AIDS – A Metaphor for American Society

GUEST: Mary Catherine Bateson
VTR: 4/30/88

I’m Richard Heffner, your host on THE OPEN MIND. Astonishing, it was but a few years ago that in our arrogance we thought – as far as disease is concerned – that we humans had progressed so far, we were essentially merely in a cleaning up phase…that basically we had licked most of the diseases that earlier had been the scourge of mankind: from polio to smallpox, to syphilis, to diphtheria, to tuberculosis…that even cancer’s code would soon be broken, and what essentially was left for us to solve were only the problems of aging. Having essentially controlled illness, we had only to cope with the challenges of longer life: how to better human existence as it inexorably got longer and longer still.

How proud we were of our achievements.

But pride goeth before a fall…and perhaps that is what hurts most about the epidemic upon us. We are not free of disease. Far from it. Along with the reappearance and resurgence of older ills, we are now confronted with AIDS…and the social, political, and psychological impact of the very realization that our command over our own destiny is nowhere what we thought it had become, cries out itself for recognition and understanding. What does it do to our pride, our sense of ourselves? How, indeed, does this newly recognized vulnerability impact upon our judgments as a people, upon our very capacity to deal with AIDS reasonably, rationally, wisely?

In the years ahead, AIDS may have even more than the impact of a war upon us, changing vitally the dimensions of our society. So that we must look now to what others have called the sociological anatomy of AIDS. The epidemic upon us will affect our laws, our customs, our politics, our entertainments, our social ability, our patterns of commerce, our sense of self. Precisely how we don’t yet know…but surely we must begin to inquire how now, not later. If the societal effects no less than the physical scourge of AIDS itself are to be controlled, recognition, surely, is the first step. Which is why I have invited today Mary Catherine Bateson, the distinguished anthropologist, to join me on THE OPEN MIND. Later this year Addison Wesley will publish Thinking AIDS, by Dr. Bateson and Richard Goldsby. Today I want to “think AIDS” with her. Thanks a lot for joining me again Dr. Bateson. And, you know, I want to ask you first to elaborate upon something that you write in this extraordinary book, and I’m sorry that one has to wait until September to see it really in print. You write, “AIDS moves along the fault lines of our society and becomes a metaphor for understanding that society”. You say, “It throws certain characteristics of society in to sharp relief, just as radioisotopes, moving through the body can be used to highlight physiological processes for diagnosis. It belies our habitual self deceptions, tracing interactions that would otherwise be secret. Sexual practices that most people have preferred not to know about, extramarital sex, homosexuality, prostitution and drug addiction. It forces us to acknowledge bisexuality, a pattern of sexual preference that most Americans, who like their distinctions clear, have tended to ignore. And it is making us more aware of middle class intravenous drug use”. Now, really, what do you mean when you write “AIDS moves along the fault lines of our society and becomes a metaphor for understanding that society”?

Bateson: Well, there’s really two issues here that you’ve combined in the quote that you chose. One is the fact that AIDS is transmitted through interactions that tend to be kept secret and that therefore carry many of the negative connotations that go with secret interactions. Some of them are defined as criminal, some are stigmatized, some go with various forms of prejudice and discrimination and all tend to have ignorance clustered around them. They’re not the interactions that we are most able, as a society, to think about, learn about and make conscious choices about. So that’s one side of it. The other side is that it’s becoming increasingly clear that the likelihood of getting AIDS is related to exclusion, and poverty, and discrimination. When someone undertakes to refashion their behavior to protect themselves from infection, underlying that decision must be a strong sense of self-esteem. They must be well informed, they must believe they have choices open to them. And there are far too many people in our society who do not experience choices open in front of them.

Heffner: Then if the choiceless people are essentially the victims, or those who perceive themselves as having fewer choices are themselves the victims, you’ve drawn a picture that is almost hopeless.

