The Anticipatory Care Paradox and Overdiagnosis: Subjective Pragmaticism trumps Objective Empiricism

An example:

Take the sentence:

“Early diagnosis of cancer by population based screening prevents cancer deaths and is a good thing.”

This summarises the concept underlying, say, the UK national breast cancer screening programme (UKNHSBCSP).

It is an example of the concept of anticipatory care in general where :

“Predictive risk measurement and diagnosis by population based anticipatory care programmes prevents premature death and is a good thing.”

What is at stake here is “a good thing”.

The question is: “What determines whether the concept should be marketed, commissioned or translated into state policy, as so-called evidence based healthcare, as, that is, a good thing ?”

For pragmatism (P) ‘a good thing’ is a practical thing, where the term practical, as used here, specifically means that the specific form of anticipatory care achieves the active intent of the programme, here defined as preventing specific forms of (premature) death.

By contrast, for Logical Empiricism (LE), the question posed of a good thing depends upon an evaluation of all of the possible conceivable and observable effects of the programme.

So, for example, LE would take into account and value as meaningful, as many empirical observations of harms as possible, such as the impacts on health of for example, mastectomy as such, of side effects and complications, and of longer term but still conceivable, observable, sequelae (such as radiation induced cancer and heart disease).

For LE the so-called observation-sentences (for example, “mastectomy can lead to wound infections and chronic pain”) that attest to the predicate “a good thing” must refer to observable empirical outcomes that make sense, have empirical meaning, and are therefore sensuous, imaginable or conceivable at an individual level.

Therefore, overdiagnosis (OD) is not a meaningful outcome for LE because, most simply put, it is not sensually experienced.

This is a dilemma for scientists who ‘feel’ OD is important but are unable, under the precepts of LE, the basis of Evidence Based Healthcare (EBHC), to make it count as value-able in the inquiry into, say, breast cancer screening.

As an aside, the term premature functions here as an imperative term for the subject. It signifies the subject for another signifier thus: “You not only can but should, even must, try to prevent your premature death, because your proper mature death lies further in the future, some time, not defineable.”

LE accepts the existence and importance of causes and mechanisms of ill health production, such as, say, radiation inducing cancers, because these help to identify possible conceivable, observable, outcomes, which will therefore influence methodology and study design. For P, these causes and mechanisms do not exist, or are meaningless, because the focus is on the relevance of outcomes to the active intent of the programme of anticipatory care and not the wider evaluation of what might be, or attest to, a “good thing”.

In the evaluation of the UKNHSBCSP we can see the workings of a subjective pragmaticist empiricism, that trumps LE in general.

So, that a statement by a cancer expert in 2012 , by Prof. David Cameron, who was on the UK’s independent review panel for the UKNHSBCSP:

“I personally would prefer to avoid a breast cancer death … and the risk that I might have a cancer over diagnosed and therefore treated is one I would be prepared to take”

effectively privileges the active intent of the programme at the expense of other harms that may, if counted and valued as harm as such, negate the conclusion that screening is a “good thing”.

This privileging of the active intent of an intervention devalues harms as such and leads to ever expanding, intensifying forms of anticipatory care and overdiagnosis. It also privileges the intent, scientific interests and healthcare goals of particular clinical specialisms. Cancer specialists tend to be pragmaticist, and therefore interventionist, with respect to their own cancer research and interventions.

Overdiagnosis is an anomaly, meaningless for P, and a contradiction for LE.For P it is meaningless because it is not relevant to the active intent of anticipatory care. For LE, it may be conceivable and measurable at a population level but it is not observable. To be observable is to be experienceable at an individual level. And although it is (indirectly) deduced and measured by LE as a logical (positivist) population outcome – OD is not empirical, it is purely positivist. Thus, OD is, in theory, finite and determinate, and measureable, but it is not imaginable, experienceable, or, literally, sensible.

LE is an ally for social democracy under capitalism because it attempts to value all possible conceivable and observable outcomes that attest to a good thing. It is more likely to objectively strike a more equal, just balance between the harms and benefits of forms of healthcare.

Conversely, P is an ally of neoliberalism under capitalism. Capitalism needs competition and innovation and monetised growth to survive. Because P ignores harms not relevant to the active intent it privileges intervention, and therefore promotes neoliberalism’s necessary endless innovation and the marketisation of ‘new’ products as a good thing.

Therefore, LE has more potential to limit harms due to anticipatory care whereas P continually intensifies harms due to anticipatory care.

The social democratic LE scientists would like to value OD, as harm as such in determining a good thing, for the sake of collective justice, but are unable to make it count as value-able for themselves, and even less so for the neoliberal pragmaticists who are only swayed by active intent, that is, for example, by saving lives from breast cancer deaths.

In the anticipatory mode of care overdiagnosis is an inevitability, but, at the same time it is personally unimaginable, and so compelling citizens to decide whether to comply with screening invitations, as if this is a ‘fully informed’ and ‘fair’process, is anti-democratic.

The cause of this situation is the belief that it is possible to scientifically define the precise biological boundary between normal and pathological forms of life in order to predict future disease. But, because life itself functions alongside and through error: environmental contingencies, constant mutations and non-linear responses – it is inherently unpredictable. To claim, for example, that a screen diagnosed cancer is always ‘real cancer’ when only 1 in 3 of them would have caused harm in the future, is to deny life’s mystery, this unpredictability.

Because of the unpredictability pre-emptive attempts to treat on the basis of anticipation will always over treat, and this will always result in non-empirical, non-sensible, unimaginable, non experienced, overdiagnosis at an individual level. And therefore anticipatory modes of care will always be unjust and anti democratic. It will make the citizen increasingly vulnerable to being positioned as limitless clinical labour for a neoliberalised monetised market, warranted not by a social democratic objective logical empiricism but by an interest driven neoliberal subjective pragmaticist empiricism.

Individual, Masse and Mass

Individual becomes Masse

Value Religion Racism Price Neoliberalism and consciousness.

We should be worrying about questions of value where value is absolutely distinct from price.

This is because neoliberalism both embellishes some values whilst hiding others behind a screen. It fools us, makes us feel aware even while we only have an imaginary relation to our real existing conditions, value is hidden, and values are manipulated behind an apparent democratisation of decision making based on price, numbers, and in the name of rational choice. The felt value and the stated price are two very different things.

To fight the deception and destructive effects of this we must realise that values can only be felt by us and shape us as if true if they are effects of conceivable practical consequences for the individual (to paraphrase Pierce).

If we can’t conceive it or imagine it it can’t be true.

Neoliberalism is a mask for the obfuscation of felt values, and is a filter that drains human value, and life, and agency, and retains only the compliant automaton, who ‘stupidly’, dehumanised, tries to calculate his or her way through decisions – not knowing how the dice have been loaded, how the individuals health is being stolen for the market. Individual become Masse – raw material, under a totalitarian ideological pragmatic philosophy of pure selfishness. Where the measure of truth is personal satisfaction and personal prejudice at the expense of the ‘totality of facts’.

Supporting Israel, is supporting a totalitarian neoliberal ideology of selfishness, identical to the ones we face ‘back home’ – in the U.K., Canada, USA, etc.

As Kurt Tucholsky put it, who in 1933 warned against totalitarianism under Hitler, whose un-German books were burned, and who probably committed suicide in 1935: “A country is not just what it does, it is also what it tolerates.”

