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Human agency and social suffering


Liz Frost and Paul Hoggett Critical Social Policy 2008 28: 438 DOI: 10.1177/0261018308095279 The online version of this article can be found at: http://csp.sagepub.com/content/28/4/438

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L I Z F R O S T & PA U L H O G G E T T University of the West of England

Human agency and social suffering

Abstract In this paper the authors are primarily exploring the notion of social suffering within a psychosocial paradigm. A brief outline of Bourdieus concept of social suffering, and a similarly concise explication of the psychosocial subject as contemporarily theorized are given. The central section of the paper looks at some understandings of social suffering that are experienced internally as well as within structural inequalities and power relations. The concept of hurt is considered, offering the internalized injuries of class as an example. Loss is then examined in relation to the severing of, for example, communities and the losses of social recognition and internal esteem. The complex concept of double suffering, in which hurt accrues more hurt and is re-experienced, is then discussed. The welfare subject of contemporary policy and practice is, finally, briefly revisited. Key words: Bourdieu, double suffering, hurt, loss, recognition

Introduction
Enlightenment liberalism bequeathed a particular view of a rational and autonomous human subject from which both traditional social policy and progressive alternatives drew. The aim of this paper is to challenge this model by placing emotional life at the heart of social policy and welfare practice whilst retaining a critical perspective on issues of power. In the UK this emerging approach is termed psychosocial (Clarke, 2006; Frosh, 2003). We also propose to use here Bourdieus (1999) concept of social suffering to undertake a psychosocial analysis of the welfare subject. Pierre Bourdieus conceptualization of social suffering draws attention to social misery: not just the unequal distribution of material goods in society, as welfare policy has tended to emphasize, but also peoples
Critical Social Policy Ltd 2008 0261 0183 97 Vol. 28(4): 438 460; 095279 SAGE PUBLICATIONS, Los Angeles, London, New Delhi, Singapore and Washington DC 10.1177/0261018308095279
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lived experience of domination and repression, including feelings humiliation, anger, despair, resentment that may accompany, for example poverty, class or race. In this paper the notion of suffering denotes the intermeshed components of thinking, feeling, responding, acting. We are also concerned with suffering as both a reflexive and non-reflexive phenomenon: as something which at times can be thought about, critically and creatively, and at times is embodied, enacted or projected precisely because it cannot be thought about. First we will briefly outline the post-liberal subject of welfare the psychosocial position from which we are working here. Then the paper considers the central theme of the relationship between psychosocial understandings of subjectivity, the non-unitary self and the implications for human agency. Next, through a discussion of hurt, we will consider how psychosocial models of suffering provide a framework for understanding the experience of welfare subjects and how their agency is expressed. We then consider the notion of loss, using examples of loss of recognition in ageing and gendered losses. Finally the notion of double suffering and its manifestation as enactment, embodiment and projection is discussed, with some thoughts also on loneliness and foreclosure.

A post-liberal conception of the human subject


The notion of the liberal subject as addressed by much welfare policy is well known and needs scant reiteration here. Very briefly we are using this term to mean a person with autonomy, a unified consistent coherent identity, rationality and agency. Against this version of humanity, the welfare subject is invariably construed within a deficit model, as lacking these enlightenment traits: as dependent, unpredictable, unable to act in their own best interests, lacking agency. However Anna Yeatman (2007) and others have recently argued that a post-liberal subject is now emerging. Drawing on feminism and non-positivist approaches to knowing about human relations, this perspective emphasizes relationality not autonomy and insists that reason, passion and embodiment are integrally related not in opposition (Ahmed, 2004; Clarke, Hoggett and Thompson, 2006; Emirbayer and Goldberg, 2004). Both the new social movements and psychoanalysis offer a fundamental critique of the human subject of classical liberalism. Central to this is an alternative vision of the subject as a unique centre of

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subjective experience. Both perspectives are concerned with forms of human suffering, as a consequence either of the exigencies of human relationships or of oppression. Within this psychosocial paradigm the subject can be understood as ambivalent and emotionally driven, existing outside (but defined within) processes of language (Frost, 2008). Here the psychosocial subject is being theorized psychoanalytically as possessing an unconscious dimension of subjectivity. Equally importantly the subject here is a social subject in a world of power relations and status hierarchies: a social subject with agency, though not necessarily in a position to exercise this reflexively. Most importantly to the whole concept, though, is that the psycho and social elements are not two parallel paradigms, but represent a whole epistemological shift into theorizing the passionately rational subject, one which is saturated by, impacting on and impacted by its social world. As Wendy Hollway and Tony Jefferson describe:
Subjects whose inner worlds cannot be understood without knowledge of their experiences in the world, and whose experiences of the world cannot be understood without knowledge of the way in which their inner worlds allow them to experience the outer world. (Hollway and Jefferson, 2000: 4)

This, then, captures the notion of the post-liberal, the psychosocial subject as currently emerging in social science theory. It is this welfare subject with whom this paper is concerned. Social suffering lies at the heart of this subjective experience, the lived experience of the social damage inflicted in late capitalist societies on the least powerful and the intra-psychic and relational wounds that result. In other words, both inner worlds of psychic suffering and outer worlds of social structural oppression are constitutive of such subjects, their capacity for agency, and the forms of agency that are possible.

