Does Covid-19 require radical group-analytic thinking?

Introduction

Brexit effectively drove all other issues off the political agenda in the United Kingdom, from June 2016 to January 2020. Since then, Covid-19 has done the same thing.

The ongoing pandemic has unfolded as an extraordinary global challenge to societies across the world. What began as a health crisis has rapidly and directly led to emergencies of an economic, psychosocial, and even existential nature. So far, there have been lights and shadows in the management of the pandemic; full engagement requires the ability to perceive both.

The virus has hit harder more disadvantaged urban areas, the poor and more vulnerable, older adults, migrants and ethnic minorities. An honest and coordinated global-group response is desperately needed, as well as safe, fair and effective vaccination programs.

The need for a group response

The European Union has become the most ambitious and advanced collaborative, transnational group project in the world. However, whilst still struggling to accommodate the Brexit mess, the EU is now facing another huge challenge as member states keep bickering over how best to respond to the crises unleashed by the coronavirus pandemic: soaring levels of unemployment, overwhelming uncertainty and mental distress, as well as hundreds of thousands of deaths.

In 1992, in the wake of the social chapter of the Maastricht Treaty, which created a common EU citizenship, the European Commission had proposed a directive on a Europe-wide minimum income. Predictably, the richer northern member-states contested the proposal since, they said, it would be an unacceptable wading into national sovereignty and social policies. The UK was indeed one of the countries which opposed the idea more fiercely – never mind Brexit (Ezquerro, 2019a, 2020). The proposed directive was downgraded to a non-binding recommendation, which was buried under countless tons of red tape.

The idea of a pan-EU minimum wage has recently been resurrected in the socialist-led Spanish Parliament, and supported by ministers from other southern European countries, as Europe is devastated by the worse tragedy since the Second World War and also sinking into the worst recession for generations. This is a moment for radical group-attachment and group-analytic thinking (Ezquerro, 2017, 2019b).

Some of the key functions of attachment are protection and accessibility to attachment figures and to groups constituted as attachment figures (Bowlby, 1969). The pandemic is showing that individual attachment can only be secure-enough as part of secure group attachment. People who find themselves in particularly vulnerable situations should have access to health and social protective mechanisms that allow them to care for themselves and their families.

More than 100 million people face poverty and social exclusion in the EU. A minimum wage would offer a safety net as the pandemic threatens to pull millions more into the poverty trap. It is our collective responsibility to become involved at some level with the politics of attachment, and to contribute in some way to turning the coronavirus political tide towards the creation of a kind of society that can be perceived as a secure-enough base (Kraemer and Roberts, 1996).

On 12 March 2020, the World Health Organisation declared Covid-19 a pandemic. The following day, whilst mainland Europe was shutting down schools, cancelling flights and imposing strict quarantines, the British government employed a ‘herd immunity’ strategy. Boris Johnson, the Prime Minister, who had dismissed the experts during the Brexit referendum campaign, was now heavily relying on the opinion of his own expert advisers.

Johnson appeared not to understand the urgency of the situation; his plan was callous and dangerous. He seemed to believe that the health of the economy was more relevant than the health of the population – profit and wealth more important than human lives. His initial approach meant that tens of thousands of people, especially older adults, would be sacrificed for the sake of the economy. As casualties increased exponentially and the NHS was on the verge of collapse, Johnson had to do a U-turn and put the country on lockdown.

The NHS called for an optimal number of 250,000 volunteers to sign up to help seniors, people who were isolating and medical staff who needed deliveries. The response was overwhelmingly positive; more than three times that many volunteers signed up. Soon after, a website was launched listing several hundred new mutual aid groups across the country.

As the crisis unfolded, there have been countless acts of kindness and solidarity. However, there have also been acts of carelessness and selfishness. The anxiety and confusion of the first moments of the pandemic in the UK contributed to a generalised reaction of panic, which resulted in the sudden emptying of supermarket shelves.

In particular, the toilet paper crisis that lasted several weeks could be seen as an example of collective psychosis. In a way, it was also a powerful metaphor for the excrements that human beings produce in situations of intense undigested fear. In contrast to this emotional diarrhoea, many volunteers bought food and delivered it to the door of their elderly neighbours.

Fortunately, creative and generous altruism has predominated over destructive selfishness. Solnit (2020b) emphasised that the Covid-19 tragedy has generated collective and empathic urges and actions of mutual aid. It is everywhere, aid offered in a spirit of solidarity and reciprocity, often emerging from struggling communities. We are seeing new or renewed forms of generosity that resemble war-like altruistic engagement (volunteer coalitions organising food distribution, online social and professional networking, donations, support and outreach).

