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Review: The Wellness Syndrome

How are you feeling? How well are you? Is your weight where you want it to be? Smoking too much? How happy are you on a scale of one to ten? Are you optimising your personal brand? How fast was your last five kilometre run? Would you like to share that via social media? Would you like a life-coach to help you overcome these challenges on a way to a better, happier, more awesome you?

If such questions fill you with dread, don’t worry, you’re not alone. We have become a culture of Bridget Joneses, anxiously pursuing an ever-retreating ideal of wellness. The ruling ideology of our time, argue Carl Cederstrom and Andre Spicer, is ‘the wellness syndrome’, which makes the urge to self-improvement a moral imperative, and our own bodies the battleground.

Cederstrom and Spicer thinks the wellness syndrome is a mistake and a trap, for three reasons. First, it is based on a foolish myth of the individual as ‘neoliberal agent’, able to exert perfect control of their body, their emotions and their life. If you’re poor or fat or unhappy, it’s your fault, and you need some life-coaching or military fitness boot-camp to get into shape. This is a convenient shifting of personal responsibility from the state onto us hapless Bridget Joneses.

Secondly, the constant search for personal authenticity and fulfillment is deeply narcissistic. Aristotle and Rousseau’s eudaimonic society was about fulfillment through civic activity. Rousseau would be ‘apalled’ by our culture’s ‘blind celebration of individual narcissism’ (really? Have you read his Confessions? But let’s press on.)

Thirdly, the dream of autonomy and authenticity we’re chasing is a mirage – in fact, the wellness syndrome is deeply conformist, and the ultimate aim of all this self-improvement is simply to make us more productive and sellable in the capitalist marketplace. We think we’re becoming more ourselves, when in fact we’re becoming more alienated.

The way to rebel against the wellness syndrome, the authors argue, is to embrace illness and impotence. Live like Sartre’s students, who existed on a diet of ‘cigarettes, coffee and hard liquor’. Take sick days. Over-eat. Go ‘barebacking’ – a culture in which ‘bug-chasers’ (people who want to get HIV) have unprotected sex with ‘gift-givers’ (people who have the illness).

Cederstrom and Spicer are professors of organizational theory and organizational behaviour, respectively. However, this book is basically a rant, like an extended Spectator column by Rod Liddle, moving effortlessly from anecdote to rumour, without ever troubling itself with scientific evidence.

We are told the anecdote of the two life-coaches who killed themselves in a suicide pact. Why did they kill themselves? We’re not informed, but it seems damning, and we move on. We’re told David Cameron is a fan of Rhonda Byrne’s The Secret. Really? Well, a Guardian columnist said so, let’s move on. We’re told the Wellness Syndrome leads to an obsession with dieting and personal fitness. Then why, if this is the ruling ideology of our time, are 67% of men and 57% of women in the UK overweight or obese? And why is the sex addict in Steve McQueen’s Shame also an example of the Wellness Syndrome? We’re never told – move on to the next anecdote.

Epictetus, lifecoach to the Roman aristocracy

The core claim of the book – that we’re being sold a toxic idea of neoliberal personal autonomy – deserves more careful examination, because it has some validity. The roots of this model of personal autonomy lie not in neoliberalism, in fact, but in Stoicism, and particularly in Epictetus, who was a sort of life-coach for Roman aristocrats, urging them to take responsibility for their thoughts and beliefs in order to heal their emotions and improve their selves. ‘It’s not events which cause humans suffering, but our opinion about events’, he insisted. And our opinions are always in our control. ‘The robber of your free will does not exist’. This Stoic libertarian ethos fed into Enlightenment liberalism, into Victorian self-help, and into the modern wellbeing movement and the idea – at the heart of cognitive therapy and Positive Psychology – that our emotions are our choices, and that ‘there is nothing more tractable than the self’, as Epictetus put it.

Of course, Epictetus’ philosophy can be taken too far. The Stoics focused entirely on the individual, and ignored society. They thought a wise individual could be free and happy even in the midst of a toxic and unequal society (Epictetus himself was a slave). Most of us are not such citadels of serenity. That’s why there’s a strong correlation between poverty and depression. Shit gets us down. So it’s unfair and unwise to make people’s emotional or behavioural problems entirely their responsibility – our personal agency is weak, at best. Most of us are to some extent the creatures – Epictetus would say the slave – of our circumstances.

