struggle. Another unique aspect of Vietnam’s material conditions was the fact that the colonial administration of Vietnam changed hands throughout the revolution: from France, to Japan, back to France, then to the USA. Ho Chi Minh was able to dynamically and creatively apply Marxism-Leninism to these shifting material conditions. For instance, in Founding of the Indochinese Communist Party, written in 1930, Ho Chi Minh explains some of the unique problems faced by the colonized people of Indochina (modern day Vietnam, Laos, and Cambodia) and proposes solutions specific to these unique material conditions:

On the one hand, they (the French) use the feudalists and comprador bourgeoisie (of Vietnam) to oppress and exploit our people. On the other, they terrorize, arrest, jail, deport, and kill a great number of Vietnamese revolutionaries. If the French imperialists think that they can suppress the Vietnamese revolution by means of terror, they are grossly mistaken. For one thing, the Vietnamese revolution is not isolated but enjoys the assistance of the world proletariat in general and that of the French working class in particular. Secondly, it is precisely at the very time when the French imperialists are frenziedly carrying out terrorist acts that the Vietnamese Communists, formerly working separately, have united into a single party, the Indochinese Communist Party, to lead the revolutionary struggle of our entire people.

During this period, the nations of Indochina were predominantly agricultural, prompting Ho Chi Minh to suggest in the same text that it would be necessary “to establish a worker-peasant-soldier government” and “to confiscate all the plantations and property belonging to the imperialists and the Vietnamese reactionary bourgeoisie and distribute them to the poor peasants.” Obviously all of these considerations are specific to the material conditions of Indochina under French colonial rule in 1930.

By 1939, the situation was changing rapidly. Ho Chi Minh was operating from China, which was being invaded by fascist Japan. He knew that it was only a matter of time before the Japanese imperial army would come to threaten Vietnam and the rest of Indochina. As such, Ho Chi Minh wrote a letter to the Indochinese Communist Party outlining recommendations, strategies, and goals pertaining to the precipitating material conditions. At that time, France had not yet been invaded by Germany, but Ho Chi Minh was very aware of the looming threat of fascism both in Europe and in Asia. He realized that rising up in revolutionary civil war against the French colonial administration would give fascist Japan the opportunity to quickly conquer all of Indochina, which is why he made the following recommendations in a letter to the Communist Party of Indochina in 1939:

Our party should not strive for demands which are too high, such as total independence, or establishing a house of representatives. If we do that, we will fall into the trap of fascist Japan. For now, we should only ask for democracy, freedom to organize, freedom to hold meetings, freedom of speech, and for the release of political prisoners. We should also fight for our party to be organized and to operate legally.

Once France fell to Germany in 1940, Indochina was immediately handed over to Japanese colonial rule. The Japanese army was brutal in its occupation of Vietnam, and the French colonial administrators surrendered entirely to the Japanese empire and helped the Japanese to administer all of Indochina. Ho Chi Minh returned to Vietnam in January of 1941 and participated directly with the resistance struggle against Japan until 1945, when the situation once again changed dramatically due to the Japanese military’s surrender to allied forces and withdrawal from Vietnam. He immediately took advantage of this situation and held a successful revolution against both the Japanese and French administrators. In the Declaration of Independence for the Democratic Republic of Vietnam, Ho Chi Minh wrote:

After the Japanese had surrendered to the Allies, our whole people rose to regain our national sovereignty and to found the Democratic Republic of Vietnam. The truth is that we have wrested our independence from the Japanese and not from the French. The French have fled, the Japanese have capitulated, Emperor Bao Dai has abdicated. Our people have broken the chains which for nearly a century have fettered them and have won independence for the homeland.

As France began to make their intentions clear that they would be resuming their colonialist claim to Indochina, Ho Chi Minh began preparing the country for a new chapter in revolutionary struggle. In his 1946 letter to the people of Vietnam, entitled A Nationwide Call for Resistance, Ho Chi Minh wrote:

We call everyone, man and woman, old and young, from every ethnic minority, from every religion, to stand up and fight to save our country. If you have guns, use guns. If you have swords, use swords. If you have nothing, use sticks. Everyone must stand up and fight.

As these historical developments illustrate, Ho Chi Minh was able to creatively and dynamically apply the principles of Marxism-Leninism to suit the shifting material conditions of Vietnam, just as Lenin had to creatively and dynamically apply these principles to the emerging situation in Russia in the early 20^th century. So is the task of every student of Marxism-Leninism: to learn to apply these principles creatively and dynamically to the material conditions at hand.

Second, the birth and development of Marixst-Leninist theses is a process. In that process, all Marixst-Leninist theses have strong relationships with each other. They complement and support each other. Thus, students studying each Marxist-Leninist thesis need to put it in proper relation and context with other theses found within each different component part of Marxism-Leninism in order to understand the unity in diversity [see: Annotation 107, p. 110], the consistency of every thesis in particular, and the whole of Marxism-Leninism in general.

Third, an important goal of studying the basic principles of Marxism-Leninism is to understand clearly the most important theoretical basis of Ho Chi Minh Thought, of the Vietnam Communist Party and its revolutionary path. Therefore, we must attach Marxist-Leninist theses to Vietnam’s revolutionary practice and the world’s practice in order to see the creative application of Marxism-Leninism that President Ho Chi Minh and the Vietnam Communist Party implemented in each period of history.

Fourth, we must study the basic principles of Marxism-Leninism to meet the requirements for a new Vietnamese people in a new era. So, the process of studying is also the process of self-educating and practicing to improve ourselves step-by-step in both individual and social life.

Fifth, Marxism-Leninism is not a closed and immutable theoretical system. On the contrary, it is a theoretical system that continuously develops based on the development of reality. Therefore, the process of studying Marxism-Leninism is also a process of reflection: summarizing and reviewing your own practical experiences and sharing what you’ve learned from these experiences in order to contribute to the scientific and humanist development of Marxism-Leninism. In addition, when studying the basic principles of Marxism-Leninism, we need to consider these principles in the proper context of the history of the ideological development of humanity. Such context is important because Marxism-Leninism is quintessentially^[19] the product of that history.

These requirements have strong relationships with each other. They imbue the studying process with the quintessence of Marxism-Leninism. And more importantly, they help students apply that quintessence into cognitive and practical activities.

Part I: The Worldview and Philosophical Methodology of Marxism — Leninism

Worldview refers to the whole of an individual’s or society’s opinions and conceptions about the world, about humans ourselves, and about life and the position of human beings in that world. Our worldview directs and orientates our life, including our cognitive and practical activities, as well as our self-awareness. Our worldview defines our ideals, our value system, and our lifestyle. So, a proper and scientific worldview serves as a foundation to establish a constructive approach to life. One of the basic criteria to evaluate the growth and maturity of an individual or a whole society is the degree to which worldview has been developed.

Methodology is a system of reasoning: the ideas and rules that guide humans to research, build, select, and apply the most suitable methods in both perception and practice. Methodologies can range from very specific to broadly general, with philosophical methodology being the most general scope of methodology.

Annotation 47

Tran Thien Tu, the vice-dean of the Department of Marxist-Leninist Theoretical Studies at the Le Duan Political Science University in Quang Tri, Vietnam, defines three degrees of scopes of Methodology. They are, from most specific to most general:

1. Field Methodology

The most specific scope of methodology; a field methodology will apply only to a single specific scientific field.

2. General Methodology

A more general scope of methodology; a general methodology will be shared by various scientific fields.

3. Philosophical Methodology

The most general scope of methodology, encompassing the whole of the material world and human thought.

Worldview and philosophical methodology are the fundamental knowledge-systems* of Marxism-Leninism.

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* In the original Vietnamese, the word lý luận is used, which we roughly translate to the phrase “knowledge-system” throughout this book. Literally, lý luận is a combination of the words lý lẽ, which means “argument,” and bàn luận, which means “to infer.”

The full meaning of lý luận is: a system of ideas that reflect reality expressed in a system of knowledge that allows for a complete view of the fundamental laws and relationships of objective reality.

The Worldview and Philosophical Methodology of Marxism-Leninism

Marxist-Leninist worldview and philosophical methodology emerge from the quintessence [see Annotation 6, p. 8] of dialectical materialism, which itself developed from other forms of dialectics, which in turn developed throughout the history of the ideological development of humanity.

Materialism is foundational to Marxism-Leninism in two important ways:

Dialectical Materialism is the ideological core of a scientific worldview.

Historical Materialism is a system of dialectical materialist opinions about the origin of, motivation of, and the most common rules that dominate the movement and development of human society.

Dialectics are also foundational to Marxism-Leninism, specifically in the form of Materialist Dialectics, which Lenin defined as “the doctrine of development in its fullest, deepest and most comprehensive form, the doctrine of the relativity of human knowledge.”^[20] Lenin also defined Materialist Dialectics as “what is now called theory of knowledge or epistemology.”^[21] [Note: Epistemology is the theoretical study of knowledge; for more information see Cognitive Theory of Dialectical Materialism, p. 204.]

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For beginning students of Marxism-Leninism, distinguishing between Dialectical Materialism and Materialist Dialectics may at first be confusing. Here is an explanation of each concept and how they relate to one another:

Dialectical Materialism and Materialist Dialectics.

Dialectical Materialism is a scientific understanding of matter, consciousness and the relationship between the two. Dialectical Materialism is used to understand the world by studying such relationships.

Materialist Dialectics is a science studying the general laws of the movement, change, and development of nature, society and human thought.

Relationship between Dialectical Materialism and Materialist Dialectics.

And so, we use Dialectical Materialism to understand the fundamental nature of reality. This understanding is used as a basis for changing the world, using Materialist Dialectics to guide our activities. We can then reflect on the results of our activities, using Dialectical Materialism, to further develop our understanding of the world.

As Marxist-Leninists, we utilize this continuous cycle between studying and understanding the world through Dialectical Materialism and affecting change in the world through Materialist Dialectics with the goal of bringing about socialism and freeing humanity.

It is also important to understand the nature of dialectical relationships.

A dialectical relationship is a relationship in which two things mutually impact one another. Dialectical materialism perceives all things in motion [see Mode and Forms of Existence of Matter, p. 59] and in a constant state of change, and this motion and change originates from relationships in which all things mutually move and change each other through interaction, leading to development over time.

Thoroughly understanding the basic content of the worldview and methodology of Marxism-Leninism is the most important requirement in order to properly study the whole theory system of Marxism-Leninism and to creatively apply it into cognitive and practical activities in order to solve the problems that our society must cope with.

3. Excerpt From Modifying the Working Style By Ho Chi Minh

Ho Chi Minh training cadres in 1959.

Training is a must. There is a proverb: “without a teacher, you can never do well;” and the expression: “learn to eat, learn to speak, learn to pack, learn to unpack.”

Even many simple subjects require study, let alone revolutionary work and resistance work. How can you perform such tasks without any training?

But training materials must be aimed at the needs of the masses. We must ask: after people receive their training, can they apply their knowledge immediately? Is it possible to practice right away?

If training is not immediately practical, then years of training would be useless.

Unfortunately, many of our trainers do not understand this simple logic. That’s why there are cadres who train rural people in the uplands in the field of “economics!”

In short, our way of working, organizing, talking, propagandizing, setting slogans, writing newspapers, etc., must all take this sentence as a model:

“From within the masses, back into the masses.”

No matter how big or small our tasks are, we must clearly examine and modify them to match the culture, living habits, level of education, struggling experiences, desire, will, and material conditions of the masses. On that basis we will form our ways of working and organizing. Only then can we have the masses on our side.

Otherwise, if you just do as you want, following your own thoughts, your subjectivity, and then force your personal thoughts upon the masses, it is just like “cutting your feet to fit your shoes.” Feet are the masses. Shoes are our ways of organizing and working.

Shoes are made to fit people’s feet, not the other way around.

Chapter 1: Dialectical Materialism

Dialectical Materialism, one of the materialist foundations of Marxism-Leninism, uses the materialist worldview and dialectical methods to study fundamental philosophical issues. Dialectical Materialism is the most advanced form of Materialism, and serves as the theoretical core of a scientific worldview. Therefore, thoroughly understanding the basic content of Dialectical Materialism is the essential prerequisite to study both the component principles of Marxism-Leninism in particular, and the whole of Marxism-Leninism in general.

I. Materialism and Dialectical Materialism

1. The Opposition of Materialism and Idealism in Solving Basic Philosophical Issues

Philosophy is a system of the most general human theories and knowledge about our world, about ourselves, and our position in our world.

Philosophy has existed for thousands of years. Philosophy has different objects of study depending on different periods of time. Summarizing the whole history of philosophy, Engels said: “The great basic question of all philosophy, especially of more modern philosophy, is that concerning the relation of thinking and being^[22].”

So, philosophy studies the relations between consciousness and matter, and between humans and nature.

In philosophy, there are two main questions:

Question 1: The question of consciousness and matter: which came first; or, to put it another way, which one determines which one?

In attempting to answer this first question, philosophy has separated into two main schools: Materialism, and Idealism.

Question 2: Do humans have the capacity to perceive the world as it truly exists?

In answer to this second question, two schools: Intelligibility — which admits the human cognitive capacity to truly perceive the world — and unintelligibility — which denies that capacity.

Materialism is the belief that the nature of the world is matter; that matter comes first; and that matter determines consciousness. People who uphold this belief are called materialists. Throughout human history, many different factions of materialists with various schools of materialist thought have evolved.

Idealism is the belief that the nature of the world is consciousness; consciousness precedes matter; consciousness decides matter. People who uphold this belief are called idealists. Like materialism, various factions of idealists with varying schools of idealist thought have also evolved throughout history.

Idealism has cognitive origins and social origins.

Annotation 50

Cognitive origin refers to origination from the human consciousness of individuals.

Social origin refers to origination from social relations between human beings.

So, idealism originates from both the conscious activity of individual humans as well as social activity between human beings.

These origins are unilateral consideration and absolutization of only one aspect or one characteristic of the whole cognitive process.

Annotation 51

Unilateral consideration is the consideration of a subject from one side only.

Absolutization occurs when one conceptualizes some belief or supposition as always true in all situations without exception.

Both unilateral consideration and absolutization fail to consider the dynamic, constantly changing, and interconnected relations of all things, phenomena, and ideas in our reality.

Idealism originates from unilateral consideration because idealists ignore the material world and consider reality only from the perspective of the human mind. It also originates from absolutism because idealists absolutize human reasoning as the only source of truth and knowledge about our world without exception.

As Lenin wrote in On the Question of Dialectics: “Philosophical idealism is a unilateral development, an overt development, of one out of many attributes, or one out of many aspects, of consciousness.”

Historically, idealism has typically benefitted the oppressive, exploitative class of society. Idealism and religions usually have a close relation with each other, and support each other to co-exist and co-develop.

Annotation 52

Idealists, in absolutizing human consciousness, have a tendency to only give credence to the work of the mind and ignore the value of physical labor. This has been used to justify class structures in which religious and intellectual laborers are given authority and privilege over manual laborers.

This situation has also led to the idea that mental factors play a decisive role in the development of human society in particular and the whole world in general. This idealist view was supported by the ruling class and used to justify its own power and privilege in society. The dominant class has historically used such idealist philosophy as the justifying foundation for their political-social beliefs in order to maintain their ruling positions.

Marx discusses this tendency for rulers to idealistically justify their own rule in The German Ideology:

The ideas of the ruling class are in every epoch the ruling ideas, i.e. the class which is the ruling material force of society, is at the same time its ruling intellectual force. The class which has the means of material production at its disposal, has control at the same time over the means of mental production, so that thereby, generally speaking, the ideas of those who lack the means of mental production are subject to it. The ruling ideas are nothing more than the ideal expression of the dominant material relationships, the dominant material relationships grasped as ideas; hence of the relationships which make the one class the ruling one, therefore, the ideas of its dominance. The individuals composing the ruling class possess among other things consciousness, and therefore think. Insofar, therefore, as they rule as a class and determine the extent and compass of an epoch, it is self-evident that they do this in its whole range, hence among other things rule also as thinkers, as producers of ideas, and regulate the production and distribution of the ideas of their age: thus their ideas are the ruling ideas of the epoch. For instance, in an age and in a country where royal power, aristocracy, and bourgeoisie are contending for mastery and where, therefore, mastery is shared, the doctrine of the separation of powers proves to be the dominant idea and is expressed as an ‘eternal law.’

Marx goes on to explain how the idealist positions of the ruling class tend to get embedded in historical narratives:

Whilst in ordinary life every shopkeeper is very well able to distinguish between what somebody professes to be and what he really is, our historians have not yet won even this trivial insight. They take every epoch at its word and believe that everything it says and imagines about itself is true. This historical method which reigned in Germany, and especially the reason why, must be understood from its connection with the illusion of ideologists in general, e.g. the illusions of the jurist, politicians (of the practical statesmen among them, too), from the dogmatic dreamings and distortions of these fellows; this is explained perfectly easily from their practical position in life, their job, and the division of labour.

In history, there are two main forms of idealism: subjective and objective.

Subjective idealism asserts that consciousness is the primary existence. It asserts that all things and phenomena can only be experienced as subjective sensory perceptions while denying the objective existence of material reality altogether.

Objective idealism also asserts the ideal and consciousness as the primary existence, but also posits that the ideal and consciousness are objective, and that they exist independently of nature and humans. This concept is given many names, such as “absolute concept”, “absolute spirit,” “rationality of the world,” etc.

Annotation 53

Primary existence is existence which precedes and determines other existences.

Idealists believe that consciousness has primary existence over matter, that the nature of the world is ideal, and that the ideal defines existence.

Materialists believe the opposite: that matter has primary existence over the ideal, and that matter precedes and determines consciousness.

Dialectical Materialism holds that matter and consciousness have a dialectical relationship, in which matter has primary existence over the ideal, though consciousness can impact the material world through willful conscious activity.

The primary existence of matter within Dialectical Materialism is discussed further in The Relationship Between Matter and Consciousness, p. 88.

Willful activity (willpower) is discussed in Nature and Structure of Consciousness, p. 79.

The key difference between subjective and objective idealists is this:

Subjective idealists believe that there is no external material world whatsoever — that what we imagine as the material world is merely illusory — and that all reality is created by consciousness, whereas objective idealists believe that there is a material world outside of human consciousness, but it exists independently of human consciousness; therefore (according to objective idealists), since humans can only observe the world through conscious experience, the material world can never be truly known or observed by our consciousness.

In opposition to Idealism, Materialism originated through practical experience and the development of science. Through practical experience and systematic development of human knowledge, Materialism has come to serve as a universally applicable theoretical system which benefits progressive social forces and which also orients the activities of those forces in both perception and practice.

Annotation 54

Materialism benefits progressive social forces by showing reality as it is, by dispelling the idealist positions of the ruling class, and by revealing that society and the world can be changed through willful activity.

Materialism guides progressive social forces by grounding thought and activity in material reality, enabling strategies and outcomes that line up with the realities of the material world. For instance, we must avoid utopianism [see Annotation 17, p. 18] in which emphasis is placed on working out ideal forms of society through debate, conjecture, and conscious activity alone. Revolution against capitalism must, instead, focus on affecting material relations and processes of development through willful activity.

As Engels pointed out in Socialism: Utopian and Scientific: “The final causes of all social changes and political revolutions are to be sought, not in men’s brains, not in men’s better insights into eternal truth and justice, but in changes in the modes of production and exchange.”

2. Dialectical Materialism — the Most Advanced Form of Materialism

In human history, as human society and scientific understanding have developed, materialism has also developed through three forms: Primitive Materialism, Metaphysical Materialism, and Dialectical Materialism.

Primitive Materialism is the primitive form of materialism. Primitive materialism recognizes that matter comes first, and holds that the world is composed of certain elements, and that these were the first objects, the origin, of the world, and that these elements are the essence of reality. These Primitive Materialist concepts can be found in many ancient materialist theories in such places as China, India, and Greece. [These Primitive Materialist elemental philosophies are discussed more in Matter, p. 53] Although it has many shortcomings, Primitive Materialism is partially correct at the most fundamental level, because it uses the material of nature itself to explain nature.

Metaphysical Materialism is the second basic form of Materialism. This form of materialism was widely discussed and developed in Western Europe in the 17^th and 18^th centuries. During this time, the metaphysical method of perceiving the world was applied to materialist philosophy. Although Metaphysical Materialism does not accurately reflect the world in terms of universal relations [see p. 108] and development, it was an important step forward in the fight against idealist and religious worldviews, especially during the transformational period from the Middle Ages to the Renaissance in many Western European countries.

Annotation 55

Metaphysical materialism was strongly influenced by mechanical philosophy, a scientific and philosophical movement popular in the 17^th century which explored mechanical machines and compared natural phenomena to mechanical devices. Mechanical philosophy led to a belief that all things — including living organisms — were built as (and could theoretically be built by humans as) mechanical devices. Influenced by this philosophy, metaphysical materialists came to see the world as a giant mechanical machine composed of parts, each of which exists in an essentially isolated and static state.

Metaphysical materialists believed that all change can exist only as an increase or decrease in quantity, brought about by external causes Metaphysical materialism contributed significantly to the struggle against idealistic and religious worldviews, especially during the historical transition period from the Middle Ages to the Renaissance in Western European countries. Metaphysical materialism also had severe limitations; especially in failing to understand many key aspects of reality, such as the nature of development through change/motion and relationships.

Dialectical Materialism is the third basic form of materialism. It was founded by Karl Marx and Friedrich Engels, and defended and developed by Vladimir Ilyich Lenin as well as many of his successors. By inheriting the quintessence of previous theories and thoroughly integrating contemporary scientific achievements, Dialectical Materialism immediately solved the shortcomings of the Primitive Materialism of ancient times as well as the Metaphysical Materialism of modern Western Europe. It reaches the highest development level of materialism so far in history.

By accurately reflecting objective reality with universal relations and development*, Dialectical Materialism offers humanity a great tool for scientific cognitive activities and revolutionary practice. The Dialectical Materialist system of thought was built on the basis of scientific explanations about matter, consciousness, and the relationship between the two.

Annotation 56

* Materialist Dialectical methodology explains the world in terms of relationships and development. This is discussed in Basic Principles of Materialist Dialectics, p. 106.

II. Dialectical Materialist Opinions About Matter, Consciousness, and the Relationship Between Matter and Consciousness

1. Matter

a. Category of “Matter”

Matter is a philosophical subject which has been examined for more than 2,500 years. Since ancient times, there has been a relentless struggle between materialism and idealism around this subject. Idealism asserts that the world’s nature, the first basis of all existence, is consciousness, and that matter is only a product of that consciousness. Conversely, materialism asserts that nature, the entirety of the world, is composed of matter, that this material world exists indefinitely, and that all things and phenomena are composed of matter.

Before dialectical materialism was born, materialist philosophers generally believed that matter was composed of some self-contained element or elements; that is to say some underlying substance from which everything in the universe is ultimately derived. In ancient times, the five elements theory of Chinese philosophy held that those self-contained substances were metal — wood — water — fire — earth; in India, the Samkhya school believed that they were Pradhana or Prakriti^[23]; in Greece, the Milesian school believed they were water (Thales’s^[24] conception) or air (Anaximene’s^[25] conception); Heraclitus^[26] believed the ultimate element was fire; Democritus^[27] asserted that it was something called an “atom,”' etc. Even as recently as the 17^th-18^th centuries, conceptions about matter belonging to modern philosophers such as Francis Bacon^[28], Renes Descartes^[29], Thomas Hobbes^[30], Denis Diderot^[31], etc., still hadn’t changed much. They continued following the same philosophical tendency as ancient philosophers by focusing their studies of the material world through elemental phenomena.

These conceptions of matter which were developed by philosophers before Marx’s time laid a foundation for a tendency to use nature to explain nature itself, but that tendency still had many shortcomings, such as: oversimplification of matter into fictitious “elements;” failure to understand the nature of consciousness as well as the relationships between matter and consciousness; failure to recognize the significance of matter in human society, leading to a failure to solve social issues based on a materialist basis, etc.

Annotation 57

Here are further explanations of these shortcomings of early materialists:

Oversimplification of matter into fictitious “elements”

Due to a lack of understanding and knowledge of matter, metaphysical materialists created erroneous conceptions of “elements” which do not accurately describe the nature of matter. By using such an erroneously conceived system of non-existing elements to describe nature, metaphysical materialists were prevented from gaining real insights into the material world which delayed and hindered scientific progress.

Failure to understand the nature of consciousness as well as the relationships between matter and consciousness

Many early materialists believed that consciousness was simply a mechanical byproduct of material processes, and that mental events (thoughts, consciousness) could not affect the material world, since these events were simply mechanically determined by the material world.

As a first principle, Dialectical Materialism does hold that consciousness is created by matter. However, Dialectical Materialism also holds that consciousness can influence the material world through conscious action. This constitutes a dialectical relationship.

As Lenin explains in Materialism and Empirio-criticism: “Consciousness in general reflects being—that is a general principle of all materialism... social consciousness reflects social being.”

Whereas early materialists erroneously held that consciousness is simply an “accidental” byproduct of matter, Dialectical Materialism holds that consciousness is a characteristic of the nature of matter. As Engels wrote in the notation of Dialectics of Nature:

That matter evolves out of itself the thinking human brain is for mechanism a pure accident, although necessarily determined, step by step, where it happens. But the truth is that it is the nature of matter to advance to the evolution of thinking beings, hence this always necessarily occurs wherever the conditions for it (not necessarily identical at all places and times) are present.

Dialectical materialism also breaks from early materialism by positing that consciousness has a dialectical relationship with matter. Consciousness arises from the material world, but can also influence the material world through conscious action. In other words, mental events can trigger physical actions which affect the material world.

As Marx explains in Theses on Feuerbach:

The materialist doctrine that men are products of circumstances and upbringing, and that, therefore, changed men are products of changed circumstances and changed upbringing, forgets that it is men who change circumstances and that the educator must himself be educated. Hence this doctrine is bound to divide society into two parts, one of which is superior to society. The coincidence of the changing of circumstances and of human activity or self-change [Selbstveränderung] can be conceived and rationally understood only as revolutionary practice... Philosophers have hitherto only interpreted the world in various ways; the point is to change it.

Put more simply, we as humans are capable of “revolutionary practice” which can “change the world” because our consciousness allows us to “change circumstances.” This is discussed further in Nature and Structure of Consciousness, p. 79.

Failure to recognize the significance of matter in human society, leading to a failure to solve social issues based on a materialist basis

Dialectical materialists believe that matter exists in many forms, and that human society is a special form of existence of matter. Lenin referred to the material existence of human society as social being, which stood in contrast with human society’s social consciousness. Social being encompasses all of the material existence and processes of human society.

As Lenin wrote in Materialism and Empirio-criticism:

Social being is independent of the social consciousness of men. The fact that you live and conduct your business, beget children, produce products and exchange them, gives rise to an objectively necessary chain of events, a chain of development, which is independent of your social consciousness, and is never grasped by the latter completely. The highest task of humanity is to comprehend this objective logic of economic evolution (the evolution of social life) in its general and fundamental features, so that it may be possible to adapt to it one’s social consciousness and the consciousness of the advanced classes of all capitalist countries in as definite, clear and critical a fashion as possible.

Early materialists failed to recognise the relationship between matter and consciousness — as Lenin puts it, specifically, between social being and social consciousness. Thus in contemplating social issues, these early materialists were unable to find proper materialist solutions.

These shortcomings resulted in a non-thorough materialist viewpoint: when dealing with questions about nature, the early materialists had a strong materialist viewpoint but when dealing with social issues, they “slipped” into an idealist viewpoint.

Annotation 58

Lenin explains this concept of “slipping into” idealism through a non-thorough materialist viewpoint in Materialism and Empirio-Criticism: “Once you deny objective reality, given us in sensation, you have already lost every one of your weapons against fideism, for you have slipped into agnosticism or subjectivism — and that is all fideism wants.”

Note: fideism is a form of idealism which holds that truth and knowledge are received through faith or revelation. Subjectivism is the centering of one’s own self in conscious activities and perspective; see Annotation 222, p. 218.

In the same work, Lenin upholds that objective reality can be known through sense perception:

We ask, is a man given objective reality when he sees something red or feels something hard, etc., or not? [...] If you hold that it is not given, you... inevitably sink to subjectivism... If you hold that it is given, a philosophical concept is needed for this objective reality, and this concept has been worked out long, long ago. This concept is matter. Matter is a philosophical category denoting the objective reality which is given to man by his sensations, and which is copied, photographed and reflected by our sensations, while existing independently of them.

Lenin also explains that proper materialism must recognize objective/absolute truth:

To be a materialist is to acknowledge objective truth, which is revealed to us by our sense-organs. To acknowledge objective truth, i.e., truth not dependent upon man and mankind, is, in one way or another, to recognise absolute truth.

A failure to recognize the existence of such objective, absolute truth, according to Lenin, constitutes “relativism,” a position that all truth is relative and can never be absolutely, objectively knowable.

It is unconditionally true that to every scientific ideology (as distinct, for instance, from religious ideology), there corresponds an objective truth, absolute nature. You will say that this distinction between relative and absolute truth is indefinite. And I shall reply: yes, it is sufficiently ‘indefinite’ to prevent science from becoming a dogma in the bad sense of the term, from becoming something dead, frozen, ossified; but it is at the same time sufficiently ‘definite’ to enable us to dissociate ourselves in the most emphatic and irrevocable manner from fideism and agnosticism, from philosophical idealism and the sophistry of the followers of Hume and Kant. Here is a boundary which you have not noticed, and not having noticed it, you have fallen into the swamp of reactionary philosophy. It is the boundary between dialectical materialism and relativism.

In other words, while proper materialism must contain a degree of relativistic thinking sufficient to challenge assumptions and reexamine perceived truth periodically, materialists must not fall into complete relativism (such as that espoused by Hume and Kant) lest they fall into idealist positions. Ultimately, Absolute Truth — according to Lenin — constitutes the alignment of conscious understanding with objective reality (not to be confused with Hegel’s notion of Absolute Truth; see Annotation 232, p. 228).

Lenin recognized the development of Marx and Engels as “modern materialism, which is immeasurably richer in content and in comparably more consistent than all preceding forms of materialism,” in large part because Marx and Engels were able to apply materialism properly to social sciences by taking the “direct materialist road as against idealism.” He goes on to describe would-be materialists who fall to idealist positions due to relativism and other philosophical inadequacies as “a contemptible middle party in philosophy, who confuse the materialist and idealist trends on every question.”

Lenin warned that a failure to hold a thoroughly materialist viewpoint leads philosophers to become “ensnared in idealism, that is, in a diluted and subtle fideism; they became ensnared from the moment they took ‘sensation’ not as an image of the external world but as a special ‘element.’ It is nobody’s sensation, nobody’s mind, nobody’s spirit, nobody’s will — this is what one inevitably comes to if one does not recognise the materialist theory that the human mind reflects an objectively real external world.”

In other words, idealist conceptions of sensation inject mysticism into philosophy by conceiving of sensation as otherworldly, supernatural, and detached from material human beings with material experiences in the material world.

The development of natural sciences in the late 19^th century and early 20^th centuries (especially the inventions of Roentgen^[32], Becquerel^[33], Thomson^[34] etc.), disproved the theories of “classical elements” such as fire, water, air, etc. [see Primitive Materialism, p. 52]. These innovations led to a viewpoint crisis in the field of physical science. Many idealists used this opportunity to affirm the non-material nature of the world, ascribing the roles of supernatural forces to the birth of the world.

Annotation 59

Lenin discussed this viewpoint crisis extensively in Materialism and Empirio-Criticism. Here Lenin discusses relativist reactions to new breakthroughs in natural science, which led even scientists (who proclaimed to be materialists) to take idealist positions:

We are faced, says Poincaré [a French scientist], with the “ruins” of the old principles of physics, “a general debacle of principles.” It is true, he remarks, that all the mentioned departures from principles refer to infinitesimal magnitudes; it is possible that we are still ignorant of other infinitesimals counteracting the undermining of the old principles... But at any rate we have reached a “period of doubt.” We have already seen what epistemological deductions the author draws from this “period of doubt:” “it is not nature which imposes on [or dictates to] us the concepts of space and time, but we who impose them on nature;” “whatever is not thought, is pure nothing.” These deductions are idealist deductions. The breakdown of the most fundamental principles shows (such is Poincaré’s trend of thought) that these principles are not copies, photographs of nature, not images of something external in relation to man’s consciousness, but products of his consciousness. Poincaré does not develop these deductions consistently, nor is he essentially interested in the philosophical aspect of the question.

Lenin concludes by stating that the non-thorough materialist position has lead directly to these idealist positions of relativism:

The essence of the crisis in modern physics consists in the breakdown of the old laws and basic principles, in the rejection of an objective reality existing outside the mind, that is, in the replacement of materialism by idealism and agnosticism.

With this historical background, in order to fight against the distortions of many idealists and to protect the development of the materialist viewpoint, Vladimir Ilyich Lenin simultaneously summarized all the natural scientific achievements in late 19^th and early 20^th century and built upon Karl Marx and Friedrich Engels’ thought to develop this definition of matter:

“Matter is a philosophical category denoting objective reality which is given to man in his sensations, and which is copied, photographed, and reflected by our sensations, while existing independently of them.”

Lenin’s definition of matter shows that:

First, we need to distinguish between the definition of “matter” as a philosophical category (the category that summarizes the most basic and common attributes of all material existence, and which was defined with the objective of solving the basic issues of philosophy) from the definition of “matter” that was used in specialized sciences (specific and sense-detectable substance).

Second, the most basic, common attribute of all kinds of matter [and under both definitions listed in the previous paragraph] is objective existence, meaning matter exists outside of human consciousness, independently of human consciousness, no matter whether humans can perceive it with our senses or not.

Third, matter, with its specific forms, can cause and affect mental events in humans when it directly or indirectly impacts the human senses; human consciousness is the reflection of matter; matter is the thing that is reflected by human consciousness.

Lenin’s definition of matter played an important role in the development of materialism and scientific consciousness.

First, by pointing out that the most basic, common attribute of matter is objective existence, Lenin successfully distinguished the basic difference between the definition of matter as a philosophical category and the definition of matter as a category of specialized sciences. It helped solve the problems of defining matter in the previous forms of materialism; it offered scientific evidence to define what can be considered matter; it layed out a theoretical foundation for building a materialist viewpoint of history, and overcame the shortcomings of idealist conceptions of society.

Second, by asserting that matter was “objective reality,” “given to man in his sensations,” and “copied, photographed and reflected by our sensations,” Lenin not only confirmed the primary existence of matter and the secondary existence of consciousness [see The Relationship Between Matter and Consciousness, p. 88] but he also affirmed that humans had the ability to be aware of objective reality through the “copying, photographing and reflection of our sensations” [in other words, sense perceptions].

b. Mode and Forms of Existence of Matter

According to the dialectical materialist viewpoint, motion is the mode of existence of matter; space and time are the forms of existence of matter.

Annotation 60

Mode refers to the way or manner in which something occurs or exists. You can think of mode as pertaining to the “how,” as opposed to the “what.” For example, the mode of circulation refers to how commodities circulate within society [see Annotation 14, p. 16]; mode of production refers to how commodities are produced in society. So, mode of existence of matter refers to how matter exists in our universe.
Form comes from the category pair [see Basic Pairs of Categories of Materialist Dialectics, p. 126] of Content and Form [see p. 147]. Form refers to how we perceive objects, phenomena, and ideas. So, form of existence of matter refers to the ways in which we perceive the existence of matter [explained below] in our universe.

- Motion is the Mode of Existence of Matter

As Friedrich Engels explained: “Motion, in the most general sense, conceived as the mode of existence, the inherent attribute of matter, comprehends all changes and processes occurring in the universe, from mere change of place right up to thinking.”

According to Engels, motion encompasses more than just positional changes. Motion embodies “all the changes and processes happening in this universe;” matter is always associated with motion, and matter can only express its existence through motion.

Annotation 61

In Dialectical Materialist philosophy, “motion” is also known as “change” and it refers to the changes which occur as a result of the mutual impacts which occur in or between subjects through the negation of contradictions. Motion is a constant attribute of all things, phenomena, and ideas (see Characteristics of Development, p. 124).

Because matter is inseparable from motion (and vice versa), Engels defined motion as the mode of matter — the way or manner in which matter exists. It is impossible for matter in our universe to exist in completely static and unchanging state, isolated from the rest of existence; thus matter exists in the mode of motion. Over time, motion leads to development as things, phenomena, and ideas transition through various stages of quality change [see Annotation 117, p. 119].

Matter exists objectively, therefore motion also exists objectively. The motion of matter is self-motion^[35].

Annotation 62

It is important to note that “matter,” in the philosophical sense as used in dialectical materialist phlosophy, includes all that is “objective” (external) to individual human cosnciousness. This includes objective phenomena which human senses are unable to detect, such as objective social relations, objective economic values, etc. Objectiveness is discussed more in Annotation 108, p. 112; objective social relations are discussed more in Annotation 10, p. 10.

In Dialectics of Nature, Friedrich Engels discussed the properties of motion and explained that motion can neither be created nor destroyed. Therefore, motion can only change form or transfer from one object to another. In this sense, all objects are dynamically linked together through motion:

The whole of nature accessible to us forms a system, an interconnected totality of bodies, and by bodies we understand here all material existence extending from stars to atoms... In the fact that these bodies are interconnected is already included that they react on one another, and it is precisely this mutual reaction that constitutes motion. It already becomes evident here that matter is unthinkable without motion. And if, in addition, matter confronts us as something given, equally uncreatable as indestructible, it follows that motion also is as uncreatable as indestructible. It became impossible to reject this conclusion as soon as it was recognised that the universe is a system, an interconnection of bodies.

In other words, every body of matter is in motion relative to other bodies of matter, and thus matter is inseparable from motion. Motion results from the interaction of bodies of matter. Because motion and matter define each other, and because motion can only exist in relation to matter and matter can only exist in relation to motion, the motion of matter can be described as “self-motion,” because the motion is not created externally but exists only within and in relation to matter itself. Engels further explains that if this were not true — if motion were external to matter — then motion itself would have had to have been created external to matter, which is impossible:

To say that matter during the whole unlimited time of its existence has only once, and for what is an infinitesimally short period in comparison to its eternity, found itself able to differentiate its motion and thereby to unfold the whole wealth of this motion, and that before and after this remains restricted for eternity to mere change of place — this is equivalent to maintaining that matter is mortal and motion transitory. The indestructibility of motion cannot be merely quantitative, it must also be conceived qualitatively; matter whose purely mechanical change of place includes indeed the possibility under favourable conditions of being transformed into heat, electricity, chemical action, or life, but which is not capable of producing these conditions from out of itself, such matter has forfeited motion; motion which has lost the capacity of being transformed into the various forms appropriate to it may indeed still have dynamis but no longer energeia, and so has become partially destroyed. Both, however, are unthinkable.

So, motion can change forms and can transfer from one material body to another, but it can never be created externally from matter, and neither motion nor matter can be created or destroyed in our universe. Thus, matter exists in a state of “self-motion;” motion can never externally be created nor externally applied to matter.

To put it another way, motion results from the fact that all things, phenomena, and ideas exist as assemblages of relationships [see The Principle of General Relationships, p. 107], and these relationships contain opposing forces. As Lenin explained in his Philosophical Notebooks:

The condition for the knowledge of all processes of the world in their ‘self-movement,’ in their spontaneous development, in their real life, is the knowledge of them as a unity of opposites. Development is the ‘struggle’ of opposites.

Based on the scientific achievements which occurred in his lifetime, Engels classified motion into 5 basic forms: mechanical motion (changes in positions of objects in space); physical motion (movements of molecules, electrons, fundamental particles, thermal processes, electricity…); chemical motion (changes of organic and inorganic substances in combination and separation processes…); biological motion (changes of living objects, or genetic structure…); social motion (changes in economy, politics, culture, and social life).

These basic forms of motion are arranged into levels of advancement based on the level of complexity of matter that is affected.

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The basic forms of motion each affect different forms of matter, but these forms of motion do not exist independently from each other; they actually have strong relationships with each other, in which the more advanced forms of motion develop from lower forms of motion; the more advanced forms of motion also internally include lower forms of motion. [I.e., biological motion contains chemical motion; chemical motion contains physical motion; etc.]

Every object exists with many forms of motion, but any given object is defined by its most advanced form of motion. [I.e., living creatures are defined in terms of biological motion, societies are defined in terms of social motion, etc.]

By classifying the basic forms of motion, Engels laid out the foundation for classification and synthesization of science. The basic forms of motion differ from one another, but they are also unified with each other into one continuous system of motion. Understanding this dialectical relationship between different forms of motion helped to overcome misunderstandings and confusion about motion.

Annotation 63

In Dialectics of Nature, Engels clears up a great deal of confusion and addresses many misconceptions about matter, motion, forces, energy, etc. which existed in both science and philosophy at the time by defining and explaining the dialectical nature of matter and motion.

When Dialectical Materialism affirmed that motion was the mode of existence — the natural attribute of matter — it also confirmed that motion is absolute and eternal. This does not mean that Dialectical Materialism denies that things can become frozen; however, according to the dialectical materialist viewpoint, freezing is a special form of motion, it is motion in equilibrium and freezing is relative and temporary.

Motion in equilibrium is motion that has not changed the positions, forms, and/or structures of things.

Freezing is a relative phenomenon because freezing only occurs in some forms of motion and in some specific relations, it does not occur in all forms of motion and all kinds of relations. Freezing is a temporary phenomenon because freezing only exists for a limited period of time, it cannot last forever.

Annotation 64

Equilibrium can exist at any advancement of motion. Lenin discussed equilibrium as it pertains to the social form of motion in discussing an equilibrium of forces existing in Russia in 1905 in this article, An Equilibrium of Forces:

1) The result to date (Monday, October 30) is an equilibrium of forces, as we already pointed out in Proletary, No. 23.
2) Tsarism is no longer strong enough, the revolution not yet strong enough, to win.
3) Hence the tremendous amount of vacillation. The terrific and enormous increase of revolutionary happenings (strikes, meetings, barricades, committees of public safety, complete paralysis of the government, etc.), on the other hand, the absence of resolute repressive measures. The troops are wavering.
4) The Tsar’s Court is wavering (The Times and the Daily Telegraph) between dictatorship and a constitution.
The Court is wavering and biding its time. Strictly speaking, these are its correct tactics: the equilibrium of forces compels it to bide its time, for power is in its hands.
The revolution has reached a stage at which it is disadvantageous for the counter-revolution to attack, to assume the offensive.
For us, for the proletariat, for consistent revolutionary democrats, this is not enough. If we do not rise to a higher level, if we do not manage to launch an independent offensive, if we do not smash the forces of Tsarism, do not destroy its actual power, then the revolution will stop half way, then the bourgeoisie will fool the workers.
5) Rumour has it that a constitution has been decided upon. If that is so, then it follows that the Tsar is heeding the lessons of 1848 and other revolutions: he wants to grant a constitution without a constituent assembly, before a constituent assembly, apart from a constituent assembly. What kind of constitution? At best (for ’the Tsar) a Constitutional-Democratic constitution.
This implies: achievement of the Constitutional-Democrats’ ideal, skipping the revolution; deceiving the people, for all the same there will be no complete and actual freedom of elections.
Should not the revolution skip this granted constitution?

- Space and Time are Forms of Existence of Matter

Every form of matter exists in a specific position, with specific space particularity (height, width, length, etc.), in specific relation (in front or behind, above or under, to the left or right, etc.) with other forms of matter. These positional relations exist in what we call space. [Space is defined by positional relations of matter.]

On the other hand, the existence of matter is also expressed in the speed of change and the order in which changes occur. These changes occur in what we call time. As Engels wrote: “For the basic forms of all existence are space and time, and a being outside of time is as absurd as an existence outside space.” Matter, space, and time are not separable; there is no matter that exists outside of space and time; there is also no space and time that exist outside of matter’s motion.

Annotation 65

Space and time, as the forms of matter, i.e.: the ways in which we perceive the existence of matter. We are only able to perceive and understand material objects as they exist within space and time.

Space and time, as forms of existence of matter, exist objectively [see Annotation 108,

p. 112], and are defined by matter. [Space is defined by the positional relations between material objects; time is defined by the speed of change of material objects and the order in which these changes occur.] Space has three dimensions: height, width, length; time has one direction: from the past to the future.

c. The Material Unity of the World

Dialectical Materialism affirms that the nature of the world is matter, and the world is unified in its material properties. [In other words: the entire universe, in all its diversity, is made of matter, and the properties of matter are the same throughout the known universe.]

The material nature of the world is proven on the following basis:

First, there is only one world: the material world; the material world is the first existence [i.e., it existed before consciousness], it exists objectively, and independently, of human consciousness.

Second, the material world exists eternally, endlessly, infinitely; it has no known beginning point and there is no evidence that it will ever disappear.

Third, all known objects and phenomena of the material world have objective relations with each other and all objects and phenomena exist in unity with each other. All of them are specific forms and structures of matter, or have material origin which was born from matter, and all are governed by the objective rules of the material world. In the material world, there is nothing that exists outside of the changing and transforming processes of matter; all of these processes exist as causes and effects of each other.

Annotation 66

The most important thing to understand here is that every object and phenomenon in the universe arises as matter, all material objects and phenomena are dynamically linked to one another in an infinite chain of causes and effects and changes and transformations, all governed by the material laws of our reality. This understanding is the material foundation of dialectical materialism.

2. Consciousness

a. The Source of Consciousness

According to the materialist viewpoint, consciousness has natural and social sources.

Annotation 67

Consciousness arises from nature, and from social activities and relations.

Natural refers to the material world. Without the material world of matter, material processes, and the evolution of material systems — up to and including the human brain — consciousness would never have formed.

Social activities and relations also contributed to the development of consciousness. The social processes of labor and language were also prerequisites for the development of conscious activity in human beings.

- Natural Source of Consciousness

There are many factors that form the natural sources for consciousness, but the two most basic factors are human brains and the relationship between humans and the objective world which makes possible creative and dynamic reflection.

About human brains: consciousness is an attribute of a highly organized form of matter, which is the brain. Consciousness is the function and the result of the neurophysiological activities of human brains. As human brains evolved and developed over time, their neurophysiological activities became richer, and, as these activities progressed, consciousness developed further and further over time. This explains why the human evolution process is also a process of developing the capacity for perception and thinking. Whenever human neurophysiological activities don’t function normally because of damaged brains, our mental life is also disturbed.

About the relationship between humans and the objective world which made possible creative and dynamic reflection: The relationship between humans and the objective world has been essential for as long as humans have existed. In this relationship, the objective world is reflected through human senses which interact with human brains and then form our consciousness.

Consciousness exists as a dynamic set of relationships between the external material world, human sense perception, and the functions of the human brain.

Reflection is the re-creation of the features of one form of matter in a different form of matter which occurs when they mutually impact each other through interaction. Reflection is a characteristic of all forms of matter.

There are many forms and levels of reflection such as [from more simple to more complex]: physical and chemical reflection, biological reflection, mental reflection, creative and dynamic reflection, etc.

Annotation 68

Change is driven by mutual impacts between or within things, phenomena, and/or ideas. Any time two such subjects impact one another, traces of some form or another are left on both interacting subjects. This characteristic of change is called reflection.

The concept of reflection, first proposed by Marx, Engels, and Lenin, has been advanced through the work of various Soviet psychologists, philosophers, and scientists (including Ivan Pavlov, Todor Pavlov, Aleksei Leontiev, Lev Vygotsky, Valentin Voloshinov, and others), and is used as a basis for scientific inquiry up to this day by mainstream researchers in Cuba, Vietnam, China, and Laos. The information provided below is somewhat simplified and generalized to give the reader a basic familiarity with the theory of reflection and the development of reflection in nature.

Dialectical materialist scientists have developed a theory of the development of evolution of forms of reflection, positing that forms of reflection have become increasingly complex as organic processes and life have evolved and grown more complex over time.

The chart below gives an idea of how different forms of reaction have evolved over time:

This chart outlines the basic development tendency of Forms of Reflection in matter which lead from inorganic matter, to life, to human consciousness and society.

Obviously, not all subjects develop completely along the path outlined above. Thus far, to our knowledge, only human beings have developed entirely to the level of consciousness and society. It is also unknown whether, or how, human society may develop into some future, as-yet-unknown, form.

Physical and chemical reflection is the simplest form of reflection, dealing with the ways in which inorganic matter is reflected in human consciousness. Physical and chemical reflection is the reflection of mechanical, physical, and chemical changes and reactions of inorganic matter (i.e., changes in structures, positions, physical-chemical properties, and the processes of combining and dissolving substances). Physical and chemical reactions are passive: when two objects interact with each other physically or chemically, they do not do so consciously.

Annotation 69

Reflection occurs any time two material objects interact and the features of the object are transferred to each other. Below are some very simplified illustrations to relate the basic idea of the physical reflection of material objects.

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Reflection as Change in Position:

1. Round Object moves towards Square Object.

2. Round Object impacts Square Object.

3. Square Object changes position; Round Object “bounces” and reverses direction.

4.Thus, Square Object’s change in position reflects the motion of Round Object (and vice-versa). Traces of both contradicting objects are reflected in the respective motion and position of each object.

File:T-w-the-worldview-and-philosophical-methodology-of-12.png

Reflection as Change in Structure:

1. Round Object moves toward Square Object.

2. Round Object impacts Square Object.

3. Structural changes (traces) occur in both Round and Square Object as a result of impact.

4. These changes constitute structural, physical reflection.

File:T-w-the-worldview-and-philosophical-methodology-of-13.png

Chemical Reflection:

1. Atom C is attached to Atom B.

2. Atom C detaches from Atom B and transfers to attach to Atom A.

3. This is a process of chemical reflection, in which both molecules mutually reflect one another after A _CB a process of chemical reaction (one molecule loses Atom C while the other gains Atom C).

As dialectical materialists, we must strive to develop our understanding of the reflections of physical and chemical changes and reactions so that our conceptions reflect the material world as accurately as possible. For example: we must not ascribe consciousness to physical processes. Example: a gambler who comes to believe that a pair of dice is “spiteful” or “cursed” is attributing conscious motivation to unconscious physical processes, which is an inaccurate ideological reflection of reality.

Biological reflection is a higher, more complex form of reflection [compared to physical reflection]. It deals with reflection of organic material in the natural world. As our observations of biological processes have become more sophisticated and complex [through developments in natural science, the development of better tools for observation such as microscopes and other technologies, and so on], our conscious reflections of the natural world have also become more complex.

Biological reflection is expressed through excitation, induction, and reflexes.

Excitation is the reaction of simple plant and animal life-forms which occurs when they change position or structure as a direct result of physical changes to their habitat [i.e., a plant which moves toward the sun throughout the day].

Induction is the reaction of animals with simple nerve systems which can sense or feel their environments. Induction occurs through unconditioned reflex mechanisms.

Annotation 70

Unconditioned reflexes are characterized by permanent connections between sensory perceptions and reactions. Such reactions are not learned, but simply occur automatically based on physiological mechanisms occurring within the organism. An example of an unconditioned reflex response would be muscles in the leg twitching at the response of a tap on the knee. Such responses are purely physiological and are never learned (“conditioned” into us) — these reactions are simply induced physiologically.

Mental reflections are reactions which occur in animals with central nervous systems. Mental reflections occur through conditioned reflex mechanisms.

Annotation 71

Conditioned reflexes are reactions which are learned by organisms. These responses are acquired as animals learn to associate previously unrelated neural stimuli to elicit a particular reaction. The Russian psychologist Ivan Pavlov famously developed our understanding of conditioned responses by ringing a dinner bell shortly before giving dogs food. After a few repetitions, dogs would begin to salivate upon hearing the dinner bell being rung, even before any food was offered. Any dog which did not receive this conditioning would not salivate upon hearing a dinner bell. This is what makes it a learned, conditioned response — a type of mental reflection.

Dynamic and creative reflection is the most advanced form of reflection. It only occurs in matter that has the highest structural level, such as the human brain. Dynamic and creative reflection is done through the human brain’s nervous physiological activities whenever the objective world impacts human senses. This is a kind of reflection that actively selects and processes information to create new information and to understand the meaning of that information. This dynamic and creative reflection is called consciousness.

Annotation 72

Remember Lenin’s definition of matter from Materialism and Empirio-Criticism: “Matter is a philosophical category denoting objective reality which is given to man in his sensations, and which is copied, photographed, and reflected by our sensations, while existing independently of them.”

An intrinsic property of matter is that it can be sensed by human beings, and through this sensation, reflected in human consciousness. Thus, all forms of matter share the characteristic of being able to be reflected in the human mind.

Criticizing Karl Pearson, who said that it was not logical to maintain that all matter had the property of being conscious, Lenin wrote in brackets: “But it is logical to suppose that all matter possesses a property which is essentially kindred to sensation: the property to reflect.” Understanding the concept of dynamic and creative reflection is critical to understanding the role of consciousness and the ideal in Dialectical Materialism. In particular, reflection differentiates Dialectical Materialism from the idealist form of dialectics used by Hegel [see Annotation 9, p. 10]. As Marx famously wrote in Capital Volume I:

My dialectic method is not only different from the Hegelian, but is its direct opposite. To Hegel, the life process of the human brain, i.e., the process of thinking, which, under the name of ‘the Idea,’ he even transforms into an independent subject, is the demiurgos [craftsman/artisan/creator] of the real world, and the real world is only the external, phenomenal form of ‘the Idea.’ With me, on the contrary, the ideal is nothing else than the material world reflected by the human mind, and translated into forms of thought.

In other words, Hegelian idealism saw human consciousness as defining the material world. Dialectical Materialism inverts this relationship to recognize that what we conceive in our minds is only a reflection of the material world. As Marx explains in The German Ideology, all conscious thought stems from life processes through reflection:

Consciousness can never be anything else than conscious existence, and the existence of men is their actual life-process. If in all ideology men and their circumstances appear upside-down as in a camera obscura, this phenomenon arises just as much from their historical life-process as the inversion of objects on the retina does from their physical life-process.

Marx and Engels argued that consciousness arose from the life-processes of human beings. Life-processes are processes of motion and change which occur within organisms to sustain life, and these processes have a dialectical relationship with consciousness: the processes of life, therefore, reflect consciousness, just as consciousness reflects human life-processes. Conscious activities (such as being able to hunt, gather, and cook food, build shelter, and so on) improve the life-processes of human beings (by improving our health, extending our life-spans, etc.); and as our life-processes improved, our consciousness was able to develop more fully. As a concrete example of the dialectic between life processes and consciousness, it is now widely believed by scientists that the advent of cooking and preparing food (conscious activity) improved the functioning of the human brain^[36] (a life process) which, in turn, developed human consciousness, and so on. Life-processes thus determine how consciousness reflects reality, while consciousness impacts back on life-processes, reflecting the dialectical relationship between matter and consciousness [see p. 88] and between practical activities and consciousness [see Annotation 230, p. 226].

Because consciousness arose from life-processes of human beings in the material world, we know that the material world is reflected in our consciousness. However, these reflections do not determine the material world, and do not mirror the material world exactly [see Annotation 77, p. 79]. It is also important to understand that, since life-processes in the material world predate and determine consciousness, consciousness can never be a first basis of seeking truth about our world. As Marx further explains in The German Ideology:

Since the Young Hegelians consider conceptions, thoughts, ideas, in fact all the products of consciousness, to which they attribute an independent existence, as the real chains of men (just as the Old Hegelians declared them the true bonds of human society) it is evident that the Young Hegelians have to fight only against these illusions of consciousness. Since, according to their fantasy, the relationships of men, all their doings, their chains and their limitations are products of their consciousness, the Young Hegelians logically put to men the moral postulate of exchanging their present consciousness for human, critical or egoistic consciousness, and thus of removing their limitations. This demand to change consciousness amounts to a demand to interpret reality in another way, i.e. to recognise it by means of another interpretation.

In other words, Hegelian idealism makes the critical mistake of believing that the ideal — consciousness — is the first basis of reality, and that anything and everything can be achieved through mere conscious activity. Marx, on the other hand, argues that “life is not determined by consciousness, but consciousness by life,” and that we must understand the ways in which reality is reflected in consciousness before we can hope to affect change in the material conditions of human beings:

In direct contrast to German philosophy which descends from heaven to earth, here [in the materialist perspective] we ascend from earth to heaven. That is to say, we do not set out from what men say, imagine, conceive, nor from men as narrated, thought of, imagined, conceived, in order to arrive at men in the flesh. We set out from real, active men, and on the basis of their real life-process we demonstrate the development of the ideological reflexes and echoes of this life-process. The phantoms formed in the human brain are also, necessarily, sublimates of their material life-process, which is empirically verifiable and bound to material premises. Morality, religion, metaphysics, all the rest of ideology and their corresponding forms of consciousness, thus no longer retain the semblance of independence. They have no history, no development; but men, developing their material production and their material intercourse, alter, along with this their real existence, their thinking and the products of their thinking. Life is not determined by consciousness, but consciousness by life. In the first method of approach the starting-point is consciousness taken as the living individual; in the second method, which conforms to real life, it is the real living individuals themselves, and consciousness is considered solely as their consciousness.

So, the work of the Dialectical Materialist is not to try to develop Utopian conceptions of reality first, to then proceed to try and force such purely ideal conceptions onto reality (see Annotation 17, p. 18).

Rather, we must understand the material basis of reality, as well as the material processes of change and motion which govern reality, and only then can we search for ways in which human beings can influence material reality through conscious activity. As Marx explains, the revolutionary must not be fooled into believing we can simply conceive of an ideal world and then replicate it into reality through interpretation and conscious thought alone. Instead, we must start with a firm understanding of material conditions and, from that material basis, determine how to build our revolutionary movement through conscious impact of material relations and processes of development in the material world.

As Marx wrote in The German Ideology: “Communism is for us not a state of affairs which is to be established, an ideal to which reality [will] have to adjust itself. We call communism the real movement which abolishes the present state of things. The conditions of this movement result from the premises now in existence.” This distinction may seem subtle at first, but it has massive implications for how Marx suggests we go about participating in revolutionary activity. For Marx, purely-idealist debates and criticisms are an unproductive waste of time:

The Young-Hegelian ideologists, in spite of their allegedly ‘world-shattering’ statements, are the staunchest conservatives. The most recent of them have found the correct expression for their activity when they declare they are only fighting against ‘phrases.’ They forget, however, that to these phrases they themselves are only opposing other phrases, and that they are in no way combating the real existing world when they are merely combating the phrases of this world. The only results which this philosophic criticism could achieve were a few (and at that thoroughly one-sided) elucidations of Christianity from the point of view of religious history; all the rest of their assertions are only further embellishments of their claim to have furnished, in these unimportant elucidations, discoveries of universal importance.

Marx also discusses the uselessness of idealist conjecture:

Moreover, it is quite immaterial what consciousness starts to do on its own: out of all such muck we get only the one inference that these three moments, the forces of production, the state of society, and consciousness, can and must come into contradiction with one another, because the division of labour implies the possibility, nay the fact that intellectual and material activity — enjoyment and labour, production and consumption — devolve on different individuals, and that the only possibility of their not coming into contradiction lies in the negation in its turn of the division of labour. It is self-evident, moreover, that ‘spectres,’ ‘bonds,’ ‘the higher being,’ ‘concept,’ ‘scruple,’ [terms for idealist conceptions] are merely the idealistic, spiritual expression, the conception apparently of the isolated individual, the image of very empirical fetters and limitations, within which the mode of production of life and the form of intercourse coupled with it move.

What Marx means by this is that we should focus on the material processes and conditions of society if we intend to change society, because idealist speculation, conjecture, critique, and thought alone, at the individual level, will never be capable of affecting revolutionary change in our material world.

Instead, we must focus on the material basis of reality, the material conditions of society, and seek revolutionary measures which are built upon materialist foundations. Only by understanding material processes of development, as well as the dialectical relationship between consciousness and matter, can we reliably and effectively begin to impact reality through conscious activity. This begins with the recognition that conscious thought itself is a reflection of material reality which developed and results from life-processes of material motion and processes of change within the human brain.

This concept of reflection, pioneered by Marx and Engels, was significantly developed by V. I. Lenin in his response to Machian positivists who posited that what we perceive is not truly reality [see Annotation 32, p. 27]. In his Philosophical Notebooks, Lenin wrote: “Life gives rise to the brain. Nature is reflected in the human brain.”

In Materialism and Empirio-Criticism, Lenin further defined the relationship between matter and consciousness through reflection.

LENIN’S PROOF OF THE THEORY OF REFLECTION

In Materialism and Empirio-Criticism, Lenin offered the following arguments to back up the theory of reflection.

1) Things exist independently of our consciousness, independently of our perceptions, outside of us, for it is beyond doubt that alizarin [a chemical substance which was newly discovered at time of writing] existed in coal tar yesterday and it is equally beyond doubt that yesterday we knew nothing of the existence of this alizarin and received no sensations from it.

Lenin is saying that the material world must exist outside of and independent from our consciousness. He cites as evidence the discovery of a chemical substance which until recently we had no sensory perception of, noting that this substance must have existed long before we became aware of it through sensory observation.

2) There is definitely no difference in principle between the phenomenon and the thing-in-itself, and there can be no such difference. The only difference is between what is known and what is not yet known. And philosophical inventions of specific boundaries between the one and the other, inventions to the effect that the thing-in-itself is “beyond” phenomena (Kant) or that we can or must fence ourselves off by some philosophical partition from the problem of a world which in one part or another is still unknown but which exists outside us (Hume) — all this is the sheerest nonsense, [unfounded belief], trick, invention.

Lenin is referencing a centuries-old debate about whether or not human beings are capable of having real knowledge of a “thing-in-itself,” or if we can only perceive phenomena of things (characteristics observable to our senses). The “thing-in-itself” refers to the actual material object which exists outside of our consciousness. So the question being posed is: can we REALLY have knowledge of material objects outside of our consciousness, or does consciousness itself act as a barrier to ever REALLY knowing anything about material objects and the material world outside of our consciousness?

Immanuel Kant argued that we can never know the true nature of the material world, writing: “we indeed, rightly considering objects of sense as mere appearances, confess thereby that they are based upon a thing-in-itself, though we know not this thing as it is in itself, but only know its appearances, viz., the way in which our senses are affected by this unknown something.” This idea that the senses could not be trusted to deliver accurate knowledge — and thus, the “thing-in-itself” is essentially unknowable — was carried forward by later empiricists such as Bacon and Hume [see Annotation 10, p. 10]. In Ludwig Feuerbach and the End of Classical German Philosophy, Marx and Engels refute this notion, arguing that practice allows us to discover truth about “things-in-themselves:”

The most telling refutation of this as of all other philosophical crotchets is practice — namely, experiment and industry. If we are able to prove the correctness of our conception of a natural process by making it ourselves, bringing it into being out of its conditions and making it serve our own purposes into the bargain, then there is an end to the Kantian ungraspable “thing-in-itself”.

Lenin expanded on this argument, explaining that the phenomena of objects which we observe with our senses do accurately reflect material objects, even though we might not know everything about these objects at once. Over time, as we learn more and more about material objects and the material world through practice and repeated observation, we more fully and accurately come to understand “things-in-themselves, as he writes in Empirio-Criticism and Materialism:

3) In the theory of knowledge, as in every other branch of science, we must think dialectically, that is, we must not regard our knowledge as readymade and unalterable, but must determine how knowledge emerges from ignorance, how incomplete, inexact knowledge becomes more complete and more exact.

Here, Lenin further elaborates on the dialectical nature of knowledge: we must simultaneously accept that our knowledge is never perfect and unchanging, but we must also recognize that we are capable of making our knowledge more exact and complete over time. To further defend his ideas about reflection, Lenin cited Czech philosopher Karl Kautsky’s argument against Kant:

That I see green, red and white is grounded in my faculty of sight. But that green is something different from red testifies to something that lies outside of me, to real differences between the things... The relations and differences between the things themselves revealed to me by the individual space and time concepts are real relations and differences of the external world, not conditioned by the nature of my perceptive faculty... If this were really so [i.e., if Kant’s doctrine of the ideality of time and space were true], we could know nothing about the world outside us, not even that it exists.

Lenin followed from Marx and Engels that, in order to further develop our understanding and knowledge of the material world, it was necessary to engage in practice [see Annotation 211, p. 205]. Engels wrote in Socialism: Utopian and Scientific:

The proof of the pudding is in the eating. From the moment we [use] these objects, according to the qualities we perceive in them, we put to an infallible test the correctness or otherwise of our sense-perceptions. If these perceptions have been wrong, then our estimate of the use to which an object can be turned must also be wrong, and our attempt must fail. But if we succeed in accomplishing our aim, if we find that the object does agree with our idea of it, and does answer the purpose we intended it for, then that is positive proof that our perceptions of it and of its qualities, so far, agree with reality outside ourselves.

Notice that Engels is careful to use the words so far: “its qualities, so far, agree with reality outside ourselves.” Engels does not argue that human understanding of the material world is infallible: mistakes are often made. But over time, as such mistakes are discovered and our understanding improves, our knowledge of the material world develops. This is only possible if the phenomena of objects which we observe — the reflections within our consciousness — do actually and accurately represent material reality. Lenin elaborated on this necessity to constantly update and improve dialectical materialist philosophy as new information and knowledge became available:

Engels, for instance, assimilated the, to him, new term, energy, and began to employ it in 1885 (Preface to the 2^nd ed. of Anti-Dühring) and in 1888 (Ludwig Feuerbach), but to employ it equally with the concepts of ‘force’ and ‘motion,’ and along with them. Engels was able to enrich his materialism by adopting a new terminology.

Engels provided further elaborations on how practical experience and mastery of the material world refutes the notion that it is impossible to have real knowledge of the material world in Ludwig Feuerbach and the End of Classical German Philosophy:

The most telling refutation of this as of all other philosophical fancies is practice, viz., experiment and industry. If we are able to prove the correctness of our conception of a natural process by making it ourselves, bringing it into being out of its conditions and using it for our own purposes into the bargain, then there is an end of the Kantian incomprehensible or ungraspable... The chemical substances produced in the bodies of plants and animals remained just such thingsin-themselves until organic chemistry began to produce them one after another, whereupon the thing-in-itself became a thing for us, as for instance, alizarin [a dye which was originally plant-based], which we no longer trouble to grow in in the field, but produce much more cheaply and simply from coal tar.

So, dialectical materialism holds that there is a material world external from our consciousness; that conscious thoughts are reflections of this material world; that we can have real knowledge of the material world through sensory observation; and that our knowledge and understanding of the material world is best advanced through practice in the material world.

- Social Sources of Consciousness

There are many factors that constitute the social sources of consciousness. The most basic and direct factors are labor and language.

Labor is the process by which humans interact with the natural world in order to make products for our needs of existing and developing. Labor is also the process that changes the human body’s structure [i.e., muscles developing through exercise].

Annotation 73

In Dialectics of Nature, Engels describes the dialectical relationship between labor and human development:

Labour is the source of all wealth, the political economists assert. And it really is the source — next to nature, which supplies it with the material that it converts into wealth. But it is even infinitely more than this. It is the prime basic condition for all human existence, and this to such an extent that, in a sense, we have to say that labour created man himself.
Before the first flint could be fashioned into a knife by human hands, a period of time probably elapsed in comparison with which the historical period known to us appears insignificant. But the decisive step had been taken, the hand had become free and could henceforth attain ever greater dexterity; the greater flexibility thus acquired was inherited and increased from generation to generation.
Thus the hand is not only the organ of labour, it is also the product of labour. Only by labour, by adaptation to ever new operations, through the inheritance of muscles, ligaments, and, over longer periods of time, bones that had undergone special development and the ever-renewed employment of this inherited finesse in new, more and more complicated operations, have given the human hand the high degree of perfection required to conjure into being the pictures of a Raphael, the statues of a Thorwaldsen, the music of a Paganini.
But the hand did not exist alone, it was only one member of an integral, highly complex organism. And what benefited the hand, benefited also the whole body it served.

Labor also allows us to discover the attributes, structures, motion laws, etc., of the natural world, via observable phenomena.

Annotation 74

We discover truth about the natural world through labor — through physical practice in the material world. See the discussion of practice in Annotation 211, p. 205.

All of these phenomena, through our human senses, impact our human brains. And through brain activity, knowledge and consciousness of the objective world are formed and developed.

Language is a system of material signals that carries information with cognitive content. Without language, consciousness could not exist and develop.

The birth of language goes hand in hand with labor. From the beginning, labor was social. The relationships between people who perform labor processes require them to have means to communicate and exchange thoughts. This requirement caused language to arise and develop along with the working processes. With language, humans not only communicate, but also summarise reality and convey experience and thoughts from generation to generation.

Annotation 75

From Dialectics of Nature:

It has already been noted that our simian ancestors were gregarious; it is obviously impossible to seek the derivation of man, the most social of all animals, from non-gregarious immediate ancestors. Mastery over nature began with the development of the hand, with labour, and widened man’s horizon at every new advance. He was continually discovering new, hitherto unknown properties in natural objects. On the other hand, the development of labour necessarily helped to bring the members of society closer together by increasing cases of mutual support and joint activity, and by making clear the advantage of this joint activity to each individual. In short, men in the making arrived at the point where they had something to say to each other. Necessity created the organ; the undeveloped larynx of the ape was slowly but surely transformed by modulation to produce constantly more developed modulation, and the organs of the mouth gradually learned to pronounce one articulate sound after another.
Comparison with animals proves that this explanation of the origin of language from and in the process of labour is the only correct one. The little that even the most highly-developed animals need to communicate to each other does not require articulate speech. In its natural state, no animal feels handicapped by its inability to speak or to understand human speech. It is quite different when it has been tamed by man. The dog and the horse, by association with man, have developed such a good ear for articulate speech that they easily learn to understand any language within their range of concept. Moreover they have acquired the capacity for feelings such as affection for man, gratitude, etc., which were previously foreign to them. Anyone who has had much to do with such animals will hardly be able to escape the conviction that in many cases they now feel their inability to speak as a defect, although, unfortunately, it is one that can no longer be remedied because their vocal organs are too specialised in a definite direction. However, where vocal organs exist, within certain limits even this inability disappears. The buccal organs of birds are as different from those of man as they can be, yet birds are the only animals that can learn to speak; and it is the bird with the most hideous voice, the parrot, that speaks best of all. Let no one object that the parrot does not understand what it says. It is true that for the sheer pleasure of talking and associating with human beings, the parrot will chatter for hours at a stretch, continually repeating its whole vocabulary. But within the limits of its range of concepts it can also learn to understand what it is saying. Teach a parrot swear words in such a way that it gets an idea of their meaning (one of the great amusements of sailors returning from the tropics); tease it and you will soon discover that it knows how to use its swear words just as correctly as a Berlin costermonger. The same is true of begging for titbits.
First labour, after it and then with it speech — these were the two most essential stimuli under the influence of which the brain of the ape gradually changed into that of man, which, for all its similarity is far larger and more perfect. Hand in inevitably accompanied by a corresponding refinement of the organ of hearing, so the development of the brain as a whole is accompanied by a refinement of hand with the development of the brain went the development of its most immediate instruments — the senses. Just as the gradual development of speech is all the senses. The eagle sees much farther than man, but the human eye discerns considerably more in things than does the eye of the eagle. The dog has a far keener sense of smell than man, but it does not distinguish a hundredth part of the odours that for man are definite signs denoting different things. And the sense of touch, which the ape hardly possesses in its crudest initial form, has been developed only side by side with the development of the human hand itself, through the medium of labour.

So, the most basic, direct and important source that decides the birth and development of language is labor. Language appeared later than labor but always goes with labor. Language and labor were the two main stimulations affecting the brains of the primates which evolved into humans, slowly changing their brains into human brains and transforming animal psychology into human consciousness.

This diagram is based on work from an article titled “Evidence in Hand: Recent Discoveries and the Early Evolution of Human Manual Manipulation[37].”Modern research has discovered strong evidence[38] that the human hand evolved along with tool use, in line with Engels’ analysis in Dialectics of Nature.

Annotation 76

It is also worth noting that, just as human consciousness derived from labor and language and social activity, so too did society itself arise from language and labor, as Engels explained in Dialectics of Nature:

The reaction on labour and speech of the development of the brain and its attendant senses, of the increasing clarity of consciousness, power of abstraction and of conclusion, gave both labour and speech an ever-renewed impulse to further development. This development did not reach its conclusion when man finally became distinct from the ape, but on the whole made further powerful progress, its degree and direction varying among different peoples and at different times, and here and there even being interrupted by local or temporary regression. This further development has been strongly urged forward, on the one hand, and guided along more definite directions, on the other, by a new element which came into play with the appearance of fully-fledged man, namely, society.

In other words, these factors of human’s physical nature and human society have a dialectical relationship with one another. Elements of human nature — in particular labor and language — led to the development of human society, which in turned played a key role in the development of human language and labor.

Human language and human labor mutually develop one another through a dialectical process to develop human nature. Simultaneously, human nature and human society mutually develop one another through a dialectical process.

Elements of human nature — in particular labor and language — led to the development of human society, which in turned played a key role in the development of human language and labor.

b. Nature and Structure of Consciousness

- Nature of Consciousness

Consciousness is the dynamic and creative reflection of the objective world in human brains; it is the subjective image of the objective world. [See discussion of dynamic and creative reflection on p. 68]

The dynamic and creative nature of reflection is expressed in human psycho-physiological activities when we receive, select, process, and save data in our brains. Within the human brain, we are able to collect data from the external material world. Based on this information, our brain is capable of creating new information, and we are able to analyze, interpret, and understand all of this information collectively within our consciousness.

The dynamic and creative nature of reflection is also expressed in several human processes:

The creation of ideas, hypotheses, stories, etc.
The ability to summarize nature and to comprehend the objective laws of nature.
The ability to construct models of ideas and systems of knowledge to guide our activities.

Consciousness is the subjective image of the objective world. Consciousness is defined by the objective world in both Content and Form [see Annotation 150, p. 147]. However, consciousness does not perfectly reflect the objective world. It modifies information through the subjective lenses (thoughts, feelings, aspirations, experiences, knowledge, needs, etc.) of humans. According to Marx and Engels, ideas are simply “sublimates [transformations] of [the human brain’s]... material life-process, which is empirically verifiable and bound to material premises.”^[39]

Annotation 77

In The German Ideology, Marx and Engels refer to ideas somewhat poetically as “the phantoms formed in the human brain,” and explains that ideas arise directly from material human life processes [see Annotation 72, p. 68]. Lenin makes it very clear in Materialism and Empirio-Criticism that consciousness is not a mirror image, or exact reproduction of reality, quoting Engels:

The great basic question of all philosophy,” Engels says, “especially of modern philosophy, is that concerning the relation of thinking and being,” of “spirit and nature.” Having divided the philosophers into “two great camps” on this basic question, Engels shows that there is “yet another side” to this basic philosophical question, viz., “in what relation do our thoughts about the world surrounding us stand to this world itself? Is our thinking capable of the cognition of the real world? Are we able in our ideas and notions of the real world to produce a correct reflection of reality?” “The overwhelming majority of philosophers give an affirmative answer to this question,” says Engels, “including under this head not only all materialists but also the most consistent idealists.

Of extra importance is Lenin’s footnote to the above passage, regarding what he purports to be Viktor Chernov’s mistranslation of Engels:

Fr. Engels, Ludwig Feuerbach, etc., 4^th Germ. ed., S. 15. Russian translation, Geneva ed., 1905, p. 12–13. Mr. V. Chernov translates the word Spiegelbild literally (a mirror reflection) accusing Plekhanov of presenting the theory of Engels “in a very weakened form” by speaking in Russian simply of a “reflection” instead of a “mirror reflection”. This is mere cavilling. Spiegelbild [mirror reflection] in German is also used simply in the sense of Abbild [reflection, image].

Here, Lenin reaffirms and clarifies Engels’ idea that consciousness is not a perfect, exact duplicate of reality; not a “mirror image.” This, however, does not contradict the fact that we can obtain real knowledge of the real world in our consciousness, and that this knowledge improves over time through practice and observation. Indeed, Lenin’s passage on practice cited first in this annotation directly follows the above passage in Materialism and Empirio-Criticism.

See: Natural Source of Consciousness, p. 64, and Annotation 32, 27.

Consciousness is a social phenomenon and has a social nature. Consciousness arose from real life activities. Consciousness is always ruled by natural law and by social law.

Annotation 78

Natural law includes the laws of physics, chemistry, and other natural phenomena which govern the material world. Consciousness itself can never violate natural law as it arises from the natural processes of the natural world.

Social law includes the objective and universal relationships between social phenomena and social processes. Human society was created through labor, and this labor was performed in very specific material relations between humans and the natural world.

Note: social law is a key concept of historical materialism, which is the topic of Part 2 of the textbook from which this entire text has been translated, which we hope to translate in the future.

In A Contribution to the Critique of Political Economy, Marx explains how social existence and social laws govern the consciousness of individuals:

In the social production of their existence, men inevitably enter into definite relations, which are independent of their will, namely relations of production appropriate to a given stage in the development of their material forces of production. The totality of these relations of production constitutes the economic structure of society, the real foundation, on which arises a legal and political superstructure and to which correspond definite forms of social consciousness. The mode of production of material life conditions the general process of social, political and intellectual life. It is not the consciousness of men that determines their existence, but their social existence that determines their consciousness.

Consciousness is determined by the social communication needs of human beings as well as the material conditions of reality.

Annotation 79

The term material conditions refers to the external environment which humans inhabit. Material conditions include the natural environment, the means of production and the economic base^[40] of human society, and other objective externalities and systems which affect human life and society. Note that material conditions don’t refer to physical matter alone, but also include objective social relations and phenomena. In A Contribution to the Critique of Political Economy, Marx argues that “neither legal relations nor political forms could be comprehended whether by themselves or on the basis of a so-called general development of the human mind, but that on the contrary they originate in the material conditions of life.”

Consciousness is dynamic in nature, constantly learning and changing flexibly. Consciousness guides humans to transform the material world to suit our needs.

Annotation 80

Consciousness and material conditions have a dialectical relationship with one other, just as the base of society and the superstructure have a dialectical relationship with one other [see Annotation 29, p. 24]. Consciousness arises from material conditions, though conscious activity can affect material conditions.

As Marx explains in Capital Volume I:

At the end of every labour-process, we get a result that already existed in the imagination of the labourer at its commencement. He not only effects a change of form in the material on which he works, but he also realises a purpose of his own that gives the law to his modus operandi, and to which he must subordinate his will. And this subordination is no mere momentary act. Besides the exertion of the bodily organs, the process demands that, during the whole operation, the workman’s will be steadily in consonance with his purpose.

In A Contribution to the Critique of Political Economy, Marx explains how the development of material conditions eventually leads to conscious activity which will in turn lead to changes in society:

At a certain stage of development, the material productive forces of society come into conflict with the existing relations of production or — this merely expresses the same thing in legal terms — with the property relations within the framework of which they have operated hitherto. From forms of development of the productive forces these relations turn into their fetters. Then begins an era of social revolution. The changes in the economic foundation lead sooner or later to the transformation of the whole immense superstructure.

As Marx further explains, material conditions must first be met before such revolutionary social changes can be made through conscious activity:

No social order is ever destroyed before all the productive forces for which it is sufficient have been developed, and new superior relations of production never replace older ones before the material conditions for their existence have matured within the framework of the old society.

- Structure of Consciousness

Consciousness has a very complicated structure, including many factors which have strong relationships with each other. The most basic factors are knowledge, sentiment and willpower.

Annotation 81

As with the concept of reflection (see Annotation 68, p. 65), the analysis of the structure of consciousness which follows is rooted in ideas first proposed by Marx, Engels and Lenin, and later developed through the work of various Soviet psychologists, philosophers, and scientists including Ivan Pavlov, Todor Pavlov, Aleksei Leontiev, Lev Vygotsky, Valentin Voloshinov, and others, and is used as a basis for scientific inquiry and development up to this day. According to Where is Marx in the Work and Thought of Vygotsky? by Lucien Sève (2018), much of this work, such as the groundbreaking work of Lev Vygotsky, has been heavily “de-Marxized,” stripped of all aspects of Marxism and, by extension, dialectical materialism, in translation to English.

Knowledge constitutes the understanding of human beings, and is the result of the cognitive process. Knowledge is the re-created image of perceived objects which takes the form of language. Knowledge is the mode of existence of consciousness and the condition for consciousness to develop.

Annotation 82

Marx and Engels discussed the relationship between language and consciousness extensively in The German Ideology, explaining that language — the form of knowledge which exists in human consciousness — evolved dialectically with and through social activity, and that consciousness also developed along with and through the material processes that gave rise to speech:

From the start the ‘spirit’ is afflicted with the curse of being ‘burdened’ with matter, which here makes its appearance in the form of agitated layers of air, sounds, in short, of language. Language is as old as consciousness, language is practical consciousness that exists also for other men, and for that reason alone it really exists for me personally as well; language, like consciousness, only arises from the need, the necessity, of intercourse with other men.”So, language, physical speech organs, and human society all developed in dialectic relations with one another. Since language is the form of knowledge in human consciousness, this means that knowledge arose directly from these dialectical processes:
Consciousness is, therefore, from the very beginning a social product, and remains so as long as men exist at all. Consciousness is at first, of course, merely consciousness concerning the immediate sensuous environment and consciousness of the limited connection with other persons and things outside the individual who is growing self-conscious.

The fact that knowledge has a language-form in human consciousness is also important to understand because it shows that consciousness arose dialectically as, and through, social activity, and indeed, language and social activity gave rise to consciousness as a replacement for animal instinct in our relations with nature.

Man’s consciousness of the necessity of associating with the individuals around him is the beginning of the consciousness that he is living in society at all. This beginning is as animal as social life itself at this stage. It is mere herd-consciousness, and at this point man is only distinguished from sheep by the fact that with him consciousness takes the place of instinct or that his instinct is a conscious one.

And, as language and social activity dialectically developed through one another, human society became complex enough to give rise to human societies and human economies:

This sheep-like or tribal consciousness receives its further development and extension through increased productivity, the increase of needs, and, what is fundamental to both of these, the increase of population. With these there develops the division of labour…

Knowledge can be separated into two broad categories: knowledge of nature, and knowledge of human society. Each of these categories of knowledge reflects its corresponding entity in the external world.

Annotation 83

Each category of knowledge reflects a corresponding entity in the external world.

It’s also important to note that human society and nature have a dialectical relationship with each other and mutually impact one another, and, by extension, knowledge of nature and knowledge of human society also dialectically influence one another. So these categories of knowledge are not isolated from one another but rather dynamically shape and influence each other continuously through time.

Based on levels of cognitive development, we can also classify knowledge into categories of: daily life knowledge and scientific knowledge, experience knowledge and theory knowledge, emotional knowledge and rational knowledge.

Annotation 84

The following information is from the Marxism-Leninism Textbook of Students Who Specialize in Marxism-Leninism, released by Vietnam’s Ministry of Education and Training:

Daily Life and Scientific Knowledge

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Daily Life Knowledge is the knowledge we acquire in our daily lives to deal with our daily tasks. From our interactions with nature and human society, we cultivate life experience and our understanding of every aspect of our daily lives in relation to human society and nature.

Scientific Knowledge arises from Daily Life Knowledge: as our daily lives become more complex, we develop a need to understand the material world and human society more deeply and comprehensively. Scientific Knowledge is thus a developed system of knowledge of nature and human society. Scientific Knowledge can be tested and can be applied to human life and activity in useful ways.

Experience and Theory Knowledge:

File:T-w-the-worldview-and-philosophical-methodology-of-18.png

Experience Knowledge is cultivated from direct observation of nature and human society. This kind of knowledge is extremely diverse, and we can apply this kind of knowledge to guide our daily activities.

Theory Knowledge arises from Experience Knowledge. Theory Knowledge is composed of abstract generalizations of Experience Knowledge. Theory Knowledge is more profound, accurate, and systematically organized than Experience Knowledge and gives us an understanding of the laws and dynamics of nature and human society.

Emotional and Rational Knowledge:

File:T-w-the-worldview-and-philosophical-methodology-of-19.png

Less Developed More Developed

Emotional Knowledge is the earlier stage of cognitive processing. Emotional Knowledge comes directly to us from our human senses. We obtain emotional knowledge when we use our human senses to directly learn things about nature and human society. Emotional Knowledge is usually manifested as immediate cognitive responses such as pleasure, pain, and other such impulses.

Rational Knowledge arises from Emotional Knowledge. It is a higher stage of cognitive processing, involving abstract thought and generalization of emotional knowledge.

Rational Knowledge is usually manifested as definitions, conjectures, judgments, etc.

See also: Principle of Development, p. 119; Cognitive Theory of Dialectical Materialism, p. 204.

Sentiment is the resonant manifestation of human emotions and feelings in our relationships. Sentiment is a special form of reality reflection [see Annotation 68, p. 65]. Whenever reality impacts human beings, we feel specific sensations and emotional reactions to those impacts. Over time, these specific sensations and emotions combine and dialectically develop into generalized human feelings, and we call these generalized feelings sentiment. Sentiment expresses and develops in every aspect of human life; it is a factor that improves and promotes cognitive and practical activities.

Annotation 85

As Marx explains in Economic and Philosophic Manuscripts of 1844: “Man as an objective, sensuous being is therefore a suffering being — and because he feels that he suffers, a passionate being. Passion is the essential power of man energetically bent on its object.” Marx further elaborates that sentimental emotion is essential to human nature: “The domination of the objective essence within me, the sensuous eruption of my essential activity, is emotion which thereby becomes the activity of my nature.”

Depending on the subjects that are perceived, as well as our human emotions about them, sentiments can be manifested in many different forms such as: moral emotion, aesthetic emotion, religious emotion, etc.

Annotation 86

Moral Emotion is the basic manifestation of moral consciousness at an emotional level. For example: when we see people helping other people, we have positive emotional responses, yet when we see people harming other people, we have negative emotional responses. (Source: Nguyen Thi Khuyen of the National Institute of Administration of Vietnam)

Aesthetic Emotion refers to the the resonant feelings which arise from our interaction with beauty, sadness, comedy, etc., in life and in art. For example: when humans encounter beauty, we feel positive emotional responses. When humans encounter ugliness, we feel negative emotional responses. When we witness pain, we feel sympathetic feelings of pain and a desire to help. When we witness comedy, we feel humorous emotions ourselves. (Source: Textbook of General Aesthetic Studies from the Ministry of

Education and Training of Vietnam)

Religious Emotion is the human belief in supernatural or spiritual forces which can’t be tested or proved through material practice or observation. However, belief in these forces can give human beings emotional responses such as hope, love, etc. (Source: Pham Van Chuc, Doctor of Philosophy, Central Theoretical Council of the Communist Party of Vietnam)

These are just a few illustrative examples; there are many other ways in which human emotion and sentiment can manifest.

Willpower is the manifestation of one’s own strength used to overcome obstacles in the process of achieving goals. Willpower is a dynamic aspect of consciousness, a manifestation of human consciousness in the material world.

Annotation 87

An unnamed poem by Ho Chi Minh, written in 1950 for the Revolutionary Youth Pioneers, addresses the phenomenon of willpower:

Nothing in this world must be difficult
The only thing that we should fear is having a waivering heart
We can dig up mountains and fill the sea
Once we’ve willfully made a firm decision

Today, this poem serves as the lyrics for anthem of the Ho Chi Minh Communist Youth Union (formerly the Revolutionary Youth Pioneers).

Willpower arises from human self-awareness and awareness of the purposes of our actions. Through this awareness and through willpower, we are able to struggle against ourselves and externalities to successfully achieve our goals. We can consider willpower to be the power of conscious human activity; willpower controls and regulates human behaviors in order to allow humans to move towards our goals voluntarily; willpower also allows humans to exercise self-restraint and self-control, and to be assertive in our actions according to our views and beliefs.

Annotation 88

In Dialectics of Nature, Engels explains how willpower developed in human beings as we separated from animals through the development of consciousness: “The further removed men are from animals, however, the more their effect on nature assumes the character of premeditated, planned action directed towards definite preconceived ends.”

In Capital Volume I, Marx explains how willpower uniquely allows humans to consciously change our own material conditions to suit our needs according to pre-conceived plans:

Labour is, in the first place, a process in which both man and Nature participate, and in which man of his own accord starts, regulates, and controls the material re-actions between himself and Nature. He opposes himself to Nature as one of her own forces, setting in motion arms and legs, head and hands, the natural forces of his body, in order to appropriate Nature’s productions in a form adapted to his own wants. By thus acting on the external world and changing it, he at the same time changes his own nature. He develops his slumbering powers and compels them to act in obedience to his sway. We are not now dealing with those primitive instinctive forms of labour that remind us of the mere animal. An immeasurable interval of time separates the state of things in which a man brings his labour-power to market for sale as a commodity, from that state in which human labour was still in its first instinctive stage. We pre-suppose labour in a form that stamps it as exclusively human. A spider conducts operations that resemble those of a weaver, and a bee puts to shame many an architect in the construction of her cells. But what distinguishes the worst architect from the best of bees is this, that the architect raises his structure in imagination before he erects it in reality. At the end of every labour-process, we get a result that already existed in the imagination of the labourer at its commencement. He not only effects a change of form in the material on which he works, but he also realises a purpose of his own that gives the law to his modus operandi, and to which he must subordinate his will. And this subordination is no mere momentary act. Besides the exertion of the bodily organs, the process demands that, during the whole operation, the workman’s will be steadily in consonance with his purpose. This means close attention. The less he is attracted by the nature of the work, and the mode in which it is carried on, and the less, therefore, he enjoys it as something which gives play to his bodily and mental powers, the more close his attention is forced to be.

The true value of willpower is not only manifested in strength or weakness, but is also expressed in the content and meaning of the goals that we try to achieve through our willpower. Lenin believed that willpower is one of the factors that will create revolutionary careers for millions of people in the fierce class struggles to liberate ourselves and mankind.

Annotation 89

In “Left-Wing” Communism: an Infantile Disorder, Lenin explains how revolutions are born from the collective willpower of thousands of people:

History as a whole, and the history of revolutions in particular, is always richer in content, more varied, more multiform, more lively and ingenious than is imagined by even the best parties, the most class-conscious vanguards of the most advanced classes. This can readily be understood, because even the finest of vanguards express the class-consciousness, will, passion and imagination of tens of thousands, whereas at moments of great upsurge and the exertion of all human capacities, revolutions are made by the class-consciousness, will, passion and imagination of tens of millions, spurred on by a most acute struggle of classes. Two very important practical conclusions follow from this: first, that in order to accomplish its task the revolutionary class must be able to master all forms or aspects of social activity without exception (completing after the capture of political power — sometimes at great risk and with very great danger — what it did not complete before the capture of power); second, that the revolutionary class must be prepared for the most rapid and brusque replacement of one form by another.

All of these factors [knowledge, sentiment, and willpower] which, together, create consciousness, have dialectical relationships with each other. Of these factors, knowledge is the most important, because it is the mode of existence of consciousness, and also the factor which guides the development of all the other factors, and it also determines how the other factors manifest.

3. The Relationship Between Matter and Consciousness

The relationship between matter and consciousness is dialectical. In this relationship, matter comes first, and matter is the source of consciousness; it decides consciousness. However, consciousness is not totally passive, it can impact back to matter through the practical activities of human beings.

Annotation 90

Engels explained in Dialectics of Nature that “matter evolves out of itself the thinking human brain,” which means that matter must necessarily come prior to consciousness.

As Marx explains in Capital Volume I, matter determines conscious activity:

The production of ideas, of conceptions, of consciousness, is at first directly interwoven with the material activity and the material intercourse of men, the language of real life. Conceiving, thinking, the mental intercourse of men, appear at this stage as the direct efflux of their material behaviour. The same applies to mental production as expressed in the language of politics, laws, morality, religion, metaphysics, etc., of a people. Men are the producers of their conceptions, ideas, etc. – real, active men, as they are conditioned by a definite development of their productive forces and of the intercourse corresponding to these, up to its furthest forms. Consciousness can never be anything else than conscious existence, and the existence of men is their actual life-process. If in all ideology men and their circumstances appear upside-down as in a camera obscura, this phenomenon arises just as much from their historical life-process as the inversion of objects on the retina does from their physical life-process.

However, it’s important to remember that the relationship between matter and consciousness is dialectical, and that conscious activity — through the combination of willpower and labor — can also impact the material world; social change arises through the combined willpower of many human beings. See: Annotation 80, p. 81.

a. The Role of Matter in Consciousness

Dialectical Materialism affirms that:

• Matter is the first existence, and that consciousness comes after.

• Matter is the source of consciousness, it decides consciousness.

We know that matter determines consciousness because consciousness is the product of the high-level-structured matter such as the human brain. Consciousness itself can only exist after the development of the material structure of the human brain. Humans are the result of millions of years of development of the material world. We are, therefore, products of the material world. This conclusion has been firmly established through the development of natural science, which has given us great insight into the long history of the Earth and of the evolution of living organisms, including human beings.

All of this scientific evidence stands as the basis for the viewpoint: matter comes first, consciousness comes after [see Annotation 114, p. 116].

We have already discussed the factors which constitute the natural and social sources of consciousness:

• Human brains

• Impacts of the material world on human brains that cause reflections

• Labor

• Language

[See Annotation 72, p. 68 and Annotation 73, p. 75]

All of these factors also assert that matter is the origin of consciousness.

Annotation 91

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The material basis of consciousness is rooted in the following phenomena:

1. The material structure of the human brain.
1. Impacts from the material world cause reflections in human consciousness.
1. Human Labor — physical process which dialectically develops consciousness.
1. Human Speech — physical process which dialectically develops consciousness.
1. Evolution of human brains and consciousness through material processes of the material world.

For more information, see: Nature and Structure of Consciousness.

Consciousness is composed of reflections and subjective images of the material world, therefore the content of consciousness is decided by matter [see Annotation 68, p. 65]. The development of consciousness is determined by natural laws and by social laws^[41] as well as the material environment which we inhabit. All of these factors which determine consciousness are material in nature. Therefore, matter determines not only the content but also the development of consciousness.

b. The Role of Consciousness in Matter

In relation to matter, consciousness can impact matter through human activities.

When we discuss consciousness we are discussing human consciousness. So, when we talk about the role of consciousness, we are talking about the role of human beings. Consciousness in and of itself cannot directly change anything in reality. In order to change reality, humans have to implement material activities. However, consciousness controls every human activity, so even though consciousness does not directly create or change the material world, it equips humans with knowledge about objective reality, and based on that foundation of knowledge, humans are able to identify goals, set directions, develop plans, and select methods, solutions, tools, and means to achieve our goals. So, consciousness manifests its ability to impact matter through human activities.

The impact of consciousness on matter can have positive or negative results.

Annotation 92

“Positive” and “negative,” in this context, are subjective and relative terms which simply denote “moving towards a goal” and “moving away from a goal,” based on a specific perspective.

From the perspective of revolutionary communism, “positive” can be taken as moving towards the end goal of the liberation of the working class from capitalist oppression and the construction of a stateless, classless society. Likewise, “negative” can be taken as moving away from that goal. See: Annotation 114, p. 116.

Humans have the ability to overcome all challenges in the process of achieving our goals and improving our world, so long as our conscious activities meet the following criteria:

We must perceive reality accurately.
We must properly apply scientific knowledge, revolutionary sentiments, and directed willpower.
We must avoid contradicting objective laws of nature and society.

Successfully achieving our goals and improving the world in this manner constitutes the positive outcome of human consciousness.

On the contrary, if human consciousness wrongly reflects objective reality, nature, and laws, then, right from the beginning, our actions will have negative results which will do harm to ourselves and our society.

Therefore, by directing the activities of humans, consciousness can determine whether the results of human activities are beneficial or harmful. Our consciousness thus determines whether our activities will succeed or fail and whether our efforts will be effective or ineffective.

By studying the matter, origin, and nature of consciousness, as well as the relationships between matter and consciousness, we can see that:

Matter is the source of consciousness ^[42].
Matter determines the content and creative capacity of consciousness ^[43].
Matter is the prerequisite to form consciousness ^[44].
Consciousness only has the ability to impact matter, and this impact is indirect, because it has to be done through human material activities within material reality ^[45].

Matter determines consciousness while consciousness impacts matter indirectly through human activity.

The strength with which consciousness can impact the material world depends on:

The accuracy of reflection of the material world in consciousness ^[46].
Strength of willpower which transmits consciousness to human activity ^[47].
The degree of organization of social activity ^[48].
Material conditions in which human activity occurs ^[49].

Annotation 93

The importance of organization in determining the outcomes of human social activity is one of the most important concepts of Marxism-Leninism and is discussed frequently by Marx, Engels, Lenin, and nearly every other important communist revolutionary in history. Marx explains the connections between social organization and conscious human activity in Capital Volume I [see Annotation 80, p. 81].

4. Meaning of the methodology

Dialectical Materialism builds the most basic and common methodological^[50] principles for human cognitive and practical activities on the following bases:

The viewpoint of the material nature of the world [matter comes first, consciousness comes after].
The dynamic and creative nature of consciousness ^[51].
The dialectical relationship between matter and consciousness ^[52].

All cognitive and practical activities of humans originate from material reality and must observe objective natural and social laws, however, our activities are capable of impacting the material world through dynamic and creative conscious activity. [See The Relationship Between Matter and Consciousness, p. 88].

Annotation 94

The above paragraph summarizes an important methodological concept which is critical for undestanding the philosophical framework of Dialectical Materialism. Dialectical Materialism, as a philosophy, synthesizes earlier materialist and idealist positions by recognizing the fact that the material determines consciousness, while consciousness can impact the material world through willful activity.

From this philosophical basis, the methodology of Materialist Dialectics has been developed to provide a deeper understanding of dialectical development, which is rooted in contradiction and negation within and between subjects. Materialist Dialectics is the subject of Chapter 2, p. 98.

According to this methodological principle [i.e., the Principle of the Dialectic Relationship Between Matter and Consciousness], if we hope to succeed in accomplishing our goals in the material world, then we must simultaneously meet two criteria:

1. We must ensure that our knowledge reflects the objective material world as much as possible, respecting the objective natural and social laws of the material world.

2. We must simultaneously recognize the dynamic and creative nature of our conscious activity.

When we say that human activities originate from material reality and must observe objective natural and social laws we' mean that human knowledge must originate from the material world. This means that if we hope to be successful in our activities, we should respect the natural and social laws of the material world.

This means that in our human perception and activities, we must determine goals, and set strategies, policies, and plans which are rooted firmly in objective material reality. Humans have to take objective material reality as the foundation of our activities and plans, and all of our activities must be carried out in the material world. Humans have to examine and understand our material conditions and transform them in ways that will help us to accomplish our goals.

When we talk about impacting the material world through dynamic and creative conscious activity, we mean we must recognize the positive, dynamic, and creative roles of consciousness. We must recognize the role human consciousness plays in dynamically and creatively manifesting our will in the material world through labor. Impacting the material world through conscious activity at a revolutionary scale requires humans to respect and understand the role of scientific knowledge; to study laboriously to master such knowledge; and then to propagate such knowledge so to the masses to develop public knowledge and belief so as to guide the people’s action.

Moreover, we also have to voluntarily study and practice^[53] in order to form and improve our revolutionary viewpoint^[54] and willpower^[55] in order to have both scientific and humanitarian activity guidelines.

To implement this principle [i.e., the Principle of the Dialectic Relationship Between Matter and Consciousness], we have to avoid, fight against, and overcome the diseases of subjectivism^[56] and idealism^[57] through such errors as:

Attempting to impose idealist plans and principles [which are not rooted in material conditions] into reality.
Considering fantasy, illusion, and imagination instead of reality.
Basing policies and programs on subjective desires.
Using sentiment as the starting point for developing policies, strategies, etc.

On the other hand, in cognitive and practical activities, we also have to fight against empiricism^[58], which disregards scientific knowledge and theories, and which is also very conservative, stagnant and passive.

Annotation 95

Process of Developing Revolutionary Public Knowledge

Developing revolutionary public knowledge must be preceded by mastery of knowledge and a firm grounding in the role and nature of knowledge.

In Socialism: Utopian and Scientific, Engels makes a scathing critique of idealist socialist revolutionary thought, writing:

To all these [idealist socialists], Socialism is the expression of absolute truth^[59], reason and justice, and has only to be discovered to conquer all the world by virtue of its own power. And as an absolute truth is independent of time, space, and of the historical development of man, it is a mere accident when and where it is discovered. With all this, absolute truth, reason, and justice are different with the founder of each different school. And as each one’s special kind of absolute truth, reason, and justice is again conditioned by his subjective understanding, his conditions of existence, the measure of his knowledge and his intellectual training, there is no other ending possible in this conflict of absolute truths than that they shall be mutually exclusive of one another.

Here, Engels points out the absurdity of the idea that some abstract, purely ideal “truth” could liberate workers in the material world. Engels continues on, explaining how such idealist socialism could never lead to meaningful revolutionary change:

Hence, from this nothing could come but a kind of eclectic, average Socialism, which, as a matter of fact, has up to the present time dominated the minds of most of the socialist workers in France and England. Hence, a mish-mash allowing of the most manifold shades of opinion: a mish-mash of such critical statements, economic theories, pictures of future society by the founders of different sects, as excite a minimum of opposition; a mish-mash which is the more easily brewed the more definite sharp edges of the individual constituents are rubbed down in the stream of debate, like rounded pebbles in a brook.

In other words, idealist revolutionary movements only tend to result in endless debate and meaningless theories which are divorced from objective reality and material conditions. Such theories and idealist constructions do not lead to effective action in the real world. Socialism must become real (i.e., based in objective material conditions and praxis^[60] in the real world) to affect change in the material world, as Engels explains elsewhere in Socialism: Utopian and Scientific [see Annotation 17, p. 18].

In Critique of the Gotha Program, Marx lays out an excellent case study of the failings of incoherent, idealist socialism. He begins by quoting the Gotha Program, which was an ideological program which the German Workers Party hoped to implement. In this text, Marx cites the Gotha Program line by line and offers his materialist critique of the idealist principles presented. In the following passage, Marx refutes some key errors caused by idealism and offers materialist correction:

Labor is not the source of all wealth. Nature is just as much the source of use values (and it is surely of such that material wealth consists!) as labor, which itself is only the manifestation of a force of nature, human labor power... But a socialist program cannot allow such bourgeois phrases to pass over in silence the conditions that lone give them meaning. And insofar as man from the beginning behaves toward nature, the primary source of all instruments and subjects of labor, as an owner, treats her as belonging to him, his labor becomes the source of use values, therefore also of wealth. The bourgeois have very good grounds for falsely ascribing supernatural creative power to labor; since precisely from the fact that labor depends on nature it follows that the man who possesses no other property than his labor power must, in all conditions of society and culture, be the slave of other men who have made themselves the owners of the material conditions of labor. He can only work with their permission, hence live only with their permission.

Here, Marx points out the importance of having a firm understanding of the material reality of labor and its relation to the material, natural world. Marx points out that the idea that labor, alone, is the source of all wealth is an idealist notion of the bourgeoisie, a false consciousness [see Annotation 235, p. 231] which prevents proper material analysis and props up the capitalist viewpoint. A failure to grasp the truth of the material basis of reality weakens the socialist position, and any movement built on such weak idealist foundations will lead to failure in trying to bring about revolutionary change.

We have already discussed the shortcomings of empiricism in Annotation 10, p. 10, but it might be helpful to see another case study, this time from Engels, pointing out the flaws of empiricist analysis in his text Anti-Dühring. Engels begins by quoting the empiricist Eugen Dühring, who wrote:

Philosophy is the development of the highest form of consciousness of the world and of life, and in a wider sense embraces the principles of all knowledge and volition. Wherever a series of cognitions or stimuli or a group of forms of being come to be examined by human consciousness, the principles underlying these manifestations of necessity become an object of philosophy. These principles are the simple, or until now assumed to be simple, constituents of manifold knowledge and volition. Like the chemical composition of bodies, the general constitution of things can be reduced to basic forms and basic elements. These ultimate constituents or principles, once they have been discovered, are valid not only for what is immediately known and accessible, but also for the world which is unknown and inaccessible to us. Philosophical principles consequently provide the final supplement required by the sciences in order to become a uniform system by which nature and human life can be explained. Apart from the fundamental forms of all existence, philosophy has only two specific subjects of investigation — nature and the world of man. Accordingly, our material arranges itself quite naturally into three groups, namely, the general scheme of the universe, the science of the principles of nature, and finally the science of mankind. This succession at the same time contains an inner logical sequence, for the formal principles which are valid for all being take precedence, and the realms of the objects to which they are to be applied then follow in the degree of their subordination.

Engels then proceeds to critique this empiricist worldview, showing that it does not properly reflect the material world and amounts to idealism in its own right:

What [Dühring] is dealing with are therefore principles, formal tenets derived from thought and not from the external world, which are to be applied to nature and the realm of man, and to which therefore nature and man have to conform. But whence does thought obtain these principles? From itself?
No, for Herr Dühring himself says: the realm of pure thought is limited to logical schemata and mathematical forms (the latter, moreover, as we shall see, is wrong). Logical schemata can only relate to forms of thought; but what we are dealing with here is solely forms of being, of the external world, and these forms can never be created and derived by thought out of itself, but only from the external world. But with this the whole relationship is inverted: the principles are not the starting-point of the investigation, but its final result; they are not applied to nature and human history, but abstracted from them, it is not nature and the realm of man which conform to these principles, but the principles are only valid in so far as they are in conformity with nature and history. That is the only materialist conception of the matter, and Herr Dühring’s contrary conception is idealistic, makes things stand completely on their heads, and fashions the real world out of ideas, out of schemata, schemes or categories existing somewhere before the world, from eternity — just like a Hegel.

Lenin also heavily criticized empiricism in his work Materialism and Empirio-Criticism, which we discuss at length in Annotation 32, p. 27.

Chapter 2: Materialist Dialectics

Materialist dialectics is one of the basic theoretical parts that form the worldview and philosophical methodology of Marxism-Leninism. It is the “science of common relations” and also the “science of common rules of motion and development of nature, society, and human thoughts... Dialectics, as understood by Marx, and also in conformity with Hegel, includes what is now called the theory of knowledge, or epistemology.”^[61]

[Note: Epistemology is the theoretical study of knowledge; for more information see Cognitive Theory of Dialectical Materialism, p. 204.]

I. Dialectics and Materialist Dialectics

1. Dialectics and Basic Forms of Dialectics

a. Definitions of Dialectics and the Subjective Dialectic

In Marxism-Leninism, the term dialectic refers to regular relationships, interactions, transformations, motions, and developments of things, phenomena, and processes in nature, society and human thought.^[62]

There are two forms of dialectic: the objective dialectic and the subjective dialectic. The objective dialectic is the dialectic of the material world, while the subjective dialectic is the reflection of objective dialectic in human consciousness. [See Annotation 68, p. 65].

According to Engels, “Dialectics, so-called objective dialectics, prevail throughout nature, and so-called subjective dialectics (dialectical thought), is only the reflection of the motion through opposites which asserts itself everywhere in nature, and which by the continual conflict of the opposites and their final passage into one another, or into higher forms, determines the life of nature.”^[63]

Annotation 96

Dialectics is an umbrella term which includes both forms of dialectical systems: subjective and objective dialectics.

Objective dialectics are the dialectical processes which occur in the material world, including all motion, relationships, and dynamic changes which occur in space and time.

Subjective dialectics, or dialectical thought, is a system of analysis and organized thinking which aims to reflect the objective dialectics of the material world within human consciousness. Dialectical thinking has two component forms: dialectical materialism and materialist dialectics [see Annotation 49, p. 45].

Subjective dialectics is the theory that studies and summarises the [objective] dialectic of nature into a system with scientific principles and rules, in order to build a system of methodological principles of perception and practice. Dialectics is opposed to metaphysics — a system of thought which conceives of things and phenomena in the world in an isolated and unchanging state [See Annotation 8, p. 8].

b. Basic Forms of Dialectics

Dialectics has developed into three basic forms and levels: ancient primitive dialectics, German idealist dialectics, and the materialist dialectics of Marxism-Leninism.

Ancient primitive dialectics is the earliest form of dialectics. It has developed independently in many philosophical systems in ancient China, India and Greece.

Chinese philosophy has two major forms of ancient primitive dialectics:

“Changing Theory” (a theory of common principles and rules pertaining to the changes in the universe)
The “Five Elements Theory” (a theory of the principles of mutual impact and transformation of the five elements of the universe) of the School of Yin-Yang. [See: Primitive Materialism, p. 52]

In Indian philosophy, Buddhist philosophy is a quintessential [see Annotation 6, p. 8] form of ancient primitive dialectics, which includes such concepts as “selflessness,” “impermanence,” and “predestination.”

An ancient, primitive form of dialectics also developed in Ancient Greek philosophy.

Friedrich Engels wrote: “The old Greek philosophers were all born natural dialecticians, and Aristotle, the most encyclopaedic of them, had already analyzed the most essential forms of dialectic thought… This primitive, naive, but intrinsically correct conception of the world is that of ancient Greek philosophy, and was first clearly formulated by Heraclitus: everything is and is not, for everything is fluid, is constantly changing, constantly coming into being and passing away.”^[64]

Engels also wrote of Greek dialectics: “Here, dialectical thought still appears in its pristine simplicity, as yet undisturbed by the charming obstacles which the metaphysicists of the seventeenth and eighteenth centuries — Bacon and Locke in England, Wolff in Germany — put in its own way... Among the Greeks — just because they were not yet advanced enough to dissect and analyse nature — nature is still viewed as a whole, in general. The universal connection of natural phenomena is not proved in regard to particular; to the Greeks it is the result of direct contemplation.”^[65]

Annotation 97

Engels, here, is explaining how the ancient Greek dialecticians were correct to view nature as a cohesive system, a “whole, in general,” which they determined through direct observation of the natural world. The major shortcoming of this ancient Greek form of dialectics was a lack of inquiry into the specific processes and principles of nature. Engels laments that seventeenth and eighteenth century metaphysicists took us backwards by disregarding this view of nature as a cohesive, general whole.

Ancient, primitive dialectics had an accurate awareness of the dialectical characteristic of the world but with its primitive and naive perspective, it still lacked evidence-based forms of natural scientific achievements.

Jumping forward to the late 16^th century, natural sciences started developing rapidly in Europe. Scientists began deeply analysing and studying specific factors and phenomena of nature which led to the birth of modern European metaphysical analysis. In the 18^th century, metaphysics became the dominant methodology in philosophical thought and scientific study. However, when natural scientists moved from studying each subject separately to studying the unification of all those subjects in their relationships, the metaphysical method proved insufficient. Thus, European scientists and philosophers had to transition into a more advanced system of thought: dialectical thought.

The classical German idealist dialectics were founded by Kant and completed by Hegel. According to Engels: “The second form of dialectics, which is the form that comes closest to the German naturalists [natural scientists], is classical German philosophy, from Kant to Hegel.”^[66]

Annotation 98

Engels discusses this history, and the shortcomings of the metaphysical philosophy of his era, in The Old Preface to Anti-Dühring. First, Engels explains why early modern natural scientists initially did not feel constrained by their adherence to metaphysics, since inquiries in the initial revolution of scientific study were limited to the narrow development of specific fields of inquiry by necessity:

Empirical natural science has accumulated such a tremendous mass of positive material for knowledge that the necessity of classifying it in each separate field of investigation systematically and in accordance with its inner inter-connection has become absolutely imperative.

Engels goes on to explain that at the time he was writing, enough knowledge had been accumulated within specific, distinct fields that it becomes necessary to begin studying the connections and overlaps between different fields, which called for theoretical and philosophical foundations:

It is becoming equally imperative to bring the individual spheres of knowledge into the correct connection with one another. In doing so, however, natural science enters the field of theory and here the methods of empiricism will not work, here only theoretical thinking can be of assistance.

Unfortunately, natural scientists were held back by the existing metaphysical theoretical foundations which were dominant at the time as, according to Engels, “theoretical thinking is an innate quality only as regards natural capacity. This natural capacity must be developed, improved, and for its improvement there is as yet no other means than the study of previous philosophy.”

Metaphysical theory and formal logic were in common use by natural scientists at the time. As Engels explained in On Dialectics and Dialectics of Nature, metaphysics and formal logic could never be as useful as dialectical analysis for examining and unifying concepts from wide-ranging dynamic systems of overlapping fields of inquiry.

Unfortunately, dialectics had not yet been suitably developed for use in the natural sciences before the work of Marx and Engels in developing dialectical materialism, as Engels explained in On Dialectics:

Formal logic itself has been the arena of violent controversy from the time of Aristotle to the present day. And dialectics has so far been fairly closely investigated by only two thinkers, Aristotle and Hegel. But it is precisely dialectics that constitutes the most important form of thinking for present-day natural science, for it alone offers the analogue for, and thereby the method of explaining, the evolutionary processes occurring in nature, inter-connections in general, and transitions from one field of investigation to another.

The Idealist Dialectics of Hegel [see Annotation 9, p. 10] constituted a major development of dialectics, but the idealist nature of Hegelian dialectics made them unsuitable for natural scientists, who therefore discarded “Old-Hegelian” dialectics and were thus left without a suitable dialectical framework. Again, from On Dialectics:

The year 1848, which otherwise brought nothing to a conclusion in Germany, accomplished a complete revolution there only in the sphere of philosophy [and] the nation resolutely turned its back on classical German philosophy that had lost itself in the sands of Berlin old-Hegelianism... But a nation that wants to climb the pinnacles of science cannot possibly manage without theoretical thought. Not only Hegelianism but dialectics too was thrown overboard — and that just at the moment when the dialectical character of natural processes irresistibly forced itself upon the mind, when therefore only dialectics could be of assistance to natural science in negotiating the mountain of theory — and so there was a helpless relapse into the old metaphysics.

Engels goes on to explain that, having rejected Hegel’s dialectics, natural scientists were set adrift, cobbling together theoretical frameworks from the works of philosophers which were plagued by idealism and metaphysics, and which were therefore not suitable for the task of unifying the disparate fields of natural sciences together:

What prevailed among the public since then were, on the one hand, the vapid reflections of Schopenhauer, which were fashioned to fit the philistines, and later even those of Hartmann; and, on the other hand, the vulgar itinerant-preacher materialism of a Vogt and a Büchner. At the universities the most diverse varieties of eclecticism competed with one another and had only one thing in common, namely, that they were concocted from nothing but remnants of old philosophies and were all equally metaphysical. All that was saved from the remnants of classical philosophy was a certain neo-Kantianism, whose last word was the eternally unknowable thing-in-itself, that is, the bit of Kant [see Annotation 72, p. 68] that least merited preservation. The final result was the incoherence and confusion of theoretical thought now prevalent.

Engels explains that this lack of a proper dialectical materialist framework had frustrated natural scientists of his era:

One can scarcely pick up a theoretical book on natural science without getting the impression that natural scientists themselves feel how much they are dominated by this incoherence and confusion, and that the so-called philosophy now current offers them absolutely no way out. And here there really is no other way out, no possibility of achieving clarity, than by a return, in one form or another, from metaphysical to dialectical thinking.

After explaining that Hegel’s system of dialectics came closest to meeting the needs of contemporary science, Engels explains why Hegelian dialectics were ultimately rejected by the scientific community:

Just as little can it be a question of maintaining the dogmatic content of the Hegelian system as it was preached by the Berlin Hegelians of the older and younger line. Hence, with the fall of the idealist point of departure, the system built upon it, in particular Hegelian philosophy of nature, also falls. It must however be recalled that the natural scientists’ polemic against Hegel, in so far as they at all correctly understood him, was directed solely against these two points: viz., the idealist point of departure and the arbitrary, fact-defying construction of the system.”

In other words, it was the idealism and the unworkable structuring of Hegelian dialectics that prevented its adoption by natural scientists. Engels finally explains how Marx was able to modify Hegel’s idealist dialectics into a materialist form which is suitable for empirical scientific inquiry:

It is the merit of Marx that... he was the first to have brought to the fore again the forgotten dialectical method, its connection with Hegelian dialectics and its distinction from the latter, and at the same time to have applied this method in Capital to the facts of an empirical science, political economy.

These Classical German philosophers [Kant, Hegel, etc.^[67]] systematically organized idealist dialectics into formal philosophies. Of particular note was Hegel’s belief that the dialectical process would eventually lead to an “absolute idea.” This foundational belief in an “absolute idea” is what chiefly defines Hegelian dialectics as idealist in nature [see Annotation 98, p. 100].

Hegel believed that the subjective dialectic is the basis of the objective dialectic. [In other words, Hegel believed that dialectical thought served as the objective dialectics of the material world.]

According to Hegel, the “absolute idea” was the starting point of all existence, and that this “absolute idea,” after creating the natural world, then came to exist within human consciousness.

Engels wrote that in Hegelian dialectics: “... spirit, mind, the idea, is primary and that the real world is only a copy of the idea.”^[68]

Annotation 99

In the above quoted passage, Engels was explaining why Hegelian dialectics were unsuitable for use in natural sciences. Here is a longer excerpt:

First of all it must be established that here it is not at all a question of defending Hegel’s point of departure: that spirit, mind, the idea, is primary and that the real world is only a copy of the idea... We all agree that in every field of science, in natural as in historical science, one must proceed from the given facts, in natural science therefore from the various material forms and the various forms of motion of matter; that therefore in theoretical natural science, too, the inter-connections are not to be built into the facts, but to be discovered in them, and when discovered to be verified as far as possible by experiment.

The German idealists (most notably Hegel) built an idealist system of dialectics organized into categories and common laws along with a strict logic of consciousness.

Lenin stated that: “Hegel brilliantly divined the dialectics of things (phenomena, the world, nature) in the dialectics of concepts.”^[69]

Annotation 100

What Lenin means, here, is that Hegel inadvertently and unconsciously discovered the concept of reflection [see Annotation 68, p. 65]. Hegel intuitively understood that the material world was reflected in human consciousness, and, by extension, subjective dialectics (dialectical thought) reflected objective dialectics (of the material world). Hegel’s error was an inversion of the ideal and the material. As Marx later pointed out in the Afterword to the Second German Edition of Capital Volume I, it is the material which precedes the ideal, and not the other way around:

My dialectic method is not only different from the Hegelian, but is its direct opposite. To Hegel, the life process of the human brain, i.e., the process of thinking, which, under the name of ‘the Idea,’ he even transforms into an independent subject, is the demiurgos [craftsman/artisan/creator] of the real world, and the real world is only the external, phenomenal form of ‘the Idea.’ With me, on the contrary, the ideal is nothing else than the material world reflected by the human mind, and translated into forms of thought.

Engels also quoted and emphasized Marx’s thoughts [in the Old Preface to Anti-Dühring, citing another quote of Marx from the Afterword to the Second German Edition of Capital Volume I, further quoted in Annotation 100 above]: “The mystification which dialectics suffers in Hegel’s hands by no means prevents him from being the first to present its general form of working in a comprehensive and conscious manner. With him it is standing on its head. It must be turned right side up again, if you would discover the rational kernel within the mystical shell.”^[70]

Annotation 101

In the Old Preface to Anti-Dühring, Engels explains some of the contemporary currents of science and philosophy of his era. Engels explains that Hegelian philosophy had been dismissed by a newer current of natural scientists who dismissed “the idealist point of departure and the arbitrary, fact-defying construction of the system.” In other words, the natural scientists rejected Hegelianism because it was both idealist and was not built on a foundation of objective facts.

Engels points out, however, that Marx “was the first to have brought to the fore again the forgotten dialectical method” of Hegel.

The dialectical method was forgotten in the sense that the natural scientists ignored and dismissed dialectics along with the rest of Hegel’s philosophy. So, Engels is pointing out that one of the great contributions of Marx was salvaging the dialectical method from Hegel while rejecting the idealist and non-fact-based characteristics of Hegelian philosophy.

Marx, according to Engels, proved that the dialectical method could be separated from idealism by “[applying the dialectical method] in Capital to the facts of an empirical science, political economy.” This was the origin of dialectical materialism: the resurrection of the dialectical method and the development of a dialectical method in a materialist and scientific form.

The idealist characteristics of classical German dialectics and Hegelian philosophy was a limitation that needed to be overcome [so that it could be utilized for scientific inquiry]. Marx and Engels overcame that limitation and in so doing developed materialist dialectics. This system of dialectics is the most advanced form of dialectics in the history of philosophy to date. It is the successor of previous systems of dialectics, and it arose as a critique of the classical German dialectics.

Engels said: “Marx and I were pretty well the only people to rescue conscious dialectics from German idealist philosophy and apply it in the materialist conception of nature and history.”^[71]

2. Materialist Dialectics

a. Definition of Materialist Dialectics

Materialist dialectics have been defined in various ways by many prominent Marxist-Leninist philosophers.

Engels defined materialist dialectics as: “nothing more than the science of the general laws of motion and development of nature, human society, and thought.”^[72]

Engels also emphasized the role of the principle of general relations.^[73] As John Burdon

Sanderson Haldane noted in the 1939 preface to Dialectics of Nature: “In dialectics they

[Marx and Engels] saw the science of the general laws of change.”^[74]

Lenin emphasized the important role of the principles of development^[75] (including the theory of cognitive development) in the dialectics that Marx inherited from Hegelian philosophy.

Lenin wrote: “The main achievement was dialectics, i.e., the doctrine of development in its fullest, deepest, and most comprehensive form, the doctrine of the relativity of human knowledge that provides us with a reflection of eternally developing matter.”^[76]

b. Basic Features and Roles of Materialist Dialectics

There are two basic features of the materialist dialectics of Marxism-Leninism:

First, the materialist dialectics of Marxism-Leninism is a system of dialectics that is based on the foundation of the scientific materialist viewpoint.

Annotation 102

Remember that scientific in Marxism-Leninism refers broadly to a systematic pursuit of knowledge, research, theory, and understanding [see Objects and Purposes of Study, p. 38]. Remember also that materialism in Marxism-Leninism has specific meaning as well, which differentiates it from other forms of materialism [see Dialectical Materialism — the Most Advanced Form of Materialism, p. 52]. Here, materialism includes an understanding that the material is the first basis of reality, meaning that the material determines the ideal (though human consciousness can impact the material world through willpower and labor [see Nature and Structure of Consciousness, p. 79]). Materialism is also built upon scientific explanations (rooted in empirical data and practice, i.e. systematic experimentation and observation) of the world. And finally, remember that viewpoint is the starting point of inquiry [see Annotation 11, p. 12].

Thus, a scientific materialist viewpoint is a perspective which begins analysis of the world in a manner that is both scientifically systematic in pursuit of understanding and firmly rooted in a materialist conception of the world.

Note: Materialist Dialectics contains Twelve Basic Pairs of Categories, Two Basic Principles and Three Universal Laws. These are summarized, respectively, in Appendix A (p. 246), Appendix B (p. 247), and Appendix C (p. 248), and explained in depth throughout the rest of this chapter.

In this way, materialist dialectics fundamentally differs from the classical German idealist dialectics, and especially differs from Hegelian dialectics^[77] (as these dialectics were founded on idealist viewpoints).

Moreover, it also has a higher level of development compared to other dialectical systems of thought found in the history of philosophy going back to ancient times. Such previous forms of dialectics were fundamentally based on materialist stances, however the materialism of those ancient times was still naive, primitive and surface-level.

Second, the materialist dialectics of Marxism-Leninism unifies dialectical materialist viewpoints and materialist dialectical methodology, so it not only explains the world, but is also a tool humans can use to perceive and improve the world.

Every principle and law of Marxist-Leninist materialist dialectics is both:

1. An accurate explanation of the dialectical characteristics of the world.

2. A scientific methodology for perceiving and improving the world.

By summarizing the general interconnections and development of all things — every phenomenon in nature, society and human thought — Marxist-Leninist materialist dialectics provides the most general methodological principles for the process of perceiving and improving the world. They are not just objective methodological principles; they are a comprehensive, constantly developing, and historical methodology.

This methodology can be used to analyze contradictions [see Annotation 119, p. 123] in order to find the basic origins and motivations of both motion and developmental processes. Therefore, materialist dialectics is a great scientific tool for the revolutionary class to perceive and improve the world.

With these basic features, materialist dialectics plays a very important role in the worldview and philosophical methodology of Marxism-Leninism. Materialist dialectics are the foundation of the scientific and revolutionary characteristics of Marxism-Leninism and also offer the most general worldview and methodology for creative activities in scientific study and practical activities.

II. Basic Principles of Materialist Dialectics

Annotation 103

The Principle of General Relationships and the Principle of Development are the most basic principles of materialist dialectics. These two principles are dialectically related to one another.

The following sections will outline the Principle of General Relationships and the Principle of Development, which are the most fundamental principles of materialist dialectics. These two concepts are closely (and dialectically) related:

1. The Principle of General Relationships

a. Definition of Relationship and Common Relationship

Annotation 104

The Principle of General Relationships describes how all things, phenomena, and ideas are related to one another, and are defined by these internal and external relationships

The Principle of Development relates to the idea that motion, change, and development are driven by internal and external relationships.

These two principles are dialectically linked: any given subject is defined by its internal relationships, and these same relationships drive the development of every subject.

Note: The foundation of the principles of Materialist Dialectics were laid out by

Engels in Dialectics of Nature. Engels began working on Dialectics of Nature in February, 1870 and had to stop in 1876 to work on Anti-Dühring. He then restarted work on Dialectics of Nature in 1878 and continued working on it until 1883, when Karl Marx died. Engels felt that it was more important to try and put together Marx’s great unfinished works, Capital Volumes 2, 3, and 4, and so stopped working on Dialectics of Nature once again. So, unfortunately, Engels died before this seminal work on Materialist Dialectics could be completed, and what we have instead is an unfinished assemblage of notes.

What follows in the rest of this book is a cohesive system of Materialist Dialectics which was built upon the foundations laid out by Engels in Dialectics of Nature and many other works of political and scholarly writing from various sources. This is the system of Materialist Dialectics studied by Vietnamese students and applied by Vietnamese communists today.

Because this text comes from predominantly Vietnamese scholarship and ideological development, we have had to translate some terms into English which are not derived from the “canon” of Marx, Engels, and Lenin. In some cases, various terms have been consolidated into one concept. For example: Engels used the term “interconnection” (German: innern Zusammenhang, literally: “inner connections”) in Dialectics of Nature, but Vietnamese political scientists use the term “relationship.” Where Engels uses the term “motion” (German: Bewegung) modern Vietnamese communists tend to use the word “development.” Wherever this is the case, we have chosen to use the words in English which most closely match the language used in the original Vietnamese of this text.

In materialist dialectics, the word relationship refers to the regulating principles, mutual interactions, and mutual transformations which exist between things, phenomena, and ideas, as well as those existing between aspects and factors within things, phenomena, and ideas.

Annotation 105

Throughout this book, phenomenon/phenomena simply refers to anything that is observable by the human senses.

Materialist dialectics examines relationships between things, phenomena, and ideas and within things, phenomena, and ideas. A relationship which occurs between two separate things or phenomena is referred to as an external relationship. A relationship which occurs within a thing or phenomenon is referred to as an internal relationship.

These terms are relative; sometimes a relationship may be internal in one context but external in a different context. For example, consider a solar system:

When considering a solar system as a whole, the orbit of a moon around a planet may be considered as an internal relationship of the solar system. But when considering the moon as an isolated subject, its orbit around a planet may be seen as an external relationship which the moon has with the planet.

File:T-w-the-worldview-and-philosophical-methodology-of-24.png

The diagram above illustrates different types of relationships:

Object 1 has its own internal relationships (A), and, from its own perspective, it also has external relationships with Object 2 (B). From a wider perspective, the relationship between Object 1 and Object 2 (B) may be viewed as an internal relationship.

This system of relationships (between Object 1 and Object 2) will also have external relationships with other things, phenomena, and ideas (C).

Relationships have a quality of generality, which refers to how frequently they occur between and within things, phenomena, and ideas. When we refer to general relationships, we are usually referring to relationships which exist broadly across many things, phenomena, and ideas. General relationships can exist both internally, within things, phenomena, and ideas, and externally, between things, phenomena, and ideas.

The most general relationships are universal relationships: these are relationships that exist between and within everything and all phenomena, and they are one of the two primary subjects of study of materialist dialectics. [The other primary subject of study is the Principle of Development; see page 119.]

Annotation 106

File:T-w-the-worldview-and-philosophical-methodology-of-25.png

The discussion of generality of relationships can seem confusing at first. What’s important to understand is that generality is a spectrum ranging from the least general relationships (unique relationships, which only occur between two specific things/phenomena/ideas) and the most general relationships (universal relationships, which occur between or within all things/phenomena/ideas).

Of particular importance in the study of materialist dialectics are universal relationships which exist within and between all things, phenomena, and ideas [see below].

Translation Note: In the original Vietnamese, the word “universal” is not used. Instead, the compound term “phổ biến nhất” is used, which literally means “most general.” In Vietnamese, this phrasing is commonly used to describe the concept of “universal” and it is thus not confusing to Vietnamese speakers. For this translation, we have opted to use the word “universal” because we feel it is less confusing and better explains the concept in English.

The universal relationships include (but are not limited to):

Relationships between basic philosophical category pairs (Private and Common, Essence and Phenomenon, etc.). ^[78]
Relationships between quantity and quality. ^[79]
Relationships between opposites. ^[80]

Together, in all forms of relationships in nature, society and human thought (special, general, and universal) there is unity in diversity and diversity in unity.

Annotation 107

Principle of General Relationships

According to Curriculum of the Philosophy of Marxism-Leninism For University and College Students Specializing in Marxism-Leninism and Ho Chi Minh Thought: “Materialist dialectics upholds the position that all things, phenomena, and ideas exist in mutual relationships with each other, regulate each other, transform into each other, and that nothing exists in complete isolation. That is the core idea of the Principle of General Relationships.”

From this Principle, we find the characteristics of Diversity in Unity and Unity in Diversity; the basis of Diversity in Unity is the fact that every thing, phenomenon, or idea, contains many different relationships; the basis of Unity in Diversity is that many different relationships exist — unified — within each and every thing, phenomenon, and idea.

Diversity in Unity

There exist an infinite number of diverse relationships between things, phenomena, and ideas, but all of these relationships share the same foundation in the material world.

An infinite diversity of relationships exist within the unity of the material world.

The material world is not a chaotic and random assortment of things, phenomena, and ideas. Rather, it is a system of relationships between things, phenomena, and ideas. Likewise, since the material world exists as the foundation of all things, phenomena, and ideas, the material world is thus the foundation for all relationships within and between things, phenomena, and ideas. Because all relationships share a foundation in the material world, they also exist in unity, even though all relationships are diversified and different from one another.

Universal relationships which unite all things, phenomena, and ideas manifest in infinitely diverse ways.

Unity in Diversity

When we examine the universal relationships that exist within and between all different things, phenomena, and ideas, we will find that each individual manifestation of any universal relationship will have its own different manifestations, aspects, features, etc. Thus even the universal relationships which unite all things, phenomena, and ideas exist in infinite diversity.

Paraphrased From: Curriculum of the Philosophy of Marxism-Leninism For University and College Students Specializing in Marxism-Leninism and Ho Chi Minh Thought

b. Characteristics of Relationships

Objectiveness, generality, and diversity are the three basic characteristics of relationships.

- The Characteristic of Objectiveness of Relationships

According to the materialist dialectical viewpoint, relationships between things, phenomena, and ideas have objective characteristics.

Annotation 108

In materialist dialectics, objectiveness is an abstract concept that refers to the relative externality of all things, phenomena, and ideas. Every thing, phenomena and idea exists externally to every other thing, phenomena, and idea. This means that to each individual subject (i.e., each individual thing/phenomena/idea), all other things, phenomena, and ideas are external objects

All things, phenomena, and ideas have the relative characteristic of objectiveness.

All together, the collection of all things, phenomena, and ideas in the universe create the external reality of any given subject. So, objectiveness is relative. In the case of human beings, every individual person exists as an individual subject to which all other things, phenomena, and ideas (including other human beings) have objective characteristics.

Alice and Bob are external to one another; each is objective from the other’s perspective.

Of course, objectiveness is always relative. Something might be external from a certain perspective but not from another perspective. For example, say there are two people: Bob and Alice. From Bob’s perspective, Alice has objective characteristics. But from Alice’s perspective, Bob would have objective characteristics.

The relationship between Alice and Bob has objective characteristics to both Alice and Bob.

As all relationships are inherently external to any given subject (even subjects which are party to the relationship), relationships also have objective characteristics.

Whenever two things, phenomena, or ideas have a relationship with one another, they form a pair. The relationship is inherent to this pair and external to any subject which exists outside of the pair. The mutual interaction and mutual transformation which occurs to the things, phenomena, or objects within the pair as the result of the relationship are inherent and objective properties of the pair.

Annotation 109 Translation note:

In the original Vietnamese text, the word for “objective” is “khách quan.” This is a compound word in which “khách” means “guest,” and “quan” means “point of view.” Therefore, “khách quan” literally means “the guest’s (or outsider’s) point of view.”

Thus we translate this to “objectiveness/objective,” the characteristic of being viewed from the outside.

The word “inherent” in the original Vietnamese is “vốn có.” This is another compound word: “vốn” is a shortened form of the word “vốn dĩ,” which means “by or through nature,” “naturally,” and “intrinsically.” “Có” means “to have” or “to exist.” “Vốn có” thus means “already existing naturally” or “already there, through nature.”

So we use the word “inherent” to mean “existing intrinsically or naturally within, without external influence.”

Human beings can’t change or impact external things and phenomena — and the relationships between them — through human will alone. Humans are limited to perceiving relationships between things and phenomena and then impacting or changing them through our practical activities.

- The Characteristic of Generality of Relationships

According to the dialectical viewpoint, there is no thing, phenomenon, nor idea that exists in absolute isolation from other things, phenomena and ideas.

Annotation 110

Although all things, phenomena, and ideas have the characteristic of externality and objectiveness to all other things, phenomena, and ideas [see Annotation 108, p. 112], this does not mean that they exist in isolation. Isolation implies a complete lack of any relationships with other things, phenomena, and ideas. On the contrary, according to the Principle of General Relationships [see p. 107], all things, phenomena, and ideas have relationships with all other things, phenomena, and ideas.

Simultaneously, there is also no known thing, phenomenon, nor idea that does not have a systematic structure, including component parts which in turn have their own internal relationships. This means that every existence is a system, and, moreso, is an open system that exists in relation with other systems. All systems interact and mutually transform one another.

Annotation 111

As explained above, a systematic structure is a structure which includes within itself a system of component parts and relationships. It has been postulated by some scientific models that there may be some “fundamental base particle” (quarks, preons, etc.), which, if true, would mean that there is a certain basic material component which cannot be further broken down. However, this would not contradict the Principle of Materialist Dialectics of General Relationships (which states that all things, phenomena, and ideas interact with and mutually transform one another — see Annotation 107, p. 110).

- The Characteristic of Diversity of Relationships

In addition to affirming the objectiveness^[81] and generality^[82] of relationships, the dialectical viewpoint of Marxism-Leninism also emphasizes the diversity of relationships. The characteristic of diversity is defined by the following features:

All things, phenomena, and ideas have different relationships. Every relationship plays a distinct role in the existence and development of the things, phenomena, and ideas which are included within.
Any given relationship between things, phenomena, and ideas will have different characteristics and manifestations under different conditions and/or during different periods of motion and/or at different stages of development.

Annotation 112

One of Marx’s most critical observations was that things are defined by their internal and external relationships, including human beings. For example, in Theses on Feuerbach, Marx wrote that “the essence of man is no abstraction inherent in each single individual. In reality, it is the ensemble of the social relations.” It is only through relationships — through mutual impacts and transformations — that things, phenomena, and ideas (including human beings and human societies) change and develop over time. All of these relationships — which both define and transform all things, phenomena, and ideas in existence — exist in infinite diversity [see Annotation 107, p. 110].

Just as things, phenomena, and ideas change and transform through the course of relations with one another, the nature of the relationships themselves also change and develop over time.

Characteristics refer to the features and attributes that exist internally within a given thing, phenomena, or idea.

Manifestation refers to how a given thing, phenomena, or idea is expressed externally in the material world.

For example, a ball may have the characteristics of being made of rubber, having a mass of 100 grams, and having a melting point of 260℃. It may manifest by bouncing on the ground, having a spherical shape, and having a red appearance to human observers.

If ten such balls exist, they will all be slightly different. Even if they have the same mass and material composition, they will have slightly different variations in size, shape, etc. Even if each ball will melt at 260℃, the melting will manifest differently for each ball — they will melt into slightly different shapes, at slightly different speeds, etc.

Relationships also have characteristics and manifestations. For example, the moon’s orbit around the Earth is a relationship. It has characteristics such as the masses of each related body, forces of gravity, and other factors which produce and influence the orbit. The same orbital relationship also has manifestations such as the duration of the moon’s orbit around the Earth, the size of its ellipse, the orbit’s effects on the tides of the Earth’s ocean, etc.

Characteristics and Manifestation correspond, respectively, to the philosophical category pair of Content and Form, which is discussed in section page 147.

Therefore, no two relationships are exactly the same, even if they exist between very similar things, phenomena, and ideas and/or in very similar situations.

It is also important to note that the characteristic of diversity also applies to things, phenomena, and ideas themselves. In other words, every individual thing, phenomenon, and idea in existence also manifests differently from every other thing, phenomenon, and idea in existence, even if they seem quite similar.

c. Meaning of the Methodology

Based on the objective and popular characteristics of relationships, we can see that in our cognitive and practical activities, we have to have a comprehensive viewpoint.

Having a comprehensive viewpoint requires that in the process of perceiving and handling real life situations, humans have to consider the internal dialectical relationships between the component parts, factors, and aspects within a thing or phenomenon. We also need to consider the external mutual interactions they have with other things, phenomena, and ideas. Only on such a comprehensive basis can we properly understand things and phenomena and then effectively handle problems in real life. So, the comprehensive viewpoint is the opposite of a unilateral and/or metaphysical viewpoint [see Annotation 51, p. 49] in both perception and practice.

Lenin said: “If we are to have true knowledge of an object we must look at and examine all of its facets, its connections, and ‘mediacies [indirect relationships].’”^[83]

Annotation 113

The comprehensive viewpoint sees the subject in terms of all of its internal and external relationships.

Consider a factory. A factory exists as a collection of internal relationships (between the workers, between machines, between the workers and the machines, etc.) and external relationships (between the factory and its suppliers, between the factory and its customers, between the factory and the city, etc.). In order to have a comprehensive viewpoint when examining the factory, one must consider and understand all of the internal and external relationships which define it.

The diversified characteristic of relationships [see Annotation 107, p. 110] shows that in human cognitive and practical activities, we have to simultaneously use a comprehensive viewpoint and a historical viewpoint.

Having a historical viewpoint requires that, in perceiving and handling real life situations, we need to consider the specific properties of subjects, including their current stage of motion and development. We also need to consider that the exact same methods can’t be used to deal with different situations in reality — our methods must be tailored to suit the exact situation based on material conditions.

Annotation 114

While the comprehensive viewpoint focuses on internal and external relationships of subjects, the historical viewpoint focuses on the specific properties of subjects — especially the current stage of motion and development. In order to have a proper historical viewpoint, we must study and understand the way a subject has developed and transformed over time. To do this, we must examine the history of the subject’s changes over time, hence the term “historical viewpoint.” In addition, it’s important to understand that no two situations which we might encounter will ever be exactly the same. This is because the component parts and relationships that make up any given situation will manifest differently.

So, in order to properly deal with situations, we have to understand the component parts and relationships of examined subjects as well as their histories of development so that we can develop plans and strategies that are suitable to the unique circumstances at hand.

For example, it would be disastrous if communists today tried to employ the exact same methods which were used by the Communist Party of Vietnam in the 20^th century to defeat Japan, France, and the USA. This is because the material conditions and relationships of Vietnam in the 20^th century were very different from any material conditions existing on Earth today. It is possible to learn lessons from studying the methods of the Vietnamese revolution and to adapt some such methods to our modern circumstances, but it would be extremely ineffective to try to copy those methods and strategies — exactly as they manifested then and there — to the here and now.

In order to come up with suitable and effective solutions to deal with real life problems, we must clearly define the roles and positions of each specific relationship that comes into play, and the specific time, place, and material conditions in which they exist.

Annotation 115

A historical viewpoint focuses on the roles and positions of relationships and properties of subjects as well as their development over time.

The role of a relationship has to do with how it functions within a system of relationships and the position refers to its placement amongst other subjects and relationships.

Consider once again the example of the factory [see Annotation 113]. In addition to its internal and external relationships, the factory also has various roles — it functions within various systems and from various perspectives. For instance, the factory may have the role of financial asset for the corporation that owns it, it may have the role of place of employment for the surrounding community, it may have the role of supplier for various customers, etc.

The factory is also positioned among other subjects and relations. If it’s the only employer in town then it would have a position of great importance to the people of the community. If, on the other hand, if it’s just one of hundreds of factories in a heavily industrialized area, it may have a position of much less importance. It may have a position of great importance to an individual factory worker who lives in poverty in an economy where there are very few available jobs, but of less importance to a freelance subcontractor for whom the factory is just one of many customers, and so on.

These positions and roles will change over time. For example, the factory may initially exist as a small workshop with a small handful of workers, but it may grow into a massive factory with hundreds of employees. It is vital to understand this Principle of Development, which is discussed in more detail on the next page.

In summary, proper dialectical materialist analysis requires a comprehensive and historical viewpoint — we must consider subjects both comprehensively in terms of the internal and external relationships of the subject itself as well as historically in terms of roles and positions of subjects, as well as their relationships, material conditions, and development over time.

So, in both perception and practice, we have to avoid and overcome sophistry and eclectic viewpoints.

Annotation 116

Sophistry is the use of falsehoods and misleading arguments, usually with the intention of deception, and with a tendency of presenting non-critical aspects of a subject matter as critical, to serve a particular agenda. The word comes from the Sophists, a group of professional teachers in Ancient Greece, who were criticized by Socrates (in Plato’s dialogues) for being shrewd and deceptive rhetoricians. This kind of bad faith argument has no place in materialist dialectics. Materialist dialectics must, instead, be rooted in a true and accurate understanding of the subject, material conditions, and reality in general.

Eclecticism is an incoherent approach to philosophical inquiry which attempts to draw from various different theories, frameworks, and ideas to attempt to understand a subject, applying different theories in different situations without any consistency in analysis and thought. Eclectic arguments are typically composed of various pieces of evidence that are cherry picked and pieced together to form a perspective that lacks clarity. By definition, because they draw from different systems of thought without seeking a clear and cohesive understanding of the totality of the subject and its internal and external relations and its development over time, eclectic arguments run counter to the comprehensive and historical viewpoints. Eclecticism is somewhat similar to dialectical materialism in that it attempts to consider a subject from many different perspectives, and analyzes relationships pertaining to a subject, but the major flaw of eclecticism is a lack of clear and coherent systems and principles, which leads to a chaotic viewpoint and an inability to grasp the true nature of the subject at hand.

2. Principle of Development

a. Definition of Development

According to the metaphysical viewpoint, development is simply a quantitative increase or decrease; the metaphysical viewpoint does not account for qualitative changes of things and phenomena. Simultaneously, the metaphysical viewpoint also views development as a process of continuous progressions which follow a linear and straightforward path.

Annotation 117

In materialist dialectics, it is important to distinguish between quantity and quality.

Quantity describes the total amount of component parts that compose a subject.

Quality describes the unity of component parts, taken together, which defines the subject and distinguishes it from other subjects.

Both quantity and quality are dynamic attributes; over time, the quantity and quality of all things develop and change over time through the development of internal and external relationships. Quantity and quality itself form a dialectical relationship, and as quantity develops, quality will also develop. A given subject may be described by various quantity and quality relationships.

Example 1:

In the process of development, Quantity Change leads to Quality Change

A single football player, alone, has the quantity value of 1 football player and the quality of a football player. Eleven football players on a field would have the quantity value of 1 and will develop the quality of a football team. This subject, football team, is composed of the same component parts as the subject football player, but the quantity change and other properties (being on a field, playing a game or practicing, etc.) change the quality of the component parts into a different stable and unified form which we call a football team.

The relationship between quantity and quality is dynamic:

If one of the players doesn’t show up for practice, and there are only ten players on the field, it might still have the quality of football team, but in a live professional game there will be a certain threshold — a minimum number of players who must be present to officially be considered a team. If this number of players can’t be fielded then they will not be considered a full team and thus won’t be allowed to play.

Likewise, if there are only one or two players practicing together in a park, they would probably not be considered a football team (though they might be described in terms of having the quality of being on the same team).

Example 2:

Quantity: 1 O + 2 H atoms Quantity: Billions of H2O Molecules Quantity: ~5,000 Drops of Water Quality: Water Quality: Drop of Water Quality: Cup of Water

DEVELOPMENT: QUANTITY CHANGE LEADS TO QUALITY CHANGE

All of these have the quality of water because of the molecular quantities of hydrogen and oxygen atoms, however, from the perspective of volume, quantity changes still lead to quality changes.

The properties of quantity and quality are relative, depending on the viewpoint of analysis.

A single molecule of water has a quantity of one in terms of molecules, but it still retains the quality of “water” because of the quantities of one oxygen atom and two hydrogen atoms per molecule which, in this stable form, give it the quality of water.

A drop of water might have a quantity of many billions of molecules, but it would still have the quality of “water.” It would also now assume the quality of a “drop.”

When you combine enough drops of water, you will eventually have a quality shift where the “drops” of water combine to form another quality — i.e., a “cup” of water. The quantity change leads to a change in quantity; we would no longer think of the water in terms of “drops” after the quantity rises to a certain level.

In terms of temperature and physical properties, if the water is heated to a certain point it will boil and the water will become steam. The quantity of water in terms of drops wouldn’t change, but the quantity-value of temperature would eventually lead to a quality value change from “water” to “steam.”

Example 3:

AS QUANTITY OF AGE INCREASES, QUALITY CHANGES

The same human being will undergo various quality changes as age quantity increases over time.

As humans age and the quantity of years we’ve lived builds up over time, our “quality” also changes, from baby, to child, to teenager, to young adult, to middle age, to old age, and eventually to death. The individual person is still the same human being, but the quality of the person will shift over time as the quantity-value of age increases.

Metaphysical vs. Dialectical Materialist Conceptions of Change

Metaphysics only consider linear properties of quantitychange; Materialist Dialectics takes quantity changes and quality shifts into consideration when considering change over time.

Because the metaphysical perspective tries to define the world in terms of static, isolated subjects, only quantity is considered and quality shifts are not taken into account. Thus, metaphysical logic sees development as linear, simple, and straightforward. Materialist dialectics, on the other hand, sees development as a more complicated, fluid, and dynamic process involving multiple internal and external relationships changing in quantity and quality over time.

In contrast to the metaphysical viewpoint, in materialist dialectics, development refers to the motion of things and phenomena with a forward tendency: from less advanced to more advanced, from a less complete to a more complete level.

Annotation 118

In materialist dialectics, motion (also known as change) is the result of mutual impacts between or within things, phenomena, and ideas, and all motion and change results from mutual impacts which themselves result from internal and external relationships with other things, phenomena, and ideas. Any given motion/change leads to quantity changes, and these quantity changes cumulatively lead to quality changes [see Annotation 117, p. 119]. Grasping this concept — that development is driven by relations — is critically important for understanding materialist dialectics.

The concept of “change” in materialist dialectics centers on internal and external relationships causing mutual impacts which lead to quantity changes which build into quality shifts.

This process, taken in total, is referred to as development. Development represents the entire process in which internal and external change/motion leads to changes in quantity which in turn lead to changes in quality over time. The process of development can be fast or slow, complex or simple, and can even move backwards, and all of these properties are relative. Development has a tendency to develop from less advanced to more advanced forms. The word tendency is used to denote phenomena, development, and motion which inclines in a particular direction. There may be exceptional cases which contradict such tendencies, but the general motion will incline towards one specific manner. Thus, it is important to note that “development” is not necessarily “good” nor “bad.” In some cases, “development” might well be considered “bad,” or unwanted. For example, rust developing on a car is typically not desired. So, the tendency of development from lower to higher levels of advancement implies a “forward motion,” though this motion can take an infinite number of forms, depending on the relative perspective. Development can also (temporarily) halt in a state of equilibrium [see Annotation 64, p. 62] or it can shift direction; though it can never “reverse,” just as time itself can never be “reversed.”

For example, during a flood, water may “develop” over the land, and as the floodwaters recede this may alternatively be viewed as another “forward” development process of recession — a development of the overall “flooding and receding” process. The flood is not actually “reversing” — the development is not being “undone.” Flood water may recede but it will leave behind many traces and impacts; thus it is not a true “reversal” of development.

Both flooding and flood recession are development processes with the same forward tendency. Flood recession may appear to be a “reversal,” but it is in fact forward development.

The false belief that development can be reversed is the root of conservative and reactionary positions [see Annotation 208].

Development can be considered positive or negative, depending on perspective. Some ecosystems have natural flood patterns which are vital for sustaining life. For a person living in a flood zone, however, the flood would most likely be considered an unwanted development, whereas flood recession would be a welcomed development.

It is important to note that the definition of development is not identical to the concept of “motion” (change) in general. It is not merely a simple quantitative increase or decrease, nor a repetitive cyclic change in quantity. Instead, in materialist dialectics, development is defined in terms of qualitative changes with the direction of advancing towards higher and more advanced levels. [See diagram Relationship Between Motion,

Quantity/Quality Shifts, and Dialectical Development, Annotation 119, below]

Development is also the process of creating and solving objective contradictions within and between things and phenomena. Development is thus the unified process of negating negative factors while retaining and advancing positive factors from old things and phenomena as they transform into new things and phenomena.

Annotation 119

A contradiction is a relationship in which two forces oppose one another. Although a contradiction might exist in equilibrium for some amount of time [see Annotation 64, p. 62], eventually, one force will overcome the other, resulting in a change of quality. This process of overcoming is called negation. In short, development is a process of change in a subject’s quantity as well as negation of contradictions within and between subjects, leading to quality shifts over time.

b. Characteristics of Development

Every development has the characteristics of objectiveness,^[84] generality,^[85] and diversity.^[86]The characteristic of objectiveness of development stems from the origin of motion.

Annotation 120

Remember that, in materialist dialectics, objectiveness is the relative characteristic that every subject has of existing and developing externally to all other subjects [see Annotation 108, p. 112]. Since motion originates from mutual impacts which occur between external things, objects, and relationships, the motions themselves also occur externally (relative to all other things, phenomena, and objects). This gives motion itself objective characteristics.

Dialectical Development consists of Quantity and Quality Shifts, which in turn derive from motion.

Development is derived from motion as a process of quality shifting which arise from quantity changes which arise from motion [see Annotation 117, p. 119]. Since development is essentially an accumulation of motion, and motion is objective, development itself must also be objective.

The Principle of Development states that development is a process that comes from within the thing-in-itself; the process of solving the contradictions within things and phenomena. Therefore, development is inevitable, objective, and occurs without dependence on human will.

Annotation 121

The “thing-in-itself” refers to the actual material object which exists outside of our consciousness [see Annotation 72, p. 68]. Development arises from motion and self-motion [see Annotation 62, p. 59] with objective characteristics. Although human will can impact motion and development through conscious activity in the material world [see The Relationship Between Matter and Consciousness, p. 88], motion and development can and does occur without being dependent on human will. Human will is neither a requirement nor prerequisite for motion and development to occur.

Development has the characteristic of generality because development occurs in every process that exists in every field of nature, society, and human thought; in every thing, every phenomenon, and every idea and at every stage* of all things, phenomena, and ideas. Every transformation process contains the possibility that it might lead to the birth of a new thing, phenomenon, or idea [through a change in quality, i.e. development].

Annotation 122

* In materialist dialectics, “stage” (or “stage of development”) refers to the current quantity and quality characteristics which a thing, phenomenon, or object possesses. Every time a quality change occurs, a new stage of development is entered into.

Development has the characteristic of diversity because every thing, phenomenon, and idea has its own process of development that is not totally identical to the process of development of any other thing, phenomenon, or idea. Things and phenomena will develop differently in different spaces and times. Simultaneously, within their own processes of development, things, phenomena, and ideas are impacted by other things, phenomena, and ideas, as well as by many other factors and historical conditions. Such impacts can change the direction of development of things, phenomena, and ideas. They can even temporarily set development back, and/or can lead to growth in one aspect but degeneration in another.

Annotation 123

Because development has the characteristic of generality and the characteristic of diversity, the principle of diversity in unity and unity in diversity also applies to development [see: Annotation 107, p. 110].

c. Meaning of the Methodology

Materialist dialectics upholds that the principle of development is the scientific theoretical basis that we must use to guide our perception of the world and to improve the world. Therefore, in our perception and reality, we have to have a development viewpoint.

According to Lenin: “dialectical logic requires that an object should be considered in development, in change, in ‘self-movement.”^[87]

This development viewpoint [which holds that all things, phenomena, and ideas are constantly developing, and that development is thus unavoidable] requires us to overcome conservatism, stagnation^[88], and prejudice, which are all opposed to development.

Annotation 124

Conservatism and prejudice are mindsets which seek to prevent and stifle development and to hold humanity in a static position. Not only is this detrimental to humanity, it is also ultimately a wasted effort, because development is inevitable in human society, as in all things, phenomena, and ideas. Therefore, we must avoid and fight against such stagnant mindsets.

According to this development viewpoint, in order to perceive or solve any problem in real life, we must consider all things, phenomena, and ideas with their own forward tendency of development taken in mind. On the other hand, the path of development is a dialectical process that is reversible and full of contradictions. Therefore, we must be aware of this complexity in our analysis and planning. This means we need to have a historical viewpoint [see Annotation 114, p. 116] which accounts for the diversity and complexity of development in perceiving and solving issues in reality.

Annotation 125

Materialist dialectics requires us to consider the complexity and constant motion of reality. By comparison, the metaphysical viewpoint (which considers all things, phenomena, and ideas as static, isolated entities which have linear and simple processes of development) stands as a barrier to understanding this complexity and incorporating it into our worldview. Thus, it is vital that we develop comprehensive and historical viewpoints which acknowledge the diversity and complexity of reality.

In summary, as a science of common relations and development, Marxist-Leninist materialist dialectics serve a very important role in perception and practice. Engels affirmed the role of materialist dialectics in this passage:

“An exact representation of the universe, of its evolution, of the development of mankind, and of the reflection of this evolution in the minds of men, can therefore only be obtained by the methods of dialectics, with its constant regard to the innumerable actions and reactions of life and death, of progressive or retrogressive changes.”

Lenin also said: “Dialectics requires an all-round consideration of relationships in their concrete development, but not a patchwork of bits and pieces.”^[89]

III. Basic Pairs of Categories of Materialist Dialectics

Category* is the most general grouping of aspects, attributes, and relations of things, phenomena, and ideas. Different specific fields of inquiry may categorize things, phenomena, and/or ideas differently from one another.

Annotation 126

* Translation note: In Vietnamese, the word “phạm trù” is used here, which translates in this context more closely to the English philosophical term “category of being,” which means “the most general, fundamental, or broadest class of entities.” “Category of being” is sometimes simplified in English-language philosophical discourse to “category,” which we have chosen to do here for ease of reading and to better reflect the way it reads in the original Vietnamese.

Every science has its own systems of categories that reflect the aspects, attributes, and basic relations that fall within its scope of study. For example, mathematics contains the categories “arithmetic,” “geometry,” “point,” “plane,” and “constant.” Physics contains the categories of “mass,” “speed,” “acceleration,” and “force,” and so on. Economics includes “commodity,” “value,” “price,” “monetary,” and “profit” categories.

Every such category reflects only the common relations found within the specific fields that fall within the scope of study of a specific science.

Categories of materialist dialectics, on the other hand, such as “matter,” “consciousness,” “motion,” “contradiction,” “quality,” “quantity,” “reason,” and “result,” are different. Categories of materialist dialectics reflect the most general aspects and attributes, as well as the most basic and general relations, of not just some specific fields of study, but of the whole of reality, including all of nature, society and human thought.

Every thing, phenomenon, and idea has many properties, including: a reason for existing in its current form, a process of motion and change, contradictions, content, form, and so on. These properties are aspects, attributes, and relations that are reflected in the categories of materialist dialectics. Therefore, the relationship between the categories of specific sciences and categories of materialist dialectics is a dialectical relationship between the Private and the Common [see Private and Common, p. 128].

Annotation 127

The categories of specific sciences are limited to the scope of study, while the categories of materialist dialectics encompass all things, phenomena, and ideas.

Unlike the categories contained within specific scientific fields, the philosophical categories of materialist dialectics can be used to analyze and define all things, phenomena, and ideas. The categories of specific scientific fields and the materialist dialectical categories have a Private/Common dialectical relationship [discussed on the next page].

As a science of general relations and development, materialist dialectics summarizes the most general relations of every field of nature, society, and human thought into basic category pairs: Private and Common, Reason and Result, Obviousness and Randomness, Content and Form, Essence and Phenomenon, Possibility and Reality.

Annotation 128

Every individual materialist dialectical category has a dialectical relationship with another materialist dialectical category. Thus, all categories in materialist dialectics are presented as category pairs. So, a category pair is simply a pair of categories within materialist dialectics which have a dialectical relationship with one another.

Note that the this formalized system of category pairs reflects many decades of work by Vietnamese philosophical and political scientists based on the works of Marx, Engels, Lenin, and other socialist thinkers. Also note that these are not the only category pairs that can be discussed; there are potentially an infinite number of categories which can be used in materialist dialectical analysis. However, universal category pairs, which can be applied to analyze any and all things, phenomena, and ideas, are much fewer and farther between. That said, the universal category pairs discussed in this book are the ones which have most often been used by Marx, Engels, Lenin, and other prominent materialist dialecticians.

1. Private and Common

a. Categories of Private and Common

The Private Category encompasses specific things, phenomena, and ideas; the Common Category defines the common aspects, attributes, factors, and relations that exist in many things and phenomena.

Within every Private thing, phenomenon, and idea, there exists the Common, and also the Unique. The Unique encompasses the attributes and characteristics that exist in only one specific thing, phenomenon, or idea, and does not repeat in any other things, phenomena, or ideas.

Annotation 129

File:T-w-the-worldview-and-philosophical-methodology-of-41.png

The Private category includes specific individual things, phenomena and ideas.

The Common category includes aspects, factors, and relations that exist in many things, phenomena, and ideas. For example, say there are two apples: Apple A and Apple B. Apple A is a specific individual object. Apple B is another distinct, separate object. In that sense, both apples are private apples, and fall within the Private category.

However, both Apple A and Apple B share common attributes. For instance, they are both fruits of the same type: “apple.” They may have other attributes in common: they may be the same color, they may have the same basic shape, they may be of similar size, etc. These are common attributes which they share. Thus, Apple A and Apple B will also fall within the common category, based on these common attributes.

Apple A and Apple B will also have unique attributes. Only Apple A has the exact molecules in the exact place and time which compose Apple A. There is no other object in the world which has those same molecules in that same place and time. This means that Apple A also has unique properties.

All private subjects have attributes in common with other private subjects.

The Common and Private categories have a dialectical relationship. The Common contains the Private, and the Private contains the Common. Every private subject has some attributes in common with other private subjects, and common attributes can only exist among private subjects. Thus every thing, phenomenon, and idea in existence contains internally within itself dialectical relationships between the Private and the Common, and has dialectical Private/Common relationships externally within other things, phenomena, and ideas.

All private subjects have attributes in common with other private subjects.

It is also true that every private subject contains within itself Unique attributes which it does not share with any other thing, phenomenon, or idea. For example, Mount Everest is unique in that it is 8,850 meters tall. No other mountain on Earth has that exact same height. Therefore, the private subject “Mount Everest” has unique properties which it does not share with any other subject, even though it has other attributes in common with countless other private entities.

All things, phenomena, and ideas contain the unique, the private, and the common.

Whenever two individual subjects have a relationship with one another, that relationship is a unique relationship in the sense that it is a relationship that is shared only by those two specific subjects; however, there will also be common attributes and properties which any such relationship will share with other relationships in existence. This recalls the principle of Unity in Diversity and Diversity in Unity [see Annotation 107, p. 110]. So, every thing, phenomenon, and idea contains the Common and the Unique and has unique and common relationships with other things, phenomena, and ideas.

This category pair is very useful in developing a comprehensive viewpoint [see Annotation 114, p. 116]. Remember that a comprehensive viewpoint indicates an understanding of the internal and external relations of a given subject. This means that in order to develop a comprehensive viewpoint, you must know the private aspects of each individual relation, component, and aspect of the subject, and you must also study the commonalities of the subject as well. It’s also important to study a variety of private information sources or data points to look for commonalities between them. In other words, if you want to have a proper comprehensive viewpoint [see Annotation 113, p. 116] about any subject, you have to find and analyze as many private data points and pieces of evidence as possible.

For example: If a person only ever saw one apple, a green apple, then that person might believe that “all apples are green.” This conclusion would be premature: the person is attempting to make an assumption about the Common without examining enough Privates. This is a failure of mistaking mistaking the Private for the Common which stems from a lack of a comprehensive viewpoint.

Now, let’s take a look at an example of how the “Unique” can become “Common,” and vice-versa: 1947 TODAY

File:T-w-the-worldview-and-philosophical-methodology-of-45.png

“Unique” things, phenomena, and ideas can become “common” through development processes (and vice-versa).

In 1941, a Soviet soldier named Mikhail Kalashnikov was in the hospital after being wounded in the Battle of Bryansk. Another soldier in the hospital said to Kalashnikov, “why do our soldiers only have one rifle for two or three of our men, while the Germans have automatics?” To solve this problem, Kalashnikov designed the AK-47 machine gun. When he finished making the first prototype, it was the only AK-47 in the world.

At this precise moment, the AK-47 was simultaneously Unique, Private, and Common.

It was Unique because it was the first and only AK-47 in the world, and no other object in the world had those properties. It was Private because it was a specific object with its own individual existence. It was Common — even though it was the only existing prototype — because it shared Common features with other rifles, and with other prototypes. It was the only AK-47 in existence.

Soon, however, the Soviet Union began manufacturing them, and they became very common. Now there are millions of AK-47s in the world. So, today, that prototype machine gun remains simultaneously Unique, Private, and Common, with some slight developments:

It remains Private because it is a specific object with its own individual existence. Even though it is no longer the only AK-47 in existence, it remains Unique because it is still the very first AK-47 that was ever made, and even though there are now many other AK-47s, there is no other rifle in the universe that shares that same unique property. It remains Common because it still shares common features with other rifles and other prototypes, but it now also shares commonality with many other AK-47 rifles. It is no longer Unique for having the properties of an AK-47 in and of itself.

If someone were to destroy Kalashnikov’s prototype AK-47, the Private of that object would no longer exist — it would remain only as an idea, and the Private would transform to whatever becomes of the material components of the rifle. The Unique would also no longer remain specifically as it was before being destroyed. However, there would still be many other AK-47s which would share common features related to that prototype; for instance, that they were all designed based on the prototype’s design.

Translator’s Note: The words “Private,” “Common,” and “Unique” may seem unusual because they are direct translations from the Vietnamese words used to describe these concepts in the original text. Various other words have been used by Marx, Engels, Lenin, and other materialist dialecticians when discussing the underlying concepts of these philosophical categories. For instance, in most translations of Lenin, his discussion of such topics is typically translated into English using words such as “universal,” “general,” “special,” “particular,” etc.

Example (from Lenin’s Philosophical Notebooks): “Language in essence expresses only the universal; what is meant, however, is the special, the particular. Hence what is meant cannot be said in speech.” Here, “universal” refers to that which is Common in all things, phenomena, and ideas, and “special/particular” refers to the Private — specific individual things, phenomena, and ideas — along with their Unique properties.

Here are excerpts from Lenin’s Philosophical Notebooks discussing these concepts:

(‘It?’ The most universal word of all.) Who is it? I. Every person is an I.
Das Sinnliche? It is a universal, etc., etc. ‘This??’ Everyone is ‘this.’
Why can the particular not be named? One of the objects of a given kind (tables) is distinguished by something from the rest...
Leaves of a tree are green; John is a man; Fido is a dog, etc. Here already we have dialectics (as Hegel’s genius recognised): the individual is the universal... And a naïve confusion, a helplessly pitiful confusion in the dialectics of the universal and the particular — of the concept and the sensuously perceptible reality of individual objects, things, phenomena.
Further, the ‘subsumption’ under logical categories of ‘sensibility’ (Sensibilität), ‘irritability’ (irritabilität) — this is said to be the particular in contrast to the universal!! — and ‘reproduction’ is an idle game.

Marx, too, discussed these concepts using words which are commonly translated into English using different terms. For example, in Capital:

The general form of relative value, embracing the whole world of commodities, converts the single commodity that is excluded from the rest, and made to play the part of equivalent – here the linen – into the universal equivalent.

Here, “general form” refers to the commonalities of form that exist between all commodities. The “single commodity” refers to a private commodity; a specific commodity that exists separately from all other commodities. And when referring to a “universal equivalent,” Marx is referring to equivalence which such a commodity has in common with every other commodity.

The rest of this passage continues as a materialist dialectical analysis of the Private, Common, and Unique features and aspects of commodities:

The bodily form of the linen is now the form assumed in common by the values of all commodities; it therefore becomes directly exchangeable with all and every of them. The substance linen becomes the visible incarnation, the social chrysalis state of every kind of human labour. Weaving, which is the labour of certain private individuals producing a particular article, linen, acquires in consequence a social character, the character of equality with all other kinds of labour. The innumerable equations of which the general form of value is composed, equate in turn the labour embodied in the linen to that embodied in every other commodity, and they thus convert weaving into the general form of manifestation of undifferentiated human labour. In this manner the labour realised in the values of commodities is presented not only under its negative aspect, under which abstraction is made from every concrete form and useful property of actual work, but its own positive nature is made to reveal itself expressly. The general value form is the reduction of all kinds of actual labour to their common character of being human labour generally, of being the expenditure of human labour power. The general value form, which represents all products of labour as mere congelations of undifferentiated human labour, shows by its very structure that it is the social resumé of the world of commodities. That form consequently makes it indisputably evident that in the world of commodities the character possessed by all labour of being human labour constitutes its specific social character.

We have chosen to use the terms “Private,” “Common,” and “Unique” in the translation of this text because they most closely match the words used in the original Vietnamese. In summary, it is important to realize that you may encounter the underlying concepts which are related by these words using various phrasings in the writings of Marx, Engels, Lenin, etc.

b. Dialectical Relationship Between Private and Common

According to the materialist dialectical viewpoint: the Private, the Common and the Unique exist objectively [see Annotation 108, p. 112]. The Common only exists within the Private. It expresses its existence through the Private.

Annotation 130

The Common can’t exist as a specific thing, phenomenon, or idea. However, every specific thing, phenomenon, or idea exists as a private subject which has various features in common with other private things, phenomena, and ideas. We can therefore only understand the Common through observation and study of various private things, phenomena, and ideas. For example, a human can’t perceive with our senses alone the Common of apples. Only by observing many private apples can begin to derive an understanding of what all private apples have in common.

The Common does not exist in isolation from the Private. Therefore, commonality is inseparable from things, phenomena, and ideas. The Private only exists in relation to the Common. Likewise, there is no Private that exists in complete isolation from the Common.

Annotation 131

No commonality can possibly exist outside of private things, phenomena, and ideas because commonality describes features which different things, phenomena, and ideas share. No private thing, phenomenon, or idea can possibly exist absolutely without commonality because there is no thing, phenomenon, or idea that shares absolutely no features with any other thing, phenomenon, or idea.

The Private category is more all-encompassing and diverse than the Common category; Common is a part of Private but it is more profound and more “essential” than the Private. This is because Private is the synthesis of the Common and the Unique; the Common expresses generality and the regular predictability of many Privates.

Annotation 132

The Private encompasses all aspects of a specific, individual thing, phenomenon, or idea; thus it encompasses all aspects, features, and attributes of a given subject, including both the Common and the Unique. In this way, the Private is the synthesis of the Common and the Unique.

Common attributes require more consideration, effort, and study to properly determine, because multiple private subjects must be considered and analyzed before common attributes can be confidently discovered and understood. They offer us a more profound understanding of the essence [see Essence and Phenomenon, p. 156] and nature of things, phenomena, and ideas because they offer insights into the relationships between and within different things, phenomena, and ideas. As we discover more commonalities, and understand them more deeply, we begin to develop a more comprehensive perspective of reality. We begin to develop an understanding of the laws and principles which govern relations between and within things, phenomena, and ideas, and this gives us the power to more accurately predict how processes will develop and how things, phenomena, and ideas will change and mutually impact one another over time.

Under specific conditions, the Common and the Unique can transform into each other [See Annotation 129, p. 128].

The dialectical relationship between Private and Common was summarised by Lenin:

“Consequently, the opposites (the individual as opposed to the universal) are identical: the individual exists only in the connection that leads to the universal. The universal exists only in the individual and through the individual. Every individual is (in one way or another) a universal. Every universal is (a fragment, or an aspect, or the essence of) an individual. Every universal only approximately embraces all the individual objects. Every individual enters incompletely into the universal, etc., etc. Every individual is connected by thousands of transitions with other kinds of individuals (things, phenomena, ideas) etc.”^[90] [Note: “individual and universal” here refer the same underlying concepts of “Private and Common” (respectively); see translator’s note on p. 132].

c. Meaning of the Methodology

We must acknowledge and recognize the Common in order to study the Private in our cognitive and practical activities. If we fail to acknowledge the Common, then whenever we attempt to understand and comprehend any Private thing, phenomenon or idea, we will make mistakes and become disoriented. To understand the Common we have to study and observe the Private because the Common does not exist abstractly outside of the Private.

Annotation 133

Our understanding of Common attributes arise from the observation and study of private things, phenomena, and ideas. At the same time, developing our understanding of Commonalities between and within Private subjects deepens our understanding of their essential nature [see: Essence and Phenomenon].

Dialectical analysis of private and common characteristics involves observing private subjects to determine common attributes and considering common attributes to gain insights about private subjects.

It is impossible to know anything at all about the Common without observing Private subjects, and attempting to understand Private subjects without taking into consideration the attributes and features which they have in Common with other Private subjects will lead to incomplete and erroneous analysis.

In addition, we must identify the Common features and attributes of every specific Private subject we study. We must avoid being dogmatic, metaphysical, and inflexible in applying our knowledge of commonalities to solve problems and interpret the world.

Annotation 134

Dogmatism and Revisionism in Relation to the Private and Common

Dogmatism is the inflexible adherence to ideals as incontrovertibly true while refusing to take any contradictory evidence into consideration. Dogmatism stands in direct opposition to materialist dialectics, which seeks to form opinions and conclusions only after careful consideration of all observable evidence.

Dogmatism typically arises when the Common is overemphasized without due consideration of the Private. A dogmatic position is one which adheres to ideals about commonalities without taking Private subjects into consideration.

Dogmatism can be avoided by continuously studying and observing and analyzing

Private subjects and taking any evidence which contradicts erroneous perceptions of “false commonalities” into consideration. This will simultaneously deepen our understanding of the Private while improving our understanding of the Common. For example: Sally might observe a few red apples and arrive at the conclusion: “all apples are red.” If Sally is then presented with a green apple, yet refuses to acknowledge it by continuing to insist that “all apples are red,” then Sally is engaging in dogmatism.

According to Vietnam’s Curriculum of the Philosophy of Marxism-Leninism For University and College Students Specializing in Marxism-Leninism and Ho Chi Minh Thought, the opposite of Dogmatism is Revisionism. Revisionism occurs when we overestimate the Private and fail to recognize commonalities. In failing to recognize common attributes and features between and within things, phenomena, and ideas, the Revisionist faces confusion and disorientation whenever they encounter any new things, phenomena, and ideas, because they lack any insight into essential characteristics of the subject and its relations with other subjects.

For example: if Sally has spent a lot of time studying a red apple, she may start to become confident that she understands everything there is to know about apples. If she is then presented with a green apple, she might become confused and disoriented and draw the conclusion that she has to start all over again with her analysis, from scratch, thinking: “this can’t possibly be an apple because it’s not red. It must be something else entirely.” Sally can avoid this revisionist confusion by examining the other common features which the red and green apples share before making any conclusions.

Metaphysical Perception of the Private and Common

The metaphysical position attempts to categorize things, phenomena, and ideas into static categories which are isolated and distinct from one another [see Annotation 8,

p. 8]. In this way, the metaphysical perception ultimately fails to properly understand the role of both the Private and the Common. Categories may be arranged in taxonomic configurations based on shared features, but ultimately every category is seen as distinct and isolated from every other category. This perspective severs the dialectical relationship between the Private, the Common, and the Unique, and thus leads to a distorted perception of reality. As Engels wrote in Socialism: Utopian and Scientific:

The analysis of Nature into its individual parts, the grouping of the different natural processes and objects in definite classes, the study of the internal anatomy of organized bodies in their manifold forms — these were the fundamental conditions of the gigantic strides in our knowledge of Nature that have been made during the last 400 years. But this method of work has also left us as legacy the habit of observing natural objects and processes in isolation, apart from their connection with the vast whole; of observing them in repose, not in motion; as constraints, not as essentially variables; in their death, not in their life. And when this way of looking at things was transferred by Bacon and Locke from natural science to philosophy, it begot the narrow, metaphysical mode of thought peculiar to the last century.”

In other words, Engels points out that separating and dividing Private subjects into distinct and isolated categories without acknowledging the dialectical nature of the Private and the Common leads to severe limitations on what we can learn about the world. Instead, we have to examine things, phenomena, and ideas in relation to one another, which must include the analysis of Commonalities.

Rather than divide subjects into distinct, separate categories, materialist dialectics seek to examine Private subjects as they really exist: as a synthesis of Unique and Common attributes; and simultaneously to examine commonalities as they really exist: as properties which emerge from the relations of Private objects.

In our cognitive and practical activities, we must be able to take advantage of suitable conditions that will enable transformations from the Unique and the Common (and vice versa) for our specific purposes.

Annotation 135

In advancing the cause of socialism, revolutionaries must work to transform our Unique positions into common positions. For instance, the process of developing revolutionary public knowledge [see Annotation 94, p. 93] begins with studying and understanding revolutionary knowledge. Initially, this knowledge will be unique to the socialist movement. By disseminating the knowledge to the public, we hope to transform this knowledge into common knowledge.

Likewise, we hope to transform other common things, phenomena, and ideas back towards the Unique. For instance, the capitalist mode of production is currently the most common mode of production on Earth. In order to advance humanity towards communism, we must transition the capitalist mode of production from the Common towards the Unique, with the ambition of eventually eliminating this mode of production altogether.

2. Reason and Result

a. Categories of Reason and Result

The Reason category is used to define the mutual impacts between internal aspects of a thing, phenomenon or idea, or between things, phenomena, or ideas, that bring about changes.

The Result category defines the changes that were caused by mutual impacts which occur between aspects and factors within a thing, phenomenon, or idea, or externally between different things, phenomena, or ideas.

Annotation 136

Translation note: the Vietnamese words for “reason and result” can also be translated as “cause and effect.” We have chosen to use the words “reason and result” to distinguish materialist dialectical categories from metaphysical conceptions of development.

In metaphysics [see Annotation 8, p. 8], any given effect is seen to have a single cause. In materialist dialectics, we instead examine the mutual impacts which occur within and between subjects through motion and development processes.

Metaphysical vs. Materialist Dialectical conceptions of development.

In the metaphysical conception of cause and effect, (A) causes effect (B), then effect (B) causes effect (C), and so on. Materialist dialectics, on the other hand, uses the model of development (see Annotation 117, p. 119), wherein objects (A) and (B) mutually impact one another, resulting in development (C). (C) will then have relations with other things, phenomena, and/or ideas, and the mutual impacts from these new relations will become the reasons for future results. Consider the following example:

Metaphysical vs. Materialist Dialectical conceptions of frying and eating an egg.

In the metaphysical “cause and effect” model, putting an egg in a hot pan is the cause which results in the effect of producing a fried egg. The egg being fried has the effect of the egg now being suitable for eating, which is the cause of the egg being eaten by a hungry person.

This is a simplification of the metaphysical conception of causes and effects, since metaphysics does recognize that one cause can have branches of multiple effects, but the essential characteristic of the metaphysical conception of causality is to break down all activity and change in the universe into static and distinct episodes of one distinct event causing one or more other distinct events.

In contrast, the materialist dialectical model of development holds that every result stems from mutual impacts which occur relationally between things, phenomena, and ideas, and that the resulting synthesis — the newly developed result of mutual impacts — will then have new relations with other things, phenomena, and ideas, and that these relations will become new reasons for new results through mutual impact.

In this example, the egg and the hot pan will mutually impact each other. The frying pan will become dirty and need to be washed (the result of putting an egg in the frying pan); meanwhile, the egg will become a fried egg, which is fit for human consumption (the result of being cooked in the frying pan). The fried egg will then have a relationship with a hungry human, and this relationship will be a new reason which will lead to further results (i.e., the human eating and digesting the egg).

So, the key difference between the classical metaphysical conception of causality and the materialist dialectical model of development is that metaphysics focus more on individual events in time whereas materialist dialectics focus on the relations and mutual impacts between things, phenomena, and ideas over time.

b. Dialectical relationship between Reason and Result

The relationship between Reason and Result is objective, and it contains inevitability: there is no Reason that does not lead to a Result; and likewise, there is no Result without any Reason.

Reasons cause Results, which is why Reason always comes before Result, and Result always comes after Reason.

A Reason can cause one or many Results and a Result can be caused by one or many Reasons.

When many Reasons lead to a single Result, the impacts which lead to the Result are mutual between all things, phenomena, and ideas at hand. These mutual impacts can have many relational positions or roles, including: direct reasons, indirect reasons, internal reasons, external reasons, etc.

Annotation 137

As stated in the previous annotation, Reasons which lead to Results stem from mutually impacting relations between things, phenomena, and ideas. There is no way for one subject to affect another subject without also being affected itself in some way.

Reasons can take many forms, including (but not limited to):

Types of Reasons and Results

Direct Reasons stem from immediate relations.

Direct Reasons are Reasons which stem from immediate relations, with no intervening relations standing between the Reason and Result.

For example, dropping a coffee cup causes an immediate relationship between the cup and the ground, and that relation leads directly to the Result of the coffee cup breaking to pieces.

Indirect Reasons have an intervening relationship between the Reason and the Result.

Indirect Reasons are Reasons which have intervening relations between a Reason and a Result.

For example, the dropped coffee cup above may have smashed into pieces directly because it hit the ground, but it may also have indirect Reasons. The person holding the cup may have been frightened because she heard a loud noise, and the loud noise was caused by a car backfiring, and the car backfiring was caused by the driver not maintaining his car engine.

In materialist dialectical terms, the driver’s relationship with his car would be an indirect Reason for the car backfiring; the relationship between the car (which backfired) and the person holding the coffee cup would be the direct Reason for dropping the cup; and the cup’s relationship with the ground would be the direct reason for the cup smashing. At the same time, the driver’s relationship with his car would be an indirect Reason for the Result of the coffee cup smashing to pieces.

Internal Reasons stem from internal relationships.

Internal Reasons are Reasons which stem from internal relations that occur between aspects and factors within a subject.

For example, if a building collapses because the steel structure within the building rusts and fails, then that could be viewed as an internal Reason for the collapse.

External Reasons stem from external relations.

External Reasons are reasons which stem from external relations that occur between different things, phenomena, and ideas.

For example, if a building collapses because it is smashed by a wrecking ball, then that could be viewed as an external Reason for the collapse.

All of these roles and positions can be viewed relatively. From one viewpoint, a Reason may be seen as internal, but from another viewpoint, it might be viewed as external. For example, if a couple has a disagreement which leads to an argument, the disagreement may be seen as an external Reason from the perspective of each individual within the couple. But to a relationship counselor viewing the situation from the outside, the disagreement may be seen as an internal Reason which leads to the couple (a subject defined by the internal relationship between the husband and wife) arguing.

From one perspective, a government official ordering a building to be torn down may be seen as the direct Reason for the Result of the building being torn down. But from a different perspective, one can see many intervening relations: complaints from local residents may have led to the government official making the order, the order would be delivered to a demolition crew, the demolition crew would assign a crew member to operate a wrecking ball, the crew member would operate the wrecking ball, the wrecking ball would smash the building. All of these can be seen as intervening relations which constitute indirect reasons leading up to the direct Reason of the wrecking ball smashing the building. Choosing the right viewpoint during analysis is critical to make sure that Reason and Result relations are viewed properly and productively, and care must also be taken to ensure that the correct Reasons are attributed to Results (see Reason and Result, p. 138).

Likewise, a Reason can cause many Results, including primary and secondary Results.

Annotation 138

Primary Results are Results which are more direct and predictable.

Secondary Results are Results which are indirect and less predictable.

For example, an earthquake may have primary Results such as the ground shaking, buildings being destroyed, etc. Secondary Results from the earthquake might include flights being rerouted from local airports, shortages at grocery stores, etc.

In the motion of the material world, there is no known “first Reason” or “final Result.”

Annotation 139

With our current understanding of the universe, it is uncertain what might have caused the creation of all existence. Was it the Big Bang? If so, did the Big Bang have some underlying reason? There is also no way to know if there will ever be a “final Result.” Will the heat death of the universe occur, and if so, will that end all transpiring of relations which would end the cycle of development — of Reasons and Results?

As of now, we do not have solid answers to these questions. If and when answers arise, it is possible that the materialist dialectical framework will need to be updated to reflect new scientific knowledge, just as Marx, Engels, and Lenin have updated materialist dialectics in the past [see Annotation 72, p. 68]. What’s important to understand in the meantime is that within our realm of human experience and understanding, for all practical purposes, every Result which we live through and observe has some underlying Reason, and will itself lead to one or more Results.

Engels said: “we find upon closer investigation that the two poles of an antithesis [see Annotation 200, p. 192], positive and negative, e.g., are as inseparable as they are opposed, and that despite all their opposition, they mutually interpenetrate [are mixed together]. And we find, in like manner, that cause and effect are conceptions which only hold good in their application to individual cases; but as soon as we consider the individual cases in their general connection with the universe as a whole, they run into each other, and they become confounded when we contemplate that universal action and reaction in which causes and effects are eternally changing places, so that what is effect here and now will be cause there and then, and vice versa.”^[91]

Annotation 140

In the above passage, Engels is simply explaining that since all things, phenomena, and ideas are relationally linked and inter-related [see Basic Principles of Materialist Dialectics, p. 106], the mutual impacts and processes of change which lead to development (the reasons and results which transpire between all things, phenomena, and ideas) are also all linked and inter-related. What might be viewed as a Reason is also a Result of one or more prior Reasons, just as every Result is also a Reason for future Results.

c. Meaning of the Methodology

Because the relationship between Reason and Result is objective and inevitable, we can’t ignore the relationship between Reason and Result in our perception and practice. In reality, there is no thing, phenomenon or idea that can exist without any underlying Reason or Reasons; and vice versa, there is no Reason that does not lead to any Result.

Annotation 141

In political activity, it is important to remember that every interaction within every relationship will lead to mutual impacts which will cause change and development; in other words, everything we choose to do will be the Reason for one or more Results. We must be aware of unintended or unpredicted Results from our activities.

Reason-Result relationships are very complicated and diverse. Therefore, we must accurately identify the types of Reasons [direct, indirect, internal, external, etc.] so that we can come up with proper solutions which are suitable for the specific situation in both perception and practice. A Reason can lead to many results and, likewise, a Result can be caused by many Reasons, which is why we must have a comprehensive viewpoint and a historical viewpoint [see Annotation 114, p. 116] in our perception of reality so we can properly analyse, solve and apply Reason-Result relationships.

Annotation 142

It is critical to understand that there may be many events or relationships which might be falsely ascribed as Reasons for a given Result (and vice-versa).

For example: in 1965, the United States of America officially declared war on North Vietnam after the so-called “Gulf of Tonkin Incident,” in which Vietnamese forces supposedly fired on a United States Navy ship in the Gulf of Tonkin. The Gulf of Tonkin Incident is often described as the “cause” or the “Reason” that the Vietnam War began.

However, the real “Reason” why the USA declared war on North Vietnam had to do with the underlying contradiction between capitalist imperialism and communism in Vietnam. This contradiction had to be resolved one way or another. The United States of America willfully decided to try to negate this contradiction by instigating war, and this was the true reason the war began. In fact, the so-called “Gulf of Tonkin Incident” never even occurred as described — the attack on the USA’s ship never really occurred. A document released by the Pentagon in 2005 revealed that the incident was completely fabricated. So, saying that the “Gulf of Tonkin Incident” was the Reason for the war is nonsensical, since it’s an event which never even occurred in reality.

Understanding the true nature of Reason and Result is very important for making decisions and choosing a path forward in political action. Attributing the wrong Reason to a Result, or misunderstanding the Results which stem from a Reason, can lead to serious setbacks and failures. Therefore, it is vital for revolutionaries to properly identify and understand the actual Reasons and Results which drive development.

3. Obviousness and Randomness

a. Categories of Obviousness and Randomness

Annotation 143

In Vietnamese, the words for these categories are “tất nhiên” and “ngẫu nhiên,” which respectively translate to “obvious” and “random.” In socialist literature, various words have been used by different authors to convey the underlying meaning of these categories (Engels, for instance, used the terms “necessary” and “accidental” to mean “obvious” and “random,” respectively). We have chosen to use words which closely match the Vietnamese used in the original text, but the reader should be aware that these same concepts may be described using many different words in various English translations of Marx, Engels, Lenin, Ho Chi Minh, etc.

The Obviousness category refers to events that occur because of the essential [see Essence and Phenomenon, p. 156] internal aspects of the material structure of a subject. These essential internal characteristics become reasons for certain results under certain conditions: the Obvious has to happen in a certain way, it can’t happen any other way.

Annotation 144

Obviousness can only apply to material subjects in the material world and results which are certain to happen based on the material laws of nature. Obviousness arises from the internal aspects, features, and relations of physical objects. Paper will burn under certain specific conditions, due its internal material structure. If those conditions (i.e., temperature, the presence of oxygen, etc.) exist, then paper will catch fire predictably. In other words, paper will obviously burn under certain circumstances due to its internal composition,.

The Randomness category refers to things that happen because of external reasons: things that happen, essentially, by chance, due to impacts from many external relations. A Random outcome may occur or it may not occur; a Random outcome could happen this way or it could happen that way.

Annotation 145

As we discussed above, paper will burn if it reaches a certain temperature — that much is obvious. If your friend holds paper over the flame of the lighter, the paper will burn — that’s obvious. But you can’t be certain whether your friend will actually hold the paper to the flame or not. This demonstrates Randomness. Whether your friend will ultimately hold the paper to the flame or not depends on an external relation which is not defined by the internal structure of the paper, and which can’t be predicted with the same predictability as obvious events which are rooted in internal material aspects.

b. Dialectical relationship between Obviousness and Randomness

Obviousness and Randomness both exist objectively and play an important role in the motion and development of things and phenomena. Obviousness plays the decisive role.

Annotation 146

Obviousness plays the decisive role simply because Obviousness is far more predictable and the laws which govern material phenomena are essentially fixed. We can’t change the laws of physics, the nature of chemical reactions, etc.

Obviousness and Randomness exist in dialectical unity; there is no pure Obviousness, nor pure Randomness. It is obvious that Randomness shall occur in our universe, however Obviousness clears a path through this Randomness.

Annotation 147

Our universe is incredibly complex and there are many different potential external relations which could impact any given situation, such that some degree of Randomness is always present in any situation; in other words, the presence of Randomness can be seen as Obvious.

In 1922, Ho Chi Minh identified objective internal characteristics of the working class of France and its colonies. He wrote: “The mutual ignorance of the two proletariats gives rise to prejudices. The French workers look upon the native as an inferior and negligible human being, incapable of understanding and still less of taking action. The natives regard all the French as wicked exploiters. Imperialism and capitalism do not fail to take advantage of this mutual suspicion and this artificial racial hierarchy to frustrate propaganda and divide forces which ought to unite.”

In this example, Ho Chi Minh identifies prejudice as an obvious outcome of mutual ignorance. The prejudice arises as a matter of course from internal objective aspects of the two proletarian groups. As long as French and native workers remain ignorant of one another, prejudice will arise. The specific forms which this prejudice will take, however, and their resulting impacts and developments, will be more or less Random because there are many external factors (including the external impacts of the capitalist class, which seeks to take advantage of these prejudices) which can’t be predicted. Therefore, it is necessary for political revolutionaries to account for both random and obvious factors in confronting such prejudice. Ho Chi Minh’s suggestion for overcoming these difficulties was concise and to-the-point: “Intensify propaganda to overcome them.” Only by negating the internal aspects of mutual ignorance through education and propaganda could communists hope to negate the resulting prejudice.

As Engels said: “One knows that what is maintained to be necessary [obvious] is composed of sheer accidents, and that the so-called accidental [random] is the form behind which necessity hides itself — and so on.”^[92]

Obviousness and Randomness are not static properties: Randomness and Obviousness continuously change and develop over time. Under specific conditions, Obviousness and Randomness can transform into each other: Obviousness can become Random and Randomness can become obvious.

Annotation 148

Randomness can be introduced to an obvious situation: it may be obvious that a mineshaft will collapse, until human beings come along and intervene by repairing the structural integrity of the mineshaft. It may seem Random whether a city’s economy will grow or shrink, until a volcano erupts and buries the city in lava and ash, making it obvious that the economy will not grow because the city no longer exists.

Most situations are in a flux, as Obviousness and Randomness dialectically develop and change over time, with outcomes becoming more or less obvious or Random over time. It is vital that we, as political revolutionaries, are able to distinguish between Obviousness and Randomness and to leverage this understanding to our advantage.

c. Meaning of the Methodology

Basically, in our perception and reality, we have to base our plans, strategies, and actions as much as possible on the Obvious, not the Random. However, we must not ignore Randomness, nor try to separate the Obvious from the Random. When faced with situations which seem very Random, we must find ways to develop Obviousness. When faced with what seems obvious, we must keep an eye out for Randomness. Obviousness and Randomness can mutually transform, so we need to create suitable conditions to hinder or promote such transformation to suit our purposes.

Annotation 149

We must always remember that no situation is purely obvious, nor purely Random, and to take this into account in all of our planning and activity.

A skyscraper made from heavy steel beams may seem quite sturdy and stable; it may appear obvious that the structure will remain stable and sound for decades. However, it is still important for engineers to periodically confirm that the steel is still sound through testing and observation. Engineers must also be prepared for Random events like lightning, earthquakes, storms, etc., which may affect the seemingly obvious structural integrity of the building.

Likewise, when faced with extremely complex situations which seem completely Random, we must seek out (or bring about) the obvious. Wildfires are extremely chaotic and difficult to predict. However, firefighters can rely on certain obvious patterns and natural laws which govern the spread of fire. By digging trenches, lighting counter-fires, spraying water, and other such actions, firefighters can bring wildfires under control. This illustrates how humans are able to make situations less Random by bringing about an increasing amount of Obviousness over time through practical activity.

4. Content and Form

a. Categories of Content and Form

The Content category refers to the sum of all aspects, attributes, and processes that a thing, phenomenon, or idea is made from.

The Form category refers to the mode of existence and development of things, phenomena, and ideas. Form thus describes the system of relatively stable relationships which exist internally within things, phenomena, and ideas.

Annotation 150

Content and Form can be difficult to comprehend at first because the ways in which Content and Form manifest and interact can vary wildly depending on the subject being discussed and the viewpoint from which the subject is being considered.

Content represents the component things, materials, attributes, features, etc., which, together, make up a thing, phenomenon, or idea. You can think of it as the “ingredients” from which a subject is made.
Form refers to a stable system of internal relationships which compose a thing, phenomenon, or idea, as well as the mode of existence and development [see Annotation 60, p. 59] of those relations.

Remember that from a dialectical materialist perspective, everything in our universe is defined by internal and external relations. If a thing, phenomenon, or idea has internal relations which are relatively stable, then it has a Form.

We would not call all of the assorted ingredients which are used to make a cake “a cake” unless they have been assembled together and baked into the stable form which we interpret as “a cake.” Once a portion is removed from the cake, the portion itself assumes a new stable form which we call “a slice of cake.” The slice of cake will maintain its relatively stable form until being eaten, discarded, or otherwise transitioning into some other form. It is only considered a “slice of cake” for as long as it maintains its own specific stable form.

Stability itself is also relative: a “spray” of water may only last for a few seconds but we can still conceive of it as having Form. On the other hand, a mountain has a set of stable internal relations (a Form) which might last for millions of years.

We can think of Form as having two aspects: inner Form and outer Form.

Inner form refers to the internal stable relations which we have already discussed.

Outer form is how an object “appears” to human senses.

In this book, we are primarily concerned with the inner Form of subjects, however, in other contexts (such as art and design), the outer Form plays a more prominent role.

Now, let’s identify some of the common viewpoints from which Content and Form might be considered.

Material vs. Ideal

When discussing the material — i.e., objective systems and objects^[93] — discussion of Content and Form is more straightforward.

Material

With material things and phenomena, the Content is what the thing is made out of: the physical parts, aspects, attributes, and processes that compose the subject. For example, the Content of a wooden chair might be the wood, nails, paint, and other materials which are used to create the chair.

A material object can be described in terms of content, inner form, and outer form.

The inner Form of a material object refers to stable internal relations which compose the object. The stable relationship between the wood and the nails — the nails bind the wood together, the wood is cut in certain patterns, the paint adheres to the wood through physical and chemical bonds, etc. Stability is, again, relative — over time, the paint will chip and flake, the wood will rot, the nails will rust, etc. Dialectical processes of change will eventually reduce the chair into something other than a chair (i.e., through rotting, burning, disassembly, etc.), but as long as the internal relations maintain the Form of a chair we conceive of it as a chair.

The outer Form of a material object refers to the way it appears to human consciousness. Its shape, aesthetics, etc.

Ideal

With the ideal — i.e., abstract ideas and concepts — discussion of Content and Form becomes more complicated. As Vietnam’s Marxism-Leninism Textbook for Students Who Specialize in Marxism-Leninism explains:

Many times, human consciousness has difficulty in trying to clearly define the Content of a subject — especially when the subject is an abstract idea. We often mistake Content with inner Form. Usually, in this situation, there is a strong combination and intertwining between both Content and Form. In such a situation, the Form can be referred to as the “inner Form,” or the “Content-Form.”
With physical things and phenomena, this type of Form usually belongs to a very specific Private, it doesn’t exist in any other Private, it is the Unique [see Annotation 129, p. 128].

The reason the inner Form of physical objects usually exists in Private as the Unique is because the stable internal relations of any given physical object are equivalent to the specific material components which distinguish one physical object from all other physical objects. In other words, if you have two chairs which are exact copies of each other, made from the same kind of wood, cut into the same shape, using the same type and configuration of fasteners, etc., they are still not the exact same object. The internal relations of one chair are what make it that chair and distinguish it from all other objects in the universe. The outer Form of these chairs may have many commonalities (they look similar, they have the same color, etc.), but the inner Form is what distinguishes one chair from the other.

However, within the realm of abstract ideas, there are also Forms which many abstract Privates share. In the context of abstract ideas, we call this kind of Form the “outer Form,” the “form-Form,” or the “common Form.”
When we try to define the Content of a subject which is an abstract idea, our consciousness usually tries to answer the question: “what is the subject?”

This is usually a simple matter. Take, for example, the abstract idea of “freedom.” When we try to think of the Content of freedom we can answer it pretty easily. What is the subject of freedom? It is the condition which allows humans to follow their own will, it is the absence of external coercion, etc., etc.

But, when we try to define the Form of an abstract idea, our consciousness tries to answer the question: “how is the subject?” — this is when we have to define the mode of existence (the Form) of that subject.

This is where things get more complicated. The mode of existence of an abstract idea can usually be considered to be language, since our ideas are usually expressed through language, but it can take on other modes of existence as well, such as visual media (paintings, photographs), physical motions of the human body (body language, dance), etc. This is how the field of art studies is concerned with the philosophical categories of Content and Form.

Content and Form in Art

Many readers may already be familiar with the subject of Content and Form from studying art, design, communications, and related fields. At first glance, the definitions of Content and Form may seem different from what we’ve been discussing so far.

This is because art concerns itself with abstract ideas expressed through various Forms of physical representations.

These physical representations may include physical objects (photographs, paintings, sculptures), performed and/or recorded physical activities (dance, music, theater, film), human language recorded in stable physical Forms of written language (novels, poems, stories) or spontaneously performed oral language (storytelling, impromptu spoken-word poetry).

Because the study of art is primarily concerned with interpreting and understanding ideas expressed through these physical manifestations, art is concerned with the stable inner relations of the ideas which artists imbue within their works of art — much more than the stable inner relations of the physical components of the object.

According to the Vietnamese art textbook Curriculum of General Aesthetics:

What is the Form of a work of art? Form is the way to express the Content of an artwork. Form and Content within a work of art have a strong unity with each other and they regulate each other. Form is the organization, the inner structure of the Content of an artwork. Therefore, Form is the way that the Content expresses itself, and that way is described by two features. We must ask:
First: what expresses the Content of a work of art?
Second: how is it expressed?
Art exists when two conditions are met: first, there must be a subject with an outer Form. Second, an artist must convey aesthetic meaning, or humanization, of that subject. This aesthetic meaning is the Content.

So, in studying works of art, we are less concerned with the physical content of the artwork (the canvas, paint, etc.) than we are with the abstract content of the artwork (the ideas which the artist imbues within the artwork).

As for Form, the inner Form of art represents the stable internal relations which compose the art (both ideal, i.e., the stable internal relations of the abstract ideas imbued within the art by the artist, as well as physical, i.e., the stable internal relations of the physical media of the art).

The outer Form of art represents how our human senses perceive the art, such as composition techniques, the use of color, etc.

The chart below breaks down the differences in a general, non-artistic viewpoint of physical objects and processes in materialist dialectical terms (i.e., the viewpoint an engineer might have), as compared with the artistic viewpoint of physical objects and processes (which an art critic might have). Some fields, such as designing products for human use, might draw from both viewpoints.

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Content and Form in Specific Artistic Media

Every medium of art will interpret Content and Form in its own way. For example:

Literature is a specific art discipline which deals with recorded human language in the Form of writing. In written literature, the Content would be the ideas expressed in a piece of writing; what the words say. The inner Form would be the way the ideas relate to each other — i.e., story structure, pacing, character development, etc. The outer form would be the physical format of the writing — i.e., manuscript, magazine article, paperback book, ebook, etc.

Painting is a specific art discipline in which pigments are applied to objects to create images which convey ideas and emotions. In painting, the Content would be the meaning which an artist embodies in a work of art. The inner Form would include the stable internal relations within the artwork (i.e., the bonds and mixtures between the pigments, the canvas, etc.), while the outer Form would be how the artwork appears to human senses (composition, aesthetics, etc.). Generally speaking, the creator of the art will have to make decisions about the inner Form (i.e., selection of oil vs. acrylic vs. watercolor, selection of shade, tint, and hue, physical brush strokes, etc.) so as to produce the desired outer Form (the way the finished artwork will appear to viewers).

Theater is a specific art discipline in which human beings perform physical actions and use their voices to convey ideas to an audience. In theater, the Content includes the ideas which are being presented, such as the script, the musical score, the story, the performance choices of actors, costumes, props, etc. The inner Form would include the stable relations between the members of the cast, the director, the physical stage, the lighting, etc., and the outer Form would be the way the play appears to the audience.

These are just some examples. Each medium of expression will have its own variations in how Content and Form are considered.

Engels described the manifestation of Content and Form in Dialectics of Nature:

The whole of organic nature is one continuous proof of the identity or inseparability of form and content. Morphological and physiological phenomena, form and function, mutually determine one another. The differentiation of form (the cell) determines differentiation of substance into muscle, skin, bone, epithelium, etc., and the differentiation of substance in turn determines difference of form.

Content and Form are discussed frequently in analysis of human social systems and objective relations which occur within society. For example, Marx made many criticial insights into economics by analyzing and explaining the form of value [see Annotation 14, p. 16] under capitalism.

Indeed, the entire capitalist system can be viewed in terms of content and form. The current form of human civilization is capitalism. That is to say, capitalism is the stable set of relations and characteristis of the current political economy which dominates the planet. The content of capitalism includes all the components of the base and superstructure, including the various classes (capitalists, working class, etc.), the means of production, government institutions, corporate institutions, etc. All of these elements are configured together into the relatively stable form which we call “capitalism.”

b. Dialectical relationship between Content and Form

Content and Form have a strong dialectical relationship with one other. There is no Form that does not contain any Content. Simultaneously, there is no Content that does not exist in a specific Form. The same Content can manifest in many Forms and a Form can contain many Contents.

The relationship between Content and Form is a dialectical relationship in which Content decides Form and Form can impact Content.

Annotation 151

For example, if you want to make a table, and all you have available are wood and nails, then that Content (the wood and the nails) will determine the Form the table ends up taking. You are going to end up with a wooden table, and it will therefore have to have certain characteristics of Form.

When Content changes, the Form must change accordingly. If, instead of wood, you have iron, then the table you end up building will have a much different Form. Form can also influence the Content, but not nearly as much as Content determines Form. For instance, if you have wood and nails, but you develop a technique for building a table that doesn’t need any nails, then the result (a wooden table without any nails) would be an example of a development in Form reflecting as a change in Content.

The main tendency of Content is change. On the other hand, Form is relatively stable in every thing and phenomenon. As Content changes, Form must change accordingly. However, Content and Form are not always perfectly aligned.

Annotation 152

Since all things, phenomena, and ideas are constantly changing, it stands to reason that the internal components (things, phenomena, and ideas, and their relations) which compose the Content of a subject will constantly be undergoing processes of change and development. Thus, we say that the tendency of Content is change. Since the Form is based on the internal relations of the components of Content, it stands to reason that a change in Content will lead to change in Form. These kinds of changes in Content and Form also occur through the dialectical process: changes in quantity lead to changes in quality [see Annotation 117, p. 119].

Quantity changes in Content lead to quality shifts in Form.

As soon as a wooden chair is finished being built, the paint is already beginning to degrade. The wood is already beginning to rot. The iron nails are already beginning to rust. These changes may be imperceptibly slow — they may even take centuries to occur, if the chair is kept in a hospitable environment — but the changes are occurring, quantitatively, over time, none-the-less.

Eventually, changes in quantity will lead to changes in quality. At some point, the chair might weaken and begin to wobble whenever it’s sat in. Human beings might recognize this quality and begin to think of it as a “wobbly chair.” The chair might degrade to the point where it can’t be safely used at all, in which case it will have quality shifted into a “broken chair.” If the chair is repaired, that would represent another quality shift. If it is used for firewood, that would be another quality shift.

Keep in mind that changes in Form do not directly cause changes in Content. If you disassemble a wooden chair into the constituent wood and nails, the wood and nails remain more or less unchanged. But if you burn a wooden chair, it’s the change in Content which leads to the change in Form from “chair” to “pile of ash.”

Form simply represents the stable relationships between the component parts of the subject’s Content. The only way to change Form is to change those inner relations, or to change the components which are relating. There is no way to change Form without changing the Content, and changing the Content changes the Form by definition.

Content determines Form, but Form is not fully decided by Content, and Form can impact back on Content. If a Form is suitable with its Content, it can improve the development of its Content. If a Form is not suitable with its Content, it can constrain the development of its Content.

Annotation 153

The dialectical relationship between Content and Form is somewhat similar to the dialectical relationship between the material and the ideal (see Matter and Consciousness,

p. 88). Just as the material world determines consciousness while consciousness impacts the material world, the Content of a subject determines the Form while the Form impacts the Content.

Suitability describes the applicability of a subject for a specific application or role. Whether or not something is “suitable” or not can be highly subjective (i.e., which music would be “suitable” to play at a party), or it can be more objective (i.e., what kind of batteries to use with an electronic device).

We might say that hardwood is “suitable” Content for the Form of a chair because it is durable, strong, relatively inexpensive, and long-lasting. It might be “unsuitable” to have a chair made of hardwood if it is to be used as an office chair, because the hard surfaces might cause strain and discomfort. However, we can utilize conscious activity to adjust and develop suitability between Content and Form. Changing the Content by adding cushioning or padding might make the Content and Form more suitable with each other. Similarly, changing the Form by designing contours and adding adjustability to the chair might make the Content and Form more suitable with each other for their intended application as an office chair.

If a Form is not suitable with the Content, it restrains the development of the Content. Just think of a shovel (Form) made of wood (Content), which will degrade very rapidly over time, vs. a shovel (Form) made of steel (Content) which will last much longer. This works in both directions. Consider the Content of drinking cups: a porcelain cup might last for a long time and even develop positively over time (by acquiring a desirable patina), while a cup made out of mild steel would not be desirable, as it would be highly prone to rust from extended use containing liquids.

c. Meaning of the Methodology

Content and Form always have a dialectical relationship with each other. Therefore, in our perception and practice, we must not try to separate Content and Form, nor should we solely focus on one and ignore the other.

Because Content determines Form, whenever we are considering a thing, phenomenon, or idea, we must base our consideration first on its Content. If we want to change a thing or phenomenon, we have to change its Content first.

In reality, we must promote the positive impact of Form on Content by making the Form fit the Content. Likewise, we must also change the Form that is no longer suitable with its Content and therefore constrains the development of its Content.

Annotation 154

In any analysis, it is very important that we carefully consider whether or not Content and Form are suitable with each other in our own projects and activities. We can learn a lot about suitability from observation and practice (see Cognitive Theory of Dialectical Materialism, p. 204) and improve suitability through conscious activity.

Marx believed that it is vital to consider Content and Form when analyzing human society and political economy. One of his core critiques of political economists like Adam Smith and David Ricardo was a failure to consider Content and Form when it comes to value, commodities, and money. He discusses this extensively in Capital Volume 1, as in this excerpt:

The value-form, whose fully developed shape is the money-form, is very elementary and simple. Nevertheless, the human mind has for more than 2,000 years sought in vain to get to the bottom of it all, whilst on the other hand, to the successful analysis of much more composite and complex forms, there has been at least an approximation. Why? Because the body, as an organic whole, is more easy of study than are the cells of that body. In the analysis of economic forms, moreover, neither microscopes nor chemical reagents are of use. The force of abstraction must replace both.

Marx, here, is saying that studying the economy is more difficult than studying the human body because it can’t be physically observed and dissected. Rather, we have to rely on abstraction, which leaves us prone to making many more mistakes in analyzing Content and Form.

But in bourgeois society, the commodity-form of the product of labour – or value-form of the commodity – is the economic cell-form. To the superficial observer, the analysis of these forms seems to turn upon minutiae. It does in fact deal with minutiae, but they are of the same order as those dealt with in microscopic anatomy.

Marx’s analysis of capitalism relies to great extent upon recognizing the commodity-form of the product (Content) of labor. Labor existed long before capitalism. Labor has existed for as long as humans have worked to change our own material conditions. But under capitalism, labor specifically takes on the Form of a commodity which is bought by capitalists. This becomes the basis for Marx’s entire critique of capitalism.

Obviously, there is much more to Marx’s use of Content and Form in analyzing capitalism and human society, but this should hopefully give you some idea of the importance of Content and Form in analysis of human society and revolutionary activity.

5. Essence and Phenomenon

a. Categories of Essence and Phenomenon

The Essence category refers to the synthesis of all the internal aspects as well as the obvious and stable relations that define the existence, motion and development of things, phenomena, and ideas.

The Phenomenon category refers to the external manifestation of those internal aspects and relations in specific conditions.

Annotation 155

Understanding Essence and Phenomena can be challenging at first, but it is very important for materialist dialectical analysis.

Essence should not be confused with Form. Form represents the stable internal relations of the component content of a subject, whereas Essence represents the synthesis of all internal aspects as well as all obvious and stable attributes which define the existence, motion, and development of a subject.

Phenomena are simply external manifestations of a subject which occur in specific conditions.

The Essence of a subject is not dependent on conditions, whereas in different conditions, the same subject will exhibit different Phenomena. For example, COVID-19 is, essentially, a specific virus strain. That is to say, all of the internal aspects and stable relations that define the existence, motion, and development of COVID-19 are synthesized as a virus which we call COVID-19.

The Phenomena of COVID-19 which we can observe in patients would include symptoms such as fever, coughing, trouble breathing, etc.

The Essence of a cloud is water vapor in the atmosphere: that is the synthesis, the coming-together, of all the internal stable relations and aspects which will determine how a cloud exists, moves, and develops over time.

The Phenomena of clouds are all the things we can sense: the appearance of big fluffy white things in the air, shadows on the ground, and, sometimes, rain.

Essence defines Phenomenon: the internal attributes and stable relations will produce the Phenomena which we can observe. A cloud is not essentially defined as a fluffy white thing in the air; that is just the appearance a cloud has to our human senses in certain specific conditions.

b. Dialectical relationship between Essence and Phenomenon

Essence and Phenomenon both exist objectively as two unified but opposing sides.

The unity between Essence and Phenomenon: Essence always manifests through Phenomena, and every Phenomenon is always the manifestation of a specific Essence. There is no pure Essence that exists separately from Phenomena and there is no Phenomenon that does not manifest from any kind of Essence.

When Essence changes, Phenomena also change accordingly. When Essence appears, Phenomena also appear, and when Essence disappears, Phenomena also disappear. Therefore, Lenin said: “The Essence appears. The appearance is essential.”^[94]

The Opposition of Essence and Phenomenon: Essence is that which defines a thing, Phenomenon, or idea, while Phenomena are diversified and conditional. Essence is internal, while Phenomena are external. Essence is relatively stable, while Phenomena continuously change.

Annotation 156

Essence and Phenomenon are simultaneously unified and opposite because neither can exist without the other, yet they have completely opposite features from one another.

Discussing the Essence and Phenomena of physical objects is relatively straight-forward. The Essence will typically encompass the physical object or system itself. For example, a car engine is essentially a machine; that is to say, the synthesis of all the internal aspects (the engine parts) as well as the obvious and stable relations (the relations between the parts of the engine; how they are assembled and work together in the engine system) that define the existence, motion and development of the engine (the way it works) are what essentially make it a car engine. All of these essential characteristics are internal, relatively stable, and remain the same regardless of the condition of the engine (i.e., they continue to exist whether the engine is turned on, turned off, inoperable, etc.).

The Phenomena of the car engine are all the things that we can sense from it, but this can vary a great deal depending on conditions. When the car engine is turned off, it will be silent. It may be cool to the touch. It will be at rest. If the engine is turned on, the parts will move, it will become hot, it will make noise. In some situations it might smoke or even catch on fire. All of these Phenomena are conditional, unstable, and external to the engine itself.

With ideas and abstract thought, Essence and Phenomenon becomes more difficult to determine and analyze. Lenin discussed this in his Philosophical Notebooks, beginning with a quote from Hegel:

Dialectics in general is “the pure movement of thought in Notions“ (i.e., putting it without the mysticism of idealism: human concepts are not fixed but are eternally in movement, they pass into one another, they flow into one another, otherwise they do not reflect living life.

Knowing that Hegel was an idealist, Lenin wanted to strip all idealism from his conception of dialectics, and thus made it clear that “the pure movement of thought” simply refers to the fact that human thoughts are constantly changing, always in motion, within the living human mind, writing:

The analysis of concepts, the study of them, the “art of operating with them” (Engels) always demands study of the movement of concepts, of their interconnection, of their mutual transitions).

This is a description of materialist dialectical analysis of human thought. We must understand that human thoughts are always in motion, always developing, and always mutually impacting other thoughts.

In particular, dialectics is the study of the opposition of the Thing-in-itself, of the essence, substratum, substance — from the appearance, from “Being-for-Others.” (Here, too, we see a transition, a flow from the one to the other: the essence appears. The appearance is essential.) Human thought goes endlessly deeper from appearance to essence, from essence of the first order, as it were, to essence of the second order, and so on without end.

This is where Lenin introduces the concept of Essence and Phenomenon (or “appearance,” as Lenin puts it) as simultaneously oppositional and in unity. Essence refers to the qualities and nature of the “thing-in-itself” (its internal components, relations, etc.) while Phenomena represents “being-for-others” (that which external observers can sense or witness of a subject). However, as Lenin notes, Essence and Phenomena have a dialectical relationship with each other — a “flow from the one to the other.” The Essence “appears” by exuding Phenomena which we can sense.

Conscious thoughts also have Essence and Phenomena of their own. With thought, the development from Essence to Phenomena is constant and inevitable. The Essence of each thought leads to thought-Phenomena which develop in turn into the Essence of new thoughts in a constant flow.

In this sense, Essence and Phenomenon of abstract thought is somewhat different from Essence and Phenomenon of physical objects, but physical objects can have this same dialectical pattern of development. For example, the emissions from the engine of a car can be considered Phenomena of the engine, but as these Phenomena build up in the air (along with the emissions from many other cars), they can develop into a physical subject with a new Essence of its own, which we call “air pollution.”

We can also think of the light which comes from the sun. The light itself can be thought of as Phenomena of the sun, but the light energy can be captured by a solar panel and converted into energy, creating a new subject with its own Essence which we would describe as “solar energy.” In this sense, it is possible for Phenomena to have Phenomena. If you witness light waves in the desert which cause an optical illusion, then the illusion is a Phenomenon of the light waves (the light waves being the Essence which exuded the Phenomenon of illusion), and the light waves are the Phenomena of the sun (the essential subject which exudes the Phenomena of the light waves).

Essence and Phenomena can also be contextual. In some contexts, physical objects which have their own Essence (and Phenomena) may be the Phenomena of some other entity. For example, archaeologists can’t observe prehistoric civilizations directly. They can only study the things which are left behind. In this sense, we can think of an archaeological artifact, like a stone tool, as a Phenomenon of a prehistoric civilization. The tool has its own Essence and Phenomena, but it is also itself a Phenomenon. A single stone tool can’t tell archaeologists much about an ancient civilization, however, archaeologists can gather many Phenomena (tools, structural ruins, nearby animal bones and seeds, human remains, etc.) to look for patterns which reveal more insights about the Essence of the prehistoric civilization which exuded those Phenomena.

Dialectics in the proper sense is the study of contradiction in the very essence of objects: not only are appearances transitory, mobile, fluid, demarcated only by conventional boundaries, but the essence of things is so as well.

Lenin, here, points out that proper analysis hinges on understanding the Essence of a subject, since the Phenomena are fleeting and subject to change. Most notably, we should look for contradictions within the subject (see Definition of Contradiction and Common Characteristics of Contradiction, p. 175), because contradictions are what drive dialectical development of a subject over time.

c. Meaning of the Methodology

If we want to be accurately aware of things, phenomena, and ideas, we must not just stop at studying their Phenomena, we have to study their Essence. Only through examining many Phenomena of a subject can we fully and correctly understand the Essence of said subject.

Annotation 157

With physical objects, we must study the Phenomena to know anything about a subject, since Phenomena is, by definition, that which we can observe. Only through systematic, repeated observations can we come to understand the Essence of the object which exudes the Phenomena. Because Phenomena can change based on conditions, we must observe Phenomena under various conditions in a systematic way. This is the basis of all scientific inquiry.

This is also true for analyzing aspects of human society. To understand a social system, we must observe its Phenomena systematically over time and look for patterns which form under various conditions. We must also keep in mind that social systems develop and change over time, and so the Essence might develop with or without changes in certain Phenomena. For example, the phenomena of the United States of America have changed significantly over the years. The national flag, military uniforms, seals, and other iconography have changed throughout the history of the USA. Similarly, there have been many presidents, and the government and constitution have also been through many changes. That said, the essential nature of the USA’s political economy has not changed significantly since its foundation; the USA has been a capitalist bourgeois democracy since the beginning and remains so to this day. Regardless of which bourgeois-dominated political party holds power in the white house and congress — Whig, Republican, Democrat, or otherwise — the essential nature of the USA as a capitalist bourgeois democracy has remained the same.

According to Lenin: “Human thought goes endlessly deeper from appearance to essence, from essence of the first order, as it were, to essence of the second order, and so on, without end.”^[95] On the other hand, Essence is what defines a thing, phenomenon, or idea. Therefore, in our perception and practice, we must recognize a thing, phenomenon, or idea based on its Essence, not its Phenomena, to evaluate it correctly, and after that, we can make fundamental improvements.

Annotation 158

For example: Thousands of years ago, people observed that the sun rises in the east and sets in the west everyday. Based on these Phenomena, many human civilizations developed the belief that the Essence of our solar system was that the earth was the center of the universe and the sun rotated around it. Today, thanks to scientific observation and practice, we have proven that the sun is the center of the solar system and that the earth is rotating around it, which is totally opposite to what many believed hundreds of years ago. In this case, the initially observed Phenomena were misleading, and it was only by getting a better grasp of the essential nature of the solar system that we could better comprehend its functioning.

It is usually easy to observe Phenomena (since they are defined by being observable) but it’s also easy to misunderstand relationships between Essence and Phenomena. Sometimes people get a false perception of Essence from real Phenomena, such as believing the Sun revolves around the Earth. Sometimes people attribute the wrong Phenomena to Essences as well, such as believing that all poor people are lazy.

Phenomena can easily be mistaken for essence. For example, bourgeois liberal political parties often portray themselves as being pro-worker and therefore exhibit phenomena such as rhetoric, slogans, propaganda, and even platform positions which appeal to workers. These phenomena may confuse many into believing that they are workers’ parties when, in reality, they are essentially dominated by the capitalist class. The reverse can also occur. For example, workers may be fooled into believing that a ruthless capitalist politician or celebrity is “working class at heart,” falsely believing that the capitalist’s class position is merely a phenomenon when in fact it is essential.

Understanding true Essence based on real Phenomena is one of the most important aspects of analysis. It is the primary realm of science. In politics, misunderstanding or mischaracterizing Essence and Phenomena can reinforce false beliefs about the way society works which can lead to promulgation of dangerous and reactionary ideologies like neoliberalism and fascism amidst the working class. For this reason, we must avoid examining Phenomena alone. We have to dive deep to discover and understand the essential nature of things, phenomena, and ideas in our analysis.

6. Possibility and Reality

a. Categories of Possibility and Reality

The Possibility category refers to things that have not happened nor existed in reality yet, but that would happen, or would exist given necessary conditions.

The Reality category refers to things that exist or have existed in reality and in human thought.

b. Dialectical Relationship Between Possibility and Reality

Possibility and Reality have a unified and inseparable relationship: Possibility can transform into Reality and Reality contains new Possibility; any given Possibility, under specific conditions, can transform into Reality.

Given specific conditions, there could be one or many possibilities for the development of any given thing, phenomenon, or idea: practical Possibility, random Possibility, obvious Possibility, abstract Possibility, near Possibility, far Possibility, etc.

Annotation 159

Excerpt From Marxism-Leninism Textbook of Students Who Specialize in Marxism-Leninism

Editor’s notes in [brackets]

Reality has many aspects. It also has many tendencies of development. These aspects and tendencies of Reality have different roles and positions in the development process of Reality. For example, manifesting any given Possibility into Reality requires us to change a specific subject from one status to a different status. Some subjects are easier to transform and others are more difficult to transform. Some require us to change quality, others only require quantity changes [see Annotation 117, p. 119].

Because Reality has many aspects and tendencies of development, it is useful to classify Possibility. There are at least four types of Possibility, in two separate categories.

[The categorization below draws a distinction between the obvious and the practical.

The obvious is that which will certainly occur. If you drop an object, it will obviously fall. The practical is that which we certainly could make occur through human will. If you are holding an object, you could practically drop it.]

Obvious Possibility and Random Possibility [see: Obviousness and Randomness, p. 144].

Obvious Possibility refers to Possibility that will happen, because conditions to make it happen are set in place so that the Possibility developing into Reality is unavoidable.

[If the conditions arise for a hurricane to form, it eventually becomes obvious that a hurricane will form.]

Random Possibility is Possibility which may or may not happen depending on how external factors develop, our actions, the actions of others, etc. [Whether or not a hurricane may develop on any given day is, from our human perspective, random, since we do not have any technology to cause or prevent the development of hurricanes. Other events may be more or less random. We can, for instance, prepare for an incoming hurricane to minimize the risk of harm to human communities.]

Second, based on the practical relationships between subjects, we have:

Practical Possibility vs. Abstract Possibility:

Practical Possibility means that conditions in Reality which could make something happen are already in place. [If you have all the ingredients, knowledge, and equipment needed to make a pie, you could make a pie. The material conditions are in place.]

Abstract Possibility is Possibility which may become Reality in the future but the conditions which would make this Possibility become Reality have not yet developed.

[It is an abstract Possibility that you could make a pie, even if you don’t have the tools, ingredients, or knowledge. It is possible, in the abstract, that you could buy the ingredients and equipment and learn the necessary skills to make a pie. Near Possibility simply refers to Possibility which may become Reality in the shorter term, far Possibility refers to things which may happen in a more distant future, relative to the subject being discussed.]

In social life, in order to transform a Possibility into Reality, there must be objective conditions and subjective factors. Subjective factors include the ability of humans to change Possibility into Reality. Objective conditions refer to the situations needed to make such a change occur. [In other words, humans are able to subjectively change possibility into reality, but only when the objective circumstances exist in the external world.]

c. Meaning of the Methodology

We must base our perception and practice on Reality.

Lenin said: “Marxism takes its stand on the facts, and not on possibilities. A Marxist must, as the foundation of his policy, put [forth] only precisely and unquestionably demonstrated facts.”^[96]

However, in our perception and practice, we also need to comprehensively recognize possibilities which could arise from Reality. This will allow us to develop methods of practical operation which are suitable to changes and developments which might occur. We must actively make use of subjective factors in perception and practice to turn Possibility into Reality whenever it would serve our purposes.

Annotation 160

This idea is perhaps best exemplified in the traditional Vietnamese proverb: “you can’t just open your mouth and wait for fruit to drop into your mouth.” We have to actively apply our will, through practice and labor, to develop the best possibilities into manifested Reality. See more about subjective factors in Annotation 207, p. 202.

IV. Basic Laws of Materialist Dialectics

Laws are the regular, common, obvious, natural, and objective relations between internal aspects, factors, and attributes of a thing or phenomenon or between things and phenomena.

There are many types of laws in this world and they all have different prevalence, reach, characteristics, and roles in regard to the motion and development processes of things and phenomena in nature, society, and human thought. So, it is necessary to classify different laws for humans to understand and apply them effectively into practical activities. Classifying laws based on prevalence, we have: private laws, common laws, and universal laws [see: Private and Common, p. 128].

Private laws are laws that only apply to a specific range of things and phenomena. For example: laws of mechanical motion, laws of chemical motion, laws of biological motion, etc.

Common laws are laws that apply to a broader range of subjects than private laws, and they impact many different subjects. For instance: the law of preservation of mass, the law of preservation of energy, etc.

Universal laws are laws that impact every aspect of nature, society, and human thought. Materialist dialectics is the study of these universal laws.

If we classify laws based on the reach of impact, we will have three main groups: laws of nature, laws of society, and laws of human thought.

Laws of nature are laws that arise in the natural world, including within the human body. They are not products of human conscious activities.

Laws of society are the laws of human activity in social relations; these laws only apply to the conscious activities of humans, yet they are still objective.

Annotation 161

We have already discussed how relations between human beings are objective [see Annotation 108, p. 112]. By extension, the human relations which compose human societies are objective, and thus, any laws which govern objective human relations must also be objective.

Marx’s assertion that human social relations are objective is critical to understanding his work. Marx pointed out that social relations may not be “physical,” in the sense that they can’t be observed directly with human senses, but that they still have an objective character — they exist externally to a given subject, and they have objective impacts on reality. For instance, the class relations between the capitalist class and the working class result in objective manifestations in reality, such as wealth accumulation, modes of circulation, etc.

Laws of human thought are laws of the intrinsic relationships between concepts, categories, judgments, inference, and the development process of human rational awareness.

As the science of common relations and development, materialist dialectics studies the universal laws that influence the entire natural world, human society, and human thought, all together as a whole.

These universal laws are:

The law of transformation between quantity and quality.
The law of unification and contradiction between opposites.
The law of negation of negation.

Annotation 162

Each of these laws is considered universal because they apply to all things, phenomena, and ideas, and all the internal and external relations thereof, in human perception and practice. All things, phenomena, and ideas change and develop as a result of mutual impacts and relationships in accordance with these universal laws. On a fundamental level, materialist dialectics is the study of these universal laws and their utility.

1. Law of Transformation Between Quantity and Quality

The law of transformation between quantity and quality is a universal law which concerns the universal mode of motion and development processes of nature, society, and human thought.

Annotation 163

Remember that mode refers to how something exists, functions, and develops [see Annotation 60, p. 59]. The universal mode of motion and development processes thus refers to how all things, ideas, and phenomena move, change, and develop.

Friedrich Engels defined the law of transformation between quantity and quality in Dialectics of Nature:

The law of the transformation of quantity into quality and vice versa. For our purpose, we could express this by saying that in nature, in a manner exactly fixed for each individual case, qualitative changes can only occur by the quantitative addition or subtraction of matter or motion (so-called energy).

In other words, quantitative changes of things, phenomena, and ideas lead to quality shifts.

The universal mode of motion and development processes follows the law of transformation between quantity and quality, which states:

Qualitative changes of things, phenomena, and ideas arise from the inevitable basis of the quantitative changes of things, phenomena, and, ideas; and, vice versa: quantitative changes of things, phenomena, and ideas arise from the inevitable basis of qualitative changes of things, phenomena, and ideas.

Annotation 164

Put simply: quantity changes develop into quality changes, and quality changes lead to quantity changes [see Annotation 117, p. 119]. We say that these changes to quantity and quality occur on the “inevitable basis” of one another because quality changes always, invariably, arise from quantity changes, and, likewise, quantity changes always, invariably, arise from quality changes.

Just as quantity shifts lead to quality shifts, it is also true that quality shifts lead to quantity shifts. For example, if you have 11 donuts, then add 1 donut, you now have 1 dozen donuts. If you add 12 more donuts, you would then have 2 dozen.

Another example of quality shift leading to quantity shift would be a pond filling with rain water. Once enough drops of water collect and the pond is considered full — that is to say, once it is considered to be “a pond” of water — we will no longer think of the pond in terms of “drops.” We would think of the pond as “filled,” “overfilled,” “underfilled,” etc.

Note that both of these examples are related to our human perceptions and understanding of the material world. The material world does not change based on our perceptions, nor how we classify the quantity or quality of a given subject. There are also objective aspects related to quality shifts leading to quantity shifts. For example, if we adjust the quantity of the temperature of a sheet of paper to the point of burning, and the paper burns, then the quantity of paper would be reduced from one sheet to zero sheets. In other words, the quality shift arising from temperature quantity increase (i.e., the paper burning into ash) results in a quantity shift in how many pieces of paper exist (from one sheet to zero sheets). However, even this is ultimately a subjective assessment rooted in human consciousness, since we subjectively think in terms of “sheets of paper,” and the concept of a “sheet of paper” is essentially a classification rooted in human consciousness. It is merely an abstract way of perceiving and considering the quantity and quality of the material subject which we think of as “paper.”

The law of transformation between quantity and quality is an inevitable, objective, and universal relationship that repeats in every motion and development process of all things, phenomena, and ideas in nature, human society, and human thought.

a. Definitions of Quality and Quantity

- Definition of Quality

Quality refers to the organic unity which exists amongst the component parts of a thing, phenomenon, or idea that distinguishes it from other things, phenomena, and ideas.

Annotation 165

Note: we have already given basic definitions of quantity and quality in Annotation 117, p. 119. What follows are more comprehensive philosophical definitions of quality and quantity. Our world exists as one continuity of matter. All things and phenomena in our universe exist essentially as one unified system — namely, the entity which we call “the universe.” This unified nature of existence is extremely difficult for human beings to comprehend. Georg Wilhelm Friedrich Hegel pointed out that, in this sense, the unity of “pure being” is indistinguishable from “nothingness.” In Science of Logic, Hegel noted that if we try to comprehend pure material existence, as a whole, without distinguishing any component thing or phenomenon from any other, then all is incomprehensible. Human consciousness needs to delineate and distinguish the component parts of this unified system from each other in order to make sense of it all.

Pure light and pure darkness are two voids which are the same thing. Something can be distinguished only in determinate light or darkness... [F]or this reason, it is only darkened light and illuminated darkness which have within themselves the moment of difference and are, therefore, determinate being.

The human mind has evolved to perceive various things, phenomena, and ideas as differentiated. Quality is the basis on which we perceive subjects as distinct from one another. Every thing, phenomenon, and idea is composed of internal components and relations. The unity of these internal components and relations is what we refer to as quality. For example, a human being’s quality refers to the unity of all the internal components and relationships of which the human being is composed (i.e., the cells, organs, blood, etc., as well as the thoughts, memories, etc., which make the human) in unity. Quality is also a subjective phenomenon: a reflection of the material world in human consciousness [see Annotation 68, p. 65]. Therefore we may conceive of various qualities for the same subject. We can think of 12 donuts as “a box of donuts,” “a dozen donuts,” or as 12 individual donuts. We could consider a building as “one apartment building” or “forty apartments,” depending on the viewpoint of analysis.

So, objective and inherent attributes form the quality of things, phenomena, and ideas, but we must not confuse quality and attribute with one another. Every thing, phenomenon, and idea has both fundamental and non-fundamental attributes. Only fundamental attributes constitute the quality of things, phenomena and ideas. When the fundamental attributes change, the quality also changes. The distinction between fundamental and non-fundamental attributes of things, phenomena, and ideas must depend on the purpose of the analysis; the same attribute may be fundamental when analyzing with one purpose but non-fundamental when analyzing with another purpose.

Annotation 166

Whether or not an attribute is considered “fundamental” depends entirely on conscious perspective. For example, one baker may consider chocolate chips to be “fundamental” for baking cookies while another baker may not. This subjective characteristic of what might be considered “fundamental” or not is reflected in how we consider quality. If you are trying to determine how much water you need to fill a swimming pool, you may think of a pool in terms of size (i.e., “this is an Olympic sized pool”), but if you just want to go for a swim, you are likely to just think in terms of the water level (i.e., “the pool is empty, we can’t swim”).

If you are planning the construction of a school and want to know how many classrooms it will need, you might think in terms of “classrooms of students.” But if you are considering funding for a school year, you might consider the total number of students.

The quality of a thing, phenomenon, or idea is determined by the qualities of its component parts.

Annotation 167

Qualities are composed of qualities, combined, in unity. “A swimming pool” may consist of a certain amount of concrete in a specific configuration combined with 5,000 gallons of water. A car may be composed of a body, an engine, four tires, etc. Each individual component exists as a quality — a unity of component attributes — in and of itself.

Quality is also determined by the structures and connections between component parts which manifest in specific relations. Therefore, distinction between fundamental and non-fundamental attributes is also relative.

Annotation 168

It’s not just the component parts of a subject which define its quality, but also the relations of those component parts. For instance, a quantity of wood and nails configured in one set of structural relations may have the quality of a chair, whereas the same component parts arranged with different structures and relations may have the quality of a table. In this sense, quality can be thought of as a synthesis of the Content and Form [see Content and Form, p. 147] of a thing, phenomenon, or idea from a certain perspective.

For example, if we see two shoes, we may think of each shoe as an individual qualitative object (two shoes). On the other hand, we may think of the shoes, together, as a single qualitative “object” in terms of its utility and in terms of synthesis of content and form (“a pair of shoes”), so much so that if one shoe is lost then the remaining shoe is considered useless and discarded as trash.

Because there are countless ways in which quality — the configuration and relations and composition of constituent parts of any given subject — can manifest, we must recognize that quality itself, based on the distinction between fundamental and non-fundamental attributes, is a relative and subjective phenomenon of human consciousness.

Any given subject will have multiple qualities, depending on the relations which exist between and within that subject and other subjects.

Annotation 169

Any thing, phenomenon, or idea may be perceived from various different perspectives which would cause us to consider it as having different qualities. A single shoe may be considered as: a shoe, 3 pounds of leather, half of a pair, etc., depending on its internal and external relations and the perspective of the person considering the shoe.

We can’t consider things, phenomena, and ideas apart from quality. Quality exhibits a subject’s relative stability.

Annotation 170

Remember that quality is the way in which the human mind conceives of the world as a collection of distinct things, phenomena, and ideas. These perceptions of quality are purely relative, but they are important, because they are what allow us to develop an understanding of the complicated system of things, phenomena, and ideas which make up our universe. In our perception, quality represents the relative stability of a thing, phenomenon, or idea which makes it a subject that we can consider and analyze in and of itself. Understanding how we distinguish between different subjects is crucial in developing a scientific understanding of the world which is rooted in observation and practice.

- Definition of Quantity

Quantity refers to the amount or extent of specific attributes of a thing, phenomenon, or idea, including but not limited to:

The amount of component parts.
Scale or size.
Speed or rhythm of motion.

A thing, phenomenon, or idea can have many quantities, with each quantity determined by different criteria. [i.e., a car may be measured by many criteria of quantity, such as: length in meters, weight in kilograms, speed in kilometers per hour, etc.]

Quality and quantity embody two different aspects of the same subject. Both quality and quantity exist objectively [see Annotation 108, p. 112]. However, the distinction between “quality” and “quantity” in the process of perceiving things, phenomena, and ideas has only relative significance: an attribute may be considered “quantity” from one perspective but “quality” from another perspective.

Annotation 171

If you are filling a box with a dozen donuts, then once you add the 12^th donut, one “dozen” may represent the quality which you seek. From the perspective of a customer buying donuts for a party, “dozen” may represent the “quantity.” In other words, you need to make an order (quality) of three dozen donuts (quantity). And the manager of the store, at the end of the day, may tally twenty orders (quantity) as the day’s sales goal (quality). Quantity and quality, therefore, are both considered relatively, based on perspective and the purpose of analysis at hand.

b. Dialectical Relationship Between Quantity and Quality

Every thing, phenomenon, and idea exists as a unity of two aspects: quality and quantity. Quantity and quality do not exist separate from one another. Quantity and quality dialectically and mutually impact one other. Changes in quantity lead to changes in quality. However, not every change in quantity will cause a change in quality.

Annotation 172

In order for quantity change to lead to quality change, a certain amount must be met.

This amount is called the threshold, which is explained further below in this section. A threshold may be exact and known (i.e., it takes exactly 12 donuts to make a dozen donuts) or it may be relative and unknown (i.e., a certain quantity of air inflated into a balloon may cause it to burst, but the exact, specific quantity of air may be relative to other factors such as air temperature and may be unknown to the observer until the balloon actually bursts).

With any given subject, there will be a range of quantity changes which can accumulate without leading to change in quality. This range is called the quantity range.

Quantity range is defined as a relationship between quantity and quality: the range of intervals in which the change in quantity does not substantially change the quality of a given subject. Within the limits of a quantity range, the subject retains the same quality.

Annotation 173

The quantity range is a range of quantities between quality shifts.

Quantity range can be thought of as the range of quantities which exists between thresholds. For instance, between the qualities of “one donut” and “one dozen donuts,” there is a quantity range of 10 donuts (2 donuts through 11 donuts) which can be added before the quality shifts to “one dozen donuts.” You can keep adding additional donuts, up to the quantity of 11 donuts, without reaching the threshold of quality shift to “one dozen donuts.” This is the quantity range between the qualities of donut and one dozen donuts. Again, the quantity range is relative to the perspective and the nature of analysis. One person may only be concerned with “dozens of donuts,” while another may consider the quality of “half dozens,” which would consider a quality shift to “one half-dozen donuts” to occur once the sixth donut (quantity) is added.

Motion and change usually begins with a change in quantity. When changes in quantity reach a certain amount, quality will also change. The amount, or degree, of quantity change at which quality change occurs is called the threshold.

Annotation 174

File:T-w-the-worldview-and-philosophical-methodology-of-57.png

Note that the threshold is an approximate range. At a certain quantity, a glass may be considered “half full” and at another certain quantity, after passing the threshold, the glass will be considered “full,” though there may be a wide range of quantities at which the glass would be considered to have the quality of being “full,” depending on perspective and purpose of analysis.