Bateson: Well, nobody is entirely choiceless. But I think we have to do two things at once. I would like to see all of the highly targeted programs to increase awareness of the danger of HIV transmission supported and increased. But I also would like to see us use the occasion of this epidemic to think through some of the facts about our society. Poverty and ignorance create opportunity for disease. They always have. This has been true in many previous epidemics. And yet it’s only perhaps when the middle class begins to feel threatened by the spread of a disease that attention is paid to the suffering that has pre-existed the outbreak. And in this case I’m talking both about racial prejudice and poverty and the discrimination that has existed against homosexuals.

Heffner: But, you know, going…you say what I had done in my quotation here was to combine segments of what you said. True. But what about the segment that has to do with the way in which AIDS is forcing us to admit or deal with our habitual self-deceptions? “Tracing interactions that would otherwise be secret”…You’re not there referring, essentially, or at least only, are you, to an underclass? You’re referring to a larger segment of the American society.

Bateson: You know, I’m very interested in the phenomenon of double standards. We use the notion “double standard” sometimes very specifically to talk about a gender-linked “double standard”. But also it’s very common, very closely related to that, that there are ideal rules in a society and there’s what’s really happens. And there is a kind of a public conspiracy of silence to ignore what is really happening. There are a number of other processes that have taken place in the last few years, where we have become aware of activities hidden by a conspiracy of silence. Incest is one such area. A few years before the development of substantial research on incest, there was a tremendous increase of awareness about rape. And what I’ve tried to emphasize is that if an area of behavior is kept secret and there are society-wide habits of lying about that area of behavior, that area of behavior is subject to a whole set of other problems.

Heffner: And in your…

Bateson: And sexuality is one of those things. Although, obviously, sexuality is becoming less and less hidden as time goes on.

Heffner: But you make the point, too, that middle class drug use is susceptible to being delineated. Now you…this wonderful metaphor of the radioisotope, radioactive isotope here revealing so much more about our society than we have ever wanted ourselves to know. But I have to go on from there to ask – this “opportunity” to come to deal, to come to grips more with our own real patterns. Too late, in your estimation? Are we looking at a society that, to which we are about to bid good-bye and say, “here is the means by which we are better able to dissect, to see that society?” Or are you saying “There is much time here. We’re going to find the ways illumined to pull ourselves out of this situation?”

Bateson: You know, one of the very tricky things in talking about AIDS is, it’s very hard to strike the right balance between, on the one hand saying, “It really is very important to act quickly”, and on the other hand saying that this is not a matter for panic. So, before I start, I was saying that I want to say both of those things. I do not think it is too late. It is obviously too late for many individuals and there’s going to be a lot of grief and a lot of unhappiness. But I think we have the capacity, as a society, to acquire what might be called “behavioral immunity” and the capacity to acquire that while becoming a better society. That is I don’t think we have to be sucked into a permanent state of fearfulness and repression to deal with the epidemic.

Heffner: Suppose you were to conclude that we do have to be in a permanent state of panic, of fear, of overwhelming concern. Would you consent then to wave the flag of fear? Seriously, I mean, is there something in which just as a very highly intellectual person, as a trained scholar you just automatically resist the notion of panic?

Bateson: I don’t think that’s what you’re saying. I think you’re just saying I’m temperamentally up-beat. (Laughter)

Heffner: Okay. Good. You’re temperamentally up-beat, but I also think that as a scholar you find it very difficult to be panicked.

Bateson: I think panic is a short-term measure. The AIDS epidemic is, I believe, a permanent fact, almost certainly a permanent fact, of human life, which we’re going to have to adapt to. And which we have the capacity to adapt to. It’s going to require behavioral change. There’s nothing new in that. That is the essential adaptive pattern of the human species…is to learn and teach and change. The question that arises, how is long-term learning achieved? Not this week, not next week, alright. Precautions are needed this week and next week. But we have to think about the possibility, the high likelihood that we won’t have anything like a vaccine for at least ten years and may never have anything like a vaccine. And this is simply an on-going circumstance of our life. One of the questions that I’m asking is, “How do people change their behavior?” And I believe that people will change out of panic and fear, short-term. But that if you want long term change, what’s important is to support the process whereby people find meaning in a new pattern of behavior and pleasure in it and satisfaction.

