The Inner Level

by Richard Wilkinson

  What this suggests is that greater societal inequality makes status, self-advancement and self-interest more powerful influences on us – as if the only way to respond to a competitive, unequal world is through self-aggrandizement, through competing to claw our way up. But there is also evidence that self-enhancement and narcissism can mask great insecurity, and inhibit people from happy and fulfilling relationships. Feelings of scorn and envy up and down the social hierarchy are bad for well-being – whether you scorn or are scorned, envy others or are envied.

  Empathy is a keystone of human social relationships and well-being. Simon Baron-Cohen describes it as a universal solvent: interpersonal problems and marital difficulties, problems at work or with neighbours, political deadlock and international conflict can all be solved when immersed in empathy. Empathy is free, and the exercise of empathy cannot oppress anyone. Despite its erosion by inequality, the potential benefits of unleashing and optimizing empathy by reducing inequality should give us enormous hope that we can create a better world.

  ‘Actually, I don’t consider myself a have or a have-not. I’m more of a have-to-have.’

  4

  False Remedies

  ‘Every night I lay in bed and say never again. “Tomorrow will be different” but no … it’s always the same, it never stops, I’m worthless, I can see how my friends are so happy and I’m just sort of there. Not a part of it. I’m in my own world, looking in at this life I could have … I should have.’

  Posted online, 2014

  ‘I have that hole again, the one in my stomach that begs to be filled. Not that it is food I am hungering for.

  ‘A touch, a caress, would be a good start. But none for me, not tonight.

  ‘I guess I’ll go eat after all …’

  Posted online, 2014, on the internet chat site I Have An Addiction

  Shopaholic, alcoholic, workaholic, chocoholic, sexaholic, gizmoholic. It seems we can be addicted to anything and everything. Many claim to be obsessed with the latest video game or television series, others say they are addicted to bacon, sleep or cupcakes. The online Urban Dictionary rather sniffily claims that the ‘holic’ suffix is ‘always improperly used unless referring to an addict of alcohol’, but a lot of people are clearly willing to admit to an overwhelming involvement or an obsession with something that, when indulged, makes them feel temporarily better about themselves and about their lives.

  As we have seen, trying to maintain self-esteem and status in a more unequal society can be highly stressful. Whether a person’s confidence collapses and they feel defeated by intensified social comparisons, or whether they brazen it out in a struggle to convince the world that they are managing successfully (usually on the basis of fairly fragile egos), this experience of stress can lead to an increased desire for anything which makes them feel better – whether alcohol, drugs, eating for comfort, ‘retail therapy’ or another crutch. It’s a dysfunctional way of coping, of giving yourself a break from the relentlessness of the anxiety so many feel.

  Many professionals who work with people addicted to drugs or alcohol object to the language and labels of addiction being applied to any other kind of behaviour, but here we adopt a definition offered by psychologist Bruce Alexander, famous for a series of experiments known as the Rat Park studies. These studies showed that rats housed in social groups took far less opioid drugs than those housed in isolation, leading Alexander to suggest that the characteristics and qualities of the drugs themselves – their inherent addictiveness – explains only a small part of the ‘drugs problem’. He demonstrated that addiction is as much a social as an individual problem, and this perspective is borne out by the evidence we examine in this chapter. In his overview of the history of addiction, The Globalization of Addiction: A Study in Poverty of the Spirit, Alexander defines addiction as ‘an overwhelming involvement in any pursuit whatsoever that is harmful to the addicted person, to society, or to both’.156 This is a broad definition, inclusive of all the ways in which people might become trapped in repetitive behaviours that endanger themselves and others, and one which allows us to consider addiction at a societal level and ask why people increasingly engage in addictive behaviour and to so many different things.

  Alexander sees addiction, in this broad sense, as a by-product of modernity. He believes that free market economies break down social cohesion, creating dislocation, which he also calls ‘poverty of spirit’. In his view, addictions are ways that we adapt to feeling dislocated, alienated, disconnected. By ‘dislocation’ Alexander means feeling out of place, excluded, disconnected from good social relationships, unhappy in ourselves. In modern, free market societies, he argues, dislocation is not a pathological state confined to a few individuals, but a general condition propagated by the antisocial conception of ‘economic man’. This is the idea that human nature makes us act with rational self-interest, pursuing individualistic goals with no thought for the common good – an idea that has become entrenched over the last half century. Alexander points out that material poverty can be borne with dignity, but that poverty of spirit, or dislocation, cannot, and it cannot be overcome with material things.

  Alexander’s interpretation of the roots of addiction is based on some long-standing psychological thinking about what it means to be a healthy individual. Healthy people maintain a balance between their individual needs for autonomy and achievement and their equally vital need for social connection and belonging.157 According to Alexander, ‘free market society can no more be free of addiction than it can be free of intense competition, [and] income disparity’. Individual competition is overemphasized at the expense of social cohesion, and (as we have seen) increasing levels of inequality heighten status anxiety. Under these conditions, people struggle to achieve psychosocial integration and turn instead to a variety of addictive crutches. That these behaviours are generally self-defeating in varying degrees only cements the mental distress which motivated them in the first place.