When quantity change meets a threshold, within necessary and specific conditions, quality will change. This change in quality, which takes place in the motion and development process of things, phenomena, and ideas, is called a quality shift.

A quality shift occurs when a quantity changes beyond a threshold, leading to a change in quality.

Quality shifts inevitably occur as transformations in the development processes of things, phenomena, and ideas. Qualitative changes can be expressed or manifested through many forms of quality shifts which are determined by the contradictions, characteristics and conditions of a given subject, including such characteristics as: fast or slow, big or small, partial or entire, spontaneous or intentional.

Annotation 175

Quality shifts are inevitable because there is no thing, phenomenon, nor idea which can exist statically, forever, without ever undergoing change. Eventually, any given subject will undergo quality shifts, even if such transformation may take millions of years to occur.

Quality shifts can take various forms, depending on the nature of internal and external relationships, contradictions, and mutual impacts. For instance, a river may dry up or it may flood depending on internal and external relations and characteristics, but it will not simply flow at the same level forever without ever undergoing any quality shifts.

The rate and degree of quality shifts can vary considerably based on such internal and external factors, and may be “spontaneous,” that is to say, without human intervention, or may be the result of the intentional, conscious action of human beings.

Quality shifts mark the end of one motion period and the start of a new motion period.

Annotation 176

The Quantity Range (A) refers to the range of quantities between two qualities in the process of development. The Quality Shift (B) refers to the point at which quantity accumulates to the point of changing the Quality of the developing subject. The Period of Motion (C) includes both the quantity range and the quality shifts themselves.

Period of motion refers to the development which occurs between two quality shifts, including the quality shifts themselves.

Period of motion differs from quantity range because quantity range only includes the range of quantity change which can occur between quality shifts, without including the quality shifts themselves.

For example, a period of motion for a cup filling with water from a half cup would include all of the change which occurs from the cup being half full to the cup becoming entirely full. The quantity range of this same process would only include the quantities of water that stand between half-full and full, where the cup is neither considered to be “half full” or “full” but somewhere in between, i.e., between quality shifts.

Quality shift represents discontinuity within the continuous development process of things and phenomena. In the material world, all things, phenomena, and ideas are constantly undergoing continuous sequences of quantitative changes leading to quality shifts, creating an endless line of nodes, showing how all things, phenomena, and ideas move and develop to increasingly advanced degrees [see illustration on p. 121 for a visualization of this “endless line of nodes”].

As Friedrich Engels summarised: “merely quantitative changes beyond a certain point pass into qualitative differences.”^[97]

Annotation 177

Processes of change and development in our universe are continuously ongoing. Whenever a quality shift occurs, it represents a brief discontinuity in the sense that we perceive a definite and distinct transformation from one thing, phenomenon, or idea into another; in other words, we can distinguish between the mode of existence of the thing, phenomenon, or idea before and after the quality shift.

Take, for example, the “lifespan” of a house. A human being could easily distinguish between the empty land which exists before the house is built, the construction site which exists as it’s being built, and the house itself once construction is completed. In reality, this process of change is continuous, but to our human perception, each quality shift represents a definite and distinct period of change and discontinuity in terms of our perception of the “thing” which is the house.

This is related to the historic perspective of things, phenomena, and ideas, in which we recognize the continuity of existence between different stages of development of things, phenomena, and ideas [see Annotation 201, p. 195].

When a quality shift occurs, there is an impact on the quantity. Quality impacts quantity in a number of ways, including [but not limited to]:

Changing the structure, scale, or level of the subject.
Changing the rhythm or speed of the motion and development of the subject.

In summary, dialectical unity between quantity and quality exists in every thing, phenomenon, and idea. A gradual quantitative change [through the quantity range] will eventually meet the threshold, which will inevitably lead to a qualitative change through quality shift. Simultaneously, the new quality will mutually impact the quantity, causing new quantitative changes of things, phenomena, and ideas. This process takes place continuously, forming the fundamental and universal mode of movement and development processes of all things, phenomena, and ideas.

Annotation 178

Transformation between quantity and quality is the mode of movement and development of all things, phenomena, and ideas, because it reflects the way in which human consciousness perceives movement and development.

So, it is important to understand that there is no material manifestation of quantity and quality. They are simply mental constructs which reflect the ways in which we observe and understand change, motion, and development of things, phenomena, and ideas. Transformation processes in the material world are fully fluid and continuous, but our consciousness perceives change in stages of development. Quality simply reflects how we distinguish one subject from another subject, as well as how we recognize the transformation process (and stages of development) of a single subject over time.

There is no specific point, metaphysically distinct point at which a “puppy” becomes an “adult dog,” but human beings will distinguish between a puppy and an adult dog, or recognize at a certain point that a puppy has “become” an adult dog, based on observation of quality.

Quality refers to the differences which are distinguished in human consciousness between one subject and another, or changes in a subject’s form over time.

There is no metaphysically distinct point at which a “puppy” becomes an “adult dog,” but human beings will distinguish between a puppy and an adult dog, or recognize at a certain point that a puppy has “become” an adult dog, based on observation of quality. We create categories which reflect quality to organize and systematically understand the world around us, and to distinguish between different subjects, and to distinguish between different stages of development of a given subject.

We can also distinguish differences of quality between different subjects: we can distinguish a cat from a dog, and we can distinguish one dog from another dog. These distinguishing attributes constitute differences in quality. Note that this conception of differentiation of things, phenomena, and ideas into qualities which constantly change and develop over time is fundamentally distinct from metaphysical categorization, which seeks to divide all things, phenomena, and ideas into static, perpetually unchanging categories (see Annotation 8, p. 8).

Distinction within the human mind is reflected in the concept of quantity and quality. If we do not observe quality differences between subjects, then we would not be able to distinguish between different subjects at all. If we could not recognize the quality shifts of any given subject, then we would not be aware of change or motion at all.

c. Meaning of the Methodology

Every thing, phenomenon and idea has characteristics of quality and quantity which mutually impact and transform one another. Therefore, in perception and practice, we need to understand and take into account the law of transformation between quantity and quality in order to have a comprehensive viewpoint of things, phenomena, and ideas [see Annotation 114, p. 116].

Quantitative changes of things, phenomena and ideas inevitably lead to qualitative changes in all things, phenomena, and ideas. Therefore, in our perception and practice, as we plan and enact change in our world and in human society, it is necessary to gradually accumulate changes in quantity in order to make changes in quality. At the same time, we must recognize and make use of the fact that quality shifts also lead to changes in quantity.

Annotation 179

We have to understand and utilize the law of transformation between quantity and quality in our activities. For instance, if a group of activists hopes to address hunger in their community, they have to realize that they can’t immediately enact a quality shift which solves the entire problem of hunger across the city instantaneously. Instead, the activists must recognize that quantity shifts lead to quality shifts through stages of development. In planning and acting, they may need to set certain development targets, predict thresholds at which quality shifts will occur, etc.

For instance, the first goal for these activists may be to provide free lunches to houseless people in a particular park every weekend. If they can accomplish this, then they will not have completely eliminated hunger in the city, but they will have reached a threshold — a quality shift — in that nobody in that specific park will be hungry at lunch time on weekends. From there, they can continue to build quality shifts through accumulation of changes in quantity, one stage of development at a time.

Quality shifts leading to quantity shifts must also be recognized and utilized in our planning and activities. For example, once an effective strategy is developed for eliminating hunger in one park through quantity changes leading to quality shifts, this strategy can then be implemented in other parks. Thus the quality shift of “eliminating hunger in one park” can lead to a quantity shift: “eliminating hunger in two parks, three parks, etc.,” until the quantity shift of “eliminating hunger in parks” leads to the quality shift of “eliminating hunger in all the parks in the city.” This entire process of enacting quantity changes to lead to quality shifts, and accumulating quality shifts to change quantity, are all focused toward the ultimate goal of achieving the quality shift of “eliminating hunger in the entire city.”

In short, it’s vital for us to understand the ways in which quantity and quality mutually impact each other so that we can formulate plans and activities which will lead to motion and development which accomplish our goals, step by step, through one stage of development at a time.

Changes in quantity can only lead to changes in quality provided the quantity accumulates to a certain threshold. Therefore, in practice, we need to overcome impatient, left-sided thought. Left-sided thinking refers to thinking which is overly subjective, idealistic, ignorant of the laws which govern material reality. Left-sided thinking neglects to acknowledge the necessity of quantity accumulation which precedes shifts in quality, focusing instead on attempting to perform continuous shifts in quality.

On the other hand, we must also recognize that once change in quantity has reached a threshold, it is inevitable that a quality shift will take place. Therefore, we need to overcome conservative and right-sided thought in practical work. Right-sided thinking is the expression of conservative, stagnant thought that resists or refuses to recognize quality shifts even as changes in quantity come to meet the threshold of quality shift.

Annotation 180

“Right-sided thinking” and “left-sided thinking” are Vietnamese political concepts which are rooted in the ideas of Lenin’s book: Leftwing Communism: an Infantile Disorder. In Vietnamese political philosophy, “left-sided thinking” is a form of dogmatic idealism which upholds unrealistic conceptions of change and development. Left-sided thinkers don’t have the patience for quantity accumulation which are prerequisite to quality shifts, or expect to skip entire stages of development which are necessary to precipitate change in the real world. An example of left-sided thinking would be believing that a capitalist society can instantly transition into a stateless, classless, communist society, skipping over the transitions in quantity and quality which are required to bring such a massive transformation in human society to fruition.

“Right-sided thinking,” on the other hand, is conservate resistance to change. Right-sided thinkers resist quality changes to human society; they either want to preserve society as it exists right now, or reverse development to some previous (real or imagined) stage of development. Right-sided thinkers also refuse to acknowledge quality shifts once they’ve occurred, idealistically pretending that changes in material conditions have not occurred. For example, right-sided thinkers may refuse to recognize advances which have been made in the liberation of women, or even attempt to reverse those advances in hopes of returning to previous stages of development when women had fewer freedoms. Here is a practical example of these concepts in use, from the Vietnam Encyclopedia, published by the Ministry of Culture and Information of Vietnam:

Opportunism is a system of political views that do not follow a clear direction nor a clear line, do not have a definite stance, and are inclined toward the immediate personal gain of the opportunist. In the proletarian revolutionary movement, opportunism is a politics of compromise, reform, and unprincipled collaboration with the enemy which run contrary to the basic interests of the working class and the working people. In practice, opportunism has two main trends, stemming from right-sided thinking and from left-sided thinking, respectively:
Right-wing opportunism is reformist, favors undue compromise, and aims to peacefully “convert” capitalism into socialism while abandoning the struggle for meaningful victory of the working class. Right-wing opportunism, typified by Eduard Bernstein and Karl Kautsky, has its origins in the Workers’ Parties of the Second International era and exists to this day.
Left-wing opportunism is a mixture of extremism and adventurism, dogmatism, arrogance, subjectivity, cults of violence, and disregard for the objective situation.
Both “right” and “left” opportunism push the workers’ movement to futile sacrifice and failure.

Quality shifts are diverse and plentiful, so we need to promote and apply quality shifts creatively and flexibly to suit the specific material conditions we face in a given situation. This is especially true in changing human society, as social development processes depend not only on objective conditions but also on subjective human factors. Therefore, we need to be active and take the initiative to promote the process of converting between quantity and quality in the most effective way.

Annotation 181

Put simply, we have to use our human will and labor to actively promote quantity changes which lead to quality changes, and quality changes which lead to quantity changes, which move us towards our goal of ending all forms of oppression in human society. This will involve not just objective factors^[98] (i.e., material conditions which are necessary to accomplish something), but subjective factors^[99] as well (factors which we, as a subject, are capable of impacting directly).

2. Law of Unification and Contradiction Between Opposites

The law of unification and contradiction between opposites is the Essence of dialectics [see: Essence and Phenomenon, p. 156]. According to Lenin: “In brief, dialectics can be defined as the doctrine of the unity of opposites. This embodies the Essence of dialectics, but it requires explanations and development.”^[100] According to the law of unification and contradiction between opposites, the fundamental, originating, and universal driving force of all motion and development processes is the inherent and objective contradiction which exists in all things, phenomena, and ideas.

Annotation 182

In other words, contradiction (defined further in the next section) is the force which serves as the fundamental, originating, and universal force which drives all motion and development of all things, phenomena, and ideas.

Contradiction is a fundamental driving force because it is the most basic driving force which all other forms of motion and development are based upon.

Contradiction is the originating driving force because all motion and development arises from contradiction.

Contradiction is the universal driving force because all things, phenomena, and ideas — without exception — are driven to motion and development by contradiction.

a. Definition of Contradiction and Common Characteristics of Contradiction

- Definition of Contradiction

In dialectics, the concept of contradiction is used to refer to the relationship, opposition, and transformation between opposites which takes place within all things, phenomena, and ideas, as well as between all things, phenomena, and ideas. This dialectical concept of contradiction is fundamentally different from the metaphysical concept of contradiction. The metaphysical concept of contradiction is an illogical conception of opposition without unity and without dialectical transformation between opposites.

Annotation 183

A contradiction is, fundamentally, just a type of relationship. In a contradictory relationship, two things, phenomena, and/or ideas mutually impact one another, resulting in the eventual negation of one subject and the synthesis of the negator and the negated into some new form.

The metaphysical concept of contradiction is considered illogical because it establishes no connection between that which is negated and the resulting synthesis.

In the metaphysical conception of contradiction, the negated “disappears” and is not represented in the resulting synthesis.

Metaphysical contradiction presents contradicting subjects as isolated from one another and completely distinct, when in reality the relationship between the negated and the negator essentially defines the contradiction. The negated subject is seen as completely negated; that is to say, it is conceived of as essentially “disappearing” into the synthesized result of the contradiction. In this sense, this metaphysical conception of negation is inaccurate in that it is represented as a complete, terminating process.

In the above example, once the fox eats the rabbit, the rabbit is considered “gone” after a terminal negation process (see Annotation 196, p. 188) ends the contradiction.

The materialist dialectical conception of contradiction recognizes that contradicting subjects are defined by their relationship and that the synthesis of the contradiction carries forward attributes and characteristics from both the negator and the negated.

Materialist dialectical contradiction recognizes that every contradiction is defined by the relationship between the negated and the negator. Materialist dialectics also recognizes that attributes and characteristics of the negated subject are carried forward into the synthesized subject [see Annotation 203, p. 198]. Materialist dialectics also recognizes that contradiction continues indefinitely, as the negated becomes negated again, and so on, continuously, forever [see Negation of Negation, p. 185].

In the example on the previous page, the fox consuming the rabbit constitutes a negation process in which the fox takes on characteristics from the rabbit (i.e., nutritional and energy content, any diseases which may be carried forward to the fox, etc.).

Contradiction arises from opposition which exists within or between things, phenomena, and ideas. The concept of opposing “sides” refers to such aspects, properties, and tendencies of motion which oppose one another, yet are, simultaneously, conditions and premises of the existence of one another. Examples include:

Negative charge and positive charge within atoms.
Anabolism and catabolism within living organisms [anabolism refers to the growth and building up of molecules within an organism, while catabolism refers to the digestion and breaking down of molecules within an organism].
Production and consumption as socioeconomic activities.
Trial and error which leads to cognitive development.

Annotation 184

All of the above forms of contradiction drive motion and development. These processes exist in unity and opposition. For example, in political economics, production is driven by consumption and consumption is facilitated by production. Even though these are fundamentally opposite forces (production adds to the total quantity of products, while consumption reduces the total quantity of products), they can’t exist without one another, and they drive each other forward. This is the dialectical nature of contradiction as the driving force of all motion and development as defined in materialist dialectics.

- The General Properties of Contradictions

Contradiction is objective and universal. According to Friedrich Engels: “If simple mechanical change of position contains a contradiction, this is even more true of the higher forms of motion of matter, and especially of organic life and its development. We saw above that life consists precisely and primarily in this — that a being is at each moment itself and yet something else. Life is therefore also a contradiction which is present in things and processes themselves, and which constantly originates and resolves itself; and as soon as the contradiction ceases, life, too, comes to an end, and death steps in. We likewise saw that also, in the sphere of thought, we could not escape contradictions, and that, for example, the contradiction between man’s inherently unlimited capacity for knowledge and its actual presence only in men who are externally limited and possess limited cognition finds its solution in what is — at least practically, for us — an endless succession of generations, in infinite progress.”^[101]

Annotation 185

Here, Engels is explaining how contradiction is the driving force in both material and conscious processes of motion and development. The process of life is a process of contradiction — all organic life forms must consume organic matter so that they can produce growth and offspring, must produce certain molecules and metabolic processes so that they can consume nutrients, and so on. Once these contradictory processes stop, as Engels says, “death steps in” (though even death is a transition forward).

Conscious motion and development are also rooted in contradictory forces. Engels points out the contradiction between humanity’s seemingly infinite capacity for learning with the seemingly infinite amount of knowledge which can be obtained in the world. This great contradiction drives a seemingly endless process of expanding human knowledge, collectively, over countless generations.

Contradictions are not only objective and universal, but also diverse and plentiful. The diverse nature of contradictions is evident in the fact that every subject can include many different contradictions and that contradictions manifest differently depending upon specific conditions. Contradictions can hold different positions and roles in the existence, motion, and development of things, phenomena, and ideas. These positions and roles include [but are not limited to]:

Internal and external contradictions
Fundamental and non-fundamental contradictions
Primary and secondary contradictions

Annotation 186

Internal contradictions are contradictions which exist in the internal relations of a subject, while external contradictions exist between two or more subjects as external relations.

For example: a sports team might have internal contradictions between players, between the players and the coach, between the coach and management, etc. External contradictions might exist between the team and other teams, between the team and league officials, between the team and the landlords who own the team’s practice space, etc.

A fundamental contradiction is a contradiction which defines the Essence of a relationship [see Essence and Phenomenon, p. 156]. Fundamental contradictions exist throughout the entire development process of a given thing, phenomenon, or idea. A non-fundamental contradiction exists in only one aspect or attribute of a thing, phenomenon, or idea. A non-fundamental contradiction can impact a subject, but it will not control or decide the essential development of the subject. Whether or not a contradiction is fundamental is relative to the point of view.

For example: the fundamental contradiction of one nation engaged in war against one another might be the war itself. There will exist many other contradictions; one nation at war might have a trade dispute with a third nation which is not participating in the war. From the “war perspective,” this contradiction is non-fundamental, as it does not define the essential characteristic of the nation at war (though from the perspective of a diplomat charged with ending the trade dispute, the war may be seen as a non-fundamental contradiction while the dispute would be seen as fundamental).

In the development of things, phenomena, and ideas, there are many development stages. In each stage of development, there will be one contradiction which drives the development process. This is what we call the primary contradiction. Secondary contradictions include all the other contradictions which exist during that stage of development. Determining whether a contradiction is primary or secondary is relative: it depends heavily upon the material conditions and the situation.

For example: when restoring an old car that doesn’t run any more, a mechanic may consider the primary contradiction to be the non-functioning engine. There may be many secondary contradictions which contribute to the problems with the car’s engine problems. The battery may be dead, the spark plugs may need to be bad, the tires may need replacement, the timing belt may be loose, etc. Those are all secondary contradictions which do not define the stage of development which is “repairing the engine.” Some of these secondary contradictions may need to be resolved (such as replacing the spark plugs) before the primary contradiction can be fully addressed; others, such as a cracked windshield, may not need to be addressed before the primary contradiction can be dealt with.

On the other hand, a secondary contradiction may become the primary contradiction: if a mechanic resolves every problem with the engine except for one bad spark plug, then the bad spark plug will shift from being a secondary contradiction to being the primary contradiction: the bad spark plug is now the primary reason the car won’t start and this stage of development can’t be completed.

Within all the various fields of inquiry, there exist contradictions which have a diverse range of different properties and characteristics.

Annotation 187

Different fields of study will focus on different forms of contradictions, and any given thing, phenomenon, or idea may contain countless contradictions which can be analyzed and considered for different purposes. For example, consider a large city, which might contain far too many contradictions to count. Civil engineers may focus primarily on contradictions in traffic patterns, the structural integrity of bridges and roads, ensuring that buildings are safe and healthy for inhabitants, etc. Utilities departments will focus on contradictions related to sewage, electrical, and sanitation systems. The education system will focus on contradictions which prevent students from achieving success in schools.

All of these various methods of analysis may focus on specific forms of contradictions, though there will also be overlap. For instance, designing a school bus system will require the education system and civil engineers to discover and grapple with contradictions which might be hindrances for transporting students safely to school.

b. Motion Process of Contradictions

In every contradiction, the opposing sides are united with each other and opposed to each other at the same time. The concept of “unity between opposites” refers to the fact that a contradiction is a binding, inseparable, and mutually impacting relationship which exists between opposites.

Annotation 188

Contradictions are binding and inseparable because they hold a relationship together. If two opposing things, phenomena, or ideas simply separate, then contradiction, by definition, no longer exists. For example, an economy is bound together by the contradiction of production and consumption; if production exists without consumption (or vice-versa), it can’t be considered to be an economy.

Contradictions are said to be mutually impacting because any time a contradiction exists between two opposing sides, both sides are mutually impacted for as long as the contradiction exists and develops. Of course, it is possible for two opposing sides to separate from one another; for example, a factory which produced buggy whips may have failed to find consumers after the invention of the car. Thus, there would exist a situation in which production exists without consumption. In this situation, the termination of the contradiction between production and consumption leads to a new contradiction: the factory will now be in the midst of a crisis which will require it to either provide a different product or go out of business.

Thus we see that production and consumption can’t be separated from one another without leading to a change in the essential nature of the relationship and the opposing subjects, and we see that the opposing sides mutually impact one another (a change in consumption will affect production, and vice-versa).

In any given contradictory relationship, each oppositional side is the premise for the other’s existence. Unity among opposites also defines the identity of each opposing side. Lenin wrote: “The identity of opposites (it would be more correct, perhaps, to say their ‘unity,’—although the difference between the terms identity and unity is not particularly important here. In a certain sense, both are correct) is the recognition (discovery) of the contradictory, mutually exclusive, opposite tendencies in all phenomena and processes of nature (including mind and society).”^[102]

Annotation 189

Here, Lenin is explaining that identity and unity are (more or less) the same concept when it comes to understanding the nature of contradiction between opposites. In material processes of nature, social processes, and processes of consciousness, we perceive and define oppositional forces by recognizing mutually exclusive and contradictory tendencies within and between things, phenomena, and ideas. In other words, whenever we think of an oppositional relationship, we define it in terms of the opposition.

War, disease, and economy are all examples of unity in contradiction.

When we think of a war, we think of the contradictions which exist between the opposing nations. When we think of a disease, we define it by the oppositional forces between the ailment and the human body. When we think of an economy, we think of the oppositional forces of production and consumption within the economy.

In other words, the identity of contradictory relationships is defined by the unity of the opposing sides with one another.

The concept struggle of opposites refers to the tendency of opposites to eliminate and negate each other. There exist many diverse forms of struggle between opposites. Struggle can manifest in various forms based on:

The nature of a given thing, phenomenon, or idea.
Relationships within a thing, phenomenon, or idea (or between things, phenomena, and ideas).
Specific material conditions [see Annotation 10, p. 10].

The process of unity and struggle of opposites inevitably leads to a transformation between them. The transformation between opposites takes place with rich diversity, and such transformations can vary depending on the properties of the opposite sides as well as specific material conditions.

Annotation 190

Opposing sides, by definition, oppose one another. If forces or characteristics which exist within or between things, phenomena, or ideas do not oppose one another, then they are not, by definition, opposites. Thus, it can be understood that opposing sides have a tendency to struggle against one another. It is this very struggle which defines two sides as opposites, and as contradictory.

Lenin explained that some contradicting opposite sides can exist in what he described as equilibrium, but that this is only ever a temporary state of affairs, as exemplified in his article An Equilibrium of Forces.

[See Annotation 64, p. 62 for relevant text and more info on equilibrium.]

Clearly, Lenin sees that this equilibrium of contradictory forces is not permanently sustainable. Indeed, no equilibrium of contradictory forces can be permanent. Eventually, one opposing side will overtake the other, and eventually, any given contradiction will result in one opposing side overcoming the other.

According to the law of unification and contradiction between opposites, the struggle between two opposing sides is absolute, while the unity between them is relative, conditional, and temporary; in unity there is a struggle: a struggle in unity. According to Lenin: “The unity (coincidence, identity, equal action) of opposites is conditional, temporary, transitory, relative. The struggle of mutually exclusive opposites is absolute, just as development and motion are absolute.”^[103]

Annotation 191

“Absolute” and “Relative” are philosophical classifications which refer to interdependence. That which is absolute exists independently and with permanence. That which is relative is temporary, and dependent on other conditions or circumstances in order to exist.

So Lenin’s point is that unity exists temporarily in any given pair of opposing sides, as the unity only exists as long as the opposing sides are opposing one another. As soon as one side eliminates or negates the other, the unity subsides. However, opposition is considered absolute, because it is opposition which drives motion and change in all things, phenomena, and ideas through contradictory processes of opposing sides.

In the same text quoted in the passage above, On the Questions of Dialectics, Lenin notes:

The distinction between subjectivism (skepticism, sophistry, etc.) and dialectics, incidentally, is that in (objective) dialectics the difference between the relative and the absolute is itself relative. For objective dialectics there is an absolute within the relative. For subjectivism and sophistry the relative is only relative and excludes the absolute...
Such must also be the method of exposition (i.e., study) of dialectics in general... To begin with what is the simplest, most ordinary, common, etc., with any proposition: the leaves of a tree are green; John is a man: Fido is a dog, etc. Here already we have dialectics (as Hegel’s genius recognised): the individual is the universal.
The individual exists only in the connection that leads to the universal. The universal exists only in the individual and through the individual. Every individual is (in one way or another) a universal. Every universal is (a fragment, or an aspect, or the essence of) an individual. Every universal only approximately embraces all the individual objects. Every individual enters incompletely into the universal, etc., etc. Every individual is connected by thousands of transitions with other kinds of individuals (things, phenomena, processes) etc. Here already we have the elements, the germs, the concepts of necessity, of objective connection in nature, etc. Here already we have the contingent and the necessary, the phenomenon and the essence; for when we say: John is a man, Fido is a dog, this is a leaf of a tree, etc., we disregard a number of attributes as contingent; we separate the essence from the appearance, and counterpose the one to the other.

In other words, we must understand that in materialist dialectics, the absolute and the relative exist within one another; in other words, the absolute and the relative have a dialectical relationship with one another in all things, phenomena, and ideas.

Relative unity refers to the nature of unity between contradictory subjects. Contradictory subjects are unified in the sense that any given contradiction is essentially defined by the contradiction between two subjects. Thus, the two subjects are unified in contradiction. However, this unity is relative in the sense that this unification is temporary (the unity will end upon negation and synthesis) and relative (i.e., defined by the relationship between the two contradicting subjects).

Absolute struggle refers to the fact that contradiction, negation, and synthesis will go on forever; in this sense, contradictory processes are absolute because such struggle exists permanently; struggle has no set beginning or end point, and exists independently of any specific thing, phenomenon, or idea.

Relative Unity refers to the temporary and relative nature of specific relationships which define and unify specific contradictions; Absolute Struggle refers to the permanent, constant nature of development through contradiction.

The relationship between relative unity and absolute struggle defines and drives change, motion, and development through contradiction.

This applies to contradictions. The relative unity and the absolute struggle between opposing sides have a dialectical relationship with one another. The permanent absoluteness of struggle — the fact that all things, phenomena, and ideas are constantly undergoing processes of change through contradictory forces — can only manifest in the relative unity of opposing sides, which can only exist through the temporary existence of conditional relations between opposing sides.

The interaction that leads to the transformation between opposites is a process. At the beginning, contradictions manifest as differences and then develop into two opposing sides. When the two contradictions are fiercely matched and when the conditions are ripe, they will transform each other, and finally, the conflict will be resolved. As old contradictions disappear, new contradictions are formed and the process of mutual impact and transformation between opposites continues, which drives the motion and development of all things, phenomena, and ideas. The relationship, impact and transformation between opposites are the source and driving force of all movement and development in the world. Lenin affirmed: “Development is the ‘struggle’ of opposites.”^[104]

Annotation 192

Any given process of development — that is to say, of transformation or motion — can be seen as a struggle between opposites. Various forms of struggle can exist simultaneously for any given subject, and the way we interpret struggle can depend on our point of view.

For an engineer, a car moving along a road might be seen as a struggle between the power generated by the engine against the mass of the car itself and the friction of the tires on the ground. The driver of the car might see the process in terms of the struggle between the driver and the environment as they navigate across town avoiding accidents and following traffic laws.

An organism’s life can be seen as a struggle between the organism’s life processes and its environment, or it might be seen as a struggle of contradictory forces within the organism itself (i.e., forces of consumption of nutrition vs. forces of expending energy to survive, forces of disease vs. forces of the organism’s immune system, etc.).

Materialist dialectics requires us to identify, examine, and understand the opposing forces which drive all development in our universe. Only through understanding such contradictions can we intercede and affect changes in the world which suit our purposes.

For example, in order to fight against capitalism and other forms of oppression, we must first understand the contradictory forces which exist within and between those oppressive social structures. Only then can we determine how we might best apply our will, through labor processes, to dismantle such oppressive structures. We might do this by exacerbating existing contradictions within oppressive structures, by introducing new contradictions, by negating contradictions which inhibit our own progress, etc.

c. Meaning of the Methodology

Given that contradictions are objective and universal, and that they are the source and driving force of movement and development, it is therefore necessary to detect, recognize, and understand contradictions, to fully analyze opposing sides, and to grasp the nature, origin and tendencies of motion and development in our awareness and practice.

Lenin said: “The splitting of a single whole and the cognition of its contradictory parts… is the essence… of dialectics.”^[105]

Annotation 193

In other words, materialist dialectics is simply a system of understanding the world around us by viewing all things, phenomena, and ideas as collections of relationships and contradictions which exist within and between all things, phenomena, and ideas.

Since contradictions exist with such rich diversity, it is necessary to have a historical point of view [see Annotation 114, p. 116] — that is, to know how to analyze each specific type of contradiction and have appropriate methods for resolving them. In our perception and practice, it is necessary to properly distinguish the roles and positions of different types of contradictions in each situation and condition; we must also distinguish between different characteristics which contradictions might have in order to find the best method of resolving them.

Annotation 194

The historical viewpoint is vital because in order to fully understand any given contradiction, we must understand the process of development which led to its formation.

For example, before a car engine can be repaired, we must first find out what caused the engine to stop working to begin with. If the car is out of fuel, we must determine what caused it to run out of fuel. Did the driver simply drive until the fuel tank was empty, or is there a hole or leak in a fuel line, in the tank, etc.?

It is vital to know the history of development of a given pair of opposing sides, as well as the characteristics and other properties of both opposing sides, to fully understand the contradiction. Since all conscious activity (like all processes of motion and change) ultimately derives from the driving force of contradiction, it is vital for us to develop a historical and comprehensive perspective of any contradictions we hope to affect through our conscious activities.

3. Law of Negation of Negation

The law of negation of negation describes the fundamental and universal tendency of movement and development to occur through dialectical negation, forming a cyclical form of development through what is termed “negation of negation.”

a. Definition of Negation and Dialectical Negation

The world continuously and endlessly changes and develops. Things, phenomena, and ideas that arise, exist, develop and perish, are replaced by other things, phenomena, and ideas; one form of existence is replaced with another form of existence, again and again, continuously, through this development process. This procedure is called negation.

All processes of movement and development take place through negation. From certain perspectives, negations can be seen as end points to the development (and thus, existence) of a given thing, phenomenon, or idea [which we can think of as “terminal negations;” see Annotation below]. But from other perspectives, negations can also create the conditions and premises for new developments. Such negations, which create such conditions and premises for the development of things and phenomena, are called dialectical negation.

Annotation 195

Negation refers to any act of motion or transformation which arises from contradiction. Specifically, negation is what occurs when one opposing side completely overcomes the other. Nothing in our universe can transform or move all by itself, without any contradiction. Thus, negation drives all development and motion of all things, phenomena, and ideas [see Annotation 119, p. 123]. There are various forms of negation, and the same negation process may be seen to take different forms depending on viewpoint of analysis [see Annotation 11, p. 12, and Annotation 114, p. 116], as depicted in the diagram below.

An overview of various forms of negation as they relate to dialectical development.

Dialectical negation occurs when the end of development leads directly to some new development process. Dialectical negation occurs through quality shifts [see Annotation 117, p. 119], which, themselves, occur through negation of opposite sides.

Replacement negation refers to the replacement of one thing, phenomenon, or idea with another through dialectical negation.

Translation Note: The terms “terminal negation” and “replacement negation” do not appear in the original Vietnamese text. We chose to assign terms to these concepts for clarity.

Replacement negation occurs when one thing, phenomenon, or idea takes the place of another. Replacement negation is always a dialectical process, where one subject is replaced gradually by another. Replacement may be relatively fast or slow, but it is never instantaneous — nothing can pop in and out of existence instantaneously. For example: swords were gradually replaced by firearms as the primary weapons of war over the course of many centuries. Today, swords have been completely replaced by firearms on the battlefield. This was a process of replacement negation — weapons are still used in war, but the type of weapon used has been completely replaced. Development continues, even though development of swords as battle weapons has essentially ended.

Terminal negation refers to the end of a specific cycle of development.

Terminal negation is what happens when development completely ends for a given thing, phenomenon, or idea. For example, from one viewpoint, the development of swords as weapons of war can be seen as having ended — having been terminally negated — due to the innovation of firearms. In essence, swords are no longer developed, nor implemented, in modern warfare.

Replacement negation and terminal negation must be considered in relative terms. From one viewpoint, we can see the rise of firearms as the underlying reason for the terminal negation of military use of swords. Today, no army on Earth uses swords as primary battlefield weapons and militaries no longer develop sword technology for battlefield use. However, from another viewpoint, the development of battlefield weapons has continued on long after the end of the primacy of swords, and it could be said that firearms have replaced swords as the primary battlefield weapon.

Consider the death of a human being. From one perspective, death is a terminal negation — the person’s consciousness has ended, and no further development of consciousness will occur for that individual. From other perspectives, development continues. The individual may have had children who will continue their familial lineage, they may have contributed ideas which will continue to impact other people for centuries to come, and so on. In that sense, replacement negation may be viewed as dialectical negation. For example, someone studying modes of transportation in the history of the USA may see the process of steam locomotives replacing horses, and then cars replacing steam locomotives, as processes of dialectical negation from the overarching perspective of the transportation system.

Materialist dialectics is concerned with all forms of negation, but focuses primarily on dialectical negation. Therefore, materialist dialectics is not just a theory of transformation in general, but fundamentally a theory of development

Annotation 196

All transformation is driven by negation. Development is a process, specifically, of dialectical negation, which is a specific form of transformation in which an end of development creates the conditions for new development, either through internal quality shifts or through replacement by some external subject.

Materialist dialectics is primarily concerned with dialectical negation (which drives development) because it is development which brings forth continuous change in our world. Terminal negations and other forms of transformation which do not drive further development are of limited utility, and can only represent certain limited viewpoints [i.e., the viewpoint of that which is terminated].

From a broader perspective, nearly all “terminations” are replaced in some way or another by some other form of development. For instance, even when a person dies, although the consciousness of that person may terminate, there will be continuous impacts which will be carried forward from the deceased person’s lifetime of consciousness, as well as from the developments which arise from the death itself.

This dialectical definition of negation differs greatly from metaphysical conceptions of development [see Annotation 201, p. 195], which are essentially viewed as terminal. From the metaphysical perspective, all things, phenomena, and ideas are viewed as separate from one another; therefore negations are viewed as terminal processes which bring development processes to their ends.

The metaphysical perspective of terminal negation views negation as an essentially terminal process representing the end point of the existence of a static and isolated thing, phenomenon, or idea.

In the above example, the metaphysical framework would present smashing a vase with a hammer as a terminal negation from the perspective of the observer. Once the vase is smashed, the vase is considered to no longer exist, and the broken shards are not considered to be “a vase” any more. Materialist dialectics, on the other hand, view “the shards” as merely a developed form of the vase; a transition to a new stage of development; the negation was only terminal from the perspective of the vase itself.

Excerpt From Vietnam’s High School Freshman Civic Education textbook:

Metaphysical and dialectical negation share one commonality: they both see development as the replacement of an old subject with a new subject. However, metaphysical negation happens when outside forces impact on a subject, deleting completely the existence of the old subject. According to this metaphysical perspective, the old subject and the new subject which replaces it do not have any connection.

Dialectical negation fundamentally differs from metaphysical negation because it views development as a process of internal development. Dialectical negation does not view complete erasure or deletion of any former subject; instead, dialectical development sees the older subject, which is replaced (negated), as the premise or basis of existence for the new subject.

Comparison Examples:

Metaphysical Negation	Dialectical Negation
The earthquake destroyed the house.	The house was impacted by the external force of an earthquake, which caused it to collapse, due to internal characteristics of the house itself (which could not withstand the forces of the earthquake). The debris from the collapsed house will be cleared away, and will continue to develop. The space where the house stood will also continue to develop in some way, with the earthquake and the resulting collapse serving as the basis for this further development.
Water eroded the mountain.	The external force of water caused erosion by transferring material away from the mountain, due to the internal characteristics of the mountain’s composite material. The water, the material which was washed away, and the mountain will all continue to develop. The erosion process will be the basis for this further development.
The car has a new tire because it ran over a nail.	The external force of the nail caused the tire to permanently deflate, due to the internal characteristics of the tire, which could not withstand running over a nail. This served as the basis for further development: the old tire was removed and will be disposed of, which will serve as the basis for further development (i.e., the tire may be recycled or sent to a landfill); the removal of the tire serves as the basis for the further development of a new tire being installed.
When you add water, sunlight, and nutrition to a seed, it will grow into a plant.	The seed went through a process of negation as a sprout grew, through various stages of development, into a plant, facilitated by outside forces (such as water, nutrition, sunlight, etc. — the seed would not grow in isolation) as well as the internal characteristics of the seed itself; the seed served as the basis of the sprout’s development. The sprout then served as the basis for the growth of a seedling, and the seedling served as the basis for the growth of a fully grown plant. All of this development was driven by negation processes as quantity shifts gradually led to quality shifts through those various stages of development.

As you can see from the examples above, the metaphysical perspective focuses on external forces affecting a given subject and views every development process as terminal, with a beginning, middle, and end. The metaphysical perspective thus views negation as a termination of the subject (and, by extension, of development).

Materialist dialectics, on the other hand, views development as a continuous and never-ending process of mutual impact, negation, and further negation of each negation. A comprehensive and historical viewpoint [see Annotation 114, p. 116] must thus be sought to fully comprehend development and negation processeses.

Dialectical negation has two basic characteristics: objectivity and inheritance.

Dialectical negation is objective because negation arises from contradictions which exist between two opposite sides. These opposing sides may exist within a thing, phenomenon, or idea, but the opposing sides are still, by definition, externally opposed to one another from the perspective of either side.

Annotation 197

Though any given negation may be viewed as terminal from a certain perspective, materialist dialectics is most concerned with processes of development wherein the end of one stage of development creates the conditions for further development [see Annotation 117, p. 119].

Therefore, every development is simultaneously an internal and an external process, depending on perspective. Development processes may, from certain perspectives, be seen to take place within a subject or between two subjects, but they are always external (and, therefore, objective — see Annotation 108, p. 112) from the perspective of either opposing side while simultaneously internal to the relationship.

For example: The relationship between a husband and wife may be seen as an internal process of development of “the marriage” from the perspective of a marriage counselor. However, from their own perspectives, each “opposing side” (i.e., the husband and the wife) see one another as external to each other.

Therefore, the development of a marriage may be seen as an internal process, but the mutual impacts and negations which occur within the relationship are objective and external forces from the perspective of either opposing side.

This is important because it means that all development and all negation are essentially objective processes; therefore no entity has complete, omniscient control over any development process. We must, therefore, understand the nature of development and negation in order to be able to properly plan and affect change in our world.

Dialectical negation is, therefore, the result of the process of resolving inevitable contradictions within a subject [i.e., a relationship] itself. Dialectical negation allows for the old to be replaced by the new, thereby creating trends of development. Therefore, dialectical negation is also self-negation.

Annotation 198

To reiterate: from the perspective of either opposing side, development is an external, objective process. From the perspective of the contradictory relationship, processes of development are internal processes of self-negation. Thus, dialectical negation is both an objective process which no entity can completely control, while, simultaneously, an internal process of self-negation and self-development.

If two nations go to war, either nation may view the war as an objective, external development process, but from a wider perspective, the war is an internal development process of the diplomatic relationship between the two warring nations. This is drastically different from the metaphysical perspective, which views any negation process as a purely external process of development wherein one subject is permanently deleted from existence, then replaced by another subject [see Annotation 196, p. 188]. From the metaphysical perspective, a war is simply a conflict between two distinct and separate nations, and the conclusion of the war is a terminal negation which ends development of the war. From the materialist dialectical perspective, on the other hand, the end of the war would be seen as the basis of future development of the relationship between the two formerly warring nations.

Dialectical negation also has an inheritance characteristic: when one opposing side negates another, the remaining side inherits factors from the negated side which are suitable with present conditions.

Annotation 199

Every negation process arises from contradictions between two opposing sides. Within any such negation process, we can think of one side as the “negator” and the other side as the “negated.” Negation, like all relational processes, leads to mutual impact between both sides [see Annotation 136, p. 138]. Therefore, the negated will impact the negator; in other words, the negated side will be somehow reflected in the negator [see Annotation 68, p. 65]. This means that the negator will inherit and carry forward certain attributes, factors, and characteristics which it receives from the negated side.

Again, consider a war between two nations. Even if one nation completely conquers and subjugates the other in total victory, the victorious nation will still inherit certain factors from the defeated nation. Which factors are inherited will depend on the conditions. The victorious nation may pick up some cultural aspects from the defeated nation, such as cuisine, fashion, etc., they may incorporate tactics and strategies which they observed the defeated enemy using on the battlefield, and so on. The point is that the victorious nation will be impacted in some way by the defeated nation.

The factors which are adopted will be suitable with the present conditions. Take, for example, a car breaking down due to engine failure. This can be seen as an opposing relationship between the car itself and the car’s owner. If the present conditions are suitable [i.e., the owner has the funds and resources available, and the desire to repair the car], then the car may be repaired and continue operating for years to come. If, on the other hand, conditions aren’t suitable [i.e., the owner does not have the funds or resources or the owner no longer wants the car], then the car may be sent to the scrapyard.

As another example, if a fox eats a rabbit, it will inherit certain characteristics from the rabbit. It will inherit nutrition from the rabbit’s body. It may also inherit other characteristics, such as a disease the rabbit was carrying, if the conditions of the fox’s biological composition are suitable [i.e., if the disease can be transferred from the rabbit to the fox].

Dialectical negation is not a complete negation [i.e., deletion] of the old. Rather, dialectical negation is a continuity of growth in which the old develops into the new. In processes of dialectical negation, “the new” forms and develops on its own [see Annotation 62, p. 59], through the process of filtering out unsuitable factors, while retaining suitable content. Vladimir Lenin described dialectical negation as:

“Not empty negation, not futile negation, not skeptical negation, vacillation and doubt is characteristic and essential in dialectics — which undoubtedly contains the element of negation and indeed as its most important element — no, but negation as a moment of connection, as a moment of development, retaining the positive, i.e., without any vacillations, without any eclecticism.”^[106]

Annotation 200

The passage from Lenin above comes from Clemence Dutt’s popular English translation of one of Lenin’s notebooks. Below is our translation from the Vietnamese version of this text from the original text of this book, which we hope might be somewhat easier to understand:

Dialectical negation is not empty negation, it’s not negation without any thoughts, it’s not skeptical negation, it’s not hesitation. Skepticism is not a feature of the essence of the dialectic — of course, dialectics include the negative, it even plays as one of the important factors of a given subject — no, it is negation as the moment of development. Dialectical negation retains the positive, meaning there is no hesitation, there is no eclecticism.

In order to understand what Lenin is saying here, we should first understand what Lenin is responding to. The above notes are referring to the chapter titled “The Absolute Ideal” within Hegel’s Science of Logic [see note at the end of this Annotation]. In this chapter, Hegel recounts various critiques of dialectics and counters them.

Skepticism, here, refers to the tendency to address all human knowledge with doubt.

Philosophical skepticism never moves past two questions: 1. “Is this knowledge true?” 2. “Will human beings ever obtain true knowledge?” Skeptics of this nature engage in a sort of metaphysical inquisition in which every thesis that is ever encountered is immediately and utterly refuted and thus “negated” in the metaphysical sense of termination [see Annotation 196, p. 188].

Eclecticism refers to philosophical and ideological conceptions which draw from a variety of theories, styles, and ideas in an unsystematic manner. Lenin contends that dialectical negation is non-eclecticist because it rises above mere rhetorical combativeness and “total negation.” [This concept is explained more below within this annotation.]

With all this in mind, we see that Lenin is refuting the notion that dialectics are and can only be negative in nature. The metaphysical-skeptic conception of dialectics holds that negation takes the form of rhetorical arguing and refutation, in which one idea is presented, and a second idea is offered to counter the first idea, which completely and totally negates the first idea. According to this argument, dialectics is, therefore, a totally negative process.

A common misperception of dialectical development is that it is “fully negative,” insomuch as the initial thesis (initial subject) is completely negated by the antithesis (impacting subject). In fact, characteristics from both the thesis and antithesis are carried forward into the synthesis.

In the chapter from Science of Logic which Lenin is responding to in the referenced text, Hegel is arguing that the conception of dialectics as only negative — i.e., a system of thinking in which counter-arguments are presented to completely negate initial arguments — is inaccurate. Hegel explains that when one opposing side negates another, it thereafter “contains in general the determination of the first [opposing side] within itself.” In other words, after one opposing side negates another, it retains features and aspects from the opposing side which was negated. Lenin found this particular point to be so important that he wrote “this is very important for understanding dialectics” in the margin of his notebook.

The reason both Hegel and Lenin found this idea, that the “negator” contains elements of the “negated” after negation [see Annotation 231, p. 227], is that this counters the accusation that dialectics are “only negative.” This is why Lenin’s notes highlight the importance of the negator “retaining the positive” after negation. Lenin is pointing out the importance of the retention of features of the negated in the negator because it is this retention which prevents dialectical development from becoming a purely negative process.

In materialist dialectics, it is understood that negation is a process of retention: characteristics from both the thesis (initial subject) and antithesis (impacting subject) are retained in the resulting synthesis

We must also understand what Lenin means when he refers to “skepticism” in his notes. Lenin, here, is referring to the philosophical view that we can never know whether or not our beliefs are true. This belief was popularly known as Machism, or Empirio-Criticism, in Lenin’s time (see Annotation 32, p. 27).

A common critique of dialectics is that it is an inherently skeptical system of thought, since dialectics is seen as a process of presenting counter-arguments to suppositional arguments. Lenin, in his notes, presents the idea that such skepticism is “not a feature of dialectics” precisely because nothing is ever completely, totally, and entirely negated. In other words, the accusation that dialectical analysis is essentially skeptical is rooted in the mistaken notion that one opposing side (i.e., a counter-argument) completely negates the original supposition. In fact, according to materialist dialectics, the negator always retains features and aspects from the negated side, which counters this critique. Thus, dialectical development, which occurs through dialectical negation, is a process of forward motion — not a process of “vacillating” back and forth from one position to another — and there is no skeptical “hesitation” preventing forward progress.

This same idea (that the negator retains features from the negated) also counters another common critique of materialist dialectics: that dialectical analysis is simply a system of rhetorical sophistry [see Annotation 36, p. 33] and eclecticism.

Eclecticism is a conceptual approach that is completely unsystematic, drawing from a variety of theories, styles, and ideas without any cohesive and all-encompassing philosophical framework.

Some critics claim that dialectics must be eclecticist and sophistic in nature. These critics claim that dialectics is simply rhetorical disputation in which any given supposition is counter-argued, and that this counter-argument is negation. But materialist dialectics defines negation as one contradicting side overtaking the other while retaining traces and characteristics from the negated side — it is in no way simply an act of rhetorical dispute or refutation.

In summary, materialist dialectics upholds that nothing is ever completely and utterly deleted or erased from existence through negation. Instead, any time one opposing side negates another, aspects of the negated side are inherited by the negating side.

Note: For reference, here is Hegel’s passage which Lenin is referring to from Science and Logic in the cited notes above:

...a universal first, considered in and for itself, shows itself to be the other of itself. Taken quite generally, this determination can be taken to mean that what is at first immediate now appears as mediated, related to an other, or that the universal appears as a particular. Hence the second term that has thereby come into being is the negative of the first, and if we anticipate the subsequent progress, the first negative. The immediate, from this negative side, has been extinguished in the other, but the other is essentially not the empty negative, the nothing, that is taken to be the usual result of dialectic; rather is it the other of the first, the negative of the immediate; it is therefore determined as the mediated — contains in general the determination of the first within itself. Consequently the first is essentially preserved and retained even in the other. To hold fast the positive in its negative, and the content of the presupposition in the result, is the most important part of rational cognition; also only the simplest reflection is needed to furnish conviction of the absolute truth and necessity of this requirement, while with regard to the examples of proofs, the whole of Logic consists of these.

Therefore, dialectical negation is the inevitable tendency of progression of the inner relationship between the old and the new. It is the self-driving assertive force of all motion and development of all things, phenomena, and ideas.

b. Negation of Negation

In the perpetual movement of the material world, dialectical negation is an inexhaustible process. It creates a development tendency of things from lower level to higher level, taking place in a cyclical manner in the form of a “spiral.”

Annotation 201

The concept of the “spiral” form of development in dialectical materialist philosophy stands in contrast to the metaphysical conception of “linear” development.

Metaphysical Conception of Linear Development

The metaphysical viewpoint holds that development is more or less a straight line: as one subject is negated, it is replaced by another. This subject will then be negated by another, and so on, in what is essentially conceived of as a straight line of development [see Annotation 196, p. 188].

The metaphysical “line development” model sees an initial form as being “replaced” or entirely negated into a completely distinct entity.

In the above example, metaphysical line development simply sees raw aluminum as being negated and “replaced” in the real world. Once the aluminum can is created, the “raw aluminum” as a metaphysical entity is considered no longer to exist. Likewise, when the soda can is transformed into recycled aluminum, the can is considered “replaced,” and is no longer considered to have a metaphysical existence.

This conception of metaphysical line development directly contradicts the materialist dialectical concept of historical viewpoint [see Annotation 114, p. 116].

Dialectical Materialist Conception of Development

The dialectical materialist conception of cyclical development stems from essential attributes of dialectical negation processes:

1. In every dialectical negation, the negating side inherits features and characteristics from the negated side.

2. When the negating side is, itself, negated (i.e., negation of the negation), the new negating side will retain features and aspects of the old negator.

3. This development process will continue indefinitely, so that negation is not simply a straight line of complete negation, but rather takes the shape of a “spiral” of negations of negations which always inherit features from previous forms.

Note that this conception of development as a spiral is simply an abstraction to help understand the essential characteristics of dialectical development and to distinguish this form of development from metaphysical conceptions of “linear development.”

In the example below, we see a depiction of the spiral development of aluminum through various stages of development. After raw aluminum is mined from the Earth, it begins a repeating spiral development process of being refined into usable goods, then recycled into raw material.

The “Spiral Development” model of materialist dialectics sees every stage of development as a higher form of the previous stage which carries forward characteristics from previous stages.

The illustrated example on the previous page plots the spiral development of aluminum as it cycles between stages defined as raw materials and refined products. Another perspective might depict development differently. For example, if we are examining development in terms of external relations between aluminum other elements, the development pattern would look different. In reality, all subjects have countless internal and external relations and development processes which can be examined.

The “raw aluminum” stage of development pictured in the illustration is not truly the beginning of this development process; there were millions of years of development which occurred before it was first discovered by humans. Similarly, the landfill will not be the end of this development process; there will be continued development forever for as long as motion in the universe continues.

This is a simplified and abstract model of development of aluminum. A more accurate representation might show any number of interim steps between each step depicted in the graphic above. For example: it must also be recognized that in reality the molecules of aluminum which the development process began with will be scattered and mixed with other subjects throughout the development process, and various other complexities exist in terms of the mutual impacts of internal and external relationships.

Determining the amount of detail to include or exclude in materialist dialectical analysis is crucial: too much detail and analysis might become unwieldy; too little detail and analysis might become too abstract and idealized to be useful in the real world. So, the idea of development as a spiral should not be taken literally; it is simply a way of conceptualizing the differences between dialectical negation and development as opposed to “straight-line” development upheld by metaphysical conceptions of negation and development, always carrying forward traces of previous stages of development.

In the chain of negations that make up the development processes of things, phenomena, and ideas, each dialectical negation creates the conditions and premises for subsequent developments. Through many iterations of negation, i.e., “negations of negations,” dialectical negation will inevitably lead to a forward tendency of motion.

Annotation 202

The forward tendency of motion describes the tendency for things, phenomena, and ideas to move from less advanced to more advanced forms through processes of motion and development.

As a reminder, “lower level” and “higher level,” i.e., “less advanced” and “more advanced,” should not be taken to have any connotations of “good” and “bad,” nor of “desirable” and “undesirable,” nor even of “less complex” and “more complex.”

Development from “lower levels” to “higher levels” is simply a shorthand for understanding the fact that development processes always move “forward,” that is to say, development can never happen in reverse, just as time itself can never be reversed. For example, society in Italy will never go back to the civilization of the Roman empire. It is conceivable that Italian society could develop to be more similar to Ancient Rome, but it would be impossible for Roman society to ever take on the exact characteristics of the Roman Empire ever again.

Cyclicality of development processes usually takes place in the form of a spiral, which is another result of “negation of negation.” Negations of negations lead to a development cycle in which things, phenomena, and ideas often undergo two fundamental negations carried through three basic forms. Through this negation pattern, basic features of the initial form are ultimately inherited by the “third form,” but at a higher level of development.

Annotation 203

Dialectical development tends to take place through a cyclical pattern in which development is carried through a triad of forms which develop through a pair of dialectical negation processes:

The cyclical pattern of development is an abstract pattern of dialectical change over time.

The graphic above illustrates this cyclical pattern, in which:

1. The initial form (the Assertion) begins the pattern. Contradiction within the initial subject or between it and another subject leads to the first negation.

2. The first negation leads to a second form (the Negation). This second form inherits some features or characteristics from the initial form.

3. The second form then encounters opposition, which leads to a second negation.

4. The second negation leads to a third form (Unity), which retains the features or characteristics of the second form, but now more closely resembles the first, initial form, only at a higher level of development.

Imagine a new car (initial form) crashes into another car (contradicting subject). The new car is dialectically developed (negated) into a second form: a wrecked car. This second form is now contradicted by a new subject — a recycling center — and negated into a third form: new steel. The third form possesses characteristics of the first form, but in a more developed form: after being recycled, the resulting steel it is newly made, in good condition for sale, etc., similarly to the first form of the new car.

In this example, a new car goes through a cyclical pattern of development in which the third form (new steel) possesses characteristics of the first form (a new car).

Keep in mind that this is relative to one’s perspective. If you consider the wrecked car to be the first form, then the steel would be the second form. The new steel will then need to be developed in some way (melted, hammered, cut, etc.) in order to be processed into some new product. From this perspective, the third form (i.e., molten steel) will have characteristics of the first form (i.e.: “unrefined”).

According to Marx and Engels, the development of capitalism from feudalism assumed this cyclical pattern:

The development of class structure is a dialectical process in which different classes synthesize to form the next era of class society. For example, the capitalist class emerged primarily as a synthesis of the feudal lords and peasants of the medieval era.

Note that this is only an abstract description of a tendency of dialectical development; exceptions can and do occur. Presumably, the development of communism as a stateless, classless society would constitute the negation of the “Class Society” form of human civilization. The Post-Class stage of development which follows would, itself, be a higher form — a unity — of pre-class human civilization, carrying forward traces from the Class Society stage of development.

Also note that determining which form is the “first” or “initial” pattern is entirely relative. Using the example of the development of class society: from one perspective, the Patricians may be seen as the initial form, but from another perspective the Plebeians might be considered the initial form. This depends entirely on the viewpoint and purpose of analysis. These conceptions of “spirals of development” and the pattern of “three forms through two negations” are, in essence, models which describe general tendencies and patterns of development and which help us understand the basic characteristics of dialectical negation and development.

Lenin describes this cycle of dialectical development as going “[f]rom assertion to negation — from negation to ‘unity’ with the asserted — without this, dialectics becomes empty negation, a game, skepsis [examination, observation, consideration].”^[107]

Annotation 204

Here, “assertion” simply refers to the initial form of a dialectical development cycle. The negation is the second form, and the “unity” is the third form, which resembles the first form (the assertion) at a higher stage of development. So, in this quotation, Lenin is simply recounting the “three steps” of a typical dialectical development cycle, and indicating that it is necessary to recognize this process, which is rooted in the inheritance of properties of prior forms through development into ever-higher forms, to prevent dialectics from becoming “empty negation,” or otherwise falling prey to the critiques that dialectics are purely negative, skeptical, and eclectic in nature [see Annotation 200, p. 192 and Annotation 36, p. 33].

The law of negation of negation generalizes the pervasive nature of development: dialectical development does not take the form of a straight path, but rather in the form of a spiral path. Lenin summarised that this path is “[a] development that repeats, as it were, stages that have already been passed, but repeats them in a different way, on a higher basis (‘the negation of the negation’), a development, so to speak, that proceeds in spirals, not in a straight line…”^[108] The tendency to develop in a spiral curve demonstrates the dialectical nature of development; i.e., the cycle of inheritance, repetition, and progression. Each new round of the spiral appears to be repeating, but at a higher level. The continuation of the loops in a spiral reflects an endless progression from lower levels to higher levels of things, phenomena, and ideas.

In short, the law of negation of negation in materialist dialectics reflects the dialectical relationship between the negative and the assertion [i.e., the second and first forms of a dialectical development cycle; see Annotation 203, p. 198] in the development process of things, phenomena and ideas. Dialectical development is driven by dialectical negation; in the development of all things, phenomena, and ideas, the new is the result of inheriting characteristics from prior forms. This process of inheritance, repetition, and progression through negation leads to cyclical development. Engels wrote: “what is the negation of the negation? An extremely general — and for this reason extremely far-reaching and important — law of development of nature, history, and thought.”^[109]

Annotation 205

In the same text quoted above, Engels elaborates that dialectical development is composed of “processes which in their nature are antagonistic, contain a contradiction; transformation of one extreme into its opposite; and finally, as the kernel of the whole thing, the negation of the negation.”

c. Meaning of the Methodology

The law of negation of negation is the basis for correct perception of the tendency of motion and development of things, phenomena, and ideas. Development and motion processes do not take place in a straight line; rather, it is a winding, complex road, consisting of many stages, and each process can be broken down into many different sub-processes. However, it must be understood that this complexity of development is only the manifestation of the general tendency to move forward [see Annotation 118, p. 122]. It is important to understand the nature of motion and development so that we can systematically change the world according to our revolutionary viewpoint. In order to consciously impact the development of things, phenomena, and ideas, we need to know their characteristics, nature, and relationships so that we can influence their motion and development in the direction that suits our purposes. We must comprehend and leverage the tendency of forward movement — in accordance with a scientific and revolutionary worldview — in order to effectively and systematically change the world.

Annotation 206

Understanding the forward tendency of motion is vital for cultivating a worldview which is both scientific and revolutionary. Such a worldview is scientific because it recognizes the material reality that all things, phenomena, and ideas are constantly undergoing change and development. Nothing in our universe is static, and all things are connected and defined by internal and external relationships (which are also constantly developing). Furthermore, this development progresses with a forward tendency, meaning that no process can be completely “reversed.” For example, you can clean rust from a car [which would be forward progress], but you can’t reverse the temporal process of rust.

Once we understand that all things, phenomena, and ideas in our universe are constantly developing and moving forward, we can then begin to find ways to impact motion and development systematically to consciously change the world around us. This is the foundation of a revolutionary worldview, since revolutionary change requires us to leverage and influence development processes to suit our needs and revolutionary ambitions. Thus, materialist dialectics are an applied system of observation and practice through which we seek to understand development processes and consciously impact them to suit our needs.

According to the rule of negation of negation, in the objective world, the new must inevitably come to replace the old. In nature, the new develops according to objective laws. In social life, new things arise from the purposeful, self-conscious, and creative actions of human beings. Therefore, it is necessary to leverage subjective factors as we seek to consciously impact the development of things, phenomena, and ideas.

Annotation 207

Subjective factors are factors which we, as a subject, are capable of impacting. This may seem confusing, since we have previously established that all external things, phenomena, and ideas have objective relationships with all other things, phenomena, and ideas [see Annotation 108, p. 112], meaning that any given subject is external to every other subject, and thus no subject can directly and completely control the motion and development of any other subject.

However, from the perspective of any given individual, there are certain things, phenomena, and ideas [as well as processes of motion and development] which we can impact. For example, if I see an apple on a table, the apple is objective to me. I can’t simply will the apple to move with my consciousness alone. However, I can impact the apple through conscious activity — I can consciously will my hand to pick up the apple and move it to another location.

Thus, factors which an individual can consciously impact are subjective factors. As revolutionists, we must focus on subjective factors. In other words, we must concentrate on that which we are capable of changing, since our purpose is to change the world. Focusing on factors which we can’t impact is a waste of time; we must simply determine what can be changed and then determine the most efficient and effective ways of impacting development processes and changing the world.

As revolutionists, we must have faith that we can introduce the “new,” faith in the success of the “new,” we must support the “new,” and fight for the victory of the “new.” Therefore, it is necessary to overcome conservative, stagnant, and dogmatic thoughts which restrain the development of the “new” and resist the law of negation of negation.

Annotation 208

Change is inevitable. All things, phenomena, and ideas undergo processes of motion and development. Any philosophy, ideology, or strategy which attempts to restrain motion and development is doomed to failure because change can neither be halted nor restrained. Thus, our strategies and actions must align with the material reality that change is inevitable, and we must seek to change the world by impacting processes of development and motion rather than attempting to reverse, restrain, or halt such processes.

Ideologies which erroneously strive to restrict change and development include rigidity (see Annotation 222, p. 218) and conservativism (see Annotation 236, p. 233).

In the process of negating the old we must leverage the principle of inheritance with discretion: we must encourage the inheritance of factors that are beneficial to our goals as we simultaneously attempt to filter out, overcome, and reform factors which would negatively impact our goals.

Annotation 209

If we understand the principle of inheritance, we can impact inheritance processes which derive from negation. For example, when repairing a car, we can seek out parts of the car which do not function properly or which do not suit the use-case of the car and add or replace parts which are more suitable.

In the same way, we can impact inheritence processes in our revolutionary political activities. We can seek to inherit characteristics from previous stages of development of our political organizations, social institutions, culture, etc., while simultaneously seeking to prevent the inheritence of traits and characteristics which are unsuitable for our revolutionary purposes. Over time, we can attempt to impact the inheritance of traits and aspects which are more conducive to our purposes while limiting and filtering out traits and aspects which are hindrances.

In an article titled “New Life” written in 1947, Ho Chi Minh wrote about the dialectical relationship between the new and the old in building a new society, writing:

Not everything old must be abandoned. We do not have to reinvent everything. What is old but bad must be abandoned. What is old but troublesome must be corrected appropriately. What is old but good must be further developed. What is new but good must be done.
... Growing up in the old society, we all carry within us more-or-less bad traces of the old society in terms of our ideas and habits... Habits are hard to change. That which is good and new is likely to be considered bad by the people because it is strange to them. On the contrary, that which is evil yet familiar is easily mistaken as normal and acceptable.

Ho Chi Minh understood the principles of development very well, as well as the difficulties we will face as revolutionaries as we try to change ourselves and our society. We must strive to develop a similar understanding as we move forward and attempt to affect the development of our world through practice and struggle.

Chapter 3: Cognitive Theory of Dialectical Materialism

In Marxism, epistemological reasoning (or epistemology) is the foundation of dialectics. Dialectical materialist epistemology is a theory of applying human cognitive ability to the objective world through practical activities. It explains the nature, path and general laws of the human process of perceiving truth and objective reality to serve human practical activities.

Annotation 210

Epistemology is the theoretical study of knowledge. It also deals with the philosophical question of: “how do we know what is true?”

Throughout history, philosophers have tried to determine the nature of truth and knowledge. In the era of Karl Marx and Friedrich Engels, there was an ongoing dispute between the materialists, who believed that truth could only be sought through sense experience of the material world, and the idealists, who believed that truth could only be sought through reasoning within the human mind.

Marx and Engels developed the philosophical system of dialectical materialism to resolve this dispute. Dialectical materialism upholds that the material and the ideal have a dialectical relationship with one another: the material determines the ideal, while the ideal impacts the material [see The Relationship Between Matter and Consciousness, p. 88].

However, it’s important to understand that Marx and Engels didn’t develop the system of dialectical materialism simply to understand the world. As Marx wrote in Theses on Feuerbach:

The philosophers have only interpreted the world, in various ways; the point is to change it.

So, Marxist dialectical materialist epistemology is developed specifically to enable human beings to not only perceive truth and objective reality, but to then be able to apply our conscious thought, through practical activity, in order to bring about change in the world.

1. Praxis, Consciousness, and the Role of Praxis in Consciousness

a. Praxis and Basic Forms of Praxis

Praxis includes all human material activities which have purpose and historical-social characteristics and which transform nature and society. Unlike other activities, praxis is activity in which humans attempt to materially impact the world to suit our purposes. Praxis activities define the nature of human beings and distinguish human beings from other animals. Praxis is objective activity, and praxis has been constantly developed by humans through the ages.

Annotation 211

In English, the words “practice” and “praxis” are often distinguished from one another. “Practice” is often used to refer to human activity which provides more information about the world around us and improves our knowledge and understanding, whereas “praxis” often refers to conscious human activity which is intended to change the world in some manner. In their original German, Marx and Engels used the same German word — Praxis — to refer to both concepts. Similarly, in the original Vietnamese text of this book, the same word — thực tiễn — is used for both “practice” and “praxis.”

One reason that these concepts are so closely related is that all conscious activity serves both rolls by simultaneously telling us more about reality and consciously changing reality in some way. For example, by pushing a heavy stone, you may be able to move the stone a small amount — constituting praxis — while simultaneously learning how heavy the stone is and how difficult it is to move — constituting practice. The main point of distinction, therefore, is intention. Virtually all conscious activity is practice, but only activity which has purpose and historical-social characteristics might be considered praxis:

Purpose simply describes a goal or desired outcome; specifically: a desired change in nature or human society. Activities with historical-social characteristics are activities which contribute in some way to the development of human society.

In this translation, we use “practice” and “praxis” interchangably to mean “conscious activity which improves our understanding, and which has purpose and historical-social characteristics.” You are likely to find these words used differently (as described above, or in other ways) in other texts. Engels explains the importance of practice/praxis in Socialism: Utopian and Scientific:

The proof of the pudding is in the eating. From the moment we [use] these objects, according to the qualities we perceive in them, we put to an infallible test the correctness or otherwise of our sense-perceptions. If these perceptions have been wrong, then our estimate of the use to which an object can be turned must also be wrong, and our attempt must fail. But if we succeed in accomplishing our aim, if we find that the object does agree with our idea of it, and does answer the purpose we intended it for, then that is positive proof that our perceptions of it and of its qualities, so far, agree with reality outside ourselves.

Marx wrote in Theses on Feuerbach that “the coincidence of the changing of circumstances and of human activity or self-change can be conceived and rationally understood only as revolutionary practice [German: revolutionäre Praxis].” Engels further expounds upon this concept in Ludwig Feuerbach and the End of Classical German Philosophy, writing:

The most telling refutation of this as of all other philosophical fancies is practice [original German: Praxis], viz., experiment and industry. If we are able to prove the correctness of our conception of a natural process by making it ourselves, bringing it into being out of its conditions and using it for our own purposes into the bargain, then there is an end of the Kantian incomprehensible or ungraspable.

Praxis defines the nature of human beings because human beings are (to our present knowledge) the only beings which undertake actions with conscious awareness of our desired outcomes and comprehension of the historical development of our own society, which distinguishes human beings from all other animals. Praxis is objective activity, meaning that all praxis activities are performed in relation to external things, phenomena, and ideas [see Annotation 108, p. 112].

Praxis has been constantly developed by humans through the ages, meaning that as we learn more about the nature of reality, of human society, and the laws of nature, we are able to develop our praxis to become more efficient and effective.

Praxis activities are very diverse, manifesting with ever-increasing variety, but there are only three basic forms: material production activities, socio-political activities, and scientific experimental activities.

Material production activity is the first and most basic form of praxis. In this form of praxis activity, humans use tools through labor processes to influence the natural world in order to create wealth and material resources and to develop the conditions necessary to maintain our existence and development.

Socio-political activity includes praxis activity utilized by various communities and organizations in human society to transform political-social relations in order to promote social development.

Scientific experimental activity is a special form of praxis activity. This includes human activities that resemble or replicate states of nature and society in order to determine the laws of change and development of subjects of study. This form of activity plays an important role in the development of society, especially in the current historical period of modern science and technological revolution.

Annotation 212

The three basic forms of praxis activities listed above obviously do not include all forms of human activity, as praxis only includes activities which have purpose and historical-social characteristics.

Material production activity has a very clear purpose: to improve the material conditions of an individual human being or a group of human beings. Material production activity has historical-social characteristics because developing material conditions for human beings leads directly to the development of human society. For example, as food production increases in terms of yield and efficiency, society can support a larger number of human beings and a wider range of human activities, which leads to the development of human society.

Socio-political activity has the purpose of promoting social development, which is obviously inherently historical-social in nature. An example of socio-political activity would include any sort of political campaign, liberation struggle, political revolutionary activity, etc.

Scientific experimental activity has the purpose of expanding our understanding of nature and human society, which leads directly to historical-social development in a variety of ways. For example, improving our scientific understanding of medicine through scientific experimental activity leads to longer lives and improved quality of life. Improving our scientific understanding of chemistry through scientific experimental activity leads to all sorts of materials which improve the quality of life and enable human beings to solve a variety of social problems.

In order to qualify as praxis activity, a given human activity must have a purpose and it must have historical-social characteristics. For instance, drawing is not always praxis in the sense of the word used in this text, but it would be praxis if it would qualify as material production activity (i.e., making art in order to sell, so as to make a living) or if the art is made with the intention of invoking social change.

Every basic praxis activity form has an important function, and these functions are not interchangeable with each other. However, they have close relationships with each other and different praxis activity forms often interact with each other. In these relationships, material production is the most important form of praxis activity, playing a decisive role in determining other praxis activities because material production is the most primitive activity and exists most commonly in human life. Material production creates the most essential, decisive material conditions for human survival and development. Without material production there cannot be other praxis activities. After all, all other praxis activities arise from material production praxis and all praxis activities ultimately aim to serve material production praxis.

Annotation 213

Without material production activity, human beings would not be able to live at all.

Thus, material production activities make all other forms of human activities possible. In addition, the primary reason we participate in socio-political activity is to ensure material security (food, water, shelter, etc.) for members of society, which ultimately relies on material production activity. Therefore, the primary reason we engage in scientific experimental activity is to improve material production activities in terms of efficiency, yield, effectiveness, etc

Of course, we engage in scientific experimental activity and material production activity for other reasons (art, entertainment, recreation, etc.), but these activities require that material security be secured first for those participating in the production and consumption of such products. In other words, material production activity is a prerequisite for all other forms of activity, since without some measure of material security humans cannot survive.

Material production activity has a dialectical relationship with all other praxis activity, with material production activity determining, while being impacted by, all other forms of praxis activity.

Thus, material production activity has a dialectical relationship with other forms of praxis activities, in which material production activity determines both socio-political and scientific experimental activity while socio-political and scientific experimental activity impact material production activity.

b. Consciousness and Levels of Consciousness

The dialectical materialist perspective sees consciousness as a process of reflecting the objective world within the human brain on a practical basis to create knowledge about the objective world. Consciousness is a self-aware process that is productive and creative.

This view stems from the following basic principles:

The dialectical materialist worldview acknowledges that the material world exists objectively and independently of human consciousness.
The dialectical materialist worldview recognizes the following human abilities:
- To perceive the objective world.
- To reflect the objective world into the human mind, which enables human subjects to learn about external objects. [see Annotation 66, p. 64]
- To admit that there are no material things nor phenomena which are unrecognizable, but only material things and phenomena that humans have not yet recognised. [see The Opposition of Materialism and Idealism in Solving Basic Philosophical Issues, p. 48]

The dialectical materialist worldview affirms that conscious reflection [see Annotation 67, p. 64] of the objective world is a dialectical, productive, self-aware, and creative process. This reflection process develops from the unknown to the known, from knowing less to knowing more, from knowing less profoundly and less comprehensively to knowing more profoundly and more comprehensively.

Annotation 214

The above principle (that human knowledge develops from less, and less comprehensive, to more, and more comprehensive states) stands in contrast to various other philosophical systems of belief, including:

Hegel’s Absolute Idealism upholds a belief in an “absolute ideal” which constitutes an ultimate limit or “end point” of knowledge which humanity is moving towards. Dialectical materialism upholds that there is no such absolute ideal and thus no such terminal end point of human understanding. [See Annotation 234, p. 230] As Engels wrote in Anti-Dühring:

If mankind ever reached the stage at which it should work only with eternal truths, with results of thought which possess sovereign validity and an unconditional claim to truth, it would then have reached the point where the infinity of the intellectual world both in its actuality and in its potentiality had been exhausted, and thus the famous miracle of the counted uncountable would have been performed.

Fideism, which is the belief that knowledge is received from some higher power [i.e., God]. Fideism upholds that all knowledge is pre-existing, and that humanity simply receives it from on high. Dialectical materialism, on the other hand, argues that knowledge is developed over time through dialectical processes of consciousness and human activity.

Positivism, or empiricist materialism, which holds that there are hard limits to human knowledge, or that human knowledge — which can only be obtained from sense data — can’t be trusted. Dialectical materialism upholds that all things and phenomena can be known and understood, and that sense data can be trusted as an objective reflection of reality. For more information about skepticism about human sense data as well as positive and empiricist materialism, see Annotation 10, p. 10, and Annotation 58, p. 56].

The dialectical materialist worldview considers praxis as the primary and most direct basis of consciousness, and as the motive and the purpose of consciousness, and as the criterion for testing truth. [See: The Relationship Between Praxis and Consciousness, p. 216]

Annotation 215

Given the above principles — that human consciousness exists independently from the material world yet is capable of accurately perceiving and reflecting the material world, and that knowledge develops over time through a synthesis of consciousness and practical activity — we can conclude that consciousness is a self-aware process which is productive and creative.

Consciousness is productive and creative in the sense that conscious processes, in conjunction with practical experience and activity in the material world, leads to the development of knowledge and practical experience which allows humans to develop our understanding of the world as well as our own material conditions through the application of knowledge to our own labor activities.

Next, we will examine different ways of categorizing conscious activities as they pertain to developing knowledge and practical understanding of our world.

From the dialectical materialist point of view, consciousness is a process of development. Consciousness develops from empirical consciousness to theoretical consciousness; and from ordinary consciousness to scientific consciousness.

Annotation 216

In dialectical materialist philosophy, all systems of relation exist as processes of development in motion [see Annotation 120, p. 124]. Thus, consciousness can be defined as a system of relations between human brain activity and two forms of data input:

• Sense experience: observations of the external world detected by our senses.

• Knowledge: information which exists in the human mind as memories and ideas.

Consciousness is thus a process of the development of knowledge through a combination of human brain activity and human practical activity in the physical world (i.e., labor).

In the section below, we will explore different forms of consciousness, the development of consciousness, and the relationship between consciousness and knowledge. Note that these are abstractions of consciousness and knowledge, meant to help us understand how knowledge and consciousness develop over time. Thought processes are extremely complex, so we seek to develop a fundamental understanding of how consciousness develops and how knowledge develops because these processes are fundamental to the development of human beings and human societies.

Just as consciousness is a process of developing knowledge through brain activity, consciousness itself also develops over time. The development of consciousness can be considered based on the criteria of concrete/abstract and of passive/active.

Consciousness develops from a state of direct and immediate observation of the world which results in concrete knowledge to a higher stage which constitutes a more abstract and general understanding of the world. We call consciousness which is focused on direct, immediate, concrete, empirical observation of the world empirical consciousness, and we call consciousness which is focused on forming abstract generalizations about the world theoretical consciousness.

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Empirical consciousness is a process of collecting data about the world, which we call knowledge. We can gather two forms of knowledge through empirical consciousness: ordinary knowledge, and scientific knowledge.

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Ordinary knowledge is the knowledge we accumulate through our everyday experiences in the world. Scientific knowledge is gathered through more systematic scientific observations and experiments. Scientific knowledge usually develops from ordinary knowledge, as we begin to seek a more formal and systematic understanding of the things we witness in our daily lives.

According to Themes in Soviet Marxist Philosophy, edited by T. J. Blakely:

Ordinary knowledge notes what lies on the very surface, what happens during a certain event. Scientific knowledge wants to know why it happens in just this way. The essence of scientific knowledge lies in the confirmed generalization of facts, where it becomes necessary rather than contingent, universal instead of particular, law-bound, and can serve as a basis for predicting various phenomena, events and objects...
The whole progress of scientific knowledge is bound up with growth in the force and volume of scientific prediction. Prediction makes it possible to control processes and to direct them. Scientific knowledge opens up the possibility not only of predicting the future but also of consciously forming it. The vital meaning of every science can be expressed as follows: to know in order to predict and to predict in order to act.
An essential characteristic of scientific knowledge is that it is systematic, i.e., it is a set of information which is ordered according to certain theoretical principles. A collection of unsystematized knowledge is not yet science. Certain basic premises are fundamental to scientific knowledge, i.e., the laws which make it possible to systematize the knowledge. Knowledge becomes scientific when the collection of facts and their descriptions reach the level where they are included in a theory.

Theoretical consciousness arises from conscious reflection on accumulated knowledge, as human beings seek to develop general and abstract understanding of the underlying principles of processes we experience in the world. Once general principles of natural and social law are established, human beings then test those general conclusions against empirical reality through further observation (i.e., through empirical consciousness).

Thus, there is a dialectical relationship between empirical consciousness and theoretical consciousness, as one form leads to another, back and forth, again and again, continuously.

Empirical and theoretical consciousness have a dialectical relationship in which empirical consciousness and theoretical consciousness lead to and mutually develop one another.

Consciousness also develops from passive and surface-level observation and understanding of the world (i.e., simply considering what, where, and when things happen) to more active pursuit of the underlying meaning of the world (i.e., trying to understand how and why things happen).

Consciousness which passively observes the world, directly, in daily life is referred to as ordinary consciousness. Ordinary consciousness often develops into more active consciousness. This active pursuit of understanding through systematic observation and indirect experiences (i.e., experiences that do not occur in daily activity — such as scientific experimentation) is referred to as scientific consciousness.

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These concepts will be discussed in further detail below.

Empirical consciousness is the stage of development of consciousness in which perceptions are formed via direct observations of things and phenomena in the natural world, or of society, or through scientific experimentation and systematic observation. Empirical consciousness results in empirical knowledge.

Empirical knowledge has two types: ordinary empirical knowledge (knowledge obtained through direct observation and in productive labor) and scientific empirical knowledge (knowledge obtained by conducting scientific experiments). These two types of knowledge can be complementary, and can enrich one other.

Theoretical consciousness is the indirect, abstract, systematic level of perception in which the nature and laws of things and phenomena are generalized and abstracted.

Empirical consciousness and Theoretical consciousness are two different cognitive stages but they have a dialectical relationship with each other. In this dialectical relationship, empirical consciousness is the basis of theoretical consciousness; it provides theoretical consciousness with specific, rich material [i.e., knowledge]. Empirical consciousness is linked closely to practical activities [since practical activity in the material world is the chief method of gathering knowledge through empirical consciousness], and forms the basis for checking, correcting, and supplementing existing theories and summarizing, and generalizing them into new theories. However, empirical consciousness is still limited in that empirical consciousness stops at the description and classification of data obtained from direct observation and experimentation. Therefore, empirical consciousness only brings understanding about the separate, superficial, discrete aspects of observed subjects, without yet reflecting the essence of those subjects nor the underlying principles or laws which regulate those subjects.

Therefore, empirical consciousness, alone, is not sufficient for determining the scientific laws of nature and society. To determine such laws and abstractions, theoretical consciousness must be applied. So, theoretical consciousness does not form spontaneously, nor directly from experience, although it is formed from the summation of experiences.

Annotation 217

The knowledge we gain from our daily activity often inspires scientific inquiry and more systematic observation, which can yield scientific knowledge which will enrich and improve our daily practice and allow us to experience daily life with a deeper understanding of what we’re experiencing. Thus, the ordinary knowledge we gain through daily practice can enrich and yield scientific knowledge (and vice versa).

Empirical consciousness and theoretical consciousness have a dialectical relationship with each other in which empirical consciousness provides the basis for theoretical consciousness. Theoretical consciousness attempts to derive general abstractions and governing principles from empirical knowledge which is gained through empirical consciousness. Once theoretical principles, generalities, and abstractions are determined, they are then tested against reality through empirical consciousness (i.e., practical observation and systematic experimentation) to determine if the theory is sound.

Empirical consciousness and theoretical consciousness have a dialectical relationship with one another. Our observations of the material world lead to conscious activity which we then test in reality through conscious activity, and so on, in a never-ending cycle of dialectical development.

For example, a farmer may notice that plants grow better in locations where manure has been discarded — an act of empirical consciousness. The farmer might then form the theory that adding manure to the soil will help plants grow — an act of theoretical consciousness. This theory could then be tested against reality by mixing manure into the soil and observing the results, which would be another act of empirical consciousness. The farmer may then theorize that more manure will help plants grow even more — another act of theoretical consciousness — continuing the cycle of testing and observing.

This dialectical relationship between ordinary and theoretical consciousness is what allows human beings to develop and improve knowledge through practical experience, observation, and theoretical abstraction and generalization of knowledge.

Theoretical consciousness is relatively independent from empirical consciousness. Therefore, theories can precede expectations and guide the formation of valuable empirical knowledge. Theoretical consciousness is what allows human beings to sort and filter knowledge so as to best serve practical activities and contribute to the transformation of human life. Through this process, knowledge is organized and therefore enhanced, and develops from the level of specific, individual, and solitary knowledge to a higher form of generalized and abstract knowledge [what we might call theoretical knowledge].

Annotation 218

Knowledge which comes from empirical observations (empirical consciousness) is empirical knowledge. Theoretical knowledge is a product of theoretical consciousness. Over time, as repeated and varied observations are made through theoretical consciousness activities, knowledge becomes more generalized and abstract; this general and abstract knowledge is what we call theoretical knowledge.

Note that empirical and theoretical knowledge can be ordinary or scientific in nature; if the knowledge arises passively from daily life activities, it will be ordinary knowledge, regardless of whether or not it is empirical or theoretical in nature. If, on the other hand, the knowledge arises from methodological measurement and/or systematic observation, then it is scientific knowledge.vSo far, we have discussed ways of understanding consciousness based on the criteria of directness vs. abstractness. Next, we will discuss another way of looking at consciousness, based on the criteria of passiveness vs. activeness.

Ordinary consciousness refers to perception that is formed passively and directly from the daily activities of humans. Ordinary consciousness is a reflection of things, phenomena, and ideas, with all their observed characteristics, specific details, and nuances. Therefore, ordinary consciousness is rich, multifaceted, and associated with daily life. Therefore, ordinary consciousness has a regular and pervasive role in governing the activities of each person in society.

Scientific consciousness refers to perception formed actively and indirectly from the reflection of the characteristics, nature, and inherent relationships of research subjects. This reflection takes place in the form of logical abstraction. These logical abstractions include scientific concepts, categories, and laws. Scientific consciousness is objective, abstract, general, and systematic, and must be grounded in evidence.

Scientific consciousness utilizes systematic methodologies to profoundly describe the nature of studied subjects as well as the principles which govern them. Therefore, scientific consciousness plays an increasingly important role in practical activities, especially in the modern age of science and technology.

Annotation 219

Logical abstraction refers to an understanding of the underlying rules which govern things, phenomena, and ideas which underly objective processes, relationships, and characteristics. Logical abstraction is the result of scientific inquiry. Over time, our understanding of the rules which govern the things, phenomena, and ideas in our lives become more reliable and applicable in practical activities. This attainment of understanding and practical ability through scientific practice is scientific consciousness.

Ordinary and scientific consciousness are two different qualitative steps of cognitive processes which, together, allow humans to discover truth about our world. Ordinary and scientific consciousness have a strong dialectical relationship with each other. In this relationship, ordinary consciousness precedes scientific consciousness, as ordinary consciousness is a source of material for the development of scientific consciousness.

Although it contains the seeds of scientific knowledge, ordinary consciousness mainly stops at the reflection of superficial details, seemingly random events, and non-essential phenomena [see Essence and Phenomenon, p. 156]. Ordinary consciousness, therefore, cannot transform effortlessly into scientific consciousness. To develop ordinary consciousness into scientific consciousness, we must go through the process of accurate summarizing, abstracting, and generalization using scientific methods. Likewise, once scientific consciousness has been developed, it impacts and pervades ordinary consciousness, and therefore develops ordinary consciousness. Scientific consciousness therefore enhances our everyday passive perception of the world.

Ordinary consciousness refers to the passive observation of reality which takes place in our daily lives. Scientific consciousness refers to the systematic application of consciousness to solve specific problems in a methodological manner.

Annotation 220

For example, before developing scientific consciousness of farming, a farmer might go through daily life having no idea what makes plants grow to be larger and more healthy and might have no idea how to avoid common problems such as pests. After developing scientific consciousness of farming through scientific experimentation and other systematic methodologies, the farmer will look at things differently in daily life activities. They may see signs of pest infestation and immediately recognize it for what it is, and they may see other indications that plants are unhealthy and know exactly what to do to remedy the situation.

In this way, scientific consciousness enhances ordinary consciousness. Meanwhile, ordinary consciousness — passive observation of the world during daily activities — will lead to scientific consciousness by inspiring us to actively seek understanding of the world through scientific consciousness.

c. The Relationship Between Praxis and Consciousness

Praxis serves as the basis, driving force, and purpose of consciousness. Praxis serves as the criterion of truth by testing the truthfulness of our thoughts. [See Annotation 230, p. 226]

Praxis is able to serve these roles because reality is the direct starting point of consciousness; it sets out the requirements, tasks, and modes of consciousness, as well as the movement and development tendencies of consciousness. Humans have an objective and inherent need to explain the world and to transform it.

Annotation 221

Remember that the material world defines consciousness while consciousness allows us to impact the material world through conscious activity [see The Relationship Between Matter and Consciousness, p. 88]. Consciousness itself arose from the physical needs of the material world [see The Source of Consciousness, p. 64], and these physical needs continue to serve as the basis and driving force for all conscious activities, as we must act consciously to survive.

Our inherent need to explain the world and to transform it arises from our material needs to eat, seek shelter, cure and prevent disease, and so on. These physical needs, which stem from the material world, drive conscious activity and lead to the development of consciousness and knowledge.

Therefore, humans must necessarily impact things in the material world through our practical activities in order to survive. The impacts of our practical activities on the world cause things and phenomena to reveal their different properties, including their internal and external relationships [for example, hitting a rock will tell you properties about the rock; attempting to build something out of wood will provide data about the wood, etc.]. In this manner, praxis produces data for consciousness to process, and also helps consciousness to comprehend nature and the laws of movement and development which govern the world.

Scientific theories are formed on the basis of the dialectical relationship between practical activity and consciousness. For example: mathematics developed to allow us to count and measure things for practical activities such as agriculture, navigation, and building structures. Marxism also arose in the 1840’s from the practical activities of the struggles of the working class against the capitalist class at that time. Even recent scientific achievements arise from practical needs and activities. For example, the discovery and decoding of the human genome map was born from practical activities and needs, such as the need to develop treatments for incurable diseases. In the end, there is no field of knowledge that is not derived from reality. Ultimately, all knowledge arises from and serves practice. Therefore, if we were to break from reality or stop relying on reality, consciousness would break from the basis of reality that nurtures our growth, existence and development. Also, the cognitive subject cannot have true and profound knowledge about the world if it does not follow reality.

Practice also serves as the basis, driving force, and purpose of consciousness because, thanks to practical activities, our human ability to measure and observe reality improves increasingly over time; our logical thinking ability is constantly strengthened and developed; cognitive means become increasingly developed. All of these developments “extend” the human senses in perceiving the world [for example, by developing new tools to measure, perceive, and sense the world such as telescopes, radar, microscopes, etc.].

Reality is not only the basis, the driving force, and the purpose of discovering truth but also serves as the standard of truth. Reality also serves as the basis for examining the truthfulness of the cognitive process [i.e., we can test whether our thoughts match material reality through experimentation and practice in the real world]. This means that practice is the measure of the value of the knowledge we gain through perception. At the same time, practice is constantly supplementing, adjusting, correcting, developing, and improving human consciousness. Marx said: “The question whether objective truth can be attributed to human thinking is not a question of theory but is a practical question. Man must prove the truth — i.e. the reality and power, the this-sidedness of his thinking in practice.”^[110]

Thus, practice is not only the starting point of consciousness and a decisive factor for the formation and development of consciousness, it is also a target where consciousness must always aim to test the truth. To emphasize this role which practice plays, Lenin said: “The standpoint of life, of practice, should be first and fundamental in the theory of knowledge.”^[111]

The role of practice in consciousness requires that we always grasp the practical point of view. This point of view requires that we derive our ideas from practice, our ideas must be based on practice, and our ideas must deeply explore practice. In our conscious activities, we must attach a lot of importance to the summarization of practice [i.e., developing theoretical knowledge through theoretical consciousness which reflects practical experience]. Theoretical research must be related to practice, and learning must go hand in hand with practicing. If we diverge from practice, it will lead to mistakes of subjectivism, idealism, dogmatism, rigidity, and bureaucracy.

Annotation 222

Subjectivism occurs when one centers one’s own self and conscious activities in perspective and worldview, failing to test one’s own perceptions against material and social reality. Subjectivists tend to believe that they can independently reason their way to truth in their own minds without practical experience and activity in the material world. Related to subjectivism is solipsism, a form of idealism in which one believes that the self is the only basis for truth. As Marxist ethicist Howard Selsam wrote in Ethics and Progress: New Values in a Revolutionary World: “If I believe that I alone exist and that you and all your arguments exist only in my mind and are my own creations then all possible arguments will not shake me one iota. No logic can possibly convince [the] solipsist.”

Idealism has a strong connection with a failure to incorporate practical activity into theoretical consciousness, since idealism holds that conscious activity is the sole basis of discovering truth.

Dogmatism occurs when one only accounts for commonalities and considers theory itself as the sole basis of truth rather than practice [see Annotation 239, p. 235]. Dogmatists ignore practical experience and considering pre-established theory, alone, as unalterable truth. This results in a breakdown of the dialectical relationship between theoretical consciousness and empirical consciousness, which arrests the development process of knowledge and consciousness.

Rigidity is an unwillingness to alter one’s thoughts, holding too stiffly to established consciousness and knowledge, and ignoring practical experience and observation, which leads to stagnation of both knowledge and consciousness.

Bureaucracy arises when theory becomes overly codified and formalized, to the extent that practical considerations are ignored in favor of codified theory. Bureaucracy can be avoided by incorporating practical experience and observations continuously into the development of practical systems and methodologies so that theory and practice become increasingly aligned over time to continuously improve efficiency and effectiveness of practical activities in the material world.

On the contrary, if the role of practice is absolutized [to the exclusion of conscious activity], it will fall into pragmatism and empiricism.

Annotation 223

In this context, pragmatism refers to a form of subjectivism [see Annotation 222, above] in which one centers one’s own immediate material concerns over all other considerations. For example, workers may place their own immediate needs and desires above the concerns of their fellow workers as a whole. This may offer some temporary gains, but in the long run their lack of solidarity and class consciousness will be detrimental as workers collectively suffer from division, making all workers more vulnerable to exploitation and ill treatment by the capitalist class.

Empiricism is a faulty form of materialism in which only sense experience and practical experience are considered sources of truth. This is opposed to the dialectical materialist position that the material determines consciousness, while consciousness impacts the material world through conscious labor activity. [See The Relationship Between Matter and Consciousness, p. 88]

Thus, the principle of the unification of practice and theory must be the basic principle in practical and theoretical activities. Theory without practice as its basis and criterion for determining its truthfulness is useless. Vice versa, practice without scientific and revolutionary theory will inevitably turn into blind practice. [As Ho Chi Minh once said: “Study and practice must always go together. Study without practice is useless. Practice without study leads to folly.”]

2. Dialectical Path of Consciousness to Truth

a. Opinions of Vladimir Ilyich Lenin about the Dialectical Path of Consciousness to Truth

Annotation 224

The section below outlines and explains the Universal Law of Consciousness, which holds that consciousness is a process of dialectical development in which practical activity leads to conscious activity, which then leads back to practical activity, in a continuous and never-ending cycle, with a tendency to develop both practical and conscious activity to increasingly higher levels.

In his Philosophical Notebook, Lenin generalized the dialectical path towards the realization of truth as development from vivid visualization to abstract thinking, and then from abstraction back to practice. This process, according to Lenin, is the dialectical path towards the realization of truth, and the realization of objective reality.

According to this generalization, the dialectical path towards the realization of truth (“truth,” here, referring to a correct and accurate reflection of objective reality) is a process. It is a process that starts from “vivid visualization” (emotional consciousness) to “abstract thinking” (rational consciousness).

Annotation 225

Given that consciousness has a material basis, and that practical activities are the driving force of consciousness [see Annotation 230, p. 226], it follows that we must strive to align our conscious thoughts and ideas with the material world. The more accurately we can reflect reality in our consciousness, the more effectively and efficiently our practical activities can become.

For example, through learning more about the mechanical, material, and physical processes which take place inside of an automobile engine, the more we can improve engines to make them more efficient and effective for practical applications.

Lenin explained that consciousness develops from “emotional consciousness” to “rational consciousness.” Thought about a subject begins at a base level of consciousness that is rooted in emotional and sense-oriented conscious activity, i.e, “vivid visualization,” which then leads to rational, abstract reflection.

By “vivid visualization,” Lenin is referring to the active, real-time experience of seeing (and hearing, smelling, and otherwise sensing) things and phenomena in the world.

When a person experiences something through practical activity, the first conscious activity will tend to occur at the emotional and sensory level — in other words, the conscious activities which occur simultaneously along with practical activities. Only after this initial period of emotional consciousness will one be able to reflect on the experience on a more rational and abstract level.

For example, if a zoologist in the field sees a species of bird they have never encountered before, their first conscious activity will be at the sensory-emotional level: they will observe the shape, coloration, and motion of the bird. They may feel excitement, happiness, and other emotions. This is emotional conscious activity.

This emotional conscious activity will then develop into rational conscious activity, as the zoologist may begin to consider things more abstractly, attempting to interpret and understand this experience through reason and rational reflection, asking such questions as: “Where does this bird nest? What does it feed on? Is this a new discovery?” and so on.

Such abstractions are not the end point of a cognitive cycle, because consciousness must then continue to develop through practice. It is through practice that perception tests and proves its own correctness so that it can then continue on to repeat the cycle.

This is also the general rule of the human perception of objective reality.

Annotation 226

Thus there is a dialectical relationship between emotional consciousness (linked to practical activity) and rational consciousness (linked to purely conscious activity).

This dialectical relationship is a cycle, in which one engages in practical activity, which leads to emotional consciousness, which leads to rational consciousness, which then leads back to practical activity to test the correctness of the conclusions of rational conscious activity.

We call this cycle of development of consciousness the cognitive process.

The cognitive process is a continuous cycle which describes the dialectical development of consciousness and practical activity.

The cognitive process is explained in more detail below.

- Development From Emotional Consciousness to Rational Consciousness

Emotional consciousness is the lower stage of the cognitive process. In this stage of cognitive development, humans use — through practical activity — use our senses to reflect objective things and phenomena (with all their perceived specific characteristics and rich manifestations) in human consciousness. During this period, consciousness only reflects the phenomena [i.e, phenomena, as opposed to essence — see Essence and Phenomenon, p. 156] — the external manifestations — of the perceived subject. At this stage, consciousness has not yet reflected the essence — the nature, and/or the regulating principles — of the subject. Therefore, this is the lowest stage of development of the cognitive process. In this stage, consciousness is carried out through three basic phases: sensation, conception, and symbolization.

Human sensation of an objective thing or phenomenon is the simplest, most primitive phase of the emotional consciousness stage of the cognitive processes, but without it there would not be any perception of objective things or phenomena. Every human sensation of objective things and phenomena contains objective content [see Content and Form, p. 147], even though it arises as subjective human conscious reflection. Sensation is the subjective imagining of the objective world. It is the basis from which the next phase of emotional consciousness — conception — is formed.

Conception is a relatively complete reflection within human consciousness of objective things and phenomena. Conception is formed on the basis of linking and synthesizing sensational experiences of things and phenomena [i.e., sensation]. Compared with sensation, conception is a higher, fuller, richer form of consciousness, but it is still a reflection of the outward manifestations of objects. Conception does not yet reflect the essence, nature, and regulating principles of the perceived subject.

Symbolization is the representation of an objective thing or phenomenon that has been reflected by sensation and conception. It is the most advanced and most complex phase of the stage of emotional consciousness. At the same time, it also serves as the transitional step between emotional consciousness and rational consciousness. The defining characteristic of symbolism is the ability to reproduce symbolic ideas of objective things and phenomena within human consciousness. Symbolization describes the act of recreating the outward appearances of material things and phenomena within human consciousness, which is the first step of abstraction, and thus the first step towards rational consciousness.

Annotation 227

Here is an example of the three phases of the emotional consciousness stage of the cognitive process:

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1. Sensation: Jessica senses a cake in the window of a bakery. She sees the frosting, the shape of the cake, and the decorations which adorn the cake. She smells the cake. During this phase, objective data about the cake is received into her consciousness, developing into an immediate and subjective sense perception of the cake. The beginnings of this cognitive activity will be purely sensory in nature; she may have been thinking of other things as she walked by the bakery, but the sight and smell of the cake, upon registering in her mind, will lead to the beginning of a new cognitive process cycle.

2. Conception: Jessica begins to conceive of the cake in her mind more fully. She will associate the immediate sense experiences of seeing and smelling the cake with other experiences she has had with cake, and a complete mental image and concept of the cake will form in her mind.

3. Symbolization: The word “cake” may now form in her mind, and she may begin thinking of the cake more abstractly, as “food,” as a “temptation,” and in other ways. This is the beginning of abstraction in Jessica’s mind, which will then lead to rational conscious activities.

Note that all of these phases of emotional consciousness activity may take place very quickly, perhaps in a fraction of a second, and may coincide with other conscious activity (i.e., Jessica may simultaneously be thinking of a meeting she’s running late to and any number of other things). At this point, Jessica will transition to the rational consciousness stage of the cognitive process, which is explained in more detail below.

By the end of the emotional stage of the cognitive process, consciousness has not yet reflected the essence — the nature, regulating principles, etc. — of the perceived subject. Therefore, at the emotional stage, consciousness is not yet able to properly interpret the reflected subject. That is to say, emotional conscious activity does not meet the cognitive requirements to serve practical activities, including the need to creatively transform the objective world. To meet these requirements, emotional consciousness must develop into rational consciousness.

Rational consciousness is the higher stage of the cognitive process. It includes the indirect, abstract, and generalized reflection of the essential properties and characteristics of things and phenomena. This stage of consciousness performs the most important function of comprehending and interpreting the essence of the perceived subject. Rational consciousness is implemented through three basic phases: definition, judgment, and reasoning.

Definition is the first phase of rational consciousness. During this phase, the mind begins to interpret, organize, and process the basic properties of things and phenomena at a rational level into a conceptual whole. The formation of definition is the result of the summarization and synthesis of all the different characteristics and properties of the subject, and how the subject fits into the organized structure of knowledge which exists in the mind. Definition is the basis for forming judgments in the cognitive process.

Judgment is the next phase of rational consciousness, which arises from the definition of the subject — the linking of concepts and properties together — which leads to affirmative or negative ideation of certain characteristics or attributes of the perceived subject.

According to the level of development of consciousness, judgment may take one of three forms: unique judgment, general judgment, and universal judgment [see Annotation 105, p. 107]. Universal judgment is the form of judgement that expresses the broadest conception of objective reality.

Reasoning is the final phase of rational consciousness, formed on the basis of synthesizing judgments so as to extrapolate new knowledge about the perceived subject. Before reasoning can take place, judgments must be transformed into knowledge. A judgment can be transformed into knowledge through one of two logical mechanisms: deductive inference (which extrapolates the general from the specific), and inductive inference (which extrapolates the specific from the general).

Annotation 228

Here is an example of the three phases of the rational consciousness stage of the cognitive process, continuing from our previous example of the emotional consciousness stage [see Annotation 227, p. 222].

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1. Definition: Jessica’s conception of the cake will transition into the rational conscious activity of definition. Jessica will begin to define the concept of the cake more wholly and concretely, summarizing and synthesizing all of the features and characteristics of the cake into a cohesive mental reflection of the cake. The word “cake” may become more pronounced and defined in Jessica’s consciousness, prompting her to think of the object which she defines as a “cake” more fully and rationally.

2. Judgment: Jessica will begin to form basic judgments about the cake. “That cake looks good,” “that cake smells good,” and so on. Next, these judgments will begin to transform into knowledge through inductive or deductive inferences. An inductive inference might be: “I generally enjoy eating cakes, therefore, I might enjoy eating this cake!” An example of a deductive inference might be: “This cake looks very delicious, therefore, there might be other delicious things in this bakery!”

3. Reasoning: Processes of inductive and/or deductive inference will begin to transform Jessica’s judgments into the form of knowledge. For instance, she may now possess such knowledge as: “This bakery has delicious looking cakes, this is a cake I would like to eat,” and so on. With this newly acquired knowledge, Jessica can begin reasoning; that is to say, she can begin making rational conclusions and decisions. She might conclude: “I will go into this bakery and buy that cake.”

Note that this is not the “end” of the cognitive process, because the final phase of the reasoning stage of the cognitive process (reasoning) will lead directly into a new cycle of the cognitive process. In this example, Jessica might engage in the practical activity of checking her watch to see the time, which will begin a new cycle of cognitive process, beginning with the sensation phase of the emotional stage as the visual sense data of her watch and carrying through to the final reasoning phase of the rational stage, and so on.

It should also be noted that this is merely an abstraction of the cognitive process; in reality, the human mind is incredibly complex, capable of carrying out a variety of cognitive processes simultaneously. At any given moment, a person might be considering various different subjects, and each different subject might be at a different stage of the cognitive process. This abstract model of the cognitive process is presented to help us comprehend the component functions of consciousness more easily in the wider context of dialectical materialist philosophy.

Specifically, this model of the cognitive process is intended to help us understand how human consciousness leads to “truth.” And “truth,” here, refers to the alignment of human consciousness with the material world, so that our perceptions and understanding of the world is accurate and representative of actual reality.

- The Relationship Between Emotional Consciousness, Rational Consciousness, and Reality

Emotional consciousness and rational consciousness are stages that make up the cognitive cycle. In reality, they are often intertwined within the cognitive process, but they have different functions. If emotional consciousness is associated with reality, and with the impact of sense data received from observing the material world, and is the basis for cognitive reason, then rational consciousness, based on higher cognitive understanding and abstraction, allows us to understand the essence, nature, regulating principles, and development processes of things and phenomena. Rational consciousness helps direct emotional consciousness in a more efficient and effective direction and leads to more profound and accurate emotional consciousness.

Annotation 229

In other words, considering a subject at the level of rational consciousness allows us to then view the same subject, at an emotional consciousness level, with more depth and awareness.

For example, the more time we have spent rationally considering something like a bicycle, the more quickly and accurately we can examine a bicycle at the level of emotional consciousness. If someone is looking at a bicycle for the first time, they might not be able to distinguish its component parts or functions. On the other hand, if someone has spent more time considering bicycles at the level of rational consciousness, they may be able to immediately and rapidly understand and process a bicycle at the emotional conscious level, so that they can perceive and comprehend the different parts of a bicycle, as well as their functions, immediately and at the emotional-sensory level.

However, if we stop at rational consciousness, we will only have knowledge about the subjects we perceive, but we still won’t really know if that knowledge is truly accurate or not. In order to be useful in practical activity, we must consciously determine whether knowledge is truth [i.e., whether the knowledge accurately reflects reality]. In order to determine the truth of knowledge, consciousness must necessarily return to reality. Consciousness must use reality as a criterion — a measurement — of the authenticity of knowledge gained through purely cognitive processes. In other words, all consciousness is ultimately derived from practical needs, and must also return to serve practical activities.

Annotation 230

The dialectical relationship between consciousness and practical activities means that conscious activities develop practical activities, and vice versa, in a continuous feedback loop.

One of the fundamental principles of dialectical materialism is that the material determines the ideal, and the ideal impacts the material [see The Relationship Between Matter and Consciousness]. The fact that the material determines consciousness is reflected in the fact that material needs led to the development of consciousness, and conscious activity stems from material needs [see Social Sources of Consciousness].

The fact that the ideal impacts the material is reflected in the fact that consciousness must always return to the service of practical activities; as our consciousness develops (along with knowledge), our ability to impact and transform the material world becomes more efficient and effective.

The dialectical relationship between consciousness and practical activity is what drives the development of humanity. We imagine better ways of doing things, then test those ideas against reality through practical activity.

This dialectical relationship between consciousness and practical activity is thus cyclical. Conscious activity arises from practical activity, and returns to practical activity, in an endless process of developing both conscious ability as well as practical ability.

Therefore, it can be seen that the general, cyclical nature of the process of movement and development of consciousness develops from practice to consciousness — from consciousness to practice — from practical activity to the continued process of cognitive development, and so on. This process is repeated continuously, without end. The development level of consciousness and practice in the next cycle are often higher than in the previous cycle, and the cognitive process gradually develops more and more accuracy, as well as fuller and deeper knowledge about objective reality.

The universal law of consciousness [see Annotation 224, p. 219] is also a concrete and vivid manifestation of the universal laws of materialist dialectics, including: the law of negation of negation, the law of transformation between quantity and quality and the law of unity and contradiction between opposites. The process of cognitive motion and development, governed by these general laws, is the process of human progress towards absolute truth [see Annotation 232, p. 228].

Annotation 231

The universal law of consciousness is governed by the three universal laws of materialist dialectics:

The Law of Negation of Negation dictates that the new will arise from the old, but will carry forward characteristics from the old. This is reflected in the universal law of consciousness in that conscious activity arises from practical activity. This conscious activity then develops into improved practical activity, and so on, in a never-ending cycle of development. Throughout this development process, characteristics of previous cycles of cognitive and practical activities are carried forward and transferred on to newer cycles of cognitive and practical activities.

The Law of Transformation Between Quantity and Quality recognizes that quantity changes develop into changes in quality, and vice versa. This is reflected in the universal law of consciousness in the development of both conscious and practical activities. Conscious development also develops from quantitative changes to quality changes, and vice versa. For example, once a person accumulates a certain quantity of knowledge, the quality of their knowledge will change. For example, once a person has learned the function of every component part of a car engine, they will have a quality shift in their understanding of car engines — they will now have competency of the functioning of the engine as a whole. This is also true of practical activities. A quantity of practical experience will lead to quality shifts in practical ability. For example, once a person has practiced riding a bicycle enough that they can reliably ride the bicycle without falling, we would say that the person “knows how to ride a bicycle,” which represents a quality shift from the state of “learning how to ride a bicycle.”

The Law of Unity and Contradiction Between Opposites states that all things, phenomena, and ideas are defined by internal and external contradictions. This is reflected in the universal law of consciousness by the fact that practical needs serve as the basis for conscious activity, and that cognitive processes serve, in essence, to negate contradictions between consciousness and material reality through practical experience. In other words, the cognitive process is defined by a never-ending process of contradiction between the material and the ideal, as human beings seek to negate contradictions between our conscious understanding of the world and our practical experiences in search of truth - the accurate alignment of consciousness with the material world.

b. Truth, and the Relationship Between Truth and Reality

- Definition of Truth

All cognitive processes lead to the creation of knowledge, which is what we call human understanding of objective reality. But not all knowledge has content consistent with objective reality, because consciousness exists as the subjective reflection of objective reality in the human mind. The collective cognitive practice of all of humanity throughout history, as well as the cognitive practice of each individual human being, has demonstrated that the knowledge which people have gained and are gaining is not always consistent with objective reality. On the contrary, there are many cases of misalignment between consciousness and reality, and even complete contradiction between human thought and objective reality.

Within the theoretical scope of Marxism-Leninism, the concept of truth is used to refer to knowledge which is aligned with objective reality. This alignment is tested and proven through practice. In this sense, the concept of truth is not identical with the concept of “knowledge,” nor with the concept of “hypothesis.” According to Lenin: “The coincidence of thought with the object is a process: thought (= man) must not imagine truth in the form of dead repose, in the form of a bare picture (image), pale (matte), without impulse, without motion…”^[112]

Annotation 232

Here, Lenin is dispelling Hegel’s conception of “absolute truth,” which is not to be confused with Lenin’s concept of “absolute truth” as “objective truth” which aligns consciousness with objective reality [see Annotation 58, p. 56]. For Hegel, “absolute truth” was the idea that there will eventually be some end point to the process of rational consciousness at which we will finally arrive at some final stage of knowledge and consciousness. This rational end point of consciousness, at which the dialectic ends and all contradictions are negated, is Hegel’s “absolute truth.”

Lenin is also pushing back against the metaphysical conception that all “truths” exist as static categories of information which do not change. Instead, Lenin points out that seeking truth — i.e., aligning consciousness with material reality — is a never-ending process, in particular because reality is constantly developing and changing. Thus, the alignment of consciousness with reality — the pursuit of truth — is a living and dynamic process which will never end, since the development of reality will never end.

- The Properties of Truth

All truths are objective, relative, absolute, and concrete.

The objectivity of truth is the independence of its content from the subjective will of human beings. The content of knowledge must be aligned with objective reality, not vice versa. This means that the content of accurate knowledge is not a product of pure subjective reasoning. Truth is not an arbitrary human construct, nor is truth inherent in consciousness. On the contrary, truth belongs to the objective world, and is determined by the objective world. The affirmation of the objectivity of truth is one of the fundamental points that distinguishes the concept of absolute truth of dialectical materialism from the concept of absolute truth of idealism and skepticism — the doctrines that deny the objective existence of the physical world and deny the possibility that humans are able to perceive the world.

Annotation 233

The Dialectical Materialist conception of objective truth stands in contrast to idealism, which states that conscious reasoning alone leads to truth, and that the subjective ideal determines material reality [see Annotation 7, p. 8].

This objectivity of truth also refutes skepticism, which states that truth is essentially undiscoverable, because human consciousness is ultimately unreliable and incapable of accurately reflecting material reality [see Annotation 32, p. 27].

Distinction must also be drawn between the concept of absolute truth as it is understood in dialectical materialist philosophy and the conception of absolute truth in Hegel’s idealist dialectics. Dialectical materialism defines absolute truth as “objective truth;” that is to say: a complete alignment between objective reality and human consciousness (as compared to relative truth, which is a partial alignment between consciousness and objective reality).

Hegel, on the other hand, views absolute truth as a final point at which human consciousness will have achieved absolute, complete, and final understanding of our universe (see Annotation 232, p. 228) with the ideal serving as the first basis and primary mechanism for bringing absolute truth to fruition.

Truth is not only objective, but also absolute and relative. Absolute truth [see Annotation 58, p. 56] refers to truth which reflects a full and complete alignment of consciousness and reality. Theoretically, we can reach absolute truth. This is because, in the objective world, there exists no thing nor phenomenon which human beings are completely incapable of accurately perceiving. The possibility of acquiring absolute truth in the process of the development of conscious understanding is theoretically limitless. However, in reality, our conscious ability to reflect reality is limited by the specific material conditions of each generation of humanity, of practical limitations, and by the spatial and temporal conditions of reflected subjects. Therefore, truth is also relative.

Annotation 234

Dialectical materialist philosophy recognizes that it must be theoretically possible to know everything there is to know about a given subject, since we are theoretically capable of accurately perceiving, sensing, and measuring all data which pertains to a subject. However, dialectical materialism also recognizes the practical limitations of human beings. As Engels writes in Anti-Dühring:

If mankind ever reached the stage at which it should work only with eternal truths, with results of thought which possess sovereign validity and an unconditional claim to truth, it would then have reached the point where the infinity of the intellectual world both in its actuality and in its potentiality had been exhausted, and thus the famous miracle of the counted uncountable would have been performed.
But are there any truths which are so securely based that any doubt of them seems to us to be tantamount to insanity? That twice two makes four, that the three angles of a triangle are equal to two right angles, that Paris is in France, that a man who gets no food dies of hunger, and so forth? Are there then nevertheless eternal truths, final and ultimate truths.
Certainly there are. We can divide the whole realm of knowledge in the traditional way into three great departments. The first includes all sciences that deal with inanimate nature and are to a greater or lesser degree susceptible of mathematical treatment: mathematics, astronomy, mechanics, physics, chemistry. If it gives anyone any pleasure to use mighty words for very simple things, it can be asserted that certain results obtained by these sciences are eternal truths, final and ultimate truths; for which reason these sciences are known as the exact sciences. But very far from all their results have this validity. With the introduction of variable magnitudes and the extension of their variability to the infinitely small and infinitely large, mathematics, usually so strictly ethical, fell from grace; it ate of the tree of knowledge, which opened up to it a career of most colossal achievements, but at the same time a path of error. The virgin state of absolute validity and irrefutable proof of everything mathematical was gone forever; the realm of controversy was inaugurated, and we have reached the point where most people differentiate and integrate not because they understand what they are doing but from pure faith, because up to now it has always come out right. Things are even worse with astronomy and mechanics, and in physics and chemistry we are swamped by hypotheses as if attacked by a swarm of bees. And it must of necessity be so. In physics we are dealing with the motion of molecules, in chemistry with the formation of molecules out of atoms, and if the interference of light waves is not a myth, we have absolutely no prospect of ever seeing these interesting objects with our own eyes. As time goes on, final and ultimate truths become remarkably rare in this field.

Relative truth is truth which has developed alignment with reality without yet having reached complete alignment between human knowledge and the reality which it reflects. To put it another way, relative truth represents knowledge which incompletely reflects material subjects without complete accuracy. In relative truth, there is only partial alignment — in some (but not all) aspects — between consciousness and the material world.

Annotation 235

False consciousness is consciousness which is incorrect and misaligned from reality. Discovering and rooting out false consciousness is one of the primary concerns of dialectical materialism, as false consciousness can be a serious impediment to human progress. The term “false consciousness” was first used by Friedrich Engels in a personal letter to Franz Mehring in 1893 (a decade after the death of Karl Marx), and in this letter Engels uses the term interchangeably with the word “ideology”* to describe conscious thought processes which do not align with reality:

Ideology is a process accomplished by the so-called thinker consciously, indeed, but with a false consciousness. The real motives impelling him remain unknown to him, otherwise it would not be an ideological process at all. Hence he imagines false or apparent motives. Because it is a process of thought he derives both its form and its content from pure thought, either his own or that of his predecessors. He works with mere thought material which he accepts without examination as the product of thought, he does not investigate further for a more remote process independent of thought; indeed its origin seems obvious to him, because as all action is produced through the medium of thought it also appears to him to be ultimately based upon thought. The ideologist who deals with history (history is here simply meant to comprise all the spheres – political, juridical, philosophical, theological – belonging to society and not only to nature), the ideologist dealing with history then, possesses in every sphere of science material which has formed itself independently out of the thought of previous generations and has gone through an independent series of developments in the brains of these successive generations. True, external facts belonging to its own or other spheres may have exercised a co-determining influence on this development, but the tacit pre-supposition is that these facts themselves are also only the fruits of a process of thought, and so we still remain within that realm of pure thought which has successfully digested the hardest facts.

Although the term “false consciousness” is not found in writing until after Marx’s death, the concept underlying the term “false consciousness” is found often in the works of Marx and Engels. For instance, in The Holy Family, Marx and Engels explain how communist, class conscious workers have been able to break free of false consciousness of capitalist society:

They (the communist workers) are most painfully aware of the difference between being and thinking, between consciousness and life. They know that property, capital, money, wage-labor and the like are no ideal figments of the brain but very practical, very objective products of their self-estrangement.

This allusion to “the difference between being and thinking” recurs again and again in the works of Marx and Engels.

* Lenin also discussed the concept of false consciousness extensively, and argued that dialectical materialism was the key to negating the false consciousness of the working class, writing in What the “Friends of the People” Are:

It never has been the case, nor is it so now, that the members of society conceive the sum-total of the social relations in which they live as something definite, integral, pervaded by some principle; on the contrary, the mass of people adapt themselves to these relations unconsciously, and have so little conception of them as specific historical social relations that, for instance, an explanation of the exchange relations under which people have lived for centuries was found only in very recent times. Materialism removed this contradiction by carrying the analysis deeper, to the origin of man’s social ideas themselves; and its conclusion that the course of ideas depends on the course of things is the only one compatible with scientific psychology. Further, and from yet another aspect, this hypothesis was the first to elevate sociology to the level of a science.

Note that this convention of using the word “ideology” to mean “false consciousness” has never been common, and Marx and Engels both used the word “ideology” more often in its more usual sense of “a system of ideas,” but it is still occasionally encountered in socialist literature, as Joseph McCarney explains in Marx Myths and Legends:

Marx never calls ideology ‘false consciousness’. Indeed, he never calls anything ‘false consciousness’, a phrase that does not occur in his work... The noun is almost always accompanied by an epithet such as ‘German’, ‘republican’, ‘political’ or ‘Hegelian’, or by a qualifying phrase, as in ‘the ideology of the bourgeoisie’ or ‘the ideology of the political economist’. More typical in any case is the adjectival usage in which such varied items as ‘forms’, ‘expressions’, ‘phrases’, ’conceptions’, ‘deception’, and ‘distortion’ are said to have an ‘ideological’ character. Even more distinctive is the frequency, amounting to approximately half of all references in the relevant range, of invocations of the ‘ideologists’, the creators and purveyors of the ideological forms.

“Relative truth” and “absolute truth” do not exist separately, but have dialectical unity with each other. On the one hand, “absolute truth” is the sum of all “relative truths.” On the other hand, in all relative truths there are always elements of absolute truth.

Lenin wrote that “absolute truth results from the sum-total of relative truths in the course of their development; [...] relative truths represent relatively faithful reflections of an object existing independently of man; [...] these reflections become more and more faithful; [...] every scientific truth, notwithstanding its relative nature, contains an element of absolute truth.”^[113]

Correct realization of the dialectical relationship between relative and absolute truth plays a very important role in criticizing and overcoming extremism and false consciousness in perception and in action. If we exaggerate the absoluteness of the truth of knowledge which we possess, or downplay its relativity, we will fall into the false consciousness of metaphysics, dogmatism, conservativism, and stagnation.

Annotation 236

Intentional or unintentional exaggeration of the absoluteness of truth — i.e., considering our knowledge to be more complete and/or aligned with reality than it actually is — leads to incorrect viewpoints and mindsets, including:

Metaphysics is a philosophical system which seeks truth through the systematic categorization of knowledge [see Annotation 8, p. 8]. This is a flawed method of seeking knowledge because it considers truth to be essentially static and unchanging, and upholds the erroneous notion that truth can be systematically broken down into discrete, isolated categories. In addition to being fundamentally incorrect about the nature of truth and knowledge, it leads to the incorrect presumption that such static categorization of knowledge can lead to truth at all. Metaphysics fails to see truth and consciousness as a process, and instead sees truth as a static assembly of categorized facts and data.

Dogmatism occurs when one only accounts for commonalities and considers theory itself as the sole basis of truth. Dogmatism inherently overstates the absoluteness of knowledge, as dogmatic positions uphold certain theoretical principles as complete, inviolable, and completely developed. This explicitly denies the continuously developing process of advancing knowledge and consciousness.

Conservativism includes any position that seeks to prevent change, or to undo change to return to an earlier state of development. Such positions deny the continuous development of consciousness, knowledge, and practice, and incorrectly assert incorrect positions; or mistake relative truth for absolute truth.

Stagnation is an inability or unwillingness to change and adapt consciousness and practice in accordance with developing material conditions. Stagnation can stem from, or cause, overstatement of absolute truth in theory and forestall necessary development of both consciousness and practical ability.

On the contrary, if we exaggerate the relativity of the truth of knowledge which we possess, or downplay its absoluteness, we will fall into relativism, thereby leading to subjectivism, revisionism, sophistry, and skepticism.

Annotation 237

Relativism is the belief that human consciousness can only achieve relative understanding of the world, and that truth can therefore never be objectively discovered. Relativism is, thus, the overstatement of the relative nature of truth and the denial of the existence of absolute truth. Relativism leads to such incorrect viewpoints and mindsets as:

Subjectivism: which occurs when one centers one’s own self and one’s own conscious activities in perspective and worldview, failing to test their own perceptions against material and social reality [see Annotation 211, p. 205]. This position denies that truth can be discovered in the external material world, falsely believing that absolute truth stems only from conscious activity.

Revisionism: a failure to recognize and accept commonalities in conscious activity, focusing only on the private [see Private and Common, p. 128]. Revisionism leads to constant and unnecessary reassessment and reevaluation of both knowledge and practice. Revisionism, thus, is a position which overstates the relativity of truth and ignores truths which are more fully developed towards absoluteness.

Sophistry: the use of falsehoods and fallacious arguments to deceive [see Annotation 116, p. 118]. Sophistry is, thus, the intentional denial of truth and the intentional mischaracterization of truths as either overly relative or as not truths at all.

Skepticism: the belief that truth is essentially undiscoverable, because human consciousness is ultimately unreliable and incapable of accurately reflecting material reality [see Annotation 200, p. 192]. By denying that truth is discoverable at all, skepticism explicitly rejects absolute truth and declares that all truth is relative and unreliable.

In addition to objectivity, absoluteness, and relativity, truth also has concreteness. The concreteness of truth refers to the degree to which a truth is attached to specific objects, in specific conditions, at a specific point in time. This means that all accurate knowledge always refers to a specific situation which involves specific subjects which exist in a specific place and time. The content of truth cannot be pure abstraction, disconnected from reality, but it is always associated with certain, specific objects and phenomena which exist in a specific space, time, and arrangement, with specific internal and external relationships. Therefore, truth is associated with specific historical conditions. This specificity to time, place, relations, etc., is what we call concreteness.

Knowledge, if detached from specific historical conditions, will fall into pure abstraction. Therefore, it will not be accurate — it will not align with reality — and such knowledge cannot be considered truth. When emphasizing this property, Lenin wrote: “Truth is always concrete, never abstract.”^[114] Mastering the principle of the concreteness of truth has an important methodological significance in cognitive and practical activities. It is required that consideration and evaluation of all things and phenomena must be based on a historical viewpoint [see Annotation 114, p. 116]. In developing and applying theory, we must be conscious of specific historical conditions. According to Lenin, Marxism’s nature, its essence, lies in the concrete analysis of specific situations; Marx’s method is, above all, to consider the objective content of the historical process in a specific time.

Annotation 238

In other words, Marxism is rooted in seeking truth by examining reality from a historical and comprehensive viewpoint. For more information, see Annotation 114, p. 116.

- The Role of Truth in Reality.

In order to survive and develop, humans must conduct practical activities. These activities involve transforming the environment, nature, and human society. At the same time, through these activities, humans perform — knowingly or unknowingly — the process of perfecting and developing our conscious and practical abilities. It is this process that helps human cognitive activities develop. Practical activities can only be successful and effective once humans apply accurate knowledge of objective reality to our practical activities. Therefore, truth is one of the prerequisites that ensure success and efficiency in practical activities.

The relationship between truth and practical activities is a dialectical relationship which serves as the basis for the movement and development of both truth and practical activity: truth develops through practice, and practice develops through the correct application of truth which people have gained through practical activities.

Annotation 239

Truth and Practical Activities have a dialectical relationship in which truth develops through practice, and practice develops through the correct application of truth.

Practice only develops when truth about the universe is consciously applied to practical activities. For example, farm output increases as we learn more truth about the way crops grow and how land can be properly managed. Simultaneously, truth can only be developed through practical activity, as all ideas and knowledge must be tested through methodological observation, experimentation, and other forms of practical activity.

A theory is an idea or system of ideas intended to explain an aspect, characteristic, or tendency of objective reality. Theories are not inherently truthful; holding incorrect theories constitutes false consciousness. Practice (or praxis) is purposeful conscious activity which improves our understanding of the world. Theory and practice have a dialectical relationship with one another which, if understood, helps us to discover truth.

Truth and practical activities mutually develop one another over time.

This dialectical relationship between theory and practical activities means that we must never favor theory over practice, nor practice over theory, but that we must rather balance development of theoretical understanding as we engage in practical activities to test our knowledge against reality and to develop our practice with ever-advancing understanding of the world. As practice and theory develop one another, our understanding of objective reality comes closer and closer to truth.

In Theses on Feuerbach, Marx summarizes the relationship between theory and practice, writing:

The problem of the external world is here put as the problem of its transformation: the problem of the cognition of the external world as an integral part of the problem of transformation: the problem of theory as a practical problem.

Here, Marx explains that theory is concerned with solving the “problem” of transforming the external world through practice, and that “cognition of the external world” is required to solve the “problem of transformation. In other words, we must improve our theory in order to improve our practical ability to transform our world, and we learn about the world (thus improving our theory) through those practical activities.

Marx also writes in Theses on Feuerbach that:

The question whether objective truth can be attributed to human thinking is not a question of theory, but it is a practical question. In practice man must prove the truth, that is, the reality and power... of his thinking.

This point is key for understanding the dialectical relationship between practice and theory: in order to be useful, theory must be proven through practice. Thus, we must seek to develop our practice through theory, and our theory through practice.

Engels summarizes these ideas a bit more colorfully in Socialism: Utopian and Scientific:

Before there was argument there was action... In the beginning was the deed ... And human action had solved the difficulty long before human ingenuity invented it. The proof of the pudding is in the eating.

Engels wrote in Ludwig Feuerbach and the End of Classical German Philosophy of the uselessness of what might be called “pure theory,” divorced from practice, and the sort of radical skepticism which refutes that any practical knowledge can ever really be obtained by human beings:

There is yet a set of different philosophers — those who question the possibility of any cognition, or at least of an exhaustive cognition of the world... The most telling refutation of this (scepticism and agnosticism) as of all other philosophical crotchets, is praxis, namely experiment and industry.

It is practice, according to Engels, which proves the merit and utility of theory.

Through experiment and industry — through practical activities in the material world — we can test our ideas and dialectically develop both theory and practice. Lenin built upon these ideas in his own work, writing in Materialism and Empirio-Criticism:

The materialist theory, the theory of the reflection of objects by our mind, is here presented with absolute clarity: things exist outside us. Our perceptions and ideas are their images. Verification of these images, differentiation between true and false images, is given by practice.

Here, Lenin explains how only a proper understanding and application of the dialectical relationship between theory and practice can lead to the negation of false consciousness [see Annotation 235, p. 231] and the dialectical development of both practice and theory. Simply arguing and debating about ideas without relating them directly to practice will never lead to truth, nor will such pure-theory argumentation develop theory or practice in any meaningful way.

This brings to mind another line from Marx’s Theses on Feuerbach:

The dispute over the reality or non-reality of thinking that is isolated from practice is a purely scholastic question.

The philosophy of dialectical materialism and the system of materialist dialectics are designed specifically to produce action and to avoid such “scholastic questions” and “pure-theory argumentation.”

Ho Chi Minh summarized these ideas perhaps most clearly and precisely of all in the very title of his article: Practice Generates Knowledge, Understanding Advances Theory, Theory Leads to Practice:

Knowledge comes from practice. And through practice, knowledge becomes theory. That theory, again, has to be put into practice. Knowledge advances not just from thought to theory, but, above all, from applying theory to revolutionary practice. Once the world’s law is fully grasped as theory, it is critical to put that theory into practice by changing the world, by increasing production, and by practicing class struggle and struggling for national self-determination. This is a continuous process of obtaining knowledge.

“If Uncle Ho says we will win, we will win!” — Propaganda poster from the 30th anniversary of the Battle of Dien Bien Phu (1984).

Afterword

If it seems that this book has come to an end somewhat abruptly, it’s because this is really just the first of four major sections of the full volume from which this text is drawn. If you are reading this afterword after reading the entirety of the preceding contents, then congratulations, you have completed the equivalent to a full semester’s coursework for a class on dialectical materialist philosophy which all Vietnamese college students are required to take!

The next sections in this curriculum, each covered in the original full volume, include:

Part 2: Historical Materialism

This section covers the definition and basic principles of historical materialism, which is the field of work dedicated to applying dialectical materialism and materialist dialectics to human history and human society. In the West, historical materialism and dialectical materialism are often conflated, but this is in error. Historical materialism is an applied field of dialectical materialist philosophy and materialist dialectical methodology which is used in the pursuit of understanding and interpreting human history.

Part 3: Political Economy

This section condenses the three cardinal volumes of Capital by Karl Marx and covers three primary doctrines:

1. The doctrine of value.

2. The doctrine of surplus value.

3. The doctrines of monopolist capitalism and state monopolist capitalism.

Political Economy, in this course, can be considered the application of dialectical materialism and materialist dialectics to the analysis and understanding of the capitalist mode of production from the perspective of the socialist revolutionary movement.

Part 4: Scientific Socialism

This section relies on an established understanding of dialectical materialism, historical materialism, and political economy as a foundation for developing socialist revolution. The three chapters of this section on Scientific Socialism are:

1. The Historical Mission of the Working Class and the Socialist Revolution

2. The Primary Social-Political Issues of the Process of Building a Socialist Revolution 3. Realistic Socialism and Potential Socialism

Moving Forward

We are already working on the translation of Part 2 of this curriculum, and we hope to complete it as quickly as possible. In the meantime, we believe this book provides the reader with enough of a foundation to continue studying and to begin applying the principles of dialectical materialism and materialist dialectics in political struggle.

We highly discourage readers from self-study in isolation, just as we discourage individual political action. The best way to study socialism is alongside other socialists.

Depending on where you live, you may be able to find political education resources provided by communist parties, socialist book clubs, or other organizations. If such resources aren’t available, it should be fairly easy to find study groups, workshops, and affinity groups online where you can study with like-minded comrades. Of course, socialist revolution requires more than just study, as we hope this book has thoroughly explained. Theory must be coupled with practice. As Ho Chi Minh wrote: “If you read a thousand books, but you fail to apply theory into practice, you are nothing but a bookshelf.”

To avoid atrophying into the proverbial bookshelf, we encourage you to go out into the world and apply these ideas creatively and collectively with other socialists. Dialectical materialism is a philosophy that was developed from the ground up for application in the real world. Dialectical materialism and materialist dialectics provide a functional model of reality, a way of looking at highly complicated systems, with all their dynamic internal and external relations. Dialectical materialist philosophy demands that we see human systems as processes in motion. In order to fully comprehend such dynamic processes, we must engage with them, which is why Ho Chi Minh taught that “we are not afraid to make mistakes; we would only be afraid of making mistakes if we were not determined to correct them.”^[115]

As we mentioned in the foreword, many socialists in the West suffer from a lack of practical engagement. Far too many socialists fall into utopianism, idealism, and social chauvinism and we believe this largely stems from failures to test ideas against reality through praxis. We hope that this book has impressed upon the reader that simply arguing about pure theory is a useless and futile pursuit. Indeed, sparring verbally over such “scholastic questions,” as Marx described them, is counter-productive. Marx and Engels defined such failure to engage in theory as “critical criticism” — that is to say, criticism for the sake of criticism. As Marx and Engels wrote in The Holy Family, such critical criticism is futile, as we will never think our way to revolution:

According to Critical Criticism, the whole evil lies only in the workers’ “thinking”. It is true that the English and French workers have formed associations in which they exchange opinions not only on their immediate needs as workers, but on their needs as human beings. In their associations, moreover, they show a very thorough and comprehensive consciousness of the “enormous” and “immeasurable” power which arises from their co-operation. But these mass-minded, communist workers, employed, for instance, in the Manchester or Lyons workshops, do not believe that by “pure thinking” they will be able to argue away their industrial masters and their own practical debasement. They are most painfully aware of the difference between being and thinking, between consciousness and life. They know that property, capital, money, wage-labour and the like are no ideal figments of the brain but very practical, very objective products of their self-estrangement and that therefore they must be abolished in a practical, objective way for man to become man not only in thinking, in consciousness, but in mass being, in life. Critical Criticism, on the contrary, teaches them that they cease in reality to be wage-workers if in thinking they abolish the thought of wage-labour; if in thinking they cease to regard themselves as wage-workers and, in accordance with that extravagant notion, no longer let themselves be paid for their person. As absolute idealists, as ethereal beings, they will then naturally be able to live on the ether of pure thought.

Engels expressed his frustration with such endless, utopian, idealist debates in Socialism: Utopian and Scientific:

Hence, from this nothing could come but a kind of eclectic, average Socialism, which, as a matter of fact, has up to the present time dominated the minds of most of the socialist workers in France and England. Hence, a mish-mash allowing of the most manifold shades of opinion: a mish-mash of such critical statements, economic theories, pictures of future society by the founders of different sects, as excite a minimum of opposition; a mish-mash which is the more easily brewed the more definite sharp edges of the individual constituents are rubbed down in the stream of debate, like rounded pebbles in a brook.

Engels concludes by punctuating why he and Marx had developed dialectical materialism as a praxis-oriented philosophical foundation for scientific socialism: “To make a science of Socialism, it had first to be placed upon a real basis.” We hope that the readers of this text will seek out real bases for your development in theory and praxis, and we trust that you will quickly discover that developing practice develops theory, and vice-versa.

Remember that Marx and Engels, themselves, were not just theorists who scribbled down their thoughts in an “scholarly” vacuum. They were revolutionists themselves, highly engaged in political struggle and, in so struggling, they risked their lives and freedom over the course of many decades. This struggle is what led to the change and development of their ideas over time. The same can be said for every other successful socialist revolutionary in history.

Vo Nguyen Giap, the great general who led Vietnam’s military forces through resistance wars against fascist Japan, colonialist France, and the imperialist USA, describes how he applied such principles on the battlefield in his book People’s War, People’s Army:

During the Resistance War, owing to constant fighting, the training of our troops could not be carried out continuously for a lengthy period but only between battles or campaigns. We actively implemented the guiding principles ‘To train and to learn while we fight.’ After the difficult years at the beginning of the Resistance War, we succeeded in giving good training to our army. The practical viewpoint in this training deserves to be highlighted. The content of training became most practical and rich. Training was in touch with practical fighting: the troops were trained in accordance with the next day’s fighting, and victory or defeat in the fighting was the best gauge for the control and assessment of the result of the training. On the basis of gradual unification of the organisation and its equipment, the content of training in the various units of the regular army was also systematised step by step.

Here, Vo Nguyen Giap has provided a concrete example of the dialectical relationship between theory and practice, and their inseparability. This fundamental aspect of dialectical materialist philosophy demands that we think and act like scientists to change the world, rather than simply speculating and imagining ineffectually like armchair philosophers. As Marx wrote in Theses on Feuerbach “Philosophers have hitherto only interpreted the world in various ways; the point is to change it.” We encourage you to apply what you learn in this and other books to change the world.

Advice on Further Study

As you advance in your studies of socialist literature and theory, we offer the following advice:

First, you must recognize that the specific language used by revolutionary leaders and thinkers may vary widely across time and around the world. Fashions in language develop over time, and many contributions — like the text you’ve just read — come to us through translation from countless languages. This is why we believe it critical to develop an understanding of the spirit of the ideas of any particular text, and not to get bogged down in semantics and terminology. Liberal ideologists have done much to distract and divert intellectual energy with endless metaphysical altercation over the “proper” usage of this or that word. We caution strongly against this attitude, which makes us susceptible to sophistry, opportunism, and the sewing of undue conflict and division amidst the working class. We have pointed out various instances where Marx, Engels, and Lenin used different language to describe the same concepts. We also offer the reminder that Marx, Engels, and Lenin were writing in different languages at different times, just as socialists around the world have different linguistic and cultural backgrounds. As socialism is an international movement, we must stress the importance of avoiding linguistic barriers by engaging with one another in good faith and testing conflicting ideas and interpretations of theory against one another through practice instead of getting bogged down with “critical criticism.”

Next, we encourage students of socialist philosophy to always keep in mind that the doctrines and philosophies of revolutionary figures are products of the times and places in which they were conceived. It would be a mistake to view the works of any revolutionary figure as a road map or a set of instructions to follow by rote. Even Marx and Engels changed and developed their own ideas over the decades they were active, as they addressed in the 1872 preface to The Communist Manifesto:

The practical application of the principles will depend, as the Manifesto itself states, everywhere and at all times, on the historical conditions for the time being existing, and, for that reason, no special stress is laid on the revolutionary measures proposed at the end of Section II. That passage would, in many respects, be very differently worded today. In view of the gigantic strides of Modern Industry since 1848, and of the accompanying improved and extended organization of the working class, in view of the practical experience gained, first in the February Revolution, and then, still more, in the Paris Commune, where the proletariat for the first time held political power for two whole months, this programme has in some details been antiquated. One thing especially was proved by the Commune, viz., that “the working class cannot simply lay hold of the ready-made state machinery, and wield it for its own purposes.” (See The Civil War in France: Address of the General Council of the International Working Men’ s Association, 1871, where this point is further developed.) Further, it is self-evident that the criticism of socialist literature is deficient in relation to the present time, because it comes down only to 1847; also that the remarks on the relation of the Communists to the various opposition parties (Section IV), although, in principle still correct, yet in practice are antiquated, because the political situation has been entirely changed, and the progress of history has swept from off the earth the greater portion of the political parties there enumerated.”

Vladimir Ilyich Lenin and Ho Chi Minh also frequently took pains to point out that their revolutionary theories were devised specifically to suit the particular objective conditions of their own respective times and places. For example, in What is to be Done, Lenin discusses the question of secrecy in revolutionary activity. Lenin recognizes that secrecy is not always necessary, such as in the more liberal social democracies which existed in Europe in his era. In Russia, however — with its autocratic monarchy — material conditions called for more covert activity:

In countries where political liberty exists the distinction between a trade union and a political organisation is clear enough, as is the distinction between trade unions and Social-Democracy. The relations between the latter and the former will naturally vary in each country according to historical, legal, and other conditions; they may be more or less close, complex, etc. (in our opinion they should be as close and as little complicated as possible); but there can be no question in free countries of the organisation of trade unions coinciding with the organisation of the Social-Democratic Party. In Russia, however, the yoke of the autocracy appears at first glance to obliterate all distinctions between the Social-Democratic organisation and the workers’ associations, since all workers’ associations and all study circles are prohibited, and since the principal manifestation and weapon of the workers’ economic struggle — the strike — is regarded as a criminal (and sometimes even as a political!) offence.”

Ho Chi Minh was even more explicit about the requirement to tailor theory to current and local material conditions in a speech to the Communist Party of Vietnam in 1950:

Studying Marxism-Leninism is not just a matter of repeating the slogan ‘workers of the world, unite’ like a parrot. We must unify Marxism-Leninism with the reality of Vietnam’s revolution. Talking about Marxism-Leninism in Vietnam is talking about the specific guidelines and policies of the Communist Party of Vietnam. For example, our priority now is: great solidarity!

In a 2001 document, the Communist Party of Vietnam explained how Ho Chi Minh tailored lessons learned from prior revolutionaries to the specific material conditions of revolutionary Vietnam:

Ho Chi Minh’s thought is... the creative application and development of Marxism-Leninism to the specific conditions of our country. Ho Chi Minh learned profound lessons from Lenin and the Russian October Revolution, but he did not simply use those lessons as a template, nor did he just copy that foundation. Instead, he absorbed the spirit of Marxism-Leninism. Lenin’s thesis allowed Ho Chi Minh to see what was necessary for the Vietnamese people — the path of national liberation. Ho Chi Minh had creative arguments that contributed to enriching Marxism-Leninism in the issue of national liberation revolution, building a new democratic regime and the transitional path to socialism in an Eastern, semi-feudal colony which was still very backward: Vietnam.

As you find your own revolutionary path, you must carefully examine the objective conditions of your own time and place, and work collectively and collaboratively with your fellow revolutionists to decide how theory and lessons gleaned from history apply to your own circumstances. And, of course, you must test the validity of your conclusions against reality through practice.

Creative Application of Dialectical Materialism and Materialist Dialectics

Finally, we implore you to apply dialectical materialism creatively. Don’t look at this (or any other) book as a set of static instructions. Dialectical materialism and materialist dialectics are living, breathing systems of thought which benefit from the ideas and imagination of comrades working and struggling together. Seek the spirit of these ideas, study revolutionary theory and history, then apply what you learn in your daily life. Combat dogmatism and avoid arguments over pure theory. Determine what works and what doesn’t through activity in the real world, and apply what you learn from practical experience to your theoretical development. Over time, you will begin to see how practice and theory impact and develop one another. When you are struggling with a particular problem in revolutionary practice, you will find yourself reading theory in a new light, discovering information and ideas which might be applicable to your immediate circumstances. And as you study theory, you will find that it also impacts your practice, giving you tools and perspective and methodologies for action which you might never have imagined on your own.

We have tried to make this book a useful companion for further study. We have also made the digital version available for free online. If you have found it useful, we hope you will share it freely and widely.

In Closing

One last time we would like to thank Dr. Vijay Prashad and Dr. Taimur Rahman for their wonderful insights on our translation, and to acknowledge the monumental work of the Vietnamese scholars who wrote and revised the original text from which this volume is drawn. We also want to recognize once more the donors and supporters who have given us the precious resource of time to translate and annotate this work. Finally, we want to thank the teams at the Iskra Books and The International Magazine, who have provided invaluable editing and peer review services, promotion, and guidance. You can find all their publications, respectively, at:

IskraBooks.org

InternationalMagz.com

If you would like to download the free digital version of this book, support future translation work, or if you would like to get in touch, you can visit our website:

BanyanHouse.org

We will leave you, now, with the immortal words of the Manifesto:

Workers of the world, unite!

You have nothing to lose but your chains.

In Solidarity,

- Luna Nguyen, Translator & Annotations

- Emerican Johnson, Editor, Illustrator, & Annotations

“Marxism-Leninism — Long Live the Victories” — a demonstration to welcome the liberation army in the South of Vietnam on April 30, 1975.

[Appendices]

Appendix A: Basic Pairs of Categories Used in Materialist Dialectics

This is a summary of the basic pairs of universal categories and their characteristics which are discussed in depth starting on p. 126.

Private	Common
A specific item, event, or process.	The properties that are shared between Private things, phenomena, and ideas.

Private is commonly referred to in literature as Special/Specific while Common is commonly called General. Note: When an aspect or characteristic is not held in common with anything else in existence, it is considered Unique. The Unique can become Common, just as the Common can become Unique. Example: a Unique design for an object may be replicated, making it Common. A type of item that is Common may gradually disappear until there is only one example left, making it Unique. See p. 128.

Reason	Result
Mutual impact between things, phenomena, or ideas which causes each to change.	The change caused by a Reason.

Reason and Result may be referred to as Cause and Effect, respectively, though this should lead to confusion with metaphysical conceptions of cause and effect. Note: Reasons can be Direct or Indirect. See p. 138

Obviousness	Randomness
Refers to events that always and predictably happen due to factors of internal material structure.	Events caused by external impacts and interactions which are thus not completely predictable.

Obvious may be referred to as Necessary, while Randomness may be referred to as Accidental. See p. 145.

Content	Form
What something is made of.	The shape that contains content.

Ways in which Content and Form are discussed and perceived can can vary wildly depending on the subject being discussed and the viewpoint from which the subject is being considered. See p. 145.

Essence	Phenomena
Features that make something develop a certain way.	The expression of the essence in certain conditions.

See p. 156.

Possibility	Reality
What may happen, or might exist, in the future, if certain developments take place.	What is happening, or what exists, at the present moment.

See p. 160.

Appendix B: the Two Basic Principles of Dialectical Materialism

The Principle of General Relationships This principle states that:

“Materialist dialectics upholds the position that all things, phenomena, and ideas exist in mutual relationships with each other, regulate each other, transform into each other, and that nothing exists in complete isolation.”

From this Principle, we find the characteristics of Diversity in Unity and Unity in Diversity; the basis of Diversity in Unity is the fact that every thing, phenomenon, and idea contains many different relationships; the basis of Unity in Diversity is that many different relationships exist — unified — within each and every thing, phenomenon, and idea.

The Characteristic of Diversity in Unity is derived from the fact that there exist an infinite number of diverse relationships between things, phenomena, and ideas, but all of these relationships share the same foundation in the material world.

The Characteristic of Unity in Diversity is derived from the fact that when we examine the universal relationships that exist within and between all different things, phenomena, and ideas, we will find that each individual manifestation of any universal relationship will have its own different manifestations, aspects, features, etc. Thus even the universal relationships which unite all things, phenomena, and ideas exist in infinite diversity.

The Principle of Development This principle states that:

“Development is a process that comes from within the thing-in-itself; the process of solving the contradictions within things and phenomena. Therefore, development is inevitable, objective, and occurs without dependence on human will.”

The Characteristic of Objectiveness of Development stems from the origin of motion. Since motion originates from mutual impacts which occur between external things, objects, and relationships, the motions themselves also occur externally (relative to all other things, phenomena, and objects). This gives motion itself objective characteristics.

The Characteristic of Generality of Development stems from the fact that development occurs in every process that exists in every field of nature, society, and human thought; in every thing, every phenomenon, and every process and stage of these things and phenomena.

The Characteristic of Diversity of Development stems from the fact that every thing, phenomenon, and idea has its own process of development that is not totally identical to the process of development of any other thing, phenomenon, or idea.

Appendix C: the Three Universal Laws of Materialist Dialectics

The Law of Transformation Between Quantity and Quality

The law of transformation between quantity and quality is a universal law which concerns the universal mode of motion and development processes of nature, society, and human thought. The law was formulated by Friedrich Engels in Dialectics of Nature, and states that:

“In nature, in a manner exactly fixed for each individual case, qualitative changes can only occur by the quantitative addition or subtraction of matter or motion.” See more on p. 163.

The Law of Unification and Contradiction Between Opposites

The law of unification and contradiction between opposites is the essence of dialectics. It states, as formulated by V. I. Lenin in Summary of Dialectics:

“The fundamental, originating, and universal driving force of all motion and development processes is the inherent and objective contradiction which exists in all things, phenomena, and ideas.” See more on p. 175.

The Law of Negation of Negation

The law of negation of negation describes the fundamental and universal tendency of movement and development to occur through a cyclical form of development through what is termed “negation of negation.” Formulated by Friedrich Engels in Anti-Dühring, it states:

“The true, natural, historical, and dialectical negation is (formally) the moving source of all development--the division into opposites, their struggle and resolution, and what is more, on the basis of experience gained, the original point is achieved again (partly in history, fully in thought), but at a higher stage.” See more on p. 185.

Appendix D: Forms of Consciousness and Knowledge

Consciousness refers to the self-aware, productive, and creative motion and activity of the human brain. Practical activity is the most direct basis, motive, and purpose of consciousness, and is the criterion for testing truth. See: The Relationship Between Praxis and Consciousness, p. 216.

Knowledge is the content of consciousness. Knowledge includes data about the world, such as ideas, memories, and other thoughts which are derived by direct observation and practical activities in the material world, through scientific experiments, or through abstract reflection of practical and scientific activities which occur within consciousness.

Consciousness and Knowledge have a dialectical relationship with one another: knowledge is developed within consciousness, and consciousness develops to higher levels as knowledge is accumulated and tested against reality (which also develops knowledge itself). In this manner, consciousness and knowledge develop into higher forms over time in individual consciousness and human society. Thus, consciousness and knowledge can be considered as existing in various forms which represent stages of development in dialectical processes of development.

Note that the development processes of knowledge and consciousness are dialectical in nature, not linear. For example, after empirical consciousness develops into theoretical consciousness, theoretical consciousness will then impact empirical consciousness, developing empirical consciousness into a higher stage of development. This is true for all development processes related to empirical and theoretical consciousness. These development processes and forms of consciousness and knowledge are explained in more detail in Chapter 3: Cognitive Theory of Dialectical Materialism, starting on page 204.

Forms of Consciousness

Consciousness is a process of the development of knowledge through a combination of human brain activity and human practical activity in the physical world (i.e., labor). The development of consciousness can be considered on the criteria of concrete/abstract and of passive/active. For more information, see Annotation 216, p. 210.

File:T-w-the-worldview-and-philosophical-methodology-of-99.png

File:T-w-the-worldview-and-philosophical-methodology-of-100.png

The Cognitive Process

The Cognitive Process is a model developed by Vladimir Ilyich Lenin which represents the dialectical path of consciousness to truth. For more information, see Dialectical Path of Consciousness to Truth on page 219.

File:T-w-the-worldview-and-philosophical-methodology-of-101.png

Forms of Knowledge

For more information see Annotation 218, p. 214.

File:T-w-the-worldview-and-philosophical-methodology-of-102.png

Appendix E: Properties of Truth

Truth is the alignment of consciousness with objective reality. All truths are objective, relative, absolute, and concrete. Truths also have characteristics of concreteness and abstractness.

Objectivity: The content of truth is external to the subjective will of human beings. The content of knowledge must be aligned with objective reality, not vice versa. This means that the content of accurate knowledge is not a product of pure subjective reasoning but is objective in nature.

Absoluteness: Absolute truth^[116] is derived from the complete alignment between objective reality and human consciousness. The possibility of acquiring absolute truth in the process of the development of conscious understanding is theoretically limitless. However, in reality, our conscious ability to reflect reality is limited by the specific material conditions of each generation of humanity, of practical limitations, and by the spatial and temporal conditions of reflected subjects. Therefore, truth is also relative.

Relativity: Relative truth is truth which has developed alignment with reality without yet having reached complete alignment. To put it another way, relative truth represents knowledge which incompletely reflects material subjects without complete accuracy. In relative truth, there is only partial alignment — in some (but not all) aspects — between consciousness and the material world.

Dialectical Relationship Between Absolute and Relative Truth: Relative truth and absolute truth do not exist separately, but have dialectical unity with each other. On the one hand, “absolute truth” is the sum of all “relative truths.” On the other hand, in all relative truths there are always elements of absolute truth.

Concreteness: The concreteness of truth refers to the degree to which a truth is attached to specific objects, in specific conditions, at a specific point in time. This means that all accurate knowledge always refers to a specific situation which involves specific subjects which exist in a specific place and time. The content of truth cannot be pure abstraction, disconnected from reality, but it is always associated with certain, specific objects and phenomena which exist in a specific space, time, and arrangement, with specific internal and external relationships. Therefore, truth is associated with specific historical conditions. This specificity to time, place, relations, etc., is concreteness.

Abstractness: Abstract knowledge is knowledge which is not attached (or less attached) to specific times, places, relations, etc. Some degree of abstraction is necessary to develop theoretical understanding of general laws and the nature of objective reality, but care should be taken knowledge does not become completely detached from specific historical conditions, as this will result in pure abstraction. Knowledge which is purely abstract will not align with reality, and such knowledge cannot be considered truth.

Appendix F: Common Deviations From Dialectical Materialism

Throughout the history of the development of dialectical materialism and materialist dialectics, there have been many philosophical and methodological deviations which have derived from incorrect analysis, interpretation, and a failure to properly link theory and practice. Below are descriptions of some of the more common deviations which the reader should be aware of.

Bureaucracy: An expression of dogmatism which arises when theory becomes overly formalized, to the extent that practical considerations are ignored in favor of codified theory.

Conservativism: A mindset which seeks to prevent and stifle development and to hold humanity in a static position. Not only is this detrimental to humanity, it is also ultimately a wasted effort, because development is inevitable in human society, as in all things, phenomena, and ideas.

Dogmatism: A breakdown of the dialectical relationship between theoretical consciousness and empirical consciousness, which arrests the development process of knowledge and consciousness. Usually the result of: failure to seek commonalities; considering theory itself as the sole basis of truth rather than practice; ignoring practical experience and considering pre-established theory, alone, as unalterable truth.

Eclecticism: An approach to philosophical inquiry which attempts to draw from various different theories, frameworks, and ideas to attempt to understand a subject; the philosophical error of inconsistently applying different theories and principles in different situations. Empiricism: A broad philosophical position which holds that only experience (including internal experience) can be held as a source of knowledge or truth. Though nominally opposed to idealism, it is considered a faulty (or naive) form of materialism, since it sees the world as only unconnected, static appearances and ignores the reality of dialectical (changing) relationships between objects.

Idealism: A philosophical position which holds that the only reliable experience of reality occurs within human consciousness. Idealists believe that relying on human reason exclusively or as a first basis is the best way to seek truth. Various forms of idealism exist, broadly broken down into subjective idealism, which denies the existence of an external objective world, and objective idealism, which accepts that an external objective world exists, but denies that knowledge can be reliably gained about it through sense perception.

Opportunism: A system of political opinions with no direction, no clear path, no coherent viewpoint, leaning on whatever is beneficial for the opportunist in the short term.

Revisionism: A failure to recognize and accept commonalities in conscious activity, focusing only on the private. Revisionism leads to constant and unnecessary reassessment and reevaluation of both knowledge and practice. Revisionism, thus, is a position which overstates the relativity of truth and ignores truths which are more fully developed towards absoluteness.

Rigidity: An unwillingness to alter one’s thoughts, holding too stiffly to established consciousness and knowledge, and ignoring practical experience and observation, which leads to stagnation of both knowledge and consciousness.

Skepticism: The belief truth is essentially undiscoverable, because human consciousness is ultimately unreliable and incapable of accurately reflecting material reality. By denying that truth is discoverable at all, skepticism explicitly rejects absolute truth and declares that all truth is relative and unreliable. Solipsism: A form of idealism in which one believes that the self is the only basis for truth. As Marxist ethicist Howard Selsam wrote in Ethics and Progress: New Values in a Revolutionary World: “If I believe that I alone exist and that you and all your arguments exist only in my mind and are my own creations then all possible arguments will not shake me one iota. No logic can possibly convince [the] solipsist.”

Sophistry: The use of falsehoods and misleading arguments, usually with the intention of deception, and with a tendency of presenting non-critical aspects of a subject matter as critical, to serve a particular agenda. The word comes from the Sophists, a group of professional teachers in Ancient Greece, who were criticized by Socrates (in Plato’s dialogues) for being shrewd and deceptive rhetoricians. This kind of bad faith argument has no place in materialist dialectics. Materialist dialectics must, instead, be rooted in a true and accurate understanding of the subject, material conditions, and reality in general.

Subjectivism: The centering of one’s own self and conscious activities in perspective and worldview, failing to test one’s own perceptions against material and social reality. Subjectivists tend to believe that they can independently reason their way to truth in their own minds without practical experience and activity in the material world.

Utilitarianism: An ethical philosophical theory founded by Jeremy Bentham which seeks to maximize “utility,” which is considered to be a metaphysical property embodying “benefit, advantage, pleasure, good, or happiness.” Karl Marx dismissed utilitarianism as overly abstract, in that it reduces all social relationships to the single characteristic of “utility.” He also viewed utilitarianism as metaphysically static and tied to the status quo of current society, since utilitarianism does not address class dynamics and views all relations in the current status quo of society, making utilitarianism an essentially conservative theory. Marx also pointed out that Utilitarianism essentially views individuals as private individuals, not as social individuals, and seeks to work out solutions to the practical problems of human society through reasoning alone without examining material conditions and processes, and without taking into consideration practice and development, writing:

“The whole criticism of the existing world by the utility theory was... restricted within a narrow range. Remaining within the confines of bourgeois conditions, it could criticise only those relations which had been handed down from a past epoch and were an obstacle to the development of the bourgeoisie... the economic content gradually turned the utility theory into a mere apologia for the existing state of affairs, an attempt to prove that under existing conditions the mutual relations of people today are the most advantageous and generally useful.”

[Back Matter]

Glossary & Index

Absolute Truth	Absolute Truth can refer to: 1. The recognition that objective and accurate truth can be drawn from sense perception of the material world along with labor and practice activities in the material world. The opposite of this position is Relativism. See p. 56, 94, 194, 228–229, 232–234. 2. Hegel’s notion of Absolute Truth: that there will eventually be some end point of to the process of rational consciousness at which point humanity will arrive at a final stage of knowledge and consciousness. See p. 228. See also: Relative Truth, Relativism, Stagnation, Truth.
Absolutization	To hold a belief or supposition as always true in all situations and without exception. See p. 49.
Abstract Labor	The abstract conception of expenditure of human energy in the form of labor, without taking into account the value of labor output. When the value of labor output is taken into consideration, it is referred to as concrete labor. See p. 15, 17.
Adam Smith	(1723–1790) British logic professor, moral philosophy professor, and economist. Along with David Ricardo, Adam Smith was one of the founders of political economy, which Marx both drew from and critiqued in his analysis and critique of capitalism. See p. 14, 155.
Ahistoric Perspective	A perspective which considers aspects of human society without due consideration of historical processes of development. For example, Adam Smith and David Ricardo viewed political economy ahistorically, viewing capitalism as a static, universal, and eternal product of natural law rather than seeing capitalism as a product of historical processes of development which would change and develop over time. See p. 116.
Base	Also known as: Economic Base; Economic Basis. The material processes which humans undertake to survive and transform our environment to support our ways of living. In the dialectical relationship between base and superstructure, the base refers to the relationship which humans have with the means of production, including the ownership of the means of production and the organization of labor. See p. 23. See also: Superstructure.
Biological Motion	One of the five basic forms of motion described by Engels in Dialectics of Nature. Biological motion refers to changes and development within living objects and their genetic structure. See p. 61.
Biological Reflection	A complex form of reflection found within organic subjects in the natural world and expressed by excitation, induction, and reflexes. See p. 65.
Bourgeoisie	The owners of the means of production and the ruling class under capitalism; also known as the capitalist class. See p. 3, 23, 30, 41, 50, 63, 96. See also: Proletariat, Petty Bourgeoisie.
Bureaucracy	An expression of dogmatism which arises when theory becomes overly formalized, to the extent that practical considerations are ignored in favor of codified theory. See p. 217–218. C→→M→→C C = A Commodity M = The Money Commodity The mode of circulation described by Marx as occurring under pre-capitalist economies of simple exchange, in which the producers and consumers of commodities have a direct relationship to the commodities which are being bought and sold. The sellers have produced the commodities with their own labor, and they directly consume the commodities which they purchase. See also: M→C→M’ Marx called this mode of circulation “simple commodity production.” See p. 16.
Capitalism	The current stage of human political economy, defined by private ownership of the means of production. Referenced throughout.
Capitalist Class	See: Bourgeoisie
Capitalist Commodity Production	The capitalist mode of production which utilizes the M→C→M’ mode of circulation, in which capitalists own the means of production and pay wages to workers in exchange for their labor, which is used to produce commodities. Capitalists then sell these commodities for profits which are not shared with the workers who provided the labor. See p. 15.
Category	The most general grouping of aspects, attributes, and relations of things, phenomena, and ideas. Different specific fields of inquiry may categorize things, phenomena, and/or ideas differently from one another. See p. 126.
Category Pair	A pair of philosophical categories within materialist dialectics. Materialist dialectics tend to focus on universal category pairs which can be used to examine the characteristics, relations, and development of all things, phenomena, and ideas. Examples of category pairs include: private and common; content and form; reason and result; essence and phenomena. See p. 127.
Characteristics	The features and attributes that exist internally — within — a given thing, phenomena, or idea. See p. 115.
Chemical Motion	Changes of organic and inorganic substances in processes of combination and separation. See p. 61.
Chemical Reflection	The reflection of mechanical, physical, and chemical changes and reactions of inorganic matter (i.e., changes in structures, position, physical-chemical properties, and the processes of combining and dissolving substances). See p. 65–66.
Circulation	The way in which commodities and money are exchanged for one another. See p. 16.
Commodity	In Marxist political economy, commodities include anything which can be bought and sold, with both a use value (i.e. it satisfies a need of any kind) and a value-form (aka. ‘Exchange value’ and understood as the average socially necessary labour time needed to produce this object). Under capitalism, more and more human activity and production is ‘commodified’ (mediated through market exchange). See p. 15, 87, 133.
Common	See: Private and Common
Common Laws	Laws (of nature and/or human society) that are applicable to a broader range of subjects than private laws, and which impact many different subjects. For instance: the law of preservation of mass, the law of preservation of energy, etc. See p. 162.
Comprehensive Viewpoint	A viewpoint which seeks to consider the internal dialectical relationships between the component parts, factors, and aspects within a thing or phenomenon, and which considers external mutual interactions with with other things, phenomena, and ideas. Dialectical materialist philosophy demands a comprehensive basis in order to fully and properly understand things and phenomena in order to effectively solve problems in real life and develop humanity towards communism. See p. 115, 172, 235.
Conception	A relatively complete reflection within human consciousness of objective things and phenomena. See p. 221–22.
Concrete Labor	The production of a specific commodity with a specific value through labor. When labor is considered without the consideration of output value, it is referred to as abstract labor. See p. 15, 17.
Conditioned Reflex	Conditioned reflexes are reactions which are learned by organisms. These responses are acquired as animals associate previously unrelated neural stimuli with a particular reaction. See p. 66, 68.
Consciousness	The dynamic and creative reflection of the objective world in human brains; the subjective image of the objective world which is produced by the human brain. See p. 68–69, 70.
Content	See: Content and Form.
Content and Form (Category Pair)	Content is the philosophical category which refers to the sum of all aspects, attributes, and processes that a thing, phenomenon, or idea is made from. The Form category refers to the mode of existence and development of things, phenomena, and ideas. Form thus describes the system of relatively stable relationships which exist internally within things, phenomena, and ideas. Content and Form have a dialectical relationship with one another, in which content determines form and form impacts back on content. See p. 115, 147155, 166.
Contradiction	A contradiction is a relationship in which two forces oppose one another, leading to mutual development. See p. 123, 159, 163, 169, 175–191.
Consciousness	The self-aware, productive, creative motion and activity of the human brain. See p. 216, 249.
Conservativism	Also referred to as Prejudice; a mindset which seeks to prevent and stifle development and to hold humanity in a static position. Not only is this detrimental to humanity, it is also ultimately a wasted effort, because development is inevitable in human society, as in all things, phenomena, and ideas. See p. 125, 233.
David Hume	(1711 — 1776) Scottish philosopher who developed radical skepticism as a philosophy of empiricist rejection of human knowledge. See p. 11, 29, 56, 7273.
David Ricardo	(1772 — 1823) British economist who, along with Adam Smith, was one of the key figures in the development of Political Economy which was a basis for much of the work of Marx and Engels. See p. 14, 18, 155.
Deductive Inference	Logical inference which extrapolates from the general to the specific. See p. 224.
Definition	The first phase of rational consciousness. During this phase, the mind begins to interpret, organize, and process the basic properties of things and phenomena at a rational level into a conceptual whole. See p. 224.
Development	The change and motion of things, phenomena, and ideas with a forward tendency: from less advanced to more advanced; and/or from a less complete to a more complete level. See p. 38, 45–46, 52, 55, 61, 65, 76–96, 105–107, 114118, 119–127, 131–132, 138–140, 143, 147, 154, 155–165, 169–175, 177–181, 183–207, 210, 213, 216–223, 225–229, 233, 235–237.
Development Viewpoint	A viewpoint which considers that, in order to perceive or solve any problem in real life, we must consider all things, phenomena, and ideas with their own forward tendency of development taken in mind.
Dialectic; Dialectical; Dialectics	In Marxism-Leninism, the term dialectic (adjective: dialectical) refers to regular and mutual relationships, interactions, transformations, motions, and developments of things, phenomena, and processes in nature, society and human thought. “Dialectics” refers to a dialectical system. See p. 3, 9–11, 47.
Dialectical Materialism	A universal philosophical and methodological system which forms the theoretical core of a scientific worldview. Dialectical Materialism was first developed by Karl Marx and Friedrich Engels with the express goal of achieving communism. Dialectical Materialism has since been defended and developed by Vladimir Ilyich Lenin as well as many others. See: p. 3, 6, 1011, 19–21, 27–30, 33, 38, 45–47, 48–97, 101, 104, 204, 209, 226, 228, 230–232, 237.
Dialectical Negation	A stage of development in which a new subject arises from a contradiction between two previous subjects; dialectical negation is never an endpoint of development, as every dialectical negation creates conditions for further development and negation. See p. 123, 175–176, 183, 185–195, 197–202, 227.
Dialectical Relationship	A relationship in which two things, phenomena, or ideas mutually impact one another, leading to development and negation. See p. 47, 51, 62.
(Characteristic of) Diversity	The characteristic which all things, phenomena, and ideas share, dictating that no two subjects (and no two relationships between any two subjects) are exactly the same, even if they exist between very similar things, phenomena, and ideas and/or in very similar situations. See p. 114–115, 125.
Diversity in Unity	The universal principle which states that even though all relationships are diverse and different from one another, they also exist in unity, because all relationships share a foundation in the material world. See p. 109–110, 125, 130.
Dogmatism	An inflexible adherence to ideals as incontrovertibly true while refusing to take any contradictory evidence into consideration. Dogmatism stands in direct opposition to materialist dialectics, which seeks to form opinions and conclusions only after careful consideration of all observable evidence. See p. 136–137, 174, 217–218, 233.
Duality of Labor	The Marxist economic concept which recognizes labor as having two intrinsic and inseparable aspects: abstract labor and concrete labor. See p. 15.
Dynamic and Creative Reflection	The most advanced form of reflection, which only occurs in matter that has the highest (known) level of structural complexity, such as the human brain. See p. 68–69, 79.
Eclecticism	An approach to philosophical inquiry which attempts to draw from various different theories, frameworks, and ideas to attempt to understand a subject; the philosophical error of inconsistently applying different theories and principles in different situations. See p. 32–33, 101, 118, 192, 194.
Economic Base	See: Base
Economism	Economism is a style of political activism, typified by the ideas of German political theorist Eduard Bernstein, which stresses directing the struggle towards short-term political/economic goals (such as higher wages for workers) at the expense of the larger socialist revolutionary project. See p. 30.
Eduard Bernstein	(1850 — 1932) German political theorist who rejected many of Marx’s theories. See p. 30, 174.
Emotional Consciousness	The lower stage of the cognitive process. In this stage of cognitive development, humans, through practical activities, use our senses to reflect objective things and phenomena (with all their perceived specific characteristics and rich manifestations) in human consciousness. See p. 219224.
Empirical Consciousness	Empirical consciousness is the stage of development of consciousness in which perceptions are formed via direct observations of things and phenomena in the natural world, or of society, or through scientific experimentation and systematic observation. Empirical Consciousness results in Empirical Knowledge. See p. 210–214.
Empirical Knowledge	Knowledge which results from processes of empirical consciousness and which is characterised by rich and detailed, but still incomplete, understanding of phenomena. It can be utilized for practical ends, but still falls short of full theoretical analysis and comprehension. See p. 212–214.
Empiricism	A broad philosophical position which holds that only experience (including internal experience) can be held as a source of knowledge or truth. Though nominally opposed to idealism, it is considered a faulty (or naive) form of materialism, since it sees the world as only unconnected, static appearances and ignores the reality of dialectical (changing) relationships between objects. See p. 9–12, 29, 94, 96–97, 100, 218.
Empirio-criticism	A more developed form of empiricism, proposed by Ernst Mach, which holds that sense data and experience are the sole sources of knowledge and that no concrete knowledge of the external material world can ever be obtained due to the limitations of human senses. See p. 26–29, 32, 54, 55–57, 68.
Epistemology	The theoretical study of knowledge. It primarily deals with the philosophical question of: “how do we know what we know?” See p. 45, 98, 204.
Ernst Mach	(1838 — 1916) Austrian physicist who attempted to build a philosophy of natural science based on the works of German philosopher Richard Avenarius’ philosophical system of Empirio-Criticism. See p. 27–29, 32, 52, 72, 193.
Equilibrium	A state of motion in which one or more subjects are not undergoing changes in position, form, and/or structure. Equilibrium is only ever a temporary stasis of development which will eventually yield to motion, development, and/or negation. See p. 62–63, 122–123, 181.
Essence	See: Essence and Phenomena
Essence and Phenomena (Category Pair)	The Essence category refers to the synthesis of all the internal aspects as well as the obvious and stable relations that define the existence, motion and development of things and ideas. The Phenomena category refers to the external manifestation of those internal aspects and relations in specific conditions. Essence always determines which phenomena appear, but phenomena do not always accurately reflect essence in human perception; in other words, it is possible to misinterpret phenomena, leading to a misunderstanding of essence, or to mistake phenomena for essence. See p. 156–160.
Exchange Value	A quantity relationship which describes the ratios of exchangeability between different commodities, with Marx’s famous example of 20 yards of linen being equivalent in exchange value to one coat. Through analysis Marx shows that in reality the thing being compared is the amount of socially necessary labour required to make the commodities being compared. See p. 15, 18.
Excitation	Reactions of simple plant and animal life-forms which occur when they change position or structure as a direct result of physical changes in their habitat. See p. 66, 68.
External Contradictions	See: Internal and External Contradictions.
False consciousness	Forms of consciousness (ideas, thoughts, concepts, etc.) which are incorrect and misaligned from reality. Equated with ‘ideology’ by Engels, it refers to an idealistic, dogmatic perspective which will inevitably result in errors of analysis and therefore practice. See p. 231–233, 237.
First International	Also known as the International Workingmen’s Association; was founded in London and lasted from 1864–1876. Karl Marx and Friedrich Engels were key figures in the foundation and operation of this organization, which sought better conditions and the establishment of rights for workers. See p. 35
(Basic) Forms of Motion	Engels broke motion down into five basic forms which are dialectically linked; the different forms of motion differ from one another, but they are also unified with each other into one continuous system of motion. Understanding this dialectical relationship between different forms of motion helped to overcome misunderstandings and confusion about motion and development. See p. 61–62.
Form	See: Content and Form.
Form of existence of matter	The ways in which we perceive the existence of matter in our universe; specifically, matter in our universe has the form of existing in space and time. See p. 59.
Form of Value	See: Value-Form
Forward Tendency of Motion	The tendency for things, phenomena, and ideas to move from less advanced to more advanced forms through processes of motion and development. See p. 197.
Friedrich Engels	(1820–1895) a German theorist, politician, dialectical materialist philosopher, leader of the international working class, & co-founder of scientific socialism with Karl Marx. Referenced throughout.
Fundamental and Non-Fundamental Contradictions	A fundamental contradiction defines the essence of a relationship. Fundamental contradictions exist throughout the entire development process of a given thing, phenomenon, or idea. A non-fundamental contradiction exists in only one aspect or attribute of a thing, phenomenon, or idea. A nonfundamental contradiction can impact a subject, but it will not control or decide the essential development of the subject. See p. 178–179.
(Characteristic of) Generality	A universal characteristic which holds that all things, phenomena, and ideas interact and mutually transform one another. See p. 108–109, 111, 114, 124125.
General Relationship	Relationships which exist broadly across many things, phenomena, and ideas. General relationships can exist both internally, within things, phenomena, and ideas, and externally, between things, phenomena, and ideas. See p. 106–110, 114.
Generality (of relationships)	Relationships can exist with across a spectrum of generality; this spectrum ranges from the least general relationships (unique relationships — which only occur between two specific things/phenomena/ideas) to the most general relationships (universal relationships — which occur between or within all things/phenomena/ideas). See p. 109.
George Berkeley	(1685 — 1753) An Anglo-Irish philosopher whose main philosophical achievement was the formulation of a doctrine which he called “immaterialism,” and which later came to be known as “Subjective Idealism.” This doctrine was summed up by Berkeley’s maxim: “Esse est percipi” — “To be is to be perceived.” See p. 11, 27, 29.
George Wilhelm Friedrich Hegel	(1770 — 1831) German philosophy professor & objective idealistic philosopher; developed the system of idealist dialectics which Marx and Engels used as a basis for developing materialist dialectics. See p. 8–11, 29, 69–71, 97, 98, 100–105, 132, 157, 165, 182, 192, 193–194, 209, 228.
Historical Materialism	The application of materialist dialectics and dialectical materialism to the study of human history. See p. 21–23, 27, 36, 38, 45, 80.
Historical Viewpoint	A viewpoint which demands that subjects be considered in their current stage of motion and development, while also taking into consideration the development and transformation of the subject over time. See p. 116–118, 125–126, 143, 185, 234.
Idealism	A philosophical position which holds that the only reliable experience of reality occurs within human consciousness. Idealists believe that human reason exclusively or as a first basis is the best way to seek truth. See p. 8–12, 26–29, 48–51, 53, 56–58, 69–70, 96, 101–102, 104, 157, 174, 209, 218, 228.
Immanuel Kant	(1724 — 1804) German philosopher who developed a system of idealist dialectics which were later completed by Hegel and whose metaphysical philosophies of epistemology and rationalism served as the basis for later empiricists such as Bacon and Hume. See p. 20, 29, 56, 72–74, 100–102, 205.
Induction	The reaction of animals with simple nervous systems which can sense or feel their environments. Induction occurs through unconditioned reflex mechanisms. See p. 66, 68.
Inductive Inference	Logical inference which extrapolates from specific observations to general conclusions. See p. 223–224.
Intelligibility	The human cognitive capacity to accurately perceive the external material world. See p. 48.
Internal Contradictions	See: Internal and External Contradictions.
Internal and External Contradictions	Internal contradictions are contradictions which exist within the internal relations of a subject, while external contradictions exist between two or more subjects as external relations. See p. 178–179.
Judgment	The phase of rational consciousness which arises from the definition of the subject — the linking of concepts and properties together — which leads to affirmative or negative ideation of certain characteristics or attributes of the perceived subject. See p. 223.
Karl Marx	(1818–1883) German theorist, politician, dialectical materialist philosopher, political economist, founder of scientific socialism, and leader of the international working class. Referenced throughout.
Knowledge	The content of consciousness; data about the world, such as: ideas, memories, and other thoughts which are derived through direct observation and practical activities in the material world, through scientific experiments, or through abstract reflection of practical and scientific activities which occur within consciousness.
Labor Value	The amount of value which workers produce through labor. See p. 14, 17–18, 23.
Law of Negation of Negation	A universal law of materialist dialectics which states that the fundamental and universal tendency of motion and development occurs through a cycle of dialectical negation, wherein each and every negation is, in turn, negated once more. See p. 163, 185, 195, 198, 200, 201, 202, 227.
Law of Transformation Between Quantity and Quality	The universal law of dialectical materialism which concerns the universal mode of motion and development processes of nature, society, and human thought, which states that qualitative changes of things, phenomena, and ideas arise from the inevitable basis of the quantitative changes of things, phenomena, and, ideas, and, vice versa, quantitative changes of things, phenomena, and ideas arise from the inevitable basis of qualitative changes of things, phenomena, and ideas. See p. 163–165, 172–173, 227.
Law of Unification Contradiction Between Opposites	and The universal law of dialectical materialism which states that the fundamental, originating, and universal driving force of all motion and development processes is the inherent and objective contradictions which exists in all things, phenomena, and ideas. See p. 163, 175, 181.
Law of Development of Capitalism	Also known as Theory of Accumulation and Theory of Surplus Value. The dynamic through which the capitalist class gains wealth by accumulating surplus value (i.e., profits) and then reinvesting it into more capital to gain even further wealth; thus the goal of the capitalist class is to accumulate more and more surplus value which leads to the development of capitalism. See p. 18.
Laws	In dialectical materialism, laws are the regular, common, obvious, natural, objective relations between internal aspects, factors, and attributes of a thing or phenomenon or between things and phenomena. See p. 162.
Laws of Nature	Laws that arise in the natural world, including within the human body (and are never products of human conscious activities). Such law includes the laws of physics, chemistry, and other natural phenomena which govern the material world. See p. 162, 213.
Laws of Society	Laws of human activity in social relations; such laws are unable to manifest beyond the conscious activities of humans, but they are still objective. See p. 162–163.
Laws of Human Thought	Laws which govern the intrinsic relationships between concepts, categories, judgments, inference, and the development process of human rational awareness. See p. 163.
Life-Process	Processes of motion and change which occur within organisms to sustain life. See p. 69–72, 79, 88.
Ludwig Feuerbach	(1804 — 1872) German philosophy professor, materialist philosopher; Marx and Engels drew many of their ideas from the works of Feuerbach (whom they also criticized). See p. 8, 11–13, 21, 55, 74, 80, 114, 205, 237.
M→→C→→M’	The mode of circulation described by Marx as existing under capitalism, in which capitalists spend money to buy commodities (including the commodified labor of workers), with the intention of selling those commodities for more money than they began with. The capitalist has no direct relationship to the commodity being produced and sold, and the capitalist is solely interested in obtaining more money. See p. 16. See also: C→M→C
Machism	See: Empirio-Criticism.
Manifestation	How a given thing, phenomenon, or idea is expressed externally in the material world. See p. 115.
Marxism-Leninism	A system of scientific opinions and theories focused on liberating the working class from capitalism and achieving a stateless, classless, communist society. The core ideas of this system were first developed by Karl Marx and Friedrich Engels, then defended and further developed by Vladimir Ilyich Lenin. See. p. 1.
Material Conditions	The material external environment in which humans live, including the natural environment, the means of production and the economic base of human society, objective social relations, and other externalities and systems which affect human life and human society. See p. 6, 22, 40–42, 70–72, 80–81, 87, 92–95, 116–118, 161, 174, 179, 181, 206–207, 210, 229.
Material Production Activity	Material production activity is the first and most basic form of praxis. In this form of praxis activity, humans use tools through labor processes to influence the natural world in order to create wealth and material resources and to develop the conditions necessary to maintain our existence and development. See p. 206–208.
Materialism	A philosophical position that holds that the material world exists outside of the mind, and that human ideas and thoughts stem from observation and sense experience of this external world. Materialism rejects the idealist notion that truth can only be sought solely through reasoning and human consciousness. See p. 10–13, 48.
Materialist Dialectics	A scientific system of philosophy concerned with motion, development, and common relationships, and with the most common rules of motion and development of nature, society, and human thought. See p. 10, 21, 45–47, 98202, 227, 237.
Matter	A philosophical category denoting things and phenomena, existing in objective external reality, which human beings access through our sense perceptions. See p. 26, 27, 32, 48, 51–52, 53–69, 72, 88–95, 97, 103, 164–165.
Means of Production	Physical inputs and systems used in the production of goods and services, including: machinery, factory buildings, tools, equipment, and anything else used in producing goods and services. See p. 2–3, 7, 14–16.
Mechanical Motion	Changes in positions of objects in space. See p. 61.
Mechanical Philosophy	A scientific and philosophical movement popular in the 17^th century which explored mechanical machines and compared natural phenomena to mechanical devices, resulting in a belief that all things — including living organisms — were built as (and could theoretically be built by humans as) mechanical devices.
Mental Reflection	Reactions which occur in animals with central nervous systems. Mental reflections occur through conditioned reflex mechanisms through learning. See p. 65, 68, 224.
Metaphysical Materialism	Metaphysical materialism was strongly influenced by the metaphysical, mechanical thinking of mechanical philosophy, which was a scientific and philosophical movement which explored mechanical machines and compared natural phenomena to mechanical devices. Metaphysical materialists believed that all change can exist only as an increase or decrease in quantity, brought about by external causes.
Metaphysics	A branch of philosophy that attempts to explain the fundamental nature of reality. Metaphysical philosophy has taken many forms through the centuries, but one common shortcoming of metaphysical thought is a tendency to view things and ideas in a static, abstract manner. Generally speaking, metaphysics presents nature as a collection of objects and phenomena which are isolated from one another and fundamentally unchanging. See p. 52.
Methodology	A system of reasoning: the ideas and rules that guide humans to research, build, select, and apply the most suitable methods in both perception and practice. Methodologies can range from very specific to broadly general, with philosophical methodology being the most general scope of methodology. See p. 44.
Mode	The way or manner in which something occurs or exists. See p. 19–20.
Mode of Existence of Matter	Refers to how matter exists in our universe; specifically, matter exists in our motion in a mode of motion. See p. 59.
Motion	Also known as “change;” motion/change occurs as a result of the mutual impacts which occur between two things, phenomena, or ideas in relation with one another. See p. 23, 47, 59–63. 74, 106–107, 122–127, 145, 163–165, 169-173-186, 197, 201–202.
Motion in Equilibrium	Motion in equilibrium is motion that has not changed the positions, forms, and/or structures of things. Motion in Equlibrium is only ever temporary in nature; all motion will eventually lead to changes in position, form, and/or structure. See p. 62.
Narodnik	Agrarian socialist movement of the 1860s and 70s in the Russian Empire, composed of peasants who rose up in a failed campaign against the Czar. See p. 29–30.
Natural law	See: Laws of Nature.
Natural Science	Science which deals with the natural world, including chemistry, biology, physics, geology, etc. See p. 13, 19, 26, 103.
Negation	The development process through which two contradicting objects mutually develop one another until one is overtaken by the other. In dialectical materialism, negation takes the form of dialectical negation. See p. 123, 175176, 183, 185–202.
New Economic Policy	Also known as the NEP; this early Soviet policy was devised as Vladimir Illyich Lenin to be a temporary economic system that would allow a market economy and capitalism to exist within Russia, alongside state-owned business ventures, all firmly under the control of the working-classdominated state. See p. 33–34.
Objective Dialectics	The dialectical processes which occur in the material world, including all of the motion, relationships, and dynamic changes which occur in space and time. See p. 98, 102–103, 182.
Objective Existence	Existence which manifests outside of and independently of human consciousness, whether humans can perceive it or not. See p. 50, 58, 228.
Objective Idealism	A form of idealism which asserts that the ideal and consciousness are the primary existence, while also positing that the ideal and consciousness are objective, and that they exist independently of nature and humans. See p. 50.
Objectiveness	An abstract concept that refers to the relative externality of all things, phenomena, and ideas. Every thing, phenomena and idea exists externally to every other thing, phenomena, and idea. This means that to each individual subject, all other subjects exist as external objects. See p. 111–114, 124.
Obviousness	See: Obviousness and Randomness
Obviousness and Randomness (Category Pair)	The philosophical category of Obviousness refers to events that occur because of the essential internal aspects of a subject which become reasons for certain results in certain conditions: the obvious has to happen in a certain way, it can’t happen any other way. The Randomness category refers to things that happen because of external reasons: things that happen, essentially, by chance, due to impacts from many external relations. A random outcome may occur or it may not occur, and may occur in many different ways. Obviousness and Randomness have a dialectical relationship with one another. See p. 144–146.
Opportunism	A system of political opinions with no direction, no clear path, and/or no coherent viewpoint, focusing on whatever actions or decisions might be beneficial for the opportunist in the short term. See p. 174.
Opposites	Such aspects, properties and tendencies of motion which oppose one another, yet are, simultaneously, conditions and premises of the existence of one another. See p. 61, 175–179, 181, 184, 190, 227.
Ordinary Consciousness	Perception that is formed passively, stemming from the daily activities of humans. See p. 210–216.
Period of Motion	Development which occurs between two quality shifts, including the quality shifts themselves. See p. 170.
Perspective	See: Viewpoint.
Petty Bourgeoisie	Semi-autonomous merchants, farmers, and so on who are self-employed, own small and limited means of production, or otherwise fall in between the proletariat and the bourgeoisie. Also called the petite bourgeoisie. See p. 3–6.
Petty Commodity Production	See: Simple Commodity Production.
Phenomena	Anything that is observable by the human senses. See p. 156. See also: Essence and Phenomena.
Physical Motion	Motion of molecules, electrons, fundamental particles, thermal processes, electricity, etc., in time and space. See p. 61.
Physical Reflection	Reflection which occurs any time two material objects interact and the features of the objects are transferred to one other. See p. 67–68.
Point of View	See: Viewpoint.
Populism	The political philosophy of the Narodnik movement; this political philosophy was focused on bringing about an agrarian peasant revolution led by intellectuals with the ambition of going directly from a feudal society to a socialist society built from rural communes. Populism overtly opposed Marxism and dialectical materialism and was based on subjective idealist utopianism. See p. 30.
Positivism	The belief that we can test scientific knowledge through scientific methods, and through logic, math, etc.; positivism tends to overlap significantly with empiricism in theory and practice. See p. 32, 209.
Possibility	See: Possibility and Reality.
Possibility and Reality (Category Pair)	The philosophical category of Possibility refers to things that have not happened nor existed in reality yet, but that would happen, or would exist given necessary conditions. The philosophical category of Reality refers to things that exist or have existed in reality and in human thought. See p. 160–162.
Practice	See: Praxis.
Pragmatism	Pragmatism refers to a form of subjectivism in which one centers one’s own immediate material concerns over all other considerations. See p. 218.
Praxis	Conscious activity which improves our understanding, and which has purpose and historical-social characteristics. Used interchangeably with the word “practice” in this text. See p. 205–206, 235.
Prejudice	See: Conservatism.
Primary and Secondary Contradictions	In the development of things, phenomena, and ideas, there are many development stages. In each stage of development, there will be one contradiction which drives the development process. This is what we call the primary contradiction. Secondary contradictions include all the other contradictions which exist during that stage of development. Determining whether a contradiction is primary or secondary is relative, and it depends heavily upon the material conditions and the situation being analyzed. See p. 178–179.
Primary Existence	Existence which precedes and determines other existences; materialists believe that the external material world is the primary existence which determines the ideal, while idealists believe that human consciousness (“the ideal”) is the primary existence from which truth is ultimately derived. See p. 50–51.
Primitive Materialism	An early form of materialism which recognizes that matter is the primary existence, and holds that the world is composed of certain elements, and that these were the first objects — the origin — of the world, and that these elements are the essence of reality. This was later developed into Metaphysical Materialism and, later, Dialectical Materialism. See p. 52.
Principle of General Relationships	A principle of dialectical materialism which states that all things, phenomena, and ideas are related to one another, and are defined by these internal and external relationships. See p. 106–107, 110, 114.
Private	See: Private and Common
Private and Common (Category Pair)	The Private philosophical category encompasses specific things, phenomena, and ideas; the Common philosophical category defines the common aspects, attributes, factors, and relations that exist in many things and phenomena. Private and Common are relative in nature and have a dialectical relationship with one another. See p. 128–138.
Private Laws	Laws which apply only to a specific range of things and phenomena, i.e.: laws of mechanical motion, laws of chemical motion, laws of biological motion, etc. See p. 162.
Production Force	The combination of the means of production and workers within human society. See p. 6, 23, 36.
Proletariat	The people who provide labor under capitalism; the proletariat do not own their own means of production, and must therefore sell their labor to those who do own means of production; also called the Working Class. See also: Bourgeoisie, Petty Bourgeoisie. See p. 1–8, 22–23, 25–26, 29–31, 33–35, 40–41, 63, 231.
Quality	The unity of component parts, taken together, which defines a subject and distinguishes it from other subjects. See p. 119–121.
Quality Shift	A change in quality which takes place in the motion and development process of things, phenomena, and ideas, occurring when quantity change meets a certain perceived threshold. See p. 124, 153, 164, 168–174.
Quantity	The total amount of component parts that compose a subject. See p. 119–121.
Quantity range	The range of quantity changes which can accumulate without leading to change in quality related to any given thing, phenomenon, or idea. See p. 168–171.
Quintessence	Original Vietnamese word: tinh hoa. Literally, it means “the best, highest, most beautiful, defining characteristics” of a concept, and, unlike the English word quintessence, it has an exclusively positive connotation. See p. 8, 21, 43, 45, 52.
Randomness	See: Obviousness and Randomness.
Rational Consciousness	The higher stage of the cognitive process, which includes the indirect, abstract, and generalized reflection of the essential properties and characteristics of things and phenomena. This stage of consciousness performs the most important function of comprehending and interpreting the essence of the perceived subject. See p. 219–225.
Reason	See: Reason and Result
Reality	See: Possibility and Reality.
Reason and Result (Category Pair)	The Reason philosophical category is used to define the mutual impacts between internal aspects of a thing, phenomenon or idea, or between things, phenomena, or ideas, that bring about changes. The Result philosophical category defines the changes that were caused by mutual impacts which occur between aspects and factors within a thing, phenomenon, or idea, or externally between different things, phenomena, or ideas. Not to be confused with the metaphysical concept of “cause and effect,” which attributes a single cause to any given effect. See p. 138–144.
Reasoning	The final phase of rational consciousness, formed on the basis of synthesizing judgments so as to extrapolate new knowledge about the perceived subject. See p. 223–225, 228–229.
Reflection	The re-creation of the features of one form of matter in a different form of matter which occurs when they mutually impact each other through interaction. See p. 64–75, 79–80, 90–92, 103, 165, 208–211, 214–215, 219–224, 228, 232, 237.
Relative and Absolute	“Absolute” and “Relative” are philosophical classifications which refer to interdependence: That which is absolute exists independently and with permanence. That which is relative is temporary, and dependent on other conditions or circumstances in order to exist. See p. 56, 233. See also: Absolute Truth, Relative Truth, Relativism, Truth.
Relative Truth	Truth which has developed alignment with reality without yet having reached complete alignment between human knowledge and the reality which it reflects; knowledge which incompletely reflects material subjects without complete accuracy. See p. 230, 232. See also: Absolute Truth, Relative and Absolute, Relativism, Truth.
Relativism	A position that all truth is relative and that nothing can ever be absolutely, objectively known; that only Relative Truth can be found in our existence. See p. 56–58, 233–234. See also: Absolute Truth, Relative and Absolute, Relative Truth, Truth.
René Descartes	(1596 — 1650) French metaphysical philosopher who developed early methods of scientific inquiry. See p. 20, 53.
Result	See: Reason and Result.
Richard Avenarius	(1843 — 1896) German-Swiss philosopher who developed a system of subjective idealism known as “Empirio-Criticism.” See p. 27–29.
Rigidity	An unwillingness to alter one’s thoughts, holding too stiffly to established consciousness and knowledge, and ignoring practical experience and observation, which leads to stagnation of both knowledge and consciousness. See p. 217–218.
Robert Owen	(1771 — 1858) Wealthy Welsh textile manufacturer who tried to build a better society for workers in New Hampshire, Indiana, in the USA by purchasing the town of New Harmony in 1825. Owen’s vision failed after two years, though many other wealthy capitalists in the early 19^th century were inspired by Owen to try similar plans, which also failed.
Scientific	An adjective which describes methodologies, approaches, and practices of gaining knowledge and insight which are methodological and/or systematic in nature. See p. 1–2.
Scientific Consciousness	Conscious activities which actively gather information from the methodological and/or systematic observations of the characteristics, nature, and inherent relationships of research subjects. Scientific consciousness is considered indirect because it takes place outside of the course of ordinary daily activities. See p. 58, 210, 212, 215–216.
Scientific	Experimental Human activities that resemble or replicate states of nature and society
Activity	in order to determine the laws of change and development of subjects of study. This form of activity plays an important role in the development of society, especially in the current historical period of modern science and technological revolution. See p. 206–208.
Scientific Materialist Viewpoint	A perspective which begins analysis of the world in a manner that is both scientifically systematic in pursuit of understanding and firmly rooted in a materialist conception of the world. See p. 105.
Scientific Socialism	A body of theory and knowledge (which must be constantly tested against reality) focused on the practical pursuit of changing the world to bring about socialism through the leadership of the proletariat. See p. 1–2, 21, 37–39.
Scientific Worldview	A worldview that is expressed by a systematic pursuit of knowledge that generally and correctly reflects the relationships of things, phenomena, and processes in the objective material world, including relationships between humans, as well as relationships between humans and the world. See p. 3839, 44–45, 48.
Second International	Founded in Paris in 1889 to continue the work of the First International; it fell apart in 1916 because members from different nations could not maintain solidarity through the outbreak of World War I. See p. 35, 174.
Self-motion	In the original Vietnamese, the word “tự vận động.” Literally meaning: “it moves itself.” See p. 59–60, 124.
Sensation	The subjective reflection of the objective world in human consciousness as perceived through human senses. See p. 27, 56–58, 68–69, 72, 85, 221–222.
Sensuous Human Activity; Sensuous Activity	A description of human activity developed by Marx which acknowledges that all human activity is simultaneously active in the sense that our conscious activity can transform the world, as well as passive in the sense in that all human thoughts fundamentally derive from observation and sense experience of the material world. See p. 13.
Simple Commodity Production	What Marx called the “C→M→C” mode of circulation. See p. 16–18.
Simple Exchange	When individual producers trade the products they have made directly, themselves, for other commodities. See p. 16–17.
Social Being	The material existence of human society, as opposed to social consciousness. See also: Base. See p. 24, 54–55.
Social Consciousness	The collective experience of consciousness shared by members of a society, including ideological, cultural, spiritual, and legal beliefs and ideas which are shared within that society, as opposed to social being. See p. 22, 24, 32, 54–55, 80. See also: Superstructure.
Social Motion	Changes in the economy, politics, culture, and social life of human beings. See p. 61–62.
Socialization	The idea that human society transforms labor and production from a solitary, individual act into a collective, social act. In other words, as human society progresses, people “socialize” labor into increasingly complex networks of social relations: from individuals making their own tools, to agricultural societies engaged in collective farming, to modern industrial societies with factories, logistical networks, etc. See p. 6, 36.
Socialized Production Force	A production force which has been socialized — that is to say, a production force which has been organized into collective social activity. See p. 6.
Socio-Political Activity	Praxis activity utilized by various communities and organizations in human society to transform political-social relations in order to promote social development. See p. 206–208.
Solipsism	A form of idealism in which one believes that the self is the only basis for truth. See p. 218.
Sophistry	The use of misleading arguments, usually with the intention of deception, with a tendency of presenting non-critical aspects of a subject matter as critical, to serve a particular agenda. The word comes from the Sophists, a group of professional teachers in Ancient Greece, who were criticized by Socrates (in Plato’s’ dialogues) for being shrewd and deceptive rhetoricians. See p. 32–33, 56, 118, 182, 194.
Stage of Development	The current quantity and quality characteristics which a thing, phenomenon, or object possesses. Every time a quality change occurs, a new stage of development is entered into. See p. 24, 39, 125, 173–174, 179, 190, 196–197, 200, 212, 221.
Stagnation	An inability or unwillingness to change and adapt consciousness and practice in accordance with developing material conditions. Stagnation can stem from, or cause, overstatement of absolute truth in theory and forestall necessary development of both consciousness and practical ability. See p. 125, 218, 233. See also: Rigidity.
Struggle of Opposites	The tendency of opposites to eliminate and negate each other. See p. 61, 181, 184.
Subjective Factors	Factors which, from the perspective of a given subject, that same subject is capable of impacting. See p. 162–163, 175, 202.
Subjective Dialectics; Dialectical Thought	A system of analysis and organized thinking which aims to reflect the objective dialectics of the material world within human consciousness. Dialectical thinking has two component forms: dialectical materialism and materialist dialectics. See: p. 98–99, 103.
Subjective Idealism	Subjective idealism asserts that consciousness is the primary existence and that truth can be obtained only or primarily through conscious activity and reasoning. Subjective idealism asserts that all things and phenomena can only be experienced as subjective sensory perceptions, with some forms of subjective idealism even explicitly denying the objective existence of material reality altogether. See also: Empirio-Criticism, Objective Idealism. See p. 26–27, 50.
Subjectivism	A philosophical position in which one centers one’s own self and conscious activities in perspective and worldview, failing to test their own perceptions against material and social reality. See p. 56, 182, 217–218, 233–234.
Suitability	The applicability of a subject for a specific application or role. See p. 154.
Superstructure	The ideal (non-material) components of human society, including: media institutions, music, and art, as well as other cultural elements like religion, customs, moral standards, and everything else which manifests primarily through conscious activity and social relations. See p. 23. See also: Base.
Surplus Value	The extra amount of value a capitalist is able to secure by exploiting wagelabourers (by paying workers less than the full value of their labour). Workers will spend part of their workday reproducing their own labourpower (through earning enough to eat, secure shelter and other cultural needs) and the rest of the time will be spent producing surplus value which is then appropriated by the capitalist as profit. See p. 18, 22–23, 39.
Symbolization	The representation of an objective thing or phenomenon in human consciousness which has been reflected by sensation and conception. See p. 221–222.
Systematic Structure	A structure which includes within itself a system of component parts and relationships. See p. 114.
Theoretical Consciousness	The indirect, abstract, systematic level of perception in which the nature and laws of things and phenomena are generalized and abstracted. See p. 210–214, 217–218.
Theoretical Knowledge	Knowledge which is abstract and generalized, resulting from theoretical conscious activities which include repeated and varied observations. See p. 214, 217.
Theory	An idea or system of ideas intended to explain an aspect, characteristic, or tendency of objective reality. See p. 235.
Theory of Accumulation/Surplus Value	See: Law of Development of Capitalism.
Thing-in-Itself	The actual material object which exists outside of our consciousness, as it exists outside of our consciousness. See p. 72–74, 101, 158.
Third International	Also known as the Communist International (or the ComIntern for short); founded in Moscow in 1919, its goals were to overthrow capitalism, build socialism, and establish a dictatorship of the proletariat. It was dissolved in 1943 in the midst of the German invasion of Russia in World War II. See p. 35.
Three Component Parts	The three essential elements of Marxist-Leninist philosophy, first identified of Marxism-Leninism by Lenin in The Three Sources and Three Component Parts of Marxism. 1. The Philosophy of Marxism. 2. The Political Economy of Marxism. 3. Scientific Socialism.See p. 21, 32, 34, 38.
Threshold	The amount, or degree, of quantity change at which quality change occurs. Truth is primarily discovered through labor and practice in the physical world. See p. 120, 168–169, 171, 173.
Truth	A correct and accurate conscious reflection of objective reality. See p. 9–10, 49, 56, 70, 75, 94–96, 194, 204, 209, 215–219, 225–237. See also: Labor, Practice.
Unconditioned Reflex	Reactions which are not learned, but simply occur automatically based on physiological mechanisms occurring within an organism, characterized by permanent connections between sensory perceptions and reactions. See p. 66, 68.
Unilateral Consideration	The consideration of a subject from one side only. See p. 49.
Unintelligibility	A philosophical position which denies the human cognitive capacity to accurately perceive the external material world. See p. 48.
Unique Relationship	The least general form of relationship, which only occur between two specific things/phenomena/ideas. See p. 109, 130.
Unity in Diversity	A concept in materialist dialectics which holds that within universal relationships exist within and between all different things, phenomena, and ideas, we will find that each individual manifestation of any universal relationship will have its own different manifestations, aspects, features, etc. Thus even the universal relationships which unite all things, phenomena, and ideas exist in infinite diversity. See p. 42, 110–111, 114, 125, 130.
Universal Law of Consciousness	A universal law which holds that consciousness is a process of dialectical development in which practical activity leads to conscious activity, which then leads back to practical activity, in a continuous and never-ending cycle, with a tendency to develop both practical and conscious activity to increasingly higher levels. See p. 219.
Universal Laws	Laws that impact every aspect of nature, society, and human thought. Materialist dialectics is the study of these universal laws. See p. 15, 162–163, 227.
Universal Relationship	The most general kind of relationship; relationships that exist between and within every thing and all phenomena; along with development, universal relationships are one of the two primary subjects of study of materialist dialectics. See p. 80, 108, 109, 111, 165.
Use Value	A concept in classical political economy and Marxist economics which refers to tangible features of a commodity (a tradable object) that can fulfill some human requirement or desire, or which serve a useful purpose. See p. 15–18, 95.
Utopianism	1. A political and philosophical movement which held the belief that “a New Moral World” of happiness, enlightenment, and prosperity could be created through education, science, technology, and communal living. See p. 18. 2. The idealist philosophical concept which mistakenly asserts that the ideal can determine the material, and that ideal forms of society can be brought about without regard for material conditions and development processes. See p. 8, 17–18, 30, 94.
Value-Form	Also known as “form of value;” the social form of a commodity. Under capitalism, through the exchange of qualitatively different commodities, the money form of value is established as the general equivalent which can functionally be exchanged for all other values; money is therefore the most universal value-form under capitalism. See p. 15, 17, 155.
Viewpoint	Also known as point of view or perspective; the starting point of analysis which determines the direction of thinking from which phenomena and problems are considered. See p. 12, 20–21, 23, 25, 26, 30, 32–33, 38–39, 5559, 62, 64, 89, 93–94, 105, 111, 114–120, 122, 125–126, 130, 143, 147, 150, 172, 185–188, 195, 200–201, 233–235. See also: Comprehensive Viewpoint, Historical Viewpoint.
Viewpoint Crisis	A situation in which a specific viewpoint can’t be settled on, found, or agreed upon. See p. 26, 32–33.
Vladimir Ilyich Lenin	(1870 -1924) A Russian theorist, politician, dialectical materialist philosopher, defender and developer of Marxism in the era of imperialism, founder of the Bolsheviks, the Communist Party and the government of the Soviet Union, leader of Russia and the international working class. Referenced throughout.
Working Class	See: Proletariat
Worldview	The whole of an individual’s or society’s opinions and conceptions about the world, about humans ourselves, and about life and the position of human beings in the world. See p. 1, 11, 37–39, 44–45, 48, 52, 96, 138, 201, 208–209, 218, 234. See also: Scientific Worldview.

File:T-w-the-worldview-and-philosophical-methodology-of-2.png

For centuries, the banyan tree has been the symbol of communal life in Vietnam.

Traditionally, the entrance to a village is graced by a large and ancient banyan tree. It is in the shade of these trees that villagers gather to socialize, draw water from wells, and make collective decisions together. The drooping accessory trunks represent the longevity of villagers — and of the village itself — while the arching canopy represents the safety and protection of the village. The shape of the banyan tree is seen in the full moon, which casts peaceful light across the Earth to guide travelers in the dark of night.

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File:T-w-the-worldview-and-philosophical-methodology-of-103.png

Jump up ↑ Karl Marx, 1818–1883 (German): Theorist, politician, dialectical materialist philosopher, political economist, founder of scientific socialism, leader of the international working class.
Jump up ↑ Friedrich Engels, 1820–1895 (German): Theorist, politician, dialectical materialist philosopher, leader of the international working class, co-founder of scientific socialism with Karl Marx.
Jump up ↑ Vladimir Ilyich Lenin, 1870–1924 (Russian): Theorist, politician, dialectical materialist philosopher, defender and developer of Marxism in the era of imperialism, founder of the Communist Party and the government of the Soviet Union, leader of Russia and the international working class.
Jump up ↑ Material conditions include the natural environment, the means of production and the economic base of human society, objective social relations, and other externalities and systems which affect human life and human society. See Annotation 79, p. 81.
Jump up ↑ Georg Wilhelm Friedrich Hegel, 1770 — 1831 (German): Philosophy professor, an objective idealistic philosopher — representative of German classical philosophy.
Jump up ↑ Ludwig Feuerbach, 1804 — 1872 (German): Philosophy professor, materialist philosopher.
Jump up ↑ The Holy Family is a book co-written by Marx and Engels which critiqued the Young Hegelians, including Feuerbach.
Jump up ↑ Adam Smith, 1723 — 1790 (British): Logic professor, moral philosophy professor, economist.
Jump up ↑ David Ricardo, 1772 — 1823 (British): Economist.
Jump up ↑ Claude Henri de Rouvroy Saint Simon, 1760 — 1825 (French): Philosopher, economist, utopianist activist.
Jump up ↑ Charles Fourier, 1772 — 1837 (French): Philosopher, economist, utopianist activist.
Jump up ↑ Robert Owen, 1771 — 1858 (British): Utopianist activist, owner of a cotton factory.
Jump up ↑ The Law of Development of Capitalism referenced here is the Theory of Accumulation/Surplus Value, which holds that the capitalist class gains wealth by accumulating surplus value (i.e., profits) and then reinvesting it into more capital to gain even further wealth; thus the goal of the capitalist class is to accumulate more and more surplus value which leads to the development of capitalism. Over time, this deepens the contradictions of capitalism. This concept is related to the M→C→M mode of circulation, discussed in Annotation 14, p. 16, and is discussed in detail in Part 3 of the book this text is drawn from (Political Economy) which we hope to translate in the future.
Jump up ↑ Das Kapital: Karl Marx’s most important contribution to political economy. It is composed of four volumes. It is the work of Marx’s whole career and an important part of Engels’ career, as well. Marx started writing Das Kapital in the 1840s and continued writing until he died (1883). Das Kapital I was published in 1867. After Marx’s death, Engels edited and published the second volume in 1885 and the third volume in 1894. The Institute of Marxism-Leninism of the USSR edited and published Das Kapital IV, also known as Theories of Surplus-Value, in the 1950s, long after the death of Marx and Engels.
Jump up ↑ Populist faction: A faction within the Russian revolution which upheld an idealist capitalist ideology with many representatives such as Mikhailovsky, Bakunin, and Plekhanov. Populists failed to recognise the important roles of the people, of the farmers and workers alliance, and of the proletariat. Instead, they completely centered the role of the individual in society. They considered the rural communes as the nucleus of “socialism.” They saw farmers under the leadership of intellectuals as the main force of the revolution. The populists advocated individual terrorism as the primary method of revolutionary struggle.
Jump up ↑ Delegate Document of the 11^th National Congress of the Communist Party of Vietnam.
Jump up ↑ Delegate document of the 9^th national congress of the Communist Party of Vietnam.
Jump up ↑ Delegate document of the 10^th national congress of the Communist Party of Vietnam.
Jump up ↑ See Annotation 6, p. 8.
Jump up ↑ The Three Sources and Three Component Parts of Marxism, Vladimir Ilyich Lenin, 1913.
Jump up ↑ Karl Marx, Vladimir Ilyich Lenin, 1914.
Jump up ↑ Ludwig Feuerbach and the End of Classical German Philosophy, Friedrich Engels, 1886.
Jump up ↑ According to the Samkhya school, Pradhana is the original form of matter in an unmanifested,indifferentiated state; Prakriti is manifested matter, differentiated in form, which contains potential for motion.
Jump up ↑ Thales, ~642 — ~547 B.C. (Greek): Philosopher, mathematician, astronomer, politician.
Jump up ↑ Anaximene, ~585 — ~525 B.C. (Greek): Philosopher.
Jump up ↑ Heraclitus, ~540 — ~480 B.C. (Greek): Philosopher, founder of ancient dialectics.
Jump up ↑ Democritus, ~460 — ~370 B.C. (Greek): Philosopher, naturalist, a founder of atom theory.
Jump up ↑ Francis Bacon, 1561 — 1626 (British): Philosopher, novelist, mathematician, political activist.
Jump up ↑ Rene Descartes, 1596 — 1650 (Fench): Philosopher, mathematician, physicist.
Jump up ↑ Thomas Hobbes, 1588 — 1679 (British): Political philosopher, political activist.
Jump up ↑ Denis Diderot, 1713 — 1784 (French): Philosopher, novelist.
Jump up ↑ Wilhelm Conrad Roentgen, 1845–1923 (German): Physicist.
Jump up ↑ Henri Becquerel, 1852–1908 (French): Physicist.
Jump up ↑ Sir Joseph John Thomson, 1856–1940 (British): Physicist, professor at London Royal Institute.
Jump up ↑ In the original Vietnamese, the word tự vận động is used here, which we roughly translate to the word self-motion throughout this book. Literally, tự vận động means: “it moves itself.”
Jump up ↑ Source: “Food for Thought: Was Cooking a Pivotal Step in Human Evolution?” by Alexandra Rosati, Scientific American, February 26, 2018.
Jump up ↑ Written by Professor Tracy L. Kivell and published in The Royal Society.
Jump up ↑ Stone Tools Helped Shape Human Hands by Sara Reardon, published in New Scientist Magazine.
Jump up ↑ The German Ideology, Karl Marx and Friedrich Engels, 1846.
Jump up ↑ See Annotation 3, p. 2 and Annotation 29, p. 24.
Jump up ↑ For a discussion of the material basis of social laws, see Annotation 10, p. 10, Annotation 78, p. 80, and Annotation 79, p. 81.
Jump up ↑ See: Annotation 72, p. 68.
Jump up ↑ See: Annotation 90, p. 88.
Jump up ↑ See: The Role of Matter in Consciousness, p. 89.
Jump up ↑ See: The Relationship Between Matter and Consciousness, p. 88.
Jump up ↑ See:Annotation 68, p. 65.
Jump up ↑ See: Nature and Structure of Consciousness, p. 79.
Jump up ↑ See: Annotation 93, below.
Jump up ↑ See: Annotation 10, p. 10.
Jump up ↑ For discussion of the meaning of methodology, see Methodology, p. 44.
Jump up ↑ See: Nature of Consciousness, p. 79.
Jump up ↑ See: The Relationship Between Matter and Consciousness, p. 88.
Jump up ↑ See: Annotation 211, p. 205.
Jump up ↑ See: Annotation 114, p. 116.
Jump up ↑ See: Nature and Structure of Consciousness, p. 79.
Jump up ↑ See: Annotation 222, p. 218.
Jump up ↑ See: The Opposition of Materialism and Idealism in Solving Basic Philosophical Issues, p. 48.
Jump up ↑ See: Annotation 10, p. 10.
Jump up ↑ See: Annotation 232 and The Properties of Truth, on p. 228.
Jump up ↑ See: Praxis, Consciousness, and the Role of Praxis in Consciousness, p. 204.
Jump up ↑ Karl Marx, Vladimir Ilyich Lenin, 1914.
Jump up ↑ See Annotation 9, p. 10.
Jump up ↑ Dialectics of Nature, Friedrich Engels, 1883.
Jump up ↑ Socialism: Utopian and Scientific, Friedrich Engels, 1880.
Jump up ↑ The Old Preface to Anti-Dühring, Friedrich Engels, 1878.
Jump up ↑ The Old Preface to Anti-Dühring, Friedrich Engels, 1878.
Jump up ↑ Kant’s “transcendental dialectic” was used to critique rationalism and pure reason, but was not a fully developed dialectical system of thought. Hegel’s idealist dialectics were more universal in nature. See Annotation 9, p. 10.
Jump up ↑ The Old Preface to Anti-Dühring, On Dialectics, Friedrich Engels, 1878.
Jump up ↑ Conspectus of Hegel’s Science of Logic, Vladimir Ilyich. Lenin, 1914.
Jump up ↑ Afterword to the Second German Edition of Capital Volume I, Karl Marx, 1873.
Jump up ↑ Anti-Dühring, The 1885 Preface, Friedrich Engels, 1878.
Jump up ↑ Anti-Dühring, Friedrich Engels, 1878.
Jump up ↑ See p. 107.
Jump up ↑ Dialectics of Nature, Friedrich Engels, 1883.
Jump up ↑ See Annotation 117, p. 119.
Jump up ↑ The Three Sources and Three Component Parts of Marxism, Vladimir Ilyich Lenin, 1913.
Jump up ↑ See Annotation 98, p. 100.
Jump up ↑ See Private and Common, p. 128; Essence and Phenomenon, p. 156.
Jump up ↑ See Annotation 117, p. 119.
Jump up ↑ See Annotation 190, p. 181.
Jump up ↑ See Annotation 108, p. 112.
Jump up ↑ See p. 108.
Jump up ↑ Once Again On The Trade Unions, Vladimir Ilyich Lenin, 1921.
Jump up ↑ See: Annotation 108, p. 112.
Jump up ↑ See: Annotation 106, p. 109.
Jump up ↑ See: Annotation 107, p. 110.
Jump up ↑ Once Again On The Trade Unions, Vladimir Ilyich Lenin, 1921. See also: Mode and Forms of Matter, p. 59.
Jump up ↑ See Annotation 62, p. 59.
Jump up ↑ Once Again On The Trade Unions, Vladimir Ilyich Lenin, 1921.
Jump up ↑ On the Question of Dialectics, Vladimir Ilyich Lenin, 1915.
Jump up ↑ Socialism: Utopian and Scientific, Friedrich Engels, 1880.
Jump up ↑ Ludwig Feuerbach and the End of Classical German Philosophy, Friedrich Engels, 1886.
Jump up ↑ See Annotation 10, p. 10 and Annotation 108, p. 112.
Jump up ↑ Philosophical Notebooks, Vladimir Ilyich Lenin, 1914–16.
Jump up ↑ Philosophical Notebooks, Vladimir Ilyich Lenin, 1914–16.
Jump up ↑ To N. D. Kiknadze, Vladimir Ilyich Lenin, written after November 5, 1916.
Jump up ↑ Anti-Dühring, Friedrich Engels, 1878.
Jump up ↑ See Annotation 108, p. 112.
Jump up ↑ See Annotation 207, p. 202.
Jump up ↑ Summary of Dialectics, Vladimir Ilyich Lenin, 1914.
Jump up ↑ Anti-Dühring, Friedrich Engels, 1877.
Jump up ↑ On the Questions of Dialectics, Vladimir Ilyich Lenin, 1915.
Jump up ↑ On the Questions of Dialectics, Vladimir Ilyich Lenin, 1915.
Jump up ↑ On the Questions of Dialectics, Vladimir Ilyich Lenin, 1915.
Jump up ↑ On the Questions of Dialectics, Vladimir Ilyich Lenin, 1915.
Jump up ↑ Conspectus of Hegel’s Science of Logic, Vladimir Ilyich Lenin, 1914.
Jump up ↑ Conspectus of Hegel’s Science of Logic, Vladimir Ilyich Lenin, 1914.
Jump up ↑ Karl Marx, Vladimir Ilyich Lenin, 1914.
Jump up ↑ Anti-Dühring, Friedrich Engels, 1878.
Jump up ↑ Theses On Feuerbach, Karl Marx, 1845.
Jump up ↑ Materialism and Empirio-Criticism, Vladimir Ilyich Lenin, 1908.
Jump up ↑ Conspectus of Hegel’s Science of Logic, Vladimir Ilyich Lenin, 1914.
Jump up ↑ Materialism and Empirio-Criticism, Vladimir Ilyich Lenin, 1908.
Jump up ↑ Once Again On The Trade Unions, Vladimir Ilyich Lenin, 1921.
Jump up ↑ Revolutionary Ethics, Ho Chi Minh, December 1958.
Jump up ↑ Note: Absolute Truth in dialectical materialist philosophy should not be confused with Hegel’s conception of Absolute Truth as a final point at which human consciousness will have achieved absolute, complete, and final understanding of our universe.

[1] Jump up ↑ Karl Marx, 1818–1883 (German): Theorist, politician, dialectical materialist philosopher, political economist, founder of scientific socialism, leader of the international working class.

[2] Jump up ↑ Friedrich Engels, 1820–1895 (German): Theorist, politician, dialectical materialist philosopher, leader of the international working class, co-founder of scientific socialism with Karl Marx.

[3] Jump up ↑ Vladimir Ilyich Lenin, 1870–1924 (Russian): Theorist, politician, dialectical materialist philosopher, defender and developer of Marxism in the era of imperialism, founder of the Communist Party and the government of the Soviet Union, leader of Russia and the international working class.

[4] Jump up ↑ Material conditions include the natural environment, the means of production and the economic base of human society, objective social relations, and other externalities and systems which affect human life and human society. See Annotation 79, p. 81.

[5] Jump up ↑ Georg Wilhelm Friedrich Hegel, 1770 — 1831 (German): Philosophy professor, an objective idealistic philosopher — representative of German classical philosophy.

[6] Jump up ↑ Ludwig Feuerbach, 1804 — 1872 (German): Philosophy professor, materialist philosopher.

[7] Jump up ↑ The Holy Family is a book co-written by Marx and Engels which critiqued the Young Hegelians, including Feuerbach.

[8] Jump up ↑ Adam Smith, 1723 — 1790 (British): Logic professor, moral philosophy professor, economist.

[9] Jump up ↑ David Ricardo, 1772 — 1823 (British): Economist.

[10] Jump up ↑ Claude Henri de Rouvroy Saint Simon, 1760 — 1825 (French): Philosopher, economist, utopianist activist.

[11] Jump up ↑ Charles Fourier, 1772 — 1837 (French): Philosopher, economist, utopianist activist.

[12] Jump up ↑ Robert Owen, 1771 — 1858 (British): Utopianist activist, owner of a cotton factory.

[13] Jump up ↑ The Law of Development of Capitalism referenced here is the Theory of Accumulation/Surplus Value, which holds that the capitalist class gains wealth by accumulating surplus value (i.e., profits) and then reinvesting it into more capital to gain even further wealth; thus the goal of the capitalist class is to accumulate more and more surplus value which leads to the development of capitalism. Over time, this deepens the contradictions of capitalism. This concept is related to the M→C→M mode of circulation, discussed in Annotation 14, p. 16, and is discussed in detail in Part 3 of the book this text is drawn from (Political Economy) which we hope to translate in the future.

[14] Jump up ↑ Das Kapital: Karl Marx’s most important contribution to political economy. It is composed of four volumes. It is the work of Marx’s whole career and an important part of Engels’ career, as well. Marx started writing Das Kapital in the 1840s and continued writing until he died (1883). Das Kapital I was published in 1867. After Marx’s death, Engels edited and published the second volume in 1885 and the third volume in 1894. The Institute of Marxism-Leninism of the USSR edited and published Das Kapital IV, also known as Theories of Surplus-Value, in the 1950s, long after the death of Marx and Engels.

[15] Jump up ↑ Populist faction: A faction within the Russian revolution which upheld an idealist capitalist ideology with many representatives such as Mikhailovsky, Bakunin, and Plekhanov. Populists failed to recognise the important roles of the people, of the farmers and workers alliance, and of the proletariat. Instead, they completely centered the role of the individual in society. They considered the rural communes as the nucleus of “socialism.” They saw farmers under the leadership of intellectuals as the main force of the revolution. The populists advocated individual terrorism as the primary method of revolutionary struggle.

[16] Jump up ↑ Delegate Document of the 11^th National Congress of the Communist Party of Vietnam.

[17] Jump up ↑ Delegate document of the 9^th national congress of the Communist Party of Vietnam.

[18] Jump up ↑ Delegate document of the 10^th national congress of the Communist Party of Vietnam.

[19] Jump up ↑ See Annotation 6, p. 8.

[20] Jump up ↑ The Three Sources and Three Component Parts of Marxism, Vladimir Ilyich Lenin, 1913.

[21] Jump up ↑ Karl Marx, Vladimir Ilyich Lenin, 1914.

[22] Jump up ↑ Ludwig Feuerbach and the End of Classical German Philosophy, Friedrich Engels, 1886.

[23] Jump up ↑ According to the Samkhya school, Pradhana is the original form of matter in an unmanifested,indifferentiated state; Prakriti is manifested matter, differentiated in form, which contains potential for motion.

[24] Jump up ↑ Thales, ~642 — ~547 B.C. (Greek): Philosopher, mathematician, astronomer, politician.

[25] Jump up ↑ Anaximene, ~585 — ~525 B.C. (Greek): Philosopher.

[26] Jump up ↑ Heraclitus, ~540 — ~480 B.C. (Greek): Philosopher, founder of ancient dialectics.

[27] Jump up ↑ Democritus, ~460 — ~370 B.C. (Greek): Philosopher, naturalist, a founder of atom theory.

[28] Jump up ↑ Francis Bacon, 1561 — 1626 (British): Philosopher, novelist, mathematician, political activist.

[29] Jump up ↑ Rene Descartes, 1596 — 1650 (Fench): Philosopher, mathematician, physicist.

[30] Jump up ↑ Thomas Hobbes, 1588 — 1679 (British): Political philosopher, political activist.

[31] Jump up ↑ Denis Diderot, 1713 — 1784 (French): Philosopher, novelist.

[32] Jump up ↑ Wilhelm Conrad Roentgen, 1845–1923 (German): Physicist.

[33] Jump up ↑ Henri Becquerel, 1852–1908 (French): Physicist.

[34] Jump up ↑ Sir Joseph John Thomson, 1856–1940 (British): Physicist, professor at London Royal Institute.

[35] Jump up ↑ In the original Vietnamese, the word tự vận động is used here, which we roughly translate to the word self-motion throughout this book. Literally, tự vận động means: “it moves itself.”

[36] Jump up ↑ Source: “Food for Thought: Was Cooking a Pivotal Step in Human Evolution?” by Alexandra Rosati, Scientific American, February 26, 2018.

[37] Jump up ↑ Written by Professor Tracy L. Kivell and published in The Royal Society.

[38] Jump up ↑ Stone Tools Helped Shape Human Hands by Sara Reardon, published in New Scientist Magazine.

[39] Jump up ↑ The German Ideology, Karl Marx and Friedrich Engels, 1846.

[40] Jump up ↑ See Annotation 3, p. 2 and Annotation 29, p. 24.

[41] Jump up ↑ For a discussion of the material basis of social laws, see Annotation 10, p. 10, Annotation 78, p. 80, and Annotation 79, p. 81.

[42] Jump up ↑ See: Annotation 72, p. 68.

[43] Jump up ↑ See: Annotation 90, p. 88.

[44] Jump up ↑ See: The Role of Matter in Consciousness, p. 89.

[45] Jump up ↑ See: The Relationship Between Matter and Consciousness, p. 88.

[46] Jump up ↑ See:Annotation 68, p. 65.

[47] Jump up ↑ See: Nature and Structure of Consciousness, p. 79.

[48] Jump up ↑ See: Annotation 93, below.

[49] Jump up ↑ See: Annotation 10, p. 10.

[50] Jump up ↑ For discussion of the meaning of methodology, see Methodology, p. 44.

[51] Jump up ↑ See: Nature of Consciousness, p. 79.

[52] Jump up ↑ See: The Relationship Between Matter and Consciousness, p. 88.

[53] Jump up ↑ See: Annotation 211, p. 205.

[54] Jump up ↑ See: Annotation 114, p. 116.

[55] Jump up ↑ See: Nature and Structure of Consciousness, p. 79.

[56] Jump up ↑ See: Annotation 222, p. 218.

[57] Jump up ↑ See: The Opposition of Materialism and Idealism in Solving Basic Philosophical Issues, p. 48.

[58] Jump up ↑ See: Annotation 10, p. 10.

[59] Jump up ↑ See: Annotation 232 and The Properties of Truth, on p. 228.

[60] Jump up ↑ See: Praxis, Consciousness, and the Role of Praxis in Consciousness, p. 204.

[61] Jump up ↑ Karl Marx, Vladimir Ilyich Lenin, 1914.

[62] Jump up ↑ See Annotation 9, p. 10.

[63] Jump up ↑ Dialectics of Nature, Friedrich Engels, 1883.

[64] Jump up ↑ Socialism: Utopian and Scientific, Friedrich Engels, 1880.

[65] Jump up ↑ The Old Preface to Anti-Dühring, Friedrich Engels, 1878.

[66] Jump up ↑ The Old Preface to Anti-Dühring, Friedrich Engels, 1878.

[67] Jump up ↑ Kant’s “transcendental dialectic” was used to critique rationalism and pure reason, but was not a fully developed dialectical system of thought. Hegel’s idealist dialectics were more universal in nature. See Annotation 9, p. 10.

[68] Jump up ↑ The Old Preface to Anti-Dühring, On Dialectics, Friedrich Engels, 1878.

[69] Jump up ↑ Conspectus of Hegel’s Science of Logic, Vladimir Ilyich. Lenin, 1914.

[70] Jump up ↑ Afterword to the Second German Edition of Capital Volume I, Karl Marx, 1873.

[71] Jump up ↑ Anti-Dühring, The 1885 Preface, Friedrich Engels, 1878.

[72] Jump up ↑ Anti-Dühring, Friedrich Engels, 1878.

[73] Jump up ↑ See p. 107.

[74] Jump up ↑ Dialectics of Nature, Friedrich Engels, 1883.

[75] Jump up ↑ See Annotation 117, p. 119.

[76] Jump up ↑ The Three Sources and Three Component Parts of Marxism, Vladimir Ilyich Lenin, 1913.

[77] Jump up ↑ See Annotation 98, p. 100.

[78] Jump up ↑ See Private and Common, p. 128; Essence and Phenomenon, p. 156.

[79] Jump up ↑ See Annotation 117, p. 119.

[80] Jump up ↑ See Annotation 190, p. 181.

[81] Jump up ↑ See Annotation 108, p. 112.

[82] Jump up ↑ See p. 108.

[83] Jump up ↑ Once Again On The Trade Unions, Vladimir Ilyich Lenin, 1921.

[84] Jump up ↑ See: Annotation 108, p. 112.

[85] Jump up ↑ See: Annotation 106, p. 109.

[86] Jump up ↑ See: Annotation 107, p. 110.

[87] Jump up ↑ Once Again On The Trade Unions, Vladimir Ilyich Lenin, 1921. See also: Mode and Forms of Matter, p. 59.

[88] Jump up ↑ See Annotation 62, p. 59.

[89] Jump up ↑ Once Again On The Trade Unions, Vladimir Ilyich Lenin, 1921.

[90] Jump up ↑ On the Question of Dialectics, Vladimir Ilyich Lenin, 1915.

[91] Jump up ↑ Socialism: Utopian and Scientific, Friedrich Engels, 1880.

[92] Jump up ↑ Ludwig Feuerbach and the End of Classical German Philosophy, Friedrich Engels, 1886.

[93] Jump up ↑ See Annotation 10, p. 10 and Annotation 108, p. 112.

[94] Jump up ↑ Philosophical Notebooks, Vladimir Ilyich Lenin, 1914–16.

[95] Jump up ↑ Philosophical Notebooks, Vladimir Ilyich Lenin, 1914–16.

[96] Jump up ↑ To N. D. Kiknadze, Vladimir Ilyich Lenin, written after November 5, 1916.

[97] Jump up ↑ Anti-Dühring, Friedrich Engels, 1878.

[98] Jump up ↑ See Annotation 108, p. 112.

[99] Jump up ↑ See Annotation 207, p. 202.

[100] Jump up ↑ Summary of Dialectics, Vladimir Ilyich Lenin, 1914.

[101] Jump up ↑ Anti-Dühring, Friedrich Engels, 1877.

[102] Jump up ↑ On the Questions of Dialectics, Vladimir Ilyich Lenin, 1915.

[103] Jump up ↑ On the Questions of Dialectics, Vladimir Ilyich Lenin, 1915.

[104] Jump up ↑ On the Questions of Dialectics, Vladimir Ilyich Lenin, 1915.

[105] Jump up ↑ On the Questions of Dialectics, Vladimir Ilyich Lenin, 1915.

[106] Jump up ↑ Conspectus of Hegel’s Science of Logic, Vladimir Ilyich Lenin, 1914.

[107] Jump up ↑ Conspectus of Hegel’s Science of Logic, Vladimir Ilyich Lenin, 1914.

[108] Jump up ↑ Karl Marx, Vladimir Ilyich Lenin, 1914.

[109] Jump up ↑ Anti-Dühring, Friedrich Engels, 1878.

[110] Jump up ↑ Theses On Feuerbach, Karl Marx, 1845.

[111] Jump up ↑ Materialism and Empirio-Criticism, Vladimir Ilyich Lenin, 1908.

[112] Jump up ↑ Conspectus of Hegel’s Science of Logic, Vladimir Ilyich Lenin, 1914.

[113] Jump up ↑ Materialism and Empirio-Criticism, Vladimir Ilyich Lenin, 1908.

[114] Jump up ↑ Once Again On The Trade Unions, Vladimir Ilyich Lenin, 1921.

[115] Jump up ↑ Revolutionary Ethics, Ho Chi Minh, December 1958.

[116] Jump up ↑ Note: Absolute Truth in dialectical materialist philosophy should not be confused with Hegel’s conception of Absolute Truth as a final point at which human consciousness will have achieved absolute, complete, and final understanding of our universe.