Heffner: And survival.

Bateson: And survival.

Heffner: Which leads me to the question of whether, as an anthropologist, we have to assume that all of the groupings in our society today will survive, or whether this is not purposefully God-chosen a means of natural selection, or nature’s way, but that, in fact, those who are not equipped at this moment to learn to change, will not survive. And that that will be…have an enormous impact into the makeup of our society.

Bateson: Yes. I’m troubled by that phrase “equipped to learn”. I think almost all human beings are equipped to learn, but clearly there are factors that interfere with that.

Heffner: If I said “equipped by circumstance”?

Bateson: Equipped by circumstance, all right. I think probably, for instance, in the drug-using community, between the lack of freedom represented by addiction and the lack of societal alternatives and the lack of trust that goes with having been involved in a criminalized activity, so you don’t…you’re not really willing to take the advice of the official community, that this is a group of people who were not well sited to modify their behavior to meet the epidemic. It’s going to take a lot of help.

Heffner: And as a consequence? Not being “well-sited”…What do you think the consequence will be? I mean you painted before a picture of dire consequence. I assume you’re not going to back away from that. That, for them, meaning not…no further survival.

Bateson: I think if you’re talking about individuals, a lot of people are going to die. There are cities in which well over fifty percent of the IV drug-using community are already infected with HIV and the evidence is piling up that they’re likely, all of them, to develop AIDS eventually. Though that’s not sure.

Heffner: You know, there is…let’s see if I can find it in the typescript…here, on page 11, there is something that struck me as so enormously important. You write, “If we can use the impetus of AIDS to expand and apply knowledge cooperatively and humanely, we may also learn to control the dangers of the arms race and of world hunger and environmental degradation. For the imagination of AIDS is the imagination of human unity intimately held in the interdependent web of life”. But we have not met those other challenges before this.

Bateson: No, we haven’t.

Heffner: Therefore, I wonder, aside from you inheritance of an optimistic spirit, what would lead you, indeed, to assume the very, the very comparison you make here, “If we can lick the problem of AIDS, if we can deal with it, then perhaps we can deal with war”. We’ve never dealt with war. Which leads me to ask how you can assume that we will adequately deal with AIDS?

Bateson: I can’t assume that we will. There is some pretty good evidence that AIDS doesn’t represent a threat to the species, that it would be self-limiting, as all epidemics have been. But, of course, that’s not really what I’m talking about. I’m talking about dealing with it so that we can find a way to sustain our society commitments in spite of the fact that it’s is in the environment. We don’t…from my point of view, survival is not the issue. From my point of view, the issue is survival as the kind of people we want to be, which is somewhat different. The threat that AIDS represents to human survival is, I believe, substantially smaller than the threat of nuclear war. But the threat of nuclear war is, for most of us, very hypothetical. What AIDS gives…and I see you, you’ve taken up my phrase, my use of the word “metaphor”…

Heffner: Yes.

Bateson: … AIDS reminds us that we are mammals, that we die, that we are subject to disease, that we are dependent on each other, and that our life is interlocked with the life of other organisms, many of which live inside us. It strikes me that the…oh, and there’s another point which is particularly, has always been particularly noticeable in Americans, that we come to grips with abstract problems because of our sense of individual suffering. One child, an infant with AIDS abandoned in the hospital ward in New York. A gay man being nursed by his lover whose parents are refusing to speak to him. The series of individuals who have been presented in stories, I think, represent an opportunity to combine a response to individuals, an empathic response to individuals with an abstract appreciation of the problem. And it’s very hard to do that with nuclear war. But maybe if we can do it, vis-à-vis AIDS, we will come out of this process of coming to…of confronting AIDS with a clearer sense of interdependence and a clearer sense of the basic human adaptive problems…capacities, the capacity to make social inventions.

