from the Guilty to the Capable Individual the Capable Individual
Alain Ehrenberg Alain Ehrenberg
A. Ehrenberg (*)
CNRS (Centre National de la Recherche Scientifique), Université Paris-Descartes, Cermes3 (Centre de recherche, médecine, sciences, santé, santé mentale, société), France
e-mail:[email protected] Abstract
Abstract The aim of this chapter is to propose a sociological definition of mental health problems and practices. Due to the wide range of practices (from psychosis to self-help), this task is approached as a global idiom, enabling the formulation of mul-tiple tensions and conflicts of contemporary modern life, and providing answers for acting on them—in the family, work and workplace, between couples, in education, etc. The centrality of emotional issues in our society can be described as a form of
“mandatory expression” (Marcel Mauss), which characterizes an attitude toward con-tingency or adversity in a global context where autonomy is the supreme value. From this perspective, mental health can be seen as an individualistic way of dealing with what the ancients called the ‘passions’; it is the name individualistic society has given to what was referred to as the ‘passions’. Mental health is concerned with our ways of being affected by our ways of acting, and our ways of acting on these afflictions. A transversal viewpoint is presented, of which depression is only one aspect, at three intertwined levels of changes regarding: (1) the configuration of values and norms; (2) the concept of mental health; (3) the type of knowledge that dominates psychiatry and mental health fields, that is, the progressive replacement of psychoanalysis by cogni-tive neuroscience as the main type of knowledge of the human mind since the 1980s.
Reports on mental health published by health and political organizations, generally indicate that between 20 and 25 % of the population of any developed society is affected by a “mental illness”, but primarily by anxiety and mood disorders, and most notably, depression. The area of mental health refers to a large spectrum of problems, ranging from psychosis to personal development, self-help, and enhance-ment, or what psychiatrists have called “positive mental health” (Vaillant2008 ). So, it comes as no surprise that the number of persons affected and, consequently, the cost to society are huge – from 3 to 4 % of the GDP of EU countries (European Commission2005 ). Today, mental health certainly is a central public health issue, but contrary to cancer for instance, it is not only such an issue.
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The main difference between traditional psychiatry and modern mental health can be expressed very simply: psychiatry is a local idiom , specialized in the identification of particular problems. Mental health, because of large domain it encompasses, is a global idiom , enabling the identification of multiple tensions and conflicts of contemporary modern life, and, moreover, providing solutions.
That is, the practice of mental health is concerned with identifying problems generally linked to social relationships, seeking reasons to explain them, and finding solutions. Today, mental health is not only about the struggle against mental illness, it is also a way of addressing multiple problems in ordinary soci-ety—in the family, work and workplace , between couples, in education, etc.
Mental health concerns not only health, but also the socialization of the modern individual. It addresses the essential elements of individualistic society, such as self-value, the opposition between responsibility and illness, and the ability to succeed in life. It raises moral questions concerning good and evil, justice and injustice, dignity and shame.
One has to elaborate further about the central place mental health has come to occupy in our way of life.
In “Understanding a Primitive Society”, a discussion on the concept of objective reality with anthropologist Edward Evans-Pritchard and philosopher Alasdair McIntyre, published in 1964, Peter Winch explains that the magical rites of the Azandes observed by Evans-Pritchard “express an attitude to contingencies; one, that is, which involves recognition that one’s life is subject to contingencies, rather than an attempt to control these”. These rites:
emphasize the importance of certain fundamental features of their life […] We have a drama of resentment, evil-doing, revenge, and expiation, in which there are ways of dealing (symbolically) with misfortunes and their disruptive effects on man’s relations with his fellows, with ways in which life can go on despite such disruption (Winch 1964 , 321).
The idea I’ll develop here is that the centrality of emotional issues in our soci-ety can be described as a form of “mandatory expression” (Mauss 1921/ 1969 ), which characterizes an attitude toward contingency or adversity in a global con-text where autonomy is our supreme value. From this perspective, mental health can be seen as an individualistic way of dealing with what the ancients called the
‘passions’; it is the name individualistic society has given to what was referred to as the ‘passions’. Mental health, as we shall see, is about our ways of being affected by our ways of acting , and about our ways of acting on these afflictions .
Here I present a transversal viewpoint, of which depression is only one aspect, at three intertwined levels of changes regarding: (1) the configuration of values and norms; (2) the concept of mental health; and (3) the type of knowledge that domi-nates psychiatry and mental health fields, that is, the progressive replacement of psychoanalysis by cognitive neuroscience as the main type of knowledge of the human mind since the 1980s.
A. Ehrenberg
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