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@@ Line 1: / Line 1: @@
-{{clear}}
+'''CURRICULUM OF'''<br />
-[[Image:cover.jpg.png|center]]$$$
+'''THE BASIC PRINCIPLES OF MARXISM-LENINISM'''<br />
+'''PART 1'''
-= X =
+'''THE WORLDVIEW AND PHILOSOPHICAL METHODOLOGY OF MARXISM-LENINISM'''
-== X ==
+''For University and College Students''
-=== [Front Matter] ===
+''Not Specializing in Marxism-Leninism and Ho Chi Minh Thought''
-==== Table of Contents ====
+'''FIRST ENGLISH EDITION'''
-@@@[[#TopofLuhr9780307791900epuba|About the Author]]$$$
+Translated and Annotated by Luna Nguyen
-@@@[[#TopofLuhr9780307791900epuba1|Other Books by This Author]]$$$
+Foreword by Dr. Vijay Prashad
-@@@[[#TopofLuhr9780307791900epubt|Title Page]]$$$
+Introduction by Dr. Taimur Rahman
-@@@[[#TopofLuhr9780307791900epubc1|Copyright]]$$$
+Edited, Annotated, and Illustrated by Emerican Johnson
-@@@[[#TopofLuhr9780307791900epubd|Dedication]]$$$
+Proofread by David Peat
-@@@[[#TopofLuhr9780307791900epube|Epigraph]]$$$
+Additional Contributions and Editorial Support by Iskra Books
-@@@[[#TopofLuhr9780307791900epubt1|Contents]]$$$
+Published in association with ''The International Magazine''
-@@@[[#TopofLuhr9780307791900epuba2|Author’s Note]]$$$
+[[File:t-w-the-worldview-and-philosophical-methodology-of-2.png]]
-@@@[[#TopofLuhr9780307791900epubi|Introduction]]$$$
+=== License ===
-@@@[[#TopofLuhr9780307791900epubc2|Chapter One: What’s Wrong with the Patient?]]$$$
+This work is licensed under a<br />
+Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
-@@@[[#TopofLuhr9780307791900epubc3|Chapter Two: The Arrow of Harm]]$$$
+You are free to:
-@@@[[#TopofLuhr9780307791900epubc4|Chapter Three: The Culture and its Contradictions]]$$$
+'''Share''' — copy and redistribute the material in any medium or format
-@@@[[#TopofLuhr9780307791900epubc5|Chapter Four: The Psychiatric Scientist and the Psychoanalyst]]$$$
+'''Adapt''' — remix, transform, and build upon the material
-@@@[[#TopofLuhr9780307791900epubc6|Chapter Five: Where the Split Came From]]$$$
+The licensor cannot revoke these freedoms as long as you follow the license terms.
-@@@[[#TopofLuhr9780307791900epubc7|Chapter Six: The Crisis of Managed Care]]$$$
+Under the following terms:
-@@@[[#TopofLuhr9780307791900epubc8|Chapter Seven: Madness and Moral Responsibility]]$$$
+'''Attribution''' — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
-@@@[[#TopofLuhr9780307791900epubb|Technical Appendix]]$$$
+'''NonCommercial''' — You may not use the material for commercial purposes.
-@@@[[#TopofLuhr9780307791900epubn|Notes]]$$$
+'''ShareAlike''' — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
-@@@[[#TopofLuhr9780307791900epubb1|Bibliography]]$$$
+'''No additional restrictions''' — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
-@@@[[#TopofLuhr9780307791900epuba3|Acknowledgments]]$$$<div style="text-align:center;"></div>
+The full text of this license is available at: https://creativecommons.org/licenses/by-nc-sa/4.0/
-==== {{anchor|ACCLAIMFORTMLUHRMANNSOFT}} ACCLAIM FOR T. M. LUHRMANN’SOF TWO MINDS ====
+<br />
-===== “That rarest of achievements—a brilliant contribution to scholarship, an important document for policy, a compulsive read.” =====
+<blockquote>
+“Step by step, along the struggle, by studying Marxism-Leninism parallel with participation in practical activities, I gradually came upon the fact that only socialism and communism can liberate the oppressed nations and the working people throughout the world from slavery.”
-<div style="text-align:right;">—Howard Gardner, author of''The Disciplined Mind'' and ''Intelligence Reframed''</div>
+''- Ho Chi Minh''
+</blockquote>
-===== “Of Two Minds needs to be read by every psychiatrist, and every psychiatric resident, and by psychologists, social workers, nurses, and laypeople who possess an interest in psychiatry, because it is the single best account of what is happening to psychiatry. Beautifully written.… A triumph!” =====
+=== Support for This Work ===
-<div style="text-align:right;">—Arthur Kleinman, M.D., Professor of Anthropology and Psychiatry,Harvard University</div>
+Translating, annotating, and typesetting this book has taken three years, which would not have been possible without the support of our supporters on GoFundMe. GoFundMe is also the reason we are able to make the digital version of this entire text available for free online. We would therefore like to recognize all of our supporters:
-===== “An important book, shedding light on the world of psychotherapy as only a caring outsider would do.” =====
+{|
+| | ''Zach L.''
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+| | ''Hunter S.''
+| ''Caitlin B.''
+| ''Griffin M.''
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+| | ''Joseph Z. B.''
+| ''Aaron W.''
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+| ''Benjamin S.''
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+| ''Jonis F.''
+| ''Darsius'' ''ACAB''
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+| ''James H.''
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+|}
-<div style="text-align:right;">—Harold Kushner, author of''When Bad Things Happen to Good People''</div>
+There is still plenty of work to be done to complete the translation of this entire curriculum. If you would like to financially support our efforts, you can support us at:
-===== “Written with verve, Of Two Minds is a tour de force of careful, empathetic scholarship that deserves the widest of audiences.” =====
+BanyanHouse.org
-<div style="text-align:right;">—''Austin American-Statesman''</div>
+=== Dedication and Gratitude ===
-===== “A spirited, clear-eyed visit to the land of American psychiatry, where the insurance industry drones and the drug-cowboys of psychopharmacology are taking over. This terrific book urges us to preserve what truly heals: a shared journey of mutual, compassionate connection.” =====
+This book is dedicated to all the backers of the GoFundMe campaign that raised the funds to allow me to translate this text. What I initially believed would be a straightforward three-month process of translating ended up taking over three ''years'' of not just translation but also research, study, review, annotation, editing, proofreading, peer review, and more — with the incredible support of a full team of talented comrades — in order to make sure that everything would be digestible and intelligible for audiences outside of Vietnam. So, sincerely, thank you to everyone who backed this project for your patience, support, and encouragement.
-<div style="text-align:right;">—Samuel Shem, M.D., Ph.D., psychiatrist at Harvard Medical School,and author of ''The House of God'' and ''Mount Misery''</div>
+Thank you to my husband and comrade, Emerican Johnson, who helped me throughout the translation process, and who did such a fantastic job editing, annotating, and illustrating this text. He was my constant dialectical companion as we grappled together with the spirit and meaning of the writings of Marx, Lenin, and Engels that are the bedrock of this text.
-===== “One of the most important studies of society and mental health over the past three decades, Of Two Minds is destined to become a classic. It is must reading for everyone concerned with the study and treatment of personal distress.” =====
+Thank you, also, to Iskra Books for the absolutely vital work they have done in helping us to edit this book and hold it to a high standard. We literally could not have done it without you. In particular, thank you to Ben Stahnke for organizing and cheerleading us through to the end, and to David Peat, for the painstaking, meticulous, and no-doubt frustrating work of proofreading our very, very, very imperfect writing!
-<div style="text-align:right;">—Bertram J. Cohler, William Rainey Harper Professorof Social Sciences, University of Chicago</div>
+Thanks also to ''The International Magazine'', who have provided guidance and suggestions throughout the process of developing this translation. I have had the opportunity to work with ''The International Magazine'' on various projects and I can recommend no better monthly periodical for internationalist communists to learn about socialist movements around the world.
-===== “Scrupulously fair … Of Two Minds is the best book on mental illness and its treatment that I have read since The Powers of Psychiatry by Jonas Robitscher.… Issues of morality and responsibility—on the part of psychiatrists, of society and of the mentally ill themselves—permeate her discussion.” =====
+We owe a great deal of gratitude to Dr. Vijay Prashad and Dr. Taimur Rahman for taking the time to read through our translation and, in addition to providing their feedback and encouragement, also taking the time to write the foreword and introduction to the text. I know that you are both extremely busy with your own important literary, academic, and political work, so this assistance is so very much appreciated.
-<div style="text-align:right;">—Carol Tavris, ''The Times Literary Supplement''</div>
+Finally, I would like to thank the Vietnamese intellectuals and experts who have done such an amazing job at taking hundreds of texts and distilling them down into the original volume which I have translated here. The elegance and precision with which they have been able to capture the essence of Marxism-Leninism is a monumental contribution to the workers of the world, and I only hope my translation does their work justice.
-===== “Riveting.… Readers will turn the last page of this book feeling that they have been given a rich, generous, behind-the-scenes look at a profession that is intrinsically fascinating and that may affect them at some crucial point in their own lives.” =====
+March, 2023<br />
+Luna Nguyen
-<div style="text-align:right;">—''The Women’s Review of Books''</div>
+=== Foreword ===
-<div style="text-align:center;">{{anchor|TopofLuhr9780307791900epuba}} {{clear}}
+In December 1998, Fidel Castro addressed the Young Communist League’s 7<sup>th</sup> Congress in Havana, Cuba. The Soviet Union and the Communist state system in Eastern Europe had collapsed, which greatly weakened the cause of socialism. Not only was Cuba hit hard by the loss of its major trading partners and political ally, but socialists in general were penalised by the lethal argument made by the imperialist sections that “socialism had been defeated.” After 1991, Fidel revived the phrase “Battle of Ideas,” which was had been used in The German Ideology by Marx and Engels. To the Young Communists, Fidel said:
-[[Image:Luhr_9780307791900_epub_001_r1.jpg.png|center]]$$$</div>
-==== {{anchor|TMLUHRMANNOFTWOMINDS}} T. M. LUHRMANNOF TWO MINDS ====
+<blockquote>
+We must meet, in the heat of the battle, with the leading cadres to discuss, analyse, expand on, and draft plans and strategies to take up issues and elaborate ideas, as when an army’s general staff meets. We must use solid arguments to talk to members and non-members, to speak to those who may be confused or even to discuss and debate with those holding positions contrary to those of the Revolution or who are influenced by imperialist ideology in this great battle of ideas we have been waging for years now, precisely in order to carry out the heroic deed of resisting against the most politically, militarily, economically, technologically and culturally powerful empire that has ever existed. Young cadres must be well prepared for this task.
+</blockquote>
-T. M. Luhrmann is Professor in the Committee on Social Thought at the University of Chicago. She lives in Chicago.
+Bourgeois ideology had tried to sweep aside its most fundamental critique – namely Marxism – by saying that “socialism had been defeated” and that Marxism was now obsolete. Marxist criticisms of the “casino of capitalism” – as Fidel called it – were being set aside both inside and outside the academy, with neoliberal policy confident enough to ignore each and every criticism. Fidel argued that young communists must learn the fundamentals of Marxism – including both dialectical and historical materialism – and must learn this in a way that was not religious thinking but would allow them to become “new intellectuals” of the movement, not those who repeat dogma but who learn to understand the conjuncture and become “permanent persuaders” for socialism (the two phrases in quotations are from Gramsci’s prison notebooks). The general ideological confidence of the cadre was not clear, and that confidence and their clarity needed to be developed in a project that Fidel called the Battle of Ideas.
-==== {{anchor|TopofLuhr9780307791900epuba1}} {{anchor|ALSOBYTMLUHRMANN}} ALSO BY T. M. LUHRMANN ====
+During this period, communists around the world conceded that the demise of the Soviet Union had created a serious dilemma for the left. Not only were we penalised by the argument that “socialism has been defeated,” but our own arguments to explain the turbo-charged drive toward globalisation and neoliberalism and to make the case for a socialist alternative were not strong enough. One indication of that weakness was the 2001 World Social Forum meeting held in Brazil, which promoted the slogan – Another World is Possible, a weak slogan in comparison to a more precise slogan, such as – Socialism is Necessary. Young people drifted into our ranks in this decade, angered by the wretched social conditions created by the permanent austerity of neoliberalism, but bewildered about how to transform the political environment. The lack of Marxist political education was felt by socialist forces across the world, which is why many parties around the world began to revive a conversation about internal political education for cadre and active engagement with other social forces regarding the pressing issues of our time. Fidel called these two processes – internal education for the Party and external engagement on the dilemmas of humanity – the Battle of Ideas.
-<div style="text-align:center;">''Persuasions of the Witch’s Craft''</div>
+In line with this broad direction, the government of Vietnam worked with the national publishing house Sự Thật (The Truth) to develop a curriculum for universities and colleges in the country. They developed this order of study along five subject areas: Marxist-Leninist Philosophy, Marxist-Leninist Political Economy, Scientific Socialism, Vietnamese Communist Party History, and Ho Chi Minh Thought. This project worked to educate an entire population that would be able to understand the world in a rational and factual manner, outside the illusions of bourgeois ideology. Four years later, Communist Party of Vietnam adopted a resolution to take this work forward, and – under the leadership of Professor Nguyễn Viết Thông – produced this textbook that brought together the many themes of Marxism into focus for the introductory student and cadre. A book such as this is never easy to create, since it must introduce a form of thought that is critical of the foundations of bourgeois ideology – so it is a critique – but at the same time it provides a worldview to understand the actual world in which we live – so it is a science. The text must, therefore, show how bourgeois thought is partial and at the same time how socialist thought, creatively applied, will allow one to have a firmer grip of reality and be able to participate in fighting to transcend the obstinate facts of human indignity that are reproduced by capitalism. No manual such as this is without its flaws and without its limitations, but no education can start without a manual such as this one. The Vietnamese comrades have done a great service to the left movement by producing a text such as this, which can be used for study and then used as a model to develop similar texts in different parts of the world.
-<div style="text-align:center;">''The Good Parsi''</div>
+Ho Chi Minh, whose interpretation of Marxism and whose ideas about the Vietnamese Revolution, are all over this text once said: “Study and practice must always go together. Study without practice is useless. Practice without study leads to folly.” There can be no better injunction to get to work, to study and develop one’s theoretical armour and to use that theory as the guide to one’s work in the Battle of Ideas and in the battle for the streets, because this unity between theory and action is indeed praxis (thực tiễn), not just practice, but conscious human activity. That is what Fidel encouraged in his lectures on the Battle of Ideas.
-==== [Title Page] ====
+Dr. Vijay Prashad.<br />
+March 2023<br />
+Caracas, Venezuela.
-<div style="text-align:center;">{{anchor|TopofLuhr9780307791900epubt}} {{clear}}
+=== Preface to the First English Edition ===
-[[Image:Luhr_9780307791900_epub_tp_r1.jpg.png|none]]$$$</div>
-==== {{anchor|FIRSTVINTAGEBOOKSEDITIONAUG}} {{anchor|TopofLuhr9780307791900epubc1}} [Copyright] ====
+The text of this book constitutes part one of a four-part curriculum on Marxism-Leninism developed and published by the Ministry of Education and Training of Vietnam. This curriculum is intended for students who are not specializing in the study of Marxism-Leninism, and is intended to give every Vietnamese student a firm grounding in the political philosophy of scientific socialism.
-<div style="text-align:center;">FIRST VINTAGE BOOKS EDITION, AUGUST 2001</div>
+The entire curriculum consists of:
-<div style="text-align:center;">''Copyright © 2000 by T. M. Luhrmann''</div>
+Part 1: Dialectical Materialism (this text)
-<div style="text-align:center;">All rights reserved under International and Pan-American Copyright Conventions. Published in the United States by Vintage Books, a division of Random House, Inc., New York, and simultaneously in Canada by Random House of Canada Limited, Toronto. Originally published in hardcover in the United States by Alfred A. Knopf, a division of Random House, Inc., New York, in 2000.</div>
+Part 2: Historical Materialism
-<div style="text-align:center;">Vintage and colophon are registered trademarks of Random House, Inc.</div>
+Part 3: Political Economy
-<div style="text-align:center;">The Library of Congress has cataloged the Knopf edition as follows:Luhrmann, T. M. (Tanya M.), [date]Of two minds : the growing disorder in American psychiatry / T. M. Luhrmann.p. cm.eISBN: 978-0-307-79190-0Psychiatry—Study and teaching. 2. Psychiatry. I. Title.RC336.L78 2000616.89’0071’173—dc2199-40732</div>
+Part 4: Scientific Socialism
-<div style="text-align:center;">''Author photograph by Elena Siebert''</div>
+In Vietnam, each part of the curriculum encompasses one full semester of mandatory study for all college students. Each part builds upon the previous, meaning that this text is the foundation for all political theory education for most college students in Vietnam.
-<div style="text-align:center;">[http://www.vintagebooks.com www.vintagebooks.com]</div>
+However, it is important to note that this is not the first encounter with dialectical materialism which Vietnamese students wil have had with these ideas, because Vietnamese students also study dialectical materialism, historical materialism, political economy, and scientific socialism from primary school all the way through high school.
-<div style="text-align:center;">v3.1</div>
+As such, the text of this book — in and of itself — would probably seem overwhelmingly condensed to most foreign readers who are new to studying dialectical materialism. Therefore, we have decided to extensively annotate and illustrate this text with the information which would have been previously obtained in a basic Vietnamese high school education and/or provided by college lecturers in the classroom.
-==== [Dedication] ====
+It is our desire that these annotations will be helpful for students who hope to learn these principles for application in political activity, but we should also make it clear to academic researchers and the like that our annotations and illustrations are ''not'' present in the original Vietnamese work.
-<div style="text-align:center;">{{anchor|Formyfather}} {{anchor|TopofLuhr9780307791900epubd}} ''For my father''</div>
+We hope that this book will be useful in at least three ways:
-==== {{anchor|IwouldliketothankmywifeS}} {{anchor|TopofLuhr9780307791900epube}} [Epigraphs] ====
+* As a comprehensive introductory textbook on dialectical materialism and for selfstudy, group study, classroom use, cadre training, etc.
+* As a quick and easy to reference handbook for reviewing the basic concepts of dialectical materialism for students of theory who are already familiar with dialectical materialism.
+* As a companion book for further reading of theory and political texts rooted in dialectical materialist philosophy.
-I would like to thank my wife, Sally.… Along those lines—Thanks respectively to Wyeth/Ayerst Laboratories and Stuart Pharmaceuticals for further expanding that narrow channel of joy by manufacturing Effexor and Elavil; drugs so good they feel illegal.
+Also, please note: because this book is intended to be used as a quick reference and handbook for further study, there are many instances where we duplicate references, quotations, and other such information. We hope that this repetition may be an aid for study by reinforcing important concepts and quotations.
-<div style="text-align:right;">—Thom Jones, ''Cold Snap''</div>
+This book — Part 1 of the curriculum, which focuses on the universal philosophical system of dialectical materialism — serves as the foundation of all political theory and practice in the Vietnamese educational system as well as in the Communist Party of Vietnam and other organizations such as the Ho Chi Minh Communist Youth Union, the Women’s Union, the Farmer’s Union, the Worker’s Union, etc. Dialectical materialism is the framework for theory and practice as well as the common lens through which Vietnamese socialists relate, communicate, and work together.
-Trying to understand experiences that are at once personal and cultural calls for a kind of passionate detachment that is, I think, almost impossible to sustain alone. Susan Robertson, my psychotherapist, has been a constant source of emotional support and thoughtful analysis.
+This book focuses almost exclusively on the written works of three historical figures:
-<div style="text-align:right;">—Kathryn Dudley, ''The End of the Line''</div>
+''Karl Marx'' and ''Friedrich Engels''... who initially developed the universal philosophy of dialectical materialism by synthesizing various pre-existing philosophical, political, economic, and historical tendencies including the idealist dialectical system of Georg Wilhelm Friedrich Hegel, the political economics of Adam Smith and David Ricardo, the materialist positions of Ludwig Feuerbach, and countless others.
-<div style="text-align:center;">{{anchor|TopofLuhr9780307791900epubt1}} {{anchor|toc}} {{clear}}
+''...and Vladimir Illyich Lenin'', who further developed and defended dialectical materialism, expanded the analysis of imperialism, demonstrated how to apply dialectical materialism to local material conditions specific to Russia at the turn of the 20<sup>th</sup> century, and made many other important contributions to dialectical materialist theory and practice.
-[[Image:Luhr_9780307791900_epub_L02_r1.jpg.png|center]]$$$</div>
-==== CONTENTS ====
+Obviously, there are countless other writers, revolutionaries, philosophers, and scientists who have contributed to dialectical materialism and scientific socialism. This book focuses primarily on Marx, Engels, and Lenin, because these figures laid the foundations and formulated the basic principles of the philosophy of dialectical materialism and the methodology of materialist dialectics which are most universally applicable in all endeavors.
-<div style="color:#0000ff;"><u>''Cover''</u></div>
+It is our desire that translating this important work into English will lead to further study, understanding, and appreciation of dialectical materialism as an applied philosophy which socialists can find value in returning to periodically. At the end of the book, we offer a glossary of terms which doubles as an index, appendices with summaries of important concepts and principles, and an afterword, in which we offer advice for further study and application of dialectical materialism.
-<div style="color:#0000ff;">@@@[[#TopofLuhr9780307791900epuba|About the Author]]$$$</div>
+At the time of publication, we are already in the process of translating and annotating Part 2 of this curriculum, which focuses on historical materialism, with the hopes of eventually releasing the full curriculum. Once it is complete, it will also be made available at ''BanyanHouse.org'' — where we also invite questions, constructive feedback, and suggestions.
-<div style="color:#0000ff;">@@@[[#TopofLuhr9780307791900epuba1|Other Books by This Author]]$$$</div>
+=== Introduction ===
-<div style="color:#0000ff;">@@@[[#TopofLuhr9780307791900epubt|Title Page]]$$$</div>
+Just a generation ago, Vietnam was the site of the most brutal war of the 20<sup>th</sup> century. More tonnage of bombs were dropped on the Vietnamese people than were dropped by all sides combined throughout the Second World War. In addition, countless acts of cruelty were used to scorch the very soil of the nation. By the end of Vietnam’s Resistance War Against Imperialist USA (known to the world as “the Vietnam War”), Agent Orange, napalm, and unexploded munitions had left a land deeply scarred and a people traumatised by decades of death and murder. The impression one had was that although Vietnam had won the war, it was so badly devastated that it could not hope to win the peace. But, miraculously, Vietnam is winning this war today, as the Vietnamese economy has become one of the fastest growing in the world and quality of life for the people is improving at a pace which could scarcely have been predicted in 1975.
-<div style="color:#0000ff;">@@@[[#TopofLuhr9780307791900epubc1|Copyright]]$$$</div>
+No one could have imagined that Vietnam would turn around so dynamically and rapidly. How did they achieve this economic miracle? How could this nation — so recently devastated by imperialism and war — possibly be able to reconstruct, revive, rejuvenate, and rebuild? That story is now unfolding before our eyes.
-<div style="color:#0000ff;">@@@[[#TopofLuhr9780307791900epubd|Dedication]]$$$</div>
+Vietnam’s development has not come without hardship, struggle, setbacks, and mistakes. The people of Vietnam have had to learn hard lessons through struggle and practice to develop and strengthen ideological and theoretical positions. In this manner, the philosophical development of Vietnam deserves study and attention from socialists around the world. To outsiders, Vietnam can appear to be rife with contradictions. As depicted by Western journalists, Vietnam is simultaneously a success story driven by capitalist markets and a failing socialist state. Every victory is chalked up to private enterprise, while every setback is attributed to socialism. In this sense, the media has failed to understand the essential character of the core contradictions which drive the development of Vietnam politically, socially, and economically.
-<div style="color:#0000ff;">@@@[[#TopofLuhr9780307791900epube|Epigraph]]$$$</div>
+Luna Nguyen has used social media and played an incredibly important role in helping the English speaking world understand the complexities of such contradictions that beguile so many academics and experts. She has helped to give an insider’s perspective on her own country’s path of development towards socialism.
-<div style="color:#0000ff;">@@@[[#TopofLuhr9780307791900epuba2|Author’s Note]]$$$</div>
+Nguyen’s translation of Part 1 of this influential work, ''Introduction to the Basic Principles of Marxism-Leninism'', a textbook studied by university and college students across Vietnam, is yet another big step in the direction of making Vietnam’s understanding of their own country’s development available to the English reading world.
-<div style="color:#0000ff;">@@@[[#TopofLuhr9780307791900epubi|Introduction]]$$$</div>
+For me, as an outsider, it is fascinating not only to see how deeply Vietnamese society takes an interest in European philosophical development (referencing Hume, Hegel, Descartes, Marx, Engels, and so many other Europeans, almost as if they are figures seated in some ancient monastery in Fansipan), but, even more importantly, how they have assimilated that knowledge into the wider context of their own history, society, and culture. The textbook truly comes alive in all the parts where these ideas are shown to be relevant to Vietnam itself. For instance, the textbook stands out with discussions of Ho Chi Minh’s concept of “proletarian piety,” which artfully blends elements of Vietnamese culture with Marxist concepts of class consciousness, or the story of Chi Pheo, who stands as a sympathetic stand-in for the interpretation of the unique characteristics of the Vietnamese Lumpenproletariat. The book itself is an instance of the dialectic of the universal and the particular, the abstract and the concrete.
-<div style="color:#0000ff;">@@@[[#TopofLuhr9780307791900epubc2|CHAPTER ONE:]]$$$@@@[[#TopofLuhr9780307791900epubc2| What’s Wrong with the Patient?]]$$$</div>
+Just as importantly, it shows that, in Vietnam, Marxism-Leninism and Ho Chi Minh Thought are not mere perfunctory rituals that are repeated like a learnt formula for this or that exam; but that although the Vietnamese political economy in its current form certainly contains contradictions which must be negated in the process of building the lower stage of socialism, the government remains seriously committed to the goals, theory, and practice of Marxism-Leninism and Ho Chi Minh Thought.
-<div style="color:#0000ff;">@@@[[#TopofLuhr9780307791900epubc3|CHAPTER TWO:]]$$$@@@[[#TopofLuhr9780307791900epubc3| The Arrow of Harm]]$$$</div>
+Hence, I highly recommend this book, not merely because it is a well-illustrated and easy-to-read book on the principles of dialectical materialism, but more importantly because it offers an insight into how the Vietnamese government collects and synthesises the philosophical developments that are, on the one hand, the collective legacy of all of humanity, and, on the other hand, the concrete manifestations of a revolutionary theory of (and for the oppressed yearning for) freedom in every corner of the world.
-<div style="color:#0000ff;">@@@[[#TopofLuhr9780307791900epubc4|CHAPTER THREE:]]$$$@@@[[#TopofLuhr9780307791900epubc4| The Culture and Its Contradictions]]$$$</div>
+March, 2023
-<div style="color:#0000ff;">@@@[[#TopofLuhr9780307791900epubc5|CHAPTER FOUR:]]$$$@@@[[#TopofLuhr9780307791900epubc5| The Psychiatric Scientist and the Psychoanalyst]]$$$</div>
+Dr. Taimur Rahman<br />
-<div style="color:#0000ff;">@@@[[#TopofLuhr9780307791900epubc6|CHAPTER FIVE:]]$$$@@@[[#TopofLuhr9780307791900epubc6| Where the Split Came From]]$$$</div>
+=== Editor’s Note ===
-<div style="color:#0000ff;">@@@[[#TopofLuhr9780307791900epubc7|CHAPTER SIX:]]$$$@@@[[#TopofLuhr9780307791900epubc7| The Crisis of Managed Care]]$$$</div>
+Working on this project has been one of the most illuminating experiences of my life. In translating this work, Luna has opened a door for English speakers into the wide world of Vietnamese scholarship and pedagogy as it relates to socialist theory and philosophy.
-<div style="color:#0000ff;">@@@[[#TopofLuhr9780307791900epubc8|CHAPTER SEVEN:]]$$$@@@[[#TopofLuhr9780307791900epubc8| Madness and Moral Responsibility]]$$$</div>
+Luna and I have done our best to capture the original meaning and spirit of the text. Furthermore, as we have mentioned elsewhere, our annotations and illustrations are intended only to contextualize and expand on the core information of the original text similarly to the class/lecture setting for which the curriculum is intended.
-<div style="color:#0000ff;">@@@[[#TopofLuhr9780307791900epubb|Technical Appendix]]$$$</div>
+In their lives, Karl Marx and Friedrich Engels were never able to finish clarifying and systematically describing the philosophy of dialectical materialism which their work was built upon. Engels attempted to structurally define the philosophy in Dialectics of Nature, but unfortunately that work was never completed since he decided to prioritize publishing the unfinished works of Marx after his untimely death.
-<div style="color:#0000ff;">@@@[[#TopofLuhr9780307791900epubn|Notes]]$$$</div>
+I believe that this text is a great step forward in that work of systematically describing the philosophical system of dialectical materialism and the methodological system of materialist dialectics. I also believe it’s worth noting how the Vietnamese scholars who crafted this curriculum have embedded the urgent necessity of action — of creative application of these ideas — throughout the text in a way that I find refreshing and reflective of the works of Marx and Engels themselves.
-<div style="color:#0000ff;">@@@[[#TopofLuhr9780307791900epubb1|Bibliography]]$$$</div>
+As the text will explain, dialectical materialism is a universal system of philosophy which can be utilized to grapple with any and every conceivable problem which we humans might encounter in this universe. In Vietnam, dialectical materialism has been used to delve into matters of art, ethics, military science, and countless other fields of inquiry and endeavor. It is my hope that this book will, likewise, lead to a wider and fuller understanding and (more importantly) application of dialectical materialism in the Western world.
-<div style="color:#0000ff;">@@@[[#TopofLuhr9780307791900epuba3|Acknowledgments]]$$$</div>
+March, 2023
-<div style="text-align:center;">{{anchor|atn}} {{anchor|TopofLuhr9780307791900epuba2}} {{clear}}
+Emerican Johnson
-[[Image:Image2.png|center]]$$$</div>
-==== AUTHOR’S NOTE ====
+=== A Message From ''The International Magazine'' ===
-This ethnographic material has been taken from hundreds of hours of tape recording, note taking, and more casual conversation. In the interest of anonymity, the names of people interviewed have been changed (except for some whose work, by its visible nature, removes their anonymity). In the interests of coherence, some quotations have been edited for flow, although content has been preserved. And in the interests of both narration and anonymity, some individuals, while loosely based on real people, are intended to be composite figures, and some quotations by other people have been attributed to them. The story of “Gertrude,” for example, is a composite of events in the lives of three different women. All the events, it should be said, happened in the manner described, and all the details and quotations are accurate within the limits of anthropological note taking, although identifying details have been omitted or changed. Some quotations are based on taped conversations. Others are based on field notes taken after the encounter and often recorded in the third person.
+''The International Magazine'' began in 2020 to connect international socialist movements and to strengthen the voice of oppressed people across the globe. We have been following the work of Vietnamese communists in their unique path towards peace, prosperity, and the construction of socialist values with a keen eye and much interest. It is with this spirit of international solidarity and a deep desire to learn from and share wisdom from our comrades around the world that we celebrate the release of this First English Edition of The Worldview and Philosophical Methodology of Marxism-Leninism Part 1: The Worldview and Philosophical Methodology of Marxism-Leninism.
-<div style="text-align:center;">{{anchor|TopofLuhr9780307791900epubi}} {{anchor|itr}} [[Image:Image3.png|top]]$$$</div>
+Ho Chi Minh once said: “In order to build socialism, first and foremost, we need to have socialist people who understand socialist ideology and have socialist values.”
-== INTRODUCTION ==
+To this end, Vietnamese communists have expended tremendous resources building a curriculum on Marxist-Leninist philosophy and analysis which includes dialectical materialism, materialist dialectics, scientific socialism, historical materialism, and political economy. These topics are taught in primary and secondary schools and are mandatory subjects for all students attending public universities in Vietnam. Beyond that, Vietnam offers free degrees to students who wish to study Marxist theory and philosophy and Ho Chi Minh Thought (defined as the application of Marxist philosophy to the unique material conditions of Vietnam). In this manner, Vietnam has demonstrated a steadfast commitment to developing “socialist people” “with socialist values.”
-In the autumn of 1989, I arrived as a new assistant professor in an anthropology department known for its long tradition of psychological anthropology. I was already an experienced ethnographer, with a book on modern witchcraft behind me and another on Zoroastrianism under way. But I was a relative newcomer to psychological anthropology, at least in its American form (I had done my training in England), and my colleagues suggested that it might be helpful for me to attend the lectures to the new psychiatrists in training.
+We are, therefore, extremely excited to have worked with Luna Nguyen on the translation and annotation of Part 1 of the Vietnamese university curriculum on the worldview and philosophical methodology of Marxism-Leninism into English, which will make this unique perspective of socialist theory available to comrades around the world for the first time.
-American psychological anthropology grew out of a tradition of using psychoanalytic ideas to make sense of cultural practices. (My background was more cognitive.) Margaret Mead was one of its founding mothers. She used a loosely Freudian understanding of childhood experience in different societies to explain their adult behavior. So for years, graduate students in my department had been sent to learn a clinical perspective on Freud and psychoanalysis from the lectures given to young psychiatrists. As it happened, they had long been complaining that the lectures had nothing to do with anthropology, but I didn’t know that at the time. I just showed up, with a mixture of excitement and trepidation, in a year when no graduate students came along.
+After having read through this volume, which outlines the fundamentals of dialectical materialism and materialist dialectics, we find the most important lesson to be the relationship between theory and practice. According to the Vietnamese scholars who authored the original text, Marxist-Leninist philosophy must be considered a living, breathing philosophy which requires application in the real world — through practice — in order to be made fully manifest.
-I told myself that the lectures would not be entirely unfamiliar territory: my father is a psychiatrist, and I myself had seriously considered becoming one, settling on anthropology because I saw myself more as a writer of books than as a healer of patients. As one of my colleagues points out, this makes me a “halfie” anthropologist, someone who grew up half in the world she writes about professionally, like an anthropologist with an Egyptian father who goes off to live with the Bedouin. There are a number of halfie anthropologists these days. Being one gives you a little edge, because you grew up speaking the language of the world you later describe.
+We hope that readers of this volume will carry forward this guidance through practice which suits your material conditions, wherever you are in the world.
-So when I began to go to the Thursday-morning classes for the new psychiatrists in training, I was not thinking of writing an ethnography. I wanted to learn about psychosis and depression, how psychoanalysis works, and whether the psychiatric illnesses I saw in San Diego would look the same in Tibet and Borneo, places where virtually no one had heard of Freud. For six months I went to two classes every Thursday morning, fascinated by this complicated, contradictory, confusing world. Then one of the young psychiatrists turned around one morning and asked, “Why don’t you write about us? Isn’t that what anthropologists do?”
+If you would like to learn the perspective of socialists from other nations around the world, we invite you to visit our website at InternationalMagz.com — the home of ''The International Magazine'' online. There, you will find articles written by comrades from a wide variety of backgrounds and nationalities with a clear bias towards anti-capitalism, anti-fascism, and anti-imperialism!
-He was, of course, right. (He was also somewhat alarmed that I took him seriously.) I had found the process of psychiatric training—at least, what I could see of it then—disturbing and perplexing but also deeply intriguing. I knew I was beginning to see people in a different way, to search for the marks of darker moods in the way they held themselves and glanced and gestured. In part that was because I was literally beginning to see different people. In the everyday world, you don’t see the patients who end up in psychiatric inpatient units, or at least you don’t see them sick. The odds are that in a lecture hall of a hundred students, several have something seriously amiss psychiatrically, but I rarely saw it; nonpsychiatrists rarely do. When people were a little too impulsive, a little too sad, a little too thin, it was easy to read them as having a bad week. They were still normal, still like “us.” (There was, of course, the student who took exception to Émile Durkheim and on the morning of the final exam presented me with the charred remains of ''The Elementary Forms of the Religious Life''. She was unusual.)
+In solidarity,
-In these psychiatry classes, I saw a man brought in for treatment because he had been found in his kitchen, holding his wife’s bloody heart in his hands, a carving knife beside him on the floor. I remember a woman, a graduate student in comparative literature at one of the best schools in the country, with long, golden ''Baywatch'' hair. But she hunched over with her hair across her face and her misery was so palpable that my throat choked up as if I would cry. I remember a man so anxious that I wanted to jump from my chair and run, but the room was full of watching students and the man’s eyes scanned us forward and back. Nobody dared to move. I began to be afraid of the highway, because two patients said they had thought of committing suicide by shutting their eyes at seventy miles per hour. A little later I met an undergraduate who was sophisticated, chic, articulate, slender—when I had been an undergraduate, I had yearned to be someone like that, an Audrey Hepburn from Central Park West—and she was checking into the hospital because she was anorexic and her mother was divorcing her father and sending her money from Europe but not answering the phone.
+The Editorial Team of ''The International Magazine''
-After a few months, it was impossible to doubt that there was a “there” there of psychiatric illness. Grand sociological theories that claimed that psychiatry punished those who were merely eccentric and unconventional seemed absurd to me. I began to see in students, friends, and supermarket baggers little flickers of the craziness I saw in case conferences. Then I began to worry that I was seeing more than was there. I became fascinated by what psychiatrists saw, how they knew what they knew, whether they were right, and what that even meant.
+=== Notes on Translation ===
-Psychiatry is unquenchably compelling because it forever changes the way you understand human experience. It lets you into the back bedroom of conventional behavior, so that you glimpse behind the polite interfaces of everyday life the true weirdness of human feeling. It shows you despair harsher than you had imagined and exhilarating, terrifying ecstasy and strange irrationality. Most of us are charitable interpreters of other people’s behavior, to use the philosopher Donald Davidson’s phrase. We assume that other people are just like us—normal—until it becomes apparent that they are not. Psychiatry forces upon you, more abruptly and with an in-your-face confrontation, the lessons anthropology is meant to teach: that the landscape of human thought and feeling is more gaunt and jagged but also more breathtaking than most of us, Horatio-like, have dreamed of in our little local worlds. I thought that if I could describe the way I was learning to see, which is the way psychiatrists are taught how to see, I would be doing what every anthropologist is supposed to do, but by traveling into the familiar, not away to the exotic.
+Vietnamese is a very different language from English, which has presented many challenges in translating this book. Whenever possible, I have tried to let the “spirit” of the language guide me, without altering the structure, tone, and formatting of the book.
-But psychiatrists do not see in one single manner. The Thursday-morning lectures were remarkably diverse. Some mornings, men would come in wearing white medical coats. They would talk about neurotransmitters and catecholamines and draw diagrams of biochemical interactions on the board. They spoke a language I hadn’t heard since high school science. Other mornings, men (almost always men) would arrive in tweed jackets, wearing spectacles. They would sit, hands folded, and talk with us about loss, mourning, and the nadir point in psychotherapy. They spoke as if life happened inside the mind. There was someone who drew graphs that explained when schizophrenics were born (he thought the Christmas drinking season might be partly to blame), someone else who practiced therapy but didn’t believe in the unconscious, and yet another who carefully wrote Erik Erikson’s life stages on the board and then never discussed them. I heard lectures on alcohol, combat, sexual abuse, sleep disorders, epilepsy, and the whole range of psychopharmacological treatments. Behind all this, behind the advice, the biochemical diagrams, and the commentary about psychotherapeutic transference, lay at least two profoundly different notions of what it is to be a person: to feel, to choose, to do good, to have meaning. No one mentioned those deep issues explicitly. They talked about what you should do with a particular patient. But surrounding the practice issues around, say, a late-night suicidal phone call were some of our oldest philosophical dilemmas.
+One thing you will likely notice right away: this book is highly condensed! This is because most Vietnamese students are already familiar with these concepts. We have added annotations to try to make the book more digestible for those of you who are new to Marxism-Leninism, and these annotations are explained on the next page.
-Why do we suffer? In the dramas of classical antiquity, we watch great individuals suffer, and we feel pity and terror for them because in the inexorable doom of the unfolding story, we see that they are caught up in circumstances they have not chosen but in which they have made choices that will destroy them. Antigone does not choose the conflict between blood rights and state rights: her greatness is that she sees but does not flinch from the moral need to bury her brother, despite her king’s command that she must not. Being the person she is, she chooses to honor family over king, and so she dies whereas another person might have lived. The flaws in her character are also the unwavering commitments that make her great. Today we use the word “tragedy” in a more pedestrian sense, to refer to personal circumstances over which we genuinely have no control: an aircraft exploding in midflight, a flood wiping out a summer’s crops, a senseless, arbitrary murder. I say pedestrian, but life is really made up of small circumstances that hem us in so tightly that we can scarcely move. To understand that these circumstances are more important than the choices we make within them is to see a very different staging of human experience. That difference is the major tension in the way psychiatrists are taught to look at the world.
+I have worked hard to try to make the language in this book consistent with the language used in popular translations of works from Marx, Lenin, etc., that would be familiar to English-language students of Marxism-Leninism. That said, different translators have been translating these texts into English for over a century, such that different word choices have been used to relate the same concepts, and even Marx, Engels, and Lenin used different terms to describe the same concepts in many instances (not to mention the fact that Marx and Engels wrote primarily in German, whereas Lenin wrote primarily in Russian).
-Psychiatrists have inherited the Cartesian dualism that is so marked a feature of our spiritual and moral landscape. Sometimes they talk about mental anguish as if it were cardiac disease: you treat it with medication, rest, and advice about the right way to eat and live. A person who has had a heart attack will never be the same—he will be always a person who has been very seriously ill—but he is not his heart attack. His heart attack is in the body, not the mind. When psychiatrists talk in this manner, psychosis and depression become likewise written on the body. This style of speaking has gained preeminence in the last two decades. It is usually called “biomedical” psychiatry, an approach to mental illness that treats it as an illness of the body that is more or less comparable to other physical illnesses. Sometimes, though, psychiatrists talk about distress as something much more complicated, something that involves the kind of person you are: your intentions, your loves and hates, your messy, complicated past. This style is associated with psychoanalysis and psychoanalytic psychotherapy, usually called “psychodynamic,” which dominated psychiatry in the middle decades of this century and which remains the fountainhead of all psychotherapies. From this vantage point, mental illness is in your mind and in your emotional reactions to other people. It is your “you.”
+As such, I have made it my first priority to keep the language of this translation internally consistent to avoid confusion and, again, to match the spirit of the original text as much as possible. As a result, you may find differences between the translation choices made in this text and other translations, but it is my hope that the underlying meaning of each translation is properly conveyed.
-Of course, this is a false dichotomy, as most psychiatrists would agree. But it is the way that psychiatrists are taught. It seemed clear to me that there were, broadly speaking, two main areas of skill that psychiatrists in training are expected to acquire: on the one hand, diagnosis and psychopharmacology, which are usually the dominant focus of inpatient psychiatry, and, on the other, psychodynamic psychotherapy, which tends to be taught as an outpatient specialization distinct from the skills of hospital psychiatry. The psychiatrists and the staff I spent time with spoke comfortably about the differences between psychotherapy and biomedical psychiatry. They argued about psychiatry in ways that took the dichotomy for granted. Their training schedule (at least two lectures a week, usually one on psychopharmacology and diagnosis, another on psychotherapy) clearly indicated that their seniors thought that those were the two major and different areas of skill. They learned two different ways to identify, understand, and respond to mental anguish. Young psychiatrists are supposed to learn to be equally good at both talk therapy and drug therapy, psychotherapy and biomedical psychiatry, and the American Psychiatric Association thinks that this integration is what training programs in psychiatry teach. Psychiatrists are supposed to understand these approaches as different tools in a common toolbox. Yet they are taught as different tools, based on different models, and used for different purposes. Some psychiatrists do integrate them to some extent. But those who do have to integrate two approaches that are different from the outset that carry with them different models of the person, different models of causation, and different expectations of how a person might change over time.
+March, 2023
-The actual practice of psychiatry is, of course, greatly complex. Psychoanalysts, although they dominated psychiatry for many years, never had an exclusive hold on psychotherapy inside or outside the psychiatric profession: milieu therapy, group therapy, cognitive behavioral therapy, interpersonal therapies—talk therapies are as various as the country is wide. Nor are biomedical psychiatrists a single kind of doctor. Different psychopharmacologists have very different styles, and the gap between a clinician’s view of an illness and the view of a laboratory-based psychiatric scientist can be a ravine. There are psychiatric specialties in community psychiatry, geriatric psychiatry, cultural psychiatry, the psychiatry of substance abuse, and many others that are not primarily oriented toward psychotherapy but certainly could not be classified as “biological.” Nevertheless, the psychiatry of the last half century has been formed around the psychoanalytic rise to power and the new psychiatric science, followed by the health care revolution, which has brought psychoanalytic dominance to its knees.
+Luna Nguyen
-These two approaches now exist in uneasy alliance with each other. They are a kind of contradiction to each other because their models of how suffering works are so opposed. Young psychiatrists are socialized into this contradiction, so that they learn to believe and to say that these different models should be integrated in the practice of psychiatry. But no one really knows where truth lies, although periodically brilliant new syntheses are published in the leading journals. As an anthropologist, I was interested not in answering the question of which approach was more correct but in understanding how the approaches worked as “culture” for the psychiatrists and thus for their patients. I wanted to know the way these different approaches changed the way the psychiatrist perceived, felt, thought, the way he became excited and challenged, the way he became bored. After all, these two approaches, the psychodynamic and the biomedical, have their roots in the more fundamental Western division between mind and body that our society, for all its sophisticated caveats, still endorses. We still think of the body as something unintentional, something given, something for which any individual is not responsible. That is why we are so interested in metabolic set points, inborn temperaments, learning disabilities, and the genetic roots of attention deficit disorder. If something is in the body, an individual cannot be blamed; the body is always morally innocent. If something is in the mind, however, it can be controlled and mastered, and a person who fails to do so is morally at fault. If someone is fat because he gives in to craving, we can laugh at him, we think; certainly for years, during the height of the fat-conscious decades, those who were fat were perceived by many, not least themselves, as morally weak. But if someone is fat because his metabolism is unalterably askew, we must admire his courage. If a child gets poor grades because of a learning disability, she should not be punished for not studying but should be given special help, the way we help those with other special physical needs. If I am lazy because I was born that way, I don’t need to be guilty and embarrassed by the slope of my career. Biology is the great moral loophole of our age. This is not to say that I think this to be entirely inappropriate. As a good American, I believe that it is wrong to hold people responsible for something they cannot control. Nevertheless, a moral vision that treats the body as choiceless and nonresponsible and the mind as choice-making and responsible has significant consequences for a view of mental illness precariously perched between the two.
+=== Guide to Annotations ===
-Understanding the way a set of ideas and practices can change a person is what anthropologists are trained to do, and as an anthropologist, I was better positioned to observe these changes than a member of the tribe. I went through much of the formal learning process. But I didn’t need to commit myself professionally as a member of the field. My professional job was to watch myself learning, to watch others learning, to sketch out a kind of anatomy of the way learning took place, and to understand what was learned that was not necessarily intentionally taught. My job was to understand how a nonpsychiatrist (an ex–medical student) can enter the culture of psychiatry and become a fluent speaker of the local tongue. This informal learning is manifestly not the kind of thing that people talk about in interviews, because it happens so accidentally and changes you so incrementally that people often do not even notice that they have become profoundly different. Like the rest of medicine, psychiatry is a craft. It involves a kind of hands-on knowledge that is as much doing as knowing, something that invokes the philosopher’s distinction between “knowing that” and “knowing how” (this is also known as declarative and procedural knowledge). A young psychiatrist—skilled, competent, articulate—learns to ''do'' psychiatry, not so much to describe what she does. She learns her psychiatry the way a young violinist learns to play the violin: to listen for the notes of a scale, to hear pitch and know when a string is in tune, to feel pride in the calluses that develop on the tips of the fingering hand, to know how to hold a bow by the feel of its weight. For someone who is good at her task, those ways of perceiving settle in so deeply that they become the way the person moves, hears, and observes when at that task. To understand what psychoanalysts and psychopharmacologists see, you must follow what young psychiatrists are taught and how they learn it. You must understand what they begin to do naturally as they carry out their tasks. You must understand how they come to think, how they feel, to what they aspire, and from what they flinch. You must understand how they handle their own anxiety about being any good at their profession. You cannot understand this just by asking people about it, any more than you can learn to canoe in an armchair with a reading lamp.
+This book was written as a textbook for Vietnamese students who are not specializing in Marxism-Leninism, and so it is meant to be a simple and condensed survey of the most fundamental principles of dialectical materialism to be used in a classroom environment with the guide of an experienced lecturer. That said, a typical Vietnamese college student will already have been exposed to many of the concepts presented herein throughout twelve years of primary and secondary education. As such, in translating and preparing this book for a foreign audience who are likely to be reading it without the benefit of a lecturer’s in-person instruction, we realized that we would need to add a significant amount of annotations to the text.
-Since 1989, I have done more than four years of fieldwork, including more than sixteen months of full-time, intensive immersion. (I should say that I did all the work within the constraints of the willingness of the participants. Patients were always asked if they were comfortable having me sit in on a clinical interview, and if they declined, as they sometimes did, I left; I also left when psychiatrists were not comfortable with my presence.) The work began in a local hospital, where I attended lectures, hung out with residents (residency is the three-year specialty training in psychiatry after medical school and a one-year internship), and participated in medical meetings. I also spent four months at an elite private psychiatric hospital; three months in a community service hospital; and stretches of a week or two each in a psychoanalytic hospital, a scientific research unit, a state hospital, and a nonacademic community hospital’s psychiatric unit. I traveled around the country (to Kansas, Louisiana, New York, Massachusetts, California) speaking with hospital administrators, psychiatry residency program directors, and young psychiatrists. I watched hundreds of lectures to residents through three years of training; I attended well over a hundred rounds or team meetings in which patients are presented and sometimes interviewed with the aim of establishing a diagnosis and treatment plan; I have “shadowed” residents during the day on the inpatient unit and during on-call evenings, and I have spent substantial periods of time on psychodynamic, eclectic, and biological units; I have watched countless admissions interviews; I have interviewed most residents in every class at one program annually for three years and many others elsewhere; I have followed eight individual patients for psychotherapy under the supervision of a senior psychoanalyst, one once a week and three twice a week for more than a year; I was in twice-a-week psychotherapy with a senior psychoanalyst for more than three years; I jointly led a group for indigent patients for a year; I attended fifteen major psychiatric conferences; I had so many meals with psychiatrists that for a time there was a standing joke among my friends that my entire social life was tax-deductible.
+These annotations will take the following forms:
-Let me say quickly that my role as an anthropologist is compromised (or liberated, depending on your point of view) by the fact that I believe both the biomedical and psychodynamic approaches to psychiatric illness to be substantially correct and equally effective, although not always for the same person. It seems clear to me that people have motivations that are not apparent to them, and that the way they experience the world is profoundly shaped by their personal history, often in ways they do not grasp; it also seems clear that there is something organically wrong with most people who are sick enough that they are admitted, these days, into a psychiatric hospital. I don’t think that either approach mirrors the reality of mental illness, but then I don’t think that any domain of knowledge “mirrors” the world as it is. The real issue for me is how one learns to look at mental illness through different lenses and the consequences of those ways of seeing.
+* Short annotations which we insert into the text itself [will be included in square brackets like these].
-The lenses are terribly important, and understanding how psychiatrists see is also terribly important, because madness is both frighteningly, palpably present, and yet elusive. There are no diagnostic tests in psychiatry (at least, none for genuinely psychiatric disorders: there are some conditions, such as brain tumors, that at first appear to be classic psychiatric disorders but are not). You cannot draw someone’s blood, stick someone into a magnetic resonance imager, or take any medical reading that will tell you definitively whether that person is depressed or not. So it matters a great deal how a psychiatrist is taught to look at mental illness, because the “how” cannot be clearly separated from the “what” of the disease. To understand psychiatric ways of seeing, we have to proceed knowing that what counts as “fact” is a tinted window onto a world you cannot step outside to see.
+-----
-It used to be fashionable in intellectual circles to say that madness didn’t really exist at all, that it had been created when society’s quest for order defined some people as deviant. This was done with crudeness by the antipsychiatry movement of the 1960s and 1970s and with finesse by Michel Foucault. Foucault did presume that madness had always existed, but he romanticized it in a way that, despite all his insights, did a terrible disservice to its pain. He argued that asylums had emerged in the eighteenth century as embodiments of middle-class morality and were like a kind of “gigantic moral imprisonment”; they dampened the free intensity of madness into “the stifling anguish of responsibility.”@@@[[#1MichelFoucaultMadnessand|1]]$$$ He wrote movingly about the way that after the asylum, the true genius of madness could be seen only in the writings of philosophers and poets. Others made similar arguments out of a naive yearning for a past when those we now call psychotic would have been esteemed as religious experts. (Some of these arguers come to my office wanting to write papers on how today’s schizophrenics would have been yesteryear’s shamans.) George Devereux, a psychiatric anthropologist who was not so much romantic as persuaded that the shamans in the society he worked in were pretty odd, wrote a famous paper arguing that shamanism provided a social role for the mentally ill that our society conspicuously lacked. “Briefly stated, my position is that the shaman is mentally deranged.”@@@[[#2GeorgeDevereuxBasicProble|2]]$$$ He suggested that the difference between the publicly recognized shaman and the “private” psychotic is that the shaman is able to use ritualized conventions in his society to manage his distress. This is a complicated and important issue, because it is clear that the way a culture interprets symptoms may affect an ill person’s prognosis. However, in the 1960s and 1970s, people used popular versions of this notion to suggest that our society was too fearful and uptight to tolerate vivid passions and so condemned these people as sick. Peter Shaffer’s very successful play ''Equus'', for instance, dramatized a young boy whose therapist comes to see the attempt at therapy as the destruction of his passion and a kind of moral hubris. “The Normal is the indispensable, murderous God of Health, and I am his Priest,” the therapist says. “I have talked away terrors and relieved many agonies. But also—beyond question—I have cut from them parts of individuality repugnant to this God.”@@@[[#3PeterShafferEquusandShri|3]]$$$ R. D. Laing argued, with the style of a social prophet, that the schizophrenic was just someone who was too creative, too insightful, too existentially aware for our society. We normals were afraid, he implied, to be so bold.@@@[[#4RDLaingTheDividedSelf|4]]$$$
+Longer annotations which add further context and background information will be included in boxes like this.
-More recently, Susanna Kaysen wrote ''Girl, Interrupted'', an account of her psychiatric hospitalization as a teenager. She was admitted when she was an adolescent, when she was angry at her parents. It was 1967, and she wore black and slept around and was deeply unhappy. When she went for a doctor’s appointment, he put her in a taxi and sent her to McLean, a lovely, graceful hospital, where she remained for nearly two years. When the book was published, the reviewers condemned psychiatry for characterizing emotional women as mentally unstable and for treating teenage unhappiness as a scapegoat for a dysfunctional family. “How thin the line is,” Susan Cheever fumed in the ''New York Times Book Review'', “between those society deems mad and those it deems sane.”@@@[[#5SusanCheeverADesignated|5]]$$$ Yet despite Cheever’s understandable indignation, it is clear that something was wrong. Kaysen had tried to kill herself before she was admitted. She was suicidal. She wrote, “I was having a problem with patterns. Oriental rugs, tile floors, printed curtains, things like that. Supermarkets were especially bad, because of the long, hypnotic checkerboard aisles. When I looked at these things, I saw other things within them.… Reality was getting too dense.”@@@[[#6SusannaKaysenGirlInterru|6]]$$$ She describes the experience of what she calls insanity, which she says comes in two forms, a viscosity so sluggish you cannot breathe and a velocity so frenetic you cannot cope.@@@[[#7Ibidp75|7]]$$$
+-----
-Madness is real, and it is an act of moral cowardice to treat it as a romantic freedom. Most people who end up in a psychiatric hospital are deeply unhappy and seriously disturbed, and many of them lead lives of humiliation and great pain. To try to protect the chronic mentally ill by saying that they are not ill, just different, is a misplaced liberalism of appalling insensitivity to the patients and to the families who struggle so valiantly with the difficulties of their ill family members. Most people who are really schizophrenic are far too ill to serve as religious experts.
+We have also added diagrams to our annotations, as well as a detailed glossary/index and appendices, which are located in the back of the book. We hope these will resources will also be of use in studying other texts which are rooted in dialectical materialist philosophy.<br />
-Moreover, the fantasy that innocent victims are imprisoned in asylums where they go slowly mad under the weight of the psychiatrist’s expectation and society’s rejection is exactly that, a fantasy. These days, with the pressure of insurance companies eager to deny psychiatric care if at all possible, the only people admitted to psychiatric services are usually so ill that there is no other option. Patients’ rights are in general well protected, although this varies from state to state, and a patient who is able to explain where he lives, perhaps has some money—maybe $20—or at least some place to go, and claims to have no intent to kill himself or anyone else goes free if he wants. Given that one of the common characteristics of psychosis is that the person does not experience himself as ill, people just barely able to function often reject psychiatric help. (“Psychosis” describes an unmistakable distortion of reality, such as believing that the CIA has implanted a microchip radio broadcaster in your mind. It is not a psychiatric disorder per se but a symptom of psychiatric illness, the way a sore throat is a symptom of a cold.) I never saw anyone held against his or her will in a hospital whom I felt was there unjustly. On the contrary, my experience was that people were denied clinical care when they should have been treated. At one point during my study, my liberal friends would lecture me on the evils of psychiatric incarceration while one of my psychiatrist friends was being stalked by a psychotic man refusing psychiatric care.
+=== Original Vietnamese Publisher’s Note ===
-It is hard to describe, to someone who has never seen it, how terrible and intractable madness often is. Even firsthand narratives do not always help, either because the author (now recovered) seems either too sane to have been ill (as in Kaysen’s case) or because the story seems too storied and bizarre (as in ''I Never Promised You a Rose Garden''). The way we perceive madness does affect the madness experienced, but still there is an obdurate, unignorable presence to these illnesses. Over the years, at least for the last few centuries (some people argue that schizophrenia is a product of the last few centuries@@@[[#8IrvingGottesmanSchizophren|8]]$$$), certain strange miseries have recurred in the history and literature of madness. Psychiatrists have classified them somewhat differently over the past few decades, but the symptoms and their severity have remained consistent. These days, they are classified as depression, manic depression (also known as bipolar disorder), and schizophrenia. Residents call them the “big three” because they dominate inpatient services and psychiatric emergency rooms. They have a kind of irrefutable reality.
+In 2004, under the direction of the Central Government, the Ministry of Education and Training, in collaboration with Sự Thật [Vietnamese for “The Truth,” the name of a National Political Publishing House], published a [political science and philosophy] curriculum for universities and colleges in Vietnam. This curriculum includes 5 subjects: Marxist-Leninist Philosophy, Marxist-Leninist Political Economy, Scientific Socialism, Vietnamese Communist Party History, and Ho Chi Minh Thought. This curriculum has been an important contribution towards educating our students — the young intellectuals of the country — in political reasoning, so that the next generation will be able to successfully conduct national innovation.
-William Styron was able to capture some of the gravitas of major depression in ''Darkness Visible'' by recounting, in blunt detail, the forced steps taken by his mind as the depression came upon him like a darkness with talons:
+With the new practice of education and training, in order to thoroughly grasp the reform of the Party’s ideological work and theory, and to advocate for reform in both teaching and learning at universities and colleges in general, on September 18<sup>th</sup>, 2008, the Minister of Education and Training, in collaboration with Sự Thật, have issued a new program and published a textbook of political theory subjects for university and college students who are not specialized in Marxism — Leninism with Associate Professor and Doctor of Philosophy Nguyen Viet Thong as chief editor. There are three subjects:
-===== I was on Martha’s Vineyard, where I’ve spent a good part of each year since the 1960s, during that exceptionally beautiful summer. But I had begun to respond indifferently to the island’s pleasures. I felt a kind of numbness, an enervation, but more particularly an odd fragility.… [T]he overall effect was immensely disturbing, augmenting the anxiety that was by now never quite absent from my waking hours.… [Then] it was October, and one of the unforgettable features of this stage of my disorder was the way in which my old farmhouse, my beloved home for thirty years, took on for me at that point when my spirits regularly sank to their nadir an almost palpable quality of ominousness.… One bright day on a walk through the woods with my dog I heard a flock of Canada geese honking high above the trees ablaze with foliage; ordinarily a sight and sound that would have exhilarated me, the flight of birds caused me to stop, riveted with fear, and I stood stranded there, helpless, shivering, aware for the first time that I had been stricken by no mere pangs of withdrawal but by a serious illness whose name and actuality I was able finally to acknowledge.… [F]ood … was utterly without savor … my few hours of sleep were usually terminated at three or four in the morning.… Death … was now a daily presence, blowing over me in cold gusts.@@@[[#9WilliamStyronDarknessVisi|9]]$$$ =====
+Curriculum of the Basic Principles of Marxism-Leninism
-Those who suffer from major depression cannot sleep, do not eat, and are obsessed by the thought of their own death. Their depression feels to them like a physical pain. They cannot concentrate. They cannot function. Many of them cannot leave their beds. One in every six will kill themselves.@@@[[#10HaroldKaplanandBenjaminS|10]]$$$ Styron was lucky, even though he did not respond to medication. He came very close to suicide. He destroyed his personal notebook (emblem of a writer’s self), rewrote his will, plotted his death. (He couldn’t write a suicide note; this Pulitzer Prize—winning author could not find the words.) He felt, he wrote, that he had made an irreversible decision. Then, late at night, brooding, he heard some music that somehow pierced his desolate chill. He roused his wife. She made some phone calls. He soon found himself in the safety of the hospital, protected from the domestic goods that seem harmless to most of us but are deadly invitations to the suicidal: razors, staircases, knives, plastic bags, ropes, vodka, medicine cabinets. Time slowly healed him.
+Curriculum of Ho Chi Minh Thought
-Depression, psychiatrists say, strikes one in five to ten people.@@@[[#11Thelifetimeprevalenceisr|11]]$$$ Schizophrenia strikes one in one hundred. Recent research suggests that there may be more than one disease process involved in schizophrenia (in other words, more than one bodily abnormality), but patients bearing this diagnosis have similar traits. They have seriously abnormal thoughts: that Peter Jennings is speaking specifically to them, that their bodies have died and been replaced by plastic. Psychiatrists call this divorce from reality “psychosis.” In addition, their faces seem curiously flat and blunted, and their lives fall apart. One in ten will commit suicide.@@@[[#12Thisisobviouslyalimited|12]]$$$ Their illness tends to have a chronic, debilitating course, although as many as a third of schizophrenic patients may ultimately recover or at least lead somewhat normal lives.@@@[[#13KaplanandSadockPocketHa|13]]$$$ One of the most famous literary schizophrenics was a real woman known as Sylvia Frumkin whose life was chronicled by Susan Sheehan in ''The New Yorker'' and later in ''Is There No Place on Earth for Me?'' It is a painstaking account of the life of a young, brilliant woman whose illness was basically unaltered by either medication or psychotherapy, who went into and out of psychiatric institutions of varying quality, and whose life was chaotic and painful for herself and her family. This remarkable book opens with this paragraph:
+Curriculum of the Revolutionary Path of the Communist Party of Vietnam.
-===== Shortly after midnight on Friday, June 16, 1978, Sylvia Frumkin decided to take a bath. Miss Frumkin, a heavy, ungainly young woman who lived in a two-story yellow brick building in Queens Village, New York, walked from her bedroom on the second floor to the bathroom next door and filled the tub with warm water. A few days earlier, she had had her hair cut and shaped in a bowl style, which she found especially becoming, and her spirits were high. She washed her brown hair with shampoo and also with red mouthwash. Some years earlier, she had tinted her hair red and had liked the way it looked. She had given up wearing her hair red only because she had found coloring it every six weeks too much of a bother. She imagined that the red mouthwash would somehow be absorbed into her scalp and make her hair red permanently. Miss Frumkin felt so cheerful about her new haircut that she suddenly thought she was Lori Lemaris, the mermaid whom Clark Kent had met in college and had fallen in love with in the old “Superman” comics. She blew bubbles into the water.@@@[[#14SusanSheehanIsThereNoP|14]]$$$ =====
+Curriculum of the Basic Principles of Marxism-Leninism was compiled by a collective of scientists and experienced lecturers from a number of universities, with Pham Van Sinh, Ph.D and Pham Quang Phan, Ph.D as co-editors. This curriculum has been designed to meet the practical educational requirements of students.
-Sylvia Frumkin was articulate, engaging, and bizarre. When she was tested in grade school, her IQ was 138. She was not well liked then, although her teacher thought her sensitive and eager. Other girls her own age said she was uncouth. Sylvia went to one of New York’s best public high schools, but in tenth grade things began to go wrong. The psychiatrist she saw at that point described her as unattractive, untidy, restless, overtalkative; she switched too readily from tearfulness to giggles; she interpreted people poorly and in odd ways. She was diagnosed as paranoid schizophrenic. Sylvia seemed to do well in therapy and to become more like a normal adolescent: she acquired a best friend, she listened to popular music, she liked the Beatles, she cut her hair and bought attractive clothes. Then she was hit by a car, by a teenager driving alone on a learner’s permit. She briefly lost consciousness and suffered a concussion. Soon she became more anxious than before (she had always been nervous). She would stay up all night; each day she smoked three packs of cigarettes and took three showers. Her casual comments sounded more and more crazy. Her therapist began to give her small doses of Stelazine, an antipsychotic. Two months later, Sylvia became highly agitated and began asking people to adopt her. She was hospitalized for the first time. She insisted, as she drove to the hospital, that Paul McCartney was going to come and take her away to England. From then on she went into and out of psychotic delusions and psychiatric hospitals.
+We hope this book will be of use to you.
-Manic depression, or bipolar disorder, is the third of the trio. It is, like depression but unlike schizophrenia, classified as a “mood” disorder, which means that the most salient problem lies with the patient’s emotional tone, not his or her thought process, although a bipolar patient in the grip of mania can seem crazy in the same way as an acutely psychotic schizophrenic patient. People with manic-depressive disorder experience periods when they are profoundly depressed and other periods when they are manic, a state of erratic, disinhibited euphoria: they don’t sleep, they talk wildly, they are grandiose and sometimes psychotic. Kay Jamison’s memoir of manic-depressive disorder, ''An Unquiet Mind'' (1995), describes her years before she allowed herself to manage the illness with lithium:
+April, 2016
-===== I was a senior in high school when I had my first attack of manic-depressive illness; once the siege began, I lost my mind rather rapidly. At first everything seemed so easy. I raced about like a crazed weasel, bubbling with plans and enthusiasms, immersed in sports, and staying up all night, night after night, out with friends, reading everything that wasn’t nailed down, filling manuscript books with poems and fragments of plays, and making expansive, completely unrealistic, plans for my future.… Not only did everything make perfect sense, but it all began to fit into a marvelous kind of cosmic relatedness.… I did, finally, slow down. In fact I came to a grinding halt. Unlike the very severe manic episodes that came a few years later and escalated wildly and psychotically out of control, this first sustained wave of mania was like a light, lovely tincture.… Then the bottom began to fall out of my life and mind.… Nothing made sense.… [My mind] was incapable of concentrated thought and turned time and again to the subject of death.@@@[[#15KayRedfieldJamisonAnUnq|15]]$$$ =====
+NATIONAL POLITICAL PUBLISHING HOUSE — SỰ THẬT
-Many people who are manic-depressive, or who experience bouts of depression, function quite well when not ill, but some never manage to live a normal life. Like those who have a “unipolar” depression (they are never manic), one in six will kill themselves. “He reminded me,” Jamison writes of a patient who was not among the lucky ones, “of films I had seen of horses trapped in fires with their eyes wild with fear and their bodies paralyzed in terror.”@@@[[#16JamisonAnUnquietMindp|16]]$$$ Her own life after high school became a riveting story of voyaging between extremes. In her first job, as assistant professor of psychiatry at UCLA, she found herself exuberant and brilliant at a professional party and went higher; she bought a fantastic array of stuff, among it three expensive watches, twelve snakebite kits, and, most horrifying later on, a stuffed, preserved fox; higher still, she wrote a poem, inspired by her spice collection and archived in the refrigerator, entitled “God Is a Herbivore.” Then she crashed, with a bloodred vision of a splattered test tube. Over the years she swung high, then low. She bought a gun, confessed she owned it, gave it away. She fought with lithium and the need to take it, then overdosed on a massive amount of it. She was saved by sheer luck. She wrote of that time, “I can’t calm this murderous cauldron, my grand ideas of an hour ago seem absurd and pathetic, my life is in ruins and—worse still—ruinous.… In the mirror I see a creature I do not know but must live and share my mind with.”@@@[[#17Ibidp114|17]]$$$
+=== Original Vietnamese Preface ===
-These are not romantic illnesses. Nor are they creativity and insight in another form. Every culture recognizes certain people at certain times as mad, and treats them as being different.@@@[[#18ArthurKleinmanRethinking|18]]$$$ (The diagnoses that are generally accepted to be valid worldwide are schizophrenia, manic-depressive disorder, major depression, substance abuse, and certain anxiety disorders, although, as we will see, the local experience of illness may vary widely.) These people do not become shamans and priestesses and artists because they are mad, although artists may possibly be more successful if they are (mildly) manic-depressive. (This is an important distinction. Being mad probably does not make you creative, but if you are creative, glimpsing the depths of human despair and then reaching the heights of confidence with infinite energy probably enhances your ability to use your gift.@@@[[#19SeeKayRedfieldJamisonss|19]]$$$) Crazy people cannot fend for themselves when they are sick. They struggle to survive with the generosity and protection of others. There is no reasonable doubt that madness is an intrinsic feature of human life, not a by-product of asylum building or of a shift in religious practice.
+To implement the resolutions of the Communist Party of Vietnam, especially the 5<sup>th</sup>
-At the same time, it is true that madness is involved with our social fabric. To return to the sociological point, the way illness is socially conceived does seem to alter the way it is individually expressed and experienced. It is true, as Sue Estroff wrote in her classic ethnography of psychiatric clients, that “being a full-time crazy person is becoming an occupation among a certain population in our midst.”@@@[[#20SueEstroffMakingItCrazy|20]]$$$ Our psychiatric professionals, as well as the rest of us, have expectations of the psychiatrically ill, and we institutionalize those expectations in subtle and unsubtle ways that can lead people to mimic the symptoms we think that they should have. If a homeless veteran wants a warm bed for the night, he can learn what words and gestures will persuade the psychiatrist on call to admit him to the hospital. If a woman receives a disability check each month for her psychiatric diagnosis, she will learn how to avoid having the support curtailed. When Erving Goffman wrote in ''Asylums'' of an institution’s “direct assault on the self,” he was describing the reality that, both inside the hospital and without, the psychiatrically ill learn to play roles our society has designed for them.@@@[[#21ErvingGoffmanAsylumsp|21]]$$$ One of the unintended consequences of social assistance is that we reward people for becoming and remaining ill. Sometimes we trap them in their illness.
+Central Resolution on ideological work, theory, and press, on September 18<sup>th</sup>, 2008, The Ministry of Education and Training has issued Decision Number 52/2008/QD-BGDDT, issuing the subject program: The Basic Principles of Marxism-Leninism for Students Non-Specialised in Marxism-Leninism and Ho Chi Minh Thought. In collaboration with Truth — the National Political Publishing House — we published the Curriculum of the basic principles of Marxism-Leninism for Students Non-Specialised in MarxismLeninism and Ho Chi Minh Thought.
-This is where much of the good psychiatric anthropology has been focused. These anthropologists have shown us that there is a complex dance between what a clinician learns to treat and how a patient learns to be treated. For example, Allan Young describes the gradual construction of “posttraumatic stress disorder” out of the lives of traumatized Vietnam veterans, the way the clinicians used the diagnostic criteria to include people they felt ought to be seen as sick, and the way patients began to present themselves in order to fit into that diagnostic structure.@@@[[#22AllanYoungTheHarmonyof|22]]$$$ It has now become apparent that not all women diagnosed with multiple personality disorder had that disorder before they walked into the psychiatric consulting room. That many of them had major emotional and behavioral problems seems clear. Many seem to have struggled with dissociation, a long-term consequence of a childhood escape mechanism used when a child confronts bullying or abuse she cannot physically flee. Such a child learned to “check out” when the distress began. She would no longer be there, in the same way you can “check out” when the dentist’s drill begins to whir. As adults, these women had difficulties with concentrating, keeping track of time, being effective and reliable in human relationships. Some learned—from popular best-sellers such as ''The Courage to Heal'', from support groups, from Internet chat groups, and from therapists sensitized by feminism to the dangers of male sexual authority—to understand their pain as caused by male transgression and to experience their disconnectedness as the result of a fragmented self. Dissociation is a skill, and the use of that skill can be learned. Some learn involuntarily, and their dissociation is pathological: unwanted, intrusive, uncontrollable. Some learn willingly to go into trance, possession, out-of-body states, and, for that matter, channeling. And the content is manipulable. Someone can dissociate by zoning out and then learn to experience that sensation as possession. In the 1980s, many women learned to handle their dissociation and general distress by learning to experience multiple personalities that switched on and off in disturbing ways.@@@[[#23SeeJoanAcocellaThePoli|23]]$$$ By that point, a therapist who helped a woman to gain control over a disturbing, unwanted dissociation by teaching her how to “call” her “alters” (alternative personalities) was acting appropriately and effectively to help her. But the therapist may not have been doing what she thought she was.
+The authors of this text have drawn from the contents of the Central Council’s previous programs (Marxist-Leninist Philosophy, Marxist-Leninist Political Economy, and Scientific Socialism) and compiled them into national textbooks for Marxist-Leninist science subjects and Ho Chi Minh Thought, as well as other curriculums for the Ministry of Education and Training. The authors have received comments from many collectives, such as the Ho Chi Minh National Academy of Politics and Administration, the Central Propaganda Department, as well as individual scientists and lecturers at universities and colleges throughout the country. Notably:
-History shapes the kind of madness people experience and the frequency with which it occurs. Poverty, war, and dislocation are bad for people—an obvious point, but important if you are tempted to think of psychiatric illness as purely hereditary. A recent survey on world mental health observed that in all different age, gender, and cultural categories everywhere, the most important risk factor for mental health is social disruption.@@@[[#24RobertDesjarlaisetalWo|24]]$$$ Social isolation also seems to exact a high cost. Depression, and mood disorders in general, may be more common in the twentieth century than ever before, because in no other time of human history have so many people been so isolated.@@@[[#25RobertWrightTheEvolutio|25]]$$$ (It is, however, extremely difficult to figure out what would count as evidence here—it is very difficult to judge the rate of mental illness in earlier centuries.) More people live alone in America than ever before—a quarter of all Americans, compared to less than 10 percent in 1940 and probably almost none in our ancestral past. Mothers who work hand their children over to strangers for long periods of time. Mothers who don’t work are at home alone with small children. From a human evolutionary perspective, this is bizarre. In hunter-gatherer societies, child rearing is extensively social, as are work and life in general. In modern societies, isolation is a leading risk factor for suicide.@@@[[#26KaplanandSadockPocketHa|26]]$$$
+Associate Professor To Huy Rua, Ph.D, Professor Phung Huu Phu, Ph.D, Professor Nguyen Duc Binh, Professor Le Huu Nghia, Ph.D, Professor Le Huu Tang, Ph.D,
-Historical and cultural conditions also seem to affect significantly the way mental anguish is internally experienced and socially expressed. For instance, people in non-Western societies are likely to report somatic symptoms—aches, pains, problems of the body—as the primary difficulty of being abnormally sad, while Westerners are more likely to report psychological symptoms—feeling down, guilty, suicidal, having difficulty concentrating. Are they suffering from the same psychiatric difficulty? When Arthur Kleinman went to China as an American psychiatrist in the 1970s, he thought that the Chinese who came to the clinic complaining of aches and anxieties often looked depressed. Moreover, most of them met the American psychiatric criteria for major depression. But they called their difficulties neurasthenia, the major symptoms were not those of depression, and the meaning and explanation of the difficulties were quite distinct. Neurasthenia was (conceived as) a physical problem having to do with nerves, not an emotional problem with sadness. And it became apparent that neurasthenia was also a role for people whose lives had been crippled by the Cultural Revolution, which had left a generation terrorized and humiliated and then stranded them without any way to compete professionally with the next generation. This is not to say that people pretended to have neurasthenia: they experienced neurasthenia, and not all victims of the Cultural Revolution had it. But Kleinman, whose 1986 study has become a classic, came to believe that to understand these patients, you had to understand their difficulties as part of a social suffering, as part of a culture’s history, not as a series of unrelated personal complaints.
+Professor Vo Dai Luoc, Ph.D, Professor Tran Phuc Thang, Ph.D, Professor Hoang
-Anthropologists have learned to address these ambiguities by distinguishing between “illness” and “disease.”@@@[[#27Thisdistinctionismadein|27]]$$$ “Disease” refers to abnormalities in the structure and function of bodily organs and systems. Physicians, for example, refer to “disease pathways” when describing the physical causes of the symptoms that bring someone to a clinic. “Illness,” by contrast, refers to the patient’s experience. A person can experience illness without having a disease (Kleinman points out that 50 percent of doctor visits may be for complaints without a curable biological base).@@@[[#28Ibidp252|28]]$$$ The same disease can underlie different illness experiences, depending on the cultural, historical, and personal circumstances of the people involved. The distinction is helpful when the distinction is clear—when looking at the difference between the way a local population and the World Health Organization manage a cholera outbreak, for instance. Often, however, the distinction is more ambiguous. Japanese women, for example, do not experience menopause in the same way as American women. They do not feel the same demoralization and passing of youth; this may be because Japanese women may have more respect and power in their maturity than in their youth. They also do not have hot flashes. Is their lack of hot flashes their culture’s impact on the same bodily process (one hesitates to call menopause a “disease”), or does their diet of soy and fish alter their biology? Or is their biology different to begin with?@@@[[#29Thesedataarereportedand|29]]$$$ The distinction between disease and illness is deeply ambiguous in psychiatry, because while psychiatric problems often clearly have an organic element, they are also enmeshed with the social context. Nor is it usually clear what the psychiatric “disease process” is—unlike the case with, for instance, cholera.
+Chi Bao, Ph.D, Professor Tran Ngoc Hien, Ph.D, Professor Ho Van Thong, Associate
-There is no medical test for a specific disease pathology for any major psychiatric illness. You cannot know whether there really is an underlying “disease” in psychiatric illness. There is no way to determine, once and for all, whether someone has depression or not, and there is no reason to suppose—despite occasional claims to the contrary—that we will have any way to do so anytime soon. No one can say whether Chinese neurasthenia is “really” the same as American depression. It ''is'' clear that, no matter how you slice the research, psychiatric problems involve genetic vulnerability, bodily stress, social milieu, cultural interpretation, family history, and individual temperament. (The unwieldy term that was supposed to sum this up was “biopsychosocial,” but even that refers to too few factors.@@@[[#30GeorgeEngelTheClinical|30]]$$$) As a result, it is particularly important to understand how psychiatrists look at these illnesses and thus how we in turn understand them (psychiatric knowledge seeps into popular culture like the dye from a red shirt in hot water). The way we understand these illnesses affects not only the way they are treated but the way they are experienced, their outcomes, and our sense of responsibility toward those who suffer.
+Professor Duong Van Thinh, Ph.D, Associate Professor Nguyen Van Oanh, Ph.D,
-This is what an anthropologist can observe. I was, after all, watching people learn. They came into psychiatric residency as nonpsychiatrists, and they left as qualified psychiatric professionals. I could see what they were taught explicitly, by those appointed to teach them; I could also see what everyday experience with psychiatric patients confronted them with and how they learned from one another to defend themselves against its assaults. I saw how they learned to find significance and meaning in behavior other people might not even notice and how they learned to communicate their sense of that behavior in an ordinary language other people might not grasp, even when understanding each individual word. And so I was able to observe what anthropologists now call the “transformation of subjectivity.” You cannot observe a man think and feel, but if there is a group of men, you can see what a man needs to do to be a member of that group. You can see what he learns to react to, how he learns to react, how he comes to joke about it, what he comes to fear. The anthropologist Clifford Geertz pointed out that what the anthropologist can find out through fieldwork is what is public in the exchanges people have with one another. This doesn’t mean that the psyche remains closed to observation. It means that what you can observe is how the psyche is shaped by practical and mundane things.
+Associate Professor Nguyen Van Hao, Ph.D, Associate Professor Nguyen Duc Bach, PhD. Pham Van Chin, Phung Thanh Thuy, M.A., and Nghiem Thi Chau Giang, M.A.
-For example, Hugh Gusterson, another anthropologist of science, described the way politically liberal young men at Lawrence Livermore Laboratory turned into weapons scientists. They graduated with doctorates in physics from elite universities. Not all of them were politically liberal, but many were, and many were hesitant about contributing to the nuclear arms race. But they didn’t believe in unilateral disarmament, and these jobs paid well and were more secure than the precarious world of up-or-out university tenure decisions. So the men took these jobs and years later found themselves committed to the importance of nuclear weapons with a passion that matched that of the antinuclear protestors. Why? This anthropologist argued that through the process of living in their skins at work, coming to terms with their fear of radiation and annihilation, and feeling pride in their skill, they came to feel powerfully and deeply that their work was morally important and necessary to human survival. He saw three features of their everyday environment that were crucial to that unintended transformation. First, there was the thrill of being in a secret group, with the sense of specialness but also of constant panopticon surveillance, and the slow corrosive impact of that separate, secret world on the intimacies of private life, as a result of which the laboratory loomed ever larger in the scientists’ sense of self. Then there was the way the men handled their fears by jokes in which they identified with the machines and not with fleshly corpses—they were powerful, like the bombs, not weak, like the bodies burned by them. He described the way they learned from laboratory culture to experience excitement and not desperation at the violence of explosion. (At least, those who stayed in the lab did. The others left.) Finally, they felt a sense of mastery when the nuclear tests actually worked, and in the joy of a job well done, those tests became fun for the scientists and seemed reasonable, ordinary, and intrinsic to the proper functioning of the lab.@@@[[#31HughGustersonNuclearRite|31]]$$$ And so these Berkeley doctoral students grew into the men the Berkeley radicals came to protest.
+After a period of implementation, the contents of the textbooks have been supplemented and corrected on the basis of receiving appropriate suggestions from universities, colleges, the contingent of lecturers of political theory, and scientists. However, due to objective and subjective limitations, there are still contents that need to be added and modified, and we would love to receive more comments to make the next edition of the curriculum more complete.
-I will describe here an anatomy of the way psychiatrists come to see the people who come to them as patients. It is an anatomy of how a psychiatrist empathizes with a patient because it became clear to me that these different tasks—biomedical and psychodynamic—teach young doctors to empathize with their patients in different ways. Both are empathic, but they are not empathic in the same way. Empathy is a process''—not'' a squashy, feel-good emotion nor, as the colloquial use would have it, the state of being warm and fuzzy. It is a process in which you, the empathizer, imagine what it is to be someone else, the person you are empathizing with. Empathy can never be completely accurate. The density of one person’s experience exceeds what an observer can grasp, and so in empathy as in life, there are many truths, each one springing from a specific conjunction of the empathizer and the empathized with. You can be more empathic or less, but the way you are empathic and with what in a person’s life you empathize and how, has a great deal to do with who you are and how you conceive of your task at that moment, in that place.@@@[[#32Seriousdiscussionsofempat|32]]$$$ And empathy has components that an observer can observe when a student is taught to perform an empathic task: how to perceive the person being empathized with, how to relate to him, how to behave appropriately with him, and whom to aspire to be with him. We know that all these are present in the way we hear and respond to one another: the person we see, as the person we hope we are, with feelings and behaviors we have been encouraged to adopt.
+MINISTRY OF EDUCATION AND TRAINING
-No person is simple. We hear their sorrows through the din of our occluding pasts, and we can grasp only the sounds to which we are attuned. Psychiatrists are taught to listen to people in particular ways: they listen for signals most of us cannot hear, and they look for patterns most of us cannot see. Their two primary tasks, however—diagnosis and psychopharmacology, on the one hand, and psychodynamic psychotherapy, on the other—teach them to listen and look in different ways. As an anthropologist, I could see what young psychiatrists had to achieve in diagnosis and in psychotherapy, and I could see what they learned to do in order to achieve it. I could see how they learned to perceive the patient in order to do their task, and I could see that what they had learned was inherent in the tasks themselves, not due to the style or personality of the doctor. I could also see how they learned to anticipate patients in the settings of their different tasks, how they learned to fear or hate or love them, and I could see what counted as appropriate behavior on the units dominated by either biomedical or psychodynamic concerns. Again, these differences were part of the tasks, not the result of the doctor’s personality, although certainly different tasks did seem to draw different kinds of people for keeps. And I could see who was admired in these different domains, so that one could ask, when a young doctor was with a patient, not only what he saw in the patient but whom he should aspire to be in response. All this is part of the way young psychiatrists learn to be doctors with patients, focused on two different tasks. That is the anatomy this book sets out to describe.
+=== Table of Contents ===
-This book also reaches a more disturbing conclusion. However we understand the possible causes of mental illness, the available evidence we have suggests that for most patients and for most disorders, psychopharmacology and psychotherapy work best in combination. Patients improve more quickly and stay out of the hospital for longer when the two approaches are used in tandem. Both are important; both are necessary, as most psychiatrists—regardless of their orientations—agree. But a combination of socio-economic forces and ideology is driving psychotherapy out of psychiatry. It is harder than ever before for residents to learn psychotherapy or to see its relevance in a hospital setting, harder than before for a patient or doctor to be reimbursed for it. If psychotherapy is axed from psychiatry by the bottom-line focus of managed care companies, psychiatrists will be taught to see, think, and respond only as the biomedical task would teach them. That would be a terrible mistake. It would be bad for psychiatrists, who are more perceptive about patients, even when diagnosing and prescribing medication, when they have some psychotherapeutic background. It would be bad for our society, for biomedicine encourages a way of thinking about mental illness that can strip humanity from its sufferers. And above all it would be bad for patients, who will be treated less well and less effectively if treated from a purely biomedical perspective.
+'''Introduction to The Basic Principles of Marxism-Leninism'''
-There is also a more subtle risk. Psychiatry is inevitably entangled with our deepest moral concerns: what makes a person human, what it means to suffer, what it means to be a good and caring person. By the word “moral” here I do not mean a code of right behavior so much as our instinctive sense of what it is to be responsible, when to assign blame, how we come to see our ambitions as fundamentally right and good. The biomedical and psychodynamic approaches nurture two very different moral instincts by shaping differently the fundamental categories that are the tools of the way we reason about our responsibilities in caring for those in pain: who is a person (not an obvious question), what constitutes that person’s pain, who are we to intervene, what intervention is good. These two approaches teach their practitioners to look at people differently. They have different contradictions and different bottom lines. Both have their strengths and their weaknesses. Each changes the way doctors perceive patients, the way society perceives patients, and the way patients perceive themselves. The irony is that while Freud perhaps saw himself as demonstrating that human nature was shackled by its own design, his legacy has been to create a moral expectation of human agency and self-determination that we do ill to jettison.
+'''I. Brief History of Marxism Leninism'''
-What I wanted to do that morning when the resident turned around and suggested I write about what he was being taught to do was just to understand how these ways of knowing differ. I wanted to know what these young psychiatrists learn to notice and how they come to notice it. Lenses are important; they enable us to see. But when we use this metaphor to describe how we come to understand one another, we must remember that lenses, while necessary, are a distortion, for humans always slip away from the clarity we impose on them. Now, as we risk the loss of one of the lenses entirely, there is a possibility that our psychiatrists, and perhaps our society, will learn to see even less complexity than before.
+. Marxism and the Three Constituent Parts
-== {{anchor|CHAPTERONE}} {{anchor|TopofLuhr9780307791900epubc2}} CHAPTER ONE: WHAT’S WRONG WITH THE PATIENT? ==
+. Summary of the Birth and Development of Marxism-Leninism
-What’s wrong with the patient? That is the most basic question in medicine. And when new psychiatrists begin to act as psychiatrists, what they learn to see as the patient’s problem is shaped not only by what they are taught explicitly about psychiatric illness but also by how they learn to act like a psychiatrist in that setting. In the hospital, the way psychiatrists learn to admit patients and present them to supervisors encourages them to think of psychiatric illness as an organic disease, a “thing” underlying and generating the symptoms. Doing the same things in the outpatient clinic encourages that same psychiatrist to think in terms of interaction, about the way the patient has learned to be with people. And so complex, inchoate misery is crystallized into two different kinds of clarity. Because psychiatrists start their training in the hospital, we begin the story there. Then we turn to the experience of outpatient psychiatry.
+'''II. Objects, Purposes, and Requirements for Studying the Basic Principles of Marxism-Leninism'''
-=== {{anchor|INTHEHOSPITAL}} IN THE HOSPITAL ===
+. Objects and Purposes of Study
-Gertrude was one of nine new residents I met on July 1, 1992, in the oak-paneled room the hospital reserved for its occasional formal events, such as board meetings and residency orientation. She seemed young and wary, determined not to look nervous. This was her first day of psychiatric training (the medical year runs from July to July). She had graduated from medical school one year previously. Her first year after graduation from medical school had been spent in internship, an intensive, lived-in-the-guts, all-consuming apprenticeship in a general hospital. Some psychiatrists-to-be take a rotating internship, with several months on a psychiatric or neurological service. But the more elite internships are a rigorous, focused, sleep-deprived, and thoroughly medical experience. Gertrude had been such an elite intern. Her only experience of psychiatry had been as a medical student, as an insubstantial presence on a psychiatry unit for some weeks, assigned to residents only marginally less naive than she, whom she and her fellow students had followed around like abandoned puppies. She had good reason to be anxious.
+. Some Basic Requirements of the Studying Method
-Medicine trains its students by having them act as if they are competent doctors from their first days on the job. Although psychiatric residents are “in training,” they are also acting—from the day they arrive—as psychiatrists. Gertrude was assigned to a hospital unit as one of its psychiatrists. She was immediately assigned patients to care for. As the year progressed, she needed less supervision, but she was still doing the same tasks. As is common in medicine, she learned by doing. She was expected to be able to manage the hospital’s entire psychiatric service after hours by herself in a matter of weeks: doing emergency admissions, signing orders that only doctors can authorize, prescribing emergency medications to calm unexpectedly agitated patients. During that summer I sat through two months of orientation, the “summer seminar,” some analogue of which is held at every psychiatric residency in the country. It taught the basic survival skills of psychiatry. In the summer seminar, Gertrude and her peers were taught by residents one or two years older—psychiatric residency is a three-year training in which senior residents train junior ones—with a kind of in-group coaching meant to get them up to speed rapidly so that they could pull their own weight in caring for patients and dispense with step-by-step supervision. There were lectures for a few hours a day. The rest of the time the residents spent doing their jobs with patients. “These are basic lectures,” the chief resident said during the first class on psychopharmacology. (The chief resident is the young doctor in charge of all the other residents.) “When it gets down to gamma-2 level receptors, then it’s religion, not science.” He meant that the psychiatrist’s basic skill is knowing how to use medications, that only the overzealous care exactly how they work. The new psychiatrists were expected to understand this, to come prepared with the pragmatic expectation that they must avoid disaster but not strive for perfection. “I can tell who the weak residents are already,” the chief resident said to me after a week. “They’re the people who are taking this too seriously. Those are the ones who will have trouble.”
+. Excerpt from ''Modifying the Working Style''
-The summer seminar series aimed to teach Gertrude and her fellow students how to avoid egregious errors, not how to become excellent psychiatrists. What it taught, then, teaches us what counts as basic adequacy. The lecture list went as follows:
+'''Chapter I: Dialectical Materialism'''
-<div style="margin-left:0.423cm;">''Week one:'' On call in the hospital; psychiatric emergencies; introduction to psychopharmacology; process notes and supervision.</div>
+'''I. Materialism and Dialectical Materialism'''
-<div style="margin-left:0.423cm;">''Week two:'' Antipsychotics; the dangerous patient; mental status examination; diagnosis.</div>
+. The Opposition of Materialism and Idealism in Solving Basic Philosophical Issues
-<div style="margin-left:0.423cm;">''Week three:'' Antipsychotics; beginning psychotherapy (1); beginning psychotherapy (2); medical issues in psychiatric care.</div>
+. Dialectical Materialism — the Most Advanced Form of Materialism
-<div style="margin-left:0.423cm;">''Week four:'' Sedatives, hypnotics, and stimulants; overview of substance abuse; introduction to interviewing; violent patients.</div>
+'''II. Dialectical Materialist Opinions About Matter, Consciousness, and the Relationship Between Matter and Consciousness'''
-<div style="margin-left:0.423cm;">''Week five:'' Tricyclic antidepressants, overview of sleep disorders; legal issues in psychiatry; suicidal patients.</div>
+. Matter
-<div style="margin-left:0.423cm;">''Week six:'' MAOIs [monoamine oxidase inhibitors, a kind of antidepressant medication] and novel antidepressants; overview of cognitive/behavioral treatment; psychological testing; rating scales.</div>
+. Consciousness
-<div style="margin-left:0.423cm;">''Week seven:'' Mood stabilizers; neurologic emergencies; sexual issues in psychiatry; case presentations.</div>
+. The Relationship Between Matter and Consciousness
-<div style="margin-left:0.423cm;">''Week eight:'' ECT [electroconvulsive therapy]; history of psychiatry; case formulation; case presentation.</div>
+. Meaning of the methodology
-<div style="margin-left:0.423cm;">''Week nine:'' Psychopharmacology of Axis II disorders; wrap-up.</div>
+'''Chapter 2: Materialist Dialectics'''
-The first lectures were on psychiatric emergencies and the dangerous patient, then the admissions process and an overview of various medications. Eventually they moved to psychotherapy but really focused on hospital psychiatry. What the young psychiatrist has to know—and immediately—is how to handle psychiatric emergencies and admissions. New apprentices must know how to cope with people who may be violent or intensely suicidal, people who are brought in by the police or by a distraught family, people who have intentionally sliced their wrists or necks, spent seven hours in surgery, and been transferred by ambulance to the psychiatric hospital. It is the resident’s job formally to admit the patients and to make the first decisions about treatment—whether to prescribe medications and the kind and dose, whether the patient should be on a locked or unlocked unit, and so forth.
+'''I. Dialectics and Materialist Dialectics'''
-The most unnerving time for the new residents was when they were “on call.” Then they were the psychiatrist in charge of the entire psychiatric service in the evening and throughout the night, when the senior psychiatrists had departed and only the night staff—some nurses, some mental health workers—stayed on. After only a month of experience in psychiatry, the on-call doctor might be the only doctor in a hospital with more than a hundred patients (other doctors were available by phone, but it is hard to call a senior in the middle of the night to ask him a question he thinks you ought to be able to answer yourself). If a patient went out of control, the nurses needed the doctor to prescribe a tranquilizer or sign an order to use physical restraints. If a patient arrived—that is, had showed up in some urban hospital’s emergency room and a transfer had been arranged—the doctor admitted the patient and signed the orders. If a person showed up crazy, on grounds, the doctor had to decide whether to commit him. If a patient suddenly developed an acute allergic reaction to antipsychotic medication, that doctor had to know what to do. Depending on the level of anticipated work, there might be other residents on call as well, to help with admissions or to advise the nervous newcomer. Often in those first few months, a somewhat more senior resident would also stay on to help out. But not always. The resident had to act like a knowledgeable doctor despite the newness of the patients, the circumstances, and his task. “So you’re on call,” the chief resident said, “and some guy has come into the entrance [a lonely house, set far back from the main admissions building] and he’s punched the emergency number into the hospital phone. You and Sergeant Carter go over [all forays to distant buildings at night are accompanied by the security guard], and you ask this guy why he rang in an emergency. He says he thought he might want to be admitted, but now he’s not sure. Sergeant Carter is getting bored. You ask the guy why he wanted to come in, and he says, ‘Just …’ and trails off. Sergeant Carter says that you seem to have this under control and can he leave? You say ''‘No.’'' Why? Because you don’t know. You don’t know. When the guy trails off into silence, he might just be hearing a voice that says, ‘Eliminate this fool.’ ”
+. Dialectics and Basic Forms of Dialectics
-In August, I went on call with Gertrude. She was noticeably uneasy. This was her first night as DOC, “doctor on call.” She was one month into her training, and she was legally liable (although covered by the hospital’s malpractice plan) for every decision she made. Although she had some help—another resident, one year her senior, joined her for part of the evening—she was alone (apart from the watchful anthropologist) for much of the night, running back and forth from building to building, holding the walkie-talkie that enabled the switchboard operator to reach her, assigning admissions to the one or two other residents who remained in the hospital, covering orders for psychopharmacological and physical restraints, doing admissions herself, trying to get enough time to eat and, if possible, change into the casual clothes that a doctor is allowed to wear on call but never during the day.
+. Materialist Dialectics
-At night the hospital was an eerie place. Located as it was in the suburbs, this hospital had many “scheduled” admissions, patients whose doctors called up to arrange for hospitalization and who then arrived on the subdued afternoons of the regular workweek. But often the patients arrived unexpectedly and after hours, brought in by police or despairing relatives to a city emergency room and shipped out to the suburban hospital because the city hospitals were full. Even a large urban hospital is strange after midnight, as the acoustics of the long, empty corridors change markedly when there are no people in them. This hospital, with its strung-out buildings, each containing different units, was so much like a small liberal arts college that in the day I would have to stop myself from referring to the patients as students. At night it became forbidding. The grounds felt deserted, and the distances between the buildings were dark fields broken by inadequate pools of light. No matter how many residents there were in the early part of the evening, spread out in the great stretches of the hospital grounds, the night was still desolate. The security guard told me that the most dangerous creatures at the hospital at night were the raccoons. But it is nerve-racking to be alone at midnight by the dark woods of an asylum. When I was there I found myself repeating the guard’s words sternly to myself.
+'''II. Basic Principles of Materialist Dialectics'''
-Gertrude made it through the night without mishap, but her personality style, like that of many doctors, did not sit comfortably with the sudden demand to care for people in ways she did not understand. She seemed as if she had always been competent, that she was a responsible older sister who had baby-sat her younger brother and washed the dishes. She did not like the model of good-enough adequacy; she was not laissez-faire; she worried that if she pretended to be competent without having full knowledge, one of her patients would develop a strange undiagnosed disease and die. She had been a solid, successful undergraduate—the kind who’d been accepted by many medical schools—and had done it by working until she became one of the best in her class. Like many psychiatrists, she was shy and had always been reserved. She loved parties but was vaguely embarrassed when standing around in a chattering group. She seemed to manage well, but that was because she did what other people told her to do, and it left her cynical and distrustful. It bothered her intensely to cut so many corners and to have to depend on other people to give her a sheen of adequacy in doing a job she had not yet been taught to do well.
+. The Principle of General Relationships
-“It’s all politics,” she said bitterly. “That’s what you learn—how to talk on rounds, how to talk to patients, how to talk to nurses. You’re taught by mistakes and by apprenticeship coaching, not all of which are consistent. Sometimes people give completely different advice. You start out so idealistic. Then you begin to cut your losses.
+. Principle of Development
-“Because the nurses will call and say, ‘We’ve put so-and-so in restraints [leather cuffs for ankles and wrists], please write the order,’ or ‘We’ve just given so-and-so Ativan [a minor tranquilizer used to calm agitated patients], please write the order.’ And in three months it won’t matter, I’ll know people, know whether I can trust their judgment. Still, I’m the one who takes the legal responsibility now. And where’s my legitimacy? What is it like to be the nurse who’s worked here for twenty years and calls up a new resident in July and has to persuade him to do something? They ''have'' to push me into agreeing with them, but the whole mess seems kind of inappropriate. Like, as DOC I need to be a protective watchdog on the phone. I need to protect the nurses by not taking patients that will make them feel uncomfortable. But I need to protect the hospital from bankruptcy. There’s no way of doing it well.”
+'''III. Basic Pairs of Categories of Materialist Dialectics'''
-This practical, rapid apprenticeship remains the primary teaching method throughout the residency period (as is typical in medicine). During the three-year training period, residents usually spend their first year in inpatient care, their second in outpatient, and their final year either in administrative positions (as “chief resident” for various services in the hospital) or in some other elective pursuit: research or in further specialized training. Often, what the resident does in the third year tends to mimic her first, the difference being that in her third she tends to have supervisory responsibilities. The second year, the outpatient year, is unusual because the resident is working not in the hospital but in a clinic, sometimes some distance from the hospital to which it is attached. That is when residents commonly have the greatest exposure to psychotherapy.
+. Private and Common
-Gertrude’s program was in a large psychiatric hospital. At the time I was visiting, there were nine units, each oriented to a different patient population: patients who were depressed or traumatized or had eating disorders and so forth. Gertrude and her peers would rotate through three units for four months apiece. While in the rotation, they would be assigned one or more patients on the unit as their primary responsibility. Gertrude would attend most meetings concerning her patients—meetings to discuss the patient’s treatment, meetings with family members—and most meetings of the unit. In addition, she was expected to work in the admissions building, admitting patients, one afternoon a week, to be on call one or two evenings a week, to attend four hours of lectures a week, to participate in a group therapy session for the entire class of residents, and to begin to follow at least one outpatient for psychotherapy. In fact, residents often attended lectures sporadically after the first few months. In one residency, faculty resorted to attendance sheets and still the residents refused to show up; they pointed out irritably that their responsibility was to care for their current patients, not to sit dutifully in a class. What residents actually learn is to do what they have to do: admit, diagnose, and medicate patients, and—less pressing these days—see them in psychotherapy.
+. Reason and Result
-Of all the skills that Gertrude had to master, the most important, most tested, and most public was her ability to admit patients to a hospital service. An “admission” is a ritual-filled process that identifies an ill person as a patient and produces a few pages that are the single most consistently read document about the person as a patient throughout the hospitalization and beyond. As the hospitalization goes on, more and more pages are added: nursing notes, psychiatrists’ notes, notes from the occupational therapist and the social worker and so forth. Each subsequent admission adds more paper. Soon the patient’s chart—the folder with his name on it—bulges out to one inch, then to three; patients from the old psychiatric units, where stays were long and note taking was extensive, have charts that are literally feet in width. You see residents carrying these older charts out of Medical Records with hunched, strained shoulders. Every time a hospital staff member sees a patient, every time a doctor consults or a nurse takes over a shift or an occupational therapist drops by, a note is added to the chart. To read such a massive dog-eared volume, you turn first and foremost to the admission notes: clean, typed summaries that explain why the patient came into the hospital and what the doctor thought about that person at that time. To write that note, the doctor interviews the patient and dictates several paragraphs, which are the medical and legal justification for the patient’s presence in the hospital and which provide the evidence and argument for the identification of the illness.
+. Obviousness and Randomness
-During my summer at the oak-paneled hospital, I saw Gertrude prepare her first psychiatric admission note. It took four hours. By the end of the year, it would take her no more than an hour to interview the patient and dictate the admission note to the chart, but the afternoon I sat with her she was paralyzed. She had been a highly effective intern at her prestigious internship. She knew, she said, what to do about chest pain. At the end of her internship she knew which patient would “code” that night—who would slip into cardiac or respiratory arrest and need to be resuscitated. But now she was panicked.
+. Content and Form
-What I found fascinating about her panic was that she had all the intellectual knowledge she needed. She had interviewed her first patient with a senior resident, and they had concluded that the patient had obsessive-compulsive disorder. She had the official diagnostic handbook for psychiatry, which she’d opened to the page on obsessive-compulsive disorder. She had a copy of another admission note for a patient with obsessive-compulsive disorder. She had a mass of notes on the patient she’d just interviewed. But after the patient had gone she stood behind the desk, her body tight and clenched, swaying slightly, desperate and terrified in her neat suit.
+. Essence and Phenomenon
-She understood that she had to provide, for the section marked “History of the Present Illness,” a chronological account of the illness, with generalizations backed up by specifics that provided evidence for one or more diagnoses. The admission note, she said, was not an account of what the patient had said; it was what the doctor, who supposedly excludes irrelevant details, interpreted the patient to have been saying. The note was supposed to demonstrate that the patient met the criteria for the diagnosis of obsessive-compulsive disorder. (There might later be a longer note detailing the entire course of the patient’s history.) These criteria basically are the following:# ''The patient must have'' obsessions ''(recurrent thoughts or impulses that are intrusive and distressing; they are not simply excessive worries about real-life problems; the person attempts to suppress them; the person knows the thoughts are a product of his own mind; e.g., he is not psychotic) or'' compulsions ''(repetitive behaviors such as hand washing, door checking, and so on, or mental acts such as praying, that the person feels driven to perform; these acts are aimed at preventing some dreaded event but are not realistically connected to its prevention)''.
+. Possibility and Reality
-# ''The person has recognized at some point that these obsessions or compulsions are unreasonable''.
-# ''The obsessions or compulsions cause marked distress, are time-consuming (requiring more than an hour a day), or significantly interfere with the person’s life''.
-# ''The obsessions or compulsions are not due to another psychiatric illness (such as obsessing about food in anorexia nervosa)''.
-# ''Nor are they due to some other medical or drug-related condition''.@@@[[#1Thisisadaptedwithmoreuse|1]]$$$
+'''IV. Basic Laws of Materialist Dialectics'''
+. Law of Transformation Between Quantity and Quality
-An appropriate admissions note would probably have looked like this example from a psychiatric textbook:
+. Law of Unification and Contradiction Between Opposites
-===== The patient is a 24-year-old white single man who comes to the clinic, referred by and accompanied by his mother, for consultation about compulsions and obsessions. He presents with a history of rituals starting in childhood and becoming more disabling over time. He reports that after college he began checking the locks on his house repeatedly and checking his car for break-ins, then checking household appliances repetitively for safety. He developed excessive grooming rituals and became so obsessive at his work as an accountant that he was forced to quit. He then became fearful of losing control and of public aggression, fearful of acquiring AIDS, and concerned about the symmetry of objects. He has recently moved back into his parents’ home, where his rituals have become so extensive that they consume the entire day, and he is no longer able to bathe or groom himself in consequence. The patient is aware that these behaviors are excessive and unreasonable, but when he attempts to stop them he becomes so overwhelmed with anxiety that he ends up redoubling his ritual efforts. There appears to be no precipitating cause for these behaviors in medical illness or any other psychiatric illness. There also appears to be no family history of this condition. The patient presents as an unkempt, poorly groomed man who is intellectually intact and without symptoms of psychosis.@@@[[#2NancyAndreasenandDonaldBl|2]]$$$ =====
+. Law of Negation of Negation
-<div style="margin-left:0.508cm;margin-right:0.508cm;">diagnosis: obsessive-compulsive disorder 300.3</div>
+'''Chapter 3: Cognitive Theory of Dialectical Materialism'''
-But Gertrude’s patient hadn’t produced a story much like that: organized, abstract, distant from the minutiae of the facts. Patients never do, unless they have been through many, many admissions, and then only if they want to cooperate with the doctor. In psychiatry, patients don’t produce information as easily as they do in other medical settings. Most patients with physical disorders are frightened by their pain and eager to give information about it. Psychiatric patients have a very different relationship to their symptoms and don’t always want to answer questions. Gertrude’s patient probably found his rituals deeply embarrassing. He probably wanted the help, but he also probably wanted to tell this stranger as little as possible to get it. The paranoid patient, who has an unrealistic fixed belief that people are out to get him, may not feel, at the time, that it is of any relevance to the doctor that there is a conspiracy of aliens against him. The manic-depressive patient, whose judgment is usually quite poor during periods of illness, may take a dislike to the doctor and say that she has been behaving perfectly normally. Interviewing a psychiatric patient can be like trying to catch fish with your hands.
+. Praxis, Consciousness, and the Role of Praxis in Consciousness
-Moreover, while Gertrude had a clear, abstract idea about obsessive-compulsive disorder (all those notes), she had no “intuition.” The diagnosis didn’t feel ingrained, at her fingertips. “In internship,” she said, “at the beginning of the year, I remember the senior resident rotating around the floors checking out how things were going for the intern who was there all night. What would happen would be that the nurses would pull him aside and say, ‘You know, this patient in room 114 doesn’t look too good to me.’ So the senior resident would, in a very nonchalant way, saunter over and say, ‘How’s it going, how is that patient in 114 doing?’ and the intern might say, ‘Oh, not so bad,’ and the senior would say, ‘Oh, let me look at the vital signs [blood pressure, temperature, etc.]. Oh, that looks kind of funny, let’s go take a look at him together.’ As a beginner, you miss a lot of things, because you haven’t seen the volume of patients. As the year progresses, you find that by even walking into the room and just ''looking'', you can tell, this patient does not look good. That’s intuition.”
+. Dialectical Path of Consciousness to Truth
-Clinical intuition is what doctors develop when they become what other doctors call “good.” It is their expertise. Intuition is the capacity to recognize patterns in body and behavior that are relevant to clinical problems, to see what is wrong with a patient, to judge the severity of the problem, and to choose an intervention that leads as quickly as possible to the patient’s recovery. When the average person walks through fields with a birder, he or she sees flowers and grass; the birder sees twenty species of birds and a complex range of their habitats. In bird-watching as in medicine, intuition means being able to pick up little, unobvious details, such as a type of grass or a smell or a little phrase, that helps you to know what you are seeing. But in medicine, the field guides to disease have an oblique relationship to sick people. It is rarely the case that a particular symptom (dizziness, for example) is produced by one and only one disease. Physicians learn how to diagnose from clusters of related symptoms so that they recognize patterns even when many of the pieces aren’t manifest. Part of their skill involves making helpful guesses about which disease the pattern of symptoms suggests. A “good” or “classic” case of hypothyroidism is a depressed-looking, overweight woman with a thick tongue and dry, scaly arms. If you were a senior doctor, you might teach “hypothyroidism” to your medical students with such a case, but the hypothyroidism you diagnose in your office might have very few of those classic features. Luckily, for some illnesses, there is a simple test—a “pathognomonic test”—that confirms the diagnosis, such as a brain scan that reveals a tumor that has been causing headaches. Even in medicine this is often not true: Alzheimer’s disease, for example, can be diagnosed definitively only by autopsy. In psychiatry, of course, there are no such tests—no blood tests, no X rays, no urine samples apart from those used to detect alcohol or drugs.
+'''Afterword'''
-Because none of the psychiatric categories (at least, none of the ones that count as truly psychiatric) can be diagnosed by a test or a telltale symptom, most of the diagnoses are presented as a checklist of criteria, in which the patient has to have some but not all of the items on the list to qualify for the diagnosis. This, for example, is the diagnostic checklist for major depression:
+'''Appendices'''
-===== Five or more of the following symptoms have been present during the same two-week period, and at least one of them is depressed mood or loss of interest and pleasure: =====
+Appendix A: Basic Pairs of Categories Used in Materialist Dialectics
-# ''Depressed mood''
+Appendix B: The Two Basic Principles of Dialectical Materialism
-# ''Markedly diminished interest or pleasure''
-# ''Significant weight loss or gain''
-# ''Insomnia or hypersomnia''
-# ''Psychomotor agitation or retardation (being agitated or moving leadenly)''
-# ''Fatigue or loss of energy''
-# ''Feelings of worthlessness or guilt''
-# ''Diminished concentration''
-# ''Recurrent thoughts of suicide''@@@[[#3AmericanPsychiatricAssociat|3]]$$$
+Appendix C: The Three Universal Laws of Materialist Dialectics
+Appendix D: Forms of Consciousness and Knowledge
-The obsessive-compulsive disorder checklist is more straightforward, but there is still a gulf between what a patient says and the abstract itemized diagnosis. The reason the admissions process for Gertrude’s first admission took so long was that Gertrude kept trying to match up what the patient had said with what the diagnostic criteria stated. She had difficulty remembering the details in the patient’s account because they didn’t really yet seem like part of a story. Washing one’s hands a hundred times a day seems frankly incomprehensible to most of us, a weird Borgesian exaggeration, not evidence of “excessive grooming.” Ditto for checking the house lock thirty times before leaving for work or not taking out the garbage for six months. The young psychiatrist’s pen hesitates at that thought: What does the place really look like? What makes it an illness, not a Hollywood fantasy? Admissions notes seem so calm and measured. Those first interviews are alien.
+Appendix E: Properties of Truth
-To new psychiatrists, fresh from treating cardiovascular disorders and lung cancer, diagnoses for which you need five of nine symptoms seem strange, despite the fact that certain medical diseases, such as lupus, are also diagnosed by checklist. These diagnoses become particularly suspect when the criteria include items such as “feelings of detachment or estrangement from others” or “feelings of worthlessness or guilt.” These complaints do not seem like “real” diseases; they do not feel “organic.” They suggest that a committee sat down one afternoon and voted on what “depression” should include. Which, of course, some committee did. To a young psychiatrist like Gertrude, this committee work initially has the look of whim. It is not clear to her that she is dealing with distinctly different physical processes in the body. “It was very different being an intern,” she said in her first summer. “As an intern you had an agenda. You knew much more precisely what to ask. And there was always something ''organically wrong'', even if it presented with a variety of symptoms. There was none of this five of nine of this or that.”
+Appendix F: Common Deviations from Dialectical Materialism
-Through the process of psychiatric training, those doubts disappear in practice, even among those who remain vociferously skeptical to the end. By the time young psychiatrists have finished training they can recognize the disorders immediately, the way plane spotters can spot Boeing 747s, the way bird-watchers can spot great snowy owls, the way dog lovers know the difference between a Jack Russell terrier and a beagle. Often, they talk and act as if the diagnoses pick out diseases that are as clear and distinct from one another as Jack Russells and beagles. That first year, when Gertrude learned to diagnose quickly and accurately, she began to behave as if there were psychiatric diseases that people came down with, just as they came down with meningitis. “You’re sizing up the patient right away,” Gertrude told me some months later, “just like in medicine. After a year of seeing people and doing countless admissions, two to five or more a week, you walk into a room, you see how they address you, and you’re already thinking the diagnosis.”
+'''Glossary and Index'''
-That summer I watched the new residents do admissions. Each was assigned one case at one o’clock and another at three. The resident would walk over to the Admissions Building after lunch, pick up any previous medical chart in the main office, thumb through it, go out to meet the patient in the waiting room, and take him or her to an interview room. Usually, the resident spent an hour interviewing the patient, and then, after a quick physical exam, the patient would be sent out to wait for an escort to the unit. One resident said to me after her first admission interview, “My job, in the admission interview, is first that I’m the primary contact with the hospital, and I want that to be a good and healing experience for the patient, and I want to convey interest in her life. But what I ''have'' to do is to collect information. ''That’s'' what goes into the admission note. The art is to produce the information in a seamless way, as if you were naturally having a conversation. But that’s hard. I haven’t learned it, and so I fire streams of questions at the poor patient.” As the doctor you want to behave “normally” in an initial interview, in a trustworthy and compassionate way, both because you want to be helpful and because the patient won’t talk unless he trusts you. At the same time, your real job is to probe with specific questions into areas the patient may find embarrassing, humiliating, or distressing.
+<br />
-There are two distinct kinds of questions. First, there are direct questions about illness, like those medical doctors ask about medical diseases. A psychiatrist “probes” for obsessive-compulsive illness by asking questions such as “Do you wash your hands very often?” He probes for psychosis with questions such as “Do you feel that the television has special messages for you?” He probes for depression with questions such as “Have you thought recently about killing yourself?” The younger the clinician, the more likely he is to pursue the full range of possible questions with the medical student’s studious anxiety, regardless of what the patient thought he came in to talk about. I once saw a second-year resident interview a nineteen-year-old man who had made the appointment because he’d decided to tell his mother that he was gay and it happened to be the one-year anniversary of his father’s death from AIDS. People who lose someone close to them often feel a return of acute grief on the anniversary of the death. It was very likely that the young man had come in for psychotherapeutic counseling. He probably wanted to talk about his grief, his anxiety, and his need to be honest but not to hurt his mother. The young psychiatrist asked him all the diagnostic questions for psychosis (Do you think that you can read my mind? Do you have special thoughts about the cosmos?), for depression (Have you lost weight recently? Do you have difficulty concentrating?), and for antisocial personality disorder (Did you ever set fires before you were sixteen?). The adolescent, who had clearly cinched up his courage to come talk about his decision, sat in baffled astonishment. More often the clinician will ask a series of targeted questions around the diagnosis the psychiatrist thinks will fit the patient, and those questions will focus on the defining characteristics of that category. If a psychiatrist suspects that the patient became manic, she will ask: Were you talking very quickly? Did you spend a lot of money? Was it a great weekend for sex?
+[[File:t-w-the-worldview-and-philosophical-methodology-of-3.png|''“Great Victory for the People and Army of South Vietnam!”'']]
-Then there are questions that are essentially indirect ways of getting information the patient may not want to, or cannot, give. Often the psychiatrist asks some everyday questions and gives small tests to judge whether there is anything bizarrely amiss in the patient’s thinking. A patient may, for example, be asked to count backward from one hundred by sevens; to remember the words “car,” “book,” and “umbrella” and repeat them a few minutes later; who the president is; what day it is; what “A stitch in time saves nine” means; what he would do if he saw a stamped, addressed envelope lying on the sidewalk. There are at least two versions of this last test of common sense, the other being “What would you do if you saw a fire?” In the summer seminar session on the mental status exam, one of the senior residents described a patient, bored at the end of his admission interview, who when asked what he would do if he saw a fire said that he would put it in the mailbox. That, said the resident, was a patient of many admissions.
+<br />
-==== {{anchor|SAMPLEADMISSIONSPROTOCOL}} SAMPLE ADMISSIONS PROTOCOL ====
+= Introduction to the Basic Principles of Marxism-Leninism =
-<div style="margin-left:0.423cm;">''Patient name:''</div>
+== I. Brief History of Marxism-Leninism ==
-<div style="margin-left:0.423cm;">''Identifying data:'' Age, ethnic group, sex, marital status, employment status, referral source.</div>
+=== 1. Marxism and the Three Constituent Parts ===
-<div style="margin-left:0.423cm;">''Chief complaint:'' Complaint in patient’s own words.</div>
+Marxism-Leninism is a system of scientific opinions and theories which were built by Karl Marx<ref>Karl Marx, 1818–1883 (German): Theorist, politician, dialectical materialist philosopher, political economist, founder of scientific socialism, leader of the international working class.</ref> and Friedrich Engels<ref>Friedrich Engels, 1820–1895 (German): Theorist, politician, dialectical materialist philosopher, leader of the international working class, co-founder of scientific socialism with Karl Marx.</ref>, and defended and developed by Vladimir Ilyich Lenin<ref>Vladimir Ilyich Lenin, 1870–1924 (Russian): Theorist, politician, dialectical materialist philosopher, defender and developer of Marxism in the era of imperialism, founder of the Communist Party and the government of the Soviet Union, leader of Russia and the international working class.</ref>. Marxism-Leninism was formed and developed by interpreting reality as well as building on preceding ideas. It provides the fundamental worldview* and methodology of scientific awareness and revolutionary practice. It is a science that concerns the work of liberating the proletariat from all exploitative regimes with the ambition of liberating all of humanity from all forms of oppression.
-<div style="margin-left:0.423cm;">''History of present illness:'' Use problem-oriented format. For each symptom/problem include age of onset, severity and duration of symptoms, precipitating and maintaining factors, presence or absence of neurovegetative signs, response to medications. Use back of page if necessary.</div>
+Marxism-Leninism is made up of three basic theories which have strong relationships with each other. They are: ''Philosophy of Marxism-Leninism, Marxist-Leninist Political Economics,'' and ''Scientific Socialism''.
-<div style="margin-left:0.423cm;">''Past psychiatric history:''</div>
+''Philosophy of Marxism-Leninism'' studies the basic principles of the movement and development of nature, society and human thought. It provides the fundamental worldview and methodology of scientific awareness and revolutionary practice.
-<div style="margin-left:0.423cm;">''Substance abuse:'' Number of drinks/day, last drink. History of DWIs, etc.</div>
+Based on this philosophical worldview and methodology, ''Marxist-Leninist Political Economics'' studies the economic rules of society, especially the economic rules of the birth, development, and decay of the capitalist mode of production, as well as the birth and development of a new mode of production: the communist mode of production.
-<div style="margin-left:0.423cm;">''Medications:'' Current psychotropic and nonpsychotropic medications.</div>
+''Scientific Socialism''** is the inevitable result of applying the philosophical worldview and methodology of Marxism-Leninism, as well as Marxist-Leninist Political Economics, to reveal the objective rules of the socialist revolution process: the historical step from capitalism into socialism, and then communism.
-<div style="margin-left:0.423cm;">''Allergies:''</div>
+-----
-<div style="margin-left:0.423cm;">''Family history:'' List current and past family psychiatric disorders (including substance abuse) and medical disorders. List treatment received and effectiveness. Also include suicides in the family.</div>
+==== Annotation 1 ====
-<div style="margin-left:0.423cm;">''Medical history:'' Include history of head trauma, major illnesses, hospitalizations, and operations.</div>
+<nowiki>*</nowiki> A ''worldview'' encompasses the whole of an individual’s or society’s opinions and conceptions about the world, about ourselves as human beings, and about life and the position of human beings in the world.
-<div style="margin-left:0.423cm;">''Current functioning:'' Indicate living arrangements, occupation, economic status, social and leisure activities, sexual orientation and functioning.</div>
+<nowiki>**</nowiki> The word “science,” and, by extension, “scientific” in Marxism-Leninism has specific meaning. Friedrich Engels was the first to describe the philosophy which he developed with Marx as “Scientific Socialism” in his book Socialism: Utopian and Scientific.
-<div style="margin-left:0.423cm;">''Past development:'' Describe sibling rank, relationships with family members and peers. Describe key relationships and dating, marital and sexual history (including sexual abuse). Describe educational history, highest grade completed, and work history.</div>
+However, it should be noted that the English phrase “scientific socialism” comes from
-==== {{anchor|MENTALSTATUSEXAM}} MENTAL STATUS EXAM ====
+Engels’ use of the German phrase “wissenschaftlich sozialismus.”
-# ''General appearance and behavior''Examples: Appearance: in relation to age, grooming, clothing, eye contact; behavior: agitated, retarded, bizarre, abnormal movements, restlessness; attitude: cooperative, defensive, guarded, hostile.
+“Wissenschaft” is a word which can be directly translated as “knowledge craft” in German, and this word encompasses a much more broad and general concept than the word “science” as it’s usually used in English.
-# ''Speech''Examples: Rate, rhythm, pitch, intensity, fluency.
-# ''Mood and affect'' (Mood: patient’s subjective description of feeling tone over time. Affect: the outward manifestation of the patient’s emotional state at the moment.)Examples: Mood: happy, sad, depressed, irritable, angry; affect: appropriate, flat, constricted, depressed, euphoric, anxious, elated, angry.
-# ''Thought process and content''Examples: Tangential, circumstantial, loose associations, flight of ideas, thought blocking, delusions, paranoia, ideas of reference, intrusive thoughts, obsessions, compulsions, phobias, hallucinations, illusions, suicidal/homicidal ideation.
-# ''Cognitive functions''Examples: Orientation, attention, memory, serial 7s, presidents, proverbs.
-# ''Insight and judgment'' (Insight: awareness of being ill; judgment: ability to compare and assess facts and alternatives in deciding on a course of action).DSM ''diagnosis and code (five axes):Psychosocial assessment:Goals:Treatment plan:''
+In common usage, the word “science” in English has a relatively narrow definition, referring to systematically acquired, objective knowledge pertaining to a particular subject. But “wissenschaft” refers to a systematic pursuit of knowledge, research, theory, and understanding. “Wissenschaft” is used in any study that involves systematic investigation. And so, “scientific socialism” is only an approximate translation of “wissenschaftlich sozialismus.” So, “scientific socialism” can be understood as a body of theory which analyzes and interprets the natural world to develop a body of knowledge, which must be constantly tested against reality, with the pursuit of changing the world to bring about socialism through the leadership of the proletariat.
+-----
-From Gertrude’s earliest days on the ward, as she prepared to take call and to do her first admissions, she memorized lists of diagnostic criteria, sometimes with mnemonic aids, such as SIGECAPS for depression (depressed mood plus four of these eight: sleep, interest, guilt, energy, concentration, appetite, psychomotor retardation or agitation, suicidality). Medical students attend lectures on the differences between depression and psychotic depression, or between organic delusional disorder and schizophrenia, in which the resident who is teaching the class writes the criteria out on the board and explains them. During the first months of doing admissions, new residents will pick up the small ''DSM (Diagnostic and Statistical Manual)'' handbook while talking to a patient and turn to a specific diagnosis to make sure they’ve asked about all the criteria. And often the lore passed on to new residents about the admission process circles around the symptoms and the criteria. In the summer seminar series the chief resident advised Gertrude’s class, “Try to memorize the topic you always forget; I always used to forget about obsessive symptoms.” And the daily structure of hospital life creates a learning environment that is highly effective in persuading residents to memorize these complex categories by criteria, because the failure to be “good enough” becomes a public humiliation.
+Even though these three basic theories of Marxism-Leninism deal with different subjects, they are all parts of a unified scientific theory system: the science of liberating the proletariat from exploitative regimes and moving toward human liberation.
-Medical rounds, for instance, often amount to a junior resident’s public performance of diagnostic knowledge. In a hospital, most of the important decisions are made or discussed in team meetings, or rounds, where all ward staff members—junior and senior psychiatric residents, psychiatric attendings, psychologists, nurses, social workers, and so forth—meet to discuss each patient assigned to their team. These meetings take place usually twice a week, although “sign-in rounds,” when the on-call doctors hand off responsibility to the day staff, meet every morning. Newly admitted patients are presented and discussed in detail, in discussions that may take more than half an hour each. Other patients are more briefly presented, and their progress is assessed. In most cases the presentations are done by a junior resident (or his or her medical student) who has been assigned as the responsible doctor on the case. When this is so, the job of the assembled ten people is to check the work of the most junior doctor. If the junior doctor gets the diagnosis or medication wrong, he is made to feel not only stupid but culpable. There is, after all, a patient’s life involved, and most residents and students feel guilty and embarrassed when they make mistakes. Sometimes the senior doctors deliberately humiliate them. I remember this happening most commonly over prescription errors. In one hospital, the resident did not want to place her patient on an antipsychotic. Her senior psychiatrist disagreed. When they got to her patient in the team meeting, he announced that she had made a mistake and insisted that she write the order in the chart during the meeting, so that everyone could see that she had done it. Shame is a common teaching tool in medical education.
+=== 2. Summary of the Birth and Development of Marxism-Leninism ===
-In one hospital, each inpatient team had two junior residents, and each semiweekly team meeting ran through all of one resident’s eight to twelve patients. The resident would pull out his patient identification cards from his shirt pocket and begin to recite in a tired voice, “Mr. Jones is our fifty-one-year-old depressed divorced white male. He presented in the ER last Thursday with suicidal ideation, sleep disturbance, and appetite loss. We’ve started him on imipramine, and he’s now up to fifty milligrams t.i.d. [three times a day].” These are, of course, the criteria: depressed mood for at least two weeks and at least four out of eight further criteria, of which—and this is the clinical knowledge that accompanies the memorization of diagnostic criteria—suicidality, weight loss, and changed sleep patterns are really the most distinctive and important. When a patient has been admitted and is being presented for the first time, the resident develops the account more fully and presents the diagnosis as a conclusion. New presentations are an argument for a diagnosis: “Mr. Jones is a fifty-one-year-old divorced white male with the chief complaint ‘I don’t want to live anymore.’ He presented in the ER last night with intense suicidal ideation. He described feelings of hopelessness and guilt and reported a weight loss of ten pounds in the last three weeks. He reports extremely poor sleep with early-morning awakening.…”
+There have been two main stages of the birth and development of Marxism-Leninism:
-By their second year, residents begin to talk about the “feel” of the disorders. They say that they “sense” or “intuit” psychosis. In her second year, Gertrude remarked, “There’s something to be said for having seen a thousand schizophrenics and a thousand bipolars. You begin to get a ‘feel.’ It’s kind of the art of medicine.” A classmate remarked around the same time that “if you’re doing your medical clerkship, your admission note is eight pages long and you have every detail under the sun. Then the intern comes along and writes a two-page note and the resident comes along and writes a one-page paragraph. Somehow that paragraph is able to distill what is important, pick it out much more clearly than the eight pages by the clinical students. Now, for me, diagnosis is more of a feel. You kind of have a feel for a patient. Someone just comes across to you as a schizophrenic or bipolar patient. I’ve come to appreciate what clinicians gain with time, that these people fifty and sixty years old have this wealth of experience and they really get to the heart of the problem in a way that I’m only beginning to understand.”
+''1.'' ''Stage of formation and development of Marxism'', as developed by Karl Marx and Friedrich Engels.
-At some point in the first year, then, the resident moves from memorizing criteria to recognizing prototypes. By “prototype,” I mean a cluster of characteristics that constitute a “good example” of a class. When you use prototypes in your thinking, you ask whether the item in question resembles the best example of that class, not whether it meets specified rules or criteria of that category. Is an ostrich a bird or a grazing animal? A prototype user asks himself whether the ostrich is more like a sparrow or more like a cow, relying both on what he can see and on an array of background theory and assumptions. An impressive battery of work in cognitive science argues that for most of our everyday categories—particularly our “basic-level” categories such as “table, “chair,” and “dog”—we reason by prototype. When you look at a piece of furniture to decide whether it is a table or a chair, you do not list the rules of membership in the “table” and “chair” categories in your mind. That takes time. It also often does not work, since many category members do not have all the apparent criteria of the class. (A bird that cannot fly, like the penguin, is still a bird.) Instead, the evidence suggests, you call to mind the best examples of each category, and you decide which one the questionable object most resembles.@@@[[#4EleanorRoscheg197319|4]]$$$ You don’t ask yourself whether this chair meets the criteria for chairship. You look at it, and you know it’s a chair.
+''2.'' ''Stage of defense and developing Marxism into Marxism-Leninism'', as developed by Vladimir Ilyich Lenin.
-The great advantage of prototype use is that it is fast and efficient. You recognize rather than remember a list of membership rules. The cost is that the boundaries between categories become starker. Cognitive scientists use the phrase “prototype effects” to describe this phenomenon. People process information about prototypes more quickly than about nonprototypes, but they also tend to clump information around prototypes, so they are more likely to overinterpret similarity to a prototype.@@@[[#5Aclassicexampleofasomewh|5]]$$$ If a very new resident is asked whether a patient meets ''DSM'' criteria for, say, schizophrenia or paranoia, that resident will pick up ''DSM'' and read the criteria for each. She may find that the patient meets some for both and that the difference between the two categories is not that straightforward, at least in this case. If you ask that same resident about such a patient one year later, when she has developed prototypes for the illnesses, she will probably not reach for the diagnostic handbook, and she will probably not feel that the difference between the categories is inherently uncertain. She is more likely to believe that there are clear differences between illness categories and more likely to pick up data in a case presentation that correspond to the prototype and ignore information that does not. As this happens, it becomes difficult for the psychiatrist to remember that initial skepticism about the diagnostic criteria. A patient’s illness seems less like a sorting problem—is it like this or like that?—and more like a simple identification task. Diagnoses begin to feel like real, distinct objects in the body.
+==== a. Conditions and Premises of the Birth of Marxism ====
-Certainly young psychiatrists talk about the diagnostic manual as if they use it casually and as if the disorders are there in the person’s body regardless of what the manual says. As a second-year resident said, “I’m fairly sloppy about [DSM]. I use it to diagnose several broad categories, and I don’t worry much about the nuances.” Another, at the end of his first year, remarked, “PTSD [posttraumatic stress disorder].… I couldn’t give you every little ABCD, but I know what PTSD is. You have to experience one of these four things, ABCD. Category B, you have to have two of these seven things. I don’t know what these things are precisely, but I kind of know what it feels like. For generalized anxiety disorder you have to worry about things, and then you have to have, like, six out of the eighteen somatic symptoms—I have no idea of what those eighteen things are, but I know when someone’s anxious.” Sometimes the residents seem more interested in treating people who need help than finding out whether, strictly speaking, those patients meet the printed criteria. One second-year resident remarked, “There’s a lot of gray. They’re sad, they’re not sleeping too well, their wife just left them. Or they’re anxious and it sounds like a panic attack but it just doesn’t meet the criteria. If someone had to meet the diagnosis strictly before getting treated, a lot of people wouldn’t be treated.” Sometimes they think about the social impact of the diagnosis they choose, mostly preferring to give a diagnosis with a better prognosis for the long term (such as manic-depressive disorder) than one with a less good prognosis (such as schizophrenia) if there’s any ambiguity. And they will sometimes mention diagnostic characteristics not listed in the diagnostic handbook, such as clothing or makeup. “I once diagnosed someone as hypomanic by the way they listed their name in the phone book, with ''all'' their names,” someone told me. Or “If you ask a depressed woman whether she’s ever tried to kill herself and she says, ‘Fifty times,’ you’ve got a diagnosis [borderline personality disorder].”
+-----
-Young psychiatrists also act with the speed that suggests that diagnosis is more like recognizing chairs and tables than it is like pulling out a manual and carefully double-checking the printed criteria. When I began this study, an anthropologist told me that University of Kentucky residents took thirty seconds to make a diagnosis.@@@[[#6ThiswasCharlesNuckollsfro|6]]$$$ I thought at the time that he was pulling my leg. Then I spent an evening with a resident at her night job. To entertain me, she would diagnose the patient after glancing at him through the plate-glass window that separated the staff room from the waiting area. We sat in the staff room; we looked at the patient as he or she walked in the door, and my friend would say, this one’s depressed, that one’s manic, that one’s high. Then we walked out together and she interviewed the patient, often in the presence of the police. The man she said was depressed had been picked up on a bridge, threatening to jump because he wanted to die. The man she said was manic had been running down the street half naked and was, when he began talking, clearly on a drugless high. The one she said was on drugs obviously was. That is, it was obvious to me when he began to speak; it was obvious to my psychiatric friend when she glanced at him. Shortly after I had seen Gertrude struggle through her four-hour marathon to admit ''one'' patient, I had lunch with a senior resident who merrily announced that he’d admitted seven patients the previous evening (in other words, after 5 p.m.) and been in bed by 1 a.m. That is less than an hour each to meet a patient, interview him or her, do a physical exam, and dictate the admission note for the chart. When I began to canvass people on the anthropologist’s provocative comment the senior faculty were alarmed and defensive—they took pains to explain how carefully diagnoses were made—but residents chuckled and wondered why those Kentucky residents were so slow. Of course, few patients who appear in the hospital are totally new to psychiatry, so in most cases the patient carries a prior diagnosis, but even so the quick assessment occurs. “It’s pattern recognition,” Gertrude explained. “Does this seem like somebody who as you sit with them seems psychotic? Do they seem depressed? Like a trauma patient? I kind of ask myself what are they making me feel, what sense am I getting, and then once I feel confident about what direction they’re heading, I’ll kind of go through a list more confirming what I already sense. Just in case I’m missing something, I’ll also ask about hallucinations even if they don’t seem psychotic, suicide even if they don’t seem suicidal. Things like that. But first I get this general gist, and then I confirm it.” Psychiatrists do treat these initial diagnoses like hypotheses that their interviews will support or overturn, but the point is that they are fast. I once stood in an elevator with a psychiatrist known for his work on the diagnostic categories, and I asked him how long it took him to make a diagnosis. He looked thoughtful and slightly troubled, and then he said, “Quickly. Very quickly.”
+==== Annotation 2 ====
-It doesn’t always work like this, of course. Once a week, a hospital (or a hospital unit) will hold a case conference, and usually the point of that conference is to have a senior clinician diagnose a “diagnostic difficulty,” a patient who doesn’t seem to fit any category well, as if he were part table, part chair, or both at once. For example, I attended one about a patient admitted to the hospital because of a dangerous suicide attempt. He didn’t really seem depressed. He “felt” psychotic to some of the doctors. When he talked about his life, it sounded schizophrenic to them. “He’s very isolated,” one psychiatrist said. “He has a lot of crazy ideas about the Internet, and when you talk to him, he comes across as disconnected and sort of affectless.” But the patient said he was bipolar, and he talked about being “manic” and “depressed” with accomplished ease. He’d been hospitalized several times, but the medical charts from the other hospitals probably wouldn’t arrive until after he’d been discharged, so it was impossible to know what he had looked like to other doctors then. He said he didn’t “like” lithium or the other mood stabilizers. He said they didn’t help. Was he a schizophrenic who had once been told he was bipolar and had since worked that up into a near delusion? Was he bipolar? Did he have a psychotic depression? When I saw him interviewed, the senior clinician was sure he was bipolar. But then, this senior clinician specialized in the treatment of bipolar patients. He more or less thought that most patients were bipolar. This is not that uncommon. One hospital has a PTSD (posttraumatic distress disorder) research unit with a charismatic leader, and in an admission interview the residents probe more deeply about abuse than they might elsewhere and diagnose PTSD more often. Another program is known for its schizophrenia research. There the eager residents are more likely to suspect schizophrenia than bipolar disorder in patients. In this case, the other two mature clinicians in the room thought the patient was schizophrenic.
+The following sections will explain the conditions which led to the birth of Marxism. First, we will examine the Social-Economic conditions which lead to the birth of Marxism, and then we will examine the theoretical premises upon which Marxism was built. Later, we will also discuss the impact which 18<sup>th</sup> and 19<sup>th</sup> century advances in natural science had on the development of Marxism.
-Still, the cumulative effect of the learning process is to imply that for each diagnosis there is an underlying disease, a “stuff” the diagnosis names, and that the stuff trumps the diagnosis. That is, through the process of memorizing the criteria and learning to prototype the categories, psychiatrists learn to talk and act as if the disorders are there in the world, that they are instantly recognizable, and that the printed diagnostic criteria may only partially describe the real disorders. Young psychiatrists behave as if these categories are “natural kinds.” A “natural kind” is something real in the world, such as a zebra or a horse (but not a table). We know that there is a “natural” difference between a zebra and a horse, even if an albino zebra has no stripes and a troublesome philosopher has painted black stripes on a white horse. The difference between zebras and horses is genuine. It is not a matter of social convention, we didn’t invent it, and whatever makes the difference is intrinsically, even causally, related to the difference between categories. Gold is not the same as fool’s gold, even though both are golden, because it is made from a different chemical compound.@@@[[#7Thephilosophersperhapsmost|7]]$$$ We know that experts know the difference between the two, and we know that there is a real, underlying difference, even though we may not know what it is.
+''- Social-Economical Conditions''
-Doing a lot of diagnoses, using prototypes, and writing those admission notes tends to give one the sense that there ''are'' underlying essences that can be seen, named, and possibly controlled, even when the actual problem seems elusive and perplexing. One of the oldest ideas in human thought is that when you name something mysterious and out of control, you gain mastery over it. In magic and religion in cultures throughout history, to know the name for a tree or a person or a malicious spirit was to grasp its essence and so control it (unless you were too weak or impure, in which case uttering the sacred name might kill you). In medicine, of course, diagnosis gives a doctor control because it tells him how he might be able to help a patient. But something of the old magical echoes linger. To produce a name makes you feel that you have begun to master the reality of the problem and that there is, in fact, something there to master. And medical training has already persuaded the resident that diseases are natural kinds existing in the body. A viral infection is not the same as a bacterial infection, even if they sometimes produce similar symptoms and even if the difference between them is not easily explained, and the doctor’s job is to figure out which disease it is.
+Marxism was born in the 1840s. This was a time when the capitalist mode of production was developing strongly in Western Europe on the foundation of the industrial revolution which succeeded first in England at the end of the 18<sup>th</sup> century. Not only did this industrial revolution mark an important step forward in changing from handicraft cottage industry capitalism into a more greatly mechanized and industrialized capitalism, it also deeply changed society, and, above all, it caused the birth and development of the proletariat.
-The practical demands of psychiatric training lead young psychiatrists to speak and act as if the illnesses they diagnose in the hospital are diseases of inherently different kinds. As a result of the demands placed on them in this situation, they are told that the patient has an illness that they must identify. They are told as well by this situation that they can get the identification wrong, and if so they will be humiliated; the identification, in other words, is not trivial but meaningful. They are told that identifying a patient as having both bipolar disorder and schizophrenia, for example, is a mistake, whereas suggesting that a patient has either bipolar disorder or schizophrenia (or even schizoaffective disorder) can be understood as a reasonable identification.@@@[[#8Therearemanydiagnosesthat|8]]$$$ They learn to identify a category by clumping available information around good examples. They know that although the diagnostic handbooks are composed by committees, there are experts, revered within psychiatric culture, who believe that the basic diagnoses are diseases. They have already been deeply schooled in the disease model of medicine by their training in medicine. Psychiatric illness is probably more complicated than many medical diseases and certainly in many cases less well understood. The difference between the diagnostic categories is genuinely more ambiguous because there are no clear-cut medical tests that distinguish them unambiguously and there are genuine questions about whether there really are distinct underlying diseases or not. Yet because the disease model of illness is reinforced by the cognitive experience of psychiatric training in the hospital, the inherent ambiguity of psychiatric diagnosis can rapidly disappear from the young psychiatrist’s experience.
+-----
-Gertrude started out skeptical and uncomfortable with the categories and their lists. By the end of the year she saw the illnesses as clearly as when we suddenly catch on to an optical trick and can no longer see the feature that makes it a puzzle for everyone else. And with that she became confident. She could do admissions quickly, manage night call easily, and she no longer looked fraught and tense at lectures. “The more you see,” she said over lunch one day, “the more you develop a sense for a problem. You do work with prototypes, you see a number of patients with OCD, you know what questions to ask, what’s important, you learn to ask for the HPI [history of the present illness], you learn what the clinician on the other end will be interested in knowing about the person’s presentation. That knowledge only comes from seeing people over and over again. With a patient with bipolar disorder, you know what to ask for: sleep is a ''major'' marker for what’s going on with this person. You’ll ask them why they are in the hospital. With bipolar disorder, they often exhibit no insight or judgment [i.e., they don’t perceive themselves as ill]. That helps you. You just learn certain—formulas, in a way. Okay, this is a person with bipolar disorder, these are the things I have to look at. But I also try, in my formulation, to raise a differential diagnosis [list other possible diagnoses for the condition]. The problem with prototypes is that you forget what other things might be happening. The person I admitted last night has only a three-year history of bipolar disorder and she’s forty-eight, so she got it when she was forty-five. So she’s presenting manic, but I’m not totally convinced, because it doesn’t really jive with what we know about bipolar disorder [which usually manifests itself before thirty-five]. It makes me think there might be something else. Does she have a tumor in her head? Does she have an occult cancer that’s metastasized to her brain and is causing this funny behavior? It makes you suspicious that something else could be going on, and that’s what we mean by differential diagnosis. Clinicians put a lot of emphasis on that.”
+==== Annotation 3 ====
-There are two important caveats here. The training experience that tends to encourage young psychiatrists to treat diagnoses like different underlying diseases is relevant, these days, only to some diagnoses. The organizing committee for the first postpsychoanalytic diagnostic manual (''DSM III'', in 1980) wanted the manual to bridge the field’s differences, to be accepted by everyone in the field, even while knowing that they were creating a revolutionary document. So they made an effort to be deferential to the psychoanalysts, and they created two kinds of diagnostic categories, Axis I and Axis II. (There were and are other axes as well: one for medical conditions, one for stressors such as divorce or moving, one for general level of functioning. The authors of ''DSM III'' seem to have envisioned a set of continua that located a patient precisely in some multidimensional descriptive world. For the most part, psychiatrists worry only about the first two axes.) Axis I, the first group of diagnoses, is thought of as being more “biological.” It was the product of the new psychiatric scientists who began to emerge in the 1970s and 1980s. In this group one finds schizophrenia, bipolar disorder, major depression, obsessive-compulsive disorder, panic disorders, posttraumatic stress disorder, dissociative disorder, and a great many other categories. These are supposed to be “clinical syndromes.” The thinking behind this was that one has such a disorder more or less for life but there are certain times when it becomes more “active.” Axis II, the second group, was developed by the psychodynamically oriented members of the committee. Here one finds “personality disorders” of various types: narcissistic, schizoid, obsessive-compulsive (as distinguished from the Axis I clinical syndrome), borderline, antisocial, and so forth. These are supposed to be long-standing problems of character. They are not supposed to become more active at one time than at another (although clinicians in fact treat them as if they do). They just are, like being a nervous person or an intense one. Sometimes psychiatrists say that Axis I disorders are like “states”—you go into and out of them—while Axis II disorders are like “traits,” such as having brown hair.
+Marx saw human society under capitalism divided into classes based on their relation to the means of production.
-These days psychiatric researchers have heated debates about whether these clusters are fundamentally distinct. Certainly some of the personality disorders can be as deadly as Axis I disorders, in that people with personality disorders can be at significant risk for suicide. But—and here enters a social force—only Axis I diagnoses are learned with bird-watching acuity as distinct, clear-cut objects. Because the character disorders are supposed to imply long-standing, constant problems, most hospitals (or at least their insurers) insist on limiting psychiatric hospital admissions to patients who can be described as having an Axis I category in an acute phase. Hospital admissions are meant to be limited to those who are a danger to themselves or others or incapable of self-care. In the admission note, those states are usually attributed to an Axis I disorder, the patient is treated for the Axis I disorder, and the personality disorder becomes something that makes him more or less difficult to treat (he is dramatic, irritable, entitled, and so forth) and not the cause of his illness. Whether or not these Axis I disorders (or for that matter the Axis II disorders) turn out to have underlying diseases, they are already powerfully institutionalized as if they did and as if the personality disorders did not.
+''Means of production'' are physical inputs and systems used in the production of goods and services, including machinery, factory buildings, tools, and anything else used in producing goods and services. ''Capitalism'' is a political economy defined by private ownership of the means of production.
-The second caveat is that there is a major contradiction in the learning process that challenges the naturalness of these distinctions. Psychopharmacology is the great, silent dominatrix of contemporary psychiatry. It is what psychiatrists do that other mental health professionals cannot do; and as mental health jobs become defined more by their professional specificity, more and more psychiatrists spend more of their time prescribing medication. This is where the weight of most psychiatric research is placed. More money is spent developing, testing, and analyzing psychopharmacological drugs than in any other area of psychiatry; more people are involved in the research; more patients (these days) are probably touched by these agents than by anything else the psychiatric profession does. And when a doctor medicates in psychiatry, he or she is thinking in a way that can cut across diagnostic categories and undermine the notion that there are separate underlying diseases that correlate with those categories.
+Within the framework of Dialectical Materialism, all classes are defined by internal and external relationships [see ''The Principle of General Relationships'', p. 107]; chiefly, classes are defined by their relations to the means of production and to one another.
-Psychiatric medications treat symptoms, not diseases. They touch the way people act, not the underlying mechanisms. So when psychiatrists focus on medications, they sometimes behave as if the symptoms are the things in the world and the diagnostic categories have been invented by committees and reified by insurance companies. They say things such as “First you sort of break things down into gross categories. Are you dealing with a mood disorder? Is there more an anxiety component or an affective component? The bulk of what you treat, the question is psychotic spectrum versus biochemical depression or anxiety versus neurotic issues.” At the end of her first year, Gertrude said, “The first thing I’m trying to get a handle on is whether they will need medication. I’m kind of thinking ''DSM'', and, based on their chief complaint, they’re either going to go down a depression road, a psychotic road, or an anxiety road.” There are only a small number of symptoms that make up a wide variety of psychiatric illnesses, and even these symptoms are not straightforward. You can’t see them directly like a runny nose or test them objectively like a fever. There is the lead-dragging soul weariness of depression; the hallucinatory disconnectedness of psychosis; mood swings; and anxiety. There are, of course, many more particular symptoms—obsessiveness, impulsivity, addiction, and more—but depression, psychosis, mood swings, and anxiety are the most important. They are, however, inferred from behavior. Depression is inferred from lethargy, insomnia, poor appetite, suicidal thoughts, and other behaviors; psychosis is inferred from hallucinations, bizarre beliefs, and the like. You call someone “psychotic” when you ''interpret'' him as having a seriously and significantly distorted view of reality. You call someone depressed when you ''interpret'' her as having a seriously and significantly lower mood than is normal. Psychiatric disorders are inferred, in turn, from different combinations of these symptoms. Psychosis is a symptom of schizophrenia, bipolar disorder, delusional disorder, psychotic depression, and other disorders. Someone can be interpreted as being psychotic (he has told a doctor that she is the president’s sister), but that in itself is not enough to diagnose him as schizophrenic. Depression is a symptom of depressive illness but is also found in bipolar disorder, schizoaffective disorder, and others. And medication treats the symptom, not the disease.
+The ''proletariat'' are the working class — the people who provide labor under capitalism, but who do not own their own means of production, and must therefore sell their labor to those who ''do'' own means of production: the ''bourgeoisie''. As the owners of the means of production, the bourgeoisie are the ruling class under capitalism.
-Because of the way she has been trained, Gertrude acts as if she believes that psychiatric illnesses pick out real and discrete disease processes in the body. She talks about figuring out what is going on with a patient the way an ophthalmologist talks about figuring out if a patient has a corneal erosion. At the same time, her primary practical concern is with what medication to prescribe, and the medications target symptoms found across many diagnostic categories. So she also behaves as if the symptoms are the “real” physical processes and the diagnoses are just some labels some committee dreamed up. That ambiguity arises from the intersection of diagnosis and medication. It is a messy, complicated intersection.
+According to Marx and Engels, there are other classes within the capitalist political economy. Specifically, Marx named the ''petty'' ''bourgeoisie'' and the ''lumpenproletariat''. Marx defined the ''petty bourgeoisie'' as including semi-autonomous merchants, farmers, and so on who are self-employed, own small and limited means of production, or otherwise fall in between the proletariat and the bourgeoisie.
-It is true that medication can help a doctor to specify a diagnosis. If a patient doesn’t seem to need medication for a particular symptom, he shouldn’t be diagnosed with a disorder in which that symptom is prominent. For example, mood swings are necessary (but not sufficient) for the diagnosis of bipolar disorder. If the supposed manic-depressive does not respond to lithium or to another of the mood stabilizers, a psychiatrist will wonder whether after all he’s schizophrenic. If a supposed schizophrenic is managed effectively on antianxiety agents or even without medication, a psychiatrist will question whether she is, in fact, schizophrenic. For instance, a first-year resident remarked, “This guy, I’m not convinced he is schizophrenic although he probably meets criteria; in ways he’s a sort of classic description of it. But there are some things in his background that make me wonder about whether he really is a paranoid schizophrenic. Because he’s been treated with a lot of different medications, and none of them are antipsychotic, and it makes me wonder. And then he was off meds for four or five years, and before that he was on Valium. ''Valium'' [i.e., not a very strong medication and certainly not one that targeted psychotic symptoms].” Another psychiatrist said about a different patient, “I don’t know about this label [schizophrenia]. She’s had a partner, she’s actually got this guy interested in marrying her and he’s apparently perfectly reasonable, she’s managed without meds. I just don’t think that the label makes sense.” Or a second-year resident: “You try to give them the benefit of the doubt, you call them manic-depressive, and you put them on lithium and see what happens. I like to give the better diagnoses, the ones with better prognoses, unless there’s no choice.”
+In the ''Manifesto of the Communist Party,'' Marx described the petty bourgeoisie as:
-The psychiatrist’s willingness to diagnose post facto on the basis of medication is not unlike the rest of medicine. (“Take the antibiotics, and if the rash doesn’t go away, we’ll know it wasn’t Lyme disease.”)@@@[[#9Theexamplewasprovidedbyt|9]]$$$ But at least in medicine, some problems can be diagnosed through tests and scans. Combine the fact that in psychiatry you cannot test for the disease with the fact that the medications often don’t work, and the psychiatric picture begins to look murkier than the medical. To make matters even more complicated, most patients are on more than one medication. They may be on Stelazine or Risperdal for psychotic symptoms, as well as on Prozac or Elavil for their depression; maybe Cogentin to counteract the others’ side effects; trazodone, another antidepressant, for sleep; occasionally Ativan for agitation; Tegretol because someone wondered whether mood instability was involved. The patient may enter the hospital with an arm’s-length list of different medications, the cumulative result of multiple “doctors’ attempts to be both conservative and effective. Occasionally a scientific paper is published arguing that patients should be taken off their multiple medications to create “baseline” conditions, but more often the study fails because some patients who have been medicated for years cannot function without their pills and the doctor is sued for his negligence. Hospitals used to admit patients for long inpatient stays for precisely this reason. Some were famous for taking their patients off all medications and then adding them back slowly one by one to see which ones were helpful and which not. Most psychiatric medications take several weeks to take effect, and even those that create behavioral changes immediately—such as the antipsychotics—need time in order to determine the most effective dosage. But in a five-day admission, which is fairly standard these days, there is no time to take a patient off medications to see what works or doesn’t. Most patients, then, tend to be continued on whatever they are on.
+<blockquote>
+... fluctuating between proletariat and bourgeoisie, and ever renewing itself as a supplementary part of bourgeois society... The individual members of this class, however, are being constantly hurled down into the proletariat by the action of competition, and, as modern industry develops, they even see the moment approaching when they will completely disappear as an independent section of modern society, to be replaced in manufactures, agriculture and commerce, by overlookers, bailiffs and shopmen.
+</blockquote>
-Moreover, while the major psychiatric symptoms are targeted by clusters of medications—antipsychotics, antidepressants, antianxiety agents (or anxiolytics), and mood stabilizers—not all medications of a cluster will help a patient with a particular symptom. Different bodies respond differently to medications in the same chemical family, and there are many subtleties in the common interactions between different medications. In fact, there is no reason to be confident that any medication will work. Sometimes depression doesn’t respond to anything. All of the symptoms are associated with more than one illness. As a result, a medication response really alters diagnosis in psychiatry only when a medication works when you would not expect it to, or when a patient does well without a medication the diagnosis would seem to demand. A medicine’s failure to work reveals nothing.
+Vietnam’s Textbook of History for High School Students gives this definition of the petty bourgeoisie in the specific context of Vietnamese history:
-Thinking in terms of medication can leave a psychiatrist skeptical and hesitant about diagnosis itself because ultimately the medication is more important than the diagnosis, and because prescribing medication is what the doctor actually does. For all the uncertainty, psychopharmacology makes young residents feel like doctors. Prescribing medication makes them feel as if they are doing something to relieve the body’s pain, to act against the venom of disease within the body. They borrow the verb “use” to describe what they do when they prescribe. Psychiatrists say, “With an older patient I’ll use half or a third what I’d use with an adult.” Or “I use trazodone at lower levels during the day if the patient is still anxious and depressed.” It is a striking verb: doctors, of course, never touch the medication. They merely write a few words on a piece of paper and hand it to the patient, or perhaps make a note in the chart. But this action serves metaphorically as their incising surgical knife in an act to remove the tumorous illness, and so well established is this metaphorical sensibility that some insurance companies will not cover a psychiatric inpatient stay unless the psychiatrist prescribes psychiatric medication and the patient takes it. (I remember standing at the door in rounds once, listening to a doctor plead with his patient to take his medications, because the insurance company would not cover his stay if he did not.) As young psychiatrists inhabit this metaphor, they come to feel convinced that they are dealing with organic disease.
+<blockquote>
+The petty bourgeois class includes: intellectuals, scientists, and small business owners, handicraftsmen, doctors, lawyers, and civil servants. The vast majority of contemporary intellectuals before the August Revolution of 1945, including students, belonged to the petty bourgeoisie. In general, they were also oppressed by imperialism and feudalism, often unemployed and uneducated.
-Then they can turn around and question the diagnostic categories because in a sense they no longer need them. At this point, challenging the categories does not challenge the existence of organic disease. For instance, by the end of their residency, young psychiatrists will say that the people “just don’t fit the categories” and will not infrequently describe themselves as focusing on symptoms rather than on categories. They’ll talk of being “phenomenologically” minded. They’ll talk about the “lore” of psychiatry, rule-of-thumb generalizations that have arisen from their own experience and that they will teach their students but that rarely appear in the official teaching texts of the profession. As one psychiatrist said, “Mine is a very experiential diagnosis. When I have to bill for services or write something down in the chart, I’ll follow the basic guidelines of ''DSM'', but with regard to treatment [sometimes] you have to use other rules.” Another said, “You know, you’ve been asking me about ''DSM'' and it’s funny.… Now, I see three patients an hour, about three hundred a month, and I love it.… I do the diagnosis, the treatment plan, the med management and you know, I don’t find slapping ''DSM'' labels on patients all that useful. I find, at these clinics, that it’s a lot more useful to use a symptom-oriented approach, keeping in mind that it’s a whole syndrome, because a psychotic agitated schizophrenic can look a lot like a psychotic manic and someone who’s suicidal because they’re depressed can end up killing himself just like someone who kills himself because he’s psychotic. Sometimes,” this resident continued, “I think there’s too much time and energy wasted on trying to redefine everything. There’s this idea, the great medical model, that if we get the chronic paranoid schizophrenic nailed exactly right, then we’ll have our diagnostic category, we’ll have everyone fit into this category, you’ll have the treatment, but I don’t think so. And the patients are more compliant if they feel that you’re working with their symptoms rather than putting some proclamation down.”
+The petty bourgeoisie were intellectually and politically sensitive. They did not directly exploit labor. Therefore, they easily absorbed revolutionary education and went along with the workers and peasants.
-One of the results of this complexity is that an anthropologist can see a two-tier level of expertise among psychiatrists. There is what I call “basic competence.” After a year, a young psychiatrist can usually diagnose very rapidly, and he knows a fair amount about some medications associated with the major disorders. “Learn three medications well,” the chief residents advised in the summer seminar. An adequate young psychiatrist can sound knowledgeable, prescribe adequate doses, and expect to see behavioral change if he is familiar with one antipsychotic, one or two antidepressants, one mood stabilizer, and perhaps one or two antianxiety agents for good measure. At this level of expertise, sometimes a psychiatrist behaves as if the underlying “stuff” is the disease and sometimes as if the “stuff” is symptoms picked out by medication. In team meetings and case conferences, he talks about schizophrenia, psychotic depression, and so forth. When he worries about what to do for the patient, he talks about anxiety, psychosis, and despair.
+However, the intelligentsia and students often suffer from great weaknesses, such as: theory not being coupled with practice, contempt for labor, vague ideas, unstable stances, and erratic behavior in political action.
-Ten years later (in any field, it seems to take about ten years to acquire deep expertise), some psychiatrists seem to reach what I call a level of “connoisseurship” in diagnosis and psychopharmacology. In some ways, this is what physicians call the “art” of medicine. Older psychiatrists who work in a hospital describe themselves as being faster and sharper in diagnosis than they were when they were younger. They say that they move more economically down a decision tree; that they rarely ask all the questions they used to; that they rely more heavily on questions that discriminate between categories; that they interpret with cues arising out of clinical experience in addition to those in ''DSM''. “Compared to the residents, my hypotheses are faster, there’s better intuition, an interview that’s shorter but obtains more information. There’s more economy of effort. I can be more conversational. More relaxed. I can spend the first fifteen minutes on ''DSM'' and the rest on psychodynamics.” They become very sophisticated in their views on drugs and their interactions. The resident says that she doesn’t think that Mr. X is responding well to drug Y; the senior psychiatrist responds, “Someone who comes in agitated like him rarely does; if you supplement with drug Z, you’ll find that drug Y is more effective.” On one unit, a woman admitted after a car accident had become so depressed that she couldn’t formulate sentences. The resident said to the senior doctor that she thought Prozac would be a good drug for the patient, because it was stimulating. He replied, “No. People think that Prozac’s stimulating because it’s not sedating, but I think that she has dopaminergic problems. If you want to stimulate her, you’d use something that would hit that neurotransmitter, like Wellbutrin. Or maybe try an MAOI. You can try Prozac, but I think you’ll fail.” The cynical take on this “art” is that psychiatrists prescribe medications according to simple inductive rules. As one resident remarked sardonically, “I had five patients and each had one brown eye and one blue eye, and each responded well to Wellbutrin [an atypical antidepressant].” The less cynical take is that after a physician has seen a thousand depressed patients, he may have a good “nose” for the issues. Of course, people often act as if they know what they are talking about even when they do not. When I was spending time with psychiatrists, there were some whose inferences I’d have trusted absolutely and others who I thought were selling snake oil.
+Some other petty bourgeoisie (scientists and small businessmen, freelancers, etc.) were also exploited by imperialism and feudalism. Their economic circumstances were precarious, and they often found themselves unemployed and bankrupt. Therefore, the majority also participated in and supported the resistance war and revolution. They are also important allies of the working class.
-At this level, the distinctions between the categories break down, and the contradiction between the thinglike diseases that the diagnoses pick out (in which the symptoms are merely surface features) and the thinglike symptoms that the medications treat (in which the diagnoses are merely convenient labels) tends to be replaced by more tentative subcategories generated by knowledge of the brain, of psychopharmacological process, and by sheer clinical experience of illness behavior. And as at other levels of high expertise (in cardiology, oncology, or, for that matter, stamp collecting), consensus breaks down. Different senior psychiatric experts have widely diverging ideas about what they are treating and how to treat it. One expert sees mood disorders where another sees personality disorders. One expert sees dissociative disorder where another sees histrionics. More generally, connoisseurship in the biomedical domain involves complicated knowledge of biological pathways. An adequate resident can recognize depression and know which drugs to prescribe and at what dose without knowing anything about what happens to the brain in depression or anything about how the drugs might work. That ignorance makes depression seem particularly thinglike because it makes the depression-disease relationship seem simple. The more sophisticated the psychiatrist the more depression appears to be the behavioral endpoint of an array of neural pathways shaped by genes, environment, life events, psychodynamic habits, temperament, diet, and luck.
+In general, these members of the petty bourgeoisie had a number of weaknesses: self-interest, fragmentation, and a lack of determination. Therefore, the working class has a duty to agitate and spread propaganda to such members of the petty bourgeoisie, organize them, and help them to develop their strong points while correcting their weaknesses. It is necessary to skillfully lead them, make them determined to serve the people, reform their ideology, and unite with the workers and peasants in order to become one cohesive movement. Then, they will become a great asset for the public in resistance war and revolution.
+</blockquote>
-This becomes particularly evident when you realize how poorly we understand the way the drugs actually work. Neurotransmitters are the chemicals that communicate at the synapse of two neurons. Generally speaking (according to the experts), there are at least three neurotransmitter systems that are thought to be involved with psychiatric illness: the dopamine system, the norepinephrine system, and the serotonin system. For years, schizophrenia was explained by the “dopamine hypothesis,” which supposed that psychosis (and other symptoms) resulted from a functional excess of dopamine; mood disorders were explained by the “catecholamine hypothesis,” which supposed that depression was the result of too little norepinephrine and mania the result of too much; then, because the Prozac family blocks serotonin reuptake, the new depression hypothesis held that depression had to do with serotonin. But none of those theories appears to be accepted anymore, because research and the new medications that treat these various symptoms suggest more complicated stories. The new antipsychotics, for example, also seem to be involved with serotonin, and the dopamine receptors that are blocked by the old antipsychotics are not very common in the areas of the brain associated with cognition, which one would think would be associated with schizophrenic deficits. In fact, the more that is learned about neurotransmitters and psychopharmacology, the more complex the picture grows: there are more kinds of neurotransmitters, more kinds of receptors, more interdependence. There are, as a recent textbook explains, no simple neurotransmitter-illness relationships.@@@[[#10Thisparagraphhasbeenpara|10]]$$$ On the other hand, enough is now known about these various systems that it is an enormously exciting time to be a psychiatric scientist, because there are so many puzzles to solve.
+Marx defined the “lumpenproletariat” as another class which includes the segments of society with the least privilege — most exploited by capitalism — such as thieves, houseless people, etc.
-Many psychiatric publications attempt to bridge the gap between complex knowledge and basic competency. One example is Stephen Stahl’s ''Essential Psychopharmacology''. Its pages bristle with detailed information about what is currently known and hypothesized about the neural pathways of the major psychiatric disorders. It is full of incomprehensible sentences like these (in the depression chapter): “Receptor subtyping for the serotonergic neuron has proceeded at a very rapid pace, with at least four major categories of 5-HT receptors, each further subtyped depending upon pharmacological or molecular properties. 5-HT receptors are a good example of how the description of neurotransmitter receptors is in constant flux, and is constantly being revised.”@@@[[#11StephenStahlEssentialPsy|11]]$$$ Most psychiatrists have last encountered such sentences in medical school, and the words have no relationship to what they do day to day as clinicians. Thus, accompanying the prose are delightful cartoons of the synapses and the activity around them. Enzymes are drawn as little ghosts that pump and kill and otherwise bat the neurotransmitters around. Stahl explains the various competing biological theories of depression and the evidence for and against each; he then explains how the drugs affect each pathway involved in the different viable hypotheses (to the extent that this is understood). He points out the differences between these treatments and the biochemical logic of how they might be combined. The book can be read and used effectively by people with varying degrees of knowledge (thus the cartoons), but one point shines clearly: the deeper your knowledge, the less you are convinced that there is a simple disease process and the more you are convinced that medications affect particular pathways that are often, but not always, involved in the behavioral manifestation of a very complex illness.
+In the ''Manifesto of the Communist Party,'' Marx defined the lumpenproletariat as: “The ‘dangerous class’ (''lumpenproletariat''), the social scum, that passively rotting mass thrown off by the lowest layers of the old society.” Marx did not have much hope for the revolutionary potential of the lumpenproletariat, writing that they “may, here and there, be swept into the movement by a proletarian revolution; its conditions of life, however, prepare it far more for the part of a bribed tool of reactionary intrigue.”
-<div style="text-align:center;">• • •</div>
+''Political Theories'', an official journal of the Ho Chi Minh National Institute of Politics, discussed the lumpenproletariat in the specific context of Vietnamese revolutionary history:
-Psychopharmacology is a remarkable enterprise, full of hope and greed and also spectacle. In 1994, a pharmaceutical company launched a new antidepressant at the annual meeting of the American Psychiatric Association, a professional convention attended by more than a quarter of the practicing psychiatrists in the country. The annual meeting’s air of carnival is much enhanced by the exhibition area, a vast gymnasium space subdivided into small display areas usually occupied by pharmaceutical companies. There are other occupants, residential treatment centers or new health care services, but their small booths have a lonely, fretful feel. The large pharmaceutical companies—Upjohn, Sandoz, Dista—rent areas the size of large houses and install in them classical temples to their drugs, with “Paxil,” “Xanax,” “Risperdal” in the tympana. Some of them devise complex strategies to attract passersby. That year, Sandoz had a high-tech video display of Freud’s life and its neighbor mounted a show of art by the mentally ill. Most booths gave out pens and occasionally more expensive items. Over several years I acquired an umbrella, William Styron’s memoir of depression, and varied mugs, one of them a heat-sensitive cup with a blue stripe that faded, when the cup was filled with hot water, into the phrase “panic comes out of the blue.” If the marketing works, the reward is considerable: with 20 million people on Prozac, there are still millions more who may need but are not given treatment. One reputable estimate states that the lifetime prevalence for psychiatric illness is 22 percent of all Americans, more if alcoholism and substance abuse are included. Most of these illnesses strike young and are chronic or recurring, and 20 to 30 percent of those affected are never treated.@@@[[#12Thesefigureswerereported|12]]$$$ The needs of this market are a manufacturer’s dream.
+<blockquote>
+It should be noted that Marxism-Leninism has never held that the historical mission of the working class is rooted in poverty and impoverishment. Poverty and low standards of living make workers hate the regime of capitalism, and causes disaster for workers, but the basic driving force behind the revolutionary struggle of the working class lies in the very nature of capitalist production and from the irreconcilable contradiction between the working class and the bourgeoisie.
-In 1994, the largest, most dramatic, and by far the most memorable exhibit on the floor was the “brain booth,” Wyeth-Ayerst’s marketing device for Effexor. It was a sort of converted Volkswagen minibus. Above it hung huge flat brains with drooping brain stems. Red lightning shot through the brains at intervals. Somewhere discreetly to the side was the name “Effexor.” You could line up to enter the brain booth, for a voyage to the interior of the brain. I did so and found myself in a small, dark cavity with eleven other people. The door shut, and in the darkness a screen lit up with a picture meant to represent the inside of the brain stem. To add a sense of drama, the minibus now began pitching and heaving, so as to evoke the rough, uncharted terrain through which we were passing. I stopped focusing on not being claustrophic and began to concentrate on not having motion sickness. We stopped the voyage at various points, mostly at neuronal synaptic clefts, where geometric shapes of different colors floated around to demonstrate neurotransmitter activity. There were also opportunities for interactive learning, with a little board in front of us with buttons to push in response to questions posed by bearded, knowledgeable scientists in the video. (I noticed at these points that my fellow travelers seemed also to be more intent on their lack of motion sickness than on the little boards.) Which neurotransmitter was commonly associated with depression? Which did new research suggest might also be involved? Which neurotransmitters, now that we were on the topic, did Effexor target? Exactly those. “You should see the brain booth,” a psychoanalyst told me before I entered the exhibit area. “If you can explain the brain booth, you can explain contemporary psychiatry.”
+Moreover, it should not be conceived that a class is capable of leading the revolution because it is the poorest class. In the old societies, there were classes that were extremely poor and had to go through many struggles against the ruling class, but they could never win and keep power, and did not become the ruling class of society.
-=== {{anchor|INOUTPATIENTPSYCHOTHERAPY}} IN OUTPATIENT PSYCHOTHERAPY ===
+History has proven that the class that represents newly emerging productive forces which are able to build a more advanced mode of production than the old ones can lead the revolution and organize society into the regime they represent. Fetishizing poverty and misery is a corruption of Marxism-Leninism...
-“Beginning to get decent at psychotherapy is like discovering an extra limb and finding it incredibly useful. Once you discover it, it’s a little difficult to go back to doing things with two hands. When I’m in a social interaction, I get a little embarrassed with myself. You see people who have boundary problems, and they’re seductive and alluring and you can get sucked in. It would be hard, now, to let myself go with the flow with someone like that. Part of me would be noticing what was going on, what was happening. I can’t turn it off completely.”
+The very existence of the lumpenproletariat is strong evidence of the inhumane nature of capitalist society, which regularly recreates a large class of outcasts at the bottom of society.
+</blockquote>
-Earle is a tall, slim New Yorker, quite elegant, rather sardonic. He had, as most psychiatrists used to, a background in the humanities. He was thought to be one of the better psychotherapists in his residency program. He was considering analytic training. “The way I think now,” he said, “is very different from the way I thought in medicine. There is so much less that is explained by rules that apply to more than one person. When I first started, I wanted there to be some unifying theory. Rules and so on. Actually, what’s important is knowing the particular person. All people have their own system, their own way of how things work, with particular fears, particular wishes. Getting to know that instance is much more important than the rule it may test or not. One thing I’ve noticed is that I’m much less judgmental of my patients than they imagine me to be. I really am. It’s not interesting to me anymore to make a judgment; it’s interesting to understand. The more I know my patients, the less I diagnose them. The closer you get, the less helpful it is to classify and the more you doubt the classifications. I think my process has been that of coming at the patients with some vague and cherished theories and hoping that they won’t disprove them. And they did. They always do.”
+In the late 19<sup>th</sup> and early 20<sup>th</sup> centuries, millions of Vietnamese people were forced to leave their homes in rural farmlands to work for plantations and factories which were owned by French colonialists. These workers were functionally enslaved, being regularly physically abused by colonial masters, barred from any education whatsoever, and receiving only the bare minimum to survive. As a result, under French colonial rule, about 90% of Vietnamese were illiterate and the French aimed to indoctrinate Vietnamese people into believing that they were inferior to the French.
-Psychodynamic thinking is a curious and highly distinctive manner of thought: between those who think psychodynamically and those who do not, there is a gulf as wide and alienating as between those who think logically and those who do not. It is notoriously difficult to characterize. Psychotherapists produce an array of metaphors to describe the therapeutic encounter—it is a dance, a duel, a drama, an attempt to listen with a different ear, to listen for what is under the surface or behind the words; it is peeling the onion, unraveling the psyche, piercing the armor of the character; it is an attempt to see the translation of motive into action in which every action serves the self.
+The French colonialists also worked with Vietnamese landlords to exploit peasants in rural areas. Those peasants received barely enough to survive and, like the plantation slaves, were prohibited from receiving education. Because Vietnamese peasants and colonial slaves composed the majority of workers while being so severely oppressed and living in conditions of such abject poverty, it was difficult to fully distinguish between the proletariat and the lumpenproletariat in Vietnam during the colonial era.
-If achieving basic competence in diagnosis and psychopharmacology is like becoming a master bird-watcher, learning the skill of psychotherapy is more like learning to be a storyteller. One might describe Freud’s central contribution to psychotherapy by saying that he “discovered” the unconscious, or at least that more than any of its other discoverers he demonstrated that we are all motivated in ways we do not grasp for reasons we cannot give.@@@[[#13Therewasagreatdealofdi|13]]$$$ But his more fundamental legacy was to suggest that we can decode our behavior and our history to discover the grammar of a particular person’s emotions, the implicit rules that explain why a remark offends one person but makes another laugh, why one person enjoys aggression and another finds it terrifying. Analysts listen for the stories that emerge from the way people talk about other people, the way they experience those people, the way they experience the therapist, and the way they experience themselves, although what the analyst hears is not just what the patient says. As diagnosticians listen for clues to a diagnosis, therapists too listen for clues to a model. They listen, however, in a very different way.
+During this time, Ho Chi Minh and other Vietnamese communists developed the philosophy of “Proletarian Piety.” The word “piety,” here, is a translation of the Vietnamese word ''hiếu'', which originally comes from the Confucianist philosophy of “filial piety.” Filial piety demanded children to deeply respect, honor, and obey their parents. Through the concept of Proletarian Piety, Ho Chi Minh adapted this concept to proletarian revolution, calling for communists to deeply love, respect, and tirelessly serve the oppressed masses. This philosophical concept sought to unite the proletariat, lumpenproletariat, and petty bourgeoisie into one united revolutionary class. Even some feudal landlords and capitalists — who were, themselves, oppressed by the colonizing French — were willing to fight for communist revolution and were welcomed into the revolutionary movement if they were willing to adhere to the principle of proletarian piety. The working class and peasantry would lead the revolution, the more privileged classes would follow, and all communist revolutionists would serve the oppressed masses through sacrifice and struggle.
-At some point in their first year, young psychiatrists are assigned their first psychotherapy outpatient. In their second year, which is their outpatient year, residents can take on more cases, but only an ambitious resident—ambitious, that is, as a psychotherapist—will take on as many as ten. (That year, their other patients are outpatient psychopharmacology patients. A resident may carry a monthly caseload of more than one hundred psychopharmacology patients, whom he sees for fifteen or twenty minutes apiece, and three psychotherapy patients.) In the past, residents were encouraged to see their psychotherapy patients twice or even three times weekly, but these days many factors militate against doing so. Usually a resident meets with each patient once a week for forty-five or fifty minutes, although occasionally a patient will arrange to come in less frequently (usually for financial reasons) or more frequently (maybe twice a week). For each patient, or for every two patients, the resident has a supervisor, usually an analyst who volunteers his time in exchange for an affiliation with the medical school. The resident meets in private with the supervisor once a week to discuss the case. During the outpatient year, each resident also runs a therapy group for patients, usually with two residents per group, and as a class residents participate in a once-a-week session that is described as their own group therapy. At least one hour of lecture time each week (usually out of two to four hours) is devoted to psychotherapy throughout the residency, in all residency programs I have seen. Most residents also enter psychotherapy, some even psychoanalysis, at some point during residency, in part for their own training and in part because they feel they need it. A great deal of time, then, is designated for learning psychotherapy, or at least was when I was doing fieldwork. This training, however, is more optional than the training in diagnosis and psychopharmacology. As a psychiatric resident, you ''must'' admit patients and diagnose them. That is your job. Psychotherapy training involves more choice, more willingness to go along with what is offered or seek out what is not.
+During this period, many novels were written and circulated widely which featured main characters who were members of the lumpenproletariat or enslaved by the French, such as ''Bỉ'' ''Vỏ,'' a story about a beautiful peasant girl who was forced to become a thief in the city, and ''Chí Phèo'', the story of a peasant who worked as a servant in a feudal landlord’s house who was sent to prison and became a destitute alcoholic after being released. The purpose of these stories was to show the cruelty of the colonialist-capitalist society of Vietnam in the 1930’s and to inspire proletarian piety, including empathy and respect for the extreme suffering and oppression of the lumpenproletariat, peasantry, and colonial slaves. These stories also presented sympathetic views of intellectuals and members of the petty bourgeoisie: for instance, in the novel ''Lão'' ''Hạc'', the son of a peasant leaves to work for a French plantation and the father never sees him again. The aged peasant becomes extremely poor and sick without the support of his son, and the only person in the village who helps him is a teacher, representing the intellectual segment of the petty bourgeoisie.
-The specific kind of therapy taught to psychiatric residents is called “psychodynamic psychotherapy,” and its theories and practice derive from psychoanalysis. Psychiatrists use the term to refer to therapy that is guided by psychoanalytic thinking but in which a patient may come anywhere from five times a week to once a month and may use a couch but usually sits in a chair and talks with the therapist face-to-face. The term “psychoanalysis” is reserved for a specific kind of practice: the patient has very frequent sessions, the patient lies on a couch and cannot see the analyst, the therapist is in or has completed training at a psychoanalytic institute. The term “psychodynamic” is used more broadly to include not only psychoanalysis per se but a way of thinking and practicing that is psychoanalytic in feel and style. Psychoanalysts serve as the primary psychotherapy teachers for young psychiatrists, and psychoanalytic writings serve as the primary texts. Residents are supposed to learn the theory and practice of other kinds of psychotherapy as well—cognitive-behavioral therapy, couples therapy, family therapy—but in general these approaches have low visibility and low prestige in psychiatric training programs. When I refer to psychotherapy, then, my prototype is psychodynamic psychotherapy.
+The writers of these novels were communists who wanted to promote the principles of proletarian piety. Rather than looking down on the most oppressed members of society, and rather than sewing distrust and contempt for the petty bourgeoisie, Vietnamese communists inspired solidarity and collaboration between all of the oppressed peoples of Vietnam to overthrow French colonialism, feudalism, and capitalism. Proletarian piety was crucial for uniting the divided and conquered masses of Vietnam and successfully overthrowing colonialism. Note that these strategies were developed specifically for colonial Vietnam. Every revolutionary struggle will take place in unique ''material conditions''<ref>Material conditions include the natural environment, the means of production and the economic base of human society, objective social relations, and other externalities and systems which affect human life and human society. See Annotation 79, p. 81.</ref>, and the composition and characteristics of each class will vary over time and from one place to another. It is important for revolutionists to carefully apply the principles of dialectical materialism and materialist dialectics to accurately analyze class conditions in order to develop strategies and plans which will most suitably and efficiently lead to successful revolution.
-The learning process itself is more practical than this description suggests. In American culture, psychoanalysis is often associated with intellectuals. People who read Freud are often fairly highbrow. What is taught to young psychiatrists about psychodynamic psychotherapy is not intellectual at all. The expertise they acquire has to do with Freud only obliquely. It develops beneath the surface of texts and lectures.
+The deep contradictions* between the socialized production force** and the capitalist relations of production*** were first revealed by the economic depression of 1825 and the series of struggles between workers and the capitalist class which followed.
-In the first place, the lectures on psychotherapy, for the most part, do not present general theories of human experience. They do not discuss the extensive scientific literature on emotion and human development. They do not explore the difficult psychoanalytic writings of W. R. D. Fairbairn, D. W. Winnicott, Otto Fenichel, Heinz Kohut, Harry Stack Sullivan, Otto Kernberg, and others. Discussion of Sigmund Freud and human development is extremely cursory. No young psychiatrist is seriously expected to read much; even when reading is assigned, there is no sanction against a resident who does not read, and it is widely understood that the clinical needs of the hospital take precedence over a resident’s lectures. The primary method of training is apprenticeship. I sat through an eight-week seminar on child development in which Jean Piaget’s stages were presented but never fully explained, never critiqued—despite an enormous psychological literature on the topic—and never mentioned by any resident again. I have listened to hundreds of lectures to psychiatric residents. Few of them presented as much material as an average professor’s lecture to undergraduates. Very few of them gave evidence of even an hour’s preparation for an hour’s lecture. Virtually none was attended by all of the residency class.
+-----
-Nor, for that matter, does the institution treat the lectures as very important. In the first year the first psychotherapy patient is often assigned before residents have been told much, formally, about the actual process of psychotherapy, as if to imply that the resident can’t do much harm, even though the gist of the teaching is that in fact the resident is a lumbering bear in the patient’s porcelain psyche. One first-year resident was incensed by this: “Well, there was a lot of anxiety because you don’t know what you’re doing, and I was very angry at the department for thrusting us into that situation before we had had any lectures at all. What is psychotherapy? How does it work? What are some basic principles? I knew a little bit by reading and by three months of therapy I had had, but that wasn’t much, and I just really didn’t know. My role was very ill defined, and I just felt a lot of anger.”
+==== Annotation 4 ====
-The point of the lectures is not to teach facts or a science but to teach a practical skill. The lectures talk about what to do in therapy rather than why the therapy works. (This is also true for the lectures on psychopharmacology and diagnosis.) In the summer seminar series I attended, the lectures on psychotherapy were so down-to-earth as to seem brutally naive to the outsider. Where do you put the clock in your office? If you must meet a patient a hundred feet from your office, do you talk on the way there? About what? Do you shake hands? These turn out, as it happens, to be matters of great concern, but they do have a fugitive air of teaching etiquette to someone about to host a dinner party with neither food nor drink.
+<nowiki>*</nowiki> See: ''Definition of Contradiction and Common Characteristics of Contradiction'', p. 175.
-When a seminar does focus on a text, as did one that I attended with advanced psychiatric residents, the discussion tends to circle around the ways that the ideas can be borrowed to understand one’s current patients. Even in this class, where the text—Melanie Klein’s ''Envy and Gratitude''—was treated with greater historical and textual sensitivity than I had ever encountered in a psychiatric setting, the young psychiatrists took the ideas loosely to interpret their patients’ behavior. When the class looked at a sentence in which Klein talked about “incorporating the breast,” for example, one of the psychiatrists exclaimed that this was exactly what her patient was doing with her now. Klein, of course, was being somewhat metaphorical about infant thought, but whereas a psychology graduate student might have struggled to understand the specific meaning of the metaphor for Klein, the clinically oriented resident ignored that question and instead stretched the metaphor further.
+<nowiki>**</nowiki> In Marxism, “socialization” is simply the idea that human society transforms labor and production from a solitary, individual act into a collective, social act. In other words, as human society progresses, people “socialize” labor into increasingly complex networks of social relations: from individuals making their own tools, to agricultural societies engaged in collective farming, to modern industrial societies with factories, logistical networks, etc.
-The primary teaching of psychotherapy takes place in the one-on-one “supervision” for an hour a week, often days after the actual therapy has taken place. Unlike the rest of medicine, the teacher sees the student perform very rarely. In surgery, there may be a see-one, do-one, teach-one approach to cutting, but a senior surgeon hovers by a student’s elbow. In most cases, a psychotherapy supervisor never sees a patient in person. In many cases, the supervisor never sees a video of the session or listens to a tape recording of it. Instead, the resident and supervisor meet at a prearranged time, the resident tells the supervisor what went on in the session, and the supervisor advises the resident on what to do next. Periodically the supervisor sends an evaluation of the resident to the director of residency education. The belief that residents learn anything more than the fine art of deception from this process springs directly out of the psychodynamic way of looking at the world.
+The production force is the combination of the means of production and workers within any society. The “Socialized Production Force,” therefore, is a production force which has been socialized — that is to say, a production force which has been organized into collective social activity. Under capitalism, the “Socialized Production Force” consists of the proletariat, or the working class, as well as means of production which are owned by capitalists.
-In psychodynamic psychotherapy, one person pays a second person a significant sum—$50 to $150, occasionally more—for the privilege of talking to him for less than an hour. He may repeat the exercise once or more each week for many years. The second person, the “expert,” comments on what the first person has said. What makes the relationship strange is that the goal of the second person is not to understand and say what is true about the first person’s remarks or even what he thinks. The psychotherapist is explicitly taught not to give advice, not to counsel, not to act as a kindly friend. The psychotherapy relationship is deliberately not modeled on teaching, though there is often more coaching in it than is acknowledged.
+<nowiki>***</nowiki> Marx and Engels defined “relations of production” as the social relationships that human beings must accept in order to survive. Relations of production are, by definition, not voluntary, because human beings must enter into them in order to receive material needs in order to survive within a given society. Under capitalism, the relations of production require the working class to rent their labor to capitalists to receive wages which they need to procure material needs like food and shelter. This is an inherent contradiction because a small minority of society (the capitalist class) own the means of production while the vast majority of society (the working class) must submit to exploitation through wage servitude in order to survive.
-Psychodynamic psychotherapy has developed out of the belief that our deepest motivations are occult, for the expert as well as for the seeker of help. Thus, therapy cannot provide a one-way window into the patient’s soul. The patient cannot see the real source of his unhappiness—we cannot see our sunglasses when we are wearing them, but everything we see is darkened by them—and the therapist knows that he too is limited by his own personality, though because of his training less so than the patient. Instead, therapy is conceived of as a relationship between two people from which the nature of the patient’s hidden psyche must be inferred. Freud’s metaphor was that the psychoanalyst and the patient were like passengers on a train. The patient sits by the window, describing the scenery as it passes by, but she does not know what is important. The psychoanalyst knows what is important, but he sits beside her blindfolded. He must infer from the way she talks to him what the landscape really looks like. The therapist’s job is also to interpret the relationship between therapist and patient as a means of understanding the patient, despite the full awareness that neither party has full access to the thoughts and feelings of either.
+Examples of such early struggles include: the resistance of workers in Lyon, France in 1831 and 1834; the Chartist movement in Britain from 1835 to 1848; the workers’ movement in Silesia (Germany) in 1844, etc. These events prove as historical evidence that the proletariat had become an independent political force which pioneered the fight for a democratic, equal, and progressive society.
-Psychodynamic supervisors assume that because we are all shrouded from ourselves, young residents cannot but reveal their implicit assumptions about their relationships with a patient. Particularly in residency—that is, at the earliest stage of training in psychotherapy—supervisors tend to treat supervision as being focused on residents’ insecurities and blind spots, for our inability to understand other people owes much to the hard shell of our emotional defenses. In other words, supervision is really about the resident. That’s why handwritten notes—“process notes,” scribbled dialogue written on scrap paper at the end of the session—are understood (in this culture) to be as helpful as video recordings.
+-----
-A supervisor listens primarily to the way in which a resident thinks and responds. He is trying to understand the way a resident presents herself and what she presumes in a conversation that might be interpreted by someone else in a way the resident might not expect. One supervisor told me that he treated the supervision as couples’ counseling with half the couple present. There is also more than this. A supervisor tries to interpret, through a resident’s account, what a patient is actually like. But the focus tends to be upon the resident even when the discussion centers on the patient. In 1992, I sat through a summer’s worth of one resident’s supervisions with two different supervisors. Paula spent hours writing up the notes from each session (she was very conscientious), and at each supervision she would arrive with the sheaf of paper and read it through, with the supervisor commenting on what was said and whether it should have been said another way.
+==== Annotation 5 ====
-The transcript of one such supervision ran in part as follows. In the therapy hour, the patient and therapist (the resident) were discussing the patient’s anger at seeing the therapist in the supermarket, because the patient claimed that the therapist had seen her and turned away, while the therapist said she had not seen her. The resident read these notes to her supervisor:
+Here are some brief descriptions of the early working class movements mentioned above:
-<div style="margin-left:0.229cm;">PT: You’ve misunderstood me.</div>
+'''Resistance of Workers in Lyon, France:'''
-<div style="margin-left:0.229cm;">TH: No, you’ve been saying a lot of hurtful things.</div>
+In 1831 in France, due to heavy exploitation and hardship, textile workers in Lyon revolted to demand higher wages and shorter working hours. The rebels took control of the city for ten days. Their determination to fight is reflected in the slogan: “Live working or die fighting!”
-<div style="margin-left:0.229cm;">PT: No.</div>
+This resistance was brutally crushed by the government, which supported the factory owners. In 1834, silk mill workers in Lyon revolted again to demand the establishment of a republic. The fierce struggle went on for four days, but was extinguished in a bloody battle against the French army. About 10,000 insurgents were imprisoned or deported.
-<div style="margin-left:0.229cm;">TH: It’s hard to see that you can be hurtful. When you hurt, perhaps it helps to put people down.</div>
+'''The Chartist Movement in Britain:'''
-<div style="margin-left:0.229cm;">PT: No, I never put anyone down.</div>
+Chartism was a working class movement in the United Kingdom which rose up in response to anti-worker laws such as the Poor Law Amendment of 1834, which drove poor people into workhouses and removed other social programs for the working poor. Legislative failure to address the demands of the working poor led to a broadly popular mass movement which would go on to organize around the People’s Charter of 1838, which was a list of six demands which included extension of the vote and granting the working class the right to hold office in the House of Commons.
-<div style="margin-left:0.423cm;">[The supervisor remarks to her, “You are young, and you have everything you want.” Paula continues to read without comment:]</div>
+In 1845, Karl Marx visited Britain for the first time, along with Friedrich Engels, to meet with the leaders of the Chartist movement (with whom Engels had already established a close relationship). After various conflicts and struggles, Chartism ultimately began to decline in 1848 as more socialist-oriented movements rose up in prominence.
-<div style="margin-left:0.229cm;">TH: In a relationship, you feel that no one should get hurt.</div>
+'''Workers’ Movement in Silesia, Germany:'''
-<div style="margin-left:0.229cm;">PT: Yes, that’s right.</div>
+In June, 1844, disturbances and riots occurred in the Prussian province of Silesia, a major center of textile manufacturing. In response, the Prussian army was called upon to restore order in the region. In a confrontation between the weavers and troops, shots were fired into the crowd, killing 11 protesters and wounding many others. The leaders of the disturbances were arrested, flogged, and imprisoned. This event has gained enormous significance in the history of the German labor movement.
-<div style="margin-left:0.229cm;">TH: That’s why you’re so isolated. It’ll be a long wait for a relationship that doesn’t hurt.</div>
+In particular, Karl Marx regarded the uprising as evidence of the birth of a German workers’ movement. The weavers’ rebellion served as an important symbol for later generations concerned with poverty and oppression of the working class in German society.
-<div style="margin-left:0.229cm;">PT: I’m isolated?</div>
+It quickly became apparent that the revolutionary practice of the proletariat needed the guidance of scientific theories. The birth of Marxism was to meet that objective requirement; in the meantime, the revolutionary practice itself became the practical premise for Marxism to continuously develop.
-<div style="margin-left:0.229cm;">TB: Yes.</div>
+''- Theoretical Premises''
-<div style="margin-left:0.229cm;">PT: You have something there—but the issue here is chemistry.</div>
+The birth of Marxism not only resulted from the objective requirement of history, it was also the result of inheriting the ''quintessence''* of various previously established frameworks of human philosophical theory such as German classical philosophy, British classical political economics, and utopianism in France and Britain.
-<div style="margin-left:0.423cm;">[Paula says in an aside to the supervisor, “Every time it gets heated, it goes into chemistry.”]</div>
+-----
-<div style="margin-left:0.229cm;">PT: Like Sam.</div>
+==== Annotation 6 ====
-<div style="margin-left:0.229cm;">TB: Were there specific things that bothered you about Sam?</div>
+<nowiki>*</nowiki> In the original Vietnamese, the word ''tinh'' ''hoa'' is used, which we roughly translate to the word ''quintessence'' throughout this book. Literally, it means “the best, highest, most beautiful, defining characteristics” of a concept, and, unlike the English word ''quintessence'', it has an exclusively positive connotation. ''Quintessence'' should not be confused with the universal category of ''Essence'', which is discussed on p. 156.
-<div style="margin-left:0.229cm;">PT: Yes [she lists them].</div>
+German classical philosophy, especially the philosophies of Georg Wilhelm Friedrich Hegel<ref>Georg Wilhelm Friedrich Hegel, 1770 — 1831 (German): Philosophy professor, an objective idealistic philosopher — representative of German classical philosophy.</ref> and Ludwig Feuerbach<ref>Ludwig Feuerbach, 1804 — 1872 (German): Philosophy professor, materialist philosopher.</ref>, had deeply influenced the formation of the Marxist worldview and philosophical methodology.
-<div style="margin-left:0.229cm;">TB: And with me?</div>
+-----
-<div style="margin-left:0.229cm;">PT: No, it’s just chemistry.</div>
+==== Annotation 7 ====
-<div style="margin-left:0.229cm;">TB: Baloney. I think you call it chemistry because you’re uncomfortable.</div>
+German classical philosophy was a movement of ''idealist'' philosophers of the 18<sup>th</sup> and 19<sup>th</sup> centuries. Idealism is a philosophical position that holds that the only reliable experience of reality occurs within the human consciousness. Idealists believe that human reason is the best way to seek truth, and that consciousness is thus the only reliable source of knowledge and information.
-<div style="margin-left:0.229cm;">PT: It just reminds me, when I come here, that I see someone younger, who has done something with her life. I haven’t.</div>
+One of Hegel’s important achievements was his critique of the metaphysical method.
-<div style="margin-left:0.423cm;">[Supervisor doesn’t say anything here, even though it confirms his earlier comment.]</div>
+-----
-<div style="margin-left:0.229cm;">PT: I don’t mean to change the subject, but I was thinking about how you think I’ve tried to hurt you. People always misunderstand me. They used to call me a snob. I’m shy.</div>
+==== Annotation 8 ====
-<div style="margin-left:0.229cm;">SUPERVISOR: The subtext here is that she was shy in the supermarket, that’s why she didn’t come over. She’s not a snob, not aggressive—just avoidant. If you were feeling less embattled and more warmly, you could have interpreted that to her and said, “I wish I ''had'' seen you, so that you wouldn’t have had to feel as rejected as you did. I hope that if I had seen you, I would have had the wherewithal to introduce you to my husband.”</div>
+Metaphysics is a branch of philosophy that attempts to explain the fundamental nature of reality by classifying things, phenomena, and ideas into various categories. Metaphysical philosophy has taken many forms through the centuries, but one common shortcoming of metaphysical thought is a tendency to view things and ideas in a static, abstract manner. Metaphysical positions view nature as a collection of objects and phenomena which are isolated from one another and fundamentally unchanging. Engels explained the problems of metaphysics in ''Socialism: Utopian and Scientific'':
-<div style="margin-left:0.229cm;">PAULA: She never says things directly, never owns things. I had to do this for me.</div>
+<blockquote>
+The analysis of Nature into its individual parts, the grouping of the different natural processes and objects in definite classes, the study of the internal anatomy of organized bodies in their manifold forms — hese were the fundamental conditions of the gigantic strides in our knowledge of Nature that have been made during the last 400 years.
+</blockquote>
-<div style="margin-left:0.229cm;">SUPERVISOR: She said pretty directly that you bothered her, and that you’ve succeeded at things she’s failed at. She hints at this, as if you could be two girls chatting together.</div>
+<blockquote>
+But this method of work has also left us as legacy the habit of observing natural objects and processes in isolation, apart from their connection with the vast whole; of observing them in repose, not in motion; as constraints, not as essentially variables; in their death, not in their life. And when this way of looking at things was transferred by Bacon and Locke from natural science to philosophy, it begot the narrow, metaphysical mode of thought peculiar to the last century.
+</blockquote>
-<div style="margin-left:0.229cm;">PAULA: She asked me if we could do therapy outside.</div>
+Francis Bacon (1561 — 1626) is considered the father of empiricism, which is the belief that knowledge can only be derived from human sensory experience [see Annotation 10, p. 10]. Bacon argued that scientific knowledge could only be derived through inductive reasoning in which specific observations are used to form general conclusions. John Locke (1632 — 1704) was another early empiricist, who was heavily influenced by Francis Bacon. Locke, too, was an empiricist, and is considered to be the “father of liberalism.”
-<div style="margin-left:0.229cm;">SUPERVISOR: Talking about it is more important than doing it.</div>
+Engels was highly critical of the application of metaphysical philosophy to natural science. As Engels continues in ''Socialism: Utopian and Scientific:''
-<div style="margin-left:0.229cm;">PAULA: With her, in therapy, doing is key.</div>
+<blockquote>
+To the metaphysician, things and their mental reflexes — ideas — are isolated, are to be considered one after the other and apart from each other, are objects of investigation fixed, rigid, given once for all. He thinks in absolutely irreconcilable antitheses... For him a thing either exists or does not exist; a thing cannot at the same time be itself and something else. Positive and negative absolutely exclude one another; cause and effect stand in a rigid antithesis one to the other.
-<div style="margin-left:0.229cm;">SUPERVISOR: The issue is doing it with you. You embody so much she’s not. She’s on a slippery slope, got a late start, blew it with the first attempt. You come along, dressed in ''pink'', even, she’s seen you smile—think of her fantasy life. You’re lucky, and you don’t deserve it. How can she justify this? She’s been unfairly treated, and it will come so easy for you and you don’t even make attempts to be nice the way she does.</div>
+At first sight this mode of thinking seems to us very luminous, because it is that of so-called sound common sense. Only sound common sense, respectable fellow that he is, in the homely realm of his own four walls, has very wonderful adventures directly he ventures out into the wide world of research. And the metaphysical mode of thought, justifiable and necessary as it is in a number of domains whose extent varies according to the nature of the particular object of investigation, sooner or later reaches a limit, beyond which it becomes one-sided, restricted, abstract, lost in insoluble contradictions. In the contemplation of individual things, it forgets the connection between them; in the contemplation of their existence, it forgets the beginning and end of that existence; of their repose, it forgets their motion. It cannot see the wood for the trees.
+</blockquote>
-<div style="margin-left:0.229cm;">PAULA: How would you make her feel more comfortable?</div>
+Dialectical Materialism stands in contrast to metaphysics in many ways. Rather than splitting the world into distinct, isolated categories, Dialectical Materialist philosophy seeks to view the world in terms of relationships, motion, and change. Dialectical Materialism also refutes the hard empiricism of Bacon and Locke by describing a dialectical relationship between the material world and consciousness [see: ''The Relationship Between Matter and Consciousness'', p. 88].
-<div style="margin-left:0.229cm;">SUPERVISOR: Well, you could apologize for what happened in the supermarket.</div>
+-----
-<div style="margin-left:0.229cm;">PAULA: But I’ve ''done'' that. I truly think she needs me to go to lunch with her or walk around the campus. All I was trying to get her to do was to own her own aggressiveness.</div>
+For the first time in the history of human philosophy, Hegel expressed the content of dialectics in strict arguments with a system of rules and categories.
-<div style="margin-left:0.229cm;">SUPERVISOR: Good, but you would have done it differently if you’d realized that this issue was jealousy, not the comparison with her previous therapist. You are acting here as if you don’t think enough of yourself to believe that someone could be jealous of you.</div>
+-----
-What the supervisor said quite clearly is that this resident could not hear the patient envy her. To become a better therapist, she would have to learn to listen to all the ways a patient might perceive her. But now she cannot hear the patient clearly because her own personality muffles her ears. For the supervisor to see this, it didn’t really matter that the session had been written down from memory. As Freud remarked about dreams, recollection is as useful as exact recall because what was unconscious then will not be consciously removed in the retelling. We reveal ourselves as vividly when we lie as when we are trying to be honest.
+-----
-Supervisors tend to be supportive. This supervisor was consistently so. Supervision can nevertheless be exquisitely painful. Paula was just shy of thirty during these sessions, and at the time she was lonely and depressed. (There was something going on at home.) I am struck, looking back over my notebooks several years later, that I knew she felt bad about herself when we met. I wrote about her bad feelings in my notebooks. Yet somehow, as we spoke over the course of the summer, as I talked to her about psychotherapy and what it was like to do it, as I went from supervision to supervision with her, I could no longer see her as someone who might be stiff and awkward with patients because she was depressed. I think that it was so painful to see her expose herself week after week despite her determination to present herself as a good therapist that I could not bear to see her as clearly as her supervisor did, although I sat there recording the supervision in my notes; I think that may be a clue to the level of shame residents can experience in the kindest supervision. Certainly Paula experienced the supervisions like a switch on sunburnt skin. Shortly after this exchange, the patient left therapy.
+==== Annotation 9 ====
-If a therapist is not helpful, whatever that means to a patient, the patient usually goes away. The force of this experience as a training exercise, that the outpatient is not like some graduate school paper assignment but an independent person who votes on your skills by choosing to see you or not (which the inpatient, of course, cannot) did not become clear to me until my own bout of doing psychotherapy. To get some sense of this skill, I had signed up as a volunteer at a local outpatient clinic. I had eight patients, one once a week and three twice a week for more than a year. I was supervised by the same people who supervised the residents.
+Dialectics is a philosophical methodology which searches for truth by examining contradictions and relationships between things, objects, and ideas. Ancient dialecticians such as Aristotle and Socrates explored dialectics primarily through rhetorical discourse between two or more different points of view about a subject with the intention of finding truth.
-My second patient was a rude, miserable man who didn’t think much of women to start with—his girlfriend had just thrown him out—and when he called up the outpatient clinic for an appointment, he protested at the standard price and asked for someone cheaper. He was passed on to me, the anthropologist in training who because she was not training for a degree could accept reduced fees ($10 per session; it went to the clinic). Although he no doubt felt that he had been offered cut-rate goods, he decided to see me. During our first hour, he remarked aloud that I probably wasn’t smart enough to have gone to medical school, suggested that I was too young to be of any use to him, told me that when I grew up I’d have some business cards, and then, after railing about my inability to get his girlfriend back, left after several sessions and did not return for months. He was not, as they say, an ideal candidate for psychotherapy. Yet I felt terrible when he dropped out of therapy and tremendously reassured when, eight months later, he decided to reconnect. (I referred him elsewhere because of my teaching schedule.)
+In this classical form of dialectics, a thesis is presented. This thesis is an opening argument about the subject at hand. An antithesis, or counter-argument, is then presented. Finally, the thesis and antithesis are combined into a synthesis, which is an improvement on both the thesis and antithesis which brings us closer to truth.
-Very few of the patients whom residents see for psychotherapy are ideal candidates for psychotherapy, and so the feeling of being abandoned by a patient is quite common. Student therapists enter the clinic hoping to do long-term therapy with people like themselves and instead find themselves speaking in rounds about the self-esteem issues of drug addicts and felons. (At clinics where trainees are allowed to take patients for very low fees, there are more noncriminal, job-holding, well-put-together patients who are willing to see a student therapist if it costs them virtually nothing.) Even so, what students learn is that keeping patients is more important than understanding theory. In private practice, a psychiatrist has an income only if he keeps his patients. That is why there are two Freuds, the Freud who is read by scholars and intellectuals, who take the abstract portrait of the psyche seriously and who debate the epistemological issues he raises, and the Freud of the clinicians, sometimes unread but inspiring, who helps clinicians think in a way that is helpful to patients.
+Hegel resurrected dialectics to the forefront of philosophical inquiry for the German Idealists. As Engels wrote in ''Socialism: Utopian and Scientific'':
-One way to characterize the Freud of the clinicians is by saying that training in psychodynamic psychotherapy teaches student therapists to be more conscious of the way they empathize. Empathy is a natural human process. You see someone crying; you feel sad. You see someone smile; your day brightens. It is also true that when you become more self-conscious about empathy, you see how constrained it is by who you are—the way you perceive someone, the way you feel about that person as a certain sort of person, the form of your own past and of your own anxieties, hopes, fears, ambivalences. The psychoanalyst Roy Schafer places a dissection of the therapist’s empathy at the center of his book ''The Analytic Attitude'', a taut exegesis of the way analysts do their work. Schafer does not pretend that analysts have an uncluttered, transparent view of patients, nor that analytic theory—the intellectual’s Freud—always provides accurate and reliable insight. He sees that a patient tries to describe himself to an analyst and that the analyst experiences empathy for the patient. That is, the analyst genuinely tries to understand what the patient is feeling and thinking, and in that process vicariously experiences some of what the patient thinks and feels. Schafer points out that what the analyst feels empathically is not exactly what the patient feels. For a start, an analyst may build many models in his mind of who the patient is, all of which might be consistent with the “data,” with what the patient has said. The analyst has his own sense of who he is in the analytic setting; so too does the patient. Each has a kind of “second self”: the patient presents himself as more miserable than most of his colleagues think he is; the analyst presents himself as more competent than most of his colleagues think ''he'' is. In fact, Schafer says, the relationship between analyst and analysand—between their second selves—is “fictive.” The two create it together. It is their own narrative, and it is a story about who they are to each other. That, Schafer says, is what makes analysis work as therapy. The analyst does not feel exactly what the patient is feeling, because his perceptions of the patient, drawing as they do from his prior analytic experience and his idiosyncratic understandings, are always subtly different from the patient’s own, particularly because the patient is slightly different in the consulting room and in his life outside the analytic encounter. When a patient looks into the mirror of his analysis, then, he sees not a direct reflection of who he thinks he is but something different.@@@[[#14HeinzKohutisanobviousps|14]]$$$ This gives him possibility, Schafer argues. It makes him feel free.
+<blockquote>
+Hegel’s work’s greatest merit was the taking up again of dialectics as the highest form of reasoning. The old Greek philosophers were all born natural dialecticians, and Aristotle, the most encyclopaedic of them, had already analyzed the most essential forms of dialectic thought.
+</blockquote>
-That awareness of the difference between what a patient thinks and feels, what a therapist thinks and feels, and how each thinks and feels about the other, is one of the first major lessons of the resident’s psychotherapy training. Suzanne, for instance, started out shocked that psychiatric patients were not always grateful for her help but would actually see her as the enemy. She was the classic “nice girl,” always friendly, always helpful, a June Cleaver in a brash late-twentieth-century world. By the end of her first year, she had decided that “sensitivity” was her main problem. She called it “overinvolvement”: “Working with these disturbed patients, they can pick up things and they can read things that normal patients cannot, and they zero in on your insecurities. I had one patient whom we committed to the hospital. Every day she would say to me, ‘I hate you, I hate you because you keep me here.’ For me it was a devastating thing to be told. I care about people a lot, more than they care about themselves sometimes, more than I should.”
+Hegel’s great contribution to dialectics was to develop dialectics from a simple method of examining truth based on discourse into an organized, systematic model of nature and of history. Unfortunately, Hegel’s dialectics were idealist in nature. Hegel believed that the ideal served as the primary basis of reality. Karl Marx and Friedrich Engels strongly rejected Hegel’s idealism, as well as the strong influences of Christian theology on Hegel’s work, but they also saw great potential in his system of dialectics, as Marx explained in ''Capital (Volume 1)'':
-By the end of her second year, Suzanne felt far more competent as a therapist. She ridiculed herself for thinking that she had known what she was doing before: “This year has been an incredible year for personal growth. I laugh sometimes because at the end of last year, my first year, we had what we called ‘therapy patients.’ What a joke! I had no idea of what I was doing at all. I remember this one young woman, a young married woman who had a new baby and was having sexual problems. I would sit there week after week not knowing what to say, just feeling totally overwhelmed. [Suzanne, never married, had at that point just broken up with her boyfriend.] She came back week after week; it was just beyond me. Hearing all these intimate things and not knowing what to say or do, what my role was, I felt that I wasn’t prepared for this, the lecture course we had just wasn’t enough to prepare me to sit in a room with another person who was suffering and feel like I can work with them in some way to help them gain insight and make changes.
+<blockquote>
+The mystification which dialectic suffers in Hegel’s hands, by no means prevents him from being the first to present its general form of working in a comprehensive and conscious manner. With him it is standing on its head. It must be turned right side up again, if you would discover the rational kernel within the mystical shell.
+</blockquote>
-“I started to understand more and more. I could see why the patients were coming back, that if a patient feels understood he’s going to come back, he is getting something. I learned to lower my expectations, to meet people where they are and they will feel understood. Sometimes they feel like maybe you’re the only person on earth that they can come and sit in a room with.
-“Sometimes I feel like I’m engaged in a dance with the patient—they’re doing some steps around me and I’m trying to follow them on the dance floor in a sort of figurative way. Sometimes we’re moving in the same direction, and other times we’re just falling over each other. One week a patient all of a sudden turned on me. It felt like a bucket of anger just thrown over me. At first I was shocked. Then I said to myself, wait a minute. This has got to be transference [“transferred” from another context] because I know realistically I’ve done nothing to offend him. Sure enough, it had to do with feelings from his mom that were projected in the anger and the hurt. I didn’t confront him at the time because he was too upset to appreciate the interpretation, plus he was mad. Weeks later we did. But I’ll tell you, even more critical to me was the fact that during the session, I had stepped back. I had recognized this. It feels like I now have a view of the world that is very special and is kind of neat.”
+-----
-Recognizing the patient’s distortion of the therapist is the psychotherapeutic equivalent of getting a driver’s license. The story implies that the young therapist is beginning to do real therapy because she is able to distinguish what the patient is experiencing from what she has experienced. All of us know that sometimes someone is angry at us because he’s really furious at the boss, but most of us still get angry in response. Therapists try to live in a double-entry bookkeeping state at all times. They try to be deeply, emotionally engaged with the patient and yet not to respond out of their own needs, not to hit back after being hit, not to express pain after being hurt. They try not to respond in kind. That is the “special, neat” way of perceiving the world in psychodynamics: that we each create the world we live in; that we always see through molded glass; and that much of the time, when people are angry at us, we are not the cause of their anger but merely the vehicle for their self-generated, self-inflicted, wounding rage.
+Starting with a critique of the mysterious idealism of Hegel’s philosophy, Marx and Engels inherited the “rational kernel” of Hegelian dialectics and successfully built materialist dialectics.
-After the end of residency, Suzanne explained that what she had learned in residency was to understand the patient without interrupting with her own needs (getting angry at an insult), yet still to be able to use her own sense of self in the service of understanding someone else: “What psychiatry did for me was to take away my insulation. I found myself face-to-face with a lot of ugliness, and I had to learn to tolerate it, to let it be real. There was no way to close my own pain out, and if you’re careful it becomes really useful. For example, I don’t think I ever really learned how to deal with anger or process anger myself, and I see that in a lot of my female patients. It’s real useful for me because I know where they’re coming from. I know what the problem is. At first you think, what do I bring to them, I haven’t solved this one. But I’m not in the same boat. I don’t walk in their shoes. I may have gone through similar things but not the same thing, and I can keep the distance. You can say, ‘When he said that to you, I bet you were furious,’ and the look of relief on their face! ‘How did you know? I could have stabbed him.’ So you use your experiences, and you help the patient.”
+-----
-Young psychiatrists say repeatedly that what they learn to do in psychotherapy is to interpret someone else by factoring out their own participation, by overriding their need to see a good, just world, their need to maintain their honor, or their need to have other people see them as kind. That is, they become increasingly capable of understanding a relationship as the outcome of two complex interacting individuals and to interpret the behaviors of the other person more intricately through the contours of their own selves, as if they were predicting the speed and height of waves by the features of the shore on which they break. They say that they learn to bring their experience to bear on understanding someone else and yet to act on none of their own reactions, which are merely tools for further understanding.
+-----
-In order to do this, young psychiatrists (or student therapists) need to construct self-conscious models of patients and themselves: “I know realistically I’ve done nothing to offend him.… [The anger] had to do with feelings from his mom.” The way they develop those models is by talking endlessly about people and what makes them tick: their secret fears, their wants, their dreams, their embarrassments, their confusions. They learn to talk about an event by explaining it from the perspective of all the different actors, and their tales get funnier because they develop a sharper sense of the parallel universes people sometimes seem to inhabit. This is not like the process of learning to diagnose. The person diagnosing learns to distill a diagnosis out of a patient’s narrative and to see that many different lives can share a common label. In psychodynamics, the models are rarely taught and memorized abstractly (although some models are, such as the Oedipus complex, in which a male child separates from his mother and identifies with his father). For the most part, the models remain specific, as something some patient did at some time that is kind of like what she did some months later. Mostly, the models are about motivation, and because of the cleaner attention to motivation, the young psychiatrist becomes an increasingly better spinner of tales.
+==== Annotation 10 ====
-Tom, for example, entered residency later than most of his peers, first working for years in internal medicine. He is a bluff man, pragmatic and to the point. He spends Saturday playing ball with his kids, rarely reads novels, and thinks he ought to follow the research in his field but doesn’t. In the first months of his residency, he felt demoralized about doing psychotherapy: “I’m frankly terrible still at any kind of real psychotherapy. I mean, basically I’m comfortable with trying to make a diagnosis and prescribe the right medicines for these guys. If it’s just me sitting there trying to help someone in psychotherapy, I just don’t know enough. Actually, I don’t know anything.” He was reassured to discover that he liked the patients. He had had dreams, before residency, about being locked up with crazy people. “But the real surprise here has been that I’ve really enjoyed the patients. No matter how crazy some of these guys are, I can really empathize with them. It’s made me feel real good to feel that kind of a bond with the patients.”
+In order to understand the ways in which the critique of Hegel’s philosophy by Marx and Engels led to the development of dialectical materialism, some background information on materialism — and the conflicts between idealist and materialist philosophy in the era of Marx and Engels — is needed.
-At the end of that year, Tom said that one of his greatest problems was empathizing too well. Understanding his patient’s misery made him miserable: “It’s terribly difficult. People come to you day after day, just pour out all this misery and open up to you. It’s gut-wrenching. When someone’s not psychotic but they live with so much pain, you really feel it. Psychiatry just pulls down all these horrors. You feel so drained.” At the same time, he was clear that he felt that he had become better at understanding his therapy patients: “It’s hard to say how you arrive at some kind of idea of what kind of person you’re talking to. It’s not any one question or one physical or emotional characteristic of that person. It’s the combination of a lot of little things. I think I’ve become a much more feeling and sensitive person this year.” In his last year, Tom said he didn’t believe in classical technique. He thought that a good therapist is more helpful when he does not try to help. He said that psychotherapy worked because he had seen it work for him; but he said that it worked in spite of and not because of grand theory. He said that what was important about the process was that a patient was willing to give up the “big secret” that he had been holding inside, namely that things had not been working right. He said that he didn’t think it mattered so much what you did at that point as a therapist as long as you were “there to help guide them in this exploration of themselves.”
+Materialism is a philosophical position that holds that the material world exists outside of the mind, and that human ideas and thoughts stem from observation and sensory experience of this external world. Materialism rejects the idealist notion that truth can only be sought through reasoning and human consciousness. The history and development of both idealism and materialism are discussed more in the section ''The Opposition of Materialism and Idealism in Solving Basic Philosophical Issues'' on page 48.
-And as his sense of what he was doing seemed to become more simple and concrete, his account of motivation grew more acute: “I had this one patient, this huge woman who came in last year. She’s a really good person, funny, witty, would never miss an appointment. We have a great time. Her whole story is kind of indicative of how loose my psychotherapy can be. Once her depression had cleared [this is a very medical phrase], I was trying to explore her childhood [first the medical necessities, then the psychotherapy]. She picked up that I felt uneasy about what I was doing.
+In the era of Marx and Engels, the leading philosophical school of materialism was known as ''empiricism''. Empiricism holds that we can ''only'' obtain knowledge through human sense perception. Marx and Engels were materialists, but they rejected empiricism (see Engels’ critique of empiricism in Annotation 8, p. 8).
-“Well, I moved offices after we’d started meeting, and when she saw how desolate this room is, she brought in a plant. It was pretty much a sick plant. I said, ‘You’re not supposed to bring gifts, and I can’t take care of plants. These things die. I don’t even water them. I’m incapable of watering plants.’ She said, ‘No problem.’ She just left it there. Unconsciously, I guess I wanted to torture her by letting this plant die in front of her. Every week we would joke because I never watered it. I honestly completely forgot about it consciously when she wasn’t there, and she would accuse me of being sadistic.
+One reason Marx and Engels opposed the strict empiricist view was that it made materialism vulnerable to attack from idealists, because it ignored objective relations and knowledge that went beyond sense data. The empiricist point of view also provided the basis for the ''subjective idealism'' of George Berkeley [see Annotation 32, p. 27] and the ''skepticism'' of David Hume. Berkeley’s Subjective Idealism is empiricist in that it supports the idea that humans can only discover knowledge through direct sense experience. Therefore, Berkeley argues, individuals are unable to obtain any real knowledge about abstract concepts such as “matter.”
-“Now, I have this other patient who is young and attractive. I didn’t think she was that seductive, but I had her on videotape, and my supervisor certainly thought she was. He said that there was all this transference. In fact what he said was ‘Oh, boy.’ Well, she starts to comment on the plant, week after week. I never told her somebody gave it to me, I just said, ‘I never water it. I don’t take care of it.’ She said, ‘Well, I’ll take it home. I’ll bring it to life.’ I said, ‘No, you can’t do that.’ At the end of one session she just picked it up and left with it. So one of these weeks she’s going to come in with the plant she brought back to life for her psychotherapist, whom she loves, which is okay except that now I have to explain this to the other patient who thinks I’m a sadist. I never should have taken the thing to begin with.”
+Similarly, David Hume’s radical skepticism, which Engels called “agnosticism,” denied the possibility of possessing any concrete knowledge. As Hume wrote in ''A Treatise on Human Nature'': “I am ready to reject all belief and reasoning, and can look upon no opinion even as more probable or likely than another.” Hume’s radical skepticism lay in his empiricist belief that the only source of knowledge is sense experience; but Hume went a step further, doubting that even sense experience could be reliable, adding: “The essence and composition of external bodies are so obscure, that we mustnecessarily, in our reasonings, or rather conjectures concerning them, involveourselves in contradictions and absurdities.”
-“We’re really storytellers,” one resident remarked. One of the more remarkable qualities of psychotherapeutically oriented psychiatrists is how capable they are of remembering the story. This becomes obvious in a case presentation or a seminar with psychodynamic clinicians. Like any academic presentations, a presentation has a great deal of data and some theoretical framing. In an academic setting, however, the audience tends to focus on the theory. The listeners remember the theoretical claim being advanced, and they tend to pursue it with questions, often quite forgetful about the actual data mentioned by the speaker. In the psychodynamic setting, the listening clinicians tend not to pursue the theoretical argument (the speaker disagreed with So-and-so’s reformulation of such-and-such an argument). Instead, they talk about patients, and they remember what seems to an outsider to be a stunning amount of detail: where a forty-year-old patient attended school, how her mother behaved at graduation, what her father said about it. A first-year resident said, “I used to find it very difficult to remember what was going on with a patient. Then the guy who ran the psychiatric emergency room said, ‘Remember the story. Everyone’s got a story.’ And then I began to remember.”
+Later, in the appendix of the same text, Hume argues that conscious reasoning suffers from the same unreliability: “I had entertained some hopes (that) the intellectual world ... would be free from those contradictions, and absurdities, whichseem to attend every explication, that human reason can give of the material world.”
-What they remember has a certain form. Master chess players can be distinguished from nonplayers because they hold thousands upon thousands of chessboard positions in their memory. When master chess players are shown, in an experimental setting, a chessboard pattern that could be arrived at by play, they can remember it far more accurately than non-chess-playing subjects—and probably associate with it moves that would take advantage of the position or even specific games. But they are no better than non—chess players at remembering random images or randomly rearranged chessboards that could not be arrived at by normal play.@@@[[#15Theclassicfamousarticle|15]]$$$ Academic psychologists have argued that expertise depends in large part on the amount and organization of knowledge around the area of expertise—what they call the “domain”: chess, ballet, Aztecs, psychiatry, whatever the expert is an expert in. Many argue that the highest level of expertise is indeed (as therapists argue) reached after ten years in the domain. Experts’ memories seem to depend on their capacity for perceiving meaningful patterns (cognitive scientists would call them “schemas”), and the immense storage in their domain of expertise seems to enable them to plan strategically in that domain and anticipate potential sequences of moves in the future.@@@[[#16Oneoftheeasiestwaystod|16]]$$$
+Engels dismissed radical skepticism as “scientifically a regression and practically merely a shamefaced way of surreptitiously accepting materialism, while denying it before the world.” Engels directly refutes radical skepticism in ''Socialism: Utopian and Scientific:''
-What a psychotherapist remembers is a lexicon of narrative patterns that she uses to understand what is going on with a patient, moment to moment, in a particular session and over a long analysis. The complexity of this memory is not unlike the complexity of a chess player’s memory. Like the psychodynamic understanding of a life, a chess game consists of a series of patterns each of which has some causal relationship to the past but is not entirely determined by it. Like a life, each chess game is unique, but, also like a life, the chess game moves from pattern to pattern (board position to board position, event to event) that appear in many other games and many other lives. And like the skilled therapist’s, the skilled chess player’s expertise lies in part in being able to remember and recognize these patterns far more readily than the untrained person and to anticipate strategy on the basis of those patterns.
+<blockquote>
+... how do we know that our senses give us correct representations of the objects we perceive through them? ... whenever we speak of objects, or their qualities, of which (we) cannot know anything for certain, but merely the impressions which they have produced on (our) senses. Now, this line of reasoning seems undoubtedly hard to beat by mere argumentation. But before there was argumentation, there was action... And human action had solved the difficulty long before human ingenuity invented it. The proof of the pudding is in the eating. From the moment we turn to our own use these objects, according to the qualities we perceive in them, we put to an infallible test the correctness or otherwise of our sense-perception.
+</blockquote>
-These patterns are best described as “emotion-motivation-behavior bundles.” By that I mean an emotion (such as anger) that interacts with a motivation (she is a nice person and does not see herself as hating her patient) that causes some piece of behavior (she was furious at her patient but didn’t allow herself to recognize the anger, and during the session for some reason she was unable to hear her patient). Young psychiatrists tell stories by chunking details around such patterns, which can then be combined in many different ways, or which may emerge in new form in new patients. (The word “chunk” is used by cognitive scientists to evoke the way people remember details by pulling them into a central concept, like iron filings to a magnet.) Identifying these bundles is complicated by the inherent oddity of separating out an expert’s own emotional responses from the relationship the expert is trying to interpret. That is why it takes so long to become a psychotherapist and why it is easier to be a competent diagnostician (but not a psychopharmacological connoisseur). In psychotherapy, there are many more patterns related to one another in more complicated ways. In some important sense, you are not a competent psychotherapist until you are a connoisseur-level expert. There is no public and clear-cut threshold of adequacy, no basic competence, as there are in diagnosis and psychopharmacology.
+This concept of determining the truth of knowledge and perception through practical experience is fundamental to dialectical materialist philosophy and the methodology of materialist dialectics, and is discussed in further detail in Chapter 3, p. 204.
-When psychotherapists tell stories, they are learning to figure out the emotion-motivation-behavior bundles that (as they would see it) explain the way people in the story relate. Telling the story well (convincingly) demonstrates their mastery. For example, for many months I met with a psychotherapeutically oriented resident every Friday and chatted with her while the tape recorder was running. When I met her, she was the chief resident of the outpatient clinic. The strain of this responsibility on someone naturally shy and prone to identify even with people she didn’t like made her so nervous that she lost ten pounds in the course of the year and began to smoke. Over that year we talked about psychotherapy, how she had learned to do it, what it was like to go into analysis—she had just started analysis at the time of our conversations—and how she understood what she was doing. These excerpts from our conversations give a flavor of the way she told stories about how people were with people, why they acted, and what they felt.
+Another weakness of empiricism is that it denies the objectiveness of ''social relations'', which cannot be fully and properly analyzed through sensory experience and observation alone. Marx saw that social relations are, indeed, objective in nature and can be understood despite their lack of sensory observability, and that doing so is vital in comprehending subjects such as political economy, as he observes in ''Capital Volume I'':
-===== She’s a very troubled lady. She was incredibly depressed, chronically suicidal. She would come to my office and—“sob” is not the word for it, the building would empty. Everyone in the annex knew my Friday 3:00 patient was there. Through all this she kept telling me in a semiconvincing way how she loved me, in a maternal way. She suddenly partially got it together, decided to get a job, went from no Prozac to three pills a day, and started doing wonderfully. We went from doing crisis management to talking about how she felt about things and how she reacted to people and what hurt her. How she felt about being in therapy as opposed to how suicidal she was this week. Then I went on vacation. I came back and tried to talk to her about what she felt like. She says, yes, she missed me, but you know she understands I have to go on vacation. By the way, she says, I flushed my Prozac down the toilet and there’s nothing to talk about because I can’t help her and life is hopeless. Then she canceled her appointment the next week. I tried to bring it up, but she was absolutely not angry at me, I was important to her, all this positive stuff. What happened to me is that I sat there and I started to get furious at her. At some point I realized how angry I was, I realized it was probably coming across to her, and I felt I had to make some acknowledgment of that. But then she canceled the next appointment. What my anger was telling me was how incredibly angry and hurt she was but she’s not able to express that to me. So what she did was not conscious, obviously, but basically she made me feel it and one of us was conscious of it and could do something with it. The initial reaction is, no, I’m not really feeling this because it wouldn’t be right to feel that, how can I get angry at my wonderful poor sick kind patient who obviously needs help and is in such distress. I couldn’t be having thoughts of strangling her right now, could I? So first you try to pretend it’s going to go away or it’s not really there. When denial doesn’t work, you hopefully start to become aware of it, and if you’re comfortable enough with yourself and your emotions, you can pick it up and look at it. =====
+<blockquote>
+(The true) reality of the value of commodities contrasts with the gross material reality of these same commodities (the reality of which is perceived by our bodily senses) in that not an atom of matter enters into the reality of value. We may twist and turn a commodity this way and that — as a thing of value it still remains unappreciable by our bodily senses.
+</blockquote>
-<div style="margin-left:0.508cm;margin-right:0.508cm;">I think [a second-year resident] has learned to be out there, to really let his emotions out with the patient, to really react however you react and be able to feed that back. Because he doesn’t feel threatened anymore. I think I’m more engaged now than I was a year or two ago because I know I can shut it off. I know that I have control over myself and my life, and I’m not going to lose it in a session with a patient if I let myself get angry, if I let myself feel close to them. I used to have a lot of reluctance to doing that. Supervisors would say, what are you afraid of? The more I let myself be comfortable looking at that, then I could use the information. I could drift into a fantasy about this patient and wonder, what’s the character of the fantasy? That tells me where the patient is. But the threat is that your emotions are out. It’s safer to say, no matter what this patient says or does it will not affect my life. I’m not going to get upset or angry.</div>
+In other words, Marx pointed out that no amount of sense data about a commodity will fully explain its value. One can know the size, weight, hardness, etc., of a commodity, but without analyzing the social relations and other aspects of the commodity which can’t be directly observed with the senses, one can never know or understand the true value of the commodity. The materialism of Marx and Engels acknowledges the physical, material world as the ''first basis'' for reality, but Marx and Engels also understood that it was vital to account for other aspects of rational knowledge (such as social relations). Marx and Engels believed that empiricist materialism had roughly the same flaw as idealism: a lack of a connection between the material and consciousness. While the idealists completely dismissed sense data and relied exclusively on reasoning and consciousness, the empiricists dismissed conscious thought to focus solely on what could be sensed.
-<div style="margin-left:0.508cm;margin-right:0.508cm;">I got this intake, there was this couple that had come in basically because the wife was having so much trouble with her workaholic husband and she really felt like he was putting in too many hours and working too hard, he wasn’t home for her, he wasn’t emotionally available, he wasn’t this, that, and the other thing, and I sat through the interview going, this is my life, I don’t know how to help myself, I don’t know how to help them, and I presented in team. I went with the facts, but basically my presentation to the team leader was, I can’t take this case, first of all, I relate too much, and second, I haven’t figured out how to deal with it and maybe someone older and wiser could figure out how to deal with it. I haven’t been able to figure out how to do it in my own life. And the team leader just thought it was charming and wonderful and he said, “Well that’s great I think that’s exactly why you have to take the case. Because you have so much common experience, you can really use that to help them.” I said, “I’ve been struggling with this at home for a year and a half and all we do is scream at each other.” He said, “Trust me.” They had five sessions of couples therapy and sent me a postcard six months later saying that their marriage had never been better. I have no idea what I did.</div>
+It is important to note that, while Marx and Engels rejected ''empiricism,'' they did not reject ''empirical knowledge'' nor ''empirical data'' which is collected from scientific observation [see Annotation 216, p. 210]. On the contrary, empirical data was key to the works of Marx and Engels in developing dialectical materialism. As Lenin explained: “(Marx) took one of the economic formations of society – the system of commodity production – and on the basis of a vast mass of data which he studied for not less than twenty-five years gave a most detailed analysis of the laws governing this formation and its development.” And so, the dialectical materialism of Marx and Engels served to bridge the gap between idealism and materialism. They believed that our conscious thoughts are derived from ''material'' processes, but that consciousness can also influence the material world. This is discussed in more detail in the section ''“Materialism and Dialectical Materialism”'' on page 48.
-<div style="margin-left:0.508cm;margin-right:0.508cm;">Analysis—I’m now in the second week—truly is regressive. I’ve gotten back in touch with feelings that I had as a child, which I never had access to. In face-to-face therapy, I was making some effort to dredge up all this stuff, and it wasn’t working. Now, it seems like all this stuff is accessible that wasn’t accessible before. The whole experience has been rather like being in the dark and having the lights turned on. They’re not all turned on at once, but you can now start to make out shapes where all you could see before was black. You have a little more access to yourself. But also, as you find the light switch for yourself, you go back to your office and show someone else where it is so they can turn their own on.</div>
+-----
-<div style="margin-left:0.508cm;margin-right:0.508cm;">I think as I get more experienced, I have a better cognitive understanding of what I’m doing. I feel more like, you know, when someone asks you how to get to the restaurant and you can’t really draw the map. I want to say, I know how to get there, I know that when I see this house I turn, but I can’t say, well it’s on this street. That’s kind of how I feel.</div>
+Marx and Engels also criticized many limitations of Feuerbach’s methodology and viewpoint* — especially Feuerbach’s prescriptions for how to deal with social problems — but they also highly appreciated the role of Feuerbach’s thought in the fight against idealism and religion to assert that nature comes first, and that nature is permanent and independent from human willpower.
-Here feelings are causes. They become entangled with a motivation, with someone’s complicated set of hopes, fears, and dreams, and through that entanglement they cause a particular behavior. Mostly, the feelings the therapist talks about are negative. That makes sense because the negative ones are those that trouble people most. (“I didn’t realize that I was upset with her, but I put the oatmeal on the burner for breakfast, and you know, I just forgot about it and her pot was destroyed.”) What the therapist often does in a story is to follow a feeling through a range of emotion-motivation-behavior bundles. For instance, in the discussion of the “very troubled lady,” the resident talks about the good-girl patient who is so miserable (and, one later infers, angry) that she lets the entire building know but also loves the therapist, wants to please the therapist, and so pulls her life together. The therapist goes on to say that the patient is furious at the therapist when she takes a vacation but does not want to acknowledge the anger, and the conflict leads her to flush away the medication that she was taking to please her therapist. Then the therapist segues into an account of how the patient’s unacknowledged anger made her, the therapist, angry, and how she sort of recognized it and tried to “catch” it but didn’t entirely succeed, and the patient felt hurt and mad and canceled the next session. This then led into a discussion of communicating anger without being able to express it and ultimately into the therapist’s anxiety about her difficulty in acknowledging her own anger. A major theme of “powerful feelings that you are afraid to acknowledge” dominates the account, but there are multiple smaller patterns that the therapist infers and patches together into a coherent narrative of a portion of someone’s life. In listening to this story, it becomes clear that the therapist has met many people who have difficulty recognizing their own anger. They are all different from this woman—each person is unique—yet, listening to this therapist talk was like watching a chess player recognize board positions and know instinctively what is going on and what to do next.
+-----
-There are several other features of this therapist’s discourse that are not uncommon. First, while good psychodynamic residents use a language marked as a specialist’s language, with words such as “regressive,” “transference,” “internalized,” and so forth, the language rarely—at least in my experience—dominates the discourse, which tends to be couched in commonplace words. Second, they use abundant metaphors to indicate the thinking and feeling process. This woman uses spatial metaphors to indicate emotionally powerful events—“shaping” events—and she uses contact metaphors to indicate her capacity to understand her own emotions: she “is in touch with” or “has access to” herself.@@@[[#17SeeLakoffWomenFireand|17]]$$$ All people do this, but this discourse is so much more feeling-focused than average that the metaphorical quality seems very marked. The metaphors are particularly striking when this resident talks about what she does ''as'' a therapist. Again and again, this therapist resorts to spatial and contact metaphors to point to what she does, and she feels inadequate to put the details of her practice into words. This feeling of inadequacy is quite common among even the most skilled and senior therapists. They have, in general, a remarkably difficult time verbalizing what it is that they do. Third, many therapists tell stories against themselves and use patients’ stories to make sense of their own experience. This is what this woman does, for instance, in the supervision anecdote and the couples therapy anecdote: the resident who cannot listen when he is threatened, the workaholic husband who frustrates his wife because he is unavailable. The stories are funny because they suggest that the doctor must remember that the patient is the one with the illness. Finally, this therapist, like many others, thinks that what she has learned to do requires courage and is inherently good.
+==== Annotation 11 ====
-For young psychiatrists—particularly psychotherapeutically oriented ones—this language of feeling pervades their lives. “Two visitors? Oh no, that brings up all my childhood anxieties.” They are encouraged to talk about their feelings about their patients, their teachers, and one another. They are told that the most important feature of relationships is talking about feelings. They are told—and they experience—that psychotherapy is full of intense feelings. They are told—probably correctly—that emotion is at the center of psychotherapy, that the therapy will “take” only if a patient is emotionally involved in it, that a patient can hear something fifty different times but will understand it only if he hears it when he is emotionally vulnerable. They are told that understanding people is understanding emotions. They use a language that is so feeling-rich that to outsiders it seems a little strange.
+<nowiki>*</nowiki> Viewpoint, point of view, or perspective, is the starting point of analysis which determines the direction of thinking from which problems are considered. Marx and Engels were critical of Feurbach’s hyper-focused ''humanist'' viewpoint.
-Residents become deeply immersed in one another’s lives. Despite the striking and increasing emphasis on biomedicine, young psychiatrists are enculturated by their institution into the expectation of intense involvement with one another. My field notes are full of this intensity, of April’s feelings about Bambi, of Bambi’s interpretation of Chris’s anxiety about April’s feelings about Bambi, of David’s understanding of the role of Dr. Edwards’s supervision of Bambi on April’s feelings about Bambi, of a constant over-interpreted interdependence with peers. With psychiatrists, particularly young psychiatrists testing the waters of their psychodynamic knowledge, standard expectations of social distance disappear. If you do not talk about your feelings and their personal sources in one-on-one social interaction, you are substandard. This is heightened by an intensified observational alertness, which means that psychiatrists notice anxiety or distress more quickly than nonpsychiatrists and are much more likely to ask about its meaning (this livens up dinner parties attended by both psychiatrists and nonpsychiatrists).
+Feuerbach’s atheism and materialism offered an important foundation for Marx and Engels to develop from an idealist worldview into a materialist worldview, which led them directly to developing the philosophical foundation of communism.
-A resident breaks up with her boyfriend and says, “But it’s really good to go through this with a group of psychiatrists, they really understand.” Chances are that she will speak about the breakup in detail with many, if not most, members of her class. Young psychiatrists will talk and talk about their experiences and one another’s with them, with others. They are, with respect to private matters, the singularly most talkative people I have ever met. They talk about private matters to the point that they may feel abused. “We were very, very close,” Suzanne said when she was talking about another resident. “We started out last year in the same location, even on the same team. He trusted me, I trusted him. We were both going through a bad time, he’s having trouble with his girlfriend, I’m having trouble with my boyfriend. We’re very supportive of each other. What happened was that I started going to a therapist so I had someone to unload on, but he didn’t, he kept coming to me. Boy, did he need to go to a therapist, but he didn’t, he kept coming to me. I had to sort of withdraw. I love this person, I care about him a lot. It felt like his problems were starting to overwhelm me, and I started to feel used.”
+-----
-The rest of the class talked about whether she had a crush on him or he on her; why had he talked to her so much; why had she put up with what had become an asymmetrical exchange; could she tell, once he went into therapy, that he was changing; what about her; what did that say about their therapists? their capacity for therapy?
