A distinctive feature of much of the left in Britain, going right back to the early Fabians, is the way in which its view of good and bad has focused upon material goods and conditions rather than on social relations. For the socialist left this found expression in demands for greater equality, and in particular greater access to material goods such as housing, health care and income. For the Labour right, especially in recent years, it has strongly coloured the managerialism of the volume-indicator-obsessed Blair/Brown regime. Here progress has become synonymous with the achievement of a range of measurable targets, largely but not exclusively geared to economic competitiveness. Both left and right have privileged quantity over quality, material progress over the quality of social relations.

This was something that Richard Titmuss, one of the key thinkers behind the post-war welfare state, was careful not to do. For Titmuss, social policy was about what he called ‘social growth’, something that lay precisely in the quality of social relations, whose ‘indicators cannot be measured, cannot be quantified, but relate to the texture of relationships between human beings’.[1] Unfortunately, this relational view of social well-being became eclipsed by generations of public sector economists whose view of the human being was essentially one of the rational, autonomous, interest-maximising individual. In the public sphere nowadays, as the saying goes, what counts is what can be counted. My argument in this essay is that we need to return to positions that place human relationships at the centre of politics.

There has always been a strand in British socialism, from at least the time of Edward Carpenter, that connected social transformation with change in the nature of social relations; this theme was taken up again in the 1960s and 1970s, by feminists, anarchists and libertarian socialists. From this perspective, socialism needs to hold up a picture of a different future, of a society in which human relations are qualitatively transformed for the better: one in which relations between employers and workers, men and women, intimates and strangers, old and young, are based upon a set of values and principles that are radically different to those that pertain today. This strand needs to be reasserted in the face of the current impoverishment of the political and cultural spheres.

Social suffering, CBT and managerialism

In recent years the shortcomings of the conventional economistic approach have become increasingly apparent. First, a growing body of evidence, drawn largely from international survey research, has demonstrated that the massive growth in GDP in western democracies since the Second World War has not been accompanied by any appreciable increase in happiness.[2] The evidence seems to suggest that it is simply not true that the more you have the happier you are. Second, psychiatric morbidity rates indicate that the incidence of mental illnesses such as clinical depression and schizophrenia, and of self-harming behaviours such as alcohol and drug abuse, has increased signifi cantly in recent decades.[3] Moreover there is some evidence to suggest that this may be more pronounced in societies which have embraced neoliberalism.[4]

Richard Layard, an influential contributor to the happiness debate, has recently pointed to the economic costs incurred by the 1 in 5 adults who suffer from mental illness at some time in their lives (perhaps recognising that this is the best way to gain the attention of government ministers).[5] Given the traditionally shameful levels of NHS spending on mental illness, anything which seeks to highlight this suffering, and the absence of even a half-decent set of services and treatment programmes to deal with it, is to be welcomed. However, Layard’s report suffers from some significant weaknesses. First, he ignores decades of accumulated evidence that link the incidence of virtually all forms of mental illness to social causes – social exclusion and marginalisation. Second, he prescribes as a remedy a massive programme of Cognitive Behavioural Therapy, to be delivered from a network of Psychological Treatment Centres: this is likely to serve simply to sustain and reproduce the very social relations that contributed to the lack of well-being in the first place.

The relationship between social inequality, stress and lack of well-being has been documented for over three decades now in journals such as the Journal of Health and Social Behaviour. Not only do poverty and social marginalisation increase the scale and intensity of stress-inducing life events and incidents; they also decrease the social resources – such as the presence of others in whom one can confide – that enable people to cope with such stressful environments. In the last couple of years I have started to use the term ‘social suffering’ – coined by the French sociologist Pierre Bourdieu – as a way of examining how poverty and inequality get inside the soul and eat away at the human spirit. Social suffering draws our attention to the shame, humiliation, despair and frustration that make up the day-to-day experiences of those who are not only poor, but are also made to feel responsible for their own misfortune; to the suffering of those who are made to feel stupid because of their skin colour or accent; of those who feel they are ‘losers’, where being a loser means that you are ‘sad’, inadequate, something to be pitied. Social suffering is not just about lack of respect and lack of recognition; it is about disrespect and misrecognition; it’s about the ways in which one class or cultural group preserves its own (fragile) sense of superior identity by denigrating another group. Social suffering also draws our attention to what happens when those who suffer lack a political explanation for their experience, and thus embody it in stress-related illnesses; project it onto others (for instance through racism and homophobia); or enact it by ‘being hard’, or by demanding recognition through what we now call ‘anti social behaviour’.

