Salvos Against Everything

On Ivan Illich, scourge of the professions

George Scialabba

The 1950s, ’60s, and ’70s—les trente glorieuses, the French call them—were indeed fat years in Western Europe and the United States. Unions were strong, unemployment was low, and a lot of jobs still came with health insurance and pensions. The jobs in question also stood a fair chance of not either migrating at any moment to lower-wage countries or suddenly being replaced by software, hardware, or a fiendish combination of the two. Notwithstanding an ugly racist backlash to the civil rights movement and an unjust, hideously destructive war in Indochina, it was possible, for a few brief years, to believe that the American economy and polity were sound in their fundamentals, however much in need of reform.

And yet radical social criticism flourished in those decades as never before in America, not even in the Great Depression: C. Wright Mills, Herbert Marcuse, Paul Goodman, James Baldwin, Michael Harrington, Christopher Lasch, Jonathan Kozol, Norman O. Brown, Wendell Berry, Shulamith Firestone, and the authors of the Port Huron Statement, among others. Perhaps there’s something to the idea that revolutions are a response to rising expectations: that economic success and apparent security liberate the radical imagination, while widespread insecurity cramps it, inducing a defensive crouch. At any rate, an awful lot of people back then professed themselves—ourselves, I must acknowledge sheepishly—revolutionaries.

Ivan Illich was an idiosyncratic revolutionary. Fundamentally, most radical critics object that our institutions unfairly allocate good and services—education, health care, housing, transportation, consumer goods—or jobs, or respect, or, simply, money. Illich nicely summarized the left’s perennial program as “more jobs, equal pay for equal jobs, and more pay for every job.” For Illich, these demands were beside the point. He thought that, by and large, the goods, services, jobs, and rights on offer in every modern society were not worth a damn to begin with. In fact, he thought they, and the way of life they constituted, were toxic. He was not a reactionary in any useful sense of that term, but he was a fervent anti-progressive.

The Prickly Priest

Illich was born in Vienna in 1926 of Jewish and Catholic parents. The family fled the Nazis in 1942, and after the war, Illich studied cell biology and crystallography in Florence, theology and philosophy in Rome, and medieval history in Germany. He was ordained a Roman Catholic priest and in 1951 was sent to a poor Puerto Rican parish in New York City. He was very successful, both as a parish priest and also, somewhat more surprisingly, in charming the ultra-conservative Cardinal Francis Spellman. In 1956 he became vice-rector of the Catholic University of Puerto Rico. By then he was a fairly outspoken critic of pre-Vatican II Catholic orthodoxy, and his new superiors were not charmed. He spent 1959 wandering around Latin America and then settled in Cuernavaca, Mexico, where he founded a freewheeling language school and research center, the Center for Intercultural Documentation (CIDOC), which became, like Berkeley and Greenwich Village, a seedbed of sixties radicalism.

At some point the Vatican became alarmed—it’s rumored that the CIA had complained about him—and Illich was summoned to Rome to explain himself. Apparently the Church authorities satisfied themselves that this retiring polyglot cleric was not actively subversive. Illich resigned from active priestly duty but remained in holy orders. Meanwhile, CIDOC had become a distraction, as had his own growing celebrity. Illich had no taste for empire-building, so he phased out the Center in 1976 and became an itinerant scholar, living from course to lecture series to research grant, with occasional royalties as well. He wrote a dozen books (or fifteen, depending on how strict your definition is) and died in 2002.

The first of Illich’s books, Deschooling Society (1971), made him very famous. It caught the crest of a wave of critique and experiment in American education: Paul Goodman, John Holt, Paulo Freire, free schools, community control. Illich shared his contemporaries’ anti-authoritarianism but not their reasons. For most educational radicals, the enemies were tradition—the age-old authority of church and state, bosses, and parents—and inequality: the gap between resources devoted to rich and poor children. From this point of view, the remedies were plain: practice emancipatory social relations in all schools and lavish more resources on those serving poorer children.

Perhaps there’s something to the idea that revolutions are a response to rising expectations: that economic success and apparent security liberate the radical imagination, while widespread insecurity cramps it.