+==== Annotation 12 ====
-One could argue that these young adults have chosen a career in psychiatry because they enjoy talking about feelings, and for many of them this might be true. But it is not true for all, and whatever an individual’s motivations may be, the culture created by psychotherapy training is so powerful that the social demands are hard to avoid. Residents get to know one another extremely well. They work with one another, hang out with one another, are enculturated side by side. They also participate in group therapy together. Most residencies have what is known as a therapy “T-group,” or training group, which is run by a professional expert in group therapy and meets every week for an hour. In the residencies I visited, participation was explicitly required only for a year, but most groups continued to meet throughout the residency period. I was never allowed to attend these groups, on the grounds that they were too private. But I frequently heard about what had happened in them. During these sessions, people who worked together daily were expected to talk about their private vulnerabilities and fantasies about one another. Sessions not infrequently ended up in tears or rage. They were promptly followed by working interactions with the same people.
+Ludwig Feuerbach was one of the “Young Hegelians” who adapted and developed the ideals of Hegel and other German Idealists. Feuerbach was a humanist materialist: he focused on humans and human nature and the role of humans in the material world. Like Marx and Engels, Feuerbach dismissed the religious mysticism of Hegel. Importantly, Feuerbach broke from Hegel’s religious-mystical belief that humans descended from supernatural origins, instead describing humans as originating from the natural, material world.
-In the T-group, discourse was actively psychodynamic. “There is a lot that goes on in the group,” remarked one resident, “and it’s weird because we’re aware of it. I’ve had kind of transferential feelings towards Fred because I consider him to be like a father. I project feelings onto him. I’ve told him so. I caught myself doing it. I described to him that I felt that way, and fifteen seconds later I was doing it again.” This discussion must have been particularly memorable in the group—I heard about it from several people—because the two men involved were at that time competing, at the end of their second year, for a chief residency position, an administrative post with a fair amount of prestige. The resident continued, “For me to drop my guard and admit my weaknesses to someone that I’m openly competing with is a concern to me because I’m showing weakness when I’m supposed to be in competition and looking strong. Also, thoughts come to your head, like you realize that you just admitted some degree of psycho-pathology to everyone you work with. What will people think?” Yet to be open is to be competitive, because it is to assert psychodynamic competence, as if to say, “I know myself, while you fear yourself, you refuse to acknowledge your weaknesses.” Another resident said irritably about the first meeting of one T-group that Agnes—the resident who was soon labeled the most psychodynamically astute in the group—had asked to be the first person to tell the story of her life (they went around the group in turn, in the beginning), and, by choosing to be very personal, she had upped the ante and taken control of the group.
+Feuerbach also distinguished between the objectivity of the material external world and the subjectivity of human conscious thought, and he drew a distinction between external reality as it really exists and external reality as humans perceive it. Feuerbach believed that human nature was rooted in specific, intrinsic human attributes and activities. As Feuerbach explains in ''The Essence of Christianity'': “What, then, is the nature of man, of which he is conscious, or what constitutes the specific distinction, the proper humanity of man? Reason, Will, Affection.”
-When young psychiatrists gossip, they are learning how to work. They are at least as nosy and curious as the rest of us. Unlike the rest of us, what they get from their gossip is professional expertise, little narrative packets of behaviors, motivations, and emotions. And the gossip is probably as important to their development as their supervision is. I found the informal focus on how people are emotionally put together particularly remarkable in the discussions about residents who were disliked. Those residents the other residents dissected. They knew that they should not really pass judgment on these people, who they thought might be much like themselves, yet they couldn’t stand them. They really tried to figure out what drove them nuts about these people. The following are excerpts from my conversations.
+Feuerbach explained that the actions of “thinking, willing, and loving,” which correspond to the essential characteristics of “reason, will, and love,” are what define humanity, continuing: “Reason, Will, Love, are not powers which man possesses, for he is nothing without them, he is what he is only by them; they are the constituent elements of his nature, which he neither has nor makes, the animating, determining, governing powers — divine, absolute powers — to which he can oppose no resistance.”
-===== I don’t really know, all I know is that he apparently has a much harder time. When he was growing up, he didn’t have any parents, or maybe a stepmother or something like that, and Florida was kind of a drug capital in that period, and I think he probably had a lot of problems. I know he had a lot of therapy, but trying to give him the benefit of the doubt, I just hope this is an improvement over the way it used to be. I hope he’s going in the right direction. I think there are a lot of times when he shows that he has a conscience and he’s genuinely sorry for what he does. It doesn’t seem like it prevents him from doing a similar thing again. I will say this, though, he has definitely added a lot of life, a lot of spark to our otherwise kind of boring social life that we had last year. There’s a certain neediness about it. =====
+In his ''Collected Works'', Feuerbach further explains that materialism is supported by the fact that nature predates human consciousness:
-<div style="margin-left:0.508cm;margin-right:0.508cm;">I’ve had conflicts with Anne, for example. I’ve definitely used my understanding of her dynamics. I’ve understood that the only way to resolve problems is to be very frank and honest rather than harbor resentments. I haven’t told her why I feel that she’s done what she’s done. Very often, my understanding of her is that she’s rather narcissistic and that she really tends to walk over people sometimes, and so when she goes to walk over me, I’ve called her on it and I’ve told her that this is where I stand and these are my concerns and this I why I would appreciate it if she wouldn’t do what she’s doing, and she’s responded to that. I haven’t told her, well, you’re narcissistic and just don’t think about other people. Obviously that wouldn’t go over too well.</div>
+<blockquote>
+Natural science, at least in its present state, necessarily leads us back to a point when the conditions for human existence were still absent, when nature, i.e., the earth, was not yet an object of the human eye and mind, when, consequently, nature was an absolutely non-human entity (''absolut'' ''unmenschliches Wesen''). Idealism may retort: but nature also is something thought of by you (''von dir gedachte''). Certainly, but from this it does not follow that this nature did not at one time actually exist, just as from the fact that Socrates and Plato do not exist for me if I do not think of them, it does not follow that Socrates and Plato did not actually at one time exist without me.
+</blockquote>
-<div style="margin-left:0.508cm;margin-right:0.508cm;">Diane is what I would call a group deviant. She’s flamboyant, she’s hysterical, by that I mean very dramatic, everything’s extreme in her descriptions of things. People looked at that as peculiar and odd. So she got set on the outside fringe of the group, not yet labeled the group deviant. Then she engaged in some behaviors that irritated and angered, alienated her from certain charismatic members of the group, and these charismatic members spread the word. So everyone became sympathetic to the charismatic members and further alienated from the outlier, and that was when she became the group deviant. To fit in now, she would have to dump the odd behavior, I mean that’s like telling someone to grow two right arms. It’s just not possible for her to change her behavior like that. She would have to go through five years of analysis to be able to change her defense patterns and behaviors. When people get together and talk about the difficulties of residency, it’s Diane. All their concerns were legitimate, but they weren’t talking about anything more important, like how hard it is to take care of people who don’t want to become better. How hard it is to take care of people who will never be functional. That’s hard. So we use Diane as a way of expressing anxieties and frustrations and ventilating.</div>
+Marx and Engels were heavily influenced by Feuerbach’s materialism, but they took issue with Feuerbach’s sharp focus on human attributes and activities in isolation from the external material world. As Marx wrote in ''Theses on Feuerbach:'' “The chief defect of all hitherto existing materialism – that of Feuerbach included – is that... reality... is conceived only in the form of the object... but not as sensuous human activity.”
-These accounts display many features of a young therapist’s discourse: the technical language, the spatial metaphor (although in the absence of personal reflections, there are no contact metaphors), the identification of feelings, and sequences of emotion-motivation-behavior patterns. What they add is the sense of relentless determination in trying to figure out why, despite all their training and all their rationality, some of their peers behaved so badly (on the one hand) and the other residents weren’t mature enough to cope (on the other).
+“Sensuous human activity” has a very specific meaning to Marx; it grew from two conflicting schools of thought:
-Psychologically minded people create such models (large and specific) all the time. Psychiatric residents (and others in training) have two additional sources of help in building these models. The first is psychodynamic theory, which provides a great abundance of partially abstract models to interpret human behavior. The residents learn this theory from teachers, from peers, and occasionally from books. The theoretical model suggests that if someone exhibits a certain set of behaviors, the behavioral pattern is this and the motivating emotions are that. For example, in a well-known book entitled ''The Drama of the Gifted Child'', the analyst Alice Miller describes highly successful people who do not have the secure self-assurance you would imagine. Their success seems hollow to them, their failures monumental; although they are envied and admired by many, they feel empty, abandoned, and depressed. They strive for more success to quench these feelings, but to no avail. Miller calls these patients “narcissistic.” She describes a narcissistic person as someone who learned to be and to do in order to please someone else and to be loved by them in return. That is why they are so successful and why their success is so meaningless to them. Such a model explains what motivates these patients and, ultimately, how therapy should be focused so as to help them understand and reshape their motivations. Young psychiatrists read such a book and make sense of it by using the model to explain people they know or indeed to explain themselves. (Miller remarks that many insightful, intuitive children who grow up taking care of their parents by being good, responsible children become psychotherapists as adults. That is how they make use of their earlier intense interest in what their parents felt and needed.) The models offered in various texts do not all complement one another. Sometimes they flatly contradict one another. (A famous example is penis envy. Some psychoanalytic writers believe that women are motivated by penis envy; others do not.) In general, psychiatric residents (or psychiatric clinicians) are not worried by the contradictions, and in general they do not see their task as one of arbitrating them. These models are tools they can use to help them understand their patients. They are like spades and garden shears, useful or not useful, rather than like equations, true or false.
+The idealists believed the external world can only be understood through the ''active'' subjective thought processes of human beings, while the empiricist materialists believed that human beings are ''passive'' subjects of the material world. Marx synthesized these contradicting ideas into what he called “sensuous activity,” which balanced idealist and materialist philosophical concepts.
-The second source of models is a privileged access not only to a greater-than-average range of human experience (including serious depression and psychosis, which laypeople rarely see and recognize) but also to feelings and stories usually kept private. By the time they graduate, psychiatric residents not only have seen hundreds of severely disturbed patients, they have heard hundreds of detailed accounts of fantasies, actions, desires, frustrations, and so forth, the likes of which most people encounter only in novels and in a handful of living people. These are not abstract models. They are stories of how one patient spoke about commonplaces for three months in therapy and suddenly began to cry or another abruptly quit therapy and called back four months later, or how the son of an entrepreneur was crippled by his father’s great success, yet had to take care of him as he sank into senility. These are like chess games a young psychiatrist plays again and again, seeing lives unfold, looking for the ways different strategies play out in different settings. They help a psychiatrist say to herself, “Ah, that is the way ''you'' reacted to your brother’s death, but it is not the way all people would react. It is a unique reaction, and it tells me something about you, because I have seen similar reactions to different problems and I have seen people react differently to similar problems.”
+According to Marx, humans are simultaneously ''active'' in the world in the sense that our conscious activity can transform the world, and ''passive'' in the sense that all human thoughts fundamentally derive from observation and sense experience of the material world (see Chapter 2, p. 53). So, Marx and Engels believed that Feuerbach was misguided in defining human nature by our traits alone, portraying “the essence of man” as isolated from the material world and from social relations. In addition, Feuerbach’s humanism was based on an abstract, ideal version of human beings, whereas the humanism of Marx and Engels is firmly rooted in the reality of “real men living real lives.” As Engels wrote in ''Ludwig Feuerbach and the End of Classical German Philosophy'':
-This learning process probably helps most young psychiatrists to sense other people’s emotions more accurately.@@@[[#18Thereissomeexperimentale|18]]$$$ At least the process helps residents to make fine distinctions between emotions and their roles in different settings. I think it also enables residents to sense emotions more keenly. My evidence is simple and observational. I believe, having spent years in this world, that good, psychodynamically oriented residents become more intuitive over time. They seem to be able to meet a person for a short time and to summarize that person’s experience in a manner that rings true. Some residents become identified as “wizards” who are able to interview a patient and dazzle a crowd with their skill in understanding, who give people in their office a sense that they have understood them deeply. Even so, the understanding is undoubtedly shaped in an idiosyncratic fashion: out of the many possible valid interpretations of one person’s behavior, a therapist settles on one, and, because no person has a single interpretation of his own life, a patient’s sense of being understood arises in what is essentially a negotiation between his perspective and that of his therapist. It must also be said that some psychiatrists never learn. Some residents are clumsy in the psychodynamic china shop at the beginning of their residency and remain so at the end.
+<blockquote>
+He (Feuerbach) clings fiercely to nature and man; but nature and man remain mere words with him. He is incapable of telling us anything definite either about real nature or real men. But from the abstract man of Feuerbach, one arrives at real living men only when one considers them as participants in history... The cult of abstract man, which formed the kernel of Feuerbach’s new religion, had to be replaced by the science of real men and of their historical development. This further development of Feuerbach’s standpoint beyond Feuerbach was inaugurated by Marx in 1845 in ''The Holy Family''.<ref>''The Holy Family'' is a book co-written by Marx and Engels which critiqued the Young Hegelians, including Feuerbach.</ref>
+</blockquote>
-“It’s an anxious profession,” another resident remarked at the end of his first year. It seemed to me, in sorting through my transcripts and notes, that there were different modes of and stages in coming to terms with psychotherapy. First and most common was rejection and a sense of inadequacy, coupled with an appreciation that psychopharmacology is easier to master. All psychiatry residents feel this inadequacy to some degree throughout most of their residency. How could they not? A second-year resident, skeptical of psychotherapy but caught by his own expectation that to be a good psychiatrist was to be a good therapist, reported, “I felt like an imposter. Someone was actually coming to me weekly for psychotherapy, and I didn’t know what I was doing. My supervisors would reassure me by explaining that it takes ten years before you become comfortable doing psychotherapy. And I thought, ten years? ''ten years?'' I didn’t expect to be an analyst after my residency, but I expected to be confident. I thought, don’t give me that crap. But everyone said ten years. So I felt better, but I am still much more secure with the psychopharmacology and much less secure with psychotherapy. I feel very put off by it. It’s easier to be a competent psychopharmacologist than it is to be a competent psychotherapist. The patients don’t seem like they’re getting better, or a patient leaves and I feel terrible. And I feel anxious, because even though I know it takes ten years and all that, still I feel sheepish and stupid with a new supervisor.”
+Marx and Engels believed that human nature could only be understood by examining the reality of actual humans in the real world through our relationships with each other, with nature, and with the external material world. Importantly, it was Marx’s critique of Feuerbach which led him to define political action as the key pursuit of philosophy with these immortal words from ''Theses on Feuerbach:'' “Philosophers have hitherto only interpreted the world in various ways; the point is to change it.”
-Then one must become engaged with the ideas of psychotherapy before being able to feel much ease in the practice. This leads to mild paranoia, because a resident who recognizes that there is a new way of seeing but feels he hasn’t got it thinks that everyone is pointing at him. Of course, he is right. Senior psychiatrists have meetings to talk about the residents and how they are doing, and these discussions are in large part about the residents’ personalities and whether they can make it as psychiatrists. “They have these meetings,” Phil complained in his second year, “and they talk about us. I’m sure they think I’m too extroverted and outgoing. It’s so unfair. I can’t stand it.”
+-----
-Phil turned out to be a reasonably gifted therapist, but he was not an intellectual, and he was not comfortable in the training experience. By the beginning of his second year, he had the guarded look of the hunted. “Before I was a psychiatrist,” he said, “I was innocent on the unconscious level. Now I’m guilty on the unconscious level. The year has been really hard. I’m sure psychiatric training is harder than other fields. For myself, I’ve had a lot of self-doubt about professional identity, about my ability to do this work, the ability to be a psychiatrist, whether I’ve got it inside of me. In cardiology, if someone had a specific arrhythmia, there is just one specific treatment, and if that treatment doesn’t work there’s a specific alternative. In psychiatry, first of all, you don’t have anything to diagnose that’s as concrete as an arrhythmia. But then, you can make a good clinical assessment on one level, but if you neglected something you would be called on and criticized, and you’d have to ask yourself, why did I do that? The chances are that the reason I didn’t go into a certain detail was so deeply seated in myself that I’d have to do some serious self-analysis to understand why I missed it.
+The British classical political economics, represented by such economists as Adam Smith<ref>Adam Smith, 1723 — 1790 (British): Logic professor, moral philosophy professor, economist.</ref> and David Ricardo<ref>David Ricardo, 1772 — 1823 (British): Economist.</ref>, also contributed to the formation of Marxism’s historical materialist conception [see p. 23].
-“There are no excuses in psychiatry. Everything you do is for a reason. Circumstance just doesn’t exist in the minds of psychiatrists. Senior psychiatrists are always looking at you and judging you. I was on call the other day, and I slept from about 11 p.m. to 3:30 a.m. I went to sleep again at 6:00 a.m., and for some reason my watch alarm didn’t wake me up. I was late for sign-up, and my excuse that my watch didn’t wake me up was meaningless. I missed the time for some reason: some unconscious motivation meant that my watch didn’t wake me up. That’s understood. Any psychiatrist would say that it’s understood. My unconscious is guilty of not wanting to go to morning sign-up rounds.”
+Smith and Ricardo were some of the first to form theories about labor value in the study of political economics. They made important conclusions about value and the origin of profit, and about the importance of material production and rules that govern economies. However, because there were still many limitations in the study methodology of Smith and Ricardo, these British classical political economists failed to recognise the historical characteristic of value*; the internal contradictions of commodity production**; and the duality of commodity production labor***.
-The final step in the learning process is developing some sense of mastery. That people feel as if they know who the good therapists are says something very interesting about this profession, where you never see the professional’s work. Residents and more senior psychiatrists certainly had clear views about who was likely to be a good therapist and who was not. Often the judgments were quite consistent. The capacity to use oneself to understand another self is not, after all, a mystical quality. It is a part of human intuition that some people have naturally and that psychotherapists, who often fall into this category, learn to hone. What becomes surprising is how the process of honing can make a person feel as if he is becoming unnatural. It transforms the way he looks at people, thinks about people, reacts to people. Good psychotherapists sometimes say that they have always had the skills they have now learned to use, but that using them skillfully has changed them utterly. Or so at least they perceive.
+-----
-In both of these approaches, the biomedical and the psychodynamic, what one learns to do affects the way one sees. A psychiatrist in a hospital (or a more biomedically minded psychiatrist) learns to memorize patterns and starts to use them in a rough-and-ready way. He learns to think in terms of disease and to see those diseases as quickly and as convincingly as a birdwatcher identifies different birds. For him, what is wrong with a patient is that the patient has a disease, and being a good psychiatrist involves seeing the patient in terms of the disease. For him there is a clear-cut difference between illness and health. A psychiatrist in an outpatient clinic (or a psychiatrist thinking psychodynamically) learns to construct complex accounts of his patients’ lives. He thinks in terms of the way his patients are with other people and in terms of the emotions and unconscious motivations that lead his patients to hurt themselves. Here there is no clear-cut line between health and illness. What is wrong with a patient is that his interactions with other people go or have gone awry, and being a good psychiatrist involves understanding how and why. Both take the complex mess that is human misery and simplify it in order to do something about it. In the process, each approach constructs a different person out of one unhappy patient.
+==== Annotation 13 ====
-== {{anchor|CHAPTERTWO}} {{anchor|TopofLuhr9780307791900epubc3}} CHAPTER TWO: THE ARROW OF HARM ==
+<nowiki>*</nowiki> '''Historical Characteristic of Value'''
-Knowing what is wrong with a patient is only part of the way a psychiatrist learns to be in relationship with patients. Another piece is the way a young doctor learns to feel about patients and how he comes to judge who is a risk to whom. Unfortunately, the somewhat brutal experience of medical training tends to teach young doctors, among them young psychiatrists, that patients are a source of harm to a doctor. In psychotherapy training, the arrow of harm is pointed the other way. It is, of course, more complicated than that. But much about hospital experience invites a young psychiatrist to feel detached and distant from her patients, while outpatient psychotherapy invites a more tangled, intimate involvement.
+Marx generally admired the work of Smith and Ricardo, but saw major flaws which undermined the utility of their classical economic theories. Perhaps chief among these flaws, according to Marx, was a tendency for Smith and Ricardo to uphold an ''ahistoric'' view of society and capitalism. In other words, classical economists see capitalism as existing in harmony with the eternal and universal laws of nature, rather than seeing capitalism as a result of historical processes of development [see Annotation 114, p. 116]. Marx did not believe that the economic principles of capitalism resulted from nature, but rather, from historical conflict between different classes. He believed that the principles of political economies changed over time, and would continue to change into the future, whereas Smith and Ricardo saw economic principles as fixed, static concepts that were not subject to change over time. As Marx explains in ''The Poverty of Philosophy:''
-=== {{anchor|INTHEHOSPITAL1}} IN THE HOSPITAL ===
+<blockquote>
+Economists express the relations of bourgeois production, the division of labour, credit, money, etc. as fixed, immutable, eternal categories... Economists explain how production takes place in the above mentioned relations, but what they do not explain is how these relations themselves are produced, that is, the historical movement that gave them birth... these categories are as little eternal as the relations they express. They are historical and transitory products.
+</blockquote>
-<div style="text-align:center;">''Medical School Training''</div>
+<nowiki>**</nowiki> '''Internal Contradictions of Commodity Production'''
-===== When I was an intern, I came in one morning to rounds and heard one of my classmates discussing his previous night on call. “Oh,” he said, “a woman came in, and we did such and such and such and such, but luckily she died by morning.” What appalled me was that I understood how he felt: if she had lived, he would have had someone else to take care of. =====
+In Marxist terms, a commodity is specifically something that has both a use value and a value-form (see Annotation 14, p. 16), but in simpler terms, a commodity is anything that can be bought or sold. Importantly, capitalism transforms human labor into a commodity, as workers must sell their labor to capitalists in exchange for wages. Marx pointed out that contradictions arise when commodities are produced under capitalism: because capitalists, who own the means of production, decide what to produce based solely on what they believe to be most profitable, the commodities that are being produced do not always meet the actual needs of society. Certain commodities are under-produced while others are over-produced, which leads to crisis and instability.
-<div style="text-align:right;margin-right:1.058cm;">—Psychiatric resident</div>
+<nowiki>***</nowiki> Duality of Commodity Production Labor
-That a patient can be seen—as this one was—as a threat to a doctor’s personal survival is the result of our country’s approach to medical training. Psychiatrists have their initial apprenticeship in the intestines of the modern hospital. They are physicians. For five years, in medical school and internship, they confront the body immediately, directly, often horribly. They cannot, like the rest of us, hide from old age, from broken veins and sagging flesh. They see bodies fail. They see bodies mangled in car accidents and eaten by cancers. In medical school, doctors-to-be dissect the groins and brains of dead bodies, and a young student on a date sees not only a handsome face across the table but a thick neck stem of muscles, veins, and nerves whose simulacra she has sliced and pinned and studied. For five years these young adults cut dead flesh, do cardiac massage, assist at surgeries, sew up wounds, insert hypodermic needles, memorize body parts, and eventually sleep every third night in the hospital in a training so intense that few of them can imagine that any other training might be as powerful.
+In ''Capital'', Marx describes commodity production labor as existing in a duality — that is to say, it exists with two distinct aspects:
-The experience seems to change students forever. At least, when psychiatric residents come straight from medical school and internship, they seem to be in almost a state of shock, and they talk about medical school the way anthropologists used to talk about their years in distant, savage lands. No one who hasn’t been there can possibly understand, and having been there you become part of a club no one else can join. It used to irritate me, this sense that I would never understand what it felt like to be a psychiatrist unless I went to medical school and struggled through internship. One resident even explained that he deserved to earn an enormous salary because medical training was so miserable, as if thirty years of well-paid clinical work would barely compensate for his five years of pain. But I have come to believe that in medical training, there are irrevocable changes to your sense of who you are, and to some extent it is true that no one who has not had to draw blood from a dying patient in the emergency room, after having worked continuously through the previous night, can really understand. An anthropologist who did fieldwork in Turkey and then found himself enmeshed as an observer-teacher in medical school, agrees: “Not only was the language as different as Turkish and English, but the dimensions of the world that were beginning to appear—intricate details of the human body, of pathology and medical treatment—were more profoundly different from my everyday world than nearly any of those I have experienced in other field research.”@@@[[#1ByronGoodMedicineRationa|1]]$$$ The key difference, I think, that sets the training apart from other preprofessional experience—law school, graduate school, where the hours may also be long—is that in medicine, the student’s failure to know can be the on-the-spot cause of the death of another human being. Practically speaking, of course, this is rare. Students are too well supervised and hospital emergencies too well attended for a student’s ignorance to cause much harm (usually). Nevertheless, most people go to medical school in order to do what doctors do: to heal the sick, to save the dying. Especially now, when the financial windfalls of the eighties are fading under the hot glare of health care reform, they go to medical school to learn how to cure. The single most powerful lesson that students seem to learn in medical school is that they carry the responsibility for life. The second most important lesson is that they aren’t responsible enough, they can never learn as much as they are supposed to know, and they cannot be as effective as they should be.
+First, there is ''abstract labor'', which Marx describes as “labor-power expended without regard to the form of its expenditure.” This is simply the expenditure of human energy in the form of labor, without any regard to production or value of the labor output. Second, there is ''concrete labor'', which is the aspect of labor that refers to the production of a specific commodity with a specific value through labor.
-That painful tension between inadequacy and responsibility—one sociologist calls it a “training for uncertainty”@@@[[#2ReneeFoxTrainingforUnce|2]]$$$—is the first and most sharply obvious emotional demand in medicine. Medical students are confronted with a vast array of knowledge. Unlike in their undergraduate years, when the culture taught them to do the assigned reading in order to be rewarded with a decent grade, this culture tells them that they must master this knowledge not for their own glory—most medical schools do not give grades—but because they need it, all of it, in order to do decent work. The jejune joke is that you cannot tell a patient, “Sorry, I didn’t go to class that day.” Residents speak of making heroic efforts to memorize and of the stunned recognition of their own limitations. One psychiatric resident told me that he had written out the anatomy of the body on hundreds of index cards that he pinned to his walls; before exams he would pace nervously before them and memorize. He passed his exams. Most medical students pass their exams. Still, they are conscious of their inadequacy. Nobody can master the leviathan of anatomical detail, nor is there enough knowledge, in all we know of the pathways of disease, to map and chart and heal the degradation of the body.@@@[[#3Thisimpossibilityistheins|3]]$$$
+Marx argues that human labor, therefore, is simultaneously, an activity which will produce some specific kind of product, and also an activity that generates value in the abstract. Marx and Engels were the first economists to discuss the duality of labor, and their observations on the duality of labor were closely tied to their theories of the different aspects of value (use value, exchange value, etc.), which was key to their analysis of capitalism.
-They also very quickly learn detachment. The need for detachment probably becomes apparent for the first time in anatomy lab, a class in which students spend between three months and a year carving up a formaldehyde-soaked cadaver and identifying its various parts. One sociologist who studied the learning process in anatomy lab reported that in the weeks before it and then throughout, medical students tell “cadaver stories” in which some student (elsewhere) plays a gruesome jest on, say, a bus driver by handing over the fare with a severed hand. Medical students laugh uproariously at these accounts; their laughter in the face of the bus driver’s imagined horror displays their toughness. The sociologist followed medical students in their first six months of training, through anatomy lab, through visits to a local hospital for the dying, and through the unexpected death of their first psychiatric interviewee during the interview. Most of the students tried desperately not to let others know how difficult these experiences were for them, and most of them strove for an “ethic of stoicism,” based on the formula that emotionalism equals weakness equals lack of scientific objectivity. A curtain of silence, the sociologist reported, falls around the cadaver experience: no one is supposed to let anyone know that it affects them, though much evidence suggests that it does. (Most of them rejected with horror the idea of donating their own body to a medical school’s anatomy lab.) “The dissection of a human cadaver represents a test of one’s emotional competence to become a physician, no less an entrance requirement than a high grade-point average or a double-digit Medical College Admissions Test score.”@@@[[#4FredericHaffertyIntotheV|4]]$$$ Yet you know, as a medical student, that the true test of your emotional competence for medicine will be in the trenches of internship. Most medical students seem to feel tremendous fear that their detachment will not hold.
+-----
-That detachment is magnified by the theory of disease. Medical students are taught a profound awareness of the body as organism—not as a person. A medical student remarked to an interviewer, “I’ll find myself in conversation.… I’ll start to think about, you know, if I took the scalpel and made a cut [on you] right here, what would that look like?” An anthropologist participating in anatomy lab remarked, “I would occasionally be walking along a street and find myself a body amidst bodies, rather than a person amidst persons.”@@@[[#5BGoodMedicineRationalit|5]]$$$ What doctors are taught, what they assimilate more deeply than any other professional, is that we are creatures of the body, and that bodily processes, which they know in excruciating detail, are our life. When medical students dissect cadavers, the didactic aim is that they should be able to name and know every slithering piece of it, turn what we would see as a clammy mass into a road map. As they memorize the hyperdetails of bodily process, they similarly turn the emotional horror of disease into a scientific entity. That transformation leaves the person and the pain out of illness.@@@[[#6Thisclearseparationofmind|6]]$$$
+Smith and Ricardo also failed to distinguish between simple commodity production and capitalist commodity production*, and could not accurately analyse the form of value** in capitalist commodity production.
-Thus, for young doctors, illness in those they love is peculiarly weird and upsetting. Two of my psychiatrist friends listened to family members’ worries, diagnosed their metastatic cancer over the phone, and watched them die, all the while shepherding them through the tests, doctors, and chemotherapy that eventually failed to help. Most of us confront illness in the comforting obscurity of the hospital’s antiseptic bustle. We believe—at least we hope—that modern doctors can cure anything if they try hard enough. Doctors rarely share the illusion that modem medicine is invincible. They do know how to ask questions about the body itself. “It’s a profound shift,” a resident said sadly. “I remember having a friend call from Europe, very sick. Rather than identifying with my friend, feeling how awful it must be to be sick abroad, I began asking all these clinical questions, very detailed, very careful. I knew too much, I had seen too much, and it prevented me from being as emotionally helpful as I might have been otherwise.” She became the doctor; her friend was the patient. Patients are not friends. “I’ll focus,” she explained, “on the event as a phenomenon, not as something that happened to my mother.” For a young doctor, family illness becomes a disturbing kind of doubleentry bookkeeping. New doctors know enough not to be innocent of what a doctor in charge is doing. And so a young doctor may find himself the agent of his mother’s death, because he knows that she needs a second opinion and whom she should call, and he knows if the doctor’s reassurance is hollow or the advice sensible. Yet the more he keeps his cool, to stay on top of the specialists and the treatment options, the less he is part of her journey. He becomes the doctor, his mother is the patient. He needs to feel distant to keep his perspective. But he is her son, and she is dying.
+-----
-This is a model of disease in which the body is unmindful, in which human intention and personality disappear from the body like figures from a photograph bleached by the sun. In medical school students are taught that the source of illness lies in the body and that the job of the physician is to deal with pain by locating its genesis in bodily dysfunction. In the last two years of medical school, the “clinical years,” when students graduate from lecture-and-laboratory courses to trail around behind ward doctors like obedient shadows, their main task is to learn how to write down and present the salient facts of a “case,” a patient’s experience of illness. This is called “taking a history” and involves making a “differential diagnosis.” It is an exercise in writing narrative history by agenda: to identify in the vague blur of a patient’s story the specific symptoms that might be the signs of medical illness. To “take a history” means to collect the available information and present it in such a way that the potential signs of illness are clear; to “make a differential diagnosis” means to identify which illnesses the symptoms might indicate and in what order of reasonable likelihood. The narrative of a person has become a case study of a body. “When you’re in a training program for medicine, you treat the problem and not the patient,” a psychiatric resident said with some bitterness. “You get the person outof your face. The patient is a disease. That’s the way you look at it. It’s not Mr. Jones, it’s the heart attack or the gastrointestinal bleed in room whatever.”
+==== Annotation 14 ====
-The heroism in medical school lies in solving the “puzzles” of patients’ complaints (what is going on with her liver?) with solutions, which are diagnoses that identify the diseases that produce the problems patients complain about. Medical students appear in a hospital unit for some short period of time (often a month or two) to learn about some specialty in medicine (psychiatry, obstetrics, surgery) as a low-level apprentice. Usually, they are given several patients to “work up”: to talk to, to learn to feel doctorly with, to learn what it is to take a history. The competent medical student “presents” the patient in “rounds” to general criticism. That is, as the clinicians of the unit gather to discuss the patients, the medical student describes his patient in the approved way, listing the symptomatic history in such a way that it argues for a particular disease (the diagnosis), yet allows for the possibility of other plausible interpretations, which must be ruled out before proceeding in full confidence. A competent student, then, demonstrates that he understands how to think—in some fledgling way—like a physician. A star student solves a puzzle that has stumped the senior staff by reading the lab results more carefully or researching the journals on some topic more deeply than her seniors. And always the interpretive structure is the same: there is a biological problem that is hidden and that must be inferred.
+<nowiki>*</nowiki> '''Commodity Production'''
-All too often, this lesson is taught through humiliation and shame. The senior doctor in rounds will interrupt a resident’s case presentation, turn to the medical student, and ask her to explain congestive heart failure. These unexpected public examinations are less common in psychiatry than they are in other fields of medicine, but students behave as if they expect them to occur, and when they do the student grows quiet and stiff. Medical students live in dread of being publicly humiliated, and vicious shaming—“God help medicine when you graduate!”—takes place often enough to keep the anxiety skyscraper-high. Medical memoirs paint the years of training as periods of cringing embarrassment and a pummeling sense of insufficiency. Very little actual humiliation is required to produce this state because of the student’s intense awareness that the doctor carries the final responsibility for patients’ health.
+''Simple commodity production'' (also known as ''petty commodity production'') is the production of commodities under the conditions which Marx called the “Simple Exchange” of commodities. ''Simple exchange'' occurs when individual producers trade the products they have made directly, themselves, for other commodities. Under simple exchange, workers directly own their own means of production and sell products which they have made with their own labor.
-Medical responsibility asserts that it is the doctor’s job to draw the correct inferences about disease. In contemporary medicine, where there is so much knowledge and yet so much is still unknown, where the interventions—surgery, chemotherapy, cell-killing and hormone-cycle-flipping medications—can do great harm, correct identification of an illness is crucial. Still, there are many conditions for which there is no blood test or scan that will reveal whether a doctor’s guesswork is correct. This leads to the final powerful lesson that medical students are taught in medical school: that experience is more important than book learning, and that what counts is whether a patient gets better. A “bad outcome” is the tactful phrase used for patients who die. The good doctor has plenty of these. What makes him a good doctor, however, is that he rarely makes the same mistake twice—that he has the clinical experience with patient after patient that enables him to interpret his patients’ symptoms accurately, and he has the reputation of helping them to improve. The doctor is autonomous, the doctor is responsible, and what counts in the end is his own experience as an expert. Doctors hate placing the reins of treatment into the hands of the insurance companies.
+Simple commodity production and simple exchange use what Marx referred to as “C'''→'''M'''→'''C mode of circulation” [see Annotation 60, p. 59]. Circulation is simply the way in which commodities and money are exchanged for one another.
-==== {{anchor|SAMPLELAWSOFTHEHOUSEOFGO}} [SAMPLE] LAWS OF THE HOUSE OF GOD ====
+'''C→M→C stands for:'''
-<div style="margin-left:0.423cm;">The patient is the one with the disease.</div>
+Commodity '''→''' Money '''→''' Commodity
-<div style="margin-left:0.423cm;">They can always hurt you more.</div>
+So, with simple commodity production and simple exchange, workers produce commodities, which they then sell for money, which they use to buy other commodities which they need. For example, a brewer might make beer, which they sell for money, which they use to buy food, housing, and other commodities which they need to live.
-<div style="margin-left:0.423cm;">The only good admission is a dead admission.</div>
+In the C'''→'''M'''→'''C mode of circulation, the producers and consumers of commodities have a direct relationship to the commodities which are being bought and sold. The sellers have produced the commodities sold with their own labor, and they directly consume the commodities which they purchase with the money thus obtained.
-<div style="margin-left:0.423cm;">The delivery of medical care is to do as much nothing as possible.</div>
+''Capitalist commodity production'' and ''capitalist exchange'', on the other hand, are based on the M'''→'''C'''→'''M’ mode of circulation.
-<div style="margin-left:0.423cm;">—From Samuel Shem, ''The House of God'' (p. 420), a darkly comic account of medical internship about which several residents independently said, “When I read it in medical school, it seemed absurd and extreme, but after internship I thought it was tame.”</div>
+'''M→C→M’ stands for:'''
-<div style="text-align:center;">{{anchor|Internship}} '''''Internship'''''</div>
+Money '''→''' Commodity '''→''' More Money
-Internship is the year of intense medical apprenticeship that follows four years of medical school. As far as an anthropologist can tell, a doctor leaves internship shaped by two powerful lessons.
+Under this mode of circulation, capitalists spend money to buy commodities (including the commodified labor of workers), with the intention of selling commodities for MORE MONEY than they began with. The capitalist has no direct relationship to the commodity being produced and sold, and the capitalist is solely interested in obtaining ''more money.''
-First, by the end of the year, the doctor feels like a doctor. He can do lumbar punctures, blood transfusions, and cardiac resuscitations. He can answer a code—a sudden flashing alert that a patient is on the verge of death—and save the patient. He feels competent.
+Capitalist commodity production, therefore, uses the M'''→'''C'''→'''M’ mode of circulation, in which capitalists own the means of production and pay wages to workers in exchange for their labor, which is used to produce commodities. The capitalists then sell these commodities for profits which are not shared with the workers who provided the labor which produced the commodities.
-Second, the patient has become the enemy. In many hospitals, interns spend more than a hundred hours a week in the hospital. They arrive at perhaps 7 a.m. and leave at 7 p.m.; the next day they arrive at 7 a.m. and depart at 7 p.m. of the day following (not that night but the next). Then they repeat the sequence: one night off, one night spent fully awake and working, the third night sleeping the sleep of the exhausted. (Some hospitals humanized this schedule after a famous lawsuit charging that sleep-deprived interns had inadvertently killed a patient.) The work the interns do is often repulsive. Their hands are in constant contact with diseased, dying, often elderly bodies, with blood, feces, and spumata. They stay in the hospital until their work is done. They are tired, overworked, and miserable. The people who are the direct cause of the work are the patients.
+<nowiki>**</nowiki> '''Value-Form'''
-Even after internship, an admission is often called a “hit.” House staff—interns and residents—take turns handling admissions. In psychiatry, depending on the hospital and the level of the doctor’s expertise, it takes between one and three hours to admit a patient. This means, for instance, that if you are “up next” but not on call, and the casual rule in your group is that the on-call doctor is responsible for all admissions that arrive in the hospital after 5 p.m., you have two choices if a nurse calls at 4:30 to say that a patient has unexpectedly arrived for admission. You can pretend that the patient didn’t arrive, for which the on-call doctor, one of eight of your classmates, will hate you; or you can do the admission and be late for your date or dinner or the movies by two hours—again. In medicine, by the time tests are ordered and consulted, admissions can take longer. Like medical school, the basic struggle of internship is that there is far too much work. But whereas in the early years of medical school the work was contained in books and charts, in internship that work is the patient. And most of it is “scut” work that is disgusting, routine, and essential: doing spinal taps, drawing blood. Patients may be AIDS patients, demented screaming patients, patients with easily communicable diseases. As one of the residents said, “In internship, it’s so busy that you begin to resent patients and to hate patients. It was so difficult that I loved to have a comatose patient. You wouldn’t have to get a history, just check their labs.”
+This is one of the most important, and potentially most confusing, concepts in all of Marx’s analysis of capitalism. Marx explains these principles at length in ''Appendix of the 1<sup>st</sup> German Edition of Capital, Volume 1'', but here are some of the fundamentals:
-Sometimes things become much worse. One of my psychiatric friends was assigned to an HIV unit during internship, which is not uncommon. She was new, of course, at drawing blood. Shortly after her arrival, she pulled a needle out of a patient’s arm and accidentally stuck it into her finger. She tried to leave the room immediately but keeled over in a dead faint. In the end, she did not become infected. But she described that twilight period before she knew as a strange, existential desert. She had chosen medicine partly because she loved it, partly because it was safe, and now she was going to die because of that choice.
+One of Marx’s key breakthroughs was understanding that commodities have many different properties which have different effects in political economies.
-===== As I’d walked into the [hospital] that morning, deflated by the transition from the bright and healthy July to the diseased neon and a-seasonal stink of the corridor, I’d passed the room of the Yellow Man [a Czech patient with a fatal liver disease]. Outside it were the bags marked “Danger—Contaminated,” now full of bloodstained sheets, towels, scrubs suits, and equipment. The room was covered in blood.… The Runt [another intern] told us about the exchange transfusion, about taking the old blood out of one vein and putting the new blood into another: “Things were going pretty well, and then, I’d taken a needle out of the groin and was about to put it into the last bag of blood, and that porpoise, Celia the nurse, well she held up this other needle from the Yellow Man’s belly and … stuck it into my hand.” =====
+Just as Commodity Production Labor exists in a duality of Concrete Labor and Abstract Labor (see Annotation 13, p. 15), commodities themselves also exist in duality according to Marx:
-===== There was a dead silence. The Runt was going to die.@@@[[#7SamuelShemTheHouseofGod|7]]$$$ =====
+Commodities have both “use-value” and “value.”
-In the novel, he wasn’t, of course, and didn’t. But this classic comic novel, the one I kept being told didn’t convey the full gore of internship, is about overwork, gruesome elderly bodies and more gruesome illness, and the wild doctor-nurse sex that affirms life in the face of death. After years of listening to residents and walking down overscrubbed corridors, the part of the novel that seems overdone is the social bonhomie.
+Use-Value (which corresponds to Concrete Labor) is the commodity’s ''tangible form'' of existence; it is what we can physically sense when we observe a commodity. By extension, use-value encompasses how a commodity can be used in the material world.
-A cruel system breeds callous survivors. Medicine has a macho culture passed on from brutalized class to brutalized class. Those who have survived the razing process of a sleepless, difficult year often see toughness as a virtue and persuade themselves that sadism brings out the right stuff in those that follow them. Interns rank on the lowest rank of the doctorly ladder in the hospital, just above medical students, and, being in one-year positions, they are often the most dispensable and insultable members of the medical staff. “I said I loved her too but it was a lie because they had destroyed something in me and it was some lush thing that had to do with love,” moans the hero of ''The House of God'', “and I was asleep before she closed the door.”@@@[[#8Ibidp97|8]]$$$ Resident after resident told me about nurses who punished interns by refusing to help them out with difficult bloodwork, or refusing to allow the intern to sign a three-hour order in such a way that he would not have to return three hours later, when he hoped to be asleep, to renew the signature. (The nurses would do these things for interns they liked, I was told.) They told me that senior doctors belittled junior doctors, junior doctors belittled residents, and everyone humiliated the interns. “You can’t understand doctors without understanding internship,” a first-year resident said vehemently. “I hated it. It was horrible. You know that book ''The House of God?'' That’s what it was like, I swear.”
+Value, or the Value-Form, is the ''social form'' of a commodity, which is to say, it represents the stable relationships intrinsic to the commodity [see ''Content and Form'', p. 147].
-A consequence of all this—the responsibility, the hierarchy, the autonomy, the temptation to resent the patient, and the terrible uncertainty as to what is wrong and what to do—is that a developing doctor is judged by a certain kind of cultural standard as much as or even more than by technical competence. Students make mistakes. Young doctors doing their first physical exams or lumbar punctures make mistakes. Technical errors (how much medication to give) and errors of judgment (whether to give it at all, whether the patient is really sick) are errors of inexperience. What really counts is demonstrating a willingness to learn from experience and, along with that, respect for the patient—however much you hated missing the movie that night—and respect for experience. An ethnographer of error on the surgical service titled his study ''Forgive and Remember'', which, he argued, was the moral principle of that service. Errors are forgiven, so long as they are not repeated, so long as the young surgeon understands that he made the error and acknowledges his desire to learn. And unfortunate accidents do happen. A patient who was admitted and discharged with all the standard symptoms of an ulcer turns out to have had a strange form of esophageal cancer instead and dies. A rape victim admitted with stab wounds to the stomach turns out also to have been stabbed in the back, and as her stomach is stitched she bleeds to death through the back. Terrible things happen in hospitals. The unforgivable errors are actions that a reasonable person at that level of training should not make.@@@[[#9CharlesBoskForgiveandRem|9]]$$$
+Note that this relates to the dialectical relationship between the material and the ideal [see ''The Relationship Between Matter and Consciousness'', p. 88].
-Often, this cultural ethos becomes a profoundly conventionalizing force. In any field, of course, it helps to look like the applauded image of the discipline: to tilt your hat just so, to formulate questions in just such a manner and with just such a style. The university world of the arts and sciences is no stranger to these presumptions. Yet in the academy there is a clear and explicitly formulated understanding that the quality of a scientist/scholar is judged by her work and that age and experience may bring pomposity without authority. Doctors, on the other hand, are powerfully enculturated into the belief that there is a doctorly manner, that looking like a doctor is important, and that those with more experience are usually right. It follows, then, that the power of doctorly convention is enormous, and it influences both the dress and the bearing of first-year medical students. Every hospital I was in had an implicit dress code in which doctors looked like one another and emphatically not like the nurses. This is particularly striking in psychiatry units, where no uniforms are worn. Nurses, for the most part, dress casually and for comfort, in sneakers and sweatshirts. Doctors dress for mainstream authority. The local style varies from Indonesian casual chic to Armani and bow ties, but the markers are always clear. “I could tell that you were the doctor just by the way you dressed,” a patient said one evening, looking not at me but at the woman with whom I was on call. I no longer remember what I was wearing, but I remember that I suddenly realized that to fit in with the doctors at that hospital I would have to wear linen and pumps. As with clothes, so with style: the seductive authority of age and experience leads doctors to want to look like doctors, and those who violate the normative standard are marginalized.
+Value-forms represent relational equivalencies of commodities, i.e.: '''20 yards of linen = 10 pounds of tea'''
-Young psychiatrists leave internship with a clear sense of the difference between doctor and patient: that patients are the source of physical exhaustion, danger, and humiliation and that doctors are superior and authoritative by virtue of their role. A friend of mine, a chief resident in psychiatry who helped select future residents, pointed out that her job in selecting residents was specifically to find people who had not absorbed the clear message: “When I look for good residents, the most important characteristic is their open-mindedness: being willing not to judge too quickly, to be humble. They need to be capable of listening quietly before they form an opinion. They have to be able to allow people to be heard. That’s really part of what it is to be a good clinician in medicine, anyway. And there are other clinicians’ traits which are also very important: the sense of responsibility, the capacity to serve the patient’s needs and not your own. I look for these things. And also the capacity to be comfortable with a ''wide'' range of people, to be natural with people. Tolerance, responsibility, and comfort.
+These relational equivalencies are tied to the equivalent labor value (see Annotation 15 below, and Annotation 26, p. 23) used to produce these commodities. The value-form of a commodity is the ''social form'' because it embodies relational equivalencies:
-“What you want to encourage in the residents, once they arrive, is ‘good clinical judgment,’ a sort of ineffable skill best characterized by the capacity to use patients’ past experience to predict their future behavior. Medicine suffers when doctors are lax in listening to the history. Sometimes people order a whole slew of tests for no reason. Sometimes they don’t do the expensive tests, and they ought to. You ''have'' to listen, because patients don’t tell the story in a straightforward kind of way.
+. The value-form represents the relationship between the commodity and the labor which was used to produce the commodity.
-“That’s one reason why psychiatrists are experienced as good doctors, because they ''do'' listen. And listening saves money. We had a patient come in once who had tried to commit suicide because she was a musician and could no longer play her instrument, and she’d been told it was fatigue. Psychosomatic. Well, when she came in here, we listened. It sounded when you listened carefully that it might be myasthenia gravis [a disease of weakening muscles due to the impaired functioning of the nerves], and it was. And if the doctor had listened carefully in the first place, the patient could have avoided that expensive trip to the ICU [the intensive care unit] after the suicide attempt. That’s what doctoring is all about. It’s so important.”
+. The value-form represents the relationship between a commodity and one or more other commodities.
-When this chief resident chooses future residents, she looks for people who survived internship with their humanism intact.
+As Marx explains in ''Appendix to the 1<sup>st</sup> German Edition of Capital'': “Hence by virtue of its value-form the (commodity) now stands also in a social relation no longer to only a single other type of commodity, but to the world of commodities. As a commodity it is a citizen of this world.”
-Still, the hospital training in psychiatry continues the demand for emotional detachment that is so powerful a lesson in medical school and internship. The basic activities, for instance, feel much of a piece: admitting patients, prescribing medications, daily rounds, filling in forms. The lectures on psychopharmacology recapitulate the style of knowledge presented in medical school lectures. Residents memorize lists of medications with their side effects and learn something about their mechanisms, in the same way they memorized body parts and mechanisms as students. The hospital setting in psychiatry recapitulates the medical setting of internship: hospital corridors, bustling emergency rooms, wards, rounds, team meetings. The doctor’s role is understood as it was in internship: he is supposed to make a diagnosis that is more or less reasonable, for which at any rate he will not be yelled at in rounds, and prescribe a medication for that condition that is also reasonable.
+Understanding the social form of commodities — the value-form — was crucial for Marx to develop a deeper understanding of money and capitalism. Marx argued that classical economists like Ricardo and Smith conflated economic categories such as “exchange value,” “value,” “price,” “money,” etc., which meant that they could not possibly fully understand or analyze capitalist economies.
-What is also perpetuated by the experience of internship is the antagonism against the patient. I was particularly struck by this in a hospital system in a city with relatively poor facilities for the homeless. There was a Veterans Administration Hospital uptown, in a genteel area located on a bus line, and a large city hospital located in the middle of downtown. Each evening, residents were assigned to cover the psychiatric service from 5 p.m. until 7 or so the next morning, after which they would carry on with the day. During the period of my fieldwork, residents were on call slightly more often than once a week.
+-----
-The main burden of call in this hospital system was that many of the chronically ill homeless patients—most of whom were also drug and alcohol abusers—would try to talk their way into the hospital to get a free bed for the night. Particularly at the VA hospital, they would present themselves in the emergency room at odd hours in the evening (the bus ran all night) and claim that their voices were acting up and that they felt suicidal and would kill themselves unless they were admitted to the hospital. “The most striking thing to me,” a first-year resident said, “was how many patients look at the VA hospital as their home. It was very frustrating, and I ran into that over and over again. If I were in a setting where there weren’t so many people who wanted to get something, I would tend to be a lot more believing of people. In this system, you wind up hearing ‘suicide’ a lot, and it’s not always true. You get cynical.” These patients were often big men, often weighing 200 pounds, often unkempt and unwashed. The security guards were supposed to search them for weapons, but they were usually too busy. The resident, as often as not a slight twenty-seven-year-old woman, would take such a patient into an interview room down the length of a corridor, away from the public openness of the emergency room waiting area. In principle, she could ask a security guard to stand outside the door, but the security guards were hard to find and often uncooperative, and anyway such a request was perceived as weak-kneed and unmacho. So the resident would be confronted with a large, possibly dangerous man, who she knew was probably desperate for a clean bed for the night. If she admitted him, based upon his claims of suicidality, and he slept off his alcoholic stupor and was cheerful in the morning, she risked being yelled at by the team director of whichever team the patient was assigned to. If she did not admit him, she risked that he might swear at her or even lunge at her in anger.
+British classical political economists like Ricardo and Smith outlined the scientific factors of the theories of labor value* and contributed many progressive thoughts which Marx adapted and further developed.
-She also faced the risk that he might actually be suicidal. When I was there, one resident, jaded from a year of what she took to be the manipulative lying by VA patients, did refuse to admit such a patient, and he did make a suicide attempt. She was severely reprimanded, and the story of her error spread throughout the residency. She felt humiliated for months. The senior doctors tell the junior doctors that if they are in any doubt they must admit the patient. But those are cold words when a resident knows equally well how ridiculous she will look in the morning with an inappropriate admission. The residents, then, were the gatekeepers to the desirable good—a warm bed—but they were also servants and underlings in a house run by stern masters. Nor surprisingly, they spent a lot of time worrying about protecting themselves. “When I assess a person that I don’t know,” said a first-year resident, “I’m looking to see whether this person is safe, whether he can talk to me or whether he’s going to try to jump over the railing and kill himself, or to choke my throat because I look like a demon or like his mother. Then I want to know whether he’s just wasting my time. Does he want me just to fill out a disability form? Is he a crock or really in distress? Boy, some of those crocks are really good. They can really fool you.”
+==== Annotation 15 ====
-One night, I was on call with one of the kinder, more compassionate residents, a petite woman in heels, in the downtown city hospital. Several hours into the evening, we got a message that there was a patient waiting to see her in the emergency room. He was a thin, middle-aged man, poorly dressed and unwashed, and after some conversation it became clear that what he really wanted was a place to sleep. He spoke about needing to “detox”—he was coming down from crack—but he wasn’t eligible for the substance abuse unit at the VA and couldn’t have been admitted so abruptly even if he had been. The resident, excusing herself, went to call the various shelters in town. None had room, and after half an hour or so—there may have been another task for her to deal with in the meantime—she went back into the consulting room to tell this man that there was no place that could take him.
+<nowiki>*</nowiki> Adam Smith and David Ricardo revolutionized the labor theory of value, which held that the value of a good or service is determined by the amount of human labor required to produce it.
-At first he didn’t understand: he kept saying, “I dream about the rock, if it was here I couldn’t stop myself.” Then, when it became clear that the resident, as gentle as she was, would not admit him to the hospital, he hurled himself forward and swiped at her (luckily he was lying in a bed with sidebars, which held him back). The resident stepped back, unsurprised and self-composed, and called politely for the security guards. By this point the man was screaming and thrashing, and he pulled off his belt and began to pound the buckle into his wrist. Four guards ran in and pinned him to the bed, and others went to find leather straps to belt him to the bars. Now he could be admitted: he met the criteria of being a danger to himself or others. The resident seemed cool, but later, when we had stepped into a private office and I asked her whether she was okay, she burst into tears.
+Thus, Marx was able to solve the contradictions that these economists could not solve and he was able to establish the theory of surplus value*, scientific evidence for the exploitative nature of capitalism, and the economic factors which will lead to the eventual fall of capitalism and the birth of socialism.
-Sometimes patients are admitted against their will. They are brought in by police because they began to campaign in the street for their brother Bill Clinton. They scream at the doctor, threaten to sue, and not uncommonly, after they have been admitted, they take the doctor to court. If a patient has been committed, she can demand a court hearing. If she can demonstrate that she can take care of herself—she is competent enough to take a bus; she knows who she is and where—and if she can claim that she has no plans to hurt herself or others (the laws differ from state to state), a hospital cannot keep her no matter how fiercely she is protecting herself from nonexistent CIA agents. If she is so psychotic that the courts will not release her, she may curse out the doctor in front of the staff. She may wait until there is a staff meeting, then lie down, drumming her heels into the carpet, and scream that Dr. Brown hates her. A young doctor, like all of us, likes to be appreciated for his work. These patients do not generate the warm, proud feeling doctors feel when a patient thanks them for saving his life.
+==== Annotation 16 ====
-The residents at this hospital had to fight to keep their compassion intact against the creeping cynicism that runs through conditions like these—not the conditions of the hospital but the unavailability of shelter care in the city, its inadequate disability services, or the fact that patients often no longer stay long enough to become better enough to be grateful for the help. In their first year, residents would spend nine months on a VA unit where the chronic patients rotated in and out. The model was biomedical, for the most part—inpatient stays weren’t really long enough for psychodynamic work, and most of the patients, it was said, weren’t capable of functioning at that level—and the new resident’s primary responsibility was to write the admission and discharge notes and prescribe medications. Mostly they represcribed what had been prescribed in the last visit. Inside the hospital patients would “comply” with the prescription (that is, they would usually swallow the pills), but they often stopped taking the medication outside. Antipsychotic medication in particular often has unpleasant side effects: you feel itchy or as if you can’t keep still, or your body doesn’t move the way it used to.@@@[[#10Thiswasoneofthemorestr|10]]$$$ Many patients, then, do not take their medications outside the hospital, but then they get too sick to care for themselves. They return to the hospital, adjust to the medications again, improve, are discharged, stop their medications, and fall apart. It is a dreary, demeaning, and irritating cycle.
+<nowiki>*</nowiki> David Ricardo developed the concept of surplus value. Surplus value is the difference between the amount of income made from selling a product and the amount it costs to produce it. Marx would go on to expand on the concept of surplus value considerably.
-“You can bring in a schizophrenic who doesn’t take his meds and make him better in the hospital, and that’s satisfying. But if he does it over and over again, if he never takes his meds outside, it’s frustrating. And it’s very unsatisfying to have someone who is suicidal and say to him, ‘Well, I can’t treat you because you’re drinking too much.’ ” The chronically ill often came back in when their delusions or depression got too bad to bear. One resident told me that once when he had been on the main unit and had felt depressed about the relentless quality of these illnesses, he had had a conversation with one of the nurses. The nurse had told him that in order to cope with these patients, she transferred off the unit for a while every few years. The last time she had done that, she told the resident, she had been gone for a year. When she had returned, she said, she had recognized none of the other nurses, and all of the residents had changed. But she had known every patient by name.
+Utopianism'''' had been developing for a long time and reached its peak in the late 18<sup>th</sup> century with famous thinkers such as Henri de Saint-Simon<ref>Claude Henri de Rouvroy Saint Simon, 1760 — 1825 (French): Philosopher, economist, utopianist activist.</ref>, François Marie Charles Fourier<ref>Charles Fourier, 1772 — 1837 (French): Philosopher, economist, utopianist activist.</ref> and Robert Owen<ref>Robert Owen, 1771 — 1858 (British): Utopianist activist, owner of a cotton factory.</ref>. Utopianism sought to elevate the humanitarian spirit and strongly criticised capitalism by calling attention to the misery of the working class under capitalism. It also offered many far-ranging opinions and analyses of the development of human history and laid out some basic foundational factors and principles for a new society. However, Utopianism could not scientifically address the nature of capitalism. It failed to detect the Law of Development of Capitalism<ref>The Law of Development of Capitalism referenced here is the Theory of Accumulation/Surplus Value, which holds that the capitalist class gains wealth by accumulating surplus value (i.e., profits) and then reinvesting it into more capital to gain even further wealth; thus the goal of the capitalist class is to accumulate more and more surplus value which leads to the development of capitalism. Over time, this deepens the contradictions of capitalism. This concept is related to the M'''→'''C'''→'''M mode of circulation, discussed in Annotation 14, p. 16, and is discussed in detail in Part 3 of the book this text is drawn from (Political Economy) which we hope to translate in the future.</ref> and also failed to recognise the roles and missions of the working class as a social force that can eliminate capitalism to build an equal, non-exploitative society.
-That first year, these residents were also assigned to work for a month in the daytime psychiatric emergency clinic. There was always a press of patients in the clinic, many of them in for a refill of their prescriptions. Residents were expected to be competent at reviewing patient symptoms and prescribing medications without more than nominal supervision. They managed this requirement by railroading through a patient’s narrative to identify his or her symptoms and prescription needs, patient after patient. The goal was to get through the line of patients in the waiting room. For me, that clinic produced one of my favorite psychiatric anecdotes. The resident, a tough, efficient ex-bouncer, ushered in a ragged-looking young man whom I assumed slept under a bridge. He carried a diagnosis of schizophrenia, and he reported that he had run out of his antipsychotic medication. The resident began writing quickly in his chart, firing off the psychosis questions to see whether the young man had become psychotic while off his medication: “Think I can read your mind?” “No.” “Think you can read my mind?” “No.” “Ever get any messages from the radio? TV?” “No.” “Think you have any special powers?” “No.” “Had any thoughts about the cosmos recently?” “Well,” said the man, “now that you mention it, I’ve been reading Stephen Hawking’s book about the nature of time, and I say he’s wrong. Even if,” the patient went on, “time is like the fourth dimension of a three-dimensional balloon skin expanding in space, I say that it had to start somewhere, and Hawking says time has no beginning.” The doctor looked at him as if he’d sprouted wings and wrote the prescription for the antipsychotic.
+==== Annotation 17 ====
-Senior doctors could probably do something to lessen the cynicism and alienation that become so marked in a young psychiatrist’s first year. However, the tough, see-if-they-swim ethos of medicine tends to mitigate most attempts at nurturance. Residents’ relations with senior doctors are guarded and mistrustful (or, occasionally, hopelessly and unrealistically idealizing). Most of them complain bitterly that no one is interested in mentoring them; the senior doctors shrug and say that residents aren’t interested in being mentored. I saw an egregious instance of this culture of contempt around a brilliant, well-known doctor who ran a unit (in another hospital system) through which the first-year residents rotated. I arrived with two of the brightest and shyest residents of the class, one of whom was desperate to do research and eager to work with the senior doctor. He rarely saw him. The senior doctor was too busy to spend time on the unit; in fact, senior psychiatrists spent so little time on the unit that they rarely interviewed the patients these raw beginners were diagnosing and treating. The residents felt that they presented the patients in team meetings and the social worker and psychologist would advise them on appropriate medications. The residents approached the senior doctor and wondered whether they might have more supervision and fewer meetings. The senior doctor held a meeting attended by all thirty or so staff members who worked on the unit, most of whom were older than the residents. He asked the residents to present their views and then went around the room, person by person, asking everyone what he or she thought of the residents’ ideas. Most people opined that the residents were inexperienced, arrogant, and confused. The senior doctor then turned to the residents and asked them whether they could think of any constructive suggestions for the unit. The residents sat in silence. The senior doctor smiled gently and asked them why they had put the unit to so much trouble if they weren’t willing to say anything. Six months later, the research-oriented resident transferred to another program.
+The early industrial working class existed in miserable conditions, and the political movement of utopianism was developed by people who believed that a better world could be built. The utopianists believed they could create “a New Moral World” of happiness, enlightenment, and prosperity through education, science, technology, and communal living. For instance, Robert Owen was a wealthy textile manufacturer who tried to build a better society for workers in New Harmony, Indiana, in the USA. Owen purchased the entire town of New Harmony in 1825 as a place to build an ideal society. Owen’s vision failed after two years for a variety of reasons, and many other wealthy capitalists in the early 19<sup>th</sup> century drew up similar plans which also failed.
-The toughness needed to survive all this becomes associated with biomedicine. As it is carried over from medicine, biomedical psychiatry is about doing something, about acting and intervening, the way doctors are supposed to do. Summarizing in his final year, one resident said, “Coming into this from medicine, a different field, the first year is pretty much organized around the medicine bottle, biological medication. Coming from internship, it really didn’t feel that foreign.” As the differences between psychiatry and medicine become more apparent to the young psychiatrist—the fact that the illnesses take a long time to improve, that compared to medicine there are few interventions, that patients are not always grateful for a doctor’s help—the biomedical approach becomes a way to cling to one’s doctorly identity. As another resident remarked at the end of his first year, “Psychiatry ranges from the very biological and medical end all the way to the dynamic analytical end. But to be a very good psychoanalytic therapist, you don’t need to go to med school.” One of the main anxieties residents have when they begin their training in psychiatry is that they will lose their medical skills. They speak with pride about keeping up those skills, about being able to handle cardiac arrest or emergency care. Supervisors and residents talk about psychiatrists who prescribe medication in order to make themselves feel like doctors. They tell stories about young doctors doing therapy who become nervous about not being doctors and prescribe sleeping pills to patients who don’t need them.
+Utopianism was one of the first political and industrial movements that criticized the conditions of capitalism by exposing the miserable situations of poor workers and offering a vision of a better society, and was one of the first movements to attempt to mitigate the faults of capitalism in practice.
-In fact, one of the common remarks about psychopharmacology is that psychiatrists prescribe medication in order to avoid the awkward intimacy that is created with a patient in psychotherapy. This, of course, was the charge leveled by senior analysts against the first group of young, biologically oriented psychiatrists in the late seventies. Even now it remains a powerful critique. “At that hospital,” a resident said to me, speaking critically of a group of psychiatrists she thought were too determined to prove their toughness to a top-ranked medical house staff, “the neurologists never ask for a psychiatric consult anymore because the psychiatrist always prescribes Tegretol for complex partial seizures and the neurologists think the patients need family meetings and aftercare.” Sometimes a young psychiatrist explains that the emotional distance imposed by the biomedical perspective is in fact one of the appealing things about the biomedical orientation. One resident, for instance, who told me that he didn’t like the intimacy and emotional closeness of psychotherapy, explained near the end of his residency that what attracted him in biological psychiatry was “the ability to maintain a comfortable distance from the patient. When I’m prescribing medicine, I don’t have to establish this real close relationship with the patient.”
+Unfortunately, the utopianists were not ideologically prepared to replace capitalism, and all of their attempts to build a better alternative to capitalism failed. Marx and Engels admired the efforts of the utopianist movement, and studied their attempts and failures closely in developing their own political theories, concluding that the utopianists failed in large part because they did not understand how capitalism developed, nor the role of the working class in the revolution against capitalism.
-This bias produces a kind of sex stereotyping of the biomedical and the psychotherapeutic. Biological psychiatry is said to be masculine, what manly doctors do. Psychodynamic psychiatry is women’s work. Male senior analysts say, when you ask them how people respond to them, that other people think it odd that a man should be interested in feelings. Young psychiatrists point out that the women in the class tend to be more interested in psychotherapy and that after all the wider culture prepares women for talking about emotions. Supervisors say ruefully that as more and more women end up in psychiatry, psychotherapy is increasingly becoming a woman’s game. It is not clear to me that the facts bear this out. But the perception is a striking feature of the culture. “Biological psychiatry just seems more masculine to me,” a resident admitted. “It’s pretty tough to go into psychotherapy if you’re a guy. People think you’re a wimp.”
+As Engels wrote in ''Socialism: Utopian and Scientific:''
-With psychopharmacology, it is the medication, not the doctor’s relationship with the patient, that cures. That’s one of the things that makes it “manly.” (Another is that it is more connected to hard science.) And when the drugs work, they work relatively quickly, within weeks. One resident, who started medical school interested in Freud and psychoanalysis but in his last year of residency was among the more biomedical of his class, said, “When I first started here, my psychotherapy outpatient was this borderline patient that no one had been able to help in twenty-five years. My inpatients were all these manic patients who kept coming in, getting neuroleptics and lithium. Two weeks later they were totally switching around and becoming normal human beings. I had one lady who was deliriously manic in the quiet room, picking at the air and talking to the wall. She was a schoolteacher before she came in. Within a month she totally switched out of it. One day later she was coming up to me and saying, ‘What was I doing in that room? How was I acting?’ She seemed like a totally normal schoolteacher. She seemed like ''my'' old schoolteacher. She was back teaching within a week. On that unit, patients came in wanting to kill themselves, out-of-this-world depressed. We gave them Prozac, and within three weeks they seemed normal like the rest of us.”
+<blockquote>
+(The) historical situation also dominated the founders of Socialism. To the crude conditions of capitalistic production and the crude class conditions correspond crude theories. The solution of the social problems, which as yet lay hidden in undeveloped economic conditions, the Utopians attempted to evolve out of the human brain. Society presented nothing but wrongs; to remove these was the task of reason. It was necessary, then, to discover a new and more perfect system of social order and to impose this upon society from without by propaganda, and, wherever it was possible, by the example of model experiments. These new social systems were foredoomed as Utopian; the more completely they were worked out in detail, the more they could not avoid drifting off into pure phantasies.
+</blockquote>
-And medication works, straightforwardly (except when it doesn’t). It is immensely satisfying to do something that soon diminishes a patient’s pain. At graduation one resident said about his diagnostic and psychopharmacological skills, “I feel good about those skills. It’s something people sort of belittle because it’s kind of cookbook, but when you see a large number of patients and it is abundantly clear that they need their medication, and you give them a medication and they come back two weeks later enormously grateful because their business is back to functioning, it’s nice.” A first-year resident said, “It’s very gratifying to have people you’re able to help and then in a few days they say, ‘Boy, was I really out of control that day. I’m feeling much better. I realize that I was out of control because I was not taking that medicine. I didn’t know what was going on. I’m glad you helped me.’ ” (By contrast, a few minutes later that resident said about psychotherapy, “I’ve never had a long, ongoing, intimate relationship with a patient. I don’t know whether I would enjoy it or not. It scares me because I don’t think I’m capable of it. Somehow I feel I’m abandoning all the scientific skill that I have if I go to do that.”) A second-year resident explained, “It’s fun to play with the meds and get them right and get the combination right and know what to expect.” A graduating resident said, “When I’m giving someone relief from acute anxiety with medication, I find it gratifying.” Psychotherapy is a slow, often difficult process, and young psychiatrists are often not very good at it. Even when they are, it doesn’t always work. It is greatly satisfying to become quickly good at a skill that often does, even when your other skills are pretty raw.
+Engels is explaining, here, that — in a sense — the utopian socialists were victims of arriving ''too early''. Capitalism had not yet developed enough for its opponents to formulate plans based on actual material conditions, since capitalism was only just emerging into a stable form. Without a significant objective, material basis, the utopians were forced to rely upon reasoning alone to confront capitalism.
-The patient remains set apart, as a diagnosis (“our suicidal bipolar”), as a body (“that psychosis needs more Haldol”), and as a person. Despite all that, residents often are or become compassionate about even the most difficult patients, and many residencies encourage a kind of medical agape. But the social process of hospital psychiatry teaches a young psychiatrist to anticipate that harm runs from the patient toward the doctor, not the other way around. In the hospital, at least in the early years of residency, one of the primary emotions generated through contact with patients is fear. There is fear of getting the diagnosis wrong and being yelled at in the morning, and perhaps a general existential fear of madness. There are also the basic fear of threats to one’s bodily safety and resentment about putting that safety into jeopardy. “Call” hurts the doctors who do it. It keeps them up all night, or maybe all but several hours of the night, and it makes them exhausted and cranky. On call, a young doctor confronts dangerous patients who are manipulative and deceitful. (An emergency room is one of the most dangerous places in which to work.) Inner-city hospitals and Veterans Administration hospitals generate this fear more than do the elite nonurban hospitals. Psychosis, however, is not obedient to the rules of class etiquette. In elite hospitals patients may also be dangerous and decidedly ungrateful. When young psychiatrists learn to diagnose and prescribe, they learn that a patient can hurt a doctor. They learn to keep their distance.
+In this sense, the early historical utopianists fell into ''philosophical utopianism'' in its broader sense — defined by the mistaken assertion that the ideal can determine the material [see Annotation 95, p. 94]. In believing that they could build a perfect society based on ideals and “pure fantasy” alone without a material basis for development, the utopians were, in essence, idealists. As Engels explained: “from this nothing could come but a kind of eclectic, average Socialism.” Engels concluded that in order to successfully overthrow capitalism, revolution would need to be grounded in materialism: “To make a science of Socialism, it had first to be placed upon a real basis.”
-=== {{anchor|OUTPATIENTPSYCHOTHERAPY}} OUTPATIENT PSYCHOTHERAPY ===
+-----
-When young psychiatrists learn to do psychotherapy, what they learn is that doctors can hurt patients. Psychotherapy teachers talk about psychotherapy’s demands for establishing intimacy, for tolerating the needs of other people, and for responding to their emotional needs as they are, without the interference of a therapist’s own anxieties and troubles. They talk about the personal intrusiveness of psychotherapy, the fact that learning to practice psychotherapy means that young therapists must learn to tolerate knowledge about their own selves that may be embarrassing and shameful. They point out the way the patient perceives the therapist and how the therapist perceives the patient, and they make it clear that both parties distort the relationship but that it is the therapist’s responsibility not to act on the distortion. They talk about the need for trust in the psychotherapeutic relationship and about the delicacy and strength of that trust. They talk about the difficulties of really understanding someone else, and they repeatedly emphasize the way people mishear one another. In fact, the whole point of psychotherapy training, its basic stance, is for trainees not to hurt the patients. This is thought to be very hard.
+The humanitarian spirit and compassionate analysis which the utopians embodied in their efforts to lay out concrete features of a better future society became important theory premises for the birth of the scientific theory of socialism in Marxism.
-In some sense, it is also the goal of therapy. It is not clear what causes psychotherapeutic change, but a young therapist knows that simply explaining what is going on with a patient to the patient is not sufficient to enable that patient to change. As it happens, truth frees relatively few of us. So understanding a patient, being able to explain a patient’s behavior to him through these emotion-motivation-behavior bundles, is not in itself thought to be useful, because the patient may not be able to hear and understand what the therapist has to say. The goal of therapy is for a therapist to be able to use his knowledge of a patient to construct a relationship with the patient in which the patient feels safe enough, and trusting enough, to learn from what the therapist has to say. For a therapist to be able to do this, he must be able to respond to a patient according to the patient’s needs rather than his own. He must be able to listen to a patient without being caught up in his own embarrassment, fear, desire. As one supervisor remarked to me, “When the patient says, ‘You are a fascist,’ the therapist must be able to say, ‘How am I a fascist?’ To explain to him that she is not a fascist serves her own needs. To understand how she appears to be one serves his.”
+''- Natural Science Premise:''
-So one of the first hard lessons for a student of psychotherapy is learning how your own self-involvement inevitably prevents you from listening as clearly as possible. Supervision confronts young therapists with the fact that the habitual ways in which they act in the world construct their perceptions of it, and moreover that what a resident takes to be objectively true can tell an astute observer more about the resident’s own awkward conflicts than about the patient. “All supervision, virtually, if it is going to be any good,” a supervisor remarked to me, “is going to address the most problematic issues of the supervisee. For instance, if I can’t stand it when the patient doesn’t like me, I’m going to work nonstop to be funny and charming and so forth. And if I present that session in supervision, it’s going to take someone three minutes before they say, ‘Why don’t you let this patient tell you how angry he is at you?’ ” For me, that moment of shocked recognition came when my first supervisor said, “You’ve done that before. You’re listening to the words she’s speaking and not to the feelings she’s trying to keep hidden.” I felt caught out, as if in a dream when you are lecturing to a hundred students and you realize you’re wearing pajamas. At the time, what the patient didn’t want to tell me I was too anxious to interpret.
+Along with social-economic conditions and theory premises, the achievements of the natural sciences were also foundational to the development of arguments and evidence which assert the correctness of Marxism’s viewpoints and methodology.
-“I remember we had these hall meetings,” Earle recalled once when we were talking about the way young psychiatrists learn how inadequate they are as unbiased listeners, how profoundly they shape the world they take to be objective. “All the patients and all the staff would sit in this big circle. There was this patient, Susan. She carried the diagnosis of borderline personality, and she’d been there awhile, and one time, near the end of the meeting—this was my first rotation in the hospital, mind you—she started screaming, ‘I hate this place, it’s terrible, you’re treating me like a prisoner, I’m here because I’m sick and because my mother fucked up and she’s a bitch.’ Screaming bloody murder. I looked at the unit director, and he was relaxed, saying, ‘Okay, could you lower your voice now?’ Everyone was just acting like this was a normal kind of thing to happen, and I just could not tolerate it. After the meeting I said, ‘That was the most horrible thing I ever sat through.’ I hadn’t yet picked up that they didn’t think that way. The unit director said to me, ‘What was it that bothered you?’ and I thought, ‘Oh, come ''on'', you know,’ and I said, ‘How could anyone tolerate that?’ and the nurse said, ‘This is nothing.’ The unit director took me upstairs and sat with me a little, and he said, ‘Why do you think that this is so upsetting to you?’ It was such a shock, to hear that I was the only one who was upset and that it could be something about me which was responsible. I talked with him for a while, and it occurred to me that this patient looked like my older sister, and at dinner at home my sister would frequently shout and scream and storm up to her room. We would all have to sit there and hope that she would feel better and not hit us. That kind of thing. It was such a shock to me to make that association, and it was one of the first associations I had that explained to me what transference was.”
+==== Annotation 18 ====
-“Transference” is the term given to this insistent re-creation of the world according to our hidden emotional expectations. It is the central term in psychoanalytic psychotherapy, but, like other powerful terms, it refers to more than one phenomenon. Transference “with a little t,” everyday transference, the transference we all act out of all the time, refers to the way we all see one another through the filtering lenses of our own pasts and temperaments, so that Smith sees Boggs as a kindly old man and Jones sees Boggs as an authoritative force, and this has less to do with Boggs than with Smith’s and Jones’s experiences of their own fathers and uncles and grandfathers. Transference in that sense is alarming enough, because when as a therapist you begin to see so clearly the way other people distort the world, it is hard not to worry that you yourself see nothing clearly, that no human being sees the world straightforwardly, that objectivity is a flickering chimera. Adapting to a patient’s needs begins to seem like a distant fantasy as you begin to realize how deeply rooted are your own needs to see people in certain ways.
+''Natural science'' is science which deals with the natural world, including chemistry, biology, physics, geology, etc.
-Transference “with a big T” refers to the fact that in therapy those needs become even stronger and more overwhelming. Transference “with a big T” evokes the emotional intensity generated by the therapy relationship itself: the focused involvement with the therapist, an endless wondering about what she does in her off-hours, what she’s really like, what he’s like with his family. It is common for an analysand to say that the analyst is the most important person in his life. When I was in therapy, I thought of this attachment as the “Wizard of Oz” phenomenon. For me, my therapist became a floating head that accompanied me everywhere, with whom I had conversations that extended way past my sessions, late at night and early in the morning. Psychoanalysts often explain these intense feelings as the reenactment of childhood experiences, but they probably owe their intensity to the weird asymmetry of the therapeutic relationship. In any case, transference “with a big T” points to the fact that psychotherapy is utterly and overwhelmingly emotional. Therapy, when it is working well, is a powerful, intimate experience.
+Three major scientific breakthroughs which were important to the development of Marxism include:
-From the very beginning, young psychiatrists know the great power a therapist has to hurt, as well as to heal, because most of them know firsthand what it is like to have intense feelings about a therapist who accidentally, inadvertently, does something that feels cruel. It is often said that to learn psychotherapy, you must not only do psychotherapy but be in psychotherapy, and most young therapists who are interested in psychotherapy present themselves for psychotherapy at some point in their residency. When they do, and when they become involved with the therapy, they rapidly see how fragile, dependent, and needy patients can be with their therapist and how a patient scrutinizes a therapist for slight clues to her love or hate. The hall-of-mirrors quality of a student therapist in therapy makes that fragility even more apparent than it is to an ordinary patient. “When I came in the first time,” Earle said, “my therapist said, ‘Why are you interested in therapy?’ and I said, ‘Well, you know I’m in training, and I’ve heard a lot of people say that their therapist is their best supervisor.’ He threw that back in my face. He said, ‘Oh, I’m glad you’re here for training purposes.’ Well, there went that defense.”
+''•'' ''The law of conservation and transformation of energy'' scientifically proved the inseparable relationships and the mutual transformation and conservation of all the forms of motion of matter in nature.
-Most nonpsychiatrists in therapy have very private experiences of therapy. Their therapist knows no one they know. They often tell relatively few people about their therapy, or, if they do, there is little more to report than an endless string of comments about what the therapist said and when. Their therapist can be their personal, sacred, perfect source of wisdom.
+''•'' ''The theory of evolution'' offered a scientific basis for the development of diverse forms of life through natural selection.
-For a young psychiatrist, the experience of therapy isn’t like that. Particularly if the psychiatric community is a small one, as it was in the town in which I did much of my work, most residents choose their therapist from the same small group deemed good enough to supervise them for their psychotherapy. The two roles are not allowed to overlap: you may not have your therapist as your supervisor. You are always, then, intimately involved with more than one senior psychiatrist. In my town, most residents knew that their therapist was the therapist for at least one other resident and who it was; most residents in therapy knew that their therapist was a supervisor and for whom. They called this “cobwebbing”: that they knew one another’s supervisors, therapists, and consultants, that when they joined their residency psychotherapy group they might realize that their T-group leader is their analyst’s husband or that their supervisor supervised their therapist. In turn, their seniors have lived in a cobwebbed world for years, and their close knowledge of one another has not always made them friendly. Small-town psychodynamically oriented societies probably re-create the forced intimacy of early American small-town society better than any other institution does. As in Salem, their worlds have strains.
+''•'' ''Cell theory'' was a scientific basis proving unity in terms of origins, physical forms and material structures of living creatures. It also explained the development of life through those relationships.
-So in addition to the everyday intimacies of the psychotherapeutic experience, there was a world of backdoor gossip about the upsetting behavior of the senior psychiatrists on staff at the hospital. A great many residents reported to me things that their therapists or supervisors had said about senior colleagues. This illicit gossip becomes even more noticeable in psychoanalytic institutes, where analysts see their young student analysands four times a week, during which there is much time for discussion of students’ supervisors and seminar leaders. Analytic orthodoxy suggests that analysts should listen silently, without comment but with confidentiality, to their analysands’ tearful tales. No one I talked to suggested that this had happened in his own case. Several people spoke of being outraged when an indiscretion revealed in the consulting room made its way into the public domain. One person told me that he had nearly been dismissed from his analytic training because of some remark that had made it from the consulting room to the student evaluation meeting. (In earlier days, a trainee’s chief evaluator was his analyst; not unnaturally, successful candidates were often reluctant to criticize their training in their analyses.) I went to a seminar on analytic supervision in which an analyst in training spoke about her difficulties with her supervisor, how she’d been convinced that she’d done a terrible job, and how her analyst had later told her that he’d talked to her supervisor and that her supervisor had thought she was good. Some members of the audience were predictably indignant at this breach of confidence, although it would have been cruel for the analyst to insist upon principle rather than kindness. At the same time, these indiscretions spoil the ideal of therapeutic neutrality and perfect privacy.
+These scientific discoveries led to the rejection of theological and metaphysical viewpoints which centered the role of the “creator” in the pursuit of truth.
-Meanwhile, each resident is rudely confronted with the fact that his therapist, the sacred being to whom he confesses his most embarrassing, upsetting thoughts, is shared by other people he knows and may even be thought to be less than perfect by them. I remember having lunch with a woman, a perfectly reasonable lunch in which we talked freely about our friends and activities, and as we returned to the clinic she asked me who my newly assigned supervisor was. When I told her, she blanched, and I realized that he was her therapist. She felt acutely embarrassed that I knew her therapist in a more relaxed way than she did, that I called him by his first name, that I could have lunch with him; on my side, I began sorting out the comments I’d made to check whether I’d be embarrassed if anything I’d said were to be passed on in the consulting room. I had dinner with another resident who talked about her annoying new patient who, to demonstrate his professional skills, had given her some articles to read. She would, she announced, have to ask her supervisor whether she really had to read them. She then told me who her supervisor was—and I wanted to punch her because he was my therapist, and I knew he would have advice because when I’d met him, I had of course presented him with my first book. In my therapy-anxious state, I heard her saying that my gift had been an annoyance to my therapist. This kind of thing happens constantly. There is even a tactful etiquette about how to manage the awkwardness: the more sensitive residents (who are almost all in psychotherapy or psychoanalysis) find out whom a friend is seeing for therapy and then never mention that name casually in the presence of that friend. (This habit is uncannily similar to the tabooing of powerful names in parts of India, Africa, and Melanesia.)
+==== Annotation 19 ====
-Even more tarnishing than realizing that your therapist is merely human and shared by others is the fact that you are able to see the insincerity inherent in his technique. Young therapists see that their own patients feel as powerfully about them as they feel about their own therapists. It scares them, because they do not feel competent and trustworthy the way they feel their own therapists are. Then they begin to wonder whether all patients trust their therapists blindly. They wonder whether their own therapist is incompetent, the way they feel themselves to be. It becomes hard for residents to trust their therapists because the residents do not say everything they believe to their patients. They know that they say things to make the patient feel better that are not entirely honest (for example, when a patient wonders how sick he is), and they know that therapists change their minds over time. Things they say casually to their patients in the first month, they have forgotten or ignored by the sixth month, yet their patients carry the words around like mantras. How, then, can young therapists trust their own therapists? All young doctors, of course, become mistrustful of their doctors when they see the imperfections of medicine. In my experience, most doctors firmly believe that you should never have surgery in the hospital—whichever hospital—in which they were interns. Rarely are their feelings so intense, and their idealizations so shining, as when they begin to see the flaws in psychodynamic psychiatry.
+For centuries in Europe, natural science and philosophy had been heavily dominated by theological viewpoints which centered God in the pursuit of truth. Descartes, Kant, Spinoza, and many other metaphysical philosophers who developed the earliest theories of modern natural science centered their religious beliefs in their philosophies. These theological viewpoints varied in many ways, but all shared a characteristic of centering a “creator” in the pursuit of philosophical and scientific inquiry.
-“It makes it very difficult, because I’m looking for the wires,” Earle said. “I’m looking for the mechanism behind what he’s doing because he presents this smooth exterior and he says little things, little interpretations, and I want to see the strategies he’s using, the decisions he’s making, the formulations that he’s making and why he’s doing something now and not then. He’s closing up an hour by making a statement that brings us back to the beginning. I know exactly what he’s doing because I do that daily. He wants the end not to be painful to me. It’s hard for me not to know the truth, not to know what he’s really thinking, not to know the interpretations he’s not giving me because he doesn’t think I’m ready for them.” This double-entry bookkeeping epistemological commitment—I believe my therapist, and I understand that these are the techniques that I should use to persuade my patients to believe me—is like an anthropologist’s experience of going native and trying to reflect upon what it is like to live that life unreflectively. Anthropologists do this for a year or two at a time. Psychotherapists develop it as an ethos.
+Together, the law of conservation and transformation of energy, the theory of evolution, and cell theory provided an alternative viewpoint which allowed scientists to remove the “creator” from the scientific equation. For the first time, natural scientists and philosophers had concrete theoretical explanations for the origin and development of the universe, life, and reality which did not rely on a supernatural creator.
-Despite seeing more of the human, flawed, technician-at-work side of the therapist than the nonpsychiatrist sees (most people idealize their therapists as unflappable heroes), a young therapist learns to trust his own therapist deeply, possibly more than a nonpsychiatrist trusts his therapist. In the psychiatric culture of therapy, you learn that trusting your therapist in spite of his flaws is a mark of your own psychodynamic skill. “You begin by telling everyone you’re in therapy,” a senior resident explained. “You tell them about your therapist and what he said. Then you find you don’t want to tell anyone anything. And then you find that when someone mentions his name, you feel hot and embarrassed and you blush, just because he knows so much, now, that you never thought you’d tell anyone.” These feelings are supposed to be overwhelming. If they are not—if you do not convey the fact that you cry in therapy—your fellow residents will wonder whether there is something wrong with you (particularly if you are female, but even if you are male). I had recurrent conversations with female residents about how to walk out of a session in which you had cried for half an hour—and then take a session with a patient of your own. (Waterproof mascara.) In casual conversation, in interviews, in gossip, we talked about what our therapists had done for us and what our friends’ therapists had or had not done for them. If a resident was not in therapy, it was because she was afraid of therapy—afraid of its intimacy, afraid to learn so much about her own unhappiness. In psychiatric residency, being aware of your anger and misery is good. Some residents took my involvement in therapy as a sign that I was okay—in psychiatric residency, a decision to go into therapy is a sign of health—and always in my conversations with them there would come a moment when their voice would drop, they would become conspiratorial, and then they would ask, “Are you still seeing Dr. Cohen?”
+Marx and Engels closely observed and studied the groundbreaking scientific progress of their era. They believed strongly in materialist scientific methods and the data which they produced, and based their analysis and philosophical doctrines on such observations. They recognized the importance and validity of the scientific achievements of their era, and they developed the philosophy of Dialectical Materialism into a system which would help humans study and understand the whole material world.
-In the end, what a young psychiatrist’s knowledge does is to make even clearer the basic lesson of the field: that we profoundly shape our world, that we throw ourselves against the hard wall of our therapist’s personality only to discover that we built it ourselves.@@@[[#11JanetMalcolmusesthismeta|11]]$$$ That is one of the great strengths of having patients, for a patient experiences his reactions to his therapist as natural, as the way any sensible person would react to such a rude or loving remark, while a therapist discovers that most people believe they act as any sensible person would act, when in fact they act quite differently from one another. One patient thinks it peculiar and self-absorbed that you should ask her whether she is upset because you are leaving on vacation soon; another cries violently when you ask her the same question, because she is overwhelmed by your kindness in mentioning something she could never bring herself to say without what she calls your permission.
+In ''Socialism: Utopian and Scientific'', Engels explained that ancient Greek dialecticians had correctly realized that the world is “an endless entanglement of relations and reactions, permutations and combinations, in which nothing remains what, where and as it was, but everything moves, changes, comes into being and passes away.”
-“It’s odd,” Earle remarked, “you begin to disengage your feelings about the person from the person himself, and you realize that this person is just an innocent bystander of these feelings of yours, that he has accidentally stepped into your life. The important part of that, for me, is that this realization does not get in the way of having those feelings. The feelings are just as intense and just as unavoidable no matter how much I know about the transferential process. What it ''has'' made me wonder about is that I’m supposed to be reproducing my early object relations, my feelings about my mother and father. Because the experience makes me think that my parents, too, were bystanders. That these are not feelings about my father, but feelings I had for my father that emerged because of the situation we were in and how he happened to be the person who was there. Some people will say that my father did this to me, or they hold their parents to blame for so many things or consider them to be responsible. I can’t do that, because of my understanding of how these things evolved. I just have to think of my father having to be there at the right time and how what followed actually had to do with the dynamic interaction with my personality and his personality and the situation we were in. That’s the conclusion that a lot of patients reach in the course of therapy. They sort of let go of blaming their parents and come to accept the situation that created the experiences. But I think it just happened earlier in me because of my understanding of transference and projection.” (“Projection” occurs when you “project” something you are feeling, such as anger, “into” someone else. So, for example, you might feel angry, not know that you feel angry, but experience a friend as being angry at you.)
+Engels goes on to explain that it was understandable for early natural scientists to break their inquiries and analysis down into specialized fields and categories of science to focus on precise, specific, narrow subject matters so that they could build up a body of empirical data. However, as data accumulated, it became clear that all of these isolated, individual fields of study must somehow be unified back together coherently and cohesively in order to obtain a deeper and more useful understanding of reality.
-The vivid lesson of psychotherapy is that in the end we are responsible for the way we feel, that other people are bystanders to our private dramas, and that becoming bystanders to ourselves—''seeing'' ourselves—is an enormously difficult task, yet essential to effective therapy. Therapists are always partially blind, preoccupied by their own troubles and driven by their own unconscious needs and expectations. All people are; the therapist at least has a greater opportunity to know the areas of his blindness, so that he can attempt to peer around them. But in the world of doctorly superiority, this opportunity to see one’s own blindness comes hard and is humbling. The young psychiatrist fears that he is not saying the right thing and not doing the right thing, because (he fears) he is too narcissistic, too hysterical, too something. Often when I asked residents whether they thought that psychotherapy worked, they said that they knew it did from their own experiences in psychotherapy but not from doing it themselves, because they felt too awkward and clumsy with a patient.
+As Engels wrote in ''On Dialectics:''
-What they know about why therapy works when it works just enhances their nervousness. In medical school, they have already absorbed the lesson that a doctor is immediately responsible for a patient’s life. In medical school, that responsibility hinges on factual knowledge: a doctor must have the intelligence and memory to know the criteria for a diagnosis and to choose an intervention that will work. In earlier decades, that was more or less the model that explained therapeutic efficacy. Freud, although unfailingly complex, wrote for the most part as if it were intellectual insight that made the difference. An analyst was able to understand a patient’s associations and behavior and presented the understanding to the patient in a series of interpretations. From the interpretations, the patient learned to understand his or her implicit assumptions, and through this new understanding the patient changed. Psychoanalysis worked because the analyst provided the patient with knowledge.
+<blockquote>
+Empirical natural science has accumulated such a tremendous mass of positive material for knowledge that the necessity of classifying it in each separate field of investigation systematically and in accordance with its inner inter-connection has become absolutely imperative. It is becoming equally imperative to bring the individual spheres of knowledge into the correct connection with one another. In doing so, however, natural science enters the field of theory and here the methods of empiricism will not work, here only theoretical ''thinking'' can be of assistance.
+</blockquote>
-Over the last two decades, psychoanalysts have increasingly turned their attention to how an analyst relates—not to what he knows. In the 1950s, a psychoanalyst named Heinz Kohut began to write articles and books couched in an obscure jargon about “self-objects” that made much psychoanalytic discourse seem simple by comparison. Nevertheless, his work revolutionized American psychoanalysis, because he essentially argued that the therapeutic relationship was what made the therapy work. Many psychoanalytic patients, Kohut claimed, came from emotionally deprived backgrounds in which they were not allowed to be genuine but were forced to live out their parents’ needs. The children became narcissistic adults, incapable of empathizing with others because no one had truly empathized with them. A therapist’s job was really to reparent them, to let them experience trust and steadfast affection, and from this experience the patients would remake themselves as more confident adults. To put it crudely, in the Freudian model a therapist’s job was to interpret a patient’s unconscious conflicts; in Kohut’s “self psychology” a therapist’s job was to repair a patient’s emotional deficits through the relationship in therapy. What a therapist did became at least as important as what he knew, and transference became an even more complex, weighty concept in which not all the feelings were just about the past.@@@[[#12Perhapstheclassicstatemen|12]]$$$ “We were all less stiff than the Freudian was supposed to be,” one analyst confided to me over lunch. “It was just that you weren’t meant to say anything about it.”
+As science grows increasingly complex, a necessity develops for a philosophical and cognitive framework which can be used to make sense of the influx of information from disparate fields. In ''Dialectics of Nature,'' Engels explains how dialectical materialism is the perfect philosophical foundation for unifying scientific fields into one cohesive framework'':''
-From a young psychiatrist’s perspective, however, contemporary changes in psychoanalysis have sharpened the recognition that when a therapist meets a patient, he must do so without a shield of elaborate theory. In the 1960s, a young, frightened therapist could bolster his confidence by seeing himself as a scientist. He could hide behind the belief that he could be a scientist observing some data. He could protect himself from intimacy with a fantasy of intellectual authority. These days, that protective fantasy is simply less available. A psychiatrist’s psychotherapy is no longer conceived of as the encounter of a scientific and theoretically trained mind with a needy patient. It has become the naked emotional encounter of two souls.
+<blockquote>
+Dialectics divested of mysticism becomes an absolute necessity for natural science, which has forsaken the field where rigid categories sufficed, which represent as it were the lower mathematics of logic, its everyday weapons.
+</blockquote>
-There is, in fact, much to fear. Therapy relationships are emotionally intense in ways that are quite incomprehensible to an outsider. A resident has some patients who love him, others who loathe him, and some who threaten to kill themselves when he goes on vacation. Many of his patients cry copiously into his Kleenex. Sometimes he buys Kleenex by the case. When he is in psychotherapy, he too weeps copiously, apologizes for it, and then weeps some more. Young therapists are often taken aback by the strength of their own and their patients’ feelings. Some of them make decisions about where to live on the basis of where their analysts live. “My analyst is unwilling to relocate to San Francisco [to which this resident had planned to move at the end of residency]. Well, I like this city, even if it isn’t San Francisco. So for now I’ll stay.” Or, as one resident more simply said about his analyst, “God, I like him.”
+So, Marx and Engels developed Dialectical Materialism not in opposition to science, but as a way to make better use of scientific data, and to analyze the complex, dynamic, constantly changing systems of the world in motion. While distinct scientific discoveries and empirical data are invaluable, each data point only provides a small amount of information within a single narrow, specific field of science. Dialectical Materialism allows humans to view reality — as a whole — in motion, and to examine the interconnections and mutual developments between different fields and categories of human knowledge.
-To learn how not to hurt a patient, how to construct a relationship in which a patient is not limited by the therapist, creates a world of paradox. The blunt, peculiar worldview shaped by this training embodies therapists’ inherent inability to meet the impossible demands of this profession, the impossibly difficult task of listening without desire or memory (to borrow a phrase), to be perfectly compassionate and objectively intimate. On the one hand, psychotherapeutically oriented psychiatrists place great value on honesty. Yet therapists are often dishonest, for they are always forming hypotheses about other people and holding back from using them, and they are psychologically coy, in that they value the ambiguity that comes from seeing too much complexity to be certain about anything. They value emotional openness, a kind of alert willingness to listen that many of them call “being available” but what they mean by that is less of an emotional presence than an emotional reserve, a capacity for responsiveness that is very different from directness. They value having a rich understanding of a human being but they often see people as types, so that one graduating resident complained that he couldn’t read novels anymore, because he had immediately seen that Lawrence Durrell’s Justine had a borderline personality disorder and Emily Brontë’s Catherine Earnshaw was histrionic, and so the novels lost their mystery. This world admires honest emotional expression, yet many psychiatrists are hesitant to reveal themselves to their colleagues because they are afraid of being interpreted (and shamed) by them. This world admires people who are courageously honest, who understand their pain and can express the complex contradictions of human emotion—yet because a therapist is the one who must encourage that honesty and understanding, she becomes indirect, manipulative, and quiet. As Earle observed, “The thing that’s most odd is to undo your socialization. My style is to be right in there, as you would at a cocktail party, to oil the social intercourse. I had to learn not to do that, not to nod so much, not to agree instinctively but to step back, to say, ‘You’re asking that question, and it’s important. Why are you asking? What’s behind it?’ It’s really a perverse act, because you are taught socially to cooperate, and as a psychiatrist you learn to resist, to introduce some discomfort in order to create the space for them to discover something. That is why shrinks are strange, because they’ve unlearned all that stuff. Shrinks will pause and think.”
+-----
-<div style="text-align:center;">• • •</div>
+These scientific principles confirmed the correctness of the dialectical materialist view of the material world, with such features as: endlessness, self-existence, self-motivation, and self-transformation. They also confirmed the scientific nature of the dialectical materialist viewpoint in both material processes and thought processes.
-The counterpart of “transference” is “countertransference,” a term that refers to the way a therapist feels about a patient (transference refers to the way patients feel about therapists), and the interesting thing about the diagnosis of disorders most specifically associated with therapy is that the skill is taught not through a disease model but through an interaction model. The diagnosis of personality disorders is informally taught through countertransference, through the way the interaction with a patient makes a therapist feel. Here the lesson is that identifying those feelings gives the therapist knowledge and that ignoring them can wreak chaos in the therapeutic relationship and damage the patient’s ability to heal.
+-----
-In psychotherapy, diagnosis is not terribly important, at least as it is taught in psychiatric residencies. When I asked a second-year resident whether diagnosis mattered when doing therapy, she looked at me as if I’d said something very stupid and snapped, “No, it’s a waste of time, it’s absurd. There is no diagnosis in therapy.” She went on, “We all know the feel of a borderline, but the diagnosis isn’t relevant. If they’re schizophrenic, you’re going to write them a prescription; if they’re borderline, what are you going to do?” In long-term therapy, a resident’s only important senior is her supervisor, who tries to teach a way of interacting with the patient, a way of thinking about people in general or one person in particular, that crosses diagnostic boundaries. I rarely—I am inclined to say never—heard a psychodynamically oriented psychiatrist discuss diagnostic categories in a supervision. (For a time, I had a clinical psychologist as a supervisor; she did think more diagnostically than the psychiatrists, but that was in part because her academic interests included personality disorders.)
+==== Annotation 20 ====
-Nevertheless, there are diagnoses for which the primary treatment is psychotherapy (although medication is also usually prescribed). These are the personality disorders, which are described as long-standing character difficulties. In the diagnostic handbook, they are separated from the other serious psychiatric disorders such as schizophrenia and depression, which can become acute. The acute disorders are called Axis I; the personality disorders are identified on another axis, Axis II. The personality disorders come in three groups, the “anxious,” the “dramatic,” and the “odd.” The “anxious” include the avoidant, dependent, and obsessive-compulsive personality disorders; the “dramatic” include the histrionic, narcissistic, antisocial, and borderline personality disorders; the “odd” include the paranoid, schizoid, and schizotypal personality disorders. Like the Axis I diagnoses (schizophrenia, depression, psychotic depression, bipolar disorder, obsessive-compulsive disorder, and so forth), each personality disorder is defined by a list of specific criteria. The patient must meet a specified number of criteria in order to qualify for the diagnosis. But because personality disorders are not by themselves generally considered to be valid reasons for hospital admission (they are not thought to become “acute”), a resident never has to memorize their criteria and never prototypes them as thoroughly as the Axis I disorders. A resident rarely has to write an admissions note for a patient that demonstrates that the patient meets the official diagnostic criteria for an Axis II category. Hospital admission forms are likely to be examined by people whose job it is to determine whether the admission was necessary, and failure to display evidence that a patient meets criteria for an Axis I diagnosis can lead to disqualification for payment. An Axis II diagnosis by itself commonly does not qualify the admission. Even if a clinician believes that a patient’s borderline personality disorder is responsible for her suicidal rage, he will list a diagnosis like “major depressive disorder” on Axis I, and “borderline personality disorder” on Axis II, and usually his admission note will demonstrate the criteria for the Axis I depression more systematically than for the Axis II personality disorder. Access to outpatient psychotherapy is not controlled by disorder status in the same way, and the outpatient intake form, for admission to the outpatient clinic, does not have to provide evidence for a diagnosis to the same degree that a hospital requires. As a result, residents do not pay as much attention to the diagnostic criteria, and most of them have much hazier notions about the content of a personality disorder diagnosis than they do about the other common diagnoses.
+''Endlessness'' refers to the infinite span of space and time in our universe. ''Self-existence'' means that our universe exists irrespective of human consciousness; it existed before human consciousness evolved and it will continue to exist after human consciousness becomes extinct. ''Self-motivation'' and ''Self-transformation'' refer to the fact that motion and transformation exist within the universe independent of human consciousness.
-Instead, these categories are taught by the way a patient makes a doctor feel. The category “borderline personality disorder,” for example, identifies an angry, difficult woman—almost always a woman—given to intense, unstable relationships and a tendency to make suicide attempts as a call for help. At one outpatient clinic, the category “borderline” was taught through the “meat-grinder” sensation: the chief resident explained to the others that if you were talking to a patient and felt as if your internal organs were turning into hamburger meat (you felt scared; you felt manipulated by someone unpredictable; still, you liked her), that patient most likely had a borderline personality disorder. That internal feeling was insisted upon as a diagnostic tool in a way that bypassed the usual emphasis on “meeting the criteria.” When I presented one of these patients in a meeting at the outpatient clinic, the team leader stopped me before I got to the diagnosis and asked, “How would you describe this woman’s experience?” I cautiously said, “Well, she’s got a lot of anger, no coherent sense of identity, experiences a sense of inner emptiness”—I was listing diagnostic criteria for the borderline personality disorder—and the leader cut me off, smiling, and said, “No, that’s cheating. What does she ''feel'' like?” Had I been presenting a patient with schizophrenia, the team leader would probably have taken that time to focus on the criteria. But I wasn’t. I explained that in the interview I had felt intensely needed and flattered and a little scared by her anger at the world. When you feel that way, the team leader said, think “borderline.”
+Engels wrote of the scientific nature of the dialectical materialist viewpoint in ''Socialism: Utopian and Scientific'':
-When residents first encounter the personality disorder categories in the inpatient setting, those categories usually appear as an aside, as a means of explaining why a patient does not want to take the medication she has been prescribed. And it is the general idea of the personality disorder, with shades of awkwardness and annoyance, rather than a specific diagnostic category, that is invoked. In the first year of residency, a common phrase is “Axis II flavor.” A junior resident will present a newly admitted patient and diagnose him as depressed, possibly secondary to substance abuse—in other words, he’s an addict—then put down the notes and say, “But you know, there really was an Axis II flavor to this guy”—which means that the resident mistrusts the patient, may not like the patient, and probably doesn’t quite believe everything the patient told him. (On the specific occasion I’m remembering, the fact that the patient had announced in the admissions interview—he was admitted for depression—that he was HIV positive but that his test came back negative was seen as strong evidence of his Axis II character. He was seen as manipulative and deceitful.) Or a resident will say about a patient she has just interviewed and diagnosed as having panic disorder, “There’s something really weird about this guy. I couldn’t put my finger on it. Probably Axis II.”
+<blockquote>
+Nature is the proof of dialectics, and it must be said for modern science that it has furnished this proof with very rich materials increasingly daily, and thus has shown that... Nature works dialectically and not metaphysically; that she does not move in the eternal oneness of a perpetually recurring circle, but goes through a real historical evolution.
+</blockquote>
-The personality disorders become insults in the way new psychiatrists learn to gossip. Your fellow residents are people whose work you have to do if they don’t do it, who may get pregnant and dramatically increase the amount of overnight call everyone else in the class must do, who may overinterpret you, show up late for your meeting, and take all the attention in seminars. A new resident learns to describe those unendearing traits as personality disorders: the other residents are narcissistic, obsessive, hysterical, and borderline. The patients whom they begin to call Axis II are the ones who’ve come to get all they can from the system and see a resident as a means to that end. Such patients are the tough thugs who come in (the resident thinks) because they want a prescription for their street drugs. I remember sitting in one intake interview where a patient was meeting his outpatient psychiatrist for the first time, when the patient began to go on and on about how his last doctor had prescribed Xanax (a tranquilizer not unlike Valium) and how helpful it had been, and the doctor began looking more and more stony. When the patient left, I asked what had been going on. “This guy has a problem,” the resident said. “His problem is that he wants a prescription to abuse.” Residents refer to such patients as having an “antisocial personality disorder.” ASPD is the other major personality disorder category commonly used by residents, the first being “borderline.” A shorthand recall for the diagnosis is that the ASPD patient is a male criminal; the borderline is a female who grew up in a criminally abusive household.@@@[[#13ThecriteriaoftheASPDcat|13]]$$$ Personality disorder patients are the patients you don’t like, don’t trust, don’t want.
-One of the reasons you dislike them is an inexpungable sense that they are morally at fault because they could choose to be different. This is the inherent danger of the interaction model of psychiatric illness, the fact that believing that someone has the capacity to change his behavior can lead you to blame them for the way they behave. Let me quote a resident who said clearly what I have heard others say less directly: “I have more respect for Axis I. I feel better about it. If they’re really depressed, have all the neuro-vegetative symptoms, you feel like they came by their diagnosis honestly. The same thing if they’re manic, have classic psychotic symptoms—it’s exciting. You think, oh, they have a real diagnosis, you can treat it with medication, and you also give them the benefit of the doubt. They’ve got genetic loading to have this terrible disease. On the other hand, Axis II is almost like an insult. You kind of attribute more blame, even though that’s not true. In Axis II, I think there may be some genetic linkage, but there’s probably a lot of early childhood experience. It’s not their fault. But somehow you have a worse feeling about them.”
+-----
-In psychodynamic psychotherapy, treatment involves helping a patient take responsibility first for his or her behavior and then for changing it. Therapy may be based on the premise that a patient is not responsible for the circumstances that led to such maladaptive behavior—a cold or abusive parent—but it must be premised on the belief that the maladaptive behavior that developed out of those circumstances is under the patient’s conscious or unconscious control. This is a major difference from the disease model. When schizophrenia is treated as a disease, it is presumed that the patient cannot control his symptoms. Working from the interaction model, a patient’s symptoms are much more a part of him, much more a part of his intentions, and hard to conceptualize as disease. It is easy for a resident to skip from this complexity to the irritated sense that the personality disorder patient is intentionally creating havoc. As one explained, “On the psychosis unit, the staff agreed about what the person had and how to treat it. People didn’t really judge the person, as if he’d done something wrong. On units with people with personality disorders, people do judge the patients. [Some hospitals have units for patients who are admitted because of a suicide attempt but whose most important problem appears to be their personality disorder, not their depression; the admission note is still likely to justify the admission on the basis of the suicidal depression.] I’m not wild about that but it does feel like those patients act out with more volition. They’re not having hallucinations, they’re throwing chairs across the room. It’s like sabotage. It may be driven by unconscious needs, and in that sense it’s not chosen. But nevertheless, their illness is more problematic than for someone who has a frank psychosis. When someone has a frank psychosis, the staff doesn’t argue about whether or not the person has contributed to their own difficulties.” As another remarked, when patients have Axis I problems, “they have a real diagnosis; you can treat it with medication.”
+In conclusion, the birth of Marxism is a phenomenon which is compatible with scientific principles; it is the product of the social-economic conditions of its time of origin, of the human knowledge expressed in science at that time, and it is also the result of its founders’ creative thinking and humanitarian spirit.
-Yet while the personality disorders may make a psychiatrist angry, that anger also makes him feel guilty. Most residents said that it was harder to be empathic with personality disorder patients because it felt as if they had more choice, but they were embarrassed by the admission. The woman who talked about having a “worse feeling” about people with personality disorders awkwardly explained a year later that she no longer felt that way. Another resident said, “Somehow you think that they should know better, it’s their fault, you say to yourself, ‘Straighten up.’ It’s harder with them, especially people with borderline personality. You feel like they’re persecuting you on purpose. That’s how I feel. But I can’t defend that intellectually.” Gertrude had started out her outpatient year focused on learning to be a good psychotherapist. She wanted to present her patient in the psychotherapy seminar that an analyst ran for her class. She was eager to take on psychotherapy patients. Then she rotated onto a unit that was known for its borderline patients. She acquired a patient who would wait until the team meeting to which Gertrude was assigned began. The patient would then wander onto the corridor on which the meeting was being held and begin to scream how much she hated Gertrude. Had Gertrude been an experienced therapist, this would not have fazed her greatly (perhaps). As it was, she felt humiliated, the other staff on the unit saw that she felt humiliated, and the story that circulated about her was not about the patient’s anger but about Gertrude’s shame about her hatred of the experience.
+==== b. The Birth and Development Stage of Marxism ====
-These kinds of patients are the most difficult to work with. Borderline patients cause fighting and confusion. The patient typically tells some of the staff that they are the very best, most wonderful doctors, nurses, psychologists, and so forth that she has ever known. Others she decides she dislikes. Unless the staff is well managed, it “splits”: some staff members, whom the patient has told are wonderful, think she is a lovely woman, misunderstood and badly treated by all the other staff members, who are mean. The “good” staff then confront the “bad” staff. There are scenes. These patients threaten to commit suicide when the doctor leaves town for the weekend, and he does and they do. At least, a patient may make a suicide attempt that lands her back in the hospital, but sometimes she is unfortunate and succeeds and then the doctor must struggle with guilt and a lawsuit. These are patients who because of their volatile intensity engage their doctors deeply, and the doctors sometimes believe that they can save them and are also terrified by the idea that the suicide attempts might someday work. These are patients who have usually been badly abused and oversexualized, and they are often seductive, charming, and thoroughly absorbing. In 1987, Robert Waldinger and John Gunderson published a book, ''Effective Psychotherapy with Borderline Patients: Case Studies'', detailing six case studies, which examined the use of psychotherapy to change borderline behavior. (The answer was that a great deal of therapy over a great deal of time made a difference.) The case studies were anonymously written. One of the authors, who was married with children, remarked of one patient that he had never felt more involved with anyone in his life, ever.
+Marx and Engels initiated the birth and development stage of Marxism from around 1842~1843 through around 1847~1848. Later, from 1849 to 1895, Marxism was developed to be more thorough and comprehensive, but in this early period of birth and development, Marx and Engels engaged in practical activities [Marx and Engels were not just theorists, but also actively supported and participated with various revolutionary and working class organizations including the Chartists, the League of the Just, the Communist League, the International Workingmen’s Association, etc.] and studied a wide range of human thought from ancient times on through to their contemporaries in order to methodically reinforce, complement and improve their ideas.
-As a result, precisely because the patient is engaging, exciting, and dangerous, the borderline patient becomes for a psychiatric resident what a schizophrenic was thirty years ago: the tough, difficult patient who makes her a psychiatrist. That is because to do good therapy with these patients—to help them feel safe, to help them talk frankly, and to talk with them in a way that they can hear and from which they can learn—requires one to have the capacity not to act on one’s love or hate or anger for them, which in turn requires one to recognize those emotions in oneself and also in the patient. Young psychiatrists are scared of these patients but also proud when they can work with them. I was interviewing a chief resident once when one of the newly minted second-year residents came by, essentially to get some support but also to show off. She had a patient on the (mostly) personality disorder unit, she said, who was infuriating the staff. “Borderline, of course,” the chief resident said. “Of course,” she replied. This was a patient, she said, who talked about horrible sexual abuse, who showed other patients pictures that her brother had supposedly sent to her, with abusive phrases scrawled on the back. “Once she has the unit in hysterics, she goes to sleep. She’s ''really'' lethal,” the younger resident continued excitedly. “She hoarded some of her tricyclic antidepressants [these older-generation antidepressants can kill you if you overdose on them] and hid them and they were discovered, maybe by accident. The hospital can’t possibly let her out,” the resident said, “but the unit staff wants so much to let go of her that she packed her bags on Sunday and they didn’t even call me. So she left and put a note on my door saying how wonderful I was.” The chief resident chuckled. “You’re in the thick of it. Most residents wouldn’t take a patient like this. Do you think that Jones [a supervisor whom the chief resident didn’t much like] would take a patient like this?” “No, but Judith [another supervisor] might. I’m going to go process this with Judith for an hour.” And she left.
+Many famous works such as ''The Economic and Philosophical Manuscripts'' (Marx, 1844), ''The Holy Family'' (Marx and Engels, 1845), ''Thesis on Feuerbach'' (Marx, 1845), ''The German Ideology'' (Marx and Engels, 1845–1846), and so on, clearly showed that Marx and Engels inherited the quintessence [see Annotation 6, p. 8] of the dialectical and materialist methods which they received from many predecessors. This philosophical heritage led to the development of the dialectical materialist viewpoint and materialist dialectics.
-Young psychiatrists learn in psychotherapy, as they do in medicine, a kind of twinning of responsibility and imperfection. They are taught that in psychotherapy, it is a psychiatrist’s responsibility to understand how his feelings shape his interactions with a patient, that the efficacy of therapy depends on a therapist’s self-awareness (and also on the self-awareness of the patient), and that a therapist will never be as aware as he should be. What makes a borderline patient so compelling is that if a therapist can get drawn in to the intensely emotional world of that patient and still use his feelings as a tool in the service of the therapy, he has mastered the nearly impossible task of being a bystander to himself, at least well enough to help. Before this point, he will be taught that he might hurt the patient instead of help.
+-----
-But in a medical setting, young doctors learn (more or less by accident) to fear and resent the hospital patient. The conditions under which they work make that inevitable. Those conditions are less marked in psychotherapy. That is, borderline patients and other difficult patients may lead young therapists to fear, resent, and guard against their patients. But these patients are not such an assault on the young doctor as is internship and, later on, night call in the psychiatric setting. Moreover, the teaching in psychotherapy insists on the doctor potentially being a source of harm to the patient in a way that biomedical teaching does not. Residents learn in psychotherapy that the arrow of harm flies from doctor to patient, not the other way. To the extent that the initial training and experience in diagnosis are frightening and exhausting—and they nearly always are, and for a significant length of time—the emotional experience of doing a psychiatric admission signals the need for a psychiatrist to guard himself against a patient. To the extent that the early training experience in psychotherapy is experienced as hurtful to others—and it nearly always is—the experience of doing more psychotherapy signals the need for a psychiatrist to protect a patient. These are powerful responses. And a psychiatrist who is anticipating the need to protect herself is alert for very different cues from those anticipated by a psychiatrist who feels the need to protect a patient.
+==== Annotation 21 ====
-== {{anchor|CHAPTERTHREE}} {{anchor|TopofLuhr9780307791900epubc4}} CHAPTER THREE: THE CULTURE AND ITS CONTRADICTIONS ==
+There is a subtle, but important, distinction between Dialectical Materialism and Materialist Dialectics. This will be explained further in chapters I (p. 48) and II (p. 98).
-People laugh at the contradictions their culture sets up for them. They laugh at the paradoxes, the idiocies, the inanities, their attempts to do what they must do under impossible conditions. Meanwhile, their conventions adapt to the contradictions to make them as bearable and reasonable as they can be. Treating psychiatric patients can be a near-impossible task. People who do so collapse with foxhole hilarity around the stress and the demands. Depending on their model of illness, though, they laugh and adapt in different ways. Like the interpretive patterns that lead psychiatrists who are thinking psychotherapeutically or biomedically to evaluate patients in different ways and to anticipate different kinds of emotional responsibilities and responses to them, the psychotherapeutic interaction model of illness has a different impact on the life of a hospital unit than the biomedical disease model of illness. Working with these different models changes the way the staff joke, the way doctors relate to nurses, and even the sense of the unit’s ultimate goal. Ultimately, these differences help to produce different moral sensibilities about mental illness.
+With works such as ''The Poverty of Philosophy'' (Marx, 1847) and ''The Manifesto of the Communist Party'' (Marx and Engels, 1848), Marxism was presented as a complete system of fundamental views with three theoretical component parts.
-Hospital units are small societies. Typically, a psychiatric unit—the older name was “ward”—is a corridor or small building where the patients sleep and spend most of their days and where doctors, psychologists, social workers, mental health workers, and so forth come to treat them. These different professionals have very different training. The doctors have medical degrees. They have spent a year in internship, and on the unit they are either in training, as residents, or they have completed a three-year residency and are now on staff. Some of them may have additional training though fellowships (for example, in substance abuse) or more extended residency training (as in child psychiatry). All (or nearly all) orders in the patient’s chart—from allowing smoking privileges to prescribing medications—must be signed by a doctor, even if the primary responsibility for the patient rests with a psychologist or a psychology intern (a psychologist in training). In that case, the psychologist makes the decision about whether the patient should have smoking privileges. Nevertheless, a doctor on that unit must cosign the order for it to take effect.
+-----
-Psychologists are trained in nonmedical university departments, and they take doctorates. They read a great deal about normal and abnormal psychology (more than the psychiatrists do) and are often (depending on the program) well trained in psychotherapy. They do not have any medical school training. They are also usually trained in “psychological testing.” Psychological testing refers to a complex battery of written and oral tests such as the Rorschach, the Thematic Apperception Test, the Minnesota Multiphasic Personality Inventory, Draw-a-Person, and others. The goal of these tests is to reveal underlying psychological issues by using more “objective” measures. Sometimes, especially if the Rorschach (the ink-blot test) is used, the test report will have a psychodynamic flavor. In one case conference, the summary for a report began, “The patient has grown up with an intense sense of inferiority spawned by her sense of neglect by her parents, especially her mother. In her efforts to be found pleasing to her parents, she created a shell identity which others would find acceptable and which shielded her inner world and its insecurities.” Different psychologists and different hospitals use different tests, but almost always the tests take several hours for the patient to complete and many hours for the psychologist to analyze. If there are psychologists or psychology interns on the unit, they typically do psychological testing on each patient. However, that depends on the unit. In one hospital I visited, when the length of admission dropped to under a week and the hospital grew panicked about its financial stability, the administrators cut out all psychological testing. (Psychological testing had been billed to the patient or the insurance company at around $700. When the hospital was forced to cover the costs of patient stays for a basic daily fee rather than billing each service separately, many services were simply dropped.) Then they cut out the psychology interns altogether. In another hospital, the psychology interns did not always do psychological testing on each patient, but they were given primary responsibility for about half of the patients on the unit. Each intern and each resident would be responsible for the care of three to four patients at a time. Even so, the residents had to countersign all instructions for the care of the psychologists’ patients.
+==== Annotation 22 ====
-Social workers typically have a master’s degree and are less likely to be given primary responsibility for patient care. A social worker manages the interaction between a patient and the patient’s life outside the hospital. The social worker finds an aftercare program willing to accept the patient after discharge and handles the transition into that program (this is called the “disposition” of the patient). The social worker is often also the primary interface with the family. Some social work programs train their students to do psychotherapy. Usually, the fewer the hospital’s resources, the more powerful the social workers’ roles.
+According to Lenin, the three component parts of Marxism (and, by extension, of Marxism-Leninism) are:
-Mental health workers often have no formal academic training for their jobs (although they are sometimes required to have a bachelor’s degree). They are paid to sit with patients, to walk out with them to their appointments and to lunch if they must be escorted, and in general to keep an eye on things. Some mental health workers become very senior and keep the job for decades. Many others go back to school to pursue better-paid careers in mental health. In one of the units I visited, the director of the unit—an older, highly experienced psychiatrist—had first worked on the unit as a mental health worker some twenty years before.
+<blockquote>
+. The Philosophy of Marxism: Including Dialectical Materialism and Historical Materialism
-In many ways, the nurses are the most formidable presence on the unit. Nurses handle most of the hour-to-hour care of the patient. Psychiatrists move into and out of the unit over the course of a day because they also work in the emergency room, in admissions, in research, in the consulting service for the main hospital; they go to lectures; they give lectures; they go to and give supervision. The same is true (in different ways) for psychologists and social workers. Like the nurses, mental health workers take shifts on the unit, but mental health workers make few decisions about the patients’ care and cannot dispense medication. Nurses do both. They dispense medication and take care of patients’ medical needs, and they carry out the doctor’s orders. There are always nurses on the unit, and they stay on the unit for hours at a time (shifts often run for eight hours). Because they have the most contact with patients, they are often very knowledgeable about the patients and their care. When a psychiatrist (or psychologist or social worker) is in training, the nurses know far more about the patient and how to treat him than the new trainee does. A new resident is in the awkward position of giving orders to a nurse who knows what he should do better than he does. The relationship between nurse and resident, then, can be a nurturing apprenticeship or a tortured, humiliating power struggle, depending on the graciousness and maturity of each party and the general climate of the place.
+. The Political Economy of Marxism: A system of knowledge and laws that define the production process and commodity exchange in human society.
-The climate varies widely, and units vary widely in the way they organize these roles. Some units are formal and hierarchical. Some are not. Some allow psychiatrists and psychologists nearly the same power and authority. Most do not. Some are rife with power struggles and territory wars, some are not. One of the most important factors in determining the organization of a unit is what the staff takes to be wrong with the patient, what an anthropologist would call their “model of illness.” Why is the patient sick? The answer to that question tells the doctor what she is treating and how best to treat it, and her answer to that question in turn structures her relations with other staff in surprisingly predictable ways. That is because different models create predictable problems for the unit that the culture of the unit has to solve.
+. Scientific Socialism: The system of thought pertaining to the establishment of the communist social economy form.
+</blockquote>
-=== {{anchor|ABIOMEDICALUNIT}} A BIOMEDICAL UNIT ===
+These are discussed in more detail in Chapter 2, p. 38.
-On a biomedical unit, the model of illness is that psychiatric patients are rational adults with medical problems. The implicit presumption is that the patients have come into the hospital with brain dysfunctions, just as the patients down the hall have come in with liver failures and cardiac dysfunctions. It follows from that implicit model that the doctor should discuss the medical problem with the patient, as if he in fact had liver disease. And indeed, many conversations on these units imitate other medical discussions. A doctor walks into a patient’s room and says, “Well, Mrs. Jones, how is your depression today?” or “How are your voices?” I once heard a doctor ask his patient how her psychosis was doing. But psychiatric illness, of course, inhibits patients’ rational capacities. That is the problem this model creates. A doctor needs to talk to her patient about his illness, the way any doctor consults with her patient, but the patient has been admitted because he was blocking traffic and explaining that he is the risen son of God.
+In the book ''The Poverty of Philosophy'', Marx proposed the basic principles of Dialectical Materialism and Scientific Socialism,* and gave some initial thoughts about surplus value. ''The Manifesto of the Communist Party'' laid the first doctrinal foundation of communism. In this book, the philosophical basis was expressed through the organic unity between the economical viewpoint and socio-political viewpoint.
-San Juan County Hospital is the safety net for psychiatric patients from a forty-mile urban stretch of northern California. Anyone in this area who falls between the many cracks in the medical insurance floor ends up in the county’s system. They tend to stay in the system a long time, shuttling into and out of the community hospital and its associated clinics, halfway houses, rehabilitation centers, and so forth. Because the seriously mentally ill tend to drop down through the class levels, these patients are usually the poorest and sickest. Many of them carry the diagnosis of schizophrenia. Most of them live in marginal conditions. When they are outside the hospital, many of them use crack or vodka instead of antipsychotics to control their symptoms, so that when they are released from the hospital, it sometimes takes no more than a few weeks—and sometimes only a few days—until their harassed relatives call the police to take the ex-patients back. The police handle this part of their job with understanding but distaste.
+-----
-The practical demands on this unit were staggering. It worked with a biomedical model not out of choice but because the patients spent too little time in the unit for the staff to do much else besides medicate them and because the patient turnover was so great that the staff found it hard to spend much time with any of them. This was a community hospital. It accepted people without insurance, without documentation, without anything, and it received some special funds from the state for this purpose. That was what it was supposed to do. But it had never been intended to handle as many patients as now came flooding through its open gates. As the health care system went into crisis, nearby hospitals had begun to refuse more and more of the bottom rung of patients because they couldn’t afford to care for people without insurance. In earlier days, these other hospitals had covered a certain amount of the expense of that care, and the federal reimbursement policy for the care of the poor had been more generous. Now the homeless who showed up in these other emergency rooms were shipped out to the community system immediately, and as the long-term care facilities in the county had decreased, the demand for beds in this hospital had become intense. Patients who clearly needed care were pushed out of the units to make room for people even sicker than they. An ethnographer of a similar psychiatric unit entitled her terrific study ''Emptying Beds'' to make the point that, in times of such pressure, the goal of the unit could be summarized as making room for the sickest of the sick.@@@[[#1LornaRhodesEmptyingBeds|1]]$$$
+==== Annotation 23 ====
-They were indeed very sick. When I arrived at the hospital for a week in 1995, one of the new patients was a handsome twenty-year-old man who, while wearing nothing but boxer shorts, had walked onto the busiest freeway near San Francisco and attempted to herd the cars, a kind of postmodern sheepdog for the mechanical age. He refused any medication after the police escorted him onto the unit. When the young psychiatrist tried to persuade him to change his mind, saying that the staff really thought that medication would be useful, he shook his head decisively. If it would help, he said, he would agree to eat the food. But medication was out of the question because he was training for the Marines. Throughout the day he proceeded to “train,” now wearing a hospital gown and socks in addition to his boxers, by jogging around the nurses’ station in short, determined, high-kneed steps. He jogged for six hours.
+<nowiki>*</nowiki> Scientific Socialism is a series of socio-political-economic theories intended to build socialism on a foundation of science within society’s current ''material conditions'' [see Annotation 79, p. 81]. Scientific Socialism is the topic of Part 3 of the textbook from which this entire text has been translated, which we hope to translate in the future.
-Most of the patients on the unit were as flamboyant and as sick. There were two women married to God; one also claimed to be a samurai warrior. She walked around the unit with her arms stretched out before her, trembling but stiff, occasionally holding an open plastic bag as if it were a ritual offering. When she was distracted, her arms would drop down to her sides, but at the end of the conversation they would rise again and she would continue her tremulous sleepwalker’s tread. There was a woman who had already been admitted twice that month. She was a large African-American woman, and she wore a platinum blond wig that perched on her head like a moth-eaten hat. She was pregnant with her ninth child. All of her previous children were with relatives or in foster homes. She was not always psychotic. At times her eyes gleamed with what looked like irony, and then she would pinch her arm and say, “Look, the hospital hasn’t helped, I’m still black.” She called herself Shirley Temple. There was an even larger woman who, when she was admitted, had not bathed in five weeks. She had lain in a depressed stupor on her bed, and body cheese and fungus fell out from the folds of her flabby skin when her husband finally brought her into the hospital.
+''The Manifesto of the Communist Party'' outlined the laws of movement in history,* as well as the basic theory of socio-economic forms.
-The average length of stay on the unit, adjusted to exclude the few patients who stayed on and on, was around eight days. Roughly twenty-nine patients could be accommodated. The month before I arrived, around a third of the patients were new to the unit, but the rest had been admitted to the unit at least one time previously. The unit worked like that, as containment for the sickest periods in the lives of the sickest patients. They would come in, be stabilized, get discharged, come in again. Many of them came in refusing to acknowledge that there was any reason for the admission and sometimes unable to understand that they were on a psychiatric unit. They often refused to take psychiatric medication. They were often admitted under a three-day “hold,” meaning that they had refused to come into the hospital and that the psychiatrist who had interviewed them had decided that they needed to be in inpatient psychiatric care nonetheless. In these circumstances, they could be kept in the hospital for no more than three days (this was also called a “commitment”). However, to force a patient to take medication or to keep him in the hospital for longer, a psychiatrist had to go to court (or, more commonly, court, in the form of a judge, came to the unit to hold a hearing). The standard of measurement was pretty basic. Unless the patient was actively suicidal or homicidal or could not explain who and where he was, a psychiatrist could not force him to do anything and was unable to provide care the patient didn’t want. As a result, blatantly psychotic patients often left the hospital as disturbed as they had been when admitted.
+-----
-Terry, for example, was the kind of derelict beatnik who makes some Berkeley citizens proud and most a little nervous. He was a child of the sixties and had worked as an artist for twenty years, supported by his wife. Eventually, she had thrown him out. He had either refused to get a job or failed to keep one. His family had supported him for a while and then stopped. By the time he came into the hospital, he had been living in a van on Telegraph Avenue for several years. He was brought in by police because he had jumped through security at Oakland Airport and begun to scream. He hated being hospitalized. He saw it as a form of state oppression. He saw me as the neutral recorder of truth, of higher status than the patients’ but not on the staff’s side, and so he hovered around me to discuss his sense that psychiatry perverted human justice and constrained people against their will and their rights.
+==== Annotation 24 ====
-When the judge came to hold commitment hearings—Terry was on a three-day hold—Terry became so anxious that the judge would hear his case without him that he hung around the door to the room, periodically pressing his nose against its tiny, wire-reinforced window. During his turn (the judge heard eight cases in just over an hour) he explained to the judge that he had run through airport security because he was being pursued by big, bad, dangerous people. When the doctor later referred to him as paranoid and psychotic, Terry jumped up, obviously agitated, and demanded to know what evidence there was that he was psychotic. The judge was a large, practical man. “Probably the big, bad, dangerous people,” he said dryly. But he then went on to point out that Terry had both the resources and ability to care for himself and the hospital could no longer hold him unless he chose to stay voluntarily. Terry smiled jubilantly and left the airless room with pride. But then he refused to leave the ward. He went to stand in the door of the nursing station. When he was told that he could leave now, he announced pugnaciously that he was a free citizen and they could not make him leave. He was offered the opportunity to sign in to the hospital voluntarily and thus stay on as a patient. He declined. He was then told that he would have to leave. He began stating his rights, loudly. Meanwhile, people kept trying to get into and out of the nursing station, where all the charts and medications were kept. Eventually Terry was escorted out of the hospital by police. “He’s more realistic than he seems,” a resident said sadly. “He’s afraid of us, but he’s even more scared of living on the Berkeley streets.”
+<nowiki>*</nowiki> The laws of movement in history are the core principles of ''historical materialism'', which is the topic of Part 2 of the textbook from which this entire text has been translated, which we hope to translate in the future.
-The staff here were faced with an increasingly impossible task. The hospital’s resources were excellent for a county hospital, but they were woeful in relation to the need and declining fast. The patients were chronically ill. There was little chance that most of them would improve. Most of them could not get adequate care at home. Many of them were homeless. As the pressure to handle more such patients continually mounted, resources declined even faster. Neither the laws nor the circumstances permitted the staff to take charge of patients who felt they could manage on their own. (I heard one psychiatrist wonder wistfully whether the current legal situation didn’t infringe on the patient’s right to treatment.) The problem, then, was that the staff essentially ''had'' to treat patients as rational adults capable of making reasonable and informed choices about their illnesses, and most of them obviously were not.
+The basic theory of socio-economic forms dictates that material production plays a decisive role in the existence and development of a society, and that the material production methods decide both the political and ''social consciousness'' of a society.
-There was, then, a begrudging, wry, self-deprecating tolerance of the fact that patients could decide what they wanted, which usually had a nonobvious relationship to what the psychiatrists thought they needed and what the county would provide. “He’s back ''already?”'' someone said of a recently re-admitted patient. “Take him for a walk and see if you can lose him.” Or to me, “If you really want to know about discharge planning, go to the Round Table Pizza around the corner. There’s a table in the back that has a lot of the patients who’ve been here already and a lot of the others who haven’t been here yet.” The psychiatrists resigned themselves to putting the patients back on medications and discharging them to some less expensive facility or to their families. “Let’s go over the patients tomorrow,” a senior psychiatrist said with a sigh. “Maybe some of them will leave by then, and all that work would have been wasted.” “That’s our job,” someone remarked to me on the first day. “We get them into the hospital, and then we get them out.” Doctors on an elite unit might invest considerable time pointing out to a patient that her belief that she was not ill was part of the illness and persuading her to stay in the hospital for a few more days. These doctors more pragmatically accepted the fact that if a patient wanted to leave, he would leave, and there were plenty of others who needed help. Here, they saw themselves as just barely keeping pace. When someone actually ''did'' want their help, though, they were delighted.
+-----
-For example, on my first day on the unit I watched a resident admit a man whose father had died three weeks earlier and who hadn’t eaten or drunk for six days. It was a slow and relatively nonlethal suicide attempt. He had been admitted thirteen times before and been given a diagnosis of schizophrenia. He had not been taking his medication recently, because he claimed it made him worse (“They’re giving me a lobotomy”) and he didn’t want any. He said he had no hallucinations—“Except for the Devil,” he added, but it wasn’t clear what he meant. He was obviously deeply depressed and was unable to talk about his father. Several times he started a sentence with “My father” but couldn’t complete it.
+==== Annotation 25 ====
-After we left the room, the resident remarked, “Poor guy. In some ways this is a social admission. He’s suicidal, but he’s not going to die tomorrow. He wants to come in, though, he needs the help, and maybe we can persuade him to get some food and even some medication.” She dictated the admission note and wrote out some prescriptions. “He’s probably going to refuse them, but you have to do it for the liability issues we love so much.” She gave him an antipsychotic, an antianxiety agent, and a medication for the side effects of the antipsychotic. She also wrote orders for the nonprescription drugs that patients often want in the hospital but cannot get unless the doctor has agreed: Tylenol, Mylanta, Nicorette. “He doesn’t look like a smoker, but so many of them are, and they can’t smoke on the ward.” But Terry wouldn’t stay long enough to get help; “Shirley Temple” would leave before the medication took effect; the samurai warrior would also leave, taken home by her distrustful family, to be brought back when they’d had enough. Even this willingly admitted suicidal patient would refuse the medication. The resident decided not to force it upon him, because although he clearly needed medication, he was not about to die, as she put it, tomorrow. She also felt more comfortable leaving him without medication because it was Monday. If it had been Friday, he might not have seen a doctor again for three days (there would be a doctor on call, but that doctor would not be required to see him; on-call doctors handle emergencies and admissions). That was too long a period for a patient to go untreated, she felt. It ''was'' Monday, however, and on Tuesday another doctor would see him and he would be assigned to that doctor’s team and be that doctor’s responsibility. Such small details are the stuff of hospital life.
+''Social consciousness'' refers to the collective experience of consciousness shared by members of a society, including ideological, cultural, spiritual, and legal beliefs and ideas which are shared within that society. This is related to the concept of base and superstructure, which is discussed later in this chapter.
-On the unit, patients participated in countless “groups”: on substance abuse, on discharge planning, on goals, on weekend planning, on living skills, and so forth. These were not the touchy-feely gatherings that we associate with the term “group therapy”; they taught the patients how to function in the most basic way. The goals group, for example, tried to teach the patients that they should have goals. The weekend-planning group tried to teach the patients that you could make plans for your free time. I had run a similar group once, with someone else, as a volunteer. The group I had run had been for outpatients and for people who were less sick to begin with, but it had still been a demoralizing experience. People didn’t talk about their feelings or their reflections or their relationships with one another. When they spoke, which was not so often, they talked about how it was more difficult to get to one prison than to another and how when their son came home on probation they really hoped he wouldn’t keep a gun in his car the way he had last time. The patients in the San Juan groups lived in that world, but they had less ability to cope.
+''The Manifesto of the Communist Party'' also showed that for as long as classes have existed, the history of the development of human society is the history of class struggle. Through class struggle, the proletariat can liberate ourselves only if we simultaneously and forever liberate the whole of humanity. With these basic opinions, Marx and Engels founded Historical Materialism.
-For instance, in the discharge-planning group I attended, the leader asked each person in turn what his or her plans were for after discharge. “Sam?” Sam didn’t answer, but he shifted in his seat. When she asked him again, he said, “I’m going to the place I was at before.” The group leader want around the group and asked each person what his or her plans were. Her own goal was to make sure that they knew that there were plans for discharge and to underscore the importance of patients taking their medications, of complying with the rules of the halfway house (if that was where they were headed), and of getting along with other people. (Halfway houses, sometimes call “board and cares,” are boardinghouses with varying degrees of supervision over cooking, cleaning, personal and medical care, and so forth. They are “halfway” between the hospital and independent living.) The conversation was often prosaic in the extreme. It was also geared to childhood standards of politeness. “It’s not your turn to speak now,” the leader (always a staff person) might say when a patient suddenly started talking “inappropriately,” as a staff person would say. “Stanley is speaking now, and it’s not right to interrupt him.” Asking each of the eight or so patients and getting answers took the entire hour.
+By applying Historical Materialism to the comprehensive study of the capitalist production method, Marx made an important discovery: separating workers from the ownership of the means of production through violence was the starting point of the establishment of the capitalist production method. Workers do not own the means of production to perform their labor activities for themselves, so, in order to make income and survive, workers have to sell their labor to capitalists. Labor thus becomes a special commodity, and the sellers of labor become workers for labor-buyers [the proletariat and capitalist class respectively]. The value that workers create through their labor is higher than their wage. And this is how surplus value* is formed. Importantly, this means that the surplus value belongs to people who own the means of production — the capitalists — instead of the workers who provide the labor.
-There was an intensely practical ethos to the place. When a patient kept dropping his pants in front of women, the resident arranged for the nurse to buy him overalls. When another patient claimed he didn’t live at the address the computer listed for him but at another one, a resident drove out to the two apartments to check. Because it had become more complicated to place patients outside the hospital (there were so few beds, and the halfway houses just said no to the difficult patients), one of the nurses had arranged for people from all the relevant facilities to meet once a week for a “disposition meeting.” People from every place to which a patient could be discharged met over coffee and doughnuts to discuss where each patient would go. “This is where managed care really works,” someone whispered to me unironically when I attended. There was someone from each halfway house. There was someone from the overburdened long-term placement hospital, someone from each of the community outpatient services, someone from each homeless shelter, and so forth. This meeting, the nurse explained, created a “put-up-or-shut-up attitude.”
+-----
-The day I attended, there must have been thirty people in the room. The meeting went person by person through the people on the list of current patients. Most of them were known to at least some members of the group. After all, on average two thirds of these patients had been inpatients on the unit before, and some came in several times a month. The discussion began with an account of a man who had described himself as “suicidal and hearing voices.” The speaker had spoken in a monotone, but a nurse winked at him and the room collapsed in laughter. Apparently, the patient wanted to avoid being sent to jail (he had stolen a purse) and had gotten himself diverted to psychiatry by claiming that he was mentally ill. Discussing another patient, one nurse presented a long, compelling argument about why she needed long-term care; that whenever she left the hospital she went back home, took drugs, was unable to care for herself, and was getting worse, and she needed a lengthy spell of treatment to reverse the pattern. People nodded in agreement, but then someone else said, “Good luck—she wants to go home, and she’s got a hearing this Friday that she’ll probably win.” People talked about a patient who had done badly at one board and care and whether it would be possible for him to return to it, and they reluctantly concluded that he should not. They talked about whether there was any way to persuade “Shirley Temple” not to have yet another child, a tenth, that she could not care for. It was a good-natured, task-oriented gathering, nonhierarchical and casual.
+==== Annotation 26 ====
-In the disposition meeting and in the staff room people laughed about the craziness. They told stories about these patients and other patients and what the patients had done. They chuckled about the women who were married to God—that week, God was a bigamist—and about the mad, strange, funny things the patients said. They came into the staff room (it was inside the nurse’s station, which was a kind of booth in the middle of the unit) when the man in the boxer shorts jogged determinedly around the nurses’ station, and they chortled. “Who’s the Energizer bunny?” His doctor and I went out to talk to him. We had to stand at a corner of his route. We could do a two- or three-sentence exchange per circuit. In between these exchanges we chatted idly and joked about jogging alongside. The staff here were clearly overburdened. The whole system groaned. A little humor helped.
+<nowiki>*</nowiki> Surplus value is equal to labor value (the amount of value workers produce through labor) minus wages paid to workers. Under capitalism, this surplus value is appropriated as profit by capitalists after the products which workers created are sold.
-The adaptations and contradictions on this unit—that people laughed at the craziness, that the roles were so clear that hierarchy became irrelevant, that there was a crazy contradiction between treating patients as adults and treating them as incompetent dependents—become even sharper on a unit that works with the disease model deliberately and has the resources to deliver more conclusive care.
+So, in discovering the origin of surplus value, Marx pointed out the exploitative nature of capitalism [because capitalists essentially steal surplus labor value from workers which is then transformed into profits], though this exploitative nature is concealed by the money-commodity relationship.
-For two months in 1993, I spent perhaps ten hours a week on a biomedical psychiatry unit in Gertrude’s hospital.@@@[[#2Iamfocusingononeparticul|2]]$$$ It was known for its explicitly “scientific” orientation. The senior psychiatrists conducted empirical research on schizophrenia and bipolar disorder. One had an international reputation as a researcher. Residents rotated onto the unit with the idea that they would get a taste of how to combine scientific research with clinical practice. The unit was acknowledged throughout the hospital to be effective and harmonious. There were no wars, no hostilities, no attempt to turn rounds into ideological skirmishes. No one pulled me aside to explain what was wrong with the unit director and how someone else would run the unit better. This was, in my experience, rare. Most psychiatric units seem to generate cross fire about the way the unit director does his job, mostly because the job can be done so many different ways.
+-----
-The unit could accommodate just over twenty patients. For the most part it remained full. It catered primarily (although not exclusively) to bipolar patients, who became acutely and unmistakably ill and then more or less recovered. This may have explained some of the good cheer. Not unnaturally, psychiatrists like being told by their patients that they are doing a good job. But in a world of short (five- to ten-day) admissions, few patients recover enough to feel gratitude. Sometimes bipolar patients do. The unit was a satisfactory place to work for that reason. And the patients themselves were colorful and interesting and did not lead you to have depressed thoughts about the human condition. For the most part the patients came in manic: very energetic, wildly talkative, uninterested in sleep, grandly confident, and usually very, very psychotic. That is, they seemed to have no grasp on reality. They had written the greatest American poetry, they had solved unified field theory, they had arrived at the airport shouting to the world about this important news and taken offense at an airline’s request for a ticket. Psychosis is one of the most frightening psychiatric symptoms, because psychotic patients are unpredictable and unconstrained by everyday common sense. Yet someone who is psychotic can be exhilarating for the same reason. His or her imagination is free to fly. Patients who came in psychotic with mania tended to have grandiose, dramatic thoughts. When they were not manic, they were often delightful people, more than usually intense, focused, and energetic, and as often as not successful in the wider world.
+==== Annotation 27 ====
-So the place was full of professors, scientists, doctors, and others who came in because they had been working harder and harder at their jobs and then had stopped sleeping, started speaking rapidly and incomprehensibly, and begun acting in strange, extravagant ways. Their exhausted families could no longer cope. Sometimes it was not their families that brought them in but the police, because they had been behaving so flamboyantly and bizarrely in some public place. Once I was sitting in the dingy anonymity of some midwestern airport when a man in a charcoal gray suit strode down the corridor swinging his briefcase, shouting about moral purpose and corruption. He was loud and scary and obviously psychotic, and everyone else suddenly became still. The police wrestled him to the ground in front of our gate. That is the kind of thing that happens during mania. Manic people make noisy, disturbing, frightening scenes, and then the police take them away and deliver them to a psychiatric emergency room. Often, patients have no sense of why the police have taken them into custody. On this unit, for instance, there was a visiting foreign scientist whom the police had brought in when they had found him wandering crazily around the streets near the university. When they had stopped him, he had volubly explained his new solution to a physics problem they could not follow. He clearly was unfit to care for himself. He had been unable to eat, clean himself, or find his way back to his apartment. Yet he was quite offended that the police had detained him. He didn’t see himself as ill, didn’t understand that he had been brought to the hospital, and demanded to be released immediately because he had to represent his country at an important conference where his new ideas would make him famous.
+Under capitalism, a worker’s labor is a commodity which capitalists pay for with money in the form of wages. Workers never know how much of their labor value is being withheld by employers, which conceals the nature of capitalist wage-theft.
-This was a locked unit. (When I arrived at the hospital, I had to sign out a fist-sized ring of keys.) The large, heavy door to the unit, hospital pink, had a metal plate around its lock. The key was cumbersome, and the door swung open slowly. Sometimes the door had a sign on it that read “Split risk.” This meant that the staff thought that one of the patients might shove past someone coming in and bolt for freedom. In fact, the passage between the inside world of madness and the outside was closely monitored. On the wall next to the door there hung a large whiteboard with a hierarchically ranked list of what were called “privileges.” The first privilege was to go out onto the porch with other patients, at designated times, to smoke. (Many psychiatric patients smoke; some researchers think that nicotine may help control depression and psychosis.) The next was to go out on the grounds for an errand or appointment with a staff person. Then patients could go out in a group, accompanied by a staff person, usually for a meal. Then one patient could leave the unit with another patient; then by himself, as long as he telephoned back when he reached his destination. Then patients could have total freedom, except that they were never given a key. Facing the list of privileges was another list, on a blackboard, of all the patients, their dates of admission, and their privilege levels. There was another list of daily activities and the privilege level required for each. On the unit, patients wandered from room to room or sat in the large shared areas and watched television. Often they seemed groggy and disoriented (that was the medication), and they also often seemed unsure. The patient population was quite transient. Patients would generally be admitted for a week or less, then discharged. Occasionally there were real problems with “discharge placement,” finding a facility that would accept a patient. (These hard-to-place patients were often drug abusers, violent, or simply underinsured.) Then, a patient might stay for weeks, once, for three months. But those patients were unusual. More common was the patient who would be seen in two or three of the twice-weekly team rounds and then vanish.
+The theory of surplus value was deeply and comprehensively researched and presented in ''Capital''<ref>''Das Kapital:'' Karl Marx’s most important contribution to political economy. It is composed of four volumes. It is the work of Marx’s whole career and an important part of Engels’ career, as well. Marx started writing ''Das Kapital'' in the 1840s and continued writing until he died (1883). ''Das Kapital I'' was published in 1867. After Marx’s death, Engels edited and published the second volume in 1885 and the third volume in 1894. The Institute of Marxism-Leninism of the USSR edited and published ''Das Kapital IV'', also known as ''Theories of Surplus-Value'', in the 1950s, long after the death of Marx and Engels.</ref> by Marx and Engels. This work not only paves the way to form a new political-economic theory system based on the working class’s viewpoint, it also firmly consolidates and develops the historical-materialist viewpoint through the theory of socio-economic forms.
-The patients here were understood to be suffering from a dysfunction of the brain, and although there were undoubtedly things about their families, their spouses, or the way they lived their lives that made things much worse, none of that really mattered except as a practical concern. The doctor’s task was to identify the disease clearly enough to treat it effectively, which he usually did with medication. He would also try other interventions, such as electroshock therapy, if the medication did not work. The goal of the hospitalization was to keep a patient safe so the acute problem could cool down enough for the patient to leave without obvious risk that he might hurt himself or others. Most of the patients on the unit came in psychotic, and antipsychotics work quickly enough to begin to de-escalate them within hours or a few days, but other medications would not take full effect until days or perhaps weeks after discharge. (Antipsychotics and antianxiety agents take effect within minutes or hours; mood stabilizers and antidepressants often do not work until the patient has taken them for weeks.) The goal of the unit, then, was explicitly minimal: to prescribe the medications, to make sure a patient did not have a toxic reaction to them, to begin to see whether they might work, and to be sure that a patient was sufficiently stabilized so that she was neither suicidal nor at risk of killing herself by accident—by “insanely” reckless driving, by wild promiscuity, by the invincible manic confidence that leads to very poor assessment of risk.
+-----
-Because of the emphasis on medical science, doctors were more respected on this unit than on many. One of the difficulties of being a psychiatrist is that many of your skills, particularly the more psychodynamic ones, do not seem to be the kinds of things one needs to go to medical school to learn. Even the biomedical skills seem like things nondoctors can learn. Psychologists, social workers, and nurses know a lot about medications, even if most of them can’t legally write prescriptions. They spend more time with the patients than psychiatrists do. (Psychiatrists typically spend less time on the unit than any other staff people.) When new residents arrive, fresh from internship, nearly every other staff member on the unit knows more about psychiatry than they do. Meanwhile, psychiatrists are paid far more (after residency) than anyone else on the unit. It is easy for the rest of the staff to regard psychiatrists as arrogant, overpaid extravagances.
+==== Annotation 28 ====
-On this unit, the doctors were accepted as experts in dealing with disease. This was because there was a medical research emphasis, because doctors were associated with science, research, and “real” medicine, and because when the psychiatrists spoke about psychopharmacology they spoke as connoisseurs, with an expertise genuinely beyond nonpsychiatrists’ grasp. The young psychiatrists were not resented by the other staff. The hierarchy of power replicated the hierarchy of knowledge. There was no question—given the biomedical model of illness—that the psychiatrists knew more about the patients’ problems than any other staff members did, particularly if the psychiatrists were doing research. Psychologists did not compete for equal time and authority with them. Nurses presumed that while the residents needed nurturing now, in a few years their knowledge would exceed their own. Secure in that expectation, the residents could tolerate being mentored by people of lesser status. Moreover, just as a patient’s personhood was not integral to his disease, a staff member’s personality was believed not to be intrinsic to the performance of her job. Staff were, of course, grateful for people who were cheerful and effective. But the complicated, messy analysis of what people really felt about one another and why never took place. The kind of people staff members were and the feelings they had were regarded as irrelevant to the business of doing the job. As a result, staff members never “processed” very much about social life on the unit, they never found out how much they disagreed with each other about specific issues, and so they had, relatively speaking, few fights.
+Karl Marx explained that the goal of writing ''Capital'' was “to lay bare the economic law of motion of modern society.” By “laws of motion,” Marx refers to the origins and motivations for change within human society. Historical materialism holds that human society develops based on internal and external relationships within and between aspects of society. Historical materialism is the topic of Part 2 of the textbook from which this entire text has been translated, which we hope to translate in the future.
-The unit modeled itself on other, nonpsychiatric, hospital units, as if the illnesses really were like heart attacks in the brain. We met for rounds in two different teams, twice a week, for two hours each time. There were lithium graphs pinned to the wall and a sleep chart that listed how many hours each patient had slept each night. It was always consulted during these rounds. Each team was led by a senior psychiatrist called an “attending,” who not infrequently wore a medical doctor’s white laboratory coat. For the first hour, the attending doctor, the resident, and assembled nurses, social workers, psychiatric workers, and others (the anthropologist, for instance) sat in a separate locked room to discuss the patients. (Nurses on the other team remained outside to supervise the ward.) The conversation was full of comments about how one patient was suitable for the first break study and why benzodiazepines rather than neuroleptics might be more helpful for a certain condition. “If you want to endear yourself to Dr. Smith [the local psychopharmacology researcher],” the senior psychiatrist would say to the resident, “call him about this patient and put her on his study.” Relatively little time was spent discussing anyone’s personal psychodynamics. The issues were practical: whether the dosage of antipsychotic was high enough, how to deal with the fact that the staff knew that such-and-such a patient was HIV-positive and had been found trying to seduce another patient, who because of doctor-patient confidentiality couldn’t be told of the first patient’s diagnosis but who nevertheless had to be prevented from sleeping with him; how far the social worker had gotten in the discharge planning for a patient who was ready to leave the hospital but clearly could not return home.
+According to the theory of socio-economic forms [which is the basis of historical materialism], the movements and developments of human society are natural-historical processes based on dialectical interactions between forces of production and relations of production; between infrastructure basis [commonly referred to as “base” in English] and superstructure.
-In fact, the whole tenor of the place was briskly practical, as if the staff were all working mothers planning play dates. I would later sit in psychodynamically oriented units and participate in staff meetings where everyone would gather, without an agenda, to “process” the week’s experience for several hours at a time. On the biomedical unit, staff meetings were brisk, matter-of-fact, and agenda-driven. People held them to plan the end-of-year barbecue and to figure out how many nurses and mental health workers would be needed in the coming weeks. The senior psychiatrist never bothered with people’s finer feelings. Once one of the patients decided to explain to the other patients that she liked torturing animals. She told them that she liked to stick pins into rats’ eyes and listen to them squeal, that she would chop them up and drink their squirting blood. She remarked that she drank her own menstrual blood and that she liked to rape herself with carrots and then eat them. She apparently liked to share these things when she saw people sitting around in the common room, preferably at night. When they became hysterical, she would decide to go to bed. Her attending doctor did not try to explore with her what she was trying to communicate with these stories. Nor did he warn her pet-owning neighbors. He walked in to see her during rounds the morning after this was reported, the group of us following behind him, and asked her whether she wanted to spend her entire life behind hospital walls. “If you feel like you want to harm animals and babies and you need some help controlling those thoughts, tell us,” he said. “Otherwise, don’t tell us, because no hospital can legally discharge you if you do.” She stopped making the comments. When the social worker spoke with her mother, it turned out that they were fantasies.
+-----
-A senior psychiatrist once said to me that pain can metabolize three ways: in anger, humor, or wisdom. Few of us have the spiritual depth to be wise, he said, so it is important to us to find humor. This unit was downright funny. The staff were playful, relaxed, and hilarious in rounds. They laughed about the craziness and how utterly, impossibly crazy it was, and they named the craziness with irreverent, colloquial, nonspecific names. In otherwise sober team meetings, a resident might present a newly admitted patient’s symptoms and diagnosis, then lower the notes to say, “Frankly, this person is totally out to lunch.” Or “He’s bonkers. Bouncing off the walls.” Patients were crazy as a loon, nutty as a fruitcake, major-league wacko, out there, in space, really “something else.” A presentation might begin, “Mr. Hill has been traveling in outer space for two days now, and we have failed to establish contact. He is our forty-one-year-old white single male admitted on …”
+==== Annotation 29 ====
-When psychosis is not brutally awful, it ''is'' funny, and sometimes looking for the humor in it makes it more possible to handle the pain of seeing a human being lose his mind. One of the patients on the unit decided that another patient was trying to poison him and gave up eating. The patient he chose as the villain was so depressed that the staff had been worrying about how to get him out of bed, let alone do anything that required as much energy as diabolical crime. Another patient came onto the unit somewhat violent. He had already broken one of his legs. By the end of the first evening, he tried to smash his crutch into a patient (who ducked), broke it against the wall, and then ripped out the public phone box, more commonly known as the patients’ phone. When the doctor tried to talk to him the next morning in rounds about losing control, the patient paused, opened his eyes wide, and asked, “Me?” In practice, the joke could run the other way as well. There was, for example, the very psychotic patient who had been raving about his astrophysics articles. This had been taken as further evidence of his psychosis until a curious resident looked them up in the library and found them. There was the narcissistic patient who spoke grandly about his personal friendship with the director of the hospital and other important people. His resident was touched by what he took to be the needy loneliness of the old man and mentioned it to the director at a social function. “Sam’s here?” the director said. “Why didn’t anyone tell me? I must go see him. He’s been an important friend to the university.”
+The forces of production consist of the combination of means of production and workers within society. Under capitalism, the production force consists of the proletariat (working class) and means of production which are owned by the bourgeoisie (capitalist class).
-The point is that the staff made jokes about the craziness—not about the patient himself, not about the staff, not about prescribing medication, not about doing therapy. Laughter circles around the contradictions in our world.@@@[[#3Theclassicanthropologicald|3]]$$$ Here that contradiction was the commitment to the patient as a rational person with a disease. The patient was, and wasn’t.
+Marx viewed society as composed of an ''economic base'' and a ''social superstructure''. The base of society includes the material relationships between humans and the means of productions and the material processes which humans undertake to survive and transform our environment. The superstructure of society includes all components of society not directly relating to production, such as media institutions, music, and art, as well as other cultural elements like religion, customs, moral standards, and everything else which manifests primarily through conscious activity and social relations.
-Nick, the attending doctor of the “rats and pins,” was smart and quick, a little out of place in these patrician surroundings but rather pleased to be in charge of them. (Some of the staff referred to him as “the cowboy.”) He had entered medicine to be a psychoanalyst, but during internship one of his friends had fallen asleep, driven off the side of the road, and woken up, as a psychiatrist would say, crazy as a bedbug. It had taken antipsychotics and weeks in the hospital to calm him down. The friend had survived (he had eventually become completely normal), but the psychiatrist-to-be’s commitment to psychoanalysis had not. He said that the accident had persuaded him that the brain had more of an impact on who you were and how you got sick than the kinds of complicated unconscious motives that psychoanalysts talked about. I once saw Nick in a therapy session with a patient. They talked briefly about her classes, her flower arranging, her son. She brought in a letter that her mother had written to the last psychiatrist to explain that her daughter’s low self-esteem was not her (the mother’s) fault. “Anyone would be crazy with a mother like that,” she said. These are things that a psychodynamic psychiatrist would talk about. But Nick wasn’t particularly interested in the psychodynamics: what she really felt about her mother, why she felt that way. Nick wanted to figure out how the new medication was affecting her. He wanted to learn, by listening to her and asking her questions, whether she was concentrating better, whether she was feeling more energetic or more depressed, and when, and what kind of energy or anxiety or depression it felt like. So he chatted away amiably about the details of her life while trying to hear the underlying phenomenology. The patient was telling the doctor about her soul’s history, and he was hearing through it the shape and balance of her brain.
+In the preface to ''A Contribution to the Critique of Political Economy'', Marx explained:
-Nick was the senior psychiatrist who led my team. We met on Tuesdays and Fridays, a collection of residents, psychology interns, social workers, and mental health workers who were responsible as a team for about half the patients on the unit. After the first hour of discussion in the team meeting, we would all get up and stroll around after Nick, stopping at every room to visit with each patient we had discussed. (This is the way nonpsychiatric medical rounds are often organized, but not psychodynamic rounds. In psychodynamic rounds, team members often do not actually speak with a patient. If they do, the patient comes to see them in a private room.) Those patients were not allowed to go out of the unit during these rounds. They were made to wait patiently (or not) until the team came to see them, much as they would be forced to wait during medical rounds in a general hospital. When we arrived at a room, Nick (or sometimes the resident, if this was her patient) would enter first, followed by the rest of us. Nick would sit down in a chair facing the patient while the rest of us stood around him as he spoke. He would ask the patient how he was, how he was feeling, and what his plans were. Sometimes this was quite painful to watch. Because manic patients often do not realize, in the grip of their mania, that they are ill, the discussions occasionally became hostile confrontations over the patient’s right to leave and the doctor’s insistence that he stay. When the patient got a little better, the discussion tended to center on the illness as if it were a separate, malfunctioning organ. Then Nick wanted to know how bad the black despair was, whether the patient was hearing voices, was able to sleep, was able to sit through a meeting, and so forth.
+<blockquote>
+In the social production of their life, men enter into definite relations that are indispensable and independent of their will; these relations of production correspond to a definite stage of development of their material forces of production. The sum total of these relations of production constitutes the economic structure of society — the real foundation, on which rises a legal and political superstructure and to which correspond definite forms of social consciousness. The mode of production of material life determines the social, political and intellectual life process in general. It is not the consciousness of men that determines their being, but, on the contrary, their social being that determines their consciousness.
+</blockquote>
-Often, this approach worked well. A patient admitted to the unit after intentionally driving her car into a tree was able to say, on the sixth day, that even though she still felt awful, she had been able to get out of bed and walk about. During the rounds just after admission, she had lain in bed without moving or speaking. By her second rounds (so perhaps the fourth day after admission; her doctor and some other staff would have seen her daily), she was able to talk about the depression as “depression.” Following Nick’s phrasing, she talked about “symptoms” and about her despair as an “it,” about how she was handling “it.” She seemed to conceptualize her troubles as an illness; she knew that the illness made her feel terrible, and she wanted to treat it so that she would no longer feel so awful.
+RELIGION GOVERNMENT EDUCATION
-Other patients, however, were not able to behave as if they grasped the disease model of illness (at least, they were not able to behave as if it applied to them). There was, for instance, the patient whose husband brought her in after an altercation at home. She wasn’t manic; in fact, she seemed quite reasonable, except that she believed that there were laser beams in her house that were poisoning her, and her husband said that when she was at home she would become hysterical about the laser beams and hit him. She denied this, refused the antipsychotic medication, and demanded that she be allowed to leave. She had been hospitalized many times previously for suspected psychosis and violent outbursts, and after a week on the antipsychotics and in the hospital she had always calmed down. She said to Nick that she knew what was best for her and wanted to go home, that she was the person who knew herself best, wasn’t she? Nick answered, “Well, that’s a complicated question.” Then it turned out that when her husband had brought her to the hospital, the physician on call had actually suggested that she might go home. At this she had become more paranoid and delusional; had begun to speak about the laser beams that cut through her house, and had refused to leave. During the entirety of her time in the hospital, in every rounds meeting she followed the team around, explaining how she needed to go home, almost bleating in her efforts to change Nick’s mind after he had negotiated with her a willingness to stay a few more days, refusing adamantly to leave when he seemed to relent. She never spoke as if there were a dysfunction in her body.
+POLITICAL ECONOMY NATURE
-There was the person who seemed totally lucid in rounds but was in the hospital because after two years of psychodynamic therapy she had suddenly told her therapist that she was worried about the green blobs on her therapist’s legs. She also never spoke in terms of an “illness.” Then there was the brilliant young graduate student in physics. He was recovering from his first manic break. His father had been manic-depressive, and the son’s first break had occurred at the same age as his father’s. The son had calmed down after his first few days on an antipsychotic and lithium and then in rounds explained that he no longer wanted to take the medication. He was not going to write his thesis, he said, while taking psychiatric medication. (There is some point to this. People not infrequently report feeling that lithium takes the edge off of their creativity.) Nick patiently explained manic-depressive disorder to him—“Many excellent scientists have been bipolar; it’s nothing to be ashamed of”—and pointed out that if he did not take his medication, he would have another manic episode. The patient explained that he knew his mental state better than those who were treating him. And this is a great ambiguity in psychiatry: Who owns a person’s mental state? Who has the right to know it? Your model of mental illness makes a difference in the way you answer this question.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-4.png|''The base of society includes material-based elements and relations including political economy, means of production, class relations, etc. The superstructure includes human-consciousness-based elements and relations including government, culture, religion, etc.'']]
-For all Nick’s efforts to hear the structure of the disorder through the flow of conversation, a person remains the best reporter on his or her own psychic state. I know whether I am sad, anxious, or happy better than anyone else does. Psychiatrists know this. Yet they know that people can mislead themselves and that they lie. Thus a person may not see himself as unhappy because he thinks he should be happy. It is also true that being wrong, intentionally or not, about my mental state can change that very state, at least sometimes. If I insist to myself that I am happy despite a stock market tumble, that the sky is blue, the flowers are blooming, and it was only money on paper anyway, sometimes I can make myself happier than I was. Sometimes people who come into the hospital depressed decide to leave when they have regained just enough energy to go home to commit suicide, and they know perfectly well that if they tell this to the doctor, he won’t let them go. So they lie and then go home and kill themselves. So how seriously should a psychiatrist take a patient’s words about himself if the patient is the best source on his own mental state and yet the patient can be wrong?
+In other words, Marx argued that superstructure (which includes social consciousness) is shaped by the infrastructural basis, or base, of society. This reflects the more general dialectical relationship between matter and consciousness, in which the material, as the first basis of reality, determines consciousness, while consciousness mutually impacts the material [see ''The Relationship Between Matter and Consciousness'', p. 88]. So, the base of society — being material in nature — ''determines'' the superstructure, while the superstructure ''impacts'' the base. It couldn’t possibly be the other way around, according to the dialectical materialist worldview, because the primary driving forces of conscious activity are rooted in material needs.
-Psychiatry is straightforward when a person is starkly crazy, very psychotic. You know that you cannot trust what he says about himself. A doctor knows he has to be in charge, the way a mother is in charge of her child and makes decisions for him (no ice cream before dinner) that violate his wants and yet are better for him in the long run. It is easy to say that there is an illness affecting that person’s judgment. But if it’s not like that, if a patient is depressed but says she’s fine now and wants to leave, or, as this young man said, he thinks that psychiatric medication slows down his thoughts and he doesn’t want to write his dissertation on lithium, how does a doctor decide who really knows best? Who gives a young psychiatrist the authority to say, “You’re more depressed than you think”? That “you have an illness that impairs your thinking and so I cannot believe what you say”? A more psychodynamic approach handles this major epistemological issue by emphasizing that all mental states, including the psychiatrist’s, are inherently complex, layered, and to some extent unknowable. That, as we shall see, creates its own problems. When a doctor takes that perspective seriously, it becomes much harder for him to believe that he understands a patient. From a biomedical perspective, there is more of a direct contradiction. The new resident on that unit told me that it really bothered her when she had to take control over an adult as if he were a child: “I think if I could just see the person as crazy, that these patients aren’t themselves and you have to deal with them as if they were crazy, it would be much easier,” she said. “But I still see that there is a person there, whose personality is showing through even in his psychosis, and that makes it hard for me to treat him as a child.”
+The theory of socio-economic forms proves that the materialist viewpoint of history is not just a hypothesis, but a scientifically-proven principle.
-On this kind of unit, with this kind of model of illness, the residents wanted to see the patients as reasonable, responsible human beings struggling with physical illness as all who are in the hospital struggle. In general, we believe what people say about their pain in the hospital, and the expectation was that this was also true for these patients. When it was not true, what the patients said became part of their illness, not part of them. When a patient said she wasn’t sick and the resident didn’t believe her, her statement became a symptom. She became an irresponsible, incompetent dependent, who had to have decisions made for her and be managed by someone else’s authority. The person was either a rational person with a sickness or an irrational person whose irrationality ''was'' the sickness. But people aren’t really like that, either crazy or rational. There are genuine uncertainties. Perhaps the physics student was right, that his thesis would be better if he were off lithium. Only he can know if the risk of another manic episode is worth bearing.
+-----
-This is a real dilemma in psychiatry. The patients on this unit could not take care of themselves, so a psychiatrist had to take over. Yet this authority has many risks. Psychiatrists can make mistakes. They can interpret someone as incompetent who might indeed be able to manage without hospital level care. Over the last few decades there has been a shift in psychiatric and legal thinking. It used to be that all that was required to commit a patient was a doctor’s signature. Now there must be the kind of proof that a judge will accept in court, and sometimes patients who need help cannot be forced to get it unless they hurt someone. Yet patients are more protected from psychiatrists’ misjudgments. This kind of dilemma is particularly complex for a unit such as the one described here, both because the disease model has a harder time dealing with ambiguity and because psychosis debilitates a person more profoundly than any other symptom does.
+==== Annotation 30 ====
-This unit’s culture dealt with the ambiguity by making the line between the patient’s person and the patient’s illness as clear as possible. No one spoke (for the most part) as if an illness were connected to what made a person tick, to that person’s unique personhood. No one thought of the nurses and mental health workers as being there to understand the patients. They thought of them as keeping the patients safe. Staff did not talk (for the most part) about the way they identified with patients or the way patients made them feel. They treated privileges not as rewards for good behavior but as practical means of protecting patients while their disease dominated their rational faculties. So, for example, a patient was given smoking privileges not because she felt that she needed that respect or that freedom. Her hopes, fears, and anxieties weren’t really relevant. She was given smoking privileges because the staff thought she could manage outside the unit without being uncontrollably crazy in the way that had gotten her admitted in the first place but wanted to test this out under reasonably well supervised conditions—“although no one explained that to me logically,” the resident on the unit said to me, “and it was strange to take away these things that other people took for granted.” (When patients go outdoors to smoke—and it is always outdoors, even in a New England winter—staff members go with them to chat, watch, and keep control.) In this culture, interactions with patients were discussions around organic illness only, so that the understanding of patients’ intentions was never muddied by dynamic complexity. Even when meeting a patient for the first time, the senior psychiatrist rarely spoke about the subtleties of personal history and desire. Instead, he focused quite explicitly on drugs and mood and attempted as far as possible to understand the patient’s response as a rational self-report. The doctor would say, “If there was anything you could change about your mood now, what would it be? Are you frightened? Anxious?” as if he were palpating the abdomen, as if he could palpate the mind, even though he knew he could not.
+As Lenin explains in ''What the “Friends of the People” Are and How They Fight the Social-Democrats:''
-Meanwhile, the doctors managed the contradiction between patient-as-child and patient-as-adult by defining those states as different aspects of a patient. They then acted out those differences in their relationships with patients. Doctor-patient relationships were negotiations about how to categorize patients’ intentions—which parts were part of the disease and which were part of the patient’s rational, reasonable personhood. For example, I once watched a well-heeled but psychotic young man try to persuade the attending doctor to let him leave the unit. He said he was fine. He explained that he was determined to go to Chicago Law School (to which he’d been admitted) that autumn, to spend the upcoming July weekend at the Hamptons, and to buy some khakis for the weekend. He said that all this was not going to be a problem for him and that if he was going to law school in a month he’d better get out into the real world now. The doctor did not interpret what the patient said, and he did not allow the patient to develop and explain his wishes. He said that the patient needed more time to recover. When the patient said, tell me what specifically you would have me do before you let me go, the doctor behaved as if there were no point explaining. He told the patient that he would have to trust the doctor’s judgment and strode off down the hall. There, the desire to leave was seen as a symptom, part of the illness. The patient’s illness left him still in the dependent position of a child.
+<blockquote>
+Now — since the appearance of Capital — the materialist conception of history is no longer a hypothesis, but a scientifically proven proposition. And until we get some other attempt to give a scientific explanation of the functioning and development of some formation of society — formation of society, mind you, and not the way of life of some country or people, or even class, etc. — another attempt just as capable of introducing order into the “pertinent facts” as materialism is, that is just as capable of presenting a living picture of a definite formation, while giving it a strictly scientific explanation -until then the materialist conception of history will be a synonym for social science. Materialism is not ‘primarily a scientific conception of history’... but the only scientific conception of it.
-When that young man could say that he had been ill and begin to discuss the problem of being ill, his intentions and his reports on his state of mind began to be treated like responsible, reasonable assertions. That part of him moved into the adult category. He became a person with an illness, not an illness in a body. The unfortunate but accurate implication here is that if you wanted to leave the hospital, you were still sick, but if you agreed to stay, you were treated as if you were getting well. This is not an unreasonable inference, because hospital stays are now so very short that if the police have brought you into a psychiatric emergency room and two days later you think you are not sick, chances are that your denial ''is'' part of the illness. Still, the presumption can make an observer uneasy. “Do you realize that you have been ill?” Nick asked a patient (a biochemistry professor) on the fifth day of her admission. “Don’t be an idiot!” she snapped back. “Do you take me for a fool? You’ve been forcing my illness down my throat so much it would be impossible for me not to notice.” Three days earlier when he had asked her this, she had looked at him as though he were insane. The turning point in a patient’s stay (as perceived by the unit) was when she understood herself to be and have been very sick. If a patient could realistically discuss her plans for discharge, the doctor would negotiate which part of those plans were appropriate: whether it was reasonable to consider going back to her job, her apartment, her life. Patients who wanted to leave and were not “committable” (they were not suicidal, not homicidal, they knew who and where they were) generally had to file notice three days before they were allowed to walk free. During that time, the doctor would repeat in as many ways as he knew how that the staff thought that she was too sick to leave and that the desire to leave was part of her illness. Despite my uneasiness at watching the way the desire to leave became construed as a symptom of the illness, when I was watching these exchanges, I rarely felt that a patient was unjustly confined. I was far more worried that if the patient left, he would start screaming on the plane to New York and lose his job; that she would tear up her apartment in a paranoid fit; that he would go to a conference and make an utter, irredeemable fool of himself before his professional peers and seniors.
+-----
-Finally, the staff on this unit, as on any psychiatric unit, worried that psychiatric illness was misunderstood by the wider world. But they had a very different take on what had to be communicated to the public or (to be more specific) what I should communicate to what they took to be a psychiatrically naive world. The more psychodynamic psychiatrists tended to assume that other people thought that psychiatric patients were strange and different. They were likely to tell me to tell people how similar we all were. At the end of my visit to a psychoanalytically oriented hospital, a senior clinician told me that when he had been a resident, he had rotated onto a unit and discovered that one of the patients was a man whom he had known in college. One day the man had reached out, grabbed his cigar (psychiatrists used to smoke cigars more frequently), thrown it down, and ground it into the floor with his heel. “This taught me,” the psychodynamic director said, “that psychiatric illness is merely a powerful magnification of the emotional currents in all our lives.”
+''Capital'' is Marx’s main work which presents Marxism as a social science by illuminating the inevitable processes of birth, development, and decay of capitalism; the replacement of capitalism with socialism; and the historical mission of the working class — the social force that can implement this replacement. Marx’s materialist conception of history and proletarian revolution continued to be developed in ''Critique of Gotha Programme'' (Marx, 1875). This book discusses the dictatorship of the proletariat, the transitional period from capitalism to socialism, and phases of the communism building process, and several other premises. Together, these premises formed the scientific basis for Marx’s theoretical guidance for the future revolutionary activity of the proletariat.
+</blockquote>
-By contrast, on this biomedical unit the staff were more likely to assume that other people thought that the patients are like all of us and that the problem was that the public did not properly understand how different they were, that they were far more sick than most people imagined, and that this sickness was a terrible, terrible accident in their lives. Once a nurse on the unit asked me what I was going to do with all the data I was gathering. I replied that I was going to write a book, and what would she write if she were I? “The public,” she said, “does not understand these illnesses. Even my husband has no idea of what I’m working with. No one conceives of the severity. You ought to write about that.”
-=== {{anchor|APSYCHODYNAMICHOSPITAL}} A PSYCHODYNAMIC HOSPITAL ===
+-----
-From a psychodynamic perspective, a patient is ill because he has learned to interpret and respond to other people in maladaptive ways. (At least, that is part of his problem. These days, most psychodynamically oriented psychiatrists acknowledge that there is also a biological vulnerability.) One helps him by helping him to be aware of those unconscious patterns. But because all people, including psychoanalytically trained staff, are limited by their own unconscious, no one person can be an authority on what is going on with any other. No one can state definitively what is a mental illness and what is not. That is the problem. You need to identify what is mal-adaptive in the patient’s unconscious to help the patient cope, but you cannot know clearly whether you are seeing the patient’s craziness or whether you are looking at the patient through your own craziness. To understand patients, the staff on a psychodynamic unit talk about how they perceive the patients, how they perceive one another, and how they perceive one another perceiving the patients far more openly and exhaustively than in any other setting I have ever seen. But because none of these comments about the people one works with intimately are objective and most are personal, the emotional temperature of such a community can run rather high. Most psychoanalytic encounters take place behind closed doors, within confidentiality, with a person the patient will never see outside the session. Once the psychoanalytic context broadens to include the office, the cafeteria, and the assembly hall, a certain kind of public culture emerges to keep the potential chaos in check.
+==== Annotation 31 ====
-The Norton Inn is a small psychodynamic hospital in western Virginia, widely thought to be among the best of its kind and certainly among the last, a determined tortoise in a world of eager hares. It has the feel of something that belonged to a different generation but has not outlived its usefulness, like an old and beloved desk. When I arrived for two weeks in 1995, there were somewhat more than forty patients. They stayed in a large white colonial building called the “Inn,” or in smaller, porch-wrapped clapboard houses within easy walking distance. Next to the Inn there was another elegant building, which housed the staff offices and the conference rooms. This twin building used to be called the Medical Office Building, but after the new director arrived to help the hospital face the changing health care world, he added the phrase “and Administration” to the small green sign on the front lawn. He felt that this was only fair. That year, for the first time in many years, the hospital settled its accounts in the black.
+When Marx refers to a “dictatorship of the proletariat,” he does ''not'' mean “dictatorship” to mean “totalitarian” or “authoritarian.” Rather, here “dictatorship” simply refers to a situation in which political power is held by the working class (which constitutes the vast majority of society). “Dictatorship,” here, refers to full control of the means of production and government. This stands in contrast to capitalism, which is a dictatorship of the bourgeoisie, in which capitalists (a small minority of society) have full control of the means of production and government.
-This was an open hospital. It is harder now than it would have been twenty years ago to convey the sense of what this means. Twenty years ago, there were many open units. Now almost all psychiatric inpatient settings are locked. Patients are escorted onto psychiatric units, the doors are locked behind them, and over their stay privileges are doled out to them that hinge on the locked door: going out to smoke, going to the cafeteria to eat, and so forth.
+==== c. The Defending and Developing Stage of Marxism ====
-In an open hospital, there are no privileges, no seclusion rooms, no security guards to wrestle an out-of-control patient to the ground and place him in restraints. In an open hospital, patients come and go as they please. In the grand hallway of the old colonial Inn, the door swung free. Patients went out for walks, to work out at the local gym, to see their therapist, to see friends. Occasionally, they went out into the woods to hang themselves. That is the danger of an open hospital, and one reason that more hospital units are locked these days than in earlier decades is to deflect insurance companies’ argument that if the patient isn’t sick enough to need a locked door, he isn’t sick enough to need a psychiatric admission. This hospital, however, argued that the locked door was infantilizing, demeaning, and ultimately counterproductive to the psychiatric treatment, because the ultimate goal was to enable people to feel responsible for their lives. It is hard, one staff member remarked to me, to feel in charge of yourself in prison. Most of the patients in the hospital had been admitted first onto a locked psychiatric unit somewhere else, and most had found the experience humiliating. Nevertheless, the admitting physician at this hospital had to explain to a potential patient (and, often, the family) before admission that he or she had to take responsibility for staying alive and would be admitted only if he or she took that responsibility, despite the fact that many patients are suicidal when admitted. Suicide threats are only occasionally theatrical. Fifteen percent of depressed patients eventually kill themselves. The day I left, the hospital admitted a woman with a bright pink scar on her throat that ran from ear to chin: she had sliced into her carotid artery because she had had thoughts, she said, of shooting her children.
+''- Historical Background and the Need for Defending and Developing Marxism''
-Some patients had been at the hospital for years. Many of the staff looked back nostalgically to the times when all patients were expected to stay at least a year. When I was there, the average length of treatment was about eight months, although usually that figure included many months when patients would stay near the hospital for partial care but would not receive “hospital-level” care, in which all needs are provided for and nursing care is always available. The hospital had developed a variety of less expensive “step-down” residential and outpatient programs, in which patients took more or less responsibility for their food, housing, and selfcare but could still participate in most of the hospital activities, such as community meetings and other group meetings. Insurance would invariably pay for some of this, and the hospital was, compared to others, cheaper both for full care and for step-down care. Once, the director said, an insurance company had sent the hospital a letter of thanks for the (relatively) low cost of its treatment of a patient who had bounced from inpatient unit to inpatient unit in the years previous to her Norton admission and afterward had not needed readmission. Her year at Norton had cost significantly less than her previous year of revolving-door hospitalizations. Most patients at the Norton Inn had “failed” treatment elsewhere, by which is meant that multiple hospitalizations, medications, and psychiatrists hadn’t really helped. Some of the insurance companies would pay for a longer-than-average stay for these patients out of desperation, in the hope that one long stay would “stabilize” the patient and enable him to function as an outpatient. (A five-day inpatient admission can cost $5,000. Multiple short admissions become extremely costly.) But many of the patients and their families would pay directly out of their own pocket bills that were more than $20,000 for the first month of hospitalization and evaluation, then sank as low as $9,000 per month for residential care, and $2,700 for after care, but not lower.
+In the late 19<sup>th</sup> century and early 20<sup>th</sup> century, capitalism developed into a new stage, called imperialism. The dominant and exploitative nature of capitalism became increasingly obvious. Contradictions in capitalist societies became increasingly serious — especially the class struggles between the proletariat and capitalists. In many colonised countries, the resistance against imperialism created a unity between national liberation and proletarian revolution, uniting people in colonised countries with the working class in colonial countries. The core of such revolutionary struggles at this time was in Russia. The Russian proletariat and working class under the leadership of the Bolshevik Party became the leader of the whole international revolutionary movement.
-These costs, the open-door policy, and the reputation the place had for tertiary care meant that the patients were mostly upper middle class, very smart, and young, often under thirty. They were (for example) Yale students and Columbia medical residents who had arrived at school, done well, then fallen apart. Most of them—roughly 70 percent—were women. Why there were so many women no one seemed to know, although it is a psychiatric cliché that disturbed men tend to act out their aggression on others and end up in jail, whereas disturbed women tend to act out on themselves—slash their wrists, take overdoses—and end up hospitalized. Most of the patients were depressed or bipolar (or had some kind of mood disorder) and also had personality disorders. A few were psychologically minded patients with schizophrenia. That the patients also had personality disorders is not surprising. An uncomplicated, “easy” depression or manic state can be treated well in a short admission that “brings down” the mania or “relieves” the depressive suicidality with medication. This is not the case if the patient also has a personality disorder, which a course of antidepressants will barely impact. Those were the patients who ended up in this hospital. Mostly, their personality disorder was of the type called “borderline”: as before, women with a history of intense but unstable relationships, deep identity confusion, and anger. Such patients wind up in the hospital because they can be astonishingly destructive to themselves and others.
+During this time, both capitalist industry and natural sciences developed rapidly. Some natural scientists, especially physicists, lacked a grounding in materialist philosophical methodology and therefore fell into a viewpoint crisis. Idealist philosophers used this crisis to directly influence the perspective and activities of many revolutionary movements.
-Tracy, for example, was a beautiful, blond, twenty-eight-year-old Southern belle with high cheekbones, a body conditioned by long winters on the ski slopes, and a taut, forlorn stillness. (To protect patient confidentiality, “Tracy” is a composite of several different patients.) She had ostensibly arrived in the hospital because, she said, her relationship with her mother had become too difficult for her to live at home. Her chart told a more dramatic story of violence, alcohol, sexual abuse, and suicide attempts. In her first interview with her treatment team, she announced that her mother had given her free access to her bank account. She needed to use the money wisely, she said, to make it last as long as possible.
+-----
-Within a few days Tracy had slept with one of the few male patients. Sex between patients was actively discouraged. Officially this was because it was supposed to create dyads that pulled against the cohesive quality of the group. It was also, no doubt, because psychiatric patients can be stunningly nonchalant about their sexual practices—in these times, unprotected sex can be a form of passive suicidality, and in this population it not uncommonly is. In any event, the patients held a meeting to talk about the divisiveness of sexual dyads (the sex had not been particularly secretive) and the need for commitment to the community. Tracy essentially shrugged and remarked that it hadn’t been a big deal for her, that sex was sex, and that she had slept with the man only because she had been horny. Two days later she saw him sitting on a sofa next to a newly admitted female patient. To show her displeasure, Tracy picked up a large bowl on the coffee table and hurled it through the closed glass window. She was angry.
+==== Annotation 32 ====
-As the staff understood it, Tracy’s treatment rested on a tripod of psychosocial interventions: intensive psychodynamic psychotherapy, the therapeutic community program, and the “interpretation-free” zone of the art studio. Psychopharmacology was also important, and in keeping with standard hospital practice, most patients were medicated. Tracy was placed on Paxil for her depressive symptoms. She was assigned a therapist, whom she saw four times a week. At Norton, all patients saw their therapist four times a week. This therapy was insight-oriented psychotherapy, psychoanalytic therapy, the kind of therapy in which (as the more orthodox analysts conceive of it) therapists do not reassure, console, or soothe. I sat in the corner one afternoon as Tracy’s therapist was supervised on her sessions by a senior staff member. The young therapist, reading from notes written after the sessions, reported that Tracy had said, “I’ve got to get rid of this stuff with my mother.” The supervisor interrupted, “That’s great, she’s in the language.” The therapist continued, reading what she had said to Tracy: “I think that this is a core issue for you, that in your relationship with your mother you were never sure of what other people felt, you felt teased and criticized.” The supervisor murmured in approval, “You’ve joined her.” The therapist continued reading: soon thereafter, Tracy had said, “I begged you for something for sleep, and you never gave it to me.” The young therapist looked up from her notes sheepishly and told the supervisor that she had responded by explaining to Tracy that she had tried to help but Tracy had refused her help at the time. Now the supervisor said, “Look at the process. You say, get into the transference, and she says, ‘You don’t give me what I need.’ That’s what you want. It’s great; and then you panicked. Give with the one hand and take with the other, that’s what my teacher said. Keep backing up, and she’ll lay it all out.”
+==== Imperialism ====
-There was a sense at the Norton Inn that patient and therapist were locked in mortal combat. “You couldn’t engage with her,” a young therapist said about one of his patients, proud that the patient had improved under his care, “unless you could accept that she thought that there would be death, and that it would be either yours or hers.” Indeed many of the patients—witness Tracy—were angry, at everyone. The therapeutic focus on aggression was understood to be appropriate to these patients; there was a sense that patients who “failed” at other hospitals and were sent to Norton were likely to be the kind of patients whose anger made them hard to handle. Some of the clinicians drew from a theoretical perspective often attributed to Melanie Klein and Otto Kernberg, analysts whose work teaches that hostility—not loneliness, not love—is a driving emotion behind human experience, that idealization can be a mask for persecutory anger and affection a subterfuge for sadomasochism.
+Lenin defined imperialism as “the monopoly stage of capitalism,” listing its essential characteristics as “finance capital (serving) a few very big monopolist banks, merged with the capital of the monopolist associations of industrialists” and “a colonial policy of monopolist possession of the territory of the world, which has been completely divided up.”
-“What’s missed in the field’s dominant model of the therapeutic interaction is Klein’s perspective,” one of the senior clinicians said. “The more the patient sees you as a good parent, the more it leads to envy, malice, and a desire to kill.” A patient is perceived to be using the therapist to advance her own pathological goals of selfhood: to defend against connection, to induce guilt, to punish herself and others. The only hope for therapeutic success is for a therapist to confront a patient’s need to bend the world to serve her needs by helping her to see the awesome destructiveness of her own rage. This is not comfortable for young therapists. One of the young fellows had grown up in a religious background that directed her to look for the good in human nature. When she had chosen psychiatry, she had seen it as one way out of a world that covered over the unpleasantness of human life. She told me that when she had been sixteen, the truck carrying her horse had jackknifed and crashed. She had sat by the horse’s body, waiting for the police and ambulance, asking God how he could allow such unfairness and pain. Norton pushed her to the edge of her ability to tolerate the contradiction she lived within. “It is very disillusioning,” she said, “to think that I have to believe that all of these good people have murderers inside them. You would think that it would be reassuring to discover that we are all alike, but it’s not. They teach me,” she continued, “that for the patients I am a coatrack to hang coats on.”
+==== Subjective and Empiricist Idealism ====
-If therapy is the naked encounter of two souls, these souls are imagined as wrestling in a mud pit. A case report about a patient who was being discharged described her as having entered with a “black, despairing and fragmented psychic state.” In therapy, “she has easily, repeatedly and ragefully experienced empathic breaks.” Her previous therapist had said that “the metaphor of a hurricane was appropriate in describing Ms. Deever’s emotional struggle. He states that, like Ms. Deever, in a hurricane there is a hole in the center which is a vacuum and the hurricane swirls around it, trying to fill that hole.” She had been hospitalized at Norton for three years. Her most recent therapist—she had run through a number; a senior clinician said that this patient was more difficult to work with than any other he had seen—presented her case to the staff. He was a laconic, low-key man, once an English major, who said that he had not understood racism until he had worked with this child of racial intermarriage and seen her rage and guilt. He spoke about her for more than an hour, without notes. He talked about the way she had told him how pathetic he was, how little he, an ambitious Jewish Long Islander, knew about the world. It was clear that she had made him feel small. He said that she had gone for his defenses, the ways he hid to protect himself against a patient’s rage. He frequently said, when he was reporting such an attack, that she was right. When he finished speaking, he had tears in his eyes. “The patient has made him honest,” a senior clinician said with respect.
+In the late 19<sup>th</sup> century, natural scientists were exploring various philosophical bases for scientific inquiry. One Austrian physicist, Ernst Mach, attempted to build a philosophy of natural science based on the works of German-Swiss philosopher Richard Avenarius known as “Empirio-Criticism.” Empirio-Criticism, which also came to be known as Machism, has many parallels with the philosophy of George Berkeley. Berkeley (1685 — 1753) was an Anglo-Irish philosopher whose main philosophical achievement was the formulation of a doctrine which he called “immaterialism,” and which later came to be known as “Subjective Idealism.” This doctrine was summed up by Berkeley’s maxim: “''Esse est percipi''” — “To be is to be perceived.” Subjective Idealism holds that individuals can only directly perceive and know about physical objects through direct sense experience. Therefore, individuals are unable to obtain any real knowledge about abstract concepts such as “matter”.
-One of the patient’s problems, as her therapist saw it, was that she failed to perceive herself as having a psychodynamic problem. She needed to be persuaded of her responsibility for her experience. “This work is difficult,” a senior clinician said, “because analytic work is about responsibility, taking responsibility. There’s a fine line that separates responsibility from guilt, and this patient has a huge amount of guilt.” The case report said, “Over the course of the meetings with me over the months, Ms. Deever has demonstrated an increased capacity to experience her symptoms as a result of psychological stressors rather than biochemical imbalances.” Patients at the Norton Inn learned to see problems that seemed to be uncontroversially biological in psychodynamic terms. A bipolar woman told me that privately, she thought her illness had something to do with the brain but that a person like her needed to understand it as dynamic. One of the patients told me that his psychosis was a defense against his angry feelings, which had something to do with his family’s lack of boundaries (in other words, he had become psychotic because he couldn’t emotionally handle his family). The patient of the case presentation could not make this shift to psychodynamic thinking, and this was seen as a problem for her. She had a dream about hummingbirds, which she interpreted as her GABA receptors crying out for Ativan [a Valium-like tranquilizer]. “Actually,” her therapist murmured, “I thought it was about separation anxiety.”
+The philosophy of Empirio-Criticism, which was developed by Avenarius and Mach, also holds that the only reliable human knowledge we can hold comes from our sensations and experiences. Mach argued that the only source of knowledge is sense data and “experience,” but that we can’t develop any actual knowledge of the actual external world. In other words, Mach’s conception of empirio-criticism holds all knowledge as essentially subjective in nature, and limited to (and by) human sense experience. Mach’s development of Empirio-Criticism (which can also be referred to as ''empirical idealism'' or ''Machism'')'''' was therefore a continuation of Berkeley’s subjective idealism. Both Berkeley’s Immaterialism and Empirio-Criticism are considered to be ''subjective idealism'' because these philosophies deny that the external world exists — or otherwise assert that it is unknowable — and, as such, hold that all knowledge stems from experiences which are essentially ''subjective'' in nature.
-The second leg of the psychosocial treatment tripod is the psychotherapeutic community. In this “therapeutic community,” the patients, with the help of some staff, essentially manage the social and some of the administrative life of the patient group. The large community meeting was held four times a week for fifty minutes and included everyone who was willing to come; at the largest ones, it seemed that most of the people in the patients’ building (patients, nurses, and psychiatric workers) and some of the therapy staff and social workers were there. There might be thirty or more people in the room. The agenda (reports from community groups, for example, and reviews of people’s difficulties and relationships to staff) was just a mechanism to generate discussion. There was a sense that the group should meet, that someone would speak about something that had been bothering him, and that as other people began to contribute to the discussion, everyone present would learn what “the issues” were. Staff assumed that this public airing would help people learn to handle those issues. The goal here was to give patients another mirror in which to see how they came across to other people and to give them a sense of being responsible members of the group. Much about these meetings reminded me of a small boarding school.
+Mach argued that reality can only be defined by our sensual experiences of reality, and that we can never concretely know anything about the objective external world due to the limitations of sense experience. This stands in direct contradiction to dialectical materialism, which holds that we can develop accurate knowledge of the material world through observation and practice. Whereas Berkeley developed subjective idealist theological arguments to defend the Christian faith, Mach employed subjective idealism for purely secular purposes as a basis for scientific inquiry.
-There were also smaller groups. There was an activities group, which controlled a significant annual budget (more than $10,000 per year) and a task group, which dealt with social problems in the community. If a patient kicked in a plate-glass window, he or she was “referred” to the task group, and roughly eight patients and three staff members discussed with the patient the community’s perspective on his or her behavior and its impact on the group. There were groups for each house outside the main hospital, as well as a women’s group, a men’s group, an eating disorders group, a substance abuse group, and a relationships group. Patients were elected to major positions in these groups and through their election acquired certain responsibilities, such as chairing meetings, running discussions, and, in the case of the activities group, allocating money. One patient who left the hospital and subsequently prospered in business said that her experience of being community chairperson and its associated responsibilities had been the single most important preparation for running her business.
+''Note: all quotations below come from Lenin’s book:'' Materialism and Empirio-Criticism''.''
-Emotions could run high. I attended one smaller meeting where the discussion turned to the larger meeting, where a patient who hadn’t been present had been criticized. She was, however, now sitting in the smaller meeting. People began to use convoluted sentences to explain how distressed they had been that someone had been criticized in her absence without telling the victim who it had been. She sat knitting obliviously until one of the patients said, “Oh, hang it, Kate, you’re the one they’re talking about. They think that you’re a little uptight.” This was, of course, an understatement. Kate was one of the most anxious people I have met, a tense sparrow with a drawn, well-bred face. “Well,” she said, “you’re just annoyed at me because I’m more competent than any of you are.” The sympathy for her evaporated at once, and various people explained crisply just how uptight, defensive, and pretentious she was: “I mean, the other day you told me you were writing the most amazing novel, and finally you showed it to me. All you had was a page, and that page stinks.” For the next few days, Kate drooped like a withered balloon. She would come up to me and say plaintively, “But it was an accident, really. You must know that. I really didn’t mean it. Really.”
+Vladimir Lenin strongly opposed Empirio-Criticism and, by extension, Machism, which was becoming popular among communist revolutionists in the late 19<sup>th</sup> century, because it pushed forward idealist principles which directly opposed the core tenets of dialectical materialism.
-“Eighty to ninety percent of behavior is a function of expectation,” a senior clinician told me. “If you make it clear to people that they have the capacity to engage in the community process and that their treatment is their responsibility, they will respond. The culture must give them responsibility.” The counterbalance to the stress of public unveiling is supposed to be responsibility. You are supposed to learn, through such interactions, how to be responsible for your feelings and their impact on others.
+Lenin believed that revolutionaries should be guided not by idealism, but by dialectical materialism. He believed that Empirio-Criticism and Machism consisted of mysticism which would mislead political revolutionaries.
-In general, these meetings were remarkable for their tone. Discussions were usually straightforward, calm, and inquiring. They were often psychologically astute. People often took responsibility for something that had bothered others: unwashed coffee cups, a monopolized phone. The content of the discussion tended to circle around an individual and his or her role: as a member of a community, as a member of a meeting, as a group leader, and so forth, with a kind of insistent focus on the expectations of the group. (“Why do you feel the need to use the phone in that room, where we can all hear you? How do you conceive of your role here as a patient, and where do the rest of us fit in?”) They called this “examined living”: all behaviors were up for discussion.
+Lenin outlined Machian arguments against materialism:
-In this spirit, once a month there was an all-hospital meeting of patients, clinicians, nurses, even the cook. It lasted about an hour. As in many meetings, technically there was no agenda, but there was often a sense of what “needed” to be discussed. When I was there, the issue was confidentiality. A patient in the hospital had thrown a glass of water at another patient, and there had been a great deal of communal distress about why and whether it might happen again, and so forth. The water throwing had been a major discussion point for the community meeting on more than one occasion. In a therapy session, the water thrower told her therapist that it had been only a joke. This was not something she mentioned to anyone else. Afterward, a social worker (who was not her therapist) came to the community meeting and when the water-throwing incident was raised again, the social worker pointed out that it had been meant as a joke. She had intended to calm the patients down. Instead, when the patients talked to the water thrower, they became very distressed. They saw the social worker’s remark as a violation of patient-therapist privilege. They assumed that what they told their therapists was confidential. Yet here was clear evidence that their sessions could be discussed in meetings in which they were not present and with people they had never meant to hear them. They wanted what they said in therapy to stay behind closed doors.
+<blockquote>
+The materialists, we are told, recognise something unthinkable and unknowable — ’things-in-themselves’ — matter ‘outside of experience’ and outside of our knowledge [see: Annotation 72, p. 68]. They lapse into genuine mysticism by admitting the existence of something beyond, something transcending the bounds of ‘experience’... When they say that matter, by acting upon our sense-organs, produces sensations, the materialists take as their basis the ‘unknown,’ nothingness; for do they not themselves declare our sensations to be the only source of knowledge?
+</blockquote>
-So in the meeting, once the sixty or so people had gathered in the conference room, a patient raised the point with the director of the hospital. Several patients spoke; some staff spoke; the discussion occupied most of the allotted time. “We don’t know the truth of what happened,” the director said. “There may be many truths. In this case there seems to have been a boundary violation. But we must recognize that therapists must talk to other staff members and that they try to be thoughtful about issues of confidentiality.” The hospital discussion didn’t set any new rules about what was sacred to therapy and what not, but it did point out that there were inherent awkwardnesses in the combination of therapy and communal life. “It’s hard to get hold of the ethic of examined living simply by making rules,” the director said. I was sitting in back with some of the patients. The discussion seemed to resolve the tension.
+Lenin argued that this new form of Machist subjective idealism was, in fact, simply a rehashing of “old errors of idealism,” disguised and dressed up with new terminology. As such, Lenin simply reiterated the longstanding, bedrock dialectical materialist arguments against idealism [see Annotation 10, p. 10]. He was especially upset that contemporary Marxists of his era were being swayed by Machist Empirio-Criticism because he found it to be in direct conflict with dialectical materialism, writing: “(These) would-be Marxists… try in every way to assure their readers that Machism is compatible with the historical materialism of Marx and Engels.”
-The goal of this community structure, as staff conceived of it, was to provide what the analyst Donald Winnicott called a “holding environment”: a place where people could act out their feelings without retaliation or withdrawal by others. Within the resilience of a good psychotherapeutic community, staff members argued, a patient should be able to play out the developing parts of his or her personality, see how people reacted to them, and learn from the reaction without actually risking anything in the real world—a job, a partner—in the process. I was impressed by how well it seemed to work. That is, I was impressed by the effectiveness with which patients could define their roles as members of the community to one another and to new patients, who entered the hospital irrational and deeply disturbed. There was a kind of insistence on maintaining the limits of acceptable behavior that seemed as if it might be comforting if your world were falling apart. But it is a strange society, in which the unconscious intentions of all its members are the focus of its intellectual and social life. “The issue is,” a patient said in community meeting, “what is the meaning of these unwashed cups? What do we want to say when we leave our coffee cups on the table?”
+Lenin goes on to describe the work of philosophers such as Franz Blei, who critiqued Marxism with Machist arguments, as “quasi-scientific tomfoolery decked out in the terminology of Avenarius.” He saw Empirio-Criticism as completely incompatible with communist revolution, since idealism had historically been used by the ruling class to deceive and control the lower classes. In particular, he believed that Machist idealism was being used by the capitalist class to preach bourgeois economics, writing that “the professors of economics are nothing but learned salesmen of the capitalist class.”
-Tracy told me that before she had been referred to the task group, it had never occurred to her that her actions had an impact on people. She had felt voiceless, as many psychiatric patients do, inadequate and without self. The community, however, was clear that her voice was strong. They had noticed the broken plate-glass window. However, it was not until the incident with Stoddard that she heard them tell her how powerful she was. Stoddard was a tall, round man about Tracy’s age, with intellectual pretensions and a scraggly beard. He announced one evening, in one of the smaller community meetings, that he would never sleep with a slut like Tracy. Few people in the room seemed to believe this, but some hours later, when news of the comment got back to Tracy, it did not occur to her to chuckle. She called Stoddard, cursed him, and declared her intention of coming over to see him in person. Stoddard then promptly called the town police, who were there to greet her when she arrived. (He was a citizen of the town. He could call the police.) Tracy was profoundly humiliated (this probably was what Stoddard had intended). She ran out of the building into the woods, pulled out a razor, and made twenty parallel cuts up the side of her arms and in her cheeks. She returned to the building dripping blood. By then the police had gone, and the nurses patched her up.
+Lenin was deeply concerned that prominent Russian socialist philosophers were adopting Machist ideas and claiming them to be compatible with Marxism, writing:
-Over the next two days, I saw Tracy in various group meetings. I have never been as viscerally aware of someone’s anger. Tracy sat in the meetings quite silent, pulsing with rage. I think she was on the cliff edge of control. I know that I was seriously worried, for the first time in a psychiatric setting, about where I sat in the room lest she should suddenly decide to leave and kick her way out. Patient after patient said, “You scare me; use words instead of razors.” She said only, “Stoddard is an asshole. If he says one more thing about this, I won’t be responsible for what happens.” I had not realized until those meetings that the members understood themselves to be involved with keeping Tracy safe in the community and keeping the community safe with her, and how much senior patients saw themselves as coaching patients who had not yet learned to manage.
+<blockquote>
+The task of Marxists in both cases is to be able to master and adapt the achievements of these ‘salesmen’... and to be able to lop off their reactionary tendency, to pursue your own line and to combat the whole alignment of forces and classes hostile to us. And this is just what our Machians were unable to do, they slavishly follow the lead of the reactionary professorial philosophy.
+</blockquote>
-The third leg of the tripod was an “interpretation-free zone”—the studio, where patients painted, worked in clay, and did other crafts. “These creative activities,” a history of Norton recounts, “aimed to uncover, explore, preserve and enlarge those areas of activity which were relatively free of conflict for each patient.” Intensive psychotherapy is said to be “regressive” for patients, to throw them back into a more infantile, more emotionally overwhelming experience of the world. Some psychiatrists argue against long, psychodynamically oriented hospital admissions precisely because, they say, such intensive therapy encourages already shaky people to fall apart, not to cope. That was the point of arguing, back in the sixties, that only people who were actually pretty healthy could tolerate the strains of psychoanalysis: the intense emotions that helped neurotics to see themselves more clearly would throw the seriously ill into psychosis. Norton argued that the regressive pull of intensive psychotherapy was counterbalanced by the progressive demands of the therapeutic community and the art. Patients in therapy were ''supposed'' to fall apart. Then they could put themselves together in healthier ways by using the art studio and the therapeutic community to bolster their creativity and personal authority. In 1994, artwork was sold in a crafts store for summer vacationers; the annual play auditioned both townspeople and patients. Over the course of her stay, Tracy became a weaver. She would bend over the angled loom, open like a mechanical butterfly, and concentrate on threading and then passing the shuttles through to create her pattern. Her blue-and-purple chenille scarves sold easily in the crafts store, even for extraordinary prices. She began to feel like a craftswoman.
+Lenin further explains how Empirio-Criticism serves the interests of the capitalist class:
-The goals at Norton are very high: not simply to keep a patient safe until he can survive outside but to come as close as possible to curing him, to restructuring a self-destructive personality. “Psychiatric units these days do good work,” one of the most respected (non-Norton) senior administrators in psychiatry told me. “They do good medicine. But if my daughter were ill, I’d send her to Norton. At Norton they adopt their patients and keep them until they get better.” If the biomedical world takes responsibility for a patient’s body, the psychodynamic one takes responsibility for a patient’s soul and for teaching that person how to take responsibility for himself. That is a more taxing role in a person’s life. It is much harder on therapists, who become, as it were, surrogate parents for these bright, promising, and profoundly destructive patients.
+<blockquote>
+The empirio-criticists as a whole... claim to be non-partisan both in philosophy and in social science. They are neither for socialism nor for liberalism. They make no differentiation between the fundamental and irreconcilable trends of materialism and idealism in philosophy, but endeavor to rise above them. We have traced this tendency of Machism through a long series of problems of epistemology, and we ought not to be surprised when we encounter it in sociology.
+</blockquote>
-Therapy is hard on therapists. It is harder the more they identify with their patients, and it is harder the more they feel attacked by patients or the more patients attack themselves. At Norton it is easy to feel involved with the patients because it seems that if you could only change them a little, they could do so very much. When one treats the cynical ne’er-do-well derelicts who haunt many of the places where psychiatrists train, it is hard to convince oneself that they will change, let alone make a difference to the world. At Norton, the patients come from families that are often wealthier and more distinguished than the psychiatrists’ own. It is easy to fantasize that they could be powerful and effective doctors, lawyers, professors, philanthropists. Because they are young, bright, and rich, their prognosis, if the illness can be dented, is far better than that of people who are old, dull, and poor. Patients like Tracy seem to have everything but happiness. They desperately need and want help; then, when a therapist reaches out to them, they bite the hand—hard. Most analysts do not take extremely disturbed patients into intensive psychotherapy, not only because their theory suggests that the therapy will be too powerful but because they fear that as therapists they will get too involved, that these patients need help so badly that they will want to help equally badly, and then, because the patients are so disturbed, the patients will hurt them more than the therapist can bear.
+In the conclusion of the same text, Lenin explains why communists should reject Empirio-Criticism and Machism with four “standpoints,” summarized here:
-Norton took these very ill patients and gave them intensive psychoanalytic psychotherapy, and the psychiatry and psychology fellows—fresh from residency and its equivalent—felt beaten up and hollowed out by them. When I was there, the hospital had five full-time senior clinicians and seven fellows, a mixture of psychiatrists and psychologists. Fellows work there for two to four years. If they are psychiatrists, they are likely to spend their last year of residency there. Each fellow sees a maximum of four patients, and each full-time therapeutic staff member sees usually one and occasionally more patients.
+. The theoretical foundations of Empirio-Criticism can’t withstand comparison with those of dialectical materialism. Empirio-Criticism differs little from older forms of idealism, and the tired old errors of idealism clash directly with Marxist dialectical materialism. As Lenin puts it: “only utter ignorance of the nature of philosophical materialism generally and of the nature of Marx’s and Engels’ dialectical method can lead one to speak of ‘combining’ empirio-criticism and Marxism.”
-The fellows dreamed about their patients. They said that the patients got under their skin and into their lives in ways that were nearly intolerable. “I live with them in me, and it makes me crazy,” a new fellow said. “But then I really see how the theory works, because I ''see'' it, the way I’m projecting, the way I get angry and then paranoid. You’re forced into really grasping that you construct your own world, that your language is drenched in your history.” These are not the obedient conflicted patients of Upper West Side New York who worry about their unconscious aggression in paying their bill three weeks late. These patients walk into sessions furious that their therapist (they say) is sadistically torturing them with his or her sexual feelings for them. They try to make the therapist confess those feelings. (Psychiatric patients can be unnervingly insightful.) They talk about their hatred for their therapist and their therapists’ hatred for them. They threaten to commit suicide. One fellow, confident and poised, with five years of psychotherapeutic experience behind her, found herself so shaken after the sessions with one patient that she vomited after the therapy hour, session after session. “I feel things first in my body,” she said, “all this anger and rage. It was too much.” Feelings about patients, particularly for new fellows, seemed barely under control, or what the staff would call “contained.” Sometimes they spilled out from the therapy session to the therapist’s dealings with the nurse, social worker, or check-in person at the local gym. And these are patients who talk about suicide and go back to a hospital building without locks, who talk about their therapy to nurses who may question the therapist’s wisdom. There is always a hovering question in a nurse’s mind about the doctors anyway, particularly new doctors, because doctors conduct their work behind closed doors.
+. The philosophical foundations of Empirio-Criticism are flawed. “Both Mach and Avenarius started with Kant (see: Annotation 72, p. 68) and, leaving him, proceeded not towards materialism, but in the opposite direction, towards Hume and Berkeley (see: Annotation 10, p. 10)... The whole school of Mach and Avenarius is moving more and more definitely towards idealism.”
-The heart of this culture, confronted by its terrible uncertainties and risks of emotional chaos, lies in a paradox: that feelings are its insistent focus, yet its public culture repeatedly and consistently defuses strong feelings. That is the way this culture manages the greatest threat its intellectual commitments pose to its existence. Emotions are to be spoken about, not expressed. “The whole damn place is affect-avoidant,” a social worker grumbled. Tears were utterly unsanctioned. In any meeting of more than four people the correct tone of voice was deadpan. When people mentioned that a first-year fellow had cried in a team meeting, they lowered their voices and raised their eyebrows. A therapist’s inability to manage his feelings in public would lead the general staff to question his ability to manage the intense emotions of the therapy relationship in private. In the staff’s culture, the psychotherapeutic culture of examined living—in the clinical case conference, when all staff meet for two hours twice a week to discuss one patient; in the thrice-weekly clinical meetings, when all staff meet for an hour to discuss all the patients; even in the smaller twice-weekly team meetings, when ten staff members meet to discuss perhaps a third of the patients—there was a style that took the wind out of overwrought passion as effectively as a damp English afternoon.
+. Machism is little more than a relatively obscure trend which has not been adopted by most scientists; a “reactionary (and) transitory infatuation.” As Lenin puts it: “the vast majority of scientists, both generally and in this special branch of science... are invariably on the side of materialism.”
-These meetings set a premium on formal, crafted, eloquent speech. The senior staff spoke in sentences rounded out with caveats and considerations, with deliberate, complex rhythms. They spoke well and fluidly in psychoanalytic prose: “For this patient, connecting to her feelings and communicating them to the other is fraught with peril.” My notes on one patient presented in a team meeting read, “Youngest of five, can’t leave home for fear of what will happen to parents or to her—possible history of sexual abuse—that may in turn contribute to her difficulties in being sexual, may be afraid of being ''father’s'' wife, as ''re'' morning seminar—fears of oedipal victory over father’s wife, who doubles as her mother—rage at mother for unavailability—may have contributed to eating disorder at time of puberty—fearful, insecure attachment style.” Presentations were done with an implicit bow, not a sense of brisk efficiency.
+. Empirio-Criticism and Machism reflect the “tendencies and ideology of the antagonistic classes in modern society.” Idealism represents the interests of the ruling class in modern society, and is used to subjugate the majority of society. Idealist philosophy “stands fully armed, commands vast organizations and steadily continues to exercise influence on the masses, turning the slightest vacillation in philosophical thought to its own advantage.” In other words, idealism is used by the ruling class to manipulate our understanding of the world, as opposed to materialism (and especially dialectical materialism) which illuminates the true nature of reality which would lead to the liberation of the working class.
-Defensiveness was bad. In this public culture, when staff or patients were confronted with criticism in public, they were expected not to deflect the criticism but to address it. At one staff meeting, a senior staff member announced that the executive committee had decided to hire a senior staff member’s wife to serve as a therapist from time to time, and did anyone have any feelings about that? One of the fellows—the one who vomited after difficult sessions—stuck her hand up aggressively and said, “You’ve made the decision; we won’t influence it, so why are you bothering to ask for our response, which will just leave us vulnerable and won’t have any impact?” I was watching the senior clinician at the time. He did not, as I thought he would, stiffen up. After a moment, his shoulders relaxed. “You’re right,” he said. “We have made the decision, and unless you feel very strongly about it we won’t change it. But if you do feel strongly that it is inappropriate, we will consider changing our minds.”
+At this time, Marxism was widely disseminating throughout Russia, which challenged the social positions and benefits of capitalists. In reaction to Marxism, many ideological movements such as empiricism, utilitarianism, revisionism, etc. [see: Appendix F, p. 252] rose up and claimed to renew Marxism, while in fact they misrepresented and denied Marxism.
-There were jokes here as well. “The patient,” said the therapist for the interracial woman, “had a dream that she would die in a plane accident and on the weekend she was scheduled to fly to Canada, she learned that the East Coast would experience its worst winter storm of the season. She was superstitious and became quite agitated in the session. Now, as it happens, I am a little superstitious, too. I told her that she might consider the train.” But the humor was not about madness. It stabbed at the high seriousness of the therapeutic endeavor, and it was self-deprecating for the therapist. Staff laughed comfortably at themselves. When they laughed at the patients, they immediately became apologetic and nervous. In this case conference, the therapist remarked that the patient, who kept saying that she was desperate to leave, had developed striking neurological symptoms before discharge. Everyone listening laughed, because to them this meant that despite her many protests, she liked her therapist and wanted to stay in the hospital. But they quickly became contrite. A senior clinician immediately said that the laughter might be a way of “breaking out of the confining frame that the patient has set.” A fellow pointed out that the patient’s symptoms were real for her. The director remarked that laughter was a healthy response to the countertransference. Clearly, at Norton you are not supposed to laugh at madness. But staff members laughed at doing therapy. They laughed at therapeutic blunders, at the ambitions of the therapist, at the difficulty of being what they would call “in role.” That is because the contradiction in this culture, its impossible model, is about the therapist, not the patient’s madness. These therapists did not think that patients are rational people with a physical illness. They did not put much stock in anyone’s rationality, or at least in his ability to think clearly and independently of his unconscious desires. What was funny, then, was not the patient’s madness but the very attempt to do therapy, to comment objectively on a patient’s superstitious comment when you yourself are a little superstitious and think she ought to take the train. The stories they told were often about the doing of therapy: how a patient worried that her boyfriend would kill her and the therapist made a psychodynamic interpretation of that fear and the patient then brightened with visible relief and said that she was so relieved that there was a psychological explanation, because her boyfriend’s brother had gone after ''his'' ex-girlfriend with a gun. They laugh at the way a patient turned an interpretation around and suddenly the therapist was the one receiving therapy. They traded stories about the way senior clinicians had been narcissistically preoccupied and failed to attend to something they thought was obvious about a patient, and how that had backfired. They laughed at the attempt to step outside one’s own dynamic frame to understand another person, which is what a therapist is supposed to do.
+In this context, new achievements of natural science needed to be analyzed and summarized in order to continue the authentic development of Marxist viewpoints and methodologies. Theoretical principles to fight against the misrepresentation of Marxism needed to be developed in order to bring Marxism into the new era. Vladimir Ilyich Lenin would fulfill this historical requirement with his theoretical developments.
-And I have never seen an institution so focused on the roles, hierarchical and otherwise, of its members: discussion of how a patient had not improved until her therapist had assumed his appropriate role with respect to her; the role of the hospital in interaction with the insurance company and the patient’s parents; the role of the community with respect to the behavior of two patients. The reason for this is, no doubt, that people were not, in fact, defined by their roles. In a biomedical unit, the hierarchy of power can reflect what was assumed to be the hierarchy of knowledge in an unproblematic way because the possessing of knowledge is not problematic. In a psychodynamic setting, knowledge is complex, ambiguous, and uncertain. A patient can see things about her therapist, about a nurse, about the director of the hospital that these people do not recognize, and the structure of the hospital life is set up to allow the patient to point out to these people what she perceives about them. It becomes easy to doubt that someone has accumulated knowledge, no matter what his credentials. In any event, this institution was profoundly conscious of its social structure. What the social workers did was clear, and it was not what therapists did (much to the distress of the social workers, who wanted to do individual therapy and were not allowed). Even the small lunchroom was informally segregated, so that senior clinicians ate at one table, fellows at another, administrative staff in a separate room, and patients, nurses, and mental health workers in another building. Patients would have long discussions about whether the eating disorders group would still be the eating disorders group if its members met without their leader, whom they had decided they didn’t like; they concluded that without a leader, however irritating she was, it would not be a group. “You have to stay in the role,” the supervisor earnestly told his supervisee, a fellow. “Educating the patient, doing reality testing for him, telling him whether his responses are appropriate—that is not staying in role. Staying in the transference is your role as a therapist, allowing yourself to be trapped, to be stuck in an enactment, and then taking a step back to ask what this has to do with the patient’s inner life.” The explicit emphasis on role definition—far more explicit and formal than in the biomedical setting—becomes a way of clarifying the realistic differences in training and stature despite the interest in unconscious fantasy that dominates the intellectual life.
+''- The Role of Lenin in Defending and Developing Marxism.''
-In the end, it seemed to me that one could summarize the complex culture of this place around four paradoxes. First, emotion was the content, focus, and most important issue of most clinical discussions, yet feeling was not to be displayed; it was to be discussed formally and calmly. Second, psychotherapy took place in private and was confidential, yet the environment of examined living demanded that everything be open to discussion. Third, this hospital hierarchy was as clear and as solid as I have ever seen, yet it was consistently flattened in the service of an egalitarian democracy of open discussion. Fourth, there was a great deal of discussion about limits and boundaries—whether patients should have sex, whether throwing a glass of water was an effective means of communication—yet the hospital had no real constraints, no doors, no security guards, no watchdogs. Thus, to live in the culture successfully as a doctor (or another staff person) meant that you had to talk about your own emotions in public and in depth, but not express them; you had to keep secrets but know when to share them; you had to behave democratically but with a deep respect for hierarchy; you had to substitute talk about responsible living with your patient for taking responsibility for that patient’s life by keeping her under lock and key. It was a hard transition for the new clinicians, who felt the deep strain of living rubbed raw in open view of other people. “They are used to controlling people, to managing them,” a senior clinician said severely. “They have to get used to doing therapy.”
+Lenin’s process of defending and developing Marxism can be separated into three periods: first, from 1893 to 1907; next, from 1907 to 1917; and finally from the success of the October socialist revolution in 1917 until Lenin’s death in 1924.
-Norton is a very special hospital. The psychiatrists at San Juan would probably love to do this kind of work, but they can’t. Even if they could, their patients would not have the success that Norton’s seem to have. They do not have the money. They do not have the time. They must handle thousands of patients each year. Norton handles perhaps several hundred, with more staff. Norton’s patients are young, bright, often wealthy, and usually struggling with disorders that, when managed, can leave the patient highly functional and effective. The upper reaches of our society hold many depressed and bipolar high achievers, not to mention mild borderline personality disorders. San Juan’s patients are often uneducated, unemployed and unemployable, and older. Their prognosis is poor. It would be poor no matter where they were treated. They struggle with substance abuse, and are treated and then discharged into a community where crack and heroin are rampant. They struggle with depression, and are treated and then discharged into the realistically depressing world of the underclass. They struggle with schizophrenia, and though medication will stabilize them it will not make them self-sufficient. Psychiatric illness, like all medical problems but more so, is mired in the ugly realities of the American class structure. This is one reason psychiatric illness presents our society with moral choices.
+From 1893 to 1907, Lenin focused on fighting against populists<ref>Populist faction: A faction within the Russian revolution which upheld an idealist capitalist ideology with many representatives such as Mikhailovsky, Bakunin, and Plekhanov. Populists failed to recognise the important roles of the people, of the farmers and workers alliance, and of the proletariat. Instead, they completely centered the role of the individual in society. They considered the rural communes as the nucleus of “socialism.” They saw farmers under the leadership of intellectuals as the main force of the revolution. The populists advocated individual terrorism as the primary method of revolutionary struggle.</ref>. His book ''What the Friends of the People are and How They Fight Against the Social Democrats (1894)'' criticized the serious mistakes of this faction in regards to socio-historical issues and also exposed their scheme of distorting Marxism by erasing the boundaries between Marxism’s materialist dialectics and Hegel’s idealist dialectics. In the same book, Lenin also shared many thoughts about the important roles of theory, reality, and the relationship between the two.
-== {{anchor|CHAPTERFOUR}} {{anchor|TopofLuhr9780307791900epubc5}} CHAPTER FOUR: THE PSYCHIATRIC SCIENTIST AND THE PSYCHOANALYST ==
+==== Annotation 33 ====
-What does it mean to be a good psychiatrist? Who do you aim to be? The biomedical and psychodynamic domains each has its own ideals. Most young psychiatrists do not in fact choose a route into rigorous scientific research or lengthy psychoanalytic training. Nonetheless, their sense of what it means to be the best is framed by the models of those who have been held up to them as epitomes of excellence. Because psychiatry has been dominated by two competing models of illness, and because true excellence in either has historically been understood as attained through the kind of training that precludes true excellence in both, the two ideals of excellence are quite distinct. In the one domain, there is the scientist, the fearless investigator of truth. In the other, there is the psychoanalyst, the wise wizard of insight. These two ideals embody different moral sensibilities, different fundamental commitments, different bottom lines. In some ways the differences are subtle; in others they are sharp and striking. The differences become part of the way the young psychiatrist imagines himself with patients, the way he comes to empathize with patients, and, ultimately, the way he comes to regard his patients as moral beings.
+The ''populist'' philosophy was born in Russia in the 19<sup>th</sup> century with roots going back to the Narodnik agrarian socialist movement of the 1860s and 70s, composed of peasants who rose up in a failed campaign against the Czar. In the late 19<sup>th</sup> century, a new political movement emerged rooted in Narodnik ideas and a new party called the Socialist Revolutionary Party was formed. The political philosophy of this movement, now commonly translated into English as “populism,” focused on an agrarian peasant revolution led by intellectuals with the ambition of going directly from a feudal society to a socialist society built from rural communes. This movement overtly opposed Marxism and dialectical materialism and was based on subjective idealist utopianism (see Annotation 95, p. 94).
-=== {{anchor|THEPSYCHIATRICSCIENTIST}} THE PSYCHIATRIC SCIENTIST ===
+With the book ''What is to be Done?'' (1902), Lenin developed Marxist viewpoints on the methods for the proletariat to take power. He discussed economic, political, and ideological struggles. In particular, he emphasized the ideological formation process of the proletariat.
-“I hate it,” a resident wailed at the end of her second year. “They seem to think that if we don’t go into research we’ve failed somehow.” The practice of medicine rests on scientific knowledge. That knowledge is the justification of the practice. Yet the practitioners, the pure clinicians, do not produce the knowledge. Knowledge is produced by researchers, and in the late twentieth century the promise of medical science is that knowledge will always increase and always increasingly achieve its aims. Research scientists, then, are the sine qua nons of contemporary medicine. They are also its secular ascetic priests. They are paid less than their clinical counterparts for generating the knowledge that the clinicians sell in the marketplace for a higher price. They are rewarded with prestige and, occasionally, fame. They tend to have positions in medical schools and to do at least some teaching of medical students and residents. Students and residents meet the researchers during a period when their own identities are still being formed and their sense of the “good psychiatrist” is still emerging. They meet many other kinds of psychiatrists as well: the senior psychiatrists who run their unit teams, the psychoanalysts who supervise their psychotherapy sessions, the somewhat older residents or young faculty members who are mostly deeply involved in the teaching process. But the research scientists have the greatest halo in the hospital and medical school context, particularly in the very good schools. When bright residents decide not to pursue research—and most of them do not—they must struggle with a sense of letting down the teachers they have admired and even idealized. Most residents in the prestige-conscious residencies I visited had considered going into research at one time or another. When they decided not to, they felt not regret, but shame.
+==== Annotation 34 ====
-This shame is curious to the outsider, because in many ways our society sees clinical work as the more noble and more moral task. Clinicians deal one-on-one with human suffering. They see the intimate pain of individual lives, and they try to heal that pain. We allow them to put their hands where no other stranger’s would be allowed because we trust them to help us and at least to some extent believe they can. Most people go to medical school because they want to work with people who are suffering and to heal them. This is what medical school (more or less) teaches its students to do. Researchers do not help individual sufferers—at least, not directly nor do they, when they are doing research, do anything they were taught to do in medical school. They are distant from human pain. They do not see it, do not deal with it, do not cure it, at least not face-to-face. They are not, as we would say, in the trenches or the soup kitchens. They stand back. Yet young psychiatrists can speak of choosing to be “mere clinicians.”
+In ''What is to be Done?,'' Lenin argues that the working class will not spontaneously attain class consciousness and push for political revolution simply due to economic conflict with employers and spontaneous actions like demonstrations and workers’ strikes. He instead insists that a political party of dedicated revolutionaries is needed to educate workers in Marxist principles and to organize and push forward revolutionary activity. He also pushed back strongly against the ideas of what he called “economism,” as typified by the ideas of Eduard Bernstein, a German political theorist who rejected many of Marx’s theories.
-This moral hierarchy owes much to the knowledge hierarchy between the clinician and the scientific researcher. The American Psychiatric Association convention is the meeting for general clinicians, who hurry between large panel discussions designed to deliver sound bites from the academic front—“Attention Deficit Disorder,” “Schizophrenia and Depression”—and smaller sessions—“The Pregnant Resident,” “Smoke-Free Psychiatric Units: Progress and Problems.” There are usually more than ten thousand attendees. The large panels are held in huge, dark ballrooms filled with rows of metal seats. The speaker’s face is projected onto a hanging screen behind his back as he speaks, so that people in the thirtieth row can see him, and people wander anomically in and out as one graph after another goes up beside his image. The task force for the next edition of the diagnostic manual presents the latest thinking on various topics to rooms packed with more than a thousand people: how coherent the personality diagnoses are as a group; whether it has decided to change the criteria for, say, obsessive-compulsive disorder; whether a new antipsychotic really works as well as the earlier reports suggested. The American Psychiatric Press’s ''Review of Psychiatry'' presents symposia on new research on (for instance) schizophrenia, bipolar disorder, posttraumatic stress disorder. “Hot” topics, such as sexual abuse or managed care, may fill a large room to standing room only. Through all this there is a sense of grand spectacle, of theater and crowds and entertainment; and in fact the conference information booklet is full of special events, trips to the Louisiana bayou or around Capitol Hill, tax-deductible vacations for the frugal. Those who put on the spectacle—those who perform, who write the chapters, do the epidemiological surveys, and run the validity studies, who collect and analyze the data—have enormous symbolic power. They are the scientific researchers. It is because clinicians must keep abreast of the new science that they fly from Minneapolis to Washington, D.C., and spend five days in an overpriced Hilton.