And it was surely ironic to read these words in the Holocaust museum in Jerusalem yesterday August 2017. Where even the holocaust becomes a propaganda tool spreading fear amongst Israeli Jews in order to support Zionism and a Jewish, ethnocentric and inevitably racist apartheid state.
The Jews in Israel face exactly the same problem we face in the U.K. and the USA. The congregation in the liberal re-constructionist synagogue in Jerusalem, with their songs, fellowship, face the same problem. But, does religion offer a kind of seductive but false ‘hope’ that after the darkness God will fix things in the end? The talk of God, as Opioid, Tylenol for the masses. How do we resist the power of the neoliberal elite most effectively today. Israel is surely one of neoliberalism’ weakest spots because here the contradictions of neoliberalism, the brutal oppression of millions of Palestinians through colonisation, are most visible. What is the most effective response? Organise? Educate? Write? Publish?
Religion might offer the most personally satisfactory solution to life’s inherent paradoxes but that does not make it true. Even just as the arch pragmatist the American William James persuaded young minds to believe in God, using neoliberal arguments, his economised religious pragmatic form of belief devalues our own consciousness and increases our vulnerability to becoming disciples of false Gods, Gods of racism.

Scary EBM rationality is beyond care

Care is required because the EBM methodology and rationale reinforces the maximalist mindset

It is natural and makes sense to want to improve medical practice.  And it seems to make perfect sense to want to intensify the application of the scientific method and EBM methodology to the problem of misdiagnosis. However, isn’t the sheer rationality of this quite scary, quite inhuman, as if beyond care?

 

This positivist EBM methodology has the same rationale that has led us from Halstead’s mastectomies, to national breast cancer screening programmes to Oncotype DX.   And it is this EBM methodology and rationale that produces more interventions for the market.   This reinforces the maximalist mindset that functions for capitalism to increase the economic productivity of life itself.  But what is the aim of this EBM rationale today? Is EBM derived innovation aimed at reducing levels of iatrogenic harms already in existence, a damage limitation exercise, or to provide care that is harmless, or to make us live longer?

 

Remember that the policies of national screening, early referral, and predictive diagnostic interventions are aimed at prolonging, or to use the rhetoric, saving, life. They are the biggest cause of misdiagnosis and harm and, like austerity, are a matter of politicised choice. This preventive medicine is imposed upon the well.  This kind of care goes beyond care.  It is not the imperative, must do, kind of care for the present day suffering of the already unwell.

 

There are ways to use EBM to reduce iatrogenic harm and improve care.

 

Firstly, would be to actively identify and disinvest in flawed EBM practices, and not only, but especially, the least cost-effective.(Culyer et al, 2007)  Flawed EBM practices would be those that fail to reach a much higher imposed burden of proof of benefit than currently exists. No longer imposed on the basis of possibilities, as with e.g. the UK NHS breast cancer screening programme (Baum, 2013), but instead ‘not commissioned til proven beneficial beyond reasonable doubt’.

 

This would, secondly, increase the options available to re-invest in re-commissioning care that works (e.g. mental health services for the young, palliative care etc) and for practitioners to communicate with people.

 

Thirdly, the pressure to do this will be helped by insisting the teaching of EBM always includes a real world module on ideology and biopolitical theory.  This would be Real Education for Real EBM, teaching the student practitioners about the way ‘the social’ interacts with real EBM’s most crucial object, namely, the diagnosis, and how capitalist ideology creates the maximalist mindset (Horton, 2017).

 

Baum, M. (2013) The Marmot report: accepting the poisoned chalice. British Journal of Cancer (2013) 00, 1-2, 00: 1-2.

Culyer, A., McCabe, C., Briggs, A., Claxton, K., Buxton, M., & Akehurst, R. (2007) Searching for a threshold, not setting one: The role of the National Institute for Health and Clinical Excellence. Journal of Health Services Research and Policy, 12(1): 3.

Horton, R. (2017) Offline: The Donald Trump Promise. The Lancet, 389(10087): 2360.

Diagnosing Healthcare Harms and Mis-diagnosis

Here is an analysis of the underlying causes of healthcare harms and misdiagnosis from Juan from the EBM mailbag discussion list yesterday, and below my attempt to re-phrase this in terms of processes:

-yes, Owen, apparently, EBM has only benefits without harms

-but, how can we “believe” in the application of EBM in the consultation room, in front of the clinico/statistical tragedy 1/ many doctors do not understand health statistics http://library.mpib-berlin.mpg.de/ft/gg/GG_Helping_2008.pdf

2/ many doctors do no know about their patients’ culture, expectations and values http://pubmedcentralcanada.ca/pmcc/articles/PMC4484696/

and 3/ many doctors ignore the principal/agent theory and how to stand in “another’s shoes” so they practice “defensive medicine” (“offensive” from my point of view)

-we need to be more critic with guidelines that have, as in this example, only 9–12% based on the best  quality (Grade A) evidence https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4245184/

-EBM is a god that justify anything in its implementation

 

Juan,

 

Your very useful analysis points us towards some of the most important processes that are contributing to healthcare harms and misdiagnosis.

 

I paraphrase your analysis here as key processes and possible key sites of intervention:

 

1) the education of healthcare workers,

2) the political (de-)regulation of harmful healthcare interventions (the ‘weak’ guidelines as they are euphemistically called), and

3) the power of, and use of rhetoric by, experts (including e.g. GPs) to impose these on unsuspecting patients.

 

The belief of experts in the implementation of EBM is underpinned and dominated by a dominant rational positivist empiricism with a hat tip to ‘values’ (Howick, 2011). Because of this EBM has become a means of production for capitalism. And it is this, ideological, process that produces the predominantly maximalist and technologist mindset described by Groopman. This is the mindset that produces so much harm and misdiagnosis.

 

I suggest that EBM’s fatal flaw, the crisis of EBM, is the failure to consider that ideology in capitalism may be the site of formation of the mindsets, and therefore the values and beliefs, of both experts and patients (Greenhalgh et al, 2014; Kelly et al, 2015). And that it is the mechanisms of ideology in capitalism that requires analysis. But there is a kind of mental block resisting this.

 

Greenhalgh, T., Howick, J., & Maskrey, N. (2014) Evidence based medicine: a movement in crisis? BMJ, 348.

Howick, J. (2011) The Philosophy of Evidence Based Medicine. Chichester: Wiley-Blackwell.

Kelly, M.P., Heath, I., Howick, J., & Greenhalgh, T. (2015) The importance of values in evidence-based medicine. BMC medical ethics, 16(1): 69.

Evidence Based Medicine, Mindsets, and The Donald Trump Promise

Here is an excerpt from an editorial in the Lancet this week.  It is an unusual admission from corporate media that it is our mindsets that determine healthcare practice and influence behaviour. And it is a tacit invitation to ask why our mindsets can be so dominated by  Donald Trump’s Promise. Is this ‘mindset’ the same as consciousness? If so, and it varies, what of the unconscious?

