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Participatory democracy is presumed to be the gold standard. Here’s why it isn’t.
Political activism may get people invested in politics, and affect urgently needed change, but it comes at the expense of tolerance and healthy democratic norms.
- Polarization and extreme partisanships have been on the rise in the United States.
- Political psychologist Diana Mutz argues that we need more deliberation, not political activism, to keep our democracy robust.
- Despite increased polarization, Americans still have more in common than we appear to.
Imagine everyday citizens engaging in the democratic process. What images spring to mind? Maybe you thought of town hall meetings where constituents address their representatives. Maybe you imagined mass sit-ins or marches in the streets to protest unpopular legislation. Maybe it's grassroot organizations gathering signatures for a popular referendum. Though they vary in means and intensity, all these have one thing in common: participation.
Participatory democracy is a democratic model that emphasizes civic engagement as paramount for a robust government. For many, it's both the "hallmark of social movements" and the gold standard of democracy.
But all that glitters may not be gold. While we can all point to historical moments in which participatory democracy was critical to necessary change, such activism can have deleterious effects on the health of a democracy, too. One such byproduct, political psychologist Diana Mutz argues, can be the lessening political tolerance.
Participation or deliberation?
In her book Hearing the Other Side: Deliberative Versus Participatory Democracy, Mutz argues that participatory democracy is best supported by close-knit groups of like-minded people. Political activism requires fervor to rouse people to action. To support such passions, people surround themselves with others who believe in the cause and view it as unassailable.
Alternative voices and ideologies — what Mutz calls "cross-cutting exposures" — are counterproductive to participation because they don't reinforce the group's beliefs and may soften the image of the opposing side. This can dampen political zeal and discourage participation, particularly among those averse to conflict. To prevent this from happening, groups can become increasingly intolerant of the other side.
"You can have a coup and maximize levels of participation, but that wouldn't be a great thing to do. It wouldn't be a sign of health and that things were going well."
As the book's title suggests, deliberative democracy fosters a different outlook for those who practice it. This model looks toward deliberation, communication, compromise, and consensus as the signs of a resilient democracy. While official deliberation is the purview of politicians and members of the court, it's worth noting that deliberative democracy doesn't mean inactivity from constituents. It's a philosophy we can use in our daily lives, from community memberships to interactions on social media.
"The idea is that people learn from one another," Mutz tells Big Think. "They learn arguments from the other side as well as learn more about the reasons behind their own views. [In turn], they develop a respect for the other side as well as moderate their own views."
Mutz's analysis leads her to support deliberation over activism in U.S. politics. She notes that the homogeneous networks required for activism can lead to positive changes — again, there are many historical examples to choose from. But such networks also risk developing intolerance and extremism within their ranks, examples of which are also readily available on both the right and left.
Meanwhile, the cross-cutting networks required for deliberative democracy offer a bounty of benefits, with the only risk being lowered levels of participation.
As Mutz writes: "Hearing the other side is also important for its indirect contributions to political tolerance. The capacity to see that there is more than one side to an issue, that political conflict is, in fact, a legitimate controversy with rationales on both sides, translates to greater willingness to extend civil liberties to even those groups whose political views one dislikes a great deal."
Of politics and summer camp
Take that! A boxing bout between two members of a schoolboys' summer camp at Pendine, South Wales, takes place in a field within a ring of cheering campmates.
(Photo by Fox Photos/Getty Images)
Of course, listening openly and honestly to the other side doesn't come naturally. Red versus blue. Religious versus secular. Rural versus cosmopolitan. We divide ourselves into polarized groups that seek to silence cross-cutting communication in the pursuit of political victory.
"The separation of the country into two teams discourages compromise and encourages an escalation of conflict," Lilliana Mason, assistant professor of Government and Politics at the University of Maryland, writes in her book Uncivil Agreement: How Politics Became Our Identity. "The cooperation and compromise required by democracy grow less attainable as partisan isolation and conflict increase."
Mason likens the current situation to Muzafer Sherif's famous Robbers Cave Experiment.
In the early 1950s, Sherif gathered a group of boys for a fun summer camp at Robbers Cave State Park, Oklahoma. At least, that was the pretense. In reality, Sherif and his counselors were performing an experiment in intergroup conflict that would now be considered unethical.