+Bernstein opposed a working class revolution and instead focused on reform and compromise. He believed that socialism could be achieved within the capitalist economy and the system of bourgeois democracy. Lenin argued that Bernstein and his economist philosophy was opportunistic, and accused economists of seeking positions within bourgeois democracies to further their own personal interests and to quell revolutionary tendencies. As Lenin explained in ''A Talk With Defenders of Economism:''
-The Society of Biological Psychiatry meetings are utterly different. Gone is the attention to clinical matters and the air of frenzied holiday. The hundred or so scientists who attend the meeting—not the most elite of its kind, but attended by many elite scientists—are colleagues. They present their work for information and critique, not as bullets of truth condensed for an unsophisticated audience. The atmosphere is competitive, ambitious, and democratic.
+<blockquote>
+The Economists limited the tasks of the working class to an economic struggle for higher wages and better working conditions, etc., asserting that the political struggle was the business of the liberal bourgeoisie. They denied the leading role of the party of the working class, considering that the party should merely observe the spontaneous process of the movement and register events. In their deference to spontaneity in the working-class movement, the Economists belittled the significance of revolutionary theory and class-consciousness, asserted that socialist ideology could emerge from the spontaneous movement, denied the need for a Marxist party to instill socialist consciousness into the working-class movement, and thereby cleared the way for bourgeois ideology. The Economists, who opposed the need to create a centralized working-class party, stood for the sporadic and amateurish character of individual circles. Economism threatened to divert the working class from the class revolutionary path and turn it into a political appendage of the bourgeoisie.
+</blockquote>
-The word that marks these meetings is “data.” Data are good or bad, massive or thin, coherent or messy. If data are good, they are convincingly the result of an experiment, and they tell a story. Good data help support one or more hypotheses and cast doubt on others. Participants in these conferences talk about good data and bad data and who has which. They stand around after sessions and gossip about the way people interpret their data and what the correct interpretation ought to be. It is said that you can figure out whether the talk was good just by looking at the way the data were presented—if the speaker spent too much time summarizing previous work or concentrated too much on the demographic characteristics of the patients, the data were thin and unconvincing, there weren’t enough to fill a talk. Poor papers present the data raw and undigested; good papers explain the scientific problem, what the scientist did, why the data are significant. There are poster sessions in which the people who don’t give spoken talks type up their work on pieces of paper and pin them to bulletin boards, the conference organizers set out cheap Chardonnay and plates of Cheddar cubes with cellophane-decorated toothpicks, and conference participants walk around with little paper plates and read the posters to see who is doing what and how. Sometimes the posters are more eagerly anticipated than the spoken talks. At humanities conferences, participants might say that they go to sessions to find out what is trendy. These conference attendees say that they go to sessions to find out what other people’s experimental results are. And they look at data in other ways as well. These are government-funded grantees, people given more than a half-million dollars to carry out their experiments, who support their staff, their salaries, and their laboratories by the money they are able to raise by writing dense, careful grant applications. As I sat in one paper session of the Society of Biological Psychiatry meetings, listening to a group of eminent scientists explore the use of a new brain-imaging technique, another scientist leaned towards me and whispered, “Now, do you think those data were worth three hundred thousand dollars?”
+''The Encyclopedic Dictionary of Vietnam'', published by the National Committee of the Communist Party of Vietnam, defines opportunism, in this context, as “a system of political opinions with no direction, no clear path, no coherent viewpoint, leaning on whatever is beneficial for the opportunist in the short term.”
-Data ultimately create knowledge; knowledge creates intervention; and intervention is what the clinician uses to treat the patient, as both scientists and clinicians tend to frame their respective roles. In that sense, there is something of an intellectual food chain between research and clinical practice. Clinicians use medications to treat the patients they diagnose. Some researchers (clinical psychopharmacological researchers) do drug studies. They try out not-yet-approved medications (the next generation of anti-depressants, for example) on suitable patients who agree to participate in their study. Neither patients nor researcher know which patients receive the actual drug and which receive sugar pills; thus, these studies are called “double-blind.” While some researchers in this domain are very serious, many of the studies are routine and what the researcher does is close to clinical work.
+Lenin critiques opportunist socialism — referring to it as a “critical” trend in socialism — in ''What is to be Done?:''
-Then there are researchers who try to develop new diagnostic categories to replace older ones or to explain underutilized diagnoses. They develop interview “schedules” and “recruit subjects” that meet the criteria for some diagnosis; then they try to demonstrate that a subgroup of those patients can be more accurately described with the new criteria or explain some characteristics of that group that have been ignored. Or they explore an under-studied phenomenon: they try to figure out, for example, why so many psychiatric patients smoke, and they begin by taking smoking histories of a wide range of patients. This work is further away from everyday clinical work, and a researcher, not a drug company, develops the topic to be investigated. These researchers are still called “clinical.” The word “clinical” simply refers to working with people, or working in the clinic. Usually, the word “clinician” is reserved for someone who does not do research, and always refers to someone in the capacity of a treater of patients, not as a researcher. A “clinical researcher” does his research in a clinical setting, with patients, and though he may do some treatment-oriented doctoring, which he calls his “clinical work,” his primary identity is as a scientist.
+<blockquote>
+He who does not deliberately close his eyes cannot fail to see that the new “critical” trend in socialism is nothing more nor less than a new variety of opportunism. And if we judge people... by their actions and by what they actually advocate, it will be clear that “freedom of criticism” means “freedom for an opportunist trend in Social-Democracy, freedom to convert Social-Democracy into a democratic party of reform, freedom to introduce bourgeois ideas and bourgeois elements into socialism.”
-Scientists who are not clinical are at the beginning of the food chain. They do not work with people. They often work with rats. They work on brain mechanisms, and they work in laboratories. They study the processes that create (or accompany) an actual disorder, what might be termed the “source” of the illness, and their work, though in many ways incomprehensible to clinicians, is seen as the most important and most exciting of all psychiatric science.
+-----
-In the summer of 1994, I called Randy Gollub because a senior psychiatrist had described her to me as a star. (Unless otherwise indicated, the psychiatric scientists in this chapter are identified by their real names.) She was a laboratory scientist. Because she was female, she was an unusual scientist. There were some well-known female psychiatric scientists, but few of them conducted “basic” research, research about mechanisms in the brain, the kind of research that commanded the field’s deepest respect. By 1994, only one woman, Paula Clayton, had been named to the chair of a prestigious department of psychiatry (chairmanship is far more powerful in medicine than in the arts and sciences, as a chairman controls a department’s financial resources, which can be considerable, and holds the chair more or less until he or she chooses to resign). Some psychiatrists thought that the lack of women in this role was due to the kind of science the women did. In any event, I was not interested in the political future that other people envisioned for Randy; I wanted to know what it was like to live life as a laboratory scientist.
+The first revolution of the Russian working class, from 1905 to 1907, failed. Lenin summarized the reality of this revolution in the book ''Two Tactics of Social-Democracy in the Democratic Revolution'' (1905). In this book, Lenin explains that the capitalist class in Russia was actively engaged in its own revolution against Czarist feudalism. In this context of this ongoing bourgeois revolution, Lenin deeply developed Marxist concepts related to revolutionary methodologies, objective and subjective factors that will affect the working class revolution, the role of the people, the role of political parties etc.
+</blockquote>
-We arranged to meet in her office, which meant that I traveled the length of Boston to find the dockyard skyscraper into which the Massachusetts General Hospital, a Harvard affiliate, has deposited its laboratory scientists. MGH (Massachusetts General Hospital) East is a strikingly beautiful building. Randy’s lab lies above a red-marble-walled lobby with a sparkling fountain, and, in its first years as laboratory space, it is elegant: there are fresh offices, space for the secretaries, newly laid carpet. This is a world of scientists: of postdocs and lab technicians, small offices and large laboratories with long, cluttered work spaces. It is obviously not a hospital space. There is no bustle. The cafeteria is small and gracious. No one is dressed in surgical scrubs or, for that matter, in expensive doctorly suits. There is not a patient in sight.
+==== Annotation 35 ====
-Randy turned out to be a lean, lanky woman, rather attractive, very determined. At first, she said, her scientific zeal had indeed been fueled in part by her feminism and by her determination to advance the status of women in science. “I didn’t want to earn as much as a man,” she recalled. “I wanted to earn more.” So she credentialed herself well. She took a medical degree not because she wanted to do clinical work but because she had been advised that as a neuroscientist she would do better in the grant world with an M.D. The lore says that doctors are better funded, because they have more resources to tap for funds and more prestige. The lore also points out that a medical degree is superfluous to their work, at least in comparison to their academic training, that it is graduate and postdoctoral work that teaches a doctor to think like a scientist. Many future scientists get their medical degrees nonetheless.
+From 1905 to 1907, Russia was beset by political unrest and radical activity including workers’ strikes, military mutinies, and peasant uprisings. Russia had just suffered a humiliating defeat in the Russo-Japanese war which cost tens of thousands of Russian lives without any benefits to the Russian people. In addition, the economic and political systems of Czarist Russia placed a severe burden on industrial workers and peasant farmers.
-Then she fell in love with the science and, more remarkable to her, the clinical side of medicine. “Much to my surprise, I really enjoyed the clinical work, and I couldn’t give it up now.” Randy did an M.D./Ph.D. at Duke and a postdoc and residency at Yale. Eighteen years after she started her undergraduate degree (four for the B.A.; four for the M.D.; four for internship and residency; six for the Ph.D. and postdoc), she took her first nonstudent job. She was over thirty-five. In 1994, the American Psychiatric Association Press published a book coauthored by one of Randy’s mentors—the director of the lab in which she was given space—that set out the intellectual basis for this kind of serious psychiatric science. ''The Molecular Foundations of Psychiatry'' by Steven Hyman (then at Harvard, now the director of the NIMH) and Eric Nestler (at Yale) describes the neural structure of the brain. It is a brilliant book, written with a sophisticated understanding of the interaction between genetic abnormality and environmental influence. It is also strikingly technical, with paragraphs for the “general” reader distinguished from paragraphs for the reader who wishes to pursue material in depth. It displays the brute fact that psychiatric laboratory science exceeds the everyday medical student as graduate-level work exceeds the freshman and is beyond the grasp of the average psychiatric resident. The determination and early dedication needed to choose this professional road winnow out all but the very few. This makes a person like Randy very rare. The existence of people like her can make a young psychiatrist who discovers this kind of psychiatric science in residency feel awed and humbled.
+In response, the Russian proletariat rose up in various uprisings, demonstrations, and clashes against government forces, landlords, and factory owners. In the end, this revolutionary activity failed to overthrow the Czar’s government, and the Czar remained firmly in power until the communist revolution of 1917.
-Like many psychiatric scientists, Randy had at first wanted to solve the problem of schizophrenia. (Schizophrenia is perhaps the least understood and most important, because most debilitating, of the major mental illnesses.) Her tack was to focus on a discrete issue in the hopes that twenty years further on she might have part of the general answer. In her fellowship in electrophysiology, Randy had learned to read the electrical signals produced by certain kinds of cells. In these days of elaborate techniques, a postdoctoral fellowship is often focused on learning to carry out a specific technical process. Her MGH workstation consisted of a microscope, a petri dish, and what looked like expensive stereo components, piled up in a rack of six or so beside her. She would slice a piece of living rat brain into a petri dish—the slice continued to live in a complex, soupy bath—and poke at the sliced brain with a sensitive electrode attached to the layered components. Once she found a “good” neuron (“good” meant that it was easy to take readings from it) she added various fluids to the bath to see how the cell reacted.
+Lenin wrote ''Two Tactics of Social-Democracy in the Democratic Revolution'' in 1905 in
-What she had discovered was that there are certain kinds of rat brain cells that no longer respond to the neurotransmitter serotonin when the new antipsychotics clozapine and risperidone are added to the bath. Those new medications target what are sometimes seen as the true, core symptoms of schizophrenia: the listless apathy and emotional withdrawal, the “negative” symptoms. All antipsychotics target the flamboyant delusions and hallucinations (the so-called positive symptoms). But psychosis is a symptom of many conditions—mania, psychotic depression, and so forth. Only schizophrenia, the most intractable mental illness, generates the flat disconnection from the world. Cells that respond so powerfully to these new antipsychotics as to ignore a basic neurotransmitter such as serotonin might be important indicators of the schizophrenic process—particularly if they could be localized in one region of the brain. Randy had already localized them in the long, thin interneurons of the rat cortex and had used the data to suggest a potential site of action for these drugs. As is typical of psychiatric medication, psychiatrists know far more about a drug’s efficacy—whether or not it works—than how or by what mechanisms.@@@[[#1SeeegRLGellmanGol|1]]$$$ It was not unreasonable to hope that she might eventually find a similar site in human brains. She thought she probably could.
+Geneva, Switzerland. In it, he argues forcefully against the political faction within the Russian socialist movement that came to be known as the “Mensheviks.” The Mensheviks, as well as the Bolsheviks (Lenin’s contemporary faction) emerged from a dispute within the Russian Social Democratic Labour Party which took place in 1903.
-To a young psychiatrist looking in from the outside during residency, this is a glamorous, powerful world. From the inside, it often seems less romantic, and the noble pursuit of truth seems chained to pragmatic expediency. Randy had an enviable position: an academic title, start-up money for the lab, the support of a powerful university’s name. But her salary support was not guaranteed beyond a few years. In a time in which perhaps 10 percent of all scientific grants were funded, the medical school expected her to generate her own salary from grants. Any grant submission requires an intense period of work; many people suggest that a reasonable scientist should devote an entire month to the preparation and submission of one of these twenty-five-page, single-spaced packets, which have accompanying pages and pages of appendices, human subjects clearances, cost estimates, budgets, summaries of previous work, and so forth. After a year or two, Randy would be expected to pay for all her expenses: petri dishes, lab technicians, postdoctoral fellows, secretarial support. Her mentor then had fifteen people on his payroll, and their livelihood depended entirely upon his capacity to generate funds. “As a scientist,” he said, “you must live with a combination of great confidence and great fear.”
+In the same text, Lenin argued that the Mensheviks misunderstood the forces that were driving revolutionary activity in Russia. While the Mensheviks believed that the situation in Russia would develop along similar lines to previous revolutionary activity in Western Europe, Lenin argued that Russia’s situation was unique and that Russian Marxists should therefore adopt different strategies and activities which reflected Russia’s unique circumstances and material conditions.
-These days, science is about generating money. Very few psychiatric scientists are paid by their universities to teach and do research, the way historians and anthropologists and classicists are, even though they too have academic titles and teach in academic settings. Almost all of them must, like Randy, raise their own salary from grants as well as pay the costs of running their labs. (Actually, some portions of their salary may be generated by clinical work. The actual structure of an academic physician’s salary can be fearsomely complex, with “X,” “Y,” and “Z” components subdivided and assigned to different grants, different clinics, and so forth.) To be a working scientist—to pay your mortgage, buy your groceries, clothe your children—you must be funded. Not only must you be funded once, but you must work on projects that can be reliably funded year after year until you retire. Most scientists, then, cannot indulge themselves in good but speculative ideas. The peer review system that awards the grants tends to be conservative, and speculative projects often fail. Those projects do not, by their nature, have much preliminary data. The system is intensely competitive, and your chief rivals may be the ones to review your grant submission. The whole setup makes many researchers bitter and tense. “What I hate about science,” said one of Randy’s senior colleagues with a grimace, “is the financial structure. If you don’t get the grant, you can’t do the work. So you go from gig to gig. You go where the money’s good because you can’t afford not to. I’ve been one of the lucky ones. But you worry about when you’ll be forced to leave Broadway and take a cheap soap opera job to make ends meet.”
+Specifically, the Mensheviks believed that the working class should ally with the bourgeoisie to overthrow the Czar’s feudalist regime, and then allow the bourgeoisie to build a fully functioning capitalist economy before workers should attempt their own revolution.
-To handle such a job well, you need to be able to handle stress well, or at least develop a modus vivendi. While I was writing this chapter, I had lunch with a biologist at my own university. He told me—he is a very accomplished scientist—that he would become so tense about grants and laboratory results and whether the laboratory would produce enough data for him to give talks and get funded that he had developed long-standing problems with his jaws. (It is quite possible for a very bright postdoctoral or doctoral student to work on a project for an entire year and get nowhere, with no data to present. If a senior scientist has a small laboratory, with perhaps one to three people working there, it is quite possible for the lab to produce no data for a year or more and thus to fail to be funded again and be forced to close.) He then recounted the back problems of a score of other scientists. He explained that one of the most important issues for a scientist was whether and how he was able to relax. He himself, he said, read pulp fiction. It is not pleasant to live on grants or even to have to rely on grants to be able to do your research. Historians, anthropologists, and literary critics can continue to work and think regardless of whether they get funded. Scientists can’t.
+Lenin, on the other hand, presented a completely different analysis of class forces in Russia. He believed the bourgeoisie would seek a compromise with the Czar, as both feudal and bourgeois classes in Russia feared a proletarian revolution.
-The hours are also long. Experiments often don’t work, data are often jumbled and messy, techniques fail more often than they succeed, and getting data means interpreting an array of results that may be largely due to error. Young, ambitious scientists are expected to spend all their time in the lab. One postdoctoral fellow in a large lab, where corridors of tables were lined with beakers and little plastic cartons and young people in sneakers were perched on high swivel seats, told me a story about such-and-such famous lab, where the lab director—the gray-bearded senior who directed the lab’s research—would come around the lab on Saturday nights and Sunday mornings to make sure that the students and postdocs were there. It may be an apocryphal story, but the postdoctoral fellow swore that it was true.
+It’s important to note that Russia’s industrial workforce was very small at this time, and most Russians were peasant farmers. The Mensheviks believed Russian peasants would not be useful in a proletarian revolution, which is why they argued for allowing capitalism to be fully established in Russia before pushing for a working class revolution. They believed it was prudent to wait until the working class became larger and more dominant in Russia before attempting to overthrow capitalism. They believed that the peasant class would not be useful in any such revolution.
-Young psychiatrists do not see all of this when they look up to a clinical researcher or a laboratory scientist. They don’t really see the pragmatism in the way scientists tailor their science to ensure their funding. They don’t really see the stress. That is, they know that it is hard and competitive to get grants, and many of them chose not to enter scientific careers because they seem too hard—and because they like treating patients, which is why they chose medical school in the first place. But they do not know on a visceral level what it is to wake up in the night in a cold sweat when your wife is pregnant and you don’t know if a grant will come through. Nor do they really know what research is like and how tentative and controversial the results can be.
+In contrast, Lenin believed that the peasants and industrial workers would have to work together to have any hope of a successful revolution. He further argued that an uprising of armed peasants and workers, fighting side by side, would be necessary for overthrowing the Czar.
-On the other hand, they sometimes don’t see how much fun it can be. Randy loved what she did, and she loved the doing of it. She seemed to have a wonderful time collecting data, chatting about how to analyze it with colleagues, flying around to conferences delivering talks. For her, science seemed like an intellectual sandbox. And it was the playing that fascinated and satisfied her. She wasn’t that tied to the specific topic she worked on. She couldn’t afford to be.
+From 1907 to 1917, there was a viewpoint crisis among many physicists. This strongly affected the birth of many idealist ideologies following Mach’s Positivism that attempted to negate Marxism [See: Annotation 32, p. 27]. Lenin summarized the achievements of natural science as well as historical events of the late 19<sup>th</sup> century and early 20<sup>th</sup> century in his book ''Materialism and Empirio-Criticism'' (1909). By giving the classical definitions of matter, proving the relationships between matter and consciousness and between social existence and social consciousness, and pointing out the basic rules of consciousness, etc., Lenin defended Marxism and carried it forward to a new level. Lenin clearly expressed his thoughts on the history, nature, and structure of Marxism in the book ''The Three Sources and Three Component Parts of Marxism'' (1913). He also talked about dialectics in ''Philosophical Notebooks'' (1914–1916) and expressed his thoughts about the proletarian dictatorship, the role of the Communist Party, and the path to socialism in his book ''The State and Revolution'' (1919).
-Despite her long training in electrophysiology, Randy herself switched out of her first field into the world of neuroimaging. Neuroimaging is the new chic darling of psychiatric science. It is a technology-heavy field that uses various methods—magnetic resonance imaging (MRI), positronemission tomography (PET)—to take what looks like a picture of the brain. The functional MRI, for example, takes advantage of the coupling of neural activity and blood flow. A scientist exposes a subject’s head to a high magnetic field and in effect measures the amount of blood flow to any region. The appeal of these methods is that the subjects appear to experience no side effects. So for the first time, scientists can study the brains of living humans without damaging them. With these new methods, psychiatric scientists are able to study the way blood flows to different areas of the brain when the subject performs different tasks. Scientists put people into these brain scanners and ask them to read words, remember phrases, so forth. One of Randy’s colleagues, Scott Rauch, had done an experiment in which he put patients with obsessive-compulsive disorder into a brain scanner and then asked them to touch some object—a soiled paper towel, for instance—that was at the center of their obsessive rituals. Touching the object triggered unbearable feelings of dread and contamination. And the blood flow to certain regions of the brain increased.@@@[[#2ThisworkwasreportedinDan|2]]$$$
+The success of the October revolution in Russia in 1917 brought about a new era: the transitional period from capitalism to socialism on an international scale. This event presented new theoretical requirements that had not existed in the time of Marx and Engels’ time.
-“In psychiatry,” he explained, “disorders are syndrome-based. You see how people behave and label the illness based on some set of behaviors. In internal medicine, we usually know ''something'' about the physiological process, and that helps the internal medicine people to develop better treatments and better diagnoses. In psychiatry, we’re still trying to figure out whether eating disorders, for example, are really just a sign of an underlying depression, or whether they’re a different disease. We don’t know. And sometimes diagnoses that look pretty much alike are grouped in very different ways across the diagnostic manual. Take OCD [obsessive-compulsive disorder], for instance. There’s Tourette’s syndrome in a section on movement disorder, body dysmorphic disorder in the somatoform disorders, trichotillomania in the impulse disorders, OCD itself in the anxiety disorders. They all involve problematic, compulsive repetition. But then, so does sneezing with hay fever. How do you figure out what goes with what? My hope is that neuroimaging will help psychiatry do better at pathophysiological classification. We’ve got a while to go yet, because we’ve had no way to distinguish the physiology of these illnesses at all. And if we can do that, our diagnoses and, ultimately, our treatments will get a whole lot better.”
+In a series of works including: “''Left-Wing” Communism: an Infantile Disorder'' (1920),
-Because the granting agency shared these hopes, there was money in abundance to carry out neuroimaging studies and few people to compete for it, because neuroimaging was a new technique (relatively speaking) and not many scientists had learned to use it. Randy’s mentor wanted her to apply for at least one grant because the grant-giving body had put aside money for the area and that meant that the odds of being funded had improved from something like one in twenty to one in four or less. For the same reason, it also became clear that with a little background work, Randy stood an excellent chance of getting a highly prestigious five-year award if she went into the area full-time. “We were virtually guaranteed to get the money for the first grant if we applied for it,” she told me. “My mentor was really excited about the possibilities of this technology. He worked hard to recruit me for the project. He didn’t back down for months, and finally I began to listen.… And I liked the people I would be working with. In physiology, I worked by myself. Me and the petri dishes. I thought it would be interesting to work with a group of people. We laughed a lot when we were writing the grant. It felt like good energy. And we got a fantastic score on the grant.
+''Once Again on the Trade Unions'', ''The Current Situation and the Mistakes of Trotsky and Bukharin'' (1921), ''The Tax in Kind'' (1921), etc., Lenin summarized the revolutionary practice of the people, continued defending Marxist dialectics, and uncompromisingly fought against eclecticism and sophistry.
-“Initially I’d been pretty skeptical about neuroimaging because I didn’t think it could give me the answers I was interested in. I thought that the tool would smush together too much of the brain, that it was too crude. So I went to the neurosciences meetings—you know, there are these enormous meetings, thousands and thousands of people—and I specifically went to all the talks on neuroimaging, and I was really impressed by the quality of information that people were getting from this tool. I learned that if you were clever about how you used the tool, you could learn a lot. Then I found out that the same Washington source that had funded the first grant was looking to recruit new people to the field, and by luck I was at one of the best places in the world to do the work. It was like a sale on money. If you had a good idea, with good people to help you and the support of your institution, you had a really good chance of getting the money. They would pay my salary and my lab costs for five years to train me to do this.
+==== Annotation 36 ====
-“So I wrote a grant, and it got funded. And you know, that was really lucky. It turned out that the project I abandoned was a sinking ship. There were other, more experienced people using electrodes to look for that localized area in the human brain that responded so well to the new antipsychotics, and they couldn’t find it. They just couldn’t find it. In humans, it doesn’t exist.”
+In ''Anti-Dühring'', Engels identifies the historical missions of the working class as:
-She found a way to make the new project fun. She enjoyed the way the data would crystallize on the computer screen. It was a little like taking photographs of different slices of the brain. Randy got excited as she showed me the different slices and what you could see in them. She also decided that she liked doing the experiments. Once she took me to one. Her subject lay in a darkened room with his feet sticking out of what appeared to be a large metallic doughnut. In the antechamber, Randy and her colleagues sat in front of computer screens and monitoring devices. Her subject, a cocaine user who was being paid well for participating, was being fed intravenously with a sequence of cocaine and sugar water. He reported to the team when he felt high and described how high he felt. They were scanning his brain to be able to learn, eventually, what areas of his brain seemed to be active at different moments and how the activity correlated with his physical and subjective state. Randy frowned at the controls and entered data into the computer. At one point she turned to me and grinned. “I like working with people,” she said. “I mean, there’s a lot of technology here, but at least I’m working directly with people. I don’t have to get to people by going through rats.”@@@[[#3Foramoretechnicalreviewo|3]]$$$
+. Becoming the ruling class by establishing a dictatorship of the proletariat.
-The play here is important. There is an entrepreneurial quality to the skills that make one a successful scientist. They are not entirely unlike the skills a scientist needs to figure out how to stay funded, although they are not the identical skill set. Scientists can be very good at grant writing and rather poor at interpreting data and formulating, and also the reverse. But still there is a kind of overlap, an ability to see in a boring experimental outcome the edge of something interesting, something that other people think to be important, something people will “buy.”
+. Seizing the means of production from the ruling class to end class society.
-At their best, these scientists do what is in essence a complex sorting task, making unusual distinctions and then trying to figure out whether they are significant in some way. The point of that sorting is to look, always, for useful but unrecognized distinctions or clusterings, often in a particular group of patients. Is there a consistent pattern of behavior in this set of people who have often been called schizophrenic or depressed that would lead us to think that they have a different problem altogether? That question led to the development of the “borderline personality disorder” category. Some depressed patients seem to have an elevated cortisol level. Is that true for a large enough percentage of depressed patients that it could be something like a blood test for depression? The answer to that turned out to be no, but in the meantime there were great hopes for the “dexamethasone suppression test.”
+''Eclecticism'' is an incoherent approach to philosophical inquiry which attempts to draw from various different theories, frameworks, and ideas to attempt to understand a subject, applying different theories in different situations without any consistency in analysis and thought. Eclectic arguments are typically composed of various pieces of evidence that are cherry picked and pieced together to form a perspective that lacks clarity. By definition, because they draw from different systems of thought without seeking a clear and cohesive understanding of the totality of the subject and its internal and external relations and its development over time, eclectic arguments run counter to the ''comprehensive'' and ''historical'' viewpoints [see p. 116]. Eclecticism bears superficial resemblance to dialectical materialism in that it attempts to consider a subject from many different perspectives, and analyzes relationships pertaining to a subject, but the major flaw of eclecticism is a lack of clear and coherent systems and principles, which leads to a chaotic viewpoint and an inability to grasp the true nature of the subject at hand.
-What you hear when you listen to many researchers is a continuous, creative, sometimes slightly zany pairing and splitting apart and repairing. Jonathan Cole, for example, is a well-known clinical researcher who ran the first NIMH psychopharmacology center when it was established in the 1960s by Nathan Kline and Mary Lasker. He is a warm, jocular man known throughout his hospital not only for his quick mind but also for the bottle of M&Ms marked “Happy Pills” that he keeps on his desk. Like many of the other smart scientists I knew, he is what a psychiatrist would call “hypomanic,” not manic but talkative, boundlessly energetic, with a capacity to generate multiple ideas. Only some of those ideas would eventually make it into research protocols and be analyzed with comparison groups, controls, and the various slow constraints of scientific study.
+''Sophistry'' is the use of falsehoods and misleading arguments, usually with the intention of deception, and with a tendency of presenting non-critical aspects of a subject matter as critical, to serve a particular agenda. The word comes from the Sophists, a group of professional teachers in Ancient Greece, who were criticized by Socrates (in Plato’s dialogues) for being shrewd and deceptive rhetoricians. This kind of bad faith argument has no place in materialist dialectics. Materialist dialectics must, instead, be rooted in a true and accurate understanding of the subject, material conditions, and reality in general.
-“Play with the data,” I once heard Cole say to a much younger colleague. “Play with it until something interesting emerges.” He seems to chop standard categories apart and lump the segregated pieces together in unexpected ways: What (for example) are the differences between schizophrenia and dissociation when it comes to hearing voices? Will the ways in which the two disorders respond to medication tell you anything? “Many people believe, you know, that research purity is next to godliness, that if you can’t ask the question right you shouldn’t ask it at all. I tend to believe that if you’ve got some data on a messy area you may be better off than if you have no data. Good psychiatric problems,” he continued, “ask interesting questions which can be clearly answered. One of the problems of research in psychoanalysis is that it is very hard to make a prediction that could be proven right or wrong, and one of the nice things about drug studies is that the placebo at least gives you a chance of showing that something is different from something else. They’re interesting. We did a study of drug abuse liability for a drug somewhat like trazodone [an older-generation antidepressant]. Most college-age kids didn’t like it. But some did. Why? [It turns out that most psychiatric drugs are abused on the street. This is a genuinely puzzling fact, given that many have unpleasant side effects and are often described as unpleasant to take.] But drug studies don’t solve all the problems of the world. As I get older, I am increasingly interested in things that give big differences. I’ve been trying to get a resident to do a project on epilepsy. Psychiatric patients with epileptic features will, if you give them one word in one ear and another in the other, eighty percent of the time be able to tell you only one of the words. Other psychiatric patients can usually tell you both words. It’s as if patients with epileptic features can’t grab both words at the same time, and because most psychiatric patients can tell you both words, this struck me as interesting. But I haven’t found a resident yet to do it.”
+Simultaneously, Lenin also developed his Marxist viewpoint of the factors deciding the victory of a social regime, about class, about the two basic missions of the proletariat, about the strategies and tactics of proletarian parties in new historical conditions, about the transitional period, and about the plans of building socialism following the New Economic Policy (NEP), etc.
-Another example of psychiatric scientific play, linking unconventional ideas together and then seeing which are foolish and which are powerful, comes from a man who is trying to restructure the field’s ideas about personality disorders. I first saw Hagop Akiskal in one of these giant American Psychiatric Association sessions, where he stood in front of a thousand attendees and presented a remarkable theory of mood disorders. Akiskal argues that many of the problems that are now diagnosed as personality disorders—borderline personality disorder, for example—are really mood disorders, disturbances in the regulation of mood the same way depression or mania are disturbances in the regulation of mood. He retreats (astonishingly) to classical antiquity to find his categories, citing Aristotle, Soranus, Aretaeus, and Avicenna. He points out that in Graeco-Roman medicine there were four temperaments: the sanguine, which made people active, amiable, and funny; the melancholic, which made them lethargic, brooding, and contemplative; the choleric, which made them irritable, hostile, and given to rage; and the phlegmatic, which made them indolent, irresolute, and timid. In excess, he argues, the same four temperaments become manic, depressed, borderline, and “avoidant.” In the official diagnostic manual, these last two are personality disorders.@@@[[#4HagopAkiskalMoodDisorder|4]]$$$ Leaving out the phlegmatic as possibly more associated with thought disorders such as schizophrenia, he argues for four basic “affective” (or mood) temperaments: the depressive or dysthymic, the manic or hyperthymic, the irritable or labile (depressed and hypomanic at once), and the cyclothymic or cycloid (a rapid cycle between depressed and hypomanic). “Dysthymic individuals were gloomy, given to worry, self-reproachful and self-disciplining, and possessed such character traits as nonassertiveness, pessimism, and incapacity for fun. Hyperthymic individuals, by contrast, were habitually cheerful, sociable, self-assured, eloquent, boastful, improvident, and uninhibited. Cyclothymic individuals ''alternated'' from the hyperthymic extreme to the dysthymic, while irritable characters were hypothesized to possess hyperthymic and dysthymic traits ''simultaneously.”''@@@[[#5AkiskalBorderlineAnAdje|5]]$$$ Cyclothymic and irritable people often, he suggests, get diagnosed not only as borderline but also as a range of other personality disorders: narcissistic, histrionic, and so forth.
+-----
-These personality disorders are thought by most psychiatrists to be coping responses to unfortunate circumstances—bad parenting, bad home environments, or bad luck in life—that have become chronically dysfunctional in dealing with other people. If Akiskal is right, people diagnosed with personality disorders struggle because they were born that way, and their life history sounds messy because life has always been difficult for them to handle. Psychotherapy might teach them how to manage their vile humors more effectively by being more self-aware, he argues, but the only thing that will really check their mood is medication.
+==== Annotation 37 ====
-Akiskal is a flamboyant, provocative man, and he enjoys perturbing what he sees as a placid psychiatric pond. “This is something that would offend the humanistic mind, to think that these more abstract issues of the human being, which have defied explanation and understanding, could have some material base.” He has, as many scientists do, a “discovery story,” an account of how he came to recognize that there are (as he sees it) underlying mood problems in patients diagnosed with personality disorders: “There was a group of people in the seventies who were called characterological depressives. It was believed that these people really did not have depression, but that their character structure was depressive—unfortunate experiences made them perceive the world and people in a depressive way. It was thought that they developed that way and they were serious, they were pessimistic, they were somber, low in self-esteem, and they ''suffered''. If you ask them how long they have felt this way, they say, ‘I brought depression to this world.’ Or ‘I’ve never felt joy in my life.’ This is a very fascinating group of patients who until then were being put on the couch because, to put it in psychoanalytic language, they had sucked the ‘bad breast.’
+The early 1920s were a period of great internal conflict in revolutionary Russia, with various figures and factions wanting to take the revolution in different directions. As such, Lenin wrote extensively on the direction he believed the revolution should be carried forth to ensure lasting victory against both feudalism and capitalism. He believed that the October, 1917 revolution represented the complete defeat of the Czar, however he believed the proletarian victory over the bourgeoisie would take more time. Russia was a poor, agrarian society. The vast majority of Russians under the Czar were poor peasants. Industry — and thus, the proletariat — was highly undeveloped compared to Western Europe. According to Lenin, a full and lasting proletarian victory over the bourgeoisie could only be won after the means of production were properly developed. In ''Fourth Anniversary of the October Revolution'', Lenin wrote:
-“I seem to be making fun of this way of thinking—and perhaps I am, because this was a crazy way to think about these patients. Okay, it’s a metaphor, the bad breast, but to think that something like a pervasive alteration in one’s personality arose from early misfortune has never made sense to me. If that were true there should not be one sane person on the planet. At any rate, we didn’t know how to treat these patients, and one day such a patient was sent by an analyst to our laboratory because the patient was sleeping on the couch. The roles were reversed”—here he chuckled—“the ''patient'' was sleeping. Anyway, the patient was sent to our sleep laboratory and he didn’t have narcolepsy, didn’t have sleep apnea, but his latency to REM sleep was very short, forty-five minutes. That you see only in psychotic depression and rarely in outpatients. So this rang a bell, that this so-called depressive character might have a real underlying depression and the depressive character was really secondary. This gave me an idea, that we should study a large number of these patients, and we did that, and the next step was to give them medication. But in those days the medications had a lot of side effects. It has taken a decade until the medications came along with an acceptable profile of side effects [the Prozac family] and patients can now take them for a long period of time. This observation, which was made in the late seventies, has made a difference in the lives of three to five percent of the population. What is the psychotherapeutic part? That comes in your approach to these patients, because they can’t just take the medication and get well. They have no social skills, they are loners. And one of the things that may happen if you treat a patient like this is that you may get a wedding invitation. For the first time in their life they feel good enough to date, to fall in love, and to marry. That is a lot of change fast, and psychotherapy can help them.”
+<blockquote>
+This first victory [the October, 1917 revolution] is not yet the final victory, and it was achieved by our October Revolution at the price of incredible difficulties and hardships... We have made the start... The important thing is that the ice has been broken; the road is open, the way has been shown.
+</blockquote>
-Akiskal’s story also points out that psychiatric science is now configured, at least for many of the more senior scientists, as a rejection of the psychodynamic approach to mental illness. This rebellious aspect of psychiatric science might well vanish in two decades. But now it is very real. Many of the more senior scientists (particularly those who went to medical school when the psychoanalytic model still dominated psychiatry) tell their career story around that turning point. One brilliant, maverick scientist was still angry at his analytic supervisors from a residency of decades earlier. He told me that one of his patients had complained of sudden attacks of intense anxiety in public places, the symptoms of which would now be called “panic attacks.” When he wondered out loud to his residency supervisor whether the problem could be organic, his supervisor chided him for his fear of therapeutic intimacy. Now the standard psychopharmacological line on panic disorder is that 95 percent of the cases are manageable with antidepressants. The maverick scientist still has not lost his fury at an explanatory system that told him that he was emotionally inadequate when he questioned the standard psychoanalytic explanation of his patient’s pain. Neither have many others who became the first large generation of psychiatric scientists and tell stories about psychoanalytic supervisors who questioned their motives when they questioned the psychological cause of illness.
+So, Lenin knew that the victory over the Czar and feudalism was only a partial victory, and that more work needed to be done to defeat the bourgeoisie entirely. He believed the key to this victory over the capitalist class would be economic development, since Russia was still a largely agrarian society with very little industrial or economic development compared to Western Europe:
-Many of these older scientists adopt a style that seems deliberately to signal that they are not the tweedy, reserved psychoanalysts of their supervisors’ generation. This is not true of all scientists. Neither Cole nor Akiskal has chosen this style, nor, in my experience, have any female scientists. The male scientists who do display little stern abstinence. They pump iron, play squash, and are the aging athletes of psychiatry. They go drinking and dancing with their lab technicians and junior colleagues. They talk quickly and loudly. Their ideal is the scientist—usually the laboratory scientist, even if they themselves do clinical research. They are fiercely scornful of Freud, some of them the more intensely because they came to Freud after being philosophy majors and initially saw Freud as a means of putting philosophical skills to practical use. Many of them came of age in the era not only of Thorazine but of LSD, and many came to the recognition of brain rather than mind through youthful experimentation during college. “One of the things that was pretty important was getting into the drug scene,” one of these men explained to me. “That was what you did then, but it was pretty striking for someone interested in psychodynamics who had been taught that our experience of reality is shaped by our history with our parents. I mean, one day I went along to my professor’s office—and he was a pretty well known analyst, as well as being a professor, and I was tripping my brains out and the swirls in the carpet stood up and walked around the room and I thought, if a drug can do this to my sense of reality, what am I doing taking all this psychoanalytic stuff at face value?” Above all, these men present themselves as people to be judged by their accomplishments, not by their personalities.@@@[[#6Asurveyfromthe1980sJA|6]]$$$
+<blockquote>
+Our last, but most important and most difficult task, the one we have done least about, is economic development, the laying of economic foundations for the new, socialist edifice on the site of the demolished feudal edifice and the semi-demolished capitalist edifice.
+</blockquote>
-George Banks (a pseudonym) is a good example of this kind of psychiatric scientist, although no one, of course, is “typical.” I met him on a balmy spring day in California. He had an elite, rugged, sailing-on-the-bay look. He was Protestant. He was in his forties. He lifted weights. He identified himself primarily as a scientist. He was a clinical researcher and was looking for interesting connections between behaviors and drug response, and he also had an extensive clinical practice in psychopharmacology. He had, however, started out planning to be a psychoanalyst.
+Lenin’s plan for rapidly developing the means of production was his New Economic Policy, or the NEP. The New Economic Policy was proposed to be a temporary economic system that would allow a market economy and capitalism to exist within Russia, alongside state-owned business ventures, all firmly under the control of the working-class-dominated state. As Lenin explains in ''Fourth Anniversary of the October Revolution'':
-“I went off to college to study philosophy, and it was great,” he told me. “I was definitely on the humanities track, not natural science, not even social sciences. I wanted to know how people had conceived of the great problems throughout human history. They were heady, passionate times. We would stay up all night, talking about Suzanne Langer, thinking exciting thoughts. I did some pretty good work, actually. But you couldn’t really go to grad school then [in the middle 1970s]. I had sent off for applications to a number of graduate programs. One of them—I think it was the University of California—sent me an application with a frank letter, thanking me for my interest and not wishing to discourage me but wanting me to know, before I committed myself, that there were no jobs currently available in the field. I went to Europe for a time, to be a little closer to the sources of Western ideas, and I visited Freud’s house in Vienna. That was pretty powerful, and I thought that medicine was kind of practical, and that was good. I had what seemed like an inspired insight at the time, that to be a psychoanalyst would allow me not only to reflect on life but also to provide a service that would guide others through the philosophical way of life. So I went to medical school to be a psychoanalyst.”
+<blockquote>
+At this very moment we are, by our New Economic Policy, correcting a number of our mistakes. We are learning how to continue erecting the socialist edifice in a small-peasant country.
+</blockquote>
-Many of the older scientists first chose psychiatry in order to learn about psychoanalysis. A psychiatrist who initially conceived of himself as a future psychoanalyst and then rejected that view is likely to be quite clear—and angry—about the conceptual orientation that sets the two approaches apart. George continued, “I’m sure I read more of Freud’s work than any of my colleagues. I read at least three quarters of it by the end of college. It was fascinating, that he recognized that the attraction the patient felt towards him seemed to be transferred from other relationships, that he could sit back and say, this isn’t just me. I had never been in psychotherapy myself, had never seen it done, and I didn’t really have any clinical experience. It was all very interesting, but it was all pretty theoretical. That probably is one of the reasons I became disenchanted by the model. It’s much harder to become disenchanted once you’ve paid for your own psychoanalysis.” (This is probably an accurate remark. To go into analytic training and claim at the end of the more than one hundred thousand dollars it costs you that the enterprise is misguided demands a great deal of our limited human capacity for disinterested objectivity.)
+He continues later in the text:
-“So anyway, I entered medical school having done all this work in philosophy and psychoanalysis, but right at the beginning, I think I had a really strong interest in neuroscience. Neuroanatomy, neuropharmacology, the brain. And the psychiatry teaching was dumb. Like, you should be kind to your patients because they are people just like you. I was insulted. Then I signed up for a course that turned out to be about the leading ideas in biological psychiatry by the leading researcher into the genetics of schizophrenia. I had the sense that things were moving, that these people were in the forefront of something, and meanwhile there was this dull course taught by a psychoanalyst who was presenting Freud in a really diluted way. I had the impression that I’d read more than he had. He spoke as if he had no understanding that there were several Freudian models of mind and many post-Freudian ones, as if he had no awareness of his intellectual roots. I tried to ask questions, and I would be given various responses, like ‘You’re going to have to delve further,’ but it didn’t seem like anyone could tell me exactly what they were seeing that I wasn’t. It was like the analysts had this knowledge but they couldn’t impart it. And if they did really understand, why weren’t the patients getting better?
+<blockquote>
+The proletarian state must become a cautious, assiduous and shrewd “businessman,” a punctilious wholesale merchant — otherwise it will never succeed in putting this small-peasant country economically on its feet. Under existing conditions, living as we are side by side with the capitalist (for the time being capitalist) West, there is no other way of progressing to communism. A wholesale merchant seems to be an economic type as remote from communism as heaven from earth. But that is one of the contradictions which, in actual life, lead from a small-peasant economy via state capitalism to socialism. Personal incentive will step up production; we must increase production first and foremost and at all costs. Wholesale trade economically unites millions of small peasants: it gives them a personal incentive, links them up and leads them to the next step, namely, to various forms of association and alliance in the process of production itself. We have already started the necessary changes in our economic policy and already have some successes to our credit; true, they are small and partial, but nonetheless they are successes. In this new field of “tuition” we are already finishing our preparatory class. By persistent and assiduous study, by making practical experience the test of every step we take, by not fearing to alter over and over again what we have already begun, by correcting our mistakes and most carefully analyzing their significance, we shall pass to the higher classes. We shall go through the whole “course,” although the present state of world economics and world politics has made that course much longer and much more difficult than we would have liked. No matter at what cost, no matter how severe the hardships of the transition period may be — despite disaster, famine and ruin — we shall not flinch; we shall triumphantly carry our cause to its goal.
+</blockquote>
-“Still, I entered my psychiatry rotation with contempt for psychopharmacology. But within three days, I remember this guy came in from the street absolutely psychotic. His mind was splattered on the wall. He came swinging onto the ward, everyone’s tugging on their neckties [to get them off in case he tried to choke them], and he gets an injection of Haldol [an antipsychotic], and within a hour and a half he was a normal human being again—idiosyncratic, mind you, but making sense in his own way—and I was stunned, absolutely stunned that a very simple and intrinsically uninteresting intervention could so dramatically transform the subjective universe. I had been completely in the psychodynamic camp, and this just woke me up to the fact that there is this other dimension, and it is real. It is concrete.
+With these great works dedicated to the three component parts of Marxism [see Annotation 42, p. 38], the name Vladimir Ilyich Lenin became an important part of Marxism. It marked a comprehensive developing step from Marxism to Marxism-Leninism.
-“I was still pretty dynamic. I was trying to do psychoanalytic research, which was completely obsessional and now, I think, pretty meaningless, trying to define undefined terms and at the same time getting pretty angry at some of these psychodynamic diagnoses which let you claim victim-hood. But then in residency I started out on a largely biomedical unit, and it was a completely unanticipated delight. Patients were getting better. If the first medication didn’t work, you tried another, and there was always a solution to a problem. And you felt so powerful and effective because you were actually doing this action. It was really exciting. One of the key questions was whether all people with psychotic symptoms were schizophrenic or whether some of them were manic depressive. This was terribly important, because if they were manic you could give them lithium, which you wouldn’t do if they were schizophrenic. And it was very exciting to see the way the doctors approached the problem and the impact: these guys were changing the way psychiatry was done in this country. It was totally different from the psychodynamic unit, where the patients were treated for much, much longer periods of time, with minimal medication interventions and maximal interpretations. There the patients never got to go home and the staff were always second-guessing you and talking about you behind your back and the emotional tone of the place was incredible. The nurses were always irritated or offended by something you did or didn’t mean to do, and you would be called to account for these tiny slights you weren’t even aware of. You were always apologizing for something, you never did anything right. Part of the staff’s task seemed to be to expose you as completely as possible. On top of it, the patients really didn’t get better.
+==== d. Marxism-Leninism and the Reality of the International Revolutionary Movement ====
-“And it didn’t make any sense. Even then I thought that the psychoanalytically oriented physicians weren’t listening to the right part of the patient’s story. They might be listening, but they’d already made up their minds that the illness was due to something else. And from my perspective, to see a college student doing fine and suddenly end up manic and then come down with lithium and be back in control, it really is much more consistent with acute episodes of the brain than it is with childhood conflicts that are so quickly erupting and resolving. And [in the late 1970s] I could admit a patient and write a great dynamic summary and present her to a case conference and someone might suggest a psychopharm consult and then another person would say, ‘Why do that?’ And yet I sort of felt that another dynamic formulation might be as plausible and it wouldn’t really matter if I’d chosen that and in retrospect of course it doesn’t, what matters is that the patient has classic major depression, she’s not thinking well or eating well and she needs an antidepressant, fast.
+The birth of Marxism greatly affected both the international worker movements and communist movements. The revolution in March 1871 in France could be considered as a great experiment of Marxism in the real world. For the first time in human history, a new kind of state — the dictatorship of the proletariat state (Paris Commune) was established.
-“I had this analytic preceptor, who wasn’t pleased that I didn’t have complaints about the biological unit and was pretty explicit about not spending time with those types because, he said, people take up sides around here and you’ll find yourself on the wrong side. Watch who you chat with at lunch, that kind of thing.
+-----
-“And gradually, my confidence just eroded. I realized what had happened when I read this book about language and the brain which had a really coherent view of brain function and the way it affects speech. I couldn’t believe that anyone could still believe, as they did, that stuttering was rooted in childhood conflict. I mean, you’d see psychoanalytic interpretations of ulcers, that the introjected mother was eating the stomach lining, before they realized that ulcers were caused by bacteria. And I realized that whenever an effective biological treatment or explanation emerged, there went the psychoanalytic explanation, and I thought, what next?
+==== Annotation 38 ====
-“I saw an intellectual pattern emerging, that psychoanalytic theory was so plastic that it could explain anything. That that is the nature of psychoanalytic principles. You just can’t test them. You can make any conclusion consistent with the story, and I started to learn that I had patients that I treated with one psychoanalytic supervisor one year and another the next, and with each different supervisor I’d be given a different causal story about the patient. And the analysts, after all those years in therapy, maybe they improved in some ways, but judging by what I saw they seemed to be every bit as human and every bit as unenlightened. I got involved in my own research and found an incredible wealth of new information and ways of looking at things. Every once in a while I’d contrast it with other views, but I just found them wanting. The biomedical model just seemed to be more exciting and to offer more chances of new insights and better treatment, better understanding.”
+The Paris Commune was an important but short-lived revolutionary victory of the working class which saw a revolutionary socialist government controlling Paris from March 18 to May 28, 1871.
-Banks is describing a time when there seemed to be an either- or choice between the biomedical and the psychodynamic. Leaving that aside, his account captures a central feature of the psychiatric scientist: that the personhood of neither the psychiatrist nor the patient is relevant to the efficacy of psychiatric treatment. By “personhood,” I mean the idiosyncratic features that make someone who he is: how and when he gets angry, what he fears, how he raises his eyebrow, whether he is abrupt or rude or gentle. Those features (unless they are diagnostic) simply aren’t salient to whether the psychiatrist has chosen the right medication or whether the medication will work. The independence of personhood and the things that count repeats itself through most aspects of psychiatric science.
+During the brief existence of the Paris Commune, many important policies were set forth, including a separation of church and state, abolishment of rent, an end to child labor, and the right of employees to take over any business which had been abandoned by its owner. Unfortunately, the Paris Commune was brutally toppled by the French army, which killed between 6,000 and 7,000 revolutionaries in battle and by execution. The events of the Paris Commune heavily influenced many revolutionary thinkers and leaders, including Marx, Engels, and Lenin, and was referenced frequently in their works.
-For a start, scientists can be indifferent human beings and still have good reputations as scientists, whereas a psychiatric therapist, whose authority rests on being perceived as a good, kind, reliable listener, a non-surgical Marcus Welby, damages his professional reputation and his income by becoming known as a jerk. The same is, if possible, more true for psychoanalysts, whose authority rests in addition upon their own experience of and response to their personal psychoanalysis. We know psychiatrists who might be regarded as narcissistic fools, and some of them are remarkably successful, in part because of a social context that persuades their patients that it is they who are the inadequate parties. But calling a psychodynamic psychiatrist a jerk has a different implication for his work than insulting a scientist in the same way. A therapist’s work depends directly on his human capacity. A scientist’s does not; and many esteemed scientists have been known for their human incapacities as well. We think more warmly of scientists who are generous and kind, but those qualities do not make their science great. This was the unsettling revelation for those who read ''The Double Helix'', that the most capable of scientists could at times come across as an accomplished lout.
+In August 1903, the very first Marxist proletariat party was established — the Russian Social Democratic Labor Party. It was a true Marxist party that led the revolution in Russia in 1905. In October 1917, the victory of the socialist revolution of the proletariat in Russia opened a new era for human history.
-The scientist’s personal qualities do matter if they affect the reliability of his empirical reports. “Data” emerge out of the morass of real-world particularities —the skewed measurement, the contaminated sample, the imprecise assay—that embed the general mechanism that the scientist wants to identify. Scientists strain to see the data through the specificity of the experimenter who conducted the experiment and the lab where it was done, through the crankiness of the equipment or the humid weather. They reach for what they take to be the regularities beneath the surface noise of individual events. They need to be able to believe that the experimenter’s report is an accurate reflection of what happened; that he does not publish without double-checking his results; that his laboratory is orderly enough that his published work is likely to be replicable. “Scientists know so much about the natural world,” the sociologist of science Steven Shapin remarks, “by knowing so much about whom they can trust.”@@@[[#7StevenShapinASocialHisto|7]]$$$ It is so hard to get evidence for one’s scientific theory that one’s reputation for coming by it honestly is terribly important.
+In 1919, the Communist International* was held; in 1922, the Union of Soviet Socialist Republic was established. It marked the alliance of the proletariat of many countries. With the power of this alliance, the fight against Fascism not only protected the achievements of the proletariat’s revolution, but also spread socialism beyond the borders of Russia. Following the lead of the Soviet Union, a community of socialist countries was built, with revolutions leading to the establishment of socialism in the following countries [and years of establishment]: Mongolia [1921], Vietnam [1945], the Democratic People’s Republic of Korea [1945], Yugoslavia [1945], Albania [1946], Romania [1947], Czechoslovakia [1948], East Germany [1949], China [1949], Hungary [1949], Poland [1956], and Cuba [1959].
-When a scientist is trusted, what is trusted is the data. The individuality of both patient and doctor fade to unimportance. From the point of view of his work, the person of the scientist is less important than the data he collects and the papers he writes. George Banks was morally offended by the discovery that different psychoanalysts describe the same patient in different ways; that psychoanalytic theories might not be disprovable; that psychoanalysts lack interpretive caution and controls. He was shocked by analysts’ relationship to their description of psychiatric patients and by the way they treat what he calls “data.” He assumes that good descriptions of psychiatric patients must be extended beyond the individual: that a door blew open not because the wind was strong that day but because when the wind blows with such-and-such a force, it moves objects whose resistance is below a certain threshold. Banks wants psychiatry to make claims that are independent of the particularities of the psychiatrist and his patient.
+-----
-This ethos is very different from that of a clinician, a person who treats patients to help them, not to study them. A clinician—psychodynamic or psychopharmacological—is interested in what can be done for a person right here, for this unique person with his own story and his idiosyncratic responses to different medications. What matters is whether a patient gets better. A scientist—even though she may be a good clinician when she works in a clinic as a doctor—is interested as a scientist in patients as data points. When she goes to conferences and wanders from poster to poster, she is interested in the experimental results that have been generated. Often she is more interested in experimental results as additional data points than she is in a researcher’s more general theory. When she refers to conferences as having “lots of good science,” she means that she saw good data on interesting problems rather than (usually) that she acquired an approved and agreed-upon conclusion that she can take back to help her with her patients. Scientists go to conferences to look at data and to get ideas about data that will eventually produce interventions that clinicians can use to help their patients; clinicians go to conferences to learn from the scientists what to do to help their patients.
+==== Annotation 39 ====
-The joy of doing science seems to come from this sense you have as a scientist that you have discovered something “true.” Randy Gollub felt in doing each project that she was doing something fundamentally important. The psychiatric scientists I knew saw themselves as finding things out about the world that no one else yet knew. They did behave as if their own discoveries were contingent: true given what we know now, true given the questionable accuracy of the categories we now use, true subject to revision. Still, for all the subtlety of this decade of strained awareness of the flimsy hold we have on the real, these scientists really seemed to feel that they were on a search for a bodily mechanism that could explain some aspect of mental illness, that they would find one, and that “true” for them meant true for all people of a certain type, true beyond the surface, the appearances, and the individual idiosyncracies of human beings. They felt so strongly that they were doing this that they were sometimes shocked when everyday human politics got into the interstices of their science. That, for instance, was what happened to my friend Susan.
+<nowiki>*</nowiki> The First International, also known as the International Workingmen’s Association, was founded in London and lasted from 1864–1876. Karl Marx and Friedrich Engels were key figures in the foundation and operation of this organization, which sought better conditions and the establishment of rights for workers.
-Susan (a pseudonym) had trained at an elite residency program. Then she spent some years at a research institute where the brightest young psychiatric scientists are invited to spend a postresidency fellowship. She had decided to become a scientist in part because of a premenstrually psychotic woman she’d encountered during residency: “I saw a patient who was quite psychotic, and we didn’t know the etiology, couldn’t figure out what was going on. My unit director said, ‘Don’t medicate her until we have a better sense of the problem.’ The next thing you know, she walks into my office and she is crystal clear and she has her period. It turned out she had gotten psychotic in response to her menstrual period. That was pretty fascinating. We followed her, did serial taps on her spinal fluid, and we found that during her period her dopamine/serotonin ratio went off kilter. We could track that for her and medicate her appropriately, and she no longer became psychotic with her menstrual cycle.”
+The Second International was founded in Paris in 1889 to continue the work of the First International. It fell apart in 1916 because the members from different nations could not maintain solidarity through the outbreak of World War I.
-Susan wrote a paper on that in residency. To turn the anecdote into a scientific study, she advertised for more subjects, collected more spinal fluid, and analyzed the data. When she arrived at her research institute, she continued the work and found that women often had higher prolactin levels and lower thyroid levels than usual during their premenstrual phase. She reasoned that sleep deprivation might reverse those trends, and it did. She found a research group working with people suffering from seasonal affective disorder, who respond with particular intensity to the lower level of light in winter and become depressed. As she became involved with the project, she began to talk to the patients. The women said that their premenstrual syndrome improved when they were treated with light for the seasonal affective disorder. Susan speculated that the light suppressed their melatonin. Indeed, she then discovered that the good effects of the light therapy could be reversed just by giving the women doses of melatonin. She moved into the field of “chronobiology”—“Hormones and neurotransmitters are connected all over the place,” she said. “It gets messy”—and started flying around the world to attend meetings on circadian rhythms. She became widely known for her work on women, hormones, light, and psychiatric illness.
+The Third International, also known as the Communist International (or the ComIntern for short), was founded in Moscow in 1919 (though many nations didn’t join until later in the 1920s). Its goals were to overthrow capitalism, build socialism, and establish a dictatorship of the proletariat. It was dissolved in 1943 in the midst of the German invasion of Russia in World War II.
-When the official psychiatric diagnostic manual was being revised in the middle eighties, Susan was part of the battalion of psychiatrists who helped evaluate the existing diagnostic structure. She and others argued that there should be a category for “late luteal phase dysphoric disorder,” which by this point was more commonly thought of as PMS, or premenstrual syndrome. To receive the diagnosis, a woman had to experience five of the following ten symptoms before her period, of which the first four were the most important: (1) marked affective lability (suddenly feeling sad, tearful, angry, or irritable); (2) persistent and marked anger or irritability; (3) marked anxiety, tension, feelings of being “keyed up” or “on edge”; (4) markedly depressed mood, feelings of hopelessness, or self-deprecating thoughts; (5) decreased interest in usual activities, such as work, friends, hobbies; (6) easy fatigability or marked lack of energy; (7) subjective sense of difficulty in concentrating; (8) marked change in appetite; (9) hypersomnia or insomnia; (10) physical symptoms such as breast tenderness or swelling, headaches, joint or muscle pain, a sensation of bloating, or weight gain. Everyone on the committee voted to include the diagnosis in the diagnostic manual.
+These great historical events strongly enhanced the revolutionary movement of the working class all around the whole world. The people awakened and encouraged the liberation resistance of many colonised countries. The guiding role of Marxism-Leninism brought many great results for a world of peace, independence, democracy, and social progress.
-At this point the Women’s Committee of the American Psychiatric Association, aided by the Women’s Committee of the American Psychological Association, held meetings, contacted the media, and in general made their distress about the diagnosis so public that the officials of the American Psychiatric Association backed down from their pledge to support the scientists. The diagnosis was printed in the appendix, as a topic for further research. Susan was horrified that a belief in what ''should'' be the case should override what science had demonstrated to ''be'' the case: that some women had premenstrual periods that caused them to experience symptoms of mental illness. It was unfortunate, but it happened to be true. “Those women just didn’t want to see any difference between men and women at all,” she complained. “I thought, this is ''science''. This is supposed to be a scientific document based on clinical work. Some women have these problems. It’s ridiculous to think that men and women aren’t different. They have different endocrine systems. Hormones protect against some diseases, but they make you more vulnerable to others. That’s the science. It was so upsetting to find out that you could be scuppered by the media, as if the politics could matter more than the truth.”
+However, because of many internal and external factors, in the late 1980s, the socialist alliance faced a crisis and fell into a recession period. Even though the socialist system fell into crisis and was weakened, the socialist ideology still survived internationally. The determination of successfully building socialism was still very strong in many countries and the desire to follow the socialist path still spread widely in South America.
-The psychoanalytic theory of mind will never anymore be understood to provide the explanatory foundation of mental illness, because that foundation, as it is culturally constructed in this age of electron microscopes and genetic analysis, lies beyond personhood, in biological microstructures that escape uniqueness. There is a quality here of the deepest and most real. It has a moral quality: that this knowledge is what really counts, what really makes a difference, what in the end creates the greatest good for the greatest number. Even if one scientist accomplishes little, every scientist participates in the aspirations of the whole. And that is why when young psychiatrists choose to become clinicians, they can see themselves as choosing self-indulgence or lifestyle over the search for truth. For many young psychiatrists, at least in residency, the moral authority of science outranks the moral authority of helping people one person at a time. That is why they may feel shamed by their decision to leave scientific research behind and go out into the private or public sector to become clinicians.
+Nowadays, the main feature of our modern society is fast and varied change in many social aspects caused by technology and scientific revolution. But, no matter how quickly and diversely our society changes, the nature of the capitalist production method never changes. So, in order to protect the socialist achievements earned by the flesh and blood of many previous generations; and in order to have a tremendous development step in the career of liberating human beings, it is very urgent to protect, inherit and develop Marxism-Leninism and also innovate the work of building socialism in both theory and practice.
-=== {{anchor|THEPSYCHOANALYST}} THE PSYCHOANALYST ===
+The Communist Party of Vietnam declared: “Nowadays, capitalism still has potential for development, but in nature, it’s still an unjust, exploitative, and oppressive regime. The basic and inherent contradictions of capitalism, especially the contradictions between the increasing socialization of the production force and the capitalist private ownership regime, will never be solved and will even become increasingly serious. The feature of the current period of our modern society is: countries with different social regimes and different development levels co-exist, co-operate, struggle and compete fiercely for the interests of their own nations. The struggles for peace, independence, democracy, development, and social progress of many countries will still have to cope with hardship and challenges but we will achieve new progress. ''According to the principles of historical development, human beings will almost certainly go forward to socialism.”''<ref>''Delegate Document of the 11<sup>th</sup> National Congress of the Communist Party of Vietnam.''</ref>
-When I began this work, I found a mentor in a gifted senior analyst, who told me, when I spoke to him about the pathways of young psychiatrists, that I should read ''Magister Ludi''. What I’d told him, he said, reminded him of the selection process for the elite players of the fictional glass bead game at the novel’s center. He thought the novel would help me to understand the process of becoming a psychoanalyst.
+-----
-''Magister Ludi (The Glass Bead Game)'' is Hermann Hesse’s most elaborate novel, possibly his best. It presents the putative history of Joseph Knecht (in German, “servant”), the legendary master of the glass bead game, and his rise to prominence. The game itself is never fully described, yet it becomes clear that it demands not only sophisticated intellectual skill but a kind of personal grace and purity that direct ambition will thwart. The hero “had no desire to dominate, took no pleasure in commanding; he desired the contemplative life far more than the active life, and would have been content to spend many years more, if not his whole life, as an obscure student, an inquiring and reverent pilgrim.”@@@[[#8HermannHesseTheGlassBead|8]]$$$ He becomes a powerful ruler of men. Most of Hesse’s novels have a sometimes irritatingly noble character who struggles against a plot of human pettiness, and Knecht is his fullest characterization.
+==== Annotation 40 ====
-This is an unusual way to describe what is, after all, a well-institutionalized profession, but it captures a quality that is often missed by those who look at psychoanalysis from the outside. This quality is its ethos, its moral tone. Psychoanalysis has a profound moral vision, but that vision is not focused on the rights and wrongs of behavior. That is why Philip Rieff, in a famous book, ''Freud: The Mind of a Moralist'', could argue that though Freud had a sternly moralistic mind, psychoanalysis by its nature was amoral because it ignored conventional standards. A world that took psychoanalysis seriously, Rieff said, would have no ethical core because its culture would have no basis for guidance. Analysts do tend—as Earle pointed out—to listen in order to understand, not to judge. They want to know why someone committed adultery and lied about it more than they want to condemn the action. They are interested in intentions, both conscious and unconscious, and in how those intentions lead to action. They see, as one senior analyst put it, action as in service to the self, and what fascinates them is not what people do but why—what self those actions serve. Analysts also believe that the “why” is inherently unknowable, because aspects of one’s own psyche are always hidden and an observer can never see clearly because his own unconscious intentions distort his vision. But analysts also believe that you can come to know more than you did, even if you can never know everything. The psychoanalytic ethos, then, focuses on the honesty with which you try to know and the caring in the way you try to help another person know. If what really counts for the psychiatric scientist is knowledge, what really counts for the psychoanalyst is the process of coming to know. Joseph Knecht was a model for my mentor because he was not self-interested: he was able to act for others, to serve them, without the intrusion of his own wants, fears, and needs. My mentor did not really believe that it was possible to be like that. But he took it as a kind of analytic ideal.
+Historical materialism is the application of dialectical materialist philosophy and materialist dialectical methodology to the analysis of human history, society, and development. The principles of historical materialism, as developed by Marx, Engels, and Lenin, indicate that human society is moving towards socialism and will almost certainly — in time — develop into socialism, and then proceed towards a stateless, classless form of society (communism). These principles of historical materialism were initially formulated and discussed in several books by Marx, Engels, and Lenin, including:
-A psychoanalyst is evaluated by peers first and foremost as a certain kind of person. That is, analysts judge themselves and other analysts on the basis of criteria that are primarily about who they are, not what they do. In part this is the simple consequence of a practice in which no one ever sees a practitioner perform except his patients, who (as analysts see it) are not able to have an objective judgment about an analyst’s performance. In fact, satisfied customers do generate more customers. At least some of an analyst’s patients come to him because they have heard about him from other patients. An analyst’s reputation owes something to what other analysts have heard about the way he treats his patients. I was once standing in the cocktail lounge during the annual meeting of the American Psychoanalytic Association and, striking up a conversation with the man waiting behind me in line for wine, asked him what he thought of an analyst whose work I had been reading. The man winced, and said with contempt that the writer sounded good on the page but he was mean to his patients. An analyst’s reputation also owes something to the way he appears in public. When he speaks, his listeners draw conclusions not only about whether he is smart or stupid but about whether they would send a patient to him for analysis. This fact about psychoanalysis not unnaturally shapes the way analysts present their public papers.
+''•'' ''The German Ideology'', by Marx and Engels
-The main gathering of the American Psychoanalytic Association occurs in New York the week before Christmas. Despite the freezing, wintry weather, the conference is called the “fall meeting.” It is always held at the Waldorf-Astoria, a hotel, like the profession itself, that is elegant and nostalgic for its past. The first time I attended, the hotel seemed full of elderly Europeans in fur coats embracing in the lobby. (One young analytic candidate told me that going to the American Psychoanalytic Association meetings was like watching dinosaurs deliberate over their own extinction.) Lately among the two thousand attendees I can see more of the young people who are, rather surprisingly, entering the profession. The demand for full psychoanalysis is declining rapidly, so that in few places apart from New York can analysts with full analytic practices be found, and few enough even there. But most people do not enter analytic training in order to establish an analytic practice. Far more, in my experience, choose analytic training because they believe, probably correctly, that the training will improve their psychotherapeutic skills. Some of them simply want to become part of what even now is thought to be a psychiatric elite. “A friend of mine said that she was interested in psychotherapy,” one of the residents remarked to me, “and that she’d probably go to one of the uptown analysts, and I thought to myself, right, that’s what I should be if I want to make it, an uptown analyst.” But my mentor thought that people entered analytic training only if their own personal pain drove them to it.
+''•'' ''Socialism: Utopian and Scientific'', by Marx and Engels
-The fall meetings of the American Psychoanalytic Association have a hushed, respectful quality. The men wear professorial jackets, sometimes a little scruffy. The women wear soft, textured knee-length suits in muted colors. These are not sharp-edged businessmen. They are people who work alone, often in little offices in their attics or basements; cramped, sparsely furnished rooms at the margins of their more capacious houses, with a narrow entrance at the back or side so that a patient need never see the wife unpacking groceries on the kitchen table. This conference is their social fraternity as well as their public examination. Their clothes are intended to display their graciousness and their carefully calibrated tolerance for the unconventional. “Anthropologists,” a psychoanalyst said to me with some disapproval, “can be flamboyant. Psychoanalysts are not allowed to be flamboyant.”
+''•'' ''Karl Marx'', by Lenin
-The papers given at the meetings are also intended to display their presenters’ psychoanalytic suitability. It is common for an analyst to criticize another analyst not only for his intellectual argument but for his quality as an analyst, which is imagined on the basis of what he has written in his paper and the way in which he has presented it. One senior analyst, for instance, dismissed a paper he didn’t like at the American Psychoanalytic Association meeting with “He struck me as somebody who really had this very limited view of what it was that he was doing and how he was doing it. I was struck by his exhibitionism. He really took off, and he was, I think, the least qualified person there. And I could imagine how he might be with a patient.” In other words, the senior analyst disliked the intellectual content of the paper, formulated his dislike around the personal characteristics of the paper presenter, and summarized his criticism by suggesting that these were not characteristics that would be helpful for an analyst doing analysis. This is not an uncommon sort of comment, nor indeed is it easy not to wonder, when watching analysts deliver a paper, what they are like with a patient, what it would be like to be in analysis with them. Just being on a panel, however, can increase referrals, a term used to describe one doctor’s decision to refer a patient to another doctor. The better known the analyst is, the more his name crops up when potential analysands ask for advice. “It really helps when someone has a patient coming here from elsewhere, and they get my name because that analyst heard me give a paper,” an analyst remarked to me. “If they’ve heard someone speak, it really helps. I get a lot of referrals from the outside.”
+The Communist Party of Vietnam has also declared:
-The result of this scrutiny is that the papers delivered at these meetings are often somewhat odd attempts to convey the restrained sobriety of the field’s ideal representation of the good analyst: unexcitable (excitability would imply that the analyst would respond to his own needs rather than those of his patient), unimpressionable (impressionability would imply that the analyst could not retain sufficient emotional distance from his patients; the result of this hesitation to show gullibility is that the only really acceptable reference is Freud), and reserved (there are lengthy, laboriously argued papers on the question of under what circumstances it might be appropriate to touch a patient on the shoulder: none, for the most part). The technical term for this restraint is “abstinence.” The analyst abstains from responding to the analysand in kind but analyzes the analysand’s behavior and discourse. In demonstration of these ideal traits, paper presentations at the American Psychoanalytic Association are sometimes dull. Most papers are read in a flat monotone devoid of emotional inflection.
+“In the opinion of the Vietnam Communist Party, using Marxism-Leninism and Ho Chi Minh Thought as the foundation for our ideology, the guideline for our actions is an important developmental step in cognition and logical thinking<ref>''Delegate document of the 9<sup>th</sup> national congress of the Communist Party of Vietnam.''</ref>. Achievements that the Vietnamese people have gained in the war to gain our independence, in peace, and in the renovation era, are all rooted in Marxism-Leninism and Ho Chi Minh Thought. Therefore, we have to ‘creatively apply and develop Marxism-Leninism and Ho Chi Minh Thought in the Party’s activities. We have to regularly summarise reality, complement and develop theory, and soundly solve the problems of our society.’”<ref>''Delegate document of the 10<sup>th</sup> national congress of the Communist Party of Vietnam.''</ref>
-At the same time, some papers attempt to indicate the analyst’s gift for human warmth. Warmth is not an obvious characteristic of this severe, restrained world. Yet in recent years, as psychoanalysis has become a buyer’s market and particularly after self psychology began to provide a theoretical justification for paying attention to a therapist’s relationship skills, appearing to be approachable and easy to talk to has become important. Analytic “stars” have acquired sufficient authority to perform their papers as theatrical events: to modulate their tone of voice; to show evidence of having practiced the talk before presenting it to an audience. They are eager to indicate their personableness, their interest in other people, and their capacity to understand. They speak of their concern for their patients and speak lovingly of patients who have been “failed” by their analysts. They talk of discovering their patients’ capacity to forgive themselves. They will, if they accidentally make a Freudian slip (and analysts not infrequently make such slips when presenting papers), smile at the audience as if to say, I am human, I forgive myself, I share with you the tolerance of human weakness.
+-----
-The route into this contradictory psychoanalytic world is closely guarded, and despite the fact that no analyst-to-be is ever directly observed in the analytic hour, there are certain performance criteria for success. Candidates must meet three conditions in order to graduate. They must have completed a training analysis at an institute with a senior member who has been designated a “training analyst.” In analysis, a patient comes each day (more or less) of the five-day workweek, for roughly hour-long sessions (actually forty-five or fifty minutes) each day. Analysis often lasts for six to eight years. Candidates must also participate in seminars on psychoanalytic theory and practice that run perhaps six hours a week for four years. In addition, they must carry out three analyses, of which one must have reached termination and the two others been ongoing for at least two years, and each of which has been supervised weekly by a training analyst. The process is fantastically expensive. The training analysis can cost $20,000 for each of five or more years, and weekly supervision can add $5,000 per annum per case; by three years into the training, when the candidate is still in analysis, still attending classes, but also carrying “control” cases for a very low fee, the time spent in training can run more than twenty hours per week. The standard calculation made by psychiatric residents is that analytic training could generate a $40,000 drop in income for five years or more and that the total time in training would be at least eight years. (Time spent in training could otherwise generate income.) Nor is this loss necessarily recouped: nonanalytically trained psychiatrists often set their fees as high as those who are analytically trained.
+==== Annotation 41 ====
-In 1990, the American Psychoanalytic Association surveyed its approximately three thousand members (2,083 returned the questionnaires).@@@[[#9LeeDavidBrauerBasicRepo|9]]$$$ Analysts, the report noted, are not young. The typical analyst graduated from training in 1972 and was in his late fifties; “his” because only 17 percent were female, although there has recently been a marked increase of women in the profession. He earned an average of $128,000 and was a psychiatrist. He worked an average of forty-five hours a week, with 76 percent of that time spent in private practice. He had two analytic patients—training analysts had an average of four analytic patients, but the modal number was two—with a total of eighteen patients, most of whom he saw once or twice a week in psychotherapy. (When an analyst sees patients in analysis four times a week, as well as patients who come in less frequently, he refers to the second group as “psychotherapy patients.” He treats his psychotherapy patients with psychoanalytically oriented psychodynamic psychotherapy.) He spent most of his time, then, doing something other than psychoanalysis in the strict sense.
+Ho Chi Minh Thought refers to a system of ideas developed by Ho Chi Minh and other Vietnamese communists which relate to the application of Marxist-Leninist philosophy and methodology to the specific material conditions of Vietnam during the revolutionary period.
-The training analyst is the most powerful member of this field. A training analyst is one of a subset of analysts associated with a particular institute who have been handpicked to do all the supervision and analysis of candidates at that institute. The American Psychoanalytic Association sets certain restrictions on those who can be named training analysts: they must have carried five analytic cases since graduation and written case reports about three of them. In the golden years of psychoanalysis, most institutions had many analysts who were qualified to be training analysts but who were not (or not yet) selected. This could be a powerful conventionalizing force, because training analysts were often not chosen until years after their own graduation. The fear of being passed over could keep an analyst’s criticism of his seniors in check for a decade.
+There is no universal road map for applying the principles of Marxism-Leninism. How the philosophy of Marxism-Leninism should be applied will vary widely from one time and place to another. This is why Ho Chi Minh and other Vietnamese communists had to develop Ho Chi Minh Thought: so that scientific socialism could be developed within the unique context of Vietnam’s particular historical development and material conditions.
-Training analysts earn more than other analysts ($139,000 compared to $112,000 for the just-graduated in the 1990 study). They have a steady stream of patients, because all candidates must have analysis and supervision, and the candidates pay the training analysts for their time. Training analysts run the local institutes, and the mystery of their selection process has a kind of Skull & Bones mystique that reduces grown men and women to childish panic. “To be selected as a training analyst,” said one aspirant, visibly more agitated on this topic than he had been during our talk about theory, “they have to scrutinize your character, which is a whole mysterious process. Talk about being subject to their moral attitudes! God knows who says what about you and in what context—I mean, they integrate what they hear from the couch, and it is this ''totally'' bizarre process.”
+It is the duty of every revolutionary to study Marxism-Leninism as well as specific applied forms of Marxism-Leninism developed by revolutionaries for their own specific times and places, such as: Ho Chi Minh (Vietnam), Mao Zedong (China), Fidel Castro and Che Guevera (Cuba), etc. However, it must be recognized that the ideas, strategies, methodologies, and philosophies developed in such particular circumstances can’t be applied in exactly the same way in other times and places, such as our own contemporary material conditions.
-The history of psychoanalysis is a history of schism. Analytic institutes are famous for their tribalism and the smallness and ferocity of their quarrels. “They ''all'' act like they haven’t been analyzed,” an analyst said bleakly in an interview about psychoanalytic social life. More than 20 percent of the respondents in the 1990 study complained about institute politics. (The authors of the study pointed out that the complainers were not training analysts.) One respondent fumed, “On the national level, virtually every decision of the American [he refers to the Association and, for example, the decision to allow non-M.D.s to receive training] seems to have been wrong or ill timed; opportunities to unify psychoanalysis have been squandered or allowed to slip out of its grasp; on the local level, pettiness abounds.”@@@[[#10Ibidp18|10]]$$$ Many local institutes have splintered after terrible fights.
+''The Renovation Era'' refers to the period of time in Vietnam from the 1980s until the early 2000s during which the Đổi Mới (renovation) policies were implemented. These policies restructured the Vietnamese economy to end the previous subsidizing model (which was defined by state ownership of the entire economy). The goals of the Renovation Era were to open Vietnam economically and politically and to normalize relations with the rest of the world. The Đổi Mới policies were generally successful and paved the way to ''the'' ''Path to Socialism Era'' which Vietnam exists in today. The goals of the Path to Socialism Era are to develop Vietnam into a modern, developed country with a strong economy and wealthy people, which will allow us to transition towards the lower stage of communism, which Lenin called “socialism.”
-Some of this death-grip infighting over trifles must have to do with the odd quality of these relationships. Most analysands, after the emotional drama of psychoanalytic treatment, walk out of their analyst’s office and never see him again. When analytic candidates finish their treatment, by contrast, they join their analysts as supposed equals in the intimate setting of the committee room. All of a sudden, the lopsided power relationship of the consulting room becomes a relationship between peers. The transition is hard and, some would say, never complete. Small squabbles become family dramas with contingents of angry, loyal, competitive siblings. This stems from the terrible contradiction of consulting room relationships: that they generate feelings of intense emotional attachment that violate most of the standard cultural expectations of human closeness.
+And, finally: “We have to be consistent with Marxism-Leninism and Ho Chi Minh Thought. We have to creatively apply and develop the ideology correspondingly with the reality in Vietnam. We have to firmly aim for national independence and socialism.”
-Even the architecture surrounding these relationships is unusual. The analyst has an office, which often has been architecturally rebuilt so that arriving and departing patients never lay eyes on each other. The door to the clinical consulting room is extra thick, like the “piano doors” of music practice rooms, or doubled with two doors to insulate the room from the outside world. The consulting room itself is quietly spare. I met only one analyst whose office resembled the sprawling collectorly chaos of Freud’s own, with a kelim-covered couch and antiques strewn around the room. Usually there is an unadorned analytic couch—a flat bed with a slightly raised headrest—in leather or tweed and some abstract art. The couch’s headrest is covered by a paper napkin, freshly changed for each patient. The analyst sits behind the couch’s head, often on a comfortable black leather swivel chair. Directly across from him is another, often identical, chair for the psychotherapy patients whom he sees sitting up. The chairs are identical so that the patient will not feel belittled by his own chair’s inadequacy.
+== II. Objects, Purposes, and Requirements for Studying the Basic Principles of Marxism-Leninism ==
-In analysis, an analytic patient lies on the couch, from which he cannot see the analyst. Analysts often say that it is easier to do therapy when you don’t have to look at the patient. It is easier because you do not need to observe the social niceties; you can, as one analyst observed, scratch your behind. It is easier, also, because violating the social niceties is what analysis is about. An analyst is silent about the common subjects of everyday conversation. He does not tell analysands about the people he knows. He does not talk about his family, his work, or himself. He does not respond to his patients with the usual conversational latency. Often, he says very little. He waits and lets them say more. If he tells his patients that he will be away on vacation and they ask him where he is going, he is more likely to ask them what their fantasies are about his vacation than to reveal where he is headed. This habit, which is useful in the consulting room, is sometimes maddening in ordinary social conversation, into which it sometimes creeps. When an analyst does speak, he rarely says all that he knows, infers, or speculates about the other person when in conversation with that person. “You’re taught never really to say anything during the analysis,” a senior analyst explained.
+=== 1. Objects and Purposes of Study ===
-This is a profession that you enter to help other people. Yet its method demands that an analysand, the person in analysis, lie on a couch so that he or she is unable to see the analyst, and the demand of abstinence further dictates that the analyst not reveal herself, not talk about her home life or her feelings. In analysis, a patient is asked to reveal his most private thoughts and emotions, an act that usually entails reciprocity. Not only is an analyst not expected to reveal herself, she is expected not even to respond with normal emotions. “When the young man in one of his first hours with me on the couch took out a cigarette and lit it,” a well-known analyst reminisced in a famous text on psychoanalytic technique, “I asked him how he felt when he decided to light the cigarette. He answered that he knew he was not supposed to smoke in his previous analysis and now he supposed that I, too, would forbid it. I told him immediately that all I wanted at that moment was to know what feelings, ideas and sensations were going on in him at the moment that he decided to light the cigarette.”@@@[[#11RalphGreensonTheTechniqu|11]]$$$ Analysis is a deliberate frustration in the name of caring. “You’re on the couch,” one analyst explained, “on my lovely couch staring off onto the blank wall and window. I’m sitting here, and you say something. You don’t know whether I’m yawning or frowning or smiling or whether that funny look of interest is on my face.”
+The objects of study of this book, ''The Basic Principles of Marxism-Leninism,'' are the fundamental viewpoints of Marxism-Leninism in its three component parts.
-The structure of the psychoanalytic relationship is one of great emotional deprivation. In a conversation in which one person is pouring forth a tale of pain, the psychoanalytic relationship does not allow the other listener to respond with his face, with a touch, nor even much with his words. It does not allow him to reciprocate or respond in kind.@@@[[#12PaulEkmanisthepsychologi|12]]$$$ At the same time, the analytic relationship permits the analysand an extraordinary degree of freedom. Here, for the first time, he is encouraged to say any-thing—everything—that enters his mind, without worrying whom he might offend or what social mores he might violate. It permits him to say everything and places him in a passive, dependent, exposed position from which to do so. The combination of the analysand’s confessional experience and the analyst’s inhibition makes for a very asymmetrical relationship. The asymmetry makes the confessor—the patient—feel extremely vulnerable. And the consequence of the vulnerability is a rush of emotion.
+-----
-It is a remarkable rush, over the top and out of control. Within months, weeks, or even minutes of the first analytic encounter, patients develop powerful feelings about their analysts or their analyses. The content of those feelings can be wildly varied: hate, love, fear, anger, anything. But the intensity is undeniable and obvious. Residents become deeply uncomfortable when they catch sight of their analyst in the hospital. A young woman I met on the plane to the American Psychiatric Association meeting said, smiling nervously, that she actually felt quite shaken and insecure these days, that she often cried without reason, but that this was to be expected in the first year of analysis and she was sure the analysis would eventually help. Young psychiatrists hear their peers report, as I heard a resident do, that a resident had been saying thus-and-such in his session with his therapist and then “He”—using the pronoun in a hushed, reverential tone—had said such-and-such. They become suddenly, deeply, awkwardly, pinkly embarrassed when they talk about their analysts and unexpectedly and excruciatingly shy when they attend one of his lectures at the local institute. They arrive at their analyst’s office and burst into tears, because it is her office. Wherever they come from, these feelings grip an analysand with such iron teeth that it is not unusual to hear people declare that their life was profoundly disrupted for the first two years they were in analysis and that their analyst has become the most important person in their life. The violence of these feelings cannot simply be attributed to the cultural expectations about psychoanalysis. The feelings are too sudden, too unexpected, too strong.
+==== Annotation 42 ====
-As I have said before, the analytic explanation of this intensity is that the feelings re-create the experience of earlier relationships from which they are transferred. As one analyst wrote, “The important and enduring aspect of the concept of transference neurosis [is]: it defines the analytic process as [a] repetition of early pathogenic experiences and their intrapsychic pathological vicissitudes.”@@@[[#13HansLoewaldPapersonPsyc|13]]$$$ Hans Loewald, who is known for the brilliance and subtlety of his work on transference, goes on to pry gently loose the idea that transference only evokes feelings from the past, and he and later analysts do articulate the complexity of transference as incorporating an analysand’s present relationship with the analyst and the great range of experiences incorporated in an analysand’s response to the analyst. But the analytic discussion of transference tends to ignore the far more basic (and anthropological) question of why these feelings are so very, very strong.
+Remember that a viewpoint is the starting point of analysis which determines the direction of thinking and the perspective from which problems are considered. Also remember that Marxism-Leninism has three component parts:
-I suspect that the structure of the analytic relationship itself, and particularly its emotional deprivation, generates the intensity of the analysand’s response. Not the content: undoubtedly the content of each analysand’s emotional response to the analyst is the result of the personal history of that analysand’s experience. But it may be the case that the intensity of the feelings, this great amplification, is the consequence of the unusual communicative structure of the analytic relationship: that the analysand tells the secrets of his soul to a person who does not reciprocate, does not respond in kind, and whose face he cannot even see. In a “normal” relationship—one that conforms to standard expectations of human relatedness—when one person makes himself vulnerable to another person, that person reciprocates by being equally vulnerable, telling the story of her personal afflictions and struggles. In a “normal” relationship, one person’s expression of love or hatred is met by a symmetrically powerful feeling, not a cool voice inquiring in what way the analyst is lovable or despicable. In a “normal” relationship, you see the face of the person to whom you are talking, and you read immediately the emotional response of your companion. That none of these normal features is present in an analytic relationship makes that relationship most unusual. Yet the emotional strength of the analysand’s experience probably stems from a very general feature of human relationships, the fact that emotions intensify the way we communicate. Emotions help us to reach one another. If I tell you that my foot hurts, you may listen; if I scream in pain, you will help me or flee.@@@[[#14Oneofthemorerecentappro|14]]$$$ When one person opens his heart to another and the response is not “normal” but not a straightforward rejection (the beloved has not said no, but perhaps the beloved is a little deaf), the emotional volume may go up in a desperate attempt to get through. Psychoanalytic relationships have a distorted reciprocity in which one person is powerful, distant, and withholding and the other is vulnerable, yearning, and revealed. They are relationships in which the patient feels forced to scream. This is useful to the psychoanalysis, because when a patient screams—or rather, amplifies her emotions because she feels that she has not been heard—the analyst can see the emotions all the more clearly.
+'''1. The Philosophy of Marxism:'''
-If the emotional deprivation of the analytic relationship turns the analysand’s feelings into forced hothouse blooms, it also removes the analyst’s ordinary emotional resources. “Empathy, when you’re not looking at someone, it’s clunkier, it’s less …” The analyst I was talking to broke off and looked at me in perplexity. “First of all, I don’t understand empathy, and I don’t think anyone does. There’s a lot of mysticism and hokum about it. But empathy is basically the sum total of what you pick up and ways you have of sort of identifying with other people and comparing their experience to your experience and then imagining that we’re in similar situations. But when they’re on the couch, you don’t see their face. Somebody could be silently tearing up, and you don’t know it. It puts pressure on the patient to verbalize, to put everything into words. The advantage of the couch is that there are experiences you’re not going to talk about sitting in a chair. When you’re the patient, you can see the analyst sitting there, looking at you. You’re going to tell him that you masturbate to the image of a meat loaf? It’s not so easy to say that. On the analyst’s side, there is more room to, in a sense, miss what someone’s up to and leave them alone.” Analysis may make it easier for a patient to talk about his most embarrassing problems than face-to-face psychotherapy does. In Catholic confession, as well, he who confesses does not have to look into the eyes of someone he respects as he reveals his shame. But though it is easier to confess when you do not have to look someone in the eyes, it is harder for the person to whom you confess to understand. As the philosopher John Searle remarks, we know that our dogs are conscious when we look them in the eyes. Our faces are remarkable tools in emotional interpretation, and in analysis they cannot be used. Even when the analyst sits facing the patient, the asymmetry of the relationship remains.
+Including Dialectical Materialism and Historical Materialism
-What are these peculiar relationships like for those who engage in them as a professional occupation? Whereas each analysand has only one analyst, who is in some ways and for some time the most important person in the analysand’s life, someone about whom the analysand dreams and fantasizes and to whom he attributes nightmarish power, each analyst has an average of eighteen patients. Some of them are analytic patients, whom he sees four to five times each week; some are psychotherapy patients. The general rule is that the more frequent the visits and the more orthodox (more abstinent) the technique, the more powerful the patient’s feelings. Still, even in once-a-week psychotherapy a patient’s feelings may be vivid. Not only does each patient have powerful feelings about his therapist, but people come in for psychotherapy and psychoanalysis because they are in pain. They pour their anguish of loss and misery into the therapist’s lap and leave.
+'''2. The Political Economy of Marxism:'''
-The short answer to the question of what analysis is like for an analyst is that analysts often say that they never quite manage to adjust to its demands. “I would defend myself with curiosity,” one analyst explained. “I tried to think rather than to feel, to protect myself from being overwhelmed by feeling. I could deal with the obvious feelings I had for this person by trying to find out more about them. That was productive, because it helped me to figure out what was going on. But it also protected me against the suffering that you have to feel because patients suffer in your presence. They suffer. But I don’t really think that analysts do handle their patients’ pain. I think that’s one of the big sources of stress. Obvious and deep sources of stress. It will not go away, and psychoanalysts never resolve it.” Yet there is often great pressure, professionally, to deny the emotional stress, to deny even the emotional connection to the patients. Analysts are supposed to treat their patients with clinical indifference. Any sign of attachment can indicate a patient’s manipulation or a doctor’s error. At least that was standard theory in the field until recently, when analysts began to suggest that the feelings analysts had for analysands were not simply “false” feelings, figments of a relationship with somebody else, or a countertransference mistake. (In recent years, psychoanalysis has become more relaxed, more open.) One paper at a recent American Psychoanalytic Association meeting argued that analysts should not distance themselves from their feelings of love for their patients by calling them “countertransference,” as if they were delusions rather than the real thing.
+A system of knowledge and laws that define the production process and commodity exchange in human society.
-The longer answer is that an analyst has intense feelings about his or her analysands that are as entangled as the analysands’. I interviewed a number of analysts in depth. I remember being taken aback at first by how excited they were about their patients’ achievements, as if they were parents or teachers or lovers. One analyst had a patient so brilliant and so exciting that he had to force himself not to discuss literature; another analyst had a patient who would be one of the greatest writers of her generation; yet another analyst had a patient with such courage that he nearly cried explaining it. Yet the content of their interactions seemed so banal. One analyst explained that a female patient had walked out of his office and dropped her sweater on the carpet. He had picked it up for her—and that was what they had talked about for three weeks, the sweater and the fact that he had picked it up. There is some sense to this. Just as you hear emotional style more clearly when someone screams than when he whispers (there is more emotion to listen to), you can see much in the microcosm of that moment. When the analyst picked up the sweater, did the patient feel he was being chivalrous? Aggressive? Flirtatious? Intrusive? But it is not just patients who have strong feelings.
+'''3. Scientific Socialism'''
-After the 1989 San Francisco earthquake, ''American Psychoanalyst''—a news sheet sent to members of the American Psychoanalytic Association—carried an apparently inane article. It explained, anecdotally and at length, that after a rush-hour jolt that had destroyed freeways, buildings, and bridges, many San Francisco analysts were worried about their patients. “If you know psychoanalysis, it wasn’t a silly article,” an analyst explained to me. “What was striking about that article was that here are a bunch of psychoanalysts who are surprised to learn that they cared deeply about their patients. You know, ‘I was in my office and I heard about the earthquake and I thought, “Oh, my God, my patient lives on that street where that house collapsed.” “Oh, my God, I hope my patient is all right.” ’ They’re ''surprised'' to learn that. That was what I found so amazing about that article. That’s a different generation of analysts than me and my friends. If there’s an accident on the freeway when my patient is driving in to see me, I’m concerned, because I know I have a tie, a real relationship with those people, which is very intense. When you meet with somebody four or five times a week and talk about very intense issues for two, three, four, six, seven years … you don’t talk to your ''wife'' that much. In psychoanalysis you have very intense relationships, and they are really quite private. It’s a very strange business, doing analysis.”
+The system of thought pertaining to the establishment of the communist social economy form.
-This man, Ethan Bass, is a young analyst (in analytic time; he is fifty) who is also a training analyst, a warm, feisty man who initially treated me with the gingerly respect one might accord an ink-spitting squid but who then decided to trust me. He was one of the most desirable supervisors at the hospital at which he held an appointment; he was also among the most feared, for he was blunt and smart. He ran the main psychotherapy seminar for residents and taught at the psychoanalytic institute. He had six analytic patients, one person who came for psychotherapy four times a week (that patient did not lie on the couch but instead sat facing the analyst), and another who came three times. He was an experienced, respected, articulate analyst. One of the things about which he was most articulate was what he described as the emotional nakedness of doing this work and its weirdly exhausting quality.
+These objects of study stand as the viewpoints — the starting points of analysis — of Marxist-Leninist philosophy and the three component parts of which it’s composed.
-“It’s different from psychotherapy,” he told me. “It’s more intense, it’s more intimate.… I always tell my patients or a potential patient that doing psychotherapy is like renting the movie and analysis is like going to the theater. It really has much more impact, and it’s really more—you know, the theater’s dark and you can’t get up and go to the bathroom, you’re really surrounded by it, and it grips you. In psychotherapy, you come in on Tuesday and the next week you come in again. You’ve had seven days to get away from whatever was going on. So analysis is really marvelous, but then again it is much more stressful than psychotherapy for the analyst. The treatment itself is also very gratifying for the analyst. But it’s intense.”
+-----
-The analyst’s experience of nakedness is, of course, paradoxical in this context, because it is the analysand who feels exposed and defenseless against the cool imperturbability of the analyst. But such is the strange power of the relationship that the analyst too feels exposed and visible, even though he cannot be seen. The formidable barriers to reciprocal emotional communication with the analyst press the analysand into hawkeyed attention to responsive detail. This is another reason analysts sometimes find it hard to do psychotherapy, because their face is so carefully scrutinized for emotional indicators. “You can’t hide in analysis,” continued Bass. “I mean, the patient really begins to know who you are, and if you have a little trouble with this or that, or, you know, you’d really rather not be sad today, thank you very much, the patient sort of—since you are the place where they are doing their emotional work, they get to know pretty well where it’s solid and where it is not, and they poke at you in your most vulnerable places.
+In the scope of '''Marxist-Leninist Philosophy''' [the first component part of Marxism-Leninism], these objects of study are:
-“My first control was very, very difficult. I had a very brilliant, very disturbed man in analysis, and he was not going to be a classical patient. He was not going to be the kind of patient that I had read about and that my teachers knew about and that they wanted to teach me about, and I wanted him to be that. We had a big-time struggle, which was not good for either of us, and my supervisor was, of all potential supervisors, probably the worst I could have chosen for this case and I didn’t know any better. This was a guy who really needed me, at times, to hold his hand. Now, I was not going to hold his hand any more than I was going to sleep with him. I just couldn’t do it. I still don’t think I would hold his hand, but I would be able to deal with that now, and that kind of need and that kind of hunger, and that kind of anxiety, but I couldn’t deal with it then. I really didn’t know how, I wasn’t competent enough or confident enough to know that I could find a way to help him with that. So it made me anxious, I made him anxious, it was very difficult. The path to analytic nirvana is not a simple one.”
+* Dialectical Materialism — the fundamental and most universal worldview and methodologies which form the theoretical core of a scientific worldview*. [See Part 1, p. 44]
+* Materialist Dialectics — the science of development, of common relationships, and of the most common rules of motion and development of nature, society and human thought. [See Chapter 2, p. 98]
+* Historical Materialism — the application and development of Materialism and Dialectics in studying social aspects. [Historical materialism is the topic of Part 2 of the textbook from which this entire text has been translated, which we hope to translate in the future.]
-Certainly the analytic path forces the analysts who follow it to unlearn many of their basic expectations of human interaction. As psychoanalysis confronts analysands with emotional deprivation, it confronts analysts with a strange combination of omnipotence and a kind of perpetual absence. An analyst is often for a time the most present person in an analysand’s life, the person around whom his fantasies revolve, a homunculus he carries in his head to comment on his actions. Yet the same analyst remains, with respect to the outside world, his analysand’s silent shadow. If an analysand breaks through his creative writing block while in analysis and writes a brilliant novel, the analyst cannot crow his victory. If an analysand turns out brilliant or wealthy or a national figure, the analyst cannot boast that he helped. If an analysand is a famous writer and commits suicide and years later a biographer approaches the analyst for tapes of the sessions and he chooses to give them over, having decided that this is what the analysand would have wanted, he will be vilified by his peers.@@@[[#15AnneSextonstherapistmade|15]]$$$ Most of us rely on some public affirmation for our achievements. An analyst has little. His clinical work is private to all but his patients, and in their emotional upheavals they cannot be trusted in their judgments. An analyst is hired help, employed by a client who tells him about her life and loves him and hates him, in the interest of a development in which he plays no future role. In the same way that kids develop their coordination and people skills through playing tag and capture-the-flag, psychoanalysis is like a large emotional sandbox in which analyst and analysand play at relationship to prepare the analysand for real life.
+-----
-“My role is to be the sidekick,” remarked Bass. “In the child consulting room the kid’s got the toys. He says, you stand there. Then he throws darts at you. You’re the one who loses at checkers, the one who is always frustrated. But what you are in charge of is the only certainty, the ground rules. I’m in charge in some ways. In other ways I’m the employee, the guy who’s given a script or told to stand over there.
+==== Annotation 43 ====
-“I mean, you try to create the space in which someone can use the space, the freedom to get into whatever they need to get into. I think of it as a kind of light play. I think that the transference is a playing out of something. It’s as if the patient comes in and you say, ‘Tell me about it, what was it that went on when you were a kid that is still so problematic for you that you can’t get married or it’s ruining your love life?’ And it’s as if they say, ‘I can’t talk about it, but let me show you.’ ”
+<nowiki>*</nowiki> Remember that ''Scientific'' in Marxism-Leninism refers to a systematic pursuit of knowledge, research, theory, and understanding [see Annotation 1, p. 1]. Note, also, that ''Worldview'' refers to the whole of an individual’s or society’s opinions and conceptions about the world, about humans ourselves, and about life and the position of human beings in the world. This is discussed in more detail on page 44.
-It is remarkable and often moving to hear analysts talk about their patients, because it is so clear that they are caught up in their lives and idealize their patients as much as their patients idealize them. But what gives the analyst’s role its piquancy is that analysts never see their patients outside the consulting room—analysts know everything about their patients except what they are like in normal human relationships—and that for them, it is a job. It is something they do for money, and it is a hard job, for change comes slowly and reluctantly to most human lives.
+Thus, a ''scientific worldview'' is a worldview that is expressed by a systematic pursuit of knowledge of definitions and categories that generally and correctly reflect the relationships of things, phenomena, and processes in the objective material world, including relationships between humans, as well as relationships between humans and the world.
-Certainly the fact that an analyst is doing a job helps him to handle his everyday frustrations. “God knows, most of us do work in which we are not free to express ourselves, whether we are shoveling peat or doing psychoanalysis,” Bass said once. “That’s why they call it work—like anything you start out knowing how to do and then you do some and you get pretty good at it and you do some more and you get better. And you know, you can be sitting there having had a disappointment or an upsetting hour with the previous patient and still what is happening in this hour has its own logic and its own meaning and is compelling enough so that you can sort of forget the other stuff.” Analysis is, nonetheless, a job that asks that someone have feelings for the sake of money and in which an analyst feels a close and honest connection to someone whom he also believes not to be telling the truth, because that person can’t.
+In the scope of '''Marxist-Leninist Political Economics''' [the second component part of Marxism-Leninism], the objects of study are:
-“You’re immersed in feelings every day,” Bass continued. “And it isn’t possible in the moment to separate it out. I mean, when you’re dealing with something sad, when you might find yourself crying, you can’t distinguish the sadness the patient has experienced and is inducing in you from your own sadness, which is the source of the way the patient induces sadness in you. The way you get sad is for some sadness of your own to be mobilized, touched. But at the same time you’re working, you’re doing your job. You’re thinking about this, you’re making interventions about that, you’re noticing the way you are responding to the patient. So there’s something comforting about that. It’s like when you go into work, into the office, and people say hi to you and they recognize who you are and whatever was happening before, you know there’s something normal. Well, when you’re functioning in the analytic situation and you’re functioning well, that has its beneficial effect. But it is complicated because you are functioning by emoting and being touched and being intimate with someone. And one of the tenets about psychoanalysis is that people don’t tell you the truth. They tell you things for a reason, and they tell you things in a particular way.”
+* The theory of value and the theory of surplus value.
+* Economic theory about monopolist capitalism and state monopolist capitalism.
+* General economic rules about capitalist production methods, from the stage of formation, to the stage of development, to the stage of perishing, which will be followed by the birth of a new production method: the communist production method.
-This relationship blows apart most American notions about good relationships: the separation of friendship from commerce, the association of intimacy with reciprocity, the affiliation of trust and honesty. These are among the reasons that people have pointed to psychoanalysts’ amoralism: hiring a friend is like renting a prostitute, they murmur. Analysts are usually acutely aware of the oddity of these relationships. Their patients, of course, insistently confront them about their irritating refusal to reveal where they are headed on vacation or whether they are married. But the analyst too struggles against the constraints of abstinence: the desire to name their patients’ names in public, touch their shoulders when they cry, or join them in an intellectual jousting match. “He’s so smart and creative,” an analyst commented regretfully about a patient, “that I really have to work not to engage on that level, it’s so much fun.” The struggle itself becomes important to analysts as a “place” in which the psychoanalytic work is done.
+-----
-Milton Spyer is an elegant man with a soft voice who worries, despite his evident reserve, that he may be perceived as too flashy a dresser, too outspoken a thinker, too prolific a writer to be made a training analyst at his local institute. He has an attentive, uneasy, Jamesian alertness. He is much sought after as a supervisor and has eleven patients in psychoanalysis, a figure that is remarkably high for his geographic area, where most analysts do not have full practices. He speaks, in the same way that young therapists do, of using his own experience to interpret someone else’s, but his description of that process is, like most analysts’, more nuanced: “I do find that the experience of being an analyst with each patient is different, because I think that what I do is wittingly or unwittingly—all at once to coalesce around someone else’s nature or the nature of their personality and, at the same time, to use the French term, do violence to it. Not in the sense of trying to cause someone pain, but a useful collision. Enough to provide a complementarity that lets someone look at what they’re doing at the same time, but enough of my adaptation to someone’s nature to get into it, to know what they’re experiencing.”
+==== Annotation 44 ====
-Spyer thus understands himself to act in two ways. He tries to understand the analysand’s experience from the inside, as it were: “The first thing I’m doing, trying to listen to what someone is feeling as they describe an event, as I sense them with me. And I’m always trying to understand what I’m feeling.” He also comments on what he calls “the unconscious,” ways in which he says the patient’s experience is determined or defended against or not quite experienced because of prohibition or conflict. In this he is standing on the outside, looking in. He is “doing violence”: “As I listen to the content, then I start to think more about the unconscious part, what they might not be aware of, what in their conscious experience may be defending against something else. For instance, when someone says, ‘I’m sorry for being late,’ and I think to myself, you’re not sorry for being late, you’ve been late frequently. You may regret it at some level, because you feel that you might be hurting me or insulting me, but we both know that you want to hurt me, and yet you’re very critical of yourself about that wish. That would be the kind of thing I might say to someone at a particular point. If I really knew it was true.”
+Marxist-Leninist political economics is the topic of Part 3 of the textbook from which this entire text has been translated, which we hope to translate in the future.
-We are usually unconscious of our motivations when we would be embarrassed to know them; the analyst’s job is to point these out. That is why Spyer describes interpretation as “doing violence.” An unproven interpretation can create a high cost in pain—and if Freud says that “no damage is done if, for once in a while, we make a mistake and offer the patient a wrong construction as the probable truth,” he also says that “a mistake, once made, cannot be rectified.”@@@[[#16SigmundFreudTherapyand|16]]$$$ Yet it is impossible to know whether an interpretation is correct or whether this is the time, of all possible times, to make it. In recent years, analysts have begun to argue that it is the moments of misunderstanding, not of understanding, that provide the greatest opportunity for the patient to know himself. This is also what Spyer argues.
+In the scope of '''Scientific Socialism''' [the third component part of Marxism-Leninism], the objects of study are:
-“These little points of interaction between the patient and the analyst, these little shifts, become so crucial,” he reflected. “More and more I see those moments as related to a countertransference-transference impasse, where you get into listening in a particular way and you’re not really getting it in some way. You’re listening but not getting it. Then something happens in a way which allows you to see who you are to this person in the transference, what you feel like, what you are doing not to put forward some mutual understanding, what they’re doing with you not to let you. Not that the seas part when you make these awarenesses known to the patient. But sometimes they do, and sometimes they give you a new working model.
+* The historical mission of the working class and the progression of a socialist revolution.
+* Matters related to the future formation and development periods of the communist socio-economic form.
+* Guidelines for the working class in implementing our historical mission.
-“I think I know less and less about technique, and I believe less and less about technique. I really believe that technique is something that each analyst and patient discover together—guided, certainly, by principles that I could articulate, and they’re important principles. This is not a completely wild process at all.@@@[[#17Thephrasewildanalysisw|17]]$$$ But when you read what people write about as abstract principles of technique, they’re really stupid. I mean, I guess I’m more skilled now at figuring out how to work with each person individually.”
+''The purposes'' of studying ''The Basic Principles of Marxism-Leninism'' are:'''' to master Marxist-Leninist viewpoints of science, revolution, and humanism*; to thoroughly understand the most important theoretical foundation of Ho Chi Minh Thought, the revolutionary path, and the ideological foundation of the Vietnam Communist Party. Based on that basis, we can build a scientific worldview and methodology and a revolutionary worldview; build our trust in our revolutionary ideals; creatively apply them in our cognitive and practical activities and in practicing and cultivating morality to meet the requirements of Vietnamese people in the cause of building a socialist Vietnam.
-For the expert therapist, the dilemma of therapy is that on the one hand, there is the demand to identify, to imagine patients’ deepest idiosyncracies, to try to understand what makes them individual, what gives them specificity, to feel with them what they feel; on the other, there is the demand to step back from the identification and to understand through comparison with others—to wonder whether a patient’s sense of inferiority does, as Charles Brenner suggests it might in ''An Elementary Textbook of Psychoanalysis'', emerge from some form of self-attack.@@@[[#18CharlesBrennerAnElementa|18]]$$$ Psychoanalysts fret about the ways in which the pattern-identifying interferes with connecting to the patient. Often, like Spyer, they talk about suppressing the temptation to think with detachment—the temptation, literally, to analyze.
+-----
-“The way I listen now,” Spyer continued, “is very different from the way I used to listen. I find I don’t rely so much on formulations now. I almost try to undo formulations. I don’t like thinking in that way anymore. I mean, I make formulations, but I’m more struck by how they get in the way as I’m listening. A formulation would be that a man fears castration by his mother in some way and out of fear identifies with her and becomes her in some way, and that there is an underlying wish for a father who will protect him from his mother and blah blah blah. Now, I wouldn’t say that I don’t form impressions like that, dynamic understandings of each person, but I don’t feel that they are on my mind as much as they used to be.”
+==== Annotation 45 ====
-This, of course, is a conceit on the same order as that of a professional photographer who talks about the wisdom of the untrained eye. Spyer feels free to dispense with formulations only because the art of constructing them has become so automatic for him. But the conceit is revealing. Analysts pay a great deal of attention to their inevitable failure to understand perfectly. They struggle to understand everything, to realize the meaning of all acts and wishes, while deeply believing that the project of complete understanding is doomed. One might call this the paradox of human knowing: that the more we understand someone, the more we realize how little we can know them. Sophisticated analysts entangle themselves in the contradictions of this paradox. To quote Spyer, “Listening without memory or desire, nobody can do that. I mean, what a horrible idea. How can the field believe in the unconscious and say that anyone can do that?” Analysts often focus upon the difficulty of doing therapy. Unlike specialists in other fields, they publish accounts of cases that ''didn’t'' work, as Freud did most famously with ''Dora''.@@@[[#19SigmundFreudDoraAnAnal|19]]$$$ They talk and write about the impossibility of ever fully understanding, of listening without filtering the other through the self. They teach that you must accept uncertainty and that you must give up the need to be right.
+<nowiki>*</nowiki> The humanism of Marxism-Leninism differs greatly from the humanism of Feuerbach discussed in Annotation 12, p. 13. Marxist-Leninist humanism concerns itself with the liberation of all humans. As Marx and Engels wrote in ''The Communist Manifesto:'' “the free development of each is the condition for the free development of all.”
-From that sense of failure emerges a powerful sensibility: that what is admirable is not ''behaving'' in a certain way—analysts are often quite tolerant of patients’ less conventional behavior—but ''understanding'' one’s own behavior as honestly as possible, despite the impossibility of the task. There is a firm moral commitment to trying to see yourself clearly, with your inadequacies, your awkwardnesses, your discomfort, your own dishonesty about the very process of coming clean. Psychoanalysts, of course, have personal moralities in which they abhor murder, lying, embezzlement, and so forth. But those moral stances are not particularly psychoanalytic. The specifically psychoanalytic ethos involves a commitment to the process of self-understanding.
+=== 2. Some Basic Requirements of the Studying Method ===
-“Are they trying to be true to themselves?” Spyer continued. “With a big emphasis on ''trying'', because many people lie, and it’s a very wonderful thing when someone can talk about lying and how they lie to themselves and to the people they love and look into it and understand it more and change it. And I think there’s something about someone who wants to overcome pain. Some people would call that taking responsibility. I think there’s something else that’s valued, too, which is the suppleness with which someone can look into themselves, delving into affect. Someone who can look at their interior map in a very rich way and work with it. To know what they feel, so if they decide to take a new job with different risks, they’ve checked in with the part of them that’s ambitious or grandiose or the part of them that’s not feeling creative enough and the part of them that’s self-destructive. So what are these things? They’re some sort of courage. One more thing: I think there’s also value placed on someone’s capacity to bear affect. To bear intense emotion. Love, passion, pain. Aloneness, intimacy, cruelty, excitement. You know. The whole range. To experience them, to enjoy them. To bear them.”
+There are some basic requirements for studying the basic principles of Marxism-Leninism:
-Philip Rieff understood that the entire field of psychoanalysis rests on an innocent, noble hope. Strictly speaking, there is no reason that learning to know and experience our feelings, which is more or less what Spyer means by “bearing them,” should make us good. “Freud gives no reason why unblinking honesty with oneself should inhibit unblinking evil.”@@@[[#20PhilipRieffFreudTheMin|20]]$$$ There is no guarantee, Rieff points out, that once people unrepress their murky depths, those who have greater awareness of those depths will act more justly or caringly. Perhaps the neurosis actually inhibits the patient from acting on scurrilous impulses. After all, much of what Freud said about our unconscious was alarming. If he was right, there are desires in our dark cauldrons of hatreds and sweaty yearnings that no one would let loose upon humanity. But psychoanalytic practice proceeds as if knowledge (and the care of the analyst) will lead to goodness, at least for those who come into therapy because they are unhappy. Rieff underestimated the degree to which analysts see the attempt to achieve authenticity as an ethical stance. Analysts do seem to want genuinely to believe that if you know and accept yourself, you will be loving to others. In the footsteps of Hannah Arendt, they want to presume that evil is not done by those who learn to think and feel.
+First, Marxist-Leninist theses were conceptualized under many different circumstances in order to solve different problems, so the expressions of thought of Marxist-Leninists can vary. Therefore, students studying the basic principles of Marxism-Leninism must correctly understand its spirit and essence and avoid theoretical purism and dogmatism.
-“Psychoanalysis helps people,” a senior analyst reflected to me once (I had heard him defend a notorious analyst once at a public meeting on the grounds that she had meant well, even though she had acted naively and to disastrous effect), “but its truths are not appetizing. You get a sense of man’s fallibility and the constant way in which he tries to protect himself through illusion. In the acceptance of oneself, there is a giving up of the grandiose fantasies that one could be anything or that there will be this idealized parental figure who will take care of everything. You give up the sort of everyday dishonesty that gets people by. The positive side is that you can bear it alone, you can stand on your own feet, you can accept the failures of your spouse, your work, and your own capacity, and find a way of making a place for yourself that is fulfilling. The psychoanalytic experience can confront you with your dishonesty, the sort of everyday dishonesty that gets people by.”
+-----
-Psychoanalysis is a powerful expression of the modern age’s belief in authenticity. If we are able to understand who we “really” are, somehow we will become ourselves. We will be able to acknowledge the ways in which we are other people, the ways in which other people have made us, the ways in which we are unique because of the particularities of those of whom we are both a reflection and a transformation. Our uniqueness lies in part in our limitations. To live without lying to ourselves about those limitations is to be ourselves—and to be free. This conviction of salvation through self-discovery is a real feature of psychoanalysis, and Rieff is right when he points to the weakness of this claim. At the end of this self-involved and destructive century, the claim that knowledge, particularly self-knowledge, will inevitably lead to goodness seems naive.
+==== Annotation 46 ====
-But psychoanalysis also embodies an older, more religious impulse that Rieff did not really grasp but that runs through the practice of psychoanalysis in the way analysts respond to their patients, the way they judge one another as analysts, and the way they see themselves acting in the world. Freud remarked, in a letter to Carl Jung, that psychoanalysis is a cure through love. The philosopher and analyst Jonathan Lear develops this theme in a book entitled ''Love and Its Place in Nature''. Love in Lear’s sense really means wise nurturing. He sees that nurturing embodied in a fundamental analytic commitment: that for therapy to be therapeutic, an analyst must engage emotionally with a patient and must empathize and sympathize (to some extent) with the patient, and that through this process the patient may grow into a better-formed individual with a more developed sense of inner responsibility and freedom. Analysts believe that respect and love for others grow along with respect and love for oneself and that respect and love for oneself can be nurtured by a caring analyst. Analysts talk about their patients as if they thought of themselves as wise mentors or parents. They obviously care for their patients, and they care deeply. No other word but “love” quite captures this emotional tone of an analyst’s involvement with his patients (although the presence of love need not imply the absence of other feelings). No other word captures the tone in the way that analysts imagine themselves to help patients “become” themselves. As Lear puts it, in psychoanalysis “the creation of the individual and the caring for the individual are of a piece.”@@@[[#21JonathanLearLoveandIts|21]]$$$
+Marxism-Leninism should be understood as an applied science, and application of this science will vary based on material conditions. As Engels wrote in a personal letter in 1887, remarking on the socialist movement in the USA: “Our theory is a theory of evolution, not a dogma to be learned by heart and to be repeated mechanically. The less it is drilled into the Americans from outside and the more they test it with their own experience... the deeper will it pass into their flesh and blood.”
-This, too, has its naiveness, but it is naiveness with a genealogy as old as human faith. There is, in fact, a somewhat Christian feel to contemporary psychoanalysis, though most psychoanalysts might be taken aback by that characterization. Their love for their patients is rarely stated in such bald terms as to make the comparison striking. Nonetheless, the love represented in the Christian tradition is not so dissimilar to the way that analysts conceive of their care for the patient. The psychoanalytic credo that self-knowledge and authenticity are good and help to make us good really must be understood as framed within a belief that love will make us loving and that when we love we trust others and protect them. We become good friends, good citizens, good, whole people. More and more psychoanalysts emphasize in their writings and discourse the necessity and power of analysts’ love for and acceptance of their patients. They quickly qualify the kind of love they mean: not carnal, not possessive. They seem to mean the kind of belief in another’s capacity for goodness sometimes captured by the word ''agape'', brotherly love, the unselfish love of one person for another, the love of God for humankind. This is the kind of love that the great teacher Elvin Semrad invoked when he spoke about loving the patient: “The most important thing, the thing that makes the difference, the thing that we as psychiatrists are dealing in, is love and humanity.”@@@[[#22ElvinSemradinSusanRakoa|22]]$$$ One analyst explained to me that she could not accept a war criminal in therapy, nor indeed anyone whom she was unable to love in some way. This is a common sentiment, though it is more often expressed through practice than articulated as a principle. Most analysts really do behave as if they love their patients. In this sensibility there is a rock-bottom commitment to the belief that an unhappy person will flourish and become a decent person when he is nurtured, mentored, and accepted as a wise parent loves, nurtures, mentors, and accepts a child. At least, there is a commitment to the belief that such love is necessary for that unhappy person to become good and trusting, even if, as in the case of war criminals and sociopaths, it may not be sufficient. This is the kind of sentiment that motivated my own mentor, I believe, when he told me to read ''Magister Ludi''. A psychoanalytic patient carries out his process of self-discovery in the presence of his analyst’s love, just as Joseph Knecht carried out his work in the presence of his love for those he governed. In the psychoanalytic framework, to serve is to love, and to love is to accept people and to nurture them so that they grow healthily and wisely. “This book is an interpretation,” Lear writes. “As such it is an act of love.”
+As an example, Lenin tailored his actions and ideas specifically to suit the material conditions of Russia under the Czar and in the early revolutionary period. Russia’s material conditions were somewhat unique during the time of Lenin’s revolutionary activity, since Russia was an agrarian monarchy with a large peasant population and a relatively undeveloped industrial sector. As such, Lenin had to develop strategies, tactics, and ideas which suited those specific material conditions, such as determining that the industrial working class and agricultural peasants should work together. As Lenin explained in ''The Proletariat and the Peasantry'':
-The senior analyst I quoted above continued his remarks with these words: “I love this great tenth-century picture of this big fat Zen monk. He’s holding a bunch of shrimp in his hand and he’s got this exquisite kind of laughing face and he clearly has tremendous pleasure about holding those shrimp in his hands. I love that picture. It represents an image that I have about what one needs to do with oneself where you can hold yourself in your hand in a loving way and an accepting way and kind of embrace it.” If the moral authority of the scientist derives from the knowledge he acquires, the moral authority of the analyst derives from the love he gives.
+<blockquote>
+Thus the red banner of the class-conscious workers means, first, that we support with all our might, the peasants’ struggle for full freedom and all the land; secondly, it means that we do not stop at this, but go on further. We are waging, besides the struggle for freedom and land, a fight for socialism.
+</blockquote>
-== {{anchor|CHAPTERFIVE}} {{anchor|TopofLuhr9780307791900epubc6}} CHAPTER FIVE: WHERE THE SPLIT CAME FROM ==
+Obviously, this statement would not be specifically applicable to a society with highly developed industry and virtually no rural peasants (such as, for instance, the modern-day USA), just as Lenin’s remarks about the Czar would not be specifically applicable to any society that does not have an institution of monarchy.
-Whence did this divided consciousness arise? The story of twentieth-century psychiatry is that psychoanalysis was imported from Europe at a time when the approach to mental illness was essentially custodial. Psychoanalysis rapidly became entrenched as ''the'' theory that explained mental illness and ''the'' treatment that would cure it. Like most single-answer cures, it overpromised. When new psychopharmacological treatments and theories emerged and successfully treated what psychoanalysis could not, the new psychiatric science claimed to win the ideological battle and to supplant its former rival. To the new adherents, psychoanalysis was charlatanry and psychiatric disorder was brain dysfunction. The psychoanalysts responded in kind. In practice, the more biomedical and the more psychodynamic approaches settled down in the 1980s into what one senior clinician called a “happy pluralism.” Then the economic currents changed. As managed care companies began to take control over insurance reimbursements, the ideological tension between the psychopharmacological and the psychoanalytic looked as if it presented a choice, and the psychopharmacological approaches seemed cheaper and more like the rest of medicine. Compared to the power of these economic forces, the ideological tensions seem like domestic squabbles. But together they are pushing the psychodynamic approach out of psychiatry with a nearly irresistible force.
+As another example, take the works of Ho Chi Minh. Ho Chi Minh Thought is defined by the Communist Party of Vietnam as “a complete system of thought about the fundamental issues of the Vietnam revolution.” In other words, Ho Chi Minh Thought is a specific application of the principles of Marxism-Leninism to the material conditions of Vietnam.
-From the patient’s perspective, this is a mistake. Whatever the cause of psychiatric illness, practically speaking the evidence is fairly clear that for most psychiatric problems, a combination of psychopharmacology and psychotherapy provides the most effective treatment. The American Psychiatric Association has recently started issuing what are called “practice guidelines.” These aim to describe appropriate standards for treatment that represent “the consensus of experts in the field regarding current scientific knowledge and rational clinical practice” for selected disorders. For the most part, the guidelines concerning psychotherapy for each disorder are supported by careful studies of psychotherapy outcomes for patients with that disorder, and for the most part the guidelines suggest that a combination of psychotherapy and psychopharmacology provides the optimal treatment.@@@[[#1Foradultpatientswithmajor|1]]$$$ The most widely used guide in the field says bluntly that “psychotherapy in conjunction with antidepressants is more effective than either treatment alone in the treatment of major depressive disorder”; “psychotherapy [of bipolar patients] in conjunction with antimanic drugs, e.g., lithium, is more effective than either alone”; “antipsychotic medication is not as effective in treating schizophrenic patients as when the drugs are coupled with psychosocial interventions.”@@@[[#2HaroldKaplanandBenjaminSa|2]]$$$
+One unique aspect of Vietnam’s revolution which Ho Chi Minh focused on was colonization. As a colonized country, Ho Chi Minh realized that Vietnam had unique challenges and circumstances that would need to be properly addressed through revolutionary struggle. Another unique aspect of Vietnam’s material conditions was the fact that the colonial administration of Vietnam changed hands throughout the revolution: from France, to Japan, back to France, then to the USA. Ho Chi Minh was able to dynamically and creatively apply Marxism-Leninism to these shifting material conditions. For instance, in ''Founding of the Indochinese Communist Party,'' written in 1930, Ho Chi Minh explains some of the unique problems faced by the colonized people of Indochina (modern day Vietnam, Laos, and Cambodia) and proposes solutions specific to these unique material conditions:
-This makes good intuitive sense. One could fairly comfortably separate the psychiatric illnesses into three groups: those in which the brain-driven, organic quality of the illness is flagrant, as in (for example) schizophrenia, major depression, manic depression, and obsessive-compulsive disorder; those in which learning and physiological vulnerability seem to be equally important, as in the panic disorders and possibly the personality disorders; and those in which learning probably predominates, as in eating disorders and possibly trauma disorders. (I hasten to point out that this classification is controversial and merely illustrative.) The most organic are probably much like other medical problems: you carry a predisposition to the illness, and if it is a strong predisposition, you will likely get sick even in good circumstances, but if it is a weak predisposition, you will get sick only under stressful circumstances. Bad parenting can certainly play a role here, but so can poverty, a parent’s illness, or, for that matter, being a temperamentally hyperactive child of a temperamentally high-strung mother. The point is that learning plays a role in acquiring most psychiatric illness. It certainly plays a role in being able to live with that illness. Psychotherapy is fundamentally a learning process. In it, a patient learns how to verbalize and to understand his difficulties. It makes good sense that teaching a patient how to understand his emotional world—how he interprets and reacts to people and how they interpret and react to him—might help him cope more effectively, particularly as he begins to regulate his emotions pharmacologically.
+<blockquote>
+On the one hand, they (the French) use the feudalists and comprador bourgeoisie (of Vietnam) to oppress and exploit our people. On the other, they terrorize, arrest, jail, deport, and kill a great number of Vietnamese revolutionaries. If the French imperialists think that they can suppress the Vietnamese revolution by means of terror, they are grossly mistaken. For one thing, the Vietnamese revolution is not isolated but enjoys the assistance of the world proletariat in general and that of the French working class in particular. Secondly, it is precisely at the very time when the French imperialists are frenziedly carrying out terrorist acts that the Vietnamese Communists, formerly working separately, have united into a single party, the Indochinese Communist Party, to lead the revolutionary struggle of our entire people.
+</blockquote>
-Certainly a fair amount of research supports this view. There have been many studies of psychotherapy. Some focus on patients suffering from depression, others on those with bulimia, bipolar disorder, schizophrenia, social phobia, borderline personality disorder—all kinds of problems.@@@[[#3LLuborskyLBSingeran|3]]$$$ Such studies have repeatedly concluded that psychotherapy of all forms helps patients to suffer fewer symptoms, to feel more effective, to stay out of the hospital for longer, and to perform more productively at work. Like those made for medication studies, this is a statistical claim. Bad therapy can make things worse. Nevertheless, studies have repeatedly demonstrated that on average psychotherapy is helpful both for the very ill and for the somewhat disconsolate. For example, a much-cited three-year follow-up of 128 depressed patients treated with psychotherapy and with medication revealed that psychotherapy alone significantly lengthened the time between recurrences, whether medication was used or not (the best outcome appeared to be the combination).@@@[[#4EFranketalEfficacyof|4]]$$$ A 1994 study suggested that at the end of psychotherapy, the average treated patient is better off than 80 percent of untreated patients.@@@[[#5MJLambertandAEBergin|5]]$$$
+During this period, the nations of Indochina were predominantly agricultural, prompting Ho Chi Minh to suggest in the same text that it would be necessary “to establish a worker-peasant-soldier government” and “to confiscate all the plantations and property belonging to the imperialists and the Vietnamese reactionary bourgeoisie and distribute them to the poor peasants.” Obviously all of these considerations are specific to the material conditions of Indochina under French colonial rule in 1930.
-Yet by their nature, psychotherapy studies are less rigorous than most medication studies. By the time the research parameters are tight enough to produce testable results, the conditions of psychotherapy have often left the real world far behind.@@@[[#6Someremainskepticalbecause|6]]$$$ In research settings, therapists often carry out therapy from highly specific manuals with patients who have one and only one diagnosable complaint. But most patients do not go to a therapist because they are having trouble sleeping; they see a therapist because they are in despair. If they feel better after six months of once-a-week psychotherapy, it is hard to say exactly what the therapist did because no one knows exactly why therapy works (this is true for medication as well, but the uncertainty is considerably more diffuse when it comes to psychotherapy). As a result, a report from the Outcome Measures Project of the National Institute of Mental Health could state in 1995 that “despite hundreds of studies in this area, we can make few definitive statements about the changes brought about by various forms of therapy.”@@@[[#7IreneWaskowandMorrisParlo|7]]$$$ The most convincing controlled outcome studies are actually those done with patients sick enough to be hospitalized, because there are crude measures that can distinguish a study group from a control group—namely, how many days the patients spent as in-patients in the hospital. The impact of psychotherapy on those not sick enough to be hospitalized is harder to judge. Does staying in a marriage or a job prove the worth of the therapy or its worthlessness? To those focused on a “rationalized” medicine that ties specific outcome to specific intervention, studies of psychotherapy seem inherently fuzzy.
+By 1939, the situation was changing rapidly. Ho Chi Minh was operating from China, which was being invaded by fascist Japan. He knew that it was only a matter of time before the Japanese imperial army would come to threaten Vietnam and the rest of Indochina. As such, Ho Chi Minh wrote a letter to the Indochinese Communist Party outlining recommendations, strategies, and goals pertaining to the precipitating material conditions. At that time, France had not yet been invaded by Germany, but Ho Chi Minh was very aware of the looming threat of fascism both in Europe and in Asia. He realized that rising up in revolutionary civil war against the French colonial administration would give fascist Japan the opportunity to quickly conquer all of Indochina, which is why he made the following recommendations in a letter to the Communist Party of Indochina in 1939:
-One way to avoid worrying about objective parameters of change is simply to ask a very large number of people who have had psychotherapy what they thought of the experience. In 1995, ''Consumer Reports'' reported on a survey of its subscribers, the largest ever survey on mental health care. About 2,900 respondents had received psychotherapy from mental health professionals, mostly psychiatrists or psychologists. “Most had made strides towards resolving the problems that led to treatment,” stated the report, “and almost all said that life had become more manageable. This was true for all the conditions we asked about, even among the people who had felt the worst at the beginning.”@@@[[#8MentalHealthDoesTherapy|8]]$$$ In fact, the people who had started out feeling the worst made the most progress.@@@[[#9p735|9]]$$$
+<blockquote>
+Our party should not strive for demands which are too high, such as total independence, or establishing a house of representatives. If we do that, we will fall into the trap of fascist Japan. For now, we should only ask for democracy, freedom to organize, freedom to hold meetings, freedom of speech, and for the release of political prisoners. We should also fight for our party to be organized and to operate legally.
+</blockquote>
-Moreover, the ''Consumer Reports'' survey was very clear about the length of treatment: the longer people stayed in therapy, the more they improved. Obviously there were no controls in the ''Consumer Reports'' survey, but it did rely on real-world conditions, and it does tell us something important: that most people who chose to consult psychotherapists felt that they had benefited from therapy, and the longer they had it, the better they felt they did. The data suggest that a year of therapy “may be very worthwhile” and that “people who stayed in treatment for more than two years reported the best outcomes of all.”@@@[[#10Ibidp739|10]]$$$ A number of recent studies support the claim that long-term therapy tends to produce better results, particularly if a psychiatric condition is chronic (as for some patients with depression) or if a patient has been traumatized or has difficulty maintaining a stable relationship with a therapist (as in borderline personality disorder, the most dramatic of the personality disorders).@@@[[#11SeeegDSpiegeletal|11]]$$$ One unusually large 1992 study reported on more than 650 German patients in psychodynamic psychotherapy (including psychoanalytic therapy). Over the course of their treatment, the patients significantly decreased their use of medications. They had a one-third decline in medical visits, a two-fifths decline in lost workdays, and a two-thirds decline in days hospitalized. The declines persisted more than two years after the end of therapy, and the longer the therapy, the more successful it was.@@@[[#12RDossmanetalTheLong|12]]$$$
+Once France fell to Germany in 1940, Indochina was immediately handed over to Japanese colonial rule. The Japanese army was brutal in its occupation of Vietnam, and the French colonial administrators surrendered entirely to the Japanese empire and helped the Japanese to administer all of Indochina. Ho Chi Minh returned to Vietnam in January of 1941 and participated directly with the resistance struggle against Japan until 1945, when the situation once again changed dramatically due to the Japanese military’s surrender to allied forces and withdrawal from Vietnam. He immediately took advantage of this situation and held a successful revolution against both the Japanese and French administrators. In the Declaration of Independence for the Democratic Republic of Vietnam, Ho Chi Minh wrote:
-The ''Consumer Reports'' survey also concluded that a mental health professional’s level of training in psychotherapy made a difference. Some of those who responded had sought help from their family doctor. They tended to have done well, but those who had sought out a mental health specialist had done much better. Respondents were equally satisfied whether they had seen a psychiatrist, a psychologist, or a social worker. They were less likely to feel that they had been helped after seeing a marriage and family counselor. Marriage and family counselors typically have a shorter master’s degree than a social worker and one year, not two, of supervised clinical experience. This evidence does not suggest that psychiatrists do better therapy than psychologists and social workers. It does suggest that psychotherapy is very helpful, that it should be available in conjunction with psychopharmacology, and that if someone is treating serious psychiatric illness it should be a tool she understands and can use. It may, however, reduce overall costs to have a psychiatrist deliver the therapy if a patient is receiving medication, for then the insurer need not be responsible for separate charges for medication visits and psychotherapy visits.
+<blockquote>
+After the Japanese had surrendered to the Allies, our whole people rose to regain our national sovereignty and to found the Democratic Republic of Vietnam. The truth is that we have wrested our independence from the Japanese and not from the French. The French have fled, the Japanese have capitulated, Emperor Bao Dai has abdicated. Our people have broken the chains which for nearly a century have fettered them and have won independence for the homeland.
+</blockquote>
-Yet the ''Consumer Reports'' study has been much criticized, not least for its selection bias. Who, the critics ask, would respond to such a survey? Surely, they answer, those who have benefited from psychotherapy and want to defend it, and surely those who have stayed in psychotherapy the longest will be the most committed to the psychotherapeutic cause.@@@[[#13SeeforexampleTimothyBr|13]]$$$ These doubts also cast a shadow on the claim that training made a difference.
+As France began to make their intentions clear that they would be resuming their colonialist claim to Indochina, Ho Chi Minh began preparing the country for a new chapter in revolutionary struggle. In his 1946 letter to the people of Vietnam, entitled ''A Nationwide Call for Resistance'', Ho Chi Minh wrote:
-In fact, one of the most important problems in assessing psychotherapy is that there are now many kinds of psychotherapy that a psychotherapist can be trained to do. Psychodynamic therapy, of course, focuses on unconscious conflicts and defense mechanisms that hinder adult behavior. This is the therapy closely associated with psychoanalysis and the one in which psychiatric residents are most thoroughly trained (when they are trained in psychotherapy), although they are exposed to all kinds. “Interpersonal” therapy derives from psychodynamic therapy and focuses specifically on present relationships and communication with others. “Cognitive behavioral” therapy helps patients recognize and interrupt distorted (and negative) patterns of thinking. “Behavioral” therapy addresses specific behaviors and tries to supplant harmful ones with more helpful ones. “Family” therapy treats a family as a unit, rather than focusing on one member as the client.
+<blockquote>
+We call everyone, man and woman, old and young, from every ethnic minority, from every religion, to stand up and fight to save our country. If you have guns, use guns. If you have swords, use swords. If you have nothing, use sticks. Everyone must stand up and fight.
+</blockquote>
-In the real world, people enter therapy with a host of complaints, not one specific symptom, and therapists typically use a combination of these different approaches to treat them. Indeed, as I observed psychiatrists learn about different therapies and practice their techniques, it seemed to me, as an anthropologist, that most psychotherapies were more similar than different and that a clinician who could not switch from one emphasis to another was probably a bad clinician. The ''Consumer Reports'' study also explicitly supported what is known as the “Dodo hypothesis,” which is that there is no evidence that one mode of psychotherapy is superior to any other, assuming the same amount of contact between patient and therapist.@@@[[#14ThisisLesterLuborskysar|14]]$$$ (In ''Alice’s Adventures in Wonderland'', the Dodo judged a footrace and declared that ''“everyone'' has won and ''all'' must have prizes!”)
+As these historical developments illustrate, Ho Chi Minh was able to creatively and dynamically apply the principles of Marxism-Leninism to suit the shifting material conditions of Vietnam, just as Lenin had to creatively and dynamically apply these principles to the emerging situation in Russia in the early 20<sup>th</sup> century. So is the task of every student of Marxism-Leninism: to learn to apply these principles creatively and dynamically to the material conditions at hand.
-Yet in the new world of rationalized and rationed medicine, such claims seem unbearably ambiguous. They provide no guidelines to anyone about the length of an adequate trial of therapy, about its type, or about who should deliver it. As one researcher in the new field of “quality of care” pointed out to me, “True or not, the long-standing assertions about psychotherapy—that therapy of all forms helps patients and that longer is always better—won’t work in the resources allocation processes afoot in contemporary health care. You can’t counter managed care by pushing back with broad claims like that. You have to identify focal areas where therapy has an identified role and frame this role in terms of a defined population, a clear therapeutic process, and specified outcomes with a credible time course.” But, he continued, many psychiatrists resist this kind of piecemeal approach, and across-the-board resistance perpetuates across-the-board cost-cutting activity by managed care.
+-----
-Some research does indicate that specific therapies are better or worse for specific symptoms—family therapy for schizophrenia, cognitive behavioral therapy for panic disorder, interpersonal therapy for depression, and so forth—although these claims are often controversial in the research literature.@@@[[#15ForexampleMKShearet|15]]$$$ But there are not only many psychotherapies but many psychosocial treatments: clubhouses for clients, residential and day treatment programs, family education, vocational training, substance abuse counseling, community treatment programs for clients with chronic and severe problems. To persuade a skeptical company that these interventions are helpful demands the kind of rigorous analysis that compares one program to another for similar kinds of patients and with numbers large enough to make differences statistically significant.
+Second, the birth and development of Marixst-Leninist theses is a process. In that process, all Marixst-Leninist theses have strong relationships with each other. They complement and support each other. Thus, students studying each Marxist-Leninist thesis need to put it in proper relation and context with other theses found within each different component part of Marxism-Leninism in order to understand the unity in diversity [see: Annotation 107, p. 110], the consistency of every thesis in particular, and the whole of Marxism-Leninism in general.
-Yet medication alone is often not effective. “You want to use a medication,” a psychiatrist once observed to me, “in the first few years, when it still works.” He meant that the newness and the chicness of the medication give it a placebo aura that helps it take effect in a way it might not later on. The mantra one hears throughout psychiatry is that ''both'' psychotherapy and psychopharmacology have the same crude success rate: a third of the time, they work well; a third of the time, they have some impact; a third of the time, they don’t work at all.@@@[[#16Thefigureonethirdcropsu|16]]$$$ Needless to say, the mantra needs qualification, but it captures some truth. It would now be considered malpractice for a psychiatrist not to prescribe (or offer to prescribe) medication for patients suffering from most serious psychiatric disorders. For patients with serious symptoms, psychopharmacological treatment is imperative. However, the medications often do not work, and they often do not work well. About two thirds of depressed patients respond positively (50 percent or greater improvement) to at least one of the antidepressants, but about a third also respond that well to placebo. Meanwhile, one third of depressed patients—a huge number, given that one in ten Americans will suffer from major depression in their lifetime—respond to no medications at all.@@@[[#17StevenStahlEssentialPsyc|17]]$$$ Eighty percent of bipolar patients respond to lithium, which is a high figure—but a fifth do not, and one to two in a hundred people are bipolar.@@@[[#18HaroldKaplanandBenjaminS|18]]$$$ For schizophrenic patients, relapse rates are 40 percent within two years while taking medication.@@@[[#19Ibidp84|19]]$$$
+Third, an important goal of studying the basic principles of Marxism-Leninism is to understand clearly the most important theoretical basis of Ho Chi Minh Thought, of the Vietnam Communist Party and its revolutionary path. Therefore, we must attach Marxist-Leninist theses to Vietnam’s revolutionary practice and the world’s practice in order to see the creative application of Marxism-Leninism that President Ho Chi Minh and the Vietnam Communist Party implemented in each period of history.
-Psychotherapy helps some people who do not respond to medication or who relapse. (At least 10 to 25 percent of patients—pregnant women, for example—cannot or will not take medication.@@@[[#20MWeissmanetalSexDif|20]]$$$) Family therapy reduces the relapse rate in schizophrenic patients to the same extent as antipsychotic medications do, according to one study.@@@[[#21GEHogartyetalTheE|21]]$$$ Many studies comparing psychotherapy and psychopharmacology even suggest that they are often equally effective. For example, in one study, 150 depressed female outpatients, all of whom had responded to a common antidepressant medication (amitriptyline) in preliminary treatment, were randomly assigned to treatment with medication, with a placebo, with psychotherapy, with psychotherapy and medication, with psychotherapy and placebo, and with nothing. Treatment with medication alone or with psychotherapy alone was nearly as effective in preventing relapses.@@@[[#22GKlermanetalTreatmen|22]]$$$
+Fourth, we must study the basic principles of Marxism-Leninism to meet the requirements for a new Vietnamese people in a new era. So, the process of studying is also the process of self-educating and practicing to improve ourselves step-by-step in both individual and social life.
-There is even evidence that sometimes psychopharmacology and psychotherapy may have the same ultimate impact on the patient, each method altering the neurotransmitter chemistry, although psychiatrists more often conceive of medication and psychotherapy as working in different ways: that drugs reduce symptoms and psychotherapy helps people cope with other people. In a now-famous study of obsessive-compulsive disorder, patients were given either medication (Anafranil) or psychotherapy. If a patient improved, his brain scan changed, and the scan changed in the same way regardless of whether drugs or talk was used.@@@[[#23JMSchwartzetalSyst|23]]$$$ Psychotherapy, after all, is a learning process that involves the brain. (There is a delightful study of the neurological reality of learning in sea slugs entitled “Psychotherapy and the Single Synapse.”@@@[[#24EKandelPsychotherapyan|24]]$$$) In 1996, ''Scientific American'' reported that “claims about the ‘wonder drug’ Prozac notwithstanding, numerous independent studies have found that drugs are not significantly more effective than ‘talking cures’ aimed at treating the most common ailments for which people seek treatment, including depression, obsessive-compulsive disorder, and panic attacks.”@@@[[#25HHorganWhyFreudIsnt|25]]$$$ At least some research suggests that there are only two illnesses for which drugs are clearly better than talk therapy: lithium for bipolar disorder and antipsychotics, particularly the new atypical antipsychotics, for schizophrenia.@@@[[#26AttributedtoMartinSeligma|26]]$$$
+Fifth, Marxism-Leninism is not a closed and immutable theoretical system. On the contrary, it is a theoretical system that continuously develops based on the development of reality. Therefore, the process of studying Marxism-Leninism is also a process of reflection: summarizing and reviewing your own practical experiences and sharing what you’ve learned from these experiences in order to contribute to the scientific and humanist development of Marxism-Leninism. In addition, when studying the basic principles of Marxism-Leninism, we need to consider these principles in the proper context of the history of the ideological development of humanity. Such context is important because Marxism-Leninism is quintessentially<ref>See Annotation 6, p. 8.</ref> the product of that history.
-Meanwhile, providing psychotherapy to these patients may make for cheaper health care costs. Why? At the minimum, psychotherapy helps a patient to stay on medication, no small matter because when patients stop taking their “meds,” they usually get so sick they return to the hospital until they are stable enough to survive outside it—often a matter of five to ten days.@@@[[#27SeeEFranketalEffica|27]]$$$ Refusal to take medication (it is technically called “noncompliance”) is one of the chief reasons for hospital readmissions. At $60 per psychotherapy session and $600 per hospital day (both are estimates; both are frequently more expensive), a year of weekly outpatient psychotherapy saves money if it prevents even one six-day admission. In fact, there is good evidence that providing psychotherapy is cost-effective for that reason.@@@[[#28Recentworkintheareamor|28]]$$$ A recent analysis of English-language scientific papers on the subject published between 1984 and 1994 found that in 88 percent of studies, psychotherapy reduced the cost of treatment for patients with severe psychiatric disorders (schizophrenia, bipolar disorder, borderline personality disorder, substance abuse, and others).@@@[[#29GGabbardetalTheEcon|29]]$$$ And the savings hold across the illness spectrum. When Aetna shifted from unlimited outpatient psychotherapy in 1975 to twenty visits per year in 1976 and 1977, there were no savings because the rate of psychiatric hospitalization rose abruptly. When Champus expanded its outpatient psychiatric coverage (its costs grew from $81 million to $103 million) between 1989 and 1992, it gained a net saving of $200 million because its customers’ hospitalization rate dropped sharply. For every dollar spent on psychotherapy, four dollars were saved.@@@[[#30AZientsAPresentationt|30]]$$$ A 1990 study discovered that schizophrenic patients who received psychotherapy in addition to medication reduced the average number of days spent in the hospital from 112 days (for controls) to 43 over a period of twenty months.@@@[[#31NSchoolerandSKeithT|31]]$$$ A 1992 study on borderline personality disorder patients found that twice-a-week psychotherapy decreased the number of days in inpatient care, emergency room care, and appointments with nonpsychiatric medical doctors; the saving was calculated at an astonishing $10,000 per patient, a reflection of the high cost of hospital care and the high risk of hospitalization for these patients.@@@[[#32MLinehanetalACognit|32]]$$$
+These requirements have strong relationships with each other. They imbue the studying process with the quintessence of Marxism-Leninism. And more importantly, they help students apply that quintessence into cognitive and practical activities.
-Some studies indicate that people receiving psychotherapy reduce their use not only of psychiatric inpatient services but of medical inpatient and outpatient nonpsychiatric services. A 1990 study showed that group therapy sessions had led to a 50 percent reduction in medical outpatient visits at one HMO.@@@[[#33CHellmanetalAStudy|33]]$$$ A 1991 study reported that psychiatric consultation for elderly patients with hip fractures led to reduced hospitalization, with savings of five times the cost of the psychotherapy.@@@[[#34JStrainetalCostOffs|34]]$$$ Metastatic breast cancer patients given a year of weekly group therapy experienced less anxiety, nausea, and pain and had double the survival rate of the control group.@@@[[#35DSpiegeletalEffecto|35]]$$$ There is a similar result for patients with malignant melanomas.@@@[[#36FIFawzyetalMaligna|36]]$$$ There have been many such studies.@@@[[#37SeeLazarandGabbardThe|37]]$$$
+==== Part I: The Worldview and Philosophical Methodology of Marxism — Leninism ====
-Yet what we do not know is how many people would avail themselves of psychotherapy if it were freely available through the average health insurance policy. Some researchers refer to this as the problem of the “hidden iceberg.”@@@[[#38IlearnedthistermfromKim|38]]$$$ Seeing a psychotherapist carries a certain amount of stigma even now. What might happen to the demand if the stigma disappeared altogether? On the other side sits the worry that perhaps as many as 70 percent of all nonpsychiatric medical visits are for essentially psychosomatic or psychosocial problems. That, goes the argument, is why freely available psychotherapy would cut overall medical costs. Yet how do we know when a psychotherapy session is “medically necessary”? Most people in therapy for help with a bad relationship or a stressful job would happily accept that a suicidal patient needs psychotherapy more desperately than they do, just as most people in the emergency room with a sprained ankle accept that a patient with a heart attack needs a physician’s care more urgently than they do. But then, most people make appointments with their internist for stuffed noses and aching knees, not major medical crises. Identifying equity in psychiatric and nonpsychiatric medical care is a nightmarish policy problem.
+''Worldview'' refers to the whole of an individual’s or society’s opinions and conceptions about the world, about humans ourselves, and about life and the position of human beings in that world. Our worldview directs and orientates our life, including our cognitive and practical activities, as well as our self-awareness. Our worldview defines our ideals, our value system, and our lifestyle. So, a proper and scientific worldview serves as a foundation to establish a constructive approach to life. One of the basic criteria to evaluate the growth and maturity of an individual or a whole society is the degree to which worldview has been developed.
-There are, of course, problems with some of the ways in which psychotherapy has been used. Most recently, there has been a public outcry about false memories “retrieved” by psychotherapy and about some of the more bizarre claims that patients have been abducted by aliens and abused by Satanists. There have been cases when therapists have been accused of inducing patients to remember events that may not have occurred. It is sometimes forgotten in the tumult that the process of diagnosis, both psychiatric and nonpsychiatric, is always subject to enthusiasm. People come into a clinician’s office complaining of distress. Those with confusing symptoms are more likely to be given a diagnosis that is then receiving a good deal of professional and public attention, and the condition is thus overdiagnosed. Attention deficit disorder is an example of a now-trendy diagnosis; eating disorders and schizophrenia were trendy in their day. In the early eighties, the trauma diagnoses seemed to explain problems that had previously been ignored. It may well be the case that those who complain of bizarre trauma in fact experienced more commonplace trauma (sexual abuse, bullying) that did make them ill. In fact, the existence of Satanic and alien abduction fantasies probably tells us a good deal about the suggestibility of certain kinds of traumatized patients.
+''Methodology'' is a system of reasoning: the ideas and rules that guide humans to research, build, select, and apply the most suitable methods in both perception and practice. Methodologies can range from very specific to broadly general, with ''philosophical methodology'' being the most general scope of methodology.
-But the bottom line is that mistakes happen in medicine. In the 1960s, the “appropriate” dose of antipsychotic was hugely greater than it is today. Surgeons once recommended the removal of the uterus for menopausal women who found hot flashes troubling. Just as psychopharmacological overenthusiasm and surgical overenthusiasm should not lead one to dismiss psychopharmacology or surgery, so too psychotherapeutic zealotry should not lead one to dismiss psychotherapy as a technique. There will always be controversies. The evidence, however, suggests that the general technique of psychotherapy helps patients feel better and cope more effectively.
+-----
-The dilemma for psychotherapists in the age of managed care is how to maintain medical funding for a “procedure” that they know to be useful but that lends itself poorly to the type of rigorous study that is increasingly necessary in the current health care environment.
+-----
-Psychiatric medications—especially Prozac—have profoundly changed the way many Americans think about psychotherapy. When I teach psychological anthropology to undergraduates, some of them shift irritably during the lectures on psychoanalysis. Then they go to the small discussion groups and complain that they shouldn’t have to read Freud because he has been “disproved.” They often see an either- or choice between these two ways of looking at mental illness, the one rooted in medication with a discourse about brains and neurotransmitters, the other rooted in language with a discourse about self-awareness. This is a mistaken perception. It is also not an unreasonable inference from the history of twentieth-century psychiatry, for psychoanalysis was once the dominant key of psychiatric practice, and in the last few decades the history of psychiatry had been the story of psychoanalytic decline and psychopharmacological ascendence. But the real story of twentieth-century psychiatry is how complex mental illness is, how difficult it is to treat, and how, in the face of this complexity, people cling to coherent explanations like poor swimmers to a raft.
+==== Annotation 47 ====
-By the end of World War II, psychoanalysis completely dominated American psychiatry and was nearly synonymous with it. The American Psychoanalytic Association had voted to permit only medical doctors—de facto, only psychiatrists—to train as psychoanalysts, overturning Freud’s explicit wishes.@@@[[#39TheQuestionofLayAnalysis|39]]$$$ (When psychologists won a suit against the American Psychoanalytic Association in 1986, that changed, and psychologists and other professionals are now admitted for training. Even in earlier decades, there were some exceptions.) In the decades after the war, most psychiatric residents were immersed in psychoanalysis. Most ambitious psychiatrists became psychoanalysts, most psychiatric textbooks were written by psychoanalysts, and most teachers of psychiatry taught psychoanalytic theory. Almost all psychiatric leaders (there were exceptions) were psychoanalysts. “In some quarters,” mused an éminence grise in 1990, looking back on the postwar decades, “it was believed that psychoanalysis had taken over United States psychiatry lock, stock and barrel.”@@@[[#40MSabshinTurningPoints|40]]$$$
+Tran Thien Tu, the vice-dean of the Department of Marxist-Leninist Theoretical Studies at the Le Duan Political Science University in Quang Tri, Vietnam, defines three degrees of scopes of Methodology. They are, from most specific to most general:
-Why? Psychoanalysis introduced a theory of mind that in its complexity and explanatory power was clearly superior to its predecessors and clearly better equipped to handle mental distress. In mid- to late-nineteenth-century America, marital difficulties, financial misfortunes, and anxiety were not the domain of professionals whose job it was to remove them. By the end of the nineteenth century, Americans apparently began to believe that rapid social change was creating an epidemic of “nerves” that was causing just those difficulties. And by the 1920s, there were numerous competitors for the personal problems clientele: neurologists, social workers, clergymen, advocates of “positive thinking,” and the like. Inevitably, a professional tussle arose over which discipline would take charge of the many people who wanted help with the discords and distresses of everyday life.@@@[[#41Thestrugglebetweenneurolo|41]]$$$ In this setting, Freud’s theories were like a flashlight in a candle factory. He offered models of the mind, elaborate theories, specific explanations (for psychosis, hysteria, even jokes), and a specific technique. The competitors had an optimistic theology and some homespun remedies. Freud’s ideas decisively won for the psychiatrists the battle for jurisdiction over ordinary human unhappiness. That victory considerably broadened the patient pool for psychiatrists.
+'''1. Field Methodology'''
-Psychoanalysis was also associated with a distinct improvement in patient care. The postwar period was not a medical era given to systematic outcome studies, so although many case studies testify to the power of the psychoanalytic method, there are little systematic data. However, those prewar decades ushered in a more compassionate and optimistic era of psychiatric care. A study of the Boston Psychopathic Hospital elegantly describes an early-twentieth-century shift from a warden’s sensibility of locking up the mad to a doctorly sensibility of helping the nearly normal to adjust socially and find their bearings in a frenetic world.@@@[[#42ElizabethLunbeckThePsych|42]]$$$ The new psychiatrists did not have asylums; they had hospitals. Soon they had outpatient clinics and private practices. Patients were no longer imagined as weird, different, and bodily impaired, as they had been (more or less) in the nineteenth century. They were like the rest of us, victims of an ordinary struggle that wounded a patient somewhat more than those who were not patients. Psychoanalysis was not responsible for this shift in attention from the “alien” to the everyday (it was under way before psychoanalysis had much impact in American psychiatry), but as that shift occurred, psychoanalysis became a powerful theory that justified psychiatrists’ treatment of ordinary people, and psychoanalysis was hailed as a powerful method that outshone any other in complexity and technical depth. Not all psychiatric hospitals held to the new standards of humanitarian care (in 1946, for example, one unnerving autobiographical novel, ''The Snake Pit'', depicted a psychiatric hospital as a prison). But the tenor of patient care does seem to have grown distinctly more kindly and hopeful.@@@[[#43LunbeckPsychiatricProfess|43]]$$$
+The most specific scope of methodology; a field methodology will apply only to a single specific scientific field.
-World War II itself established the value of psychoanalysis both within psychiatry and within the public awareness of psychiatric problems.@@@[[#44LaurenceFriedmanMenninger|44]]$$$ At the front, shell-shocked soldiers were treated with various techniques, but the symptoms—incapacitating anxiety, recurrent nightmares, intrusive thoughts about one’s victims—seemed to cry out for an account of something like an “unconscious.” One contemporary recalled, “You didn’t have to go into profound theory to demonstrate such things as symptom substitution or repression [in combat trauma]. No one had explanations for these things except the analysts, and they could mobilize them for treatment.”@@@[[#45JuddMarmorquotedinHale|45]]$$$ The public had been horrified by the news that at least 1,100,000 and perhaps as many as 1,875,000 men had been rejected for military duty because of psychiatric or neurological disorders, and then that more than a million patients with neuropsychiatric casualties had been admitted to military hospitals between January 1942 and December 1945.@@@[[#46Ibidp188alsoseepp|46]]$$$ Psychoanalytically oriented psychiatry seemed to promise a cure. Later, novels such as ''Captain Newman, M.D''. gave (apparently) thinly fictionalized accounts of the war and the way military psychiatrists, equipped with psychoanalytic concepts of repression, transference, displacement, and above all the unconscious, could figure out the roots of a soldier’s fear and restore him to effective functioning. In 1946, the National Mental Health Act vastly increased the money available for training and research, created the National Institute of Mental Health, and created a network of sixty-nine new hospitals for the Veterans Administration, mostly to deal with psychiatric casualties. Most, by then, had a psychoanalytic focus.@@@[[#47JohnTalbottTheDeathoft|47]]$$$
+'''2. General Methodology'''
-By the early sixties, the American public had adopted psychoanalysis with gushing enthusiasm. Looking back on that era from the distance of four decades, psychoanalysis seems so alien, so peculiarly European against the postwar cheeriness of Tupperware suburbia that one concludes that the American public can have adopted it so eagerly only by not quite understanding Freud’s essential pessimism. Some scholars link the popular eagerness to a peculiarly American and deeply un-Freudian optimism about the perfectability of self.@@@[[#48SeeegSherryTurklePs|48]]$$$ In any event, in 1961, ''The Atlantic'' devoted a special issue to “Psychiatry in American Life.” The editor’s introduction remarked, “The impact of [the psychoanalytic] revolution has been incalculable. To an extent not paralleled elsewhere, psychoanalysis and psychiatry in general have influenced medicine, the arts and criticism, popular entertainment, advertising, the rearing of children, sociology, anthropology, legal thought and practice, humor, manners and mores, even organized religion.”@@@[[#49TheAtlanticSpecialSupple|49]]$$$ In the Fall 1963 issue of ''Daedalus'', an issue devoted to the professions, a psychiatrist remarked, “It is hardly necessary to document the extent to which psychoanalytic thought has pervaded every aspect of modern American life.”@@@[[#50NZinbergPsychiatryAP|50]]$$$ The author described the widespread appeal of psychoanalysis as a “professional dilemma”: psychiatrists wanted to help but could not solve all social problems and could not be everywhere at once. The assumption seemed to be that if a psychiatrist ''could'' be everywhere, he ''would'' be able to solve all social ills. This was not the psychoanalysis of devastated Europe but a bright, shiny intellectual appliance, an automated floor buffer for messy psyches. One American commentator (a nonpsychiatrist) happily described psychoanalysis as making possible “a community favorable to the emergence of a humanity more humane than any we have ever known.”@@@[[#51TheAtlanticSpecialSupple|51]]$$$
+A more general scope of methodology; a general methodology will be shared by various scientific fields.
-Power magnifies weakness. Even at the time, it should have been clear that psychoanalytic dominance could not sustain itself. There was, for a start, the problem of verification created by the theory itself. Psychoanalysis emphasizes the role of unconscious motivation in human suffering. The central hypothesis in psychoanalysis is that our deepest motivations are usually unconscious and often horrid (self-destructive, other-destructive, full of rage, greed, lust, and envy), that we create a panoply of defenses to protect ourselves from acting on those impulses (repression, avoidance, displacement, humor, sublimation, to name just the more obvious), and that the emotional conflicts we thus create drive us nonetheless. From this perspective, people fall ill because they are unable to tolerate the conflicts they find themselves saddled with. If they cannot bear the fact that in some ways they hate their mothers, they may make themselves sick and miserable so as to make her life a burden, while themselves remaining unconscious of their malice. Caught between their love and their hatred, they may feel so guilty that they refuse to allow themselves comfort and peace. The role of the analyst was (then, at least) conceived as helping someone understand aspects of his inner life he could not see for himself and then take responsibility in relation to them. The psychoanalytic process (as it was conceptualized) helped patients understand how they damaged themselves unconsciously, learn to interrupt those patterns, and live a more rewarding and realistic life.
+'''3. Philosophical Methodology'''
-In fact, not even Freud was certain whether an analyst’s interpretations and a patient’s insight together enabled human change or whether some other feature of treatment—an analyst’s unwavering attention, his consistent concern, his reliable presence—was as or more important. But insight—a patient’s cognitive understanding of his own psychological dynamics—has always been understood to be important to the psychoanalytic process, and in the postwar period insight was often understood to play the crucial role in therapeutic change.
+The most general scope of methodology, encompassing the whole of the material world and human thought.
-By their nature, interpretation and insight are unreliable. A trained psychoanalyst, having read much and seen many people in therapy, might be able to understand a person’s psychic “grammar” and so help that person understand what he is trying to hide from himself because he fears it. To make this possible, an analyst offers an interpretation, or a description, of a patient’s unconscious patterns to the patient. If the patient accepts that interpretation as accurate, he experiences what the analyst calls insight (he may also experience insight independently of the analyst’s interpretation). There can be no proof that an analyst is right, nor is an analyst immune to his own unconscious fears, doubts, and blunderings. A patient’s rejection of the interpretation does not prove that the interpretation was wrong, nor does her enthusiastic endorsement prove its accuracy.@@@[[#52ThisisthearenainwhichA|52]]$$$
+-----
-Yet when psychoanalytic power was at its crest, psychoanalysts casually assumed that criticisms of psychoanalysis—by the patient, by the press, eventually by the new psychiatric scientists—were driven by fear and anxiety in the face of psychoanalytic interpretation. In a field dominated by the notion of an unknowable unconscious, criticisms can always be interpreted as “resistance” to the hard truths of Freud’s theory. Thus, younger analysts who protested aspects of psychoanalytic theory or even the behavior of their seniors were often thought to be acting out their unconscious conflicts, like patients, rather than expressing legitimate criticism, like colleagues. In the period of its greatest success, psychoanalysis became an orthodox profession, stern and unforgiving to those who strayed outside conventional limits. “Newcomers to contemporary analysis,” an eminent psychoanalyst writes gently, “are not in a good position to fully appreciate the rigidity that characterized the Freudian psychoanalytic writing and discussion of the 1950s and 1960s.”@@@[[#53RoySchaferAspectsofInte|53]]$$$ All patients were understood to be crippled by emotional conflict, which made them desperately unhappy. Yet the patients themselves were thought to provide the greatest impediment to the resolution of that conflict. This was their “resistance”: a refusal to see the conflict for what it was, a psychically manufactured distortion of their real experience. The recognition that each of us builds the cage of our own imprisonment and then howls against the injustice of our confinement is brilliant and deep. But it can also be used to argue that the analyst is always right. The failure of therapy could always be attributed to the patient.
+''Worldview'' and ''philosophical methodology'' are the fundamental knowledge-systems* of Marxism-Leninism.
-This arrogance, the implicit assumption that accepting an analyst’s authority was the route to cure, could also have the effect of focusing attention on the interpretation of an illness rather than on the illness itself. For example, here is a text, published in 1961, that explains that the mania of manic-depressive disorder is a defense against the recognition of a painful personal reality. The author quotes Helene Deutsch, a senior psychoanalytic maven, for support:
+==== Annotation 48 ====
-===== The patient was denying that she lacked a penis, and from this central latent denial irradiated a host of manifest secondary ones. “During the time that she was in analysis,” Deutsch wrote (1933), “her husband and lover both deserted her, she lost most of her money, and she experienced the melancholy destiny of mothers whose growing son deserts them for another woman. Finally, she had to accept the narcissistic blow of my telling her that she could not become a psychoanalyst. None of this was capable of disturbing her euphoria.”@@@[[#54BertramLewinThePsychoana|54]]$$$ =====
+<nowiki>*</nowiki> In the original Vietnamese, the word ''lý'' ''luận'' is used, which we roughly translate to the phrase “knowledge-system” throughout this book. Literally, ''lý luận'' is a combination of the words ''lý'' ''lẽ,'' which means “argument,” and ''bàn'' ''luận,'' which means “to infer.”
-The modern reader is startled not only by the interpretation but by the fact that the analyst could mention as an aside the disintegration of a life she was supposedly overseeing. In the late 1990s, a psychiatrist would see the “euphoria” of mania as the mood swing that might be causing the loss of husband, lover, money, and son. In 1961, the patient’s refusal to acknowledge the analyst’s interpretation (of penis envy) was the “central” denial. The collapse of the rest of her life was “secondary.” This emphasis on the analyst’s explanation would come back to haunt psychoanalysts later, when the new psychiatric scientists accused them of ignoring patients’ sicknesses altogether.
+The full meaning of ''lý'' ''luận'' is: a system of ideas that reflect reality expressed in a system of knowledge that allows for a complete view of the fundamental laws and relationships of objective reality.
-Another problem was that it was possible to attribute a patient’s failure to improve not to the patient but to the therapist, and specifically to the therapist’s anxiety and fear about that patient. Here the real resistance lay in the doctor, not the patient. Psychoanalysts who emphasized a doctor’s struggles were likely to teach compassion and kindness to young psychiatrists. They would argue that a doctor must be taught explicitly to learn to care because otherwise his unconscious fear of intimacy and connection would inhibit him from helping patients as much as he could. Nothing in the last few decades has dimmed the salience of this concern. But again, it has a danger, which is that the approach can lead one to confuse the limitations of the practitioners with the limits of the practice. The arrogance that grew out of this approach to psychoanalysis was that the only limits to what psychoanalysis could treat were the limits of the doctor’s compassion.
+<br />
-From 1954 to 1976, Elvin Semrad was the legendary residency director of the Massachusetts Mental Health Center, a Harvard teaching hospital where many of today’s psychiatric leaders trained. Semrad was a portly Nebraskan, not particularly handsome but warm, with a deeply attentive presence. He seems to have been one of those people who makes you feel clear-headed and capable, as if you can face the reality you fear directly and decide competently what to do about it. He made people feel, as one of his residents told me, as if he listened to them more carefully than anyone had ever done before, and he taught his students that this was what their patients should feel about them. He told them that their job was to “sit” with patients, a term analysts often use to describe the process of trying to understand, to tolerate, and to accept a patient’s anger and pain in the patient’s presence and to help patients to look at their lives in a way that can help them find their own solutions to their problems. Semrad hated medication; he thought it was a cheap crutch that people used to avoid addressing the real issues. “If they have to get addicted,” he said of the patients, “I would rather have them addicted to psychotherapy than to drugs.… When you take poison, sooner or later you get poisoned. And all drugs are poison.”@@@[[#55SusanRakoandHarveyMazer|55]]$$$
+==== The Worldview and Philosophical Methodology of Marxism-Leninism ====
-Semrad taught that doctors cure through love—of a particular, reserved kind, of course, but love nonetheless. A doctor’s ability to heal was his ability to care. One of Semrad’s ex-residents who was, when I knew him, a popular supervisor in his own right, still spoke of Semrad with reverence and in Semrad’s tradition taught his students through stories. “When I first arrived at Mass Mental,” he said, “before I’d gotten the feel of the place, I was given a patient who was a wrist cutter. She would cut her wrists with anything she could get her hands on, and it was driving me mad. I couldn’t stop her, and everyone was angry at me. Well, Semrad kept his door open. He formed intense bonds with his residents. It was a very intense apprenticeship in being there for your patient, curing through care, but I really didn’t understand that well then. I only knew that I was desperate, and I went to talk to him. To my great embarrassment, I began to cry. Semrad said nothing. So I pulled myself together, and I sat there thinking that my psychiatric career was in ruins. In many hospitals, those tears would have been a sign of overinvolvement. But Semrad said, in a very gentle but confident tone—it is impossible to convey the quality of that tone—‘I’m sure that if you show her how much you care, she will stop.’ And so I went back to her. I told her that I was confused, that I didn’t know what to do, I was so upset—and she stopped.” Semrad seems to have been fairly direct, but he used aphorisms, often paradoxical: that love, for example, was “the only socially acceptable psychosis”@@@[[#56Ibidp36|56]]$$$ or, in advice to a resident, “Go after what the patient feels and cannot do himself. Help him to acknowledge what he cannot bear himself, and stay with him until he can stand it.”@@@[[#57Ibidp105|57]]$$$ After his death, two students collected the sayings that they could remember in a book. It is clear that they reciprocated the love.
+Marxist-Leninist worldview and philosophical methodology emerge from the quintessence [see Annotation 6, p. 8] of dialectical materialism, which itself developed from other forms of dialectics, which in turn developed throughout the history of the ideological development of humanity.
-This made sense if psychiatric illness were understood solely as a response to emotional conflict. From this perspective, the difference between psychosis, neurosis, and health was a matter of degree. True mental health was an illusion. To some measure we were all damned. We had all lusted in our hearts and loins for unallowed parents in unallowed ways, and emotionally we were all groping toward the light. Psychiatric patients were people more overwhelmed than others by anxiety or rage, and psychosis and depression were various ways of handling their otherwise unmanageable feelings. Young psychiatrists learned that their basic job was to listen empathically to the patient, to try to understand the patient’s experience from the patient’s point of view, and to understand and to describe (or interpret) the patient’s conflicts. A psychiatrist’s presence would help a patient understand that he could live a different sort of life, one less haunted by misery, and with that understanding, the patient could decide to relinquish the symptoms that, until then, had been a refuge. But the psychiatrist could work this miracle only if he genuinely accepted and understood the things the patient feared, so that those things would seem less terrifying. That was why the psychiatrist’s loving acceptance of the patient was so important.
+Materialism is foundational to Marxism-Leninism in two important ways:
-It was also, at Mass Mental, very difficult. The clients at Mass Mental were among the sickest, poorest, and most chronic patients in Boston. Most of them were thought to have schizophrenia, the darkest of all psychiatric illnesses, an illness of psychosis, emotional withdrawal, and profound dysfunction. In those days the label included the same chronic, difficult, apparently untreatable and incurable patients who had filled the state mental hospitals since they had opened. Many people, working with these patients, have a palpable sense that something has gone physically wrong with their brains. But in the period of psychoanalytic imperialism, the schizophrenic’s psychosis, emotional apathy, and inability to function were said to arise from his intense emotional ambivalence. The schizophrenic’s mother (she was called “schizophrenigenic”) had given him conflicting signals that he was unable to resolve except through psychotic emotional withdrawal. The famous example of this kind of double bind was this: a mother visits her schizophrenic son; he is glad to see her, and hugs her; she stiffens; he draws back; she asks, “Don’t you love me anymore?”@@@[[#58GregoryBatesonStepstoan|58]]$$$ To Semrad, a schizophrenic was the most exciting patient, the tough, difficult patient that made a young resident a “real” psychiatrist, particularly the schizophrenic in his first “break,” or psychotic episode, because that was when consciousness broke open like a cracked skull to display the hidden workings of the unconscious inside. By seeing in the psychosis the meaning of meaningless words and gestures, a doctor could help a patient. Semrad recognized that it was hard to do daily therapy with these patients. Nonetheless, the ethos was clear. As the chronicler of the classic study of Mass Mental pointed out, “to treat schizophrenics psychoanalytically became the ultimate professional challenge at which most psychiatrists tried their hand.”@@@[[#59DonaldLightBecomingPsych|59]]$$$ It proved that the doctor did not fear the patient, that his own unconscious defenses were not so steep as to prevent him from making emotional contact with that patient, that he had the courage, as Semrad would have put it, to bear what the patient could not, so that the patient could see that the burden was bearable. As Semrad wrote, “In order to engage a schizophrenic patient in therapy, the therapist’s basic attitude must be an acceptance of the patient as he is—of his aims in life, his values, and his modes of operating, even when they are different and very often at odds with his own. Loving the patient as he is, in his state of decompensation [his psychosis], is the therapist’s primary concern in approaching the patient.”@@@[[#60QuotedinEKandelANew|60]]$$$
+''Dialectical Materialism'' is the ideological core of a scientific worldview.
-These were terribly important lessons. But loving the patient did not, by itself, do much for the symptoms of severe mental illness, although it probably helped lessen the intense loneliness most schizophrenic patients fear and probably prevented relapses into more severe psychosis. Not even all of Semrad’s residents believed the message of hope about the hard but rewarding work of doing therapy with schizophrenics. “It was nonsense,” one said to me thirty years after the fact. “You couldn’t do anything with them.” That the ethos sustained itself at all was probably due to the fact that the word “schizophrenic” was more capacious then than it is now and in fact included many people who would not now be called schizophrenic and did in fact improve. (Some of them would now be called borderline personality disorder, manic-depressive, and so forth. Also, even with the current narrow definition, some significant percentage of schizophrenics—perhaps as high as 30 percent—do eventually improve. It is not clear whether their improvement has to do with their treatment.) As a result, while popular accounts described the miraculous transformations wrought by psychoanalytic psychotherapy on the very sick—''Dibs; Jordi; Lisa and David; The Fifty Minute Hour; I Never Promised You a Rose Garden; Autobiography of a Schizophrenic Girl''—many of the sickest patients remained as ill as ever.
+''Historical Materialism'' is a system of dialectical materialist opinions about the origin of, motivation of, and the most common rules that dominate the movement and development of human society.
-Psychoanalysis, on its own, without appropriate medication, did not have much impact on severe psychiatric illness. Yet it was terribly difficult to make that criticism stick, because the theory itself invited the observer to blame the patient or the therapist rather than the technique. When a psychiatrist complained openly that psychoanalysis didn’t work for his patients, he was at risk of looking like a fool. In the end, economic and social problems created the conditions under which the old psychoanalytic paradigm gave way. And because it gave way reluctantly, it did so without grace.
+Dialectics are also foundational to Marxism-Leninism, specifically in the form of ''Materialist Dialectics,'' which Lenin defined as “the doctrine of development in its fullest, deepest and most comprehensive form, the doctrine of the relativity of human knowledge.”<ref>''The Three Sources and Three Component Parts of Marxism'', Vladimir Ilyich Lenin, 1913.</ref> Lenin also defined Materialist Dialectics as “what is now called theory of knowledge or epistemology.”<ref>''Karl Marx'', Vladimir Ilyich Lenin, 1914.</ref> [Note: Epistemology is the theoretical study of knowledge; for more information see ''Cognitive Theory of Dialectical Materialism'', p. 204.]
-There was, for a start, the problem of whom the analysts would treat. In 1970, Arnold Rogow published a remarkable book called ''The Psychiatrists'' that probably represents the peak of public confidence in the psychoanalytic method. Rogow was a political scientist who justified his interest in psychiatry on the basis of the enormous power psychiatrists seemed to have over American lives: “Perhaps it is not too much to say that where the public once turned to the minister, or the captain of industry, or the scientist, it is now turning more and more to the psychiatrist.”@@@[[#61ArnoldRogowThePsychiatri|61]]$$$ He was tempted, he said, to recall Winston Churchill’s words about British fighter pilots in connection with the psychiatrists: “Never have so many owed so much to so few.” The paean call of the study was that far more people ought to become psychotherapists because so many Americans needed the help so badly. By 1970, the demand for psychotherapy far exceeded the number of psychiatrists qualified to provide it. Rogow wrote urgently about the need for more psychotherapists. He called on professors to lay down their books and take up training in any form they could, and he supported his call by citing a 1969 study of New York City schoolchildren that claimed that only 12 percent of them enjoyed good mental health.
+-----
-In fact, by now there were many reports of high levels of mental illness in the American community. In 1962, the Midtown Manhattan Study reported that in a sample of 1,020 men and women in the “lowest” level of socio-economic status, 47 percent were “impaired” and 23 percent had “moderate symptom formation.” Only 5 percent were “well.”@@@[[#62LeoSroleetalMentalHea|62]]$$$ The literature of the period uses data like these to document a desperate need for psychiatrists. A 1968 report prepared under the auspices of the National Commission on Mental Health Manpower presents itself as an eager recruitment plea, “an invitation to explore a career in mental health.” ''“No'' state,” it implored, “can meet even minimal staffing standards; ''no'' profession can produce enough graduates to meet the demand. The situation is now critical, and the future looms even worse, for the population is expanding while the pool of mental health manpower remains almost static.” The psychoanalyst, the report promised, will “find himself in tremendous demand.”@@@[[#63AmericanPsychiatricAssocia|63]]$$$ In the flush of their own authority, psychiatrists took up a social responsibility that from this distance seems poignantly ambitious. In the 1970 presidential address to the American Psychiatric Association, the speaker announced that “for too long we as psychiatrists have focused on the mental health of the individual.”@@@[[#64RWaggonerThePresidenti|64]]$$$ It was time, he went on, for psychiatry to turn its attention to pollution, overpopulation, racism, and nuclear war.
+==== Annotation 49 ====
-But Rogow’s own data reveal a major economic difficulty with the psychoanalytic enterprise. Analysts did not like to treat the very sickest patients, even though the promise of psychoanalysis was to treat all mental illness and even though most psychiatrists had been trained by treating very sick patients. One hundred eighty-four psychiatrists answered the questionnaire Rogow sent to every thirtieth name on the lists of members of the American Psychiatric Association and the American Psychoanalytic Association. Thirty-five were psychoanalysts as well as psychiatrists. A quarter were Jewish and most were middle class in origin. Most of them described themselves as psychoanalytically oriented and used this approach with most kinds of patients. Most of them preferred to treat “neuroses”—in other words, patients who were not very sick. Most patients were white and in business or the professions. For a fifth of the analysts, 75 to 100 percent of their patients were Jewish; for an additional quarter, 50 to 75 percent of their patients were Jewish. No analyst had any Puerto Rican, Mexican, or Native American patients. Only three analysts had any black patients, and very few of those. Only one analyst had any blue-collar patients, whereas slightly more than half of the psychiatrists had at least one blue-collar patient. Half of the patients were women, most of them housewives. The cost of an average psychotherapy visit in many cities in 1970 was $35, so that a year of once-a-week therapy cost $1,500 to $2,000 and a year of analysis cost well over $5,000. In 1969, the median earnings of a civilian American man was $6,899.@@@[[#65StatisticalAbstractofthe|65]]$$$
+For beginning students of Marxism-Leninism, distinguishing between ''Dialectical Materialism'' and ''Materialist Dialectics'' may at first be confusing. Here is an explanation of each concept and how they relate to one another:
-The unavoidable picture that emerges from this document is of a medical profession whose most important practitioners saw the wealthiest and healthiest members of the patient population. Another study, published in 1969, unironically remarks, “Although it is true that only two percent of the adult American population will admit that they have ever consulted a psychiatrist or a psychologist for a personal problem, the importance of the people who have actually received therapy transcends the sheer numbers involved.”@@@[[#66CharlesKadushinWhyPeople|66]]$$$ This is in damning contrast to the rest of medicine, where the patients of the best doctors may be wealthy, but they are usually also among the sickest. The important people who consulted psychiatrists were hardly in that category. In 1970, one out of every two hospital beds was occupied by a psychiatric patient, and most psychiatric training took place in hospitals filled with chronic patients. But those patients were not the patients of the most esteemed psychiatrists (although it was always true that despite the class bias, some of the best psychiatrists chose to continue to work with the sickest and the poorest of the patient population). The most esteemed psychiatrists were psychoanalysts, and their patients were too healthy to be admitted to a hospital. There was even common psychoanalytic wisdom that supported this position. Freud had written on the question of analytic “suitability” and had been clear that only patients with healthy ego strength (not psychotic) were suitable for psychoanalytic therapy. There was a contradiction, then, between the ambitious promises of the field and its actual practice. Until there were real treatment alternatives, however, there wasn’t much motivation to confront that contradiction.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-5.png|''Dialectical Materialism and Materialist Dialectics.'']]
-However, in the early 1970s, the visible failure of the community mental health movement, which was an attempt to apply psychiatric thinking to the poor and sick in society at large, began to discredit psychoanalysis, at least as a treatment for the very ill. In 1963, John F. Kennedy’s presidential address on mental health had argued that “the time has come for a bold new approach.”@@@[[#67Theaddresswasgalvanizedb|67]]$$$ The initiative had established community mental health centers, which were to treat psychiatric problems locally and preemptively, so that the hospitalized could return to their families and those at risk would not get so sick. Local psychiatrists would take responsibility for local areas and, by dint of their professional skills, maintain the community’s mental health. The idealism of this time still lingers in the memory of those who became psychiatrists, social workers, and psychologists in order to participate. “It was wonderful,” a psychiatric nurse said sadly of the days when she had worked in a hospital that had been founded to serve the community mental health purpose. “Spirits were so high. We were all so committed. It was so exciting. It’s different now.” The money never really materialized, but many of the hospitalized were released from hospitals despite the lack of local community care.@@@[[#68ThesociologistAndrewScull|68]]$$$ This was called “deinstitutionalization.” Because the infrastructure of community mental health care was never established, homelessness became the only option for many of the former patients. The profound chronicity of much mental illness became evident to the public, particularly in the next decade, when the real estate market skyrocketed and much formerly affordable housing was converted into more profitable investment.@@@[[#69SeeKimHopperMoreThanP|69]]$$$
+''Dialectical Materialism'' is a scientific understanding of matter, consciousness and the relationship between the two. Dialectical Materialism is used to understand the world by studying such relationships.
-Meanwhile, an “antipsychiatry” movement emerged and gathered force. Since the early sixties, Erving Goffman, R. D. Laing, Thomas Szasz, Thomas Scheff, and others (some psychiatrists, some not) had been writing vivid, brilliant books arguing that the mentally ill were not ill, just unconventional. The movement was a child of its rebellious, antiestablishment times, and it gained a wide audience. There were different ways of running the critique: Goffman pointed out that human behavior was profoundly shaped by institutional life, so that asylum patients rapidly learned to be psychiatrically ill; Scheff argued that the apparent symptoms of mental illness were better understood as nonconformity, which was labeled “deviant” by the social group. The general claim was that psychiatric illness was a problem of “labeling” and mental illness was a myth.@@@[[#70ThomasScheffsbookBeingM|70]]$$$ In 1974, the psychiatrist E. Fuller Torrey published a book entitled ''The Death of Psychiatry'', which began, “Psychiatry is an emperor standing naked in his new clothes.” Most people treated by psychiatrists, he argued, had problems in living and certainly did not need to be treated by people with medical training; all the others had brain disease and ought to be given back to the neurologists. What psychoanalytic psychiatrists saw as the emotional conflicts at the root of mental illness, these antipsychiatrists saw as a rebellious, artistic, unconventional rejection of the establishment. The fact that homosexuality had been removed from the list of psychiatric illnesses in 1973 by, of all things, a vote of the membership of the American Psychiatric Association, as if an illness label were a matter of opinion, did not help to allay these widely publicized doubts.
+''Materialist Dialectics'' is a science studying the general laws of the movement, change, and development of nature, society and human thought.
-Indeed, with the fluid psychoanalytic boundary between health and illness, it was difficult to say who was really sick. In 1973, ''Science'' published an article that deeply embarrassed the psychiatric world. The author, an academic psychologist named David Rosenhan, had persuaded eight people to present themselves at twelve different hospitals, complaining that they each had heard a voice saying “Thud.” Beyond this “auditory hallucination” they changed nothing in their life histories save their names and, if they were in the mental health field, their professions. Each pseudopatient was admitted; all but one were diagnosed as schizophrenic; their average length of stay was nineteen days. It was common for other patients on the wards to suspect the pseudopatients of being journalists or inspectors or in any event sane, but the staff members never did. On the contrary, they prepared notes and case reports as if the pseudopatients really were schizophrenic. One pseudo patient was described in his discharge summary as follows:
+[[File:t-w-the-worldview-and-philosophical-methodology-of-6.png|''Relationship between Dialectical Materialism and Materialist Dialectics.'']]
-===== This white 39 year old male … manifests a long history of considerable ambivalence in close relationships, which begins in early childhood. A warm relationship with his mother cools during adolescence. A distant relationship to his father is described as being very intense. His attempts to control emotionality with his wife and children are punctuated by angry outbursts and, in the case of children, spankings. And while he says he has several good friends, one senses considerable ambivalence embedded in these relationships also.@@@[[#71DavidRosenhanOnBeingSa|71]]$$$ =====
+And so, we use Dialectical Materialism to understand the fundamental nature of reality. This understanding is used as a basis for changing the world, using Materialist Dialectics to guide our activities. We can then reflect on the results of our activities, using Dialectical Materialism, to further develop our understanding of the world.
-Ambivalence was the trademark of the schizophrenic’s psychodynamics. Rosenhan neatly summarized the attitude of the psychiatric staff toward the pseudopatients: the patient is in a psychiatric hospital, so he must be psychiatrically disturbed.@@@[[#72Ibid|72]]$$$
+As Marxist-Leninists, we utilize this continuous cycle between studying and understanding the world through Dialectical Materialism and affecting change in the world through Materialist Dialectics with the goal of bringing about socialism and freeing humanity.
-Again, this fluidity had economic repercussions. In the psychoanalytic era, diagnosis per se was not terribly important. Many psychiatrists believed that diagnostic labels were irrelevant and used them cavalierly. Study after study bore out the unreliability of the diagnostic process; one found that young psychiatrists were no more likely to agree with an examiner’s diagnosis of a patient than would be expected by chance.@@@[[#73RKendellJCooperandA|73]]$$$ With this level of vagueness, deciding how many people were actually ill became a significant public health puzzle and certainly cast into doubt the earlier dire estimates of the Midtown Manhattan Study. In 1978, the President’s Commission on Mental Health reported that 15 percent of the population needed some form of mental health services at any one time—and then, astonishingly, mentioned in a footnote that this estimate had no data to support it: “Ideally, we would like to know the true prevalence of psychiatric disorders.… How do we come to terms with the fact that such data do not as yet exist?”@@@[[#74PresidentsCommissiononMe|74]]$$$ The estimate, in other words, was a guess.
+It is also important to understand the nature of ''dialectical relationships.''
-This was a significant problem for insurance companies, which by the 1970s had began to cover medical care widely. In the 1960s, Aetna and Blue Cross, through the Federal Employees Benefit Program, reimbursed for treatment for psychiatric illness dollar for dollar with other medical illnesses. By the mid-1970s, Aetna had cut back coverage to twenty outpatient visits and forty inpatient hospital days per year. An official explained why:
+A dialectical relationship is a relationship in which two things mutually impact one another. Dialectical materialism perceives all things in ''motion'' [see ''Mode and Forms of Existence of Matter'', p. 59] and in a constant state of ''change'', and this motion and change originates from relationships in which all things mutually move and change each other through interaction, leading to development over time.
-===== Compared to other types of [medical] service there is less clarity and uniformity of terminology concerning mental diagnosis, treatment modalities and types of facilities providing care.… One dimension of this problem arises from the latent or private nature of many services; only the patient and the therapist have direct knowledge of what services were provided and why.@@@[[#75TheVicePresidentofBlueC|75]]$$$ =====
+-----
-This, of course, was true. No information other than the diagnosis was released to insurance companies on the grounds of confidentiality, and the diagnosis provided almost no information.
+Thoroughly understanding the basic content of the worldview and methodology of Marxism-Leninism is the most important requirement in order to properly study the whole theory system of Marxism-Leninism and to creatively apply it into cognitive and practical activities in order to solve the problems that our society must cope with.
-In addition, the psychoanalytic citadel suddenly faced competition from the interlopers allowed in to help shoulder the increased demand for psychotherapy. In the middle 1960s, only psychiatrists were recognized as legitimate providers of psychotherapy, and, as we have seen, only psychiatrists could train as psychoanalysts. Psychologists did offer therapy, but only psychiatrists could be reimbursed by insurance companies. But because the demand for therapy far exceeded the supply, by 1972 Medicaid allowed psychologists to bill for services, first for psychological testing and then for psychotherapy, and by 1974 the government allowed clinical psychologists to be named as qualified independent providers of psychotherapy.@@@[[#76AbbottTheSystemofProfes|76]]$$$ Social workers soon followed suit, and the gates swung open. Psychiatrists no longer looked as if they were doing something special, something that no one else could do.
+-----
-It was around this period, in the 1970s, that a new kind of psychiatrist began to emerge. These psychiatrists saw themselves as scientists, and to them that word set them apart from psychoanalysis, to which many of them were openly hostile and which few of them regarded as scientific. (Psychoanalysts still tended to think of themselves as scientists, as had Freud. I will use the term “psychiatric science” to refer to this new movement in psychiatry.) The psychiatric scientists were committed to what they called strict standards of evidence, and they tended to view psychoanalytic theories of causation as neither provable nor disprovable by those standards. They were determined to create a psychiatry that looked more like the rest of medicine, in which patients were understood to have diseases and in which doctors identified the diseases and then targeted them by treating the body, just as medicine identified and treated cardiac illness, thyroiditis, and diabetes.
+=== 3. Excerpt From ''Modifying the Working Style'' By Ho Chi Minh ===
-They already had the medication. Psychiatric medication had existed since 1954, when Smith Kline and French had introduced Thorazine, a medication that reduced the hallucinatory symptoms of psychosis.@@@[[#77SmithKlineandFrenchLabor|77]]$$$ (Actually, even earlier a drug called reserpine had been used, but as it induced depression it is no longer prescribed much.) Many psychiatrists—among them many of those who taught residents, published in journals, and set policy—were scornful of the medications in the early years, seeing them as crude instruments that addressed the symptoms but not the underlying psychodynamics of illnesses. It is true that Thorazine is a blunt instrument: it reduces psychosis but often leaves the patient in a daze. It can also produce muscular twitches and a shuffling gait. Residents from the sixties, when chronic patients were put on huge doses of Thorazine and the psychoanalytic model still dominated as the explanation for their symptoms, learned to talk about the “Thorazine shuffle” in the hospital. By the seventies, however, a whole crop of new psychiatric medications had appeared, many of them more precise in their action and less devastating in their side effects.@@@[[#78Tardivedyskinesiainvolunt|78]]$$$ Lithium began to be widely used to manage the mood swings of manic depression, and it was strikingly helpful (lithium had been discovered in 1949, by John Cade, but because it can be toxic it was not used freely until the early seventies, when tests were developed to measure and control blood levels). Miltown, Librium, Valium, and other antianxiety agents—“mother’s little helpers”—were often prescribed. Reliable antidepressants (the tricyclics) were available, although their side effects were unpleasant. There were medications in abundance. What psychiatrists did not yet have was a clear connection between what was medically wrong with a patient and how to tie that specific judgment to a specific medical plan.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-7.jpg|''Ho Chi Minh training cadres in 1959.'']]
-The emerging school of “scientific” or “remedicalized” psychiatry owed its allegiance not to Freud but to Emil Kraepelin, a German psychiatrist born the same year as Freud (1856). Kraepelin had created an important taxonomy of psychiatric illness by studying symptom clusters and final outcomes, and by collecting family histories to trace hereditary traits.@@@[[#79Hehaddistinguishedmanicd|79]]$$$ He is famous for, among other things, applying the term “dementia praecox” to a group of illnesses that began in adolescence and ended in dementia. (The term now used is “schizophrenia.”) The new psychiatric scientists argued, in effect, that psychiatry had made a wrong turn by following Freud instead of Kraepelin. (Their approach is called neo-Kraepelinian.) They tended to believe that if a disorder could be distinctly identified with specific criteria, a common clinical course, and perhaps a family history, it probably had an underlying organic cause and was a disease like any other.
+Training is a must. There is a proverb: “without a teacher, you can never do well;” and the expression: “learn to eat, learn to speak, learn to pack, learn to unpack.”
-Much of the initial work came out of Washington University, where a collection of researchers—most famously, Eli Robins, Lee Nelken Robins, Samuel Guze, and George Winokur—had been doing research since the 1950s. What they did was to describe a disorder and then draft criteria for its diagnosis (for example, suicidal thoughts, depressed mood, inability to concentrate) that were clear enough for different observers to give the same diagnosis to the same patient. They did this through clinical wisdom, but also by using laboratory studies, family studies, and follow-up studies. This was a novel and threatening idea, odd as that seems on this side of the 1980s. The criteria they produced are sometimes known as the “Feighner criteria,” after the lucky resident who was the first author of what became a famous paper, “Diagnostic Criteria for Use in Psychiatric Research,” published in ''The Archives of General Psychiatry'' in 1972. The paper sits oddly in the table of contents among papers with titles such as “On the Incapacity to Love” and “The Chinese Attitude Toward Parental Authority as Expressed in Chinese Children’s Stories.” It is modestly written, but the dry prose has a revolutionary tone: “Diagnosis has functions as important in psychiatry as elsewhere in medicine.”@@@[[#80JFeighneretalDiagnos|80]]$$$
+Even many simple subjects require study, let alone revolutionary work and resistance work. How can you perform such tasks without any training?
-In 1980, the American Psychiatric Association published the ''Diagnostic and Statistical Manual of Mental Disorders'', third edition, called more commonly ''DSM III''. The two previous ''DSMs'' had been slight, spiral-bound pamphlets not taken terribly seriously by the field. When the American Psychiatric Association published its first diagnostic manual in 1952, most psychiatric disorders were listed under the explicit title “Disorders of Psychogenic Origin or Without Clearly Defined Physical Cause or Structural Change in the Brain.”@@@[[#81AmericanPsychiatricAssocia|81]]$$$ The diagnostic ancestors of the current psychiatric labels were clearly marked; but they were adjectives, not nouns. The manual spoke not of “schizophrenia” but of a “schizophrenic reaction.” Its language was distinctly psychoanalytic. The “psychoneurotic disorders,” for instance, were “anxiety reaction,” “obsessive-compulsive reaction,” and “depressive reaction,” rather than (as now) “generalized anxiety disorder,” “obsessive-compulsive disorder,” “major depression.” The early manual described all those problems this way: “The chief characteristic of these disorders is ‘anxiety,’ which may be directly felt and expressed or which may be unconsciously and automatically controlled by the utilization of various psychological defense mechanisms.”@@@[[#82Ibidp31|82]]$$$
+But training materials must be aimed at the needs of the masses. We must ask: after people receive their training, can they apply their knowledge immediately? Is it possible to practice right away?
-''DSM III'' was a fat book. There were many more diagnoses, they were more precisely detailed, and they were decked out with the accoutrements of scientific research. The psychodynamics were gone. In the place of Freud’s ghost stood Kraepelin. (“It’s extraordinary,” a psychoanalyst said to me when I described the training of young psychiatrists. ''“Kraepelin''. They’re going back to Kraepelin.”) ''DSM III'', like the Feighner criteria out of which it had grown, was “scientific,” medically speaking (at least, that was the intended point). The psychiatrists responsible for ''DSM III'' had assembled under the guidance of Robert Spitzer, a tall, quick, shy man trained as a psychoanalyst. Spitzer argued that the “innovation” of ''DSM III'' would be a “defense of the medical model as applied to psychiatric problems.”@@@[[#83WilsonDSMIIIandtheTra|83]]$$$ The minutes from the first meeting of the Task Force on Nomenclature and Statistics read:
+If training is not immediately practical, then years of training would be useless.
-===== A diagnosis should be made if the criteria for that diagnosis are met.… It is hoped that this will stimulate appreciation, among psychiatrists, of the distinction between the known and the assumed.… The diagnostic manual will be essentially behavioral, with exceptions for conditions of known etiology.… It was agreed that “functional” is no longer a suitable designation for a group of conditions—schizophrenias and affective disorders—which are no longer seen as purely psychogenic.@@@[[#84Ibid|84]]$$$ =====
+Unfortunately, many of our trainers do not understand this simple logic. That’s why there are cadres who train rural people in the uplands in the field of “economics!”
-In other words, psychiatric diagnosis should matter. A diagnosis should mean that the diagnosed person was sick, and sick in a way that different physicians could reliably recognize. The manual listed more than two hundred categories (only a few are commonly used). Under each category there were criteria, often with inclusion rules: six of the following nine, eight of the following sixteen. If the patient met the criteria, the patient had a mental illness. If the patient did not, he or she did not. The patient’s personal history—his or her ambivalence, potty training, basic trust, resolution of the Oedipus complex, dependency, whatever—was irrelevant. From the vantage point of ''DSM III'', it didn’t matter how a patient had become depressed or why. What mattered was that he met the necessary number of criteria, which could be determined (more or less) by a short interview. All of a sudden, there was a sharp, clean dividing line between mental health and illness.
+In short, our way of working, organizing, talking, propagandizing, setting slogans, writing newspapers, etc., must all take this sentence as a model:
-And that line was thought to be determined by science. Gone was the wise clinician’s sensitivity to the subtleties of psychodynamic communication. These diagnoses were based on what anyone could observe (in theory; actually, using the manual involves considerable skill), and the committee went to great effort to show that different people would give the same diagnosis to the same patient. Research on the validity and reliability of these categories was reported with numbers and with statistical terms that most psychiatrists had never encountered. A 1979 article on the diagnostic reliability of affective disorder categories, for instance, has tables that include “F” scores, “kappa” scores, “two-tailed” significance scores, cross-tabulations, differentiating and nondifferentiating criteria, reliability coefficients, and the like. “Whereas most studies of diagnostic reliability,” the authors report, “yield kappas (an index of reliability that corrects for chance agreement) that range from .4 to .6, the kappas for the RDC [Research Diagnostic Criteria] were usually above .7 and usually above .8.”@@@[[#85JEndicottandRSpitzer|85]]$$$ In a bracing book called ''The Selling of DSM'', two social scientists accuse Spitzer of snowing the field with the illusory precision of statistical accuracy. They say that he used a statistical term—“kappa”—of doubtful applicability and produced kappas in abundance to prove that psychiatry was a science.@@@[[#86StuartKirkandHerbKutchin|86]]$$$ They undoubtedly have a piece of the truth; yet it is also quite clear that these new categories were far more specific than the old ones. Consider the ''DSM II'' definition of schizophrenia, which could include most people when they hit their low spots:
+“From within the masses, back into the masses.”
-===== This psychosis is characterized chiefly by a slow and insidious reduction of external attachments and interests and by apathy and indifference leading to impoverishment of interpersonal relations, mental deterioration, and adjustment on a lower level of functioning. In general, the condition is less dramatically psychotic than are the hebephrenic, catatonic and paranoid types of schizophrenia. Also, it contrasts with schizoid personality, in which there is little or no progression of the disorder. =====
+No matter how big or small our tasks are, we must clearly examine and modify them to match the culture, living habits, level of education, struggling experiences, desire, will, and material conditions of the masses. On that basis we will form our ways of working and organizing. Only then can we have the masses on our side.
-Now consider this one from ''DSM III:''# At least one of the following during a phase of the illness:
+Otherwise, if you just do as you want, following your own thoughts, your subjectivity, and then force your personal thoughts upon the masses, it is just like “cutting your feet to fit your shoes.” Feet are the masses. Shoes are our ways of organizing and working.
-## bizarre delusions (content is patently absurd and has ''no'' possible basis in fact), such as delusions of being controlled, thought broadcasting, thought insertion, or thought withdrawal
-## somatic, grandiose, religious, nihilistic, or other delusions without persecutory or jealous content
-## delusions with persecutory or jealous content if accompanied by hallucinations of any type
-## auditory hallucinations in which either a voice keeps up a running commentary on the individual’s behavior or thoughts, or two or more voices converse with each other
-## auditory hallucinations on several occasions with content of more than one or two words, having no apparent relation to depression or elation
-## incoherence, marked loosening of associations, markedly illogical thinking, or marked poverty of speech if associated with at least one of the following:
-## blunted, flat, or inappropriate affect
-## delusions or hallucinations
-## catatonic or other grossly disorganized behavior
-# Deterioration from a previous level of functioning in such areas as work, social relations, and self-care.
-# Duration: Continuous signs of the illness for at least six months at some time during the person’s life with some signs of the illness at present. The six-month period must include an active phase during which there were symptoms from A, with or without a prodromal phase, as defined below.
+Shoes are made to fit people’s feet, not the other way around.
+= Chapter 1: Dialectical Materialism =
-''Prodromal phase: A'' clear deterioration in functioning before the active phase of the illness not due to a disturbance in mood or to a Substance Use Disorder and involving at least ''two'' of the symptoms noted below.
+Dialectical Materialism, one of the materialist foundations of Marxism-Leninism, uses the materialist worldview and dialectical methods to study fundamental philosophical issues. Dialectical Materialism is the most advanced form of Materialism, and serves as the ''theoretical core of a scientific worldview.'' Therefore, thoroughly understanding the basic content of Dialectical Materialism is the essential prerequisite to study both the component principles of Marxism-Leninism in particular, and the whole of Marxism-Leninism in general.
-''Residual phase:'' Persistence, following the active phase of the illness, of at least ''two'' of the symptoms noted below not due to a disturbance in mood or to a Substance Use Disorder.
+== I. Materialism and Dialectical Materialism ==
-''Prodromal or Residual Symptoms:''#
+=== 1. The Opposition of Materialism and Idealism in Solving Basic Philosophical Issues ===
-## social isolation or withdrawal
-## marked impairment in role functioning as wage-earner, student, or homemaker
-## markedly peculiar behavior (e g., collecting garbage, talking to self in public, or hoarding food)
-## marked impairment in personal hygiene and grooming
-## blunted, flat, or inappropriate affect
-## digressive, vague, overelaborate, circumstantial, or metaphorical speech
-## odd or bizarre ideation, or magical thinking, e.g., superstitiousness, clairvoyance, telepathy, “sixth sense,” “others can feel my feelings,” overvalued ideas, ideas of reference
-## unusual perceptual experiences, e.g., recurrent illusions, sensing the presence of a force or person not actually present
+''Philosophy is a system of the most general human theories and knowledge about our world, about ourselves, and our position in our world.''
+Philosophy has existed for thousands of years. Philosophy has different objects of study depending on different periods of time. Summarizing the whole history of philosophy, Engels said: “The great basic question of all philosophy, especially of more modern philosophy, is that concerning the relation of thinking and being<ref>''Ludwig Feuerbach and the End of Classical German Philosophy'', Friedrich Engels, 1886.</ref>.”
-''Examples:'' Six months of prodromal symptoms with one week of symptoms from A; no prodromal symptoms with six months of symptoms from A; no prodromal symptoms with two weeks of symptoms from A and six months of residual symptoms; six months of symptoms from A, apparently followed by several years of complete remission, with one week of symptoms in A in current episode.# The full depressive or manic syndrome (criteria A and B of major depressive or manic episode), if present, developed after any psychotic symptoms, or was brief in duration relative to the duration of the psychotic symptoms of A.
+So, philosophy studies the relations between consciousness and matter, and between humans and nature.
-# Onset of prodromal or active phase of the illness before age 45.
-# Not due to any Organic Mental Disorder or Mental Retardation.@@@[[#87AmericanPsychiatricAssocia|87]]$$$
+In philosophy, there are two main questions:
+'''Question 1: The question of consciousness and matter: which came first; or, to put it another way, which one determines which one?'''
-However manipulative one can accuse the task force of being, there is no question that two psychiatrists were more likely to use the same labels to describe the same patient when they were using ''DSM III'' than when using ''DSM II''. It is also clear that Rosenhan’s pseudopatients would never have been diagnosed as schizophrenic if the interviewing psychiatrists had been using ''DSM III''.
+In attempting to answer this first question, philosophy has separated into two main schools: ''Materialism,'' and ''Idealism.''
-There was a great debate in the field over ''DSM III'' (which was nonetheless immediately adopted), and to an onlooker the debate is fascinating because its advocates could clearly spell out the benefits and its opponents struggled with an inarticulate dread: that in the lust for scientific respectability, something had gone terribly wrong. In 1984, the ''American Journal of Psychiatry'' published a debate about ''DSM III'' among four great shaggy lions of the psychiatric field: Gerald Klerman, George Vaillant, Robert Spitzer, and Robert Michels. Spitzer, as mentioned, had led the ''DSM III'' task force. Vaillant was a beloved psychodynamic teacher, famous for a book on adult development called ''Adaptation to Life''. Michels was a psychoanalyst and chair of psychiatry at Cornell and would soon become dean of Cornell Medical School. Klerman held a named chair at Harvard. The pro-DSM argument (Klerman and Spitzer) pointed out that the ''DSM III'' categories enabled physicians to tease apart different psychiatric conditions and gave psychiatrists a descriptive language to talk to one another across cities, across states, even across countries. (“In Japan,” Klerman wrote, “it was a delight to see Japanese psychiatrists, particularly the professors, carrying around the mini—''DSM III'' and studying it with characteristic Japanese vigor.”) In addition, the categories did not rely on anything that had to be inferred by a complex, unprovable process.@@@[[#88GKlermanetalTreatmen|88]]$$$ The argument against (Vaillant and Michels) pointed out that data that are reliable (who is tall) may not be very valid or useful if you are interested in schizophrenia. They argued that the diagnoses were parochial and reductionistic. But mostly, the argument against claimed that there was something intrinsic to emotional suffering with which ''DSM III'' could not engage. As Vaillant pointed out, “[Psychiatry] has more in common with the inevitable ambiguity of great drama than with ''DSM'' III’s quest for algorithms compatible with the cold binary logic of computer science.”@@@[[#89Ibidp544|89]]$$$
+'''Question 2: Do humans have the capacity to perceive the world as it truly exists?'''
-By this point in the early eighties, psychiatry in many hospitals had become a sprawling confrontation between what were then thought of as the “two camps”: either psychiatric illness was like a disease, reliable diagnosis was important, and psychopharmacology was the major and crucial intervention, or diagnosis was not important and psychopharmacology was a crutch. In some hospitals there was a quiet war that, at least in the largest psychiatric hospital I studied, left behind a wreckage of bitterness and folklore about the days when the biological psychiatrists (as this group came to be called) and the psychoanalysts had sat at different tables during lunch and when case conferences could be cruel, covert duels. Some of the younger psychiatrists felt palpably relieved by the new approach. Scientific psychiatry removed the burden of responsibility from residents who were determinedly trying to cure their sickest patients through caring, only to find that despite their good intentions and hard work they made no impact. Psychoanalytic supervisors often took a patient’s lack of progress as an indication of a young doctor’s fear of intimacy and engagement: the psychiatrist wasn’t “really” trying hard. (One of the problems here is that the residents were seeing patients in the hospital who were far sicker than those the analysts saw as private patients.) With the new biomedical approach, these young psychiatrists could shake off that criticism. They weren’t inadequate; rather, they were doctors dealing with chronic patients whose diseases had no adequate medical treatments. “I was pretty distressed with psychoanalysis by the end of residency,” one senior psychiatrist reminisced. “The psychoanalytic model really dominated, and when I had a different take on the patient, I would be told that I was resisting. I felt inadequate. When the biomedical revolution came along, it felt very familiar. And I felt vindicated.”
+In answer to this second question, two schools: ''Intelligibility'' — which admits the human cognitive capacity to truly perceive the world — and ''unintelligibility'' — which denies that capacity.
-The most famous instance of the ideological struggle emerged just before the balance of power shifted in 1980 with the publication of ''DSM III''. On January 2, 1979, a forty-two-year-old internist named Rafael Osheroff was admitted to Chestnut Lodge, an elite psychiatric hospital outside Washington, D.C., with symptoms of anxiety and depression. At Chestnut Lodge, he was treated by intensive, psychoanalytically oriented psychotherapy. Despite this treatment, his depression worsened noticeably. He lost forty pounds, was unable to sleep, and began to pace so incessantly that his feet became swollen and blistered. After several months, the staff held a case conference on the treatment plan, prompted by the family’s distress at the length of hospitalization and the patient’s lack of improvement. The case conference concluded that Dr. Osheroff was being treated appropriately by psychodynamic psychotherapy. More specifically, it concluded that psychiatric medication might interfere with the psycho-therapeutic process. Osheroff’s condition continued to worsen. At the end of seven months of inpatient treatment, his frustrated family had him discharged from Chestnut Lodge and admitted to another psychiatric hospital, the Silver Hill Foundation in Connecticut. There he was immediately medicated and in three weeks showed marked improvement. He was discharged within three months and soon resumed his normal life.@@@[[#90Detailsofthecasearepres|90]]$$$
+Materialism is the belief that the nature of the world is matter; that matter comes first; and that matter determines consciousness. People who uphold this belief are called materialists. Throughout human history, many different factions of materialists with various schools of materialist thought have evolved.
-In 1982, Osheroff sued Chestnut Lodge for negligence. The psychiatrists he sued were psychoanalysts. They had believed that his depression was one of many symptoms of the disturbed personality style that he had developed. He was, they had decided, narcissistic, a term that carries a great weight of psychoanalytic theorizing. The narcissistic person is an adult infant, someone so wounded by parental failures in early childhood that he has great difficulty recognizing anyone else’s needs. From a psychoanalytic vantage point, depression indicated that Osheroff’s adaptation around this inadequacy had finally broken down. His doctors had resisted prescribing medication on the grounds that medication would not address what they saw as the basic problem and might, in fact, dampen any motivation to change. For the psychiatrists who testified for Osheroff against Chestnut Lodge, depression was a collection of symptoms—weight loss, insomnia, agitated pacing, depressed mood—and the psychiatrist’s job was to treat the symptoms in their own right, no matter what else was going on. This line of reasoning broke the causal chain between the analyst’s understanding of the origin of the illness and the illness itself and let the depression float free as a medical problem. Behind this reasoning lay the conviction that what psychiatrists can see is what psychiatrists should treat.
+Idealism is the belief that the nature of the world is consciousness; consciousness precedes matter; consciousness decides matter. People who uphold this belief are called idealists. Like materialism, various factions of idealists with varying schools of idealist thought have also evolved throughout history.
-By the time the case was settled out of court (much later, in 1988) it was clear that Osheroff had scored a moral victory. In April 1990, Gerald Klerman published an article in the ''American Journal of Psychiatry'' entitled “The Psychiatric Patient’s Right to Effective Treatment: Implications of ''Osheroff vs. Chestnut Lodge.”''@@@[[#91Klermanbecameapivotalper|91]]$$$ Klerman laid out, in clear, sensible prose, what he took to have happened in the patient’s hospitalization. A private psychiatrist had prescribed antidepressants to Osheroff before hospitalization, and although Osheroff had soon stopped taking the pills, it was apparent from the medical record available to the Chestnut Lodge physicians that the medication had improved his mood; the Chestnut Lodge physicians had refused to prescribe medication despite good evidence that he was depressed and the psychotherapeutic treatment was not working; and once Osheroff was under the care of new physicians who prescribed the medication, his illness quickly improved. The chilling part of the essay, however, was its judgment upon psychoanalytically oriented psychotherapy: that “there was no scientific evidence for the value of psychodynamically oriented intensive individual psychotherapy.”@@@[[#92KlermanThePsychiatricPa|92]]$$$ ''No scientific evidence''.@@@[[#93Therehadofcoursebeena|93]]$$$ Most psychodynamic psychiatrists perceived psychotherapy as a delicate relationship whose impact depended on the intimacy of the patient’s trust and the doctor’s intuition, and as manifestly not the sort of thing that could be measured in quantifiable units. They knew it worked; many of them called psychoanalysis a science; the charge was confusing and hard to grasp.
+<br />
-Alan Stone—a professor at Harvard Law School and once president of the American Psychiatric Association, known for his incisive wit—tried to defend the Chestnut Lodge physicians against Klerman’s charges in the same journal. He explained at length that because the case had been settled out of court, it had created no legal precedent—in fact, he announced that he would not speak of “the Osheroff case”—and then conceded that the action, along with Klerman’s paper, had “potentially serious legal consequences.”@@@[[#94AStoneLawSciencesand|94]]$$$ He defended the Chestnut Lodge doctors against Klerman’s judgment by pointing out that standards of care had been different in 1979 and then argued that those standards were still valid. He suggested that Osheroff had improved because he had been so furious at Chestnut Lodge that a transfer to another hospital had filled him with a triumphant joy indistinguishable from good health. At one point Stone even remarked, in defense of the Chestnut Lodge approach, that “much of what all physicians do has no demonstrated effectiveness—even the prescription of supposedly efficacious medications.”@@@[[#95Ibidp424|95]]$$$ “The rebuttal by Alan Stone, M.D.,” a letter to the editor remarked sadly some months later, “may well be the best case that a clever man can make.”@@@[[#96PKingsleyletter|96]]$$$
+Idealism has cognitive origins and social origins.
-The tortuousness of Stone’s argument was partly the result of fighting on the losing side. Nobody had disputed that Rafael Osheroff had been seriously depressed. By 1990, it seemed absurd that a depressed patient, so seriously ill that he was admitted to a psychiatric inpatient unit, would not have been medicated. But the back-and-forth complexity of Stone’s argument had as much to do with the sense of confronting a radical shift in argument, that those things psychoanalysts had taken for granted were suddenly not even part of the conversation. That is the feeling one has when reading these exchanges between the psychoanalysts and the psychiatric scientists from this era: perplexed groping after the argument, genuine incomprehension of what the other side has said, charging to attack a point the other side never thought it made. Throughout the 1980s, those who were groping were the analysts. They seemed to paw helplessly at the arguments, dimly recognizing that there were virtues to the other side, rarely seeming to really grasp the way the others thought because the very structure and goal of the way they thought were different. Now it is sometimes the other way around. This incomprehension is the result of the transformation of a psychiatric illness into an altogether different animal, so that the analysts, looking across at the psychiatric scientists, did not see what they worked with and the scientists, looking back, could not see why they were puzzled.
+-----
-In these battles the supporters of scientific psychiatry came across as sensible and straightforward, while the psychoanalysts, losing ground, seemed circuitous, ambiguous, and complex. Sometimes they could sound shrill. Months after the Klerman-Stone exchange on the Osheroff case, the ''American Journal of Psychiatry'' published a flurry of letters. Most of them urged psychiatrists not to bifurcate the field into biological psychiatry and psychoanalysis and promptly went on to take sides. The psychoanalytic supporters suggested that drug companies prove that drugs work only because they want to sell them—“There is considerable pressure, unconscious if not conscious, on researchers to produce findings favoring the efficacy of a drug”—and that double-blind studies of medication response (in which neither doctor nor patient know who is taking what) are rarely genuinely double-blind (that is, doctors and patients often guess which drug is being taken). Thus, the supporters argued, reports of psychopharmacological efficacy can largely be chalked up to the placebo response to the doctor’s quiet interest in the patients on the “real” medication.@@@[[#97TPearlmanletterRGree|97]]$$$ There is, in fact, some empirical support for this position. Pharmacological medications have side effects, and it is often possible to identify which patients are taking the “real” medication from the bodily sensations they report. In a review of antidepressant medication trials using active and inactive placebos (“active” placebos produce a variety of bodily sensations), 59 percent of the studies using inactive placebos reported that medication outperformed placebo but only 14 percent of those using active placebos did.@@@[[#98ThisisreportedinSFishe|98]]$$$ However, the tone of the letters invokes a more wholesale rejection of the idea of medication and its efficacy.
+==== Annotation 50 ====
-Before the balance of power shifted, psychoanalytic self-defense often came across with this regrettable tone. The year Osheroff was admitted to Chestnut Lodge, before the power of the new psychiatric science was fully evident, before outcome studies became quantifiable and reproducible, the ''American Journal of Psychiatry'' published an article that aimed to describe how effective psychoanalysis was. The author, John Gedo, explained that “reports based on the work of groups of practitioners have created a misleadingly pessimistic impression of the potential of psychoanalysis as a therapy because such surveys have included a disproportionate number of inexperienced analysts.” By “inexperienced analysts,” he appeared to mean all those who do not engage exclusively in psychoanalysis; this, as it happens, invalidates all but a handful of trained psychoanalysts, as most psychoanalysts also see nonanalytic patients on a once- or twice-a-week basis. Gedo continued by remarking that he devoted himself exclusively to psychoanalysis, so that he was in a position to have perfected himself as a technician, and he would like to point out that most of the time, the technique works. This is a defense of the field by a man who wrote without embarrassment that he has helped thirty-six people in a twenty-year career, all of them of “the professional and academic elite.” He claimed that all of his patients had been suffering from “complex and severe character disturbance” but that “whatever the symptoms, I adhered to an unvarying policy of accepting [into treatment] anyone with a serious commitment to seeking self-understanding.” He explained that his analyses reached successful conclusions with a minimum of six hundred to a thousand sessions and that even in cases of failure, he did not “reach that reluctant conclusion” until the analytic process had “been given a chance to unfold in the usual manner over a number of years.” He then explained—and this is the point of the article—that most of his patients had improved. Unfortunately, he admitted, he had carried out no systematic follow-up, but he had heard about his patients casually; “by contrast, I have seldom had news about patients who did not reach a successful analytic termination.”@@@[[#99JohnGedoAPsychoanalyst|99]]$$$ The reader gapes.
+''Cognitive origin'' refers to origination from the human consciousness of individuals.
-The sharp improvement of psychiatric medication in the last fifteen years has given powerful reinforcement to the biomedical approach. There are far more drugs than there were before, and they are sometimes more effective and usually more comfortable and less dangerous to take. (One of the major problems with older psychiatric medications was that the side effects were so unbearable that patients often did not take their medication after being released from the hospital.) The most important of the new developments is clearly Prozac (fluoxetine hydrochloride) and its cousins Paxil, Zoloft, and others. Prozac, which was first marketed in 1987 and is now taken by 20 million people worldwide, is not, in fact, more effective for depression than the older generation of antidepressants (the tricyclic antidepressants).@@@[[#100JohnHorganWhyFreudIsn|100]]$$$ But when people take tricyclics, they put on weight, have difficulty urinating, become constipated, and develop dry eyes and mouth, clammy palms, drowsiness, and an increased risk of cardiac problems. With Prozac, people actually lose weight (at least for a while), and the major side effect for most people seems to be jitteriness and, for a significant percentage of men, impotence. Prozac has meant that taking psychiatric medication for common anxiety and depression has become, practically speaking, risk free. (Of course, there are no good data on the consequences of taking Prozac for decades.) Moreover, Prozac works in a relatively well understood manner: it inhibits the neuron’s reuptake of the neurotransmitter serotonin (although what ''that'' means is still unclear). In fact, almost all effective drugs for depression have something to do with serotonin. Prozac became the first good example of a medication whose impact clearly linked it to a brain function, a problem with the regulation of serotonin. It has led many researchers to explore further the role of neurotransmitters in psychiatric disorders.
+''Social origin'' refers to origination from social relations between human beings.
-These days, research psychiatry is a branch of neuroscience. Many of the leading researchers attend and present at the annual Society for Neuroscience conference (once a tiny academic meeting, this annual event now has more than twenty thousand attendees). Many work in laboratories. They use chemicals and petri dishes. They do experiments with rats. They scan the brain to determine relative blood flow under various conditions. The scientific respect for this work is reflected in the congressional funding for the National Institute of Mental Health (NIMH). In the early 1970s, Congress deeply distrusted the NIMH—in 1976 the dollar amount of funding for the institute was actually lower than it had been in 1969—precisely because there was no way of distinguishing mental health from mental illness. One of the powerful psychiatrists of the era explained to me that the political message from Congress was “Show us that you are doing real research, and we will fund you.” In 1983, the budget for the NIMH increased by $20 million and then kept rising. By 1994, the NIMH budget stood at $600 million, up from $90 million in 1976. And under the leadership of Lewis Judd, the NIMH persuaded Congress to declare the 1990s “the Decade of the Brain,” a decade in which neuroscience research, including research in psychiatry, would be given the highest national priority. “Neuroscience,” Judd argued, “has become the fastest-growing, and arguably the fastest-moving, branch of the life sciences.… The prospect for a ''worldwide'' Decade of the Brain ‘grassroots’ effort emerging from the neuroscience and neuropsychopharmacology communities in each of the world’s sovereign nations is beginning to become a reality.”@@@[[#101LewisJuddTheDecadeof|101]]$$$
+So, idealism originates from both the conscious activity of individual humans as well as social activity between human beings.
-Yet the new psychiatric science did not in itself pose a life-threatening danger to psychodynamic psychiatry, because for all the foolishness of psychoanalysis in the era of its great arrogance, psychodynamic psychotherapy made a significant difference to the lives of patients and most psychiatrists knew it. Despite the ideological conflicts, by the middle 1980s many hospitals had settled down to what many perceived as a two-tone psychiatry. Residency programs spoke (as they continue to speak) of a need for an “integrated” psychiatry. In residency programs in the middle and late 1980s there were (roughly speaking) two kinds of psychiatric orientations: biomedical and psychodynamic. (This opposition oversimplifies the complexity of psychiatric practice, but oppositions often do simplify; one of the consequences of ideological tension was to create a more dichotomous sensibility than might have been the case otherwise.) A young resident would have extensive contact with both kinds of seniors. Admittedly, many seem to have experienced a need to choose between the two, even though there was an emphasis on integration. Even in the early 1990s, many young psychiatrists felt a sharp tension between the two approaches. They said things like “By the end of your second year, you have to decide which camp you’re in.” Many told me that they had deliberately chosen an “eclectic” residency because of what they saw as the deep divisions in the field. I myself felt that in many cases “integration” meant no more than parallel problem solving. “I attempt to integrate the two,” said a psychiatrist just out of residency, “but it’s more like I shift gears but it’s a little bit jerky. I’m always shifting back and forth.” In the early 1990s, most young psychiatrists said that there are few models of true integration. “Do you have a sense of what the good psychiatrist does?” I asked a new resident. “I do and I don’t,” she said. “One thing I know is that there’s a real split in the staff between the people who do therapy and the people who do psychopharm. I see people who are really good at one or the other, and I would like to be good at both. But it’s kind of hard to find one person on the staff who’s everything.”
+These origins are ''unilateral consideration'' and ''absolutization'' of only one aspect or one characteristic of the whole cognitive process.
-The real crisis for psychodynamic psychiatry has been not the new psychiatric science but managed care and the health care revolution of the 1990s. More specifically, it is not just managed care but managed care in the context of ideological tension that is turning psychodynamic psychiatry into a ghost. It is harder to think about psychotherapy, about a patient’s psychodynamics, about a patient as a kind of person to whom those thoughts are relevant because what must be done in the hospital belongs squarely in the domain of the new psychiatric science, and that way of thinking has been imagined as the denial and disproof of the psychotherapeutic endeavor. It isn’t that psychiatrists think that psychotherapy isn’t important. Most of them do. Most of them even think that psychiatrists should learn to do it, that psychotherapy should be the province not just of psychologists and social workers. But the more time they spend on the phone with insurance agents negotiating for a six-day admission to be extended to nine days because a patient is still suicidal, the more admissions interviews they need to do, the more discharge summaries they need to type, the less the ways of thought and experience of psychodynamic psychiatry fit in, the less they seem relevant or even real, and the more psychiatrists are willing to fall back on the ideological position that the cause and treatment of mental illness is biological and psychopharmacological. I saw these two approaches diverging just as the training programs were changing. That is what, for the most part, I have described. Then, at the end of my fieldwork, I saw the balance tilt irrevocably.
+-----
-== {{anchor|CHAPTERSIX}} {{anchor|TopofLuhr9780307791900epubc7}} CHAPTER SIX{{clear}}
+==== Annotation 51 ====
-[[Image:Image4.png|center]]$$$: THE CRISIS OF MANAGED CARE ==
-I met Jonathan at the same hospital where Gertrude had done her residency but in 1996. Gertrude had graduated along with her class, and the hospital had changed dramatically. “They’ve decided to ax the psychoanalytic journals from the library. The ''psychoanalytic'' journals.” Jonathan was a resident then, a tall, sandy-haired young man, eloquent and obviously in distress. “At times,” he continued, “it feels like those in power are willing to throw anything out the window to survive. They’ll do ''anything''. And yet it’s not like they’re saying, well, we know we should retain a balanced view of humans and psychopathology, but we’re going to lie through our teeth and say that we believe only in biology. It snowballs. People who believe in that method start to become the people who are more in charge of things. They get promoted, other people don’t, and eventually you’re surrounded by a whole institution that speaks in this language. And I think there are antagonisms from the days when psychoanalysts ruled the roosts. Some people are clearly getting back at them.
+''Unilateral consideration'' is the consideration of a subject from one side only.
-“But you know,” he continued, “I view this now less as a rift between the biologically oriented people and the dynamically oriented ones. I see it now as more between those whose central idea of their identity is clinical work and those whose central idea of their identity is being part of a treatment system. There’s a growing sense in psychiatry as a whole that it’s not that you’re a doctor and you see a patient and the patient’s best interest is what you primarily care about and what you’re involved with. Now it’s clear that the relationship is contaminated by the needs of the institution and particularly the needs of the insurers. It was always true that the doctor’s needs were involved in the relationship, but it’s much more complicated now. Before, you might have wanted to see a patient five times a week because you’d make more money that way. But you could wrestle with that in your own conscience. ''This'' is a titanic system. It goes way up past the hospital, to the insurance companies and the rest. As a doctor, you’re the leading edge of this … ''machine''. You’re not a doctor in an individual relationship with a patient. And the rift seems to be between those two groups of people, people who think you’re part of the engine of health care and the people who see themselves as doctors who take care of patients. The biological people tend to fit better into the machine, but not always, and the process by which this transforms the institution is so ''insidious''. I used to think that I should write it down while it was happening, keep notes, but I didn’t and sometimes now I sit here and think, how exactly did it happen? And I sit here with a sense of something missing, with the sense of a great loss, as if I were a refugee child. I sit here and say, the system is crazy, it doesn’t ''work'', and the older people say, it used to be different.”
+''Absolutization'' occurs when one conceptualizes some belief or supposition as ''always'' true in ''all'' situations ''without'' exception.
-Some years earlier, in the months between the two long summers I had spent with Gertrude and her class, several of the most important insurers that worked with the hospital had hired firms to manage their ballooning medical costs. I remember sitting, one balmy afternoon during that second summer, in an administrator’s office in a psychiatric hospital with a large training program, listening in increasing discomfort as a practical woman laid out what the impact of the new policies on her hospital would be. In 1988, they had had roughly 110,000 inpatient “days” for which they could bill for treatment. That year, 1993, they would have 69,000, a drop of 40,000 and a $40 million decline in a year’s revenue. The average length of a patient’s stay had dropped from a month or so down to thirteen days and was still going down. Meanwhile, the average number of admissions had more than doubled. This is a tremendous human cost, because the bulk of the difficult work is done at admission and at discharge—long notes are written, summaries are dictated, arrangements are made. To keep the beds full but cut the length of stay by more than half is to double the workload without adding staff. Staff would, in fact, have to be fired. The administrator figured that the minimum it cost the hospital to care for a patient for a day was more than $700, but it had just made a deal with a major insurer to cover the cost for $535. It had had to make that deal, she said, because if it didn’t, those patients would go elsewhere and the hospital would go bankrupt. But, she said, there’s a hospital down the road with no grounds, no students, and no senior psychiatric stars. It had offered $400. And it, she said, is the competition. At the time we spoke, her hospital faced a $9 million shortfall that year.
+Both unilateral consideration and absolutization fail to consider the dynamic, constantly changing, and interconnected relations of all things, phenomena, and ideas in our reality.
-“People used to want to be psychiatrists because they wanted to talk to their patients,” the administrator continued sadly. She didn’t think that would be possible anymore. There simply would not be enough time. Psychiatrists would be more like internists, spending fifteen minutes or so apiece with their patients. They would be the team leaders of a group of social workers and nurses, too busy to sit down and get to know the patients. And patients would come into the hospital for very brief stays, for five days or two or three. The administrator compared psychodynamic psychotherapy in this new era to cosmetic surgery. “But you know,” she added, “you can still sit down for six sessions with a patient and talk about the kids reaching adolescence.” In the room down the hall, other administrators were busy trying to design a computer program that gave precise treatment guidelines (length of stay, medications, and dosages) for patients with specific diagnoses. The presumption was that individual doctors would no longer be allowed to make those judgments.
+Idealism originates from unilateral consideration because idealists ignore the material world and consider reality ''only'' from the perspective of the human mind. It also originates from absolutism because idealists ''absolutize'' human reasoning as the ''only'' source of truth and knowledge about our world ''without exception.''
-By 1990, health care costs in the United States exceeded $600 billion, more than 12 percent of the gross national product and a 10.5 percent increase from 1989 to 1990 alone.@@@[[#1JennieKronenfeldedChan|1]]$$$ By 1994, the total cost of health care in the United States was approaching $900 billion annually.@@@[[#2RobertSchreterStevenSharf|2]]$$$ In response to these escalating costs, health insurance companies increasingly adopted strategies that have come to be called “managed care,” in which medical costs are not simply reimbursed after the fact, but rather the cost of the patient’s care is “managed” by prior agreement with the insurer. Before admitting a patient, a hospital (or doctor) would have to call the patient’s insurer and get authorization for the admission and for its length. Companies that insured large numbers of patients, such as Blue Cross/Blue Shield, would negotiate with a series of hospitals for daily hospital rates that would include all relevant charges and were sharply lower than previous reimbursements for the same services. Hospitals would compete for these contracts. As a result of this, managed care was sometimes called “managed competition.” The policy makers’ hope was that free-market competition between providers would lower the overall cost of care without greatly reducing quality. In fact, they believe that market competition can improve quality. What the policy makers did not fully understand was how difficult it would be to get meaningful and feasible measures of quality that would allow competition on the basis of quality to take place.
+As Lenin wrote in ''On the Question of Dialectics'': “Philosophical idealism is a unilateral development, an overt development, of one out of many attributes, or one out of many aspects, of consciousness.”
-Managed care is by no means an evil. The older psychoanalytic approach kept patients in hospitals for months, even years, even after the advent of psychopharmacology. For some of these patients, the extended time was a kind of salvation. In the safe environment of the hospital, they were able to try out and eventually master more effective ways of dealing with their difficulties. For many others, the prolonged stays were a kind of return to the nursery, where other people fed them, washed their clothes, and set the rules they lived by. Instead of getting better, those patients fell into a regressive state of childlike dependency. The theory was that a patient’s defenses needed to crumble so that he could emerge out of the chrysalis of his insanity as a more mature, resilient person, but even in that era many psychiatrists were not convinced. One afternoon I sat in a psychodynamically oriented psychiatrist’s office and listened as she grumbled about the field’s idiocy in not developing reasonable measures of patient improvement. After a while she stopped and looked up at me. “Actually,” she said slowly, “many of the cuts are really better for the patients. Now hospitalization will focus on moving people to healthier levels of functioning immediately rather than doing deep, intrapsychic work. Treaters will move from working from the inside to working from without. It’ll make people feel more competent, feel more mastery, develop more self-esteem. Regression is rarely good for us.” Many psychiatrists look back on the era of long-term psychoanalytically oriented hospitalization with some horror. These very long stays seem wasteful and ineffective from a more contemporary perspective, and though clinicians complain bitterly about the current chaos, few seem to want a return to the almost prisonlike confinements of the past.
+Historically, idealism has typically benefitted the oppressive, exploitative class of society. Idealism and religions usually have a close relation with each other, and support each other to co-exist and co-develop.
-Moreover, in the era before managed care some psychiatrists egregiously abused the hospital, the patients, and the insurers for their own financial gain. Rent-free offices and salaried time were used to run extensive private practices. Wealthy patients were cherry-picked off units for daily psychotherapy, even though some of them lacked the capacity to participate in or gain from it. Some of the work, such as Mass Mental’s psychoanalytic therapy with schizophrenic patients, was motivated by clinical philosophy; some was pursued principally for financial gain. And across the country, problems that were poorly defined were treated with methods that varied widely from clinician to clinician and were poorly understood by the patients who came in for help. Many psychiatrists now seem to feel relief that the profession is being required to focus more rigorously on treatment protocols and their outcomes.@@@[[#3Iowesomeofthephrasingof|3]]$$$
+-----
-However, in the short run, the problems with managed care have been significant, and many treatment programs are in painful turmoil. Hospitals with training programs suffered in the competition with less elite facilities. For a start, it is more expensive to deliver care in a hospital connected to a medical school. The students are slow, they need supervision, and they need to be provided with lectures, seminars, and case conferences. Despite the fact that students provide cheap labor, the system as a whole is more inefficient and more expensive. Medicare and Medicaid payments to “training” hospitals have always been somewhat higher to compensate for the higher costs. Then, too, the patients sent to university centers are more likely to be sicker than those sent elsewhere, because university hospitals have a concentration of researchers and elite doctors. They provide what is called “tertiary care,” a level beyond what the average hospital can provide. With patients sicker than average and costs higher than average, the new reimbursement policies have driven many university hospitals into near bankruptcy. Fields such as psychiatry faced particularly deep shortfalls, because the time needed for psychiatric treatment is ambiguous. When managed care management took over psychiatric services, there was little “outcome” research in psychiatry. “Outcome” research evaluates the relationship of treatment to patients’ recovery. Drug trials necessarily involve outcome components (the research must demonstrate that the drug works significantly more effectively than a placebo) over a specific period of time. But there was comparatively little outcome research in psychotherapy (significantly more has been done since the early 1990s), little research on the difference between a ten-day psychiatric admission for any particular diagnosis and a two-week admission, and less commonsense limitation on shrinking the length of admission than there was for many nonpsychiatric medical problems. In psychiatry, there are no expensive hospital machines or intravenous drugs that require a patient to remain in the hospital (electroshock therapy might be an exception). Psychiatric care was thus more severely walloped by managed care policies than any other branch of medicine was.
+==== Annotation 52 ====
-The experience of revisiting Gertrude’s hospital by the time Jonathan was a resident was a little like coming back to a tree-lined London neighborhood after the Blitz. Administrators were frantically trying to cut costs. Nearly all the nonmedical services—food preparation, laundry, lawn care—had been farmed out to independent contractors, and gardeners, cafeteria workers, and others who had worked at the hospital, sometimes for decades, had been summarily dismissed. Hospital units were opened and closed and moved and reorganized like circus tents. The “psychosis unit,” for example, would be moved twice during that summer to make room for one new program or another that the hospital had put together in a desperate bid to come up with unique services that no other hospital could offer. Over the weekend, the patients, their belongings, their files, their medications, the bulletin boards, the kitchen—all the paraphernalia of a space that can sleep twenty people and accommodate their staff—had to be boxed, moved, and unpacked. Sometimes a new program would be developed almost to the point where patients could be admitted, and then the new business plan would chop it and the person who had poured his life into designing it would be fired or reassigned. Shortly after that second summer, a third of the staff had been fired, the base salary of the rest would soon be cut in half, and many had left voluntarily in the hope that things would be better elsewhere. The administrators were behaving in ways that seemed sadistic to those under them, as if they were hoarding food in a severe famine. (However, they also probably saved the hospital from bankruptcy.) One clinician told me that at a rare meeting of clinicians, the hospital director showed a slide entitled “Your Options in Dealing with Managed Care” with a bulleted recommendation: “Move to Wyoming.” No one laughed. Stories circulated about how one doctor, who had spent his life at the hospital, had been fired over the phone, how another had been fired in an answering machine message, how the groundspeople hadn’t been told anything was wrong until they had gone to an all-hospital meeting and heard in the lecture that their jobs had been contracted to an outside service. The remaining staff became hostile and embittered. “Horrible things were happening,” one psychiatrist remembered. “It was like they’d take you all into a room and tell you that in a month, eighty percent of you would be shot. One month later, they’d tell you no, only twenty percent have died. You’d be so worried about your own skin that you just felt relieved at having survived.”