Evidence-based medicine (EBM) has been a powerful influence on clinical practice. But one book should make even the most ardent EBM advocates pause. That book is How Doctors Think, by Jerome Groopman (Houghton Mifflin, 2007). Groopman, an oncologist, drew on the work of Daniel Kahneman and Amos Tversky (before both were made famous by Kahneman’s own bestseller, Thinking, Fast and Slow). Groopman used his clinical experience to show how easy it was, despite the very best evidence, to be misled by multiple personal biases—most notably the bias of “availability”. Clinicians will often make diagnoses or decisions based on the mental availability of particular pieces of knowledge, including what might be considered as “best evidence”. Groopman punctures easy assumptions that high-quality evidence alone can improve the quality of medical care. Unless doctors are aware of their own informational biases, the possibility of false reliance on “evidence” is not only conceivable, but likely. How Doctors Think should be required reading before any prospective physician is allowed to lay a hand on a patient. Last week, at the annual Rambam Summit in Haifa, Israel, Groopman, together with Pamela Hartzband, deepened the scepticism with which we should approach EBM. …

…  Doctors are educated to believe in their scientific appreciation of evidence. But we may not have educated ourselves to appreciate the mindsets that interpose themselves between evidence and our interpretations of that evidence. Based on extensive interviews with physician colleagues, Groopman and Hartzband identified three dimensions of the medical mindset that any doctor (and patient) should be self-consciously aware of as they make clinical decisions. The three mindsets each have two extremes—maximalist/minimalist, naturalist/technologist, believer/doubter. Ask yourself. Are you the kind of doctor who wants to go as far as you can with the latest technology and who believes in the power of that technology to make a difference to the patient? Or are you the type of doctor who thinks that less is more and who is inherently sceptical about claims for new discoveries? Groopman readily admitted to being a maximalist-believer, which probably influenced his decision in the 1970s to choose haematology as a career when bone-marrow transplantation became popular. Hartzband, by contrast, is a self-confessed minimalist-doubter. Their point was that most clinical decisions lie in a grey zone—there is no single right answer for everyone. The important step is less to adhere to some abstract notion of EBM, but rather to think hard about what kind of medical mindset you have. Whether you are a maximalist-believer or a minimalist-doubter will have a larger effect on your clinical decisions than the result of any single systematic review or randomised trial. We see these mindsets at play all the time in today’s scientific, evidence-informed medicine. There have been at least four US expert committees ruling on the safety and efficacy of screening mammography—with four different sets of recommendations. There have been three expert committees reviewing the evidence on screening for prostate cancer using PSA—with three different conclusions. So much for science. So much for evidence. What matters more are the mindsets of those “experts” reviewing the scientific evidence.

Here is The Donald Trump Promise, according to Groopman and Hartzband. Modern scientific medicine promises the right doctor prescribing the right treatment and the right procedure for the right outcome. It’s just impossible.

In very brief format: my argument is that

The formation of our mindsets is achieved through language. Language is made meaningful, and turned into speech, through master signifiers.  These organically bind the meaning of language to our bodies.  These master signifiers or objets-à, provide objects of desire for the fantasy of immortality and sustain the authority of capitalist regulators to continue to exploit the many for the few. 

So, to take this more slowly:  Hortons’ editorial is a timely  invitation to  reconsider the mechanisms by which ideology forms our values and prompts us to ask ‘How is our mindset determined?”

Three of the  extremes of the dimensions of the mindset conceptualized by Groopman are consistent with the three elements that make up the fundamental  structure of the ideology we call capitalism. These are, a) the faith in b) technological innovation to create c) surplus value.  And these are paraphrased by Groopman under the dimensions of:  belief, technology and maximalist.

However, instead of being spread out evenly along these dimensions the capitalist system tends to polarise these mindsets in one direction only. And, therefore, individuals’ values and mindsets aren’t each just spread along the axis evenly, but are instead also polarised. In capitalism the polarity is driven by its logic: the belief in technology to take life ‘to the max’.   This is a description of how the structure forms our mindset, where it is not only surplus profit that motivates but, as we know, also the drive to surplus-life.  It is this structure  that dominates the mindsets of the experts/industrialists/politicians controlling what is produced by science, and what is marketed, and consumed.

As we know, the clinical decision at patient level is increasingly dominated by, so-called Evidence Based guidelines which, as a rule, mostly command compliance and defensive medicine.    Therefore, individual clinicians or patients, when compared to the guideline producers, can only have limited impact on these decisions .  So, therefore, it makes sense to focus more attention on the marketisation of innovation, the production of guidelines and the intensification of e.g. prevention and screening programmes. At the same time we could be more sceptical at individual level, but in order to fend off and  resist demonisation and medico-legal sanctions this would require some solidarity and collective action.

A form of resistance, and its mission, might ask for more ‘sceptical healthcare’ characterised by:  a) less belief in expert appraisals (much more rigorous standards of proof of e.g. lack of harm as well as benefit, b) less reliance/emphasis on innovation (whilst not denying its potential), and c) less emphasis on maximalist goals for life (especially longevity) and more emphasis on life-lived (today) and, d) increased ambiguity about compliance with guidelines.  But in the end  how much difference can we make as individuals?

Important questions become then: How can we challenge the power of scientific practice and industry to continue enforcing the de-regulation of marketisation and the destruction of the public heathcare systems through privatisation?

Continue reading “Evidence Based Medicine, Mindsets, and The Donald Trump Promise”

Reflections on the Zionist Mentality and the Globalisation of Security in 2017

Thoughts following a study tour to Israel and the West Bank 2017

This paper emerged out of my time on a UK Mental Health Study Tour in Israel and the West Bank in March 2017.  It is also, in part, a response to the thoughts provided by two authors.

The questions addressed here are:

Is there a psychoanalytic explanation for the persistent and increasing oppression of the Palestinians in Israel and the occupied territories? 

Why do ordinary Israelis go along with or even support this oppression? 

What underlies a collective social mentality that makes such oppression appear to be justified?

There is a contradiction at the heart of the Zionist ideology: the weak victim of the Holocaust vs the all powerful Zionist Israeli today.  The perceived weakness acts as a deficit, a flaw, an open wound and a source of guilt and trauma. It has to be covered over. 

The ‘birth of the modern Israeli’ is conceptualised by Zionists as a reaction to the Holocaust. Taking up the gun versus being herded like cattle. 

This is a quote by the disgraced Hollywood movie director Harvey Weinstein about his latest film about the Warsaw Ghetto uprising, Mila 18. Accessed 20 September 2017.

He expresses a concept of the modern Israeli. This expresses a transference of young Jewish male dismay at their perception of inadequate Jewish passivity into the aggressive law of the gun. 

“When people see ‘Mila 18,’ they can subtitle it ‘Jews with guns,’ because this is not about going into the night quietly,” Weinstein said. “This is the birth of the modern Israelis, these were the guys in the ghetto who said we are not going to walk into the concentration camps and get herded like cattle. They said, we’re going to kill some Germans instead.”
The knowledge of the Jews failure to escape the Nazi holocaust contradicts the Zionist ideology for an all powerful Israeli Jewish Nation.   For Zionist Israel the historical oppression and destruction of the Jewish peoples, signifies the Jewish peoples as inadequate. But this inadequacy, in itself, contradicts the revised secure, powerful, and warlike Jewish identity, whose truth is based on the gun itself. This is the  identity demanded by political Zionism and the new state Israel.

The destruction of the Jewish peoples in Europe in 1940s, and in antisemitic oppression for many centuries before this, is an intolerable fact for Zionist Israel, its state, and its citizens. To deal with, and repress knowledge of, this apparent weakness, and to sustain the power of the new Zionist Israeli state required a new identity for the Jewish people.  