To Illich’s mind, those remedies missed the point. He thought the educational system had no good reason to exist. It was, like every modern service industry, in the business of creating and defining the needs it purported to satisfy—in this case, the certification of experts—while discrediting alternative, usually traditional, methods of self-cultivation and self-care. The schools’ primary mission was to produce people able and willing to inhabit a historically new way of life, as clients or administrators of systems whose self-perpetuation was their overriding goal. Thus schools produce childhood, a phenomenon that is, Illich claimed, no more than a few centuries old but is now the universal rationale for imposing an array of requirements, educational and medical, on parents and for training people as lifelong candidates for credentials and consumers of expertise.

It is not what schools taught that Illich objected to; it is that they taught:

To understand what it means to deschool society, and not just to reform the educational establishment, we must focus on the hidden curriculum of schooling. . . . [It is] the ceremonial or ritual of schooling itself [that] constitutes such a hidden curriculum. Even the best of teachers cannot entirely protect his pupils from it. Inevitably, this hidden curriculum of schooling adds prejudice and guilt to the discrimination which a society practices against some of its members and compounds the privilege of others with a new title to condescend to the majority. Just as inevitably, this hidden curriculum serves as a ritual of initiation into a growth-oriented consumer society for rich and poor alike.

Once young people have allowed their imaginations to be formed by curricular instruction, they are conditioned to institutional planning of every sort. . . . Neither ideological criticism nor social action can bring about a new society. Only disenchantment with and detachment from the central social ritual and reform of that ritual can bring about radical change.

What school teaches, first and last, is “the need to be taught.”

Disabling Professions

In a series of subsequent books—Tools for Conviviality (1973), Energy and Equity (1974), Medical Nemesis (1975), Toward a History of Needs (1978), The Right to Useful Unemployment (1978), and Shadow Work (1981)—Illich formulated parallel critiques of medicine, transportation, law, psychotherapy, the media, and other preserves of self-perpetuating expertise. The medical system produces patients; the legal system produces clients; the entertainment system produces audiences; and the transportation system produces commuters (whose average speed across a city, he liked to point out, is less than the average speed of pedestrians or bicyclists—or would be, if walking or bicycling those routes hadn’t been made impossible by the construction of highways). In this process, far more important than merely teaching us behavior is the way these systems teach us how to define our needs. “As production costs decrease in rich nations, there is an increasing concentration of both capital and labor in the vast enterprise of equipping man for disciplined consumption.”

Why do we have to be taught to need or disciplined to consume? Because being schooled, transported, entertained, etc.—consuming a service dispensed by someone licensed to provide it—is a radical novelty in the life of humankind. Until the advent of modernity only a century or two ago (in most of the world, that is; longer in “advanced” regions), the default settings of human nature included autonomy, mutuality, locality, immediacy, and satiety. Rather than being compulsorily enrolled in age-specific and otherwise highly differentiated institutions, one discovered interests, pursued them, and found others (or not) to learn with and from. Sick care was home- and family-based, far less rigorous and intrusive, and suffering and death were regarded as contingencies to be endured rather than pathologies to be stamped out. Culture and entertainment were less abundant and variegated but more participatory. The (commercially convenient) idea that human needs and wants could expand without limit, that self-creation was an endless project, had not yet been discovered.

This is perhaps obvious; but can Illich seriously doubt that the great changes since then constitute progress? It’s a question to which he cannily declined to give a direct answer, even while he assailed the self-satisfaction of the age. He insisted that he was a historian and diagnostician, not an advocate or a prophet. He at any rate fleshed out the diagnosis amply and eloquently, especially in Medical Nemesis, his longest book: “The pain, dysfunction, disability, and anguish resulting from technical medical intervention rival the morbidity due to traffic and industrial accidents and even war-related activities, and make the impact of medicine one of the most rapidly spreading epidemics of our time.” Partly this was malpractice, or what he called “clinical iatrogenesis”—i.e., doctor-created medical conditions:

The Department of Health, Education, and Welfare calculates that 7 percent of all patients suffer compensable injuries when hospitalized. . . . One out of every five patients admitted to a typical research hospital acquires an iatrogenic disease. . . . The frequency of reported accidents in hospitals is higher than in all industries except mines and high-rise construction.

Ivan Illich was, unlike most political and sexual radicals, disenchanted with money and power altogether.

