how we feel about, experience & interpret our lives

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Its a hearts & minds thing Mental health & the psychologising of social justice in Scotland Lynne Friedli Centre for Human Ecology Glasgow 23 rd April 2014. (Mental )... Wellbeing . how we feel about, experience & interpret our lives. Its a hearts and minds thing. Framing and erasure. - PowerPoint PPT Presentation

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<p>NHS Confed Dec 10</p> <p>Its a hearts &amp; minds thingMental health &amp; the psychologising ofsocial justice in Scotland</p> <p>Lynne Friedli</p> <p>Centre for Human EcologyGlasgow23rd April 2014</p> <p>1Spirit of debate. Im going to talk about something thats happening to the politics of social justice what I describe as psychologising of social justiceIn other words using supposed psychological characteristics or attributes personality, disposition, ways of thinking, affect etc to explain inequalities e.g. in health, employment and income.This isnt confined to Scotland but it has gained significant power here notably through the influence of strengths/assets based approaches and the wider wellbeing movement. Theres been a sea change in how poverty and deprivation are spoken about in Scotland and a rise of psychological/cultural explanations for Scotlands problems. These days, it seems, psycho-analysis is preferred to economic analysis. What this means is that Inequalities are increasingly seen as a psycho-social problem something within the spirit of individuals in deprived communities that needs healedInequalities are understood less and less in terms of justice issues of power and privilege and more and more in terms of the ostensible presence or absence of confidence, hope, optimism, aspiration, resilience, sense of coherence...Of course if the problem is psycho-social, then so are the solutions. And what were seeing is a growing range of psycho-interventions whose primary targets are disadvantaged and excluded populations. Its not that inequality disappears. The hand wringing about that continues. What disappears, Ill argue, is an analysis of the political production of inequalities an acknowledgement that there are beneficiaries of the unequal distribution of power and wealth the hard questions about class struggle.</p> <p>how we feel about, experience &amp; interpret our livesSocial justice: its a hearts and minds thinglynne.friedli@btopenworld.com Its a hearts and minds thing....(Mental)... Wellbeing......So thats broadly what Im going to talk about. </p> <p>I want to move between accounts of social justice located in structural, material inequalities in income, wealth, power and those more concerned with the non-material mental health and wellbeing the think, feel, relate, make meaning domain of our lives </p> <p>2Framing and erasureConstruction of psychological idealPoor outcomes are a result of psychological deficitErasure of economic realities &amp; social determinantsCompulsory positive affect &amp; psychological coercion</p> <p>Social justice? It's a hearts and minds thing...lynne.friedli@btopenworld.com solutions to the widening gap in health inequalities will need to take into account early life &amp; personality, as well as the more the classically recognised factors such as smoking, diet, cholesterol &amp; blood pressure if we are to stand a chance of narrowing the gap in health by improving the health of those most in need. GCPH assets 2014Start with Example of whats happening. These days, Inequalities in Scotland are often described as if their cause were a complete mystery all efforts to reduce them have failed- - what weve tried hasnt worked so we need a new approach and that approach, broadly, is positive psychology. The following quote is from a briefing on assets and public health from GCPH but it could be from any number of papers/policies on inequality Solutions to the widening etc.Here we see how personality is slipped in to explain health inequalities. But the social determinants the distribution of income, wealth &amp; power - the actual evidence based classically recognised factors that explain health inequalities have entirely disappeared. So now were down to parenting, personality and health behaviour. Which perfectly sets the scene for public healths priorities in Scotland. </p> <p>So Im going to argue that four things are going on:the construction of a psychological ideal and labelling dissent or deviation as maladaptive or unhealthy </p> <p>i.e. poor outcomes are a result of psychological deficit.