noigroup logo

Neoliberal pain

By David Butler Education for all 05 Jul 2017

Anyone with a biopsychosocial framework and a whiff of humanism in their blood should be disturbed about the current ugly world mood and the consequences of uncontrolled neoliberal philosophy. Modern Neoliberalism dates back to Thatcher and Reagan (“government is not the solution, it is the problem”) and is currently upheld by the US Right and the Trump government but with divisions in most countries – Aussies think of Hanson and Bernadi and Brits think of the forces behind BREXIT. In short, the market and deregulation rules, the public service is the enemy, and climate change is often regarded as a hoax. In its worst incarnations such as what is emerging in the US, human life is ranked based on race, gender, sexuality, income and physical appearance. The philosophy is often supported by enhancing beliefs that we are in danger and as we have seen recently, it encourages hate. James Baldwin in ‘Notes of a Native Son’ (1955) writes:

“I imagine that one of the reasons that people cling to their hates so stubbornly is because they sense, once hate is gone, they will be forced to deal with pain”.


Uncontrolled neoliberalism hurts

Persistent pain is already at epidemic levels with massive societal and financial costs. Painful policies emerging from the Trump government include cutting meals on wheels (less nutrition and people contact), cuts to the Federal Emergency Management Agency and the removal of the program to help communities prepare for future crises. Cuts to the Environmental Protection Agency will hurt as will the elimination of the environmental justice program – a department which helped low income communities deal with living next to toxic industries. Removal of access to health insurance for millions of Americans will hurt, so will cuts to climate change research and the suppression of inconvenient research. Banking deregulation (well before Trump) has been shown to hurt – remember The Crash? Cuts to social services, increasingly militarised police and deaths from suicide and inappropriate prescription medication for pain, all add to the danger/pain mix. Yes, I have been reading Naomi Klein’s book ‘No is not enough: Resisting Trump’s shock politics and winning the world we need’, published June 13, 2017.

If we were hardened Neoliberalists, we could rejoice – more pain, anxiety, stress; thus more work and maybe more money for us! Just as wars and other disasters are likely to offer opportunity and enhanced oil prices to many in the Trump cabinet.

But no – increasing negative forces (DIMs) will make our work harder. Biopsychosocial frameworks make the links between pain and uncontrolled Neoliberal philosophy obvious and so does the definition that we have used recently –  that we will have pain when our brains weigh the world and determine that there is more danger to our bodies (and our humanity and agency) than safety. America’s collective protectometer is right out of balance.



Clearly we need to quickly find some powerful SIMs. I suggest that our audience read Klein’s book and in particular take a look at the Leap Manifesto which is a super SIM project based on communities coming together, sharing and caring on multiple levels (and which could be enhanced more with the addition of health considerations). Klein is not just attacking from the left – Hillary Clinton, Barack Obama and the Davos set are not spared either. And I see nothing wrong with balanced liberal philosophy – for the Aussies – the Hawke Keating goverments indulged in it to our broad benefit, for example, when they floated the dollar and privatised some government agencies.

But for those who support extreme deregulation, be reminded that it has a human cost – the Grenfell tower horror looms high. There are economic and health benefits in regulation in the form of less toxic food, safer work places, clean air and even freedom of speech. Ben Chu in the ‘Independent’ this week quotes the most recent report from the White House estimating that the benefits of US federal regulations were three times larger than the costs. And leavers in the recent BREXIT campaign quoted figures that EU rules cost the UK economy 33 billion pounds a year, neglecting to mention cost benefit calculations by the British government that the same regulations provided a benefit of nearly 60 billion pounds. Surely it is all about balance.

It would be easy to call this piece ‘The Pain of Trump’ or something similar, but as Klein writes “we need to get rid of our inner Trump” and look for, understand and react to the fertile ground that allows uncontrolled neoliberalism to grow in and of which Trump and others are the embodiment. And I think that this particularly applies to we non-Americans to limit our appalled fascination with what is happening and to observe the soil in our own backyard. Start with understanding neoliberal philosophy, read the Leap Manifesto (supported by two of my favourite singers – Neil Young and Leonard Cohen), and reflect on how the simple sounding but critical notion of care is a part of so many of the SIM domains that we seek for optimal neuroimmunological function.

Klein is well known from previous books and she has a remarkable skill for describing and linking complex issues and making them digestible. But there was one particular phrase that really resonated with me in her book ‘No is Not Enough’ and that was “nursing is renewable energy, education is renewable energy.”


– David Butler









  1. jqu33431quintner

    David, our “canny” political masters have already come up with their solution to the chronic pain epidemic that you mention – they have legalised the prescribing and cultivation of “medicinal” marihuana.

  2. I wouln’t puff or blow off (it is better to inhale or ingest) medical marihuana. I think much of the present problem is that Trump and many of the neo’s never inhaled.