This new identity is provided by the ‘all powerful’ fantasy  of the Zionist Israeli ideology. This acts as a  veil, or cover, for the known historical fact of Jewish oppressions and destruction. This fantasy functions through the authority of the Israeli Military State. This ‘all powerful’  state functions as an Other to the Israeli citizens. The fantasy functions through portrayal of the Arab in general, as a ubiquitous, lethal, terrorist threat. The Arab threat is absolutely necessary as an object for reaction.  It provides a focus for desire and an object that must repeatedly be both destroyed and simultaneously re-constructed so that the all powerful identity of the Zionist Nation can be continually re-affirmed. This continual demonstration of the superior  power of a state that lives by and identifies with the power of lethal force, is necessary to sustain the authority of this power. 

Without war and violence and the Arab threat the fantasy of the all powerful Jewish state would itself fail. In this situation the reality of the vulnerability of all peoples, including the Jews, to racist oppression, would re-enter consciousness that would re humanise the Arabs.

The Western versus Islamic confrontation is an ideological force that has developed since the formation of Israel.  The ideological force of the Islamic terrorist is not a feature unique to Israel. This is a western ideological force. But it is an ideology violently evident in Israel, a state under the protection of a USUKNato western axis. 

For Marton the holocaust was a trauma that was not dealt with after the war. And the failure to deal with this trauma causes a post traumatic stress reaction, a defensive reaction that materialises as pure aggression.

The first account I consider is by  Ruchama Marton, a psychiatrist and the founder of Physicians for Human Rights Israel. We had the great privilege of meeting her in Palestine in 2017.  

She wrote an article:

“Forced Existence” (2016)

In it she  attempts to account for the psyche of what she has called the Zionist Israeli Collective (ZIC).   She suggests that the aggression of the ZIC psyche emerges out of a failure to adequately deal with the historical  trauma of the Holocaust. This aggression, for Marton, has its origin in a collective reaction to the trauma and  a sense of guilt for an imagined failure of the victims of the Holocaust to adequately resist the Nazi inflicted genocide

I also consider  a second psychoanalytic approach , by Martin  Kempe, a London based psychoanalyst. 

“Collusion as a Defense against Guilt: Further Notes on the West’s Relationship with Israel
and the Palestinians” 

This explores the consequences of the Zionist colonisation of Palestine for the Zionist Israeli psyche, and the reasons underlying continued western support for this colonisation.  He suggests that this support has emerged in part as a way of evading guilt for western, historical, antisemitism and the traumas this has inflicted on Jewish populations.

I explore whether these ideas  are sufficient to explain continued Zionist Israeli aggression.

To begin, then, for example,  Jeff Halper at the ICAHD conference today, 13th May 2017, said that many Israelis do not ‘hate’ the Arabs. He  suggests that the Israelis are now more ‘ready’  than ever to accept a political concord with the Arabs, and that all they desire is individual ‘personal security’.  But what does ‘not hating’ the Arabs mean for most Israelis? More specifically are Israelis simply indifferent to the existence of the Arabs? Are Israelis indifferent to the fate of the Arab population in Israel/occupied territories/refugees abroad?  Is it possible that such Israeli indifference to ‘the Arab’ fate also coexists with a deeply felt Israeli collective fear of ‘the Arab’?

This simple indifference would seem to be an oversimplification because indifference to, defined as not-hating, implies only a lack of caring ‘for’ the fate of the Arabs. But does such indifference also mean that Israeli Jews don’t fear the Arabs and the potential  actions of the Arabs?  So, although, for example, we might also be indifferent to, in the sense of not caring for the life or welfare of a snake. This doesn’t mean that we don’t see the snake as dangerous and would do virtually anything to eliminate the threat it poses.

To summarise very briefly therefore, I suggest that the somewhat depressing complication masked by Jeff’s “The Israelis just don’t care about the Arabs” is that the Arab for the Israeli (and the UN) is ‘Beyond Care’.  This can be explained in part through  the logic of an immunitary mechanism. This is  a logic in which we we have a kind of paradigm in which the Arab provides the source of contradiction which is incorporated into the Israeli identity and is necessary for the preservation of ‘Israeli Life’ even as it destroys it from within.  This means the Arab signifies ‘mortal threat’ to Israeli Life Itself, not to any individual’s personal life but to Jewish Life itself , part of the deep meaning of Zionism for Zionists. But this immunitary logic also requires the support of a logic of fantasy, the promise of eternal security for Jews through ethnic cleansing of the Arabs.

The UN is also relevant to Palestine’s fate  – the UN was set up to protect the lives of those within states from oppression by other states – it fails, because its practice is also ‘beyond care’.  It too has an identity that requires the othering of a people, an othering that provides the contradictory antigenic stimulus that provides the very justification for its continued existence, even as it undermines itself. This is an example of Esposito’s immunity paradigm, a so-called negative dialectic based on the principle of supplementarity. 

However, I’m suggesting here that the Israeli Jewish social psyche is formed through the construction of an identity that doesn’t hate the Arab, but instead fetishises the Arab as mortal threat, as if a deadly poisonous snake. This snake isn’t hated, but it is feared, the Israelis are indifferent to it, but only on condition, that it is kept secure, far away, caged,  or even exterminated.  

This fetishised fear of the Arab is provided and its value renewed continuously by the zionist government of Israel. The government, and zionism abroad,  produces the discourse of danger, an always increasing danger, from Arabs or Religious Islamic extremists. This enemy is characterised as desiring the destruction of the Jewish State.  This is the identity, and   the Israeli collective needs an identity, and at the moment the is founded on threat and security.  Indifference is not enough to provide change in this identity.  What will be needed is sufficient reassurance that the Arab is not a mortal threat, that Israel is secure. The model of a bi-national state, with equal rights, that will allow the emergence of a new society, may be one mechanism to achieve such assurances. The narrative of threat needs to be countered.  Clearly very difficult.

PART ONE

These are further thoughts on what drives the intensification of intimidation by the Israeli state. And further thoughts on the mechanisms used by the Israel State to disintegrate Palestinian society.

This disintegration of Palestinian Society in particular affects the Palestinian nuclear family. And this takes place through its deliberate infection, by Israel,  with two ‘viruses’ and a disabling strategy.  One virus is the virus of distrust suspicion within society, and  within families and villages.  The second is the virus that beheads the family and leaves it unprotected and the father humiliated. This is the one that decapitates the family, through the repetitive and ritual humiliation of the father in front of his wife and children.  There is a third wound inflicted.  This is another amputation or beheading, this time of the symbolic `name-of-the-Father, of the political leadership.  In this strategy Palestinian society has also, in effect, been infected, or perhaps better, beheaded through its betrayal by the Palestinian Authority which, since the Oslo accord, has collaborated with the Israel State, and is being paid to brutalise its own people.

However, for now, in this paper I focus on the mechanisms that form the psyche of the ZIC, the Zionist Israeli Collective, a term coined by Ruchama Marton, an Israeli Jewish psychiatrist and founder of the Israel Physicians for Human Rights, medical-political organisation.