And yet Epictetus was not entirely wrong. Overcoming problems like depression, or alcoholism, or obesity, or injustice, or even poverty does involve personal agency. Humans do have a capacity not just to be determined by our circumstances, but to determine our own attitude to them, and through that self-determination we can get the inner strength to change our external circumstances. We don’t always have to resort to pill-popping to feel better (oddly, despite its cover, the book doesn’t ever look at our growing dependence on mood-altering pills, perhaps because that doesn’t fit with their rant against ‘the myth of neoliberal agency’).

Our powers of self-determination don’t necessarily have to be in the service of neoliberal capitalist conformity. Look at Gandhi, practicing swaraj or ‘self-governance’ in his personal life order to prove to the British Empire that Indians are not irresponsible children. Look at Nelson Mandela, reading the Stoic poem Invictus to himself while practicing ascetic self-government in Robben Island prison, to prove that black South Africans can govern themselves with dignity.

Of course, the strength or weakness of our personal agency, the extent to which it is tied up with determining factors like our environment or genes, is a very difficult question. I recently saw the documentary Amy, and was moved by the story of Amy Winehouse’s rapid self-destruction. Whose fault was it? Whose responsibility? Was it the father, for not being there when Amy was growing up, and then trying to cash in when she was famous? Was it her boyfriend, latching on and encouraging her drug dependence? Was it our celebrity-obsessed media and culture? Yes, perhaps, all of these things. But it was also Amy’s doing.

But can you say an addict ‘chooses’ to destroy themselves? To what extent does a person with mental illness really make choices? To some extent. As that famous sex-addict, St Augustine, explored in his Confessions, we make choices, which then harden into the chains of habit and addiction. Those chains are very difficult to break. It’s even harder today, when the internet remembers our habits and reflects them back to us. But change is possible. And personal choice is an important part of that liberation.

Our degree of personal agency, then, our capacity to determine our course in life, is a very complicated area, but it is one that psychology has spent decades trying to explore, through cognitive behavioural therapy, social psychology, behavioural economics, self-determination theory, and the psychology of self-control. And psychologists have begun to build up evidence that personal autonomy is limited but nonetheless real – Epictetus was, to some extent, right.

Yet Cederstrom and Spicer don’t cite a single piece of scientific evidence in their rant against personal autonomy. The closest we get is an appeal to authority: ‘We know from Freud’, ‘we know from psychoanalysis’. Do we? At one point they write: ‘As pointed out in a Huffington Post article, mindfulness advocates often make unsubstantiated claims.’ Oh the irony.

Because the authors set out to write a polemic, they make broad and usually damning generalizations, and ignore the good aspects of the phenomena they dismiss. For example, one of their favourite targets is the self-tracking movement, in which people use self-tracking devices to measure various aspects of their life, to improve them. This, the authors say, is just neoliberal alienation. Well, it can be, but not always. Self-tracking can be a way for people to empower themselves and become experts in their own health, rather than relying on the authority of external experts. One well-known self-tracking app is MoodScope, which Jon Cousins invented to help himself track his depressive episodes to see what helped him get better. He then made it freely available to other people. This seems to me worth applauding.

Finally, I’m not convinced that the moral ideology of wellness and health is a new thing. Health has always been ideological. Look at Plato’s Republic, with its diagnosis of the sick society and the healthy society. Look at the Middle Ages, with its public performances of the Seven Deadly Sins, including Gluttony. Every ideology involves some positive model of human flourishing, including Neoliberalism and Marxism. If the best model of flourishing you can offer is sick days and barebacking, why should we follow you?

Review: The Happiness Industry by William Davies

9781781688458-4171756f689401c14d3e2d09906a9e3fWatch out folks. There is a murky world lurking behind the scenes, a sinister cabal of policy-makers, psychologists, CEOs, advertizers and life-coaches, watching you, measuring you, nudging you, monitoring your every smile, all to try and make you happy. We must resist. This, broadly, is the message of sociologist William Davies’ book, The Happiness Industry: How Government and Big Business Sold Us Well-Being.

I opened Davies’ book expecting a historical critique of the so-called ‘politics of well-being’, a movement which arose in the last decade. Cognitive psychologists like Aaron Beck, Martin Seligman and Daniel Kahneman found ways to measure how our thoughts can make us miserable, and how cognitive behavioural interventions can help us to be wiser and happier.  The evidence-base they built up persuaded policy-makers – particularly in the UK, but increasingly around the world – that governments can and should try to measure and improve citizens’ well-being.