But these defects were reformable; more intractable was “cultural iatrogenesis”—the destruction of “the potential of people to deal with their human weakness, vulnerability, and uniqueness in a personal and autonomous way.” The difficulty of giving birth or dying at home is an obvious example.

Even more fundamental was “social iatrogenesis”—the damage that results from the institutional shape medicine takes in modern society. “When the intensity of biomedical intervention crosses a critical threshold, clinical iatrogenesis turns from error, accident, or fault into an incurable perversion of medical practice. In the same way, when professional autonomy degenerates into a radical monopoly and people are rendered impotent to cope with their milieu, social iatrogenesis becomes the main product of the medical organization.”

The notion of “radical monopoly” plays an important role in Illich’s critique of professionalism:

A radical monopoly goes deeper than that of any one corporation or any one government. It can take many forms. When cities are built around vehicles, they devalue human feet; when schools preempt learning, they devalue the autodidact; when hospitals draft all those who are in critical condition, they impose on society a new form of dying. Ordinary monopolies corner the market; radical monopolies disable people from doing or making things on their own. The commercial monopoly restricts the flow of commodities; the more insidious social monopoly paralyzes the output of nonmarketable use-values. Radical monopolies . . . impose a society-wide substitution of commodities for use-values by reshaping the milieu and by “appropriating” those of its general characteristics which have enabled people so far to cope on their own.

Professions colonize our imaginations; or as Michel Foucault (whom Illich’s language sometimes recalls—or anticipates) might have said, they reduce us to terms in a discourse whose sovereignty we have no idea how to contest or criticize.

Unlike Foucault, who sometimes seemed to take a grim satisfaction in demonstrating how cunningly we were imprisoned in our language and institutions, Illich was an unashamed humanist. His ties to the barrios and campesinos of North and South America were deep and abiding. His “preferential option for the poor” (the slogan of Catholic liberation theology) was a peculiar one: he hoped to save them from economic development at the hands of Western-trained technocrats. Illich had hard words for even the best Western intentions toward the Third World. (It is possible that what annoyed the CIA was Illich’s advice to the Peace Corps volunteers who came to Cuernavaca for Spanish-language instruction that they should leave Latin American peasants alone, or perhaps even try to learn from them how to de-develop their own societies.) Religious and ecological radicals, however generous and respectful, still wanted to bring the poor a poisoned gift, in Illich’s judgment:

Development has had the same effect in all societies: everyone has been enmeshed in a new web of dependence on commodities that flow out of the same kind of machines, factories, clinics, television studios, think tanks. . . . Even those who do worry about the loss of cultural and genetic variety, or about the multiplication of long-impact isotopes, do not advert to the irreversible depletion of skills, stories, and senses of form. And this progressive substitution of industrial goods and services for useful but nonmarketable values has been the shared goal of political factions and regimes otherwise violently opposed to one another.

Illich might have said more about those fugitive “stories, skills, and senses of form”; he might have tried harder to sketch in the details of a society based on “nonmarketable values.” But in Tools for Conviviality and elsewhere, he at least dropped hints. He certainly did not idealize the primitive—he might have welcomed the term “appropriate technology” if he had encountered it. He enthused over bicycles and the slow trucks and vans that moved people and livestock over the back roads of Latin America before the latter were “improved” into useless and dangerous highways. He was a connoisseur of the hand-built structures cobbled together from cast-off materials in the favelas and slums of the global South. He thought phone trees and computer databases that would match learners and teachers were a very plausible substitute for the present educational system. He thought the Chinese “barefoot doctors” were a promising, though fragile, experiment. He was friendly to any gadget or technique or practice—he called them “convivial” tools—that encouraged initiative and self-reliance rather than smothering those qualities by requiring mass production, certified expertise, or professional supervision.

The Politics of Limits

Illich proposed “a new kind of modern tool kit”—not devised by planners but worked out through a kind of society-wide consultation that he called “politics,” undoubtedly recognizing that it bore no relation to what currently goes by that name. The purpose of this process was to frame a conception of the good life that would “serve as a framework for evaluating man’s relation to his tools.” Essential to any feasible conception, Illich assumed, was identifying a “natural scale” for life’s main dimensions. “When an enterprise [or an institution] grows beyond a certain point on this scale, it first frustrates the end for which it was originally designed, and then rapidly becomes a threat to society itself.”