The thesis here is that although there is a collusion between the West and Israel, this was, and ultimately is, a collusion between the Israeli Jewish nationalist state  and the imperialist capitalist system.  This collusion originally emerged from the coming together, in the  early twentieth century, of several social forces:   political zionism, British imperialism, a benign view of the concept of settler colonialism, and a liberal Enlightenment. And all this became manifest in the 1917 Balfour agreement. I argue that this specific collusion is founded on the mutual, shared geopolitical and economic interests of a) Zionism and b) the imperialist capitalist USUKNato pact. I also argue that it is based upon the same biopolitical logic of fantasy that underpins the authority of capital itself, as described by Marx and Lacan, and as well described by Tomšič in ‘The Capitalist Unconscious’, and Kordela in ‘Being, Time, Bíos’.

This argument is based on the following four claims: a) this is a synergistic collusion between, on the one hand, a lack, and on the other a productivity, b) the lack is in the Israeli Zionist Jewish collective (ZIC) that was left without an identity after the Holocaust, c) the production of an identity  through the ZIC’s productive labour-power required for the specific imperialist political enterprise of zionism, and d) the object of the intensifying securitisation of the Jewish State Israel against the mortal danger from the Palestinians.

The ZIC Logic

One of the lessons from my recent tour was that the ongoing trauma for the Palestinians is persistent. pervasive, non-stop, and intensifying.   The Israelis are masters at psy-ops, massive intimidation and humiliation.

To challenge this it is important to understand the rationale, the logic they follow,

This is a principle guiding the work of Military Watch: to fight the Israeli State and the IDF (Israeli Defence Force) by identifying its logic and predicting their reactions, and next steps. The people are living 24/7 in fear and humiliation with hope but no optimism. A key element necessary to relieve this suffering, as for any abused subject, is to find a safe place. But there is no safe place. So, where do we turn next if we wish to help? Solidarity, BDS, international publicity and pressure, legal challenge, financial and material support are all valuable.

But what about the Zionist Israeli Collective (ZIC)?

We know that virtually the entire Israeli Jewish civil society has participated in inflicting the brutal occupation on the Palestinians for the past two and a half generations.  What is the mentality of a population that is able to participate in this process as if it is ‘normal’? Can we understand the psyche of the ZIC? Does it have an underlying logic?

This paper suggests that there is an origin and mechanism by which the ZIC is induced to accelerate their own path to self-destruction through self-dehumanisation, self-imposed hysteria and, increasingly, unbearable fear. And this mechanism involves a logic of fantasy, a neurotic repression of ongoing traumatic knowledge of atrocities, and a consequent fetishisation of the erasure of the fantasmatic ultimate threat to the Jewish States existence: the Palestinians.

On the tour I began to think about the psyche of the ZIC, and the relative contributions to its militarised machine state made by religion, the Holocaust and Zionism.

Both Marton and Kempe, in their different papers,  argue that a collective guilt and unresolved post traumatic stress has led to both silence on the part of the West as well as to the transference of aggression onto the Palestinians on the part of the Zionist Israeli Collective (ZIC).  Kempe claims the West feels guilty because of its history of antisemitism, leading to silence which he describes as collusion. Marton argues the ZIC responds to its own inadequacy and lack of legitimacy by transferring aggression onto the Palestinians. However, I use the idea that subjectivity is not the result of a collective consciousness – as if the emergence of a self consciousness is entirely the work of the subjects of the collective. Instead using the work of Marx and Lacan in particular I argue that subjectivity is produced as a result of both a desire for identity and the production of a Master Signifier that provides the object of desire that provides a specific set of targets for the search for identity.

According to both Marx and Lacan capitalism works through a structure of fantasy that provides the subject with an identity through his/her imaginary relations to his/her real existing conditions. By identifying the Master Signifier and the fantasy narrative that supports the capitalist enterprise we might be able to expose the inherent dehumanising slavery imposed on the ZIC by zionism.

This opens possibilities for making current ZIC objectivies no longer sense-making, and for shifting the specific focus of desire for the ZIC identity to something more emancipatory for both the ZIC and the Palestinians. That is to promote change.

As we have seen, capitalist systems provide the Master Signifier (the object lost and desired) that is the basis for the fantasy that sustains the authority of capital, thademands repetition and surplus. The Master Signifier for the ZIC is provided by the fantasy narrative produced by the capitalist system of labour production and the commodity form.

We can now try to apply these constructs to the ZIC and zionism. After the Holocaust, the Jewish Europeans had lost certainty about their identity, as full humans, having been dehumanised. The zionists, as imperialist capitalists, personified nationalism and capital, and as such sought effective labour-power to secure the land of Greater Palestine for the Jews. The Holocaust and the end of the Second World War provided a stimulus to the zionists. The European Jews were available to freely sell their labour to the zionists. And at the same time the zionists were wanting to secure labour, Jews to work for zionism by offering an identity for the Jews through the Master Signifier ‘National Security’.

This would take the form of the securing, for a people without a land, a land without people. As labour-power, the Jews, so recently dehumanised, desired identity, and so were especially ready to desire that which was presented to them as something they had lost, the objet à, identity through ‘national security’. The readiness of the Jews, to recognise the call for an identity, attracted the promise for the provision of such an identity. And the zionists imposed this promise as part of their endless pursuit of land, and war, providing land, more land; war, more war; wealth, more wealth. The desire for what is lost becomes, for the ZIC, a subjectivity that is responsible for a form of National Debt, a sensual suprasensual precarity in the form of the fetishisation of existential threat from ‘the other’. This debt imposes what is felt as a moral duty to dehumanise and to annhilate the other through the repetitive destruction of specific threats and that creates surplus security.

Two features of this process are important here. One feature is that the debt never actually decreases since each act of destruction provides a positive impetus to the quantitative scale of threat felt by the ZIC. The other feature is that in order to meet the increasing sense of precarity, and to continue to match this with surplus security, requires an increase in the productivity of the labour-power through both increased fear of the threat as well as through innovations in the techniques of destruction, physically and psychologically. And, in passing, it is useful to notice that Israel now markets, globally, its world leading innovations in techniques to destroy the other, as techniques that make possible the Security State, to other Nations across the USUKNato regimes and elsewhere eg Australia.

Today then it is possibly not so valid to postulate the continuing importance of a collective guilt as suggested by Marton and Kempe – a guilt due to the persistence of the effects of an unresolved post traumatic event. Perhaps instead, increasingly, the Israeli Jewish psyche has become alienated – by the production of lack as it is objectified as labour power that eliminates threat, and the production of surplus – the appearance of surplus security.

Finding an identity – nomadic options 

Israel’s main commodity is the ‘Arab Threat’ that contains use-value (genuine Arab aggression) and exchange-value (in the increased sense of threat or precarity felt and created by rhetoric of crisis, and exaggerated military response, demolitions, detentions, humiliations. incursions, water deprivation etc). This is where  Security functions like money, as a form of universal equivalent and means of exchange. This provides a nationalist identity based on security accumulation – which functions as both the universal desire in the form of the non specific and insatiable desire for ‘total’ security, the impossible aspiration, and the universal equivalent means of exchange, or currency, for the consumptions of threats (involving dehumanisation and consumption through annhilation).

Israel provides this identity for the ZIC, who are, and were, already primed to seek and recognise a subjectivity that renders and validates them as full members of the Zionist Israeli community. This establishes for them the role of a moral justified victim forced to seek surplus security by dehumanising and eliminating the Palestinians. This enrolls them in a structure that provides surplus jouissance (lustgewinn). This is, after Freud, the pleasure-gain, ‘pleasure that is not felt as such’. This role, to generate surplus security, increases libidinal tension (in the form of fear), and objectifies the ZIC as labour-objects for the state in a capitalist perversion that is a repetition of the trauma experienced in the Holocaust of Europe and the Naqba and ongoing ethnic cleansing today. 