The 20 boys were divided into two groups, the Rattlers and the Eagles. For a while, the counselors kept the groups separate, allowing the boys to bond only with their assigned teammates. Then the two groups were introduced to participate in a tournament. They played competitive games, such as baseball and tug-o-war, with the winning team promised the summer camp trophy.
Almost immediately, the boys identified members of the other team as intruders. As the tournament continued, the conflict escalated beyond sport. The Eagles burned a Rattlers flag. The Rattlers raided the Eagles' cabin. When asked to describe the other side, both groups showed in-group favoritism and out-group aggression.
Most troubling, the boys wholly assumed the identity of an Eagle or Rattler despite having never been either before that very summer.
"We, as modern Americans, probably like to think of ourselves as more sophisticated and tolerant than a group of fifth-grade boys from 1954. In many ways, of course, we are," Mason writes. "But the Rattlers and the Eagles have a lot more in common with today's Democrats and Republicans than we would like to believe."
Like at Robbers Cave, signs of incendiary conflict are easy to spot in U.S. politics today.
A 2014 Pew survey found that the ideological overlap between Democrats and Republicans is much more distant than in the past. More Republicans lie further right of moderate Democrats than before and vice versa. The survey also found that partisan animosity had doubled since 1994.
In her book, Mason points to research that shows an "increasing number of partisans don't want party leaders to compromise," blame "the other party for all incivility in government," and abhor the idea of dating someone from outside their ideological group.And let's not forget Congress, which has grown increasingly divided along ideological lines over the past 60 years.
A dose of daily deliberation
Horace, Virgil and Varius at the house of Maecenas.
Painting by Charles Francois Jalabert (1819-1901) 1846. Beaux-Arts museum, Nimes, France. Photo by Leemage/Corbis via Getty Images.
A zero-sum mindset may be inevitable in a summer camp tournament, but it's detrimental if taken into wider society and politics. Yet if participatory democracy leads to the silencing of oppositional voices, a zero-sum mindset is exactly what we get. Conversely, creating networks that tolerate and support differing opinions offers non-zero benefits, like tolerance and an improvement of one's understanding of complicated issues.
Mutz wrote her book in 2006, but as she told us in our interview, the intervening years have only strengthened her resolve that deliberation improves democratic health:
"Right now, I'm definitely on the side of greater deliberation rather than just do whatever we can to maximize levels of participation. You can have a coup and maximize levels of participation, but that wouldn't be a great thing to do. It wouldn't be a sign of health and that things were going well. Democracy [must be] able to absorb differences in opinion and funnel them into a means of governing that people were okay with, even when their side didn't win."
Unfortunately, elected officials and media personalities play up incivility and the sense of national crisis for ratings and attention, respectively. That certainly doesn't help promote deliberation, but as Mutz reminded us, people perceive political polarization to be much higher than it actually is. In our daily lives, deliberative democracy is more commonplace than we realize and something we can promote in our communities and social groups.
Remember that 2014 Pew survey that found increased levels of partisan animosity? Its results showed the divide to be strongest among those most engaged and active in politics. The majority of those surveyed did not hold uniform left or right views, did not see the opposing party as an existential threat, and believed in the deliberative process in government. In other words, the extremes were pulling hard at the poles.
Then there's social media. The popular narrative is that social media is a morass of political hatred and clashing identities. But most social media posts have nothing to do with politics. An analysis of Facebook posts from September 2016, the middle of an election year, found the most popular topics centered on football, Halloween, Labor Day, country music, and slow cookers.
And what of political partisanship and prejudice? In an analysis of polarization and ideological identity, Mason found that labels like "liberal" and "conservative" had less to do with values and policy attitudes – as the majority of Americans agree on a substantial number of issues – and more to do with social group identification.
Yes, we all know those maps that media personalities dust off every election year, the ones that show the U.S. carved up into competing camps of red and blue. The reality is far more intricate and complex, and Americans' intolerance for the other side varies substantially from place to place and across demographics.
