A State of Vital Exhaustion
In 1992 the World Health Organisation published its tenth revision of the International Statistical Classification of Diseases. Under the diagnostic code for burn-out, ‘a state of vital exhaustion’ was recorded for the first time. The term sought to outline an end-state, characterised by acute stress, anxiety and depression, of the individual life that had been rendered unliveable. With some prescience, it has come to broadly capture an experience of increasing ubiquity in the UK today, one that can be located within the emerging public discourse that is often referred to as the ‘mental health crisis’.
How might this term help us to understand the origins of this crisis? And what role can exhaustion play in our consciousness of that which constitutes vitality?
Let us first consider exhaustion as it appears in the dictionary: the action of using something up or the state of being used up. In 1897, Émile Durkheim, a founding father of modern sociology, wrote, ‘… all the organism needs is that the supplies of substance and energy constantly employed in the vital process should be periodically renewed by equivalent quantities; that replacement be equivalent to use’.1 That survival, in short, is a rhythm of use and renewal.
On the one hand then, the use of energy is bound up in the labour of breathing, drinking and eating, in work and play, that which leads to organic exhaustion, to devitalisation. But of what source revitalisation?
Oxygen certainly, food and water are there too, as there is sleep. ‘As solitary and private as sleep may seem …’, author Jonathan Crary writes, ‘… it is not yet severed from an interhuman tracery of mutual support and trust’.2 Something important is being said here about the nature of the organism, of the individual, and its vitality. Sleep, that is to say the renewal of energy, or revitalisation, is inextricably linked to security and the need for protection.
Whilst as a species we are now, on an individual level, broadly able to regulate the endangerment and insecurity that sleep engenders, sleep itself remains emblematic of a need to rest the body; of repair and recovery. It’s the very same condition Charles Darwin reflected on when he observed, ‘… the naked and unprotected state of the body, the absence of great teeth and claws for defence, the small strength and speed of man, and his slight power of discovering food or for avoiding danger by smell’.3
The fallibility of the human organism, its vulnerability therefore, could be said to originate a requisite or primitive need, a function that is, ‘… fully as important for the survival of a population as nutrition or reproduction’.4 It is to say that survival, this rhythm of use and replacement, works only when stabilised through the protection and security afforded by others.
This need might sooner be understood as a bond, a bond of cooperation or social bond, in which, ‘… sympathetic motives take priority over the egotistical instinct’.5 Think of it as a vital function in its own right, one that when activated, serves to mitigate and diminish the risk of the individual coming to any harm.
This notion can be found at the navel of all vulnerability; a need of the other in the avoidance of or escape from danger, defence in the event this were not possible, and in sourcing the water, food and shelter needed for survival.
The origination of the State can be interpreted as this protective covering in the modern era. From the provision of healthcare and defence to the regulation of water services and council housing. Institutions themselves, the National Health Service or Armed Forces, the ossification of this bond. It is to say that the State stabilises the human organism, a guarantor as it were, that arrives prior to the individual, so that the individual themselves may engage in the rhythm of survival, the use and replacement of energy.
It seems then, that this bond is not in and of itself a source of energy, the very same substance bound up in Durkheim’s vital processes, but a gesture or distributary, set to charge, ‘… the general state of vital energy’.6 As much as survival is a cycle of use and renewal, it is more urgently the practice of this bond, that which could be said to constitute vitality. It is, as Durkheim might put it, ‘… a mutual moral support, which instead of throwing the individual on his [sic] own resources, leads him to share in the collective energy that supports his own when exhausted’.7
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Energy is a useful word when thinking about capitalism. Described by sociologists Pierre Dardot and Christian Laval as the ‘motor of history’, capitalism, and its tenets of acquisition, possession and accumulation, has long vitalised the development of the modern Western world.8
As free exchange has shifted to competition for profit as the principle of the market, a truth no more so apparent than in the last forty years as capitalism has transmogrified into its neoliberal iterant, it has activated an unprecedented charge of the productive forces. These forces are then said to vitalise the economy, which, according to some ideologues, is the source of all individual wellbeing and vitality.