    A better SIM read and powerful book that talks about how we got ourselves into this position is WE DO OUR PART- Toward a fairer and more equal America by Charles Peters. “We do our part” was the American phrase during the depression and WWII that expressed a communal sense of responsibility to the whole. Peters grew up in the New Deal America and has worked within government (Peace Corps and other departments) and Academia chronicalling US government and the economy. It is a great read. In addition what a fantastic SIM, “We Do Our Part”, to counter the present DIM of the Neo’s “I got mine”. . TGD

  3. Russell

    I find it ironic that one of the “Explain Pain” authors who advocates a compassionate, rational and skeptical approach to physiotherapy resorts to parroting straw man arguments and hyperbolic language. Where is the critical examination of ideas, recognition of cognitive biases and following the evidence wherever it leads? Could your words create the very nocebo effect that physios are taught to guard against?

    Just as I am skeptical of ultrasound manufacturers who fund their own research and claim their new ultrasound device is 30% better at using high-energy sound waves to treat painful conditions, I for one am skeptical of Naomi Klein’s motives and policy recommendations. The fact remains that she is a devout anti-capitalist activist and environmentalist with ties to Occupy Wall Street and George Soros. Could she have a vested interest in discrediting Trump and furthering a biased narrative? I think these are all fair questions that need to be asked.

    Nonetheless, big fan of your work!

  4. davidbutler0noi

    Well that was a most interesting foray into politics and pain! Interesting in a number of ways – the social media responses from some Facebook warriors – of surprise, of advice as to how I should live my life, of what has it got to do with Explain Pain, and of being noncaring. There were lots of supportive responses and interest in the essential theme of the blog – that of links between pain, politics and biopsychosocial mental frameworks.

    But I did think there could have been would be more interest (the social media reach is over 30,000). I think this is an important and untouched issue in rehab but then again, if the world is still not serious about climate change and warm grandchildren, why would there be a great interest in a wider view of pain?. Maybe we are all just having an esoteric wank here?

    For the “love your work, not your philosophy” responders, note that it arises from a fundamental belief in a shared and collective human dignity at many levels, much of which I see in the Leap Manifesto.

    Best greetings and thanks to all responders


  5. janahamik

    David, I am forever grateful to you for your Explain Pain work and the meaningful and numerous ways the concepts and insights therein have helped to improve my quality of life. I have not read Klein’s book so I cannot comment on it, but the perception of Donald Trump & his policies as a big giant DIM I find to be just that , a personal perception. A perception smothered in assumptions. In the first several months of his election, people were swarming to their mental health providers, after being manipulated by the media and Trump’s political opposition to believe the next Hitler had just been put into power.

    If I had to summarize this post and the far left’s response to Donald Trump in one word, it would be “catastrophizing”, which we know of course is a big DIM regardless how you perceive the current geopolitical state.

    For example, I imagine being a women in many parts of Europe right now, without the right to carry even a can of pepper spray to protect herself from the increase incidences of rapes & violent crime or just being told to cover up or wear a bracelet would be a DIM. (What’s Really Going on in Sweden?

    Certainly, the current movement by the far-left to label opposing political speech as “hate speech” & to attempt to censor & shut down opposing political speech (which Hillary Clinton promoted) is a DIM. Also the current environment of automatically labeling people as racists, misogynists, homophobes etc. just because they have different political opinions or because they dare to step out of the ideological box & associate with an intellectual diverse group of people that is certainly is a DIM.

    Similarly the current penchant of not allowing people to simply respectfully disagree without suggesting that their ideological opponents are morally bankrupt, inhumane, selfish or lack even a whiff of humanism- is a DIM (a la Hillary’s “Basket of Deplorables” comment) Now clearly, Trump is quite the name caller himself, but the difference is SJW’s & the illiberal left become quite unglued. Again, in a word they catastrophize. Not only do they become so enraged that they need medical attention, they then want to seek revenge by banning words, doxing their ideological opponents & getting people fired – all of which is sanctioned by liberal academia, social media platforms & tech companies and all of which are DIMs to the people being targeted by their over-reaction.

    Your Donald Trump DIMS are clearly other people’s SIMs and vice-versa. I could knock out a laundry list of social & political repercussions that would have been triggers / DIMs for me had Hillary Clinton been elected. American’s, the Brit’s the good people of France and Australia we have all had to chose between the lesser of two DIMs. We don’t do ourselves or anyone else any good if we are catastrophizing and I would argue these reactions only serve to push people into Trump’s arms.

    With much gratitude, Jana

    Again, while I didn’t read Klein’s book, I loved this podcast between Sam Harris & Scott Adams which I think every person who is paying attention – whether they view Trump as a DIM or SIM would be fascinated by. Like Explain Pain helped to teach me to decrease my DIMs, this podcast might help to decrease the triggering of DIMs by reconceptualizing what’s really going on. I highly recommend it.

    Waking Up with Sam Harris #87 – Triggered (with Scott Adams)

Your email address will not be published. Required fields are marked *


Product was added to cart.