So while participation has its place, a healthy democracy requires deliberation, a recognition of the other side's point of view, and the willingness to compromise. Tolerance may not make for good TV or catchy political slogans, but it's something we all can foster in our own social groups.
Understanding what tolerance means in a highly polarized America
So far, 30 student teams have entered the Indy Autonomous Challenge, scheduled for October 2021.
- The Indy Autonomous Challenge will task student teams with developing self-driving software for race cars.
- The competition requires cars to complete 20 laps within 25 minutes, meaning cars would need to average about 110 mph.
- The organizers say they hope to advance the field of driverless cars and "inspire the next generation of STEM talent."
Indy Autonomous Challenge<p>Completing the race in 25 minutes means the cars will need to average about 110 miles per hour. So, while the race may end up being a bit slower than a typical Indy 500 competition, in which winners average speeds of over 160 mph, it's still set to be the fastest autonomous race featuring full-size cars.</p><p style="margin-left: 20px;">"There is no human redundancy there," Matt Peak, managing director for Energy Systems Network, a nonprofit that develops technology for the automation and energy sectors, told the <a href="https://www.post-gazette.com/business/tech-news/2020/06/01/Indy-Autonomous-Challenge-Indy-500-Indianapolis-Motor-Speedway-Ansys-Aptiv-self-driving-cars/stories/202005280137" target="_blank">Pittsburgh Post-Gazette</a>. "Either your car makes this happen or smash into the wall you go."</p>
Illustration of the Indy Autonomous Challenge
Indy Autonomous Challenge<p>The Indy Autonomous Challenge <a href="https://www.indyautonomouschallenge.com/rules" target="_blank">describes</a> itself as a "past-the-post" competition, which "refers to a binary, objective, measurable performance rather than a subjective evaluation, judgement, or recognition."</p><p>This competition design was inspired by the 2004 DARPA Grand Challenge, which tasked teams with developing driverless cars and sending them along a 150-mile route in Southern California for a chance to win $1 million. But that prize went unclaimed, because within a few hours after starting, all the vehicles had suffered some kind of critical failure.</p>
Indianapolis Motor Speedway
Indy Autonomous Challenge<p>One factor that could prevent a similar outcome in the upcoming race is the ability to test-run cars on a virtual racetrack. The simulation software company Ansys Inc. has already developed a model of the Indianapolis Motor Speedway on which teams will test their algorithms as part of a series of qualifying rounds.</p><p style="margin-left: 20px;">"We can create, with physics, multiple real-life scenarios that are reflective of the real world," Ansys President Ajei Gopal told <a href="https://www.wsj.com/articles/autonomous-vehicles-to-race-at-indianapolis-motor-speedway-11595237401?mod=e2tw" target="_blank">The Wall Street Journal</a>. "We can use that to train the AI, so it starts to come up to speed."</p><p>Still, the race could reveal that self-driving cars aren't quite ready to race at speeds of over 110 mph. After all, regular self-driving cars already face enough logistical and technical roadblocks, including <a href="https://www.bbc.com/news/technology-53349313#:~:text=Tesla%20will%20be%20able%20to,no%20driver%20input%2C%20he%20said." target="_blank">crumbling infrastructure, communication issues</a> and the <a href="https://bigthink.com/paul-ratner/would-you-ride-in-a-car-thats-programmed-to-kill-you" target="_self">fateful moral decisions driverless cars will have to make in split seconds</a>.</p>But the Indy Autonomous Challenge <a href="https://static1.squarespace.com/static/5da73021d0636f4ec706fa0a/t/5dc0680c41954d4ef41ec2b2/1572890638793/Indy+Autonomous+Challenge+Ruleset+-+v5NOV2019+%282%29.pdf" target="_blank">says</a> its main goal is to advance the industry, by challenging "students around the world to imagine, invent, and prove a new generation of automated vehicle (AV) software and inspire the next generation of STEM talent."
A new Harvard study finds that the language you use affects patient outcome.
- A study at Harvard's McLean Hospital claims that using the language of chemical imbalances worsens patient outcomes.
- Though psychiatry has largely abandoned DSM categories, professor Joseph E Davis writes that the field continues to strive for a "brain-based diagnostic system."