Before we consider the ways in which these forces are applied, we should mark these two, somewhat opposing, notions of vitality. On the one hand a bond of cooperation, or social bond that charges what might be described as a social vitality. And on the other, a bond of competition or economic bond, which charges what could be termed an economic vitality.
On the 4th April 1979, in a lecture given at the Collège de France as part of his Birth of Biopolitics series, Michel Foucault remarked:
‘… the economic bond plays a very strange role within civil society, where it finds a place, since while it brings people together through the spontaneous convergence of interests, it is also a principle of dissociation at the same time. The economic bond is a principle of dissociation with regard to the active bonds of compassion, benevolence, love for one’s fellows, and sense of community inasmuch as it constantly tends to undo what the spontaneous bond of civil society has joined together by picking out the egoist interest of individuals, emphasising it, and making it more incisive’.9
Foucault locates one of capitalism’s essential truths. Whilst competition might be said to charge the productive forces and the economy therefore, it does so by way of the pressure it places on that which promotes vitality over exhaustion, inasmuch as it tends to obfuscate, delegitimise even, the practice of the social bond. Think of it as the bond deactivated; the deactivation of Foucault’s bonds of compassion, benevolence, love for one’s fellows and sense of community.
Let us then consider how capitalism is iterated today, how governments have sponsored competition, the economic bond, and the ways in which these forces have been applied so as to stimulate the economy.
In 1944, economist Friedrich von Hayek, a key architect in the remodelling of economic liberalism into its neoliberal iterant, gave the following argument for the incorporation of competition within society:
‘The liberal argument is in favour of making the best possible use of the forces of competition as a means of co-ordinating human efforts … it is based on the conviction that where effective competition can be created, it is a better way of guiding individual effort than any other … and it regards competition as superior not only because it is in most circumstances the most efficient method known, but even more because it is the only method by which our activities can be adjusted to each other without coercive or arbitrary intervention of authority’.10
As political thought became political practice, most notably in the late 1970s as Margaret Thatcher took office with her Conservative government, the full use of competition and comprehensive transformation of social life into economic space would begin.
Labour markets were restructured so as to support the casualisation of work contracts, leading to the weakening of trade unions and the loss of worker rights. Productivity at work, stimulated through measures such as performance-based pay and job security, all the while, ‘… others were made psychologically insecure by dint of the fact that they do the same work as their temporary colleagues…’.11
The welfare state, as Dardot and Laval argue, ‘… was presented as a burden, a brake on growth, and source of inefficiency’, leading to cuts in public expenditure and the eradication of all norms and regulations that limited competitive dynamics.12 Now, after some forty years, neoliberal capitalism has ushered in a near total privatisation of services, no social domain left unturned, from health and education to defence and environment.
Given that these services, and the institutions that provide them, were established so as to protect and safeguard, so as to mitigate human vulnerability, their transformation should also be understood in this way. Whilst access to these services, made more and more contingent on and in proximity to capital, rests assured for some, for a great many others it now poses a very real risk to individual survival.
We arrive then at an unprecedented phase of economic vitality, a capitalism iterated as it is on the one hand through competition, and a hardworking labour force, that in these late stages is less and less remunerated for the costs arriving prior to employment, such as education, training and periods of inactivity and rest, or after it, including the rebuilding of strength, wear and tear, and ageing.13 And on the other, an absolute privatisation of social services, which has led to what can only be described as a form of state-sponsored insecurity and endangerment. After all, what could be more energising, more motivating for the individual at work, than the risk of harm or loss of one’s own life outside of it?
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Above all it marks what might be described as the predominance of the economic bond over that of the social, a society in which competition and the prioritisation of economic productivity and individual success triumphs over all else. This will to win, a fight for survival, ‘… extends and imposes the logic of capital on the totality of social relations’, activating a kind of formalisation within social life and totalising inhibition of social bonds.14
Social connectedness therefore becomes one shot, no relationships free of purpose, or as sociologist Robert Putnam observes, ‘… we use people, and they use us, to solicit more business, advance our careers, sell more products, or demonstrate our popularity’.15 In short, a society in which the individual is more bonded economically than socially. Sooner colleagues than friends.