The Uruguayan polymath Eduardo Galeano (2009) described some differences between charity and solidarity. For him, charity is vertical and goes from the top to the bottom; it often implies that the afflicted population is powerless or incompetent to address its own needs. Sometimes, charity can take away pride and confidence from people receiving it. Unlike that, Galeano suggested, solidarity is horizontal.

In a crisis like this, solidarity and mutual aid emphasise that we are together and have strength and capacity to care for ourselves. We also need to have enough public health and social resources available to be able to do so.

The lockdown itself can be seen as altruism in action – a withdrawal carried out by millions for the benefit of their communities, as well as their own safety. We withdrew from the spaces we share out of solidarity; we moved apart to come together. We intentionally produced an unprecedented economic calamity to mitigate mass death. For some, staying home may be only a strain; for others it means financial ruin. Sacrificing one´s own financial security for the common good is an extraordinary commitment that a majority of people has made everywhere (Solnit, 2020b).

The concept of mutual aid was formulated by the Russian biologist, philosopher and sociologist Peter Kropotkin (1908). He argued that aiding and protecting others, and serving the needs of the group rather than the individual, has been essential for the survival of many species and has been evident in early and traditional human societies.

Kropotkin (1908) further argued that cooperation is as important as competition, and that the highest achievements of the human race have been the result of group collaboration and of group attachment (Bowlby, 1969). According to Kropotkin, besides a law of mutual struggle, there is in Nature a law of mutual aid – which is far more important than mutual contest.

Disasters can indeed change social consciousness and priorities. At a global level, the pandemic has in some way resurrected one of the mottos of the hippy revolution of the 1960s: “Be realistic, ask for the impossible”…

Things we were told would never happen and could never happen have actually happened. Within a few weeks into the pandemic, Ireland nationalised its private hospitals, Canada gave four months of basic income to those who lost their jobs, Germany paid out €1.3 billion to the self-employed and to small businesses, Portugal decided to treat immigrants and asylum seekers as full citizens, and carbon emissions suddenly plummeted… But there has been a dark side too.

A virus of inequality and racism

It is remarkable that the world’s billionaires have been doing extremely well during the coronavirus pandemic, growing their already-huge fortunes to a record high of $10.2 trillion. A report by Swiss bank UBS (Neate, 2020) has found that billionaires increased their wealth by 27.5% at the height of the crisis from April to July, just as millions of people around the world lost their jobs or were struggling to get by on government subsidies.

Some of these billionaires have conspicuously exploited betting and gambling on the recovery of global stock markets when they were at their lowest point during the global lockdowns, others have benefited from pandemic tax relief. And when local tax relief has not been readily available, some have moved to tax-free jurisdictions.

For instance, Sir Jim Ratcliffe (the UK’s richest person and high-profile Brexiter) was anxious about how best could he protect himself from Covid-19 and, in September 2020, changed his fiscal residence from Great Britain to Monaco, the sovereign city-state that is already home to many of the UK’s richest people. It has been estimated that the move will incidentally saved Ratcliffe more than £4 billion in tax payments.

The world has not been designed with ‘us’ in mind; it has been mainly for ‘them’.

However, according to Solnit (2020a), the ongoing crisis is an opportunity for universal recognition that there must be enough food, clothing, shelter, healthcare and education for all – and that access to these things should not depend on what job you do and on whether or not you earn enough money. Hope for change can coexist with difficulty and suffering: it is not optimism that everything will be fine regardless, but a positive internal force that helps us keep going amid the uncertainty ahead.

There are now pressing messages from some politicians about the importance of going back to a previous state of ‘normality’. One of the dangers is to believe that everything was fine before the coronavirus crisis, and that all we need to do is returning to things as they were. Ordinary life before the pandemic was already a catastrophe of despair and exclusion for too many human beings, an environmental and climate calamity, an obscenity of inequality (Solnit, 2020a).

Covid-19 has further exposed the effects of racism, social marginality and other forms of inequality, as well as the ways in which race and class contribute in tandem to compound disadvantage in multiple and lethal forms. According to Godlee (2020), we cannot tackle this crisis unless we tackle racism, which is a public health issue because it kills people and puts ethnic-minority groups at the centre of the pandemic. Racism is all our individual and group responsibility.

A recent review by Public Heath England (PHE) found that people from ethnic minorities are disproportionately more likely to be infected and to die from Covid-19. Black-ethnic groups had 486 women and 649 men diagnosed for an average of 100,000 population across the country, whilst white-ethnic groups had 220 diagnoses for women and 224 for men for the same population (Iacobucci, 2020: 386).