- Chemical explanations of mental health appear to benefit pharmaceutical companies far more than patients.
Challenging the Chemical Imbalance Theory of Mental Disorders: Robert Whitaker, Journalist<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="41699c8c2cb2aee9271a36646e0bee7d"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/-8BDC7i8Yyw?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>This is a far cry from Howard Rusk's 1947 NY Times editorial calling for mental healt</p><p>h disorders to be treated similarly to physical disease (such as diabetes and cancer). This mindset—not attributable to Rusk alone; he was merely relaying the psychiatric currency of the time—has dominated the field for decades: mental anguish is a genetic and/or chemical-deficiency disorder that must be treated pharmacologically.</p><p>Even as psychiatry untethered from DSM categories, the field still used chemistry to validate its existence. Psychotherapy, arguably the most efficient means for managing much of our anxiety and depression, is time- and labor-intensive. Counseling requires an empathetic and wizened ear to guide the patient to do the work. Ingesting a pill to do that work for you is more seductive, and easier. As Davis writes, even though the industry abandoned the DSM, it continues to strive for a "brain-based diagnostic system." </p><p>That language has infiltrated public consciousness. The team at McLean surveyed 279 patients seeking acute treatment for depression. As they note, the causes of psychological distress have constantly shifted over the millennia: humoral imbalance in the ancient world; spiritual possession in medieval times; early childhood experiences around the time of Freud; maladaptive thought patterns dominant in the latter half of last century. While the team found that psychosocial explanations remain popular, biogenetic explanations (such as the chemical imbalance theory) are becoming more prominent. </p><p>Interestingly, the 80 people Davis interviewed for his book predominantly relied on biogenetic explanations. Instead of doctors diagnosing patients, as you might expect, they increasingly serve to confirm what patients come in suspecting. Patients arrive at medical offices confident in their self-diagnoses. They believe a pill is the best course of treatment, largely because they saw an advertisement or listened to a friend. Doctors too often oblige without further curiosity as to the reasons for their distress. </p>
Image: Illustration Forest / Shutterstock<p>While medicalizing mental health softens the stigma of depression—if a disorder is inheritable, it was never really your fault—it also disempowers the patient. The team at McLean writes,</p><p style="margin-left: 20px;">"More recent studies indicate that participants who are told that their depression is caused by a chemical imbalance or genetic abnormality expect to have depression for a longer period, report more depressive symptoms, and feel they have less control over their negative emotions."</p><p>Davis points out the language used by direct-to-consumer advertising prevalent in America. Doctors, media, and advertising agencies converge around common messages, such as everyday blues is a "real medical condition," everyone is susceptible to clinical depression, and drugs correct underlying somatic conditions that you never consciously control. He continues,</p><p style="margin-left: 20px;">"Your inner life and evaluative stance are of marginal, if any, relevance; counseling or psychotherapy aimed at self-insight would serve little purpose." </p><p>The McLean team discovered a similar phenomenon: patients expect little from psychotherapy and a lot from pills. When depression is treated as the result of an internal and immutable essence instead of environmental conditions, behavioral changes are not expected to make much difference. Chemistry rules the popular imagination.</p>
Why Depression Isn't Just a Chemical Imbalance<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="fbc027c9358dad4a6d9e2704fc9ddb04"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/GAC9ODvSxh0?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>Many years ago, my best friend tried to quit smoking. He asked for help. While I'm no addiction expert, I offered what I knew from my fitness toolkit: breathing exercises and cardiovascular training, methods for strengthening his body and mind that could, I hoped, inspire him to take better care of himself in general. He replied, "No, I meant something like a pill."</p><p>A few years later, he quit for good. After failing the cold turkey method a number of times, it finally stuck. Maybe it was watching his children grow up—the reason my parents quit when I was young. This method is not easy, however. It challenges you; it forces you to confront your demons; it drastically affects your brain chemistry. Yet, in the long run, it sometimes works. </p><p>Sometimes pills work, too. But often they do not. The journalist Robert Whitaker, author of "Anatomy of an Epidemic," discussed the clinical trial process <a href="https://bigthink.com/mind-brain/antidepressants-dangers" target="_self">during our recent conversation</a>. While the FDA process appears thorough from the outside, pharmaceutical companies only need to prove that a drug works better than placebo, not that it works for the most amount of people. He continues, </p><p style="margin-left: 20px;">"Let's say you have a drug that provides a relief of symptoms in 20 percent of people. In placebo, it's 10 percent. How many people in that study do not benefit from the drug? Nine out of 10. How many people are exposed to the adverse effects of the drug? 100 percent."