By adding the ‘social’ prefix to ‘suffering’ our attention is drawn to the way in which the absence of well-being is linked to structural inequalities (this is not the same thing as identifying happiness with material possessions; rather, it is to recognise the psychical consequences of such inequality). As Richard Titmuss once put it, poverty is the price some people pay for others’ social progress. By ignoring the social patterning of suffering, the Layard Report individualises mental illness: he construes it as the outcome of a generalised social malaise, which then falls haphazardly upon all of society. It follows that Layard’s prescription is necessarily an individualised one. The widening structural inequalities which have accompanied Britain’s neoliberal trajectory over the last three decades are left unquestioned; indeed Layard’s prescription is specifi cally designed to be incorporated within the disciplinary framework of Labour’s ‘welfare to work’ agenda. He makes a direct link between improved access to behavioural therapies and getting people off incapacity benefits and back to work, and argues that, even in the very short term, the costs involved in providing the new services will be more than offset by the savings to be gained by getting people off benefits and back to work. Well-being is now seen as a goal which can be measured, quantified and managed.

Cognitive Behavioural Therapy is a ‘triumph’ of one of the fastest growing and most powerful professions in the world today. Represented, regulated and policed in the UK by the British Psychological Society, modern psychology is dominated by positivist and evidence-based models of human functioning, which are almost tailor-made to fit the managerialist culture of New Labour. This is not a reflexive profession in any way sceptical of its own claims to expertise, or curious about how its practices are situated in the wider power relations of society. Moreover, its positivism has frequently led to a lack of interest in human experience (which is often viewed as an intangible and unmeasurable epiphenomenon); and indeed, when the profession has become interested, it has always resorted to proxies for human experience that can be measured – specifically self-reports. The ‘new science’ of happiness studies that is presently pouring out of psychology departments in North American universities assumes this form. For instance, the Character Strengths and Virtues project of Martin Seligman and his colleagues is creating a battery of selfreport questionnaires designed to assess respondent’s psychological well-being.[6] I’m not saying that such projects have no value – they can and do yield some important insights, and offer an antidote to the preoccupation with pathology, dysfunction and illness that has dominated psychiatry. But the use of these proxy measures inevitably reduces and simplifies human experience.

Cognitive Behavioural Therapy exemplifies this process. When as a therapist I work with someone who is acutely depressed, or who is suffering from panic attacks, I am soon immersed in the incredible complexity of human experience. For example, there may be intricate and subtle connections between the depressed part of the person and a rather triumphant and morally superior part; similarly, many people I see are constantly caught between a desperate desire for closeness and an absolute terror of the same thing. In the wrong hands CBT reduces this complexity of experience to its purely cognitive dimensions, as if depression was simply a matter of being stuck in repeated patterns of maladaptive thoughts which then have self-fulfilling consequences (‘I think I’m a loser, losers don’t pass their exams, therefore it follows that I will fail my exam’). The whole person is reduced to a set of operationalisable ‘problems’, which are sustained by maladaptive personal beliefs; thus, reframing these beliefs and setting measurable positive goals can set in motion more virtuous belief/action/emotion cycles. This kind of ‘quick fix’ can and does make a real difference to the lives of some individuals, but it must not be seen as the only available alternative to psychotropic drugs (the incontrovertible evidence-base for which seems to have evaporated recently).