  ESCAPING OURSELVES

  If sustaining our psychosocial integration with others and having a resilient sense of identity is increasingly difficult in free market societies,158 and also heightened by the constant social evaluative threat of social media and the digital world, then our need to belong and to feel valued is more important than ever. In his 1991 book, Escaping the Self, Roy Baumeister, professor of psychology at Florida State University, points out the range of things we do to maintain our self-image and our image as we present it to others159:

  We struggle to gain prestigious credentials. We read books and take courses on how to make a good impression. We discard clothes that are not worn out and buy new, more fashionable ones. We work hard to devise self-serving explanations for failures or mishaps and fight to make others take the blame. We go hungry to make ourselves fashionably thin. We rehearse conversations or presentations in advance and ruminate about them afterwards to try to imagine what went wrong. We undergo cosmetic surgery. We endlessly seek information about other people so we can have a basis for comparing ourselves. We engage in fistfights with people who impugn our respectability or superiority. We grope desperately for rationalizations. We blush and brood when something makes us look foolish. We buy endless magazines advising us how to look better, make love better, succeed at work or play or dieting, and say clever things. Maintaining self-esteem can start to seem like a full-time job!

  Living with high levels of social evaluative threat is exhausting; an almost impossible, Sisyphean task, and one that can only be getting harder with the added effort of constant self-curation of our online identities. Baumeister describes the kinds of things that make us want to escape ourselves and the effort of maintaining a good front in the eyes of others – not just calamities but also the chronic burden of other people’s expectations. Before the Renaissance, people tried to conform to standard or ideal models of conduct; now we seem increasingly concerned with a more superficial ideal, with conforming to standards of beauty and owning the right things.r />
  And when we feel looked down on by others, and we start to feel worthless, incompetent and rejected, drugs, alcohol, immersion in the fantasy worlds of video games and television, comfort food, retail therapy or the possibility of a big win become more alluring and draw so many of us in. We are endlessly tempted with products which promise to create for us the identities we desire, with activities and purchases that provide short-term fixes for our chronic stress and anxieties but nothing more.

  REPLACING PEOPLE WITH THINGS

  The idea that addiction and compulsive behaviour involve ‘replacing people with things’ has been around since the late 1980s. The phrase was originally coined by psychotherapist Craig Nakken and it features prominently in journalist Damian Thompson’s book The Fix, which describes the ways in which we’re increasingly obsessed by our mobile phones, sugary cupcakes, video games, frozen coffee drinks and online shopping.160

  Thompson tells the story of how vast numbers of American GIs in Vietnam took up heroin to cope with the lonely, stressful and frightening situation they found themselves in, but almost all kicked the habit once freed from that context and safely back home. For Thompson, modern consumers, with their addictive-like behaviours, ‘are like soldiers drafted to Vietnam – disorientated, fearful and relentlessly tempted by fixes that promise to make reality more bearable. You don’t have to be ill to give in; just human.’ The analogy is troubling because we are already ‘home’, and if we are to escape the destructive patterns he describes we need to understand what it is about unequal societies, in particular, that pushes us into them.

  START AS YOU MEAN TO GO ON

  Although the terms ‘preloading’ and ‘predrinking’ are fairly new, they describe an already widespread trend. They simply mean drinking large quantities of alcohol before going out socially, a practice that has changed the typical pattern of young people’s drinking. Instead of starting in the pub and going on to a club, they start drinking at home, with typically one-third of a night’s alcohol consumption taking place before they’ve left the premises. In all studies of this kind of drinking, the prime motivation given by young people is to save money. By drinking cut-price supermarket alcohol at home before they head out to pubs, bars and clubs, they can achieve their preferred level of drunkenness at a much lower cost – although of course many of them also concede that going out drunk is not actually conducive to sensible spending later in the evening. But another strong motivation for preloading is social anxiety. For many young people, going out drunk means not having to cope with the social evaluative threat of starting a night out cold sober. As girls in a research study161 said: ‘I get scared in clubs so drinking before I go out gives me the courage to face it’, and ‘Pubs don’t work for me and my mates until we’re pissed and ready to face the chaos.’ In a New Zealand study, the researchers describe how ‘everyday inhibition, extreme shyness and a sense of actually finding the night-time economy just too unpleasant if sober, were all given as personal motivations for pre-loading to intoxication’.162

  Socializing has always been fraught with anxiety for young people; they are unsure of their own identity while at the same time they’re looking for friendship groups, relationships and sexual partners, and feel constantly exposed to the judgement of others. But is this worse in more unequal modern societies? We saw in Chapter 2 how status anxiety is increased, across the social spectrum, for people living in more unequal countries, and we know that anxiety and depression and the use of alcohol and drugs to self-medicate go hand-in-hand163, 164; but do we know for sure that anxiety and income inequality increase preloading, binge drinking, alcoholism, drug use and other addictive behaviours? Are people living in more unequal societies more addicted to gambling, video games or cupcakes than their counterparts in more egalitarian countries?