</p><p>Even though some pharmacological interventions show little efficacy, and even though Xanax, an addictive and destructive benzodiazepine that only showed <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846112/" target="_blank">short-term (four weeks) efficacy</a> in clinical trials, is being prescribed for many months and years, doctors continue to use the language of clinical neuroscience to describe mental health issues. If chemistry is the problem, people will turn to chemistry for the solution. </p><p>Perhaps we should, as psychiatrist Dean Schuyler <a href="https://bigthink.com/surprising-science/antidepressant-effects" target="_self">writes</a> in a 1974 book, recognize that most depressive episodes "will run their course and terminate with virtually complete recovery without specific intervention." The problem is that idea isn't profitable. As long as the gatekeepers continue to use the language of chemical imbalances to describe what for many is just an episodic case of the "blahs," we'll continue creating more problems than we solve.</p><p>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a>, <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank">Facebook</a> and <a href="https://derekberes.substack.com/" target="_blank">Substack</a>. His next book is</em> "<em>Hero's Dose: The Case For Psychedelics in Ritual and Therapy."</em></p>
Is focusing solely on body mass index the best way for doctor to frame obesity?
- New guidelines published in the Canadian Medical Association Journal argue that obesity should be defined as a condition that involves high body mass index along with a corresponding physical or mental health condition.
- The guidelines note that classifying obesity by body mass index alone may lead to fat shaming or non-optimal treatments.
- The guidelines offer five steps for reframing the way doctors treat obesity.
A new 5-step system for treating obesity<p>To help primary care practitioners better treat obesity, the doctors outlined five steps:</p><ol><li>Recognition of obesity as a chronic disease by health care providers, who should ask the patient permission to offer advice and help treat this disease in an unbiased manner.</li><li>Assessment of an individual living with obesity, using appropriate measurements, and identifying the root causes, complications and barriers to obesity treatment.</li><li>Discussion of the core treatment options (medical nutrition therapy and physical activity) and adjunctive therapies that may be required, including psychological, pharmacologic and surgical interventions.</li><li>Agreement with the person living with obesity regarding goals of therapy, focusing mainly on the value that the person derives from health-based interventions.</li><li>Engagement by health care providers with the person with obesity in continued follow-up and reassessments, and encouragement of advocacy to improve care for this chronic disease.</li></ol><p>Insider noted that some health professionals and body-positive advocates don't think the guidelines go far enough in reframing obesity treatment. The update still points "to individual bodies as the problem, not culture," registered dietitian <a href="https://www.bodykindnessbook.com/" target="_blank">Rebecca Scritchfield</a>, told <a href="https://www.insider.com/canada-doctors-obesity-should-be-defined-by-health-not-weight-2020-8" target="_blank">Insider</a>.</p><p>But it's also possible to see how some health professionals may worry this new model could discourage patients from taking the initiative to tackle weight-loss on their own, through exercise and dieting.</p><p>In a 2020 opinion piece published in <a href="https://www.frontiersin.org/articles/10.3389/fnut.2020.00002/full" target="_blank">Frontiers in Nutrition</a>, Dr. <a href="https://www.frontiersin.org/people/u/69229" target="_blank">Elliot M. Berry</a> argued that misplaced "medical and political correctness" may lead to the abrogation of the physician's responsibility to properly care for patients.</p><p style="margin-left: 20px;">"For example, some doctors are now even reluctant to raise the issue of obesity lest they be accused of fat shaming by not accepting their patients' proportions (despite the quote at the head of this opinion piece), and thereby receive poor approval ratings in an atmosphere where popularity is equated with good healthcare."</p><p>Berry offers a list of nine steps that he thinks could help the healthcare industry better treat obesity, without shaming patients or falling prey to political correctness.</p>
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