All the while vitality is supposed on the strength of the market, and the practice of competition that this necessitates, we forget the practice of something else; a vital function that has safeguarded the human organism and assured its evolution from inception. The inhibition of this bond under late capitalism lays bare once more, not just human vulnerability, but that which constitutes survival for the species as a whole.
In 1871 Darwin noted, ‘… that states of pleasure are connected with an increase, and states of pain with an abatement, of some, or all, of the vital functions’.16
It is my belief that the mental health crisis is symptomatic of this condition: the body an organism through which danger is sensed as pain. That the inhibition of the social bond equates stress; that anxiety is, ‘… a growing sense at some visceral level of disintegrating social bonds’, and depression, ‘… the difficulty of identifying the origin of the threat and making plans to control it’.17 In this sense the organism itself is perhaps capitalism’s fiercest critic. Pain an inalienable form of resistance.
As capitalism takes on ever newer forms the question now is not how the term vital exhaustion might help us to understand the origins of the mental health crisis, but how, as theorist Franco Berardi poses it, we might, ‘… inscribe the reality of death in the political agenda [,] transforming decline into a lifestyle of solidarity’, so as to reconstitute vitality for all?18
If we are to refurbish a critique of capitalism that is fit for the twenty-first century I suspect it will arrive through the consciousness of individual pain as having been derived from a shared origin.
Durkheim, É. trans. John A. Spaulding and George Simpson, ed. George Simpson (2002) Suicide: A Study in Sociology. London, UK and New York, NY: Routledge. P. 207. Original text published in 1897.
Crary, J. (2014) 24/7: Late Capitalism and the Ends of Sleep. London, UK and New York, NY: Verso. P. 125.
Darwin, C. (2004) The Descent of Man: Selection in Relation to Sex. London, UK: Penguin. P. 84. Original text published in 1879.
A description psychologist John Bowlby uses to describe the function of bonding in the protection from predators in Bowlby, J. (2006) The Making and Breaking of Affectional Bonds. London, UK and New York, NY: Routledge. P. 87.
A description sociologists Pierre Dardot and Christian Laval use to expand on what Comte called a ‘radical inversion of the individual economy’ in Dardot, P. and Christian Laval trans. Gregory Elliot (2017) The New Way of the World: On Neoliberal Society. London, UK and New York, NY: Verso. P. 32.
Suicide: A Study in Sociology. P. 202.
Ibid. P. 168.
The New Way of the World. P. 9.
 Foucault, M. trans. Graham Burcell, ed. Michel Senellari (2010) The Birth of Biopolitics: Lectures at the Collège de France 1978-79. New York, NY: Palgrave MacMillan. P. 302.
von Hayek, F. (2001) The Road to Serfdom. London, UK and New York, NY: Routledge. P. 37. Original text published in 1944.
 A description used by Luc Boltanski and Ève Chiapello in Boltanski, L. and Ève Chiapello, trans. Gregory Elliot (2018) The New Spirit of Capitalism. London, UK and New York, NY: Verso. P. 243.
The New Way of the World. P. 230.
 An observation made by Boltanski and Chiapello in The New Spirit of Capitalism. P. 251.
A description used by Dardot and Laval in Dardot, P. and Christian Laval trans. Gregory Elliot (2019) Never-Ending Nightmare: The Neoliberal Assault on Democracy. London, UK and New York, NY: Verso. P. 3.
 Putnam, R. D. (2000) Bowling Alone: The Collapse and Revival of American Community. New York, NY: Simon and Schuster. P. 91.
Darwin, C. (2009) The Expression of the Emotions in Man and Animals,. London, UK: Penguin. P. 20. Original text published in 1872.
Descriptions lifted and reimagined, respectively, in Bowling Alone, P. 288, and, A New Spirit of Capitalism, P. 420.
 Berardi, F. (2019) Futurability: The Age of Impotence and the Horizon of Possibility. London, UK and New York, NY: Verso. P. 94.
Harry Woodlock is an independent curator and editor living and working in London.