  MEASURING THE SOCIALLY UNACCEPTABLE

  In our previous book, we showed that a measure of mental illness that included addictions was significantly related to income inequality in rich countries, and inequality was also related to a combined index of drug use, such as heroin, cocaine and amphetamines. Among US states, the most unequal have higher rates of drug addiction and more deaths from drug overdoses.1 And studies of New York City neighbourhoods found that those with the most income inequality had higher rates of marijuana smoking165 and deaths from drug overdose.166 The connection between inequality and illicit drugs is clear and robust, but alcohol use has more complicated social patterns. In the UK and the USA, drinking any alcohol at all is more common higher up the social ladder, but problematic drinking is more common further down. People’s own reports of the amount of alcohol they drink are suspect, and studies comparing alcohol use between different countries have often used data on sales of alcohol rather than self-reported alcohol consumption because of these concerns. It’s not just that some people prefer not to disclose how much they drink, but also that people don’t have an accurate assessment of their intake – there is understandable confusion over how many ‘units of alcohol’ are present in a large glass of wine, or a half pint of beer, or a double gin and tonic.

  Nevertheless, income inequality has been linked to more frequent drinking in New York City neighbourhoods,165 heavier drinking and drunkenness among adolescents in rich countries,167 per capita alcohol consumption in thirteen European countries,168 and (in a complicated pattern) to deaths attributable to alcohol in Australia.169 However, not all studies have straightforward results. For example, the study of thirteen European countries found links between inequality and heavier alcohol consumption but none with alcoholic liver disease. Among US states, one study found that race-related income inequality (poor minority groups compared to white people) was more closely related to higher levels of alcohol problems than an overall measure of inequality.170 In sum, the evidence that income inequality is related to risky alcohol consumption is complex but substantial and, taken alongside the studies of drug use and addiction, is another piece in the puzzle that depicts how inequality, mediated by social anxiety, causes harm.

  As for gambling, video gaming and cupcakes, there is little good, comparable data on how prevalent these behaviours are in different societies. We know that obesity is higher in more unequal countries and states, as we showed in The Spirit Level, and we might view this as some kind of proxy measure for compulsive overeating – indeed, calorie intakes per person are higher in more unequal countries.171 There is now a substantial body of evidence from observational and careful experimental studies that anxiety, including the increased anxiety resulting from inequality, contributes both to the drive to eat and to a preference for less healthy foodstuffs high in sugars and fats.172, 173 That comfort eating is a deep-seated response to stress is suggested by the fact that the same tendencies have been demonstrated in animal studies, and sugars and fats have been shown to be calming and to reach the same areas of the brain as opiates.

  Gambling and gaming are comparable to drinking in that they are not problems per se but certainly can be addictive and problematic, so knowing how many bets are placed or games are played in different places doesn’t tell us much: we need to know how many people gamble or play compulsively. Luckily, a report was published in 2012 with the results of painstaking effort to calculate the percentage of people engaged in problem gambling, adjusted for the age make-up of the population.174 We found a strong and significant relationship between these estimates and income inequality. Figure 4.1 shows the correlation between problem gambling and the ratio of the richest to the poorest 20 per cent of households in each country (as reported in the United Nations Human Development Reports, 2007–2009).fn1123

  There do not seem to be enough reliable estimates of video game addiction to look at its association with income inequality across different countries, but, to give an idea of the scale of the problem, a 2009 study in America estimated that 8 per cent of young gamers show symptoms of pathological video game behaviour.175 Other recent studies suggest figures of 9% for Singapore, 12% for Germany and 8% i
n Australia,176 but less than 1% in Norway.177 Some countries, like South Korea and Japan, now view video game addiction as a public health problem, but it is hard to be sure about its scale and severity.178

  The absence of an association between income inequality and cigarette smoking among adults in rich countries is puzzling. Perhaps because smoking provides only the very mildest feelings of psychological escape or diversion from one’s self, it may do little to diminish feelings of powerlessness, inadequacy and impotence which are heightened by social inequality, whereas depressants like alcohol, stimulants like cocaine and activities like gambling and gaming can make us feel powerful or competent, and provide an escape from social fear and helplessness.179 However, studies show that for young people in middle- and low-income countries, buying and smoking cigarettes is a status symbol, and here income inequality is linked to higher rates of smoking.180 As we shall see, buying things, particularly status goods, is also shaped by the status anxiety and the intense competition fuelled by income inequality. The deeper the inequality in society, the higher the value we seem to attach to self-regard and the tougher the consequences of being disregarded by others.