Professions colonize our imaginations; they reduce
us to terms we have no idea how to contest or criticize.

A livable society, Illich argued, must rest on an “ethic of austerity.” Of course, he didn’t mean by “austerity” the deprivation imposed by central bankers for the sake of “financial stability” and rentier profits. Nor, though he rejected affluence as an ideal, did he mean asceticism. He meant “limits on the amount of instrumented [i.e., technical or institutional] power that anyone may claim, both for his own satisfaction and in the service of others.” Instead of global mass society, he envisioned “many distinct cultures . . . each modern and each emphasizing the dispersed use of modern tools.”

Under such protection against disabling affluence . . . tool ownership would lose much of its present power. If bicycles are owned here by the commune, there by the rider, nothing is changed about the essentially convivial nature of the bicycle as a tool. Such commodities would still be produced in large measure by industrial methods, but they would be seen and evaluated . . . as tools that permitted people to generate use-values in maintaining the subsistence of their respective communities.

Whether one calls this revolution or devolution, it clearly requires, he acknowledged, “a Copernican revolution in our perception of values.” But there was nothing quixotic or eccentric about it. On the contrary, this affirmation of limits aligns Illich with what is perhaps the most significant strain of social criticism in our time: the anti-modernist radicalism of Lewis Mumford, Christopher Lasch, and Wendell Berry, among others.

Any assessment of Illich’s thought requires at least a footnote about his curious, controversial late work, Gender (1983). Like many anti-modernists, Illich had an uneasy relationship with feminism. He thought about sexual inequality much as he did about economic inequality: its injustice was too obvious to need much arguing, but more money and power for women and the poor amounted to, in effect, better seats at the banquet table when all the food was unhealthy and unpalatable. He was, unlike most political and sexual radicals, disenchanted with money and power altogether.

Illich claimed that sex, like childhood, was a modern invention. When production moved out of the household, life was sundered into two spheres: one where the means of life were gained, and another that supported those efforts. Marxists called these two realms, respectively, the sphere of production and the sphere of social reproduction. Illich called them wage labor and “shadow work.” The latter included all unpaid efforts that made the former possible: not only housework, shopping, and child care but also what has come to be called “emotional labor,” and even the family’s liaison with external caregivers. The great majority of this shadow work is done by women, increasingly alongside their own wage labor. Sex as a role, an attribute of a being abstractly conceived as a laboring subject, evolved as a rationale for this division into homo economicus and femina domestica, which Illich condemned as heartily as any feminist could wish.

Before sex, there had been only gender. Every pre-modern society, according to Illich, assigned every object and every task—and sometimes each stage of each task—either exclusively to men or exclusively to women. “From afar, the native can tell whether women or men are at work, even if he cannot distinguish their figures. The time of year and day, the crop, and the tools reveal to him who they are. Whether they carry a load on their head or shoulder will tell him their gender.” The specific assignments varied from one society to another; what never varied was that some activities and objects were only for women or only for men.

What to do with this historical and anthropological fact—if it is a fact—was not clear, even to Illich. But he was sure it mattered deeply, and he tried to say why in a remarkable passage that can serve as well as any to summarize his view of modern life. (It will help the reader to know that “vernacular” was a term of art for Illich: it meant “untaught,” with overtones of “colloquial,” “customary,” “instinctual,” and perhaps most usefully, “amateur.”)

The distinction between vernacular gender and sex role is comparable to that between vernacular speech and taught mother tongue, between subsistence and economic existence. Therefore, the fundamental assumptions about the one and the other are distinct. Vernacular speech, gender, and subsistence are characteristics of a morphological closure of community life on the assumption, implicit and often ritually expressed and mythologically represented, that a community, like a body, cannot outgrow its size. Taught mother tongue, sex, and a life-style based on the consumption of commodities all rest on the assumption of an open universe in which scarcity underlies all correlations between needs and means. Gender implies a complementarity within the world that is fundamental and closes the world in on “us,” however ambiguous and fragile this closure might be. Sex, on the contrary, implies unlimited openness, a universe in which there is always more.

Criticism of this breadth and depth illuminates everything. Exactly how to turn it against everything is usually, as in this case, more than even the critic can say.