This is a repetition compulsion necessary because of the insatiable nature of the desire for more security which both serves to sustain the post traumatic search for a moral identity for Jewish nationals as well as providing surplus power, wealth, land and war for the Zionist Israeli imperialist and capitalist elite and its western USUKNato allies. The repetition requires the continued multiplication of identifiable sources of threat from the Arabs that materialises as the ongoing intensification of oppression through massive intimidation by the security and continued ethnic cleansing, as well as the geographical extension of the source of threat to other countries such as Iran and groups such as Hamas and Hezbollah.

Ruchama Marton: in ‘Forced Existence’

Marton suggests that the post traumatic sense of victimhood justifies all acts of wrongdoing against the other, as in so-called ‘defensive marriages etc.  She blames the unforgiving guilt (or should it be embarrassed shame under the imagined gaze of the Name of the Father : zio_nism) for collective weakness or emasculation in the Holocaust – it is as if having been humiliated and slighted by the world, for all to see, the reaction is to transform this embarrassed shame or guilt into an aggressive paranoiac reaction – and the identification of the victim with power (such as the power the Nazis).

However – is this ‘guilt’ sufficient to explain the barbaric behaviour of the ZIC collective? Zionism, a corporate political goal for the Jewish State existed long before the Holocaust. So, might we find in Zionism the roots of other ideological narratives that persist today? As well as the shame transferred into hatred of the weak and oppressed, what about the role of imperialist and capitalist ambitions shared by Israel and the western coalition of the US, UK, and NATO, to dominate the Middle East for, for example, wealth creation through energy security in the natural oil and gas reserves.

There may be a synergism here with the intensification, that has taken advantage of this post traumatic state of unforgiving guilt transferred into aggressive hatred, with the intensification by discourse of Netanyahu’s ‘Life Itself’ under existential precarity using the imagined ‘truth’ of the Just Return to the Jewish State supposed to be immortal – that functions to create a reality as ‘appearance’ or representation.  This immortal life itself is a desire of the Other. It signifies a) the logic of dehumanisation: the Palestinians as inhuman threats intent on destroying Israel and driving out all the Jews, and b) the desire for ever more ‘security’ through the logic of elimination. These imperialist fantasies sustain the potential for the elite to make surplus value out of Land and the perpetual war with its industrial military business. This occurs through the ZIC, as both discursive symbolic producers of surplus threat and the means of securitisation of the threat.

The ZIC, as Marton calls it, has been primed to respond to the imperialist capitalist inspired discourse of threat as commodity form, measured in arrests, intimidation, disintegration of families, land – dunum by dunum, goat by goat – and it is the imperialist who has something to gain here – domination of the Middle East and its surplus profit reserves. The Holocaust memory is oft commemorated, repeated and refreshes the guilt and hence the antagonism. The comparison of Israeli actions with the Holocaust provokes hysterical outbursts – as if to even hint that the Holocaust was just another genocide might weaken the guilt reaction, and weaken the transference of aggression to their victims the Palestinians, might weaken the imperialist mission to accumulate surplus wealth and power.

The sense of threat also forms part of a fantasy structure. I think it remains a moot point – the relative influence of a collective sense of victimhood due to the Holocaust in relation to the mediated discourse of Palestinian threat. So where does life itself fit in as a signifier? And indeed religion; another set of fantasy structures. The Chosen People. The City of David. Jerusalem. All religiose tropes.

“The ZIC victim views present reality through the prism of the past” unacceptable knowledge is denied, or a victimhood identity becomes a motif of ‘the most moral army in the world’, the entire ZIC is in the military family. 

The mechanism of denial is based on a fantasy structure such that the present reality is refracted through the prism of the past, as Marton suggests, but is also discursively created and reproduced daily to sustain imperialist power and authority. The origins of Zionism predated the Holocaust / the imperialists took advantage of the Holocaust and still do; even being encouraging antisemitic behaviour abroad to drive Jews to this new State.

From the perspective of the Zionist, “supposed to desire the immortality of the Jewish People and the Jewish State named Israel”: the Palestinians are either just waste, to be left ‘to rot’ (Chomsky and Pappé).  Or in certain symbolic forms, for example, ‘the woman with knives at a checkpoint’ they are useful as productive raw material from which ‘threat’ can be produced and consumed by security in exchange for surplus security S – T – S’, (the same structure to be found in the exchange of the capitalist commodity form) e.g. by mediated military style discourse, such as:

“In a separate incident on Friday, Israeli security forces arrested a Palestinian woman in possession of two knives at the Qalandia checkpoint north of Jerusalem. The suspect was taken in for questioning.”

(28/04/2017 Times of Israel)

However, this should be read alongside a potential ‘hole’ in the formal Israeli logics (of dehumanisation and elimination, Pappe), a contradiction for the Israeli Jews.

One form of contradiction is created when, sometimes, Palestinians do actually resist the military occupation, incarceration, more or less violently, in ways that are felt directly by Jewish people in Israel. And, this may have two effects on Israeli consciousness: a) it reinforces the narrative (of the structure of the logic of fantasy) that the ‘threat’ is real sustaining the authority of the Israeli military junta – but b) it introduces the potential contradiction through the question ‘Why?’ ‘Why do they (appear to) want to destroy us?’ With four possible answers – a) the whole world is anti-Semitic (cite the Holocaust), b) revenge for imagined harms, c) revenge for actual harms, and d) to resist intolerable oppression of a fully human people. 

The examples of resistance also indicate a flaw in the Other, the Israel State is exposed as deficient, even as it claims to be all powerful and secure.  This reveals another form of contradiction at the core of the ZIC psyche. 

But there is a complication. These answers also suggest the possibilities of ‘revenge for actual harms’ or ‘to resist intolerable oppression’.  

To demand punishment and reprisals the Palestinians aren’t just non-humans to be eradicated, instead they may appear to have agency and intention, and crucially, in addition, ‘just cause’ – unlike the inhuman snake. But indoctrination of Jewish Israelis starts as soon as they are born (Pappe). It is as non Jews that Palestinians are les valued by God and so we cannot expect too much of this contradiction.

So, we can see that the Palestinians function as raw material, as ‘risk’ in the Israeli fantasy, and psyche.  But in another, Palestinian, symbolic network, they are also labour-power, a People, fully human, with agency, generating material and symbolic threat, through acts of resistance important to, perhaps, a fantasy based on ‘hope without optimism’, and ‘samud’ – steadfastness, resilience, the hope for future generations (Eagleton).  This actual real threat is minor compared to the threat imagined by the ZIC, its neutralisation would represent mere use-value, much less than the enhanced exchange value of the imagined value of threat produced by the ZIC.

Should we be asking what sustains our active support (USUKNATO) of Israel and not just our ‘silence’ – instead of passive silence the opposition to Zionist apartheid activities are actively silenced, boycotts are ‘criminalised’, weapons are sold and security bought.