</p> <p>The erasure of economic realities - Increasingly, a focus on the psycho-social isnt used to expose the social gradient in mental pain and dislocation, nor to deepen understanding of the psychological impact of oppression and injustice. </p> <p> Rather, it opens the way to compulsory positivity &amp; psychological coercion through health and welfare interventions targeting deprived communities. </p> <p>3Strengths based lexiconAssets/Resilience/Recovery; agency; efficacy; aspiration self-reliance, discipline, entrepreneurial, optimisticSense of coherence (strengths not deficits); hope; well note replaces sick note; self-care</p> <p>Social justice? It's a hearts and minds thing...lynne.friedli@btopenworld.com ...the development of their own capabilities to manage their way out of povertyScottish Government 2011New dictionaryClass Struggle co-productionFight for your rights count your assetsRage sense of coherenceSocial security conditionalitySolidarity recoil from dependencyJustice survival of fittestThe key attributes in this lexicon are widely celebrated in Scotland &amp; attract significant funds. Strengths based thinking is central to the discourses of assets, resilience &amp; recovery. &amp;the focus on strengths is attractive, appealing.But on second glance, isnt this about the validation of a very narrow range of attributes - aspiration, confidence, optimism - a little pocket handkerchief of positivity, with no reference to the contested nature of these terms or to ideology the process through which they gain social value and economic reward. Capitalism in crisis prefers aspiration to sufficiency for example.As K Day says in her blog how the work programme makes me feel Basically what I'm saying in short is that I feel there is no place in society for a quiet, shy, creative person like me. As Ill show, working on the self /re-making the self in the image of this lexicon is the full time unpaid labour of those receiving benefits. Its the recommended labour for achieving health. . Along with Attempts to reconfigure workers as individual entrepreneurs of their own skills, abilities, attitudes All this means we need a new political dictionary as class struggle is replaced by co-production etc dependency the dependency of those who are poor, that is tackling the dependency of the rich is rarely mentioned.Above all, the language of resilience, strengths, coherence, assets is about survival, not justice.</p> <p>4Recovery journey extended to all citizensSocial justice? It's a hearts and minds thing...lynne.friedli@btopenworld.com .</p> <p>Rooting out dependency and needBuilding psychological resilience and wellbeing for those who are still claiming after 8 weeks through expressive writing &amp; strengths identification.failure to comply may result in loss of benefits(Psychometric testing for JSA claimants)who matters and who does not, who is disposable and who is not Achille MbembeReturning, then, to thoughts about recovery. Building psychological resilience etcNow, getting people to work on their recovery is a powerful tool in the governance not just of those who are diagnosed as mentally ill, but in managing and governing a wide range of unproductive or failing citizens i.e. those who are out of work, not working enough, not earning enough and/or failing to seek work with sufficient application .</p> <p>An important aim: rooting out dependency and need dependency no longer as a fact of the human condition, or even what it means to be human but dependency as the primary deficit a deeply stigmatised moral failing.The SG wants - an assets rather than a deficits approach to tackling poverty and inequality..... moving from welfare to wellbeing and from dependency to self determination. Essentially this is Poverty and disadvantage reframed as poor self management - resulting in the ultimate taboo in Scotland these days populations with unaffordable dependency on welfare and servicesAs Mark Steel has observed it takes a trained mind to understand that the people who are robbing us are the poor</p> <p>5Social justice? It's a hearts and minds thing...lynne.friedli@btopenworld.com Is recovery about being well enough to be thrown into the world of sharks? Where is the recovery model for the society of sharks?</p> <p>Dolly Sen</p> <p>Source: http://mentalhealthrecovery.omeka.net/exhibits/show/dollysen/isrecoverytherightwordReboot your soul or find a new system</p> <p>-6Social justice? It's a hearts and minds thing...lynne.friedli@btopenworld.com Picture source: Dolly Sen My story is on my skin As material inequalities grow, so the pursuit of non material explanations proliferates</p> <p>a paradox....</p> <p>Grace beats karmahttp://mentalhealthrecovery.omeka.net/items/show/90At the heart of all this theres a paradox - As material inequalities escalate the stark statistics of food banks, in work poverty, benefit cuts, rent arrears, the growing number of Scottish millionaires</p> <p>So the pursuit of non material explanations grows more frenzied</p> <p>7Social justice? It's a hearts and minds thing...lynne.friedli@btopenworld.com </p> <p>Source: Banksy graffiti, London, EnglandI own, therefore I am....And yet. Its an old question: what matters more money or love? Class or character?Whats the relative contribution of material and non material factors to inequalities in life chances, life outcomes inequalities in the freedom to live a valued life</p> <p>Key elements of strengths based discourse also have their roots in resistance and have been important both within the user/survivor movement - Resistance to psychiatric labels, diagnostic categories. And in political activism more generally:Celebration of the power of the human spirit, recognition of peoples strengths, resourcefulness