On December 22, 1897, Sigmund Freud wrote to his friend and confidant Wilhelm Fliess about a patient who had suffered a grisly family nightmare. Her father, Freud writes in his startling, matter-of-fact way, “belongs to the category of men who stab women, for whom blood injuries are an erotic need.” Among his many heinous actions was raping his daughter and infecting her with a venereal disease. Perhaps, Freud offers, psychoanalysis needs to embrace a somber “new motto”: “What have they done to you, poor child?”

Was hat man dir, du armes Kind, getan? The line is Goethe’s, sung by the androgynous circus girl Mignon in Wilhelm Meister’s Apprenticeship. It’s a poignant and simple summation of the Freudian enterprise: The analyst invites the patient to speak of their suffering and then listens. (It was likely not lost on Freud either that Mignon is the product of incest, or that Wilhelm’s feelings toward her cycle through those of the father, the protector, and the lover.) But Freud’s new motto was short-lived; in a matter of years, he went from believing that his patients were suffering from repressed memories of actual childhood sexual abuse (“I find it’s the closest relatives, fathers or brothers, who are the guilty men,” he wrote in April 1897) to believing their memories of “infantile seduction” were imagined: incestual fantasies. Thus, as Jeffrey Masson later charged, Freud shifted his emphasis “from a real world of sadness, misery and cruelty, to an internal stage on which actors performed invented dramas for an invisible audience of their own creation.”

Masson, who shepherded the Fliess letters to publication, was obsessed with discrediting his onetime hero; he was not Freud’s most charitable chronicler. It is difficult today to regret Freud’s turn away from the seduction theory and toward dreams and fantasy, the materials from which he derived his most luminous insights. But there is a kernel of bitter truth in Masson’s charge: After the oedipal turn, the reality of an unjust and wounding social order, especially for women, became a muted factor in Freud’s etiology of mental anguish. It is not an objectively cruel world that causes us to suffer, he concluded, but our failure to adapt to it successfully. The empirical question—what have they done to you, poor child?—then becomes almost beside the point. It is not what really happened that matters, or who or what is responsible. We may remain, in some sense, poor and broken children, but with less recourse to blame and to adjudication. Therapy is a matter of accommodating ourselves to this lack of real reparation. Mental health becomes the handmaiden of social stasis; madness, the provenance of would-be revolutionaries.

This antinomy between the psychic and the social—and the ways leftist radicals have variously sought to resolve it—is the starting point of Hannah Proctor’s provocative new book, Burnout: The Emotional Experience of Political Defeat. Proctor, a research fellow at the University of Strathclyde in Glasgow, is not a partisan of the anti-psychiatry movement, which from the 1960s onward has depicted all extant mental health interventions as ideological disciplining. Nor does she wish to reify the dichotomy between internal and external sources of psychic pain. After all, she writes, “The ‘outside’ is a social world populated by other people, each with their own inner lives, each shaped by their past experiences in that social world, which they also participate in shaping.” Instead, Proctor is preoccupied with less abstract questions, at once more prosaic and more pressing: How can left-wing radicals simultaneously devise strategies for healing the wounds inflicted by a wounding world while also seeking to eradicate the social structures that wound us in the first place? And what can we do with ourselves when, inevitably, we are exhausted, physically and emotionally, by these efforts—and their failure?

Anyone who has insisted to a therapist that their depression or anxiety is principally the product of, say, capitalism, racism, or transmisogyny and then felt a sinking feeling as the therapist—ever kind, ever gentle—pulls the conversation back to family dynamics or toward a diagnosis (“Shall we up your medication?”) has experienced a version of the double bind that Proctor identifies. In the worst circumstances, the patient comes to feel that her desire to change the world, her simmering hope that it can be done, is the obstacle to her well-being, the thing being pathologized. And perhaps it should be. In a very real sense, to be committed to changing the world on a revolutionary scale is, for better and worse, a form of insanity. Your therapist is right: You are a social deviant, a hopeful freak, a heretic. And your burning desire to change the world is making you suffer, contributing to your feelings of alienation and even your actual ostracization. As Cornel West once said of radical Christian socialism: “A follower of Jesus is somebody who is on fire with a love that makes no sense through the lens of the world.” To be on fire is to be a danger to yourself and others. Out of care for you—or fear of you—the world wants desperately to douse the flames.