+Idealists, in absolutizing human consciousness, have a tendency to only give credence to the work of the mind and ignore the value of physical labor. This has been used to justify class structures in which religious and intellectual laborers are given authority and privilege over manual laborers.
-“I left myself,” the psychiatrist continued, “when a patient came onto my unit and tried to hang herself twice by the end of the first day, and then Utilization Review [a hospital office that negotiates with the insurer] said she’d only been authorized for a two-day admission and would have to be discharged. I kept thinking about what the jury would say if she killed herself and I was the one held liable.” This was a realistic fear. The legal responsibility for discharge lies with the physician. If a psychiatrist thinks that a patient is not ready for discharge but the insurer refuses to cover further treatment, the psychiatrist faces having to choose between discharging a possibly suicidal patient and risking the consequences to them both, or continuing care knowing that each extra day will be an enormous financial burden on the patient’s family that they may never be able to pay.
+This situation has also led to the idea that mental factors play a decisive role in the development of human society in particular and the whole world in general. This idealist view was supported by the ruling class and used to justify its own power and privilege in society. The dominant class has historically used such idealist philosophy as the justifying foundation for their political-social beliefs in order to maintain their ruling positions.
-The role of psychotherapy was profoundly altered by these new policies. There is little point to inpatient psychotherapy if a patient stays just for five days, and the hospital simply stopped providing it. Patients were admitted to inpatient units to be in safe, locked settings while they were medicated to dull the crisis that had led to the admission. The goal was to stabilize them, no more. Meanwhile, the outpatient therapy program was in chaos. Policies that once had covered half the cost of weekly psychotherapy for a year changed the rules so that a potential patient would have to call the insurance company, explain the problem for which he wanted psychotherapy, and be authorized for one visit; the therapist would then have to call the company after the visit, confirm the problem, and get authorization for more visits. The process was so laborious, embarrassing, and irritating that both doctor and patient often gave up. I remember a psychiatrist grimacing as she talked about a patient who had wanted therapy for anxiety and impotence who had not been able to bear what he felt was the humiliation of explaining himself repeatedly over the phone to a dry voice in the insurer’s office. Most of the analysts left or were fired. In front of the building where many of the psychoanalysts had had their offices, the parking lot was often nearly empty. Once it had been difficult to find a parking space.
+Marx discusses this tendency for rulers to idealistically justify their own rule in ''The German Ideology'':
-The inpatient units were not in great shape, either. Most of the patients were in the worst phase of their crisis because patients who weren’t in that stage were no longer hospitalized. They were heavily medicated and often angry at their doctors. This was particularly true of psychotic patients, who were often discharged before they fully realized how sick they’d been. Older psychiatrists said that in earlier days, the psychotic patients would come on the unit furious at being incarcerated; then, over the three or four weeks they were there, they’d calm down, feel depressed at what they’d done when they were crazy, and by the time they left they’d be so grateful to the psychiatrist for getting them back to normal that sometimes there would be tears in their eyes. “It made us feel good,” one psychiatrist said, “and now the patients never get to that point anymore. Now they leave as furious as when they come in and only a little less crazy.” So the units were tense, the staff were demoralized, and the patients were sicker than they ever had been. They’d be discharged sick and the psychiatrist would be frantic, feeling responsible for someone who often was suicidal and barely functional. There was a pervasive undercurrent of doom and panic.
+<blockquote>
+The ideas of the ruling class are in every epoch the ruling ideas, i.e. the class which is the ruling material force of society, is at the same time its ruling intellectual force. The class which has the means of material production at its disposal, has control at the same time over the means of mental production, so that thereby, generally speaking, the ideas of those who lack the means of mental production are subject to it. The ruling ideas are nothing more than the ideal expression of the dominant material relationships, the dominant material relationships grasped as ideas; hence of the relationships which make the one class the ruling one, therefore, the ideas of its dominance. The individuals composing the ruling class possess among other things consciousness, and therefore think. Insofar, therefore, as they rule as a class and determine the extent and compass of an epoch, it is self-evident that they do this in its whole range, hence among other things rule also as thinkers, as producers of ideas, and regulate the production and distribution of the ideas of their age: thus their ideas are the ruling ideas of the epoch. For instance, in an age and in a country where royal power, aristocracy, and bourgeoisie are contending for mastery and where, therefore, mastery is shared, the doctrine of the separation of powers proves to be the dominant idea and is expressed as an ‘eternal law.’
+</blockquote>
-By the end of her residency, Gertrude (who had become an excellent psychiatrist) was horrified at what had happened to psychiatry: “It was ''very'' depressing. It was so apparent, on the inpatient unit, that a lot of our behavior was dictated by managed care. There was a lot of pressure to move patients out before they were ready and a lot of anxiety because some of the patients were still suicidal. The managed care company would still say that we needed to move them out and the liability of course was on the doctor. If you discharged a patient who then committed suicide, it was ''your'' fault. And the managed care company would say, ‘Please don’t do anything you think is clinically unsound.’ But then they would make the family responsible for this huge bill. It was very unfair to the family and unfair to us. And it got worse. My first year there, it was only beginning. That next year, we were doing outpatient, and outpatient was still pretty good. But then if you sent an outpatient into the hospital for treatment they wouldn’t really get treatment, they’d get a Band-Aid. They’d only be there for three days because the managed care company wouldn’t pay for any more, and so you had this really, really sick person to manage as an outpatient. That was bad.
+Marx goes on to explain how the idealist positions of the ruling class tend to get embedded in historical narratives:
-“You got a real feeling that psychotherapy was shunted to the side. You learned that your goal on the inpatient unit was to stabilize them as fast as you could. In the days gone by, they would have had psychotherapy in the unit. Initially, when I was a medical student, you had to do psychotherapy three times a week. That was the expectation. Then, toward the end, that was not the expectation at all. You just did psychopharm management on the unit, and even that you couldn’t do—you can’t try new drugs when the patient’s in the hospital for three days. The psychotic patients were easiest. You had a clear justification that they had to be in the hospital. So the managed care companies would stay away, and you could at least start them on clozapine or get them on the road. With other patients, who were really sick but not flagrantly psychotic, it was more difficult. You definitely felt that at times there was inappropriate care.”
+<blockquote>
+Whilst in ordinary life every shopkeeper is very well able to distinguish between what somebody professes to be and what he really is, our historians have not yet won even this trivial insight. They take every epoch at its word and believe that everything it says and imagines about itself is true. This historical method which reigned in Germany, and especially the reason why, must be understood from its connection with the illusion of ideologists in general, e.g. the illusions of the jurist, politicians (of the practical statesmen among them, too), from the dogmatic dreamings and distortions of these fellows; this is explained perfectly easily from their practical position in life, their job, and the division of labour.
-Psychopharmacology fits more easily into these time-limited constraints than psychotherapy does. As Gertrude pointed out, however, in a very short admission (three to five days) there is not even enough time to start a new medication and judge a patient’s response to it. Psychopharmacology “management” often consists, in these circumstances, of represcribing whatever a patient was taking before the crisis that brought him into the hospital. And psychotherapy still exists outside the hospital. Psychologists, social workers, marriage counselors, and others will continue to practice psychotherapy, although as reimbursements have shrunk their practices have also suffered. But the issue here is not that clinical psychologists can take over the “relationship” aspects of treatment. The issue is that in the context of an ideological split, psychotherapy begins to appear less effective, less necessary, more wasteful. The psychotherapeutic way of thinking begins to seem less relevant to the task of taking care of patients.
+-----
-The issue Gertrude raises is not just the risk to this effective method of treatment in psychiatry and psychiatric hospitals but the risk that its loss will damage the everyday ability of psychiatrists to deal effectively with patients, whether they are treating them with drugs or with talk. From Gertrude’s perspective, the problem with managed care was not only that patients were given too little care—discharged when still suicidal, for instance, so that someone with severe depression was suddenly back home among razors, pills, and ropes—but also that training was being compromised. She felt that young psychiatrists had more difficulty diagnosing what was wrong. (She supervised them in her new job.) This she pinned on the sudden devaluation of psychotherapy. She believed this to be true even though she had clearly defined herself as a psychopharmacologist.
+In history, there are two main forms of idealism: ''subjective'' and ''objective''.
+</blockquote>
-“There’s ''no'' question,” she said, “you ''cannot'' be a good psychopharmacologist without being exposed deeply to psychotherapy. It gives you your background, your intuition. That the patient’s mom was depressed after childbirth and so this is going to affect attachment and so maybe she’ll be less likely to take the drugs you prescribe. With psychotherapy training, you know why certain patients are so difficult. Some poor internist has no idea why this patient is so difficult, and you just listen to the case and get a sense and you think, this person sounds like a borderline to me. The bottom line is that it’s all about how you were connected with your parents, which has a lot to do with how you interact with the world as an adult. People put on a facade. You have to listen for the subtle, insignificant things that they don’t think are important but make you raise an eyebrow. Someone says, my mother was never around when I was growing up, and they’ll say it nonchalantly. Well, that’s significant. What it means you don’t know yet, but you make a huge mental note of it.
+''Subjective idealism'' asserts that ''consciousness'' is the primary existence. It asserts that all things and phenomena can only be experienced as subjective sensory perceptions while denying the objective existence of material reality altogether.
-“I’ve declared myself as a psychopharmacologist, but without that psychotherapy background you’re not trained well. I see a lot of this on the unit I work on now, people who aren’t well trained in psychotherapy, and they try to use medication for inappropriate reasons. In fact, they seem to have ''no'' training in psychotherapy at all. I mean, obviously the program has to be accredited, so there must be some psychotherapy component, but it’s not the way it used to be. They think that everything’s depression. Even the senior doctors. Of course, you can’t ignore the pressures of managed care. If you say that this is something with the personality, they won’t pay for it. But I don’t think that it’s all an attempt to get the patient care funded. I think there’s a problem with the way they see the diagnosis, because they haven’t had the psychotherapy background. If psychotherapy goes, we’re in big trouble.”
+''Objective idealism'' also asserts the ideal and consciousness as the primary existence, but also posits that the ideal and consciousness are objective, and that they exist independently of nature and humans. This concept is given many names, such as “absolute concept”, “absolute spirit,” “rationality of the world,” etc.
-Gertrude is right: a psychiatrist does become a better diagnostician as a result of psychotherapeutic training. The practical training in Axis I diagnostics teaches a resident to assimilate a patient’s experience into a prototype—or, as one angry psychiatrist fumed, “Biologic psychiatrists as a whole really only listen to that portion of the patient’s discourse that corresponds to their biological paradigms.”@@@[[#4DKaiserNotbyChemicals|4]]$$$ The anger may be misplaced, but the insistence that expectations affect the way we listen is not. It is easy to listen only for the major, diagnosable, reimbursable Axis I disorder: the schizophrenia, the depression, the bipolar disorder. But people who have Axis I conditions such as depression or schizophrenia also often have personality disorders: in treatment-resistant hospitalized patients, that combination (technically called “comorbidity”) may exist in as many as 71 percent of the patients.@@@[[#5EMarcusandSBradleyCo|5]]$$$ “Symptoms are embedded in character structure,” one textbook begins, “and the dynamic psychiatrist recognizes that in many cases one cannot treat the symptoms without first addressing the character structure.”@@@[[#6GlenGabbardPsychodynamicP|6]]$$$ In fact, one cannot always recognize symptoms accurately without having some idea of the character of the person who is ill. That was Gertrude’s observation, and it has certainly been mine. What really changed as the residents went through their training was not so much their ability to recognize depression, which they could do easily in the first year, but their ability to recognize what was not depression—the fact that what might look like depression was really borderline personality disorder, alcoholism, a schizophrenic coming to terms with his illness, or an anxious, guilty student stewing in the shame of coming to see a psychiatrist in the first place. That is a recognition skill that psychodynamic training teaches and inpatient biomedical care often does not. It is for this reason that many psychiatrists argue that regardless of one’s specialization, one needs the skills of both biomedical and psychodynamic psychiatry to do the task of either well.@@@[[#7LeonEisenbergMindlessness|7]]$$$ The more psychiatrists focus exclusively on the biomedical model, the more difficulty they have in recognizing the personality disorders and other personality problems that may look like primarily biomedical issues but aren’t.
+-----
-For example, in 1993 I attended a case conference for a young woman I shall call Bonnie. She was seventeen. She seemed on balance to be schizophrenic. For the six months prior to admission, she had felt that people were looking at her and laughing. She thought they knew embarrassing details about some physical illness she had. She knew that some of her classmates were talking about her. She saw one of them across the street. That person read her lips and reported her thoughts to other people. Those other people followed her and made fun of her. They commented on her. Later, they talked to her even when they weren’t there. Their voices called Bonnie “a little shit.” She saw one of their cars outside one afternoon and tore the antenna off. A neighbor called the police when this happened, and Bonnie was brought into the hospital. She did not seem manic and reported no history of rapid speaking, racing thoughts, or high energy. Her performance at school had deteriorated markedly over the previous year. She was slightly obsessive. It took her sometimes three hours to eat her meals, and she would wash her hands repeatedly.
+==== Annotation 53 ====
-What made the diagnosis more complex than simple schizophrenia was that Bonnie’s mother colluded with the illness in many ways. She had searched vigorously for physical explanations of Bonnie’s difficulties. She had had Bonnie diagnosed with a vast array of allergies to ordinary foods, taken her out of a school because the air at the school was polluted, and attributed her distress—including her visual and auditory hallucinations—to a series of bowel disorders. She had kept Bonnie home from school to tend to the bowel problems. Bonnie reported in the hospital that she would not move her bowels unless her mother told her to, and in many respects the relationship between mother and adolescent was more like a relationship between a mother and a much younger child, seemingly at the mother’s choice. The mother found it impossible to do anything other than care for Bonnie and was unable to clean the house, so that the house was disorderly and chaotic.
+''Primary existence'' is existence which precedes and determines other existences.
-What do you do if you are a psychiatrist who sees this patient? At the least you must be able to be interested in the family setting of the illness, and you must realize that there is a kind of folie à deux in the life of this young woman. Then you must be able to know that medication alone will truly not solve the problem. Schizophrenia does not in general clear up and go away; family therapy is often very helpful in managing the disruption that such patients generate in the lives of those who live with them. But here in particular, understanding the disorder meant understanding that the mother’s behavior may have exacerbated the problem; that there may have been an underlying problem with obsessive-compulsive disorder that Bonnie’s mother may also have shared; that treating the designated patient meant also treating the mother; and that engaging the mother in therapy was central to the possibility of change. Bonnie’s problem was not only her psychosis but her enmeshment with her mother. A psychiatrist would have to see all that to help the patient, and a psychiatrist encouraged by the educational and economic environment to look only for the organic brain dysfunction might not.
+Idealists believe that consciousness has primary existence over matter, that the nature of the world is ideal, and that the ideal defines existence.
-Moreover, for psychiatrists to be effective, they must be able to discharge patients into a setting that they will accept, and they must be able to discharge patients on medications that they will be willing to take. Making these quick assessments of a patient’s abilities—being able to judge her integration into this or that group home, being able to predict her reliability in taking medications—is undoubtedly enhanced by the person-focused specificity of psychodynamic training; building a relationship that enables a patient to trust a doctor involves investing the time that psychotherapy allows. Under the new conditions of managed care, when doctors have very little time to evaluate patients and make decisions about their treatment, the skills of being able to anticipate rapidly the particular needs and vulnerabilities of each person become even more important.@@@[[#8Exemplaryarticlesonthepre|8]]$$$ Expertise in psychopharmacology involves skill in the knowledge of how drugs interact and an intuition of what drug will work well for what patient. Expertise in psychodynamics involves skill in the ability to judge what kind of person the patient is and how he or she will react to a given set of circumstances.
+Materialists believe the opposite: that matter has primary existence over the ideal, and that matter precedes and determines consciousness.
-I saw unmistakably, in my time at the hospitals and in my discussions with staff and patients, that psychotherapy had been muted under the impact of managed care policies. This was happening to meet the concerns of the insurers. It was not because the new developments in psychopharmacology and biological psychiatry had led psychiatrists to think that the more talk-oriented approach is not important but because psychotherapy just didn’t accommodate as well to the short-term approach insurance companies understandably favor. There are, of course, psychiatrists who would like to dispense with psychotherapy altogether. “Psychotherapy,” a psychiatric scientist said to me once in irritation, “is what ministers can do. We are doctors.” Most, however, believe that psychotherapy training makes psychiatrists more effective with their patients. But the overwhelming reality was that insurers would not pay for the length of hospitalization that would make psychotherapy possible inside the hospital, and they were very hesitant to pay for outpatient psychotherapy, particularly by psychiatrists, whether or not a psychiatrist was already seeing a patient for psychopharmacological treatment. By the middle 1990s, I knew very few psychiatrists, regardless of their disciplinary commitments, who thought that reimbursement policies enabled most psychiatric patients to get adequate care. Very few thought that the current training practices would teach psychiatrists to deliver that care.
+Dialectical Materialism holds that matter and consciousness have a dialectical relationship, in which matter has primary existence over the ideal, though consciousness can impact the material world through willful conscious activity.
-The real problem is not just that money has become very short. The problem is a financial crisis in the context of lingering ideological tension. Faced with the fear that psychiatric care would not be reimbursed, many psychiatrists, psychiatric lobbies, and patient lobbies (the most effective probably being the National Alliance for the Mentally Ill) have argued that psychiatric illness is a medical disease like any other and deserves equal coverage, or “parity.” Most health insurance plans have annual and lifetime limitations for mental health coverage that are far lower than the caps for nonpsychiatric medical coverage. The argument for the medical nature of psychiatric illness is a good argument, but as the debate continues, it encourages psychiatrists and nonpsychiatrists to simplify the murky complexity of psychiatric illness into a disease caused by simple biological dysfunction and best treated by simple pharmacological interventions.
+The primary existence of matter within Dialectical Materialism is discussed further in ''The Relationship Between Matter and Consciousness'', p. 88.
-Meanwhile, the institutional structure of psychiatry, again as a consequence of this ideological tension, continues to separate the psychodynamic from the biomedical. These approaches are presented in different lectures, taught by different teachers, associated with different patients, learned in different settings. The new policies have sharply enhanced that separation and severely truncated the psychotherapeutic side. Psychotherapy is no longer even nominally part of inpatient treatment, except in particular patient populations (psychotherapy remains effectively the only intervention for trauma patients, and therapeutic relations established in that inpatient setting are often continued on an outpatient basis). Even the close contact with the patient, the “intense, intimate relationship,” has become nearly impossible on an inpatient basis, given the volume of work and the short admissions. In one of the hospitals I visited, a resident used to have on her unit one or two patients who were primarily her responsibility. At that time she might spend half an hour a day or more just talking to the patient. Now that same doctor may have four or more patients to see in the same time, and the patients come and go very quickly. She can’t see each patient every day. She can’t do much more than talk to each patient when he is admitted to the unit and see him for a few minutes before or after the team meeting. Outpatient psychotherapy has been radically curtailed, and outpatient psychopharmacology patients are not uncommonly expected to be seen in visits scheduled by the clinic in fifteen-minute intervals. Psychotherapy is no longer what most psychiatrists expect they will do upon graduation from residency.
+Willful activity (''willpower'') is discussed in ''Nature and Structure of Consciousness'', p. 79.
-As a result, young psychiatrists have an increasingly harder time seeing the point of the very different approach that psychotherapy presents, and their teachers have a hard time knowing how to teach in a way that speaks to the realities of these different circumstances. Psychodynamic teachers find this depressing. “I asked the first-year class,” one teacher gloomily remarked, “what would go through their minds if a patient in psychotherapy with them called them by their first name, rather than calling them Dr. So-and-so; I asked them to think about how they would handle it. One of the residents said that she’d think that the patient was hypomanic.” In other words, it didn’t occur to the resident to imagine that therapy is often experienced by people as intimate and personal; she didn’t understand that the point of the question was to explore how to maintain that intimacy while still maintaining the boundaries appropriate to a doctor-patient relationship. Instead, the resident thought of this encounter as diagnosing a sick patient rather than as talking to a troubled person, and her dynamically oriented teacher was floored. “What do you say?” the teacher continued. “What could you possibly say to get that resident to understand what the patient felt like?” I often heard such demoralized remarks from psychodynamic teachers who had taught in a different time. “I mourn,” sighed a senior psychiatrist. “So few of the residents have any interest in learning how to get close to a patient. And so I mourn. I mourn at the passing of the torch to the biologists, however desirable it may be in some ways. I feel that something very special is going to be lost.”
+The key difference between ''subjective'' and ''objective'' idealists is this:
-The mourning is widespread. In 1995, in the beautiful hills of northern California, I attended a small, elite meeting of psychiatric department chairpersons. In their seminars they presented service utilization charts and financial flow sheets. They knew who used the services, how often, and for how long. They explained for what, in their respective states, they were reimbursed and how those reimbursement patterns were changing the future of psychiatry and, ultimately, the structure of psychiatric residency. All of their residencies were going to survive, and none of them had any real doubt about whether psychiatry would survive as a profession. Most of them had made their names as scientists and biomedical researchers. Yet nearly all of them spoke of their despair. They seemed to look at the new psychiatry of managed care with horrified resignation. These were men and women who were in many ways the architects of these changes. They had helped psychiatry to survive despite the corporate perception that psychiatric illnesses were not really medical and thus not really the domain of health insurance. They had succeeded in persuading governmental agencies and insurance companies that psychiatric illnesses were medical diseases and thus needed medical insurance coverage, but at the cost of almost destroying the sensibility that had defined the field and drawn them to it. “You have the opportunity,” an eminent psychiatrist quietly remarked to me once, “of seeing our profession in the beauty of its great sunset.”@@@[[#9Hewasnotatthemeetingal|9]]$$$
+Subjective idealists believe that there is no external material world whatsoever — that what we imagine as the material world is merely illusory — and that all reality is created by consciousness, whereas objective idealists believe that there ''is'' a material world outside of human consciousness, but it exists independently of human consciousness; therefore (according to objective idealists), since humans can only observe the world through conscious experience, the material world can never be truly known or observed by our consciousness.
-Jonathan was right. This is not the story of the triumph of brain over mind. The loss that is felt so keenly in psychiatry is the loss of a close clinical relationship with patients in which a doctor knows and understands his patients well and takes full responsibility for their care. This has been the model for clinical care across medicine, and as managed care bureaucratizes and rationalizes our health care, the loss of these long-term, personally resonant relationships is mourned across the disciplines. But nowhere else was that relationship as rich as in psychiatry, particularly psychodynamic psychiatry, nowhere else was the relationship understood so deeply, and nowhere else is its loss so striking. Under managed care, psychiatrists have begun to move from one-on-one relationships with patients to being merely the heads of treatment teams made up of psychologists, social workers, and nurses. Of course, in hospitals psychiatrists have worked as members of treatment teams for years already. They are, however, the most expensive members of those teams and, as a result, the ones the insurers want least to pay. Increasingly, psychiatrists are being pushed into management positions in the teams, or out of management positions and intoconsultant roles, and out of intense, unmediated relationships with patients.
+In opposition to Idealism, Materialism originated through practical experience and the development of science. Through practical experience and systematic development of human knowledge, Materialism has come to serve as a universally applicable theoretical system which benefits progressive social forces and which also orients the activities of those forces in both perception and practice.
-As a result, there has been a loss of an entire dimension of a way of thinking about people and their interaction in groups. The same year Gertrude’s hospital began to change in 1993, I visited another hospital in that state. By the early 1990s, Lacey Hospital had long been a place for intellectual mavericks. It was a public hospital that served the local urban poor. The offices were small, dingy, and insufficient in number: residents were sometimes assigned three to a room, so that therapy hours had to be carefully negotiated in advance. In the entire psychiatry department there was only one accessible fax machine and only one photocopy machine. The corridors were in need of paint. One of the treatment programs was housed in a trailer in a parking lot. Yet the residency program in psychiatry was one of the most competitive in the country and among the most elite. Most of the doctors had been well and expensively educated. They followed contemporary fiction. They were often aggressively liberal. During my stay a young analyst at the hospital decided to give the psychiatry department seminar. He spoke on the concept of time in Joyce and Heidegger. Not only was this topic considered suitable for the formal didactic purpose of the occasion—in other hospitals, such seminars commonly featured titles such as “Dopamine and the D2 Receptor”—but the hall was full.
+-----
-At the center of this ethos sat an odd but charismatic man. Like Semrad in Mass Mental’s heyday, Harper Frank was celebrated for his work with severely disturbed patients. He was particularly good with paranoid patients. In an interview he would set his chair side by side with the patient’s and ally himself with his crazy, skewed vision of the world—the patient would whisper, “Doc, I feel like they’re all after me” and Frank would whisper back, “Yep, you can’t trust anyone around here, turn your back and someone will plant a knife in it”—until the patient was chuckling and chiding the doctor for his outlandish beliefs. The residents usually felt that they couldn’t make that technique work. They came to Harper Frank less to learn the explicit knowledge he had to teach and more to participate in his sense of the world. He was given to aphorism and metaphor, to an intransigent scorn of institutions, and to a crabwise, quizzical peering at the world that the young residents found deeply appealing. “What he taught me,” a resident explained, “was that one could have all the facts and still not be in possession of the truth.”
+==== Annotation 54 ====
-The unit I joined for more than ten weeks was sometimes described as a time capsule, a psychiatry unit run the way units had been run before the psychopharmacological revolution. The two directors identified strongly as psychotherapists. They would say that understanding the patient was more important than diagnosing the patient. When they referred to what they did day to day, they spoke of “the task” and “the work.” Several times a week they held “community meetings” attended by all the patients (there were twenty-one beds on the unit) and most of the staff (almost as many as patients: seven psychiatrists, five of them residents; five psychologists, four of them interns; five social workers, four of them interns; a fluctuating population of full- and part-time nurses and mental health workers). Community meetings of staff and patients lasted for half an hour. There was no set agenda. People were supposed to talk about whatever was important to them. They usually talked about the director and the associate director, who usually remained silent as the conversation went on around them. Afterward, the staff met for half an hour—this was called “wrap-up”—to discuss the meaning of what had been said. Staff meetings were run in the same way, though without the official wrap-up. To understand the patients, they thought, they needed time to talk.
+Materialism benefits progressive social forces by showing reality as it is, by dispelling the idealist positions of the ruling class, and by revealing that society and the world can be changed through willful activity.
-On this unit, it was assumed that everything was open to scrutiny; that no behavior was unmotivated, but that knowledge of its motivation was always incomplete; that the leader existed not to take command but to take responsibility and to demand that all others take equal responsibility for whatever happens. The key to helping patients was assumed to be understanding their feelings, but because psychic process was said to be often unconscious for both staff and patients, in order to help the patients, the staff were assumed to need to talk to one another about what the patients made them feel and why they made them feel that way. It was assumed that the young psychiatrists would experience feelings that were intense and overwhelming, both because the patient’s anguish would catch, like a contagion, and because the group process that “the work” demanded was so stressful that they would find themselves retreating to the defensive styles they had used as children. Behind these expectations lay the weighty theories of Wilfred Bion.
+Materialism guides progressive social forces by grounding thought and activity in material reality, enabling strategies and outcomes that line up with the realities of the material world. For instance, we must avoid utopianism [see Annotation 17, p. 18] in which emphasis is placed on working out ideal forms of society through debate, conjecture, and conscious activity alone. Revolution against capitalism must, instead, focus on affecting material relations and processes of development through willful activity.
-Wilfred Bion is the giant behind the influential group relations model in the psychoanalytic world. A difficult, dense writer, he was a psychoanalyst’s psychoanalyst, and his observations about the analytic process—for instance, that an analyst should listen without memory or desire—have seeped deeply into analytic theorizing. His work on group relations generated the Tavistock Institute of Human Relations and the A. K. Rice Institute, both of which, over several decades, have seen thousands of people pass through their experiential training conferences on group dynamics. In ''Experiences in Groups'', Bion set out the premise of his approach: that people become emotionally childlike in groups: “The adult must establish contact with the emotional life of the group in which he lives; this task would appear to be as formidable to the adult as the relationship with the breast appears to be to the infant, and the failure to meet the demands of this task is revealed in his regression.”@@@[[#10WilfredBionExperiencesin|10]]$$$
+As Engels pointed out in ''Socialism: Utopian and Scientific'': “The final causes of all social changes and political revolutions are to be sought, not in men’s brains, not in men’s better insights into eternal truth and justice, but in changes in the modes of production and exchange.”
-Essentially, this approach takes Melanie Klein’s dark model of infant life and applies it to groups. Klein had argued that young infants were unable to integrate their conflicting powerful feelings about their mothers’ breasts, that they felt both loving dependence and rageful frustration, and that in consequence they swung between perceiving a good breast and perceiving a bad one. Klein’s theory is no longer taken as a plausible description of the infant mind, but what makes it powerful as psychoanalytic theory—like all powerful psychoanalytic theory—is its evocative, metaphorical power in describing adult emotions. When Bion applied the theory to groups, he did so analogically and loosely, and he suggested that while groups could occasionally, after many years and much determination, behave maturely, rationally, and scientifically (these were called “work groups”; the phrase is presumably the source of the oracular term “the work”), the rest of the time they swing in their collective perceptions from depending on their leader’s goodness or the hopefulness of an emergent pair within the group to fighting with or fleeing from the leader, who is perceived as bad.
+=== 2. Dialectical Materialism — the Most Advanced Form of Materialism ===
-As one reads Bion, it becomes clear that many of his subjects regarded the theory he derived from them with some astonishment. He describes one group thus:
+In human history, as human society and scientific understanding have developed, materialism has also developed through three forms: ''Primitive Materialism, Metaphysical Materialism,'' and ''Dialectical Materialism.''
-===== Three women and two men were present.… One woman had brought some chocolate, which she diffidently invited her right-hand neighbor, another woman, to share. One man was eating a sandwich. A graduate in philosophy, who had in earlier sessions told the group that he had no belief in God, and no religion, sat silent, as indeed he often did, until one of the women, with a touch of acerbity in her tone, remarked that he had asked no questions. He replied, “I do not need to talk because I know that I only have to come here long enough and all my questions will be answered without my having to do anything.” =====
+''Primitive Materialism'' is the primitive form of materialism. Primitive materialism recognizes that matter comes first, and holds that the world is composed of certain elements, and that these were the first objects, the origin, of the world, and that these elements are the essence of reality. These Primitive Materialist concepts can be found in many ancient materialist theories in such places as China, India, and Greece. [These Primitive Materialist elemental philosophies are discussed more in ''Matter'', p. 53] Although it has many shortcomings, Primitive Materialism is partially correct at the most fundamental level, because it uses the material of nature itself to explain nature.
-===== I then said that I had become a kind of group deity; that the questions were directed at me as one who knew the answers without need to resort to work, that the eating was part of a manipulation of the group to give substance to a belief they wished to preserve about me, and that the philosopher’s reply indicated a disbelief in the efficacy of prayer but seemed otherwise to belie earlier statements he had made about his disbelief in God. When I began my interpretation I was not only convinced of its truth but felt no doubt that I could convince the others by confrontation with the mass of material.… By the time I had finished speaking I felt I had committed some kind of gaffe; I was surrounded by blank looks; the evidence had disappeared.… The woman who was eating, hurriedly swallowed the last of her chocolate.@@@[[#11Ibidpp147148|11]]$$$ =====
+''Metaphysical Materialism'' is the second basic form of Materialism. This form of materialism was widely discussed and developed in Western Europe in the 17<sup>th</sup> and 18<sup>th</sup> centuries. During this time, the metaphysical method of perceiving the world was applied to materialist philosophy. Although Metaphysical Materialism does not accurately reflect the world in terms of universal relations [see p. 108] and development, it was an important step forward in the fight against idealist and religious worldviews, especially during the transformational period from the Middle Ages to the Renaissance in many Western European countries.
-It is very hard, when confronted with this deliberate prose, not to wonder whether the theory creates the evidence. Bion himself admitted that there was no independent means of validating his theory but for the reader “to recall to himself the memory of some committee or some gathering.”@@@[[#12Ibidp146|12]]$$$
+==== Annotation 55 ====
-Yet it is undoubtedly the case that after several hours in such a group, with such an interpretation-making leader, group members have powerful and childlike feelings about one another and particularly about the leader. Bion has captured a real phenomenon of human experience in groups. On the unit I joined, the chief resident might tell the director of the unit, in public (although not in front of the patients), that at the previous meeting she had been furious at him. Other times she might cry; other people would cry; by my third medical staff meeting, after a general staff meeting at which my presence on the unit had been a central topic of discussion (“We can’t talk openly in front of an anthropologist,” someone had stage-whispered. “It’s dangerous”) and during which the primary discussion was the residents’ rage at the director for being passive when he was attacked, I felt gripped by an emotion that somehow was not quite mine, that was bigger than I was, and that made me feel indissolubly a member of the group. The psychiatric premise was that the staff would act out the tensions felt among the patients, and vice versa, so that to keep the unit safe it was necessary to know who was mad at whom and deal with it. In 1954, a detailed anthropological study of Chestnut Lodge indeed extensively documented a relationship between the tension among the staff and the severity of the patients’ symptoms.@@@[[#13AlfredStantonandMorrisSc|13]]$$$
+Metaphysical materialism was strongly influenced by ''mechanical philosophy'', a scientific and philosophical movement popular in the 17<sup>th</sup> century which explored mechanical machines and compared natural phenomena to mechanical devices. Mechanical philosophy led to a belief that all things — including living organisms — were built as (and could theoretically be built by humans as) mechanical devices. Influenced by this philosophy, metaphysical materialists came to see the world as a giant mechanical machine composed of parts, each of which exists in an essentially isolated and static state.
-This unit was now in crisis. The pace of hospital life had shifted abruptly since Medicaid and Medicare, federal insurers that cover most patients in community hospitals such as this one, had adopted managed care strategies. The average length of inpatient stay had dropped from thirty days to twenty days since the autumn; it would drop to eight days by the following spring, one year later. In consequence, the number of admissions had risen abruptly, and the work on the unit had increased greatly. In February, the directors had announced that they could no longer carry out their work without more staff and that with the current staffing, trainees were learning how to bill insurance companies, not to understand patients. The hospital administrators rather drily replied that no one was very happy with the changes but they were here to stay and (to be blunt) the staff should damn well get used to it. The directors threatened to resign. The hospital administrators nodded politely, wished them good luck, and began to make plans to restructure care on the unit. The directors decided to go through with their resignations, and the unit sank into shock.
+Metaphysical materialists believed that all change can exist only as an increase or decrease in quantity, brought about by external causes Metaphysical materialism contributed significantly to the struggle against idealistic and religious worldviews, especially during the historical transition period from the Middle Ages to the Renaissance in Western European countries. Metaphysical materialism also had severe limitations; especially in failing to understand many key aspects of reality, such as the nature of development through change/motion and relationships.
-It did seem as if the crises among the patients grew more acute in the aftermath of the shock. “We will kill someone,” the unit director announced dramatically the second day I was on the unit. I had arrived for Morning Report, the meeting in which the events of the previous day and night are summarized for the staff. Psychologists, social workers, nurses, mental health workers, and psychiatrists were clustered into a small room around a long table. After the patients were presented, the unit director said softly and deliberately that he had “closed” the unit on the previous evening, that although not all the beds had been taken, he had refused to accept any more admissions. He had done this, he said, because the unit was not safe. “Some team members have kept things from other team members because they did not want to hurt them. This is chaos and confusion,” he said. “In these circumstances,” he said, ''“we will kill someone!”'' suddenly belting out the last sentence like a minister. A shocked, silent staff listened to the rest of the report. Later that day, when I walked out with him for coffee, he said that what you had to do on a psychiatric unit was to manage the unconscious life of the unit.
+''Dialectical Materialism'' is the third basic form of materialism. It was founded by Karl Marx and Friedrich Engels, and defended and developed by Vladimir Ilyich Lenin as well as many of his successors. By inheriting the quintessence of previous theories and thoroughly integrating contemporary scientific achievements, Dialectical Materialism immediately solved the shortcomings of the Primitive Materialism of ancient times as well as the Metaphysical Materialism of modern Western Europe. It reaches the highest development level of materialism so far in history.
-But talk about “the unconscious life of the unit” fares poorly in a world that is increasingly short term. One of the residents openly scoffed. Mary saw patients as savvy manipulators of the system. “You know,” she said, “the director was a little hysterical. I mean, I think he was referring to my patient, who earns about twenty-eight thousand dollars a year. The patient ran out of benefits and had the choice of staying on in the hospital at his own cost, to the tune of seven hundred dollars a day, or being discharged to therapy at a hundred fifteen dollars a session. So they discharged him—he said he wasn’t suicidal—and he went home and overdosed. It got him back into the hospital for free. That’s what the director was referring to, but it didn’t have anything to do with the way we treated him. It was finances, and it was a reasonable thing for the patient to do.”
+By accurately reflecting objective reality with universal relations and development*, Dialectical Materialism offers humanity a great tool for scientific cognitive activities and revolutionary practice. The Dialectical Materialist system of thought was built on the basis of scientific explanations about matter, consciousness, and the relationship between the two.
-The director had inferred that the patient’s overdose had been an act of pain and misery and that the patient might have been pushed over the edge of what he could handle by the stress and frustration on the unit. The resident thought that this interpretation was too dramatic and a little irrational. She, thinking as her environment encouraged her, assumed instead that it was perfectly “reasonable” for a patient to swallow enough medication to kill himself, call 911, be rushed to the hospital by ambulance, and have his stomach pumped on arrival, because he wanted to persuade his managed care officer to authorize a few more days in the hospital.
+-----
-What was being lost on the unit and would be lost irretrievably as the directors left for other jobs and were replaced by different people was the subtlety of human interaction, the sense that it mattered to the patients that the unit was in tension. Noticing group dynamics had become a luxury. Thinking that tension among the staff could generate or reflect tension among the patients became an extravagance. Talk of unconscious this or that perplexed the residents who had not encountered it before, even though they had come to the hospital to learn it, and they often treated it dismissively. The resident whose patient had, she thought, made a suicide attempt to get readmitted for a few days went on to say, “When I first arrived, we had a six-hour meeting about shaking the patient’s hand: Was it violating boundaries, or did it communicate something you hadn’t intended? ''Six hours''. And I thought, it’s a social ''convention''. You’re a doctor, you can shake the patient’s hand. And they’ll talk about switching an appointment on the patient, is it a loss for a patient, and I’d think come on, you’re a doctor, you end up switching appointments.
+==== Annotation 56 ====
-“Then there are the chairs,” she continued. “The chief resident always sits in the same chair for the community meetings. No one else can sit there. At first I thought it was pretty weird. Now it seems natural to tell a patient not to sit there. But in my first medical staff meeting [which was held in the director’s office], there was a desk chair and I didn’t sit there, but then when I sat down I was told that this was the associate director’s chair, please move, and then when the director went on vacation the associate director sat in the director’s chair but the chief resident didn’t sit in the associate director’s chair and that’s what we talked about for the entire hour of medical staff meeting, the meaning of who sat where. There’s a whole lingo: we talk about work, safety, and containment, you know. It’s good, in ways. I’ve begun to think about the unit as having ‘frame’ and ‘content.’ And although it’s irritating, it teaches you stuff. It’s kind of like a New York theater experience.”
+<nowiki>*</nowiki> Materialist Dialectical methodology explains the world in terms of relationships and development. This is discussed in ''Basic Principles of Materialist Dialectics'', p. 106.
-Medications increasingly took the place of relationships with patients. Another resident, a mild-mannered, generally dutiful man I shall call Stefan, had as a patient a sixty-two-year-old woman whose brother had cheated her out of tens of thousands of dollars. She had been admitted to the psychiatric unit (on the day her mother died) after threatening to kill her brother’s girlfriend. She was slightly retarded and extremely chatty, and she said that when she was at home, she thought that her mother and father and brother were all in the room. She knew it was a fantasy, but it was nice, she said, because they talked to her and warned her off certain people. Stefan thought that she might be psychotic and prescribed Trilafon, one of the more potent antipsychotics, although he laughed wryly and said he’d really rather be an old friend of the patient’s, talking about the Red Sox, than diagnosing any symptoms. But soon he decided that she wasn’t psychotic and wanted to lower the dose of Trilafon. The associate director told him to raise the dose level because the nurses said that she was becoming more agitated. They worried that she was psychotic.
+== II. Dialectical Materialist Opinions About Matter, Consciousness, and the Relationship Between Matter and Consciousness ==
-Then Harper Frank interviewed the patient at the weekly case conference, when all the staff gather to hear an outsider interview and discuss one of their patients. In front of the staff, Frank announced that the patient was overmedicated. (She may have been agitated as a side effect of the medication.) Stefan felt immensely relieved and vindicated, and he and the other residents took me down the corridor into a meeting in which they talked about how the nurses wanted the patients overmedicated because they were afraid of them. Afterward I walked into the staff room to find the chief resident in distress. She had been supporting the associate director’s insistence upon more Trilafon for this patient, because she trusted the nurses’ intuition. She had also seen the patient herself. And she knew, she said in tears, that Harper could be rude about the unit, that he thought that the patients were all overmedicated and that the real role of the psychiatrist was above all to connect to the patients. It was great to believe in this, she said, it was important and fundamentally right, but these days it didn’t work. It was medically naive. It ''wasn’t'' the role of the doctor when the patient was on the unit barely long enough to unpack. “She’s ''not'' a sweet old lady,” the chief resident said despairingly. “She came in with a plan to murder a woman and then kill herself.” Then she looked disconsolate. “Harper understands the humanity of the patient better than any of us. But she still needs the Trilafon.”
+=== 1. Matter ===
-Stefan had wanted to understand the patient’s intentions. He was very attracted to the idea of the psychodynamic model. He wanted to persuade her that she didn’t need to feel murderous or suicidal, and he felt that his relationship with her might help her to feel less isolated. He could feel this intensely because it genuinely was not clear whether she was psychotic. There was a real ambiguity about whether this patient had described fantasies she had never intended to act on or whether in fact she had crazy delusions. After all, when she had been admitted, she had talked about killing her brother’s girlfriend, but she had also recognized that some of her crazy thoughts were fantasies. But because she was in the hospital for only a week, the most reasonable, pragmatic, safe approach was to treat her as if she were psychotic and medicate her. There is a kind of Pascal’s wager here. A patient who is medicated even if she does not need the medication is not as dangerous or unpredictable as an unmedicated one who does need medication. The less time a patient spends in the hospital, the more the doctors feel forced to medicate ambiguous symptoms. There may be good reasons for shortening the length of hospital admissions, but the inevitable response is to medicate the patients more aggressively.
+==== a. Category of “Matter” ====
-When medications take the place of relationships, not only do patients suffer the side effects of aggressive medication, but they lose the healing power of the relationship. Training in psychotherapy teaches a doctor something that becomes relevant to all encounters with patients, which is the importance of the relationship between doctor and patient and the importance of understanding that relationship in some depth. That relationship can be integral to a patient’s ability to respond to treatment, to feel comforted, to trust a doctor and so to take the medication he prescribes, to feel that if the voices become violent and disturbing there is a safe place to go for care. Stefan may have romanticized the relationship he had with his patient, but at least his attachment to her gave him a willingness to listen for the ways in which she was not psychotic and gave her a conviction that someone cared for her and about her.
+<br />
+''Matter'' is a philosophical subject which has been examined for more than 2,500 years. Since ancient times, there has been a relentless struggle between materialism and idealism around this subject. Idealism asserts that the world’s nature, the first basis of all existence, is consciousness, and that matter is only a product of that consciousness. Conversely, materialism asserts that nature, the entirety of the world, is composed of matter, that this material world exists indefinitely, and that all things and phenomena are composed of matter.
-Managed care has disrupted relationships even in the emergency room, where patients come and go very quickly. The psychiatric emergency services in this hospital worked as well as any I had seen, and did so because the staff behaved as if they had long-term relationships with the patients. I spent hours down there, in a small, windowless room like the cabin of an intrepid submarine. One staff person, a man with a ponytail and a sharp sense of humor, would periodically go out to rescue patients who holed up and refused to leave home, but mostly the staff dealt with people who were brought in by family, friends, or police. They knew many of them, perhaps a third. Some just walked in off the street. (One of the startling consequences of the cost of psychiatric illness is the way state administrators sometimes offload patients onto other states. In southern California, patients would show up in the psychiatric emergency room and explain that they had been in Minnesota or Illinois and had gone to the bus station and a nice man from the county mental health had bought them a bus ticket to San Diego, which they thought they’d like to visit. When I was at Lacey, one patient showed up after having had a bad conversation with the Devil, who had been traveling with him on the train. Apparently, the patient had found himself in New York’s Pennsylvania Station and an officer had asked him whether he wanted to go away and paid his fare so he could.)
+Before dialectical materialism was born, materialist philosophers generally believed that matter was composed of some self-contained element or elements; that is to say some underlying substance from which everything in the universe is ultimately derived. In ancient times, the five elements theory of Chinese philosophy held that those self-contained substances were ''metal — wood — water — fire — earth;'' in India, the Samkhya school believed that they were ''Pradhana'' or ''Prakriti''<ref>According to the Samkhya school, Pradhana is the original form of matter in an unmanifested,indifferentiated state; ''Prakriti'' is manifested matter, differentiated in form, which contains potential for motion.</ref>'';'' in Greece, the Milesian school believed they were ''water'' (Thales’s<ref>Thales, ~642 — ~547 B.C. (Greek): Philosopher, mathematician, astronomer, politician.</ref> conception) or ''air'' (Anaximene’s<ref>Anaximene, ~585 — ~525 B.C. (Greek): Philosopher.</ref> conception); Heraclitus<ref>Heraclitus, ~540 — ~480 B.C. (Greek): Philosopher, founder of ancient dialectics.</ref> believed the ultimate element was ''fire;'' Democritus<ref>Democritus, ~460 — ~370 B.C. (Greek): Philosopher, naturalist, a founder of atom theory.</ref> asserted that it was something called an “atom,”'''' etc. Even as recently as the 17<sup>th</sup>-18<sup>th</sup> centuries, conceptions about matter belonging to modern philosophers such as Francis Bacon<ref>Francis Bacon, 1561 — 1626 (British): Philosopher, novelist, mathematician, political activist.</ref>, Renes Descartes<ref>Rene Descartes, 1596 — 1650 (Fench): Philosopher, mathematician, physicist.</ref>, Thomas Hobbes<ref>Thomas Hobbes, 1588 — 1679 (British): Political philosopher, political activist.</ref>, Denis Diderot<ref>Denis Diderot, 1713 — 1784 (French): Philosopher, novelist.</ref>, etc., still hadn’t changed much. They continued following the same philosophical tendency as ancient philosophers by focusing their studies of the material world through elemental phenomena.
-Many of the patients, though, were local people known to the staff. The emergency staff already knew what medications worked and on which wards they did better, and they were able to keep an eye on them in the community (more or less). When a familiar face showed up, which with these patients happened often, the staff knew how to handle them effectively. The staff seemed comfortable with the patients, and compared to other emergency rooms there was less violence and less apparent manipulation, with fewer patients feigning illness in order to get a bed for the night. (The homeless shelters in the city were better serviced than most.)
+These conceptions of matter which were developed by philosophers before Marx’s time laid a foundation for a tendency to use nature to explain nature itself, but that tendency still had many shortcomings, such as: oversimplification of matter into fictitious “elements;” failure to understand the nature of consciousness as well as the relationships between matter and consciousness; failure to recognize the significance of matter in human society, leading to a failure to solve social issues based on a materialist basis, etc.
-Those relationships were being broken by the system, however. Managed care policies had been put into place alongside a decision to privatize the mental health hospitals. Many hospitals had closed, and the competition for beds had become intense. Patients were shipped around like sacks of onions to people they did not know, who made judgments based on less information than was needed. This is more technically known as “fragmentation of care,” and it represents the most basic breakdown of the doctor-patient relationship.
+-----
-Because insurance companies now contract with particular hospitals, because many hospitals compete for these contracts, and because many hospitals have been closed, the old community hospital ideal has largely vanished. Lacey had been founded as one of these hospitals. The idea had been that it would handle the needs of all (or most) of the people in its “catchment area,” the geographical area it served. Patients would have long-standing relationships with the hospital and its staff, and when they came in crazy, people knew who they were and what was likely to help. This was particularly helpful for psychiatric patients. All of us benefit from long, knowledgeable relationships with particular caregivers. We don’t need to explain our medical history in detail every time we fall sick, and we know that our doctor more or less keeps track of us. For psychiatric patients, who are often fearful and angry, that trust is even more important. When people have illnesses that bring them back to the hospital frequently—schizophrenia, bipolar disorder—they do better, and stay in the hospital for less time, if they know where they are going and who will take care of them, and can be persuaded to follow their advice when they leave.
+==== Annotation 57 ====
-Until managed care, perhaps half of Lacey’s patients were “frequent fliers.” “There’d be patients in the community,” explained someone in the psychiatric emergency service, “who’d just stop by the unit once in a while. They’d walk in, say hi to the folks up there, and leave. It kept them pulled together, and then, when they did get admitted, they knew exactly what to expect.” When I was there, however, chances were that when such a patient showed up in the emergency room he’d be shipped off to another hospital, either because his insurance company didn’t have a contract with Lacey or because there were no beds since the unit was full of patients who had come from elsewhere. In a short admission, there was rarely time to get the old medical record chart from Lacey to the hospital where the patient ended up. So not only was the patient disconcerted by his new surroundings, but his doctors, who had never met him before, would have to make decisions about how to medicate him without any knowledge of his history apart from what he was able to report. Patients who once might have been admitted to Lacey three times in the course of a year might now be admitted to three different hospitals, acquire three different and unconnected charts, and be placed on three different medication regimens. The commonsense wisdom down in the emergency room was that this was costly and dangerous, that the patients got sicker, and that a great deal of psychiatric work became redundant. By the time I arrived, the staff in the psychiatric emergency room seemed to spend half their time on the phone, calling insurance companies and getting approval for care, while the patients sat listlessly in the next room. Usually there were few beds available in the hospital, which was full of patients from other catchment areas; local patients would then have to go off to other hospitals. Sometimes they were sent off even if there were beds available because their insurer had negotiated a contract with another hospital. None of this seemed to be much help to patients.
+Here are further explanations of these shortcomings of early materialists:
-The sharply limited relationship with patients imposed by managed care makes most sense with the biomedical model and offends the practitioners using that model least. If psychiatric illness is a brain dysfunction and medication is its primary treatment, relationships with patients can seem to be irrelevant. Because of the ideological tension, it makes it seem that the biomedical approach is right and the psychodynamic approach is wrong. As the argument evolved in the seventies and eighties, if psychiatric illness is biological, it should be treated with drugs; if it is psychological, it should be treated with therapy. Now many people draw the inverse conclusion: if a disease is treated with drugs, it must be a biological illness. Never mind that short-term hospitalizations and medication trials often do not work. The history of ideological warfare invites us to infer from the use of biomedical treatment the failure of the psychodynamic approach.
+'''Oversimplification of matter into fictitious “elements”'''
-But that is a mistake that blinds us to the cost of this great loss. Patients are less well off without psychotherapy. They do less well, are readmitted more quickly, diagnosed more inaccurately, and medicated more randomly. As a result, doctors who came of professional age before the health care revolution see managed care, and the loss of psychotherapy that has accompanied it, as a moral problem. They feel that they are doing something ethically wrong when they abandon their close clinical relationships with patients. They feel that they are giving bad care, that they are uncaring, and that the patients suffer.
+Due to a lack of understanding and knowledge of matter, metaphysical materialists created erroneous conceptions of “elements” which do not accurately describe the nature of matter. By using such an erroneously conceived system of non-existing elements to describe nature, metaphysical materialists were prevented from gaining real insights into the material world which delayed and hindered scientific progress.
-“What’s true is what is worth fighting for, and that is also what is good,” a senior psychiatrist told me. “What is good and what is true are united. You cannot adhere to untruths without being immoral in some way.” Michael Griffiths (a pseudonym) had in some ways rejected his psychoanalytic training, but he found himself in moral despair at the inroads made by managed care. He was a chiseled, handsome man, like many psychiatrists blunt and acute. “Michael is free,” one of his colleagues said enviously. “It doesn’t matter to him whether his patients like him or not. It makes him very good at handling these very sick patients.” Michael Griffiths had trained in Semrad’s Mass Mental program but had become famous in part by demonstrating that insight-oriented therapy—intensive psychodynamic psychotherapy—was not particularly helpful for schizophrenics. He had disrupted a main tenet of the midcentury psychoanalytic worldview, and he had been integrally involved with the development of the ''DSM'' diagnostic categories. But his ultimate commitment was to the complexity of an individual life, and while he thought that many of the analysts he worked with were mistaken in some of their beliefs, he was shocked by the unfettered biomedical vision and profoundly saddened by the loss of psychiatry as he knew it.
+'''Failure to understand the nature of consciousness as well as the relationships between matter and consciousness'''
-“Perhaps I had a little more distance than most when I was doing my psychoanalytic training,” he explained to me one afternoon. “I didn’t come from an urban Jewish background, so culturally it wasn’t part of me. I didn’t have the overwhelming personal problems—a history of failed relationships or difficulties at work—that would have made me hope ardently that the training analysis would be deeply therapeutic. And when I began my training, psychopharmacology was making its first inroads into psychiatric practice, and while it was still, at that time, viewed with suspicion by the mainstream psychoanalytic community, it was also clear that here was something that was empirically based and could not be discounted. So the eventual rift in psychiatry was already part of my experience in training.
+Many early materialists believed that consciousness was simply a mechanical byproduct of material processes, and that mental events (thoughts, consciousness) could not affect the material world, since these events were simply mechanically determined ''by'' the material world.
-“But why did I drift away from mainstream psychoanalysis? Over the course of my training, first in psychiatry and then in psychoanalysis, I felt very confident as a psychotherapist. All along the line I had very positive feedback for my abilities. The problem was that the patients weren’t responding so well. Not just the schizophrenics, all patients. Despite the beauty of the insights and the depth of the theory. Well, I was still in training. Then I was placed in charge of a long-term treatment unit. The patients would come and come and come, and all the wise people in the community were their therapists—there was no question of adequate training for them—and hell, sometimes it was clear that the patients were worse. Here were these therapists, doggedly pursuing this method with belief and commitment, and the patients weren’t getting better. I came to see many analysts as blinded by theory and self-interest. They were guided by ideas that were wrong and which could not be tested. It was like a religion, and slowly but surely this pushed me toward a multifactorial model of illness and treatment. It did not disillusion me about the place of psychoanalysis in the lives of healthier people or as a system for understanding much of what we were seeing. It wasn’t as if the explanations given by psychoanalysis were wrong. But they were insufficient. You had to look at the family and the organic side; you had to see how social rehabilitation—teaching the patient to sit at a table with other people without being grossly inappropriate—was so important and so undervalued by psychoanalysts.”
+As a first principle, Dialectical Materialism does hold that consciousness is ''created by'' matter. However, Dialectical Materialism also holds that consciousness can ''influence'' the material world through conscious action. This constitutes a dialectical relationship.
-So he challenged the assumed usefulness of insight-oriented psychotherapy for the sicker patients and began to offer alternative kinds of psychotherapeutic interventions. He began to look at the social context of patients’ experience and to provide therapy that taught patients how to function within that context. He used medications. He was seen by some in the older generation as a renegade. However, he balks at the shifts of the biologic revolution. He thinks that medication alone is less clinically effective than medication in the context of psychosocial treatment. He still thinks that psychodynamic understanding and psychosocial therapies are essential for the adequate treatment of patients. The purely psychopharmacological approach, he fears, is even more narrow than the narrowness of the psychoanalytic perspective he first protested against.
+As Lenin explains in ''Materialism and Empirio-criticism'': “Consciousness in general ''reflects'' being—that is a general principle of ''all'' materialism... social consciousness ''reflects'' social being.”
-“These days,” he continued, “the psychoanalytic or even psychosocial explanations are sometimes given the same kind of blindsided dismissal that the earlier generations of exclusively psychoanalytic thinkers gave to social or biological factors. I remember a former colleague who zealously spearheaded the shift toward a biological paradigm in my hospital here. He said that the patient who is reacting in an unusual and unhealthy way which is diagnosable has an illness, meaning a brain disorder. It was a very powerful message, and the inferences drawn from that message are ''wrong''. If you put a person in a closed room for ten years, their brain chemistry is going to change. Take them out, and it may or may not revert. That brain chemistry is not fixed by the genes. It is alterable and greatly influenced by psychosocial factors. Childhood events register themselves in the brain, and they influence its neurochemistry, and the fact that you can see something in an adult brain which may be altered by medication doesn’t say a whole lot about etiology. And to suggest, by using a term like ‘brain disorder,’ that the mind is not involved and that psychosocial factors are not involved is not right. You can get the same effect from psychosocial treatment as from medication. It just takes a little longer. It may also be longer-lasting and, depending on the patient, more effective.
+Whereas early materialists erroneously held that consciousness is simply an “accidental” byproduct of matter, Dialectical Materialism holds that consciousness is a characteristic of the ''nature'' of matter. As Engels wrote in the notation of ''Dialectics of Nature'':
-“What really bothered me was that my zealous colleague was blind. He was not seeing what was there in front of him. The people. Complicated people with life histories, with very individualized prognostic options, with a great deal of uncertainty about how they got that way and a great deal of ambiguity about what the effects of his interventions were going to be. He treated every aspect of that in black and white. As if he knew. And he didn’t know. Like a blind man touching an elephant, he ''couldn’t'' know.”
+<blockquote>
+That matter evolves out of itself the thinking human brain is for mechanism a pure accident, although necessarily determined, step by step, where it happens. But the truth is that it is the nature of matter to advance to the evolution of thinking beings, hence this always necessarily occurs wherever the conditions for it (not necessarily identical at all places and times) are present.
+</blockquote>
-Once when I went to see Griffiths, it seemed that he had been waiting to tell me about something that had greatly upset him that week. He had just done a consultation with a young man who had been diagnosed as schizophrenic. There was some justification for this diagnosis: the young man was withdrawn and intermittently psychotic, and his life had become disorganized. But what the psychiatrist in charge of the case hadn’t considered, Griffiths explained, was that his parents had divorced shortly before he had fallen ill. And in this health care system, the belief that he was schizophrenic, with its expectations of schizophrenia, would condemn him. His caretakers would assume that he would have a chronic, debilitating course. They would disconnect.
+Dialectical materialism also breaks from early materialism by positing that consciousness has a dialectical relationship with matter. Consciousness arises from the material world, but can also influence the material world through conscious action. In other words, mental events can trigger physical actions which affect the material world.
-“Of course, the economic pressures are changing how psychiatrists must work,” Griffiths said. “There is so much pressure to move patients out of the hospital, and any psychosocial treatment gets shortchanged because at present you cannot document its effectiveness the same way you can document the effectiveness of medication trials. Even now, I wake up in the middle of the night angry at the wrongheadedness of clinical decisions. What they’ve done is understandable. Managed care companies have a primary interest in cutting costs, and they need to have rules to guide what they pay for and what they won’t, and it leads to inappropriate clinical decisions. I become reconciled to this over time. I see it as part of an historical process. I can’t personalize it—the forces pushing this are very large, and I would end up aging very quickly and unhappily if I were going to the mat every day for things I care about but couldn’t win.” Then he paused, and an expression of great pain came over his face. He seemed to want to believe in what he had just said, and he clearly didn’t.
+-----
-“I’ve got to stop,” he said, shaking his head and looking out the window. “You come in here and ask me about these things I feel passionate about, and I’ve tried so hard to retain my equilibrium in the face of these terrible affronts. It is so difficult for me.”
+As Marx explains in ''Theses on Feuerbach'':
-== {{anchor|CHAPTERSEVEN}} {{anchor|TopofLuhr9780307791900epubc8}} CHAPTER SEVEN: {{clear}}
+<blockquote>
-[[Image:Image5.png|center]]$$$MADNESS AND MORAL RESPONSIBILITY ==
+The materialist doctrine that men are products of circumstances and upbringing, and that, therefore, changed men are products of changed circumstances and changed upbringing, forgets that it is men who change circumstances and that the educator must himself be educated. Hence this doctrine is bound to divide society into two parts, one of which is superior to society. The coincidence of the changing of circumstances and of human activity or self-change [Selbstveränderung] can be conceived and rationally understood only as revolutionary practice... Philosophers have hitherto only interpreted the world in various ways; the point is to change it.
+</blockquote>
-This book might have ended with the previous chapter. But there is a profound moral dimension here that transcends managed care and ideological tensions. The way we as a society conceive of mental illness matters. It affects the way mental illness is experienced by those who deal with it. It affects the way we vote on health care policy, the way we react to the homeless on the street corner, the way we care for those we love who struggle with mental illness, the way we deal with our own anxiety, depression, and despair. Above all, the way we conceive of mental illness affects the way we conceive of ourselves as people, and particularly the way we conceive of ourselves as good people when we are confronted by another person’s pain. It affects our moral instincts about what it is to be human.
+Put more simply, we as humans are capable of “revolutionary practice” which can “change the world” because our consciousness allows us to “change circumstances.” This is discussed further in ''Nature and Structure of Consciousness'', p. 79.
-The disease model of mental illness has been a tremendous asset in the fight against stigma and the fight for parity in health care coverage. And it is clear that the disease model captures a good measure of the truth. Mental illness often has an organic quality. People can’t just pull themselves back together when they are hearing voices or contemplating suicide, and their illness is rarely caused by bad parenting alone. Yet to stop at that model, to say that mental illness is nothing but disease, is like saying that an opera is nothing but musical notes. It impoverishes us. It impoverishes our sense of human possibility. And it cruelly punishes those who struggle, like Laocoön wrestling with writhing snakes, with mental illness at its most savage.
+<blockquote>
+Failure to recognize the significance of matter in human society, leading to a failure to solve social issues based on a materialist basis
+</blockquote>
-“I’m on the California Mental Health Planning Council, as a consumer appointed by the state director of mental health.” Now in his fifties, John has dealt with schizophrenia for thirty years. He is lucky, because in the last ten years his symptoms have abated somewhat. He still meets the criteria for the disorder, but he is what is called “high-functioning,” and he has become a powerful voice for clients in the California mental health policy arena. His views about diagnosis are shared by many clients whose lives have been devastated by mental illness. “When we come around for introductions, what I say is, ‘My name is John M. Hood III, and I have a diseased brain,’ and they all laugh. It’s part of my routine, my camp humor. Can you imagine how insulting it would be if you turned to me and said, ‘I’m ''sorry'' you have a diseased brain’? When it gets right down to it, the medical model is an insult to me. To say I have a diseased brain does not validate me. I have a complicated thought system, with different behaviors.”
+Dialectical materialists believe that matter exists in many forms, and that human society is a special form of existence of matter. Lenin referred to the material existence of human society as ''social being'', which stood in contrast with human society’s ''social consciousness.'' Social being encompasses all of the material existence and processes of human society.
-John is a highly intelligent person, once a teenage math whiz. He said that even in kindergarten he had been withdrawn, not “socially appropriate,” a phrase he has learned from the mental health treatment world. “Then, at the end of sixth grade, I said to myself, I will be a heavyweight, I will go out and make friends with the most popular people in school. And I did. It worked. I still wasn’t able to deal with reality, in the psychological sense. But I was elected to be the Boys Federation representative from my homeroom and the Red Cross representative from my homeroom, even the homeroom representative from my homeroom. I did some wild stuff. I skinned a cat in physiology and pinned it to the door of a young, beautiful English teacher. I think she had some identity issues around her sexuality and the emerging sexuality of these high school boys. I became notorious for that. Then once I spent an entire class reporting on a meeting that never took place. I just looked up ‘Red Cross’ in the encyclopedia. I’m good at that sort of stuff, looking things up.”
+As Lenin wrote in ''Materialism and Empirio-criticism'':
-When his father moved to London the year John graduated from high school (his father went to pursue a doctorate at University College), John ended up pumping gas in Colorado and living in a trapdoor attic above the station. He never showered. There was no shower in the station, it didn’t occur to him to find one elsewhere, and he had no friends. He lasted three months. “All this stuff is pathological in some sense, but the real symptoms, when I became aware of them as symptoms, came later.” He went to college—an excellent one—for a year and did moderately well. There he became involved in the counterculture. “If I could have made an adjustment within the counterculture, I would have been okay. The counterculture kept me stabilized that first year.”
+<blockquote>
+Social being is independent of the social consciousness of men. The fact that you live and conduct your business, beget children, produce products and exchange them, gives rise to an objectively necessary chain of events, a chain of development, which is independent of your social consciousness, and is never grasped by the latter completely. The highest task of humanity is to comprehend this objective logic of economic evolution (the evolution of social life) in its general and fundamental features, so that it may be possible to adapt to it one’s social consciousness and the consciousness of the advanced classes of all capitalist countries in as definite, clear and critical a fashion as possible.
+</blockquote>
-That summer, he went off to visit his parents in England. The Vietnam War was under way, the Beatles were hot, teenage men grew their hair past their ears and took drugs and made trouble at home. John was hardly unusual in that respect. But on his way from California to see his buttoned-up parents, he stopped for a night in New York. There, in a cheap hotel room he shared with a stranger, he felt his mind take off. “It whirled, and it would not stop.” Nonetheless, he arrived in England without incident. It was a bad summer, lonely and isolated. He knew no one and argued constantly with his parents, who were frightened by the drugs he was taking and horrified by his hair, his clothes, his lifestyle. He came back to California, but because his parents refused to support him when he was using drugs, he had no money for a room at school. He camped out on friends’ floors instead. He felt he had many friends. Still, someone made an appointment for him to talk to a psychiatrist about “the workings of the mind.” The night before the appointment, John stayed up all night and wrote page after page about his own philosophy of mind. “I expected that ''I'' would teach ''him.”'' During the appointment, the psychiatrist asked him whether he’d like to stay in the hospital for a while, and John agreed that it might be a good idea. After all, he pointed out to the psychiatrist, he was homeless. John was diagnosed as paranoid schizophrenic in the hospital and discharged after ten days because his parents wanted to care for him at home in England. He found it difficult to concentrate there. He knew no one but his parents, and he got on very poorly with them. He returned to California eight months later, after his father finished his doctorate.
+Early materialists failed to recognise the relationship between matter and consciousness — as Lenin puts it, specifically, between ''social being'' and ''social consciousness''. Thus in contemplating social issues, these early materialists were unable to find proper materialist solutions.
-Since then John has been hospitalized about a dozen times, although he hasn’t been hospitalized for more than fifteen years. He has been on psychiatric medication for more than thirty years and takes some powerful antipsychotics. He doesn’t entirely like his medication and would like to be off it, but he finds it helpful. John has never heard voices, but he hears the walls creak loudly and repeatedly. He feels that the creaks are punitive: “I am obsessed, as I am to this day, by the idea that there is a supernatural force that makes creaks in the walls, and that they are God telling me what I am doing wrong. There is a real creak. You might not notice it, but it would be there. I know, I’ve spent thirty years trying to deal with these creaks.” As a young adult he became aware of what he calls the “social game,” which is the way people signal to him that they are attacking him and defending themselves against him by scratching their chin or their ears or shifting position or leaning on their elbows. He says now that this was a delusional system—but it is also part of his training in shamanism, and he now thinks of himself as a shaman. He doesn’t really believe in any one religion’s god, he says, but from a very young age he began to think of himself as the risen Christ and to prepare for his much-anticipated return: “I thought there was this job, a good clean job, which was the Second Coming, and I thought I fulfilled the conditions for it, even though I don’t believe in biblical prophecy or anything like that. So I saw myself as able to have more authority and power than was appropriate. That was delusional.” In his home he has a collection of different-sized medication bottles. His walls are hung with another collection, the awards he has received for his work in the mental health field. He has been on many state policy planning boards and has been recognized for his work by these awards, and by ceremonies and further appointments. In 1998, he was awarded the most prestigious local prize in the mental health field, the Mental Health Person of the Year, a prize given annually to a client or provider. On receiving it, he addressed an audience of seven hundred. He has been an enthusiastic producer of newletters for the mental health community. He also writes plays and poetry. He is employed as a peer counselor at a county psychiatric hospital, where he works on a locked unit where many of the most dysfunctional patients in the county can be found.
+-----
-John is active in what is called mental health patient advocacy, a lobbying effort on behalf of those diagnosed with severe mental illness. There is a variety of such groups. Some refer to themselves as “psychiatric survivors” and take a strong stand against mandated psychiatric medication. There is, for example, a magazine called ''Dendron'' that is specifically focused on alternatives to what its writers call forced psychiatric drugging. ''Dendron'' has a circulation of 6,000 and an estimated readership of 15,000. Its Winter 1997–98 issue features Burch House, a treatment center in New Hampshire modeled after R. D. Laing’s communities in England, where patients with acute psychosis are stabilized without psychiatric medication. Many of the patient advocacy groups recognize that the Burch House treatment approach is not feasible in a managed care world. Nevertheless, they strongly tend to prefer a community-centered and therapy-centered model over a medical model.
+These shortcomings resulted in a non-thorough materialist viewpoint: when dealing with questions about nature, the early materialists had a strong materialist viewpoint but when dealing with social issues, they “slipped” into an idealist viewpoint.
-This is not true of all organizations that lobby for psychiatric patients. The National Alliance for the Mentally Ill, for example, has been a powerful voice in defense of the medical model and a powerful voice in Congress. It is one of the largest advocacy groups, with more than a hundred thousand members nationwide. It has used the medical model to argue effectively that more research in psychiatry is desperately needed because mental illness is not the result of poor socialization and inadequate parenting but rather a medical condition in need of medical attention. Its publications are full of MRI scans, psychopharmacological studies, and epidemiological surveys. Its policy statement describes it as a grassroots organization for “individuals with brain disorders and their families” and states that the organization promotes “the prevailing scientific judgment that ‘severe mental illnesses’ are brain disorders, which at the present time are neither preventable nor curable, but are treatable and manageable with combinations of medication, supportive counseling, and community support services.” It uses this approach in an effort to destigmatize mental illness and, as a corollary, to persuade the public and Congress that mental illness is an illness like any other. NAMI is widely respected within the psychiatric community as an excellent organization with powerful political clout and striking efficacy. But many within the patient-run advocacy movement are skeptical of it, seeing it as a “parents’ organization” committed to erasing parents’ guilt (NAMI is, in fact, deeply committed to the view that mental illness is no one’s fault; its policy statement states that the strongest weapon against the stigma of mental illness is science). The patients’ skepticism focuses on NAMI’s support for the medical model.
+-----
-Like many clients, John is adamantly opposed to the medical model because to him it makes his thoughts, his goals, and his desires seem as if they are not really his own but due to something separate from himself. He disapproves of NAMI’s stand: “The whole NAMI emphasis is trying to avoid looking at the upbringing. You could say, ‘John Hood thinks he’s a wizard, and has a very animated emotional style, he has too much dopamine, he’s not responsible for what he thinks.’ But as a peer counselor what I focus on is: take responsibility for your actions, treat other people as they should treat you, and have a sense of humor. If I have a client that comes up to me and says, ‘I jumped over the moon last night,’ I will validate that belief. As far as I have to go. You cannot live without validation. And you cannot live without doubt. That’s where the medical model comes in. Everyone’s looking for an answer. For something. But there’s no simple answer. There can’t be.”
+==== Annotation 58 ====
-Madness is a terrible thing. It is hard to treat, hard to live with, hard to comprehend. Most people do not grasp how strange and horrible and recalcitrant the problems are, how frightening it is to look into the eyes of a crazy person and see no answering recognition. Many would rather brush past a psychotic panhandler than deal with him, would rather pretend that the mentally ill do not exist. We are right to be terrified by psychosis and depression, because mental illness distorts the defining features of personhood, and, seeing that, we are reminded that the foundations of our being are built on sand. The mad are people who deliberately hide razors and then, in private, when their mothers have gone to bed, slice into their flesh until blood seeps into the bedsheets. They hoard sleeping pills for months, collecting new prescriptions even though the old ones are untouched, then wash them all down with vodka and leave a voice-mail message on their doctor’s line. They refuse to take out the trash for months, until the stench offends their neighbors and the janitor comes in to find a crawling pile. They skip lunch and eat only one tomato and one can of tuna fish each night, chopping the food carefully into a thousand pieces and eating forkful after tiny forkful for an hour. They act on the basis of voices we cannot hear and beliefs we cannot share. They intend; they decide; they choose. Their illnesses are a part of who they are in a way that seems very different from the alien invasion of a cancer.
+Lenin explains this concept of “slipping into” idealism through a non-thorough materialist viewpoint in ''Materialism and Empirio-Criticism:'' “Once you deny objective reality, given us in sensation, you have already lost every one of your weapons against fideism, for you have slipped into agnosticism or subjectivism — and that is all fideism wants.”
-In our society, we usually see people with cancer, heart disease, or a broken leg as innocent sufferers, and we usually feel that they have some claim to our help and that it is good and right to support them through a misery they did not ask for and do not deserve. In psychiatric illness there is no such clarity. We often find it difficult to respond to psychiatric patients as innocent sufferers, because taking an overdose seems deliberate and chosen in a way that having cancer does not. We sometimes even find it difficult to respond to them as people, because when a man is psychotic he loses the ability to behave like a person among people. That makes it difficult to empathize with madness and hard to know how to respond appropriately. That awkwardness is embedded deep within our religious heritage.
+''Note: fideism is a form of idealism which holds that truth and knowledge are received through faith or revelation. Subjectivism is the centering of one’s own self in conscious activities and perspective; see Annotation 222, p. 218.''
-We are not supposed to destroy ourselves. Fate, to borrow a Homeric phrase, has woven the thread of life with pain, and that can reflect poorly on a supposedly benevolent creator. But if (as people in earlier centuries did) you accept that there is a God who allows this sharp misery, if you grant that God sends pain for a reason, then what is the right stance to take toward it? Do you embrace bronchitis as God’s gift until he removes it? Or do you attempt to cure it yourself, in effect arrogantly challenging God’s wisdom?@@@[[#1Inantiquitythiswasmoreo|1]]$$$ Martin Luther resolved the puzzle (as others also did) by arguing that God asks of humans that they take responsibility for their own wellbeing.@@@[[#2Ibidpp1ff|2]]$$$ “A farmer does not commit the care of his field to God in such a way that he himself does none of the things that pertain to agriculture, does not plow and does not cultivate the land,” he explained.@@@[[#3MartinLutherMartinLuther|3]]$$$ “Many argue rashly about the necessity ordained by fate and say, ‘If God wants to preserve me, I will survive in a time of plague and famine even without food and medicine; but if I am to perish, all those things will not help me at all.’ These thoughts are impious and have been forbidden by God, for He has not rendered to us His secret counsels as to how or when He wants to help you.”@@@[[#4Ibidp308|4]]$$$ In other words, to refuse to seek health is to demand of God that he do for us what we can do for ourselves.
+In the same work, Lenin upholds that objective reality can be known through sense perception:
-By the same reasoning, to hurt oneself intentionally is to spurn God. It is hubris. “The body has been given to us by God,” wrote Luther, “not that we should kill it with fasting or vigils, but that we should care for it with food, drink, clothing, sleep and medicine.”@@@[[#5Ibidp113Lutheralsosa|5]]$$$ From this perspective, self-hurt is sacrilegious and possibly evil, even if done in the name of worship: “Do not choose your own affliction.… God gave you two eyes, and these you are not to injure or gouge out; also two legs, and these you are not to cut off. On the contrary, if your members are ailing, God wants you to employ medication for healing them. But if it should occur that tyrants murder you or otherwise persecute you, then you must suffer it and let God rule.”@@@[[#6Ibidvol23p203|6]]$$$
+<blockquote>
+We ask, is a man given objective reality when he sees something red or feels something hard, etc., or not? [...] If you hold that it is not given, you... inevitably sink to subjectivism... If you hold that it is given, a philosophical concept is needed for this objective reality, and this concept has been worked out long, long ago. This concept is matter. Matter is a philosophical category denoting the objective reality which is given to man by his sensations, and which is copied, photographed and reflected by our sensations, while existing independently of them.
+</blockquote>
-Luther here used an old religious distinction, which I shall call the distinction between inessential and essential suffering, between the suffering one can act on and suffering that, as a Catholic priest might say, one must offer up to God. Essential suffering is what we are not able to prevent but must survive if we can. Essential suffering is the inherent difficulty of human life, our troubles, the way we struggle in the world, being the specific people we are, of a certain character, in this specific place and time. The particular history of our pain molds our characters further into the people we become. Human pain is inevitable, and all the knowledge and fervor in the world will not wash it safe and pure. Nadine Gordimer tells a tale of a young South African radical, burning to save the world from apartheid, who one day takes her lunch to the park and finds a park bench across from a man who is quiet and untroublesome. When a pigeon perches on his shoulder, she realizes, her sandwich gone, that he is dead. When the revolution comes, she thinks, and there will be justice, equality, the brotherhood of man, and human dignity, there will still be this, and she throws away the cellophane wrapper from her sandwich and vanishes into the crowd like a thief.@@@[[#7NadineGordimerBurgersDau|7]]$$$ Human life is hard. Our personal histories are trails through small circumstances filled with hurt.
+Lenin also explains that proper materialism must recognize objective/absolute truth:
-Inessential suffering is the pain we can treat. We can remove it because it is the result of some fact that can be altered. When it is gone, it is inessential to us. It has not made us who we are. Luther argues that illness that can be cured, hunger that can be fed, and chill that can be warmed are inessential sufferings, and it is our duty to remove them. He also argues that those fervent worshipers who scourge and starve and otherwise torment themselves to honor God are terribly misguided. Only suffering that is unavoidable must be accepted. We must ask for God’s beneficence to our crops only if we have tended the fields with love and care. “Fool!” remarks the Talmud. “From your own work, do you not understand that … even as the plant, if not weeded, fertilized and ploughed, does not grow … so is the body of man. The fertilizer is the medicine, and the farmer is the physician.”@@@[[#8MidrashSamueliv1cited|8]]$$$
+<blockquote>
+To be a materialist is to acknowledge objective truth, which is revealed to us by our sense-organs. To acknowledge objective truth, i.e., truth not dependent upon man and mankind, is, in one way or another, to recognise absolute truth.
+</blockquote>
-As this distinction has been inherited by our Judeo-Christian culture, medicine handles the inessential suffering, religion the essential suffering, and intentional hurt falls into a limbo, neither treated by medicine nor tolerated by religion. The physician’s role is to treat what is treatable and to manage what is manageable. Doctors are not trained to handle the patient’s existential crisis or, in extremis, his confrontation with death. That is why there are priests, ministers, and rabbis attached to hospitals, and while doctors can hardly avoid the personal tragedy created by a diseased liver, it is not their task to attend to it, and an emergency down the hall preempts a patient who has been treated but is in despair. Doctors are taught how to understand disease processes and interrupt them. A priest or rabbi is taught how to help us through moments of the irrevocable.@@@[[#9ReligionteachesusasCliff|9]]$$$ We go to doctors to solve the problem of our aching joints and stuffed noses, as if the doctors were glorified technicians of the body, and we go to church to solve the problem of our loneliness in the infinitude of time and space. That, among other reasons, is why people in their thirties and forties often begin to feel a need for religion, because by then they have realized that life is an accumulation of forced choices, with consequences that could not be foreseen; that bad things happen to good people, sometimes in terrible ways; and that to see life as good despite this can require the kind of wisdom one finds in spirituality. Or in great novels. Mary Gordon wrote that she had read ''Middlemarch'' three times. In her teens, she yearned for Dorothea to marry the romantic, dashing Ladislaw. In her twenties, she fumed that Dorothea had lived her life in the shadow of men who were clearly not her equal. In her middle forties, she realized that the intense and passionate Dorothea had lived as best she could, in the circumstances in which she had found herself, and Gordon saw for the first time that ''Middlemarch'' was a sad book, about grace and dignity and faith.@@@[[#10MaryGordonGeorgeEliot|10]]$$$
+A failure to recognize the existence of such objective, absolute truth, according to Lenin, constitutes “relativism,” a position that all truth is relative and can never be absolutely, objectively knowable.
-The power of religious comfort lies in its ability to reframe and reinterpret the inevitable pain of life. In church we come to terms with the life that circumstances have carved out for us, and we learn to make the best we can of it and accept our struggles as essential to ourselves. We learn to understand pain as part of life and, in some senses, as a spiritual lesson. Modern medicine, by contrast, separates a person who is ill from the illness that he or she has. Intentions are cordoned off from the physical problem. No doctor refuses to set a broken arm if the patient broke it because he acted like an idiot on the soccer field. She treats lung cancer whether or not the patient smoked. In medicine, the complex circumstances that led to and result from pain are bracketed away from the injury in order to treat the injury. Even doctors who see themselves as healing the whole person or as engaged in social justice are trained to treat, act upon, and remove. We have institutionalized the distinction in the phrase “medically necessary,” the central policy concept in managed care. Medically necessary care is, in the words of a Medicaid statute, care that is “reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.”@@@[[#11Theactualsourceincludes|11]]$$$ Doctors fix abnormal conditions, ameliorate inessential suffering, and ignore the troughs of ordinary life. “If one were asked to select the single most important idea upon which medicine is based,” writes a medical historian of medicine, “it would be … that abnormal conditions in the body can be recognized.”@@@[[#12JosephMcManusTheFundamen|12]]$$$
+<blockquote>
+It is unconditionally true that to every scientific ideology (as distinct, for instance, from religious ideology), there corresponds an objective truth, absolute nature. You will say that this distinction between relative and absolute truth is indefinite. And I shall reply: yes, it is sufficiently ‘indefinite’ to prevent science from becoming a dogma in the bad sense of the term, from becoming something dead, frozen, ossified; but it is at the same time sufficiently ‘definite’ to enable us to dissociate ourselves in the most emphatic and irrevocable manner from fideism and agnosticism, from philosophical idealism and the sophistry of the followers of Hume and Kant. Here is a boundary which you have not noticed, and not having noticed it, you have fallen into the swamp of reactionary philosophy. It is the boundary between dialectical materialism and relativism.
+</blockquote>
-Psychiatry fits badly into the dichotomy between abnormal, treatable problems and the flow of life because when someone carves her initials into her arm you cannot cleanly separate the treatable problem from its personal setting. There is no tumor to excise. There is nothing specific you can set aside and say, here, if we cure this, the pain will go away. There isn’t even much of a clear-cut sense of normality—healthy people are like this and unhealthy ones like that—at least compared to medicine, where it is complicated enough.@@@[[#13Forinstanceisitnormalf|13]]$$$ Psychiatric problems are bound up with the unique life each person leads because they are bound up with the way someone willfully chooses, the way she wants, intends, decides. In psychiatric illness, the injury ''is'' the complex intentional circumstances that surround the pain. What is broken, metaphorically, is that the patient ''wanted'' to get hurt or to fail, and the want is not like a benign and operable tumor but is connected to many other wants, fears, aspirations that are knitted into the person that patient has become.@@@[[#14Contrastthestoveisburni|14]]$$$ The problem of intention is inherent in psychiatric illness. Yet we live in a culture with religious traditions that condemn intentional suffering and medical practices that bracket intention away.
+In other words, while proper materialism must contain a degree of relativistic thinking sufficient to challenge assumptions and reexamine perceived truth periodically, materialists must not fall into complete relativism (such as that espoused by Hume and Kant) lest they fall into idealist positions. Ultimately, Absolute Truth — according to Lenin — constitutes the alignment of conscious understanding with objective reality (not to be confused with Hegel’s notion of Absolute Truth; see Annotation 232, p. 228).
-And so our models of psychiatric illness are solutions to the problems that psychiatric illness presents to us. The facts, as I have pointed out, are that major psychiatric illness has a complex cause and that a combination of psychopharmacological and psychotherapeutic treatments provides the best outcome. Practicing psychiatrists often come to have a rich, complicated, multicausal understanding of an individual’s struggles. But each of the two approaches they are taught has emerged as a solution to the problem of intention and, in particular, to the problem of feeling compassion for self-destructive intention. In our Protestant, individualistic culture, we help those who help themselves. We want to help people who lose their houses because of hurricanes, floods, or other natural disasters; we have little sympathy for those who burn down their houses and then claim they have no place to live. Psychiatric science and psychodynamics are among our culture’s choices about how to make sense of self-inflicted suffering so that we can feel compassion for those who suffer, so that we can want to help.@@@[[#15AsLawrenceRosenpointsout|15]]$$$
+Lenin recognized the development of Marx and Engels as “''modern materialism'', which is immeasurably richer in content and in comparably more consistent than all preceding forms of materialism,” in large part because Marx and Engels were able to apply materialism properly to social sciences by taking the “direct materialist road as against idealism.” He goes on to describe would-be materialists who fall to idealist positions due to relativism and other philosophical inadequacies as “a contemptible ''middle party'' in philosophy, who confuse the materialist and idealist trends on every question.”
-Psychodynamics manages this by focusing on the unconscious. That makes some intentions effectively unintentional, but it leaves the cause of suffering embedded in a complex intentional web. Psychiatric science manages by aggressively minimizing intention, so that what might seem to be intentional (suicidally pulling the trigger of a gun, swallowing barbituates and rum) becomes a bodily dysfunction to treat. Both psychodynamics and psychiatric science are attempts to come to grips with crazy, incomprehensible, self-destructive intention in ways that help us to feel compassion. Both explain self-destructive intention by effectively making it nonintentional. But they do so in different ways, and the difference has profound consequences for the way we feel compassion for the person we need to help.
+Lenin warned that a failure to hold a thoroughly materialist viewpoint leads philosophers to become “ensnared in idealism, that is, in a diluted and subtle fideism; they became ensnared from the moment they took ‘sensation’ not as an image of the external world but as a special ‘element.’ It is nobody’s sensation, nobody’s mind, nobody’s spirit, nobody’s will — this is what one inevitably comes to if one does not recognise the materialist theory that the human mind reflects an objectively real external world.”
-Compassion depends upon empathy, and empathy is always imperfect. We can never really feel another person’s pain. Instead, we feel the echo of the emotional pain that we perceive, in the person we think we see, as the person we would like to be, with the expectations we carry of a person, in the way we feel able to express ourselves around that person. We ''learn'' to perceive. This is perhaps the most basic anthropological insight. People are never “in themselves” to other people. Who they are is mediated by the person ''to whom'' they are, by the way they are understood, responded to, engaged with. We are not transparent to one another. So empathy is never pure. We empathize with other people from within our own expectations. Those expectations have what I have come to think of as an “architecture.” They are built from the way we conceive of and imagine the persons we see before us, the persons we hope to be ourselves, the way we expect suffering persons to treat us, the way we learn to treat them. And that architecture is often not visible to us: we simply empathize, and feel compassion, for certain people in certain ways.
+In other words, idealist conceptions of sensation inject mysticism into philosophy by conceiving of sensation as otherworldly, supernatural, and detached from material human beings with material experiences in the material world.
-When a psychiatrist, or for that matter a nonpsychiatrist, empathizes with someone like John, he empathizes differently depending on the way he understands the patient’s pain. Who is this person, and why does he feel his pain? From the medical perspective, his pain is inessential suffering. It has not made him who he is. It does not come out of the complexities of his past, and it does not lie at the center of his future. This is the great gift of that approach to psychiatric illness. The pain is not your mother’s coolness or your father’s preoccupation; it is not your disastrous choices, your embarrassments, your inadequacies. The pain is no more you than a winter’s cold is. Thus the medical model can rescue someone from stigma, which is a real and horrifying feature of our social life. There should be no more embarrassment about depression or schizophrenia than there is about diabetes, but in fact there is, because of the awkward problem psychiatric illness poses for our religious heritage. The medical model solves this problem by treating the illness as something external, imposed from outside the intentional self the way a broken leg or dysfunctional kidney is outside of and separate from our personhood. When we learn to empathize through the medical model, we learn to empathize with someone who is a victim of external circumstances, and we are invited to empathize with that person as a member of a category of other people: those suffering from depression, from schizophrenia, from floods or other natural disasters. When psychiatrists see patients in a biomedical setting, when they must diagnose and prescribe, what they are taught to see is the category of illness: a patient is depressed, anxious, psychotic, schizophrenic, bipolar. For the purposes of treatment, a patient is the category indicated by his symptoms.
+The development of natural sciences in the late 19<sup>th</sup> century and early 20<sup>th</sup> centuries (especially the inventions of Roentgen<ref>Wilhelm Conrad Roentgen, 1845–1923 (German): Physicist.</ref>, Becquerel<ref>Henri Becquerel, 1852–1908 (French): Physicist.</ref>, Thomson<ref>Sir Joseph John Thomson, 1856–1940 (British): Physicist, professor at London Royal Institute.</ref> etc.), disproved the theories of “classical elements” such as fire, water, air, etc. [see ''Primitive Materialism'', p. 52]. These innovations led to a viewpoint crisis in the field of physical science. Many idealists used this opportunity to affirm the non-material nature of the world, ascribing the roles of supernatural forces to the birth of the world.
-From the psychodynamic perspective, the pain of psychiatric illness is an essential suffering. It is intrinsic to a person, to his experience of life, to his growth and future. The pain may have some bodily cause, but the psychodynamic enterprise tries to see the way the experience of the pain is at the center of that person’s struggles. The therapist tries to help the person to understand how he has chosen to handle his depression, how his depression has figured in the way he loves and works and plays. The gift of the psychodynamic model is that the illness is not external, arbitrary, and other. At least part of what is dysfunctional is the way the patient has chosen (unconsciously) to handle his distress: his repetitive self-accusatory thoughts, his angry explosions at his loved ones, his chaotic attempts to shake off his anxiety. The illness, then, is not out of his control but something over which he is potentially a master. When we empathize with someone through the psychodynamic model, we empathize with the unique life course of that person: his hopes, his losses, his mistakes, his frailties, his courage, and his strength. When psychiatrists see patients in a psychodynamic setting, what they see is the complexity of a particular life: how a specific person dreamed, feared, yearned, avoided, chose.
+-----
-A psychiatrist becomes different people, too, depending on his model and on who he aspires to be in that relationship. To be a certain sort of self, appropriate to a certain setting, has an aim: to be like, to be thought of as like, to be respected as being like the best that are respected here. “The very way we walk, move, gesture, speak,” remarked the philosopher Charles Taylor, “is shaped from the earliest moments by our awareness that we appear before others, that we stand in public space, and that this space is potentially one of respect or contempt or pride or shame.”@@@[[#16CharlesTaylorSourcesoft|16]]$$$ In a psycho-therapeutic setting that public space is shaped by the model of the psychoanalyst, a complex, contradictory, elusive character conscious of the multiple roles one person plays for another, constantly questioning, eternally uncertain, curious about what is hidden, opaque, elided in our interactions with one another. The psychoanalyst sees the tragedy of human lives, which is one reason we have thought of psychoanalysts as the priests and rabbis of a secular age. Here the bottom-line commitment is to a kind of nurturing, loving relationship with the patient and a belief that self-knowledge is inherently good. In a biomedical setting, that public space is shaped by the figure of the scientist, who is a person of knowledge. A scientist is a person of data, of testing, of experimental outcomes and future outcomes. A scientist is not, in his capacity as scientist, a clinician, but he or she creates the conditions under which future medical treatment can be generated. This is a powerful moral good, but it is good in relationship to all patients in general. A relationship with a particular patient is not a powerful part of what it means to be a scientist. The expertise of psychiatric scientists lies in their knowledge of neurotransmitters and brain mechanisms; the expertise of psychoanalysts lies in their knowledge of and care for individual people.
+==== Annotation 59 ====
-Reality is, of course, more complex than this; and psychiatrists have much more that shapes their involvement with these models of mental illness than the rest of us (their sense of who is at risk from whom, of where the contradictions of their culture lie). Still, there is a different ethos to an approach in which the problem is a disease and the ideal is the scientist than there is to one in which the problem is in choices and interactions and the ideal is the psychoanalyst. For those of us who are not psychiatrists, there is a difference between the way we empathize when we think in terms of a person with a disease that medication will cure and whose ultimate cure rests upon a scientific advance, and when we think in terms of a person with a messy past who can be helped by being understood and mentored.
+Lenin discussed this viewpoint crisis extensively in ''Materialism and Empirio-Criticism''. Here Lenin discusses relativist reactions to new breakthroughs in natural science, which led even scientists (who proclaimed to be materialists) to take idealist positions:
-One might call the empathy structured by the biomedical model “simple empathy.” Your job in caring for a person with psychiatric illness (if that is your job) is to treat the inessential suffering to the best extent that you can and to hope earnestly that better research will produce better ways of handling this class of problems. You feel empathically for a victim of psychiatric illness; identifying with the scientist, you feel moral urgency in removing this blight from the earth. The empathy is simple because the problem is simple. There are no complicating intentions.
+<blockquote>
+We are faced, says Poincaré [a French scientist], with the “ruins” of the old principles of physics, “a general debacle of principles.” It is true, he remarks, that all the mentioned departures from principles refer to infinitesimal magnitudes; it is possible that we are still ignorant of other infinitesimals counteracting the undermining of the old principles... But at any rate we have reached a “period of doubt.” We have already seen what epistemological deductions the author draws from this “period of doubt:” “it is not nature which imposes on [or dictates to] us the concepts of space and time, but we who impose them on nature;” “whatever is not thought, is pure nothing.” These deductions are idealist deductions. The breakdown of the most fundamental principles shows (such is Poincaré’s trend of thought) that these principles are not copies, photographs of nature, not images of something external in relation to man’s consciousness, but products of his consciousness. Poincaré does not develop these deductions consistently, nor is he essentially interested in the philosophical aspect of the question.
+</blockquote>
-By contrast, one might call the empathy structured by the psychodynamic model “complex empathy.” The suffering is not really inessential, because while the self-destructive intentions (to kill oneself, to fail, to be imperfect) are unconscious, they are still intentional, and they are interwoven in the complex web of the person’s past. They are part of him. They are who he is. You cannot feel for this person simply that he is a victim of a depression the way he might be a victim of the latest hurricane. The hurricane of depression is part of who he is, and to empathize with him is to empathize with his self-destructiveness as well as with his despair.
+Lenin concludes by stating that the non-thorough materialist position has lead directly to these idealist positions of relativism:
-And simple empathy and its compassion help sufferers only when the suffering can go away. When my broken leg is in its heavy cast, I want someone who will laugh and cry with me about the indignity and pain of my broken leg, someone who will understand how much it hurts, someone who can tell me, as I struggle upstairs on crutches, that it doesn’t really matter. I want someone to help me see that everything will be okay despite this terrible, painful, frustrating predicament, that nothing has really changed. But if I were to break my back, if I were to be in a wheelchair for good, I would not want a friend to tell me that the wheelchair didn’t matter. The wheelchair would become part of who I was in a way that my broken leg did not. If I saw myself as the same as before, just with a wheelchair, I would always be inadequate compared to that former self. If I saw myself as a different person, a different self but still a fully human self with meaning, I might be able to live with pride and optimism. John knows he is different. He knows he can never hold a high-paying job. But he thinks he has a valid way of looking at the world, that he has the right to be here, and that he contributes to the lives of others. Thinking of his thoughts and feelings as “diseased” makes him want to cringe in shame.
+<blockquote>
+The essence of the crisis in modern physics consists in the breakdown of the old laws and basic principles, in the rejection of an objective reality existing outside the mind, that is, in the replacement of materialism by idealism and agnosticism.
+</blockquote>
-Understanding a person as separate from his psychiatric illness works well when the illness climaxes and dissipates, when the depression lifts and the person emerges from her suicidal fog, when the mania abates and the person no longer believes that he has wings with which to fly. When psychiatric illness clears, it makes eminent sense to see that person as having suffered primarily from a disease. Doing so removes the threat of stigma. The misery wasn’t really that person’s fault, nor was it the fault of his or her parents. No one is to blame. Nothing but the body (and maybe a little stress) was the cause. The gift of this perspective is profound, because in the years of psychoanalytic dominance, the vulgarized psychoanalytic model was used to humiliate and insult the parents whose children suffered.
+With this historical background, in order to fight against the distortions of many idealists and to protect the development of the materialist viewpoint, Vladimir Ilyich Lenin simultaneously summarized all the natural scientific achievements in late 19<sup>th</sup> and early 20<sup>th</sup> century and built upon Karl Marx and Friedrich Engels’ thought to develop this definition of matter:
-But when the psychiatric illness is unremitting, the medical solution is not so good. If people’s personhood is independent of their psychiatric illness but the illness never goes away and the illness lies in the way they think, feel, and act, they can see themselves and be seen as never fully human. Their brains are diseased, their intentions are sick, and if (as happens too often) medication does not make the disease clear up and go away, they feel that there is nothing they or anyone else can do about it. What it is to be human in them—thinking, choosing, feeling—is sick, and it is out of their control.
+''“Matter is a philosophical category denoting objective reality which is given to man in his sensations, and which is copied, photographed, and reflected by our sensations, while existing independently of them.”''
-When a psychiatric patient conceives of himself primarily as a victim of a disease and the disease is unremitting, he loses a reason to struggle. Vernon has been involved in patient advocacy work for close to thirty years. He speaks slowly but with passion, and he has thought deeply about these dilemmas. As a child, he was diagnosed with childhood schizophrenia—“I had to live with that all my life”—but now he is more often called bipolar or “schizoaffective,” an amalgam of a mood (or affective) disorder (in his case, depression) and more schizophrenia-like symptoms, such as hearing voices. He is better now than he has been since he was first admitted to a hospital thirty-five years ago after stabbing five other boys. He has been off medication for more than a year. He credits that success in part to his joy at the birth of his first grandchild. Mostly, though, he attributes it to the way he learned to live with his illness not as an alien disease but as part of the way he is: “I still hear voices. But what I discovered was that it’s complicated. When my wife died back in 1985, when I was at that air force base, I thought I was having a complete nervous breakdown. The psychiatrist told me no. He opened the door for me to understand psychology from another point of view. He asked me, did I ever read [Elisabeth] Kübler-Ross? He said, that’s what you have, grief. Grief is like the beginning of acute mental illness. Knowing that, I knew how to take care of myself rather than have a psychiatrist tell me what to do. I help patients now the way organizations like NAMI don’t even want to try, because it takes too long. It’s taken me thirty years to not take medication. It’s been difficult, but I have a life. A lot of this came about by searching for the right alternatives. After reading Kübler-Ross, I saw myself as grieved, not mentally ill. I think of mental illness now as a life situation, kind of an extension of Kübler-Ross.”
+Lenin’s definition of matter shows that:
-Why does it help, I asked him, to shift the label from “disease” to “life situation”? “I had a psychiatrist” he said, “who put all of my problems in one category, ‘schizoaffective,’ and he didn’t see how it could be anything else. I think if you think about it differently, you realize it takes one step at a time, and you realize you can do something. I have a system I call ‘SENAP.’ S is Self-awareness and freedom of expression. E is Energy activation, in a way that’s free from stress. You have a right to be treated in a way that’s comfortable to you, in a controlled environment. N is New awareness of self. If I’m going to get better, I need to take a look at my eating habits, my clothes, and wean myself away from bad habits. A is an Awareness of reality. Really, I mean that there is a meaning to psychosis, delusions, hallucinations. There is a social and artistic meaning. You have to see that. P is Problem solving. You take things one step at a time. You have to see that there’s a creativity there.”
+''First,'' we need to distinguish between the definition of “matter” as a philosophical category (the category that summarizes the most basic and common attributes of all material existence, and which was defined with the objective of solving the basic issues of philosophy) from the definition of “matter” that was used in specialized sciences (specific and sense-detectable substance).
-So, I wondered aloud to him, when someone says you’ve got a disease, why do you feel uncomfortable with that? “When I got involved with the California Network of Mental Health Clients, we never could come up with an answer. Even now, we still haven’t come up with an answer. The only thing we do know is that we’re not accepting biochemistry. Clients will accept physiology, some neurology. They all agree that you can never get rid of the phrase ‘mental illness,’ though they would like to. But it’s like this: Say I have diabetes. It’s going to go on for years and years until maybe I lose my eyes. If you create the disease of mental illness, you’ve got to be prepared for the final outcome. I’ve lost over twelve friends to suicide since 1983. With an illness, you can do something. The common flu is an illness, and you know how to take care of it. With mental illness, knowing that there are different avenues to getting there and two avenues to cure—the drugs, but also talk, the community, places like the meeting place [a place downtown where clients can drop in and talk to each other], the psychosocial dimension—it gives you hope. It makes you real. A psychiatrist or a NAMI person does what they can, but it’s still up to that person, that client, to say, I am ready to go up to the next level. Like me, if I hadn’t gotten involved with the political work, I’d be a lot sicker. I’d be in a state hospital or in jail. I’d have just given up.”
+''Second,'' the most basic, common attribute of all kinds of matter [and under both definitions listed in the previous paragraph] is ''objective existence,'' meaning matter exists outside of human consciousness, independently of human consciousness, no matter whether humans can perceive it with our senses or not.
-Vernon cannot maintain his sense of himself independently from his psychiatrist’s and his society’s sense of who he is. He lives, as do we all, within the implicit expectations of others. And just as the way he conceives of himself is entangled with the way we conceive of and empathize with him, our expectations become entangled with our moral judgments in insidious ways that rebound upon our judgments about how to deal with mental illness. Empathy often implicates morality. To echo James Wilson’s remarkable discussion of sympathy, to empathize—at least beyond the toddler stage—''is'' to judge.@@@[[#17JamesWilsonTheMoralSens|17]]$$$ To empathize is to assess someone else’s circumstances and character, to interpret that person according to one’s profession, one’s society, and one’s own personal history; to infer, on that basis, what that person feels; and, inevitably, to make a judgment about the rightness or wrongness of what has happened. To be able to empathize, you must understand why a person has acted and whether he intended the outcome of the act.@@@[[#18SeediscussionbyMartinHof|18]]$$$ In that sense, empathy is one of our primary moral resources.
+''Third,'' matter, with its specific forms, can cause and affect mental events in humans when it directly or indirectly impacts the human senses; human consciousness is the reflection of matter; matter is the thing that is reflected by human consciousness.
-Morality, of course, has several faces. The anthropologist and psychologist Richard Shweder points out that across cultures, there are three primary discourses about what is right and good. There is an ethics of autonomy, with talk about justice, harm, rights, and human freedom; an ethics of divinity, with talk about purity, sanctity, and the will of God; and an ethics of community, with talk of duty, obligation, and the collective good.@@@[[#19Shwederisperhapsthemost|19]]$$$ Different societies organize the importance of these various ethics in various ways. But no matter whether yours is a society that sets duty to family above all or one that emphasizes individual rights, the basic tool for judging human action is to understand why a person has acted as he has done and whether he has intended the consequences of his act. You must judge what you think of the other person, who you wish to be in relation to him, and how you think he should be with you.@@@[[#20Ofcoursecommentsthean|20]]$$$
+Lenin’s definition of matter played an important role in the development of materialism and scientific consciousness.
-This is not, perhaps, the way it should be. Certainly the Enlightenment argument between David Hume and Immanuel Kant centered on the role of emotion, and of sympathy and empathy, in moral judgment. Hume argued for the all-important role that sympathy/empathy played in our motivations; he claimed that moral behavior and good conduct are based, like everything else, upon our passions. Kant countered that our moral requirements, as we understand them, are absolutely not conditional on our feelings and inclinations. Moral considerations are what provide us with reasons for actions that are, and indeed must be, independent of our mere desires. In Kantian philosophy, morality does not tell us how to treat people based on whether we happen to feel empathically for them; it defines and limits how we may permit ourselves to treat people even when we do not like them and neither experience empathy nor feel compassion for them.
+''First,'' by pointing out that the most basic, common attribute of matter is objective existence, Lenin successfully distinguished the basic difference between the definition of matter as a philosophical category and the definition of matter as a category of specialized sciences. It helped solve the problems of defining matter in the previous forms of materialism; it offered scientific evidence to define what can be considered matter; it layed out a theoretical foundation for building a materialist viewpoint of history, and overcame the shortcomings of idealist conceptions of society.
-But what is a person? That is the kind of question that anthropologists and philosophers answer very differently. A philosopher argues about the world as it should be: how we should conceive of persons and their rights, how we should conceive of our moral responsibilities, why we should think, as Kant insisted, that every person must be treated as an end and not as a means. An anthropologist, less ambitious, tries simply to describe the world as she has found it. And she has learned that the cultures she studies are quite different from one another, not merely because some societies build skyscrapers and others, mud huts, but because the basic building blocks of human understanding are quite distinct. In this Melanesian society, for example, what counts as being a person is not, as we would see it, being alive, being human, but having a role, having a status, being the one with rights to a certain pig. In that African tribe, you are not really a person unless you are the legitimate child of a lawfully wedded woman. Prejudice or genocide in any society hinges on the refusal to recognize members of a group—women, Jews, African Americans—as being fully human.@@@[[#21Therearecontradictionsin|21]]$$$
+''Second,'' by asserting that matter was ''“objective reality,” “given to man in his sensations,”'' and “''copied, photographed and reflected by our sensations,”'' Lenin not only confirmed the primary existence of matter and the secondary existence of consciousness [see ''The Relationship Between Matter and Consciousness, p. 88''] but he also affirmed that humans had the ability to be aware of objective reality through the “copying, photographing and reflection of our sensations” [in other words, sense perceptions].
-Anthropologists see not what moral judgment should be but how people in a particular time and place strive to be good people. We live (as one ethnographer has remarked) in a world of urgency and necessity, in what T. S. Eliot called “the endless struggle to think well of oneself.”@@@[[#22UnniWikanManagingTurbule|22]]$$$ Anthropologists describe, in a rich and complex way, how one should be with others in that society, what it really means to be a person ''here''. In fact, that was the primary achievement of one of the best-known attempts to understand morality in anthropology. The “Comparative Study of Values in Five Cultures” project was run out of Harvard from 1949 to 1955 and eventually published as ''The People of Rimrock'' in 1966. Evon Vogt and John Roberts organized a team of students from various social sciences and took them off to New Mexico, where they found within a single day’s drive a Navaho reservation, a Zuni pueblo, a Spanish-American village, a homesteader community of Texan and Oklahoman farmers, and a Mexican village. As a formal, scientific attempt to pin down the definition of “values” in any society, the project was an abysmal failure because no one could agree on the abstract terms. But the fieldworkers were easily able to describe what counted as moral behavior in each community.@@@[[#23ClydeKluckhohnthemajori|23]]$$$ They wrote about ideas to which people were emotionally attentive, that motivated them, and that rose from the way they had learned to be in relationship with one another in their community. That—the way we imagine people to be, how we imagine ourselves to be with them, how we come to feel deeply that something is right and good and true—is the cornerstone of human relationship, of the strenuous demand to be a certain kind of person in a certain setting.
+==== b. Mode and Forms of Existence of Matter ====
-And that involves empathy, because empathy is the name for the local process through which people carry their implicit expectations of one another as people with hopes and needs that are meaningful and worthy of respect in their community. I find “empathy” a useful way of thinking about these implicit expectations because few of us recognize how much our everyday emotional responses owe to the submerged icebergs of our cultural models, how much a particular local setting shapes what it is to be a self relating to other selves effectively and well.@@@[[#24Infactsomeanthropologist|24]]$$$ Our moral instincts rest on a complex foundation in which we have expectations about who we are with, the kind of person we would like to be when we are with them, and the right way to behave throughout. When someone does something we believe to be morally wrong, we are shocked; if we are not upset, we are likely to think of that person as being “merely” eccentric or unconventional—not immoral. When we act in a way that we feel is immoral, we feel terrible; if we do not feel bad, we are likely to say that what we are doing cannot really be wrong, because it “feels so right.” People in a community learn to relate to one another emotionally and to use their emotions to interpret, judge, and shape those relationships as good or bad.
+According to the dialectical materialist viewpoint, ''motion'' is the mode of existence of matter; ''space'' and ''time'' are the forms of existence of matter.
-And the way we conceive ourselves as and are conceived of as moral agents affects our agency—even when we struggle with schizophrenia. John Hood hates the medical model because it makes him feel like a nonperson. It is not that he thinks that its facts are inaccurate. At least, he does say that the model is wrong, but he stumbles over why it is wrong and he admits that there is something dysfunctional and organically different about his brain. He knows he needs his medication. But the way he thinks and talks cannot be separated from what it is to be schizophrenic. If schizophrenia is a brain disease, what we see as his humanity and his personhood—that he thinks, that he feels and wills and wants—is irrevocably corrupted. He must then see himself as someone whose disease should be cut away, discarded, removed; but it is also his essential “who-ness.”
+-----
-A psychiatric diagnosis of schizophrenia presents a major problem for someone like John Hood. He needs it because the diagnosis entitles him to benefits—health care, housing, a stipend—he would not otherwise receive. Yet to acknowledge the diagnosis as a medical condition is, he thinks, to say that his mind and self are biologically substandard. Dealing with this, the way he explains himself—as shaman, schizophrenic, wizard, master therapist, dependent, client—can become fearsomely complex. “I have a very complicated truth, which no one can figure out,” he says. “I work with it in a dynamic kind of way. The bottom line is that my system is so complicated that it has got me through a lot of binds.” He consistently resists thinking in diagnostic categories. I asked him once what diagnosis had been given to the founder of a client-run drop-in center. He frowned when I asked him. We were standing upstairs in a run-down stately house, its has-been elegance replaced by the mess of a communal lounge and kitchen. The founder’s photo hung upstairs in the art studio, next to bold, colorful paintings with odd perspective. “We don’t really talk about diagnosis here,” he said. “It’s not the way clients like to do things.”
+==== Annotation 60 ====
-John wants to be seen as a responsible person. He is not, he thinks, responsible for being ill. Thirty or forty years ago, the psychoanalytic model would have held him (and his mother) as being in some measure to blame. One of the great advances of psychiatric science has been to free people from the guilt of that horrendous burden. And John does admit to having an organic problem. But he resists thinking about his schizophrenia as a disease because his schizophrenia affects his mind and he wants to think of himself as responsible for his choices, his ideas, his writing, his political work. He wants to be a trustworthy member of society. He wants to be seen as someone who admittedly has limitations but who within these limitations is reliable, reputable, and upstanding. That is why he makes such a good counselor. He teaches clients that no matter what their limitations, they can be and must be citizens.
+<blockquote>
+Mode refers to the way or manner in which something occurs or exists. You can think of mode as pertaining to the “how,” as opposed to the “what.” For example, the ''mode'' of circulation refers to ''how'' commodities circulate within society [see Annotation 14, p. 16]; ''mode'' of production refers to ''how'' commodities are produced in society. So, mode of existence of matter refers to ''how'' matter exists in our universe.
-Like many clients, John casts his struggle in a heroic light.@@@[[#25Ilearnedtolookforthisq|25]]$$$ “It’s the most stigmatized group in the country,” he told me. “I can see guilt on my mother’s face even to this day when I pull a pill out of my pocket and eat it. That I have a sick mind and have to take pills—it’s enough to make you hate yourself.” Instead he creates a kind of nobility in the way he survives by affirming the value of the craziness. He calls this “validation.” “How do you feel about me being a wizard?” he once asked an overly self-confident mental health worker. The mental health worker said that of course he wasn’t. “So I said, ‘Listen buddy, I spent thirty-five years leaning how to be a wizard and I had fifteen hundred books and I knew what was in them and you have the gall to tell me I’m not a wizard?’ And then I said to him, ‘Okay, now I want you to tell me how you felt about my reaction.’ He said, ‘Well, you were out of proportion.’ So I said, ‘You have just failed to validate my system of emotional stability ''twice''. Don’t go into psychiatric nursing.’ ”
+Form comes from the category pair [see ''Basic Pairs of Categories of Materialist Dialectics'', p. 126] of Content and Form [see p. 147]. Form refers to how we perceive objects, phenomena, and ideas. So, form of existence of matter refers to the ways in which we perceive the existence of matter [explained below] in our universe.
+</blockquote>
-John wants to see himself as a special kind of person because he has managed this terrible affront. He is, he wrote in a speech, like a person in a wheelchair: “[I] have lived in sheer hell much of the past thirty years. Now, due to the skills I’ve learned and my personal growth, I am stable enough to be a mental health provider of services. I can honestly say that mental illness is no joke, requires realistic funding resources, and during the process of recovery, a compassionate community who accepts you.”@@@[[#26JohnHoodCommentaryp|26]]$$$ A belief that you are a responsible person and that you have (some) control over life and a compassionate community that accepts you: those are the key ingredients in John Hood’s recipe for recovery and the key elements of most client advocacy policy positions.
+''- Motion is the Mode of Existence of Matter''
-John Hood recognizes that his ability to teach psychiatric clients that they can become responsible members of society, to whatever extent they can, depends upon whether they are able to understand themselves as morally responsible human beings, and that in turn depends to some measure upon whether they are perceived as moral actors by our society. And that cannot be divorced from the way we choose to empathize with them, to understand their experiences, to imagine ourselves in their shoes, to feel compassion for their suffering.
+As Friedrich Engels explained: ''“Motion, in the most general sense, conceived as the mode of existence, the inherent attribute of matter, comprehends all changes and processes occurring in the universe, from mere change of place right up to thinking.”''
-There is no question that psychiatric science, and the new paradigm of biomedical psychiatry, has been an enormous advance in the battle against psychiatric illness. The treatments have improved dramatically. The loathsome stigma that attached itself to sufferers and their parents has abated greatly, though some remains. No more must “schizophrenigenic” mothers struggle not only with the horror of losing a child to madness but with blame, guilt, and self-accusation. No more must depression be treated with secrecy and hidden in an upstairs bedroom with yellow wallpaper, nor suicide disguised as a household accident. The ability to understand more of the brain’s processes has spawned tremendous growth in the exploration of new psychopharmacological treatments, such as the new antipsychotics, that have transformed the lives of many with schizophrenia.
+According to Engels, motion encompasses more than just positional changes. Motion embodies “all the changes and processes happening in this universe;” matter is always associated with motion, and matter can only express its existence through motion.
-The danger is that the biomedical approach will become the only approach to mental illness within psychiatry and the dominant popular understanding of psychiatric illness within our culture. This is a direct danger for patients, because (to repeat the mantra) research indicates that a combination of pharmacological and psychosocial (or psychotherapeutic) treatments is the best for the patient, and the research also suggests that the combination is cheaper in the long run.
+-----
-But there also is a moral danger that lies in the way we see patients and the way they see themselves. The popularized, vulgarized medical model invites us to see the mentally ill as not quite human, particularly if their problem is chronic and unremitting. It invites us into a moral instinct in which our very efforts to remove the stigma lead us to say that these ill people are not as human, not quite as alive, as we are. This is because psychiatric illness is not like liver dysfunction. It disrupts a person’s reasoning and feeling. And to say that someone’s reasoning and feeling are diseased, when the disease never goes away, is to say that she is not fully human. In the vulgarized biomedical model, the mentally ill have been struck by something that came in from the outside. It was not under control in the first place, and it remains no more under control than a doctor can control it.
+==== Annotation 61 ====
-The medical model offers tremendous hope to those for whom a cure is found but condemns those whom a cure does not redeem. On the facts, the medical model alone is wrong. An illness such as schizophrenia is, after all, a mysterious one. It is influenced by genes but not entirely genetic (if one identical twin ends up with schizophrenia, the chance that his twin will be or become schizophrenic is only 40 to 50 percent). It is also influenced by the environment. The prognosis for schizophrenia is much better in rural areas than in industrialized urban settings.@@@[[#27SeeKimHopperetaleds|27]]$$$ And its prognosis in any environment is variable. About a third of schizophrenias seem to remit spontaneously after thirty years. If we as a society understand schizophrenia—and depression and bipolar disorder and other life-threatening and incapacitating psychiatric problems—as ''only'' medical, we deprive people of hope when their medication does not fully work. We deprive them of their sense of mastery over themselves, of full personhood in our world, of their ability to see themselves as thinking and feeling, just differently from other people. They become lesser persons, lesser agents, lesser moral beings. We deprive them of the commitment we feet toward full-fledged human beings.
+In Dialectical Materialist philosophy, “motion” is also known as “change” and it refers to the changes which occur as a result of the mutual impacts which occur in or between subjects through the negation of contradictions. Motion is a constant attribute of all things, phenomena, and ideas (see Characteristics of Development, p. 124).
-This is not particularly a dilemma for psychiatrists. Psychiatrists who are exposed to both biomedical and psychodynamic approaches seem able to maintain a rich, complex understanding of these disorders. Most psychiatrists shift between their different tasks easily, as all of us shift among the morally appropriate ways to relate to students, clients, friends, children, parents, and partners. It is true that if a psychiatrist rejects one approach, she often does feel moral outrage toward it. George Banks, for instance, felt this kind of moral outrage at psychodynamic psychotherapy. There are biomedical psychiatrists, such as Banks, who simply cannot understand how in good conscience analysts can continue to accept an approach to human suffering that refuses to separate the disease from the person. These psychiatrists see psychodynamic psychiatry as a cruelty that blames the patients for their pain. Then there are psychodynamic psychiatrists who simply cannot understand what they perceive to be the biomedical psychiatrist’s cruelty to those in pain, who are shocked that a doctor might treat a depressed patient the way a surgeon might treat a cardiac patient. When you as a psychiatrist commit yourself to one side against another, you feel that someone using the other approach is doing something wrong, and because a suffering human being is at stake, you feel this deeply, passionately, morally. But most psychiatrists are not in this position. They feel the moral edge to the profession only when they are prevented from caring for people in the way they feel is right. This is why managed care is a moral crisis for doctors, particularly for those psychiatrists whose primary identity is psychotherapeutic.
+Because matter is inseparable from motion (and vice versa), Engels defined motion as the ''mode'' of matter — the way or manner in which matter exists. It is impossible for matter in our universe to exist in completely static and unchanging state, isolated from the rest of existence; thus matter exists in the ''mode'' of motion. Over time, motion leads to ''development'' as things, phenomena, and ideas transition through various stages of quality change [see Annotation 117, p. 119].
-The despair of psychiatrists who see the medical world changing around them is not—even though some think it is—just or even primarily a despair about money. Psychopharmacology pays better than psychotherapy, and hospital jobs, though rather more stressed than before, are still lucrative (and a psychiatrist who has been doing psychotherapy can always get a job as a psychopharmacologist). The despair comes from a sense of moral violation, from the horror that they cannot care for people in the way that good doctors—as they understand good doctors—do, that they have been forced to break their trust with their patients, that they can no longer respond empathically. They feel like bad people. They feel that they have been trained to see and understand a grotesque misery, yet all they are allowed to do is hand out a biomedical lollipop to its prisoners and then turn their backs. They feel as if they have been eating lunch on a park bench while the man across from them died, and they watched and did nothing.
+Matter exists objectively, therefore motion also exists objectively. The motion of matter is self-motion<ref>In the original Vietnamese, the word tự vận động is used here, which we roughly translate to the word ''self-motion'' throughout this book. Literally, tự vận động means: “it moves itself.”</ref>.
-The real dilemma is faced by our society. It is whether we will allow the seductions of the vulgarized biomedical model to overcome our own responsible commitment to a complex view of human life. As one reads the popularizations of the successes of psychiatric science, the wider culture seems to seek in biomedical psychiatry the possibility of temperamental perfection, a kind of technovision of the robotic soul. “Shy? Forgetful? Anxious? Fearful? Obsessed?” asked ''Newsweek'' in February 1994. “How Science Will Let You Change Your Personality with a Pill.” The cover article goes on to describe what is known, or thought to be known, about the neurochemistry of shyness, impulsivity, obsession, anxiety, and concentration and the medications used by various psychiatrists to regulate them. “For the first time ever,” the neuropsychiatrist Richard Restak is quoted as saying, “we will be in a position to design our own brain.”@@@[[#28SharonBegleyBeyondProza|28]]$$$ Some psychiatrists now speak of “cosmetic psychopharmacology” and argue that we should take seriously the possibility that in coming years we may be able to use medication to “cure” shyness, rejection sensitivity, and other temperamental states that cause people distress. The vision is way out of step with current capabilities, but the idea of the “designer” personality, the personality trimmed and shaped with a kind of psychopharmacological plastic surgery, has, I believe, powerful directive force. The psychiatrist Peter Kramer, who came up with the term “cosmetic psychopharmacology,” wrote in ''Listening to Prozac'' about patients who became “better than well,” more focused, less anxious, more confident, serene. Though many psychiatrists objected that those people were few in number, at least compared to the genuinely depressed, there is no doubt that Prozac appeals to the middle-class consumer in search of that ideal (this was not the point that Kramer was trying to make in his thoughtful inquiry). Also, it is hard to get psychiatric care without a diagnosis; diagnoses are treated with medication; it seems as if a new diagnosis becomes chic each year and thousands more people are placed on medication. An American pharmaceutical company executive recently speculated that in twenty years, a third of the world’s population will be on psychiatric medication.@@@[[#29HarpersIndexJuly1997p|29]]$$$
+-----
-Meanwhile, there has been fury at Freud. Prozac—or, at least, the existence of reasonably effective and easy-to-take medication that deals with problems once treated by psychoanalytic psychotherapy—allowed people to become furious at Freud because, for the first time, there was another plausible account of human unhappiness rich enough to be a genuine alternative. By the time Prozac emerged in 1987, it had become evident that not only the big-ticket items of psychosis and suicidal despair but even everyday blues could be handled by the medicine shelf, at least in part, and increasingly one could talk sensibly about unhappiness as a matter of neurotransmitters, not as denial or conflict or anger turned against the self. And there was a whole world of people and practices based upon the premise of unhappiness as a brain dysfunction treatable by drugs, a whole culture with its own sense of what a good, responsible doctor does with patients. There were famous researchers, funded generously by the government. There were clinics, hospital units, and clinicians who specialized in psychopharmacology and sometimes claimed that psychopharmacology was the only useful intervention in psychiatric illness. There was a model of the person that was strikingly different from Freud’s and a set of conventions based on that model that were as well developed as those in the psychodynamic arena. There were popular books that translated the research and the practice into the mainstream—''Mind, Mood and Medication'' in 1981, the wildly popular ''Listening to Prozac'' in 1993—and, by the early 1990s, a health care debate desperate for anything that looked cheaper than its predecessors. And so, for the first time, it became possible for someone to reject Freud’s vision of human nature without leaving himself vulnerable to the charge that a person who rejects psychoanalysis is simply too embarrassed and too weak to look at himself with honesty. It became possible to have believable moral outrage.
+==== Annotation 62 ====
-In 1995, a curious debate appeared in the leading journals of the intellectual world. The Library of Congress, which owns many of the unpublished Freud documents, had been planning to put up an exhibit in honor of Freud. The hundredth anniversary of the publication of ''The Interpretation of Dreams'' was approaching, and it seemed an appropriate time for a commemorative testimony to a man whose impact on the twentieth century had been far from negligible. The Library of Congress assembled an advisory board of psychoanalytic scholars and went to work. Six months later, the exhibit was postponed. Fifty critics had signed a petition denouncing the proposed exhibit—Gloria Steinem, one of the signatories, complained that the library had actually planned to honor the man rather than to present him as a troubled individual—and ad hominem attacks on the advisory board (the exhibit plans were “an obvious attempt to whitewash” and “a complete cave-in to the Freudian faithful”) were appearing regularly in the media. Peter Swales, one of the more vociferous critics, explained, “I’m acting in the name of consumer protection.”@@@[[#30Thesequotationsandfactsa|30]]$$$ (The exhibit has now been opened to a bemused public.)
+It is important to note that “matter,” in the philosophical sense as used in dialectical materialist phlosophy, includes all that is “objective” (external) to individual human cosnciousness. This includes objective phenomena which human senses are unable to detect, such as objective social relations, objective economic values, etc. Objectiveness is discussed more in Annotation 108, p. 112; objective social relations are discussed more in Annotation 10, p. 10.
-In the last few years, declarations of psychoanalytic inadequacies—“Freud bashing”—have been announced like major scientific findings. Freud, these writers proclaim, was a scientific charlatan, his methods corrupted, his personal integrity a sham, his entire enterprise a vehicle for a narcissistic imperialism that, since it could not depend on the truth, resorted to brazen fictionalizing. He is said to have been sexually unfaithful—with his sister-in-law, Minna Bernays—and to have doctored not his patients but his cases by suppressing the realization that his female patients had been abused by their fathers in order to retain their fathers’ patronage. “Is Freud Dead?” asked ''Time’s'' cover in Thanksgiving week of 1993. The ''New York Review of Books'' ran a series of hostile essays, whose authors continued to write to the letters-to-the-editor section for months, long, careful, joyless exchanges between psychoanalysts and antianalysts, each side launching missiles that sailed past its opponents, each side surprised and confused that the other would fail to grasp evident truth.
+In ''Dialectics of Nature'', Friedrich Engels discussed the properties of motion and explained that motion can neither be created nor destroyed. Therefore, motion can only change form or transfer from one object to another. In this sense, all objects are dynamically linked together through motion:
-“That psychoanalysis, as a mode of treatment, has been experiencing a long institutional decline is no longer in serious dispute,” began Frederick Crews in a ''New York Review'' article about recent Freud criticism entitled “The Unknown Freud.” “Nor is the reason,” he went on. “Though some patients claim to have acquired profound self-insight and even alterations of personality, in the aggregate psychoanalysis has proved to be an indifferently successful and vastly inefficient method of removing neurotic symptoms.… The experience of undergoing an intensive analysis may have genuine value as a form of extended meditation, but it seems to produce a good deal many more converts than cures.”@@@[[#31FrederickCrewsTheUnknow|31]]$$$ In the course of the essay, Crews referred to psychoanalysis as an “epistemic sieve,” as “fatally contaminated,” as derived from “misleading precedents, vacuous pseudophysical metaphors, and a long concatenation of mistaken inferences.”@@@[[#32Ibid|32]]$$$ “He questioned “whether anything is salvageable from a once respected body of theory whose evidential grounds have proved so flimsy.”@@@[[#33Ibidp65|33]]$$$ He denounced not only the validity of Freud’s claims but the quality of the man himself: “It is not recorded whether Freud ever expressed regret for having destroyed these four lives, but we know it would have been out of character for him to do so.”@@@[[#34Ibidp56|34]]$$$ “He was also quite lacking in the empirical and ethical scruples that we would hope to find in any responsible scientist, to say nothing of a major one.”@@@[[#35Ibid|35]]$$$
+<blockquote>
+The whole of nature accessible to us forms a system, an interconnected totality of bodies, and by bodies we understand here all material existence extending from stars to atoms... In the fact that these bodies are interconnected is already included that they react on one another, and it is precisely this mutual reaction that constitutes motion. It already becomes evident here that matter is unthinkable without motion. And if, in addition, matter confronts us as something given, equally uncreatable as indestructible, it follows that motion also is as uncreatable as indestructible. It became impossible to reject this conclusion as soon as it was recognised that the universe is a system, an interconnection of bodies.
+</blockquote>
-Jeffrey Moussaieff Masson, to take another example, is (or was) a dashing, colorful analyst whose rise and fall from power Janet Malcolm chronicled in ''The New Yorker''. He became disenchanted with psychoanalysis and in 1990 published ''Final Analysis'', an account of his seduction by and eventual rejection of the discipline. It is at times a petulant book but at one point the reader feels a sudden sympathy for the crestfallen young man looking out from the pages. “All of the analysts had their blind spots.… And yet all of them thought it legitimate to offer themselves up as models upon which their individual candidates [young analysts in training and in analysis with them] should pattern their lives.”@@@[[#36JeffreyMoussaieffMassonF|36]]$$$ You feel that Masson is saying: These are analysts. They presume to judge and guide and understand individual human lives, and therefore they should be better human beings than others. But they aren’t. Analysts, Masson argues, are dupes of their own theories, high-mindedly presenting a science of integrity that in fact is a parade of self-indulgent solipsism. They believe that they act in the best interests of their patients; in fact, they inevitably act out their own selfish fantasies. They are dull, ordinary people, and they are no better than the rest of us. “The only thing you can do with an illusion,” Masson explains at the end of a chapter, “is to shatter it.”@@@[[#37Ibidp86|37]]$$$
+In other words, every body of matter is in motion relative to other bodies of matter, and thus matter is inseparable from motion. Motion results from the interaction of bodies of matter. Because motion and matter define each other, and because motion can only exist in relation to matter and matter can only exist in relation to motion, the motion of matter can be described as “self-motion,” because the motion is not created externally but exists only within and in relation to matter itself. Engels further explains that if this were not true — if motion were external to matter — then motion itself would have had to have been created external to matter, which is impossible:
-The anger against Freud is not an anger against an outmoded intellectual theory. Some of the most vitriolic critics have trained or read deeply in psychoanalysis. Their anger is the dismay of betrayal and broken faith, of goodwill deceived and commitment abandoned. It has the same quality of visceral despair that one finds among the analysts who supervise young psychiatrists who no longer think that psychodynamic psychotherapy is important, and it has the same driven fury of the first generation of bio-medically minded psychiatrists who wondered to their supervisors whether panic disorder was a brain disorder, were told that they feared intimacy, and then devoted their professional lives to proving that their supervisors had been wrong. I believe that the anger is a cry of moral outrage that became possible only after Prozac and its cousins created an alternate way of conceiving of emotional pain and acting as a moral agent with respect to it.
+<blockquote>
+To say that matter during the whole unlimited time of its existence has only once, and for what is an infinitesimally short period in comparison to its eternity, found itself able to differentiate its motion and thereby to unfold the whole wealth of this motion, and that before and after this remains restricted for eternity to mere change of place — this is equivalent to maintaining that matter is mortal and motion transitory. The indestructibility of motion cannot be merely quantitative, it must also be conceived qualitatively; matter whose purely mechanical change of place includes indeed the possibility under favourable conditions of being transformed into heat, electricity, chemical action, or life, but which is not capable of producing these conditions from out of itself, such matter has forfeited motion; motion which has lost the capacity of being transformed into the various forms appropriate to it may indeed still have dynamis but no longer energeia, and so has become partially destroyed. Both, however, are unthinkable.
+</blockquote>
-Therein lies the danger. The discoveries of psychiatric science are so exciting, the promise to manage mental illness so practical, the appeal of erasing our gloominess so enticing that it is tempting for Americans to adopt the ideas and generalize them wholeheartedly to a commonplace understanding of what it is to be human despite the fact that the real science is far more nuanced and complex. Because this new psychiatric science offers so much, it is tempting to ditch all of Freud’s legacy because some of it has turned out to be wrong, misguided, or misused. That would be unfortunate. There is something of value in the approach to human suffering that emerged from Freud, for all the blindnesses and difficulties of the psychoanalytic enterprise and for all the power of the new psychiatric science. There is a sense of human complexity, of depth, an exigent demand to struggle against one’s own refusals, and a respect for the difficulty of human life. Psychoanalysis teaches humility in the face of human pain. Its central concept is the unconscious, and its burden is that less of life happens by chance than we think and more of life is hidden from our awareness than we imagine. Our life contains more meaning from a psychoanalytic vantage point; we understand it less. Psychoanalysis also teaches that to respect someone is to acknowledge how much he has struggled, how great his difficulties have been, and to see that his own fears and insecurities have been his greatest obstacle. The idea of the unconscious carries with it the implication that life is harder than we realize, because we act not only in accord with visible circumstances but against fears and angers we find so alarming that we refuse even to acknowledge them. And so psychoanalysis also admires the courage to look with unflinching curiosity at oneself, to attempt not to be a turtle with its head pulled in. “A battle may be fought over Freud,” the psychoanalyst and philosopher Jonathan Lear remarks, “but the war is over culture’s image of the human soul. Are we to see humans as having depth—as complex psychological organisms who generate layers of meaning which lie beneath the surface of their understanding? Or are we to take ourselves as transparent to ourselves?”@@@[[#38LearTheShrinkIsInp|38]]$$$
+So, motion can change forms and can transfer from one material body to another, but it can never be created externally from matter, and neither motion nor matter can be created or destroyed in our universe. Thus, matter exists in a state of “self-motion;” motion can never externally be created nor externally applied to matter.
-We desperately need to maintain (or, for the pessimists, to re-create) a culture of responsibility. As a well-known analyst, Hans Loewald, remarked about psychodynamic psychotherapy, “The movement from unconscious to conscious experience, from the instinctual life of the id to the reflective, purposeful life of the ego, means taking responsibility for one’s own history, the history that has been lived and the history in the making.”@@@[[#39HansLoewaldPsychoanalysis|39]]$$$ The psychodynamic approach teaches that a sense of responsibility must accompany the recognition of the limitations of circumstance. Circumstances are obviously important. It matters enormously that you suffer from schizophrenia or bipolar disorder, that you were born with a vulnerability and that the vulnerability has become an illness, that you were traumatized by events outside your control. This is the context of suffering. Yet within those circumstances you must learn to see yourself as an intentional, effective, whole person and be so perceived by others. Those mutual commitments create the conditions for intentional, effective personhood. It may be neither helpful nor accurate to say that a person or his family is responsible for the fact that he hears voices or feels suicidal. But to leap from that insight to the sense that he is not capable of responsible choice is to deny him status as a fully moral person, and limit his capacity to behave like one. This does not mean that psychoanalysis should be the treatment of choice for schizophrenia. Far from it. It does suggest that the insights of the psychodynamic way of thinking may help psychiatric patients in a way that purely biomedical insights cannot.
+To put it another way, motion results from the fact that all things, phenomena, and ideas exist as assemblages of relationships [see The Principle of General Relationships, p. 107], and these relationships contain opposing forces. As Lenin explained in his ''Philosophical Notebooks'':
-It has become so easy for our society to use the medical model to deny responsibility. In 1998, a jury awarded a schizophrenic man damages against his psychiatrist after the schizophrenic shot another person, on the grounds that the psychiatrist hadn’t told him how sick he really was.@@@[[#40Thiswasthecaseinvolving|40]]$$$ This is not only absurd but counterproductive. It is counterproductive in two ways. First, a patient is better off and has a better prognosis if he learns that despite his illness, he must learn to become responsible for his actions in the world. That is what John Hood tries to teach his clients as a peer counselor; it is what psychotherapeutic intervention tries to teach, that we are responsible for much that happens in our life and that to acknowledge that responsibility is to be able to take charge of our life and change it for the better. Second, as a society, we are better off if we work within our culture with an understanding of all people as complex, conflicted persons who inevitably suffer but who must learn to live with that suffering and nonetheless choose to live good and productive lives. From the psychodynamic perspective, the mastery of bad circumstances is inherent to what a person is. Pain is not really divided into the kind a doctor can remove and the kind you are forced to live with. To know that sorrow is inevitable not merely because markets fail, floods rise, and loved creatures die but because men and women entangle their hopes with nameless dreads profoundly enriches our respect for what people do manage to accomplish, despite the demons clawing at their dreams. Psychodynamics teaches a great deal about human sadness and also about mastery and faith in human possibility.
+<blockquote>
+The condition for the knowledge of all processes of the world in their ‘self-movement,’ in their spontaneous development, in their real life, is the knowledge of them as a unity of opposites. Development is the ‘struggle’ of opposites.
+</blockquote>
-“We are people, not diagnoses,” a recently deceased client called Howie the Harp announced in a book on client-run self-help groups.@@@[[#41HowietheHarpinZinman|41]]$$$ It is a common sentiment among those diagnosed with major mental illnesses. The book (and others like it) is full of statistics that the mentally ill feel powerless, stigmatized, out of control of their treatment and their lives. Clientrun groups focus on ways to help clients recognize their creativity and their human capacity, their understanding of themselves as more than psychiatric patients. As John Hood remarked, “Take the Brady Bill. I bet he’d like the dignity of being more than the guy who had his brain damaged. I think he’d like to be remembered for doing something more constructive. When it comes right down to it, NAMI or no NAMI, there’s no greater stigma than the client thinking his own brain’s diseased. If I smoke and I come down with lung cancer, no one in the city would be compassionate, because I asked for it. But putting it in a medical model is like an excuse for my behavior. When I talk to people, I have to say, ‘I am a person with schizophrenia,’ and I don’t like that. I’m not ‘with’ anything. I have severe functional limitations when it comes to certain aspects of living. I’m not ‘with’ anything, I’m me. On the unit what I do is to teach people how to do things. I do a public speaking group. Then I do a meeting skills group. It teaches people things. I teach people to take responsibility for their actions. That’s good.”
-Once when I went on rounds in a city hospital, I saw a woman who had been admitted to the psychiatric unit after seven hours of surgery to stitch back together the wrist she had intentionally sliced to the bone. Her wound was horrifying, but so was the cost in dollars and in physician hours. Looking at her from the point of view of the little group of physicians huddled at the door, it was clear how helpful it was to see her as having an illness she couldn’t control and that justified the surgery, because otherwise who were we to abort such a determined suicide? To see her despair as being only bodily, though, was not enough to help her. She was depressed, but she was also homeless and alcoholic and had grown up batted from one foster home to another. She had good reason to be angry and no reason to think that her circumstances would change. Giving her a sense of possibility required that she be taught responsibility and choice: to choose not to be alcoholic, not to be homeless. She also needed the resources to be able to make those choices in the confidence that there really were choices to make. She needed to know that if she gave up the drink, she would have someplace to go and something to do. And for someone with her history, that process can take time and error and compromise and flexibility. Our society needs to make a practical decision about how much care we owe someone like her. As one psychiatric administrator pointed out to me, you can handle schizophrenics by putting fifty of them in a room with beds, a few nurses, and lots of Thorazine. We also need, however, to make a moral decision, which is whether to understand such people only as the detritus of a broken brain or also as people whose suffering implicates us, whose struggles are resonant with our struggles, who are located in a particular culture, and whose complexity and depth demand that we see their suffering as engaged in the struggle to be decent, responsible people.
+-----
-We are so tempted to see ourselves as fixable, perfectible brains. But the loss of our souls is a high price to pay.
+Based on the scientific achievements which occurred in his lifetime, Engels classified motion into 5 basic forms: ''mechanical motion'' (changes in positions of objects in space); ''physical motion'' (movements of molecules, electrons, fundamental particles, thermal processes, electricity…); ''chemical motion'' (changes of organic and inorganic substances in combination and separation processes…); ''biological motion'' (changes of living objects, or genetic structure…); ''social motion'' (changes in economy, politics, culture, and social life).
-<div style="text-align:center;">{{anchor|TopofLuhr9780307791900epubb}} {{anchor|bm1}} [[Image:Image6.png|top]]$$$</div>
+These basic forms of motion are arranged into levels of advancement based on the level of complexity of matter that is affected.
-== TECHNICAL APPENDIX ==
+[[File:t-w-the-worldview-and-philosophical-methodology-of-8.png]]
-=== {{anchor|CONDITIONSOFTHERESEARCH}} CONDITIONS OF THE RESEARCH ===
+The basic forms of motion each affect different forms of matter, but these forms of motion do not exist independently from each other; they actually have strong relationships with each other, in which the more advanced forms of motion develop from lower forms of motion; the more advanced forms of motion also internally include lower forms of motion. [I.e., biological motion contains chemical motion; chemical motion contains physical motion; etc.]
-This work was funded as an anthropological project by the National Institute of Mental Health, the Spencer Foundation, the Wenner Gren Foundation, and the University of California, San Diego. The fieldwork period stretched from August 1989 until September 1994, with some additional weeks in 1995 and 1996, and further interviews and interactions, primarily with patients, in 1998 and 1999. Funding agencies covered different portions of the project—different time periods, locations, and specific goals.
+Every object exists with many forms of motion, but any given object is defined by its most advanced form of motion. [I.e., living creatures are defined in terms of biological motion, societies are defined in terms of social motion, etc.]
-The work received Institutional Review Board (Human Subjects) clearance both at the specific hospitals where I worked and, as a general project, from the university at which I teach. With the exception of one hospital, oral consent was permitted. Patients were always asked specifically for permission to have me observe if my presence as an observer was unusual (for example, in case conferences there are usually a number of observers, and the patient is asked whether he or she is comfortable with being observed by the group as a whole). In particular, I observed admissions or intake interviews but not therapy sessions or, in most cases, medication visits in which the patient had a long-standing relationship with the doctor. Patients often gave permission for me to sit in on initial interviews, the aim of which was to diagnose the condition, but they also frequently refused. When I served as a therapist, my patients were explicitly told that I was in training, that I was not licensed, and that I was an anthropologist. The goal of that training was to learn to act like a therapist and to provide appropriate therapy, and in that capacity, I served as a volunteer therapist at a clinic and my patients were people who would have been unable to afford therapy with someone else. Though I was in some sense trained to prescibe medication, in that I sat in on the training lectures, and while I have the expertise to understand much about psychopharmacology prescription, I never prescribed medication.
+By classifying the basic forms of motion, Engels laid out the foundation for classification and synthesization of science. The basic forms of motion differ from one another, but they are also unified with each other into one continuous system of motion. Understanding this dialectical relationship between different forms of motion helped to overcome misunderstandings and confusion about motion.
-I contacted John M. Hood III through a patient advocacy group, and Vernon (and others) through John Hood. They chose to speak with me, and we met often over the course of a year. They have read, edited, and approved the last chapter.
+-----
-=== {{anchor|CONFIDENTIALITY}} CONFIDENTIALITY ===
+==== Annotation 63 ====
-I have attempted to maintain the confidentiality of those who spoke with me, unless they agreed to be identified by name. To this end, some, but not all, of the individuals described are conflations of two or three individuals and are ascribed quotations spoken by those individuals.
+In ''Dialectics of Nature'', Engels clears up a great deal of confusion and addresses many misconceptions about matter, motion, forces, energy, etc. which existed in both science and philosophy at the time by defining and explaining the dialectical nature of matter and motion.
-I have also edited the taped conversations I had with individuals, in a way that preserves both sense and meaning but makes them easier to read. Readers read them as texts, not spoken dialogue, and the rules of those two media differ. It is not my intention to make individuals seem less fluent than they appear in person, and to quote verbatim without any editing would have done exactly that.
+When Dialectical Materialism affirmed that motion was the mode of existence — the natural attribute of matter — it also confirmed that motion is absolute and eternal. This does not mean that Dialectical Materialism denies that things can become ''frozen;'' however, according to the dialectical materialist viewpoint, ''freezing is a special form of motion, it is motion in equilibrium'' and ''freezing is relative and temporary.''
-=== {{anchor|CONTEXTOFDATACOLLECTION}} CONTEXT OF DATA COLLECTION ===
+''Motion in equilibrium'' is motion that has not changed the positions, forms, and/or structures of things.
-I was concerned to have representativeness both in the hospitals and in the programs I visited. I conducted research with several groups of residents. Most prominently, these were the residents at a public university on the West Coast and the residents at a private university on the East Coast in several different training programs. Both universities were distinguished by their teaching expertise in both the biomedical and psychodynamic domains, and both demanded, in accordance with standards established by the American Psychiatric Association, that residents be trained in both. The American Psychiatric Association, of course, has many more specific requirements, including training in neurology and the history of psychiatry. The West Coast university, however, clearly emphasized psychodynamic training as an outpatient practice. Its inpatient units included units for veterans and units attached to a busy city hospital. The East Coast university had a more diverse range of approaches. Some of its units were clearly biomedical and driven by a biomedical research paradigm; some were clearly psychodynamic, though those were changing rapidly; some were aiming to be integrative. Moreover, while some units catered to the inner city, others catered to the elite, although those too were changing rapidly. The university offered several different training programs for psychiatry.
+Freezing is a ''relative'' phenomenon because freezing only occurs in some forms of motion and in some specific relations, it does not occur in all forms of motion and all kinds of relations. Freezing is a temporary phenomenon because freezing only exists for a limited period of time, it cannot last forever.
-In addition, to put that experience in context, I visited an elite eastern psychoanalytically oriented treatment center for two weeks; I spent a week with the patients in the day treatment center attached to an eastern state hospital, where the patients were poor and chronically ill; I spent a week in the inpatient unit of a western community hospital where the patients were again poor and chronically ill; I spent more than a week’s worth of days talking to elite scientists in the research section of a major hospital; I spent a few days at a large private hospital in the Midwest not attached to a university, and a few days at a large public university hospital in the South. In addition, I interviewed and spoke informally with training directors and residents from other systems, some of which were old and established and others of which were not.
+-----
-=== {{anchor|PLANOFTHERESEARCH}} PLAN OF THE RESEARCH ===
+==== Annotation 64 ====
-My initial research premise was that some feature in the experience of residency training, in addition to individual residents’ preferences, was powerfully implicated in residents’ orientations toward biomedical and psychodynamic psychiatry. However, in the course of my work, psychiatry began to change dramatically at the sites I visited. For example, Medicaid and Medicare came under managed care between the period of my first intensive visit to the East Coast and my second, and the impact on the tasks demanded of the residents was significant. During this period, it became clear that the apparently bleak future of psychodynamic psychiatry had profoundly affected residents’ perspectives on their future practice. As a result, I refocused the work to try to understand what different perspectives demanded of the residents and what kinds of skills they had developed in order to achieve those tasks. In particular, I focused on the tasks of diagnosis and psychopharmacology, on the one hand, and psychotherapy, on the other.
+Equilibrium can exist at any advancement of motion. Lenin discussed ''equilibrium'' as it pertains to the social form of motion in discussing an equilibrium of forces existing in Russia in 1905 in this article, ''An Equilibrium of Forces:''
-=== {{anchor|SOURCESOFDATACOLLECTION}} SOURCES OF DATA COLLECTION ===
+<blockquote>
+) The result to date (Monday, October 30) is an equilibrium of forces, as we already pointed out in Proletary, No. 23.
-''Participant observation:'' I spent more than three years as a participant observer (initially, just as a student) in the western training program. Most of that period involved part-time participation—ten to twenty hours a week throughout the period—but around four months of it involved full-time immersion. I attempted to acquaint myself with the basic structure of each major unit: the admissions interview or intake interview; the team meeting; the emergency room; call; the daily life of the resident. During my periods of full-time observation, I attempted to spend two days a week at the outpatient clinic, two days a week at a unit for veterans, and one day a week at a city hospital unit. On those days I would attend lectures, staff meetings, case conferences, team meetings, and community meetings; I attempted to get to know residents, other staff, and patients.
+) Tsarism is no longer strong enough, the revolution not yet strong enough, to win.
-In one eastern training program, where I spent about ten to twelve weeks, I spent most of my time in one of the units. However, I also spent about two weeks in the child psychiatry unit and regularly visited the psychiatry emergency room. In another, where I spent more than four months, I had a regular schedule that involved going to lectures, watching admissions, and spending time on a biomedical unit, but I also attempted to sit in on rounds in a number of different units, and I attempted to meet with and follow all of the residents around at different times. In each setting I took extensive daily notes.
+) Hence the tremendous amount of vacillation. The terrific and enormous increase of revolutionary happenings (strikes, meetings, barricades, committees of public safety, complete paralysis of the government, etc.), on the other hand, the absence of resolute repressive measures. The troops are wavering.
-''Semistructured taped interviews:'' I systematically conducted semistructured interviews with two “years” of residents annually at the western program for three years. The interviews followed the flow of the conversation but were focused on what was being learned and how the resident felt about the learning process. At the eastern programs, where the duration of my stay was shorter, I conducted interviews with one class in their first months after arrival as PGYIIs (first-year residents) and then one year following. Again, I focused on the process of learning: how comfortable residents felt with diagnosis, with using ''DSM'', with the different axes in ''DSM'', with psychotherapy, and so forth. I asked residents to describe how they arrived at a diagnosis or an assessment of the patient and how they arrived at a plan for treatment.
+) The Tsar’s Court is wavering (The Times and the Daily Telegraph) between dictatorship and a constitution.
-At the eastern programs, I also selected certain residents to interview in depth on various topics. Again, I attempted to talk to a range of residents: the more research-oriented, the more clinical but psychopharmacological, the more psychotherapeutic, and so forth. My goal here was to find “stars” and ask them to explain to me what they felt they knew and how they knew it.
+The Court is wavering and biding its time. Strictly speaking, these are its correct tactics: the equilibrium of forces compels it to bide its time, for power is in its hands.
-In addition, I selected senior psychiatrists for short- or long-term taped interviews. Again, my goal was to find acknowledged expert teachers and to try to have them explain to me what they felt they taught residents, how they taught it, and whether they felt they were successful. Closer to the end of my project, I also interviewed a number of senior adminstrators about the challenges facing psychiatry. I interviewed senior psychiatrists at every program I visited, although not all of them agreed to be tape-recorded, and in some cases, where tape recording would have been inappropriate, I chose not to do so.
+The revolution has reached a stage at which it is disadvantageous for the counter-revolution to attack, to assume the offensive.
-I have approximately two hundred hours of taped semistructured interview material, most of which was transcribed and reviewed. It served as the source for most of the quotations from residents and from senior psychiatrists.
+For us, for the proletariat, for consistent revolutionary democrats, this is not enough. If we do not rise to a higher level, if we do not manage to launch an independent offensive, if we do not smash the forces of Tsarism, do not destroy its actual power, then the revolution will stop half way, then the bourgeoisie will fool the workers.
-''Educational participation:'' I attended lectures to different residency classes in different locations. At the western training program, I attended all the lectures for PGYII (first-year) residents, about a fifth of those for the PGYIIIs (second-years), and half of those for the PGYIVs (third-years). At one eastern training program, I attended lectures to PGYIIs for two months: this was their summer “crash course.” I attended lectures to their class in the summer of the second year. In addition, I read the material assigned in these classes and other material that I knew they studied and used (the standard psychiatric handbooks) but that were not specifically assigned.
+) Rumour has it that a constitution has been decided upon. If that is so, then it follows that the Tsar is heeding the lessons of 1848 and other revolutions: he wants to grant a constitution without a constituent assembly, before a constituent assembly, apart from a constituent assembly. What kind of constitution? At best (for ’the Tsar) a Constitutional-Democratic constitution.
-I also attended many (around fifteen) psychiatric conferences: the American Psychiatric Association meetings (at least three times), the Society for Biological Psychiatry meetings, the American Psychoanalytic Association meetings, and others.
+This implies: achievement of the Constitutional-Democrats’ ideal, skipping the revolution; deceiving the people, for all the same there will be no complete and actual freedom of elections.
-Finally, but not least, to the extent that I could participate in the training, I did so. I participated in seminars and asked and answered questions. I was trained to some extent as a therapist. In order to begin the therapy, I was required to conduct an “intake” interview that closely resembled an admissions note and in that context learned to write a diagnostically driven admissions note. I conducted psychodynamic psychotherapy as a volunteer with eight patients, three of them twice a week for more than a year and a fourth once a week for somewhat less than a year. I was supervised by four trained supervisors for this work. I was also in twice-weekly psychodynamic psychotherapy with a senior analyst for about three years. I did this following the advice that to understand therapy, one must do therapy and be in therapy.
+Should not the revolution skip this granted constitution?
-''Drawing on the relevant literature in psychiatric and psychological anthropology:'' I read widely in the literature associated with fieldwork in this area and used that material to formulate questions, hypotheses, and research goals. Because not all readers of this ethnography will be anthropologists, that literature is largely cited in the notes, and even there I am unable to do justice to the depth and thoughtfulness of the literature. There is a rich literature in the culture and sociology of hospitals, psychiatric and otherwise; of medical and psychiatric training; of psychiatric patients; of diagnostic practice; of morality, the self, and expertise.
+-----
-<div style="text-align:center;">{{anchor|TopofLuhr9780307791900epubn}} {{anchor|nts}} [[Image:Image7.png|top]]$$$</div>
+''- Space and Time are Forms of Existence of Matter''
+</blockquote>
-== NOTES ==
+Every form of matter exists in a specific position, with specific space particularity (height, width, length, etc.), in specific relation (in front or behind, above or under, to the left or right, etc.) with other forms of matter. These positional relations exist in what we call ''space.'' [Space is defined by positional relations of matter.]
-=== {{anchor|INTRODUCTION}} INTRODUCTION ===
+On the other hand, the existence of matter is also expressed in the speed of change and the order in which changes occur. These changes occur in what we call ''time.'' As Engels wrote: “For the basic forms of all existence are space and time, and a being outside of time is as absurd as an existence outside space.” Matter, space, and time are not separable; there is no matter that exists outside of space and time; there is also no space and time that exist outside of matter’s motion.
-Note: Short forms of references are given here; for full references, please see the Bibliography.
+-----
-<div style="margin-left:0.423cm;">@@@[[#itrnts001a|1.]]$$$ Michel Foucault, ''Madness and Civilization'', pp. 278, 247.</div>
+==== Annotation 65 ====
-<div style="margin-left:0.423cm;">@@@[[#itrnts002a|2.]]$$$ George Devereux, ''Basic Problems in Ethnopsychiatry'', p. 15.</div>
+Space and time, as the forms of matter, i.e.: the ways in which we perceive the existence of matter. We are only able to perceive and understand material objects as they exist within space and time.
-<div style="margin-left:0.423cm;">@@@[[#itrnts003a|3.]]$$$ Peter Shaffer, ''Equus and Shrivings'', pp. 63–64.</div>
+Space and time, as forms of existence of matter, exist objectively [see Annotation 108,
-<div style="margin-left:0.423cm;">@@@[[#itrnts004a|4.]]$$$ R. D. Laing, ''The Divided Self''.</div>
+p. 112], and are defined by matter. [Space is defined by the positional relations between material objects; time is defined by the speed of change of material objects and the order in which these changes occur.] Space has three dimensions: height, width, length; time has one direction: from the past to the future.
-<div style="margin-left:0.423cm;">@@@[[#itrnts005a|5.]]$$$ Susan Cheever, “A Designated Crazy.” Review of ''Girl, Interrupted'', p. 20.</div>
+==== c. The Material Unity of the World ====
-<div style="margin-left:0.423cm;">@@@[[#itrnts006a|6.]]$$$ Susanna Kaysen, ''Girl, Interrupted'', p. 41.</div>
+Dialectical Materialism affirms that the nature of the world is matter, and the world is unified in its material properties. [In other words: the entire universe, in all its diversity, is made of matter, and the properties of matter are the same throughout the known universe.]
-<div style="margin-left:0.423cm;">@@@[[#itrnts007a|7.]]$$$ Ibid., p. 75.</div>
+The material nature of the world is proven on the following basis:
-<div style="margin-left:0.423cm;">@@@[[#itrnts008a|8.]]$$$ Irving Gottesman, ''Schizophrenia Genesis: The Origins of Madness''.</div>
+''First,'' there is only one world: the material world; the material world is the first existence [i.e., it existed before consciousness], it exists objectively, and independently, of human consciousness.
-<div style="margin-left:0.423cm;">@@@[[#itrnts009a|9.]]$$$ William Styron, ''Darkness Visible'', pp. 43–50.</div>
+''Second,'' the material world exists eternally, endlessly, infinitely; it has no known beginning point and there is no evidence that it will ever disappear.
-<div style="margin-left:0.423cm;">@@@[[#itrnts010a|10.]]$$$ Harold Kaplan and Benjamin Sadock, ''Pocket Handbook of Clinical Psychiatry'', p. 97; Stephen Stahl, ''Essential Psychopharmacology'', pp. 99ff.</div>
+''Third,'' all known objects and phenomena of the material world have objective relations with each other and all objects and phenomena exist in unity with each other. All of them are specific forms and structures of matter, or have material origin which was born from matter, and all are governed by the objective rules of the material world. In the material world, there is nothing that exists outside of the changing and transforming processes of matter; all of these processes exist as causes and effects of each other.
-<div style="margin-left:0.423cm;">@@@[[#itrnts011a|11.]]$$$ The lifetime prevalence is reported at 10 percent of all men and 20 percent of all women; see Kaplan and Sadock, ''Pocket Handbook of Clinical Psychiatry'', p. 102.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#itrnts012a|12.]]$$$ This is obviously a limited description; a fuller account of current thinking can be found in psychiatric manuals, such as Kaplan and Sadock, ''Pocket Handbook of Clinical Psychiatry; Diagnostic and Statistical Manual of Mental Disorders IV;'' and later in this book. Schizophrenics are often unable to screen out irrelevant noise, their eyes often track objects in an unusual manner, and their brain ventricles become larger than the average for their skulls; see Philip Holzman et al., “A Single Dominant Gene Can Account for Eye Tracking Dysfunctions and Schizophrenia in Offspring of Discordant Twins”; David Braff, Dennis Saccuzzo, and Mark Geyer, “Information Processing Dysfunction in Schizophrenia: Studies of Visual Backward Masking, Sensorimotor Gating, and Habituation”; Nancy Andreasen et al., “Thalamic Abnormalities in Schizophrenia Visualized Through Magnetic Resonance Imaging.”</div>
+==== Annotation 66 ====
-<div style="margin-left:0.423cm;">@@@[[#itrnts013a|13.]]$$$ Kaplan and Sadock, ''Pocket Handbook of Clinical Psychiatry'', p. 83.</div>
+The most important thing to understand here is that every object and phenomenon in the universe arises as matter, all material objects and phenomena are dynamically linked to one another in an infinite chain of causes and effects and changes and transformations, all governed by the material laws of our reality. This understanding is the material foundation of dialectical materialism.
-<div style="margin-left:0.423cm;">@@@[[#itrnts014a|14.]]$$$ Susan Sheehan, ''Is There No Place on Earth for Me?'' p. 3.</div>
+=== 2. Consciousness ===
-<div style="margin-left:0.423cm;">@@@[[#itrnts015a|15.]]$$$ Kay Redfield Jamison, ''An Unquiet Mind'', 1995, pp. 36–38; Kate Millett also wrote a gripping memoir, ''The Loony-Bin Trip''.</div>
+==== a. The Source of Consciousness ====
-<div style="margin-left:0.423cm;">@@@[[#itrnts016a|16.]]$$$ Jamison, ''An Unquiet Mind'', p. 107.</div>
+According to the materialist viewpoint, consciousness has natural and social sources.
-<div style="margin-left:0.423cm;">@@@[[#itrnts017a|17.]]$$$ Ibid., p. 114.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#itrnts018a|18.]]$$$ Arthur Kleinman, ''Rethinking Psychiatry'', p. 16. Kleinman also summarizes the literature to date in the same book, pp. 18ff.</div>
+==== Annotation 67 ====
-<div style="margin-left:0.423cm;">@@@[[#itrnts019a|19.]]$$$ See Kay Redfield Jamison’s study of the relationship between creativity and bipolar disorder, particularly in poets, ''Touched with Fire''. This connection is controversial: Hagop Akiskal’s somewhat different analysis is reported in Winifred Gallagher, ''I.D''.</div>
+Consciousness arises from ''nature'', and from ''social'' activities and relations.
-<div style="margin-left:0.423cm;">@@@[[#itrnts020a|20.]]$$$ Sue Estroff, ''Making It Crazy'', p. 255.</div>
+''Natural'' refers to the material world. Without the material world of matter, material processes, and the evolution of material systems — up to and including the human brain — consciousness would never have formed.
-<div style="margin-left:0.423cm;">@@@[[#itrnts021a|21.]]$$$ Erving Goffman, ''Asylums'', p. 35. There is also good evidence that the prognosis of schizophrenia is worse in industrial societies than in tribal villages. Some argue that this difference may be an artifact of diagnostic process rather than disease, but it seems fairly evident that social structure makes a difference to the prognosis of illness. See also Kleinman, ''Rethinking Psychiatry;'' Richard Warner, ''Recovery from Schizophrenia: Psychiatry and Political Economy;'' Kim Hopper et al., ''Prospects for Recovery from Schizophrenia—An International Investigation: Report from the WHO—Collaborative Project, The International Study of Schizophrenia''.</div>
+''Social'' activities and relations also contributed to the development of consciousness. The social processes of labor and language were also prerequisites for the development of conscious activity in human beings.
-<div style="margin-left:0.423cm;">@@@[[#itrnts022a|22.]]$$$ Allan Young, ''The Harmony of Illusions''. Other notable psychiatric anthropologists include Arthur Kleinman, Nancy Scheper-Hughes, Lorna Rhodes, Richard Warner, Kim Hopper, and others.</div>
+''- Natural Source of Consciousness''
-<div style="margin-left:0.423cm;">@@@[[#itrnts023a|23.]]$$$ See Joan Acocella, “The Politics of Hysteria.”</div>
+There are many factors that form the natural sources for consciousness, but the two most basic factors are ''human brains'' and ''the relationship between humans and'' ''the objective world which makes possible creative and dynamic reflection.''
-<div style="margin-left:0.423cm;">@@@[[#itrnts024a|24.]]$$$ Robert Desjarlais et al., ''World Mental Health''.</div>
+''About human brains:'' consciousness is an attribute of a highly organized form of matter, which is the brain. Consciousness is the function and the result of the neurophysiological activities of human brains. As human brains evolved and developed over time, their neurophysiological activities became richer, and, as these activities progressed, consciousness developed further and further over time. This explains why the human evolution process is also a process of developing the capacity for perception and thinking. Whenever human neurophysiological activities don’t function normally because of damaged brains, our mental life is also disturbed.
-<div style="margin-left:0.423cm;">@@@[[#itrnts025a|25.]]$$$ Robert Wright, “The Evolution of Despair.”</div>
+''About the relationship between humans'' and ''the objective world which made possible creative and dynamic reflection:'' The relationship between humans and the objective world has been essential for as long as humans have existed. In this relationship, the objective world is reflected through human senses which interact with human brains and then form our consciousness.
-<div style="margin-left:0.423cm;">@@@[[#itrnts026a|26.]]$$$ Kaplan and Sadock, ''Pocket Handbook of Clinical Psychiatry'', p. 207.</div>
+[[File:t-w-the-worldview-and-philosophical-methodology-of-9.png|''Consciousness exists as a dynamic set of relationships between the external material world, human sense perception, and the functions of the human brain.'']]
-<div style="margin-left:0.423cm;">@@@[[#itrnts027a|27.]]$$$ This distinction is made in many places, but it is paraphrased here from Arthur Kleinman, Leon Eisenberg, and Byron Good, “Culture, Illness and Care: Lessons from Anthropologic and Cross-Cultural Research.”</div>
+''Reflection'' is the re-creation of the features of one form of matter in a different form of matter which occurs when they mutually impact each other through interaction. Reflection is a characteristic of all forms of matter.
-<div style="margin-left:0.423cm;">@@@[[#itrnts028a|28.]]$$$ Ibid., p. 252.</div>
+There are many forms and levels of reflection such as [from more simple to more complex]: physical and chemical reflection, biological reflection, mental reflection, creative and dynamic reflection, etc.
-<div style="margin-left:0.423cm;">@@@[[#itrnts029a|29.]]$$$ These data are reported and discussed in Margaret Lock, ''Encounters with Aging: Mythologies of Menopause in Japan and North America''.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#itrnts030a|30.]]$$$ George Engel, “The Clinical Application of the Biopsychosocial Model.”</div>
+==== Annotation 68 ====
-<div style="margin-left:0.423cm;">@@@[[#itrnts031a|31.]]$$$ Hugh Gusterson, ''Nuclear Rites''. For other examples, see Sharon Trawick, ''Beamtimes and Lifetimes: The World of High Energy Physics;'' and Paul Rabinow, ''Making PCR:'' A ''Story of Biotechnology''.</div>
+Change is driven by mutual impacts between or within things, phenomena, and/or ideas. Any time two such subjects impact one another, ''traces'' of some form or another are left on both interacting subjects. This characteristic of change is called ''reflection''.
-<div style="margin-left:0.423cm;">@@@[[#itrnts032a|32.]]$$$ Serious discussions of empathy can be found in Elaine Hatfield, John Cacioppo, and Richard Rapson, ''Emotional Contagion;'' Nancy Eisenberg and Janet Strayer, ''Empathy and Its Development;'' Virginia Demos, “Empathy and Affect: Reflections on Infant Experience”; and Kenneth Clark, “Empathy: A Neglected Topic in Psychological Research.” Joseph Campos et al., “A Functionalist Perspective on the Nature of Emotion,” and Joseph Campos, “A Reconceptualization of the Nature of Affect,” provide a model of emotion that helps refocus on the idealistic model of affect contagion. Most of this work focuses on the use of empathy to understand distress; certainly, colloquially, people who are described as “empathic” are usually seen as people who understand other people’s pain. For this reason, perhaps, one eminent emotion researcher, Richard Lazarus, in ''Emotion and Adaptation'', argues for the use of the word “compassion” in place of “empathy,” as implicitly so does James Q. Wilson in ''The Moral Sense'', where he discusses sympathy in his analysis of what he calls the moral sense. Academic psychologists seem more often to argue that empathy is a process, ''not'' an emotion, but the process they describe is certainly close to what is meant by compassion and sympathy. As two emotion researchers remark, empathy is “an emotional response that stems from another’s emotional state or condition and that is congruent with the other’s emotional state or situation” (see Eisenberg and Strayer, ''Empathy and Its'' ''Development'', p. 5). My sense is that those who emphasize compassion or sympathy point to behavior that depends on the recognition of the other’s experience; those who emphasize empathy focus on the process of recognizing the other’s experience. Researchers identify as among the cognitive features involved: the capacity to differentiate between self and other; a direct association between cues of another’s emotional state and the potential empathizer’s past experiences of a similar emotion; symbolic associations between cues that symbolically indicate another’s feelings and the empathizer’s own past distresses; and the ability to role-take if the empathizer has no relevant past experience.</div>
+The concept of reflection, first proposed by Marx, Engels, and Lenin, has been advanced through the work of various Soviet psychologists, philosophers, and scientists (including Ivan Pavlov, Todor Pavlov, Aleksei Leontiev, Lev Vygotsky, Valentin Voloshinov, and others), and is used as a basis for scientific inquiry up to this day by mainstream researchers in Cuba, Vietnam, China, and Laos. The information provided below is somewhat simplified and generalized to give the reader a basic familiarity with the theory of reflection and the development of reflection in nature.
+Dialectical materialist scientists have developed a theory of the development of evolution of forms of reflection, positing that forms of reflection have become increasingly complex as organic processes and life have evolved and grown more complex over time.
-=== {{anchor|CHAPTERONEWHATSWRONGWITHT}} CHAPTER ONE: WHAT’S WRONG WITH THE PATIENT? ===
+The chart below gives an idea of how different forms of reaction have evolved over time:
-<div style="margin-left:0.423cm;">@@@[[#c01nts001a|1.]]$$$ This is adapted with more user-friendly (but less precise) language from American Psychiatric Association, ''Diagnostic and Statistical Manual of Mental Disorders IV [DSM IV]'', p. 423.</div>
+[[File:t-w-the-worldview-and-philosophical-methodology-of-10.png|''This chart outlines the basic development tendency of Forms of Reflection in matter which lead from inorganic matter, to life, to human consciousness and society.'']]
-<div style="margin-left:0.423cm;">@@@[[#c01nts002a|2.]]$$$ Nancy Andreasen and Donald Black, ''Introductory Textbook of Psychiatry'', pp. 324–325.</div>
+Obviously, not all subjects develop completely along the path outlined above. Thus far, to our knowledge, only human beings have developed entirely to the level of consciousness and society. It is also unknown whether, or how, human society may develop into some future, as-yet-unknown, form.
-<div style="margin-left:0.423cm;">@@@[[#c01nts003a|3.]]$$$ American Psychiatric Association, ''DSM IV'', p. 327. Again, this is a less precise wording than that found in the ''DSM IV'', but it is more user-friendly.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c01nts004a|4.]]$$$ Eleanor Rosch (e.g., 1973, 1978) did the classic work in this area by demonstrating that commonly used categories had a definable structure: that they are built around a central member that has many features of other members of the category and is judged representative of it (this is the prototype) and that there is a level in the descriptive hierarchy of categories (man-made objects, furniture, chairs, rocking chairs) at which people learn the categories most easily, remember their names, and so forth. This level she called “basic level” categories: dogs, birds, tables, and chairs are examples of basic level categories but animals and secretary desks are not. The point is that categories are “motivated”: they reflect, as Howard Gardner points out in ''Frames of Mind'', “the perceptual structure of the perceived, the kinds of actions one can carry out, the physical structure of the world” (p. 346). This work has been considerably refined—Lakoff’s account of idealized cognitive models, in which some kind of implicit theory is inherent in category use, is one example—but the claim that people cluster or chunk information together and then interpret later experience according to prior patterns of clustering seems undeniable. Some helpful literature on the topic includes Howard Gardner, ''Frames of Mind;'' George Lakoff, ''Women, Fire and Dangerous Things;'' Ulric Neisser, ''Concepts and Conceptual Development;'' Roy D’Andrade, ''The Development of Cognitive Anthropology''.</div>
+''Physical and chemical reflection'' is the simplest form of reflection, dealing with the ways in which inorganic matter is reflected in human consciousness. Physical and chemical reflection is the reflection of mechanical, physical, and chemical changes and reactions of inorganic matter (i.e., changes in structures, positions, physical-chemical properties, and the processes of combining and dissolving substances). Physical and chemical reactions are passive: when two objects interact with each other physically or chemically, they do not do so consciously.
-<div style="margin-left:0.423cm;">@@@[[#c01nts005a|5.]]$$$ A classic example of a somewhat more general effect is that when we have a cognitive model relating two features it affects our judgment on the probability of both occurring. For example, Amos Tversky and Daniel Kahneman asked a group of subjects (prior to 1983) to rate the probability of the following two sentences:</div># A massive flood in California in 1983 causes more than a thousand people to drown.
+-----
-# An earthquake in California in 1983 causes a flood in which more than one thousand people die.
+==== Annotation 69 ====
+Reflection occurs any time two material objects interact and the features of the object are transferred to each other. Below are some very simplified illustrations to relate the basic idea of the physical reflection of material objects.
-The second sentence is usually judged more probable than the first, even though—since it requires two events and the first only one—it is less probable. However, people have models of California as a place where earthquakes happen and cause terrible damage (Lakoff, ''Women, Fire and Dangerous Things'', p. 90). When psychiatrists have cognitive models for different illnesses, they are more likely to anticipate symptoms that are congruent with the model.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-11.png]]
-<div style="margin-left:0.423cm;">@@@[[#c01nts006a|6.]]$$$ This was Charles Nuckolls from the University of Alabama, who has done extensive work with psychiatric residents and with psychiatry.</div>
+'''Reflection as Change in Position:'''
-<div style="margin-left:0.423cm;">@@@[[#c01nts007a|7.]]$$$ The philosophers perhaps most responsible for this discussion are Saul Kripke ''(Naming and Necessity)'' and Hilary Putnam ''(Reason, Truth and History)''. The psychologist Frank Keil uses experimental data to point out that while people judge that the experimenter can change the defining characteristic of an artifact and thus change the artifact, they resist the idea that the experimenter can change the defining features of a natural object and thus change it: “If one takes a chair and carefully gives it leg extensions and saws off the back, most adults say that you have now turned it into a stool. By contrast, if one takes a raccoon, dyes its fur appropriately, fluffs its tail, sews a smelly sack inside, and even trains it to secrete its contents when alarmed, most adults will say that you still have a raccoon, albeit a strange one that looks and acts just like a skunk” (Keil, in Neisser, ''Concepts and Conceptual Development'', p. 187). Keil argues that the distinction between cultural artifact and natural kind emerges very early, that it is present even in preschoolers, and that accounts of an object’s origin are crucial to the distinction.</div>
+. Round Object moves towards Square Object.
-<div style="margin-left:0.423cm;">@@@[[#c01nts008a|8.]]$$$ There are many diagnoses that can be codiagnosed: they are then called “comorbid.” However, the “big three”—schizophrenia, manic-depressive disorder or bipolar disorder, and major depression—tend to be treated as mutually exclusive.</div>
+. Round Object impacts Square Object.
-<div style="margin-left:0.423cm;">@@@[[#c01nts009a|9.]]$$$ The example was provided by the psychologist Ellen Winner, who did not have Lyme disease.</div>
+. Square Object changes position; Round Object “bounces” and reverses direction.
-<div style="margin-left:0.423cm;">@@@[[#c01nts010a|10.]]$$$ This paragraph has been paraphrased from Andreasen and Black, ''Introductory Textbook of Psychiatry'', pp. 154–160.</div>
+.Thus, Square Object’s change in position ''reflects'' the motion of Round Object (and vice-versa). Traces of both contradicting objects are reflected in the respective motion and position of each object.
-<div style="margin-left:0.423cm;">@@@[[#c01nts011a|11.]]$$$ Stephen Stahl, ''Essential Psychopharmacology'', p. 119.</div>
+[[File:t-w-the-worldview-and-philosophical-methodology-of-12.png]]
-<div style="margin-left:0.423cm;">@@@[[#c01nts012a|12.]]$$$ These figures were reported in the ''New England Journal of Medicine'' by two of the leaders in the field; see R. Michels and P. M. Marzuk, “Progress in Psychiatry.”</div>
+'''Reflection as Change in Structure:'''
-<div style="margin-left:0.423cm;">@@@[[#c01nts013a|13.]]$$$ There was a great deal of discussion about the unconscious by those preceding Freud. The classic discussion of this history can be found in Henri Ellenberger, ''The Discovery of the Unconscious''.</div>
+. Round Object moves toward Square Object.
-<div style="margin-left:0.423cm;">@@@[[#c01nts014a|14.]]$$$ Heinz Kohut is an obvious psychoanalyst to include in discussions about empathy. I have not included him here not only because his work is controversial in the programs I visited—Ralph Greenson, certainly, but also Roy Schafer were treated as main-stream—but also because empathy plays a role in his theory not only in describing the analyst’s technique but also in narcissistic psychopathology (see Kohut, ''The Analysis of the Self'' and “Introspection, Sympathy and Psychoanalysis”). A review of some of the psychoanalytic work on empathy, including Kohut’s contribution, can be found in an article by Stephen Levy, “Empathy and Psychoanalytic Technique.”</div>
+. Round Object impacts Square Object.
-<div style="margin-left:0.423cm;">@@@[[#c01nts015a|15.]]$$$ The classic, famous article is “Skill in Chess” by Herbert Simon and William Case.</div>
+. Structural changes (traces) occur in both Round and Square Object as a result of impact.
-<div style="margin-left:0.423cm;">@@@[[#c01nts016a|16.]]$$$ One of the easiest ways to describe this process is by describing the difference between trying to remember a random string of numbers—53268127—which is hard to do unless you work at it—and trying to remember 19951996. The latter is easy because you “chunk” the numbers together so that you really have to remember only two items, not eight. One of the experts in the field of expertise (K. Anders Ericsson) argues that deliberate practice—not talent—is responsible for expert performance in a knowledge-based field and that the practice mostly consists of mastering information in an organized way. A decade is assumed to be required for mastery by nearly all expertise experts. Salient literature includes K. A. Ericsson and N. Charness, “Expert Performance,” and K. A. Ericsson, R. Krampe, and C. Tesch-Romer, “The Role of Deliberate Practice in the Acquisition of Expert Performance.” Also see Michele Chi, Robert Glaser, and M. J. Farr, ''The Nature of Expertise''. Howard Gardner presents a perspective that is more brain-based but still describes expertise as the perception of meaningful patterns; see Gardner, ''Frames of Mind''.</div>
+. These changes constitute structural, physical ''reflection''.
-<div style="margin-left:0.423cm;">@@@[[#c01nts017a|17.]]$$$ See Lakoff, ''Women, Fire and Dangerous Things'', on spatial metaphors: they are very common when talking about abstractions, so there is nothing particularly special here except the abstractness.</div>
+[[File:t-w-the-worldview-and-philosophical-methodology-of-13.png]]
-<div style="margin-left:0.423cm;">@@@[[#c01nts018a|18.]]$$$ There is some experimental evidence that suggests that some people are indeed able to improve their capacity to identify emotions in other people. Some of this research is reported in Elaine Hatfield, John Cacioppo, and Richard Rapson, ''Emotional Contagion''.</div>
+'''Chemical Reflection:'''
+. Atom C is attached to Atom B.
-=== {{anchor|CHAPTERTWOTHEARROWOFHARM}} CHAPTER TWO: THE ARROW OF HARM ===
+. Atom C detaches from Atom B and transfers to attach to Atom A.
-<div style="margin-left:0.423cm;">@@@[[#c02nts001a|1.]]$$$ Byron Good, ''Medicine, Rationality, and Experience'', p. 71.</div>
+. This is a process of ''chemical reflection'', in which both molecules mutually reflect one another after A <sub>C</sub>B a process of chemical reaction (one molecule loses Atom C while the other gains Atom C).
-<div style="margin-left:0.423cm;">@@@[[#c02nts002a|2.]]$$$ Renee Fox, “Training for Uncertainty.”</div>
+As dialectical materialists, we must strive to develop our understanding of the reflections of physical and chemical changes and reactions so that our conceptions reflect the material world as accurately as possible. For example: we must not ascribe consciousness to physical processes. Example: a gambler who comes to believe that a pair of dice is “spiteful” or “cursed” is attributing conscious motivation to unconscious physical processes, which is an inaccurate ideological reflection of reality.
-<div style="margin-left:0.423cm;">@@@[[#c02nts003a|3.]]$$$ This impossibility is the insistent theme of the early ethnography of medicine. Renee Fox was among the first of these ethnographers, and her writings''—Experiment Perilous'' and others—center on the experience of facing suffering with uncertainty. Howard Becker and his coauthors, in a famous study entitled ''Boys in White'', emphasized the deep transformation of the young doctor in medical training. More recently, Mary-Jo Delvecchio Good’s study of Harvard medical students, ''American Medicine: The Quest for Competence'', underscores how impossible the task of learning to practice medicine has become. She argues that students are expected to develop both competency and caring and that the latter sometimes suffers in pursuit of the former.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c02nts004a|4.]]$$$ Frederic Hafferty, ''Into the Valley'', p. 62.</div>
+''Biological reflection'' is a higher, more complex form of reflection [compared to physical reflection]. It deals with reflection of organic material in the natural world. As our observations of biological processes have become more sophisticated and complex [through developments in natural science, the development of better tools for observation such as microscopes and other technologies, and so on], our conscious reflections of the natural world have also become more complex.
-<div style="margin-left:0.423cm;">@@@[[#c02nts005a|5.]]$$$ B. Good, ''Medicine, Rationality, and Experience'', p. 73.</div>
+Biological reflection is expressed through ''excitation, induction,'' and ''reflexes.''
-<div style="margin-left:0.423cm;">@@@[[#c02nts006a|6.]]$$$ This clear separation of mind and body is, of course, one of the striking features of Western medicine in contrast to non-Western systems.</div>
+''Excitation'' is the reaction of simple plant and animal life-forms which occurs when they change position or structure as a direct result of physical changes to their habitat [i.e., a plant which moves toward the sun throughout the day].
-<div style="margin-left:0.423cm;">@@@[[#c02nts007a|7.]]$$$ Samuel Shem, ''The House of God'', p. 79.</div>
+''Induction'' is the reaction of animals with simple nerve systems which can sense or feel their environments. Induction occurs through unconditioned reflex mechanisms.
-<div style="margin-left:0.423cm;">@@@[[#c02nts008a|8.]]$$$ Ibid., p. 97.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c02nts009a|9.]]$$$ Charles Bosk, ''Forgive and Remember''.</div>
+==== Annotation 70 ====
-<div style="margin-left:0.423cm;">@@@[[#c02nts010a|10.]]$$$ This was one of the more striking results of Sue Estroff’s remarkable participant-observer study of poor mentally ill patients. One of the reasons deinstitutionalization didn’t work, she pointed out, is that patients don’t always like their antipsychotics because of the side effects; thus they don’t take them outside the hospital, and the good effects produced by the medication do not materialize. One patient, for instance, said, “That damn Prolixin. I couldn’t think clearly on it. I wasn’t myself when I had so much of that. [The staff] wouldn’t listen to me when I told them how I felt. They’d say, ‘You look natural to us.’ My back hurt. I couldn’t sit still. Hell! I couldn’t do nothing. My legs half up in the air. They’re too heavy with that medication. I think you should be able to change doctors if you want to. I didn’t like that. You should be able to have another opinion about medications. It didn’t help me a bit.” (“Martin” in Estroff, ''Making It Crazy'', p. 99). Admittedly, Martin spoke at a time when the dosages were far heavier than what is normally given now, but nonetheless I have heard similar complaints. Some patients, it should be said, are not troubled by side effects, but many are sufficiently troubled to ditch the medication even though they admit that it makes them feel less crazy and better in that way.</div>
+''Unconditioned reflexes'' are characterized by permanent connections between sensory perceptions and reactions. Such reactions are not learned, but simply occur automatically based on physiological mechanisms occurring within the organism. An example of an unconditioned reflex response would be muscles in the leg twitching at the response of a tap on the knee. Such responses are purely physiological and are never learned (“conditioned” into us) — these reactions are simply ''induced'' physiologically.
-<div style="margin-left:0.423cm;">@@@[[#c02nts011a|11.]]$$$ Janet Malcolm uses this metaphor somewhere in her wonderful accounts of psychoanalysis. Other compelling accounts of psychoanalytic psychotherapy include Robert Lindner, ''The Fifty Minute Hour;'' Samuel Shem, ''Fine;'' Irving Yalom, ''Love’s Executioner''. There are many classic accounts of how to teach psychotherapy. Among them are Rosemary Balsam and Alan Balsam, ''Becoming a Psychotherapist: A Clinical Primer;'' Michael Franz Basch, ''Doing Psychotherapy;'' Anthony Storr, ''The Art of Psychotherapy:'' and, in a broader context, Jerome Frank, ''Psychotherapy and the Human Predicament''. See also an interesting book entitled ''A Curious Calling: Unconscious Motivations for Practicing Psychotherapy'' by Michael Sussman.</div>
+''Mental reflections'' are reactions which occur in animals with central nervous systems. Mental reflections occur through conditioned reflex mechanisms.
-<div style="margin-left:0.423cm;">@@@[[#c02nts012a|12.]]$$$ Perhaps the classic statement on contemporary, mainstream psychoanalytic thinking about transference is by Hans Loewald in ''Psychoanalysis and the History of the Individual'' and ''Papers in Psychoanalysis''.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c02nts013a|13.]]$$$ The criteria of the ASPD category have been extensively debated in part for this reason. Many people would prefer to see a more psychological account of conscienceless behavior, as for instance outlined by Hervey Cleckley in a classic called ''The Mask of Sanity'' (and indeed, some of the criteria of the most recent ''DSM''s have been modified in this direction).</div>
+==== Annotation 71 ====
+''Conditioned reflexes'' are reactions which are learned by organisms. These responses are acquired as animals learn to associate previously unrelated neural stimuli to elicit a particular reaction. The Russian psychologist Ivan Pavlov famously developed our understanding of conditioned responses by ringing a dinner bell shortly before giving dogs food. After a few repetitions, dogs would begin to salivate upon hearing the dinner bell being rung, even before any food was offered. Any dog which did not receive this conditioning would not salivate upon hearing a dinner bell. This is what makes it a learned, conditioned response — a type of mental reflection.
-=== {{anchor|CHAPTERTHREETHECULTUREANDI}} CHAPTER THREE: THE CULTURE AND ITS CONTRADICTIONS ===
+''Dynamic and creative reflection'' is the most advanced form of reflection. It only occurs in matter that has the highest structural level, such as the human brain. Dynamic and creative reflection is done through the human brain’s nervous physiological activities whenever the objective world impacts human senses. This is a kind of reflection that actively selects and processes information to create new information and to understand the meaning of that information. This dynamic and creative reflection is called consciousness.
-<div style="margin-left:0.423cm;">@@@[[#c03nts001a|1.]]$$$ Lorna Rhodes, ''Emptying Beds''.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c03nts002a|2.]]$$$ I am focusing on one particular unit here, but I have incorporated some anecdotes from another, very similar unit.</div>
+==== Annotation 72 ====
-<div style="margin-left:0.423cm;">@@@[[#c03nts003a|3.]]$$$ The classic anthropological discussion here is A. R. Radcliffe-Brown’s account, in ''Structure and Function in Primitive Society'', of what is called the “joking relationship.” In matrilineal societies, where inheritance flows through the mother’s line, sons often live with fathers but inherit from their mother’s brothers, or (in our terms) their uncles. A nephew then often expects goods from his uncle that the uncle might prefer to give to his own son, with whom he has a greater emotional tie. The uncle-nephew relationship is often protected from the tension of that relationship through a socially mandated joking relationship in which the two men are expected to tease and harass each other. The general argument is that laughter rules along the lines of social tension.</div>
+Remember Lenin’s definition of matter from ''Materialism and Empirio-Criticism'': “Matter is a philosophical category denoting objective reality which is given to man in his sensations, and which is copied, photographed, and reflected by our sensations, while existing independently of them.”
+An intrinsic property of matter is that it can be sensed by human beings, and through this sensation, ''reflected'' in human consciousness. Thus, all forms of matter share the characteristic of being able to be reflected in the human mind.
-=== {{anchor|CHAPTERFOURTHEPSYCHIATRICSC}} CHAPTER FOUR: THE PSYCHIATRIC SCIENTIST AND THE PSYCHOANALYST ===
+Criticizing Karl Pearson, who said that it was not logical to maintain that all matter had the property of being conscious, Lenin wrote in brackets: “But it is logical to suppose that all matter possesses a property which is essentially kindred to sensation: the property to reflect.” Understanding the concept of dynamic and creative reflection is critical to understanding the role of consciousness and the ideal in Dialectical Materialism. In particular, reflection differentiates Dialectical Materialism from the idealist form of dialectics used by Hegel [see Annotation 9, p. 10]. As Marx famously wrote in ''Capital Volume I'':
-<div style="margin-left:0.423cm;">@@@[[#c04nts001a|1.]]$$$ See, e.g., R. L. Gellman [Gollub] and G. K. Aghajanian, “Serotonin 2 Receptor—Mediated Excitation of Interneurons in Piriform Cortex: Antagonism by Atypical Antipsychotic Drugs.”</div>
+<blockquote>
+My dialectic method is not only different from the Hegelian, but is its direct opposite. To Hegel, the life process of the human brain, i.e., the process of thinking, which, under the name of ‘the Idea,’ he even transforms into an independent subject, is the demiurgos [craftsman/artisan/creator] of the real world, and the real world is only the external, phenomenal form of ‘the Idea.’ With me, on the contrary, the ideal is nothing else than the material world reflected by the human mind, and translated into forms of thought.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c04nts002a|2.]]$$$ This work was reported in Daniel Goleman, “Provoking a Patient’s Worst Fears to Determine the Brain’s Role”; the more technical study appeared as S. L. Rauch, et al., “A PET Study of Simple Phobic Provocation.”</div>
+In other words, Hegelian idealism saw human consciousness as defining the material world. Dialectical Materialism inverts this relationship to recognize that what we conceive in our minds is only a reflection of the material world. As Marx explains in ''The German Ideology'', all conscious thought stems from life processes through reflection:
-<div style="margin-left:0.423cm;">@@@[[#c04nts003a|3.]]$$$ For a more technical review of this area, see Randy Gollub and Scott L. Rauch, “Neuroimaging: Issues of Design, Resolution and Interpretation,” and Scott Rauch, “Advances in Neuroimaging: How Might They Influence Our Diagnostic Classification Scheme?”</div>
+<blockquote>
+Consciousness can never be anything else than conscious existence, and the existence of men is their actual life-process. If in all ideology men and their circumstances appear upside-down as in a camera obscura, this phenomenon arises just as much from their historical life-process as the inversion of objects on the retina does from their physical life-process.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c04nts004a|4.]]$$$ Hagop Akiskal, “Mood Disorders: Clinical Features”; see also Akiskal, “Cyclothymic Temperamental Disorders,” “Borderline: An Adjective in Search of a Noun,” and “The Temperamental Foundations of Affective Disorders.”</div>
+Marx and Engels argued that consciousness arose from the ''life-processes'' of human beings. Life-processes are processes of motion and change which occur within organisms to sustain life, and these processes have a dialectical relationship with consciousness: the processes of life, therefore, reflect consciousness, just as consciousness reflects human life-processes. Conscious activities (such as being able to hunt, gather, and cook food, build shelter, and so on) improve the life-processes of human beings (by improving our health, extending our life-spans, etc.); and as our life-processes improved, our consciousness was able to develop more fully. As a concrete example of the dialectic between life processes and consciousness, it is now widely believed by scientists that the advent of cooking and preparing food (conscious activity) improved the functioning of the human brain<ref>Source: “Food for Thought: Was Cooking a Pivotal Step in Human Evolution?” by Alexandra Rosati, ''Scientific American'', February 26, 2018.</ref> (a life process) which, in turn, developed human consciousness, and so on. Life-processes thus determine ''how'' consciousness reflects reality, while consciousness impacts back on life-processes, reflecting the dialectical relationship between matter and consciousness [see p. 88] and between practical activities and consciousness [see Annotation 230, p. 226].
-<div style="margin-left:0.423cm;">@@@[[#c04nts005a|5.]]$$$ Akiskal, “Borderline: An Adjective in Search of a Noun,” p. 529.</div>
+Because consciousness arose from life-processes of human beings in the material world, we know that the material world is reflected in our consciousness. However, these reflections do not ''determine'' the material world, and do not mirror the material world exactly [see Annotation 77, p. 79]. It is also important to understand that, since life-processes in the material world predate and determine consciousness, consciousness can never be a first basis of seeking truth about our world. As Marx further explains in ''The German Ideology:''
-<div style="margin-left:0.423cm;">@@@[[#c04nts006a|6.]]$$$ A survey from the 1980s (J. A. Bodkin, R. L. Klitzman, and H. G. Pope, “Distinction Between Biological Psychiatrists and Psychotherapists”) of psychiatrists associated with leading medical schools suggests that the common age-adjusted differences that distinguish biologically oriented psychiatrists from psychodynamically oriented ones were these: the biologically oriented were less likely to be “very satisfied” with their work, more likely to be male, more likely to do research, less likely to be divorced, and less likely to have, or at least to say that they have, first-degree relatives who were psychiatrically ill. Biological psychiatrists and psychotherapists were not distinguished by religious ethnicity, although lore suggests that Jewish psychiatrists are more likely to become psychodynamic psychotherapists and Christian psychiatrists to become scientists. The finding that they are less likely to be “very satisfied” with their work is surprising until one realizes that most of the survey respondents are not scientists but psychopharmacologists, and pill prescription palls after a while, particularly when compared to the intense emotional engagement of psychotherapy. A final significant difference is that more of the psychodynamically oriented psychiatrists had experimented with illicit drugs. LSD may have sent some psychiatrists into research on the brain and buttressed their beliefs in organic causes; others seem to have been drawn to the drugs for other reasons and no doubt explained their use as a symptom of their early dependency or rebellious needs. Obviously this last remark seems odd in the context of the enthusiasm I heard from the scientists for their experiences with illicit drugs—but it is true that while only scientists talked to me about the career-altering impact of recreational drugs, many more analysts seem actually to have used them.</div>
+<blockquote>
+Since the Young Hegelians consider conceptions, thoughts, ideas, in fact all the products of consciousness, to which they attribute an independent existence, as the real chains of men (just as the Old Hegelians declared them the true bonds of human society) it is evident that the Young Hegelians have to fight only against these illusions of consciousness. Since, according to their fantasy, the relationships of men, all their doings, their chains and their limitations are products of their consciousness, the Young Hegelians logically put to men the moral postulate of exchanging their present consciousness for human, critical or egoistic consciousness, and thus of removing their limitations. This demand to change consciousness amounts to a demand to interpret reality in another way, i.e. to recognise it by means of another interpretation.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c04nts007a|7.]]$$$ Steven Shapin, ''A Social History of Truth'', p. 417.</div>
+In other words, Hegelian idealism makes the critical mistake of believing that the ideal — consciousness — is the first basis of reality, and that anything and everything can be achieved through mere conscious activity. Marx, on the other hand, argues that “life is not determined by consciousness, but consciousness by life,” and that we must understand the ways in which reality is reflected in consciousness before we can hope to affect change in the material conditions of human beings:
-<div style="margin-left:0.423cm;">@@@[[#c04nts008a|8.]]$$$ Hermann Hesse, ''The Glass Bead Game (Magister Ludi)'', p. 154.</div>
+<blockquote>
+In direct contrast to German philosophy which descends from heaven to earth, here [in the materialist perspective] we ascend from earth to heaven. That is to say, we do not set out from what men say, imagine, conceive, nor from men as narrated, thought of, imagined, conceived, in order to arrive at men in the flesh. We set out from real, active men, and on the basis of their real life-process we demonstrate the development of the ideological reflexes and echoes of this life-process. The phantoms formed in the human brain are also, necessarily, sublimates of their material life-process, which is empirically verifiable and bound to material premises. Morality, religion, metaphysics, all the rest of ideology and their corresponding forms of consciousness, thus no longer retain the semblance of independence. They have no history, no development; but men, developing their material production and their material intercourse, alter, along with this their real existence, their thinking and the products of their thinking. Life is not determined by consciousness, but consciousness by life. In the first method of approach the starting-point is consciousness taken as the living individual; in the second method, which conforms to real life, it is the real living individuals themselves, and consciousness is considered solely as their consciousness.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c04nts009a|9.]]$$$ Lee David Brauer, “Basic Report about Members Who Are Graduates of Institutes. Survey of Psychoanalytic Practice.”</div>
+So, the work of the Dialectical Materialist is not to try to develop Utopian conceptions of reality first, to then proceed to try and force such purely ideal conceptions onto reality (see Annotation 17, p. 18).
-<div style="margin-left:0.423cm;">@@@[[#c04nts010a|10.]]$$$ Ibid., p. 18.</div>
+Rather, we must understand the material basis of reality, as well as the material processes of change and motion which govern reality, and only then can we search for ways in which human beings can influence material reality through conscious activity. As Marx explains, the revolutionary must not be fooled into believing we can simply conceive of an ideal world and then replicate it into reality through interpretation and conscious thought alone. Instead, we must start with a firm understanding of material conditions and, from that material basis, determine how to build our revolutionary movement through conscious impact of material relations and processes of development in the material world.
-<div style="margin-left:0.423cm;">@@@[[#c04nts011a|11.]]$$$ Ralph Greenson, ''The Technique and Practice of Psychotherapy'', p. 279.</div>
+As Marx wrote in ''The German Ideology:'' “Communism is for us not a state of affairs which is to be established, an ideal to which reality [will] have to adjust itself. We call communism the real movement which abolishes the present state of things. The conditions of this movement result from the premises now in existence.” This distinction may seem subtle at first, but it has massive implications for how Marx suggests we go about participating in revolutionary activity. For Marx, purely-idealist debates and criticisms are an unproductive waste of time:
-<div style="margin-left:0.423cm;">@@@[[#c04nts012a|12.]]$$$ Paul Ekman is the psychologist most associated with research on the facial communication of emotion. In 1975, Ekman and his colleagues published a study demonstrating high cross-cultural agreement (especially in literate societies) on the interpretation of emotional meaning of certain facial expressions. Some theorists argue that emotions are primarily facial responses, although this position is not widely shared. General surveys of emotion can be found in Robert Plutchik, ''Emotion: A Psycho-evolutionary Synthesis'', and Paul Ekman and Richard Davidson, eds., ''The Nature of Emotion''.</div>
+<blockquote>
+The Young-Hegelian ideologists, in spite of their allegedly ‘world-shattering’ statements, are the staunchest conservatives. The most recent of them have found the correct expression for their activity when they declare they are only fighting against ‘phrases.’ They forget, however, that to these phrases they themselves are only opposing other phrases, and that they are in no way combating the real existing world when they are merely combating the phrases of this world. The only results which this philosophic criticism could achieve were a few (and at that thoroughly one-sided) elucidations of Christianity from the point of view of religious history; all the rest of their assertions are only further embellishments of their claim to have furnished, in these unimportant elucidations, discoveries of universal importance.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c04nts013a|13.]]$$$ Hans Loewald, ''Papers on Psychoanalysis'', p. 308.</div>
+Marx also discusses the uselessness of idealist conjecture:
-<div style="margin-left:0.423cm;">@@@[[#c04nts014a|14.]]$$$ One of the more recent approaches to emotion has been the functional theory of emotion, argued for by Nico Frijda and Joseph Campos, among others. There the emphasis is upon the way in which emotions are not simple expressions, but regulate individual relationship to their environment and their goals. A more evolutionary approach emphasizes the communicative role of emotions; this is perhaps the ultimate thrust of Darwin’s work and plays a powerful role in later evolutionary theories. The interesting piece of psychoanalysis for this discussion is that I suspect that the strangely deprived nature of the analytic relationship forces the analysand to become more emotional than he or she ordinarily would, simply as a means of communicating. In the psychoanalytic situation, emotions function as intensifiers of communication. This aspect of emotion is perhaps most strongly identified in the work of Silvan Tompkins; see Tompkins, ''Exploring Affect;'' Nico Frijda, ''The Emotions;'' and Ekman and Davidson, ''Nature of Emotion''.</div>
+<blockquote>
+Moreover, it is quite immaterial what consciousness starts to do on its own: out of all such muck we get only the one inference that these three moments, the forces of production, the state of society, and consciousness, can and must come into contradiction with one another, because the division of labour implies the possibility, nay the fact that intellectual and material activity — enjoyment and labour, production and consumption — devolve on different individuals, and that the only possibility of their not coming into contradiction lies in the negation in its turn of the division of labour. It is self-evident, moreover, that ‘spectres,’ ‘bonds,’ ‘the higher being,’ ‘concept,’ ‘scruple,’ [terms for idealist conceptions] are merely the idealistic, spiritual expression, the conception apparently of the isolated individual, the image of very empirical fetters and limitations, within which the mode of production of life and the form of intercourse coupled with it move.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c04nts015a|15.]]$$$ Anne Sexton’s therapist made available tapes of their sessions to her biographer after her death. Although he did so after consideration and with a sense that she would have wanted him to do so, his action was harshly condemned by the psychoanalytic community.</div>
+What Marx means by this is that we should focus on the material processes and conditions of society if we intend to change society, because idealist speculation, conjecture, critique, and thought alone, at the individual level, will never be capable of affecting revolutionary change in our material world.
-<div style="margin-left:0.423cm;">@@@[[#c04nts016a|16.]]$$$ Sigmund Freud, “Therapy and Technique,” pp. 278, 236.</div>
+Instead, we must focus on the material basis of reality, the material conditions of society, and seek revolutionary measures which are built upon materialist foundations. Only by understanding material processes of development, as well as the dialectical relationship between consciousness and matter, can we reliably and effectively begin to impact reality through conscious activity. This begins with the recognition that conscious thought itself is a ''reflection'' of material reality which developed and results from ''life-processes'' of material motion and processes of change within the human brain.
-<div style="margin-left:0.423cm;">@@@[[#c04nts017a|17.]]$$$ The phrase “wild analysis” was coined by Freud to indicate that there could be misuses of psychoanalytic practice and theory that did not serve patients.</div>
+This concept of reflection, pioneered by Marx and Engels, was significantly developed by V. I. Lenin in his response to Machian positivists who posited that what we perceive is not truly reality [see Annotation 32, p. 27]. In his ''Philosophical Notebooks,'' Lenin wrote: “Life gives rise to the brain. Nature is reflected in the human brain.”
-<div style="margin-left:0.423cm;">@@@[[#c04nts018a|18.]]$$$ Charles Brenner, ''An Elementary Textbook of Psychoanalysis'', p. 120.</div>
+In ''Materialism and Empirio-Criticism'', Lenin further defined the relationship between matter and consciousness through reflection.
-<div style="margin-left:0.423cm;">@@@[[#c04nts019a|19.]]$$$ Sigmund Freud, ''Dora: An Analysis of a Case of Hysteria''. Janet Malcolm wrote a marvelous essay on the Dora case, reprinted in Malcolm, ''The Purloined Clinic''.</div>
+'''LENIN’S PROOF OF THE THEORY OF REFLECTION'''
-<div style="margin-left:0.423cm;">@@@[[#c04nts020a|20.]]$$$ Philip Rieff, ''Freud: The Mind of a Moralist'', p. 322.</div>
+In ''Materialism and Empirio-Criticism,'' Lenin offered the following arguments to back up the theory of reflection.
-<div style="margin-left:0.423cm;">@@@[[#c04nts021a|21.]]$$$ Jonathan Lear, ''Love and Its Place in Nature'', p. 187.</div>
+<blockquote>
+) Things exist independently of our consciousness, independently of our perceptions, outside of us, for it is beyond doubt that alizarin [a chemical substance which was newly discovered at time of writing] existed in coal tar yesterday and it is equally beyond doubt that yesterday we knew nothing of the existence of this alizarin and received no sensations from it.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c04nts022a|22.]]$$$ Elvin Semrad in Susan Rako and Harvey Maze, ''Semrad: The Heart of a Therapist'', p. 119. Semrad also remarked that “love is love, no matter how you slice it. A touch of love is like a touch of pregnancy” (ibid., p. 33).</div>
+Lenin is saying that the material world must exist outside of and independent from our consciousness. He cites as evidence the discovery of a chemical substance which until recently we had no sensory perception of, noting that this substance must have existed long before we became aware of it through sensory observation.
+<blockquote>
+) There is definitely no difference in principle between the phenomenon and the thing-in-itself, and there can be no such difference. The only difference is between what is known and what is not yet known. And philosophical inventions of specific boundaries between the one and the other, inventions to the effect that the thing-in-itself is “beyond” phenomena (Kant) or that we can or must fence ourselves off by some philosophical partition from the problem of a world which in one part or another is still unknown but which exists outside us (Hume) — all this is the sheerest nonsense, [unfounded belief], trick, invention.
+</blockquote>
-=== {{anchor|CHAPTERFIVEWHERETHESPLITCA}} CHAPTER FIVE: WHERE THE SPLIT CAME FROM ===
+Lenin is referencing a centuries-old debate about whether or not human beings are capable of having real knowledge of a “thing-in-itself,” or if we can only perceive ''phenomena'' of things (characteristics observable to our senses). The “thing-in-itself” refers to the actual material object which exists outside of our consciousness. So the question being posed is: can we REALLY have knowledge of material objects outside of our consciousness, or does consciousness itself act as a barrier to ever REALLY knowing anything about material objects and the material world outside of our consciousness?
-<div style="margin-left:0.423cm;">@@@[[#c05nts001a|1.]]$$$ For adult patients with major depressive disorder, the guidelines state, “Some patients with depression of mild severity can be treated with psychotherapeutic management or with psychotherapy alone.… Optimal treatment of major depression that is chronic or is moderate to severe generally requires some form of somatic intervention, in the form of medication or electroconvulsive therapy, coupled with psychotherapeutic management or psychotherapy”; see American Psychiatric Association, “Practice Guidelines for Major Depressive Disorder in Adults,” p. 6. For bipolar patients, psychotherapy is less well researched and less emphasized but nonetheless treated as important: “Psychiatric management and psychopharmacologic therapy are essential components of treatment for acute episodes and for prevention of future episodes in patients with bipolar disorder. In addition, other specific psychotherapeutic treatments may be critical components of the treatment plan for some patients”; see American Psychiatric Association, “Practice Guidelines for Bipolar Disorder in Adults,” p. 15. For patients with eating disorders, “[A]t the present time the best results appear to be linked to weight restoration accompanied by individual and family psychotherapies when the patient is ready to participate”; see American Psyciatric Association, “Practice Guidelines for Eating Disorders,” p. 214.</div>
+Immanuel Kant argued that we can never know the true nature of the material world, writing: “we indeed, rightly considering objects of sense as mere appearances, confess thereby that they are based upon a thing-in-itself, though we know not this thing as it is in itself, but only know its appearances, viz., the way in which our senses are affected by this unknown something.” This idea that the senses could not be trusted to deliver accurate knowledge — and thus, the “thing-in-itself” is essentially unknowable — was carried forward by later empiricists such as Bacon and Hume [see Annotation 10, p. 10]. In ''Ludwig Feuerbach and the End of Classical German Philosophy'', Marx and Engels refute this notion, arguing that ''practice'' allows us to discover truth about “things-in-themselves:”
-<div style="margin-left:0.423cm;">@@@[[#c05nts002a|2.]]$$$ Harold Kaplan and Benjamin Sadock, ''Pocket Handbook of Clinical Psychiatry'', pp. 109, 111, 85.</div>
+<blockquote>
+The most telling refutation of this as of all other philosophical crotchets is practice — namely, experiment and industry. If we are able to prove the correctness of our conception of a natural process by making it ourselves, bringing it into being out of its conditions and making it serve our own purposes into the bargain, then there is an end to the Kantian ungraspable “thing-in-itself”.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c05nts003a|3.]]$$$ L. Luborsky, L. B. Singer, and L. Luborsky, “Comparative Studies of Psychotherapies”; M. W. Lipsey and D. B. Wilson, “The Efficacy of Psychological, Educational and Behavioral Treatment: Confirmation from Meta-analysis.” A study of six hundred psychoanalytic patients, begun in the 1950s and reported in the ''Journal of the American Psychoanalytic Association'' (H. Bachrach et al., “On the Efficacy of Psychoanalysis”) concluded that 60 to 90 percent of patients had seen “significant” improvement as a result of psychoanalysis. See also D. H. Barlow, “Cognitive-Behavioral Therapy for Panic Disorder: Current Status” (an overview); D. H. Barlow and C. Lehman, “Advances in the Psychosocial Treatment of Anxiety Disorders” (on anxiety disorders); C. Spanier et al., “The Prophylaxis of Depression Episodes in Recurrent Depression Following Discontinuation of Drug Therapy: Integrating Psychological and Biological Factors” (on depression); E. Frank et al., “Efficacy of Interpersonal Psychotherapy as a Maintenance Treatment of Recurrent Depression” (on depression); C. Fairburn et al., “Psychotherapy and Bulimia Nervosa: Longer-Term Effects of Interpersonal Psychotherapy, Behavior Therapy, and Cognitive Behavior Therapy” (on bulimia); D. Miklowitz, “Psychotherapy in Combination with Drug Treatment for Bipolar Disorder” (on bipolar disorder); I. Falloon, “Family Management in the Prevention of Morbidity of Schizophrenia” (on schizophrenia); M. Linehan et al., “Cognitive-Behavioral Treatment of Chronically Parasuicidal Borderline Patients” (on borderline personality disorder); Robert Waldinger and John Gunderson, ''Effective Psychotherapy with Borderline Patients: Case Studies'' (on borderline personality disorder); “Mental Health: Does Therapy Help?” (original research for an overview), and John Horgan, “Why Freud Isn’t Dead” (an overview); M. Weissman and J. Markowitz, “Interpersonal Psychotherapy” (on interpersonal psychotherapy for depression); J. Persons et al., “The Role of Psychotherapy in the Treatment of Depression: Review of Two Practice Guidelines” (on depression); C. S. Gelernter et al., “Cognitive Behavioral and Pharmacological Treatments of Social Phobia” (on social phobia); and R. Ursano and E. K. Silberman, “Psychoanalysis, Psychoanalytic Psychotherapy and Supportive Psychotherapy” (an overview). Recent weaknesses of psychotherapy, along with a defense of it, can be found in a thick issue of ''The Family Therapy Networker'' (March—April 1995). My purpose is not to provide an exhaustive account of these studies but to indicate the tenor of their results. I have relied in part upon a recent issue of ''Psychoanalytic Inquiry'' (1997, suppl.) and two documents posted on the Internet: Susan Lazar, Elizabeth Hersh, and Sandra Hershberg, “The Psychotherapy Needs of Patients with Mental Disorders,” and Glen Gabbard and Susan Lazar, “Efficacy and Cost-effectiveness of Psychotherapy.”</div>
+Lenin expanded on this argument, explaining that the phenomena of objects which we observe with our senses ''do'' accurately reflect material objects, even though we might not know everything about these objects at once. Over time, as we learn more and more about material objects and the material world through practice and repeated observation, we more fully and accurately come to understand “things-in-themselves, as he writes in ''Empirio-Criticism and Materialism:''
-<div style="margin-left:0.423cm;">@@@[[#c05nts004a|4.]]$$$ E. Frank et al., “Efficacy of Interpersonal Psychotherapy as a Maintenance Treatment of Recurrent Depression”; see also D. Kupfer et al., “Five-Year Outcome for Maintenance Therapies in Recurrent Depression.”</div>
+<blockquote>
+) In the theory of knowledge, as in every other branch of science, we must think dialectically, that is, we must not regard our knowledge as readymade and unalterable, but must determine how knowledge emerges from ignorance, how incomplete, inexact knowledge becomes more complete and more exact.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c05nts005a|5.]]$$$ M.J. Lambert and A. E. Bergin, “The Effectiveness of Psychotherapy.”</div>
+Here, Lenin further elaborates on the dialectical nature of knowledge: we must simultaneously accept that our knowledge is never perfect and unchanging, but we must also recognize that we are capable of making our knowledge more exact and complete over time. To further defend his ideas about reflection, Lenin cited Czech philosopher Karl Kautsky’s argument against Kant:
-<div style="margin-left:0.423cm;">@@@[[#c05nts006a|6.]]$$$ Some remain skeptical because of earlier, critical work. Possibly the most famous early critique is a 1952 paper by Hans Eysenck, “The Effects of Psychotherapy: An Evaluation.” He argued there that the neurotic complaints that brought people into psychoanalysis would resolve after a certain length of time anyway and that there was no evidence that psychoanalytic treatment had anything to do with it. He continued his crusade through many books. Practicing psychotherapists had initially made relatively little attempt to refute his skepticism. Under the pressures of managed care reimbursement, far more studies have been done.</div>
+<blockquote>
+That I see green, red and white is grounded in my faculty of sight. But that green is something different from red testifies to something that lies outside of me, to real differences between the things... The relations and differences between the things themselves revealed to me by the individual space and time concepts are real relations and differences of the external world, not conditioned by the nature of my perceptive faculty... If this were really so [i.e., if Kant’s doctrine of the ideality of time and space were true], we could know nothing about the world outside us, not even that it exists.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c05nts007a|7.]]$$$ Irene Waskow and Morris Parloff, “Psychotherapy Change Measures: Introduction,” p. I.</div>
+Lenin followed from Marx and Engels that, in order to further develop our understanding and knowledge of the material world, it was necessary to engage in ''practice'' [see Annotation 211, p. 205]. Engels wrote in ''Socialism: Utopian and Scientific'':
-<div style="margin-left:0.423cm;">@@@[[#c05nts008a|8.]]$$$ “Mental Health: Does Therapy Help?,” p. 734.</div>
+<blockquote>
+The proof of the pudding is in the eating. From the moment we [use] these objects, according to the qualities we perceive in them, we put to an infallible test the correctness or otherwise of our sense-perceptions. If these perceptions have been wrong, then our estimate of the use to which an object can be turned must also be wrong, and our attempt must fail. But if we succeed in accomplishing our aim, if we find that the object does agree with our idea of it, and does answer the purpose we intended it for, then that is positive proof that our perceptions of it and of its qualities, so far, agree with reality outside ourselves.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c05nts009a|9.]]$$$ p. 735.</div>
+Notice that Engels is careful to use the words ''so far'': “its qualities, ''so far'', agree with reality outside ourselves.” Engels does not argue that human understanding of the material world is infallible: mistakes are often made. But over time, as such mistakes are discovered and our understanding improves, our knowledge of the material world develops. This is only possible if the phenomena of objects which we observe — the reflections within our consciousness — do actually and accurately represent material reality. Lenin elaborated on this necessity to constantly update and improve dialectical materialist philosophy as new information and knowledge became available:
-<div style="margin-left:0.423cm;">@@@[[#c05nts010a|10.]]$$$ Ibid., p. 739.</div>
+<blockquote>
+Engels, for instance, assimilated the, to him, new term, energy, and began to employ it in 1885 (Preface to the 2<sup>nd</sup> ed. of Anti-Dühring) and in 1888 (Ludwig Feuerbach), but to employ it equally with the concepts of ‘force’ and ‘motion,’ and along with them. Engels was able to enrich his materialism by adopting a new terminology.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c05nts011a|11.]]$$$ See, e.g., D. Spiegel et al., “Effect of Psychosocial Treatment on Survival of Patients with Metastatic Breast Cancer”; M. Linehan et al., “Cognitive-Behavioral Treatment of Chronically Parasuicidal Borderline Patients”; M. Linehan et al., “Naturalistic Follow-up of a Behavioral Treatment for Chronically Parasuicidal Borderline Patients”; J. Stevenson and R. Meares, “An Outcome Study of Psychotherapy for Patients with Borderline Personality Disorder”; Lizbeth Hoke, “Longitudinal Patterns of Behavior in Borderline Personality Disorder”; Richard Kluft, “The Post-unification Treatment of Multiple Personality Disorder: First Findings”; Richard Kluft, “The Natural History of Multiple Personality Disorder”; M. Strober, “Report Prepared for the Use of the Mental Health Work Group, White House Task Force for National Health Care Reform”; A. Crisp et al., “Long-Term Psychotherapy Mortality in Anorexia Nervosa”; S. Blatt et al., “Impact of Perfectionism and Need for Approval on the Brief Treatment of Depression: The NIMH Treatment of Depression Collaborative Research Program”; M. Target and P. Fonagy, “Efficacy of Psychoanalysis for Children with Emotional Disorders.”</div>
+Engels provided further elaborations on how practical experience and mastery of the material world refutes the notion that it is impossible to have real knowledge of the material world in ''Ludwig Feuerbach and the End of Classical German Philosophy'':
-<div style="margin-left:0.423cm;">@@@[[#c05nts012a|12.]]$$$ R. Dossman et al., “The Long-Term Benefits of Intensive Psychotherapy: A View from Germany.”</div>
+<blockquote>
+The most telling refutation of this as of all other philosophical fancies is practice, viz., experiment and industry. If we are able to prove the correctness of our conception of a natural process by making it ourselves, bringing it into being out of its conditions and using it for our own purposes into the bargain, then there is an end of the Kantian incomprehensible or ungraspable... The chemical substances produced in the bodies of plants and animals remained just such thingsin-themselves until organic chemistry began to produce them one after another, whereupon the thing-in-itself became a thing for us, as for instance, alizarin [a dye which was originally plant-based], which we no longer trouble to grow in in the field, but produce much more cheaply and simply from coal tar.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c05nts013a|13.]]$$$ See, for example, Timothy Brock et al., “New Evidence of Flaws in the ''Consumer Reports'' Study of Psychotherapy”; Daniel Kriegman, “The Effectiveness of Medication: The ''Consumer Reports'' Study”; Jim Mintz, Robert Drake, Paul Crits-Christoph, “The Efficacy and Effectiveness of Psychotherapy: Two Paradigms, One Science”; Timothy Brock et al., “The ''Consumer Reports'' Study of Psychotherapy: Invalid Is Invalid”; Earl Hunt, “Errors in Seligman’s The Effectiveness of Psychotherapy: The ''Consumer Reports'' Study’ ”; Mark Kotkin, Charles Daviet, and Joel Gurin, “The ''Consumer Reports'' Mental Health Survey.” I am grateful to Richard Hermann for these references.</div>
+So, dialectical materialism holds that there is a material world external from our consciousness; that conscious thoughts are reflections of this material world; that we can have real knowledge of the material world through sensory observation; and that our knowledge and understanding of the material world is best advanced through ''practice'' in the material world.
-<div style="margin-left:0.423cm;">@@@[[#c05nts014a|14.]]$$$ This is Lester Luborsky’s argument. It is summarized in John Horgan, “Why Freud Isn’t Dead,” but was reported in L. Luborsky, “Comparative Studies of Psychotherapies.”</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c05nts015a|15.]]$$$ For example, M. K. Shear et al., in “Cognitive Behavioral Treatment Compared with Nonprescriptive Treatment of Panic Disorder,” claimed that “reflective listening” was as helpful as cognitive behavioral therapy in a controlled study of panic disorder.</div>
+''- Social Sources of Consciousness''
-<div style="margin-left:0.423cm;">@@@[[#c05nts016a|16.]]$$$ The figure one third crops up fairly often. I have heard it presented by scientific panels at the American Psychiatric Association meetings; senior psychiatrists, for example Mardi Horowitz, confirm it (personal communication). Research presentations on drug efficacy tend to have numbers that break down in this way. Similar breakdowns in psychotherapy research can be seen in the Menninger Foundation Psychotherapy Research Project reported in Robert Wallerstein, ''Forty-two Lives in Treatment: A Study of Psychoanalysis and Psychotherapy'', and “The Psychotherapy Research Project of the Menninger Foundation: An Overview”; see also H. Bachrach et al., “On the Efficacy of Psychoanalysis.” Of course, there are differences among particular therapies, particular illnesses, and individuals: someone who responds well to antipsychotics may or may not respond well to supportive psychotherapy.</div>
+There are many factors that constitute the social sources of consciousness. The most basic and direct factors are ''labor'' and ''language.''
-<div style="margin-left:0.423cm;">@@@[[#c05nts017a|17.]]$$$ Steven Stahl, ''Essential Psychopharmacology'', p. 110; see also D. Antonuccio et al., “Psychotherapy vs. Medication for Depression: Challenging the Conventional Wisdom with Data” and “Raising Questions About Antidepressants”; I. Elkin, “The NIMH Treatment of Depression Collaborative Research Program: Where We Began and Where We Are.”</div>
+''Labor'' is the process by which humans interact with the natural world in order to make products for our needs of existing and developing. Labor is also the process that changes the human body’s structure [i.e., muscles developing through exercise].
-<div style="margin-left:0.423cm;">@@@[[#c05nts018a|18.]]$$$ Harold Kaplan and Benjamin Sadock, ''Pocket Handbook of Clinical Psychiatry'', p. 110.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c05nts019a|19.]]$$$ Ibid., p. 84.</div>
+==== Annotation 73 ====
-<div style="margin-left:0.423cm;">@@@[[#c05nts020a|20.]]$$$ M. Weissman et al., “Sex Differences in Rates of Depression: Cross-National Differences.”</div>
+In ''Dialectics of Nature'', Engels describes the dialectical relationship between labor and human development:
-<div style="margin-left:0.423cm;">@@@[[#c05nts021a|21.]]$$$ G. E. Hogarty et al., “The Environmental-Personal Indicators in the Course of Schizophrenia (EPICS) Research Group: Family Psychoeducation, Social Skills Training and Maintenance Chemotherapy in the Aftercare Treatment of Schizophrenia. II: Two-Year Effects of a Controlled Study on Relapse and Adjustment.”</div>
+<blockquote>
+Labour is the source of all wealth, the political economists assert. And it really is the source — next to nature, which supplies it with the material that it converts into wealth. But it is even infinitely more than this. It is the prime basic condition for all human existence, and this to such an extent that, in a sense, we have to say that labour created man himself.
-<div style="margin-left:0.423cm;">@@@[[#c05nts022a|22.]]$$$ G. Klerman et al., “Treatment of Depression by Drugs and Psychotherapy.” This was an early study but an important one. There was no difference in outcome between the use of medication alone and medication and psychotherapy, but because it was clear that medication and psychotherapy targeted somewhat different problems (psychotherapy addressed social functioning), it was concluded that the combination had produced the best outcome.</div>
+Before the first flint could be fashioned into a knife by human hands, a period of time probably elapsed in comparison with which the historical period known to us appears insignificant. But the decisive step had been taken, the hand had become free and could henceforth attain ever greater dexterity; the greater flexibility thus acquired was inherited and increased from generation to generation.
-<div style="margin-left:0.423cm;">@@@[[#c05nts023a|23.]]$$$ J. M. Schwartz et al., “Systematic Changes in Cerebral Glucose Metabolic Rate After Successful Behavior Modification Treatment of Obsessions and Compulsive Disorder”; L. Baxter et al., “Caudate Glucose Metabolic Rate Changes with Both Drug and Behavior Therapy for Obsessive-Compulsive Disorder.”</div>
+Thus the hand is not only the organ of labour, it is also the product of labour. Only by labour, by adaptation to ever new operations, through the inheritance of muscles, ligaments, and, over longer periods of time, bones that had undergone special development and the ever-renewed employment of this inherited finesse in new, more and more complicated operations, have given the human hand the high degree of perfection required to conjure into being the pictures of a Raphael, the statues of a Thorwaldsen, the music of a Paganini.
-<div style="margin-left:0.423cm;">@@@[[#c05nts024a|24.]]$$$ E. Kandel, “Psychotherapy and the Single Synapse: The Impact of Psychiatric Thought on Neurobiologic Research.”</div>
+But the hand did not exist alone, it was only one member of an integral, highly complex organism. And what benefited the hand, benefited also the whole body it served.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c05nts025a|25.]]$$$ H. Horgan, “Why Freud Isn’t Dead,” p. 106.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c05nts026a|26.]]$$$ Attributed to Martin Seligman, an authority on efficacy research; see John Horgan, “Why Freud Isn’t Dead,” p. 110; another group of psychologists, whose meta-analysis of recent outcome research was reported in the December 1995 issue of ''Professional Psychology'', concluded that “psychological interventions, particularly cognitive-behavioral, are at least as effective as medication in the treatment of depression, even if severe” (D. Antonuccio et al., “Psychotherapy vs. Medication for Depression: Challenging the Conventional Wisdom with Data,” p. 109). (Most studies of psychotherapy actually seem to argue that one type is as good on average as any other but that longer treatment is better.)</div>
+Labor also allows us to discover the attributes, structures, motion laws, etc., of the natural world, via observable phenomena.
-<div style="margin-left:0.423cm;">@@@[[#c05nts027a|27.]]$$$ See E. Frank et al., “Efficacy of Interpersonal Psychotherapy as a Maintenance Treatment of Recurrent Depression.”</div>
-<div style="margin-left:0.423cm;">@@@[[#c05nts028a|28.]]$$$ Recent work in the area, more specifically targeted than previous work and more focused to compare psychotherapy with outcome measures of other interventions, has been summarized in “Psychotherapy, Cost-Effectiveness and Cost Offset: A Review of the Literature,” by Glen Gabbard et al. (unpublished manuscript), and less comprehensively in Gabbard et al., “The Economic Impact of Psychotherapy: A Review.” They list a long series of studies on a variety of specific conditions. For example: A 1983 British study of patients with severe chronic obstructive airway disease randomly located patients in one of three kinds of therapy or to an untreated control group. At the six-month follow-up, only 31 percent of the patients in the therapeutic groups required hospitalization, while 77 percent of the no-therapy group were readmitted. The authors calculated that the use of therapy had resulted in substantial savings; see R. Rosser et al., “Breathlessness and Psychiatric Morbidity in Chronic Bronchitis and Emphysema: A Study of Psychotherapeutic Management.” See also S. Lazar and G. Gabbard, “The Cost-effectiveness of Psychotherapy.”</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c05nts029a|29.]]$$$ G. Gabbard et al., “The Economic Impact of Psychotherapy: A Review.”</div>
+==== Annotation 74 ====
-<div style="margin-left:0.423cm;">@@@[[#c05nts030a|30.]]$$$ A. Zients, “A Presentation to the Mental Health Work Group, White House Task Force for National Health Care Reform.”</div>
+We discover truth about the natural world through labor — through physical ''practice'' in the material world. See the discussion of ''practice'' in Annotation 211, p. 205.
-<div style="margin-left:0.423cm;">@@@[[#c05nts031a|31.]]$$$ N. Schooler and S. Keith, “The Role of Medication in Psychosocial Treatment”; N. Schooler and S. Keith, “The Clinical Research Base for the Treatment of Schizophrenia.”</div>
+All of these phenomena, through our human senses, impact our human brains. And through brain activity, knowledge and consciousness of the objective world are formed and developed.
-<div style="margin-left:0.423cm;">@@@[[#c05nts032a|32.]]$$$ M. Linehan et al., “A Cognitive-Behavioral Treatment of Chronically Parasuicidal Borderline Patients”; J. Stevenson and R. Meares, “An Outcome Study of Psychotherapy for Patients with Borderline Personality Disorder.”</div>
+''Language'' is a system of material signals that carries information with cognitive content. Without language, consciousness could not exist and develop.
-<div style="margin-left:0.423cm;">@@@[[#c05nts033a|33.]]$$$ C. Hellman et al., “A Study of the Effectiveness of Two Group Behavioral Medicine Interventions for Patients with Psychosomatic Complaints.”</div>
+The birth of language goes hand in hand with labor. From the beginning, labor was social. The relationships between people who perform labor processes require them to have means to communicate and exchange thoughts. This requirement caused language to arise and develop along with the working processes. With language, humans not only communicate, but also summarise reality and convey experience and thoughts from generation to generation.
-<div style="margin-left:0.423cm;">@@@[[#c05nts034a|34.]]$$$ J. Strain et al., “Cost Offset from Psychiatric Consultation—Liaison Intervention with Elderly Hip Fracture Patients.”</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c05nts035a|35.]]$$$ D. Spiegel et al., “Effect of Psychosocial Treatment on Survival of Patients with Metastatic Breast Cancer.”</div>
+==== Annotation 75 ====
-<div style="margin-left:0.423cm;">@@@[[#c05nts036a|36.]]$$$ F. I. Fawzy et al., “Malignant Melanomas: Effects of an Early Structured Psychiatric Intervention, Coping and Affective State on Recurrence and Survival Six Years Later.”</div>
+From ''Dialectics of Nature'':
-<div style="margin-left:0.423cm;">@@@[[#c05nts037a|37.]]$$$ See Lazar and Gabbard, “The Cost-effectiveness of Psychotherapy.”</div>
+<blockquote>
+It has already been noted that our simian ancestors were gregarious; it is obviously impossible to seek the derivation of man, the most social of all animals, from non-gregarious immediate ancestors. Mastery over nature began with the development of the hand, with labour, and widened man’s horizon at every new advance. He was continually discovering new, hitherto unknown properties in natural objects. On the other hand, the development of labour necessarily helped to bring the members of society closer together by increasing cases of mutual support and joint activity, and by making clear the advantage of this joint activity to each individual. In short, men in the making arrived at the point where they had something to say to each other. Necessity created the organ; the undeveloped larynx of the ape was slowly but surely transformed by modulation to produce constantly more developed modulation, and the organs of the mouth gradually learned to pronounce one articulate sound after another.
-<div style="margin-left:0.423cm;">@@@[[#c05nts038a|38.]]$$$ I learned this term from Kim Hopper of the Nathan Kline Psychiatric Institute.</div>
+Comparison with animals proves that this explanation of the origin of language from and in the process of labour is the only correct one. The little that even the most highly-developed animals need to communicate to each other does not require articulate speech. In its natural state, no animal feels handicapped by its inability to speak or to understand human speech. It is quite different when it has been tamed by man. The dog and the horse, by association with man, have developed such a good ear for articulate speech that they easily learn to understand any language within their range of concept. Moreover they have acquired the capacity for feelings such as affection for man, gratitude, etc., which were previously foreign to them. Anyone who has had much to do with such animals will hardly be able to escape the conviction that in many cases they now feel their inability to speak as a defect, although, unfortunately, it is one that can no longer be remedied because their vocal organs are too specialised in a definite direction. However, where vocal organs exist, within certain limits even this inability disappears. The buccal organs of birds are as different from those of man as they can be, yet birds are the only animals that can learn to speak; and it is the bird with the most hideous voice, the parrot, that speaks best of all. Let no one object that the parrot does not understand what it says. It is true that for the sheer pleasure of talking and associating with human beings, the parrot will chatter for hours at a stretch, continually repeating its whole vocabulary. But within the limits of its range of concepts it can also learn to understand what it is saying. Teach a parrot swear words in such a way that it gets an idea of their meaning (one of the great amusements of sailors returning from the tropics); tease it and you will soon discover that it knows how to use its swear words just as correctly as a Berlin costermonger. The same is true of begging for titbits.
-<div style="margin-left:0.423cm;">@@@[[#c05nts039a|39.]]$$$ The Question of Lay Analysis (1950); see the discussions in Peter Gay, ''Freud'', pp. 489ff., and Nathan Hale, ''The Rise and Crisis of Psychoanalysis in the United States'', pp. 214ff. It was possible for a non-M.D. to get an exemption or to train for research purposes, as many social scientists did.</div>
+First labour, after it and then with it speech — these were the two most essential stimuli under the influence of which the brain of the ape gradually changed into that of man, which, for all its similarity is far larger and more perfect. Hand in inevitably accompanied by a corresponding refinement of the organ of hearing, so the development of the brain as a whole is accompanied by a refinement of hand with the development of the brain went the development of its most immediate instruments — the senses. Just as the gradual development of speech is all the senses. The eagle sees much farther than man, but the human eye discerns considerably more in things than does the eye of the eagle. The dog has a far keener sense of smell than man, but it does not distinguish a hundredth part of the odours that for man are definite signs denoting different things. And the sense of touch, which the ape hardly possesses in its crudest initial form, has been developed only side by side with the development of the human hand itself, through the medium of labour.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c05nts040a|40.]]$$$ M. Sabshin, “Turning Points in Twentieth-Century Psychiatry,” p. 1269.</div>
+So, the most basic, direct and important source that decides the birth and development of language is labor. Language appeared later than labor but always goes with labor. Language and labor were the two main stimulations affecting the brains of the primates which evolved into humans, slowly changing their brains into human brains and transforming animal psychology into human consciousness.
-<div style="margin-left:0.423cm;">@@@[[#c05nts041a|41.]]$$$ The struggle between neurologists and psychiatrists over these potential patients is well told in Andrew Abbott, ''The System of Professions''.</div>
+[[File:t-w-the-worldview-and-philosophical-methodology-of-14.png|''This diagram is based on work from an article titled'' “Evidence in Hand: Recent Discoveries and the Early Evolution of Human Manual Manipulation<ref>Written by Professor Tracy L. Kivell and published in ''The Royal Society''.</ref>.”''Modern research has discovered strong evidence<ref>''Stone Tools Helped Shape Human Hands'' by Sara Reardon, published in New Scientist Magazine.</ref> that the human hand evolved along with tool use, in line with Engels’ analysis in'' Dialectics of Nature.]]
-<div style="margin-left:0.423cm;">@@@[[#c05nts042a|42.]]$$$ Elizabeth Lunbeck, ''The Psychiatric Profession;'' see also Abbott, ''System of Professions;'' Nancy Tomes, ''The Art of Asylum-Keeping''.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c05nts043a|43.]]$$$ Lunbeck, ''Psychiatric Profession;'' see also William Caudill, ''The Psychiatric Hospital as a Small Society;'' Alfred Stanton and Morris Schwartz, ''The Mental Hospital''.</div>
+==== Annotation 76 ====
-<div style="margin-left:0.423cm;">@@@[[#c05nts044a|44.]]$$$ Laurence Friedman, ''Menninger'', p. 197; also see a wonderful trilogy of novels on psychiatry and the First World War by Pat Barker: ''Regeneration, The Eye in the Door'', and ''Ghost Road''.</div>
+It is also worth noting that, just as human consciousness derived from labor and language ''and'' social activity, so too did society itself arise from language and labor, as Engels explained in ''Dialectics of Nature'':
-<div style="margin-left:0.423cm;">@@@[[#c05nts045a|45.]]$$$ Judd Marmor, quoted in Hale, ''The Rise and Crisis of Psychoanalysis in the United States'', p. 205.</div>
+<blockquote>
+The reaction on labour and speech of the development of the brain and its attendant senses, of the increasing clarity of consciousness, power of abstraction and of conclusion, gave both labour and speech an ever-renewed impulse to further development. This development did not reach its conclusion when man finally became distinct from the ape, but on the whole made further powerful progress, its degree and direction varying among different peoples and at different times, and here and there even being interrupted by local or temporary regression. This further development has been strongly urged forward, on the one hand, and guided along more definite directions, on the other, by a new element which came into play with the appearance of fully-fledged man, namely, society.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c05nts046a|46.]]$$$ Ibid., p. 188; also see pp. 187–210ff. Paul Starr, in ''The Social Transformation of American Medicine'', cites figures of more than a million men rejected for military service based on mental illness, and 850,000 hospitalized during the war for psychoneuroses.</div>
+In other words, these factors of human’s physical nature and human society have a dialectical relationship with one another. Elements of human nature — in particular labor and language — led to the development of human society, which in turned played a key role in the development of human language and labor.
-<div style="margin-left:0.423cm;">@@@[[#c05nts047a|47.]]$$$ John Talbott, ''The Death of the Asylum: A Critical Study of State Hospital Management'', pp. 24ff.; Sabshin, “Turning Points in Twentieth Century Psychiatry”; J. Romano, “Reminiscences: 1938 and Since.”</div>
+[[File:t-w-the-worldview-and-philosophical-methodology-of-15.png|''Human language and human labor mutually develop one another through a dialectical process to develop human nature. Simultaneously, human nature and human society mutually develop one another through a dialectical process.'']]
-<div style="margin-left:0.423cm;">@@@[[#c05nts048a|48.]]$$$ See, e.g., Sherry Turkle, ''Psychoanalytic Politics'', on the differences between psychoanalysis in the United States and France; see also Hale, ''The Rise and Crisis of Psychoanalysis in the United States;'' Lunbeck, ''The Psychiatric Profession''.</div>
+Elements of human nature — in particular labor and language — led to the development of human society, which in turned played a key role in the development of human language and labor.
-<div style="margin-left:0.423cm;">@@@[[#c05nts049a|49.]]$$$ The Atlantic, Special Supplement: “Psychiatry,” p. 62.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c05nts050a|50.]]$$$ N. Zinberg, “Psychiatry: A Professional Dilemma,” p. 10.</div>
+==== b. Nature and Structure of Consciousness ====
-<div style="margin-left:0.423cm;">@@@[[#c05nts051a|51.]]$$$ The Atlantic, Special Supplement: “Psychiatry,” p. 72.</div>
+''- Nature of Consciousness''
-<div style="margin-left:0.423cm;">@@@[[#c05nts052a|52.]]$$$ This is the arena in which Adolf Grunbaum’s scrutiny of psychoanalysis, ''The Foundations of Psychoanalysis: A Philosophical Critique'', was based. Freud argued that an analyst’s interpretations were confirmed by a patient’s ultimate (if not immediate) support of them. This (bluntly summarized) is the “tally” theory. Grunbaum rightly dismisses the tally theory as grounds for the sciencelike nature of psychoanalysis on the basis of a psychoanalyst’s influence over a patient. However, psychoanalysis has not been affected much by the arguments that soared in the philosphical journals. Contemporary analysts tend to treat interpretation and insight as only one piece of the process of therapeutic change, and not necessarily as the most important one.</div>
+''Consciousness is the dynamic and creative reflection of the objective world in human brains; it is the subjective image of the objective world.'' [See discussion of dynamic and creative reflection on p. 68]
-<div style="margin-left:0.423cm;">@@@[[#c05nts053a|53.]]$$$ Roy Schafer, ''Aspects of Internalization'', p. xx.</div>
+''The dynamic and creative nature'' of reflection is expressed in human psycho-physiological activities when we receive, select, process, and save data in our brains. Within the human brain, we are able to collect data from the external material world. Based on this information, our brain is capable of creating new information, and we are able to analyze, interpret, and understand all of this information collectively within our consciousness.
-<div style="margin-left:0.423cm;">@@@[[#c05nts054a|54.]]$$$ Bertram Lewin, ''The Psychoanalysis of Elation'', p. 54.</div>
+The dynamic and creative nature of reflection is also expressed in several human processes:
-<div style="margin-left:0.423cm;">@@@[[#c05nts055a|55.]]$$$ Susan Rako and Harvey Mazer, ''Semrad: The Heart of a Therapist'', p. 179.</div>
+* The creation of ideas, hypotheses, stories, etc.
+* The ability to summarize nature and to comprehend the objective laws of nature.
+* The ability to construct models of ideas and systems of knowledge to guide our activities.
-<div style="margin-left:0.423cm;">@@@[[#c05nts056a|56.]]$$$ Ibid., p. 36.</div>
+''Consciousness is the subjective image of the objective world.'' Consciousness is defined by the objective world in both Content and Form [see Annotation 150, p. 147]. However, consciousness does not perfectly reflect the objective world. It modifies information through the subjective lenses (thoughts, feelings, aspirations, experiences, knowledge, needs, etc.) of humans. According to Marx and Engels, ideas are simply “sublimates [transformations] of [the human brain’s]... material life-process, which is empirically verifiable and bound to material premises.”<ref>''The German Ideology'', Karl Marx and Friedrich Engels, 1846.</ref>
-<div style="margin-left:0.423cm;">@@@[[#c05nts057a|57.]]$$$ Ibid., p. 105.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c05nts058a|58.]]$$$ Gregory Bateson, ''Steps to an Ecology of Mind'', p. 217.</div>
+==== Annotation 77 ====
-<div style="margin-left:0.423cm;">@@@[[#c05nts059a|59.]]$$$ Donald Light, ''Becoming Psychiatrists'', p. 7.</div>
+In ''The German Ideology'', Marx and Engels refer to ideas somewhat poetically as “the phantoms formed in the human brain,” and explains that ideas arise directly from material human life processes [see Annotation 72, p. 68]. Lenin makes it very clear in ''Materialism and Empirio-Criticism'' that consciousness is not a ''mirror image'', or ''exact'' reproduction of reality, quoting Engels:
-<div style="margin-left:0.423cm;">@@@[[#c05nts060a|60.]]$$$ Quoted in E. Kandel, “A New Intellectual Framework for Psychiatry,” p. 459. Kandel is a famous psychiatric researcher, one of Semrad’s former residents.</div>
+<blockquote>
+The great basic question of all philosophy,” Engels says, “especially of modern philosophy, is that concerning the relation of thinking and being,” of “spirit and nature.” Having divided the philosophers into “two great camps” on this basic question, Engels shows that there is “yet another side” to this basic philosophical question, viz., “in what relation do our thoughts about the world surrounding us stand to this world itself? Is our thinking capable of the cognition of the real world? Are we able in our ideas and notions of the real world to produce a correct reflection of reality?” “The overwhelming majority of philosophers give an affirmative answer to this question,” says Engels, “including under this head not only all materialists but also the most consistent idealists.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c05nts061a|61.]]$$$ Arnold Rogow, ''The Psychiatrists'', p. 10.</div>
-<div style="margin-left:0.423cm;">@@@[[#c05nts062a|62.]]$$$ Leo Srole et al., ''Mental Health in the Metropolis: The Midtown Manhattan Study'', p. 230. One of the more remarkable things about the study is that ''all'' the Puerto Ricans were assessed as “ill.” Psychiatric anthropologists and anthropological psychiatrists interpret data like these as a powerful indication that the American diagnostic system is culturally biased.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c05nts063a|63.]]$$$ American Psychiatric Association, ''Careers in Psychiatry'', pp. 10, 85.</div>
+Of extra importance is Lenin’s footnote to the above passage, regarding what he purports to be Viktor Chernov’s mistranslation of Engels:
-<div style="margin-left:0.423cm;">@@@[[#c05nts064a|64.]]$$$ R. Waggoner, “The Presidential Address: Cultural Dissonance and Psychiatry,” p. 42.</div>
+<blockquote>
+Fr. Engels, Ludwig Feuerbach, etc., 4<sup>th</sup> Germ. ed., S. 15. Russian translation, Geneva ed., 1905, p. 12–13. Mr. V. Chernov translates the word Spiegelbild literally (a mirror reflection) accusing Plekhanov of presenting the theory of Engels “in a very weakened form” by speaking in Russian simply of a “reflection” instead of a “mirror reflection”. This is mere cavilling. Spiegelbild [mirror reflection] in German is also used simply in the sense of Abbild [reflection, image].
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c05nts065a|65.]]$$$ ''Statistical Abstract of the United States'', Table 360.</div>
+Here, Lenin reaffirms and clarifies Engels’ idea that consciousness is not a perfect, exact duplicate of reality; not a “mirror image.” This, however, does not contradict the fact that we can obtain real knowledge of the real world in our consciousness, and that this knowledge improves over time through practice and observation. Indeed, Lenin’s passage on practice cited first in this annotation directly follows the above passage in ''Materialism and Empirio-Criticism''.
-<div style="margin-left:0.423cm;">@@@[[#c05nts066a|66.]]$$$ Charles Kadushin, ''Why People Go to Psychiatrists'', p. 4. The quotation continues, “The opinion leaders of the nation’s culture … form at least one third of those who have been in analytic office treatment.” This is quite a peculiar book. It reports a study of 1,452 applicants to ten New York City psychiatric clinics and emphasizes the culturally sophisticated network that made up more than half of the sample. The author refers to this social stratum as the “Friends and Supporters of Psychotherapy” and remarks that they are “the heroes of this book” (p. 58).</div>
