The Paradox of Individualism

By Shlomo Maital

         Across the Western world, a core value has long been in consensus – freedom.   Political freedom (democracy) and economic freedom (capitalism).  At the core of this core value is the idea that individual freedom is a basic human right.  Freedom to choose. Freedom to vote. Freedom to start a business and compete fairly.

           I would never want to live in a country where freedom was abrogated or eliminated (Putin’s Russia).  Those who do live in such countries risk their lives in the millions, to flee to countries of freedom.  All too often, they encounter slammed doors and barbed wire.

        But there is a paradox.  What happens when personal freedom morphs into an “it’s all about me” society?   What happens when we are called on to sacrifice for the good of our nation?   And why is the sanctity of the individual — individual personality, physiology, and nature — not enshrined in healthcare? 

           A quarter of the countries in the world have populist leaders.  America’s Trump leads the MAGA (Make America Great Again) movement that says, to hell with the rest of the world, only I count. (Ukraine is desperate and by some accounts, running out of ammunition because of self-centred MAGA-driven obstinence blocking US aid). My country Israel was driven off a cliff by a handful of Knesset members, in a coalition government, seeking personal it’s-all-about-me vengeance to curtail democracy – and tempting Hamas to attack.

          There is a paradox here. Individualism ends in the realm of healthcare. Physical and mental health are key areas that are not at all “all about me”.  Women and men have the same hypertension thresholds, even though women have far more pathology because of ‘borderline’ hypertension leading to cardiac problems.  Personalized medicine has been a slogan for decades – but it is largely empty.  Mental health rests on a thick book labelling mental illness, and practitioners slap a label on mental illness and treat it one-size-fits-all. 

      Under murderous attack,  young Israelis have come forward, embracing “it’s all about my country and how I can defend it” – and forever refuting those who doubted the love of country of Gen X, Y and Z.  It’s a terrible shame that it came to this.  We have learned that to preserve the core value of personal freedom, sometimes we have to sacrifice for others – in some cases, the ultimate sacrifice.  This is for us senior citizens an immensely painful experience.

       Individualism in politics.  In economics. In business.  But not in the way we treat physical and mental health?

       There are strong methods for personalizing mental health care.  E.g., Steven Hayes’ ACT–  approach, acceptance and commitment therapy * — helps each individual to look inward, become mindful and self-aware, accept things like grief and traumatic experiences, and rather than ‘get over it’ or ‘suck it up’ —  make it a part of ourselves, our consciousness, in a manner that is constructive and in line with our values, in a manner suitable to who we are and what we seek in life.

  What would be a strong simple formula for individualistic healthcare? Try this, from the late Gordon Paul, back in 1969: ”What treatment, by whom, is most effecitve for this individual, with that specific problem, under which set of circumstances, and how does it come about?”

      There is a delicate and complex balance between sanctifying the individual and validating sacrifice for family, friends, and country.  One of the most precious individual rights, is the freedom and obligation to do just that.  Without such obligation, in the long run there is no freedom.   

* “Evolving an idionomic approach to processes of change: Towards a unified personalized science of human improvement”. Steven C. Hayes, Joseph Ciarrochi, Stefan G. Hofmann, Fredrick Chin, Baljinder Sahdra.   Behaviour Research and Therapy March 2022.