CBT fits snugly into Labour’s managerialist vision of welfare, which is informed by a phobia about all forms of dependency, and sees human experience as something to be acted upon through prescriptive interventions, rather than something to be listened to, respected and understood. The managerialisation of welfare has led to a situation in which the amount of one-to-one contact between clients/service users and professionals has been systematically reduced – on the ward, in the classroom, between offender and probation officer, client and social worker, troubled adolescent and youth worker. Professionals are consumed by writing up care plans or lesson plans, dreaming up ‘deliverables’ in ever more bids for new contracts or new initiatives, and completing monitoring returns and ticking off ‘outcome measures’. And any time they have left over from this for face-to-face work is itself often governed by targets, tests and treatment programmes that are interposed between them and their ‘welfare subjects’ – who are now recast as the objects of welfare interventions. This is a million miles away from an ethic of care. Care takes time, and time means money; care does not lead to predictable outcomes – because humans are not predictable beings; care is exacting and exhausting. But this is why it is also enriching, both to the giver and receiver. (In our own recent research we came to realise that for many public service workers care is inseparable from social justice: workers care about what they do because they want to make a difference. In particular, those who work with the poorest and most marginalised in society often embody what we called an ‘angry compassion’, in which the ethics of care and justice were fused.[7])

The symptoms of melancholia

Care, respect and solidarity are not just about the principles which should underline public welfare, as Fiona Williams argued in her article in Soundings 30. They are also about how each of us leads our lives, about the kind of society we want. The evidence that economic growth does not produce more human happiness should be seen as providing excellent ammunition for those who argue that global warming can only be tackled effectively by some kind of limit on economic growth. But for many, a green future seems austere and unattractive – something people would only turn to if pushed by fear of catastrophe. It follows that the task for the green left is to put forward a convincing vision of a future that combines lower economic growth and increased human happiness – that is, one which decouples human flourishing from material abundance.

A starting point is to understand that, beyond a certain level of economic scarcity, there is a direct relationship between deterioration in the quality of a society’s social relations and an increase in its preoccupation with materialistic sources of happiness. The less we invest in each other, the more we invest in material goods and services. Studies of autistic children indicate that they often cling to material objects, often hard and shiny ones. It’s as if the object becomes a substitute for the sense of human relatedness that would otherwise hold them together. Perhaps consumer objects increasingly function in this way, not so much as sublimations of desire but as items essential to our going-on-being, any threat to which produces a sense of panic. I have come to believe that anxiety saturates the pores of wealthy post-scarcity societies such as ours, constituting a particular ‘structure of feeling’, to use a term from Raymond Williams.

This is an anxiety with many sources. In post-scarcity societies citizens are no longer consumed by the struggle for physical survival, and questions of identity and recognition become more central. The individualisation of these struggles becomes manifest in the ‘problems of being’ – of the borderline personality, of self-harmers, of the millions now stuck in various addictions (including addictive consumerism), or persecuted by fears about their masculinity, body-image, and so on. These problems of ‘psychical survival’ (as Christopher Lasch once put it) are ripe for exploitation by advertising, marketing and the lifestyle media, and consumption becomes more about the alleviation of anxiety than the pursuit of pleasure. Then there are the disrupting effects of the constantly accelerating pace of economic and social change, made worse under neoliberal governments such as those in Britain and the USA, which dismantle secure labour markets and welfare safety nets and seek to strip away the regulation which might otherwise offer citizens some protection. There are also anxieties generated by the proliferation of new forms of risk, including those, like genetic engineering, consequential to technological and scientific innovations, and those that emanate from the panarchy of global security and financial systems, with their constant threat of chaos and catastrophe.

Some anxieties are global, some are more specific to particular forms of governance such as neoliberalism, and yet others may be unique to the particular historical circumstances of a nation. What might be the particular set of historical circumstances that have contributed to our own uniquely intense social malaise? My belief is that it may have something to do with the slow but seemingly inexorable economic decline of Britain, a decline concealed during the last decade by the credit bubble and turbo-capitalism. We are a country haunted by loss and decline – the loss of empire that Paul Gilroy has commented on, and the loss of our status as a world power both militarily and economically. Britain is also haunted by the loss of community and class solidarity, the loss of ‘proper jobs’ and manufacture, and the loss of respect and decency. Of course many of these things exist in other countries too, but Britain was once a hegemonic world power, the first of the modern era. I wonder if we need a new development term that could be applied to a country whose development has now been arrested. Under Labour, there seemed to be one last throw to pretend things were otherwise, as Blair strode the world stage and Brown presided over an apparent economic miracle. But in cities and towns throughout the country, particularly beyond the mania of the capital, people have been sensing this loss for some time, without being able to give words to it.