+See: Natural Source of Consciousness, p. 64, and Annotation 32, 27.
-<div style="margin-left:0.423cm;">@@@[[#c05nts067a|67.]]$$$ The address was galvanized by the Joint Commission on Mental Illness and Health, which published its report in 1961 under the direction of the director of Massachusetts Mental Hospital, Jack Ewalt. Quoted in Horace Whittington, ''Psychiatry in the American Community'', p. 13.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c05nts068a|68.]]$$$ The sociologist Andrew Scull argues that altruism and humanism had never driven the federal and state decisions in the community mental health movement anyway; it was the sheer enticement of saving money at the local level that made the program appealing; see Scull, ''Decarceration''.</div>
+''Consciousness is a social phenomenon and has a social nature.'' Consciousness arose from real life activities. Consciousness is always ruled by natural law and by social law.
-<div style="margin-left:0.423cm;">@@@[[#c05nts069a|69.]]$$$ See Kim Hopper, “More Than Passing Strange: Homelessness and Mental Illness in New York City.”</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c05nts070a|70.]]$$$ Thomas Scheff’s book ''Being Mentally III'', first published in 1966, was reissued in a new edition in 1984 with a stilted preface that revealed how deeply psychiatry had changed: “These are heady times for somatic theories of mental illness. I must point out that although their hypothesis is credible, it remains a hypothesis. To date, there has been no demonstrable link between neurotransmission and mental illness … [it] is just a theory.… Since the connection is still hypothetical, it is premature to discard the labeling theory of mental illness” (p. x).</div>
+==== Annotation 78 ====
-<div style="margin-left:0.423cm;">@@@[[#c05nts071a|71.]]$$$ David Rosenhan, “On Being Sane in Insane Places,” p. 253.</div>
+''Natural law'' includes the laws of physics, chemistry, and other natural phenomena which govern the material world. Consciousness itself can never violate natural law as it arises from the natural processes of the natural world.
-<div style="margin-left:0.423cm;">@@@[[#c05nts072a|72.]]$$$ Ibid.</div>
+''Social law'' includes the objective and universal relationships between social phenomena and social processes. Human society was created through labor, and this labor was performed in very specific material relations between humans and the natural world.
-<div style="margin-left:0.423cm;">@@@[[#c05nts073a|73.]]$$$ R. Kendell, J. Cooper, and A. Gourley, “Diagnostic Criteria of American and British Psychiatrists”; see also S. R. Goldsmith and A. J. Mandell, “The Dynamic Formulation—A Critique of a Psychiatric Ritual”; and Donald Light, ''Becoming Psychiatrists''.</div>
+''Note: social law is a key concept of historical materialism, which is the topic of Part 2 of the textbook from which this entire text has been translated, which we hope to translate in the future.''
-<div style="margin-left:0.423cm;">@@@[[#c05nts074a|74.]]$$$ President’s Commission on Mental Health, vol. 2, p. 15. They did know that 3 percent of the American population, 6.7 million people, had been seen in the specialized mental health sector in 1975, that 1.5 million had been hospitalized, and that 12 percent of the nation’s general health care expenditure was for mental health, a figure that has remained constant; see vols. 8, 9.</div>
+In ''A Contribution to the Critique of Political Economy'', Marx explains how social existence and social laws govern the consciousness of individuals:
-<div style="margin-left:0.423cm;">@@@[[#c05nts075a|75.]]$$$ The Vice President of Blue Cross, Robert Laur, in Mitchell Wilson, “DSM ''III'' and the Transformation of Psychiatry: A History,” p. 403.</div>
+<blockquote>
+In the social production of their existence, men inevitably enter into definite relations, which are independent of their will, namely relations of production appropriate to a given stage in the development of their material forces of production. The totality of these relations of production constitutes the economic structure of society, the real foundation, on which arises a legal and political superstructure and to which correspond definite forms of social consciousness. The mode of production of material life conditions the general process of social, political and intellectual life. It is not the consciousness of men that determines their existence, but their social existence that determines their consciousness.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c05nts076a|76.]]$$$ Abbott, ''The System of Professions'', p. 312.</div>
-<div style="margin-left:0.423cm;">@@@[[#c05nts077a|77.]]$$$ Smith Kline and French Laboratories, ''Ten Years of Experience with Thorazine''.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c05nts078a|78.]]$$$ Tardive dyskinesia—involuntary muscle movement—is still a major risk of most of the antipsychotic medications, and it is not necessarily dose-related. Nevertheless, risk increases with higher doses and longer courses. The “Thorazine shuffle,” however, was a result of the high doses of medication given.</div>
+Consciousness is determined by the social communication needs of human beings as well as the material conditions of reality.
-<div style="margin-left:0.423cm;">@@@[[#c05nts079a|79.]]$$$ He had distinguished manic depression from schizophrenia out of a previously chaotic category of all forms of madness.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c05nts080a|80.]]$$$ J. Feighner et al., “Diagnostic Criteria for Use in Psychiatric Research,” p. 57. The information on Washington University can be found in R. W. Hudgens, “The Turning of American Psychiatry.”</div>
+==== Annotation 79 ====
-<div style="margin-left:0.423cm;">@@@[[#c05nts081a|81.]]$$$ American Psychiatric Association, ''DSM'', p. 24.</div>
+The term ''material conditions'' refers to the external environment which humans inhabit. Material conditions include the natural environment, the means of production and the economic base<ref>See Annotation 3, p. 2 and Annotation 29, p. 24.</ref> of human society, and other objective externalities and systems which affect human life and society. Note that material conditions don’t refer to physical matter alone, but also include objective social relations and phenomena. In ''A Contribution to the Critique of Political Economy'', Marx argues that “neither legal relations nor political forms could be comprehended whether by themselves or on the basis of a so-called general development of the human mind, but that on the contrary they originate in the material conditions of life.”
-<div style="margin-left:0.423cm;">@@@[[#c05nts082a|82.]]$$$ Ibid., p. 31.</div>
+Consciousness is dynamic in nature, constantly learning and changing flexibly. Consciousness guides humans to transform the material world to suit our needs.
-<div style="margin-left:0.423cm;">@@@[[#c05nts083a|83.]]$$$ Wilson, ''“DSM III'' and the Transformation of Psychiatry: A History,” p. 405.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c05nts084a|84.]]$$$ Ibid.</div>
+==== Annotation 80 ====
-<div style="margin-left:0.423cm;">@@@[[#c05nts085a|85.]]$$$ J. Endicott and R. Spitzer, “Use of the Research Diagnostic Criteria and the Schedule for Affective Disorders and Schizophrenia to Study Affective Disorders,” p. 52.</div>
+Consciousness and material conditions have a dialectical relationship with one other, just as the base of society and the superstructure have a dialectical relationship with one other [see Annotation 29, p. 24]. Consciousness arises from material conditions, though conscious activity can affect material conditions.
-<div style="margin-left:0.423cm;">@@@[[#c05nts086a|86.]]$$$ Stuart Kirk and Herb Kutchins, ''The Selling of DSM: The Rhetoric of Science in Psychiatry''.</div>
+As Marx explains in ''Capital Volume I'':
-<div style="margin-left:0.423cm;">@@@[[#c05nts087a|87.]]$$$ American Psychiatric Association, “Schizophrenia, Simple Type,” ''DSM II'', p. 33; American Psychiatric Association, “Diagnostic Criteria for a Schizophrenia Disorder,” ''DSM III'', pp. 188–190.</div>
+<blockquote>
+At the end of every labour-process, we get a result that already existed in the imagination of the labourer at its commencement. He not only effects a change of form in the material on which he works, but he also realises a purpose of his own that gives the law to his modus operandi, and to which he must subordinate his will. And this subordination is no mere momentary act. Besides the exertion of the bodily organs, the process demands that, during the whole operation, the workman’s will be steadily in consonance with his purpose.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c05nts088a|88.]]$$$ G. Klerman et al., “Treatment of Depression by Drugs and Psychotherapy,” p. 540.</div>
+In ''A Contribution to the Critique of Political Economy'', Marx explains how the development of material conditions eventually leads to conscious activity which will in turn lead to changes in society:
-<div style="margin-left:0.423cm;">@@@[[#c05nts089a|89.]]$$$ Ibid., p. 544.</div>
+<blockquote>
+At a certain stage of development, the material productive forces of society come into conflict with the existing relations of production or — this merely expresses the same thing in legal terms — with the property relations within the framework of which they have operated hitherto. From forms of development of the productive forces these relations turn into their fetters. Then begins an era of social revolution. The changes in the economic foundation lead sooner or later to the transformation of the whole immense superstructure.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c05nts090a|90.]]$$$ Details of the case are presented in G. Klerman et al., “The Psychiatric Patient’s Right to Effective Treatment: Implications of ''Osheroff vs. Chestnut Lodge.”'' The case has been discussed both in the lay press and in professional journals without anonymity.</div>
+As Marx further explains, material conditions must first be met before such revolutionary social changes can be made through conscious activity:
-<div style="margin-left:0.423cm;">@@@[[#c05nts091a|91.]]$$$ Klerman became a pivotal person in the field at this time in part because he was so well trained and respected by the psychoanalytic elite. Later in his life he produced a method of therapy called “interpersonal therapy,” or IPT, which was intended to be a more demonstrably effective form of therapy than most eclectic psychoanalytically oriented therapies were.</div>
+<blockquote>
+No social order is ever destroyed before all the productive forces for which it is sufficient have been developed, and new superior relations of production never replace older ones before the material conditions for their existence have matured within the framework of the old society.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c05nts092a|92.]]$$$ Klerman, “The Psychiatric Patient’s Right,” p. 417.</div>
-<div style="margin-left:0.423cm;">@@@[[#c05nts093a|93.]]$$$ There had, of course, been a number of studies of psychotherapy efficacy before this time—for example, Hans J. Eysenck, “The Effects of Psychotherapy: An Evaluation,” and H. Strupp and S. Hadley, “Specific vs. Non-specific Factors in Psychotherapy: A Controlled Study of Outcome,” in the latter of which researchers found no difference between experienced psychotherapists and college professors in handling depressed and anxious college students—but much of the more sophisticated work has been done more recently, and many people believe that there still has been no comprehensive study of intensive psychotherapy or psychoanalysis. The point, of course, is that psychoanalysts did not believe in the power of psychoanalysis because of randomized, controlled trials. They believed because they felt that it worked for them, their patients, or someone they knew.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c05nts094a|94.]]$$$ A. Stone, “Law, Sciences and Psychiatric Malpractice: A Response to Klerman’s Indictment of Psychoanalytic Psychiatry,” p. 421.</div>
+''- Structure of Consciousness''
-<div style="margin-left:0.423cm;">@@@[[#c05nts095a|95.]]$$$ Ibid., p. 424.</div>
+Consciousness has a very complicated structure, including many factors which have strong relationships with each other. The most basic factors are ''knowledge, sentiment'' and ''willpower.''
-<div style="margin-left:0.423cm;">@@@[[#c05nts096a|96.]]$$$ P. Kingsley, letter.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c05nts097a|97.]]$$$ T. Pearlman, letter; R. Greenberg and S. Fisher, letter.</div>
+==== Annotation 81 ====
-<div style="margin-left:0.423cm;">@@@[[#c05nts098a|98.]]$$$ This is reported in S. Fisher and R. Greenberg, “Prescriptions for Happiness? (Effectiveness of Antidepressants).” The study described medication trials undertaken in 1958 to 1972. Fisher and Greenberg have more current work. See, for example, “How Sound Is the Double-blind Design for Evaluating Psychotropic Drugs?” They argue that a meta-analysis of recent studies of new-generation antidepressants reveals that the reported efficacy of the old antidepressants falls markedly from earlier claims: “When researchers were evaluating the antidepressants in a context where they were no longer interested in proving its therapeutic power, there was a dramatic decrease in that apparent power, as compared to an earlier context when they were enthusiastically interested in demonstrating the drug’s potency” (p. 37).</div>
+As with the concept of reflection (see Annotation 68, p. 65), the analysis of the structure of consciousness which follows is rooted in ideas first proposed by Marx, Engels and Lenin, and later developed through the work of various Soviet psychologists, philosophers, and scientists including Ivan Pavlov, Todor Pavlov, Aleksei Leontiev, Lev Vygotsky, Valentin Voloshinov, and others, and is used as a basis for scientific inquiry and development up to this day. According to ''Where is Marx in the Work and Thought of Vygotsky?'' by Lucien Sève (2018), much of this work, such as the groundbreaking work of Lev Vygotsky, has been heavily “de-Marxized,” stripped of all aspects of Marxism and, by extension, dialectical materialism, in translation to English.
-<div style="margin-left:0.423cm;">@@@[[#c05nts099a|99.]]$$$ John Gedo, “A Psychoanalyst Reports at Mid-career.”</div>
+''Knowledge'' constitutes the understanding of human beings, and is the result of the cognitive process. Knowledge is the re-created image of perceived objects which takes the form of language. Knowledge is the mode of existence of consciousness and the condition for consciousness to develop.
-<div style="margin-left:0.423cm;">@@@[[#c05nts100a|100.]]$$$ John Horgan, “Why Freud Isn’t Dead,” p. 106.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c05nts101a|101.]]$$$ Lewis Judd, “The Decade of the Brain in the United States.”</div>
+==== Annotation 82 ====
+Marx and Engels discussed the relationship between language and consciousness extensively in ''The German Ideology'', explaining that language — the form of knowledge which exists in human consciousness — evolved dialectically with and through social activity, and that consciousness also developed along with and through the material processes that gave rise to speech:
-=== {{anchor|CHAPTERSIXTHECRISISOFMANAG}} CHAPTER SIX: THE CRISIS OF MANAGED CARE ===
+<blockquote>
+From the start the ‘spirit’ is afflicted with the curse of being ‘burdened’ with matter, which here makes its appearance in the form of agitated layers of air, sounds, in short, of language. Language is as old as consciousness, language is practical consciousness that exists also for other men, and for that reason alone it really exists for me personally as well; language, like consciousness, only arises from the need, the necessity, of intercourse with other men.”So, language, physical speech organs, and human society all developed in dialectic relations with one another. Since language is the form of knowledge in human consciousness, this means that knowledge arose directly from these dialectical processes:
-<div style="margin-left:0.423cm;">@@@[[#c06nts001a|1.]]$$$ Jennie. Kronenfeld, ed., ''Changing Organizational Forms of Delivering Health Care'', p. xii.</div>
+Consciousness is, therefore, from the very beginning a social product, and remains so as long as men exist at all. Consciousness is at first, of course, merely consciousness concerning the immediate sensuous environment and consciousness of the limited connection with other persons and things outside the individual who is growing self-conscious.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c06nts002a|2.]]$$$ Robert Schreter, Steven Sharfstein, and Carol Schreter, eds., ''Managing Care, Not Dollars: The Continuum of Mental Health Services'', p. I.</div>
+The fact that knowledge has a language-form in human consciousness is also important to understand because it shows that consciousness arose dialectically as, and through, social activity, and indeed, language and social activity gave rise to consciousness as a replacement for animal instinct in our relations with nature.
-<div style="margin-left:0.423cm;">@@@[[#c06nts003a|3.]]$$$ I owe some of the phrasing of this paragraph to Richard Hermann.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c06nts004a|4.]]$$$ D. Kaiser, “Not by Chemicals Alone: A Hard Look at ‘Psychiatric Medicine.’ ”</div>
+<blockquote>
+Man’s consciousness of the necessity of associating with the individuals around him is the beginning of the consciousness that he is living in society at all. This beginning is as animal as social life itself at this stage. It is mere herd-consciousness, and at this point man is only distinguished from sheep by the fact that with him consciousness takes the place of instinct or that his instinct is a conscious one.
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c06nts005a|5.]]$$$ E. Marcus and S. Bradley, “Concurrence of Axis I and Axis II Treatment in Treatment-Resistant Hospitalized Patients.”</div>
+And, as language and social activity dialectically developed through one another, human society became complex enough to give rise to human societies and human economies:
-<div style="margin-left:0.423cm;">@@@[[#c06nts006a|6.]]$$$ Glen Gabbard, ''Psychodynamic Psychiatry in Clinical Practice'', pp. 15–16.</div>
+<blockquote>
+This sheep-like or tribal consciousness receives its further development and extension through increased productivity, the increase of needs, and, what is fundamental to both of these, the increase of population. With these there develops the division of labour…
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c06nts007a|7.]]$$$ Leon Eisenberg, “Mindlessness and Brainlessness in Psychiatry”; Phillip Slavney and Paul McHugh, ''Psychiatric Polarities;'' Gabbard, ''Psychodynamic Psychiatry''.</div>
-<div style="margin-left:0.423cm;">@@@[[#c06nts008a|8.]]$$$ Exemplary articles on the pressure that managed care can put upon doctors to judge their patients quickly but well include C. L. Caton et al., “The Impact of Discharge Planning on Chronic Schizophrenic Patients”; G. Gabbard et al., “A Psycho-dynamic Perspective on the Clinical Impact of Insurance Review”; S. Melnick and L. Lyter, “The Negative Impact of Increased Concurrent Review of Psychiatric Inpatient Care”; S. Scharfstein, “The Catastrophic Case”; N. Miller, “Managing McLean.”</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c06nts009a|9.]]$$$ He was not at the meeting, although he knew the primary players. However, he expressed their sentiments neatly.</div>
+Knowledge can be separated into two broad categories: knowledge of nature, and knowledge of human society. Each of these categories of knowledge reflects its corresponding entity in the external world.
-<div style="margin-left:0.423cm;">@@@[[#c06nts010a|10.]]$$$ Wilfred Bion, ''Experiences in Groups'', pp. 141–142.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c06nts011a|11.]]$$$ Ibid., pp. 147–148.</div>
+==== Annotation 83 ====
-<div style="margin-left:0.423cm;">@@@[[#c06nts012a|12.]]$$$ Ibid., p. 146.</div>
+[[File:t-w-the-worldview-and-philosophical-methodology-of-16.png|''Each category of knowledge reflects a corresponding entity in the external world.'']]
-<div style="margin-left:0.423cm;">@@@[[#c06nts013a|13.]]$$$ Alfred Stanton and Morris Schwartz, ''The Mental Hospital''.</div>
+It’s also important to note that human society and nature have a dialectical relationship with each other and mutually impact one another, and, by extension, knowledge of nature and knowledge of human society also dialectically influence one another. So these categories of knowledge are not isolated from one another but rather dynamically shape and influence each other continuously through time.
+-----
-=== {{anchor|CHAPTERSEVENMADNESSANDMORAL}} CHAPTER SEVEN: MADNESS AND MORAL RESPONSIBILITY ===
+Based on levels of cognitive development, we can also classify knowledge into categories of: daily life knowledge and scientific knowledge, experience knowledge and theory knowledge, emotional knowledge and rational knowledge.
-<div style="margin-left:0.423cm;">@@@[[#c07nts001a|1.]]$$$ In antiquity, this was more of a problem for Christianity than for Judaism, for Christianity in particular elevates suffering as a means of growing close to God. In early Christian churches, Christ’s face was sometimes modeled on that of Hippocrates (also, apparently, that of Aesculapius; see Immanuel Jakobovits, ''Jewish Medical Ethics'', p. 296, n. 5). Still, Jews as well as Christians had strange small sects that refused, among other things, to subvert divine will through the use of human medicine (ibid. p. 303, ns. 5, 7; also p. 2).</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c07nts002a|2.]]$$$ Ibid., pp. 1ff.</div>
+==== Annotation 84 ====
-<div style="margin-left:0.423cm;">@@@[[#c07nts003a|3.]]$$$ Martin Luther, ''Martin Luther: Selections from His Writings'', vol. 7, p. 113.</div>
+The following information is from the ''Marxism-Leninism Textbook of Students Who Specialize in Marxism-Leninism'', released by Vietnam’s Ministry of Education and Training:
-<div style="margin-left:0.423cm;">@@@[[#c07nts004a|4.]]$$$ Ibid., p. 308.</div>
+'''Daily Life and Scientific Knowledge'''
-<div style="margin-left:0.423cm;">@@@[[#c07nts005a|5.]]$$$ Ibid., p. 113, Luther also says; “God does not want bodies to be killed; He wants them spared; indeed, He wants them to be nourished and fostered, in order that they might be fit for their calling and for the duties they owe their neighbor”; (ibid., vol. 2, p. 339).</div>
+[[File:t-w-the-worldview-and-philosophical-methodology-of-17.png]]
-<div style="margin-left:0.423cm;">@@@[[#c07nts006a|6.]]$$$ Ibid., vol. 23, p. 203.</div>
+''Daily Life Knowledge'' is the knowledge we acquire in our daily lives to deal with our daily tasks. From our interactions with nature and human society, we cultivate life experience and our understanding of every aspect of our daily lives in relation to human society and nature.
-<div style="margin-left:0.423cm;">@@@[[#c07nts007a|7.]]$$$ Nadine Gordimer, ''Burger’s Daughter''.</div>
+''Scientific Knowledge'' arises from Daily Life Knowledge: as our daily lives become more complex, we develop a need to understand the material world and human society more deeply and comprehensively. Scientific Knowledge is thus a developed system of knowledge of nature and human society. Scientific Knowledge can be tested and can be applied to human life and activity in useful ways.
-<div style="margin-left:0.423cm;">@@@[[#c07nts008a|8.]]$$$ Midrash Samuel iv. 1., cited in Jakobovits, ''Jewish Medical Ethics'', p. 304, n. 7.</div>
+'''Experience and Theory Knowledge:'''
-<div style="margin-left:0.423cm;">@@@[[#c07nts009a|9.]]$$$ Religion teaches us, as Clifford Geertz has remarked, not to avoid suffering but rather how to suffer, “how to make of physical pain, personal loss, worldly defeat, or the helpless contemplation of others’ agony something bearable, supportable—something, as we say, sufferable” (Clifford Geertz, ''The Interpretation of Cultures'', p. 104).</div>
+[[File:t-w-the-worldview-and-philosophical-methodology-of-18.png]]
-<div style="margin-left:0.423cm;">@@@[[#c07nts010a|10.]]$$$ Mary Gordon, “George Eliot, Dorothea, and Me: Rereading (and Rereading) ''Middle-march''.”</div>
+''Experience Knowledge'' is cultivated from direct observation of nature and human society. This kind of knowledge is extremely diverse, and we can apply this kind of knowledge to guide our daily activities.
-<div style="margin-left:0.423cm;">@@@[[#c07nts011a|11.]]$$$ The actual source includes “not” before this sentence and defines which expenses will not be covered; the Supreme Court has suggested that the statute be interpreted to require all states to cover all medically necessary services for patients with Medicaid (Arthur Lazarus, ed., ''Controversies in Managed Mental Health Care'', p. 161).</div>
+''Theory Knowledge'' arises from Experience Knowledge. Theory Knowledge is composed of abstract generalizations of Experience Knowledge. Theory Knowledge is more profound, accurate, and systematically organized than Experience Knowledge and gives us an understanding of the laws and dynamics of nature and human society.
-<div style="margin-left:0.423cm;">@@@[[#c07nts012a|12.]]$$$ Joseph McManus, ''The Fundamental Ideas of Medicine'', p. ii.</div>
+'''Emotional and Rational Knowledge:'''
-<div style="margin-left:0.423cm;">@@@[[#c07nts013a|13.]]$$$ For instance, is it normal for a woman to have a baby, in which case infertility should be classified as an illness, an injury, or a malformed organ—or is it a privilege, like a beautiful nose? At the age of forty? At twenty-five?</div>
+[[File:t-w-the-worldview-and-philosophical-methodology-of-19.png]]
-<div style="margin-left:0.423cm;">@@@[[#c07nts014a|14.]]$$$ Contrast “the stove is burning” with “the man is paying his gas bill,” Elizabeth Anscombe explained in her classic account of intention, and then consider the “enormous apparent complexity of ‘doing’ in the latter case” (G.E.M. Anscombe, ''Intention'', p. ix). The stove ''is'', in the same way that the colon cancer is, and either it is burning or it is not. The stove has neither wants nor self-interests. The man paying his bills, however, has many complicated desires, some of which are bound to be in conflict about writing checks and giving them away. Saying exactly in what way this has more “enormous apparent complexity” is, of course, a large question, but it catches up all the skeins of essential suffering, all the small decisions with unknown consequences that shape the way we feel, hope, and decide again.</div>
+Less Developed More Developed
-<div style="margin-left:0.423cm;">@@@[[#c07nts015a|15.]]$$$ As Lawrence Rosen points out in ''Other Intentions'', the inference of intention is culturally shaped. We could, the volume reminds us, like Tibetan Sherpas, infer the presence of malevolent unearthly beings from illness, accidents, and misfortunes and conduct rituals to exorcize the demons. Or, like the Kaqchikel Maya, living through army sweeps, disappearances, and threats of civil war, we could hesitate to infer intention at all and wait with suspicious watchfulness for the worst to take place.</div>
+''Emotional Knowledge'' is the earlier stage of cognitive processing. Emotional Knowledge comes directly to us from our human senses. We obtain emotional knowledge when we use our human senses to directly learn things about nature and human society. Emotional Knowledge is usually manifested as immediate cognitive responses such as pleasure, pain, and other such impulses.
-<div style="margin-left:0.423cm;">@@@[[#c07nts016a|16.]]$$$ Charles Taylor, ''Sources of the Self'', p. 15.</div>
+''Rational Knowledge'' arises from Emotional Knowledge. It is a higher stage of cognitive processing, involving abstract thought and generalization of emotional knowledge.
-<div style="margin-left:0.423cm;">@@@[[#c07nts017a|17.]]$$$ James Wilson, ''The Moral Sense'', p. 32; see also Kenneth Clark, “Empathy: A Neglected Topic in Psychological Research”; Nancy Eisenberg and Janet Strayer, ''Empathy and Its Development;'' Virginia Demos, “Empathy and Affect: Reflections on Infant Experience.”</div>
+Rational Knowledge is usually manifested as definitions, conjectures, judgments, etc.
-<div style="margin-left:0.423cm;">@@@[[#c07nts018a|18.]]$$$ See discussion by Martin Hoffman in Eisenberg and Strayer, ''Empathy and Its Development'', pp. 47–80.</div>
+''See also: Principle of Development, p. 119; Cognitive Theory of Dialectical Materialism, p. 204.''
-<div style="margin-left:0.423cm;">@@@[[#c07nts019a|19.]]$$$ Shweder is perhaps the most important living anthropological student of morality. He sits between anthropology and psychology, enabling a fruitful interchange between the two. His work on morality is notable in part for its successful challenge of the dominant psychological paradigm of morality, Lawrence Kohlberg’s developmental model. Kohlberg developed a scale he could use to score an individual’s moral state that he modeled on a Piagetian developmental scale. There were three main stages, with two substages each. In the first stage, the individual explained moral behavior as motivated by self-interest (I won’t steal because if I did the policeman would punish me); in the second, as motivated by convention (I don’t steal because we don’t steal); and finally as motivated by abstract moral principles (I won’t steal because it is wrong to steal). Carol Gilligan argued that women often score poorly on Kohlberg’s test, but that this is because they reason in a different manner from men. They hear the voice of care, not of justice. They worry about who will be hurt by their decisions, not about the abstract principle involved. In short, they are often utilitarian, not Kantian. Elliot Turiel discovered that children of all ages distinguish the conventional—Kohlberg’s second stage—from the moral and that their ideas about things conventional and things moral develop in parallel. Shweder pointed out that Hindus have a very clear sense of the difference between what is moral and what is conventional but are willing to say that what is moral for them might be a convention for others. It is a sin, for example, for a Brahmin to eat meat, but not for an American or a lower-caste Hindu. Shweder also discovered that to Hindus it is not obvious that the correct answer to the Heinz dilemma is to steal. (The Heinz dilemma asks what you would do if your spouse were dying and the only way to save him or her was to steal some medication.) Many of his informants stubbornly refused to countenance stealing, on the grounds that immoral behavior in this life would lead to punishment in the next—which was probably why the spouse had been unlucky in the first place. Some of this discussion, as well as an argument about the necessary and discretionary features of morality, can be found in two summary articles: Richard Shweder, M. Mahapatra, and J. Miller, “Culture and Moral Development,” and Richard Shweder and Jonathan Haidt, “The Future of Moral Psychology: Truth, Intuition and the Pluralist Way.”</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c07nts020a|20.]]$$$ “Of course,” comments the anthropologist Wendy James in her wise study of a hunting people in Sudan, ''The Listening Ebony'', “the Uduk have constructed what we could, in a conventional sense, identify as a ‘morality,’ that is, a set of publicly sanctioned principles governing personal and general social behavior.” But that, she says, does not capture the way the Uduk actually live. What counts in the moral, she says, is “the store of reference points from which a people, as individuals or as a collectivity, judge their own predicament, their own condition, themselves as persons” (pp. 146–147).</div>
+''Sentiment'' is the resonant manifestation of human emotions and feelings in our relationships. Sentiment is a special form of reality reflection [see Annotation 68, p. 65]. Whenever reality impacts human beings, we feel specific sensations and emotional reactions to those impacts. Over time, these specific sensations and emotions combine and dialectically develop into generalized human feelings, and we call these generalized feelings ''sentiment.'' Sentiment expresses and develops in every aspect of human life; it is a factor that improves and promotes cognitive and practical activities.
-<div style="margin-left:0.423cm;">@@@[[#c07nts021a|21.]]$$$ There are contradictions in the use of such models, of course, because cultural models about the world confront the world’s complexities. The philosopher Sara Ruddick, who turned to an anthropology of mothering to write what must be the first closely reasoned ethics text about play dates and changing diapers, argues that the way people solve those contradictions is what we should call their “morality.” The goal of motherhood, she points out, is to protect, nurture, and to train. She asks, “If a child wants to walk to the store alone, do you worry about her safety or applaud her developing capacity to take care of herself?” (Ruddick, ''Maternal Thinking'', p. 23.) The mother makes a choice based on what she thinks is right for her child and what she believes a good mother should do. Her moral decision-making process has more to do with local sensibilities about proper behavior than with abstract, universal values.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c07nts022a|22.]]$$$ Unni Wikan, ''Managing Turbulent Hearts'', p. 107.</div>
+==== Annotation 85 ====
-<div style="margin-left:0.423cm;">@@@[[#c07nts023a|23.]]$$$ Clyde Kluckhohn, the major influence of the group, did state a formal and uselessly broad definition in which values were concepts of the desirable that influence action: “A value is a conception, explicit or implicit, distinctive of an individual or characteristic of a group, of the desirable which influences the selection from available modes, means and ends of action” (Evon Z. Vogt and Ethel Albert, eds., ''The People of Rim-rock'', p. 6).</div>
+As Marx explains in ''Economic and Philosophic Manuscripts of 1844:'' “Man as an objective, sensuous being is therefore a suffering being — and because he feels that he suffers, a passionate being. Passion is the essential power of man energetically bent on its object.” Marx further elaborates that sentimental emotion is essential to human nature: “The domination of the objective essence within me, the sensuous eruption of my essential activity, is emotion which thereby becomes the activity of my nature.”
-<div style="margin-left:0.423cm;">@@@[[#c07nts024a|24.]]$$$ In fact, some anthropologists argue that emotions are not only imbued with moral attitudes but in some sense ''are'' those attitudes. “Emotional experience,” writes Catherine Lutz, “is more aptly viewed as the outcome of social relations and their corollary worldviews than as universal psychobiological entities” (Lutz, ''Unnatural Emotions'', p. 94.) Anthropologists as a group have more or less given up explicitly theorizing about morality in recent years. Exceptions include Richard Shweder, Catherine Lutz, Wendy James, Steve Parish, Unni Wikan, and others. They stand on the shoulders of Meyer Fortes and Kenneth Read.</div>
+Depending on the subjects that are perceived, as well as our human emotions about them, sentiments can be manifested in many different forms such as: moral emotion, aesthetic emotion, religious emotion, etc.
-<div style="margin-left:0.423cm;">@@@[[#c07nts025a|25.]]$$$ I learned to look for this quality as a result of a discussion with Kim Hopper, a psychiatric anthropologist at the Nathan Kline Institute.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c07nts026a|26.]]$$$ John Hood, “Commentary,” p. i.</div>
+==== Annotation 86 ====
-<div style="margin-left:0.423cm;">@@@[[#c07nts027a|27.]]$$$ See Kim Hopper et al., eds., ''Prospects for Recovery from Schizophrenia—International Investigation''.</div>
+''Moral Emotion'' is the basic manifestation of moral consciousness at an emotional level. For example: when we see people helping other people, we have positive emotional responses, yet when we see people harming other people, we have negative emotional responses. ''(Source: Nguyen Thi Khuyen of the National Institute of Administration of Vietnam)''
-<div style="margin-left:0.423cm;">@@@[[#c07nts028a|28.]]$$$ Sharon Begley, “Beyond Prozac,” p. 37.</div>
+''Aesthetic Emotion'' refers to the the resonant feelings which arise from our interaction with beauty, sadness, comedy, etc., in life and in art. For example: when humans encounter beauty, we feel positive emotional responses. When humans encounter ugliness, we feel negative emotional responses. When we witness pain, we feel sympathetic feelings of pain and a desire to help. When we witness comedy, we feel humorous emotions ourselves. ''(Source: Textbook of General Aesthetic Studies from the Ministry of''
-<div style="margin-left:0.423cm;">@@@[[#c07nts029a|29.]]$$$ Harper’s Index, July 1997, p. 13, from Sanofi Research, Great Valley, Pa.</div>
+''Education and Training of Vietnam)''
-<div style="margin-left:0.423cm;">@@@[[#c07nts030a|30.]]$$$ These quotations and facts are taken from two excellent essays, Daniel Zalewski, “Fissures at an Exhibition,” and Jonathan Lear “The Shrink Is In.” Zalewski concludes his essay on the chaos by remarking, “Given what’s happened, maybe being a museum curator is the ''real'' impossible profession” (p. 77).</div>
+''Religious Emotion'' is the human belief in supernatural or spiritual forces which can’t be tested or proved through material practice or observation. However, belief in these forces can give human beings emotional responses such as hope, love, etc. ''(Source: Pham Van Chuc, Doctor of Philosophy, Central Theoretical Council of the Communist Party of Vietnam)''
-<div style="margin-left:0.423cm;">@@@[[#c07nts031a|31.]]$$$ Frederick Crews, “The Unknown Freud,” p. 55.</div>
+These are just a few illustrative examples; there are many other ways in which human emotion and sentiment can manifest.
-<div style="margin-left:0.423cm;">@@@[[#c07nts032a|32.]]$$$ Ibid.</div>
+''Willpower'' is the manifestation of one’s own strength used to overcome obstacles in the process of achieving goals. Willpower is a dynamic aspect of consciousness, a manifestation of human consciousness in the material world.
-<div style="margin-left:0.423cm;">@@@[[#c07nts033a|33.]]$$$ Ibid., p. 65.</div>
+-----
-<div style="margin-left:0.423cm;">@@@[[#c07nts034a|34.]]$$$ Ibid., p. 56.</div>
+==== Annotation 87 ====
-<div style="margin-left:0.423cm;">@@@[[#c07nts035a|35.]]$$$ Ibid.</div>
+An unnamed poem by Ho Chi Minh, written in 1950 for the Revolutionary Youth Pioneers, addresses the phenomenon of willpower:
-<div style="margin-left:0.423cm;">@@@[[#c07nts036a|36.]]$$$ Jeffrey Moussaieff Masson, ''Final Analysis'', p. 85.</div>
+<blockquote>
+Nothing in this world must be difficult
-<div style="margin-left:0.423cm;">@@@[[#c07nts037a|37.]]$$$ Ibid., p. 86.</div>
+The only thing that we should fear is having a waivering heart
-<div style="margin-left:0.423cm;">@@@[[#c07nts038a|38.]]$$$ Lear, “The Shrink Is In,” p. 24.</div>
+We can dig up mountains and fill the sea
-<div style="margin-left:0.423cm;">@@@[[#c07nts039a|39.]]$$$ Hans Loewald, ''Psychoanalysis and the History of the Individual'', p. 11.</div>
+Once we’ve willfully made a firm decision
+</blockquote>
-<div style="margin-left:0.423cm;">@@@[[#c07nts040a|40.]]$$$ This was the case involving Myron Liptzin and Wendell Williamson. The latter killed two men after leaving the former’s care. Williamson was awarded half a million dollars. Reported in ''Psychiatric News'', cited at [http://www.psych.org http://www.psych.org].</div>
+Today, this poem serves as the lyrics for anthem of the Ho Chi Minh Communist Youth Union (formerly the Revolutionary Youth Pioneers).
-<div style="margin-left:0.423cm;">@@@[[#c07nts041a|41.]]$$$ “Howie the Harp,” in Zinman, S. “Howie the Harp,” and S. Budd, eds., ''Reaching Across'', p. 24.</div>
+-----
-<div style="text-align:center;">{{anchor|bib}} {{anchor|TopofLuhr9780307791900epubb1}} [[Image:Image8.png|top]]$$$</div>
+Willpower arises from human self-awareness and awareness of the purposes of our actions. Through this awareness and through willpower, we are able to struggle against ourselves and externalities to successfully achieve our goals. We can consider willpower to be the power of conscious human activity; willpower controls and regulates human behaviors in order to allow humans to move towards our goals voluntarily; willpower also allows humans to exercise self-restraint and self-control, and to be assertive in our actions according to our views and beliefs.
-== BIBLIOGRAPHY ==
+-----
-<div style="margin-left:0.423cm;">Abbott, Andrew. ''The System of Professions''. Chicago: University of Chicago Press, 1988.</div>
+==== Annotation 88 ====
-<div style="margin-left:0.423cm;">Acocella, Joan. “The Politics of Hysteria.” ''The New Yorker'', April 6, 1998, pp. 64–78.</div>
+In ''Dialectics of Nature'', Engels explains how willpower developed in human beings as we separated from animals through the development of consciousness: “The further removed men are from animals, however, the more their effect on nature assumes the character of premeditated, planned action directed towards definite preconceived ends.”
-<div style="margin-left:0.423cm;">Akiskal, Hagop. “Mood Disorders.” In Harold Kaplan and Benjamin Sadock, eds., ''Comprehensive Handbook of Psychiatry VI''. Baltimore: Williams & Wilkins, 1995, pp. 1067–1079.</div>
+In ''Capital Volume I'', Marx explains how willpower uniquely allows humans to consciously change our own material conditions to suit our needs according to pre-conceived plans:
-<div style="margin-left:0.423cm;">_________. “Mood Disorders: Clinical Features.” In Harold Kaplan and Benjamin Sadock,</div>
+<blockquote>
+Labour is, in the first place, a process in which both man and Nature participate, and in which man of his own accord starts, regulates, and controls the material re-actions between himself and Nature. He opposes himself to Nature as one of her own forces, setting in motion arms and legs, head and hands, the natural forces of his body, in order to appropriate Nature’s productions in a form adapted to his own wants. By thus acting on the external world and changing it, he at the same time changes his own nature. He develops his slumbering powers and compels them to act in obedience to his sway. We are not now dealing with those primitive instinctive forms of labour that remind us of the mere animal. An immeasurable interval of time separates the state of things in which a man brings his labour-power to market for sale as a commodity, from that state in which human labour was still in its first instinctive stage. We pre-suppose labour in a form that stamps it as exclusively human. A spider conducts operations that resemble those of a weaver, and a bee puts to shame many an architect in the construction of her cells. But what distinguishes the worst architect from the best of bees is this, that the architect raises his structure in imagination before he erects it in reality. At the end of every labour-process, we get a result that already existed in the imagination of the labourer at its commencement. He not only effects a change of form in the material on which he works, but he also realises a purpose of his own that gives the law to his modus operandi, and to which he must subordinate his will. And this subordination is no mere momentary act. Besides the exertion of the bodily organs, the process demands that, during the whole operation, the workman’s will be steadily in consonance with his purpose. This means close attention. The less he is attracted by the nature of the work, and the mode in which it is carried on, and the less, therefore, he enjoys it as something which gives play to his bodily and mental powers, the more close his attention is forced to be.
+</blockquote>
-<div style="margin-left:0.423cm;">eds., ''Comprehensive Handbook of Psychiatry VI''. Baltimore: Williams & Wilkins, 1995, pp. 1123–1152.</div>
-<div style="margin-left:0.423cm;">_________. “The Temperamental Foundations of Affective Disorders.” In Christoph Mundt et al., eds., ''Interpersonal Factors in the Origin and Course of Affective Disorders''. London: Gaskell, 1996.</div>
+-----
-<div style="margin-left:0.423cm;">Akiskal, Hagop, et al. “Borderline: An Adjective in Search of a Noun.” ''Journal of Clinical Psychiatry'' 46: 41–48 (1985).</div>
+The true value of willpower is not only manifested in strength or weakness, but is also expressed in the content and meaning of the goals that we try to achieve through our willpower. Lenin believed that willpower is one of the factors that will create revolutionary careers for millions of people in the fierce class struggles to liberate ourselves and mankind.
-<div style="margin-left:0.423cm;">''Akiskal, Hagop, and William McKinney. “Overview of Recent Work in Depression.”'' ''Archives of General Psychiatry'' 32: 285–305 (1975).</div>
+-----
-<div style="margin-left:0.423cm;">American Psychiatric Association. ''Careers in Psychiatry''. New York: Macmillan, 1968.</div>
+==== Annotation 89 ====
-<div style="margin-left:0.423cm;">_________. Diagnostic and Statistical Manual of Mental Disorders. DSM I: ''1952;'' DSM II: 1968. ''DSM III:'' 1980. ''DSM IV:'' 1994. Washington, D.C.: American Psychiatric Press.</div>
+In “''Left-Wing” Communism: an Infantile Disorder'', Lenin explains how revolutions are born from the collective willpower of thousands of people:
-<div style="margin-left:0.423cm;">_________. “Practice Guidelines for Eating Disorders.” ''American Journal of Psychiatry'' 150: 212–228 (1993).</div>
+<blockquote>
+History as a whole, and the history of revolutions in particular, is always richer in content, more varied, more multiform, more lively and ingenious than is imagined by even the best parties, the most class-conscious vanguards of the most advanced classes. This can readily be understood, because even the finest of vanguards express the class-consciousness, will, passion and imagination of tens of thousands, whereas at moments of great upsurge and the exertion of all human capacities, revolutions are made by the class-consciousness, will, passion and imagination of tens of millions, spurred on by a most acute struggle of classes. Two very important practical conclusions follow from this: first, that in order to accomplish its task the revolutionary class must be able to master all forms or aspects of social activity without exception (completing after the capture of political power — sometimes at great risk and with very great danger — what it did not complete before the capture of power); second, that the revolutionary class must be prepared for the most rapid and brusque replacement of one form by another.
+</blockquote>
-<div style="margin-left:0.423cm;">_________. “Practice Guidelines for Major Depressive Disorder in Adults.” ''American Journal of Psychiatry'' 150 (suppl.): 1a—26a (1993).</div>
-<div style="margin-left:0.423cm;">_________. “Practice Guidelines for Bipolar Disorder in Adults.” ''American Journal of Psychiatry'' 151 (suppl.): 1a—36a (1994).</div>
+-----
-<div style="margin-left:0.423cm;">Andreasen, Nancy, and Donald Black. ''Introductory Textbook of Psychiatry''. Washington, D.C.: American Psychiatric Press, 1995.</div>
+All of these factors [knowledge, sentiment, and willpower] which, together, create consciousness, have dialectical relationships with each other. Of these factors, knowledge is the most important, because it is the mode of existence of consciousness, and also the factor which guides the development of all the other factors, and it also determines how the other factors manifest.
-<div style="margin-left:0.423cm;">Andreasen, Nancy, et al. “Thalamic Abnormalities in Schizophrenia Visualized Through Magnetic Resonance Imaging.” ''Science'' 266: 294–298 (1994).</div>
+=== 3. The Relationship Between Matter and Consciousness ===
-<div style="margin-left:0.423cm;">Anscombe, G. E. M. ''Intention''. New York: Cornell University Press, 1963.</div>
+The relationship between matter and consciousness is dialectical. In this relationship, ''matter comes first, and matter is the source of consciousness; it decides consciousness. However, consciousness is not totally passive, it can impact back to matter through the practical activities of human beings.''
-<div style="margin-left:0.423cm;">Antonuccio, David. “Psychotherapy for Depression: No Stronger Medicine.” ''American Psychologist'' 50: 450–452 (1995).</div>
+-----
-<div style="margin-left:0.423cm;">Antonuccio, David, William Garland, and G. DeNelsky. “Psychotherapy vs. Medication for Depression: Challenging the Conventional Wisdom with Data.” ''Professional Psychology'' 26: 574–586 (1995).</div>
+==== Annotation 90 ====
-<div style="margin-left:0.423cm;">Antonuccío, David, et al. “Raising Questions About Anti-depressants.” ''Psychotherapy and Psychosomatic'' 68: 3–14 (1999).</div>
+Engels explained in ''Dialectics of Nature'' that “matter evolves out of itself the thinking human brain,” which means that matter must necessarily come prior to consciousness.
-<div style="margin-left:0.423cm;">''The Atlantic''. Special Supplement: “Psychiatry.” 208 (1) (July 1961).</div>
+As Marx explains in ''Capital Volume I'', matter determines conscious activity:
-<div style="margin-left:0.423cm;">Axline, Virginia. ''Dibs: in Search of Self''. New York: Ballantine, 1964.</div>
+<blockquote>
+The production of ideas, of conceptions, of consciousness, is at first directly interwoven with the material activity and the material intercourse of men, the language of real life. Conceiving, thinking, the mental intercourse of men, appear at this stage as the direct efflux of their material behaviour. The same applies to mental production as expressed in the language of politics, laws, morality, religion, metaphysics, etc., of a people. Men are the producers of their conceptions, ideas, etc. – real, active men, as they are conditioned by a definite development of their productive forces and of the intercourse corresponding to these, up to its furthest forms. Consciousness can never be anything else than conscious existence, and the existence of men is their actual life-process. If in all ideology men and their circumstances appear upside-down as in a camera obscura, this phenomenon arises just as much from their historical life-process as the inversion of objects on the retina does from their physical life-process.
+</blockquote>
-<div style="margin-left:0.423cm;">Bachrach, H., et al. “On the Efficacy of Psychoanalysis.” ''Journal of the American Psychoanalytic Association'' 39 (4): 871–916 (1991).</div>
+However, it’s important to remember that the relationship between matter and consciousness is ''dialectical'', and that conscious activity — through the combination of willpower and labor — can also impact the material world; social change arises through the combined willpower of many human beings. See: Annotation 80, p. 81.
-<div style="margin-left:0.423cm;">Balsam, Rosemary M., and Alan Balsam. ''Becoming a Psychotherapist:'' A ''Clinical Primer''. Boston: Little, Brown, 1979.</div>
+==== a. The Role of Matter in Consciousness ====
-<div style="margin-left:0.423cm;">Barker, Pat. ''Regeneration''. New York: Penguin, 1991.</div>
+Dialectical Materialism affirms that:
-<div style="margin-left:0.423cm;">_________. ''The Eye in the Door''. New York: Penguin, 1993.</div>
+'''• Matter is the first existence, and that consciousness comes after.'''
-<div style="margin-left:0.423cm;">_________''The Ghost Road''. New York: Penguin, 1995.</div>
+'''• Matter is the source of consciousness, it decides consciousness.'''
-<div style="margin-left:0.423cm;">Barlow, D. H. “Cognitive-Behavioral Therapy for Panic Disorder: Current Status.” ''Journal of Clinical Psychiatry'', 58 (suppl.): 32–37 (1997).</div>
+We know that matter determines consciousness because consciousness is the product of the high-level-structured matter such as the human brain. Consciousness itself can only exist after the development of the material structure of the human brain. Humans are the result of millions of years of development of the material world. We are, therefore, products of the material world. This conclusion has been firmly established through the development of natural science, which has given us great insight into the long history of the Earth and of the evolution of living organisms, including human beings.
-<div style="margin-left:0.423cm;">Barlow, D. H., and C. Lehman. “Advances in the Psychosocial Treatment of Anxiety Disorders.” ''Archives of General Psychiatry'' 53: 727–735 (1996).</div>
+All of this scientific evidence stands as the basis for the viewpoint: ''matter comes first, consciousness comes after'' [see Annotation 114, p. 116].
-<div style="margin-left:0.423cm;">Basch, Michael F. ''Doing Psychotherapy''. New York: Basic Books, 1980.</div>
+We have already discussed the factors which constitute the natural and social sources of consciousness:
-<div style="margin-left:0.423cm;">Bateson, Gregory. ''Steps to an Ecology of Mind''. New York: Ballantine, 1972.</div>
+'''•''' Human brains
-<div style="margin-left:0.423cm;">Baxter, L., et al. “Caudate Glucose Metabolic Rate Changes with Both Drug and Behavior Therapy for Obsessive-compulsive Disorder.” ''Archive of General Psychiatry'' 49: 681–689 (1992).</div>
+'''•''' Impacts of the material world on human brains that cause reflections
-<div style="margin-left:0.423cm;">Becker, Howard S., et al. ''Boys in White''. Chicago: University of Chicago Press, 1961.</div>
+'''•''' Labor
-<div style="margin-left:0.423cm;">Begley, Sharon. “Beyond Prozac.” ''Newsweek'', February 7, 1994, pp. 37–42.</div>
+'''•''' Language
-<div style="margin-left:0.423cm;">Bion, Wilfred. ''Experiences in Groups''. New York: Basic Books, 1961.</div>
+[See Annotation 72, p. 68 and Annotation 73, p. 75]
-<div style="margin-left:0.423cm;">Blatt, S., et al. “Impact of Perfectionism and Need for Approval on the Brief Treatment of Depression: The NIMH Treatment of Depression Collaborative Research Program Revisited.” ''Journal of Consulting and Clinical Psychology'' 63: 125–132 (1995).</div>
+All of these factors also assert that ''matter is the origin of consciousness.''
-<div style="margin-left:0.423cm;">Bodkin, J. A., R. L. Klitzman, and H. G. Pope. “Distinction Between Biological Psychiatrists and Psychotherapists.” Unpublished manuscript.</div>
+-----
-<div style="margin-left:0.423cm;">Bosk, Charles. ''Forgive and Remember''. Chicago: University of Chicago Press, 1979.</div>
+==== Annotation 91 ====
-<div style="margin-left:0.423cm;">Braff, David, Dennis Saccuzzo, and Mark Geyer. “Information Processing Dysfunction in Schizophrenia: Studies of Visual Backward Masking, Sensorimotor Gating and Habituation.” In S. R. Steinhauer, J. H. Gruzelier, and J. Zubir, eds., ''Handbook of Schizophrenia'', vol. 5: ''Neuropsychology, Psychophysiology, and Information Processing''. New York: Elsevier Science Publishers, 1991.</div>
+[[File:t-w-the-worldview-and-philosophical-methodology-of-20.png]]
-<div style="margin-left:0.423cm;">Brauer, Lee David. “Basic Report About Members Who Are Graduates of Institutes. Survey of Psychoanalytic Practices.” New York: American Psychoanalytic Association, 1990.</div>
+The material basis of consciousness is rooted in the following phenomena:
-<div style="margin-left:0.423cm;">Brenner, Charles. ''An Elementary Textbook of Psychoanalysis''. New York: International Universities Press, 1973 (first published 1955).</div>
+<ul>
+<li><ol style="list-style-type: upper-alpha;">
+<li><p>The material structure of the human brain.</p></li></ol>
+</li>
+<li><ol start="2" style="list-style-type: upper-alpha;">
+<li><p>Impacts from the material world cause reflections in human consciousness.</p></li></ol>
+</li>
+<li><ol start="100" style="list-style-type: upper-roman;">
+<li><p>Human Labor — physical process which dialectically develops consciousness.</p></li></ol>
+</li>
+<li><ol start="500" style="list-style-type: upper-roman;">
+<li><p>Human Speech — physical process which dialectically develops consciousness.</p></li></ol>
+</li>
+<li><ol start="5" style="list-style-type: upper-alpha;">
+<li><p>Evolution of human brains and consciousness through material processes of the material world.</p></li></ol>
+</li></ul>
-<div style="margin-left:0.423cm;">''Campos, Joseph. “A Reconceptualization of the Nature of Affect.” Review of Nico Frijda'', ''The Emotions. Contemporary Psychology'' 34 (7): 633–635 (1989).</div>
+For more information, see: Nature and Structure of Consciousness.
-<div style="margin-left:0.423cm;">Campos, J., et al. “A Functionalist Perspective on the Nature of Emotion.” ''The Japanese Journal of Research on Emotions'' 2 (1): 1–20 (1994).</div>
+-----
-<div style="margin-left:0.423cm;">Caton, C. L., et al. “The Impact of Discharge Planning on Chronic Schizophrenic Patients.” ''Hospital and Community Psychiatry'' 35: 255–262 (1984).</div>
+Consciousness is composed of reflections and subjective images of the material world, therefore ''the content of consciousness is decided by matter'' [see Annotation 68, p. 65]''.'' The development of consciousness is determined by natural laws and by social laws<ref>For a discussion of the material basis of social laws, see Annotation 10, p. 10, Annotation 78, p. 80, and Annotation 79, p. 81.</ref> as well as the material environment which we inhabit. All of these factors which determine consciousness are material in nature. Therefore, matter determines not only the content but also the development of consciousness.
-<div style="margin-left:0.423cm;">Caudill, William. ''The Psychiatric Hospital as a Small Society''. Cambridge, Mass.: Harvard University Press, 1958.</div>
+==== b. The Role of Consciousness in Matter ====
-<div style="margin-left:0.423cm;">Cheever, Susan. “A Designated Crazy.” Review of Susanna Kaysen, ''Girl, Interrupted. New York Times Book Review'', June 20, 1993, p. 25.</div>
+In relation to matter, ''consciousness can impact matter through human activities.''
-<div style="margin-left:0.423cm;">Chi, M., R. Glaser, and M. Farr. ''The Nature of Expertise''. Hillsdale, N.J.: Lawrence Erlbaum, 1988.</div>
+When we discuss consciousness we are discussing ''human'' consciousness. So, when we talk about the role of consciousness, we are talking about the role of human beings. Consciousness in and of itself cannot directly change anything in reality. In order to change reality, humans have to implement material activities. However, consciousness controls every human activity, so even though consciousness does not directly create or change the material world, it equips humans with knowledge about objective reality, and based on that foundation of knowledge, humans are able to identify goals, set directions, develop plans, and select methods, solutions, tools, and means to achieve our goals. So, consciousness manifests its ability to impact matter through human activities.
-<div style="margin-left:0.423cm;">Clark, Kenneth. “Empathy: A Neglected Topic in Psychological Research.” ''American Psychologist'' 35 (2): 187–190 (1980).</div>
+The impact of consciousness on matter can have positive or negative results.
-<div style="margin-left:0.423cm;">Cleckley, Hervey. ''The Mask of Sanity''. St. Louis: Mosby, 1941.</div>
+-----
-<div style="margin-left:0.423cm;">Cooper, Arnold, and Robert Michels. “Review of ''Diagnostic and Statistical Manual of Mental Disorders III.” American Journal of Psychiatry'' 138 (1): 128–129 (1981).</div>
+==== Annotation 92 ====
-<div style="margin-left:0.423cm;">Crews, Frederick. “The Unknown Freud.” ''The New York Review of Books'', November 18, 1993, pp. 55–66.</div>
+“Positive” and “negative,” in this context, are subjective and relative terms which simply denote “moving towards a goal” and “moving away from a goal,” based on a specific perspective.
-<div style="margin-left:0.423cm;">Crisp, A., et al. “Long-Term Mortality in Anorexia Nervosa.” ''British Journal of Psychiatry'' 161: 104–107 (1992).</div>
+From the perspective of revolutionary communism, “positive” can be taken as moving towards the end goal of the liberation of the working class from capitalist oppression and the construction of a stateless, classless society. Likewise, “negative” can be taken as moving away from that goal. See: Annotation 114, p. 116.
-<div style="margin-left:0.423cm;">Crits-Christoph, P., A. Cooper, and L. Luborsky. “The Accuracy of Therapists’Interpretations and the Outcome of Dynamic Psychotherapy.” ''Journal of Consulting and Clinical Psychology'' 56: 490–495 (1988).</div>
+Humans have the ability to overcome all challenges in the process of achieving our goals and improving our world, so long as our conscious activities meet the following criteria:
-<div style="margin-left:0.423cm;">D’Andrade, Roy. ''The Development of Cognitive Anthropology''. Cambridge, England: Cambridge University Press, 1995.</div>
+* We must perceive reality accurately.
+* We must properly apply scientific knowledge, revolutionary sentiments, and directed willpower.
+* We must avoid contradicting objective laws of nature and society.
-<div style="margin-left:0.423cm;">Demos, Virginia. “Empathy and Affect: Reflections on Infant Experience.” In Joseph Lichtenberg, Melvin Bornstein, and Donald Silver, eds., ''Empathy''. Hillsdale, N.J.: Analytic Press, 1984.</div>
+Successfully achieving our goals and improving the world in this manner constitutes the ''positive'' outcome of human consciousness.
-<div style="margin-left:0.423cm;">Desjarlais, Robert, et al. ''World Mental Health''. New York: Oxford University Press, 1995.</div>
+On the contrary, if human consciousness wrongly reflects objective reality, nature, and laws, then, right from the beginning, our actions will have negative results which will do harm to ourselves and our society.
-<div style="margin-left:0.423cm;">''Detre, T., and M. McDonald. 1997. “Managed Care and the Future of Psychiatry.”'' ''Archives of General Psychiatry 54:'' 201–204 (1997).</div>
+Therefore, by directing the activities of humans, consciousness can determine whether the results of human activities are beneficial or harmful. Our consciousness thus determines whether our activities will succeed or fail and whether our efforts will be effective or ineffective.
-<div style="margin-left:0.423cm;">Devereux, George. ''Basic Problems in Ethnopsychiatry''. Chicago: University of Chicago Press, 1980 (first published 1956).</div>
+By studying the matter, origin, and nature of consciousness, as well as the relationships between matter and consciousness, we can see that:
-<div style="margin-left:0.423cm;">Dossman, R., et al. “The Long-Term Benefits of Intensive Psychotherapy: A View from Germany.” In Susan Lazar and James Bozzuto, eds., ''The Journal of the American Academy of Psychoanalysis: Extended Dynamic Psychotherapy: Making the Case in an Era of Managed Care.'', 1997, pp. 74–86.</div>
+* Matter is the source of consciousness <ref>See: Annotation 72, p. 68.</ref>.
+* Matter determines the content and creative capacity of consciousness <ref>See: Annotation 90, p. 88.</ref>.
+* Matter is the prerequisite to form consciousness <ref>See: ''The Role of Matter in Consciousness,'' p. 89.</ref>.
+* Consciousness only has the ability to impact matter, and this impact is indirect, because it has to be done through human material activities within material reality <ref>See: ''The Relationship Between Matter and Consciousness,'' p. 88.</ref>.
-<div style="margin-left:0.423cm;">Dudley, Kathryn. ''The End of the Line''. Chicago: University of Chicago Press, 1994.</div>
+[[File:t-w-the-worldview-and-philosophical-methodology-of-21.png|''Matter determines consciousness while consciousness impacts matter indirectly through human activity.'']]
-<div style="margin-left:0.423cm;">Eisenberg, Leon. “Mindlessness and Brainlessness in Psychiatry.” ''British Journal of Psychiatry'' 148: 497–508 (1986).</div>
+The strength with which consciousness can impact the material world depends on:
-<div style="margin-left:0.423cm;">Eisenberg, Nancy, and Jane Strayer. ''Empathy and Its Development''. Cambridge, England: Cambridge University Press, 1987.</div>
+* The accuracy of reflection of the material world in consciousness <ref>See:Annotation 68, p. 65.</ref>.
+* Strength of willpower which transmits consciousness to human activity <ref>See: ''Nature and Structure of Consciousness,'' p. 79.</ref>.
+* The degree of organization of social activity <ref>See: Annotation 93, below.</ref>.
+* Material conditions in which human activity occurs <ref>See: Annotation 10, p. 10.</ref>.
-<div style="margin-left:0.423cm;">Ekman, Paul, and Richard Davidson, eds. ''The Nature of Emotion''. New York: Oxford University Press, 1994.</div>
+-----
-<div style="margin-left:0.423cm;">Ekman, Paul, and Wallace Friesen. ''Unmasking the Face''. Englewood Cliffs, N.J.: Prentice Hall, 1975.</div>
+==== Annotation 93 ====
-<div style="margin-left:0.423cm;">Elkin, Irene. “The NIMH Treatment of Depression Collaborative Research Program: Where We Began and Where We Are.” In Allen Bergin and Sol Garfield, eds., ''Handbook of Psychotherapy and Behavior Change'', 4th ed. New York: John Wiley and Sons, 1994.</div>
+The importance of organization in determining the outcomes of human social activity is one of the most important concepts of Marxism-Leninism and is discussed frequently by Marx, Engels, Lenin, and nearly every other important communist revolutionary in history. Marx explains the connections between social organization and conscious human activity in ''Capital Volume I'' [see Annotation 80, p. 81].
-<div style="margin-left:0.423cm;">Ellenberger, Henri. ''The Discovery of the Unconscious''. New York: Basic Books, 1970.</div>
+=== 4. Meaning of the methodology ===
-<div style="margin-left:0.423cm;">Endicott, J., and R. Spitzer. “Use of the Research Diagnostic Criteria and the Schedule for Affective Disorders and Schizophrenia to Study Affective Disorders.” ''American Journal of Psychiatry'' 136 (1): 52–56 (1979).</div>
+Dialectical Materialism builds the most basic and common methodological<ref>For discussion of the meaning of methodology, see ''Methodology,'' p. 44.</ref> principles for human cognitive and practical activities on the following bases:
-<div style="margin-left:0.423cm;">Engel, George. “The Clinical Application of the Biopsychosocial Model.” ''American Journal of Psychiatry'' 137 (5): 535–544 (1980).</div>
+* The viewpoint of the material nature of the world [''matter comes first, consciousness comes after''].
+* The dynamic and creative nature of consciousness <ref>See: ''Nature of Consciousness,'' p. 79.</ref>.
+* The dialectical relationship between matter and consciousness <ref>See: ''The Relationship Between Matter and Consciousness,'' p. 88.</ref>.
-<div style="margin-left:0.423cm;">Ericsson, K. Anders, and Neil Charness. “Expert Performance.” ''American Psychologist'' 49(8): 725–747 (1994).</div>
+All cognitive and practical activities of humans ''originate from material reality'' and ''must observe objective natural and social laws,'' however, our activities are capable of ''impacting the material world through dynamic and creative conscious activity''. [See ''The Relationship Between Matter and Consciousness'', p. 88].
-<div style="margin-left:0.423cm;">Ericsson, K. Anders, Ralf Krampe, and Clemens Tesch-Romer. “The Role of Deliberate Practice in the Acquisition of Expert Performance.” ''Psychological Review'' 100: 363–406 (1993).</div>
+-----
-<div style="margin-left:0.423cm;">Estroff, Sue. ''Making It Crazy''. Berkeley: University of California Press, 1981.</div>
+==== Annotation 94 ====
-<div style="margin-left:0.423cm;">Eysenck, Hans J. “The Effects of Psychotherapy: An Evaluation.” ''Journal of Consulting Psychology'' 16: 319–324 (1952).</div>
+The above paragraph summarizes an important methodological concept which is critical for undestanding the philosophical framework of Dialectical Materialism. Dialectical Materialism, as a philosophy, synthesizes earlier materialist and idealist positions by recognizing the fact that the material determines consciousness, while consciousness can impact the material world through willful activity.
-<div style="margin-left:0.423cm;">''Fairburn, C., et al. “Psychotherapy and Bulimia Nervosa: Longer-Term Effects of Interpersonal Psychotherapy, Behavior Therapy, and Cognitive Behavior Therapy.”'' ''Archives of General Psychiatry'' 50: 419–428 (1993).</div>
+From this philosophical basis, the methodology of Materialist Dialectics has been developed to provide a deeper understanding of dialectical development, which is rooted in contradiction and negation within and between subjects. Materialist Dialectics is the subject of Chapter 2, p. 98.
-<div style="margin-left:0.423cm;">“Fallen from Grace: How Psychotherapy Can Redeem Its Tarnished Reputation.” ''Family Therapy Networker'', March—April 1995.</div>
+-----
-<div style="margin-left:0.423cm;">''Falloon, I., et al. “Family Management in the Prevention of Morbidity of Schizophrenia.”'' ''Archives of General Psychiatry'' 42: 887–896 (1985).</div>
+According to this methodological principle [i.e., the Principle of the Dialectic Relationship Between Matter and Consciousness], if we hope to succeed in accomplishing our goals in the material world, then we must ''simultaneously'' meet two criteria:
-<div style="margin-left:0.423cm;">''Fawzy, F. I., et al. “Malignant Melanoma: Effects of an Early Structured Psychiatric Intervention, Coping and Affective State on Recurrence and Survival Six Years Later.”'' ''Archives of General Psychiatry'' 50: 681–689 (1993).</div>
+. We must ensure that our knowledge reflects the objective material world as much as possible, respecting the objective natural and social laws of the material world.
-<div style="margin-left:0.423cm;">Feighner, J., et al. “Diagnostic Criteria for Use in Psychiatric Research.” ''Archives of General Psychiatry'' 26 (1): 57–63 (1972).</div>
+. We must simultaneously recognize the dynamic and creative nature of our conscious activity.
-<div style="margin-left:0.423cm;">Fisher, Seymour, and Roger P. Greenberg. “How Sound Is the Double-blind Design for Evaluating Psychotropic Drugs?” ''Journal of Nervous and Mental Disease'', 181: 345–350 (1993).</div>
+When we say that human activities ''originate from material reality'' and ''must observe objective natural and social laws'' we'''' mean that human knowledge must originate from the material world. This means that if we hope to be successful in our activities, we should respect the natural and social laws of the material world.
-<div style="margin-left:0.423cm;">_________. “Prescriptions for Happiness? (Effectiveness of Antidepressants).” ''Psychology Today'' 28: 32–38 (1995).</div>
+This means that in our human perception and activities, we must determine goals, and set strategies, policies, and plans which are rooted firmly in objective material reality. Humans have to take objective material reality as the foundation of our activities and plans, and all of our activities must be carried out in the material world. Humans have to examine and understand our material conditions and transform them in ways that will help us to accomplish our goals.
-<div style="margin-left:0.423cm;">Fonagy, P., and M. Target. “Predictors of Outcome in Child Psychoanalysis: A Retropective Study of 763 Cases at the Anna Freud Centre.” ''Journal of the American Psychoanalytic Association'' 44: 27–77 (1996).</div>
+When we talk about ''impacting the material world through dynamic and creative conscious activity,'' we mean we must recognize the positive, dynamic, and creative roles of consciousness. We must recognize the role human consciousness plays in dynamically and creatively manifesting our will in the material world through labor. Impacting the material world through conscious activity at a revolutionary scale requires humans to respect and understand the role of scientific knowledge; to study laboriously to master such knowledge; and then to propagate such knowledge so to the masses to develop public knowledge and belief so as to guide the people’s action.
-<div style="margin-left:0.423cm;">Foucault, Michel. ''Madness and Civilization''. New York: Vintage, 1965.</div>
+Moreover, we also have to voluntarily study and practice<ref>See: Annotation 211, p. 205.</ref> in order to form and improve our revolutionary viewpoint<ref>See: Annotation 114, p. 116.</ref> and willpower<ref>See: ''Nature and Structure of Consciousness'', p. 79.</ref> in order to have both scientific and humanitarian activity guidelines.
-<div style="margin-left:0.423cm;">Fox, Renee. ''Essays in Medical Sociology''. New Brunswick, N.J.: Transaction Books, 1988.</div>
+To implement this principle [i.e., the Principle of the Dialectic Relationship Between Matter and Consciousness], we have to avoid, fight against, and overcome the diseases of subjectivism<ref>See: Annotation 222, p. 218.</ref> and idealism<ref>See: ''The Opposition of Materialism and Idealism in Solving Basic Philosophical Issues,'' p. 48.</ref> through such errors as:
-<div style="margin-left:0.423cm;">_________. ''Experiment Perilous'', Philadelphia: University of Pennsylvania Press, 1959.</div>
+* Attempting to impose idealist plans and principles [which are not rooted in material conditions] into reality.
+* Considering fantasy, illusion, and imagination instead of reality.
+* Basing policies and programs on subjective desires.
+* Using sentiment as the starting point for developing policies, strategies, etc.
-<div style="margin-left:0.423cm;">Frank, Ellen, et al. “Three-Year Outcomes for Maintenance Therapies in Recurrent Depression.” ''Archives of General Psychiatry'' 47: 1093–1099 (1990).</div>
+On the other hand, in cognitive and practical activities, we also have to fight against empiricism<ref>See: Annotation 10, p. 10.</ref>, which disregards scientific knowledge and theories, and which is also very conservative, stagnant and passive.
-<div style="margin-left:0.423cm;">_________. “Efficacy of Interpersonal Psychotherapy as a Maintenance Treatment of Recurrent Depression.” ''Archives of General Psychiatry'' 48: 1053–1059 (1991).</div>
+-----
-<div style="margin-left:0.423cm;">Frank, Jerome. ''Psychotherapy and the Human Predicament''. New York: Schocken, 1978.</div>
+==== Annotation 95 ====
-<div style="margin-left:0.423cm;">Freud, Sigmund. ''The Question of Lay Analysis''. New York: Norton, 1950.</div>
+Process of Developing Revolutionary Public Knowledge
-<div style="margin-left:0.423cm;">_________. ''Therapy and Technique''. New York: Macmillan, 1963.</div>
+[[File:t-w-the-worldview-and-philosophical-methodology-of-22.png|''Developing revolutionary public knowledge must be preceded by mastery of knowledge and a firm grounding in the role and nature of knowledge.'']]
-<div style="margin-left:0.423cm;">_________. ''Dora: An Analysis of a Case of Hysteria''. New York: Collier, 1963.</div>
+In ''Socialism: Utopian and Scientific'', Engels makes a scathing critique of idealist socialist revolutionary thought, writing:
-<div style="margin-left:0.423cm;">Friedman, Laurence. ''Menninger''. New York: Knopf, 1990.</div>
+<blockquote>
+To all these [idealist socialists], Socialism is the expression of absolute truth<ref>See: Annotation 232 and ''The Properties of Truth,'' on p. 228.</ref>, reason and justice, and has only to be discovered to conquer all the world by virtue of its own power. And as an absolute truth is independent of time, space, and of the historical development of man, it is a mere accident when and where it is discovered. With all this, absolute truth, reason, and justice are different with the founder of each different school. And as each one’s special kind of absolute truth, reason, and justice is again conditioned by his subjective understanding, his conditions of existence, the measure of his knowledge and his intellectual training, there is no other ending possible in this conflict of absolute truths than that they shall be mutually exclusive of one another.
+</blockquote>
-<div style="margin-left:0.423cm;">Frijda, Nico. ''The Emotions''. Cambridge, England: Cambridge University Press, 1986.</div>
-<div style="margin-left:0.423cm;">Gabbard, Glen. ''Psychodynamic Psychiatry in Clinical Practice''. Washington, D.C.: American Psychiatric Press, 1990.</div>
+-----
-<div style="margin-left:0.423cm;">Gabbard, Glen, et al. “A Psychodynamic Perspective on the Clinical Impact of Insurance Review.” ''American Journal of Psychiatry'' 148: 318–323 (1991).</div>
+Here, Engels points out the absurdity of the idea that some abstract, purely ideal “truth” could liberate workers in the material world. Engels continues on, explaining how such idealist socialism could never lead to meaningful revolutionary change:
-<div style="margin-left:0.423cm;">_________. 1997. “The Economic Impact of Psychotherapy: A Review.” ''American Journal of Psychiatry'' 154: 147–155 (1997).</div>
+<blockquote>
+Hence, from this nothing could come but a kind of eclectic, average Socialism, which, as a matter of fact, has up to the present time dominated the minds of most of the socialist workers in France and England. Hence, a mish-mash allowing of the most manifold shades of opinion: a mish-mash of such critical statements, economic theories, pictures of future society by the founders of different sects, as excite a minimum of opposition; a mish-mash which is the more easily brewed the more definite sharp edges of the individual constituents are rubbed down in the stream of debate, like rounded pebbles in a brook.
+</blockquote>
-<div style="margin-left:0.423cm;">_________. “Psychotherapy, Cost-Effectivenss and Cost Offset: A Review of the Literature.”</div>
+In other words, idealist revolutionary movements only tend to result in endless debate and meaningless theories which are divorced from objective reality and material conditions. Such theories and idealist constructions do not lead to effective action in the real world. Socialism must become ''real'' (i.e., based in objective material conditions and praxis<ref>See: ''Praxis, Consciousness, and the Role of Praxis in Consciousness,'' p. 204.</ref> in the real world) to affect change in the material world, as Engels explains elsewhere in ''Socialism: Utopian and Scientific'' [see Annotation 17, p. 18].
-<div style="margin-left:0.423cm;">Unpublished manuscript.</div>
+In ''Critique of the Gotha Program'', Marx lays out an excellent case study of the failings of incoherent, idealist socialism. He begins by quoting the Gotha Program, which was an ideological program which the German Workers Party hoped to implement. In this text, Marx cites the Gotha Program line by line and offers his materialist critique of the idealist principles presented. In the following passage, Marx refutes some key errors caused by idealism and offers materialist correction:
-<div style="margin-left:0.423cm;">Gallagher, Winifred, ''I.D''. New York: Random House, 1996.</div>
+<blockquote>
+Labor is not the source of all wealth. Nature is just as much the source of use values (and it is surely of such that material wealth consists!) as labor, which itself is only the manifestation of a force of nature, human labor power... But a socialist program cannot allow such bourgeois phrases to pass over in silence the conditions that lone give them meaning. And insofar as man from the beginning behaves toward nature, the primary source of all instruments and subjects of labor, as an owner, treats her as belonging to him, his labor becomes the source of use values, therefore also of wealth. The bourgeois have very good grounds for falsely ascribing supernatural creative power to labor; since precisely from the fact that labor depends on nature it follows that the man who possesses no other property than his labor power must, in all conditions of society and culture, be the slave of other men who have made themselves the owners of the material conditions of labor. He can only work with their permission, hence live only with their permission.
+</blockquote>
-<div style="margin-left:0.423cm;">Gardner, Howard. ''Frames of Mind''. New York: Basic Books, 1983.</div>
+Here, Marx points out the importance of having a firm understanding of the material reality of ''labor'' and its relation to the material, natural world. Marx points out that the idea that labor, alone, is the source of all wealth is an idealist notion of the bourgeoisie, a false consciousness [see Annotation 235, p. 231] which prevents proper material analysis and props up the capitalist viewpoint. A failure to grasp the truth of the material basis of reality weakens the socialist position, and any movement built on such weak idealist foundations will lead to failure in trying to bring about revolutionary change.
-<div style="margin-left:0.423cm;">_________. The Mind’s New Science: ''A'' History of the Cognitive Revolution. ''New York: Basic'' Books, 1987.</div>
+We have already discussed the shortcomings of empiricism in Annotation 10, p. 10, but it might be helpful to see another case study, this time from Engels, pointing out the flaws of empiricist analysis in his text ''Anti-Dühring''. Engels begins by quoting the empiricist Eugen Dühring, who wrote:
-<div style="margin-left:0.423cm;">Gay, Peter. ''Freud''. New York: Doubleday Anchor, 1988.</div>
+<blockquote>
+Philosophy is the development of the highest form of consciousness of the world and of life, and in a wider sense embraces the principles of all knowledge and volition. Wherever a series of cognitions or stimuli or a group of forms of being come to be examined by human consciousness, the principles underlying these manifestations of necessity become an object of philosophy. These principles are the simple, or until now assumed to be simple, constituents of manifold knowledge and volition. Like the chemical composition of bodies, the general constitution of things can be reduced to basic forms and basic elements. These ultimate constituents or principles, once they have been discovered, are valid not only for what is immediately known and accessible, but also for the world which is unknown and inaccessible to us. Philosophical principles consequently provide the final supplement required by the sciences in order to become a uniform system by which nature and human life can be explained. Apart from the fundamental forms of all existence, philosophy has only two specific subjects of investigation — nature and the world of man. Accordingly, our material arranges itself quite naturally into three groups, namely, the general scheme of the universe, the science of the principles of nature, and finally the science of mankind. This succession at the same time contains an inner logical sequence, for the formal principles which are valid for all being take precedence, and the realms of the objects to which they are to be applied then follow in the degree of their subordination.
+</blockquote>
-<div style="margin-left:0.423cm;">Gedo, John. “A Psychoanalyst Reports at Mid-career.” ''American Journal of Psychiatry'' 136: 646–649 (1979).</div>
+Engels then proceeds to critique this empiricist worldview, showing that it does not properly reflect the material world and amounts to idealism in its own right:
-<div style="margin-left:0.423cm;">Geertz, Clifford. ''The Interpretation of Cultures''. New York: Basic Books, 1973.</div>
+<blockquote>
+What [Dühring] is dealing with are therefore principles, formal tenets derived from thought and not from the external world, which are to be applied to nature and the realm of man, and to which therefore nature and man have to conform. But whence does thought obtain these principles? From itself?
-<div style="margin-left:0.423cm;">Gelernter, C. S., et al. “Cognitive-Behavioral and Pharmacological Treatments of Social Phobia.” ''Archives of General Psychiatry'' 48: 938–945 (1991).</div>
+No, for Herr Dühring himself says: the realm of pure thought is limited to logical schemata and mathematical forms (the latter, moreover, as we shall see, is wrong). Logical schemata can only relate to forms of thought; but what we are dealing with here is solely forms of being, of the external world, and these forms can never be created and derived by thought out of itself, but only from the external world. But with this the whole relationship is inverted: the principles are not the starting-point of the investigation, but its final result; they are not applied to nature and human history, but abstracted from them, it is not nature and the realm of man which conform to these principles, but the principles are only valid in so far as they are in conformity with nature and history. That is the only materialist conception of the matter, and Herr Dühring’s contrary conception is idealistic, makes things stand completely on their heads, and fashions the real world out of ideas, out of schemata, schemes or categories existing somewhere before the world, from eternity — just like a Hegel.
+</blockquote>
-<div style="margin-left:0.423cm;">Gellman [Gollub], R. L., and G. K. Aghajanian. “Serotonin 2 Receptor—Mediated Excitation of Interneurons in Piriform Cortex: Antagonism by Atypical Antipsychotic Drugs.” ''Neuroscience'' 58: 515–525 (1994).</div>
+Lenin also heavily criticized empiricism in his work ''Materialism and Empirio-Criticism'', which we discuss at length in Annotation 32, p. 27.
-<div style="margin-left:0.423cm;">Goffman, Erving. ''Asylums''. New York: Doubleday, 1961.</div>
+= Chapter 2: Materialist Dialectics =
-<div style="margin-left:0.423cm;">Goldsmith, S. R., and A. J. Mandell. 1969. “The Dynamic Formulation—A Critique of a Psychiatric Ritual.” ''American Journal of Psychiatry''. 125(12):123–130.</div>
+Materialist dialectics is one of the basic theoretical parts that form the worldview and philosophical methodology of Marxism-Leninism. It is the “science of common relations” and also the “science of common rules of motion and development of nature, society, and human thoughts... Dialectics, as understood by Marx, and also in conformity with Hegel, includes what is now called the theory of knowledge, or epistemology.”<ref>''Karl Marx'', Vladimir Ilyich Lenin, 1914.</ref>
-<div style="margin-left:0.423cm;">Goleman, Daniel. “Provoking a Patient’s Worst Fears to Determine the Brain’s Role.” ''New York Times'', June 13, 1995.</div>
+[Note: Epistemology is the theoretical study of knowledge; for more information see ''Cognitive Theory of Dialectical Materialism'', p. 204.]
-<div style="margin-left:0.423cm;">Gollub, Randy, and Scott Rauch. “Neuroimaging: Issues of Design, Resolution and Interpretation.” ''Harvard Review of Psychiatry'' 3: 285–289 (1996).</div>
+== I. Dialectics and Materialist Dialectics ==
-<div style="margin-left:0.423cm;">Good, Byron. ''Medicine, Rationality and Experience''. Cambridge, England: Cambridge University Press, 1994.</div>
+=== 1. Dialectics and Basic Forms of Dialectics ===
-<div style="margin-left:0.423cm;">Good, Mary-Jo Delvecchio. ''American Medicine: The Quest for Competence''. Berkeley: University of California Press, 1995.</div>
+==== a. Definitions of Dialectics and the Subjective Dialectic ====
-<div style="margin-left:0.423cm;">Gordimer, Nadine. ''Burger’s Daughter''. New York: Viking, 1979.</div>
+In Marxism-Leninism, the term ''dialectic'' refers to regular relationships, interactions, transformations, motions, and developments of things, phenomena, and processes in nature, society and human thought.<ref>See Annotation 9, p. 10.</ref>
-<div style="margin-left:0.423cm;">Gordon, Mary. “George Eliot, Dorothea, and Me: Rereading (and Rereading) ''Middlemarch.” New York Times'', May 8, 1994.</div>
+There are two forms of dialectic: the ''objective dialectic'' and the ''subjective dialectic.'' The objective dialectic is the dialectic of the material world, while the subjective dialectic is the reflection of objective dialectic in human consciousness. [See Annotation 68, p. 65].
-<div style="margin-left:0.423cm;">''Gottesman, Irving. Schizophrenia Genesis: The Origins of Madness''. ''New York: Freeman'', 1991.</div>
+According to Engels, “Dialectics, so-called ''objective'' dialectics, prevail throughout nature, and so-called subjective dialectics (dialectical thought), is only the reflection of the motion through opposites which asserts itself everywhere in nature, and which by the continual conflict of the opposites and their final passage into one another, or into higher forms, determines the life of nature.”<ref>''Dialectics of Nature'', Friedrich Engels, 1883.</ref>
-<div style="margin-left:0.423cm;">Greenberg, Joanne. ''I Never Promised You a Rose Garden''. New York: Holt, Rinehart and Winston, 1964.</div>
+-----
-<div style="margin-left:0.423cm;">Greenberg, Roger, and Seymour Fisher. Letter. ''American Journal of Psychiatry'' 148 (1): 141 (1991).</div>
+==== Annotation 96 ====
-<div style="margin-left:0.423cm;">Greenson, Ralph. ''The Technique and Practice of Psychoanalysis''. New York: International Universities Press, 1967.</div>
+''Dialectics'' is an umbrella term which includes both forms of dialectical systems: ''subjective'' and ''objective'' dialectics.
-<div style="margin-left:0.423cm;">Grob, Gerald. ''Mental Institutions in America''. New York: Free Press, 1973.</div>
+''Objective dialectics'' are the dialectical processes which occur in the material world, including all motion, relationships, and dynamic changes which occur in space and time.
-<div style="margin-left:0.423cm;">_________. “Origins of ''DSM''-I: A study in Appearance and Reality.” ''American Journal of Psychiatry'' 148: 421–431 (1991).</div>
+''Subjective dialectics'', or ''dialectical thought'', is a system of analysis and organized thinking which aims to reflect the objective dialectics of the material world within human consciousness. Dialectical thinking has two component forms: dialectical materialism and materialist dialectics [see Annotation 49, p. 45].
-<div style="margin-left:0.423cm;">Grunbaum, Adolf. ''The Foundation of Psychoanalysis:'' A ''Philosophical Critique''. Berkeley: University of California Press, 1984.</div>
+-----
-<div style="margin-left:0.423cm;">Gunderson, John, et al. “Effects of Psychotherapy in Schizophrenia. II: Comparative Outcome of Two Forms of Treatment.” ''Schizophrenia Bulletin'' 10 (4): 564–598 (1984).</div>
+''Subjective dialectics'' is the theory that studies and summarises the [objective] dialectic of nature into a system with scientific principles and rules, in order to build a system of methodological principles of perception and practice. Dialectics is opposed to ''metaphysics'' — a system of thought which conceives of things and phenomena in the world in an isolated and unchanging state [See Annotation 8, p. 8].
-<div style="margin-left:0.423cm;">Gusterson, Hugh. ''Nuclear Rites''. Berkeley: University of California Press, 1996.</div>
+==== b. Basic Forms of Dialectics ====
-<div style="margin-left:0.423cm;">Hafferty, Frederic. ''Into the Valley: Death and the Socialization of Medical Students''. New Haven: Yale University Press, 1991.</div>
+Dialectics has developed into three basic forms and levels: ancient primitive dialectics, German idealist dialectics, and the materialist dialectics of Marxism-Leninism.
-<div style="margin-left:0.423cm;">Hale, Nathan. ''The Rise and Crisis of Psychoanalysis in the United States''. New York: Oxford University Press, 1995.</div>
+''Ancient primitive dialectics'' is the earliest form of dialectics. It has developed independently in many philosophical systems in ancient China, India and Greece.
-<div style="margin-left:0.423cm;">Hatfield, Elaine, John Cacioppo, and Richard Rapson. ''Emotional Contagion''. Cambridge, England: Cambridge University Press, 1994.</div>
+Chinese philosophy has two major forms of ancient primitive dialectics:
-<div style="margin-left:0.423cm;">Hellman, C., et al. “A Study of the Effectiveness of Two Group Behavioral Medicine Interventions for Patients with Psychosomatic Complaints.” ''Behavioral Medicine'' 16: 165–173 (1990).</div>
+* “Changing Theory” (a theory of common principles and rules pertaining to the changes in the universe)
+* The “Five Elements Theory” (a theory of the principles of mutual impact and transformation of the five elements of the universe) of the School of Yin-Yang. [See: ''Primitive Materialism'', p. 52]
-<div style="margin-left:0.423cm;">Hesse, Hermann. ''The Glass Bead Game (Magister Ludi)''. New York: Henry Holt, 1969 (first published 1949).</div>
+In Indian philosophy, Buddhist philosophy is a quintessential [see Annotation 6, p. 8] form of ancient primitive dialectics, which includes such concepts as “selflessness,” “impermanence,” and “predestination.”
-<div style="margin-left:0.423cm;">Hogarty, G. E., et al. “Family Psychoeducation, Social Skills Training and Maintenance Chemotherapy in the Aftercare Treatment of Schizophrenia. II: Two-Year Effects of a Controlled Study on Relapse and Adjustment.” ''Archives of General Psychiatry'' 48: 340–347 (1991).</div>
+An ancient, primitive form of dialectics also developed in Ancient Greek philosophy.
-<div style="margin-left:0.423cm;">Hoke, Lizbeth. “Longitudinal Patterns of Behavior in Borderline Personality Disorder.” Ph.D. dissertation, Boston University, 1989.</div>
+Friedrich Engels wrote: “The old Greek philosophers were all born natural dialecticians, and Aristotle, the most encyclopaedic of them, had already analyzed the most essential forms of dialectic thought… This primitive, naive, but intrinsically correct conception of the world is that of ancient Greek philosophy, and was first clearly formulated by Heraclitus: everything is and is not, for everything is fluid, is constantly changing, constantly coming into being and passing away.”<ref>''Socialism: Utopian and Scientific'', Friedrich Engels, 1880.</ref>
-<div style="margin-left:0.423cm;">Holzman, Philip, et al. “A Single Dominant Gene Can Account for Eye Tracking Dysfunctions and Schizophrenia in Offspring of Discordant Twins.” ''Archives of General Psychiatry'' 45: 641–647 (1988).</div>
+Engels also wrote of Greek dialectics: “Here, dialectical thought still appears in its pristine simplicity, as yet undisturbed by the charming obstacles which the metaphysicists of the seventeenth and eighteenth centuries — Bacon and Locke in England, Wolff in Germany — put in its own way... Among the Greeks — just because they were not yet advanced enough to dissect and analyse nature — nature is still viewed as a whole, in general. The universal connection of natural phenomena is not proved in regard to particular; to the Greeks it is the result of direct contemplation.”<ref>The Old Preface to ''Anti-Dühring'', Friedrich Engels, 1878.</ref>
-<div style="margin-left:0.423cm;">Hood, John. “Commentary.” ''Corner Clubhouse Newsletter'', Winter 1996–97, p. 1.</div>
+-----
-<div style="margin-left:0.423cm;">Hopper, Kim, “More Than Passing Strange: Homelessness and Mental Illness in New York City.” ''American Ethnologist'' 15 (1): 158–167 (1988).</div>
+==== Annotation 97 ====
-<div style="margin-left:0.423cm;">Hopper, Kim, et al., eds. ''Prospects for Recovery from Schizophrenia—An International Investigation: Report from the WHO—Collaborative Project, the International Study of Schizophrenia''. Westport: Psychosocial Press, in press.</div>
+Engels, here, is explaining how the ancient Greek dialecticians were correct to view nature as a cohesive system, a “whole, in general,” which they determined through direct observation of the natural world. The major shortcoming of this ancient Greek form of dialectics was a lack of inquiry into the specific processes and principles of nature. Engels laments that seventeenth and eighteenth century metaphysicists took us backwards by disregarding this view of nature as a cohesive, general whole.
-<div style="margin-left:0.423cm;">Horgan, John. “Why Freud Isn’t Dead.” ''Scientific American'', December 1996, pp. 106–111. Hudgens, R. W. “The Turning of American Psychiatry.” ''Missouri Medicine'', June 1996, pp. 283–291.</div>
+Ancient, primitive dialectics had an accurate awareness of the dialectical characteristic of the world but with its primitive and naive perspective, it still lacked evidence-based forms of natural scientific achievements.
-<div style="margin-left:0.423cm;">Hyman, Steven, and Eric Nestler. ''The Molecular Foundations of Psychiatry''. Washington, D.C.: American Psychiatric Press, 1993.</div>
+Jumping forward to the late 16<sup>th</sup> century, natural sciences started developing rapidly in Europe. Scientists began deeply analysing and studying specific factors and phenomena of nature which led to the birth of modern European metaphysical analysis. In the 18<sup>th</sup> century, metaphysics became the dominant methodology in philosophical thought and scientific study. However, when natural scientists moved from studying each subject separately to studying the unification of all those subjects in their relationships, the metaphysical method proved insufficient. Thus, European scientists and philosophers had to transition into a more advanced system of thought: dialectical thought.
-<div style="margin-left:0.423cm;">Jakobovits, Immanuel. ''Jewish Medical Ethics''. New York: Bloch, 1975 (first published 1959).</div>
+''The classical German idealist dialectics'' were founded by Kant and completed by Hegel. According to Engels: ''“The second form of dialectics, which is the form that comes closest to the German naturalists [natural scientists], is classical German philosophy, from Kant to Hegel.”''<ref>The Old Preface to ''Anti-Dühring,'' Friedrich Engels, 1878.</ref>
-<div style="margin-left:0.423cm;">James, Wendy. ''The Listening Ebony''. Oxford: Clarendon, 1988.</div>
+-----
-<div style="margin-left:0.423cm;">Jamison, Kay Redfield. ''Touched with Fire''. New York: Free Press, 1993.</div>
+==== Annotation 98 ====
-<div style="margin-left:0.423cm;">_________. ''An Unquiet Mind''. New York: Knopf, 1995.</div>
+Engels discusses this history, and the shortcomings of the metaphysical philosophy of his era, in ''The Old Preface to Anti-Dühring.'' First, Engels explains why early modern natural scientists initially did not feel constrained by their adherence to metaphysics, since inquiries in the initial revolution of scientific study were limited to the narrow development of specific fields of inquiry by necessity:
-<div style="margin-left:0.423cm;">Jones, Thom. ''Cold Snap''. Boston: Little, Brown, 1995.</div>
+<blockquote>
+Empirical natural science has accumulated such a tremendous mass of positive material for knowledge that the necessity of classifying it in each separate field of investigation systematically and in accordance with its inner inter-connection has become absolutely imperative.
+</blockquote>
-<div style="margin-left:0.423cm;">Judd, Lewis. “The Decade of the Brain in the United States.” Unpublished manuscript.</div>
+Engels goes on to explain that at the time he was writing, enough knowledge had been accumulated within specific, distinct fields that it becomes necessary to begin studying the connections and overlaps between different fields, which called for theoretical and philosophical foundations:
-<div style="margin-left:0.423cm;">_________. “The Decade of the Brain: Prospects and Challenges for NIMH.” ''Neuropsy-chopharmacology'' 3: 309–310 (1990).</div>
+<blockquote>
+It is becoming equally imperative to bring the individual spheres of knowledge into the correct connection with one another. In doing so, however, natural science enters the field of theory and here the methods of empiricism will not work, here only theoretical thinking can be of assistance.
+</blockquote>
-<div style="margin-left:0.423cm;">Kadushin, Charles. ''Why People Go to Psychiatrists''. New York: Atherton, 1969. Kaiser, D. “Not by Chemicals Alone: A Hard Look at ‘Psychiatric Medicine.’ ” ''Psychiatric Times'', December 1996, pp. 42–44.</div>
+Unfortunately, natural scientists were held back by the existing metaphysical theoretical foundations which were dominant at the time as, according to Engels, “theoretical thinking is an innate quality only as regards natural capacity. This natural capacity must be developed, improved, and for its improvement there is as yet no other means than the study of previous philosophy.”
-<div style="margin-left:0.423cm;">Kandel, Eric. “Psychotherapy and the Single Synapse: The Impact of Psychiatric Thought on Neurobiologic Research.” ''New England Journal of Medicine'' 301: 1028–1037 (1979).</div>
+Metaphysical theory and formal logic were in common use by natural scientists at the time. As Engels explained in ''On Dialectics'' and ''Dialectics of Nature,'' metaphysics and formal logic could never be as useful as dialectical analysis for examining and unifying concepts from wide-ranging dynamic systems of overlapping fields of inquiry.
-<div style="margin-left:0.423cm;">_________. “A New Intellectual Framework for Psychiatry.” ''American Journal of Psychiatry'' 155: 457–469 (1993).</div>
+Unfortunately, dialectics had not yet been suitably developed for use in the natural sciences before the work of Marx and Engels in developing dialectical materialism, as Engels explained in ''On Dialectics:''
-<div style="margin-left:0.423cm;">Kaplan, Harold, and Benjamin Sadock. ''Pocket Handbook of Clinical Psychiatry''. Baltimore: Williams & Wilkins, 1996.</div>
+<blockquote>
+Formal logic itself has been the arena of violent controversy from the time of Aristotle to the present day. And dialectics has so far been fairly closely investigated by only two thinkers, Aristotle and Hegel. But it is precisely dialectics that constitutes the most important form of thinking for present-day natural science, for it alone offers the analogue for, and thereby the method of explaining, the evolutionary processes occurring in nature, inter-connections in general, and transitions from one field of investigation to another.
+</blockquote>
-<div style="margin-left:0.423cm;">Kaysen, Susanna. ''Girl, Interrupted''. New York: Random House, 1993.</div>
+The Idealist Dialectics of Hegel [see Annotation 9, p. 10] constituted a major development of dialectics, but the idealist nature of Hegelian dialectics made them unsuitable for natural scientists, who therefore discarded “Old-Hegelian” dialectics and were thus left without a suitable dialectical framework. Again, from ''On Dialectics:''
-<div style="margin-left:0.423cm;">Kendell, R., J. Cooper, and A. Gourley. “Diagnostic Criteria of American and British Psychiatrists.” ''Archives of General Psychiatry'' 125 (12): 1738–1743 (1971).</div>
+<blockquote>
+The year 1848, which otherwise brought nothing to a conclusion in Germany, accomplished a complete revolution there only in the sphere of philosophy [and] the nation resolutely turned its back on classical German philosophy that had lost itself in the sands of Berlin old-Hegelianism... But a nation that wants to climb the pinnacles of science cannot possibly manage without theoretical thought. Not only Hegelianism but dialectics too was thrown overboard — and that just at the moment when the dialectical character of natural processes irresistibly forced itself upon the mind, when therefore only dialectics could be of assistance to natural science in negotiating the mountain of theory — and so there was a helpless relapse into the old metaphysics.
+</blockquote>
-<div style="margin-left:0.423cm;">Kingsley, P. Letter. ''American Journal of Psychiatry'' 148 (1): 139 (1991).</div>
+Engels goes on to explain that, having rejected Hegel’s dialectics, natural scientists were set adrift, cobbling together theoretical frameworks from the works of philosophers which were plagued by idealism and metaphysics, and which were therefore not suitable for the task of unifying the disparate fields of natural sciences together:
-<div style="margin-left:0.423cm;">Kirk, Stuart, and Herb Kutchins. ''The Selling of DSM: The Rhetoric of Science in Psychiatry''. New York: A. de Gruyter, 1992.</div>
+<blockquote>
+What prevailed among the public since then were, on the one hand, the vapid reflections of Schopenhauer, which were fashioned to fit the philistines, and later even those of Hartmann; and, on the other hand, the vulgar itinerant-preacher materialism of a Vogt and a Büchner. At the universities the most diverse varieties of eclecticism competed with one another and had only one thing in common, namely, that they were concocted from nothing but remnants of old philosophies and were all equally metaphysical. All that was saved from the remnants of classical philosophy was a certain neo-Kantianism, whose last word was the eternally unknowable thing-in-itself, that is, the bit of Kant [see Annotation 72, p. 68] that least merited preservation. The final result was the incoherence and confusion of theoretical thought now prevalent.
+</blockquote>
-<div style="margin-left:0.423cm;">Kleinman, A. ''Social Origins of Distress and Disease: Depression, Neurasthenia, and Pain in Modern China''. New Haven, Yale University Press, 1986.</div>
+Engels explains that this lack of a proper dialectical materialist framework had frustrated natural scientists of his era:
-<div style="margin-left:0.423cm;">_________. ''Rethinking Psychiatry''. New York: Free Press, 1988.</div>
+<blockquote>
+One can scarcely pick up a theoretical book on natural science without getting the impression that natural scientists themselves feel how much they are dominated by this incoherence and confusion, and that the so-called philosophy now current offers them absolutely no way out. And here there really is no other way out, no possibility of achieving clarity, than by a return, in one form or another, from metaphysical to dialectical thinking.
+</blockquote>
-<div style="margin-left:0.423cm;">_________. ''Writing at the Margin''. Berkeley: University of California Press, 1995.</div>
+After explaining that Hegel’s system of dialectics came closest to meeting the needs of contemporary science, Engels explains why Hegelian dialectics were ultimately rejected by the scientific community:
-<div style="margin-left:0.423cm;">Kleinman, A., L. Eisenberg, and B. Good. “Culture, Illness and Care: Clinical Lessons from Anthropologic and Cross-Cultural Research.” ''Annals of Internal Medicine'' 88 (2): 251–258 (1978).</div>
+<blockquote>
+Just as little can it be a question of maintaining the dogmatic content of the Hegelian system as it was preached by the Berlin Hegelians of the older and younger line. Hence, with the fall of the idealist point of departure, the system built upon it, in particular Hegelian philosophy of nature, also falls. It must however be recalled that the natural scientists’ polemic against Hegel, in so far as they at all correctly understood him, was directed solely against these two points: viz., the idealist point of departure and the arbitrary, fact-defying construction of the system.”
+</blockquote>
-<div style="margin-left:0.423cm;">''Klerman, G. “The Psychiatric Patient’s Right to Effective Treatment: Implications of'' ''Osheroff vs. Chestnut Lodge.” American Journal of Psychiatry'', 147 (4): 409–418 (1990).</div>
+In other words, it was the idealism and the unworkable structuring of Hegelian dialectics that prevented its adoption by natural scientists. Engels finally explains how Marx was able to modify Hegel’s idealist dialectics into a materialist form which is suitable for empirical scientific inquiry:
-<div style="margin-left:0.423cm;">Klerman, G., et al. “Treatment of Depression by Drugs and Psychotherapy.” ''American Journal of Psychiatry'' 131: 186–191 (1974).</div>
+<blockquote>
+It is the merit of Marx that... he was the first to have brought to the fore again the forgotten dialectical method, its connection with Hegelian dialectics and its distinction from the latter, and at the same time to have applied this method in Capital to the facts of an empirical science, political economy.
+</blockquote>
-<div style="margin-left:0.423cm;">_________, “A Debate on ''DSM-III.” American Journal of Psychiatry'' 141 539–553 (1984).</div>
-<div style="margin-left:0.423cm;">Kluft, Richard P. “The Natural History of Multiple Personality Disorder.” In Richard P. Kluft, ed., ''Childhood Antecedents of Multiple Personality''. Washington, D. C.: American Psychiatric Press, 1985, pp. 197–238.</div>
+-----
-<div style="margin-left:0.423cm;">_________. “The Post-unification Treatment of Multiple Personality Disorder: First Findings.” ''American Journal of Psychotherapy'' 42: 212–228 (1988).</div>
+These Classical German philosophers [Kant, Hegel, etc.<ref>Kant’s “transcendental dialectic” was used to critique rationalism and pure reason, but was not a fully developed dialectical system of thought. Hegel’s idealist dialectics were more universal in nature. See Annotation 9, p. 10.</ref>] systematically organized idealist dialectics into formal philosophies. Of particular note was Hegel’s belief that the dialectical process would eventually lead to an “absolute idea.” This foundational belief in an “absolute idea” is what chiefly defines Hegelian dialectics as idealist in nature [see Annotation 98, p. 100].
-<div style="margin-left:0.423cm;">Kohut, H. “Intropection, Empathy and Psychoanalysis.” ''Journal of the American Psychoanalytic Association'', 7: 459–483 (1959).</div>
+Hegel believed that the subjective dialectic is the basis of the objective dialectic. [In other words, Hegel believed that ''dialectical thought'' served as the ''objective dialectics'' of the material world.]
-<div style="margin-left:0.423cm;">_________. ''The Analysis of the Self''. New York: International Universities Press, 1971.</div>
+According to Hegel, the “absolute idea” was the starting point of all existence, and that this “absolute idea,” after creating the natural world, then came to exist within human consciousness.
-<div style="margin-left:0.423cm;">Kramer, Peter. ''Listening to Prozac''. New York: Viking, 1993.</div>
+Engels wrote that in Hegelian dialectics: “... spirit, mind, the idea, is primary and that the real world is only a copy of the idea.”<ref>''The Old Preface to Anti-Dühring, On Dialectics'', Friedrich Engels, 1878.</ref>
-<div style="margin-left:0.423cm;">Kripke, Saul. ''Naming and Necessity''. Cambridge, England: Cambridge University Press, 1980.</div>
+-----
-<div style="margin-left:0.423cm;">Kronenfeld, Jennie, et al. “Changing Health Practices: The Experience from a Worksite Health Promotion Project.” ''Social Science and Medicine'' 26: 515–523 (1988).</div>
+==== Annotation 99 ====
-<div style="margin-left:0.423cm;">Kronenfeld, Jennie, ed. ''Changing Organizational Forms of Delivering Health Care: The Impact of Managed Care and Other Changes on Patients and Providers''. Greenwich, Conn.: JAI Press, 1998.</div>
+In the above quoted passage, Engels was explaining why Hegelian dialectics were unsuitable for use in natural sciences. Here is a longer excerpt:
-<div style="margin-left:0.423cm;">Kupfer, D., et al. “Five-Year Outcome for Maintenance Therapies in Recurrent Depression.” ''Archives of General Psychiatry'' 49: 769–773 (1992).</div>
+<blockquote>
+First of all it must be established that here it is not at all a question of defending Hegel’s point of departure: that spirit, mind, the idea, is primary and that the real world is only a copy of the idea... We all agree that in every field of science, in natural as in historical science, one must proceed from the given facts, in natural science therefore from the various material forms and the various forms of motion of matter; that therefore in theoretical natural science, too, the inter-connections are not to be built into the facts, but to be discovered in them, and when discovered to be verified as far as possible by experiment.
-<div style="margin-left:0.423cm;">Laing, R. D. ''The Divided Self''. London: Tavistock, 1960.</div>
+-----
-<div style="margin-left:0.423cm;">Lakoff, George. ''Women, Fire and Dangerous Things''. Chicago: University of Chicago Press, 1987.</div>
+The German idealists (most notably Hegel) built an idealist system of dialectics organized into categories and common laws along with a strict logic of consciousness.
+</blockquote>
-<div style="margin-left:0.423cm;">Lambert, M. J., and A. E. Bergin. “The Effectiveness of Psychotherapy.” In Allen E. Bergin and Sol Garfield, eds., ''Handbook of Psychotherapy and Behavior Change'', 4th ed. New York: John Wiley and Sons, 1994, pp. 141–150.</div>
+Lenin stated that: “Hegel brilliantly ''divined'' the dialectics of things (phenomena, the world, ''nature'') in the dialectics of concepts.”<ref>''Conspectus of Hegel’s'' ''Science of Logic'', Vladimir Ilyich. Lenin, 1914.</ref>
-<div style="margin-left:0.423cm;">Lazar, Susan, ed. ''Supplement: Extended Dynamic Psychotherapy: Making the Case in an Era of Managed Care. Psychoanalytic Inquiry''. New York: Analytic, 1997.</div>
+-----
-<div style="margin-left:0.423cm;">Lazar, Susan, and Glen Gabbard. “The Cost-effectiveness of Psychotherapy.” ''Journal of Psychotherapy Practice and Research'' 6 (4): 307–314 (1997).</div>
+==== Annotation 100 ====
-<div style="margin-left:0.423cm;">Lazarus, Arthur, ed. ''Controversies in Managed Mental Health Care''. Washington, D.C.: American Psychiatric Press, 1996.</div>
+What Lenin means, here, is that Hegel inadvertently and unconsciously discovered the concept of reflection [see Annotation 68, p. 65]. Hegel intuitively understood that the material world was reflected in human consciousness, and, by extension, subjective dialectics (dialectical thought) reflected objective dialectics (of the material world). Hegel’s error was an inversion of the ideal and the material. As Marx later pointed out in the Afterword to the Second German Edition of ''Capital Volume I,'' it is the material which precedes the ideal, and not the other way around:
-<div style="margin-left:0.423cm;">Lazarus, Richard. ''Emotion and Adaptation''. New York: Oxford University Press, 1991.</div>
+<blockquote>
+My dialectic method is not only different from the Hegelian, but is its direct opposite. To Hegel, the life process of the human brain, i.e., the process of thinking, which, under the name of ‘the Idea,’ he even transforms into an independent subject, is the demiurgos [craftsman/artisan/creator] of the real world, and the real world is only the external, phenomenal form of ‘the Idea.’ With me, on the contrary, the ideal is nothing else than the material world reflected by the human mind, and translated into forms of thought.
-<div style="margin-left:0.423cm;">Lear, Jonathan. ''Love and Its Place in Nature''. New York: Farrar, Straus and Giroux, 1990.</div>
+-----
-<div style="margin-left:0.423cm;">_________. “The Shrink Is In.” ''The New Republic'', December 25, 1995, pp. 18–25.</div>
+Engels also quoted and emphasized Marx’s thoughts [in ''the Old Preface to Anti-Dühring'', citing another quote of Marx from the ''Afterword to the Second German Edition of Capital Volume I,'' further quoted in Annotation 100 above]: “The mystification which dialectics suffers in Hegel’s hands by no means prevents him from being the first to present its general form of working in a comprehensive and conscious manner. With him it is standing on its head. It must be turned right side up again, if you would discover the rational kernel within the mystical shell.”<ref>Afterword to the Second German Edition of ''Capital Volume I'', Karl Marx, 1873.</ref>
+</blockquote>
-<div style="margin-left:0.423cm;">Levy, Stephen. “Empathy and Psychoanalytic Technique.” ''Journal of the American Psychoanalytic Association'' 33: 353–378 (1985).</div>
-<div style="margin-left:0.423cm;">Lewin, Bertram D. ''The Psychoanalysis of Elation''. New York: Psychoanalytic Quarterly Press, 1961.</div>
+-----
-<div style="margin-left:0.423cm;">Light, Donald. ''Becoming Psychiatrists''. New York: Norton, 1980.</div>
+==== Annotation 101 ====
-<div style="margin-left:0.423cm;">Lindner, Robert. ''The Fifty Minute Hour''. New York: Dell, 1954.</div>
+In ''the Old Preface to Anti-Dühring,'' Engels explains some of the contemporary currents of science and philosophy of his era. Engels explains that Hegelian philosophy had been dismissed by a newer current of natural scientists who dismissed “the idealist point of departure and the arbitrary, fact-defying construction of the system.” In other words, the natural scientists rejected Hegelianism because it was both idealist and was not built on a foundation of objective facts.
-<div style="margin-left:0.423cm;">Linehan, M., et al. “Cognitive-Behavioral Treatment of Chronically Parasuicidal Borderline Patients.” ''Archives of General Psychiatry'' 48: 1060–1064 (1991).</div>
+Engels points out, however, that Marx “was the first to have brought to the fore again the forgotten dialectical method” of Hegel.
-<div style="margin-left:0.423cm;">Linehan M., H. Heard, and H. Armstrong. “Naturalistic Follow-up of a Behavioral Treatment for Chronically Parasuicidal Borderline Patients.” ''Archives of General Psychiatry'' 50: 971–974 (1993).</div>
+The dialectical method was forgotten in the sense that the natural scientists ignored and dismissed dialectics along with the rest of Hegel’s philosophy. So, Engels is pointing out that one of the great contributions of Marx was salvaging the dialectical method from Hegel while rejecting the idealist and non-fact-based characteristics of Hegelian philosophy.
-<div style="margin-left:0.423cm;">Lipsey, Mark, and David Wilson. “The Efficacy of Psychological, Educational and Behavioral Treatment Confirmation from Meta-analysis.” ''American Psychologist'', 48: 1181–1210 (1993).</div>
+Marx, according to Engels, proved that the dialectical method could be separated from idealism by “[applying the dialectical method] in ''Capital'' to the facts of an empirical science, political economy.” This was the origin of dialectical materialism: the resurrection of the dialectical method and the development of a dialectical method in a materialist and scientific form.
-<div style="margin-left:0.423cm;">Lock, Margaret. ''Encounters with Aging: Mythologies of Menopause in Japan and North America''. Berkeley: University of California Press, 1993.</div>
+The idealist characteristics of classical German dialectics and Hegelian philosophy was a limitation that needed to be overcome [so that it could be utilized for scientific inquiry]. Marx and Engels overcame that limitation and in so doing developed ''materialist dialectics.'' This system of dialectics is the most advanced form of dialectics in the history of philosophy to date. It is the successor of previous systems of dialectics, and it arose as a critique of the classical German dialectics.
-<div style="margin-left:0.423cm;">Loewald, Hans. ''Psychoanalysis and the History of the Individual''. New Haven: Yale University Press, 1978.</div>
+Engels said: “Marx and I were pretty well the only people to rescue conscious dialectics from German idealist philosophy and apply it in the materialist conception of nature and history.”<ref>''Anti-Dühring'', The 1885 Preface, Friedrich Engels, 1878.</ref>
-<div style="margin-left:0.423cm;">_________. ''Papers on Psychoanalysis''. New Haven: Yale University Press, 1980.</div>
+=== 2. Materialist Dialectics ===
-<div style="margin-left:0.423cm;">Luborsky, L., et al. “Do Therapists Vary Much in Their Success? Findings from Four Outcome Studies.” ''American Journal of Orthopsychiatry'' 56: 501–512 (1986).</div>
+==== a. Definition of Materialist Dialectics ====
-<div style="margin-left:0.423cm;">''Luborsky, L., B. Singer, and L. Luborsky. “Comparative Studies of Psychotherapies.”'' ''Archives of General Psychiatry'' 32: 995–1008 (1975)</div>
+Materialist dialectics have been defined in various ways by many prominent Marxist-Leninist philosophers.
-<div style="margin-left:0.423cm;">Lunbeck, Elizabeth. ''The Psychiatric Profession''. Princeton, N.J.: Princeton University Press, 1994.</div>
+Engels defined materialist dialectics as: “nothing more than the science of the general laws of motion and development of nature, human society, and thought.”<ref>''Anti-Dühring'', Friedrich Engels, 1878.</ref>
-<div style="margin-left:0.423cm;">Luther, Martin. ''Martin Luther: Selections from His Writings'', John Dillenberger, ed., Garden City, N.Y.: Doubleday, 1961.</div>
+Engels also emphasized the role of the principle of general relations.<ref>See p. 107.</ref> As John Burdon
-<div style="margin-left:0.423cm;">Lutz, Catherine. ''Unnatural Emotions''. Chicago: University of Chicago Press, 1988.</div>
+Sanderson Haldane noted in the 1939 preface to ''Dialectics of Nature'': “In dialectics they
-<div style="margin-left:0.423cm;">Malcolm, Janet. ''Psychoanalysis: The Impossible Profession''. New York: Knopf, 1981.</div>
+[Marx and Engels] saw the science of the general laws of change.”<ref>''Dialectics of Nature'', Friedrich Engels, 1883.</ref>
-<div style="margin-left:0.423cm;">_________. ''In the Freud Archives''. New York: Knopf, 1984.</div>
+Lenin emphasized the important role of the principles of development<ref>See Annotation 117, p. 119.</ref> (including the theory of cognitive development) in the dialectics that Marx inherited from Hegelian philosophy.
-<div style="margin-left:0.423cm;">_________. ''The Purloined Clinic''. New York: Knopf, 1992.</div>
+Lenin wrote: “The main achievement was ''dialectics'', i.e., the doctrine of development in its fullest, deepest, and most comprehensive form, the doctrine of the relativity of human knowledge that provides us with a reflection of eternally developing matter.”<ref>''The Three Sources and Three Component Parts of Marxism'', Vladimir Ilyich Lenin, 1913.</ref>
-<div style="margin-left:0.423cm;">Marcus, E., and S. Bradley. “Concurrence of Axis I and Axis II Illness in Treatment-Resistant Hospitalized Patients.” ''Psychiatric Clinics of North America'' 10: 177–184 (1987).</div>
+==== b. Basic Features and Roles of Materialist Dialectics ====
-<div style="margin-left:0.423cm;">Markus, Hazel, and Shinobu Kitayama. “A Collective Fear of the Collective: Implications of Selves and Theories of Selves.” ''Personality and Social Psychology Bulletin'' 20 (5): 568–579 (1994).</div>
+There are two basic features of the materialist dialectics of Marxism-Leninism:
-<div style="margin-left:0.423cm;">Masson, Jeffrey Moussaieff. ''Final Analysis''. Reading, Mass.: Addison-Wesley, 1990.</div>
+''First, the materialist dialectics of Marxism-Leninism is a system of dialectics that is based on the foundation of the scientific materialist viewpoint.''
-<div style="margin-left:0.423cm;">McManus, Joseph. ''The Fundamental Ideas of Medicine''. Springfield, Ill.: Charles C. Thomas, 1963.</div>
+-----
-<div style="margin-left:0.423cm;">Melnick, S., and L. Lyter. “The Negative Impact of Increased Concurrent Review of Psychiatric Inpatient Care.” ''Hospital and Community Psychiatry'' 38: 300–303 (1997).</div>
+==== Annotation 102 ====
-<div style="margin-left:0.423cm;">“Mental Health: Does Therapy Help?” ''Consumer Reports'', November 1995, pp. 734–739.</div>
+Remember that ''scientific'' in Marxism-Leninism refers broadly to a systematic pursuit of knowledge, research, theory, and understanding [see Objects and Purposes of Study, p. 38]. Remember also that ''materialism'' in Marxism-Leninism has specific meaning as well, which differentiates it from other forms of materialism [see ''Dialectical Materialism — the Most Advanced Form of Materialism'', p. 52]. Here, materialism includes an understanding that the material is the first basis of reality, meaning that the material determines the ideal (though human consciousness can impact the material world through willpower and labor [see ''Nature and Structure of Consciousness'', p. 79]). Materialism is also built upon scientific explanations (rooted in empirical data and practice, i.e. systematic experimentation and observation) of the world. And finally, remember that ''viewpoint'' is the starting point of inquiry [see Annotation 11, p. 12].
-<div style="margin-left:0.423cm;">Michels, R., and P. M. Marzuk. “Progress in Psychiatry,” part I. ''New England Journal of Medicine'' 329 (8): 552–560; part II, 329 (9): 628–638 (1993).</div>
+Thus, a ''scientific materialist viewpoint'' is a perspective which begins analysis of the world in a manner that is both scientifically systematic in pursuit of understanding and firmly rooted in a materialist conception of the world.
-<div style="margin-left:0.423cm;">Miklowitz, D. “Psychotherapy in Combination with Drug Treatment for Bipolar Disorder.” ''Journal of Clinical Psychopharmacology'' 16: 56S–66S (1996).</div>
+''Note:'' Materialist Dialectics contains ''Twelve Basic Pairs of Categories'', ''Two Basic Principles'' and ''Three Universal Laws''. These are summarized, respectively, in Appendix A (p. 246), Appendix B (p. 247), and Appendix C (p. 248), and explained in depth throughout the rest of this chapter.
-<div style="margin-left:0.423cm;">Miller, Alice. ''The Drama of the Gifted Child''. New York: Basic Books, 1981.</div>
+In this way, materialist dialectics fundamentally differs from the classical German idealist dialectics, and especially differs from Hegelian dialectics<ref>See Annotation 98, p. 100.</ref> (as these dialectics were founded on idealist viewpoints).
-<div style="margin-left:0.423cm;">Miller, N. “Managing McLean.” ''The Boston Globe Magazine'', September 10, 1995. Millett, Kate. ''The Loony-Bin Trip''. New York: Simon and Schuster, 1990.</div>
+Moreover, it also has a higher level of development compared to other dialectical systems of thought found in the history of philosophy going back to ancient times. Such previous forms of dialectics were fundamentally based on materialist stances, however the materialism of those ancient times was still naive, primitive and surface-level.
-<div style="margin-left:0.423cm;">Neisser, Ulric, ed. ''Concepts and Conceptual Development''. Cambridge, England: Cambridge University Press, 1987.</div>
+''Second, the materialist dialectics of Marxism-Leninism unifies dialectical materialist viewpoints and materialist dialectical methodology, so it not only explains the world, but is also a tool humans can use to perceive and improve the world.''
-<div style="margin-left:0.423cm;">Pearlman, T. Letter. ''American Journal of Psychiatry'' 148 (1): 139 (1991).</div>
+Every principle and law of Marxist-Leninist materialist dialectics is both:
-<div style="margin-left:0.423cm;">Persons, L., M. Thase, and P. Crits-Christoph. “The Role of Psychotherapy in the Treatment of Depression: Review of Two Practice Guidelines.” ''Archives of General Psychiatry'' 53: 283–290 (1996).</div>
+. An accurate explanation of the dialectical characteristics of the world.
-<div style="margin-left:0.423cm;">Plutchik, Robert. ''Emotion: A Psychoevolutionary Synthesis''. New York: Harper and Row, 1980.</div>
+. A scientific methodology for perceiving and improving the world.
-<div style="margin-left:0.423cm;">President’s Commission on Mental Health, ''Report to the President from the President’s Commission on Mental Health'', vols. I–IV. Washington, D.C.: U.S. Government Printing Office, 1978.</div>
+By summarizing the general interconnections and development of all things — every phenomenon in nature, society and human thought — Marxist-Leninist materialist dialectics provides the most general methodological principles for the process of perceiving and improving the world. They are not just objective methodological principles; they are a comprehensive, constantly developing, and historical methodology.
-<div style="margin-left:0.423cm;">Putnam, Hilary. ''Reason, Truth and History''. Cambridge, England: Cambridge University Press, 1981.</div>
+This methodology can be used to analyze contradictions [see Annotation 119, p. 123] in order to find the basic origins and motivations of both motion and developmental processes. Therefore, materialist dialectics is a great scientific tool for the revolutionary class to perceive and improve the world.
-<div style="margin-left:0.423cm;">Rabinow, Paul. ''Making PCR: A Story of Biotechnology'' Chicago: University of Chicago Press, 1996.</div>
+With these basic features, materialist dialectics plays a very important role in the worldview and philosophical methodology of Marxism-Leninism. Materialist dialectics are the foundation of the scientific and revolutionary characteristics of Marxism-Leninism and also offer the most general worldview and methodology for creative activities in scientific study and practical activities.
-<div style="margin-left:0.423cm;">Radcliffe-Brown, Alfred Reginald. ''Structure and Function in Primitive Society''. London: Cohen and West, 1952.</div>
+== II. Basic Principles of Materialist Dialectics ==
-<div style="margin-left:0.423cm;">Rako, Susan, and Harvey Mazer. ''Semrad: The Heart of a Therapist''. New York: Jason Aronson, 1980.</div>
+-----
-<div style="margin-left:0.423cm;">Rauch, Scott. “Advances in Neuroimaging: How Might They Influence Our Diagnostic Classification Scheme?” ''Harvard Review of Psychiatry'' 4: 159–162 (1996).</div>
+==== Annotation 103 ====
-<div style="margin-left:0.423cm;">Rauch, Scott, et al. “A Positron Emission Tomographic Study of Simple Phobic Symptom Provocation.” ''Archives of General Psychiatry'' 52: 20–28 (1995).</div>
+[[File:t-w-the-worldview-and-philosophical-methodology-of-23.png|''The Principle of General Relationships and the Principle of Development are the most basic principles of materialist dialectics. These two principles are dialectically related to one another.'']]
-<div style="margin-left:0.423cm;">Read, Kenneth. ''The High Valley''. New York: Scribner’s, 1965.</div>
+The following sections will outline the Principle of General Relationships and the Principle of Development, which are the most fundamental principles of materialist dialectics. These two concepts are closely (and dialectically) related:
-<div style="margin-left:0.423cm;">Rhodes, Lorna. ''Emptying Beds''. Berkeley: University of California Press, 1991.</div>
+-----
-<div style="margin-left:0.423cm;">Rieff, Philip. ''Freud: The Mind of the Moralist''. New York: Viking Press, 1959.</div>
+=== 1. The Principle of General Relationships ===
-<div style="margin-left:0.423cm;">Rogow, Arnold. ''The Psychiatrists''. New York: Putnam, 1990.</div>
+''a. Definition of Relationship and Common Relationship''
-<div style="margin-left:0.423cm;">Romano, J. “Reminiscences: 1938 and Since.” ''American Journal of Psychiatry'' 147: 785–792 (1990).</div>
+-----
-<div style="margin-left:0.423cm;">Rosch, Eleanor. “Natural Categories.” ''Cognitive Psychology'' 4: 328–50 (1973).</div>
+==== Annotation 104 ====
-<div style="margin-left:0.423cm;">_________. “Principles of Categorization.” In Eleanor Rosch and Barbara Lloyd, eds., ''Cognition and Categorization''. Hillsdale, N.J.: Lawrence Erlbaum Associates, 1978, pp. 27–48.</div>
+The ''Principle of General Relationships'' describes how all things, phenomena, and ideas are related to one another, and are defined by these internal and external relationships
-<div style="margin-left:0.423cm;">Rosen, Lawrence, ed. ''Other Intentions''. Santa Fe, N.M.: School of American Research, 1995.</div>
+The ''Principle of Development'' relates to the idea that motion, change, and development are driven by internal and external relationships.
-<div style="margin-left:0.423cm;">Rosenhan, David. “On Being Sane in Insane Places.” ''Science'' 179: 250–258 (1973).</div>
+These two principles are dialectically linked: any given subject is defined by its internal relationships, and these same relationships drive the development of every subject.
-<div style="margin-left:0.423cm;">Rosser, R., et al. “Breathlessness and Psychiatric Morbidity in Chronic Bronchitis and Emphysema: A Study of Psychotherapeutic Management.” ''Psychological Medicine'' 13: 93–110 (1983).</div>
+Note: The foundation of the principles of Materialist Dialectics were laid out by
-<div style="margin-left:0.423cm;">Rubin, Theodore. ''Jordi: Lisa and David''. New York: Ballantine, 1962.</div>
+Engels in ''Dialectics of Nature''. Engels began working on ''Dialectics of Nature'' in February, 1870 and had to stop in 1876 to work on ''Anti-Dühring''. He then restarted work on ''Dialectics of Nature'' in 1878 and continued working on it until 1883, when Karl Marx died. Engels felt that it was more important to try and put together Marx’s great unfinished works, ''Capital Volumes 2, 3, and 4'', and so stopped working on ''Dialectics of Nature'' once again. So, unfortunately, Engels died before this seminal work on Materialist Dialectics could be completed, and what we have instead is an unfinished assemblage of notes.
-<div style="margin-left:0.423cm;">Ruddick, Sara. ''Maternal Thinking''. Boston: Beacon Press, 1989.</div>
+What follows in the rest of this book is a cohesive system of Materialist Dialectics which was built upon the foundations laid out by Engels in ''Dialectics of Nature'' and many other works of political and scholarly writing from various sources. This is the system of Materialist Dialectics studied by Vietnamese students and applied by Vietnamese communists today.
-<div style="margin-left:0.423cm;">Sabshin, M. “Turning Points in Twentieth-Century Psychiatry.” ''American Journal of Psychiatry'' 149: 1267–1274 (1990).</div>
+Because this text comes from predominantly Vietnamese scholarship and ideological development, we have had to translate some terms into English which are not derived from the “canon” of Marx, Engels, and Lenin. In some cases, various terms have been consolidated into one concept. For example: Engels used the term “interconnection” (German: ''innern'' ''Zusammenhang'', literally: “inner connections”) in ''Dialectics of Nature'', but Vietnamese political scientists use the term “relationship.” Where Engels uses the term “motion” (German: ''Bewegung'') modern Vietnamese communists tend to use the word “development.” Wherever this is the case, we have chosen to use the words in English which most closely match the language used in the original Vietnamese of this text.
-<div style="margin-left:0.423cm;">Sargant, William. “Psychiatric Treatment Here and in England.” ''Atlantic Monthly'' 214 (1): 88–95 (1964).</div>
+In materialist dialectics, the word ''relationship'' refers to the regulating principles, mutual interactions, and mutual transformations which exist between things, phenomena, and ideas, as well as those existing between aspects and factors within things, phenomena, and ideas.
-<div style="margin-left:0.423cm;">Schafer, Roy. ''The Analytic Attitude''. New York: Basic Books, 1983.</div>
+-----
-<div style="margin-left:0.423cm;">_________. ''Aspects of Internalization''. Madison, Conn.: International Universities Press, 1990 (first published 1968).</div>
+==== Annotation 105 ====
-<div style="margin-left:0.423cm;">_________. ''Retelling a Life''. New York: Basic Books, 1992.</div>
+Throughout this book, ''phenomenon/phenomena'' simply refers to anything that is observable by the human senses.
-<div style="margin-left:0.423cm;">Scharfstein, S. “The Catastrophic Case.” ''General Hospital Psychiatry'' 11: 268–270 (1989).</div>
+Materialist dialectics examines relationships between things, phenomena, and ideas and ''within'' things, phenomena, and ideas. A relationship which occurs between two separate things or phenomena is referred to as an ''external relationship''. A relationship which occurs ''within'' a thing or phenomenon is referred to as an ''internal relationship''.
-<div style="margin-left:0.423cm;">Scheff, Thomas. ''Being Mentally Ill'', 2nd ed. New York: Aldine, 1984.</div>
+These terms are relative; sometimes a relationship may be internal in one context but external in a different context. For example, consider a solar system:
-<div style="margin-left:0.423cm;">Schooler, N., and S. Keith. “The Role of Medication in Psychosocial Treatment.” In Marvin Herz, Samuel Keith, and John Docherty, eds., ''Handbook of Schizophrenia:'' ''Psychosocial Treatment of Schizophrenia'', vol. 4. New York: Elsevier Science Foundation, 1990, pp. 45–67.</div>
+When considering a solar system as a whole, the orbit of a moon around a planet may be considered as an internal relationship of the solar system. But when considering the moon as an isolated subject, its orbit around a planet may be seen as an external relationship which the moon has with the planet.
-<div style="margin-left:0.423cm;">_________. “The Clinical Research Base for the Treatmen of Schizophrenia.” ''Psychopharmacology Bulletin'' 29: 431–446 (1993).</div>
+[[File:t-w-the-worldview-and-philosophical-methodology-of-24.png]]
-<div style="margin-left:0.423cm;">Schreter, Robert, Steven Sharfstein, and Carol Schreter, eds. ''Managing Care, Not Dollars: The Continuum of Mental Health Services''. Washington, D.C.: American Psychiatric Press, 1997.</div>
+The diagram above illustrates different types of relationships:
-<div style="margin-left:0.423cm;">''Schwartz, J. M., et al. “Systematic Changes in Cerebral Glucose Metabolic Rate After Successful Behavior Modification Treatment of Obsessive-Compulsive Disorder.”'' ''Archives of General Psychiatry'' 53: 109–113 (1996).</div>
+Object 1 has its own internal relationships (A), and, from its own perspective, it also has external relationships with Object 2 (B). From a wider perspective, the relationship between Object 1 and Object 2 (B) may be viewed as an internal relationship.
-<div style="margin-left:0.423cm;">Scull, Andrew. ''Decarceration''. Englewood Cliffs, N.J.: Prentice Hall, 1977.</div>
+This ''system of relationships'' (between Object 1 and Object 2) will also have external relationships with other things, phenomena, and ideas (C).
-<div style="margin-left:0.423cm;">Sechehaye, Marguerite. ''The Autobiography of a Schizophrenic Girl''. New York: Grune and Stratton, 1951.</div>
+-----
-<div style="margin-left:0.423cm;">Shaffer, Peter. ''Equus and Shrivings''. New York: Avon, 1975.</div>
+Relationships have a quality of ''generality'', which refers to how frequently they occur between and within things, phenomena, and ideas. When we refer to ''general relationships'', we are usually referring to relationships which exist broadly across many things, phenomena, and ideas. General relationships can exist both internally, ''within'' things, phenomena, and ideas, and externally, ''between'' things, phenomena, and ideas.
-<div style="margin-left:0.423cm;">Shapin, Steven. A ''Social History of Truth''. Chicago: University of Chicago Press, 1994.</div>
+The most general relationships are ''universal relationships'': these are relationships that exist between and within ''everything'' and ''all phenomena'', and they are one of the two primary subjects of study of materialist dialectics. [The other primary subject of study is the ''Principle of Development''; see page 119.]
-<div style="margin-left:0.423cm;">Shapiro, David. ''Neurotic Styles''. New York: Basic Books, 1965.</div>
+-----
-<div style="margin-left:0.423cm;">Shear, M. K., et al. “Cognitive Behaviorial Treatment Compared with Nonprescriptive Treatment of Panic Disorder.” ''Archives of General Psychiatry'' 51: 395–401 (1994).</div>
+==== Annotation 106 ====
-<div style="margin-left:0.423cm;">Sheehan, Susan. ''Is There No Place on Earth for Me?'' New York: Vintage, 1982.</div>
+[[File:t-w-the-worldview-and-philosophical-methodology-of-25.png]]
-<div style="margin-left:0.423cm;">Shem, Samuel. ''The House of God''. New York: Dell, 1978.</div>
+The discussion of generality of relationships can seem confusing at first. What’s important to understand is that generality is a spectrum ranging from the least general relationships (''unique relationships'', which only occur between two ''specific'' things/phenomena/ideas) and the most general relationships (''universal relationships'', which occur between or within ''all'' things/phenomena/ideas).
-<div style="margin-left:0.423cm;">_________. ''Fine''. New York: St. Martin’s Press, 1985.</div>
+Of particular importance in the study of materialist dialectics are ''universal'' relationships which exist within and between all things, phenomena, and ideas [see below].
-<div style="margin-left:0.423cm;">Shweder, Richard, and Jonathan Haidt. “The Future of Moral Psychology: Truth, Intuition and the Pluralist Way.” ''Psychological Science'' 4(6): 360–365 (1993).</div>
+''Translation Note'': In the original Vietnamese, the word “universal” is not used. Instead, the compound term “phổ biến nhất” is used, which literally means “most general.” In Vietnamese, this phrasing is commonly used to describe the concept of “universal” and it is thus not confusing to Vietnamese speakers. For this translation, we have opted to use the word “universal” because we feel it is less confusing and better explains the concept in English.
-<div style="margin-left:0.423cm;">Shweder, R., M. Mahapatra, and J. Miller. “Culture and Moral Development.” In Jerome Kagan and Sharon Lamb, eds. ''The Emergence of Morality in Young Children''. Chicago: University of Chicago Press, 1987, pp. 1–79.</div>
+-----
-<div style="margin-left:0.423cm;">Simon, Herbert, and William Case. “Skill in Chess.” ''American Scientist'' 61: 394–403 (1973).</div>
+The universal relationships include (but are not limited to):
-<div style="margin-left:0.423cm;">Slavney, Phillip R., and Paul R. McHugh. ''Psychiatric Polarities''. Baltimore: Johns Hopkins University Press, 1987.</div>
+* Relationships between basic philosophical category pairs (Private and Common, Essence and Phenomenon, etc.). <ref>See ''Private and Common'', p. 128; ''Essence and Phenomenon'', p. 156.</ref>
+* Relationships between quantity and quality. <ref>See Annotation 117, p. 119.</ref>
+* Relationships between opposites. <ref>See Annotation 190, p. 181.</ref>
-<div style="margin-left:0.423cm;">Smith Kline and French Laboratories. ''Ten Years of Experience with Thorazine 1954–1964''. Philadelphia: Smith, Kline and French Laboratories, 1964.</div>
+Together, in all forms of relationships in nature, society and human thought (special, general, and universal) there is unity in diversity and diversity in unity.
-<div style="margin-left:0.423cm;">Spanier, C., et al. “The Prophylaxis of Depressive Episodes in Recurrent Depression Following Discontinuation of Drug Therapy: Integrating Psychological and Biological Factors.” ''Psychological Medicine'' 26: 461–475 (1996).</div>
+-----
-<div style="margin-left:0.423cm;">Spiegel, D., et al. “Effect of Psychosocial Treatment on Survival of Patients with Metastatic Breast Cancer.” ''Lancet'' 2: 888–891 (1989).</div>
+==== Annotation 107 ====
-<div style="margin-left:0.423cm;">Srole, Leo, et al. ''Mental Health in the Metropolis: The Midtown Manhattan Study''. New York: McGraw-Hill, 1962.</div>
+==== Principle of General Relationships ====
-<div style="margin-left:0.423cm;">Stahl, Stephen. ''Essential Psychopharmacology''. Cambridge, England: Cambridge University Press, 1996.</div>
+According to ''Curriculum of the Philosophy of Marxism-Leninism For University and College Students Specializing in Marxism-Leninism and Ho Chi Minh Thought: “''Materialist dialectics upholds the position that all things, phenomena, and ideas exist in mutual relationships with each other, regulate each other, transform into each other, and that nothing exists in complete isolation. That is the core idea of the ''Principle of General Relationships''.”
-<div style="margin-left:0.423cm;">Stanton, Alfred, and Morris Schwartz. ''The Mental Hospital''. New York: Basic Books, 1954.</div>
+From this Principle, we find the characteristics of ''Diversity in Unity'' and ''Unity in Diversity''; the basis of Diversity in Unity is the fact that every thing, phenomenon, or idea, contains many different relationships; the basis of Unity in Diversity is that many different relationships exist — unified — within each and every thing, phenomenon, and idea.
-<div style="margin-left:0.423cm;">Stanton, A., et al. “Effects of Psychotherapy in Schizophrenia. I: Design and Implementation of a Controlled Study.” ''Schizophrenia Bulletin'' 10 (4): 520–563 (1984).</div>
+==== Diversity in Unity ====
-<div style="margin-left:0.423cm;">Starr, P. ''The Social Transformation of American Medicine''. New York: Basic Books, 1982.</div>
+There exist an infinite number of diverse relationships between things, phenomena, and ideas, but all of these relationships share the same foundation in the material world.
-<div style="margin-left:0.423cm;">''Statistical Abstract of the United States''. Washington, D.C.: United States Dept. of Commerce, 1971.</div>
+[[File:t-w-the-worldview-and-philosophical-methodology-of-26.png|''An infinite diversity of relationships exist within the unity of the material world.'']]
-<div style="margin-left:0.423cm;">Stevenson, J., and R. Meares. “An Outcome Study of Psychotherapy for Patients with Borderline Personality Disorder.” ''American Journal of Psychiatry'' 149: 358–362 (1992).</div>
+The material world is not a chaotic and random assortment of things, phenomena, and ideas. Rather, it is a system of relationships between things, phenomena, and ideas. Likewise, since the material world exists as the foundation of all things, phenomena, and ideas, the material world is thus the foundation for all relationships within and between things, phenomena, and ideas. Because all relationships share a foundation in the material world, they also exist in unity, even though all relationships are diversified and different from one another.
-<div style="margin-left:0.423cm;">Stone, A. “The New Paradox of Psychiatric Malpractice.” ''New England Journal of Medicine'' 311: 1384–1387 (1984).</div>
+-----
-<div style="margin-left:0.423cm;">_________. “Law, Sciences and Psychiatric Malpractice: A Response to Klerman’s Indictment of Psychoanalytic Psychiatry.” ''American Journal of Psychiatry'' 147: 419—427 (1990).</div>
+[[File:t-w-the-worldview-and-philosophical-methodology-of-27.png|''Universal relationships which unite all things, phenomena, and ideas manifest in infinitely diverse ways.'']]
-<div style="margin-left:0.423cm;">Storr, Anthony. ''The Art of Psychotherapy''. New York: Methuen, 1980.</div>
+'''Unity in Diversity'''
-<div style="margin-left:0.423cm;">Strain, J., et al. “Cost Offset from Psychiatric Consultation-Liaison Intervention with Elderly Hip Fracture Patients.” ''American Journal of Psychiatry'' 148: 1044–1049 (1991).</div>
+When we examine the universal relationships that exist within and between all different things, phenomena, and ideas, we will find that each individual manifestation of any universal relationship will have its own different manifestations, aspects, features, etc. Thus even the universal relationships which unite all things, phenomena, and ideas exist in infinite diversity.
-<div style="margin-left:0.423cm;">Strober, M. “Report Prepared for the Use of the Mental Health Working Group, White House Task Force for National Health Care Reform.” 1993.</div>
+''Paraphrased From: Curriculum of the Philosophy of Marxism-Leninism For University and College Students Specializing in Marxism-Leninism and Ho Chi Minh Thought''
-<div style="margin-left:0.423cm;">Strupp, H., and S. Hadley. “Specific vs. Nonspecific Factors in Psychotherapy: A Controlled Study of Outcome.” ''Archives of General Psychiatry'' 36: 1125–1136 (1979).</div>
+-----
-<div style="margin-left:0.423cm;">Styron, William. ''Darkness Visible''. New York: Vintage, 1990.</div>
+==== b. Characteristics of Relationships ====
-<div style="margin-left:0.423cm;">Sussman, Michael. ''A Curious Calling: Unconscious Motivations for Practicing Psychotherapy''. Northvale, N.J.: Jason Aronson, 1992.</div>
+Objectiveness, generality, and diversity are the three basic characteristics of relationships.
-<div style="margin-left:0.423cm;">Szasz, Thomas. ''The Myth of Mental Illness''. New York: Hoeber-Harper, 1961.</div>
+''-'' ''The Characteristic of Objectiveness of Relationships''
-<div style="margin-left:0.423cm;">Talbott, John. ''The Death of the Asylum: A Critical Study of State Hospital Management, Services and Care''. New York: Grune and Stratton, 1978.</div>
+According to the materialist dialectical viewpoint, relationships between things, phenomena, and ideas have objective characteristics.
-<div style="margin-left:0.423cm;">Target, M., and P. Fonagy. “Efficacy of Psychoanalysis for Children with Emotional Disorders.” ''Journal of the American Academy of Child and Adolescent Psychiatry'' 33: 361–371 (1994).</div>
+-----
-<div style="margin-left:0.423cm;">Taylor, Charles. ''Sources of the Self''. Cambridge, Mass.: Harvard University Press, 1989.</div>
+==== Annotation 108 ====
-<div style="margin-left:0.423cm;">Tomes, N. ''The Art of Asylum-Keeping''. Philadelphia: University of Pennsylvania Press, 1994 (first published 1984).</div>
+In materialist dialectics, objectiveness is an abstract concept that refers to the relative externality of all things, phenomena, and ideas. Every thing, phenomena and idea exists externally to every other thing, phenomena, and idea. This means that to each individual subject (i.e., each individual thing/phenomena/idea), all other things, phenomena, and ideas are external objects
-<div style="margin-left:0.423cm;">Tompkins, Silvan. ''Exploring Affect'', V. Demos, ed. Cambridge, England: Cambridge University Press, 1995.</div>
+[[File:t-w-the-worldview-and-philosophical-methodology-of-28.png|''All things, phenomena, and ideas have the relative characteristic of objectiveness.'']]
-<div style="margin-left:0.423cm;">Torrey, E. Fuller. ''The Death of Psychiatry''. Radnor, Pa.: Chilton, 1974.</div>
+All together, the collection of all things, phenomena, and ideas in the universe create the external reality of any given subject. So, objectiveness is relative. In the case of human beings, every individual person exists as an individual subject to which all other things, phenomena, and ideas (including other human beings) have ''objective characteristics.''
-<div style="margin-left:0.423cm;">Traweek, Sharon. ''Beamtimes and Lifetimes: The World of High Energy Physics''. Cambridge, Mass.: Harvard University Press, 1988.</div>
+[[File:t-w-the-worldview-and-philosophical-methodology-of-29.png|''Alice and Bob are external to one another; each is objective from the other’s perspective.'']]
-<div style="margin-left:0.423cm;">Trilling, Lionel. ''Sincerity and Authenticity''. Cambridge, Mass: Harvard University Press, 1972.</div>
+Of course, objectiveness is always relative. Something might be external from a certain perspective but not from another perspective. For example, say there are two people: Bob and Alice. From Bob’s perspective, Alice has objective characteristics. But from Alice’s perspective, Bob would have objective characteristics.
-<div style="margin-left:0.423cm;">Turkle, Sherry. ''Psychoanalytic Politics''. New York: Basic Books, 1978.</div>
+[[File:t-w-the-worldview-and-philosophical-methodology-of-30.png|''The relationship between Alice and Bob has objective characteristics to both Alice and Bob.'']]
-<div style="margin-left:0.423cm;">_________. ''Life on the Screen''. New York: Simon and Schuster, 1995.</div>
+As all relationships are inherently external to any given subject (even subjects which are party to the relationship), relationships also have objective characteristics.
-<div style="margin-left:0.423cm;">''Ursano, R., and E. K. Silberman. “Psychoanalysis, Psychoanalytic Psychotherapy and Supportive Psychotherapy.” In Robert Hales, Stuart Yudofsky, and John Talbott, eds.'', ''The American Psychiatric Press Textbook of Psychiatry'', 2nd ed. Washington, D.C.: American Psychiatric Press, 1994.</div>
+-----
-<div style="margin-left:0.423cm;">Vogt, Evon Z., and Ethel Albert, eds. ''The People of Rimrock''. Cambridge, Mass.: Harvard University Press, 1966.</div>
+Whenever two things, phenomena, or ideas have a relationship with one another, they form a pair. The relationship is inherent to this pair and external to any subject which exists outside of the pair. The mutual interaction and mutual transformation which occurs to the things, phenomena, or objects within the pair as the result of the relationship are ''inherent'' and ''objective'' properties of the pair.
-<div style="margin-left:0.423cm;">Waggoner, R. “The Presidential Address: Cultural Dissonance and Psychiatry.” ''American Journal of Psychiatry'' 127: 41–48, 1970.</div>
+-----
-<div style="margin-left:0.423cm;">Waldinger, Robert C., and John G. Gunderson. ''Effective Psychotherapy with Borderline Patients: Case Studies''. New York: Macmillan, 1987.</div>
+==== Annotation 109 Translation note: ====
-<div style="margin-left:0.423cm;">Wallerstein, Robert. ''Forty-two Lives in Treatment: A Study of Psychoanalysis and Psychotherapy''. New York: Guilford, 1986.</div>
+In the original Vietnamese text, the word for “objective” is ''“khách quan.”'' This is a compound word in which ''“khách”'' means “guest,” and ''“quan”'' means “point of view.” Therefore, ''“khách quan”'' literally means “the guest’s (or outsider’s) point of view.”
-<div style="margin-left:0.423cm;">_________. “The Psychotherapy Research Project of the Menninger Foundation: An Overview.” ''Journal of Consulting and Clinical Psychology'' 57: 195–205 (1989).</div>
+Thus we translate this to “objectiveness/objective,” the characteristic of being viewed from the outside.
-<div style="margin-left:0.423cm;">Warner, Richard. ''Recovery from Schizophrenia: Psychiatry and Political Economy''. New York: Routledge and Kegan Paul, 1985.</div>
+The word “inherent” in the original Vietnamese is ''“vốn có.”'' This is another compound word: ''“vốn”'' is a shortened form of the word ''“vốn dĩ,”'' which means “by or through nature,” “naturally,” and “intrinsically.” ''“Có”'' means “to have” or “to exist.” '''''“Vốn có”''''' thus means “already existing naturally” or “already there, through nature.”
-<div style="margin-left:0.423cm;">Waskow, Irene E., and Morris B. Parloff, eds. “Psychotherapy Change Measures: Introduction.” Outcome Measures Project, Clinical Research Branch. Rockville, Md.: National Institute of Mental Health, 1995.</div>
+So we use the word “inherent” to mean “existing intrinsically or naturally within, without external influence.”
-<div style="margin-left:0.423cm;">Weissman, M., et al. “Sex Differences in Rates of Depression: Cross-National Differences.” ''Journal of Affective Disorders'' 29: 77–84 (1993).</div>
+-----
-<div style="margin-left:0.423cm;">Weissman, M., and J. Markowitz. “Interpersonal Psychotherapy.” ''Archives of General Psychiatry'' 51: 599–606 (1994).</div>
+Human beings can’t change or impact external things and phenomena — and the relationships between them — through human will alone. Humans are limited to perceiving relationships between things and phenomena and then impacting or changing them through our practical activities.
-<div style="margin-left:0.423cm;">Whittington, Horace. ''Psychiatry in the American Community''. New York: International Universities Press, 1966.</div>
+''-'' ''The Characteristic of Generality of Relationships''
-<div style="margin-left:0.423cm;">Wikan, Unni. ''Managing Turbulent Hearts''. Chicago: University of Chicago Press, 1990.</div>
+According to the dialectical viewpoint, there is no thing, phenomenon, nor idea that exists in absolute isolation from other things, phenomena and ideas.
-<div style="margin-left:0.423cm;">Wilson, J. Q. ''The Moral Sense''. New York: Free Press, 1993.</div>
+-----
-<div style="margin-left:0.423cm;">Wilson, Mitchell. “''DSM III'' and the Transformation of Psychiatry: A History.” ''American Journal of Psychiatry'' 150: 399–410 (1993).</div>
+==== Annotation 110 ====
-<div style="margin-left:0.423cm;">Wright, Robert. “The Evolution of Despair.” ''Time'', August 28, 1995, pp. 50–57.</div>
+Although all things, phenomena, and ideas have the characteristic of ''externality'' and ''objectiveness'' to all other things, phenomena, and ideas [see Annotation 108, p. 112], this does not mean that they exist in ''isolation''. Isolation implies a complete lack of any relationships with other things, phenomena, and ideas. On the contrary, according to the ''Principle of General Relationships'' [see p. 107], ''all'' things, phenomena, and ideas have relationships with ''all other'' things, phenomena, and ideas.
-<div style="margin-left:0.423cm;">Yalom, Irvin. ''Love’s Executioner''. New York: Basic Books, 1989.</div>
+Simultaneously, there is also no known thing, phenomenon, nor idea that does not have a systematic structure, including component parts which in turn have their own internal relationships. This means that every existence is a system, and, moreso, is an ''open'' system that exists in relation with other systems. All systems interact and mutually transform one another.
-<div style="margin-left:0.423cm;">Young, Allan. ''The Harmony of Illusions''. Princeton, N.J.: Princeton University Press, 1995.</div>
+-----
-<div style="margin-left:0.423cm;">Zalewski, D. “Fissures at an Exhibition.” ''Lingua Franca'', November–December, 1995, pp. 74–77.</div>
+==== Annotation 111 ====
-<div style="margin-left:0.423cm;">Zients, A. “A Presentation to the Mental Health Working Group, White House Task Force for National Health Care Reform,” April 23, 1993.</div>
+As explained above, a ''systematic structure'' is a structure which includes within itself a system of ''component'' parts and relationships. It has been postulated by some scientific models that there may be some “fundamental base particle” (quarks, preons, etc.), which, if true, would mean that there is a certain basic material component which cannot be further broken down. However, this would not contradict the Principle of Materialist Dialectics of General Relationships (which states that all things, phenomena, and ideas interact with and mutually transform one another — see Annotation 107, p. 110).
-<div style="margin-left:0.423cm;">Zinberg, N. “Psychiatry: A Professional Dilemma.” ''Daedalus'', 1963, pp. 808–823.</div>
+''- The Characteristic of Diversity of Relationships''
-<div style="margin-left:0.423cm;">Zinman, S., “Howie the Harp,” and S. Budd, eds. ''Reaching Across''. Sacramento: California Network of Mental Health Clients, 1987.</div>
+In addition to affirming the objectiveness<ref>See Annotation 108, p. 112.</ref> and generality<ref>See p. 108.</ref> of relationships, the dialectical viewpoint of Marxism-Leninism also emphasizes the ''diversity'' of relationships. The characteristic of diversity is defined by the following features:
-<div style="text-align:center;">{{anchor|ack}} {{anchor|TopofLuhr9780307791900epuba3}} [[Image:Image9.png|top]]$$$</div>
+* All things, phenomena, and ideas have different relationships. Every relationship plays a distinct role in the existence and development of the things, phenomena, and ideas which are included within.
+* Any given relationship between things, phenomena, and ideas will have different characteristics and manifestations under different conditions and/or during different periods of motion and/or at different stages of development.
-== ACKNOWLEDGMENTS ==
+-----
-Many people have contributed to this book along the long road of its creation. It gives me great pleasure to thank Hagop Akiskal, Daniel Bell (who came up with the title), Shelley Burtt, Lincoln Caplan, Jennifer Cole, Jonathan Cole, Michael Cole, Roy D’Andrade, Steven Frisch, Howard Gardner, Randy Gollub, Alice Graham-Brown, Leslie Greis, John Gunderson, Hugh Gusterson, Leston Havens, Richard Hermann, Anne Hoger, John M. Hood III, Kim Hopper, Mardi Horowitz, Carol Janeway (a wonderful editor), Jean Jackson, Kay Jamison, Lewis Judd, Arthur Kleinman, Jill Kneerim (a great agent), Jonathan Kolb, Donald Kripke, George and Winifred Luhrmann, Matthew McCubbins, Kathleen Much, Robert Nemiroff, Joel Robbins, Lisa Robinson, Simon Schama, Edward Shapiro, Bennett Simon, Neil Smelser, Melford Spiro, Carola Suarez-Orozco, Robert Tyson, Vernon, Ellen Winner, Sidney Zisook, and the psychiatrists and patients I have not named but who generously allowed me to spend time with them.
+==== Annotation 112 ====
+One of Marx’s most critical observations was that things are defined by their internal and external relationships, including human beings. For example, in ''Theses on Feuerbach,'' Marx wrote that “the essence of man is no abstraction inherent in each single individual. In reality, it is the ensemble of the social relations.” It is only through relationships — through mutual impacts and transformations — that things, phenomena, and ideas (including human beings and human societies) change and develop over time. All of these relationships — which both define and transform all things, phenomena, and ideas in existence — exist in infinite diversity [see Annotation 107, p. 110].
+Just as things, phenomena, and ideas change and transform through the course of relations with one another, the nature of the relationships themselves also change and develop over time.
+''Characteristics'' refer to the features and attributes that exist ''internally'' within a given thing, phenomena, or idea.
+''Manifestation'' refers to ''how'' a given thing, phenomena, or idea is expressed ''externally'' in the material world.
+For example, a ball may have the ''characteristics'' of being made of rubber, having a mass of 100 grams, and having a melting point of 260℃. It may ''manifest'' by bouncing on the ground, having a spherical shape, and having a red appearance to human observers.
+If ten such balls exist, they will all be slightly different. Even if they have the same mass and material composition, they will have slightly different variations in size, shape, etc. Even if each ball will melt at 260℃, the melting will manifest differently for each ball — they will melt into slightly different shapes, at slightly different speeds, etc.
+Relationships also have characteristics and manifestations. For example, the moon’s orbit around the Earth is a relationship. It has characteristics such as the masses of each related body, forces of gravity, and other factors which produce and influence the orbit. The same orbital relationship also has manifestations such as the duration of the moon’s orbit around the Earth, the size of its ellipse, the orbit’s effects on the tides of the Earth’s ocean, etc.
+''Characteristics'' and ''Manifestation'' correspond, respectively, to the philosophical category pair of ''Content'' and ''Form,'' which is discussed in section page 147.
+Therefore, no two relationships are exactly the same, even if they exist between very similar things, phenomena, and ideas and/or in very similar situations.
+It is also important to note that the characteristic of diversity also applies to things, phenomena, and ideas themselves. In other words, every individual thing, phenomenon, and idea in existence also manifests differently from every other thing, phenomenon, and idea in existence, even if they seem quite similar.
+==== c. Meaning of the Methodology ====
+Based on the objective and popular characteristics of relationships, we can see that in our cognitive and practical activities, we have to have a ''comprehensive viewpoint''.
+Having a ''comprehensive viewpoint'' requires that in the process of perceiving and handling real life situations, humans have to consider the internal dialectical relationships between the component parts, factors, and aspects within a thing or phenomenon. We also need to consider the external mutual interactions they have with other things, phenomena, and ideas. Only on such a comprehensive basis can we properly understand things and phenomena and then effectively handle problems in real life. So, the comprehensive viewpoint is the opposite of a unilateral and/or metaphysical viewpoint [see Annotation 51, p. 49] in both perception and practice.
+Lenin said: “If we are to have true knowledge of an object we must look at and examine all of its facets, its connections, and ‘mediacies [indirect relationships].’”<ref>''Once Again On The Trade Unions'', Vladimir Ilyich Lenin, 1921.</ref>
+-----
+==== Annotation 113 ====
+[[File:t-w-the-worldview-and-philosophical-methodology-of-31.png|''The comprehensive viewpoint sees the subject in terms of all of its internal and external relationships.'']]
+Consider a factory. A factory exists as a collection of internal relationships (between the workers, between machines, between the workers and the machines, etc.) and external relationships (between the factory and its suppliers, between the factory and its customers, between the factory and the city, etc.). In order to have a comprehensive viewpoint when examining the factory, one must consider and understand all of the internal and external relationships which define it.
+-----
+The diversified characteristic of relationships [see Annotation 107, p. 110] shows that in human cognitive and practical activities, we have to simultaneously use a comprehensive viewpoint and a historical viewpoint.
+Having a ''historical viewpoint'' requires that, in perceiving and handling real life situations, we need to consider the specific properties of subjects, including their current stage of motion and development. We also need to consider that the exact same methods can’t be used to deal with different situations in reality — our methods must be tailored to suit the exact situation based on material conditions.
+-----
+==== Annotation 114 ====
+While the ''comprehensive viewpoint'' focuses on internal and external ''relationships'' of subjects, the ''historical viewpoint'' focuses on the specific ''properties'' of subjects — especially the current stage of motion and development. In order to have a proper historical viewpoint, we must study and understand the way a subject has developed and transformed over time. To do this, we must examine the history of the subject’s changes over time, hence the term “historical viewpoint.” In addition, it’s important to understand that no two situations which we might encounter will ever be exactly the same. This is because the component parts and relationships that make up any given situation will manifest differently.
+So, in order to properly deal with situations, we have to understand the component parts and relationships of examined subjects as well as their histories of development so that we can develop plans and strategies that are suitable to the unique circumstances at hand.
+For example, it would be disastrous if communists today tried to employ the ''exact same'' methods which were used by the Communist Party of Vietnam in the 20<sup>th</sup> century to defeat Japan, France, and the USA. This is because the material conditions and relationships of Vietnam in the 20<sup>th</sup> century were very different from any material conditions existing on Earth today. It is possible to learn lessons from studying the methods of the Vietnamese revolution and to ''adapt'' some such methods to our modern circumstances, but it would be extremely ineffective to try to copy those methods and strategies — ''exactly'' as they manifested then and there — to the here and now.
+-----
+In order to come up with suitable and effective solutions to deal with real life problems, we must clearly define the roles and positions of each specific relationship that comes into play, and the specific time, place, and material conditions in which they exist.
+-----
+==== Annotation 115 ====
+[[File:t-w-the-worldview-and-philosophical-methodology-of-32.png|''A historical viewpoint focuses on the roles and positions of relationships and properties of subjects as well as their development over time.'']]
+The role of a relationship has to do with how it functions within a system of relationships and the position refers to its placement amongst other subjects and relationships.
+Consider once again the example of the factory [see Annotation 113]. In addition to its internal and external relationships, the factory also has various roles — it functions within various systems and from various perspectives. For instance, the factory may have the role of financial asset for the corporation that owns it, it may have the role of place of employment for the surrounding community, it may have the role of supplier for various customers, etc.
+The factory is also ''positioned'' among other subjects and relations. If it’s the only employer in town then it would have a position of great importance to the people of the community. If, on the other hand, if it’s just one of hundreds of factories in a heavily industrialized area, it may have a position of much less importance. It may have a position of great importance to an individual factory worker who lives in poverty in an economy where there are very few available jobs, but of less importance to a freelance subcontractor for whom the factory is just one of many customers, and so on.
+These positions and roles will change over time. For example, the factory may initially exist as a small workshop with a small handful of workers, but it may grow into a massive factory with hundreds of employees. It is vital to understand this Principle of Development, which is discussed in more detail on the next page.
+In summary, proper dialectical materialist analysis requires a ''comprehensive and historical viewpoint'' — we must consider subjects both ''comprehensively'' in terms of the internal and external relationships of the subject itself as well as ''historically'' in terms of roles and positions of subjects, as well as their relationships, material conditions, and development over time.
+So, in both perception and practice, we have to avoid and overcome sophistry and eclectic viewpoints.
+-----
+==== Annotation 116 ====
+''Sophistry'' is the use of falsehoods and misleading arguments, usually with the intention of deception, and with a tendency of presenting non-critical aspects of a subject matter as critical, to serve a particular agenda. The word comes from the Sophists, a group of professional teachers in Ancient Greece, who were criticized by Socrates (in Plato’s dialogues) for being shrewd and deceptive rhetoricians. This kind of bad faith argument has no place in materialist dialectics. Materialist dialectics must, instead, be rooted in a true and accurate understanding of the subject, material conditions, and reality in general.
+''Eclecticism'' is an incoherent approach to philosophical inquiry which attempts to draw from various different theories, frameworks, and ideas to attempt to understand a subject, applying different theories in different situations without any consistency in analysis and thought. Eclectic arguments are typically composed of various pieces of evidence that are cherry picked and pieced together to form a perspective that lacks clarity. By definition, because they draw from different systems of thought without seeking a clear and cohesive understanding of the totality of the subject and its internal and external relations and its development over time, eclectic arguments run counter to the comprehensive and historical viewpoints. Eclecticism is somewhat similar to dialectical materialism in that it attempts to consider a subject from many different perspectives, and analyzes relationships pertaining to a subject, but the major flaw of eclecticism is a lack of clear and coherent systems and principles, which leads to a chaotic viewpoint and an inability to grasp the true nature of the subject at hand.
+=== 2. Principle of Development ===
+==== a. Definition of Development ====
+According to the metaphysical viewpoint, development is simply a ''quantitative'' increase or decrease; the metaphysical viewpoint does not account for ''qualitative'' changes of things and phenomena. Simultaneously, the metaphysical viewpoint also views development as a process of continuous progressions which follow a linear and straightforward path.
+-----
+==== Annotation 117 ====
+In materialist dialectics, it is important to distinguish between ''quantity'' and ''quality''.
+''Quantity'' describes the total ''amount'' of component parts that compose a subject.
+''Quality'' describes the unity of component parts, taken together, which defines the subject and distinguishes it from other subjects.
+Both quantity and quality are dynamic attributes; over time, the quantity and quality of all things develop and change over time through the development of internal and external relationships. Quantity and quality itself form a dialectical relationship, and as quantity develops, quality will also develop. A given subject may be described by various quantity and quality relationships.
+'''''Example 1:'''''
+[[File:t-w-the-worldview-and-philosophical-methodology-of-33.png|''In the process of development, Quantity Change leads to Quality Change'']]
+A single football player, alone, has the quantity value of 1 football player and the quality of ''a football player''. Eleven football players on a field would have the quantity value of 1 and will develop the quality of ''a football team''. This subject, ''football'' ''team'', is composed of the same component parts as the subject ''football player'', but the quantity change and other properties (being on a field, playing a game or practicing, etc.) change the quality of the component parts into a different stable and unified form which we call a ''football team''.
+The relationship between quantity and quality is dynamic:
+If one of the players doesn’t show up for practice, and there are only ten players on the field, it might still have the quality of ''football team'', but in a live professional game there will be a certain threshold — a minimum number of players who must be present to officially be considered a ''team''. If this number of players can’t be fielded then they will not be considered a full ''team'' and thus won’t be allowed to play.
+Likewise, if there are only one or two players practicing together in a park, they would probably not be considered a ''football team'' (though they might be described in terms of having the quality of being ''on the same team).''
+'''''Example 2:'''''
+Quantity: 1 O + 2 H atoms Quantity: Billions of H2O Molecules Quantity: ~5,000 Drops of Water Quality: Water Quality: Drop of Water Quality: Cup of Water
+DEVELOPMENT: QUANTITY CHANGE LEADS TO QUALITY CHANGE
+[[File:t-w-the-worldview-and-philosophical-methodology-of-34.png|''All of these have the quality of water because of the molecular quantities of hydrogen and oxygen atoms, however, from the perspective of volume, quantity changes still lead to quality changes.'']]
+The properties of quantity and quality are relative, depending on the viewpoint of analysis.
+A single molecule of water has a quantity of one in terms of molecules, but it still retains the quality of “water” because of the ''quantities'' of one oxygen atom and two hydrogen atoms per molecule which, in this stable form, give it the ''quality'' of water.
+A drop of water might have a quantity of many billions of molecules, but it would still have the quality of “water.” It would also now assume the quality of a “drop.”
+When you combine enough drops of water, you will eventually have a quality shift where the “drops” of water combine to form another quality — i.e., a “cup” of water. The quantity change leads to a change in quantity; we would no longer think of the water in terms of “drops” after the quantity rises to a certain level.
+In terms of ''temperature'' and physical properties, if the water is heated to a certain point it will boil and the water will become ''steam''. The quantity of water in terms of drops wouldn’t change, but the quantity-value of temperature would eventually lead to a quality value change from “water” to “steam.”
+'''''Example 3:'''''
+AS QUANTITY OF AGE INCREASES, QUALITY CHANGES
+[[File:t-w-the-worldview-and-philosophical-methodology-of-35.png|''The same human being will undergo various quality changes as age quantity increases over time.'']]
+As humans age and the quantity of years we’ve lived builds up over time, our “quality” also changes, from baby, to child, to teenager, to young adult, to middle age, to old age, and eventually to death. The individual person is still the same human being, but the quality of the person will shift over time as the quantity-value of age increases.
+'''Metaphysical vs. Dialectical Materialist Conceptions of Change'''
+[[File:t-w-the-worldview-and-philosophical-methodology-of-36.png|''Metaphysics only consider linear properties of'' quantity''change; Materialist Dialectics takes'' quantity changes ''and'' quality shifts ''into consideration when considering change over time.'']]
+Because the metaphysical perspective tries to define the world in terms of static, isolated subjects, only ''quantity'' is considered and ''quality shifts'' are not taken into account. Thus, metaphysical logic sees development as linear, simple, and straightforward. Materialist dialectics, on the other hand, sees development as a more complicated, fluid, and dynamic process involving multiple internal and external relationships changing in quantity and quality over time.
+-----
+In contrast to the metaphysical viewpoint, in materialist dialectics, ''development'' refers to the ''motion'' of things and phenomena with a forward tendency: from less advanced to more advanced, from a less complete to a more complete level.
+-----
+==== Annotation 118 ====
+In materialist dialectics, ''motion (also known as change)'' is the result of mutual impacts between or within things, phenomena, and ideas, and all motion and change results from mutual impacts which themselves result from internal and external relationships with other things, phenomena, and ideas. Any given ''motion/change'' leads to quantity changes, and these quantity changes cumulatively lead to quality changes [see Annotation 117, p. 119]. Grasping this concept — that development is driven by relations — is critically important for understanding materialist dialectics.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-37.png|''The concept of “change” in materialist dialectics centers on internal and external relationships causing mutual impacts which lead to quantity changes which build into quality shifts.'']]
+This process, taken in total, is referred to as ''development''. Development represents the entire process in which internal and external change/motion leads to changes in quantity which in turn lead to changes in quality over time. The process of development can be fast or slow, complex or simple, and can even move backwards, and all of these properties are relative. Development has a ''tendency'' to develop from less advanced to more advanced forms. The word ''tendency'' is used to denote phenomena, development, and motion which inclines in a particular direction. There may be exceptional cases which contradict such tendencies, but the general motion will incline towards one specific manner. Thus, it is important to note that “development” is not necessarily “good” nor “bad.” In some cases, “development” might well be considered “bad,” or unwanted. For example, rust developing on a car is typically not desired. So, the tendency of development from lower to higher levels of advancement implies a “forward motion,” though this motion can take an infinite number of forms, depending on the relative perspective. Development can also (temporarily) halt in a state of equilibrium [see Annotation 64, p. 62] or it can shift direction; though it can never “reverse,” just as time itself can never be “reversed.”
+For example, during a flood, water may “develop” over the land, and as the floodwaters recede this may alternatively be viewed as another “forward” development process of ''recession'' — a development of the overall “flooding and receding” process. The flood is not actually “reversing” — the development is not being “undone.” Flood water may recede but it will leave behind many traces and impacts; thus it is not a true “reversal” of development.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-38.png|''Both flooding and flood recession are development processes with the same forward tendency. Flood recession may appear to be a “reversal,” but it is in fact forward development.'']]
+The false belief that development can be reversed is the root of conservative and reactionary positions [see Annotation 208].
+Development can be considered positive or negative, depending on perspective. Some ecosystems have natural flood patterns which are vital for sustaining life. For a person living in a flood zone, however, the flood would most likely be considered an unwanted development, whereas flood recession would be a welcomed development.
+-----
+It is important to note that the definition of development is not identical to the concept of “motion” (change) in general. It is not merely a simple quantitative increase or decrease, nor a repetitive cyclic change in quantity. Instead, in materialist dialectics, development is defined in terms of ''qualitative'' changes with the direction of advancing towards higher and more advanced levels. [See diagram ''Relationship Between Motion,''
+''Quantity/Quality Shifts, and Dialectical Development'', Annotation 119, below]
+Development is also the process of creating and solving objective ''contradictions'' within and between things and phenomena. Development is thus the unified process of negating negative factors while retaining and advancing positive factors from old things and phenomena as they transform into new things and phenomena.
+-----
+==== Annotation 119 ====
+A ''contradiction'' is a relationship in which two forces oppose one another. Although a contradiction might exist in ''equilibrium'' for some amount of time [see Annotation 64, p. 62], eventually, one force will overcome the other, resulting in a change of ''quality''. This process of overcoming is called ''negation''. In short, ''development'' is a process of change in a subject’s quantity as well as negation of contradictions within and between subjects, leading to quality shifts over time.
+==== b. Characteristics of Development ====
+Every development has the characteristics of objectiveness,<ref>See: Annotation 108, p. 112.</ref> generality,<ref>See: Annotation 106, p. 109.</ref> and diversity.<ref>See: Annotation 107, p. 110.</ref>''The characteristic of objectiveness of development'' stems from the origin of motion.
+-----
+==== Annotation 120 ====
+Remember that, in materialist dialectics, objectiveness is the relative characteristic that every subject has of existing and developing externally to all other subjects [see Annotation 108, p. 112]. Since motion originates from mutual impacts which occur between external things, objects, and relationships, the motions themselves also occur externally (relative to all other things, phenomena, and objects). This gives motion itself objective characteristics.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-39.png|''Dialectical Development consists of Quantity and Quality Shifts, which in turn derive from motion.'']]
+Development is derived from motion as a process of quality shifting which arise from quantity changes which arise from motion [see Annotation 117, p. 119]. Since development is essentially an accumulation of motion, and motion is objective, development itself must also be objective.
+The ''Principle of Development'' states that development is a process that comes from within the thing-in-itself; the process of solving the contradictions within things and phenomena. Therefore, development is inevitable, objective, and occurs without dependence on human will.
+-----
+==== Annotation 121 ====
+The “thing-in-itself” refers to the actual material object which exists outside of our consciousness [see Annotation 72, p. 68]. Development arises from motion and self-motion [see Annotation 62, p. 59] with objective characteristics. Although human will can impact motion and development through conscious activity in the material world [see ''The Relationship Between Matter and Consciousness'', p. 88], motion and development can and does occur without being dependent on human will. Human will is neither a requirement nor prerequisite for motion and development to occur.
+Development has the ''characteristic of generality'' because development occurs in every process that exists in every field of nature, society, and human thought; in every thing, every phenomenon, and every idea and at every stage* of all things, phenomena, and ideas. Every transformation process contains the possibility that it might lead to the birth of a new thing, phenomenon, or idea [through a change in quality, i.e. development].
+-----
+==== Annotation 122 ====
+<nowiki>*</nowiki> In materialist dialectics, “stage” (or “stage of development”) refers to the current quantity and quality characteristics which a thing, phenomenon, or object possesses. Every time a quality change occurs, a new stage of development is entered into.
+---------
+Development has the ''characteristic of diversity'' because every thing, phenomenon, and idea has its own process of development that is not totally identical to the process of development of any other thing, phenomenon, or idea. Things and phenomena will develop differently in different spaces and times. Simultaneously, within their own processes of development, things, phenomena, and ideas are impacted by other things, phenomena, and ideas, as well as by many other factors and historical conditions. Such impacts can change the direction of development of things, phenomena, and ideas. They can even temporarily set development back, and/or can lead to growth in one aspect but degeneration in another.
+-----
+==== Annotation 123 ====
+Because development has the characteristic of generality and the characteristic of diversity, the principle of diversity in unity and unity in diversity also applies to development [see: Annotation 107, p. 110].
+==== c. Meaning of the Methodology ====
+Materialist dialectics upholds that the principle of development is the scientific theoretical basis that we must use to guide our perception of the world and to improve the world. Therefore, in our perception and reality, we have to have a ''development viewpoint''.
+According to Lenin: “dialectical logic requires that an object should be considered in development, in change, in ‘self-movement.”<ref>''Once Again On The Trade Unions,'' Vladimir Ilyich Lenin, 1921. See also: ''Mode and Forms of Matter'', p. 59.</ref>
+This development viewpoint [which holds that all things, phenomena, and ideas are constantly developing, and that development is thus unavoidable] requires us to overcome conservatism, stagnation<ref>See Annotation 62, p. 59.</ref>, and prejudice, which are all opposed to development.
+-----
+==== Annotation 124 ====
+Conservatism and prejudice are mindsets which seek to prevent and stifle development and to hold humanity in a static position. Not only is this detrimental to humanity, it is also ultimately a wasted effort, because development is inevitable in human society, as in all things, phenomena, and ideas. Therefore, we must avoid and fight against such stagnant mindsets.
+According to this development viewpoint, in order to perceive or solve any problem in real life, we must consider all things, phenomena, and ideas with their own forward tendency of development taken in mind. On the other hand, the path of development is a dialectical process that is reversible and full of contradictions. Therefore, we must be aware of this complexity in our analysis and planning. This means we need to have a ''historical viewpoint'' [see Annotation 114, p. 116] which accounts for the diversity and complexity of development in perceiving and solving issues in reality.
+-----
+==== Annotation 125 ====
+Materialist dialectics requires us to consider the complexity and constant motion of reality. By comparison, the metaphysical viewpoint (which considers all things, phenomena, and ideas as static, isolated entities which have linear and simple processes of development) stands as a barrier to understanding this complexity and incorporating it into our worldview. Thus, it is vital that we develop comprehensive and historical viewpoints which acknowledge the diversity and complexity of reality.
+In summary, as a science of common relations and development, Marxist-Leninist materialist dialectics serve a very important role in perception and practice. Engels affirmed the role of materialist dialectics in this passage:
+“An exact representation of the universe, of its evolution, of the development of mankind, and of the reflection of this evolution in the minds of men, can therefore only be obtained by the methods of dialectics, with its constant regard to the innumerable actions and reactions of life and death, of progressive or retrogressive changes.”
+Lenin also said: “Dialectics requires an all-round consideration of relationships in their concrete development, but not a patchwork of bits and pieces.”<ref>''Once Again On The Trade Unions'', Vladimir Ilyich Lenin, 1921.</ref>
+== III. Basic Pairs of Categories of Materialist Dialectics ==
+''Category*'' is the most general grouping of aspects, attributes, and relations of things, phenomena, and ideas. Different specific fields of inquiry may categorize things, phenomena, and/or ideas differently from one another.
+-----
+==== Annotation 126 ====
+<nowiki>*</nowiki> ''Translation note:'' In Vietnamese, the word “phạm trù” is used here, which translates in this context more closely to the English philosophical term “category of being,” which means “the most general, fundamental, or broadest class of entities.” “Category of being” is sometimes simplified in English-language philosophical discourse to “category,” which we have chosen to do here for ease of reading and to better reflect the way it reads in the original Vietnamese.
+Every science has its own systems of categories that reflect the aspects, attributes, and basic relations that fall within its scope of study. For example, mathematics contains the categories “arithmetic,” “geometry,” “point,” “plane,” and “constant.” Physics contains the categories of “mass,” “speed,” “acceleration,” and “force,” and so on. Economics includes “commodity,” “value,” “price,” “monetary,” and “profit” categories.
+Every such category reflects only the common relations found within the specific fields that fall within the scope of study of a specific science.
+''Categories of materialist dialectics'', on the other hand, such as “matter,” “consciousness,” “motion,” “contradiction,” “quality,” “quantity,” “reason,” and “result,” are different. Categories of materialist dialectics reflect the most general aspects and attributes, as well as the most basic and general relations, of not just some specific fields of study, but of the whole of reality, including all of nature, society and human thought.
+Every thing, phenomenon, and idea has many properties, including: a reason for existing in its current form, a process of motion and change, contradictions, content, form, and so on. These properties are aspects, attributes, and relations that are reflected in the categories of materialist dialectics. Therefore, the relationship between the categories of specific sciences and categories of materialist dialectics is a dialectical relationship between the Private and the Common [see ''Private and Common,'' p. 128].
+-----
+==== Annotation 127 ====
+[[File:t-w-the-worldview-and-philosophical-methodology-of-40.png|''The categories of specific sciences are limited to the scope of study, while the categories of materialist dialectics encompass all things, phenomena, and ideas.'']]
+Unlike the categories contained within specific scientific fields, the philosophical categories of materialist dialectics can be used to analyze and define all things, phenomena, and ideas. The categories of specific scientific fields and the materialist dialectical categories have a Private/Common dialectical relationship [discussed on the next page].
+-----
+As a science of general relations and development, materialist dialectics summarizes the most general relations of every field of nature, society, and human thought into basic category pairs: ''Private and Common, Reason and Result, Obviousness and Randomness, Content and Form, Essence and Phenomenon, Possibility and Reality.''
+-----
+==== Annotation 128 ====
+Every individual materialist dialectical category has a dialectical relationship with another materialist dialectical category. Thus, all categories in materialist dialectics are presented as ''category pairs.'' So, a ''category pair'' is simply a pair of categories within materialist dialectics which have a dialectical relationship with one another.
+Note that the this formalized system of category pairs reflects many decades of work by Vietnamese philosophical and political scientists based on the works of Marx, Engels, Lenin, and other socialist thinkers. Also note that these are not the only category pairs that can be discussed; there are potentially an infinite number of categories which can be used in materialist dialectical analysis. However, universal category pairs, which can be applied to analyze any and all things, phenomena, and ideas, are much fewer and farther between. That said, the universal category pairs discussed in this book are the ones which have most often been used by Marx, Engels, Lenin, and other prominent materialist dialecticians.
+=== 1. Private and Common ===
+==== a. Categories of Private and Common ====
+The ''Private Category'' encompasses specific things, phenomena, and ideas; the ''Common Category'' defines the common aspects, attributes, factors, and relations that exist in many things and phenomena.
+Within every Private thing, phenomenon, and idea, there exists the Common, and also the Unique. The Unique encompasses the attributes and characteristics that exist in only one specific thing, phenomenon, or idea, and does not repeat in any other things, phenomena, or ideas.
+-----
+==== Annotation 129 ====
+[[File:t-w-the-worldview-and-philosophical-methodology-of-41.png]]
+The ''Private'' category includes specific individual things, phenomena and ideas.
+The ''Common'' category includes aspects, factors, and relations that exist in many things, phenomena, and ideas. For example, say there are two apples: Apple A and Apple B. Apple A is a specific individual object. Apple B is another distinct, separate object. In that sense, both apples are ''private'' apples, and fall within the ''Private'' category.
+However, both Apple A and Apple B share common attributes. For instance, they are both fruits of the same type: “apple.” They may have other attributes in common: they may be the same color, they may have the same basic shape, they may be of similar size, etc. These are ''common'' attributes which they share. Thus, Apple A and Apple B will also fall within the ''common'' category, based on these common attributes.
+Apple A and Apple B will also have ''unique'' attributes. Only Apple A has the exact molecules in the exact place and time which compose Apple A. There is no other object in the world which has those same molecules in that same place and time. This means that Apple A also has ''unique'' properties.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-42.png|''All private subjects have attributes in common with other private subjects.'']]
+The Common and Private categories have a dialectical relationship. The Common contains the Private, and the Private contains the Common. Every private subject has some attributes in common with other private subjects, and common attributes can only exist among private subjects. Thus every thing, phenomenon, and idea in existence contains internally within itself dialectical relationships between the Private and the Common, and has dialectical Private/Common relationships externally within other things, phenomena, and ideas.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-43.png|''All private subjects have attributes in common with other private subjects.'']]
+It is also true that every private subject contains within itself ''Unique'' attributes which it does ''not'' share with any other thing, phenomenon, or idea. For example, Mount Everest is unique in that it is 8,850 meters tall. No other mountain on Earth has that exact same height. Therefore, the private subject “Mount Everest” has unique properties which it does not share with any other subject, even though it has other attributes in common with countless other private entities.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-44.png|''All things, phenomena, and ideas contain the unique, the private, and the common.'']]
+Whenever two individual subjects have a relationship with one another, that relationship is a ''unique relationship'' in the sense that it is a relationship that is shared only by those two specific subjects; however, there will also be common attributes and properties which any such relationship will share with other relationships in existence. This recalls the ''principle of Unity in Diversity and Diversity in Unity'' [see Annotation 107, p. 110]. So, every thing, phenomenon, and idea contains the Common ''and'' the Unique and has unique ''and'' common relationships with other things, phenomena, and ideas.
+This category pair is very useful in developing a comprehensive viewpoint [see Annotation 114, p. 116]. Remember that a comprehensive viewpoint indicates an understanding of the internal and external relations of a given subject. This means that in order to develop a comprehensive viewpoint, you must know the private aspects of each individual relation, component, and aspect of the subject, and you must also study the commonalities of the subject as well. It’s also important to study a variety of ''private'' information sources or data points to look for ''commonalities'' between them. In other words, if you want to have a proper comprehensive viewpoint [see Annotation 113, p. 116] about any subject, you have to find and analyze as many ''private'' data points and pieces of evidence as possible.
+For example: If a person only ever saw one apple, a green apple, then that person might believe that “all apples are green.” This conclusion would be premature: the person is attempting to make an assumption about the ''Common'' without examining enough ''Privates''. This is a failure of mistaking mistaking the ''Private'' for the ''Common'' which stems from a lack of a comprehensive viewpoint.
+Now, let’s take a look at an example of how the “Unique” can become “Common,” and vice-versa: 1947 TODAY
+[[File:t-w-the-worldview-and-philosophical-methodology-of-45.png]]
+''“Unique” things, phenomena, and ideas can become “common” through development processes (and vice-versa).''
+In 1941, a Soviet soldier named Mikhail Kalashnikov was in the hospital after being wounded in the Battle of Bryansk. Another soldier in the hospital said to Kalashnikov, “why do our soldiers only have one rifle for two or three of our men, while the Germans have automatics?” To solve this problem, Kalashnikov designed the AK-47 machine gun. When he finished making the first prototype, it was the only AK-47 in the world.
+At this precise moment, the AK-47 was simultaneously ''Unique'', ''Private'', and ''Common.''
+It was ''Unique'' because it was the first and only AK-47 in the world, and no other object in the world had those properties. It was ''Private'' because it was a specific object with its own individual existence. It was ''Common'' — even though it was the only existing prototype — because it shared Common features with other rifles, and with other prototypes. It was the only AK-47 in existence.
+Soon, however, the Soviet Union began manufacturing them, and they became very common. Now there are millions of AK-47s in the world. So, today, that prototype machine gun remains simultaneously ''Unique, Private,'' and ''Common,'' with some slight developments:
+It remains ''Private'' because it is a specific object with its own individual existence. Even though it is no longer the only AK-47 in existence, it remains ''Unique'' because it is still the very first AK-47 that was ever made, and even though there are now many other AK-47s, there is no other rifle in the universe that shares that same unique property. It remains ''Common'' because it still shares common features with other rifles and other prototypes, but it now also shares ''commonality'' with many other AK-47 rifles. It is no longer ''Unique'' for having the properties of an AK-47 in and of itself.
+If someone were to destroy Kalashnikov’s prototype AK-47, the ''Private'' of that ''object'' would no longer exist — it would remain only as an ''idea'', and the Private would transform to whatever becomes of the material components of the rifle. The ''Unique'' would also no longer remain specifically as it was before being destroyed. However, there would still be many other AK-47s which would share common features related to that prototype; for instance, that they were all designed based on the prototype’s design.
+''Translator’s Note:'' The words “Private,” “Common,” and “Unique” may seem unusual because they are direct translations from the Vietnamese words used to describe these concepts in the original text. Various other words have been used by Marx, Engels, Lenin, and other materialist dialecticians when discussing the underlying concepts of these philosophical categories. For instance, in most translations of Lenin, his discussion of such topics is typically translated into English using words such as “universal,” “general,” “special,” “particular,” etc.
+Example (from Lenin’s ''Philosophical Notebooks''): “Language in essence expresses only the universal; what is meant, however, is the special, the particular. Hence what is meant cannot be said in speech.” Here, “universal” refers to that which is ''Common'' in all things, phenomena, and ideas, and “special/particular” refers to the ''Private — s''pecific individual things, phenomena, and ideas — along with their ''Unique'' properties.
+Here are excerpts from Lenin’s ''Philosophical Notebooks'' discussing these concepts:
+<blockquote>
+(‘It?’ The most universal word of all.) Who is it? I. Every person is an I.
+Das Sinnliche? It is a universal, etc., etc. ‘This??’ Everyone is ‘this.’
+Why can the particular not be named? One of the objects of a given kind (tables) is distinguished by something from the rest...
+Leaves of a tree are green; John is a man; Fido is a dog, etc. Here already we have dialectics (as Hegel’s genius recognised): the individual is the universal... And a naïve confusion, a helplessly pitiful confusion in the dialectics of the universal and the particular — of the concept and the sensuously perceptible reality of individual objects, things, phenomena.
+Further, the ‘subsumption’ under logical categories of ‘sensibility’ (Sensibilität), ‘irritability’ (irritabilität) — this is said to be the particular in contrast to the universal!! — and ‘reproduction’ is an idle game.
+</blockquote>
+Marx, too, discussed these concepts using words which are commonly translated into English using different terms. For example, in ''Capital'':
+<blockquote>
+The general form of relative value, embracing the whole world of commodities, converts the single commodity that is excluded from the rest, and made to play the part of equivalent – here the linen – into the universal equivalent.
+</blockquote>
+Here, “general form” refers to the ''commonalities'' of form that exist between all commodities. The “single commodity” refers to a private commodity; a specific commodity that exists separately from all other commodities. And when referring to a “universal equivalent,” Marx is referring to equivalence which such a commodity has in ''common'' with every other commodity.
+The rest of this passage continues as a materialist dialectical analysis of the ''Private, Common,'' and ''Unique'' features and aspects of commodities:
+<blockquote>
+The bodily form of the linen is now the form assumed in common by the values of all commodities; it therefore becomes directly exchangeable with all and every of them. The substance linen becomes the visible incarnation, the social chrysalis state of every kind of human labour. Weaving, which is the labour of certain private individuals producing a particular article, linen, acquires in consequence a social character, the character of equality with all other kinds of labour. The innumerable equations of which the general form of value is composed, equate in turn the labour embodied in the linen to that embodied in every other commodity, and they thus convert weaving into the general form of manifestation of undifferentiated human labour. In this manner the labour realised in the values of commodities is presented not only under its negative aspect, under which abstraction is made from every concrete form and useful property of actual work, but its own positive nature is made to reveal itself expressly. The general value form is the reduction of all kinds of actual labour to their common character of being human labour generally, of being the expenditure of human labour power. The general value form, which represents all products of labour as mere congelations of undifferentiated human labour, shows by its very structure that it is the social resumé of the world of commodities. That form consequently makes it indisputably evident that in the world of commodities the character possessed by all labour of being human labour constitutes its specific social character.
+</blockquote>
+We have chosen to use the terms “Private,” “Common,” and “Unique” in the translation of this text because they most closely match the words used in the original Vietnamese. In summary, it is important to realize that you may encounter the underlying ''concepts'' which are related by these words using various phrasings in the writings of Marx, Engels, Lenin, etc.
+==== b. Dialectical Relationship Between Private and Common ====
+According to the materialist dialectical viewpoint: the Private, the Common and the Unique exist objectively [see Annotation 108, p. 112]. The Common only exists within the Private. It expresses its existence through the Private.
+-----
+==== Annotation 130 ====
+The ''Common'' can’t exist as a specific thing, phenomenon, or idea. However, every specific thing, phenomenon, or idea exists as a ''private'' subject which has various features in ''common'' with other ''private'' things, phenomena, and ideas. We can therefore only understand the ''Common'' through observation and study of various ''private'' things, phenomena, and ideas. For example, a human can’t perceive with our senses alone the ''Common'' of apples. Only by observing many ''private'' apples can begin to derive an understanding of what all ''private'' apples have in ''common''.
+The Common does not exist in isolation from the Private. Therefore, commonality is inseparable from things, phenomena, and ideas. The Private only exists in relation to the Common. Likewise, there is no Private that exists in complete isolation from the Common.
+-----
+==== Annotation 131 ====
+No commonality can possibly exist outside of private things, phenomena, and ideas because commonality describes features which different things, phenomena, and ideas share. No private thing, phenomenon, or idea can possibly exist ''absolutely without'' commonality because there is no thing, phenomenon, or idea that shares ''absolutely no features'' with ''any other'' thing, phenomenon, or idea.
+The Private category is more all-encompassing and diverse than the Common category; Common is a part of Private but it is more profound and more “essential” than the Private. This is because Private is the synthesis of the Common and the Unique; the Common expresses generality and the regular predictability of many Privates.
+-----
+==== Annotation 132 ====
+The Private encompasses all aspects of a specific, individual thing, phenomenon, or idea; thus it encompasses all aspects, features, and attributes of a given subject, including both the Common and the Unique. In this way, the Private is the synthesis of the Common and the Unique.
+Common attributes require more consideration, effort, and study to properly determine, because multiple private subjects must be considered and analyzed before common attributes can be confidently discovered and understood. They offer us a more profound understanding of the essence [see ''Essence and Phenomenon,'' p. 156] and nature of things, phenomena, and ideas because they offer insights into the ''relationships'' between and within different things, phenomena, and ideas. As we discover more commonalities, and understand them more deeply, we begin to develop a more comprehensive perspective of reality. We begin to develop an understanding of the laws and principles which govern relations between and within things, phenomena, and ideas, and this gives us the power to more accurately predict how processes will develop and how things, phenomena, and ideas will change and mutually impact one another over time.
+Under specific conditions, the Common and the Unique can transform into each other [See Annotation 129, p. 128].
+The dialectical relationship between Private and Common was summarised by Lenin:
+“Consequently, the opposites (the individual as opposed to the universal) are identical: the individual exists only in the connection that leads to the universal. The universal exists only in the individual and through the individual. Every individual is (in one way or another) a universal. Every universal is (a fragment, or an aspect, or the essence of) an individual. Every universal only approximately embraces all the individual objects. Every individual enters incompletely into the universal, etc., etc. Every individual is connected by thousands of transitions with other '''kinds''' of individuals (things, phenomena, ideas) etc.”<ref>''On the Question of Dialectics'', Vladimir Ilyich Lenin, 1915.</ref> [Note: “individual and universal” here refer the same underlying concepts of “Private and Common” (respectively); see translator’s note on p. 132].
+==== c. Meaning of the Methodology ====
+We must acknowledge and recognize the Common in order to study the Private in our cognitive and practical activities. If we fail to acknowledge the Common, then whenever we attempt to understand and comprehend any Private thing, phenomenon or idea, we will make mistakes and become disoriented. To understand the Common we have to study and observe the Private because the Common does not exist abstractly outside of the Private.
+-----
+==== Annotation 133 ====
+Our understanding of Common attributes arise from the observation and study of private things, phenomena, and ideas. At the same time, developing our understanding of Commonalities between and within Private subjects deepens our understanding of their essential nature [see: Essence and Phenomenon].
+[[File:t-w-the-worldview-and-philosophical-methodology-of-46.png|''Dialectical analysis of private and common characteristics involves observing private subjects to determine common attributes and considering common attributes to gain insights about private subjects.'']]
+It is impossible to know anything at all about the Common without observing Private subjects, and attempting to understand Private subjects without taking into consideration the attributes and features which they have in Common with other Private subjects will lead to incomplete and erroneous analysis.
+-----
+In addition, we must identify the Common features and attributes of every specific Private subject we study. We must avoid being dogmatic, metaphysical, and inflexible in applying our knowledge of commonalities to solve problems and interpret the world.
+-----
+==== Annotation 134 ====
+==== Dogmatism and Revisionism in Relation to the Private and Common ====
+''Dogmatism'' is the inflexible adherence to ideals as incontrovertibly true while refusing to take any contradictory evidence into consideration. Dogmatism stands in direct opposition to materialist dialectics, which seeks to form opinions and conclusions only after careful consideration of all observable evidence.
+Dogmatism typically arises when the Common is overemphasized without due consideration of the Private. A dogmatic position is one which adheres to ideals about commonalities without taking Private subjects into consideration.
+Dogmatism can be avoided by continuously studying and observing and analyzing
+Private subjects and taking any evidence which contradicts erroneous perceptions of “false commonalities” into consideration. This will simultaneously deepen our understanding of the Private while improving our understanding of the Common. For example: Sally might observe a few red apples and arrive at the conclusion: “all apples are red.” If Sally is then presented with a green apple, yet refuses to acknowledge it by continuing to insist that “all apples are red,” then Sally is engaging in dogmatism.
+According to Vietnam’s ''Curriculum of the Philosophy of Marxism-Leninism For University and College Students Specializing in Marxism-Leninism and Ho Chi Minh Thought,'' the opposite of Dogmatism is ''Revisionism''. Revisionism occurs when we overestimate the Private and fail to recognize commonalities. In failing to recognize common attributes and features between and within things, phenomena, and ideas, the Revisionist faces confusion and disorientation whenever they encounter any new things, phenomena, and ideas, because they lack any insight into essential characteristics of the subject and its relations with other subjects.
+For example: if Sally has spent a lot of time studying a red apple, she may start to become confident that she understands everything there is to know about apples. If she is then presented with a green apple, she might become confused and disoriented and draw the conclusion that she has to start all over again with her analysis, from scratch, thinking: “this can’t possibly be an apple because it’s not red. It must be something else entirely.” Sally can avoid this revisionist confusion by examining the other common features which the red and green apples share before making any conclusions.
+==== Metaphysical Perception of the Private and Common ====
+The ''metaphysical'' position attempts to categorize things, phenomena, and ideas into static categories which are isolated and distinct from one another [see Annotation 8,
+p. 8]. In this way, the metaphysical perception ultimately fails to properly understand the role of both the Private ''and'' the Common. Categories may be arranged in taxonomic configurations based on shared features, but ultimately every category is seen as distinct and isolated from every other category. This perspective severs the dialectical relationship between the Private, the Common, and the Unique, and thus leads to a distorted perception of reality. As Engels wrote in ''Socialism: Utopian and Scientific'':
+<blockquote>
+The analysis of Nature into its individual parts, the grouping of the different natural processes and objects in definite classes, the study of the internal anatomy of organized bodies in their manifold forms — these were the fundamental conditions of the gigantic strides in our knowledge of Nature that have been made during the last 400 years. But this method of work has also left us as legacy the habit of observing natural objects and processes in isolation, apart from their connection with the vast whole; of observing them in repose, not in motion; as constraints, not as essentially variables; in their death, not in their life. And when this way of looking at things was transferred by Bacon and Locke from natural science to philosophy, it begot the narrow, metaphysical mode of thought peculiar to the last century.”
+</blockquote>
+In other words, Engels points out that separating and dividing Private subjects into distinct and isolated categories without acknowledging the dialectical nature of the Private and the Common leads to severe limitations on what we can learn about the world. Instead, we have to examine things, phenomena, and ideas ''in relation to one another'', which must include the analysis of Commonalities.
+Rather than divide subjects into distinct, separate categories, materialist dialectics seek to examine Private subjects as they really exist: as a synthesis of Unique and Common attributes; and simultaneously to examine commonalities as they really exist: as properties which emerge from the relations of Private objects.
+In our cognitive and practical activities, we must be able to take advantage of suitable conditions that will enable transformations from the Unique and the Common (and vice versa) for our specific purposes.
+-----
+==== Annotation 135 ====
+In advancing the cause of socialism, revolutionaries must work to transform our Unique positions into common positions. For instance, the process of developing revolutionary public knowledge [see Annotation 94, p. 93] begins with studying and understanding revolutionary knowledge. Initially, this knowledge will be ''unique'' to the socialist movement. By disseminating the knowledge to the public, we hope to transform this knowledge into ''common knowledge''.
+Likewise, we hope to transform other common things, phenomena, and ideas back towards the Unique. For instance, the capitalist mode of production is currently the most common mode of production on Earth. In order to advance humanity towards communism, we must transition the capitalist mode of production from the Common towards the Unique, with the ambition of eventually eliminating this mode of production altogether.
+=== 2. Reason and Result ===
+==== a. Categories of Reason and Result ====
+The ''Reason'' category is used to define the mutual impacts between internal aspects of a thing, phenomenon or idea, or between things, phenomena, or ideas, that bring about changes.
+The ''Result'' category defines the changes that were caused by mutual impacts which occur between aspects and factors ''within'' a thing, phenomenon, or idea, or ''externally'' between different things, phenomena, or ideas.
+-----
+==== Annotation 136 ====
+''Translation note:'' the Vietnamese words for “reason and result” can also be translated as “cause and effect.” We have chosen to use the words “reason and result” to distinguish materialist dialectical categories from metaphysical conceptions of development.
+In metaphysics [see Annotation 8, p. 8], any given ''effect'' is seen to have a single ''cause''. In materialist dialectics, we instead examine the ''mutual impacts'' which occur within and between subjects through motion and development processes.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-47.png|''Metaphysical vs. Materialist Dialectical conceptions of development.'']]
+In the metaphysical conception of cause and effect, (A) causes effect (B), then effect (B) causes effect (C), and so on. Materialist dialectics, on the other hand, uses the model of ''development'' (see Annotation 117, p. 119), wherein objects (A) and (B) mutually impact one another, resulting in development (C). (C) will then have relations with other things, phenomena, and/or ideas, and the mutual impacts from these new relations will become the reasons for future results. Consider the following example:
+[[File:t-w-the-worldview-and-philosophical-methodology-of-48.png|''Metaphysical vs. Materialist Dialectical conceptions of frying and eating an egg.'']]
+In the metaphysical “cause and effect” model, putting an egg in a hot pan is the cause which results in the effect of producing a fried egg. The egg being fried has the effect of the egg now being suitable for eating, which is the cause of the egg being eaten by a hungry person.
+This is a simplification of the metaphysical conception of causes and effects, since metaphysics does recognize that one cause can have branches of multiple effects, but the essential characteristic of the metaphysical conception of causality is to break down all activity and change in the universe into static and distinct episodes of one distinct event causing one or more other distinct events.
+In contrast, the materialist dialectical model of development holds that every result stems from mutual impacts which occur relationally between things, phenomena, and ideas, and that the resulting synthesis — the newly developed result of mutual impacts — will then have new relations with other things, phenomena, and ideas, and that these ''relations'' will become new reasons for new results through ''mutual impact''.
+In this example, the egg and the hot pan will mutually impact each other. The frying pan will become dirty and need to be washed (the result of putting an egg in the frying pan); meanwhile, the egg will become a fried egg, which is fit for human consumption (the result of being cooked in the frying pan). The fried egg will then have a relationship with a hungry human, and this relationship will be a new reason which will lead to further results (i.e., the human eating and digesting the egg).
+So, the key difference between the classical metaphysical conception of causality and the materialist dialectical model of development is that metaphysics focus more on individual events in time whereas materialist dialectics focus on the relations and mutual impacts between things, phenomena, and ideas over time.
+==== b. Dialectical relationship between Reason and Result ====
+The relationship between Reason and Result is objective, and it contains inevitability: there is no Reason that does not lead to a Result; and likewise, there is no Result without any Reason.
+Reasons cause Results, which is why Reason always comes before Result, and Result always comes after Reason.
+A Reason can cause one or many Results and a Result can be caused by one or many Reasons.
+When many Reasons lead to a single Result, the impacts which lead to the Result are mutual between all things, phenomena, and ideas at hand. These mutual impacts can have many relational positions or roles, including: direct reasons, indirect reasons, internal reasons, external reasons, etc.
+-----
+==== Annotation 137 ====
+As stated in the previous annotation, Reasons which lead to Results stem from mutually impacting relations between things, phenomena, and ideas. There is no way for one subject to affect another subject without also being affected itself in some way.
+Reasons can take many forms, including (but not limited to):
+'''Types of Reasons and Results'''
+[[File:t-w-the-worldview-and-philosophical-methodology-of-49.png|''Direct Reasons stem from immediate relations.'']]
+'''Direct Reasons''' are Reasons which stem from immediate relations, with no intervening relations standing between the Reason and Result.
+For example, dropping a coffee cup causes an immediate relationship between the cup and the ground, and that relation leads directly to the Result of the coffee cup breaking to pieces.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-50.png|''Indirect Reasons have an intervening relationship between the Reason and the Result.'']]
+'''Indirect Reasons''' are Reasons which have intervening relations between a Reason and a Result.
+For example, the dropped coffee cup above may have smashed into pieces directly because it hit the ground, but it may also have indirect Reasons. The person holding the cup may have been frightened because she heard a loud noise, and the loud noise was caused by a car backfiring, and the car backfiring was caused by the driver not maintaining his car engine.
+In materialist dialectical terms, the driver’s relationship with his car would be an indirect Reason for the car backfiring; the relationship between the car (which backfired) and the person holding the coffee cup would be the direct Reason for dropping the cup; and the cup’s relationship with the ground would be the direct reason for the cup smashing. At the same time, the driver’s relationship with his car would be an indirect Reason for the Result of the coffee cup smashing to pieces.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-51.png|''Internal Reasons stem from internal relationships.'']]
+'''Internal Reasons''' are Reasons which stem from internal relations that occur between aspects and factors ''within'' a subject.
+For example, if a building collapses because the steel structure ''within'' the building rusts and fails, then that could be viewed as an ''internal Reason'' for the collapse.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-52.png|''External Reasons stem from external relations.'']]
+'''External Reasons''' are reasons which stem from external relations that occur between different things, phenomena, and ideas.
+For example, if a building collapses because it is smashed by a wrecking ball, then that could be viewed as an ''external Reason'' for the collapse.
+All of these roles and positions can be viewed ''relatively''. From one viewpoint, a Reason may be seen as internal, but from another viewpoint, it might be viewed as external. For example, if a couple has a disagreement which leads to an argument, the disagreement may be seen as an external Reason from the perspective of each individual within the couple. But to a relationship counselor viewing the situation from the outside, the disagreement may be seen as an internal Reason which leads to ''the couple'' (a subject defined by the internal relationship between the husband and wife) arguing.
+From one perspective, a government official ordering a building to be torn down may be seen as the direct Reason for the Result of the building being torn down. But from a different perspective, one can see many intervening relations: complaints from local residents may have led to the government official making the order, the order would be delivered to a demolition crew, the demolition crew would assign a crew member to operate a wrecking ball, the crew member would operate the wrecking ball, the wrecking ball would smash the building. All of these can be seen as intervening relations which constitute indirect reasons leading up to the direct Reason of the wrecking ball smashing the building. Choosing the right viewpoint during analysis is critical to make sure that Reason and Result relations are viewed properly and productively, and care must also be taken to ensure that the correct Reasons are attributed to Results (see ''Reason and Result'', p. 138).
+Likewise, a Reason can cause many Results, including primary and secondary Results.
+-----
+==== Annotation 138 ====
+'''Primary''' Results are Results which are more direct and predictable.
+'''Secondary''' Results are Results which are indirect and less predictable.
+For example, an earthquake may have ''primary'' Results such as the ground shaking, buildings being destroyed, etc. ''Secondary'' Results from the earthquake might include flights being rerouted from local airports, shortages at grocery stores, etc.
+In the motion of the material world, there is no known “first Reason” or “final Result.”
+-----
+==== Annotation 139 ====
+With our current understanding of the universe, it is uncertain what might have caused the creation of all existence. Was it the Big Bang? If so, did the Big Bang have some underlying reason? There is also no way to know if there will ever be a “final Result.” Will the heat death of the universe occur, and if so, will that end all transpiring of relations which would end the cycle of development — of Reasons and Results?
+As of now, we do not have solid answers to these questions. If and when answers arise, it is possible that the materialist dialectical framework will need to be updated to reflect new scientific knowledge, just as Marx, Engels, and Lenin have updated materialist dialectics in the past [see Annotation 72, p. 68]. What’s important to understand in the meantime is that within our realm of human experience and understanding, for all practical purposes, every Result which we live through and observe has some underlying Reason, and will itself lead to one or more Results.
+Engels said: “we find upon closer investigation that the two poles of an antithesis [see Annotation 200, p. 192], positive and negative, e.g., are as inseparable as they are opposed, and that despite all their opposition, they mutually interpenetrate [are mixed together]. And we find, in like manner, that cause and effect are conceptions which only hold good in their application to individual cases; but as soon as we consider the individual cases in their general connection with the universe as a whole, they run into each other, and they become confounded when we contemplate that universal action and reaction in which causes and effects are eternally changing places, so that what is effect here and now will be cause there and then, and vice versa.”<ref>''Socialism: Utopian and Scientific'', Friedrich Engels, 1880.</ref>
+-----
+==== Annotation 140 ====
+In the above passage, Engels is simply explaining that since all things, phenomena, and ideas are relationally linked and inter-related [see ''Basic Principles of Materialist Dialectics'', p. 106], the mutual impacts and processes of change which lead to development (the reasons and results which transpire between all things, phenomena, and ideas) are also all linked and inter-related. What might be viewed as a Reason is also a Result of one or more prior Reasons, just as every Result is also a Reason for future Results.
+==== c. Meaning of the Methodology ====
+Because the relationship between Reason and Result is objective and inevitable, we can’t ignore the relationship between Reason and Result in our perception and practice. In reality, there is no thing, phenomenon or idea that can exist without any underlying Reason or Reasons; and vice versa, there is no Reason that does not lead to any Result.
+-----
+==== Annotation 141 ====
+In political activity, it is important to remember that ''every'' interaction within every relationship will lead to mutual impacts which will cause change and development; in other words, everything we choose to do will be the Reason for one or more Results. We must be aware of unintended or unpredicted Results from our activities.
+Reason-Result relationships are very complicated and diverse. Therefore, we must accurately identify the types of Reasons [direct, indirect, internal, external, etc.] so that we can come up with proper solutions which are suitable for the specific situation in both perception and practice. A Reason can lead to many results and, likewise, a Result can be caused by many Reasons, which is why we must have a comprehensive viewpoint and a historical viewpoint [see Annotation 114, p. 116] in our perception of reality so we can properly analyse, solve and apply Reason-Result relationships.
+-----
+==== Annotation 142 ====
+It is critical to understand that there may be many events or relationships which might be falsely ascribed as Reasons for a given Result (and vice-versa).
+For example: in 1965, the United States of America officially declared war on North Vietnam after the so-called “Gulf of Tonkin Incident,” in which Vietnamese forces supposedly fired on a United States Navy ship in the Gulf of Tonkin. The Gulf of Tonkin Incident is often described as the “cause” or the “Reason” that the Vietnam War began.
+However, the real “Reason” why the USA declared war on North Vietnam had to do with the underlying contradiction between capitalist imperialism and communism in Vietnam. This contradiction had to be resolved one way or another. The United States of America willfully decided to try to negate this contradiction by instigating war, and this was the true reason the war began. In fact, the so-called “Gulf of Tonkin Incident” never even occurred as described — the attack on the USA’s ship never really occurred. A document released by the Pentagon in 2005 revealed that the incident was completely fabricated. So, saying that the “Gulf of Tonkin Incident” was the Reason for the war is nonsensical, since it’s an event which never even occurred in reality.
+Understanding the true nature of Reason and Result is very important for making decisions and choosing a path forward in political action. Attributing the wrong Reason to a Result, or misunderstanding the Results which stem from a Reason, can lead to serious setbacks and failures. Therefore, it is vital for revolutionaries to properly identify and understand the ''actual'' Reasons and Results which drive development.
+=== 3. Obviousness and Randomness ===
+==== a. Categories of Obviousness and Randomness ====
+-----
+==== Annotation 143 ====
+In Vietnamese, the words for these categories are “tất nhiên” and “ngẫu nhiên,” which respectively translate to “obvious” and “random.” In socialist literature, various words have been used by different authors to convey the underlying meaning of these categories (Engels, for instance, used the terms “necessary” and “accidental” to mean “obvious” and “random,” respectively). We have chosen to use words which closely match the Vietnamese used in the original text, but the reader should be aware that these same concepts may be described using many different words in various English translations of Marx, Engels, Lenin, Ho Chi Minh, etc.
+The ''Obviousness'' category refers to events that occur because of the essential [see ''Essence and Phenomenon'', p. 156] internal aspects of the material structure of a subject. These essential internal characteristics become reasons for certain results under certain conditions: the Obvious ''has'' to happen in a certain way, it ''can’t'' happen any other way.
+-----
+==== Annotation 144 ====
+''Obviousness'' can only apply to material subjects in the material world and results which are certain to happen based on the material laws of nature. Obviousness arises from the internal aspects, features, and relations of physical objects. Paper ''will'' burn under certain specific conditions, due its internal material structure. If those conditions (i.e., temperature, the presence of oxygen, etc.) exist, then paper ''will'' catch fire predictably. In other words, paper will ''obviously'' burn under certain circumstances due to its internal composition,.
+The ''Randomness'' category refers to things that happen because of external reasons: things that happen, essentially, by chance, due to impacts from many external relations. A Random outcome ''may'' occur or it ''may not'' occur; a Random outcome could happen ''this'' way or it could happen ''that'' way.
+-----
+==== Annotation 145 ====
+As we discussed above, paper ''will'' burn if it reaches a certain temperature — that much is ''obvious''. If your friend holds paper over the flame of the lighter, the paper ''will'' burn — that’s ''obvious''. But you can’t be certain whether your friend will actually hold the paper to the flame or not. This demonstrates ''Randomness''. Whether your friend will ultimately hold the paper to the flame or not depends on an external relation which is not defined by the internal structure of the paper, and which can’t be predicted with the same predictability as obvious events which are rooted in internal material aspects.
+==== b. Dialectical relationship between Obviousness and Randomness ====
+Obviousness and Randomness both exist objectively and play an important role in the motion and development of things and phenomena. Obviousness plays the decisive role.
+-----
+==== Annotation 146 ====
+Obviousness plays the decisive role simply because Obviousness is far more predictable and the laws which govern material phenomena are essentially fixed. We can’t change the laws of physics, the nature of chemical reactions, etc.
+Obviousness and Randomness exist in dialectical unity; there is no pure Obviousness, nor pure Randomness. It is obvious that Randomness shall occur in our universe, however Obviousness clears a path through this Randomness.
+-----
+==== Annotation 147 ====
+Our universe is incredibly complex and there are many different potential external relations which could impact any given situation, such that some degree of Randomness is always present in any situation; in other words, the presence of Randomness can be seen as Obvious.
+In 1922, Ho Chi Minh identified objective internal characteristics of the working class of France and its colonies. He wrote: “The mutual ignorance of the two proletariats gives rise to prejudices. The French workers look upon the native as an inferior and negligible human being, incapable of understanding and still less of taking action. The natives regard all the French as wicked exploiters. Imperialism and capitalism do not fail to take advantage of this mutual suspicion and this artificial racial hierarchy to frustrate propaganda and divide forces which ought to unite.”
+In this example, Ho Chi Minh identifies prejudice as an obvious outcome of mutual ignorance. The prejudice arises as a matter of course from internal objective aspects of the two proletarian groups. As long as French and native workers remain ignorant of one another, prejudice will arise. The specific forms which this prejudice will take, however, and their resulting impacts and developments, will be more or less Random because there are many external factors (including the external impacts of the capitalist class, which seeks to take advantage of these prejudices) which can’t be predicted. Therefore, it is necessary for political revolutionaries to account for both random and obvious factors in confronting such prejudice. Ho Chi Minh’s suggestion for overcoming these difficulties was concise and to-the-point: “Intensify propaganda to overcome them.” Only by negating the internal aspects of mutual ignorance through education and propaganda could communists hope to negate the resulting prejudice.
+As Engels said: “One knows that what is maintained to be necessary [''obvious''] is composed of sheer accidents, and that the so-called accidental [''random''] is the form behind which necessity hides itself — and so on.”<ref>''Ludwig Feuerbach and the End of Classical German Philosophy'', Friedrich Engels, 1886.</ref>
+Obviousness and Randomness are not static properties: Randomness and Obviousness continuously change and develop over time. Under specific conditions, Obviousness and Randomness can transform into each other: Obviousness can become Random and Randomness can become obvious.
+-----
+==== Annotation 148 ====
+Randomness can be introduced to an obvious situation: it may be obvious that a mineshaft will collapse, until human beings come along and intervene by repairing the structural integrity of the mineshaft. It may seem Random whether a city’s economy will grow or shrink, until a volcano erupts and buries the city in lava and ash, making it obvious that the economy will not grow because the city no longer exists.
+Most situations are in a flux, as Obviousness and Randomness dialectically develop and change over time, with outcomes becoming more or less obvious or Random over time. It is vital that we, as political revolutionaries, are able to distinguish between Obviousness and Randomness and to leverage this understanding to our advantage.
+==== c. Meaning of the Methodology ====
+Basically, in our perception and reality, we have to base our plans, strategies, and actions as much as possible on the Obvious, not the Random. However, we must not ignore Randomness, nor try to separate the Obvious from the Random. When faced with situations which seem very Random, we must find ways to develop Obviousness. When faced with what seems obvious, we must keep an eye out for Randomness. Obviousness and Randomness can mutually transform, so we need to create suitable conditions to hinder or promote such transformation to suit our purposes.
+-----
+==== Annotation 149 ====
+We must always remember that no situation is purely obvious, nor purely Random, and to take this into account in all of our planning and activity.
+A skyscraper made from heavy steel beams may seem quite sturdy and stable; it may appear obvious that the structure will remain stable and sound for decades. However, it is still important for engineers to periodically ''confirm'' that the steel is still sound through testing and observation. Engineers must also be prepared for Random events like lightning, earthquakes, storms, etc., which may affect the seemingly obvious structural integrity of the building.
+Likewise, when faced with extremely complex situations which seem completely Random, we must seek out (or bring about) the obvious. Wildfires are extremely chaotic and difficult to predict. However, firefighters can rely on certain obvious patterns and natural laws which govern the spread of fire. By digging trenches, lighting counter-fires, spraying water, and other such actions, firefighters can bring wildfires under control. This illustrates how humans are able to make situations less Random by bringing about an increasing amount of Obviousness over time through practical activity.
+=== 4. Content and Form ===
+==== a. Categories of Content and Form ====
+The ''Content'' category refers to the sum of all aspects, attributes, and processes that a thing, phenomenon, or idea is made from.
+The ''Form'' category refers to the mode of existence and development of things, phenomena, and ideas. ''Form'' thus describes the system of relatively stable relationships which exist internally within things, phenomena, and ideas.
+-----
+==== Annotation 150 ====
+Content and Form can be difficult to comprehend at first because the ways in which Content and Form manifest and interact can vary wildly depending on the subject being discussed and the viewpoint from which the subject is being considered.
+<blockquote>
+Content represents the component things, materials, attributes, features, etc., which, together, make up a thing, phenomenon, or idea. You can think of it as the “ingredients” from which a subject is made.
+Form refers to a stable system of internal relationships which compose a thing, phenomenon, or idea, as well as the mode of existence and development [see Annotation 60, p. 59] of those relations.
+</blockquote>
+Remember that from a dialectical materialist perspective, everything in our universe is defined by internal and external relations. If a thing, phenomenon, or idea has internal relations which are ''relatively'' stable, then it has a Form.
+We would not call all of the assorted ingredients which are used to make a cake “a cake” unless they have been assembled together and baked into the stable form which we interpret as “a cake.” Once a portion is removed from the cake, the portion itself assumes a new stable form which we call “a slice of cake.” The slice of cake will maintain its relatively stable form until being eaten, discarded, or otherwise transitioning into some other form. It is only considered a “slice of cake” for as long as it maintains its own specific stable form.
+Stability itself is also ''relative'': a “spray” of water may only last for a few seconds but we can still conceive of it as having Form. On the other hand, a mountain has a set of stable internal relations (a Form) which might last for millions of years.
+We can think of Form as having two aspects: inner Form and outer Form.
+''Inner form'' refers to the internal stable relations which we have already discussed.
+''Outer form'' is how an object “appears” to human senses.
+In this book, we are primarily concerned with the ''inner Form'' of subjects, however, in other contexts (such as art and design), the ''outer Form'' plays a more prominent role.
+Now, let’s identify some of the common viewpoints from which Content and Form might be considered.
+'''Material vs. Ideal'''
+When discussing the ''material'' — i.e., ''objective'' systems and objects<ref>See Annotation 10, p. 10 and Annotation 108, p. 112.</ref> — discussion of Content and Form is more straightforward.
+'''Material'''
+With material things and phenomena, the ''Content'' is what the thing is made out of: the physical parts, aspects, attributes, and processes that compose the subject. For example, the Content of a wooden chair might be the wood, nails, paint, and other materials which are used to create the chair.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-53.png|''A material object can be described in terms of content, inner form, and outer form.'']]
+The ''inner Form'' of a material object refers to ''stable internal relations'' which compose the object. The stable relationship between the wood and the nails — the nails bind the wood together, the wood is cut in certain patterns, the paint adheres to the wood through physical and chemical bonds, etc. ''Stability'' is, again, relative — over time, the paint will chip and flake, the wood will rot, the nails will rust, etc. Dialectical processes of change will eventually reduce the chair into something other than a chair (i.e., through rotting, burning, disassembly, etc.), but as long as the internal relations maintain the Form of a chair we conceive of it as a chair.
+The ''outer Form'' of a material object refers to the way it appears to human consciousness. Its shape, aesthetics, etc.
+==== Ideal ====
+With the ideal — i.e., ''abstract'' ideas and concepts — discussion of Content and Form becomes more complicated. As Vietnam’s ''Marxism-Leninism Textbook for Students Who Specialize in Marxism-Leninism'' explains:
+<blockquote>
+Many times, human consciousness has difficulty in trying to clearly define the Content of a subject — especially when the subject is an abstract idea. We often mistake Content with inner Form. Usually, in this situation, there is a strong combination and intertwining between both Content and Form. In such a situation, the Form can be referred to as the “inner Form,” or the “Content-Form.”
+With physical things and phenomena, this type of Form usually belongs to a very specific Private, it doesn’t exist in any other Private, it is the Unique [see Annotation 129, p. 128].
+</blockquote>
+-----
+The reason the inner Form of physical objects usually exists in ''Private'' as the ''Unique'' is because the stable internal relations of any given physical object are equivalent to the specific material components which distinguish one physical object from all other physical objects. In other words, if you have two chairs which are exact copies of each other, made from the same kind of wood, cut into the same shape, using the same type and configuration of fasteners, etc., they are still not the exact same object. The internal relations of one chair are what make it ''that'' chair and distinguish it from all other objects in the universe. The ''outer Form'' of these chairs may have many commonalities (they look similar, they have the same color, etc.), but the ''inner Form'' is what distinguishes one chair from the other.
+<blockquote>
+However, within the realm of abstract ideas, there are also Forms which many abstract Privates share. In the context of abstract ideas, we call this kind of Form the “outer Form,” the “form-Form,” or the “common Form.”
+When we try to define the Content of a subject which is an abstract idea, our consciousness usually tries to answer the question: “what is the subject?”
+</blockquote>
+This is usually a simple matter. Take, for example, the abstract idea of “freedom.” When we try to think of the Content of ''freedom'' we can answer it pretty easily. What is the subject of ''freedom''? It is the condition which allows humans to follow their own will, it is the absence of external coercion, etc., etc.
+<blockquote>
+But, when we try to define the Form of an abstract idea, our consciousness tries to answer the question: “how is the subject?” — this is when we have to define the mode of existence (the Form) of that subject.
+</blockquote>
+This is where things get more complicated. The mode of existence of an abstract idea can usually be considered to be language, since our ideas are usually expressed through language, but it can take on other modes of existence as well, such as visual media (paintings, photographs), physical motions of the human body (body language, dance), etc. This is how the field of art studies is concerned with the philosophical categories of Content and Form.
+==== Content and Form in Art ====
+Many readers may already be familiar with the subject of Content and Form from studying art, design, communications, and related fields. At first glance, the definitions of Content and Form may seem different from what we’ve been discussing so far.
+This is because art concerns itself with ''abstract ideas'' expressed through various Forms of ''physical representations.''
+These physical representations may include physical objects (photographs, paintings, sculptures), performed and/or recorded physical activities (dance, music, theater, film), human language recorded in stable physical Forms of written language (novels, poems, stories) or spontaneously performed oral language (storytelling, impromptu spoken-word poetry).
+Because the study of art is primarily concerned with interpreting and understanding ideas expressed through these physical manifestations, art is concerned with the ''stable inner relations'' of the ''ideas'' which artists imbue within their works of art — much more than the stable inner relations of the physical components of the object.
+According to the Vietnamese art textbook ''Curriculum of General Aesthetics'':
+<blockquote>
+What is the Form of a work of art? Form is the way to express the Content of an artwork. Form and Content within a work of art have a strong unity with each other and they regulate each other. Form is the organization, the inner structure of the Content of an artwork. Therefore, Form is the way that the Content expresses itself, and that way is described by two features. We must ask:
+First: what expresses the Content of a work of art?
+Second: how is it expressed?
+Art exists when two conditions are met: first, there must be a subject with an outer Form. Second, an artist must convey aesthetic meaning, or humanization, of that subject. This aesthetic meaning is the Content.
+</blockquote>
+So, in studying works of art, we are less concerned with the ''physical content'' of the artwork (the canvas, paint, etc.) than we are with the ''abstract content'' of the artwork (the ideas which the artist imbues within the artwork).
+As for Form, the ''inner Form'' of art represents the stable internal relations which compose the art (both ideal, i.e., the stable internal relations of the abstract ideas imbued within the art by the artist, as well as physical, i.e., the stable internal relations of the physical media of the art).
+The ''outer Form'' of art represents how our human senses perceive the art, such as composition techniques, the use of color, etc.
+The chart below breaks down the differences in a general, non-artistic viewpoint of physical objects and processes in materialist dialectical terms (i.e., the viewpoint an engineer might have), as compared with the artistic viewpoint of physical objects and processes (which an art critic might have). Some fields, such as designing products for human use, might draw from both viewpoints.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-54.png]]
+==== Content and Form in Specific Artistic Media ====
+Every medium of art will interpret Content and Form in its own way. For example:
+'''Literature''' is a specific art discipline which deals with recorded human language in the Form of writing. In written literature, the Content would be the ideas expressed in a piece of writing; what the words say. The inner Form would be the way the ideas relate to each other — i.e., story structure, pacing, character development, etc. The outer form would be the physical format of the writing — i.e., manuscript, magazine article, paperback book, ebook, etc.
+'''Painting''' is a specific art discipline in which pigments are applied to objects to create images which convey ideas and emotions. In painting, the Content would be the meaning which an artist embodies in a work of art. The inner Form would include the stable internal relations within the artwork (i.e., the bonds and mixtures between the pigments, the canvas, etc.), while the outer Form would be how the artwork appears to human senses (composition, aesthetics, etc.). Generally speaking, the creator of the art will have to make decisions about the inner Form (i.e., selection of oil vs. acrylic vs. watercolor, selection of shade, tint, and hue, physical brush strokes, etc.) so as to produce the desired outer Form (the way the finished artwork will appear to viewers).
+'''Theater''' is a specific art discipline in which human beings perform physical actions and use their voices to convey ideas to an audience. In theater, the Content includes the ideas which are being presented, such as the script, the musical score, the story, the performance choices of actors, costumes, props, etc. The inner Form would include the stable relations between the members of the cast, the director, the physical stage, the lighting, etc., and the outer Form would be the way the play appears to the audience.
+These are just some examples. Each medium of expression will have its own variations in how Content and Form are considered.
+Engels described the manifestation of Content and Form in ''Dialectics of Nature:''
+<blockquote>
+The whole of organic nature is one continuous proof of the identity or inseparability of form and content. Morphological and physiological phenomena, form and function, mutually determine one another. The differentiation of form (the cell) determines differentiation of substance into muscle, skin, bone, epithelium, etc., and the differentiation of substance in turn determines difference of form.
+</blockquote>
+Content and Form are discussed frequently in analysis of human social systems and objective relations which occur within society. For example, Marx made many criticial insights into economics by analyzing and explaining the form of value [see Annotation 14, p. 16] under capitalism.
+Indeed, the entire capitalist system can be viewed in terms of content and form. The current form of human civilization is capitalism. That is to say, capitalism is the stable set of relations and characteristis of the current political economy which dominates the planet. The content of capitalism includes all the components of the base and superstructure, including the various classes (capitalists, working class, etc.), the means of production, government institutions, corporate institutions, etc. All of these elements are configured together into the relatively stable form which we call “capitalism.”
+==== Other Viewpoints of Content and Form ====
+Of course, there are many other viewpoints for discussing Content and Form of abstract ideas. Every philosophical field will have its own unique ways of utilizing Content and Form analysis. One example is the concept of Content and Form in legal philosophy. Vietnamese legal expert Dinh Thuy Dung writes:
+<blockquote>
+The law has internal and external forms:
+The inner Form is the internal structure of the law, the relationships and the connections between the elements constituting the law. The inner Form of the law is called the legal structure, which includes the constituent parts of the legal system such as the branch of law, legal institutions, and legal norms.
+The outer Form is the manifestation, or mode of existence, of the law. In other words, the outer Form of the law is how we view and understand the law [i.e., who enforces the law and what repercussions will occur if we violate the law]. Based on the outer Form of the law, one can know how it exists in reality, and where and to whom it applies. The external Form of the law is also approached in relation to its Content.
+According to this understanding, the Content of the law includes all the elements that make up the law, while the Form of the law is understood as the elements which contain or express the Content.
+If you understand that the Content of the law is the will of the state, then the legal Form is the way of expressing the will of the state.
+</blockquote>
+There are countless other ways in which Content and Form can be used to analyze and understand things, phenomena, and ideas. We hope that these examples have given you a better idea of the various ways in which Content and Form can be used to understand the world. In general, socialist texts deal with the ''inner Form'' of things, phenomena, and ideas. That is to say, the inner relations which compose the subject being considered. The outer form — how things appear to our senses — tends to be less relevant in analysis of human social systems, though it is often important in consideration of specialized fields of revolutionary activity such as aesthetics, propaganda, etc.
+==== b. Dialectical relationship between Content and Form ====
+Content and Form have a strong dialectical relationship with one other. There is no Form that does not contain any Content. Simultaneously, there is no Content that does not exist in a specific Form. The same Content can manifest in many Forms and a Form can contain many Contents.
+The relationship between Content and Form is a dialectical relationship in which Content decides Form and Form can impact Content.
+-----
+==== Annotation 151 ====
+For example, if you want to make a table, and all you have available are wood and nails, then that Content (the wood and the nails) will determine the Form the table ends up taking. You are going to end up with a wooden table, and it will therefore have to have certain characteristics of Form.
+When Content changes, the Form must change accordingly. If, instead of wood, you have iron, then the table you end up building will have a much different Form. Form can also ''influence'' the Content, but not nearly as much as Content ''determines'' Form. For instance, if you have wood and nails, but you develop a technique for building a table that doesn’t need any nails, then the result (a wooden table without any nails) would be an example of a development in Form reflecting as a change in Content.
+The main tendency of Content is change. On the other hand, Form is relatively stable in every thing and phenomenon. As Content changes, Form must change accordingly. However, Content and Form are not always perfectly aligned.
+-----
+==== Annotation 152 ====
+Since all things, phenomena, and ideas are constantly changing, it stands to reason that the internal components (things, phenomena, and ideas, and their relations) which compose the Content of a subject will constantly be undergoing processes of change and development. Thus, we say that the tendency of Content is change. Since the Form is based on the ''internal relations'' of the components of Content, it stands to reason that a change in Content will lead to change in Form. These kinds of changes in Content and Form also occur through the dialectical process: changes in quantity lead to changes in quality [see Annotation 117, p. 119].
+[[File:t-w-the-worldview-and-philosophical-methodology-of-55.png|''Quantity changes in Content lead to quality shifts in Form.'']]
+As soon as a wooden chair is finished being built, the paint is already beginning to degrade. The wood is already beginning to rot. The iron nails are already beginning to rust. These changes may be imperceptibly slow — they may even take centuries to occur, if the chair is kept in a hospitable environment — but the changes are occurring, quantitatively, over time, none-the-less.
+Eventually, changes in quantity will lead to changes in quality. At some point, the chair might weaken and begin to wobble whenever it’s sat in. Human beings might recognize this quality and begin to think of it as a “wobbly chair.” The chair might degrade to the point where it can’t be safely used at all, in which case it will have quality shifted into a “broken chair.” If the chair is repaired, that would represent another quality shift. If it is used for firewood, that would be another quality shift.
+Keep in mind that changes in Form do not directly cause changes in Content. If you disassemble a wooden chair into the constituent wood and nails, the wood and nails remain more or less unchanged. But if you burn a wooden chair, it’s the ''change in Content'' which leads to the change in Form from “chair” to “pile of ash.”
+Form simply represents the stable relationships between the component parts of the subject’s Content. The only way to change Form is to change those inner relations, or to change the components which are relating. There is no way to change Form without changing the Content, and changing the Content changes the Form by definition.
+Content determines Form, but Form is not ''fully'' decided by Content, and Form can impact back on Content. If a Form is suitable with its Content, it can improve the development of its Content. If a Form is not suitable with its Content, it can constrain the development of its Content.
+-----
+==== Annotation 153 ====
+The dialectical relationship between Content and Form is somewhat similar to the dialectical relationship between the material and the ideal (see ''Matter and Consciousness'',
+p. 88). Just as the material world ''determines'' consciousness while consciousness ''impacts'' the material world, the Content of a subject ''determines'' the Form while the Form ''impacts'' the Content.
+''Suitability'' describes the applicability of a subject for a specific application or role. Whether or not something is “suitable” or not can be highly subjective (i.e., which music would be “suitable” to play at a party), or it can be more objective (i.e., what kind of batteries to use with an electronic device).
+We might say that hardwood is “suitable” Content for the Form of a chair because it is durable, strong, relatively inexpensive, and long-lasting. It might be “unsuitable” to have a chair made of hardwood if it is to be used as an office chair, because the hard surfaces might cause strain and discomfort. However, we can utilize conscious activity to adjust and develop suitability between Content and Form. Changing the Content by adding cushioning or padding might make the Content and Form more suitable with each other. Similarly, changing the Form by designing contours and adding adjustability to the chair might make the Content and Form more suitable with each other for their intended application as an office chair.
+If a Form is not suitable with the Content, it restrains the development of the Content. Just think of a shovel (Form) made of wood (Content), which will degrade very rapidly over time, vs. a shovel (Form) made of steel (Content) which will last much longer. This works in both directions. Consider the Content of drinking cups: a porcelain cup might last for a long time and even develop positively over time (by acquiring a desirable patina), while a cup made out of mild steel would not be desirable, as it would be highly prone to rust from extended use containing liquids.
+==== c. Meaning of the Methodology ====
+Content and Form always have a dialectical relationship with each other. Therefore, in our perception and practice, we must not try to separate Content and Form, nor should we solely focus on one and ignore the other.
+Because Content determines Form, whenever we are considering a thing, phenomenon, or idea, we must base our consideration first on its Content. If we want to change a thing or phenomenon, we have to change its Content first.
+In reality, we must promote the positive impact of Form on Content by making the Form fit the Content. Likewise, we must also change the Form that is no longer suitable with its Content and therefore constrains the development of its Content.
+-----
+==== Annotation 154 ====
+In any analysis, it is very important that we carefully consider whether or not Content and Form are suitable with each other in our own projects and activities. We can learn a lot about suitability from observation and practice (see ''Cognitive Theory of Dialectical Materialism'', p. 204) and improve suitability through conscious activity.
+Marx believed that it is vital to consider Content and Form when analyzing human society and political economy. One of his core critiques of political economists like Adam Smith and David Ricardo was a failure to consider Content and Form when it comes to value, commodities, and money. He discusses this extensively in ''Capital Volume 1'', as in this excerpt:
+<blockquote>
+The value-form, whose fully developed shape is the money-form, is very elementary and simple. Nevertheless, the human mind has for more than 2,000 years sought in vain to get to the bottom of it all, whilst on the other hand, to the successful analysis of much more composite and complex forms, there has been at least an approximation. Why? Because the body, as an organic whole, is more easy of study than are the cells of that body. In the analysis of economic forms, moreover, neither microscopes nor chemical reagents are of use. The force of abstraction must replace both.
+</blockquote>
+Marx, here, is saying that studying the economy is more difficult than studying the human body because it can’t be physically observed and dissected. Rather, we have to rely on abstraction, which leaves us prone to making many more mistakes in analyzing Content and Form.
+<blockquote>
+But in bourgeois society, the commodity-form of the product of labour – or value-form of the commodity – is the economic cell-form. To the superficial observer, the analysis of these forms seems to turn upon minutiae. It does in fact deal with minutiae, but they are of the same order as those dealt with in microscopic anatomy.
+</blockquote>
+Marx’s analysis of capitalism relies to great extent upon recognizing the commodity-form of the product (Content) of labor. Labor existed long before capitalism. Labor has existed for as long as humans have worked to change our own material conditions. But under capitalism, labor specifically takes on the Form of a ''commodity'' which is bought by capitalists. This becomes the basis for Marx’s entire critique of capitalism.
+Obviously, there is much more to Marx’s use of Content and Form in analyzing capitalism and human society, but this should hopefully give you some idea of the importance of Content and Form in analysis of human society and revolutionary activity.
+-----
+=== 5. Essence and Phenomenon ===
+==== a. Categories of Essence and Phenomenon ====
+The ''Essence'' category refers to the synthesis of all the internal aspects as well as the obvious and stable relations that define the existence, motion and development of things, phenomena, and ideas.
+The ''Phenomenon'' category refers to the external manifestation of those internal aspects and relations in specific conditions.
+-----
+==== Annotation 155 ====
+Understanding Essence and Phenomena can be challenging at first, but it is very important for materialist dialectical analysis.
+Essence should not be confused with ''Form''. Form represents the stable internal relations of the component content of a subject, whereas Essence represents the ''synthesis'' of all internal aspects as well as all obvious and stable attributes which ''define the existence, motion, and development'' of a subject.
+Phenomena are simply external manifestations of a subject which occur ''in specific conditions''.
+The Essence of a subject is not dependent on conditions, whereas in different conditions, the same subject will exhibit different Phenomena. For example, COVID-19 is, ''essentially'', a specific virus strain. That is to say, all of the internal aspects and stable relations that define the existence, motion, and development of COVID-19 are synthesized as a virus which we call COVID-19.
+The ''Phenomena'' of COVID-19 which we can observe in patients would include symptoms such as fever, coughing, trouble breathing, etc.
+The Essence of a cloud is water vapor in the atmosphere: that is the synthesis, the coming-together, of all the internal stable relations and aspects which will determine how a cloud exists, moves, and develops over time.
+The Phenomena of clouds are all the things we can sense: the appearance of big fluffy white things in the air, shadows on the ground, and, sometimes, rain.
+Essence defines Phenomenon: the internal attributes and stable relations will produce the Phenomena which we can observe. A cloud is not ''essentially defined'' as a fluffy white thing in the air; that is just the appearance a cloud has to our human senses in certain specific conditions.
+==== b. Dialectical relationship between Essence and Phenomenon ====
+Essence and Phenomenon both exist objectively as two unified but opposing sides.
+''The unity between Essence and Phenomenon:'' Essence always manifests through Phenomena, and every Phenomenon is always the manifestation of a specific Essence. There is no pure Essence that exists separately from Phenomena and there is no Phenomenon that does not manifest from any kind of Essence.
+When Essence changes, Phenomena also change accordingly. When Essence appears, Phenomena also appear, and when Essence disappears, Phenomena also disappear. Therefore, Lenin said: “The Essence appears. The appearance is essential.”<ref>''Philosophical Notebooks'', Vladimir Ilyich Lenin, 1914–16.</ref>
+''The Opposition of Essence and Phenomenon'': Essence is that which defines a thing, Phenomenon, or idea, while Phenomena are diversified and conditional. Essence is internal, while Phenomena are external. Essence is relatively stable, while Phenomena continuously change.
+-----
+==== Annotation 156 ====
+Essence and Phenomenon are simultaneously unified and opposite because neither can exist without the other, yet they have completely opposite features from one another.
+Discussing the Essence and Phenomena of physical objects is relatively straight-forward. The Essence will typically encompass the physical object or system itself. For example, a car engine is ''essentially'' a machine; that is to say, the synthesis of all the internal aspects (the engine parts) as well as the obvious and stable relations (the relations between the parts of the engine; how they are assembled and work together in the engine system) that define the existence, motion and development of the engine (the way it works) are what ''essentially make it'' a car engine. All of these essential characteristics are internal, relatively stable, and remain the same regardless of the condition of the engine (i.e., they continue to exist whether the engine is turned on, turned off, inoperable, etc.).
+The Phenomena of the car engine are all the things that we can sense from it, but this can vary a great deal depending on conditions. When the car engine is turned off, it will be silent. It may be cool to the touch. It will be at rest. If the engine is turned on, the parts will move, it will become hot, it will make noise. In some situations it might smoke or even catch on fire. All of these Phenomena are conditional, unstable, and external to the engine itself.
+With ''ideas'' and abstract thought, Essence and Phenomenon becomes more difficult to determine and analyze. Lenin discussed this in his ''Philosophical Notebooks'', beginning with a quote from Hegel:
+<blockquote>
+Dialectics in general is “the pure movement of thought in Notions“ (i.e., putting it without the mysticism of idealism: human concepts are not fixed but are eternally in movement, they pass into one another, they flow into one another, otherwise they do not reflect living life.
+</blockquote>
+Knowing that Hegel was an idealist, Lenin wanted to strip all idealism from his conception of dialectics, and thus made it clear that “the pure movement of thought” simply refers to the fact that human thoughts are constantly changing, always in motion, within the living human mind, writing:
+<blockquote>
+The analysis of concepts, the study of them, the “art of operating with them” (Engels) always demands study of the movement of concepts, of their interconnection, of their mutual transitions).
+</blockquote>
+This is a description of materialist dialectical analysis of human thought. We must understand that human thoughts are always in motion, always developing, and always mutually impacting other thoughts.
+<blockquote>
+In particular, dialectics is the study of the opposition of the Thing-in-itself, of the essence, substratum, substance — from the appearance, from “Being-for-Others.” (Here, too, we see a transition, a flow from the one to the other: the essence appears. The appearance is essential.) Human thought goes endlessly deeper from appearance to essence, from essence of the first order, as it were, to essence of the second order, and so on without end.
+</blockquote>
+This is where Lenin introduces the concept of Essence and Phenomenon (or “appearance,” as Lenin puts it) as simultaneously oppositional and in unity. Essence refers to the qualities and nature of the “thing-in-itself” (its internal components, relations, etc.) while Phenomena represents “being-for-others” (that which external observers can sense or witness of a subject). However, as Lenin notes, Essence and Phenomena have a dialectical relationship with each other — a “flow from the one to the other.” The Essence “appears” by exuding Phenomena which we can sense.
+Conscious thoughts also have Essence and Phenomena of their own. With thought, the development from Essence to Phenomena is constant and inevitable. The Essence of each thought leads to thought-Phenomena which develop in turn into the Essence of new thoughts in a constant flow.
+In this sense, Essence and Phenomenon of abstract thought is somewhat different from Essence and Phenomenon of physical objects, but physical objects can have this same dialectical pattern of development. For example, the emissions from the engine of a car can be considered Phenomena of the engine, but as these Phenomena build up in the air (along with the emissions from many other cars), they can develop into a physical subject with a new Essence of its own, which we call “air pollution.”
+We can also think of the light which comes from the sun. The light itself can be thought of as Phenomena of the sun, but the light energy can be captured by a solar panel and converted into energy, creating a new subject with its own Essence which we would describe as “solar energy.” In this sense, it is possible for Phenomena to have Phenomena. If you witness light waves in the desert which cause an optical illusion, then the illusion is a Phenomenon of the light waves (the light waves being the Essence which exuded the Phenomenon of illusion), and the light waves are the Phenomena of the sun (the essential subject which exudes the Phenomena of the light waves).
+Essence and Phenomena can also be contextual. In some contexts, physical objects which have their own Essence (and Phenomena) may be the Phenomena of some other entity. For example, archaeologists can’t observe prehistoric civilizations directly. They can only study the things which are left behind. In this sense, we can think of an archaeological artifact, like a stone tool, as a Phenomenon of a prehistoric civilization. The tool has its own Essence and Phenomena, but it is also itself a Phenomenon. A single stone tool can’t tell archaeologists much about an ancient civilization, however, archaeologists can gather many Phenomena (tools, structural ruins, nearby animal bones and seeds, human remains, etc.) to look for patterns which reveal more insights about the Essence of the prehistoric civilization which exuded those Phenomena.
+<blockquote>
+Dialectics in the proper sense is the study of contradiction in the very essence of objects: not only are appearances transitory, mobile, fluid, demarcated only by conventional boundaries, but the essence of things is so as well.
+</blockquote>
+Lenin, here, points out that proper analysis hinges on understanding the ''Essence'' of a subject, since the Phenomena are fleeting and subject to change. Most notably, we should look for ''contradictions'' within the subject (see ''Definition of Contradiction and Common Characteristics of Contradiction'', p. 175), because contradictions are what drive dialectical development of a subject over time.
+-----
+==== c. Meaning of the Methodology ====
+If we want to be accurately aware of things, phenomena, and ideas, we must not just stop at studying their Phenomena, we have to study their Essence. Only through examining many Phenomena of a subject can we fully and correctly understand the Essence of said subject.
+-----
+==== Annotation 157 ====
+With physical objects, we must study the Phenomena to know anything about a subject, since Phenomena is, by definition, that which we can observe. Only through systematic, repeated observations can we come to understand the Essence of the object which exudes the Phenomena. Because Phenomena can change based on conditions, we must observe Phenomena under various conditions in a systematic way. This is the basis of all scientific inquiry.
+This is also true for analyzing aspects of human society. To understand a social system, we must observe its Phenomena systematically over time and look for patterns which form under various conditions. We must also keep in mind that social systems develop and change over time, and so the Essence might develop with or without changes in certain Phenomena. For example, the phenomena of the United States of America have changed significantly over the years. The national flag, military uniforms, seals, and other iconography have changed throughout the history of the USA. Similarly, there have been many presidents, and the government and constitution have also been through many changes. That said, the essential nature of the USA’s political economy has not changed significantly since its foundation; the USA has been a capitalist bourgeois democracy since the beginning and remains so to this day. Regardless of which bourgeois-dominated political party holds power in the white house and congress — Whig, Republican, Democrat, or otherwise — the essential nature of the USA as a capitalist bourgeois democracy has remained the same.
+According to Lenin: “Human thought goes endlessly deeper from appearance to essence, from essence of the first order, as it were, to essence of the second order, and so on, ''without end.''”<ref>''Philosophical Notebooks'', Vladimir Ilyich Lenin, 1914–16.</ref> On the other hand, Essence is what defines a thing, phenomenon, or idea. Therefore, in our perception and practice, we must recognize a thing, phenomenon, or idea based on its Essence, not its Phenomena, to evaluate it correctly, and after that, we can make fundamental improvements.
+-----
+==== Annotation 158 ====
+For example: Thousands of years ago, people observed that the sun rises in the east and sets in the west everyday. Based on these Phenomena, many human civilizations developed the belief that the Essence of our solar system was that the earth was the center of the universe and the sun rotated around it. Today, thanks to scientific observation and practice, we have proven that the sun is the center of the solar system and that the earth is rotating around it, which is totally opposite to what many believed hundreds of years ago. In this case, the initially observed Phenomena were misleading, and it was only by getting a better grasp of the essential nature of the solar system that we could better comprehend its functioning.
+It is usually easy to observe Phenomena (since they are defined by being observable) but it’s also easy to misunderstand relationships between Essence and Phenomena. Sometimes people get a false perception of Essence from real Phenomena, such as believing the Sun revolves around the Earth. Sometimes people attribute the wrong Phenomena to Essences as well, such as believing that all poor people are lazy.
+Phenomena can easily be mistaken for essence. For example, bourgeois liberal political parties often portray themselves as being pro-worker and therefore exhibit phenomena such as rhetoric, slogans, propaganda, and even platform positions which appeal to workers. These phenomena may confuse many into believing that they are workers’ parties when, in reality, they are essentially dominated by the capitalist class. The reverse can also occur. For example, workers may be fooled into believing that a ruthless capitalist politician or celebrity is “working class at heart,” falsely believing that the capitalist’s class position is merely a phenomenon when in fact it is essential.
+Understanding true Essence based on real Phenomena is one of the most important aspects of analysis. It is the primary realm of science. In politics, misunderstanding or mischaracterizing Essence and Phenomena can reinforce false beliefs about the way society works which can lead to promulgation of dangerous and reactionary ideologies like neoliberalism and fascism amidst the working class. For this reason, we must avoid examining Phenomena alone. We have to dive deep to discover and understand the essential nature of things, phenomena, and ideas in our analysis.
+=== 6. Possibility and Reality ===
+==== a. Categories of Possibility and Reality ====
+The ''Possibility'' category refers to things that have not happened nor existed in reality yet, but that would happen, or would exist given necessary conditions.
+The ''Reality'' category refers to things that exist or have existed in reality and in human thought.
+==== b. Dialectical Relationship Between Possibility and Reality ====
+Possibility and Reality have a unified and inseparable relationship: Possibility can transform into Reality and Reality contains new Possibility; any given Possibility, under specific conditions, can transform into Reality.
+Given specific conditions, there could be one or many possibilities for the development of any given thing, phenomenon, or idea: practical Possibility, random Possibility, obvious Possibility, abstract Possibility, near Possibility, far Possibility, etc.
+-----
+==== Annotation 159 ====
+'''Excerpt From Marxism-Leninism Textbook of Students Who Specialize in Marxism-Leninism'''
+''Editor’s notes in [brackets]''
+Reality has many aspects. It also has many tendencies of development. These aspects and tendencies of Reality have different roles and positions in the development process of Reality. For example, manifesting any given Possibility into Reality requires us to change a specific subject from one status to a different status. Some subjects are easier to transform and others are more difficult to transform. Some require us to change quality, others only require quantity changes [see Annotation 117, p. 119].
+Because Reality has many aspects and tendencies of development, it is useful to classify Possibility. There are at least four types of Possibility, in two separate categories.
+[The categorization below draws a distinction between the ''obvious'' and the ''practical.''
+The ''obvious'' is that which will ''certainly'' occur. If you drop an object, it will ''obviously'' fall. The ''practical'' is that which we ''certainly could make occur'' through human will. If you are holding an object, you could ''practically'' drop it.]
+'''Obvious Possibility and Random Possibility''' [see: Obviousness and Randomness, p. 144].
+''Obvious Possibility'' refers to Possibility that ''will'' happen, because conditions to make it happen are set in place so that the Possibility developing into Reality is unavoidable.
+[If the conditions arise for a hurricane to form, it eventually becomes ''obvious'' that a hurricane will form.]
+''Random Possibility'' is Possibility which may or may not happen depending on how external factors develop, our actions, the actions of others, etc. [Whether or not a hurricane may develop on any given day is, from our human perspective, random, since we do not have any technology to cause or prevent the development of hurricanes. Other events may be more or less random. We can, for instance, ''prepare'' for an incoming hurricane to minimize the risk of harm to human communities.]
+Second, based on the practical relationships between subjects, we have:
+'''Practical Possibility vs. Abstract Possibility:'''
+''Practical Possibility'' means that conditions in Reality which ''could'' make something happen are already in place. [If you have all the ingredients, knowledge, and equipment needed to make a pie, you ''could'' make a pie. The material conditions are in place.]
+''Abstract Possibility'' is Possibility which may become Reality in the future but the conditions which would make this Possibility become Reality have not yet developed.
+[It is an abstract Possibility that you ''could'' make a pie, even if you don’t have the tools, ingredients, or knowledge. It is possible, in the abstract, that you could buy the ingredients and equipment and learn the necessary skills to make a pie. ''Near Possibility'' simply refers to Possibility which may become Reality in the shorter term, ''far Possibility'' refers to things which may happen in a more distant future, relative to the subject being discussed.]
+-----
+In social life, in order to transform a Possibility into Reality, there must be objective conditions and subjective factors. Subjective factors include the ability of humans to change Possibility into Reality. Objective conditions refer to the situations needed to make such a change occur. [In other words, humans are able to ''subjectively'' change possibility into reality, but only when the ''objective'' circumstances exist in the external world.]
+==== c. Meaning of the Methodology ====
+We must base our perception and practice on Reality.
+Lenin said: “Marxism takes its stand on the facts, and not on possibilities. A Marxist must, as the foundation of his policy, put [forth] ''only'' precisely and unquestionably demonstrated ''facts''.”<ref>''To N. D. Kiknadze'', Vladimir Ilyich Lenin, written after November 5, 1916.</ref>
+However, in our perception and practice, we also need to comprehensively recognize possibilities which could arise from Reality. This will allow us to develop methods of practical operation which are suitable to changes and developments which might occur. We must actively make use of subjective factors in perception and practice to turn Possibility into Reality whenever it would serve our purposes.
+-----
+==== Annotation 160 ====
+This idea is perhaps best exemplified in the traditional Vietnamese proverb: “you can’t just open your mouth and wait for fruit to drop into your mouth.” We have to actively apply our will, through practice and labor, to develop the best possibilities into manifested Reality. See more about subjective factors in Annotation 207, p. 202.
+== IV. Basic Laws of Materialist Dialectics ==
+''Laws'' are the regular, common, obvious, natural, and objective relations between internal aspects, factors, and attributes of a thing or phenomenon or between things and phenomena.
+There are many types of laws in this world and they all have different prevalence, reach, characteristics, and roles in regard to the motion and development processes of things and phenomena in nature, society, and human thought. So, it is necessary to classify different laws for humans to understand and apply them effectively into practical activities. Classifying laws based on prevalence, we have: private laws, common laws, and universal laws [see: ''Private and Common'', p. 128].
+''Private laws'' are laws that only apply to a specific range of things and phenomena. For example: laws of mechanical motion, laws of chemical motion, laws of biological motion, etc.
+''Common laws'' are laws that apply to a broader range of subjects than ''private laws,'' and they impact many different subjects. For instance: the law of preservation of mass, the law of preservation of energy, etc.
+''Universal laws'' are laws that impact every aspect of nature, society, and human thought. Materialist dialectics is the study of these universal laws.
+If we classify laws based on the ''reach of impact'', we will have three main groups: laws of nature, laws of society, and laws of human thought.
+''Laws of nature'' are laws that arise in the natural world, including within the human body. They are not products of human conscious activities.
+''Laws of society'' are the laws of human activity in social relations; these laws only apply to the conscious activities of humans, yet they are still objective.
+-----
+==== Annotation 161 ====
+We have already discussed how relations between human beings are objective [see Annotation 108, p. 112]. By extension, the human relations which compose human societies are objective, and thus, any laws which govern objective human relations must also be objective.
+Marx’s assertion that human social relations are objective is critical to understanding his work. Marx pointed out that social relations may not be “physical,” in the sense that they can’t be observed directly with human senses, but that they still have an ''objective character'' — they exist externally to a given subject, and they have objective impacts on reality. For instance, the class relations between the capitalist class and the working class result in objective manifestations in reality, such as wealth accumulation, modes of circulation, etc.
+''Laws of human thought'' are laws of the intrinsic relationships between concepts, categories, judgments, inference, and the development process of human rational awareness.
+As the science of common relations and development, materialist dialectics studies the ''universal laws'' that influence the entire natural world, human society, and human thought, all together as a whole.
+These universal laws are:
+* The law of transformation between quantity and quality.
+* The law of unification and contradiction between opposites.
+* The law of negation of negation.
+-----
+==== Annotation 162 ====
+Each of these laws is considered ''universal'' because they apply to all things, phenomena, and ideas, and all the internal and external relations thereof, in human perception and practice. All things, phenomena, and ideas change and develop as a result of mutual impacts and relationships in accordance with these universal laws. On a fundamental level, materialist dialectics is the study of these universal laws and their utility.
+=== 1. Law of Transformation Between Quantity and Quality ===
+The law of transformation between quantity and quality is a universal law which concerns the universal mode of motion and development processes of nature, society, and human thought.
+-----
+==== Annotation 163 ====
+Remember that mode refers to ''how'' something exists, functions, and develops [see Annotation 60, p. 59]. The universal mode of motion and development processes thus refers to ''how'' all things, ideas, and phenomena move, change, and develop.
+Friedrich Engels defined the law of transformation between quantity and quality in ''Dialectics of Nature'':
+<blockquote>
+The law of the transformation of quantity into quality and vice versa. For our purpose, we could express this by saying that in nature, in a manner exactly fixed for each individual case, qualitative changes can only occur by the quantitative addition or subtraction of matter or motion (so-called energy).
+</blockquote>
+In other words, ''quantitative'' changes of things, phenomena, and ideas lead to ''quality'' shifts.
+-----
+The universal mode of motion and development processes follows the law of transformation between quantity and quality, which states:
+Qualitative changes of things, phenomena, and ideas arise from the inevitable basis of the quantitative changes of things, phenomena, and, ideas; and, vice versa: quantitative changes of things, phenomena, and ideas arise from the inevitable basis of qualitative changes of things, phenomena, and ideas.
+-----
+==== Annotation 164 ====
+Put simply: quantity changes develop into quality changes, and quality changes lead to quantity changes [see Annotation 117, p. 119]. We say that these changes to quantity and quality occur on the “inevitable basis” of one another because quality changes always, invariably, arise from quantity changes, and, likewise, quantity changes always, invariably, arise from quality changes.
+Just as quantity shifts lead to quality shifts, it is also true that quality shifts lead to quantity shifts. For example, if you have 11 donuts, then add 1 donut, you now have ''1 dozen'' donuts. If you add 12 more donuts, you would then have ''2 dozen''.
+Another example of quality shift leading to quantity shift would be a pond filling with rain water. Once enough drops of water collect and the pond is considered full — that is to say, once it is considered to be “a pond” of water — we will no longer think of the pond in terms of “drops.” We would think of the pond as “filled,” “overfilled,” “underfilled,” etc.
+Note that both of these examples are related to our human perceptions and understanding of the material world. The material world does not change based on our perceptions, nor how we classify the quantity or quality of a given subject. There are also objective aspects related to quality shifts leading to quantity shifts. For example, if we adjust the quantity of the temperature of a sheet of paper to the point of burning, and the paper burns, then the quantity of paper would be reduced from one sheet to zero sheets. In other words, the quality shift arising from temperature quantity increase (i.e., the paper burning into ash) results in a quantity shift in how many pieces of paper exist (from one sheet to zero sheets). However, even this is ultimately a subjective assessment rooted in human consciousness, since we subjectively think in terms of “sheets of paper,” and the concept of a “sheet of paper” is essentially a classification rooted in human consciousness. It is merely an abstract way of perceiving and considering the quantity and quality of the material subject which we think of as “paper.”
+The law of transformation between quantity and quality is an inevitable, objective, and universal relationship that repeats in every motion and development process of all things, phenomena, and ideas in nature, human society, and human thought.
+==== a. Definitions of Quality and Quantity ====
+''- Definition of Quality''
+''Quality'' refers to the organic unity which exists amongst the component parts of a thing, phenomenon, or idea that distinguishes it from other things, phenomena, and ideas.
+-----
+==== Annotation 165 ====
+Note: we have already given basic definitions of quantity and quality in Annotation 117, p. 119. What follows are more comprehensive philosophical definitions of quality and quantity. Our world exists as one continuity of matter. All things and phenomena in our universe exist essentially as one unified system — namely, the entity which we call “the universe.” This unified nature of existence is extremely difficult for human beings to comprehend. Georg Wilhelm Friedrich Hegel pointed out that, in this sense, the unity of “pure being” is indistinguishable from “nothingness.” In ''Science of Logic'', Hegel noted that if we try to comprehend pure material existence, as a whole, without distinguishing any component thing or phenomenon from any other, then all is incomprehensible. Human consciousness needs to delineate and distinguish the component parts of this unified system from each other in order to make sense of it all.
+<blockquote>
+Pure light and pure darkness are two voids which are the same thing. Something can be distinguished only in determinate light or darkness... [F]or this reason, it is only darkened light and illuminated darkness which have within themselves the moment of difference and are, therefore, determinate being.
+</blockquote>
+The human mind has evolved to perceive various things, phenomena, and ideas as ''differentiated''. Quality is the basis on which we perceive subjects as distinct from one another. Every thing, phenomenon, and idea is composed of internal components and relations. The unity of these internal components and relations is what we refer to as ''quality''. For example, a human being’s ''quality'' refers to the unity of all the internal components and relationships of which the human being is composed (i.e., the cells, organs, blood, etc., as well as the thoughts, memories, etc., which make the human) ''in unity''. Quality is also a subjective phenomenon: a ''reflection'' of the material world in human consciousness [see Annotation 68, p. 65]. Therefore we may conceive of various qualities for the same subject. We can think of 12 donuts as “a box of donuts,” “a dozen donuts,” or as 12 individual donuts. We could consider a building as “one apartment building” or “forty apartments,” depending on the viewpoint of analysis.
+-----
+So, objective and inherent attributes form the quality of things, phenomena, and ideas, but we must not confuse quality and attribute with one another. Every thing, phenomenon, and idea has both fundamental and non-fundamental attributes. Only fundamental attributes constitute the quality of things, phenomena and ideas. When the fundamental attributes change, the quality also changes. The distinction between fundamental and non-fundamental attributes of things, phenomena, and ideas must depend on the purpose of the analysis; the same attribute may be fundamental when analyzing with one purpose but non-fundamental when analyzing with another purpose.
+-----
+==== Annotation 166 ====
+Whether or not an attribute is considered “fundamental” depends entirely on conscious perspective. For example, one baker may consider chocolate chips to be “fundamental” for baking cookies while another baker may not. This subjective characteristic of what might be considered “fundamental” or not is reflected in how we consider quality. If you are trying to determine how much water you need to fill a swimming pool, you may think of a pool in terms of size (i.e., “this is an Olympic sized pool”), but if you just want to go for a swim, you are likely to just think in terms of the water level (i.e., “the pool is empty, we can’t swim”).
+If you are planning the construction of a school and want to know how many classrooms it will need, you might think in terms of “classrooms of students.” But if you are considering funding for a school year, you might consider the ''total number of students''.
+The quality of a thing, phenomenon, or idea is determined by the qualities of its component parts.
+-----
+==== Annotation 167 ====
+Qualities are composed of qualities, combined, in unity. “A swimming pool” may consist of a certain amount of concrete in a specific configuration combined with 5,000 gallons of water. A car may be composed of a body, an engine, four tires, etc. Each individual component exists as a quality — a unity of component attributes — in and of itself.