The science of flourishing became a way for policy-makers to move beyond the cultural relativism bequeathed us by Nietzsche, through a marriage of ancient wisdom (Buddhist, ancient Greek) and empirical science. Governments could then try and improve citizens’ ‘flourishing’ without being accused of imposing their version of the good life on every else. ‘It’s not our version’, they could say. ‘It’s science.’

The politics of well-being is still quite an undeveloped movement, but in England it’s led to specific policies, particularly to the collection of well-being data to guide policies; an on-going attempt to teach ‘well-being’ and ‘character’ in schools; and the expansion of free talking therapies on the NHS.

Davies has written well on this movement for the New Left Review. But what we get in this book is a much more sprawling narrative, which looks at the history of the attempt, in economics, psychology, statistics and neuroscience, to measure moods and emotions, and to use that data either to ‘nudge’ us towards policy-outcomes, or sell us things, or keep us working. The story meanders from Bentham to JB Watson via whiplash, social networks theory, the DSM, the history of management consultancy, the Chicago school, the history of stress and the Quantified Self movement. It risks becoming a history of everything, and could more coherently have concentrated on the last decade (although oddly he doesn’t mention Kahneman, or happiness economist Ed Diener, or the various attempts to teach well-being in schools, or Martin Seligman’s attempt to teach ‘resilience’ to the entire US Army).

The ‘enemy’ of his book seems to be an overly-mechanistic or behaviourist model of the mind, in which scientific experts measure our mood-machine and try to steer it without asking people what they mean or care about. Certainly, the politics of well-being can be anti-democratic and positivistic. When our government came up with a national definition of well-being, for example, it did so via a small panel of experts, entirely made up of economists and psychologists.

However, Davies’ story risks confusing the behaviourist with the cognitive behavioural. Much of the politics of well-being sprung from the success of Cognitive Behavioural Therapy, which arose in the 1960s as a critical response to behaviourism. In CBT, people’s beliefs, meanings and values are all-important, so it’s more humanistic and potentially more democratic. It’s true that CBT can ignore the impact of external circumstances like poverty on our emotions. But people are developing more collective forms which equip us to change our circumstances (like being in debt to loan sharks) as well as our inner lives.

Probably the biggest impact of the politics of well-being so far has been to increase public funding for talking therapies, and to put mental health on the political map – there is a new campaign in the UK for ‘parity of esteem’ between physical and mental health in the NHS. But Davies ignores this. Instead, he focuses on the possibility of therapy or life-coaching being forced onto benefit-claimants in England and Wales. The Department for Work and Pensions denies therapy is ever mandatory, although it may be on occasion, and this should be opposed as an ethical breach and a waste of tax-payer money. But we also need to vigorously defend and expand free therapy for those who need it and want it.  Davies doesn’t lift a finger in support.

Instead, he lays into corporate wellness programmes and the booming wellness industry, and slams the proliferation of ‘chief happiness officers’ and ‘happiness apps’ monitoring our every smile. Are they? Does your company have a chief happiness officer? Have you ever used a ‘happiness measuring app’? It’s true that a handful of companies are taking well-being seriously (a few, like Zappos, take it too seriously). On the whole I think this is a good thing, and could mean companies take employee satisfaction and corporate ethics more seriously as well. But at the moment, most companies’ well-being programmes amount to little more than a salad option at lunch, cheap gym membership, and one away-day a year for some wacky team-building and half-baked resilience-training. Hardly Brave New World.

The over-riding tone of Davies’ book is the hermeneutics of suspicion – he is constantly expressing ‘unease’, ‘disquiet’ and the need for ‘critical resistance’ to the ‘hidden agenda’ of the elite. This is left-wing academics’ favourite posture, but it’s not really radical in that it undermines people’s agency: the ‘well-being agenda’ in this narrative is always something the elite imposes, never something citizens develop for themselves (as is actually the case with the Quantified Self movement). And his ‘perpetual unease’ doesn’t change anything. What are you actually for?

It turns out Davies is for co-operatives, for co-owned companies in which decision-making is shared. Such companies make us happier, according to research. He’s also for local community mental health initiatives like therapeutic gardening, which research suggests make us happier. And he’s for more equal and less competitive societies, which some research suggests make us happier. So on the occasions he’s arguing for something positive, Davies turns to well-being data for support.

At the extreme of his argument, he says governments should ignore people’s moods and feelings altogether, and focus on the serious business of improving material circumstances. That’s exactly the argument successive governments have used to deprive mental health services of funding. Hopefully, this is finally changing, but Davies’ book does little to help the cause.