Long ago Freud gave us a word for this – a loss which cannot be thought about. He called it melancholia. A melancholic is stuck in an endless cycle of grievance and self-reproach, irritability and despair. Perhaps this is what it means to be British today. According to Madeleine Bunting, ‘there is an increasing perception that we have become a nasty country – aggressive, quick to judge or humiliate, and profoundly competitive’ (_Guardian_ commentisfree, 19.2.07). The UNICEF Report found that little more than 40 per cent of our 11 to 15 year olds found their peers ‘kind and helpful’, the lowest score of all the richer countries.

So, if Britain were on the couch today what would follow from this diagnosis? Well, perhaps the first task would be to get the patient to face the loss, and abandon manic attempts to assert the opposite (further military adventures, the idea that we can go it alone by balancing precariously somewhere in between the USA and Europe, perhaps even the idea that we can host the Olympic Games). Second, we 115 would try and help the patient understand that what it imagines to be progress is in fact largely an illusion. This means coming to terms with the idea that, except in a very few areas, such as the cultural industries, we have ceased to be economically creative; that areas of intelligent production and manufacture in Britain are few; that we invest significantly less in R&D than nearly all of our competitors; and that the one area – banking and financial services – where there seemed to be growth and innovation was, appropriately enough, a form of parasitic rather than productive capital. Thirdly, applying a bit of CBT, we would show the patient how some of its habits of mind contribute to its own self destruction. Only recently, for example, Robin Alexander, who leads the inquiry into Britain’s primary education, bemoaned the way in which adult society rams the cult of celebrity down our children’s throats. There are also the impossible norms we impose on ourselves of masculine hardness and feminine thinness – and the whole cultural denigration of losers, chavs, feral kids, etc. Fourth, and more positively, we would indicate to the patient that their belief that they lack the internal resources to overcome the loss is one of the characteristics of depressive anxiety, and that they in fact have plenty of resources even though in phantasy they believe that they are running on empty. Britain has potentially more renewable resources (particularly wave, wind and tide) than almost any country of comparable size in the world. It is also a mongrel nation, the result of successive invasions and migrations stretching back nearly two thousand years, and, as we all know, mongrels happen to be far more resilient than pedigrees. Britain has been reasonably good at adapting to change: reactionary forms of populism and fascism have been minority responses, and whilst we complain and moan we also embrace strangers and imitate them – the vitality of British creative industries today is in no small part a result of this. Fifth, but by no means last, we would encourage the patient to rage at the source of their loss, even if the source, as in bereavement, was nature itself. For us, at this particular point in time, I think this means we must get back in touch with our anger, particularly anger at our parasitic and spineless ruling elites – which now, tragically, include much of the party that once stood for labour. The problem is that melancholics turn their anger upon themselves – hence Madeleine Bunting’s comment about the ‘nasty country’.

To speak of some kind of national psyche in this way is of course to engage in a gross over-simplification. What I am offering here is no more than a way of thinking, a thought experiment if you like. To pursue the experiment a little further, we can see how melancholics have a particular ‘problem of being’, the problem being an inability to live in the present. Unable to think realistically about and accept their loss, distorted fragments of the past continuously return to haunt them. Like a melancholic, Britain is stuck in a process of arrested development. What we need now is a new vision. A vision, like that of Richard Titmuss, of social development, concerned with the texture of relationships between human beings, and between human beings and the natural world.

Notes

1. R. Titmuss, Social Policy: An Introduction, George Allen & Unwin 1974.

2. R. Layard, Happiness: Lessons from a New Science, Penguin 2005.

3. M. Rutter & D. Smith (eds), Psychosocial Disorders in Young People: Time Trends and their Causes, Russell Sage Foundation 1995.

4. See for example Unicef’s 2007 Child Poverty in Perspective: An Overview of Child Well-being in Rich Countries, in which Britain and the US scored worst.

5. The Centre for Economic Performance, The Depression Report: A New Deal for Depression and Anxiety Disorders, London School of Economics and Political Science 2006.
6. M. Seligman & T. Steen, ‘Positive Psychology Progress’, American Psychologist, July-August 2005.

7. P. Hoggett, M. Mayo & C. Miller, The Dilemmas of Development Work, Policy Press, 2008 forthcoming.