+Quality is also determined by the structures and connections between component parts which manifest in specific relations. Therefore, distinction between fundamental and non-fundamental attributes is also relative.
+-----
+==== Annotation 168 ====
+It’s not just the component parts of a subject which define its quality, but also the relations of those component parts. For instance, a quantity of wood and nails configured in one set of structural relations may have the quality of a chair, whereas the same component parts arranged with different structures and relations may have the quality of a table. In this sense, quality can be thought of as a synthesis of the Content and Form [see ''Content and Form'', p. 147] of a thing, phenomenon, or idea from a certain perspective.
+For example, if we see two shoes, we may think of each shoe as an individual qualitative object (two shoes). On the other hand, we may think of the shoes, together, as a single qualitative “object” in terms of its utility and in terms of synthesis of content and form (“a pair of shoes”), so much so that if one shoe is lost then the remaining shoe is considered useless and discarded as trash.
+Because there are countless ways in which quality — the configuration and relations and composition of constituent parts of any given subject — can manifest, we must recognize that quality itself, based on the distinction between fundamental and non-fundamental attributes, is a relative and subjective phenomenon of human consciousness.
+Any given subject will have multiple qualities, depending on the relations which exist between and within that subject and other subjects.
+-----
+==== Annotation 169 ====
+Any thing, phenomenon, or idea may be perceived from various different perspectives which would cause us to consider it as having different qualities. A single shoe may be considered as: a shoe, 3 pounds of leather, half of a pair, etc., depending on its internal and external relations and the perspective of the person considering the shoe.
+We can’t consider things, phenomena, and ideas apart from quality. Quality exhibits a subject’s relative stability.
+-----
+==== Annotation 170 ====
+Remember that ''quality'' is the way in which the human mind conceives of the world as a collection of distinct things, phenomena, and ideas. These perceptions of quality are purely relative, but they are important, because they are what allow us to develop an understanding of the complicated system of things, phenomena, and ideas which make up our universe. In our perception, quality represents the relative stability of a thing, phenomenon, or idea which makes it a subject that we can consider and analyze in and of itself. Understanding how we distinguish between different subjects is crucial in developing a scientific understanding of the world which is rooted in observation and practice.
+''- Definition of Quantity''
+''Quantity'' refers to the amount or extent of specific attributes of a thing, phenomenon, or idea, including but not limited to:
+* The amount of component parts.
+* Scale or size.
+* Speed or rhythm of motion.
+A thing, phenomenon, or idea can have many quantities, with each quantity determined by different criteria. [i.e., a car may be measured by many criteria of quantity, such as: length in meters, weight in kilograms, speed in kilometers per hour, etc.]
+Quality and quantity embody two different aspects of the same subject. Both quality and quantity exist objectively [see Annotation 108, p. 112]. However, the distinction between “quality” and “quantity” in the process of perceiving things, phenomena, and ideas has only relative significance: an attribute may be considered “quantity” from one perspective but “quality” from another perspective.
+-----
+==== Annotation 171 ====
+If you are filling a box with a dozen donuts, then once you add the 12<sup>th</sup> donut, one “dozen” may represent the ''quality'' which you seek. From the perspective of a customer buying donuts for a party, “dozen” may represent the “quantity.” In other words, you need to make an ''order'' (quality) of ''three dozen donuts'' (quantity). And the manager of the store, at the end of the day, may tally ''twenty'' ''orders'' (quantity) as the day’s ''sales goal'' (quality). Quantity and quality, therefore, are both considered ''relatively'', based on perspective and the purpose of analysis at hand.
+==== b. Dialectical Relationship Between Quantity and Quality ====
+Every thing, phenomenon, and idea exists as a unity of two aspects: quality and quantity. Quantity and quality do not exist separate from one another. Quantity and quality dialectically and mutually impact one other. Changes in quantity lead to changes in quality. However, not every change in quantity will cause a change in quality.
+-----
+==== Annotation 172 ====
+In order for quantity change to lead to quality change, a certain amount must be met.
+This amount is called the ''threshold'', which is explained further below in this section. A threshold may be exact and known (i.e., it takes exactly 12 donuts to make a dozen donuts) or it may be relative and unknown (i.e., a certain quantity of air inflated into a balloon may cause it to burst, but the exact, specific quantity of air may be relative to other factors such as air temperature and may be unknown to the observer until the balloon actually bursts).
+With any given subject, there will be a range of quantity changes which can accumulate without leading to change in quality. This range is called the ''quantity range''.
+''Quantity range'' is defined as a relationship between quantity and quality: the range of intervals in which the change in quantity does not substantially change the quality of a given subject. Within the limits of a quantity range, the subject retains the same quality.
+-----
+==== Annotation 173 ====
+[[File:t-w-the-worldview-and-philosophical-methodology-of-56.png|''The quantity range is a range of quantities between quality shifts.'']]
+Quantity range can be thought of as the range of quantities which exists between thresholds. For instance, between the qualities of “''one donut''” and “''one dozen donuts'',” there is a quantity range of 10 donuts (2 donuts through 11 donuts) which can be added before the quality shifts to “''one dozen donuts''.” You can keep adding additional donuts, up to the quantity of 11 donuts, without reaching the threshold of quality shift to “one dozen donuts.” This is the ''quantity range'' between the qualities of ''donut'' and ''one dozen donuts''. Again, the quantity range is relative to the perspective and the nature of analysis. One person may only be concerned with “dozens of donuts,” while another may consider the quality of “half dozens,” which would consider a quality shift to “one half-dozen donuts” to occur once the sixth donut (quantity) is added.
+Motion and change usually begins with a change in quantity. When changes in quantity reach a certain amount, quality will also change. The amount, or degree, of quantity change at which quality change occurs is called the ''threshold.''
+-----
+==== Annotation 174 ====
+[[File:t-w-the-worldview-and-philosophical-methodology-of-57.png]]
+Note that the threshold is an approximate range. At a certain quantity, a glass may be considered “half full” and at another certain quantity, after passing the threshold, the glass will be considered “full,” though there may be a wide range of quantities at which the glass would be considered to have the quality of being “full,” depending on perspective and purpose of analysis.
+When quantity change meets a threshold, within necessary and specific conditions, quality will change. This change in quality, which takes place in the motion and development process of things, phenomena, and ideas, is called a ''quality shift''.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-58.png|''A quality shift occurs when a quantity changes beyond a threshold, leading to a change in quality.'']]
+''Quality shifts'' inevitably occur as transformations in the development processes of things, phenomena, and ideas. Qualitative changes can be expressed or manifested through many forms of quality shifts which are determined by the contradictions, characteristics and conditions of a given subject, including such characteristics as: fast or slow, big or small, partial or entire, spontaneous or intentional.
+-----
+==== Annotation 175 ====
+Quality shifts are ''inevitable'' because there is no thing, phenomenon, nor idea which can exist statically, forever, without ever undergoing change. Eventually, any given subject will undergo quality shifts, even if such transformation may take millions of years to occur.
+Quality shifts can take various forms, depending on the nature of internal and external relationships, contradictions, and mutual impacts. For instance, a river may dry up or it may flood depending on internal and external relations and characteristics, but it will not simply flow at the same level forever without ever undergoing any quality shifts.
+The rate and degree of quality shifts can vary considerably based on such internal and external factors, and may be “spontaneous,” that is to say, without human intervention, or may be the result of the intentional, conscious action of human beings.
+''Quality shifts'' mark the end of one motion period and the start of a new motion period.
+-----
+==== Annotation 176 ====
+[[File:t-w-the-worldview-and-philosophical-methodology-of-59.png|''The Quantity Range (A) refers to the range of quantities between two qualities in the process of development. The Quality Shift (B) refers to the point at which quantity accumulates to the point of changing the Quality of the developing subject. The Period of Motion (C) includes both the quantity range and the quality shifts themselves.'']]
+''Period of motion'' refers to the development which occurs between two quality shifts, including the quality shifts themselves.
+''Period of motion'' differs from ''quantity range'' because quantity range only includes the range of quantity change which can occur ''between'' quality shifts, without including the quality shifts themselves.
+For example, a ''period of motion'' for a cup filling with water from a half cup would include all of the change which occurs from the cup being half full to the cup becoming entirely full. The ''quantity range'' of this same process would only include the quantities of water that stand between half-full and full, where the cup is neither considered to be “half full” or “full” but somewhere in between, i.e., between quality shifts.
+Quality shift represents ''discontinuity'' within the continuous development process of things and phenomena. In the material world, all things, phenomena, and ideas are constantly undergoing continuous sequences of quantitative changes leading to quality shifts, creating an endless line of nodes, showing how all things, phenomena, and ideas move and develop to increasingly advanced degrees [see illustration on p. 121 for a visualization of this “endless line of nodes”].
+As Friedrich Engels summarised: “merely quantitative changes beyond a certain point pass into qualitative differences.”<ref>''Anti-Dühring'', Friedrich Engels, 1878.</ref>
+==== Annotation 177 ====
+Processes of change and development in our universe are continuously ongoing. Whenever a quality shift occurs, it represents a brief ''discontinuity'' in the sense that we perceive a definite and ''distinct'' transformation from one thing, phenomenon, or idea into another; in other words, we can ''distinguish'' between the mode of existence of the thing, phenomenon, or idea before and after the quality shift.
+Take, for example, the “lifespan” of a house. A human being could easily distinguish between the empty land which exists before the house is built, the construction site which exists as it’s being built, and the house itself once construction is completed. In reality, this process of change is continuous, but to our human perception, each quality shift represents a definite and distinct period of change and discontinuity in terms of our perception of the “thing” which is the house.
+This is related to the ''historic perspective'' of things, phenomena, and ideas, in which we recognize the continuity of existence between different stages of development of things, phenomena, and ideas [see Annotation 201, p. 195].
+When a quality shift occurs, there is an impact on the quantity. Quality impacts quantity in a number of ways, including [but not limited to]:
+* Changing the structure, scale, or level of the subject.
+* Changing the rhythm or speed of the motion and development of the subject.
+''In summary,'' dialectical unity between quantity and quality exists in every thing, phenomenon, and idea. A gradual quantitative change [through the ''quantity range''] will eventually meet the ''threshold'', which will inevitably lead to a qualitative change through ''quality shift''. Simultaneously, the new quality will mutually impact the quantity, causing new quantitative changes of things, phenomena, and ideas. This process takes place continuously, forming the fundamental and universal mode of movement and development processes of all things, phenomena, and ideas.
+==== Annotation 178 ====
+Transformation between quantity and quality is the mode of movement and development of all things, phenomena, and ideas, because it reflects the way in which human consciousness perceives movement and development.
+So, it is important to understand that there is no ''material manifestation'' of quantity and quality. They are simply mental constructs which reflect the ways in which we observe and understand change, motion, and development of things, phenomena, and ideas. Transformation processes in the material world are fully fluid and continuous, but our consciousness perceives change in ''stages of development''. Quality simply reflects how we distinguish one subject from another subject, as well as how we recognize the transformation process (and stages of development) of a single subject over time.
+There is no specific point, metaphysically distinct point at which a “puppy” becomes an “adult dog,” but human beings will distinguish between a puppy and an adult dog, or recognize at a certain point that a puppy has “become” an adult dog, based on observation of quality.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-60.png|''Quality refers to the differences which are distinguished in human consciousness between one subject and another, or changes in a subject’s form over time.'']]
+There is no metaphysically distinct point at which a “puppy” becomes an “adult dog,” but human beings will distinguish between a puppy and an adult dog, or recognize at a certain point that a puppy has “become” an adult dog, based on observation of quality. We create categories which reflect quality to organize and systematically understand the world around us, and to distinguish between different subjects, and to distinguish between different stages of development of a given subject.
+We can also distinguish differences of quality between different subjects: we can distinguish a cat from a dog, and we can distinguish one dog from another dog. These distinguishing attributes constitute differences in quality. Note that this conception of differentiation of things, phenomena, and ideas into qualities which constantly change and develop over time is fundamentally distinct from ''metaphysical'' categorization, which seeks to divide all things, phenomena, and ideas into static, perpetually unchanging categories (see Annotation 8, p. 8).
+Distinction within the human mind is reflected in the concept of quantity and quality. If we do not observe quality differences between subjects, then we would not be able to distinguish between different subjects at all. If we could not recognize the quality shifts of any given subject, then we would not be aware of change or motion at all.
+-----
+==== c. Meaning of the Methodology ====
+Every thing, phenomenon and idea has characteristics of quality and quantity which mutually impact and transform one another. Therefore, in perception and practice, we need to understand and take into account the law of transformation between quantity and quality in order to have a comprehensive viewpoint of things, phenomena, and ideas [see Annotation 114, p. 116].
+Quantitative changes of things, phenomena and ideas inevitably lead to qualitative changes in all things, phenomena, and ideas. Therefore, in our perception and practice, as we plan and enact change in our world and in human society, it is necessary to gradually accumulate changes in quantity in order to make changes in quality. At the same time, we must recognize and make use of the fact that quality shifts also lead to changes in quantity.
+-----
+==== Annotation 179 ====
+We have to understand and utilize the law of transformation between quantity and quality in our activities. For instance, if a group of activists hopes to address hunger in their community, they have to realize that they can’t immediately enact a quality shift which solves the entire problem of hunger across the city instantaneously. Instead, the activists must recognize that quantity shifts lead to quality shifts through stages of development. In planning and acting, they may need to set certain development targets, predict thresholds at which quality shifts will occur, etc.
+For instance, the first goal for these activists may be to provide free lunches to houseless people in a particular park every weekend. If they can accomplish this, then they will not have completely eliminated hunger in the city, but they will have reached a threshold — a quality shift — in that nobody in that specific park will be hungry at lunch time on weekends. From there, they can continue to build quality shifts through accumulation of changes in quantity, one stage of development at a time.
+Quality shifts leading to quantity shifts must also be recognized and utilized in our planning and activities. For example, once an effective strategy is developed for eliminating hunger in one park through quantity changes leading to quality shifts, this strategy can then be implemented in other parks. Thus the quality shift of “eliminating hunger in one park” can lead to a quantity shift: “eliminating hunger in two parks, three parks, etc.,” until the quantity shift of “eliminating hunger in parks” leads to the quality shift of “eliminating hunger in all the parks in the city.” This entire process of enacting quantity changes to lead to quality shifts, and accumulating quality shifts to change quantity, are all focused toward the ultimate goal of achieving the quality shift of “eliminating hunger in the entire city.”
+In short, it’s vital for us to understand the ways in which quantity and quality mutually impact each other so that we can formulate plans and activities which will lead to motion and development which accomplish our goals, step by step, through one stage of development at a time.
+Changes in quantity can only lead to changes in quality provided the quantity accumulates to a certain threshold. Therefore, in practice, we need to overcome impatient, left-sided thought. Left-sided thinking refers to thinking which is overly subjective, idealistic, ignorant of the laws which govern material reality. Left-sided thinking neglects to acknowledge the necessity of quantity accumulation which precedes shifts in quality, focusing instead on attempting to perform continuous shifts in quality.
+On the other hand, we must also recognize that once change in quantity has reached a threshold, it is ''inevitable'' that a quality shift will take place. Therefore, we need to overcome conservative and right-sided thought in practical work. Right-sided thinking is the expression of conservative, stagnant thought that resists or refuses to recognize quality shifts even as changes in quantity come to meet the threshold of quality shift.
+-----
+==== Annotation 180 ====
+“Right-sided thinking” and “left-sided thinking” are Vietnamese political concepts which are rooted in the ideas of Lenin’s book: ''Leftwing Communism: an Infantile Disorder''. In Vietnamese political philosophy, “left-sided thinking” is a form of dogmatic idealism which upholds unrealistic conceptions of change and development. Left-sided thinkers don’t have the patience for quantity accumulation which are prerequisite to quality shifts, or expect to skip entire stages of development which are necessary to precipitate change in the real world. An example of left-sided thinking would be believing that a capitalist society can ''instantly'' transition into a stateless, classless, communist society, skipping over the transitions in quantity and quality which are required to bring such a massive transformation in human society to fruition.
+“Right-sided thinking,” on the other hand, is conservate resistance to change. Right-sided thinkers resist quality changes to human society; they either want to preserve society as it exists right now, or reverse development to some previous (real or imagined) stage of development. Right-sided thinkers also refuse to acknowledge quality shifts once they’ve occurred, idealistically pretending that changes in material conditions have not occurred. For example, right-sided thinkers may refuse to recognize advances which have been made in the liberation of women, or even attempt to reverse those advances in hopes of returning to previous stages of development when women had fewer freedoms. Here is a practical example of these concepts in use, from the ''Vietnam Encyclopedia'', published by the Ministry of Culture and Information of Vietnam:
+<blockquote>
+Opportunism is a system of political views that do not follow a clear direction nor a clear line, do not have a definite stance, and are inclined toward the immediate personal gain of the opportunist. In the proletarian revolutionary movement, opportunism is a politics of compromise, reform, and unprincipled collaboration with the enemy which run contrary to the basic interests of the working class and the working people. In practice, opportunism has two main trends, stemming from right-sided thinking and from left-sided thinking, respectively:
+Right-wing opportunism is reformist, favors undue compromise, and aims to peacefully “convert” capitalism into socialism while abandoning the struggle for meaningful victory of the working class. Right-wing opportunism, typified by Eduard Bernstein and Karl Kautsky, has its origins in the Workers’ Parties of the Second International era and exists to this day.
+Left-wing opportunism is a mixture of extremism and adventurism, dogmatism, arrogance, subjectivity, cults of violence, and disregard for the objective situation.
+Both “right” and “left” opportunism push the workers’ movement to futile sacrifice and failure.
+</blockquote>
+-----
+Quality shifts are diverse and plentiful, so we need to promote and apply quality shifts creatively and flexibly to suit the specific material conditions we face in a given situation. This is especially true in changing human society, as social development processes depend not only on objective conditions but also on subjective human factors. Therefore, we need to be active and take the initiative to promote the process of converting between quantity and quality in the most effective way.
+-----
+==== Annotation 181 ====
+Put simply, we have to use our human will and labor to actively promote quantity changes which lead to quality changes, and quality changes which lead to quantity changes, which move us towards our goal of ending all forms of oppression in human society. This will involve not just objective factors<ref>See Annotation 108, p. 112.</ref> (i.e., material conditions which are necessary to accomplish something), but subjective factors<ref>See Annotation 207, p. 202.</ref> as well (factors which we, as a subject, are capable of impacting directly).
+=== 2. Law of Unification and Contradiction Between Opposites ===
+The law of unification and contradiction between opposites is the ''Essence'' of dialectics [see: ''Essence and Phenomenon'', p. 156]. According to Lenin: “In brief, dialectics can be defined as the doctrine of the unity of opposites. This embodies the Essence of dialectics, but it requires explanations and development.”<ref>''Summary of Dialectics'', Vladimir Ilyich Lenin, 1914.</ref> According to the law of unification and contradiction between opposites, the fundamental, originating, and universal driving force of all motion and development processes is the inherent and objective contradiction which exists in all things, phenomena, and ideas.
+-----
+==== Annotation 182 ====
+In other words, ''contradiction'' (defined further in the next section) is the force which serves as the fundamental, originating, and universal force which drives all motion and development of all things, phenomena, and ideas.
+Contradiction is a ''fundamental driving force'' because it is the most basic driving force which all other forms of motion and development are based upon.
+Contradiction is the ''originating driving force'' because all motion and development arises from contradiction.
+Contradiction is the ''universal driving force'' because ''all'' things, phenomena, and ideas — without exception — are driven to motion and development by contradiction.
+==== a. Definition of Contradiction and Common Characteristics of Contradiction ====
+''- Definition of Contradiction''
+In dialectics, the concept of contradiction is used to refer to the relationship, opposition, and transformation between opposites which takes place ''within'' all things, phenomena, and ideas, as well as ''between'' all things, phenomena, and ideas. This dialectical concept of contradiction is fundamentally different from the metaphysical concept of contradiction. The metaphysical concept of contradiction is an illogical conception of opposition without unity and without dialectical transformation between opposites.
+-----
+==== Annotation 183 ====
+A contradiction is, fundamentally, just a type of relationship. In a contradictory relationship, two things, phenomena, and/or ideas mutually impact one another, resulting in the eventual ''negation'' of one subject and the ''synthesis'' of the negator and the negated into some new form.
+The metaphysical concept of contradiction is considered illogical because it establishes no connection between that which is negated and the resulting synthesis.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-61.png|''In the metaphysical conception of contradiction, the negated “disappears” and is not represented in the resulting synthesis.'']]
+Metaphysical contradiction presents contradicting subjects as isolated from one another and completely distinct, when in reality the relationship between the negated and the negator essentially defines the contradiction. The negated subject is seen as completely negated; that is to say, it is conceived of as essentially “disappearing” into the synthesized result of the contradiction. In this sense, this metaphysical conception of negation is inaccurate in that it is represented as a complete, terminating process.
+In the above example, once the fox eats the rabbit, the rabbit is considered “gone” after a terminal negation process (see Annotation 196, p. 188) ends the contradiction.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-62.png|''The materialist dialectical conception of contradiction recognizes that contradicting subjects are defined by their relationship and that the synthesis of the contradiction carries forward attributes and characteristics from both the negator and the negated.'']]
+Materialist dialectical contradiction recognizes that every contradiction is defined by the relationship between the negated and the negator. Materialist dialectics also recognizes that attributes and characteristics of the negated subject are carried forward into the synthesized subject [see Annotation 203, p. 198]. Materialist dialectics also recognizes that contradiction continues indefinitely, as the negated becomes negated again, and so on, continuously, forever [see ''Negation of Negation'', p. 185].
+In the example on the previous page, the fox consuming the rabbit constitutes a negation process in which the fox takes on characteristics from the rabbit (i.e., nutritional and energy content, any diseases which may be carried forward to the fox, etc.).
+Contradiction arises from opposition which exists within or between things, phenomena, and ideas. The concept of opposing “sides” refers to such aspects, properties, and tendencies of motion which oppose one another, yet are, simultaneously, conditions and premises of the existence of one another. Examples include:
+* Negative charge and positive charge within atoms.
+* Anabolism and catabolism within living organisms [anabolism refers to the growth and building up of molecules within an organism, while catabolism refers to the digestion and breaking down of molecules within an organism].
+* Production and consumption as socioeconomic activities.
+* Trial and error which leads to cognitive development.
+==== Annotation 184 ====
+All of the above forms of contradiction ''drive motion and development''. These processes exist in ''unity and opposition''. For example, in political economics, production is driven by consumption and consumption is facilitated by production. Even though these are fundamentally opposite forces (production adds to the total quantity of products, while consumption reduces the total quantity of products), they can’t exist without one another, and they drive each other forward. This is the dialectical nature of contradiction as the driving force of all motion and development as defined in materialist dialectics.
+''- The General Properties of Contradictions''
+Contradiction is objective and universal. According to Friedrich Engels: “If simple mechanical change of position contains a contradiction, this is even more true of the higher forms of motion of matter, and especially of organic life and its development. We saw above that life consists precisely and primarily in this — that a being is at each moment itself and yet something else. Life is therefore also a contradiction which is present in things and processes themselves, and which constantly originates and resolves itself; and as soon as the contradiction ceases, life, too, comes to an end, and death steps in. We likewise saw that also, in the sphere of thought, we could not escape contradictions, and that, for example, the contradiction between man’s inherently unlimited capacity for knowledge and its actual presence only in men who are externally limited and possess limited cognition finds its solution in what is — at least practically, for us — an endless succession of generations, in infinite progress.”<ref>''Anti-Dühring'', Friedrich Engels, 1877.</ref>
+==== Annotation 185 ====
+Here, Engels is explaining how contradiction is the driving force in both material and conscious processes of motion and development. The process of life is a process of contradiction — all organic life forms must consume organic matter so that they can produce growth and offspring, must produce certain molecules and metabolic processes so that they can consume nutrients, and so on. Once these contradictory processes stop, as Engels says, “death steps in” (though even death is a transition forward).
+Conscious motion and development are also rooted in contradictory forces. Engels points out the contradiction between humanity’s seemingly infinite capacity for learning with the seemingly infinite amount of knowledge which can be obtained in the world. This great contradiction drives a seemingly endless process of expanding human knowledge, collectively, over countless generations.
+Contradictions are not only objective and universal, but also diverse and plentiful. The diverse nature of contradictions is evident in the fact that every subject can include many different contradictions and that contradictions manifest differently depending upon specific conditions. Contradictions can hold different positions and roles in the existence, motion, and development of things, phenomena, and ideas. These positions and roles include [but are not limited to]:
+* Internal and external contradictions
+* Fundamental and non-fundamental contradictions
+* Primary and secondary contradictions
+==== Annotation 186 ====
+''Internal'' contradictions are contradictions which exist in the ''internal relations'' of a subject, while ''external'' contradictions exist ''between'' two or more subjects as external relations.
+For example: a sports team might have ''internal contradictions'' between players, between the players and the coach, between the coach and management, etc. External contradictions might exist between the team and other teams, between the team and league officials, between the team and the landlords who own the team’s practice space, etc.
+A ''fundamental'' contradiction is a contradiction which defines the Essence of a relationship [see ''Essence and Phenomenon'', p. 156]. Fundamental contradictions exist throughout the entire development process of a given thing, phenomenon, or idea. A ''non-fundamental'' contradiction exists in only one aspect or attribute of a thing, phenomenon, or idea. A non-fundamental contradiction can ''impact'' a subject, but it will not control or decide the essential development of the subject. Whether or not a contradiction is fundamental is relative to the point of view.
+For example: the ''fundamental contradiction'' of one nation engaged in war against one another might be the war itself. There will exist many other contradictions; one nation at war might have a trade dispute with a third nation which is not participating in the war. From the “war perspective,” this contradiction is ''non-fundamental'', as it does not define the essential characteristic of the nation at war (though from the perspective of a diplomat charged with ending the trade dispute, the war may be seen as a non-fundamental contradiction while the dispute would be seen as fundamental).
+In the development of things, phenomena, and ideas, there are many development stages. In each stage of development, there will be one contradiction which drives the development process. This is what we call the ''primary'' contradiction. ''Secondary'' contradictions include all the other contradictions which exist during that stage of development. Determining whether a contradiction is primary or secondary is relative: it depends heavily upon the material conditions and the situation.
+For example: when restoring an old car that doesn’t run any more, a mechanic may consider the ''primary contradiction'' to be the non-functioning engine. There may be many ''secondary contradictions'' which contribute to the problems with the car’s engine problems. The battery may be dead, the spark plugs may need to be bad, the tires may need replacement, the timing belt may be loose, etc. Those are all ''secondary contradictions'' which do not define the stage of development which is “repairing the engine.” Some of these secondary contradictions may need to be resolved (such as replacing the spark plugs) before the primary contradiction can be fully addressed; others, such as a cracked windshield, may not need to be addressed before the primary contradiction can be dealt with.
+On the other hand, a secondary contradiction may become the primary contradiction: if a mechanic resolves every problem with the engine ''except'' for one bad spark plug, then the bad spark plug will shift from being a secondary contradiction to being the primary contradiction: the bad spark plug is now the primary reason the car won’t start and this stage of development can’t be completed.
+Within all the various fields of inquiry, there exist contradictions which have a diverse range of different properties and characteristics.
+==== Annotation 187 ====
+Different fields of study will focus on different forms of contradictions, and any given thing, phenomenon, or idea may contain countless contradictions which can be analyzed and considered for different purposes. For example, consider a large city, which might contain far too many contradictions to count. Civil engineers may focus primarily on contradictions in traffic patterns, the structural integrity of bridges and roads, ensuring that buildings are safe and healthy for inhabitants, etc. Utilities departments will focus on contradictions related to sewage, electrical, and sanitation systems. The education system will focus on contradictions which prevent students from achieving success in schools.
+All of these various methods of analysis may focus on specific forms of contradictions, though there will also be overlap. For instance, designing a school bus system will require the education system and civil engineers to discover and grapple with contradictions which might be hindrances for transporting students safely to school.
+==== b. Motion Process of Contradictions ====
+In every contradiction, the opposing sides are united with each other and opposed to each other at the same time. The concept of “unity between opposites” refers to the fact that a contradiction is a binding, inseparable, and mutually impacting relationship which exists between opposites.
+-----
+==== Annotation 188 ====
+Contradictions are ''binding'' and ''inseparable'' because they hold a relationship together. If two opposing things, phenomena, or ideas simply ''separate'', then contradiction, by definition, no longer exists. For example, an economy is bound together by the contradiction of production and consumption; if production exists without consumption (or vice-versa), it can’t be considered to be an economy.
+Contradictions are said to be ''mutually impacting'' because any time a contradiction exists between two opposing sides, both sides are mutually impacted for as long as the contradiction exists and develops. Of course, it is possible for two opposing sides to separate from one another; for example, a factory which produced buggy whips may have failed to find consumers after the invention of the car. Thus, there would exist a situation in which production exists without consumption. In this situation, the termination of the contradiction between production and consumption leads to a new contradiction: the factory will now be in the midst of a crisis which will require it to either provide a different product or go out of business.
+Thus we see that production and consumption can’t be separated from one another without leading to a change in the essential nature of the relationship and the opposing subjects, and we see that the opposing sides mutually impact one another (a change in consumption will affect production, and vice-versa).
+In any given contradictory relationship, each oppositional side is the premise for the other’s existence. Unity among opposites also defines the identity of each opposing side. Lenin wrote: “The identity of opposites (it would be more correct, perhaps, to say their ‘unity,’—although the difference between the terms identity and unity is not particularly important here. In a certain sense, both are correct) is the recognition (discovery) of the contradictory, mutually exclusive, opposite tendencies in all phenomena and processes of nature (including mind and society).”<ref>''On the Questions of Dialectics'', Vladimir Ilyich Lenin, 1915.</ref>
+-----
+==== Annotation 189 ====
+Here, Lenin is explaining that ''identity'' and ''unity'' are (more or less) the same concept when it comes to understanding the nature of contradiction between opposites. In material processes of nature, social processes, and processes of consciousness, we perceive and define oppositional forces by recognizing mutually exclusive and contradictory tendencies within and between things, phenomena, and ideas. In other words, whenever we think of an oppositional relationship, we ''define it'' in terms of the opposition.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-63.png|''War, disease, and economy are all examples of unity in contradiction.'']]
+When we think of a war, we think of the contradictions which exist ''between'' the opposing nations. When we think of a disease, we define it by the oppositional forces ''between'' the ailment and the human body. When we think of an economy, we think of the oppositional forces of production and consumption ''within'' the economy.
+In other words, the identity of contradictory relationships is ''defined'' by the ''unity'' of the opposing sides with one another.
+The concept ''struggle of opposites'' refers to the tendency of opposites to eliminate and negate each other. There exist many diverse forms of struggle between opposites. Struggle can manifest in various forms based on:
+* The nature of a given thing, phenomenon, or idea.
+* Relationships within a thing, phenomenon, or idea (or between things, phenomena, and ideas).
+* Specific material conditions [see Annotation 10, p. 10].
+The process of unity and struggle of opposites inevitably leads to a ''transformation between them''. The transformation between opposites takes place with rich diversity, and such transformations can vary depending on the properties of the opposite sides as well as specific material conditions.
+-----
+==== Annotation 190 ====
+Opposing sides, by definition, ''oppose'' one another. If forces or characteristics which exist within or between things, phenomena, or ideas do ''not'' oppose one another, then they are not, by definition, ''opposites''. Thus, it can be understood that opposing sides have a tendency to ''struggle against'' one another. It is this very struggle which defines two sides as opposites, and as contradictory.
+Lenin explained that some contradicting opposite sides can exist in what he described as ''equilibrium'', but that this is only ever a temporary state of affairs, as exemplified in his article ''An Equilibrium of Forces.''
+[See Annotation 64, p. 62 for relevant text and more info on equilibrium.]
+Clearly, Lenin sees that this equilibrium of contradictory forces is not permanently sustainable. Indeed, ''no'' equilibrium of contradictory forces can be permanent. Eventually, one opposing side will overtake the other, and eventually, any given contradiction will result in one opposing side overcoming the other.
+According to the law of unification and contradiction between opposites, the struggle between two opposing sides is absolute, while the unity between them is relative, conditional, and temporary; in unity there is a struggle: a struggle in unity. According to Lenin: “The unity (coincidence, identity, equal action) of opposites is conditional, temporary, transitory, relative. The struggle of mutually exclusive opposites is absolute, just as development and motion are absolute.”<ref>''On the Questions of Dialectics'', Vladimir Ilyich Lenin, 1915.</ref>
+-----
+==== Annotation 191 ====
+“Absolute” and “Relative” are philosophical classifications which refer to interdependence. That which is ''absolute'' exists independently and with permanence. That which is ''relative'' is temporary, and dependent on other conditions or circumstances in order to exist.
+So Lenin’s point is that ''unity'' exists temporarily in any given pair of opposing sides, as the unity only exists as long as the opposing sides are opposing one another. As soon as one side eliminates or negates the other, the unity subsides. However, ''opposition'' is considered absolute, because it is opposition which drives motion and change in all things, phenomena, and ideas through contradictory processes of opposing sides.
+In the same text quoted in the passage above, ''On the Questions of Dialectics,'' Lenin notes:
+<blockquote>
+The distinction between subjectivism (skepticism, sophistry, etc.) and dialectics, incidentally, is that in (objective) dialectics the difference between the relative and the absolute is itself relative. For objective dialectics there is an absolute within the relative. For subjectivism and sophistry the relative is only relative and excludes the absolute...
+Such must also be the method of exposition (i.e., study) of dialectics in general... To begin with what is the simplest, most ordinary, common, etc., with any proposition: the leaves of a tree are green; John is a man: Fido is a dog, etc. Here already we have dialectics (as Hegel’s genius recognised): the individual is the universal.
+The individual exists only in the connection that leads to the universal. The universal exists only in the individual and through the individual. Every individual is (in one way or another) a universal. Every universal is (a fragment, or an aspect, or the essence of) an individual. Every universal only approximately embraces all the individual objects. Every individual enters incompletely into the universal, etc., etc. Every individual is connected by thousands of transitions with other kinds of individuals (things, phenomena, processes) etc. Here already we have the elements, the germs, the concepts of necessity, of objective connection in nature, etc. Here already we have the contingent and the necessary, the phenomenon and the essence; for when we say: John is a man, Fido is a dog, this is a leaf of a tree, etc., we disregard a number of attributes as contingent; we separate the essence from the appearance, and counterpose the one to the other.
+</blockquote>
+In other words, we must understand that in materialist dialectics, the absolute and the relative exist within one another; in other words, the absolute and the relative have a ''dialectical relationship'' with one another in all things, phenomena, and ideas.
+''Relative unity'' refers to the nature of ''unity'' between contradictory subjects. Contradictory subjects are ''unified'' in the sense that any given contradiction is essentially defined by the contradiction between two subjects. Thus, the two subjects are ''unified'' in contradiction. However, this unity is ''relative'' in the sense that this unification is temporary (the unity will end upon negation and synthesis) and relative (i.e., defined by the relationship between the two contradicting subjects).
+''Absolute struggle'' refers to the fact that contradiction, negation, and synthesis will go on forever; in this sense, contradictory processes are ''absolute'' because such struggle exists ''permanently;'' struggle has no set beginning or end point, and exists independently of any specific thing, phenomenon, or idea.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-64.png|''Relative Unity refers to the temporary and relative nature of specific relationships which define and unify specific contradictions; Absolute Struggle refers to the permanent, constant nature of development through contradiction.'']]
+[[File:t-w-the-worldview-and-philosophical-methodology-of-65.png|''The relationship between relative unity and absolute struggle defines and drives change, motion, and development through contradiction.'']]
+This applies to contradictions. The ''relative unity'' and the ''absolute struggle'' between opposing sides have a dialectical relationship with one another. The permanent absoluteness of struggle — the fact that all things, phenomena, and ideas are constantly undergoing processes of change through contradictory forces — can only manifest in the relative unity of opposing sides, which can only exist through the temporary existence of conditional relations between opposing sides.
+-----
+The interaction that leads to the transformation between opposites is a process. At the beginning, contradictions manifest as differences and then develop into two opposing sides. When the two contradictions are fiercely matched and when the conditions are ripe, they will transform each other, and finally, the conflict will be resolved. As old contradictions disappear, new contradictions are formed and the process of mutual impact and transformation between opposites continues, which drives the motion and development of all things, phenomena, and ideas. The relationship, impact and transformation between opposites are the source and driving force of all movement and development in the world. Lenin affirmed: “Development is the ‘struggle’ of opposites.”<ref>''On the Questions of Dialectics'', Vladimir Ilyich Lenin, 1915.</ref>
+-----
+==== Annotation 192 ====
+Any given process of development — that is to say, of transformation or motion — can be seen as a struggle between opposites. Various forms of struggle can exist simultaneously for any given subject, and the way we interpret struggle can depend on our point of view.
+For an engineer, a car moving along a road might be seen as a struggle between the power generated by the engine against the mass of the car itself and the friction of the tires on the ground. The driver of the car might see the process in terms of the struggle between the driver and the environment as they navigate across town avoiding accidents and following traffic laws.
+An organism’s life can be seen as a struggle between the organism’s life processes and its environment, or it might be seen as a struggle of contradictory forces within the organism itself (i.e., forces of consumption of nutrition vs. forces of expending energy to survive, forces of disease vs. forces of the organism’s immune system, etc.).
+Materialist dialectics requires us to identify, examine, and understand the opposing forces which drive all development in our universe. Only through understanding such contradictions can we intercede and affect changes in the world which suit our purposes.
+For example, in order to fight against capitalism and other forms of oppression, we must first understand the contradictory forces which exist within and between those oppressive social structures. Only then can we determine how we might best apply our will, through labor processes, to dismantle such oppressive structures. We might do this by exacerbating existing contradictions within oppressive structures, by introducing new contradictions, by negating contradictions which inhibit our own progress, etc.
+==== c. Meaning of the Methodology ====
+Given that contradictions are objective and universal, and that they are the source and driving force of movement and development, it is therefore necessary to detect, recognize, and understand contradictions, to fully analyze opposing sides, and to grasp the nature, origin and tendencies of motion and development in our awareness and practice.
+Lenin said: “The splitting of a single whole and the cognition of its contradictory parts… is the ''essence…'' of dialectics.”<ref>''On the Questions of Dialectics'', Vladimir Ilyich Lenin, 1915.</ref>
+-----
+==== Annotation 193 ====
+In other words, materialist dialectics is simply a system of understanding the world around us by viewing all things, phenomena, and ideas as collections of relationships and contradictions which exist within and between all things, phenomena, and ideas.
+Since contradictions exist with such rich diversity, it is necessary to have a historical point of view [see Annotation 114, p. 116] — that is, to know how to analyze each specific type of contradiction and have appropriate methods for resolving them. In our perception and practice, it is necessary to properly distinguish the roles and positions of different types of contradictions in each situation and condition; we must also distinguish between different characteristics which contradictions might have in order to find the best method of resolving them.
+-----
+==== Annotation 194 ====
+The historical viewpoint is vital because in order to fully understand any given contradiction, we must understand the process of development which led to its formation.
+For example, before a car engine can be repaired, we must first find out what caused the engine to stop working to begin with. If the car is out of fuel, we must determine what caused it to run out of fuel. Did the driver simply drive until the fuel tank was empty, or is there a hole or leak in a fuel line, in the tank, etc.?
+It is vital to know the history of development of a given pair of opposing sides, as well as the characteristics and other properties of both opposing sides, to fully understand the contradiction. Since all conscious activity (like all processes of motion and change) ultimately derives from the driving force of contradiction, it is vital for us to develop a historical and comprehensive perspective of any contradictions we hope to affect through our conscious activities.
+=== 3. Law of Negation of Negation ===
+The law of negation of negation describes the fundamental and universal tendency of movement and development to occur through ''dialectical negation'', forming a cyclical form of development through what is termed “''negation of negation''.”
+==== a. Definition of Negation and Dialectical Negation ====
+The world continuously and endlessly changes and develops. Things, phenomena, and ideas that arise, exist, develop and perish, are replaced by other things, phenomena, and ideas; one form of existence is replaced with another form of existence, again and again, continuously, through this development process. This procedure is called ''negation''.
+All processes of movement and development take place through negation. From certain perspectives, negations can be seen as end points to the development (and thus, existence) of a given thing, phenomenon, or idea [which we can think of as “terminal negations;” see Annotation below]. But from other perspectives, negations can also create the conditions and premises for new developments. Such negations, which create such conditions and premises for the development of things and phenomena, are called ''dialectical negation''.
+-----
+==== Annotation 195 ====
+''Negation'' refers to any act of motion or transformation which arises from contradiction. Specifically, negation is what occurs when one opposing side completely overcomes the other. Nothing in our universe can transform or move all by itself, without any contradiction. Thus, negation drives all development and motion of all things, phenomena, and ideas [see Annotation 119, p. 123]. There are various forms of negation, and the same negation process may be seen to take different forms depending on viewpoint of analysis [see Annotation 11, p. 12, and Annotation 114, p. 116], as depicted in the diagram below.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-66.png|''An overview of various forms of negation as they relate to dialectical development.'']]
+''Dialectical negation'' occurs when the end of development leads directly to some new development process. Dialectical negation occurs through quality shifts [see Annotation 117, p. 119], which, themselves, occur through negation of opposite sides.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-67.png|''Replacement negation refers to the replacement of one thing, phenomenon, or idea with another through dialectical negation.'']]
+'''Translation Note:''' ''The terms “terminal negation” and “replacement negation” do not appear in the original Vietnamese text. We chose to assign terms to these concepts for clarity.''
+''Replacement negation'' occurs when one thing, phenomenon, or idea takes the place of another. Replacement negation is always a dialectical process, where one subject is replaced gradually by another. Replacement may be relatively fast or slow, but it is never instantaneous — nothing can pop in and out of existence instantaneously. For example: swords were gradually replaced by firearms as the primary weapons of war over the course of many centuries. Today, swords have been completely replaced by firearms on the battlefield. This was a process of ''replacement negation'' — weapons are still used in war, but the type of weapon used has been completely replaced. Development continues, even though development of swords as battle weapons has essentially ended.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-68.png|''Terminal negation refers to the end of a specific cycle of development.'']]
+''Terminal negation'' is what happens when development completely ends for a given thing, phenomenon, or idea. For example, from one viewpoint, the development of swords as weapons of war can be seen as having ended — having been ''terminally negated'' — due to the innovation of firearms. In essence, swords are no longer developed, nor implemented, in modern warfare.
+Replacement negation and terminal negation must be considered in relative terms. From one viewpoint, we can see the rise of firearms as the underlying reason for the ''terminal negation'' of military use of swords. Today, no army on Earth uses swords as primary battlefield weapons and militaries no longer develop sword technology for battlefield use. However, from another viewpoint, the development of battlefield weapons has continued on long after the end of the primacy of swords, and it could be said that firearms have ''replaced'' swords as the primary battlefield weapon.
+Consider the death of a human being. From one perspective, death is a ''terminal negation'' — the person’s consciousness has ended, and no further development of consciousness will occur for that individual. From other perspectives, development continues. The individual may have had children who will continue their familial lineage, they may have contributed ideas which will continue to impact other people for centuries to come, and so on. In that sense, replacement negation may be viewed as dialectical negation. For example, someone studying modes of transportation in the history of the USA may see the process of steam locomotives replacing horses, and then cars replacing steam locomotives, as processes of dialectical negation from the overarching perspective of the transportation system.
+-----
+Materialist dialectics is concerned with all forms of negation, but focuses primarily on dialectical negation. Therefore, materialist dialectics is not just a theory of transformation in general, but fundamentally a theory of development
+-----
+==== Annotation 196 ====
+All transformation is driven by negation. Development is a process, specifically, of ''dialectical'' negation, which is a specific form of transformation in which an end of development creates the conditions for new development, either through internal quality shifts or through replacement by some external subject.
+Materialist dialectics is primarily concerned with dialectical negation (which drives development) because it is ''development'' which brings forth continuous change in our world. Terminal negations and other forms of transformation which do not drive further development are of limited utility, and can only represent certain limited viewpoints [i.e., the viewpoint of that which is terminated].
+From a broader perspective, nearly all “terminations” are replaced in some way or another by some other form of development. For instance, even when a person dies, although the consciousness of that person may terminate, there will be continuous impacts which will be carried forward from the deceased person’s lifetime of consciousness, as well as from the developments which arise from the death itself.
+This dialectical definition of negation differs greatly from metaphysical conceptions of development [see Annotation 201, p. 195], which are essentially viewed as terminal. From the metaphysical perspective, all things, phenomena, and ideas are viewed as separate from one another; therefore negations are viewed as terminal processes which bring development processes to their ends.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-69.png|''The metaphysical perspective of terminal negation views negation as an essentially terminal process representing the end point of the existence of a static and isolated thing, phenomenon, or idea.'']]
+In the above example, the metaphysical framework would present smashing a vase with a hammer as a terminal negation from the perspective of the observer. Once the vase is smashed, the vase is considered to no longer exist, and the broken shards are not considered to be “a vase” any more. Materialist dialectics, on the other hand, view “the shards” as merely a developed form of the vase; a transition to a new stage of development; the negation was only terminal from the perspective of the vase itself.
+'''''Excerpt From'' Vietnam’s High School Freshman Civic Education textbook:'''
+Metaphysical and dialectical negation share one commonality: they both see development as the replacement of an old subject with a new subject. However, metaphysical negation happens when outside forces impact on a subject, deleting completely the existence of the old subject. According to this metaphysical perspective, the old subject and the new subject which replaces it do not have any connection.
+Dialectical negation fundamentally differs from metaphysical negation because it views development as a process of internal development. Dialectical negation does not view complete erasure or deletion of any former subject; instead, dialectical development sees the older subject, which is replaced (negated), as the premise or basis of existence for the new subject.
+'''Comparison Examples:'''
+{|
+| | '''Metaphysical Negation'''
+| '''Dialectical Negation'''
+|
+|-
+| | The earthquake destroyed the house.
+| The house was impacted by the external force of an earthquake, which caused it to collapse, due to internal characteristics of the house itself (which could not withstand the forces of the earthquake). The debris from the collapsed house will be cleared away, and will continue to develop. The space where the house stood will also continue to develop in some way, with the earthquake and the resulting collapse serving as the basis for this further development.
+|
+|-
+| | Water eroded the mountain.
+| The external force of water caused erosion by transferring material away from the mountain, due to the internal characteristics of the mountain’s composite material. The water, the material which was washed away, and the mountain will all continue to develop. The erosion process will be the basis for this further development.
+|
+|-
+| | The car has a new tire because it ran over a nail.
+| The external force of the nail caused the tire to permanently deflate, due to the internal characteristics of the tire, which could not withstand running over a nail. This served as the basis for further development: the old tire was removed and will be disposed of, which will serve as the basis for further development (i.e., the tire may be recycled or sent to a landfill); the removal of the tire serves as the basis for the further development of a new tire being installed.
+|
+|-
+| | When you add water, sunlight, and nutrition to a seed, it will grow into a plant.
+| The seed went through a process of negation as a sprout grew, through various stages of development, into a plant, facilitated by outside forces (such as water, nutrition, sunlight, etc. — the seed would not grow in isolation) as well as the internal characteristics of the seed itself; the seed served as the basis of the sprout’s development. The sprout then served as the basis for the growth of a seedling, and the seedling served as the basis for the growth of a fully grown plant. All of this development was driven by negation processes as quantity shifts gradually led to quality shifts through those various stages of development.
+|
+|}
+As you can see from the examples above, the metaphysical perspective focuses on external forces affecting a given subject and views every development process as terminal, with a beginning, middle, and end. The metaphysical perspective thus views negation as a termination of the subject (and, by extension, of development).
+Materialist dialectics, on the other hand, views development as a continuous and never-ending process of mutual impact, negation, and further negation of each negation. A comprehensive and historical viewpoint [see Annotation 114, p. 116] must thus be sought to fully comprehend development and negation processeses.
+Dialectical negation has two basic characteristics: ''objectivity'' and ''inheritance''.
+Dialectical negation is ''objective'' because negation arises from contradictions which exist between two opposite sides. These opposing sides may exist within a thing, phenomenon, or idea, but the opposing sides are still, by definition, externally opposed to one another from the perspective of either side.
+-----
+==== Annotation 197 ====
+Though any given negation may be viewed as terminal from a certain perspective, materialist dialectics is most concerned with processes of development wherein the end of one stage of development creates the conditions for further development [see Annotation 117, p. 119].
+Therefore, every development is simultaneously an ''internal'' and an ''external process,'' depending on perspective. Development processes may, from certain perspectives, be seen to take place ''within'' a subject or ''between'' two subjects, but they are always ''external'' (and, therefore, objective — see Annotation 108, p. 112) from the perspective of either opposing side while simultaneously ''internal'' to the relationship.
+For example: The relationship between a husband and wife may be seen as an ''internal process of development'' of “the marriage” from the perspective of a marriage counselor. However, from their own perspectives, each “opposing side” (i.e., the husband and the wife) see one another as external to each other.
+Therefore, the development of a marriage may be seen as an internal process, but the mutual impacts and negations which occur within the relationship are objective and external forces from the perspective of either opposing side.
+This is important because it means that all development and all negation are essentially objective processes; therefore no entity has complete, omniscient control over any development process. We must, therefore, understand the nature of development and negation in order to be able to properly plan and affect change in our world.
+Dialectical negation is, therefore, the result of the process of resolving inevitable contradictions within a subject [i.e., a relationship] itself. Dialectical negation allows for the old to be replaced by the new, thereby creating trends of development. Therefore, dialectical negation is also self-negation.
+-----
+==== Annotation 198 ====
+To reiterate: from the perspective of either opposing side, development is an ''external, objective'' process. From the perspective of the contradictory ''relationship'', processes of development are ''internal'' processes of ''self-negation''. Thus, dialectical negation is both an objective process which no entity can completely control, while, simultaneously, an internal process of self-negation and self-development.
+If two nations go to war, either nation may view the war as an objective, external development process, but from a wider perspective, the war is an internal development process of the diplomatic relationship between the two warring nations. This is drastically different from the metaphysical perspective, which views any negation process as a purely external process of development wherein one subject is permanently deleted from existence, then replaced by another subject [see Annotation 196, p. 188]. From the metaphysical perspective, a war is simply a conflict between two distinct and separate nations, and the conclusion of the war is a terminal negation which ends development of the war. From the materialist dialectical perspective, on the other hand, the end of the war would be seen as the basis of future development of the relationship between the two formerly warring nations.
+Dialectical negation also has an ''inheritance'' characteristic: when one opposing side negates another, the remaining side inherits factors from the negated side which are suitable with present conditions.
+-----
+==== Annotation 199 ====
+Every negation process arises from contradictions between two opposing sides. Within any such negation process, we can think of one side as the “negator” and the other side as the “negated.” Negation, like all relational processes, leads to mutual impact between both sides [see Annotation 136, p. 138]. Therefore, the negated will impact the negator; in other words, the negated side will be somehow ''reflected'' in the negator [see Annotation 68, p. 65]. This means that the negator will inherit and carry forward certain attributes, factors, and characteristics which it receives from the negated side.
+Again, consider a war between two nations. Even if one nation completely conquers and subjugates the other in total victory, the victorious nation will still inherit certain factors from the defeated nation. Which factors are inherited will depend on the conditions. The victorious nation may pick up some cultural aspects from the defeated nation, such as cuisine, fashion, etc., they may incorporate tactics and strategies which they observed the defeated enemy using on the battlefield, and so on. The point is that the victorious nation will be impacted in some way by the defeated nation.
+The factors which are adopted will be ''suitable with the present conditions''. Take, for example, a car breaking down due to engine failure. This can be seen as an opposing relationship between the car itself and the car’s owner. If the present conditions are suitable [i.e., the owner has the funds and resources available, and the desire to repair the car], then the car may be repaired and continue operating for years to come. If, on the other hand, conditions aren’t suitable [i.e., the owner does not have the funds or resources or the owner no longer wants the car], then the car may be sent to the scrapyard.
+As another example, if a fox eats a rabbit, it will inherit certain characteristics from the rabbit. It will inherit nutrition from the rabbit’s body. It may also inherit other characteristics, such as a disease the rabbit was carrying, if the conditions of the fox’s biological composition are suitable [i.e., if the disease can be transferred from the rabbit to the fox].
+Dialectical negation is not a complete negation [i.e., deletion] of the old. Rather, dialectical negation is a continuity of growth in which the old develops into the new. In processes of dialectical negation, “the new” forms and develops on its own [see Annotation 62, p. 59], through the process of filtering out unsuitable factors, while retaining suitable content. Vladimir Lenin described dialectical negation as:
+“Not empty negation, not futile negation, not skeptical negation, vacillation and doubt is characteristic and essential in dialectics — which undoubtedly contains the element of negation and indeed as its most important element — no, but negation as a moment of connection, as a moment of development, retaining the positive, i.e., without any vacillations, without any eclecticism.”<ref>''Conspectus of Hegel’s Science of Logic,'' Vladimir Ilyich Lenin, 1914.</ref>
+-----
+==== Annotation 200 ====
+The passage from Lenin above comes from Clemence Dutt’s popular English translation of one of Lenin’s notebooks. Below is our translation from the Vietnamese version of this text from the original text of this book, which we hope might be somewhat easier to understand:
+<blockquote>
+Dialectical negation is not empty negation, it’s not negation without any thoughts, it’s not skeptical negation, it’s not hesitation. Skepticism is not a feature of the essence of the dialectic — of course, dialectics include the negative, it even plays as one of the important factors of a given subject — no, it is negation as the moment of development. Dialectical negation retains the positive, meaning there is no hesitation, there is no eclecticism.
+</blockquote>
+In order to understand what Lenin is saying here, we should first understand what Lenin is responding to. The above notes are referring to the chapter titled “The Absolute Ideal” within Hegel’s ''Science of Logic [see note at the end of this Annotation]''. In this chapter, Hegel recounts various critiques of dialectics and counters them.
+''Skepticism'', here, refers to the tendency to address all human knowledge with doubt.
+Philosophical skepticism never moves past two questions: 1. “Is this knowledge true?” 2. “Will human beings ever obtain true knowledge?” Skeptics of this nature engage in a sort of metaphysical inquisition in which every thesis that is ever encountered is immediately and utterly refuted and thus “negated” in the metaphysical sense of termination [see Annotation 196, p. 188].
+''Eclecticism'' refers to philosophical and ideological conceptions which draw from a variety of theories, styles, and ideas in an unsystematic manner. Lenin contends that dialectical negation is non-eclecticist because it rises above mere rhetorical combativeness and “total negation.” [This concept is explained more below within this annotation.]
+With all this in mind, we see that Lenin is refuting the notion that dialectics are and can only be ''negative'' in nature. The metaphysical-skeptic conception of dialectics holds that negation takes the form of rhetorical arguing and refutation, in which one idea is presented, and a second idea is offered to counter the first idea, which completely and totally negates the first idea. According to this argument, dialectics is, therefore, a ''totally negative process''.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-71.png|''A common misperception of dialectical development is that it is “fully negative,” insomuch as the initial thesis (initial subject) is completely negated by the antithesis (impacting subject). In fact, characteristics from both the thesis and antithesis are carried forward into the synthesis.'']]
+In the chapter from ''Science of Logic'' which Lenin is responding to in the referenced text, Hegel is arguing that the conception of dialectics as ''only negative'' — i.e., a system of thinking in which counter-arguments are presented to completely negate initial arguments — is inaccurate. Hegel explains that when one opposing side negates another, it thereafter “contains in general the determination of the first [opposing side] within itself.” In other words, after one opposing side negates another, it retains features and aspects from the opposing side which was negated. Lenin found this particular point to be so important that he wrote “this is very important for understanding dialectics” in the margin of his notebook.
+The reason both Hegel and Lenin found this idea, that the “negator” contains elements of the “negated” after negation [see Annotation 231, p. 227], is that this counters the accusation that dialectics are “only negative.” This is why Lenin’s notes highlight the importance of the negator “retaining the positive” after negation. Lenin is pointing out the importance of the retention of features of the negated in the negator because it is this retention which prevents dialectical development from becoming a purely negative process.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-72.png|''In materialist dialectics, it is understood that negation is a process of retention: characteristics from both the thesis (initial subject) and antithesis (impacting subject) are retained in the resulting synthesis'']]
+We must also understand what Lenin means when he refers to “skepticism” in his notes. Lenin, here, is referring to the philosophical view that we can never know whether or not our beliefs are true. This belief was popularly known as Machism, or Empirio-Criticism, in Lenin’s time (see Annotation 32, p. 27).
+A common critique of dialectics is that it is an inherently skeptical system of thought, since dialectics is seen as a process of presenting counter-arguments to suppositional arguments. Lenin, in his notes, presents the idea that such skepticism is “not a feature of dialectics” precisely because nothing is ever completely, totally, and entirely negated. In other words, the accusation that dialectical analysis is essentially skeptical is rooted in the mistaken notion that one opposing side (i.e., a counter-argument) ''completely negates'' the original supposition. In fact, according to materialist dialectics, the negator ''always'' retains features and aspects from the negated side, which counters this critique. Thus, dialectical development, which occurs through dialectical negation, is a process of forward motion — not a process of “vacillating” back and forth from one position to another — and there is no skeptical “hesitation” preventing forward progress.
+This same idea (that the negator retains features from the negated) also counters another common critique of materialist dialectics: that dialectical analysis is simply a system of rhetorical sophistry [see Annotation 36, p. 33] and eclecticism.
+''Eclecticism'' is a conceptual approach that is completely unsystematic, drawing from a variety of theories, styles, and ideas without any cohesive and all-encompassing philosophical framework.
+Some critics claim that dialectics must be eclecticist and sophistic in nature. These critics claim that dialectics is simply rhetorical disputation in which any given supposition is counter-argued, and that this counter-argument is negation. But materialist dialectics defines negation as one contradicting side overtaking the other while retaining traces and characteristics from the negated side — it is in no way simply an act of rhetorical dispute or refutation.
+In summary, materialist dialectics upholds that nothing is ever completely and utterly deleted or erased from existence through negation. Instead, any time one opposing side negates another, aspects of the negated side are ''inherited'' by the negating side.
+''Note:'' For reference, here is Hegel’s passage which Lenin is referring to from ''Science and Logic'' in the cited notes above:
+<blockquote>
+...a universal first, considered in and for itself, shows itself to be the other of itself. Taken quite generally, this determination can be taken to mean that what is at first immediate now appears as mediated, related to an other, or that the universal appears as a particular. Hence the second term that has thereby come into being is the negative of the first, and if we anticipate the subsequent progress, the first negative. The immediate, from this negative side, has been extinguished in the other, but the other is essentially not the empty negative, the nothing, that is taken to be the usual result of dialectic; rather is it the other of the first, the negative of the immediate; it is therefore determined as the mediated — contains in general the determination of the first within itself. Consequently the first is essentially preserved and retained even in the other. To hold fast the positive in its negative, and the content of the presupposition in the result, is the most important part of rational cognition; also only the simplest reflection is needed to furnish conviction of the absolute truth and necessity of this requirement, while with regard to the examples of proofs, the whole of Logic consists of these.
+</blockquote>
+-----
+Therefore, dialectical negation is the inevitable tendency of progression of the inner relationship between the old and the new. It is the self-driving assertive force of all motion and development of all things, phenomena, and ideas.
+==== b. Negation of Negation ====
+In the perpetual movement of the material world, dialectical negation is an inexhaustible process. It creates a development tendency of things from lower level to higher level, taking place in a cyclical manner in the form of a “spiral.”
+-----
+==== Annotation 201 ====
+The concept of the “spiral” form of development in dialectical materialist philosophy stands in contrast to the metaphysical conception of “linear” development.
+==== Metaphysical Conception of Linear Development ====
+The metaphysical viewpoint holds that development is more or less a straight line: as one subject is negated, it is replaced by another. This subject will then be negated by another, and so on, in what is essentially conceived of as a straight line of development [see Annotation 196, p. 188].
+[[File:t-w-the-worldview-and-philosophical-methodology-of-73.png|''The metaphysical “line development” model sees an initial form as being “replaced” or entirely negated into a completely distinct entity.'']]
+In the above example, metaphysical line development simply sees raw aluminum as being negated and “replaced” in the real world. Once the aluminum can is created, the “raw aluminum” as a metaphysical entity is considered no longer to exist. Likewise, when the soda can is transformed into recycled aluminum, the can is considered “replaced,” and is no longer considered to have a metaphysical existence.
+This conception of metaphysical line development directly contradicts the materialist dialectical concept of ''historical viewpoint'' [see Annotation 114, p. 116].
+==== Dialectical Materialist Conception of Development ====
+The dialectical materialist conception of cyclical development stems from essential attributes of dialectical negation processes:
+. In every dialectical negation, the negating side inherits features and characteristics from the negated side.
+. When the negating side is, itself, negated (i.e., ''negation of the negation''), the new negating side will retain features and aspects of the old negator.
+. This development process will continue indefinitely, so that negation is not simply a straight line of complete negation, but rather takes the shape of a “spiral” of negations of negations which always inherit features from previous forms.
+Note that this conception of development as a spiral is simply an abstraction to help understand the essential characteristics of dialectical development and to distinguish this form of development from metaphysical conceptions of “linear development.”
+In the example below, we see a depiction of the spiral development of aluminum through various stages of development. After raw aluminum is mined from the Earth, it begins a repeating spiral development process of being refined into usable goods, then recycled into raw material.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-74.png|''The “Spiral Development” model of materialist dialectics sees every stage of development as a higher form of the previous stage which carries forward characteristics from previous stages.'']]
+The illustrated example on the previous page plots the spiral development of aluminum as it cycles between stages defined as raw materials and refined products. Another perspective might depict development differently. For example, if we are examining development in terms of external relations between aluminum other elements, the development pattern would look different. In reality, all subjects have countless internal and external relations and development processes which can be examined.
+The “raw aluminum” stage of development pictured in the illustration is not truly the beginning of this development process; there were millions of years of development which occurred before it was first discovered by humans. Similarly, the landfill will not be the end of this development process; there will be continued development forever for as long as motion in the universe continues.
+This is a simplified and abstract model of development of aluminum. A more accurate representation might show any number of interim steps between each step depicted in the graphic above. For example: it must also be recognized that in reality the molecules of aluminum which the development process began with will be scattered and mixed with other subjects throughout the development process, and various other complexities exist in terms of the mutual impacts of internal and external relationships.
+Determining the amount of detail to include or exclude in materialist dialectical analysis is crucial: too much detail and analysis might become unwieldy; too little detail and analysis might become too abstract and idealized to be useful in the real world. So, the idea of development as a spiral should not be taken literally; it is simply a way of conceptualizing the differences between dialectical negation and development as opposed to “straight-line” development upheld by metaphysical conceptions of negation and development, always carrying forward traces of previous stages of development.
+In the chain of negations that make up the development processes of things, phenomena, and ideas, each dialectical negation creates the conditions and premises for subsequent developments. Through many iterations of negation, i.e., “negations of negations,” dialectical negation will inevitably lead to a ''forward tendency of motion''.
+-----
+==== Annotation 202 ====
+The ''forward tendency of motion'' describes the tendency for things, phenomena, and ideas to move from less advanced to more advanced forms through processes of motion and development.
+As a reminder, “lower level” and “higher level,” i.e., “less advanced” and “more advanced,” should not be taken to have any connotations of “good” and “bad,” nor of “desirable” and “undesirable,” nor even of “less complex” and “more complex.”
+Development from “lower levels” to “higher levels” is simply a shorthand for understanding the fact that development processes always move “forward,” that is to say, development can never happen in reverse, just as time itself can never be reversed. For example, society in Italy will never go back to the civilization of the Roman empire. It is conceivable that Italian society could develop to be ''more similar'' to Ancient Rome, but it would be impossible for Roman society to ever take on the ''exact characteristics'' of the Roman Empire ever again.
+Cyclicality of development processes usually takes place in the form of a spiral, which is another result of “negation of negation.” Negations of negations lead to a development cycle in which things, phenomena, and ideas often undergo two fundamental negations carried through three basic forms. Through this negation pattern, basic features of the initial form are ultimately inherited by the “third form,” but at a higher level of development.
+-----
+==== Annotation 203 ====
+Dialectical development tends to take place through a cyclical pattern in which development is carried through a triad of forms which develop through a pair of dialectical negation processes:
+[[File:t-w-the-worldview-and-philosophical-methodology-of-75.png|''The cyclical pattern of development is an abstract pattern of dialectical change over time.'']]
+The graphic above illustrates this cyclical pattern, in which:
+. The initial form (the Assertion) begins the pattern. Contradiction within the initial subject or between it and another subject leads to the first negation.
+. The first negation leads to a second form (the Negation). This second form inherits some features or characteristics from the initial form.
+. The second form then encounters opposition, which leads to a second negation.
+. The second negation leads to a third form (Unity), which retains the features or characteristics of the second form, but now more closely resembles the first, initial form, only at a higher level of development.
+Imagine a new car (initial form) crashes into another car (contradicting subject). The new car is dialectically developed (negated) into a second form: a wrecked car. This second form is now contradicted by a new subject — a recycling center — and negated into a third form: new steel. The third form possesses characteristics of the first form, but in a more developed form: after being recycled, the resulting steel it is newly made, in good condition for sale, etc., similarly to the first form of the new car.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-76.png|''In this example, a new car goes through a cyclical pattern of development in which the third form (new steel) possesses characteristics of the first form (a new car).'']]
+Keep in mind that this is relative to one’s perspective. If you consider the wrecked car to be the first form, then the steel would be the second form. The new steel will then need to be developed in some way (melted, hammered, cut, etc.) in order to be processed into some new product. From this perspective, the third form (i.e., molten steel) will have characteristics of the first form (i.e.: “unrefined”).
+According to Marx and Engels, the development of capitalism from feudalism assumed this cyclical pattern:
+[[File:t-w-the-worldview-and-philosophical-methodology-of-77.png|''The development of class structure is a dialectical process in which different classes synthesize to form the next era of class society. For example, the capitalist class emerged primarily as a synthesis of the feudal lords and peasants of the medieval era.'']]
+Note that this is only an abstract description of a tendency of dialectical development; exceptions can and do occur. Presumably, the development of communism as a stateless, classless society would constitute the negation of the “Class Society” form of human civilization. The Post-Class stage of development which follows would, itself, be a higher form — a unity — of pre-class human civilization, carrying forward traces from the Class Society stage of development.
+Also note that determining which form is the “first” or “initial” pattern is entirely relative. Using the example of the development of class society: from one perspective, the Patricians may be seen as the initial form, but from another perspective the Plebeians might be considered the initial form. This depends entirely on the viewpoint and purpose of analysis. These conceptions of “spirals of development” and the pattern of “three forms through two negations” are, in essence, models which describe general tendencies and patterns of development and which help us understand the basic characteristics of dialectical negation and development.
+Lenin describes this cycle of dialectical development as going “[f]rom assertion to negation — from negation to ‘unity’ with the asserted — without this, dialectics becomes empty negation, a game, skepsis [examination, observation, consideration].”<ref>''Conspectus of Hegel’s Science of Logic,'' Vladimir Ilyich Lenin, 1914.</ref>
+-----
+==== Annotation 204 ====
+Here, “assertion” simply refers to the initial form of a dialectical development cycle. The negation is the second form, and the “unity” is the third form, which resembles the first form (the assertion) at a higher stage of development. So, in this quotation, Lenin is simply recounting the “three steps” of a typical dialectical development cycle, and indicating that it is necessary to recognize this process, which is rooted in the inheritance of properties of prior forms through development into ever-higher forms, to prevent dialectics from becoming “empty negation,” or otherwise falling prey to the critiques that dialectics are purely negative, skeptical, and eclectic in nature [see Annotation 200, p. 192 and Annotation 36, p. 33].
+The law of negation of negation generalizes the pervasive nature of development: dialectical development does not take the form of a straight path, but rather in the form of a spiral path. Lenin summarised that this path is “[a] development that repeats, as it were, stages that have already been passed, but repeats them in a different way, on a higher basis (‘the negation of the negation’), a development, so to speak, that proceeds in spirals, not in a straight line…”<ref>''Karl Marx'', Vladimir Ilyich Lenin, 1914.</ref> The tendency to develop in a spiral curve demonstrates the dialectical nature of development; i.e., the cycle of inheritance, repetition, and progression. Each new round of the spiral appears to be repeating, but at a higher level. The continuation of the loops in a spiral reflects an endless progression from lower levels to higher levels of things, phenomena, and ideas.
+In short, the law of negation of negation in materialist dialectics reflects the dialectical relationship between the negative and the assertion [i.e., the second and first forms of a dialectical development cycle; see Annotation 203, p. 198] in the development process of things, phenomena and ideas. Dialectical development is driven by dialectical negation; in the development of all things, phenomena, and ideas, the new is the result of inheriting characteristics from prior forms. This process of inheritance, repetition, and progression through negation leads to cyclical development. Engels wrote: “what is the negation of the negation? An extremely general — and for this reason extremely far-reaching and important — law of development of nature, history, and thought.”<ref>''Anti-Dühring'', Friedrich Engels, 1878.</ref>
+-----
+==== Annotation 205 ====
+In the same text quoted above, Engels elaborates that dialectical development is composed of “processes which in their nature are antagonistic, contain a contradiction; transformation of one extreme into its opposite; and finally, as the kernel of the whole thing, the negation of the negation.”
+==== c. Meaning of the Methodology ====
+The law of negation of negation is the basis for correct perception of the tendency of motion and development of things, phenomena, and ideas. Development and motion processes do not take place in a straight line; rather, it is a winding, complex road, consisting of many stages, and each process can be broken down into many different sub-processes. However, it must be understood that this complexity of development is only the manifestation of the general tendency to move forward [see Annotation 118, p. 122]. It is important to understand the nature of motion and development so that we can systematically change the world according to our revolutionary viewpoint. In order to consciously impact the development of things, phenomena, and ideas, we need to know their characteristics, nature, and relationships so that we can influence their motion and development in the direction that suits our purposes. We must comprehend and leverage the tendency of forward movement — in accordance with a scientific and revolutionary worldview — in order to effectively and systematically change the world.
+-----
+==== Annotation 206 ====
+Understanding the forward tendency of motion is vital for cultivating a worldview which is both ''scientific'' and ''revolutionary.'' Such a worldview is ''scientific'' because it recognizes the material reality that all things, phenomena, and ideas are constantly undergoing change and development. Nothing in our universe is static, and all things are connected and defined by internal and external relationships (which are also constantly developing). Furthermore, this development progresses with a ''forward tendency'', meaning that no process can be completely “reversed.” For example, you can clean rust from a car [which would be forward progress], but you can’t reverse the temporal process of rust.
+Once we understand that all things, phenomena, and ideas in our universe are constantly developing and moving forward, we can then begin to find ways to ''impact'' motion and development systematically to consciously change the world around us. This is the foundation of a ''revolutionary'' worldview, since revolutionary change requires us to leverage and influence development processes to suit our needs and revolutionary ambitions. Thus, materialist dialectics are an applied system of observation and practice through which we seek to understand development processes and consciously impact them to suit our needs.
+According to the rule of negation of negation, in the objective world, the new must inevitably come to replace the old. In nature, the new develops according to objective laws. In social life, new things arise from the purposeful, self-conscious, and creative actions of human beings. Therefore, it is necessary to leverage ''subjective factors'' as we seek to consciously impact the development of things, phenomena, and ideas.
+-----
+==== Annotation 207 ====
+Subjective factors are factors which we, as a subject, are capable of impacting. This may seem confusing, since we have previously established that all external things, phenomena, and ideas have ''objective'' relationships with all other things, phenomena, and ideas [see Annotation 108, p. 112], meaning that any given subject is ''external'' to every other subject, and thus no subject can directly and completely control the motion and development of any other subject.
+However, from the perspective of any given individual, there are certain things, phenomena, and ideas [as well as processes of motion and development] which we can ''impact''. For example, if I see an apple on a table, the apple is ''objective'' to me. I can’t simply will the apple to move with my consciousness alone. However, I can ''impact'' the apple through conscious activity — I can consciously will my hand to pick up the apple and move it to another location.
+Thus, factors which an individual can consciously impact are ''subjective factors''. As revolutionists, we must focus on subjective factors. In other words, we must concentrate on ''that which we are capable of changing'', since our purpose is to change the world. Focusing on factors which we can’t impact is a waste of time; we must simply determine what ''can be changed'' and then determine the most efficient and effective ways of impacting development processes and changing the world.
+As revolutionists, we must have faith that we can introduce the “new,” faith in the success of the “new,” we must support the “new,” and fight for the victory of the “new.” Therefore, it is necessary to overcome conservative, stagnant, and dogmatic thoughts which restrain the development of the “new” and resist the law of negation of negation.
+-----
+==== Annotation 208 ====
+Change is inevitable. All things, phenomena, and ideas undergo processes of motion and development. Any philosophy, ideology, or strategy which attempts to restrain motion and development is doomed to failure because change can neither be halted nor restrained. Thus, our strategies and actions must align with the material reality that change is inevitable, and we must seek to change the world by ''impacting'' processes of development and motion rather than attempting to reverse, restrain, or halt such processes.
+Ideologies which erroneously strive to restrict change and development include ''rigidity'' (see Annotation 222, p. 218) and ''conservativism'' (see Annotation 236, p. 233).
+In the process of negating the old we must leverage the principle of inheritance with discretion: we must encourage the inheritance of factors that are beneficial to our goals as we simultaneously attempt to filter out, overcome, and reform factors which would negatively impact our goals.
+-----
+==== Annotation 209 ====
+If we understand the principle of inheritance, we can impact inheritance processes which derive from negation. For example, when repairing a car, we can seek out parts of the car which do not function properly or which do not suit the use-case of the car and add or replace parts which are more suitable.
+In the same way, we can impact inheritence processes in our revolutionary political activities. We can seek to inherit characteristics from previous stages of development of our political organizations, social institutions, culture, etc., while simultaneously seeking to prevent the inheritence of traits and characteristics which are unsuitable for our revolutionary purposes. Over time, we can attempt to impact the inheritance of traits and aspects which are more conducive to our purposes while limiting and filtering out traits and aspects which are hindrances.
+In an article titled “New Life” written in 1947, Ho Chi Minh wrote about the dialectical relationship between the new and the old in building a new society, writing:
+<blockquote>
+Not everything old must be abandoned. We do not have to reinvent everything. What is old but bad must be abandoned. What is old but troublesome must be corrected appropriately. What is old but good must be further developed. What is new but good must be done.
+... Growing up in the old society, we all carry within us more-or-less bad traces of the old society in terms of our ideas and habits... Habits are hard to change. That which is good and new is likely to be considered bad by the people because it is strange to them. On the contrary, that which is evil yet familiar is easily mistaken as normal and acceptable.
+</blockquote>
+Ho Chi Minh understood the principles of development very well, as well as the difficulties we will face as revolutionaries as we try to change ourselves and our society. We must strive to develop a similar understanding as we move forward and attempt to affect the development of our world through practice and struggle.
+-----
+= Chapter 3: Cognitive Theory of Dialectical Materialism =
+In Marxism, epistemological reasoning (or epistemology) is the foundation of dialectics. Dialectical materialist epistemology is a theory of applying human cognitive ability to the objective world through practical activities. It explains the nature, path and general laws of the human process of perceiving truth and objective reality to serve human practical activities.
+-----
+==== Annotation 210 ====
+Epistemology is the theoretical study of knowledge. It also deals with the philosophical question of: “how do we know what is true?”
+Throughout history, philosophers have tried to determine the nature of truth and knowledge. In the era of Karl Marx and Friedrich Engels, there was an ongoing dispute between the materialists, who believed that truth could only be sought through sense experience of the material world, and the idealists, who believed that truth could only be sought through reasoning within the human mind.
+Marx and Engels developed the philosophical system of dialectical materialism to resolve this dispute. Dialectical materialism upholds that the material and the ideal have a dialectical relationship with one another: the material ''determines'' the ideal, while the ideal ''impacts'' the material [see ''The Relationship Between Matter and Consciousness'', p. 88].
+However, it’s important to understand that Marx and Engels didn’t develop the system of dialectical materialism simply to understand the world. As Marx wrote in ''Theses on Feuerbach:''
+<blockquote>
+The philosophers have only interpreted the world, in various ways; the point is to change it.
+</blockquote>
+So, Marxist dialectical materialist epistemology is developed specifically to enable human beings to not only perceive truth and objective reality, but to then be able to apply our conscious thought, through practical activity, in order to bring about change in the world.
+-----
+== 1. Praxis, Consciousness, and the Role of Praxis in Consciousness ==
+=== a. Praxis and Basic Forms of Praxis ===
+''Praxis'' includes all human material activities which have purpose and historical-social characteristics and which transform nature and society. Unlike other activities, praxis is activity in which humans attempt to materially impact the world to suit our purposes. Praxis activities define the nature of human beings and distinguish human beings from other animals. Praxis is objective activity, and praxis has been constantly developed by humans through the ages.
+<br />
+-----
+==== Annotation 211 ====
+In English, the words “practice” and “praxis” are often distinguished from one another. “Practice” is often used to refer to human activity which provides more information about the world around us and improves our knowledge and understanding, whereas “praxis” often refers to conscious human activity which is intended to change the world in some manner. In their original German, Marx and Engels used the same German word — ''Praxis'' — to refer to both concepts. Similarly, in the original Vietnamese text of this book, the same word — ''thực tiễn'' — is used for both “practice” and “praxis.”
+One reason that these concepts are so closely related is that all conscious activity serves both rolls by simultaneously telling us more about reality ''and'' consciously changing reality in some way. For example, by pushing a heavy stone, you may be able to move the stone a small amount — constituting praxis — while simultaneously learning how heavy the stone is and how difficult it is to move — constituting practice. The main point of distinction, therefore, is ''intention''. Virtually all conscious activity is practice, but only activity which has ''purpose'' and ''historical-social characteristics'' might be considered praxis:
+''Purpose'' simply describes a goal or desired outcome; specifically: a desired change in nature or human society. Activities with ''historical-social characteristics'' are activities which contribute in some way to the development of human society.
+In this translation, we use “practice” and “praxis” interchangably to mean “conscious activity which improves our understanding, and which has purpose and historical-social characteristics.” You are likely to find these words used differently (as described above, or in other ways) in other texts. Engels explains the importance of practice/praxis in ''Socialism: Utopian and Scientific'':
+<blockquote>
+The proof of the pudding is in the eating. From the moment we [use] these objects, according to the qualities we perceive in them, we put to an infallible test the correctness or otherwise of our sense-perceptions. If these perceptions have been wrong, then our estimate of the use to which an object can be turned must also be wrong, and our attempt must fail. But if we succeed in accomplishing our aim, if we find that the object does agree with our idea of it, and does answer the purpose we intended it for, then that is positive proof that our perceptions of it and of its qualities, so far, agree with reality outside ourselves.
+</blockquote>
+Marx wrote in ''Theses on Feuerbach'' that “the coincidence of the changing of circumstances and of human activity or self-change can be conceived and rationally understood only as revolutionary practice [German: ''revolutionäre Praxis''].” Engels further expounds upon this concept in ''Ludwig Feuerbach and the End of Classical German Philosophy'', writing:
+<blockquote>
+The most telling refutation of this as of all other philosophical fancies is practice [original German: Praxis], viz., experiment and industry. If we are able to prove the correctness of our conception of a natural process by making it ourselves, bringing it into being out of its conditions and using it for our own purposes into the bargain, then there is an end of the Kantian incomprehensible or ungraspable.
+</blockquote>
+Praxis defines the nature of human beings because human beings are (to our present knowledge) the only beings which undertake actions with conscious awareness of our desired outcomes and comprehension of the historical development of our own society, which distinguishes human beings from all other animals. Praxis is ''objective'' activity, meaning that all praxis activities are performed in relation to external things, phenomena, and ideas [see Annotation 108, p. 112].
+Praxis has been constantly developed by humans through the ages, meaning that as we learn more about the nature of reality, of human society, and the laws of nature, we are able to develop our praxis to become more efficient and effective.
+Praxis activities are very diverse, manifesting with ever-increasing variety, but there are only three basic forms: material production activities, socio-political activities, and scientific experimental activities.
+''Material production activity'' is the first and most basic form of praxis. In this form of praxis activity, humans use tools through labor processes to influence the natural world in order to create wealth and material resources and to develop the conditions necessary to maintain our existence and development.
+''Socio-political activity'' includes praxis activity utilized by various communities and organizations in human society to transform political-social relations in order to promote social development.
+''Scientific experimental activity'' is a special form of praxis activity. This includes human activities that resemble or replicate states of nature and society in order to determine the laws of change and development of subjects of study. This form of activity plays an important role in the development of society, especially in the current historical period of modern science and technological revolution.
+-----
+==== Annotation 212 ====
+The three basic forms of praxis activities listed above obviously do not include all forms of human activity, as praxis only includes activities which have ''purpose'' and ''historical-social characteristics''.
+''Material production activity'' has a very clear purpose: to improve the material conditions of an individual human being or a group of human beings. Material production activity has historical-social characteristics because developing material conditions for human beings leads directly to the development of human society. For example, as food production increases in terms of yield and efficiency, society can support a larger number of human beings and a wider range of human activities, which leads to the development of human society.
+''Socio-political activity'' has the purpose of promoting social development, which is obviously inherently historical-social in nature. An example of socio-political activity would include any sort of political campaign, liberation struggle, political revolutionary activity, etc.
+''Scientific experimental activity'' has the purpose of expanding our understanding of nature and human society, which leads directly to historical-social development in a variety of ways. For example, improving our scientific understanding of medicine through scientific experimental activity leads to longer lives and improved quality of life. Improving our scientific understanding of chemistry through scientific experimental activity leads to all sorts of materials which improve the quality of life and enable human beings to solve a variety of social problems.
+In order to qualify as praxis activity, a given human activity must have a purpose and it must have historical-social characteristics. For instance, drawing is not always praxis in the sense of the word used in this text, but it would be praxis if it would qualify as material production activity (i.e., making art in order to sell, so as to make a living) or if the art is made with the intention of invoking social change.
+Every basic praxis activity form has an important function, and these functions are not interchangeable with each other. However, they have close relationships with each other and different praxis activity forms often interact with each other. In these relationships, material production is the most important form of praxis activity, playing a decisive role in determining other praxis activities because material production is the most primitive activity and exists most commonly in human life. Material production creates the most essential, decisive material conditions for human survival and development. Without material production there cannot be other praxis activities. After all, all other praxis activities arise from material production praxis and all praxis activities ultimately aim to serve material production praxis.
+-----
+==== Annotation 213 ====
+Without material production activity, human beings would not be able to live at all.
+Thus, material production activities make all other forms of human activities possible. In addition, the primary reason we participate in socio-political activity is to ensure material security (food, water, shelter, etc.) for members of society, which ultimately relies on material production activity. Therefore, the primary reason we engage in scientific experimental activity is to improve material production activities in terms of efficiency, yield, effectiveness, etc
+Of course, we engage in scientific experimental activity and material production activity for other reasons (art, entertainment, recreation, etc.), but these activities require that material security be secured first for those participating in the production and consumption of such products. In other words, material production activity is a prerequisite for all other forms of activity, since without some measure of material security humans cannot survive.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-78.png|''Material production activity has a dialectical relationship with all other praxis activity, with material production activity determining, while being impacted by, all other forms of praxis activity.'']]
+Thus, material production activity has a dialectical relationship with other forms of praxis activities, in which material production activity determines both socio-political and scientific experimental activity while socio-political and scientific experimental activity impact material production activity.
+-----
+=== b. Consciousness and Levels of Consciousness ===
+The dialectical materialist perspective sees consciousness as a process of reflecting the objective world within the human brain on a practical basis to create knowledge about the objective world. Consciousness is a self-aware process that is productive and creative.
+This view stems from the following basic principles:
+* The dialectical materialist worldview acknowledges that the material world exists objectively and independently of human consciousness.
+* The dialectical materialist worldview recognizes the following human abilities:
+** To perceive the objective world.
+** To reflect the objective world into the human mind, which enables human subjects to learn about external objects. [see Annotation 66, p. 64]
+** To admit that there are no material things nor phenomena which are unrecognizable, but only material things and phenomena that humans have not yet recognised. [see ''The Opposition of Materialism and Idealism in Solving Basic Philosophical Issues,'' p. 48]
+The dialectical materialist worldview affirms that conscious reflection [see Annotation 67, p. 64] of the objective world is a dialectical, productive, self-aware, and creative process. This reflection process develops from the unknown to the known, from knowing less to knowing more, from knowing less profoundly and less comprehensively to knowing more profoundly and more comprehensively.
+-----
+==== Annotation 214 ====
+The above principle (that human knowledge develops from less, and less comprehensive, to more, and more comprehensive states) stands in contrast to various other philosophical systems of belief, including:
+Hegel’s ''Absolute Idealism'' upholds a belief in an “absolute ideal” which constitutes an ultimate limit or “end point” of knowledge which humanity is moving towards. Dialectical materialism upholds that there is no such absolute ideal and thus no such terminal end point of human understanding. [See Annotation 234, p. 230] As Engels wrote in ''Anti-Dühring'':
+<blockquote>
+If mankind ever reached the stage at which it should work only with eternal truths, with results of thought which possess sovereign validity and an unconditional claim to truth, it would then have reached the point where the infinity of the intellectual world both in its actuality and in its potentiality had been exhausted, and thus the famous miracle of the counted uncountable would have been performed.
+</blockquote>
+''Fideism'', which is the belief that knowledge is received from some higher power [i.e., God]. Fideism upholds that all knowledge is pre-existing, and that humanity simply receives it from on high. Dialectical materialism, on the other hand, argues that knowledge is developed over time through dialectical processes of consciousness and human activity.
+''Positivism, or empiricist materialism'', which holds that there are hard limits to human knowledge, or that human knowledge — which can only be obtained from sense data — can’t be trusted. Dialectical materialism upholds that all things and phenomena can be known and understood, and that sense data can be trusted as an objective reflection of reality. For more information about skepticism about human sense data as well as positive and empiricist materialism, see Annotation 10, p. 10, and Annotation 58, p. 56].
+-----
+The dialectical materialist worldview considers praxis as the primary and most direct basis of consciousness, and as the motive and the purpose of consciousness, and as the criterion for testing truth. [See: ''The Relationship Between Praxis and Consciousness'', p. 216]
+-----
+==== Annotation 215 ====
+Given the above principles — that human consciousness exists independently from the material world yet is capable of accurately perceiving and reflecting the material world, and that knowledge develops over time through a synthesis of consciousness and practical activity — we can conclude that consciousness is a self-aware process which is productive and creative.
+Consciousness is productive and creative in the sense that conscious processes, in conjunction with practical experience and activity in the material world, leads to the development of knowledge and practical experience which allows humans to develop our understanding of the world as well as our own material conditions through the application of knowledge to our own labor activities.
+Next, we will examine different ways of categorizing conscious activities as they pertain to developing knowledge and practical understanding of our world.
+From the dialectical materialist point of view, consciousness is a process of development. Consciousness develops from ''empirical consciousness'' to ''theoretical consciousness''; and from ''ordinary consciousness'' to ''scientific consciousness''.
+-----
+==== Annotation 216 ====
+In dialectical materialist philosophy, all systems of relation exist as processes of development in motion [see Annotation 120, p. 124]. Thus, consciousness can be defined as a system of relations between human brain activity and two forms of data input:
+''•'' ''Sense experience'': observations of the external world detected by our senses.
+''•'' ''Knowledge'': information which exists in the human mind as memories and ideas.
+Consciousness is thus a process of the development of knowledge through a combination of human brain activity and human practical activity in the physical world (i.e., labor).
+In the section below, we will explore different forms of consciousness, the development of consciousness, and the relationship between consciousness and knowledge. Note that these are ''abstractions'' of consciousness and knowledge, meant to help us understand how knowledge and consciousness develop over time. Thought processes are extremely complex, so we seek to develop a fundamental understanding of how consciousness develops and how knowledge develops because these processes are fundamental to the development of human beings and human societies.
+Just as consciousness is a process of developing knowledge through brain activity, consciousness itself also develops over time. The development of consciousness can be considered based on the criteria of ''concrete/abstract'' and of ''passive/active''.
+Consciousness develops from a state of direct and immediate observation of the world which results in concrete knowledge to a higher stage which constitutes a more abstract and general understanding of the world. We call consciousness which is focused on direct, immediate, concrete, empirical observation of the world ''empirical consciousness'', and we call consciousness which is focused on forming abstract generalizations about the world ''theoretical consciousness''.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-79.png]]
+Empirical consciousness is a process of collecting data about the world, which we call knowledge. We can gather two forms of knowledge through empirical consciousness: ordinary knowledge, and scientific knowledge.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-80.png]]
+Ordinary knowledge is the knowledge we accumulate through our everyday experiences in the world. Scientific knowledge is gathered through more systematic scientific observations and experiments. Scientific knowledge usually develops from ordinary knowledge, as we begin to seek a more formal and systematic understanding of the things we witness in our daily lives.
+According to ''Themes in Soviet Marxist Philosophy,'' edited by T. J. Blakely:
+<blockquote>
+Ordinary knowledge notes what lies on the very surface, what happens during a certain event. Scientific knowledge wants to know why it happens in just this way. The essence of scientific knowledge lies in the confirmed generalization of facts, where it becomes necessary rather than contingent, universal instead of particular, law-bound, and can serve as a basis for predicting various phenomena, events and objects...
+The whole progress of scientific knowledge is bound up with growth in the force and volume of scientific prediction. Prediction makes it possible to control processes and to direct them. Scientific knowledge opens up the possibility not only of predicting the future but also of consciously forming it. The vital meaning of every science can be expressed as follows: to know in order to predict and to predict in order to act.
+An essential characteristic of scientific knowledge is that it is systematic, i.e., it is a set of information which is ordered according to certain theoretical principles. A collection of unsystematized knowledge is not yet science. Certain basic premises are fundamental to scientific knowledge, i.e., the laws which make it possible to systematize the knowledge. Knowledge becomes scientific when the collection of facts and their descriptions reach the level where they are included in a theory.
+</blockquote>
+Theoretical consciousness arises from conscious reflection on accumulated knowledge, as human beings seek to develop general and abstract understanding of the underlying principles of processes we experience in the world. Once general principles of natural and social law are established, human beings then test those general conclusions against empirical reality through further observation (i.e., through empirical consciousness).
+Thus, there is a dialectical relationship between empirical consciousness and theoretical consciousness, as one form leads to another, back and forth, again and again, continuously.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-81.png|''Empirical and theoretical consciousness have a dialectical relationship in which empirical consciousness and theoretical consciousness lead to and mutually develop one another.'']]
+Consciousness also develops from passive and surface-level observation and understanding of the world (i.e., simply considering what, where, and when things happen) to more active pursuit of the underlying meaning of the world (i.e., trying to understand how and why things happen).
+Consciousness which passively observes the world, directly, in daily life is referred to as ''ordinary consciousness''. Ordinary consciousness often develops into more active consciousness. This active pursuit of understanding through systematic observation and indirect experiences (i.e., experiences that do not occur in daily activity — such as scientific experimentation) is referred to as ''scientific consciousness''.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-82.png]]
+These concepts will be discussed in further detail below.
+-----
+''Empirical consciousness'' is the stage of development of consciousness in which perceptions are formed via direct observations of things and phenomena in the natural world, or of society, or through scientific experimentation and systematic observation. Empirical consciousness results in ''empirical knowledge''.
+''Empirical knowledge'' has two types: ''ordinary empirical knowledge'' (knowledge obtained through direct observation and in productive labor) and ''scientific empirical knowledge'' (knowledge obtained by conducting scientific experiments). These two types of knowledge can be complementary, and can enrich one other.
+''Theoretical consciousness'' is the indirect, abstract, systematic level of perception in which the nature and laws of things and phenomena are generalized and abstracted.
+Empirical consciousness and Theoretical consciousness are two different cognitive stages but they have a dialectical relationship with each other. In this dialectical relationship, empirical consciousness is the basis of theoretical consciousness; it provides theoretical consciousness with specific, rich material [i.e., knowledge]. Empirical consciousness is linked closely to practical activities [since practical activity in the material world is the chief method of gathering knowledge through empirical consciousness], and forms the basis for checking, correcting, and supplementing existing theories and summarizing, and generalizing them into new theories. However, empirical consciousness is still limited in that empirical consciousness stops at the description and classification of data obtained from direct observation and experimentation. Therefore, empirical consciousness only brings understanding about the separate, superficial, discrete aspects of observed subjects, without yet reflecting the essence of those subjects nor the underlying principles or laws which regulate those subjects.
+Therefore, empirical consciousness, alone, is not sufficient for determining the scientific laws of nature and society. To determine such laws and abstractions, theoretical consciousness must be applied. So, theoretical consciousness does not form spontaneously, nor directly from experience, although it is formed from the summation of experiences.
+-----
+==== Annotation 217 ====
+The knowledge we gain from our daily activity often inspires scientific inquiry and more systematic observation, which can yield scientific knowledge which will enrich and improve our daily practice and allow us to experience daily life with a deeper understanding of what we’re experiencing. Thus, the ordinary knowledge we gain through daily practice can enrich and yield scientific knowledge (and vice versa).
+Empirical consciousness and theoretical consciousness have a dialectical relationship with each other in which empirical consciousness provides the basis for theoretical consciousness. Theoretical consciousness attempts to derive general abstractions and governing principles from empirical knowledge which is gained through empirical consciousness. Once theoretical principles, generalities, and abstractions are determined, they are then tested against reality through empirical consciousness (i.e., practical observation and systematic experimentation) to determine if the theory is sound.
+''Empirical consciousness and theoretical consciousness have a dialectical relationship with one another. Our observations of the material world lead to conscious activity which we then test in reality through conscious activity, and so on, in a never-ending cycle of dialectical development.''
+For example, a farmer may notice that plants grow better in locations where manure has been discarded — an act of empirical consciousness. The farmer might then form the theory that adding manure to the soil will help plants grow — an act of theoretical consciousness. This theory could then be tested against reality by mixing manure into the soil and observing the results, which would be another act of empirical consciousness. The farmer may then theorize that ''more'' manure will help plants grow ''even more'' — another act of theoretical consciousness — continuing the cycle of testing and observing.
+This dialectical relationship between ordinary and theoretical consciousness is what allows human beings to develop and improve knowledge through practical experience, observation, and theoretical abstraction and generalization of knowledge.
+Theoretical consciousness is relatively independent from empirical consciousness. Therefore, theories can precede expectations and guide the formation of valuable empirical knowledge. Theoretical consciousness is what allows human beings to sort and filter knowledge so as to best serve practical activities and contribute to the transformation of human life. Through this process, knowledge is organized and therefore enhanced, and develops from the level of specific, individual, and solitary knowledge to a higher form of generalized and abstract knowledge [what we might call ''theoretical knowledge''].
+-----
+==== Annotation 218 ====
+Knowledge which comes from empirical observations (empirical consciousness) is ''empirical knowledge.'' ''Theoretical knowledge'' is a product of theoretical consciousness. Over time, as repeated and varied observations are made through theoretical consciousness activities, knowledge becomes more generalized and abstract; this general and abstract knowledge is what we call ''theoretical knowledge''.
+Note that empirical and theoretical knowledge can be ''ordinary'' or ''scientific'' in nature; if the knowledge arises passively from daily life activities, it will be ordinary knowledge, regardless of whether or not it is empirical or theoretical in nature. If, on the other hand, the knowledge arises from methodological measurement and/or systematic observation, then it is scientific knowledge.vSo far, we have discussed ways of understanding consciousness based on the criteria of directness vs. abstractness. Next, we will discuss another way of looking at consciousness, based on the criteria of passiveness vs. activeness.
+''Ordinary consciousness'' refers to perception that is formed ''passively'' and ''directly'' from the daily activities of humans. Ordinary consciousness is a reflection of things, phenomena, and ideas, with all their observed characteristics, specific details, and nuances. Therefore, ordinary consciousness is rich, multifaceted, and associated with daily life. Therefore, ordinary consciousness has a regular and pervasive role in governing the activities of each person in society.
+''Scientific consciousness'' refers to perception formed ''actively'' and ''indirectly'' from the reflection of the characteristics, nature, and inherent relationships of research subjects. This reflection takes place in the form of logical abstraction. These logical abstractions include scientific concepts, categories, and laws. Scientific consciousness is objective, abstract, general, and systematic, and must be grounded in evidence.
+Scientific consciousness utilizes systematic methodologies to profoundly describe the nature of studied subjects as well as the principles which govern them. Therefore, scientific consciousness plays an increasingly important role in practical activities, especially in the modern age of science and technology.
+-----
+==== Annotation 219 ====
+Logical abstraction refers to an understanding of the underlying rules which govern things, phenomena, and ideas which underly objective processes, relationships, and characteristics. Logical abstraction is the result of scientific inquiry. Over time, our understanding of the rules which govern the things, phenomena, and ideas in our lives become more reliable and applicable in practical activities. This attainment of understanding and practical ability through scientific practice is ''scientific consciousness''.
+Ordinary and scientific consciousness are two different qualitative steps of cognitive processes which, together, allow humans to discover truth about our world. Ordinary and scientific consciousness have a strong dialectical relationship with each other. In this relationship, ordinary consciousness precedes scientific consciousness, as ordinary consciousness is a source of material for the development of scientific consciousness.
+Although it contains the seeds of scientific knowledge, ordinary consciousness mainly stops at the reflection of superficial details, seemingly random events, and non-essential phenomena [see ''Essence and Phenomenon'', p. 156]. Ordinary consciousness, therefore, cannot transform effortlessly into scientific consciousness. To develop ordinary consciousness into scientific consciousness, we must go through the process of accurate summarizing, abstracting, and generalization using scientific methods. Likewise, once scientific consciousness has been developed, it impacts and pervades ordinary consciousness, and therefore develops ordinary consciousness. Scientific consciousness therefore enhances our everyday passive perception of the world.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-83.png|''Ordinary consciousness refers to the passive observation of reality which takes place in our daily lives. Scientific consciousness refers to the systematic application of consciousness to solve specific problems in a methodological manner.'']]
+-----
+==== Annotation 220 ====
+For example, before developing scientific consciousness of farming, a farmer might go through daily life having no idea what makes plants grow to be larger and more healthy and might have no idea how to avoid common problems such as pests. After developing scientific consciousness of farming through scientific experimentation and other systematic methodologies, the farmer will look at things differently in daily life activities. They may see signs of pest infestation and immediately recognize it for what it is, and they may see other indications that plants are unhealthy and know exactly what to do to remedy the situation.
+In this way, scientific consciousness enhances ordinary consciousness. Meanwhile, ordinary consciousness — passive observation of the world during daily activities — will lead to scientific consciousness by inspiring us to actively seek understanding of the world through scientific consciousness.
+=== c. The Relationship Between Praxis and Consciousness ===
+Praxis serves as the ''basis, driving force,'' and ''purpose'' of consciousness. Praxis serves as the criterion of truth by testing the truthfulness of our thoughts. [See Annotation 230, p. 226]
+Praxis is able to serve these roles because reality is the direct starting point of consciousness; it sets out the requirements, tasks, and modes of consciousness, as well as the movement and development tendencies of consciousness. Humans have an objective and inherent need to explain the world and to transform it.
+-----
+==== Annotation 221 ====
+Remember that the material world defines consciousness while consciousness allows us to impact the material world through conscious activity [see ''The Relationship Between Matter and Consciousness'', p. 88]. Consciousness itself arose from the physical needs of the material world [see ''The Source of Consciousness'', p. 64], and these physical needs continue to serve as the basis and driving force for all conscious activities, as we must act consciously to survive.
+Our inherent need to explain the world and to transform it arises from our material needs to eat, seek shelter, cure and prevent disease, and so on. These physical needs, which stem from the material world, drive conscious activity and lead to the development of consciousness and knowledge.
+Therefore, humans must necessarily impact things in the material world through our practical activities in order to survive. The impacts of our practical activities on the world cause things and phenomena to reveal their different properties, including their internal and external relationships [for example, hitting a rock will tell you properties about the rock; attempting to build something out of wood will provide data about the wood, etc.]. In this manner, praxis produces data for consciousness to process, and also helps consciousness to comprehend nature and the laws of movement and development which govern the world.
+Scientific theories are formed on the basis of the dialectical relationship between practical activity and consciousness. For example: mathematics developed to allow us to count and measure things for practical activities such as agriculture, navigation, and building structures. Marxism also arose in the 1840’s from the practical activities of the struggles of the working class against the capitalist class at that time. Even recent scientific achievements arise from practical needs and activities. For example, the discovery and decoding of the human genome map was born from practical activities and needs, such as the need to develop treatments for incurable diseases. In the end, there is no field of knowledge that is not derived from reality. Ultimately, all knowledge arises from and serves practice. Therefore, if we were to break from reality or stop relying on reality, consciousness would break from the basis of reality that nurtures our growth, existence and development. Also, the cognitive subject cannot have true and profound knowledge about the world if it does not follow reality.
+Practice also serves as the basis, driving force, and purpose of consciousness because, thanks to practical activities, our human ability to measure and observe reality improves increasingly over time; our logical thinking ability is constantly strengthened and developed; cognitive means become increasingly developed. All of these developments “extend” the human senses in perceiving the world [for example, by developing new tools to measure, perceive, and sense the world such as telescopes, radar, microscopes, etc.].
+Reality is not only the basis, the driving force, and the purpose of discovering truth but also serves as the ''standard of truth.'' Reality also serves as the basis for ''examining the truthfulness of the cognitive process'' [i.e., we can test whether our thoughts match material reality through experimentation and practice in the real world]. This means that practice is the measure of the value of the knowledge we gain through perception. At the same time, practice is constantly supplementing, adjusting, correcting, developing, and improving human consciousness. Marx said: “The question whether objective truth can be attributed to human thinking is not a question of theory but is a practical question. Man must prove the truth — i.e. the reality and power, the this-sidedness of his thinking in practice.”<ref>''Theses On Feuerbach'', Karl Marx, 1845.</ref>
+Thus, practice is not only the starting point of consciousness and a decisive factor for the formation and development of consciousness, it is also a target where consciousness must always aim to test the truth. To emphasize this role which practice plays, Lenin said: “The standpoint of life, of practice, should be first and fundamental in the theory of knowledge.”<ref>''Materialism and Empirio-Criticism'', Vladimir Ilyich Lenin, 1908.</ref>
+The role of practice in consciousness requires that we always grasp the practical point of view. This point of view requires that we derive our ideas from practice, our ideas must be based on practice, and our ideas must deeply explore practice. In our conscious activities, we must attach a lot of importance to the summarization of practice [i.e., developing theoretical knowledge through theoretical consciousness which reflects practical experience]. Theoretical research must be related to practice, and learning must go hand in hand with practicing. If we diverge from practice, it will lead to mistakes of subjectivism, idealism, dogmatism, rigidity, and bureaucracy.
+-----
+==== Annotation 222 ====
+''Subjectivism'' occurs when one centers one’s own self and conscious activities in perspective and worldview, failing to test one’s own perceptions against material and social reality. Subjectivists tend to believe that they can independently reason their way to truth in their own minds without practical experience and activity in the material world. Related to subjectivism is ''solipsism'', a form of idealism in which one believes that the self is the only basis for truth. As Marxist ethicist Howard Selsam wrote in ''Ethics and Progress: New Values in a Revolutionary World'': “If I believe that I alone exist and that you and all your arguments exist only in my mind and are my own creations then all possible arguments will not shake me one iota. No logic can possibly convince [the] solipsist.”
+''Idealism'' has a strong connection with a failure to incorporate practical activity into theoretical consciousness, since idealism holds that conscious activity is the sole basis of discovering truth.
+''Dogmatism'' occurs when one only accounts for commonalities and considers theory itself as the sole basis of truth rather than practice [see Annotation 239, p. 235]. Dogmatists ignore practical experience and considering pre-established theory, alone, as unalterable truth. This results in a breakdown of the dialectical relationship between theoretical consciousness and empirical consciousness, which arrests the development process of knowledge and consciousness.
+''Rigidity'' is an unwillingness to alter one’s thoughts, holding too stiffly to established consciousness and knowledge, and ignoring practical experience and observation, which leads to stagnation of both knowledge and consciousness.
+''Bureaucracy'' arises when theory becomes overly codified and formalized, to the extent that practical considerations are ignored in favor of codified theory. Bureaucracy can be avoided by incorporating practical experience and observations continuously into the development of practical systems and methodologies so that theory and practice become increasingly aligned over time to continuously improve efficiency and effectiveness of practical activities in the material world.
+On the contrary, if the role of practice is absolutized [to the exclusion of conscious activity], it will fall into pragmatism and empiricism.
+-----
+==== Annotation 223 ====
+In this context, ''pragmatism'' refers to a form of subjectivism [see Annotation 222, above] in which one centers one’s own immediate material concerns over all other considerations. For example, workers may place their own immediate needs and desires above the concerns of their fellow workers as a whole. This may offer some temporary gains, but in the long run their lack of solidarity and class consciousness will be detrimental as workers collectively suffer from division, making all workers more vulnerable to exploitation and ill treatment by the capitalist class.
+''Empiricism'' is a faulty form of materialism in which ''only'' sense experience and practical experience are considered sources of truth. This is opposed to the dialectical materialist position that the material ''determines'' consciousness, while consciousness ''impacts'' the material world through conscious labor activity. [See ''The Relationship Between Matter and Consciousness'', p. 88]
+Thus, the principle of the ''unification'' of practice and theory must be the basic principle in practical and theoretical activities. Theory without practice as its basis and criterion for determining its truthfulness is useless. Vice versa, practice without scientific and revolutionary theory will inevitably turn into blind practice. [As Ho Chi Minh once said: “Study and practice must always go together. Study without practice is useless. Practice without study leads to folly.”]
+== 2. Dialectical Path of Consciousness to Truth ==
+=== a. Opinions of Vladimir Ilyich Lenin about the Dialectical Path of Consciousness to Truth ===
+==== Annotation 224 ====
+The section below outlines and explains ''the Universal Law of Consciousness'', which holds that consciousness is a process of dialectical development in which practical activity leads to conscious activity, which then leads back to practical activity, in a continuous and never-ending cycle, with a tendency to develop both practical and conscious activity to increasingly higher levels.
+In his ''Philosophical Notebook'', Lenin generalized the dialectical path towards the realization of truth as development from vivid visualization to abstract thinking, and then from abstraction back to practice. This process, according to Lenin, is the dialectical path towards the realization of truth, and the realization of objective reality.
+According to this generalization, the dialectical path towards the realization of truth (“truth,” here, referring to a correct and accurate reflection of objective reality) is a process. It is a process that starts from “vivid visualization” (emotional consciousness) to “abstract thinking” (rational consciousness).
+-----
+==== Annotation 225 ====
+Given that consciousness has a material basis, and that practical activities are the driving force of consciousness [see Annotation 230, p. 226], it follows that we must strive to align our conscious thoughts and ideas with the material world. The more accurately we can reflect reality in our consciousness, the more effectively and efficiently our practical activities can become.
+For example, through learning more about the mechanical, material, and physical processes which take place inside of an automobile engine, the more we can improve engines to make them more efficient and effective for practical applications.
+Lenin explained that consciousness develops from “emotional consciousness” to “rational consciousness.” Thought about a subject begins at a base level of consciousness that is rooted in emotional and sense-oriented conscious activity, i.e, “vivid visualization,” which then leads to rational, abstract reflection.
+By “vivid visualization,” Lenin is referring to the active, real-time experience of seeing (and hearing, smelling, and otherwise sensing) things and phenomena in the world.
+When a person experiences something through practical activity, the first conscious activity will tend to occur at the emotional and sensory level — in other words, the conscious activities which occur simultaneously along with practical activities. Only after this initial period of emotional consciousness will one be able to reflect on the experience on a more rational and abstract level.
+For example, if a zoologist in the field sees a species of bird they have never encountered before, their first conscious activity will be at the sensory-emotional level: they will observe the shape, coloration, and motion of the bird. They may feel excitement, happiness, and other emotions. This is emotional conscious activity.
+This emotional conscious activity will then develop into rational conscious activity, as the zoologist may begin to consider things more abstractly, attempting to interpret and understand this experience through reason and rational reflection, asking such questions as: “Where does this bird nest? What does it feed on? Is this a new discovery?” and so on.
+Such abstractions are not the end point of a cognitive cycle, because consciousness must then continue to develop through practice. It is through practice that perception tests and proves its own correctness so that it can then continue on to repeat the cycle.
+This is also the general rule of the human perception of objective reality.
+-----
+==== Annotation 226 ====
+Thus there is a dialectical relationship between emotional consciousness (linked to practical activity) and rational consciousness (linked to purely conscious activity).
+This dialectical relationship is a cycle, in which one engages in practical activity, which leads to emotional consciousness, which leads to rational consciousness, which then leads back to practical activity to test the correctness of the conclusions of rational conscious activity.
+We call this cycle of development of consciousness the cognitive process.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-84.png|''The cognitive process is a continuous cycle which describes the dialectical development of consciousness and practical activity.'']]
+The cognitive process is explained in more detail below.
+-----
+'''- Development From Emotional Consciousness to Rational Consciousness'''
+''Emotional consciousness is the lower stage of the cognitive process.'' In this stage of cognitive development, humans use — through practical activity — use our senses to reflect objective things and phenomena (with all their perceived specific characteristics and rich manifestations) in human consciousness. During this period, consciousness only reflects the phenomena [i.e, ''phenomena'', as opposed to ''essence'' — see ''Essence and Phenomenon'', p. 156] — the external manifestations — of the perceived subject. At this stage, consciousness has not yet reflected the ''essence'' — the nature, and/or the regulating principles — of the subject. Therefore, this is the lowest stage of development of the cognitive process. In this stage, consciousness is carried out through three basic phases: ''sensation'', ''conception'', and ''symbolization''.
+Human ''sensation'' of an objective thing or phenomenon is the simplest, most primitive phase of the emotional consciousness stage of the cognitive processes, but without it there would not be any perception of objective things or phenomena. Every human sensation of objective things and phenomena contains objective content [see Content and Form, p. 147], even though it arises as subjective human conscious reflection. Sensation is the subjective imagining of the objective world. It is the basis from which the next phase of emotional consciousness — ''conception'' — is formed.
+''Conception'' is a relatively complete reflection within human consciousness of objective things and phenomena. Conception is formed on the basis of linking and synthesizing sensational experiences of things and phenomena [i.e., ''sensation'']. Compared with sensation, conception is a higher, fuller, richer form of consciousness, but it is still a reflection of the outward manifestations of objects. Conception does not yet reflect the essence, nature, and regulating principles of the perceived subject.
+''Symbolization'' is the representation of an objective thing or phenomenon that has been reflected by sensation and conception. It is the most advanced and most complex phase of the stage of emotional consciousness. At the same time, it also serves as the transitional step between emotional consciousness and rational consciousness. The defining characteristic of symbolism is the ability to reproduce symbolic ideas of objective things and phenomena within human consciousness. Symbolization describes the act of recreating the outward appearances of material things and phenomena within human consciousness, which is the first step of abstraction, and thus the first step towards rational consciousness.
+-----
+==== Annotation 227 ====
+Here is an example of the three phases of the emotional consciousness stage of the cognitive process:
+[[File:t-w-the-worldview-and-philosophical-methodology-of-85.png]]
+''1.'' ''Sensation'': Jessica ''senses'' a cake in the window of a bakery. She ''sees'' the frosting, the shape of the cake, and the decorations which adorn the cake. She ''smells'' the cake. During this phase, objective data about the cake is received into her consciousness, developing into an immediate and subjective sense perception of the cake. The beginnings of this cognitive activity will be purely sensory in nature; she may have been thinking of other things as she walked by the bakery, but the sight and smell of the cake, upon registering in her mind, will lead to the beginning of a new cognitive process cycle.
+''2.'' ''Conception'': Jessica begins to ''conceive'' of the cake in her mind more fully. She will associate the immediate sense experiences of seeing and smelling the cake with other experiences she has had with cake, and a complete mental image and concept of the cake will form in her mind.
+''3.'' ''Symbolization'': The word “cake” may now form in her mind, and she may begin thinking of the cake more abstractly, as “food,” as a “temptation,” and in other ways. This is the beginning of abstraction in Jessica’s mind, which will then lead to rational conscious activities.
+Note that all of these phases of emotional consciousness activity may take place very quickly, perhaps in a fraction of a second, and may coincide with other conscious activity (i.e., Jessica may simultaneously be thinking of a meeting she’s running late to and any number of other things). At this point, Jessica will transition to the ''rational consciousness'' stage of the cognitive process'','' which is explained in more detail below.
+-----
+By the end of the emotional stage of the cognitive process, consciousness has not yet reflected the essence — the nature, regulating principles, etc. — of the perceived subject. Therefore, at the emotional stage, consciousness is not yet able to properly ''interpret'' the reflected subject. That is to say, emotional conscious activity does not meet the cognitive requirements to serve practical activities, including the need to creatively transform the objective world. To meet these requirements, emotional consciousness must develop into ''rational consciousness''.
+''Rational consciousness is the higher stage of the cognitive process.'' It includes the indirect, abstract, and generalized reflection of the essential properties and characteristics of things and phenomena. This stage of consciousness performs the most important function of comprehending and interpreting the ''essence'' of the perceived subject. Rational consciousness is implemented through three basic phases: ''definition'', ''judgment'', and ''reasoning''.
+''Definition'' is the first phase of rational consciousness. During this phase, the mind begins to interpret, organize, and process the basic properties of things and phenomena at a rational level into a conceptual whole. The formation of definition is the result of the summarization and synthesis of all the different characteristics and properties of the subject, and how the subject fits into the organized structure of knowledge which exists in the mind. Definition is the basis for forming judgments in the cognitive process.
+''Judgment'' is the next phase of rational consciousness, which arises from the definition of the subject — the linking of concepts and properties together — which leads to affirmative or negative ideation of certain characteristics or attributes of the perceived subject.
+According to the level of development of consciousness, judgment may take one of three forms: unique judgment, general judgment, and universal judgment [see Annotation 105, p. 107]. Universal judgment is the form of judgement that expresses the broadest conception of objective reality.
+''Reasoning'' is the final phase of rational consciousness, formed on the basis of synthesizing judgments so as to extrapolate new knowledge about the perceived subject. Before reasoning can take place, judgments must be transformed into knowledge. A judgment can be transformed into knowledge through one of two logical mechanisms: deductive inference (which extrapolates the general from the specific), and inductive inference (which extrapolates the specific from the general).
+-----
+==== Annotation 228 ====
+Here is an example of the three phases of the rational consciousness stage of the cognitive process, continuing from our previous example of the emotional consciousness stage [see Annotation 227, p. 222].
+[[File:t-w-the-worldview-and-philosophical-methodology-of-86.png]]
+''1.'' ''Definition'': Jessica’s conception of the cake will transition into the rational conscious activity of ''definition''. Jessica will begin to define the concept of the cake more wholly and concretely, summarizing and synthesizing all of the features and characteristics of the cake into a cohesive mental reflection of the cake. The word “cake” may become more pronounced and defined in Jessica’s consciousness, prompting her to think of the object which she defines as a “cake” more fully and rationally.
+''2.'' ''Judgment'': Jessica will begin to form basic judgments about the cake. “That cake looks good,” “that cake smells good,” and so on. Next, these judgments will begin to transform into knowledge through inductive or deductive inferences. An inductive inference might be: “I generally enjoy eating cakes, therefore, I might enjoy eating this cake!” An example of a deductive inference might be: “This cake looks very delicious, therefore, there might be other delicious things in this bakery!”
+''3.'' ''Reasoning'': Processes of inductive and/or deductive inference will begin to transform Jessica’s judgments into the form of knowledge. For instance, she may now possess such knowledge as: “This bakery has delicious looking cakes, this is a cake I would like to eat,” and so on. With this newly acquired knowledge, Jessica can begin reasoning; that is to say, she can begin making rational conclusions and decisions. She might conclude: “I will go into this bakery and buy that cake.”
+Note that this is not the “end” of the cognitive process, because the final phase of the reasoning stage of the cognitive process (reasoning) will lead directly into a new cycle of the cognitive process. In this example, Jessica might engage in the practical activity of checking her watch to see the time, which will begin a new cycle of cognitive process, beginning with the ''sensation'' phase of the emotional stage as the visual sense data of her watch and carrying through to the final ''reasoning'' phase of the rational stage, and so on.
+It should also be noted that this is merely an abstraction of the cognitive process; in reality, the human mind is incredibly complex, capable of carrying out a variety of cognitive processes simultaneously. At any given moment, a person might be considering various different subjects, and each different subject might be at a different stage of the cognitive process. This abstract model of the cognitive process is presented to help us comprehend the component functions of consciousness more easily in the wider context of dialectical materialist philosophy.
+Specifically, this model of the cognitive process is intended to help us understand how human consciousness leads to “truth.” And “truth,” here, refers to the alignment of human consciousness with the material world, so that our perceptions and understanding of the world is accurate and representative of actual reality.
+''- The Relationship Between Emotional Consciousness, Rational Consciousness, and Reality''
+Emotional consciousness and rational consciousness are stages that make up the cognitive cycle. In reality, they are often intertwined within the cognitive process, but they have different functions. If ''emotional consciousness'' is associated with reality, and with the impact of sense data received from observing the material world, and is the basis for cognitive reason, then ''rational consciousness'', based on higher cognitive understanding and abstraction, allows us to understand the essence, nature, regulating principles, and development processes of things and phenomena. Rational consciousness helps direct emotional consciousness in a more efficient and effective direction and leads to more profound and accurate emotional consciousness.
+-----
+==== Annotation 229 ====
+In other words, considering a subject at the level of rational consciousness allows us to then view the same subject, at an emotional consciousness level, with more depth and awareness.
+For example, the more time we have spent rationally considering something like a bicycle, the more quickly and accurately we can examine a bicycle at the level of emotional consciousness. If someone is looking at a bicycle for the first time, they might not be able to distinguish its component parts or functions. On the other hand, if someone has spent more time considering bicycles at the level of rational consciousness, they may be able to immediately and rapidly understand and process a bicycle at the emotional conscious level, so that they can perceive and comprehend the different parts of a bicycle, as well as their functions, immediately and at the emotional-sensory level.
+However, if we stop at rational consciousness, we will only have knowledge about the subjects we perceive, but we still won’t really know if that knowledge is truly accurate or not. In order to be useful in practical activity, we must consciously determine whether knowledge is ''truth'' [i.e., whether the knowledge accurately reflects reality]. In order to determine the truth of knowledge, consciousness must necessarily return to reality. Consciousness must use reality as a criterion — a measurement — of the authenticity of knowledge gained through purely cognitive processes. In other words, all consciousness is ultimately derived from practical needs, and must also return to serve practical activities.
+-----
+==== Annotation 230 ====
+[[File:t-w-the-worldview-and-philosophical-methodology-of-87.png|''The dialectical relationship between consciousness and practical activities means that conscious activities develop practical activities, and vice versa, in a continuous feedback loop.'']]
+One of the fundamental principles of dialectical materialism is that the material determines the ideal, and the ideal impacts the material [see The Relationship Between Matter and Consciousness]. The fact that the material determines consciousness is reflected in the fact that material needs led to the development of consciousness, and conscious activity stems from material needs [see Social Sources of Consciousness].
+The fact that the ideal impacts the material is reflected in the fact that consciousness must always return to the service of practical activities; as our consciousness develops (along with knowledge), our ability to impact and transform the material world becomes more efficient and effective.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-88.png|''The dialectical relationship between consciousness and practical activity is what drives the development of humanity. We imagine better ways of doing things, then test those ideas against reality through practical activity.'']]
+This dialectical relationship between consciousness and practical activity is thus cyclical. Conscious activity arises from practical activity, and returns to practical activity, in an endless process of developing both conscious ability as well as practical ability.
+-----
+Therefore, it can be seen that the general, cyclical nature of the process of movement and development of consciousness develops from practice to consciousness — from consciousness to practice — from practical activity to the continued process of cognitive development, and so on. This process is repeated continuously, without end. The development level of consciousness and practice in the next cycle are often higher than in the previous cycle, and the cognitive process gradually develops more and more accuracy, as well as fuller and deeper knowledge about objective reality.
+The universal law of consciousness [see Annotation 224, p. 219] is also a concrete and vivid manifestation of the universal laws of materialist dialectics, including: the law of negation of negation, the law of transformation between quantity and quality and the law of unity and contradiction between opposites. The process of cognitive motion and development, governed by these general laws, is the process of human progress towards absolute truth [see Annotation 232, p. 228].
+-----
+==== Annotation 231 ====
+The universal law of consciousness is governed by the three universal laws of materialist dialectics:
+''The Law of Negation of Negation'' dictates that the new will arise from the old, but will carry forward characteristics from the old. This is reflected in the universal law of consciousness in that conscious activity arises from practical activity. This conscious activity then develops into improved practical activity, and so on, in a never-ending cycle of development. Throughout this development process, characteristics of previous cycles of cognitive and practical activities are carried forward and transferred on to newer cycles of cognitive and practical activities.
+''The Law of Transformation Between Quantity and Quality'' recognizes that quantity changes develop into changes in quality, and vice versa. This is reflected in the universal law of consciousness in the development of both conscious and practical activities. Conscious development also develops from quantitative changes to quality changes, and vice versa. For example, once a person accumulates a certain quantity of knowledge, the quality of their knowledge will change. For example, once a person has learned the function of every component part of a car engine, they will have a ''quality shift'' in their understanding of car engines — they will now have competency of the functioning of the engine as a whole. This is also true of practical activities. A quantity of practical experience will lead to quality shifts in practical ability. For example, once a person has practiced riding a bicycle enough that they can reliably ride the bicycle without falling, we would say that the person “knows how to ride a bicycle,” which represents a quality shift from the state of “learning how to ride a bicycle.”
+''The Law of Unity and Contradiction Between Opposites'' states that all things, phenomena, and ideas are defined by internal and external contradictions. This is reflected in the universal law of consciousness by the fact that practical needs serve as the basis for conscious activity, and that cognitive processes serve, in essence, to negate contradictions between consciousness and material reality through practical experience. In other words, the cognitive process is defined by a never-ending process of contradiction between the material and the ideal, as human beings seek to negate contradictions between our conscious understanding of the world and our practical experiences in search of ''truth -'' the accurate alignment of consciousness with the material world.
+=== b. Truth, and the Relationship Between Truth and Reality ===
+''- Definition of Truth''
+All cognitive processes lead to the creation of ''knowledge'', which is what we call human understanding of objective reality. But not all knowledge has content consistent with objective reality, because consciousness exists as the subjective reflection of objective reality in the human mind. The collective cognitive practice of all of humanity throughout history, as well as the cognitive practice of each individual human being, has demonstrated that the knowledge which people have gained and are gaining is not always consistent with objective reality. On the contrary, there are many cases of misalignment between consciousness and reality, and even complete contradiction between human thought and objective reality.
+Within the theoretical scope of Marxism-Leninism, the concept of ''truth'' is used to refer to knowledge which is aligned with objective reality. This alignment is tested and proven through practice. In this sense, the concept of truth is not identical with the concept of “knowledge,” nor with the concept of “hypothesis.” According to Lenin: “The coincidence of thought with the object is a '''process''': thought (= man) must not imagine truth in the form of dead repose, in the form of a bare picture (image), pale (matte), without impulse, without motion…”<ref>''Conspectus of Hegel’s Science of Logic,'' Vladimir Ilyich Lenin, 1914.</ref>
+-----
+==== Annotation 232 ====
+Here, Lenin is dispelling Hegel’s conception of “absolute truth,” which is not to be confused with Lenin’s concept of “absolute truth” as “objective truth” which aligns consciousness with objective reality [see Annotation 58, p. 56]. For Hegel, “absolute truth” was the idea that there will eventually be some end point to the process of rational consciousness at which we will finally arrive at some final stage of knowledge and consciousness. This rational end point of consciousness, at which the dialectic ends and all contradictions are negated, is Hegel’s “absolute truth.”
+Lenin is also pushing back against the metaphysical conception that all “truths” exist as static categories of information which do not change. Instead, Lenin points out that seeking truth — i.e., aligning consciousness with material reality — is a never-ending process, in particular because reality is constantly developing and changing. Thus, the alignment of consciousness with reality — the pursuit of truth — is a living and dynamic process which will never end, since the development of reality will never end.
+''- The Properties of Truth''
+All truths are ''objective, relative, absolute,'' and ''concrete.''
+The ''objectivity'' of truth is the independence of its content from the subjective will of human beings. The content of knowledge must be aligned with objective reality, not vice versa. This means that the content of accurate knowledge is not a product of pure subjective reasoning. Truth is not an arbitrary human construct, nor is truth inherent in consciousness. On the contrary, truth belongs to the objective world, and is determined by the objective world. The affirmation of the objectivity of truth is one of the fundamental points that distinguishes the concept of absolute truth of dialectical materialism from the concept of absolute truth of idealism and skepticism — the doctrines that deny the objective existence of the physical world and deny the possibility that humans are able to perceive the world.
+-----
+==== Annotation 233 ====
+The Dialectical Materialist conception of objective truth stands in contrast to ''idealism'', which states that conscious reasoning alone leads to truth, and that the subjective ideal determines material reality [see Annotation 7, p. 8].
+This objectivity of truth also refutes ''skepticism'', which states that truth is essentially undiscoverable, because human consciousness is ultimately unreliable and incapable of accurately reflecting material reality [see Annotation 32, p. 27].
+Distinction must also be drawn between the concept of absolute truth as it is understood in dialectical materialist philosophy and the conception of absolute truth in Hegel’s idealist dialectics. Dialectical materialism defines absolute truth as “objective truth;” that is to say: a complete alignment between objective reality and human consciousness (as compared to relative truth, which is a partial alignment between consciousness and objective reality).
+Hegel, on the other hand, views absolute truth as a final point at which human consciousness will have achieved absolute, complete, and final understanding of our universe (see Annotation 232, p. 228) with the ideal serving as the first basis and primary mechanism for bringing absolute truth to fruition.
+Truth is not only objective, but also ''absolute'' and ''relative''. Absolute truth [see Annotation 58, p. 56] refers to truth which reflects a full and complete alignment of consciousness and reality. Theoretically, we can reach absolute truth. This is because, in the objective world, there exists no thing nor phenomenon which human beings are completely incapable of accurately perceiving. The possibility of acquiring absolute truth in the process of the development of conscious understanding is theoretically limitless. However, in reality, our conscious ability to reflect reality is limited by the specific material conditions of each generation of humanity, of practical limitations, and by the spatial and temporal conditions of reflected subjects. Therefore, truth is also ''relative''.
+-----
+==== Annotation 234 ====
+Dialectical materialist philosophy recognizes that it must be theoretically possible to know everything there is to know about a given subject, since we are theoretically capable of accurately perceiving, sensing, and measuring all data which pertains to a subject. However, dialectical materialism also recognizes the practical limitations of human beings. As Engels writes in ''Anti-Dühring'':
+<blockquote>
+If mankind ever reached the stage at which it should work only with eternal truths, with results of thought which possess sovereign validity and an unconditional claim to truth, it would then have reached the point where the infinity of the intellectual world both in its actuality and in its potentiality had been exhausted, and thus the famous miracle of the counted uncountable would have been performed.
+But are there any truths which are so securely based that any doubt of them seems to us to be tantamount to insanity? That twice two makes four, that the three angles of a triangle are equal to two right angles, that Paris is in France, that a man who gets no food dies of hunger, and so forth? Are there then nevertheless eternal truths, final and ultimate truths.
+Certainly there are. We can divide the whole realm of knowledge in the traditional way into three great departments. The first includes all sciences that deal with inanimate nature and are to a greater or lesser degree susceptible of mathematical treatment: mathematics, astronomy, mechanics, physics, chemistry. If it gives anyone any pleasure to use mighty words for very simple things, it can be asserted that certain results obtained by these sciences are eternal truths, final and ultimate truths; for which reason these sciences are known as the exact sciences. But very far from all their results have this validity. With the introduction of variable magnitudes and the extension of their variability to the infinitely small and infinitely large, mathematics, usually so strictly ethical, fell from grace; it ate of the tree of knowledge, which opened up to it a career of most colossal achievements, but at the same time a path of error. The virgin state of absolute validity and irrefutable proof of everything mathematical was gone forever; the realm of controversy was inaugurated, and we have reached the point where most people differentiate and integrate not because they understand what they are doing but from pure faith, because up to now it has always come out right. Things are even worse with astronomy and mechanics, and in physics and chemistry we are swamped by hypotheses as if attacked by a swarm of bees. And it must of necessity be so. In physics we are dealing with the motion of molecules, in chemistry with the formation of molecules out of atoms, and if the interference of light waves is not a myth, we have absolutely no prospect of ever seeing these interesting objects with our own eyes. As time goes on, final and ultimate truths become remarkably rare in this field.
+</blockquote>
+-----
+Relative truth is truth which has developed alignment with reality without yet having reached ''complete'' alignment between human knowledge and the reality which it reflects. To put it another way, relative truth represents knowledge which incompletely reflects material subjects without complete accuracy. In relative truth, there is only partial alignment — in some (but not all) aspects — between consciousness and the material world.
+-----
+==== Annotation 235 ====
+''False consciousness'' is consciousness which is incorrect and misaligned from reality. Discovering and rooting out false consciousness is one of the primary concerns of dialectical materialism, as false consciousness can be a serious impediment to human progress. The term “false consciousness” was first used by Friedrich Engels in a personal letter to Franz Mehring in 1893 (a decade after the death of Karl Marx), and in this letter Engels uses the term interchangeably with the word “ideology”* to describe conscious thought processes which do not align with reality:
+<blockquote>
+Ideology is a process accomplished by the so-called thinker consciously, indeed, but with a false consciousness. The real motives impelling him remain unknown to him, otherwise it would not be an ideological process at all. Hence he imagines false or apparent motives. Because it is a process of thought he derives both its form and its content from pure thought, either his own or that of his predecessors. He works with mere thought material which he accepts without examination as the product of thought, he does not investigate further for a more remote process independent of thought; indeed its origin seems obvious to him, because as all action is produced through the medium of thought it also appears to him to be ultimately based upon thought. The ideologist who deals with history (history is here simply meant to comprise all the spheres – political, juridical, philosophical, theological – belonging to society and not only to nature), the ideologist dealing with history then, possesses in every sphere of science material which has formed itself independently out of the thought of previous generations and has gone through an independent series of developments in the brains of these successive generations. True, external facts belonging to its own or other spheres may have exercised a co-determining influence on this development, but the tacit pre-supposition is that these facts themselves are also only the fruits of a process of thought, and so we still remain within that realm of pure thought which has successfully digested the hardest facts.
+</blockquote>
+Although the ''term'' “false consciousness” is not found in writing until after Marx’s death, the ''concept'' underlying the term “false consciousness” is found often in the works of Marx and Engels. For instance, in ''The Holy Family,'' Marx and Engels explain how communist, class conscious workers have been able to break free of false consciousness of capitalist society:
+<blockquote>
+They (the communist workers) are most painfully aware of the difference between being and thinking, between consciousness and life. They know that property, capital, money, wage-labor and the like are no ideal figments of the brain but very practical, very objective products of their self-estrangement.
+</blockquote>
+This allusion to “the difference between being and thinking” recurs again and again in the works of Marx and Engels.
+<nowiki>*</nowiki> Lenin also discussed the concept of false consciousness extensively, and argued that dialectical materialism was the key to negating the false consciousness of the working class, writing in ''What the “Friends of the People” Are'':
+<blockquote>
+It never has been the case, nor is it so now, that the members of society conceive the sum-total of the social relations in which they live as something definite, integral, pervaded by some principle; on the contrary, the mass of people adapt themselves to these relations unconsciously, and have so little conception of them as specific historical social relations that, for instance, an explanation of the exchange relations under which people have lived for centuries was found only in very recent times. Materialism removed this contradiction by carrying the analysis deeper, to the origin of man’s social ideas themselves; and its conclusion that the course of ideas depends on the course of things is the only one compatible with scientific psychology. Further, and from yet another aspect, this hypothesis was the first to elevate sociology to the level of a science.
+</blockquote>
+Note that this convention of using the word “ideology” to mean “false consciousness” has never been common, and Marx and Engels both used the word “ideology” more often in its more usual sense of “a system of ideas,” but it is still occasionally encountered in socialist literature, as Joseph McCarney explains in ''Marx Myths and Legends'':
+<blockquote>
+Marx never calls ideology ‘false consciousness’. Indeed, he never calls anything ‘false consciousness’, a phrase that does not occur in his work... The noun is almost always accompanied by an epithet such as ‘German’, ‘republican’, ‘political’ or ‘Hegelian’, or by a qualifying phrase, as in ‘the ideology of the bourgeoisie’ or ‘the ideology of the political economist’. More typical in any case is the adjectival usage in which such varied items as ‘forms’, ‘expressions’, ‘phrases’, ’conceptions’, ‘deception’, and ‘distortion’ are said to have an ‘ideological’ character. Even more distinctive is the frequency, amounting to approximately half of all references in the relevant range, of invocations of the ‘ideologists’, the creators and purveyors of the ideological forms.
+</blockquote>
+-----
+“Relative truth” and “absolute truth” do not exist separately, but have dialectical unity with each other. On the one hand, “absolute truth” is the sum of all “relative truths.” On the other hand, in all relative truths there are always elements of absolute truth.
+Lenin wrote that “absolute truth results from the sum-total of relative truths in the course of their development; [...] relative truths represent relatively faithful reflections of an object existing independently of man; [...] these reflections become more and more faithful; [...] every scientific truth, notwithstanding its relative nature, contains an element of absolute truth.”<ref>''Materialism and Empirio-Criticism'', Vladimir Ilyich Lenin, 1908.</ref>
+Correct realization of the dialectical relationship between relative and absolute truth plays a very important role in criticizing and overcoming extremism and false consciousness in perception and in action. If we exaggerate the absoluteness of the truth of knowledge which we possess, or downplay its relativity, we will fall into the false consciousness of metaphysics, dogmatism, conservativism, and stagnation.
+-----
+==== Annotation 236 ====
+Intentional or unintentional exaggeration of the absoluteness of truth — i.e., considering our knowledge to be more complete and/or aligned with reality than it actually is — leads to incorrect viewpoints and mindsets, including:
+''Metaphysics'' is a philosophical system which seeks truth through the systematic categorization of knowledge [see Annotation 8, p. 8]. This is a flawed method of seeking knowledge because it considers truth to be essentially static and unchanging, and upholds the erroneous notion that truth can be systematically broken down into discrete, isolated categories. In addition to being fundamentally incorrect about the nature of truth and knowledge, it leads to the incorrect presumption that such static categorization of knowledge can lead to truth ''at all''. Metaphysics fails to see truth and consciousness as a ''process'', and instead sees truth as a static assembly of categorized facts and data.
+''Dogmatism'' occurs when one only accounts for commonalities and considers theory itself as the sole basis of truth. Dogmatism inherently overstates the absoluteness of knowledge, as dogmatic positions uphold certain theoretical principles as complete, inviolable, and completely developed. This explicitly denies the continuously developing process of advancing knowledge and consciousness.
+''Conservativism'' includes any position that seeks to prevent change, or to undo change to return to an earlier state of development. Such positions deny the continuous development of consciousness, knowledge, and practice, and incorrectly assert incorrect positions; or mistake relative truth for absolute truth.
+''Stagnation'' is an inability or unwillingness to change and adapt consciousness and practice in accordance with developing material conditions. Stagnation can stem from, or cause, overstatement of absolute truth in theory and forestall necessary development of both consciousness and practical ability.
+On the contrary, if we exaggerate the relativity of the truth of knowledge which we possess, or downplay its absoluteness, we will fall into relativism, thereby leading to subjectivism, revisionism, sophistry, and skepticism.
+-----
+==== Annotation 237 ====
+''Relativism'' is the belief that human consciousness can ''only'' achieve relative understanding of the world, and that truth can therefore never be objectively discovered. Relativism is, thus, the overstatement of the relative nature of truth and the denial of the existence of absolute truth. Relativism leads to such incorrect viewpoints and mindsets as:
+''Subjectivism'': which occurs when one centers one’s own self and one’s own conscious activities in perspective and worldview, failing to test their own perceptions against material and social reality [see Annotation 211, p. 205]. This position denies that truth can be discovered in the external material world, falsely believing that absolute truth stems only from conscious activity.
+''Revisionism'': a failure to recognize and accept commonalities in conscious activity, focusing only on the private [see ''Private and Common'', p. 128]. Revisionism leads to constant and unnecessary reassessment and reevaluation of both knowledge and practice. Revisionism, thus, is a position which overstates the relativity of truth and ignores truths which are more fully developed towards absoluteness.
+''Sophistry:'' the use of falsehoods and fallacious arguments to deceive [see Annotation 116, p. 118]. Sophistry is, thus, the intentional denial of truth and the intentional mischaracterization of truths as either overly relative or as not truths at all.
+''Skepticism:'' the belief that truth is essentially undiscoverable, because human consciousness is ultimately unreliable and incapable of accurately reflecting material reality [see Annotation 200, p. 192]. By denying that truth is discoverable at all, skepticism explicitly rejects absolute truth and declares that all truth is relative and unreliable.
+-----
+In addition to objectivity, absoluteness, and relativity, truth also has ''concreteness.'' The concreteness of truth refers to the degree to which a truth is attached to specific objects, in specific conditions, at a specific point in time. This means that all accurate knowledge always refers to a specific situation which involves specific subjects which exist in a specific place and time. The content of truth cannot be pure abstraction, disconnected from reality, but it is always associated with certain, specific objects and phenomena which exist in a specific space, time, and arrangement, with specific internal and external relationships. Therefore, truth is associated with specific historical conditions. This specificity to time, place, relations, etc., is what we call ''concreteness''.
+Knowledge, if detached from specific historical conditions, will fall into pure abstraction. Therefore, it will not be accurate — it will not align with reality — and such knowledge cannot be considered truth. When emphasizing this property, Lenin wrote: “Truth is always concrete, never abstract.”<ref>''Once Again On The Trade Unions,'' Vladimir Ilyich Lenin, 1921.</ref> Mastering the principle of the concreteness of truth has an important methodological significance in cognitive and practical activities. It is required that consideration and evaluation of all things and phenomena must be based on a historical viewpoint [see Annotation 114, p. 116]. In developing and applying theory, we must be conscious of specific historical conditions. According to Lenin, Marxism’s nature, its essence, lies in the concrete analysis of specific situations; Marx’s method is, above all, to consider the objective content of the historical process in a specific time.
+-----
+==== Annotation 238 ====
+In other words, Marxism is rooted in seeking truth by examining reality from a historical and comprehensive viewpoint. For more information, see Annotation 114, p. 116.
+''- The Role of Truth in Reality.''
+In order to survive and develop, humans must conduct practical activities. These activities involve transforming the environment, nature, and human society. At the same time, through these activities, humans perform — knowingly or unknowingly — the process of perfecting and developing our conscious and practical abilities. It is this process that helps human cognitive activities develop. Practical activities can only be successful and effective once humans apply accurate knowledge of objective reality to our practical activities. Therefore, truth is one of the prerequisites that ensure success and efficiency in practical activities.
+The relationship between truth and practical activities is a dialectical relationship which serves as the basis for the movement and development of both truth and practical activity: truth develops through practice, and practice develops through the correct application of truth which people have gained through practical activities.
+-----
+==== Annotation 239 ====
+[[File:t-w-the-worldview-and-philosophical-methodology-of-89.png|''Truth and Practical Activities have a dialectical relationship in which truth develops through practice, and practice develops through the correct application of truth.'']]
+Practice only develops when truth about the universe is consciously applied to practical activities. For example, farm output increases as we learn more truth about the way crops grow and how land can be properly managed. Simultaneously, truth can only be developed through practical activity, as all ideas and knowledge must be tested through methodological observation, experimentation, and other forms of practical activity.
+A ''theory'' is an idea or system of ideas intended to explain an aspect, characteristic, or tendency of objective reality. Theories are not inherently truthful; holding incorrect theories constitutes ''false consciousness''. ''Practice'' (or ''praxis'') is purposeful conscious activity which improves our understanding of the world. Theory and practice have a dialectical relationship with one another which, if understood, helps us to discover truth.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-90.png|''Truth and practical activities mutually develop one another over time.'']]
+This dialectical relationship between theory and practical activities means that we must never favor theory over practice, nor practice over theory, but that we must rather balance development of theoretical understanding as we engage in practical activities to test our knowledge against reality and to develop our practice with ever-advancing understanding of the world. As practice and theory develop one another, our understanding of objective reality comes closer and closer to truth.
+In ''Theses on Feuerbach'', Marx summarizes the relationship between theory and practice, writing:
+<blockquote>
+The problem of the external world is here put as the problem of its transformation: the problem of the cognition of the external world as an integral part of the problem of transformation: the problem of theory as a practical problem.
+</blockquote>
+Here, Marx explains that theory is concerned with solving the “problem” of transforming the external world through practice, and that “cognition of the external world” is required to solve the “problem of transformation. In other words, we must improve our theory in order to improve our practical ability to transform our world, and we learn about the world (thus improving our theory) through those practical activities.
+Marx also writes in ''Theses on Feuerbach'' that:
+<blockquote>
+The question whether objective truth can be attributed to human thinking is not a question of theory, but it is a practical question. In practice man must prove the truth, that is, the reality and power... of his thinking.
+</blockquote>
+This point is key for understanding the dialectical relationship between practice and theory: in order to be useful, theory must be ''proven through practice''. Thus, we must seek to develop our practice through theory, and our theory through practice.
+Engels summarizes these ideas a bit more colorfully in ''Socialism: Utopian and Scientific'':
+<blockquote>
+Before there was argument there was action... In the beginning was the deed ... And human action had solved the difficulty long before human ingenuity invented it. The proof of the pudding is in the eating.
+</blockquote>
+-----
+Engels wrote in ''Ludwig Feuerbach and the End of Classical German Philosophy'' of the uselessness of what might be called “pure theory,” divorced from practice, and the sort of radical skepticism which refutes that any practical knowledge can ever really be obtained by human beings:
+<blockquote>
+There is yet a set of different philosophers — those who question the possibility of any cognition, or at least of an exhaustive cognition of the world... The most telling refutation of this (scepticism and agnosticism) as of all other philosophical crotchets, is praxis, namely experiment and industry.
+</blockquote>
+It is ''practice'', according to Engels, which proves the merit and utility of theory.
+Through experiment and industry — through practical activities in the material world — we can test our ideas and dialectically develop both theory and practice. Lenin built upon these ideas in his own work, writing in ''Materialism and Empirio-Criticism'':
+<blockquote>
+The materialist theory, the theory of the reflection of objects by our mind, is here presented with absolute clarity: things exist outside us. Our perceptions and ideas are their images. Verification of these images, differentiation between true and false images, is given by practice.
+</blockquote>
+Here, Lenin explains how only a proper understanding and application of the dialectical relationship between theory and practice can lead to the negation of false consciousness [see Annotation 235, p. 231] and the dialectical development of both practice and theory. Simply arguing and debating about ideas without relating them directly to practice will never lead to truth, nor will such pure-theory argumentation develop theory or practice in any meaningful way.
+This brings to mind another line from Marx’s ''Theses on Feuerbach'':
+<blockquote>
+The dispute over the reality or non-reality of thinking that is isolated from practice is a purely scholastic question.
+</blockquote>
+The philosophy of dialectical materialism and the system of materialist dialectics are designed specifically to produce ''action'' and to avoid such “scholastic questions” and “pure-theory argumentation.”
+Ho Chi Minh summarized these ideas perhaps most clearly and precisely of all in the very title of his article: ''Practice Generates Knowledge, Understanding Advances Theory, Theory Leads to Practice:''
+<blockquote>
+Knowledge comes from practice. And through practice, knowledge becomes theory. That theory, again, has to be put into practice. Knowledge advances not just from thought to theory, but, above all, from applying theory to revolutionary practice. Once the world’s law is fully grasped as theory, it is critical to put that theory into practice by changing the world, by increasing production, and by practicing class struggle and struggling for national self-determination. This is a continuous process of obtaining knowledge.
+</blockquote>
+[[File:t-w-the-worldview-and-philosophical-methodology-of-91.png|''“If Uncle Ho says we will win, we will win!” — Propaganda poster from the 30<sup>th</sup> anniversary of the Battle of Dien Bien Phu (1984).'']]
+= Afterword =
+If it seems that this book has come to an end somewhat abruptly, it’s because this is really just the first of four major sections of the full volume from which this text is drawn. If you are reading this afterword after reading the entirety of the preceding contents, then congratulations, you have completed the equivalent to a full semester’s coursework for a class on dialectical materialist philosophy which all Vietnamese college students are required to take!
+The next sections in this curriculum, each covered in the original full volume, include:
+=== Part 2: Historical Materialism ===
+This section covers the definition and basic principles of historical materialism, which is the field of work dedicated to applying dialectical materialism and materialist dialectics to human history and human society. In the West, historical materialism and dialectical materialism are often conflated, but this is in error. Historical materialism is an ''applied field'' of dialectical materialist philosophy and materialist dialectical methodology which is used in the pursuit of understanding and interpreting human history.
+=== Part 3: Political Economy ===
+This section condenses the three cardinal volumes of ''Capital'' by Karl Marx and covers three primary doctrines:
+. The doctrine of value.
+. The doctrine of surplus value.
+. The doctrines of monopolist capitalism and state monopolist capitalism.
+Political Economy, in this course, can be considered the application of dialectical materialism and materialist dialectics to the analysis and understanding of the capitalist mode of production from the perspective of the socialist revolutionary movement.
+=== Part 4: Scientific Socialism ===
+This section relies on an established understanding of dialectical materialism, historical materialism, and political economy as a foundation for developing socialist revolution. The three chapters of this section on Scientific Socialism are:
+. The Historical Mission of the Working Class and the Socialist Revolution
+. The Primary Social-Political Issues of the Process of Building a Socialist Revolution 3. Realistic Socialism and Potential Socialism
+=== Moving Forward ===
+We are already working on the translation of Part 2 of this curriculum, and we hope to complete it as quickly as possible. In the meantime, we believe this book provides the reader with enough of a foundation to continue studying and to begin applying the principles of dialectical materialism and materialist dialectics in political struggle.
+We highly discourage readers from self-study in isolation, just as we discourage individual political action. The best way to study socialism is ''alongside other socialists''.
+Depending on where you live, you may be able to find political education resources provided by communist parties, socialist book clubs, or other organizations. If such resources aren’t available, it should be fairly easy to find study groups, workshops, and affinity groups online where you can study with like-minded comrades. Of course, socialist revolution requires more than just study, as we hope this book has thoroughly explained. Theory ''must'' be coupled with practice. As Ho Chi Minh wrote: “If you read a thousand books, but you fail to apply theory into practice, you are nothing but a bookshelf.”
+To avoid atrophying into the proverbial bookshelf, we encourage you to go out into the world and apply these ideas creatively and collectively with other socialists. Dialectical materialism is a philosophy that was developed from the ground up for ''application in the real world''. Dialectical materialism and materialist dialectics provide a functional model of reality, a way of looking at highly complicated systems, with all their dynamic internal and external relations. Dialectical materialist philosophy demands that we see human systems as processes in motion. In order to fully comprehend such dynamic processes, we must engage with them, which is why Ho Chi Minh taught that “we are not afraid to make mistakes; we would only be afraid of making mistakes if we were not determined to correct them.”<ref>''Revolutionary Ethics,'' Ho Chi Minh, December 1958.</ref>
+As we mentioned in the foreword, many socialists in the West suffer from a lack of practical ''engagement''. Far too many socialists fall into utopianism, idealism, and social chauvinism and we believe this largely stems from failures to test ideas against reality through ''praxis''. We hope that this book has impressed upon the reader that simply arguing about pure theory is a useless and futile pursuit. Indeed, sparring verbally over such “scholastic questions,” as Marx described them, is counter-productive. Marx and Engels defined such failure to engage in theory as “critical criticism” — that is to say, criticism for the sake of criticism. As Marx and Engels wrote in ''The Holy Family,'' such critical criticism is futile, as we will never ''think'' our way to revolution:
+<blockquote>
+According to Critical Criticism, the whole evil lies only in the workers’ “thinking”. It is true that the English and French workers have formed associations in which they exchange opinions not only on their immediate needs as workers, but on their needs as human beings. In their associations, moreover, they show a very thorough and comprehensive consciousness of the “enormous” and “immeasurable” power which arises from their co-operation. But these mass-minded, communist workers, employed, for instance, in the Manchester or Lyons workshops, do not believe that by “pure thinking” they will be able to argue away their industrial masters and their own practical debasement. They are most painfully aware of the difference between being and thinking, between consciousness and life. They know that property, capital, money, wage-labour and the like are no ideal figments of the brain but very practical, very objective products of their self-estrangement and that therefore they must be abolished in a practical, objective way for man to become man not only in thinking, in consciousness, but in mass being, in life. Critical Criticism, on the contrary, teaches them that they cease in reality to be wage-workers if in thinking they abolish the thought of wage-labour; if in thinking they cease to regard themselves as wage-workers and, in accordance with that extravagant notion, no longer let themselves be paid for their person. As absolute idealists, as ethereal beings, they will then naturally be able to live on the ether of pure thought.
+</blockquote>
+Engels expressed his frustration with such endless, utopian, idealist debates in ''Socialism: Utopian and Scientific'':
+<blockquote>
+Hence, from this nothing could come but a kind of eclectic, average Socialism, which, as a matter of fact, has up to the present time dominated the minds of most of the socialist workers in France and England. Hence, a mish-mash allowing of the most manifold shades of opinion: a mish-mash of such critical statements, economic theories, pictures of future society by the founders of different sects, as excite a minimum of opposition; a mish-mash which is the more easily brewed the more definite sharp edges of the individual constituents are rubbed down in the stream of debate, like rounded pebbles in a brook.
+</blockquote>
+Engels concludes by punctuating ''why'' he and Marx had developed dialectical materialism as a praxis-oriented philosophical foundation for scientific socialism: “To make a science of Socialism, it had first to be placed upon a real basis.” We hope that the readers of this text will seek out real bases for your development in theory and praxis, and we trust that you will quickly discover that developing practice develops theory, and vice-versa.
+Remember that Marx and Engels, themselves, were not just theorists who scribbled down their thoughts in an “scholarly” vacuum. They were revolutionists themselves, highly engaged in political struggle and, in so struggling, they risked their lives and freedom over the course of many decades. This struggle is what led to the change and development of their ideas over time. The same can be said for every other successful socialist revolutionary in history.
+Vo Nguyen Giap, the great general who led Vietnam’s military forces through resistance wars against fascist Japan, colonialist France, and the imperialist USA, describes how he applied such principles on the battlefield in his book ''People’s War, People’s Army'':
+<blockquote>
+During the Resistance War, owing to constant fighting, the training of our troops could not be carried out continuously for a lengthy period but only between battles or campaigns. We actively implemented the guiding principles ‘To train and to learn while we fight.’ After the difficult years at the beginning of the Resistance War, we succeeded in giving good training to our army. The practical viewpoint in this training deserves to be highlighted. The content of training became most practical and rich. Training was in touch with practical fighting: the troops were trained in accordance with the next day’s fighting, and victory or defeat in the fighting was the best gauge for the control and assessment of the result of the training. On the basis of gradual unification of the organisation and its equipment, the content of training in the various units of the regular army was also systematised step by step.
+</blockquote>
+Here, Vo Nguyen Giap has provided a concrete example of the dialectical relationship between theory and practice, and their inseparability. This fundamental aspect of dialectical materialist philosophy demands that we think and act like ''scientists'' to change the world, rather than simply speculating and imagining ineffectually like armchair philosophers. As Marx wrote in ''Theses on Feuerbach'' “Philosophers have hitherto only interpreted the world in various ways; the point is to change it.” We encourage you to apply what you learn in this and other books to ''change the world.''
+=== Advice on Further Study ===
+As you advance in your studies of socialist literature and theory, we offer the following advice:
+First, you must recognize that the specific language used by revolutionary leaders and thinkers may vary widely across time and around the world. Fashions in language develop over time, and many contributions — like the text you’ve just read — come to us through translation from countless languages. This is why we believe it critical to develop an understanding of the ''spirit'' of the ideas of any particular text, and not to get bogged down in semantics and terminology. Liberal ideologists have done much to distract and divert intellectual energy with endless metaphysical altercation over the “proper” usage of this or that word. We caution strongly against this attitude, which makes us susceptible to sophistry, opportunism, and the sewing of undue conflict and division amidst the working class. We have pointed out various instances where Marx, Engels, and Lenin used different language to describe the same concepts. We also offer the reminder that Marx, Engels, and Lenin were writing in different languages at different times, just as socialists around the world have different linguistic and cultural backgrounds. As socialism is an international movement, we must stress the importance of avoiding linguistic barriers by engaging with one another in good faith and testing conflicting ideas and interpretations of theory against one another through practice instead of getting bogged down with “critical criticism.”
+Next, we encourage students of socialist philosophy to always keep in mind that the doctrines and philosophies of revolutionary figures are products of the times and places in which they were conceived. It would be a mistake to view the works of any revolutionary figure as a road map or a set of instructions to follow by rote. Even Marx and Engels changed and developed their own ideas over the decades they were active, as they addressed in the 1872 preface to ''The Communist Manifesto'':
+<blockquote>
+The practical application of the principles will depend, as the Manifesto itself states, everywhere and at all times, on the historical conditions for the time being existing, and, for that reason, no special stress is laid on the revolutionary measures proposed at the end of Section II. That passage would, in many respects, be very differently worded today. In view of the gigantic strides of Modern Industry since 1848, and of the accompanying improved and extended organization of the working class, in view of the practical experience gained, first in the February Revolution, and then, still more, in the Paris Commune, where the proletariat for the first time held political power for two whole months, this programme has in some details been antiquated. One thing especially was proved by the Commune, viz., that “the working class cannot simply lay hold of the ready-made state machinery, and wield it for its own purposes.” (See The Civil War in France: Address of the General Council of the International Working Men’ s Association, 1871, where this point is further developed.) Further, it is self-evident that the criticism of socialist literature is deficient in relation to the present time, because it comes down only to 1847; also that the remarks on the relation of the Communists to the various opposition parties (Section IV), although, in principle still correct, yet in practice are antiquated, because the political situation has been entirely changed, and the progress of history has swept from off the earth the greater portion of the political parties there enumerated.”
+</blockquote>
+Vladimir Ilyich Lenin and Ho Chi Minh also frequently took pains to point out that their revolutionary theories were devised specifically to suit the particular objective conditions of their own respective times and places. For example, in ''What is to be Done'', Lenin discusses the question of secrecy in revolutionary activity. Lenin recognizes that secrecy is not always necessary, such as in the more liberal social democracies which existed in Europe in his era. In Russia, however — with its autocratic monarchy — material conditions called for more covert activity:
+<blockquote>
+In countries where political liberty exists the distinction between a trade union and a political organisation is clear enough, as is the distinction between trade unions and Social-Democracy. The relations between the latter and the former will naturally vary in each country according to historical, legal, and other conditions; they may be more or less close, complex, etc. (in our opinion they should be as close and as little complicated as possible); but there can be no question in free countries of the organisation of trade unions coinciding with the organisation of the Social-Democratic Party. In Russia, however, the yoke of the autocracy appears at first glance to obliterate all distinctions between the Social-Democratic organisation and the workers’ associations, since all workers’ associations and all study circles are prohibited, and since the principal manifestation and weapon of the workers’ economic struggle — the strike — is regarded as a criminal (and sometimes even as a political!) offence.”
+</blockquote>
+Ho Chi Minh was even more explicit about the requirement to tailor theory to current and local material conditions in a speech to the Communist Party of Vietnam in 1950:
+<blockquote>
+Studying Marxism-Leninism is not just a matter of repeating the slogan ‘workers of the world, unite’ like a parrot. We must unify Marxism-Leninism with the reality of Vietnam’s revolution. Talking about Marxism-Leninism in Vietnam is talking about the specific guidelines and policies of the Communist Party of Vietnam. For example, our priority now is: great solidarity!
+</blockquote>
+In a 2001 document, the Communist Party of Vietnam explained how Ho Chi Minh tailored lessons learned from prior revolutionaries to the specific material conditions of revolutionary Vietnam:
+<blockquote>
+Ho Chi Minh’s thought is... the creative application and development of Marxism-Leninism to the specific conditions of our country. Ho Chi Minh learned profound lessons from Lenin and the Russian October Revolution, but he did not simply use those lessons as a template, nor did he just copy that foundation. Instead, he absorbed the spirit of Marxism-Leninism. Lenin’s thesis allowed Ho Chi Minh to see what was necessary for the Vietnamese people — the path of national liberation. Ho Chi Minh had creative arguments that contributed to enriching Marxism-Leninism in the issue of national liberation revolution, building a new democratic regime and the transitional path to socialism in an Eastern, semi-feudal colony which was still very backward: Vietnam.
+</blockquote>
+As you find your own revolutionary path, you must carefully examine the objective conditions of your own time and place, and work collectively and collaboratively with your fellow revolutionists to decide how theory and lessons gleaned from history apply to your own circumstances. And, of course, you must test the validity of your conclusions against reality through ''practice''.
+=== Creative Application of Dialectical Materialism and Materialist Dialectics ===
+Finally, we implore you to apply dialectical materialism ''creatively''. Don’t look at this (or any other) book as a set of static instructions. Dialectical materialism and materialist dialectics are living, breathing systems of thought which benefit from the ideas and imagination of comrades working and struggling together. Seek the ''spirit'' of these ideas, study revolutionary theory and history, then ''apply'' what you learn in your daily life. Combat dogmatism and avoid arguments over pure theory. Determine what works and what doesn’t through activity in the real world, and apply what you learn from practical experience to your theoretical development. Over time, you will begin to see how practice and theory impact and develop one another. When you are struggling with a particular problem in revolutionary practice, you will find yourself reading theory in a new light, discovering information and ideas which might be applicable to your immediate circumstances. And as you study theory, you will find that it also impacts your practice, giving you tools and perspective and methodologies for action which you might never have imagined on your own.
+We have tried to make this book a useful companion for further study. We have also made the digital version available for free online. If you have found it useful, we hope you will share it freely and widely.
+=== In Closing ===
+One last time we would like to thank Dr. Vijay Prashad and Dr. Taimur Rahman for their wonderful insights on our translation, and to acknowledge the monumental work of the Vietnamese scholars who wrote and revised the original text from which this volume is drawn. We also want to recognize once more the donors and supporters who have given us the precious resource of time to translate and annotate this work. Finally, we want to thank the teams at the Iskra Books and The International Magazine, who have provided invaluable editing and peer review services, promotion, and guidance. You can find all their publications, respectively, at:
+IskraBooks.org
+InternationalMagz.com
+If you would like to download the free digital version of this book, support future translation work, or if you would like to get in touch, you can visit our website:
+BanyanHouse.org
+We will leave you, now, with the immortal words of the Manifesto:
+'''Workers of the world, unite!'''
+You have nothing to lose but your chains.
+=== In Solidarity, ===
+''-'' ''Luna Nguyen, Translator &amp; Annotations''
+''-'' ''Emerican Johnson, Editor, Illustrator, &amp; Annotations''
+[[File:t-w-the-worldview-and-philosophical-methodology-of-92.jpg|''“Marxism-Leninism — Long Live the Victories” — a demonstration to welcome the liberation army in the South of Vietnam on April 30, 1975.'']]
+<br />
+= [Appendices] =
+== Appendix A: Basic Pairs of Categories Used in Materialist Dialectics ==
+This is a summary of the basic pairs of universal categories and their characteristics which are discussed in depth starting on p. 126.
+{|
+| | '''Private'''
+| '''Common'''
+|
+|-
+| | A specific item, event, or process.
+| The properties that are shared between Private things, phenomena, and ideas.
+|
+|}
+''Private'' is commonly referred to in literature as ''Special/Specific'' while ''Common'' is commonly called ''General''. ''Note:'' When an aspect or characteristic is not held in common with anything else in existence, it is considered ''Unique''. The Unique can become Common, just as the Common can become Unique. Example: a Unique design for an object may be replicated, making it Common. A type of item that is Common may gradually disappear until there is only one example left, making it Unique. ''See p. 128.''
+{|
+| | '''Reason'''
+| '''Result'''
+|
+|-
+| | Mutual impact between things, phenomena, or ideas which causes each to change.
+| The change caused by a Reason.
+|
+|}
+''Reason'' and ''Result'' may be referred to as ''Cause'' and ''Effect'', respectively, though this should lead to confusion with metaphysical conceptions of cause and effect. ''Note:'' Reasons can be Direct or Indirect. ''See p. 138''
+{|
+| | '''Obviousness'''
+| '''Randomness'''
+|
+|-
+| | Refers to events that always and predictably happen due to factors of internal material structure.
+| Events caused by external impacts and interactions which are thus not completely predictable.
+|
+|}
+''Obvious'' may be referred to as ''Necessary,'' while ''Randomness'' may be referred to as ''Accidental. See p. 145.''
+{|
+| | '''Content'''
+| '''Form'''
+|
+|-
+| | What something is made of.
+| The shape that contains content.
+|
+|}
+Ways in which Content and Form are discussed and perceived can can vary wildly depending on the subject being discussed and the viewpoint from which the subject is being considered. ''See p. 145.''
+{|
+| | '''Essence'''
+| '''Phenomena'''
+|
+|-
+| | Features that make something develop a certain way.
+| The expression of the essence in certain conditions.
+|
+|}
+''See p. 156.''
+{|
+| | '''Possibility'''
+| '''Reality'''
+|
+|-
+| | What may happen, or might exist, in the future, if certain developments take place.
+| What is happening, or what exists, at the present moment.
+|
+|}
+''See p. 160.''
+== Appendix B: the Two Basic Principles of Dialectical Materialism ==
+'''The Principle of General Relationships''' This principle states that:
+“Materialist dialectics upholds the position that all things, phenomena, and ideas exist in mutual relationships with each other, regulate each other, transform into each other, and that nothing exists in complete isolation.”
+From this Principle, we find the characteristics of ''Diversity in Unity'' and ''Unity in Diversity''; the basis of Diversity in Unity is the fact that every thing, phenomenon, and idea contains many different relationships; the basis of Unity in Diversity is that many different relationships exist — unified — within each and every thing, phenomenon, and idea.
+'''''The Characteristic of Diversity in Unity''''' is derived from the fact that there exist an infinite number of diverse relationships between things, phenomena, and ideas, but all of these relationships share the same foundation in the material world.
+'''''The Characteristic of Unity in Diversity''''' is derived from the fact that when we examine the universal relationships that exist within and between all different things, phenomena, and ideas, we will find that each individual manifestation of any universal relationship will have its own different manifestations, aspects, features, etc. Thus even the universal relationships which unite all things, phenomena, and ideas exist in infinite diversity.
+'''The Principle of Development''' This principle states that:
+'''“'''Development is a process that comes from within the thing-in-itself; the process of solving the contradictions within things and phenomena. Therefore, development is inevitable, objective, and occurs without dependence on human will.”
+'''''The Characteristic of Objectiveness of Development''''' stems from the origin of motion. Since motion originates from mutual impacts which occur between external things, objects, and relationships, the motions themselves also occur externally (relative to all other things, phenomena, and objects). This gives motion itself objective characteristics.
+'''''The Characteristic of Generality of Development''''' stems from the fact that development occurs in every process that exists in every field of nature, society, and human thought; in every thing, every phenomenon, and every process and stage of these things and phenomena.
+'''''The Characteristic of Diversity of Development''''' stems from the fact that every thing, phenomenon, and idea has its own process of development that is not totally identical to the process of development of any other thing, phenomenon, or idea.
+== Appendix C: the Three Universal Laws of Materialist Dialectics ==
+=== The Law of Transformation Between Quantity and Quality ===
+The law of transformation between quantity and quality is a universal law which concerns the universal mode of motion and development processes of nature, society, and human thought. The law was formulated by Friedrich Engels in ''Dialectics of Nature'', and states that:
+“In nature, in a manner exactly fixed for each individual case, qualitative changes can only occur by the quantitative addition or subtraction of matter or motion.” ''See more on p. 163.''
+=== The Law of Unification and Contradiction Between Opposites ===
+The law of unification and contradiction between opposites is the essence of dialectics. It states, as formulated by V. I. Lenin in ''Summary of Dialectics'':
+“The fundamental, originating, and universal driving force of all motion and development processes is the inherent and objective contradiction which exists in all things, phenomena, and ideas.” ''See more on p. 175.''
+=== The Law of Negation of Negation ===
+The law of negation of negation describes the fundamental and universal tendency of movement and development to occur through a cyclical form of development through what is termed “negation of negation.” Formulated by Friedrich Engels in ''Anti-Dühring,'' it states:
+“The true, natural, historical, and dialectical negation is (formally) the moving source of all development--the division into opposites, their struggle and resolution, and what is more, on the basis of experience gained, the original point is achieved again (partly in history, fully in thought), but at a higher stage.” ''See more on p. 185.''
+== Appendix D: Forms of Consciousness and Knowledge ==
+''Consciousness'' refers to the self-aware, productive, and creative motion and activity of the human brain. Practical activity is the most direct basis, motive, and purpose of consciousness, and is the criterion for testing truth. See: ''The Relationship Between Praxis and Consciousness'', p. 216.
+''Knowledge'' is the content of consciousness. Knowledge includes data about the world, such as ideas, memories, and other thoughts which are derived by direct observation and practical activities in the material world, through scientific experiments, or through abstract reflection of practical and scientific activities which occur within consciousness.
+Consciousness and Knowledge have a dialectical relationship with one another: knowledge is developed within consciousness, and consciousness develops to higher levels as knowledge is accumulated and tested against reality (which also develops knowledge itself). In this manner, consciousness and knowledge develop into higher forms over time in individual consciousness and human society. Thus, consciousness and knowledge can be considered as existing in various forms which represent stages of development in dialectical processes of development.
+Note that the development processes of knowledge and consciousness are dialectical in nature, not linear. For example, after empirical consciousness develops into theoretical consciousness, theoretical consciousness will then impact empirical consciousness, developing empirical consciousness into a higher stage of development. This is true for all development processes related to empirical and theoretical consciousness. These development processes and forms of consciousness and knowledge are explained in more detail in Chapter 3: Cognitive Theory of Dialectical Materialism, starting on page 204.
+=== Forms of Consciousness ===
+Consciousness is a process of the development of knowledge through a combination of human brain activity and human practical activity in the physical world (i.e., labor). The development of consciousness can be considered on the criteria of ''concrete/abstract'' and of ''passive/active''. For more information, see Annotation 216, p. 210.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-99.png]]
+[[File:t-w-the-worldview-and-philosophical-methodology-of-100.png]]
+=== The Cognitive Process ===
+The Cognitive Process is a model developed by Vladimir Ilyich Lenin which represents the dialectical path of consciousness to truth. For more information, see ''Dialectical Path of Consciousness to Truth'' on page 219.
+[[File:t-w-the-worldview-and-philosophical-methodology-of-101.png]]
+=== Forms of Knowledge ===
+''For more information see Annotation 218, p. 214.''
+[[File:t-w-the-worldview-and-philosophical-methodology-of-102.png]]
+== Appendix E: Properties of Truth ==
+Truth is the alignment of consciousness with objective reality. All truths are objective, relative, absolute, and concrete. Truths also have characteristics of concreteness and abstractness.
+'''Objectivity:''' The content of truth is external to the subjective will of human beings. The content of knowledge must be aligned with objective reality, not vice versa. This means that the content of accurate knowledge is not a product of pure subjective reasoning but is objective in nature.
+'''Absoluteness:''' Absolute truth<ref>Note: Absolute Truth in dialectical materialist philosophy should not be confused with Hegel’s conception of Absolute Truth as a final point at which human consciousness will have achieved absolute, complete, and final understanding of our universe.</ref> is derived from the complete alignment between objective reality and human consciousness. The possibility of acquiring absolute truth in the process of the development of conscious understanding is theoretically limitless. However, in reality, our conscious ability to reflect reality is limited by the specific material conditions of each generation of humanity, of practical limitations, and by the spatial and temporal conditions of reflected subjects. Therefore, truth is also ''relative''.
+'''Relativity:''' Relative truth is truth which has developed alignment with reality without yet having reached ''complete'' alignment. To put it another way, relative truth represents knowledge which incompletely reflects material subjects without complete accuracy. In relative truth, there is only partial alignment — in some (but not all) aspects — between consciousness and the material world.
+'''Dialectical Relationship Between Absolute and Relative Truth:''' Relative truth and absolute truth do not exist separately, but have dialectical unity with each other. On the one hand, “absolute truth” is the sum of all “relative truths.” On the other hand, in all relative truths there are always elements of absolute truth.
+'''Concreteness:''' The concreteness of truth refers to the degree to which a truth is attached to specific objects, in specific conditions, at a specific point in time. This means that all accurate knowledge always refers to a specific situation which involves specific subjects which exist in a specific place and time. The content of truth cannot be pure abstraction, disconnected from reality, but it is always associated with certain, specific objects and phenomena which exist in a specific space, time, and arrangement, with specific internal and external relationships. Therefore, truth is associated with specific historical conditions. This specificity to time, place, relations, etc., is ''concreteness''.
+'''Abstractness:''' Abstract knowledge is knowledge which is not attached (or less attached) to specific times, places, relations, etc. Some degree of abstraction is necessary to develop theoretical understanding of general laws and the nature of objective reality, but care should be taken knowledge does not become completely detached from specific historical conditions, as this will result in ''pure abstraction''. Knowledge which is purely abstract will not align with reality, and such knowledge cannot be considered truth.
+== Appendix F: Common Deviations From Dialectical Materialism ==
+Throughout the history of the development of dialectical materialism and materialist dialectics, there have been many philosophical and methodological deviations which have derived from incorrect analysis, interpretation, and a failure to properly link theory and practice. Below are descriptions of some of the more common deviations which the reader should be aware of.
+'''Bureaucracy:''' An expression of ''dogmatism'' which arises when theory becomes overly formalized, to the extent that practical considerations are ignored in favor of codified theory.
+'''Conservativism:''' A mindset which seeks to prevent and stifle development and to hold humanity in a static position. Not only is this detrimental to humanity, it is also ultimately a wasted effort, because development is inevitable in human society, as in all things, phenomena, and ideas.
+'''Dogmatism:''' A breakdown of the dialectical relationship between theoretical consciousness and empirical consciousness, which arrests the development process of knowledge and consciousness. Usually the result of: failure to seek commonalities; considering theory itself as the sole basis of truth rather than practice; ignoring practical experience and considering pre-established theory, alone, as unalterable truth.
+'''Eclecticism:''' An approach to philosophical inquiry which attempts to draw from various different theories, frameworks, and ideas to attempt to understand a subject; the philosophical error of inconsistently applying different theories and principles in different situations. Empiricism: A broad philosophical position which holds that only experience (including internal experience) can be held as a source of knowledge or truth. Though nominally opposed to idealism, it is considered a faulty (or naive) form of materialism, since it sees the world as only unconnected, static appearances and ignores the reality of dialectical (changing) relationships between objects.
+'''Idealism:''' A philosophical position which holds that the only reliable experience of reality occurs within human consciousness. Idealists believe that relying on human reason exclusively or as a first basis is the best way to seek truth. Various forms of idealism exist, broadly broken down into subjective idealism, which denies the existence of an external objective world, and objective idealism, which accepts that an external objective world exists, but denies that knowledge can be reliably gained about it through sense perception.
+'''Opportunism:''' A system of political opinions with no direction, no clear path, no coherent viewpoint, leaning on whatever is beneficial for the opportunist in the short term.
+'''Revisionism:''' A failure to recognize and accept commonalities in conscious activity, focusing only on the private. Revisionism leads to constant and unnecessary reassessment and reevaluation of both knowledge and practice. Revisionism, thus, is a position which overstates the relativity of truth and ignores truths which are more fully developed towards absoluteness.
+'''Rigidity:''' An unwillingness to alter one’s thoughts, holding too stiffly to established consciousness and knowledge, and ignoring practical experience and observation, which leads to stagnation of both knowledge and consciousness.
+'''Skepticism:''' The belief truth is essentially undiscoverable, because human consciousness is ultimately unreliable and incapable of accurately reflecting material reality. By denying that truth is discoverable at all, skepticism explicitly rejects absolute truth and declares that all truth is relative and unreliable. Solipsism: A form of idealism in which one believes that the self is the only basis for truth. As Marxist ethicist Howard Selsam wrote in ''Ethics and Progress: New Values in a Revolutionary World'': “If I believe that I alone exist and that you and all your arguments exist only in my mind and are my own creations then all possible arguments will not shake me one iota. No logic can possibly convince [the] solipsist.”
+'''Sophistry:''' The use of falsehoods and misleading arguments, usually with the intention of deception, and with a tendency of presenting non-critical aspects of a subject matter as critical, to serve a particular agenda. The word comes from the Sophists, a group of professional teachers in Ancient Greece, who were criticized by Socrates (in Plato’s dialogues) for being shrewd and deceptive rhetoricians. This kind of bad faith argument has no place in materialist dialectics. Materialist dialectics must, instead, be rooted in a true and accurate understanding of the subject, material conditions, and reality in general.
+'''Subjectivism:''' The centering of one’s own self and conscious activities in perspective and worldview, failing to test one’s own perceptions against material and social reality. Subjectivists tend to believe that they can independently reason their way to truth in their own minds without practical experience and activity in the material world.
+'''Utilitarianism:''' An ethical philosophical theory founded by Jeremy Bentham which seeks to maximize “utility,” which is considered to be a metaphysical property embodying “benefit, advantage, pleasure, good, or happiness.” Karl Marx dismissed utilitarianism as overly abstract, in that it reduces all social relationships to the single characteristic of “utility.” He also viewed utilitarianism as metaphysically static and tied to the status quo of current society, since utilitarianism does not address class dynamics and views all relations in the current status quo of society, making utilitarianism an essentially conservative theory. Marx also pointed out that Utilitarianism essentially views individuals as private individuals, not as social individuals, and seeks to work out solutions to the practical problems of human society through reasoning alone without examining material conditions and processes, and without taking into consideration practice and development, writing:
+<blockquote>
+“The whole criticism of the existing world by the utility theory was... restricted within a narrow range. Remaining within the confines of bourgeois conditions, it could criticise only those relations which had been handed down from a past epoch and were an obstacle to the development of the bourgeoisie... the economic content gradually turned the utility theory into a mere apologia for the existing state of affairs, an attempt to prove that under existing conditions the mutual relations of people today are the most advantageous and generally useful.”
+</blockquote>
+= [Back Matter] =
+== Glossary &amp; Index ==
+{|
+| | '''Absolute Truth'''
+| Absolute Truth can refer to:<br />
+<br />
+. The recognition that objective and accurate truth can be drawn from sense perception of the material world along with labor and practice activities in the material world. The opposite of this position is Relativism. See p. 56, 94, 194, 228–229, 232–234.<br />
+<br />
+. Hegel’s notion of Absolute Truth: that there will eventually be some end point of to the process of rational consciousness at which point humanity will arrive at a final stage of knowledge and consciousness. See p. 228.<br />
+<br />
+See also: Relative Truth, Relativism, Stagnation, Truth.
+|
+|-
+| | '''Absolutization'''
+| To hold a belief or supposition as always true in all situations and without exception. See p. 49.
+|
+|-
+| | '''Abstract Labor'''
+| The abstract conception of expenditure of human energy in the form of labor, without taking into account the value of labor output. When the value of labor output ''is'' taken into consideration, it is referred to as ''concrete labor''. See p. 15, 17.
+|
+|-
+| | '''Adam Smith'''
+| (1723–1790) British logic professor, moral philosophy professor, and economist. Along with David Ricardo, Adam Smith was one of the founders of ''political economy'', which Marx both drew from and critiqued in his analysis and critique of capitalism. See p. 14, 155.
+|
+|-
+| | '''Ahistoric Perspective'''
+| A perspective which considers aspects of human society without due consideration of historical processes of development. For example, Adam Smith and David Ricardo viewed political economy ahistorically, viewing capitalism as a static, universal, and eternal product of natural law rather than seeing capitalism as a product of historical processes of development which would change and develop over time. See p. 116.
+|
+|-
+| | '''Base'''
+| Also known as: Economic Base; Economic Basis. The material processes which humans undertake to survive and transform our environment to support our ways of living. In the dialectical relationship between base and ''superstructure'', the base refers to the relationship which humans have with the means of production, including the ownership of the means of production and the organization of labor. See p. 23. See also: Superstructure.
+|
+|-
+| | '''Biological Motion'''
+| One of the five basic forms of motion described by Engels in ''Dialectics of Nature''. Biological motion refers to changes and development within living objects and their genetic structure. See p. 61.
+|
+|-
+| | '''Biological Reflection'''
+| A complex form of reflection found within organic subjects in the natural world and expressed by ''excitation'', ''induction'', and ''reflexes''. See p. 65.
+|
+|-
+| | '''Bourgeoisie'''
+| The owners of the means of production and the ruling class under capitalism; also known as the capitalist class. See p. 3, 23, 30, 41, 50, 63, 96. See also:<br />
+<br />
+Proletariat, Petty Bourgeoisie.
+|
+|-
+| | '''Bureaucracy'''
+| An expression of dogmatism which arises when theory becomes overly formalized, to the extent that practical considerations are ignored in favor of codified theory. See p. 217–218.<br />
+C→→M→→C C = A Commodity<br />
+M = The Money Commodity<br />
+The mode of circulation described by Marx as occurring under pre-capitalist economies of simple exchange, in which the producers and consumers of commodities have a direct relationship to the commodities which are being bought and sold. The sellers have produced the commodities with their own labor, and they directly consume the commodities which they purchase. See also: M→C→M’<br />
+Marx called this mode of circulation “simple commodity production.” See p. 16.
+|
+|-
+| | '''Capitalism'''
+| The current stage of human political economy, defined by private ownership of the means of production. ''Referenced throughout.''
+|
+|-
+| | '''Capitalist Class'''
+| See: Bourgeoisie
+|
+|-
+| | '''Capitalist Commodity Production'''
+| The capitalist mode of production which utilizes the M→C→M’ mode of circulation, in which capitalists own the means of production and pay wages to workers in exchange for their labor, which is used to produce commodities. Capitalists then sell these commodities for profits which are not shared with the workers who provided the labor. See p. 15.
+|
+|-
+| | '''Category'''
+| The most general grouping of aspects, attributes, and relations of things, phenomena, and ideas. Different specific fields of inquiry may categorize things, phenomena, and/or ideas differently from one another. See p. 126.
+|
+|-
+| | '''Category Pair'''
+| A pair of philosophical categories within materialist dialectics. Materialist dialectics tend to focus on ''universal category pairs'' which can be used to examine the characteristics, relations, and development of all things, phenomena, and ideas. Examples of category pairs include: private and common; content and form; reason and result; essence and phenomena. See p. 127.
+|
+|-
+| | '''Characteristics'''
+| The features and attributes that exist internally — within — a given thing, phenomena, or idea. See p. 115.
+|
+|-
+| | '''Chemical Motion'''
+| Changes of organic and inorganic substances in processes of combination and separation. See p. 61.
+|
+|-
+| | '''Chemical Reflection'''
+| The reflection of mechanical, physical, and chemical changes and reactions of inorganic matter (i.e., changes in structures, position, physical-chemical properties, and the processes of combining and dissolving substances). See p. 65–66.
+|
+|-
+| | '''Circulation'''
+| The way in which commodities and money are exchanged for one another. See p. 16.
+|
+|-
+| | '''Commodity'''
+| In Marxist political economy, commodities include anything which can be bought and sold, with both a use value (i.e. it satisfies a need of any kind) and a value-form (aka. ‘Exchange value’ and understood as the average socially necessary labour time needed to produce this object). Under capitalism, more and more human activity and production is ‘commodified’ (mediated through market exchange). See p. 15, 87, 133.
+|
+|-
+| | '''Common'''
+| See: Private and Common
+|
+|-
+| | '''Common Laws'''
+| Laws (of nature and/or human society) that are applicable to a broader range of subjects than ''private laws'', and which impact many different subjects. For instance: the law of preservation of mass, the law of preservation of energy, etc. See p. 162.
+|
+|-
+| | '''Comprehensive Viewpoint'''
+| A ''viewpoint'' which seeks to consider the internal dialectical relationships between the component parts, factors, and aspects within a thing or phenomenon, and which considers external mutual interactions with with other things, phenomena, and ideas. Dialectical materialist philosophy demands a comprehensive basis in order to fully and properly understand things and phenomena in order to effectively solve problems in real life and develop humanity towards communism. See p. 115, 172, 235.
+|
+|-
+| | '''Conception'''
+| A relatively complete ''reflection'' within human consciousness of objective things and phenomena. See p. 221–22.
+|
+|-
+| | '''Concrete Labor'''
+| The production of a specific commodity with a specific value through labor. When labor is considered without the consideration of output value, it is referred to as ''abstract labor''. See p. 15, 17.
+|
+|-
+| | '''Conditioned Reflex'''
+| Conditioned reflexes are reactions which are learned by organisms. These responses are acquired as animals associate previously unrelated neural stimuli with a particular reaction. See p. 66, 68.
+|
+|-
+| | '''Consciousness'''
+| The dynamic and creative reflection of the objective world in human brains; the subjective image of the objective world which is produced by the human brain. See p. 68–69, 70.
+|
+|-
+| | '''Content'''
+| See: Content and Form.
+|
+|-
+| | '''Content and Form (Category Pair)'''
+| Content is the philosophical category which refers to the sum of all aspects, attributes, and processes that a thing, phenomenon, or idea is made from. The Form category refers to the mode of existence and development of things, phenomena, and ideas. Form thus describes the system of relatively stable relationships which exist internally within things, phenomena, and ideas.<br />
+<br />
+Content and Form have a dialectical relationship with one another, in which content determines form and form impacts back on content. See p. 115, 147155, 166.
+|
+|-
+| | '''Contradiction'''
+| A contradiction is a relationship in which two forces oppose one another, leading to mutual development. See p. 123, 159, 163, 169, 175–191.
+|
+|-
+| | '''Consciousness'''
+| The self-aware, productive, creative motion and activity of the human brain. See p. 216, 249.
+|
+|-
+| | '''Conservativism'''
+| Also referred to as Prejudice; a mindset which seeks to prevent and stifle development and to hold humanity in a static position. Not only is this detrimental to humanity, it is also ultimately a wasted effort, because development is inevitable in human society, as in all things, phenomena, and ideas. See p. 125, 233.
+|
+|-
+| | '''David Hume'''
+| (1711 — 1776) Scottish philosopher who developed radical skepticism as a philosophy of empiricist rejection of human knowledge. See p. 11, 29, 56, 7273.
+|
+|-
+| | '''David Ricardo'''
+| (1772 — 1823) British economist who, along with Adam Smith, was one of the key figures in the development of Political Economy which was a basis for much of the work of Marx and Engels. See p. 14, 18, 155.
+|
+|-
+| | '''Deductive Inference'''
+| Logical inference which extrapolates from the general to the specific. See p. 224.
+|
+|-
+| | '''Definition'''
+| The first phase of rational consciousness. During this phase, the mind begins to interpret, organize, and process the basic properties of things and phenomena at a rational level into a conceptual whole. See p. 224.
+|
+|-
+| | '''Development'''
+| The change and motion of things, phenomena, and ideas with a forward tendency: from less advanced to more advanced; and/or from a less complete to a more complete level. See p. 38, 45–46, 52, 55, 61, 65, 76–96, 105–107, 114118, 119–127, 131–132, 138–140, 143, 147, 154, 155–165, 169–175, 177–181, 183–207, 210, 213, 216–223, 225–229, 233, 235–237.
+|
+|-
+| | '''Development Viewpoint'''
+| A viewpoint which considers that, in order to perceive or solve any problem in real life, we must consider all things, phenomena, and ideas with their own forward tendency of development taken in mind.
+|
+|-
+| | '''Dialectic; Dialectical; Dialectics'''
+| In Marxism-Leninism, the term dialectic (adjective: dialectical) refers to regular and mutual relationships, interactions, transformations, motions, and developments of things, phenomena, and processes in nature, society and human thought. “Dialectics” refers to a dialectical system. See p. 3, 9–11, 47.
+|
+|-
+| | '''Dialectical Materialism'''
+| A universal philosophical and methodological system which forms the theoretical core of a scientific worldview. Dialectical Materialism was first developed by Karl Marx and Friedrich Engels with the express goal of achieving communism. Dialectical Materialism has since been defended and developed by Vladimir Ilyich Lenin as well as many others. See: p. 3, 6, 1011, 19–21, 27–30, 33, 38, 45–47, 48–97, 101, 104, 204, 209, 226, 228, 230–232, 237.
+|
+|-
+| | '''Dialectical Negation'''
+| A stage of development in which a new subject arises from a contradiction between two previous subjects; dialectical negation is never an endpoint of development, as every dialectical negation creates conditions for further development and negation. See p. 123, 175–176, 183, 185–195, 197–202, 227.
+|
+|-
+| | '''Dialectical Relationship'''
+| A relationship in which two things, phenomena, or ideas mutually impact one another, leading to development and negation. See p. 47, 51, 62.
+|
+|-
+| | '''(Characteristic of) Diversity'''
+| The characteristic which all things, phenomena, and ideas share, dictating that no two subjects (and no two relationships between any two subjects) are exactly the same, even if they exist between very similar things, phenomena, and ideas and/or in very similar situations. See p. 114–115, 125.
+|
+|-
+| | '''Diversity in Unity'''
+| The universal principle which states that even though all relationships are diverse and different from one another, they also exist in unity, because all relationships share a foundation in the material world. See p. 109–110, 125, 130.
+|
+|-
+| | '''Dogmatism'''
+| An inflexible adherence to ideals as incontrovertibly true while refusing to take any contradictory evidence into consideration. Dogmatism stands in direct opposition to materialist dialectics, which seeks to form opinions and conclusions only after careful consideration of all observable evidence. See p. 136–137, 174, 217–218, 233.
+|
+|-
+| | '''Duality of Labor'''
+| The Marxist economic concept which recognizes labor as having two intrinsic and inseparable aspects: abstract labor and concrete labor. See p. 15.
+|
+|-
+| | '''Dynamic and Creative Reflection'''
+| The most advanced form of reflection, which only occurs in matter that has the highest (known) level of structural complexity, such as the human brain. See p. 68–69, 79.
+|
+|-
+| | '''Eclecticism'''
+| An approach to philosophical inquiry which attempts to draw from various different theories, frameworks, and ideas to attempt to understand a subject; the philosophical error of inconsistently applying different theories and principles in different situations. See p. 32–33, 101, 118, 192, 194.
+|
+|-
+| | '''Economic Base'''
+| See: Base
+|
+|-
+| | '''Economism'''
+| Economism is a style of political activism, typified by the ideas of German political theorist Eduard Bernstein, which stresses directing the struggle towards short-term political/economic goals (such as higher wages for workers) at the expense of the larger socialist revolutionary project. See p. 30.
+|
+|-
+| | '''Eduard Bernstein'''
+| (1850 — 1932) German political theorist who rejected many of Marx’s theories. See p. 30, 174.
+|
+|-
+| | '''Emotional Consciousness'''
+| The lower stage of the cognitive process. In this stage of cognitive development, humans, through practical activities, use our senses to reflect objective things and phenomena (with all their perceived specific characteristics and rich manifestations) in human consciousness. See p. 219224.
+|
+|-
+| | '''Empirical Consciousness'''
+| Empirical consciousness is the stage of development of consciousness in which perceptions are formed via direct observations of things and phenomena in the natural world, or of society, or through scientific experimentation and systematic observation. Empirical Consciousness results in Empirical Knowledge. See p. 210–214.
+|
+|-
+| | '''Empirical Knowledge'''
+| Knowledge which results from processes of empirical consciousness and which is characterised by rich and detailed, but still incomplete, understanding of phenomena. It can be utilized for practical ends, but still falls short of full theoretical analysis and comprehension. See p. 212–214.
+|
+|-
+| | '''Empiricism'''
+| A broad philosophical position which holds that only experience (including internal experience) can be held as a source of knowledge or truth. Though nominally opposed to idealism, it is considered a faulty (or naive) form of materialism, since it sees the world as only unconnected, static appearances and ignores the reality of dialectical (changing) relationships between objects. See p. 9–12, 29, 94, 96–97, 100, 218.
+|
+|-
+| | '''Empirio-criticism'''
+| A more developed form of empiricism, proposed by Ernst Mach, which holds that sense data and experience are the sole sources of knowledge and that no concrete knowledge of the external material world can ever be obtained due to the limitations of human senses. See p. 26–29, 32, 54, 55–57, 68.
+|
+|-
+| | '''Epistemology'''
+| The theoretical study of knowledge. It primarily deals with the philosophical question of: “how do we know what we know?” See p. 45, 98, 204.
+|
+|-
+| | '''Ernst Mach'''
+| (1838 — 1916) Austrian physicist who attempted to build a philosophy of natural science based on the works of German philosopher Richard Avenarius’ philosophical system of Empirio-Criticism. See p. 27–29, 32, 52, 72, 193.
+|
+|-
+| | '''Equilibrium'''
+| A state of motion in which one or more subjects are not undergoing changes in position, form, and/or structure. Equilibrium is only ever a temporary stasis of development which will eventually yield to motion, development, and/or negation. See p. 62–63, 122–123, 181.
+|
+|-
+| | '''Essence'''
+| See: Essence and Phenomena
+|
+|-
+| | '''Essence and Phenomena (Category Pair)'''
+| The Essence category refers to the synthesis of all the internal aspects as well as the obvious and stable relations that define the existence, motion and development of things and ideas. The Phenomena category refers to the external manifestation of those internal aspects and relations in specific conditions. Essence always determines which phenomena appear, but phenomena do not always accurately reflect essence in human perception; in other words, it is possible to misinterpret phenomena, leading to a misunderstanding of essence, or to mistake phenomena for essence. See p. 156–160.
+|
+|-
+| | '''Exchange Value'''
+| A quantity relationship which describes the ratios of exchangeability between different commodities, with Marx’s famous example of 20 yards of linen being equivalent in exchange value to one coat. Through analysis Marx shows that in reality the thing being compared is the amount of socially necessary labour required to make the commodities being compared. See p. 15, 18.
+|
+|-
+| | '''Excitation'''
+| Reactions of simple plant and animal life-forms which occur when they change position or structure as a direct result of physical changes in their habitat. See p. 66, 68.
+|
+|-
+| | '''External Contradictions'''
+| See: Internal and External Contradictions.
+|
+|-
+| | '''False consciousness'''
+| Forms of consciousness (ideas, thoughts, concepts, etc.) which are incorrect and misaligned from reality. Equated with ‘ideology’ by Engels, it refers to an idealistic, dogmatic perspective which will inevitably result in errors of analysis and therefore practice. See p. 231–233, 237.
+|
+|-
+| | '''First International'''
+| Also known as the International Workingmen’s Association; was founded in London and lasted from 1864–1876. Karl Marx and Friedrich Engels were key figures in the foundation and operation of this organization, which sought better conditions and the establishment of rights for workers. See p. 35
+|
+|-
+| | '''(Basic) Forms of Motion'''
+| Engels broke motion down into five basic forms which are dialectically linked; the different forms of motion differ from one another, but they are also unified with each other into one continuous system of motion. Understanding this dialectical relationship between different forms of motion helped to overcome misunderstandings and confusion about motion and development. See p. 61–62.
+|
+|-
+| | '''Form'''
+| See: Content and Form.
+|
+|-
+| | '''Form of existence of matter'''
+| The ways in which we perceive the existence of matter in our universe; specifically, matter in our universe has the form of existing in space and time. See p. 59.
+|
+|-
+| | '''Form of Value'''
+| See: Value-Form
+|
+|-
+| | '''Forward Tendency of Motion'''
+| The tendency for things, phenomena, and ideas to move from less advanced to more advanced forms through processes of motion and development. See p. 197.
+|
+|-
+| | '''Friedrich Engels'''
+| (1820–1895) a German theorist, politician, dialectical materialist philosopher, leader of the international working class, &amp; co-founder of scientific socialism with Karl Marx. ''Referenced throughout.''
+|
+|-
+| | '''Fundamental and Non-Fundamental Contradictions'''
+| A fundamental contradiction defines the essence of a relationship. Fundamental contradictions exist throughout the entire development process of a given thing, phenomenon, or idea. A non-fundamental contradiction exists in only one aspect or attribute of a thing, phenomenon, or idea. A nonfundamental contradiction can impact a subject, but it will not control or decide the essential development of the subject. See p. 178–179.
+|
+|-
+| | '''(Characteristic of) Generality'''
+| A universal characteristic which holds that all things, phenomena, and ideas interact and mutually transform one another. See p. 108–109, 111, 114, 124125.
+|
+|-
+| | '''General Relationship'''
+| Relationships which exist broadly across many things, phenomena, and ideas. General relationships can exist both internally, within things, phenomena, and ideas, and externally, between things, phenomena, and ideas. See p. 106–110, 114.
+|
+|-
+| | '''Generality (of relationships)'''
+| Relationships can exist with across a spectrum of generality; this spectrum ranges from the least general relationships (''unique relationships'' — which only occur between two specific things/phenomena/ideas) to the most general relationships (''universal relationships'' — which occur between or within all things/phenomena/ideas). See p. 109.
+|
+|-
+| | '''George Berkeley'''
+| (1685 — 1753) An Anglo-Irish philosopher whose main philosophical achievement was the formulation of a doctrine which he called “immaterialism,” and which later came to be known as “Subjective Idealism.” This doctrine was summed up by Berkeley’s maxim: “''Esse est percipi''” — “To be is to be perceived.” See p. 11, 27, 29.
+|
+|-
+| | '''George Wilhelm Friedrich Hegel'''
+| (1770 — 1831) German philosophy professor &amp; objective idealistic philosopher; developed the system of idealist dialectics which Marx and Engels used as a basis for developing materialist dialectics. See p. 8–11, 29, 69–71, 97, 98, 100–105, 132, 157, 165, 182, 192, 193–194, 209, 228.
+|
+|-
+| | '''Historical Materialism'''
+| The application of materialist dialectics and dialectical materialism to the study of human history. See p. 21–23, 27, 36, 38, 45, 80.
+|
+|-
+| | '''Historical Viewpoint'''
+| A viewpoint which demands that subjects be considered in their current stage of motion and development, while also taking into consideration the development and transformation of the subject over time. See p. 116–118, 125–126, 143, 185, 234.
+|
+|-
+| | '''Idealism'''
+| A philosophical position which holds that the only reliable experience of reality occurs within human consciousness. Idealists believe that human reason exclusively or as a first basis is the best way to seek truth. See p. 8–12, 26–29, 48–51, 53, 56–58, 69–70, 96, 101–102, 104, 157, 174, 209, 218, 228.
+|
+|-
+| | '''Immanuel Kant'''
+| (1724 — 1804) German philosopher who developed a system of idealist dialectics which were later completed by Hegel and whose metaphysical philosophies of epistemology and rationalism served as the basis for later empiricists such as Bacon and Hume. See p. 20, 29, 56, 72–74, 100–102, 205.
+|
+|-
+| | '''Induction'''
+| The reaction of animals with simple nervous systems which can sense or feel their environments. Induction occurs through unconditioned reflex mechanisms. See p. 66, 68.
+|
+|-
+| | '''Inductive Inference'''
+| Logical inference which extrapolates from specific observations to general conclusions. See p. 223–224.
+|
+|-
+| | '''Intelligibility'''
+| The human cognitive capacity to accurately perceive the external material world. See p. 48.
+|
+|-
+| | '''Internal Contradictions'''
+| See: Internal and External Contradictions.
+|
+|-
+| | '''Internal and External Contradictions'''
+| Internal contradictions are contradictions which exist within the internal relations of a subject, while external contradictions exist between two or more subjects as external relations. See p. 178–179.
+|
+|-
+| | '''Judgment'''
+| The phase of rational consciousness which arises from the definition of the subject — the linking of concepts and properties together — which leads to affirmative or negative ideation of certain characteristics or attributes of the perceived subject. See p. 223.
+|
+|-
+| | '''Karl Marx'''
+| (1818–1883) German theorist, politician, dialectical materialist philosopher, political economist, founder of scientific socialism, and leader of the international working class. ''Referenced throughout''.
+|
+|-
+| | '''Knowledge'''
+| The content of consciousness; data about the world, such as: ideas, memories, and other thoughts which are derived through direct observation and practical activities in the material world, through scientific experiments, or through abstract reflection of practical and scientific activities which occur within consciousness.
+|
+|-
+| | '''Labor Value'''
+| The amount of value which workers produce through labor. See p. 14, 17–18, 23.
+|
+|-
+| | '''Law of Negation of Negation'''
+| A universal law of materialist dialectics which states that the fundamental and universal tendency of motion and development occurs through a cycle of dialectical negation, wherein each and every negation is, in turn, negated once more. See p. 163, 185, 195, 198, 200, 201, 202, 227.
+|
+|-
+| | '''Law of Transformation Between Quantity and Quality'''
+| The universal law of dialectical materialism which concerns the universal mode of motion and development processes of nature, society, and human thought, which states that qualitative changes of things, phenomena, and ideas arise from the inevitable basis of the quantitative changes of things, phenomena, and, ideas, and, vice versa, quantitative changes of things, phenomena, and ideas arise from the inevitable basis of qualitative changes of things, phenomena, and ideas. See p. 163–165, 172–173, 227.
+|
+|-
+| | '''Law of Unification Contradiction Between Opposites'''
+| and The universal law of dialectical materialism which states that the fundamental, originating, and universal driving force of all motion and development processes is the inherent and objective contradictions which exists in all things, phenomena, and ideas. See p. 163, 175, 181.
+|
+|-
+| | '''Law of Development of Capitalism'''
+| Also known as Theory of Accumulation and Theory of Surplus Value. The dynamic through which the capitalist class gains wealth by accumulating surplus value (i.e., profits) and then reinvesting it into more capital to gain even further wealth; thus the goal of the capitalist class is to accumulate more and more surplus value which leads to the development of capitalism. See p. 18.
+|
+|-
+| | '''Laws'''
+| In dialectical materialism, laws are the regular, common, obvious, natural, objective relations between internal aspects, factors, and attributes of a thing or phenomenon or between things and phenomena. See p. 162.
+|
+|-
+| | '''Laws of Nature'''
+| Laws that arise in the natural world, including within the human body (and are never products of human conscious activities). Such law includes the laws of physics, chemistry, and other natural phenomena which govern the material world. See p. 162, 213.
+|
+|-
+| | '''Laws of Society'''
+| Laws of human activity in social relations; such laws are unable to manifest beyond the conscious activities of humans, but they are still objective. See p. 162–163.
+|
+|-
+| | '''Laws of Human Thought'''
+| Laws which govern the intrinsic relationships between concepts, categories, judgments, inference, and the development process of human rational awareness. See p. 163.
+|
+|-
+| | '''Life-Process'''
+| Processes of motion and change which occur within organisms to sustain life. See p. 69–72, 79, 88.
+|
+|-
+| | '''Ludwig Feuerbach'''
+| (1804 — 1872) German philosophy professor, materialist philosopher; Marx and Engels drew many of their ideas from the works of Feuerbach (whom they also criticized). See p. 8, 11–13, 21, 55, 74, 80, 114, 205, 237.
+|
+|-
+| | '''M→→C→→M’'''
+| The mode of circulation described by Marx as existing under capitalism, in which capitalists spend money to buy commodities (including the commodified labor of workers), with the intention of selling those commodities for ''more money'' than they began with. The capitalist has no direct relationship to the commodity being produced and sold, and the capitalist is solely interested in obtaining more money. See p. 16. See also: C→M→C
+|
+|-
+| | '''Machism'''
+| See: Empirio-Criticism.
+|
+|-
+| | '''Manifestation'''
+| How a given thing, phenomenon, or idea is expressed externally in the material world. See p. 115.
+|
+|-
+| | '''Marxism-Leninism'''
+| A system of scientific opinions and theories focused on liberating the working class from capitalism and achieving a stateless, classless, communist society. The core ideas of this system were first developed by Karl Marx and Friedrich Engels, then defended and further developed by Vladimir Ilyich Lenin. See. p. 1.
+|
+|-
+| | '''Material Conditions'''
+| The material external environment in which humans live, including the natural environment, the means of production and the economic base of human society, objective social relations, and other externalities and systems which affect human life and human society. See p. 6, 22, 40–42, 70–72, 80–81, 87, 92–95, 116–118, 161, 174, 179, 181, 206–207, 210, 229.
+|
+|-
+| | '''Material Production Activity'''
+| Material production activity is the first and most basic form of ''praxis''. In this form of praxis activity, humans use tools through labor processes to influence the natural world in order to create wealth and material resources and to develop the conditions necessary to maintain our existence and development. See p. 206–208.
+|
+|-
+| | '''Materialism'''
+| A philosophical position that holds that the material world exists outside of the mind, and that human ideas and thoughts stem from observation and sense experience of this external world. Materialism rejects the idealist notion that truth can only be sought solely through reasoning and human consciousness. See p. 10–13, 48.
+|
+|-
+| | '''Materialist Dialectics'''
+| A scientific system of philosophy concerned with motion, development, and common relationships, and with the most common rules of motion and development of nature, society, and human thought. See p. 10, 21, 45–47, 98202, 227, 237.
+|
+|-
+| | '''Matter'''
+| A philosophical category denoting things and phenomena, existing in objective external reality, which human beings access through our sense perceptions. See p. 26, 27, 32, 48, 51–52, 53–69, 72, 88–95, 97, 103, 164–165.
+|
+|-
+| | '''Means of Production'''
+| Physical inputs and systems used in the production of goods and services, including: machinery, factory buildings, tools, equipment, and anything else used in producing goods and services. See p. 2–3, 7, 14–16.
+|
+|-
+| | '''Mechanical Motion'''
+| Changes in positions of objects in space. See p. 61.
+|
+|-
+| | '''Mechanical Philosophy'''
+| A scientific and philosophical movement popular in the 17<sup>th</sup> century which explored mechanical machines and compared natural phenomena to mechanical devices, resulting in a belief that all things — including living organisms — were built as (and could theoretically be built by humans as) mechanical devices.
+|
+|-
+| | '''Mental Reflection'''
+| Reactions which occur in animals with central nervous systems. Mental reflections occur through conditioned reflex mechanisms through learning. See p. 65, 68, 224.
+|
+|-
+| | '''Metaphysical Materialism'''
+| Metaphysical materialism was strongly influenced by the metaphysical, mechanical thinking of ''mechanical philosophy'', which was a scientific and philosophical movement which explored mechanical machines and compared natural phenomena to mechanical devices. Metaphysical materialists believed that all change can exist only as an increase or decrease in quantity, brought about by external causes.
+|
+|-
+| | '''Metaphysics'''
+| A branch of philosophy that attempts to explain the fundamental nature of reality. Metaphysical philosophy has taken many forms through the centuries, but one common shortcoming of metaphysical thought is a tendency to view things and ideas in a static, abstract manner. Generally speaking, metaphysics presents nature as a collection of objects and phenomena which are isolated from one another and fundamentally unchanging. See p. 52.
+|
+|-
+| | '''Methodology'''
+| A system of reasoning: the ideas and rules that guide humans to research, build, select, and apply the most suitable methods in both perception and practice. Methodologies can range from very specific to broadly general, with philosophical methodology being the most general scope of methodology. See p. 44.
+|
+|-
+| | '''Mode'''
+| The way or manner in which something occurs or exists. See p. 19–20.
+|
+|-
+| | '''Mode of Existence of Matter'''
+| Refers to how matter exists in our universe; specifically, matter exists in our motion in a mode of ''motion.'' See p. 59.
+|
+|-
+| | '''Motion'''
+| Also known as “change;” motion/change occurs as a result of the mutual impacts which occur between two things, phenomena, or ideas in relation with one another. See p. 23, 47, 59–63. 74, 106–107, 122–127, 145, 163–165, 169-173-186, 197, 201–202.
+|
+|-
+| | '''Motion in Equilibrium'''
+| Motion in equilibrium is motion that has not changed the positions, forms, and/or structures of things. Motion in Equlibrium is only ever temporary in nature; all motion will ''eventually'' lead to changes in position, form, and/or structure. See p. 62.
+|
+|-
+| | '''Narodnik'''
+| Agrarian socialist movement of the 1860s and 70s in the Russian Empire, composed of peasants who rose up in a failed campaign against the Czar. See p. 29–30.
+|
+|-
+| | '''Natural law'''
+| See: Laws of Nature.
+|
+|-
+| | '''Natural Science'''
+| Science which deals with the natural world, including chemistry, biology, physics, geology, etc. See p. 13, 19, 26, 103.
+|
+|-
+| | '''Negation'''
+| The development process through which two contradicting objects mutually develop one another until one is overtaken by the other. In dialectical materialism, negation takes the form of ''dialectical negation''. See p. 123, 175176, 183, 185–202.
+|
+|-
+| | '''New Economic Policy'''
+| Also known as the NEP; this early Soviet policy was devised as Vladimir Illyich Lenin to be a temporary economic system that would allow a market economy and capitalism to exist within Russia, alongside state-owned business ventures, all firmly under the control of the working-classdominated state. See p. 33–34.
+|
+|-
+| | '''Objective Dialectics'''
+| The dialectical processes which occur in the material world, including all of the motion, relationships, and dynamic changes which occur in space and time. See p. 98, 102–103, 182.
+|
+|-
+| | '''Objective Existence'''
+| Existence which manifests outside of and independently of human consciousness, whether humans can perceive it or not. See p. 50, 58, 228.
+|
+|-
+| | '''Objective Idealism'''
+| A form of idealism which asserts that the ideal and consciousness are the primary existence, while also positing that the ideal and consciousness are objective, and that they exist independently of nature and humans. See p. 50.
+|
+|-
+| | '''Objectiveness'''
+| An abstract concept that refers to the relative externality of all things, phenomena, and ideas. Every thing, phenomena and idea exists externally to every other thing, phenomena, and idea. This means that to each individual subject, all other subjects exist as external objects. See p. 111–114, 124.
+|
+|-
+| | '''Obviousness'''
+| See: Obviousness and Randomness
+|
+|-
+| | '''Obviousness and Randomness (Category Pair)'''
+| The philosophical category of Obviousness refers to events that occur because of the essential internal aspects of a subject which become reasons for certain results in certain conditions: the obvious has to happen in a certain way, it can’t happen any other way. The Randomness category refers to things that happen because of external reasons: things that happen, essentially, by chance, due to impacts from many external relations. A random outcome may occur or it may not occur, and may occur in many different ways. Obviousness and Randomness have a dialectical relationship with one another. See p. 144–146.
+|
+|-
+| | '''Opportunism'''
+| A system of political opinions with no direction, no clear path, and/or no coherent viewpoint, focusing on whatever actions or decisions might be beneficial for the opportunist in the short term. See p. 174.
+|
+|-
+| | '''Opposites'''
+| Such aspects, properties and tendencies of motion which oppose one another, yet are, simultaneously, conditions and premises of the existence of one another. See p. 61, 175–179, 181, 184, 190, 227.
+|
+|-
+| | '''Ordinary Consciousness'''
+| Perception that is formed passively, stemming from the daily activities of humans. See p. 210–216.
+|
+|-
+| | '''Period of Motion'''
+| Development which occurs between two quality shifts, including the quality shifts themselves. See p. 170.
+|
+|-
+| | '''Perspective'''
+| See: Viewpoint.
+|
+|-
+| | '''Petty Bourgeoisie'''
+| Semi-autonomous merchants, farmers, and so on who are self-employed, own small and limited means of production, or otherwise fall in between the proletariat and the bourgeoisie. Also called the petite bourgeoisie. See p. 3–6.
+|
+|-
+| | '''Petty Commodity Production'''
+| See: Simple Commodity Production.
+|
+|-
+| | '''Phenomena'''
+| Anything that is observable by the human senses. See p. 156. See also: Essence and Phenomena.
+|
+|-
+| | '''Physical Motion'''
+| Motion of molecules, electrons, fundamental particles, thermal processes, electricity, etc., in time and space. See p. 61.
+|
+|-
+| | '''Physical Reflection'''
+| Reflection which occurs any time two material objects interact and the features of the objects are transferred to one other. See p. 67–68.
+|
+|-
+| | '''Point of View'''
+| See: Viewpoint.
+|
+|-
+| | '''Populism'''
+| The political philosophy of the Narodnik movement; this political philosophy was focused on bringing about an agrarian peasant revolution led by intellectuals with the ambition of going directly from a feudal society to a socialist society built from rural communes. Populism overtly opposed Marxism and dialectical materialism and was based on subjective idealist utopianism. See p. 30.
+|
+|-
+| | '''Positivism'''
+| The belief that we can test scientific knowledge through scientific methods, and through logic, math, etc.; positivism tends to overlap significantly with ''empiricism'' in theory and practice. See p. 32, 209.
+|
+|-
+| | '''Possibility'''
+| See: Possibility and Reality.
+|
+|-
+| | '''Possibility and Reality (Category Pair)'''
+| The philosophical category of Possibility refers to things that have not happened nor existed in reality yet, but that would happen, or would exist given necessary conditions. The philosophical category of Reality refers to things that exist or have existed in reality and in human thought. See p. 160–162.
+|
+|-
+| | '''Practice'''
+| See: Praxis.
+|
+|-
+| | '''Pragmatism'''
+| Pragmatism refers to a form of subjectivism in which one centers one’s own immediate material concerns over all other considerations. See p. 218.
+|
+|-
+| | '''Praxis'''
+| Conscious activity which improves our understanding, and which has purpose and historical-social characteristics. Used interchangeably with the word “practice” in this text. See p. 205–206, 235.
+|
+|-
+| | '''Prejudice'''
+| See: Conservatism.
+|
+|-
+| | '''Primary and Secondary Contradictions'''
+| In the development of things, phenomena, and ideas, there are many development stages. In each stage of development, there will be one contradiction which drives the development process. This is what we call the primary contradiction. Secondary contradictions include all the other contradictions which exist during that stage of development. Determining whether a contradiction is primary or secondary is relative, and it depends heavily upon the material conditions and the situation being analyzed. See p. 178–179.
+|
+|-
+| | '''Primary Existence'''
+| Existence which precedes and determines other existences; materialists believe that the external material world is the primary existence which determines the ideal, while idealists believe that human consciousness (“the ideal”) is the primary existence from which truth is ultimately derived. See p. 50–51.
+|
+|-
+| | '''Primitive Materialism'''
+| An early form of materialism which recognizes that matter is the primary existence, and holds that the world is composed of certain elements, and that these were the first objects — the origin — of the world, and that these elements are the essence of reality. This was later developed into Metaphysical Materialism and, later, Dialectical Materialism. See p. 52.
+|
+|-
+| | '''Principle of General Relationships'''
+| A principle of dialectical materialism which states that all things, phenomena, and ideas are related to one another, and are defined by these internal and external relationships. See p. 106–107, 110, 114.
+|
+|-
+| | '''Private'''
+| See: Private and Common
+|
+|-
+| | '''Private and Common (Category Pair)'''
+| The Private philosophical category encompasses specific things, phenomena, and ideas; the Common philosophical category defines the common aspects, attributes, factors, and relations that exist in many things and phenomena. Private and Common are relative in nature and have a dialectical relationship with one another. See p. 128–138.
+|
+|-
+| | '''Private Laws'''
+| Laws which apply only to a specific range of things and phenomena, i.e.: laws of mechanical motion, laws of chemical motion, laws of biological motion, etc. See p. 162.
+|
+|-
+| | '''Production Force'''
+| The combination of the means of production and workers within human society. See p. 6, 23, 36.
+|
+|-
+| | '''Proletariat'''
+| The people who provide labor under capitalism; the proletariat do not own their own means of production, and must therefore sell their labor to those who do own means of production; also called the Working Class. See also: Bourgeoisie, Petty Bourgeoisie. See p. 1–8, 22–23, 25–26, 29–31, 33–35, 40–41, 63, 231.
+|
+|-
+| | '''Quality'''
+| The unity of component parts, taken together, which defines a subject and distinguishes it from other subjects. See p. 119–121.
+|
+|-
+| | '''Quality Shift'''
+| A change in quality which takes place in the motion and development process of things, phenomena, and ideas, occurring when quantity change meets a certain perceived threshold. See p. 124, 153, 164, 168–174.
+|
+|-
+| | '''Quantity'''
+| The total amount of component parts that compose a subject. See p. 119–121.
+|
+|-
+| | '''Quantity range'''
+| The range of quantity changes which can accumulate without leading to change in quality related to any given thing, phenomenon, or idea. See p. 168–171.
+|
+|-
+| | '''Quintessence'''
+| Original Vietnamese word: ''tinh hoa''. Literally, it means “the best, highest, most beautiful, defining characteristics” of a concept, and, unlike the English word quintessence, it has an exclusively positive connotation. See p. 8, 21, 43, 45, 52.
+|
+|-
+| | '''Randomness'''
+| See: Obviousness and Randomness.
+|
+|-
+| | '''Rational Consciousness'''
+| The higher stage of the cognitive process, which includes the indirect, abstract, and generalized reflection of the essential properties and characteristics of things and phenomena. This stage of consciousness performs the most important function of comprehending and interpreting the essence of the perceived subject. See p. 219–225.
+|
+|-
+| | '''Reason'''
+| See: Reason and Result
+|
+|-
+| | '''Reality'''
+| See: Possibility and Reality.
+|
+|-
+| | '''Reason and Result (Category Pair)'''
+| The Reason philosophical category is used to define the mutual impacts between internal aspects of a thing, phenomenon or idea, or between things, phenomena, or ideas, that bring about changes. The Result philosophical category defines the changes that were caused by mutual impacts which occur between aspects and factors within a thing, phenomenon, or idea, or externally between different things, phenomena, or ideas. Not to be confused with the metaphysical concept of “cause and effect,” which attributes a single cause to any given effect. See p. 138–144.
+|
+|-
+| | '''Reasoning'''
+| The final phase of rational consciousness, formed on the basis of synthesizing judgments so as to extrapolate new knowledge about the perceived subject. See p. 223–225, 228–229.
+|
+|-
+| | '''Reflection'''
+| The re-creation of the features of one form of matter in a different form of matter which occurs when they mutually impact each other through interaction. See p. 64–75, 79–80, 90–92, 103, 165, 208–211, 214–215, 219–224, 228, 232, 237.
+|
+|-
+| | '''Relative and Absolute'''
+| “Absolute” and “Relative” are philosophical classifications which refer to interdependence: That which is ''absolute'' exists independently and with permanence. That which is ''relative'' is temporary, and dependent on other conditions or circumstances in order to exist. See p. 56, 233. See also: Absolute Truth, Relative Truth, Relativism, Truth.
+|
+|-
+| | '''Relative Truth'''
+| Truth which has developed alignment with reality without yet having reached complete alignment between human knowledge and the reality which it reflects; knowledge which incompletely reflects material subjects without complete accuracy. See p. 230, 232. See also: Absolute Truth, Relative and Absolute, Relativism, Truth.
+|
+|-
+| | '''Relativism'''
+| A position that all truth is relative and that nothing can ever be absolutely, objectively known; that only Relative Truth can be found in our existence. See p. 56–58, 233–234. See also: Absolute Truth, Relative and Absolute, Relative Truth, Truth.
+|
+|-
+| | '''René Descartes'''
+| (1596 — 1650) French metaphysical philosopher who developed early methods of scientific inquiry. See p. 20, 53.
+|
+|-
+| | '''Result'''
+| See: Reason and Result.
+|
+|-
+| | '''Richard Avenarius'''
+| (1843 — 1896) German-Swiss philosopher who developed a system of subjective idealism known as “Empirio-Criticism.” See p. 27–29.
+|
+|-
+| | '''Rigidity'''
+| An unwillingness to alter one’s thoughts, holding too stiffly to established consciousness and knowledge, and ignoring practical experience and observation, which leads to stagnation of both knowledge and consciousness. See p. 217–218.
+|
+|-
+| | '''Robert Owen'''
+| (1771 — 1858) Wealthy Welsh textile manufacturer who tried to build a better society for workers in New Hampshire, Indiana, in the USA by purchasing the town of New Harmony in 1825. Owen’s vision failed after two years, though many other wealthy capitalists in the early 19<sup>th</sup> century were inspired by Owen to try similar plans, which also failed.
+|
+|-
+| | '''Scientific'''
+| An adjective which describes methodologies, approaches, and practices of gaining knowledge and insight which are methodological and/or systematic in nature. See p. 1–2.
+|
+|-
+| | '''Scientific Consciousness'''
+| Conscious activities which actively gather information from the methodological and/or systematic observations of the characteristics, nature, and inherent relationships of research subjects. Scientific consciousness is considered ''indirect'' because it takes place outside of the course of ordinary daily activities. See p. 58, 210, 212, 215–216.
+|
+|-
+| | '''Scientific'''
+| Experimental Human activities that resemble or replicate states of nature and society
+|
+|-
+| | '''Activity'''
+| in order to determine the laws of change and development of subjects of study. This form of activity plays an important role in the development of society, especially in the current historical period of modern science and technological revolution. See p. 206–208.
+|
+|-
+| | '''Scientific Materialist Viewpoint'''
+| A perspective which begins analysis of the world in a manner that is both scientifically systematic in pursuit of understanding and firmly rooted in a materialist conception of the world. See p. 105.
+|
+|-
+| | '''Scientific Socialism'''
+| A body of theory and knowledge (which must be constantly tested against reality) focused on the practical pursuit of changing the world to bring about socialism through the leadership of the proletariat. See p. 1–2, 21, 37–39.
+|
+|-
+| | '''Scientific Worldview'''
+| A worldview that is expressed by a systematic pursuit of knowledge that generally and correctly reflects the relationships of things, phenomena, and processes in the objective material world, including relationships between humans, as well as relationships between humans and the world. See p. 3839, 44–45, 48.
+|
+|-
+| | '''Second International'''
+| Founded in Paris in 1889 to continue the work of the First International; it fell apart in 1916 because members from different nations could not maintain solidarity through the outbreak of World War I. See p. 35, 174.
+|
+|-
+| | '''Self-motion'''
+| In the original Vietnamese, the word “''tự vận động''.” Literally meaning: “it moves itself.” See p. 59–60, 124.
+|
+|-
+| | '''Sensation'''
+| The subjective reflection of the objective world in human consciousness as perceived through human senses. See p. 27, 56–58, 68–69, 72, 85, 221–222.
+|
+|-
+| | '''Sensuous Human Activity; Sensuous Activity'''
+| A description of human activity developed by Marx which acknowledges that all human activity is simultaneously ''active'' in the sense that our conscious activity can transform the world, as well as ''passive'' in the sense in that all human thoughts fundamentally derive from observation and sense experience of the material world. See p. 13.
+|
+|-
+| | '''Simple Commodity Production'''
+| What Marx called the “C→M→C” mode of circulation. See p. 16–18.
+|
+|-
+| | '''Simple Exchange'''
+| When individual producers trade the products they have made directly, themselves, for other commodities. See p. 16–17.
+|
+|-
+| | '''Social Being'''
+| The material existence of human society, as opposed to ''social consciousness''. See also: Base. See p. 24, 54–55.
+|
+|-
+| | '''Social Consciousness'''
+| The collective experience of consciousness shared by members of a society, including ideological, cultural, spiritual, and legal beliefs and ideas which are shared within that society, as opposed to ''social being''. See p. 22, 24, 32, 54–55, 80. See also: Superstructure.
+|
+|-
+| | '''Social Motion'''
+| Changes in the economy, politics, culture, and social life of human beings. See p. 61–62.
+|
+|-
+| | '''Socialization'''
+| The idea that human society transforms labor and production from a solitary, individual act into a collective, social act. In other words, as human society progresses, people “socialize” labor into increasingly complex networks of social relations: from individuals making their own tools, to agricultural societies engaged in collective farming, to modern industrial societies with factories, logistical networks, etc. See p. 6, 36.
+|
+|-
+| | '''Socialized Production Force'''
+| A production force which has been socialized — that is to say, a production force which has been organized into collective social activity. See p. 6.
+|
+|-
+| | '''Socio-Political Activity'''
+| Praxis activity utilized by various communities and organizations in human society to transform political-social relations in order to promote social development. See p. 206–208.
+|
+|-
+| | '''Solipsism'''
+| A form of idealism in which one believes that the self is the only basis for truth. See p. 218.
+|
+|-
+| | '''Sophistry'''
+| The use of misleading arguments, usually with the intention of deception, with a tendency of presenting non-critical aspects of a subject matter as critical, to serve a particular agenda. The word comes from the Sophists, a group of professional teachers in Ancient Greece, who were criticized by Socrates (in Plato’s’ dialogues) for being shrewd and deceptive rhetoricians. See p. 32–33, 56, 118, 182, 194.
+|
+|-
+| | '''Stage of Development'''
+| The current quantity and quality characteristics which a thing, phenomenon, or object possesses. Every time a quality change occurs, a new stage of development is entered into. See p. 24, 39, 125, 173–174, 179, 190, 196–197, 200, 212, 221.
+|
+|-
+| | '''Stagnation'''
+| An inability or unwillingness to change and adapt consciousness and practice in accordance with developing material conditions. Stagnation can stem from, or cause, overstatement of absolute truth in theory and forestall necessary development of both consciousness and practical ability. See p. 125, 218, 233. See also: Rigidity.
+|
+|-
+| | '''Struggle of Opposites'''
+| The tendency of opposites to eliminate and negate each other. See p. 61, 181, 184.
+|
+|-
+| | '''Subjective Factors'''
+| Factors which, from the perspective of a given subject, that same subject is capable of impacting. See p. 162–163, 175, 202.
+|
+|-
+| | '''Subjective Dialectics; Dialectical Thought'''
+| A system of analysis and organized thinking which aims to reflect the objective dialectics of the material world within human consciousness. Dialectical thinking has two component forms: dialectical materialism and materialist dialectics. See: p. 98–99, 103.
+|
+|-
+| | '''Subjective Idealism'''
+| Subjective idealism asserts that consciousness is the primary existence and that truth can be obtained only or primarily through conscious activity and reasoning. Subjective idealism asserts that all things and phenomena can only be experienced as subjective sensory perceptions, with some forms of subjective idealism even explicitly denying the objective existence of material reality altogether. See also: Empirio-Criticism, Objective Idealism. See p. 26–27, 50.
+|
+|-
+| | '''Subjectivism'''
+| A philosophical position in which one centers one’s own self and conscious activities in perspective and worldview, failing to test their own perceptions against material and social reality. See p. 56, 182, 217–218, 233–234.
+|
+|-
+| | '''Suitability'''
+| The applicability of a subject for a specific application or role. See p. 154.
+|
+|-
+| | '''Superstructure'''
+| The ideal (non-material) components of human society, including: media institutions, music, and art, as well as other cultural elements like religion, customs, moral standards, and everything else which manifests primarily through conscious activity and social relations. See p. 23. See also: Base.
+|
+|-
+| | '''Surplus Value'''
+| The extra amount of value a capitalist is able to secure by exploiting wagelabourers (by paying workers less than the full value of their labour). Workers will spend part of their workday reproducing their own labourpower (through earning enough to eat, secure shelter and other cultural needs) and the rest of the time will be spent producing surplus value which is then appropriated by the capitalist as profit. See p. 18, 22–23, 39.
+|
+|-
+| | '''Symbolization'''
+| The representation of an objective thing or phenomenon in human consciousness which has been reflected by sensation and conception. See p. 221–222.
+|
+|-
+| | '''Systematic Structure'''
+| A structure which includes within itself a system of component parts and relationships. See p. 114.
+|
+|-
+| | '''Theoretical Consciousness'''
+| The indirect, abstract, systematic level of perception in which the nature and laws of things and phenomena are generalized and abstracted. See p. 210–214, 217–218.
+|
+|-
+| | '''Theoretical Knowledge'''
+| Knowledge which is abstract and generalized, resulting from theoretical conscious activities which include repeated and varied observations. See p. 214, 217.
+|
+|-
+| | '''Theory'''
+| An idea or system of ideas intended to explain an aspect, characteristic, or tendency of objective reality. See p. 235.
+|
+|-
+| | '''Theory of Accumulation/Surplus Value'''
+| See: Law of Development of Capitalism.
+|
+|-
+| | '''Thing-in-Itself'''
+| The actual material object which exists outside of our consciousness, ''as it exists outside of our consciousness''. See p. 72–74, 101, 158.
+|
+|-
+| | '''Third International'''
+| Also known as the Communist International (or the ComIntern for short); founded in Moscow in 1919, its goals were to overthrow capitalism, build socialism, and establish a dictatorship of the proletariat. It was dissolved in 1943 in the midst of the German invasion of Russia in World War II. See p. 35.
+|
+|-
+| | '''Three Component Parts'''
+| The three essential elements of Marxist-Leninist philosophy, first identified of Marxism-Leninism by Lenin in ''The Three Sources and Three Component Parts of Marxism''. 1. The Philosophy of Marxism. 2. The Political Economy of Marxism. 3. Scientific Socialism.See p. 21, 32, 34, 38.
+|
+|-
+| | '''Threshold'''
+| The amount, or degree, of quantity change at which quality change occurs. Truth is primarily discovered through labor and practice in the physical world. See p. 120, 168–169, 171, 173.
+|
+|-
+| | '''Truth'''
+| A correct and accurate conscious reflection of objective reality. See p. 9–10, 49, 56, 70, 75, 94–96, 194, 204, 209, 215–219, 225–237. See also: Labor, Practice.
+|
+|-
+| | '''Unconditioned Reflex'''
+| Reactions which are not learned, but simply occur automatically based on physiological mechanisms occurring within an organism, characterized by permanent connections between sensory perceptions and reactions. See p. 66, 68.
+|
+|-
+| | '''Unilateral Consideration'''
+| The consideration of a subject from one side only. See p. 49.
+|
+|-
+| | '''Unintelligibility'''
+| A philosophical position which denies the human cognitive capacity to accurately perceive the external material world. See p. 48.
+|
+|-
+| | '''Unique Relationship'''
+| The least general form of relationship, which only occur between two specific things/phenomena/ideas. See p. 109, 130.
+|
+|-
+| | '''Unity in Diversity'''
+| A concept in materialist dialectics which holds that within universal relationships exist within and between all different things, phenomena, and ideas, we will find that each individual manifestation of any universal relationship will have its own different manifestations, aspects, features, etc. Thus even the universal relationships which unite all things, phenomena, and ideas exist in infinite diversity. See p. 42, 110–111, 114, 125, 130.
+|
+|-
+| | '''Universal Law of Consciousness'''
+| A universal law which holds that consciousness is a process of dialectical development in which practical activity leads to conscious activity, which then leads back to practical activity, in a continuous and never-ending cycle, with a tendency to develop both practical and conscious activity to increasingly higher levels. See p. 219.
+|
+|-
+| | '''Universal Laws'''
+| Laws that impact every aspect of nature, society, and human thought. Materialist dialectics is the study of these universal laws. See p. 15, 162–163, 227.
+|
+|-
+| | '''Universal Relationship'''
+| The most general kind of relationship; relationships that exist between and within every thing and all phenomena; along with ''development'', universal relationships are one of the two primary subjects of study of materialist dialectics. See p. 80, 108, 109, 111, 165.
+|
+|-
+| | '''Use Value'''
+| A concept in classical political economy and Marxist economics which refers to tangible features of a commodity (a tradable object) that can fulfill some human requirement or desire, or which serve a useful purpose. See p. 15–18, 95.
+|
+|-
+| | '''Utopianism'''
+| 1. A political and philosophical movement which held the belief that “a New Moral World” of happiness, enlightenment, and prosperity could be created through education, science, technology, and communal living. See p. 18. 2. The idealist philosophical concept which mistakenly asserts that the ideal can determine the material, and that ideal forms of society can be brought about without regard for material conditions and development processes. See p. 8, 17–18, 30, 94.
+|
+|-
+| | '''Value-Form'''
+| Also known as “form of value;” the social form of a commodity. Under capitalism, through the exchange of qualitatively different commodities, the money form of value is established as the general equivalent which can functionally be exchanged for all other values; money is therefore the most universal value-form under capitalism. See p. 15, 17, 155.
+|
+|-
+| | '''Viewpoint'''
+| Also known as point of view or perspective; the starting point of analysis which determines the direction of thinking from which phenomena and problems are considered. See p. 12, 20–21, 23, 25, 26, 30, 32–33, 38–39, 5559, 62, 64, 89, 93–94, 105, 111, 114–120, 122, 125–126, 130, 143, 147, 150, 172, 185–188, 195, 200–201, 233–235. See also: Comprehensive Viewpoint, Historical Viewpoint.
+|
+|-
+| | '''Viewpoint Crisis'''
+| A situation in which a specific viewpoint can’t be settled on, found, or agreed upon. See p. 26, 32–33.
+|
+|-
+| | '''Vladimir Ilyich Lenin'''
+| (1870 -1924) A Russian theorist, politician, dialectical materialist philosopher, defender and developer of Marxism in the era of imperialism, founder of the Bolsheviks, the Communist Party and the government of the Soviet Union, leader of Russia and the international working class. ''Referenced throughout.''
+|
+|-
+| | '''Working Class'''
+| See: Proletariat
+|
+|-
+| | '''Worldview'''
+| The whole of an individual’s or society’s opinions and conceptions about the world, about humans ourselves, and about life and the position of human beings in the world. See p. 1, 11, 37–39, 44–45, 48, 52, 96, 138, 201, 208–209, 218, 234. See also: Scientific Worldview.
+|
+|}
+<br />
+[[File:t-w-the-worldview-and-philosophical-methodology-of-2.png]]
+''For centuries, the banyan tree has been the symbol of communal life in Vietnam.''
+''Traditionally, the entrance to a village is graced by a large and ancient banyan tree. It is in the shade of these trees that villagers gather to socialize, draw water from wells, and make collective decisions together. The drooping accessory trunks represent the longevity of villagers — and of the village itself — while the arching canopy represents the safety and protection of the village. The shape of the banyan tree is seen in the full moon, which casts peaceful light across the Earth to guide travelers in the dark of night.''
+''Vietnam’s revolution against Japanese fascism and French colonialism began in 1945 beneath the cover of the Tân Trào Banyan Tree, which still stands in the city of Tuyên Quang.''
+''It is in this deep-rooted, humanistic spirit of collective action that we founded Banyan House Publishing. We hope to deliver volumes which will inspire action and change throughout the village that is our world.''
+''Visit us at:''<br />
+''BanyanHouse.org''
+<br />
+[[File:t-w-the-worldview-and-philosophical-methodology-of-103.png]]
+<br />
+<references />

Difference between revisions of "User talk:NonZeroSum"

Latest revision as of 20:57, 17 July 2025

Contents

License

Support for This Work

Dedication and Gratitude

Foreword

Preface to the First English Edition

Introduction

Editor’s Note

A Message From The International Magazine

Notes on Translation

Guide to Annotations

Original Vietnamese Publisher’s Note

Original Vietnamese Preface

Table of Contents

Introduction to the Basic Principles of Marxism-Leninism

I. Brief History of Marxism-Leninism

1. Marxism and the Three Constituent Parts

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2. Summary of the Birth and Development of Marxism-Leninism

a. Conditions and Premises of the Birth of Marxism

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b. The Birth and Development Stage of Marxism

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c. The Defending and Developing Stage of Marxism

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Imperialism

Subjective and Empiricist Idealism

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d. Marxism-Leninism and the Reality of the International Revolutionary Movement

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II. Objects, Purposes, and Requirements for Studying the Basic Principles of Marxism-Leninism

1. Objects and Purposes of Study

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2. Some Basic Requirements of the Studying Method

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Part I: The Worldview and Philosophical Methodology of Marxism — Leninism

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The Worldview and Philosophical Methodology of Marxism-Leninism

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