Tony Greenstein provides a Marxist analysis but contradicts Moshe on his use of the concept of class consciousness that theorises that the Jewish working class would revolt against its right wing imperialist government and its genocidal activities against the Palestinians ‘if’ they were to be promised a separate Hebrew state. Greenstein argues against this saying that where nationalism and imperialism are concerned the Jewish working class see themselves as having power over the indigenous Palestinians in Israel. The Jewish working class labour under a nationalist fantasy that masks but sustains their real role as Israel’s Jewish-Hebrew working class as a proxy working class for the Israeli/western imperial ruling class.  In general this sustains Israeli elite and western interests (so far anyway) profitably for eg the USA and U.K. powers, in the Middle East.

I argue that it isn’t guilt functioning here, as much as an imperative to produce surplus – surplus power, security, wealth, meaning for life, existential survival, land and life itself. This surplus is promised through the fantasy of the consumption of the objet à, the Palestinian terrorist (or Hamas, Hezbollah, Iranian nuclear weapons, Syria etc) supposed to be identified and consumed as a ‘threat’ commodity, like a viral pandemic.  This viral threat is everywhere and nowhere, any consumption never enough, because the desire for the objet à persists, surplus value is demanded and mere destruction isn’t enough. Repetitive destruction and expansion in the name of erasure is required.

It is the repression of the knowledge of the Palestinians as a fully human people into the collective unconscious that enables the ‘truth’ of Zionism ‘The Jewish State – for a people without land a land without people’ to act as support for Zionist ethnic cleansing. Ethnic cleansing is reframed as security measures to protect The Jewish State because it makes any understood ‘meaning’ for its actions as ‘apartheid’, racist and a crime against humanity, actions comparable to the Holocaust, ungraspable, and therefore impossible.

How far will this go before built in contradictions cause it to blow up in its face is impossible to say?

One possibility is the breakdown of imperialism in the supporting nations first, rendering continued support for Israel impossible.

Kempe’s conception of collusion due to guilt implies knowledge known i.e. as meaningful – and collusion implies a ‘letting something happen’ as if by default or by silence – a passive involvement. But the UK’s involvement was active: the British Mandate, the Arab revolution, partition and the Balfour declaration. So silence is not because of a defence against the guilt of antisemitism but because of a continuing active partnership of an Imperialist Capitalist drive for not just land or wealth but ‘more’ – a gain of any kind is never enough – and the master signifiers of the illusion are in the form of ‘accusations of anti-semitism against the anti-imperialists’ and of ‘attribution of terrroist existential threat to the Arabs, Palestinians and Shia Muslims’.

Religion

Lenin suggested imperialism is the ‘highest’ form of capitalism: and the difference between imperialism and colonialism is that colonialism is one mechanism for imperialist power, for capitalism. Israeli colonialism is therefore part of the imperialist capitalist ideology of Israeli state power. As such Imperialist Israeli ideology could have different drivers, and, as well, different fantasy structures, that sustain the authority for those drivers. Each driver may represent a desire of the desire of the Other: and the illusion may represent a driver for settler colonialism that in its turn supports a different illusion that represents the driver for imperialism.

So, for example, the religious fantasy of settlers about Zion and the return of the Messiah could operate with a transcendent God external to the immanent master-slave or university discourse of capitalism – and at the same time the imperial/capitalist fantasy of state/corporate sovereignty (and the state of exception) would benefit from and encourage this religious illusion as an internal construct of its capitalist fantasy of limitless economic growth; running alongside its imperialist/capitalist fantasy based on limitless biosecurity.  This is symbolic of  limitless ‘life itself’ for the Jewish people (defined in Zionism as all Jews globally), to be secured by the exchange of objets à.

The specific objets á are  in terms of, a) limitless supplies of a commodity ‘threat’ provided by Palestinians,  ‘terrorists’ by definition, b) a barred Other, so that this threat always fails to be met so that so the nation is constantly neurotically anxious and c) the consumption of the commodity ‘threat’ by its attempted but always impossible erasure.

Security is lost, at the same time as the threat, the object à to be erased, is provided or discursively produced . The logic is of erasure, (and dehumanisation) and not just of a defence against and proportional to the guilt for the nakba, and the continuing ethnic cleansing today. Although each atrocity adds to intensify guilt which adds to denial.

But, is it possible that more important than denial of guilt is the role of a positive search for erasure, ethnic cleansing, even genocide? These aren’t just two sides of a coin.  To feel guilt implies that the actions committed have some meaning for you, but what if the imperialist/capitalist fantasy structure has made the exploitation of the Palestinians as the source of the commodity ‘threat’ actually meaningless, through the repression of their humanity into a collective Israeli unconscious, and therefore invisible so that there is no guilt, and no meaningful memories of the atrocities, as they are made unconscious through a psychic process that could operate through a university discourse.

Kempe in ‘Collusion’:

The ‘wilful blindness’ mooted by Kemp as a defence against guilt is more likely a non-intentional rendering of the guilt from the erasure of the Palestinians as ungraspable as meaning.   They ‘know’ it (intellectually) but unknow it at the same time (emotionally) – not in any defence of the ego, but as a necessity to sustain the illusion of the fantasy of Zionism – everlasting Jewish ‘life itself’.  This fantasy requires continuous nourishment through the necessary continued creation of mythical terrorists and their ‘threat’. The threat is most productive for ‘life itself’ when most fearsome and the most fearsome enemy must be met by the most ferocious and inhumane attack – aimed at the heart of the emotional bonds of Palestinian families – through covert techniques of mass and massive intimidation. The need to increase productivity as a competing global security state requires intensifying intimidation and innovative weaponry. There is also ‘a curious copulation’ ( as with Lacan’s phrase applied to science and capitalism) between religion and Zionism. And Zionism has its roots in a Central European wealthy capitalist elite that despised the Eastern European Jews – and that saw Greater Palestine as a imperialist/capitalist opportunity.

As a state Israel and the USA/Britain/UN are sometime uneasy partners in a battle for global military-industrial corporate domination, and require continuous war to sustain both the illusions of Zionist immortality – life itself- and wealth creation. Capitalism plays its role in shaping the consciousness of civil society in Israel – the erasure of the Arab threat is the objet à, (the object produced by capitalism that simultaneously creates the sense of loss for that object at the same time as the desire for it) that sustains the illusion of Zionist immortality – the surplus life that is the fantasy of secular capitalism / where life cannot have meaning in terms of working simply to sustain a mortal life – this certainty is foreclosed as we foreclose consciousness of the exploitation of the labour that is known very well to be mortal and only paid enough, or often less than the, wages necessary to sustain and reproduce labour) – the un-humanised palestinian is the exploited labour made bare life, that creates the space/territory/power/land as commodity that sustains the secular capitalist fantasy of immortality. The Palestinians are made un-human; like animals, uncanny, threatening. Living dead – like the inhabitants of concentration camps in the ‘grey zone’.

 

PART TWO: ALIENATION (dehumanisation) – SURPLUS PRODUCT (threat) – SURPLUS VALUE (security)

The Zionist Israeli Collective (ZIC) consciousness and a logic of fantasy

Norman Finklestein’s recent thesis (2016) is that, to paraphrase : Now every Israeli citizen is a soldier, a participant, a killer ‘inured’ to the humanity of the ‘other’, part of the conveyor belt that is brutalising the Palestinians in ever more horrific ways …. ‘all’ citizens have to be loyal, and remain recruited to the cause,  in order for the State to maintain political power and control (where there are only 8 million Israelis – a small country, compared to over 4 million Palestinians).