And that is often what happens: to burn brightly with radical desire and conviction is always to risk becoming burned-out. And this state of diminishment, finally, is Proctor’s principal subject. Radicals, she suggests, are not merely those who fight to make the world less wounding; they are those who become wounded in the process—and who must find ways to heal each other in order to keep on fighting. Fugitive moments of unfurled promise, and the pleasure we take in each other, can only sustain us for so long before the eventual denouement. Our emotional lives, Proctor writes, assume a predictable shape: “An original feeling of joy, followed by the curdling of hope, animosity emerging between comrades, the emotional numbness produced by prolonged political engagement, the shrinking of possibility.” The brief solidarity we may find in moments of shared disappointment is thin gruel indeed; soon we begin to resent one another for reminding us of our formerly hopeful selves. As the poet Anna Mendelssohn puts it: “There was no nourishment for us in the world we were born to, and the initial fuel we had found in each other was burning out.”

Burnout is a book about the psychic life of radical movements; it is also a book about defeat—because that is the primary psychic experience of the radical life. Losing, for revolutionaries, is more often the norm than the exception. As Marxists say, every generation of militants is doomed to fail, save the last. Thus, Proctor’s short chapters are dedicated to the negative affects that haunt the revolutionary endeavor: melancholia, nostalgia, depression, exhaustion, bitterness, and mourning, among others. In each, she relies on “secondary histories, memoirs, novels, films, as well as works by psychiatrists, psychologists and psychoanalysts” to illustrate how a sense of doom and disappointment has shaped the psychic lives of left-wing radicals from the Paris Commune to the Black freedom struggle to Italian ‘68ers, Guatemalan guerrillas, and the AIDS activists of ACT UP.

Proctor’s approach to her material, she admits, is “intensive rather than extensive, microscopic rather than synoptic, fragmentary rather than synthetic.” She mobilizes an exciting breadth and variety of reference—Che Guevara’s Congo diaries, pamphlets by communist therapy groups, the novels of Neel Mukherjee and Toni Cade Bambara, the films of Patricio Guzmán—but only rarely lingers long enough with any single artifact to draw out all its contradictions.

An exception is her treatment of Bambara’s novel The Salt Eaters. Set “in the fragmented aftermath of the movements of the sixties,” Proctor writes, the novel “captures the durational, ongoing nature of political struggle and the way political commitments become enmeshed with the quotidian churn of daily life.” Its protagonist, Velma, is burned-out—depressed and suicidal—after years of dedication to civil rights and feminism. In a state of desperation, she goes to Minnie, a healer, for help. After hearing her story, Minnie asks, “Are you sure, sweetheart, that you want to be well?” The question, Proctor writes, “suggests there is some consolation or comfort to be found in being wounded, angry, hurt, broken,” that there is something to be lost in being healed. In relinquishing her wounds, Velma fears losing herself: the hard-won, militant self, who fights from a sense of injury.

Radical politics are shot through with these contradictory impulses. Like Velma, one must be sensitive, capable of being wounded by the world, to be drawn to radical politics in the first place. That is to say, one must be gentle—perhaps too gentle. Later, however, what the movement demands is not gentleness but resilience, hardness even. “We must grow tough,” Che is supposed to have said, “but without ever losing our tenderness.” Yet that is easier said than done. As Proctor’s epigraph from Brecht puts it: “Hatred, even of meanness / Makes you ugly. / Anger, even at injustice / Makes your voice hoarse.”