Alone
in the Crowd by Professor A. Querido
Dr Arie Querido is Professor of Social Medicine at the University of Amsterdam and President of the National Federation for Mental Health of the Netherlands
In one of his stories Hans Christian Andersen tells of the councillor with the "lucky shoes"
on his feet, who following his fancy travelled back some centuries in time to the era which he expected would be in tune with his mental inclination and way of thinking.
But instead of serenity of reasoning in an atmosphere of congenial companionship he was assaulted by stench and dirt, mud and darkness, violence and cruelty before he had found even one kindred soul.
Indeed, if we think of present-day concepts of hygiene and health, the conditions in our former cities are almost unimaginable, even though their mortality bills are still preserved.
In many ways the development of mental hygiene is following a course very similar to that of general hygiene-except that it is running a considerable time behind.
I firmly believe that the conditions of many modern cities in terms of mental health are comparable to the general health conditions of cities two or more centuries ago. This is to say: they are not even mentally un-healthy, they are non-healthy. If there is a connexion between city life and mental health, it is·only imaginary. For if mental health is determined by the nat~re and quality of inter-human relations, ~ow can we discuss mental health if these ·relations under the influence of present-day metropolitan conditions atrophy, dwindle and disappear?
Here another parallelism strikes us, that between two of the most remarkable paradoxes in man's development: The city was brought into being by the social urge of man: to establish mutual safety, and to pool resources against the hostile forces of the physical and biological environment.
This aim was reached up to a point; but at the same time the new man-made environ- ment generated new dangers for the well-being of individual and community.
The success of the city drew more and more people into its structure, which in turn increased the dangers in logarithmic ratio.
In the same way man's needs demand ever larger structures in order to make his activities interlock and co-ordinate. This process at first is self-stimulating, then it becomes self- accelerating and finally it defeats its own ends.
As soon as the population exceeds a certain size-which is by present standards very low 18
indeed-the need for communication demands technical aids, which, up to a certain limit of size and complexity, facilitate mutual contact.
When this limit is exceeded, technical communication becomes an impediment instead of an aid. This point of course is reached when the mechanical ritual of a new system requires more time or energy than a former, more primitive, system.
It is only too easy to illustrate this state of affairs. Telephoning becomes maddening- literally so.
There are no adjectives to describe the anti- functioning of elevators and subway services.
And what about surface traffic which makes the more advanced participants revert to carrier- pigeons in order to inform the family that some- thing has to be kept on the hot plate since the head of the family is caught in a traffic jam which is indeterminable in space and time?
In the modern city our senses are assaulted just as much as they would have been some hundreds of years ago, in a different way, it is true, but no less harmfully.
There is noise and stench as there was in former times*, and perhaps the more unbearable as it is more mechanical, more impersonal, more relentless because there is less opportunity for escape.
The disruption of natural rhythms, the· exten- sion of the day far into night, and the waste of the blessings of the morning are perhaps more cruel than the darkness with its accom- panying hazards which descended on the city in former times.
But the greatest danger- I would almost say the greatest crime-of modern city life is its disruption of human relations, resulting in an isolation, a loneliness of the individual which increases with the size of the city and its complexity.
Human relations are of course only possible on a basis of communication. The complexity of city life demands an ever-increasing com- plexity of communications system, which however seems to have reached a point where communication is actually decreasing.
The result of this process is the crowd; the city is crowded, over-crowded.
In the crowd, being part of the crowd, we are
• Read Schopenhauer's essay " Ober Liirm und Geriiusch "
Take a bus ... ..,.
alone. In the city, the crowd is always around us: in the street, in places of amusement, in the places where we eat and drink, in the factory, in the office.
Even in our homes we remain forcibly conscious of the presence of innumerable other beings because our senses are given no rest from the evidence of their activities.
Some years ago, speaking to the World Federation for Mental Health, I had the opportunity to discuss the problems of over- population and ventured to surmise that the limits of population density determined by man's mental tolerance might be lower than those set by his physical tolerance.
It would seem that present-day development does n<;>t contradict this surmise.
High population density over vast areas no doubt offers formidable problems in the field of physical health.
Take a taxi ...
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Even if we disregard the shameful condition in the shanty-towns to be found in too many places of the world today because the reason of their existence and growth seems to be chiefly economic-it is a fact that in highly sophisticated and mainly prosperous conglom- erations, water supply has become a vast problem, air pollution offers a serious threat, traffic as a physical hazard is comparable to the major epidemic diseases of a century and more ago.
These problems, however, are recognized and defined, which means that their solution is one of technical ingenuity and technical develop- ment, both of which deserve unlimited confidence and support.
But who can tell what is happening-what has been happening-to the mental health conditions in these vast city conglomerations?
It casts an interesting light on the range of
© Keystone
the city dweller's adaptability that the number of people that have to be forcibly removed from the driver's seat or the telephone booth to be brought screaming to a psychiatric hospital ward remains very small indeed.
However, we do not know a thing about the effects of the chronic frustration that the city dweller has to suffer day-in, day-out.
Or do we? Is there a connexion with the enormous increase in drug consumption?
Is there a connexion with the remarkable increase in unexplained violence?
Is there a connexion with the curious behav- iour and the strange rituals in clothing and customs as shown by numerous groups of youths all over the world but especially in the larger cities?
Is there a connexion with the decline in birth rate noticeable in some of the highest devel- oped areas of Western culture?
Is the city population approaching the state of rats, which, under conditions of experi- mental crowding, refuse to breed and start fighting and devouring each other?
Let us not speak of cure before a modicum of certainty can be established in regard to diagnosis. At present we are even far from evaluating the symptoms from which a diagnosis will have to be built up.
It may however be permissible to regard some phenomena as symptomatically significant, as I have attempted to do.
Furthermore I should like to add one obser- vation which might be interpreted as an indication of the direction in which a solution may be sought.
People who at present call the city un-livable in are not among the most vulnerable members of the city population, on the contrary they are often very mature persons with a strong sense of identity.
When we observe in what way they try to find a solution for their problem we see that they seek to establish solitude, either within or without the city. Solitude, as opposed to loneliness, solitude which enables the indi- vidual to be himself, logically implying relations to others, since without these relations the individual is nothing.
This behaviour of a certain type of modern city dweller seems to underline some funda- mental mental hygiene principles. The crowd is deadly-against the crowd only one remedy exists-the consciousness of identity.
Therefore, whatever the authorities do in grappling with the modern city-monster;
whatever the planners may dream about the city of the future; whatever the traffic experts may design and the engineers put on their drawing-boards-let there be at the centre of their efforts one purpose: to respect the individual.
Only then can the megalopolis be prevented from becoming a tyrannopolis, as Lewis Mumford said, in which a bright new world of robots can exist in a pseudo-life only.
Attend a lecture ...
The artifical life
byL.GrazA number of psychologists have pointed out that one of the prob- lems faced by man in the big city is that his life is no longer adjusted to the rhythm of nature, that his stimuli are no longer the natural ones of water, the earth, the seasons, but rather the technical ones
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© Almasy
of the alarm clock, the production schedule and the bus timetable.
For these psychologists and for some sociologists, city life can be described as being lived on three distinct planes.
The first is the plane of social life. One example might be found in the family, where the complicated patterns of kinship are dissolved and replaced by the two-generation family unit. Even within this smaller unit, the roles of parents and children tend to become