The PHE report failed to make recommendations for further actions that should be taken to reduce disparities in risk. However, a number of advocacy groups subsequently proposed some measures. These include that NHS Trusts should treat ethnic-minority staff as high risk and vulnerable, and redeploy them away from Covid-19 areas in hospitals wherever possible (Iacobucci, 2020: 387).

The recent Black Lives Matter protests around the world point to an anguish not just about police brutality, but about the persistent and broad subjugation of marginalised communities by racist societal structures. People with complex needs, vulnerable populations and marginalised ethnic groups are at increased risk from Covid-19 and from the health effects of containment strategies.

There is a notorious silence concerning how structural inequalities may be fuelling this pandemic, and how these inequalities take root. More than 50 years ago, Martin Luther King Jr. had warned:

“In the end, we will remember not the words of our enemies but the silence of our friends” (quoted in Karan and Kats, 2020: 406).

The coronavirus pandemic is going to leave a lasting legacy in the social unconscious (Hopper, 2003) of British society and in the NHS (the jewel in the crown). The need for emotional support for those who have been most badly affected is going to be enormous (Benzeval et al, 2020).

Before Covid-19, the NHS was already struggling with workforce shortages. Hostile immigration policies, and a gradually more unsettling atmosphere since the Brexit referendum, have deterred staff from coming to the UK. During the pandemic, many ethnic-minority staff have paid for the service with their lives.

Within the current structures, there is no way to protect everyone from the virus. Consciously and unconsciously decisions have been made about which lives should be saved and which should not. Besides, the NHS has now to deal with a backlog of problems, while Covid-19 is still an ongoing threat. We might be storing up further trauma for the future.

Conclusion

Covid-19 is teaching us a lesson: the task of acting quickly to address longstanding health, social and economic inequalities is now even more urgent. The impact of the pandemic, as study upon study has revealed, has been deeply and immorally unequal.

In the context of an emergency like this, radical group-attachment and group-analytic thinking is required. As group analysts and mental health professionals, we should not accept a world in which some people are protected while others are not. We need to develop a sense of social consciousness alongside our clinical work. This may imply having to go beyond the comfort of the consulting room, in order to address problems effectively in the social, cultural and political arenas.

It is too soon to know the outcome of the pandemic, but not too soon to start looking for better ways of maximising survival for all. Before the pandemic, everyday life was a disaster for billions of people and, so, the end of the current crisis should not mean going back to how things were. It should mark the beginning of something drastically different. A new collective agreement needs to emerge from this emergency. 

References

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Ezquerro A (2017) Encounters with John Bowlby: Tales of Attachment. London: Routledge.

Ezquerro A (2019a) Brexit: Who is Afraid of Group Attachment? La Revista. The British Spanish Society Magazine 248: 18-19.

Ezquerro A (2019b) The Power of Group Attachment. In: Group Analysis North Open Seminar, University of Manchester, 8 November.

Ezquerro A (2020) Brexit: Who is Afraid of Group Attachment? Part I. Europe: What Europe? Group Analysis 53(2): 234-254.

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Neate R (2020) Billionaires’ wealth rises to $10.2 trillion amid Covid crisis. Super-rich increase fortunes by more than a quarter during market turmoil. The Guardian, 7 October. Available at https://www.theguardian.com/business/2020/oct/07/covid-19-crisis-boosts-the-fortunes-of-worlds-billionaires

Solnit R (2020a) The impossible has already happened: what coronavirus can teach us about hope. The Guardian, 7 April. Available at https://www.theguardian.com/world/2020/apr/07/what-coronavirus-can-teach-us-about-hope-rebecca-solnit

Solnit R (2020b) The way we get through this is together: the rise of mutual aid under coronavirus. The Guardian, 14 May. Available at https://www.theguardian.com/world/2020/may/14/mutual-aid-coronavirus-pandemic-rebecca-solnit

Arturo Ezquerro
British-Spanish consultant psychiatrist, psychoanalytic psychotherapist, and group analyst, based in London for the last 37 years. He is senior assessor and trainer at the Institute of Group Analysis and former Head of NHS Psychotherapy Services in Brent. He was supervised by John Bowlby at the Tavistock Clinic during the last six years of his life (1984-1990). He is an honorary member of the World Association of International Studies and of the International Attachment Network for promoting an attachment ethos in the study of human development, group relations and clinical work. He collaborates with the media and has over 70 publications in five languages, including Encounters with John Bowlby: Tales of Attachment (Routledge).
arturo.ezquerro@ntlworld.com