Heffner: Yes, but it’s so interesting. You make reference again to empathic reactions and I remember so well, this sentence: “Unfortunately, infection has tended to spread faster”, talking about AIDS, “than either empathic emotional involvement or understanding”. It’s almost as if you had thrown in the towel, which is not what you’re given to doing.

Bateson: I wouldn’t be writing a book if I had thrown in the towel!

Heffner: Fair. And you want this to be read by students.

Bateson: Yes. I think we’re going to have to work very hard at it.

Heffner: But you k now, you said a moment ago, you said “It’s not just survival”. You said, “It’s survival as the kind of people we want to be”. Hasn’t the…now you may reject this question, but the question is, whether the hedonism that is basic to the spread of AIDS thus far in this country, whether it isn’t a demonstration of the kind of people we want to be. And to the extent that that is true, how can you possibly say that it’s not just a matter of survival, it’s survival as the kind of people we want to be. We have been doing what we wanted to do for two generations now, or more. And there may be those who say, “As a consequence, we’re in the grips of this death-giving epidemic”.

Bateson: Well, I do think that there are people out there who think that if all those people whose behavior makes them vulnerable to AIDS were to die, we would be more nearly the people they want us to be.

Heffner: How do you feel about that?

Bateson: I write out of a deep commitment to human diversity. And to increasing consciousness. I do think indiscriminate sexuality is dangerous. It isn’t just dangerous vis-à-vis AIDS, it’s dangerous vis-à-vis a whole set of sexually transmitted diseases. But I think to protect against those dangers by repression is counter-productive. I’d like to see us protect against those dangers by awareness and conscious choice and getting away from situations of coercive and exploitive sex, giving people a sense of self-esteem. I’d like to have them have a sense that love is nice combined with sex, that long-term commitments are valuable. These are all things that I think need to be emphasized. But you see, I think a lot of the hedonism is a rebellion against moralistic teachings of the past. My theory as an educator is to say “Understand it, think about it, make your own choices”. Not, “This is evil, don’t do that”. This is risky, it is risky.

Heffner: Not only is it risky, we’re not reaping the…what the risk has brought upon us, would you not say. We are…at this point you talk about diversity and odds one has, of course. But isn’t an acceptance of that diversity the reason we are where we are now? I’m not sure I mean that, but I’m asking the question in one minute left.

Bateson: One minute left. New diseases will emerge. AIDS is not the last one. It’s harder to deal with AIDS because it’s associated with something we are uncomfortable talking about. We invented air conditioning systems in hotels and created the epidemic of Legionnaire’s Disease. This will recur. And the essential need to deploy human knowledge and concern to meet what is always a slowly changing environment will remain with us.

Heffner: The question, of course, I’m sure that…and I lied, it wasn’t a minute, it was a minute and 15 seconds…

Bateson: Ahhh…

Heffner: …so I have a moment to just ask whether you think your mother, Margaret Mead, would have been, today, as optimistic as you are, if that is an appropriate word, as positive as you are.

Bateson: Yes. I think she probably would have been. I think she believed very deeply, particularly on the basis of working with a society in New Guinea that, in a sense, remade itself, that there’s a great malleability in human behavior. And that we can work towards the cultural evolution, the behavioral changes that will keep our society viable.

Heffner: I hope you’re right. Mary Catherine Bateson, thank you so much for joining me today. And thanks, too, to you in the audience. I hope you’ll join us again next time. And if you care to share your thoughts about today’s program, today’s guest, today’s theme, please write to THE OPEN MIND, P.O. Box 7977, FDR Station, New York, NY 10150. For transcripts send $2.00 in check or money order. Meanwhile, as an old friend used to say, “Good night and good luck”.

Continuing production of this series has generously been made possible by grants from: The Rosalind P. Walter Foundation; The M. Weiner Foundation of New Jersey; The Mediators and Richard and Gloria Manney; The Richard Lounsbery Foundation; Mr. Lawrence A. Wien; Pfizer, Inc.; The New York Times Company Foundation.