He acknowledges that there is a very small number of exceptions to this participation, and these exceptional people themselves acknowledge they are exceptions.

But does this mass brutalisation of the Palestinians function through a capitalist logic of fantasy? How can or could we tell? If it does, and we can identify the fantasy objects, then this may point to critical pathways for resistance. And this may provoke change. We can argue, following e.g. Kordela’s biopolitics, that our historical block is based upon a secular capitalist fantasy of immortality. Does surplus security act as an object desire for immortality? And does this impact on the Israeli psyche in relation to the ‘other’?  We should ask ‘cui bono?’.

Perhaps there are two reciprocally dependent elements that ‘benefit’, a) the enablement of a neurotic repression necessary as a reaction to an inflicted and unbearable objectification (in two ways both through being dehumanised as victims in the Holocaust, and also through the historical and ongoing universal Israeli objectification as a killing labour-object : i.e. Zionist Labour-Power, since 1948) that b) both incites, and is made possible by, a sovereign power, the Zionist state.

But how would it be possible to neurotically repress the loss of one form of human identity? One possibility would be to reconstruct an identity, a process that represses the ZIC’s knowledge of the Israeli subject’s role as cog in a genocidal machine, an identity imagined instead as a source of immortal security for a Jewish state. This identity is a contender for the self consciousness of the ZIC. This is a form of alienation that can be explained by the formation of a split subject, the unconscious knowledge of the murderer within and the conscious ‘fantasy’ as ‘security for the life itself of the state. To believe one thing whilst intellectually knowing another is a process well described by O. Mannoni. It requires a fantasy structure : and this structure is the same as the structure described by Marx, which is homologous to Lacan’s University discourse.

This structure demands surplus – here, in the fantasy the desire is based upon the exchange of commodities in the form of threats produced out of ‘risk’ – this is the raw material that is embodied by Palestinians (and Israel’s enemies in Iran, Syria, Lebanon etc.). These ‘threat’ commodities are a quantifiable threat – quantifiable in terms of the security risk posed, and measured in terms of the scale of the oppressive ‘security response’ – the money required to neutralise the threat.

The threat is also measured in e.g. numbers of people, houses, land area, demographics – and form an autonomous signifying chain.  This chain demands repetitive consumption to produce surplus jouissance in the form of surplus security – simple ‘security’ alone is never enough, this is renounced and the accumulation of a security-wealth is the aspiration, but is impossible to satisfy.

The threat signifying chain functions autonomously because the creation of surplus security seems to happen ‘as if’ independently of the objectification and employment of the Israeli citizenship as a killing machine. The objectification and exploitation of ZIC labour as labour-power is covered over.  So then, the apparent self-valorisation of security makes each threat, commodity, appear to have a value in itself and not to only have a value that relates it to other threats. This decentres the zionist psyche as part of a constitutive alienation, in which the zionist becomes a personification of security, just as the capitalist is the personification of capital.  The zionist is a cog in the security machine.

So, for example, a Palestinian is not in actuality as big a threat as he/she is valued to be by the ZIC. The value is in part enhanced because it is produced by Israeli labour (the political, military, legal, and media industries that identify Palestinians as extreme existential threats). The enhanced value is achieved by relating threats to each other through such quantifiers as demographic proportions. numbers, houses, villages, or land area. Paying for the threat to achieve security provides a stimulus to the production of more threat perception. The commodity ‘threat’ contains congealed (ZIC) labour power.  It has cost less than it is now worth, because of exploitation of labour objectified as labour power.

The ZIC (through e.g. political, media, legal discourses) manufactures surplus value in the threat commodity by e.g. symbolising the threats as more threatening than they actually are, e.g the danger from the so called ‘rockets’ fired from Gaza into Israel.  In this way the ‘risk’  embodied in Palestinian people and land, is used to make ‘threat commodities’ that are fetishised as in Marx’ theory of the commodity fetish in capitalism. This generates surplus value in the threat which creates the imperative to neutralise the threat with security (S) – the military response in all its guises. This security S generates further risk which feeds back into the machine to make even more threat and therefore an imperative for more, i.e. surplus security.

This is an endless cycle, and it runs as if independently of the exploitation of the ZIC security activity which continually creates and uses more security than is actually needed to survive.  Thus, security makes more security through – just as in capitalism wealth creates more wealth.   This is based on the illusion that producing security is necessary because security is critically threatened and Israel will cease to exist unless continually innovative ways of producing more security are invented and commissioned.

The Master Signifier here is Mortal Danger – or, less succinctly, ‘The critical threat to Israel’s existence posed by the Palestinian people and non-Israeli territory in ‘the region’ (what was Greater Palestine). This Master Signifier is the object of the fantasy that sustains the authority of the sovereign power (the zionist state) which has been incited by, and provides the sense-making for, the identity of the ZIC as security enablers. Which covers over the real trauma of their lost identity through a historical and ongoing dehumanisation as both a) Holocaust victim for older generations and b) as participants in a genocidal military machine over the last two and a half generations. 

The sovereign power retains power and the authority to continue to wage permanent war, to steal land, to buy and sell security/military technology, creating surplus financial wealth for an already wealthy elite. The fetishisation of threat accomplishes the neurotic repression of traumatic loss of human identity for the ZIC, but it carries, within the psyche of the ZIC the knowledge of the real horror of the ZIC’s participation.  This persistent trace of dehumanisation  has effect as a residual monument to the dehumanisation that is itself still dehumanising the ZIC .

This remnant makes itself manifest in aggression turned in on the ZIC itself by the ZIC, eg in the increasing violence and racism within Israeli Jewish society itself. This is a part of the progressive self destruction of Israeli Jewish Society, the ZIC – but it in turn incites ever more brutalisation of the Palestinian peoples. More destruction on both sides lies ahead with an unknown ultimate outcome.

Finally – has this admittedly speculative analysis of theorisation helped to identify any critical pathways for resistance?

Perhaps.   I think there must be significance, and contradiction, in continued Western (especially United States) support because of its shared geopolitical and financial interests with Israel – and this is under appreciated.  There are gains for the West in terms of e.g. security technology sales as well as securing access to energy resources in the region and the incapacitation of non-western puppet states like Syria and Iran. This has been achieved in a politically intentional process, by spreading anarchy and chaos as per Iraq and Libya, and now as attempted in Syria. There are links between US and Western support for anarchisation of the Middle east, increasing global insecurity, and e.g the refugee crisis.  But it is difficult to see how these links can be made to become more conscious for the public.

From the ZIC perspective perhaps it is worth focussing on the falsity, illusory nature,  of the surplus threat being extracted from the Palestinians. As Ruchama Marton has pointed out Israelis military power is unimaginably massive compared to any enemy forces that would make possible any Palestinian armed resistance. The battle remains discursive and for now the dominant narratives are controlled by the elite. But public opinion is important and digital social media has the power to metastasise both within and outside Israeli society. The upsurge in western right wing nationalist populism suggests however that at the moment the media battle is being won by the Zionist/USUKNato alliance (aided and abetted by the Wahabist Islamic sect dominated by Saudi Arabia.)

The outlook remains pessimistic, more public support through BDS may inspire Palestinian non violent mass protests, as with the ongoing hunger strike by prisoners. In the short term, unfortunately this will mean more suffering before any tide is turned.