and creativity have a long history. Theyre common features of social movements and traditions of struggle for social justice. Perhaps reflecting a deep desire for intellectual/emotional spaces where the money market doesnt have a monopoly on meaning respite from the materialism/consumerism of brute capitalism - these yearnings are also felt strongly in some of the poorest communities. </p> <p>8Social justice? It's a hearts and minds thing...LifeBodily healthBodily integritySense, imagination, thoughtEmotionsPractical reasonAffiliationOther speciesPlayControl over environment:PoliticalMaterialSource: Nussbaum 2011Capabilities &amp; fundamental entitlements</p> <p>They speak to the resistance of deprived communities to being pathologised, criminalised, ostracised; to being described in public health reports in terms of multiple deficits and disorders: chaotic, unengaged, and disaffected Friedli 20139They speak to etcA concern with non material determinants is also about attempts to capture the missing dimensions of poverty explored for example in the capabilities approach of Nussbaum and Sen which offers a more complex account of human dignity. Testimonies of those living in poverty the pain of being made to feel of no account social abjection - is often experienced as more damaging than material hardship issues of choice and control theres a difference between starving and fasting wellbeing depends on more than economic assets. Sen describes the ability to go about without shame as a basic human freedom.The importance of emotions, sense, thought, imagination in Nussbaums interpretation of the capability approach. Its an important question what distinguishes the stories that form part of these traditions (making political meaning out of adversity... Civil rights, feminism, gay liberation and queer resistance, disability and crip activism,, anti poverty, trades unions, the survivor movement what distinguishes these from the recovery stories from welfare to work, from ashes to assets - appropriated, expropriated by mental health, public health, Chief Medical Officers and the DWPMaybe its about whether a story generates exclusions..... Provides respite for some, while leaving the system intact</p> <p>The holy grail of positive affectMany Americans cannot stand to be unhappy, cannot stand to grieve and cannot stand to look at poverty or the real damages of war. One could argue that this is a larger problem than the problem of excessive unhappiness.</p> <p>Martha NussbaumSocial justice? It's a hearts and minds thing...lynne.friedli@btopenworld.com Martha Nussbaum talks about the denial of pain So I want to distinguish between a Respectful optimism recognising power of human spirit but also acknowledging what people are up against the material realities of peoples lives</p> <p>And a Conspiracy of optimism which functions to obscure power relations</p> <p>So Ill turn now to two examples which make me think its more a conspiracy of optimism that is going on in Scotland just now.</p> <p>With Psychologising being used to justify, a focus on health behaviour, to aid and abet the removal of welfare rights &amp; entitlements through attacks on dependency and To coerce and punish social security claimants via workfare. </p> <p>10Personality and health in Glasgow'the identification of individuals whose personality styles render them vulnerable to particular health risks Millar et al 2013 p.8to establish if those who need to take on board lifestyle messages (weight loss, physical activity) are in a position affectively and intellectually to receive them. Velupillai et al 2008 p2 (brain) that is less robust and less efficient in information processing ... some evidence of the relationship between socioeconomic deprivation and brain network topology.Krishnadas et al 2013</p> <p>GCPH pSoBid Study http://www.gcph.co.uk/assets/0000/4244/pSoBid_FINAL_REPORT_2013_update_February2014.pdfThe first example is a series of papers linking personality characteristics to health behaviour that forms part of the Glasgow Centre for Population Health pSoBid study Addressing questions such as do deprived groups differ from affluent ones in psychological profile (affective state and cognition) (Velupillai et al 2008 p3) read outI accept that there are different ways of reading these kind of papers: with their references to 'impaired cognitive function' and 'altered (negative) mental outlook') but my own view is they reinforce certain messages about people living in deprived areas and they justify psychological interventions that target people who are poor:These developments intersect with and are reinforced by the rise in brain science, which correlates outcomes (crime, addiction, health behaviour, educational attainment) with brain structure. As a recent editorial in the BMJ observes:There is great interest in whether the structure and function of brain circuits can be changed to optimise the operation of the executive control systemThe celebration of certain personality styles/attributes is so widespread in public health that the politics and epidemiology of...</p>

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