62 SOCIAL SCIENTIST control of the state is to be granted.23 Thus, when the NMHP is seen as a hegemonical venture by the ruling class in the field of mental health it becomes possible to raise certain key explanatory issues which are not expressed by the NMHP's account. An Outline of 'Hegemony1 The conceptualisation of hegemony well suited to the modern world has been formulated by the Italian theorist-activist Antonio Gramsci. He became an outstanding contributor to Marxism by seeking to overcome orthodoxy with his two feet planted firmly in the reservoir of activism. It was his renewed focus on subjectivity which enabled him to provide the cutting edge to the Marxist concept of hegemony, thereby propelling^ the concept to a position of central importance in the tool-box of social explanation. According to Gramsci, . . . the supremacy of a social group manifests itself in two ways, as "domination" and as "intellectual and moral leadership". A social group dominates antagonistic groups, which it tends to "liquidate", or to subjugate perhaps even by armed force; it leads kindred and allied groups. A social group can, and indeed must, already exercise "leadership" before winning governmental power (this is indeed one of the principal conditions for the winning of such power); it subsequently becomes dominant when it exercises power, but even if it holds it firmly in its grasp, it must continue to "lead" as well.24 Taking up the crucial distinction between 'political society' and 'civil society'25 (between the politico-juridical apparatus of what can be narrowly called the state and the socio-cultural and consciousness apparatus26 which can be said to exist relatively outside the operation of the narrowly-conecived political state—both as parts of the superstructure of the economy), Gramsci states that the domination of a class is complete not only when it dominates other classes in political society (which corresponds to using a significant degree of 'coercion'), but mainly when it dominates in civil society (which often acquires the features of 'consensual support' rather than evident coercion). This domination by force and spirit, of the government and larger society (which is the state in the broadest sense) by a particular class, represents the hegemony of that class in a specific society. The implicit assumption here is that the more a particular class dominates the masses through the socio-cultural and consciousness apparatus, the greater the element of consent in its rule (i.e. the greater the self-supporting force of its rule from the masses) and lesser the forceful domination through the politico-juridical apparatus (i.e. the lesser the element of coercion). This ideological hegemony