Social suffering
Traditionally, social policy has understood the well-being of citizens in terms of the distribution of material goods and services rather than in terms of the lived experience of domination and exclusion and the feelings this produces. Bourdieu uses the concept of social suffering

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to draw attention to this. As he says, using material poverty as the sole measure of all suffering keeps us from seeing and understanding a whole side of the suffering characteristic of the social order (Bourdieu, 1999: 4). In other words, social suffering draws attention to the lived experience of inhabiting social structures of oppression: and the pain that arises from this. Social suffering draws attention to what those without power endure: to abjection, and to the nature of the self as object (Hoggett, 2001). In societies like Britain and the United States, where it has been argued that globalization requires flexibilization, the consequences of the neo-liberal belief that there is no such thing as society are being experienced. Trade unions appear to be rendered impotent and traditional communities fragmented, and social inequalities increase as a super-rich prosper in the absence of government intervention. The kind of collective agency that was possible to those lacking economic and cultural capital even twenty years ago rent strikes, consumer boycotts, industrial action now seems a thing of the past. Furthermore the selforganization of minority groups has been enlisted into a new politics of particularism leading to intergroup rivalry rather than solidarity. In these circumstances second order agency (Hoggett, 2001), that is agency which brings about a change of pattern in the life of an individual or group, becomes increasingly difficult to achieve, hence the inappropriateness of the rhetorics of empowerment and choice. This is not to say that the welfare citizen is without agency, but that this agency is invariably primarily about coping and surviving. The stress and coping model One source of evidence of the relation between social inequality and social suffering lies in the vast body of research literature which has been influenced by the stress and coping paradigm originating in the work of Leonard Pearlin and his colleagues in the USA (Pearlin et al., 1981). This looks at the incidence of personal stress in relation to indicators such as social class, ethnicity, and so on, and individual capacity to cope (to exercise some form of first order agency and/or control) in the face of such stresses. Most of this literature uses quantitative methodology and a positivist epistemology in which, for example, a dependent variable (e.g. the incidence of depression) is understood in terms of the presence/absence of independent variables (perhaps socioeconomic status) and mediating variables (e.g. social support) (Turner

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and Lloyd, 1999). The Journal of Health and Social Behaviour has featured this research for over twenty years now and, as discussed later, the evidence of a clear positive relation between mental health morbidity in children and adults and indicators such as poverty and ethnicity is overwhelming. This research has also made progress in revealing the factors which mediate the impact of inequality, often construed as coping resources (personal and social) which contribute to resilience. Resilience clearly involves agency (as a refusal to accept ones fate) but the action that accompanies resilience is often primarily internal rather than external, for example, the refusal of self-pity. However given its epistemological and methodological approach, little of the stress and coping research provides insights into the actual subjective experiences and lived lives of those concerned. Moreover, by neglecting the personal meanings through which individuals make sense of such things as close relationships or personal control, forms of cultural bias may well creep into the resulting analyses whereby such things as these become self-evidently good (Williams and Popay, 1999). Nevertheless the stress and coping literature provides irrefutable evidence of the massive psychical effects of social injustice. The psychical effects of social injustice As we have noted, abjection concerns being done to. It is important to remember that in unequal societies some are done to more than others. Our hypothesis is that social suffering refers to the hurt and loss accompanying the abjection that is a consequence of the continued existence of domination in democratic societies. Because the exercise of power over others appears natural and legitimate, the hurt that produces shame and humiliation and the losses that lead to grief become detached from the social relations which generate them. The suffering that then results becomes individualized and internalized built into subjectivity. Secondary damage is experienced when the defences an individual deploys to cope with hurt and loss have destructive consequences for self and others and therefore further separates the person from their sense of relatedness/belonging to the group. This (artificially, here) staged process (in reality inchoate, multiple, multidirectional) is discussed below.

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Hurt
The hidden injuries of class The positioning of classed subjects in society has both discursive and pre-discursive (i.e. affective) dimensions. It influences what people think and feel about self and others. The strong recent emphasis on the discursive dimension of subject positions has drawn attention away from how class is also experienced in visceral, affective and embodied terms. These pre-discursive anchorings of class were touched upon by Richard Sennett and James Cobb in their groundbreaking Hidden Injuries of Class (Sennett and Cobb, 1993). The search for respect and the damage done to self-esteem by the withholding of recognition were recurring themes of the working class men in their study. A growing body of recent research does draw attention to the affective dimensions of class. Beverly Skeggs (1997) study of working class women reveals the connections between the absence of respect and the pursuit and subversion of respectability. Diane Reay (2005) notes the everyday humiliations experienced by working class children, leaving them feeling dumb and stupid. Similarly, a research project in the current Economic and Social Research Council Identities and Social Action programme explores the dynamics of shame and pride on a working class housing estate (Rogaly and Taylor, 2007). Class and its hurts are highly complex and fantasized spaces. Theorists suggest that to understand class you have to understand patterns of fantasy and defence, hope and longing in other words what people longed to be and guarded against being (Walkerdine et al., 2001: 16). Within post-industrial, post-collective, consumer capitalism the realization of the distance between actual experience and the popular delusion that there is no class, that with sufficient determination anybody can be anything, is painful to bear. The reality of class and povertys cruel limitations on, for example, educational attainment, university entrance, job opportunities, and a respected and comfortable life are thus masked. Not making it is perceived as ones own failure in todays culture one becomes a loser. The hidden injuries of race The affective dimension of racial positioning was also obscured by a purely discursive understanding. The psychoanalytic concept of projective

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identification focuses on that which is put into those abjected to such discourses. It describes the process by which the other is coerced into taking in that which is disavowed in self. To cite Franz Fanon, I was battered down with tom-toms, cannibalism, intellectual deficiency, fetishism, racial defects, slave ships (Fanon, 1968: 112). As Simon Clarke (2003) notes, it is not just that self projects a feared or undesirable quality into another but the other is led to identify with this quality in themselves. Charles Taylor speaks of this in terms of the internalization of misrecognition, a form of oppression, imprisoning someone in a false, distorted and reduced mode of being (Taylor, 1995: 225). For Lynne Layton (2006) this intersubjective process splits human capacities into dichotomously defined attributes which are then ascribed to one or another of race, class and gender: the desirable attributes to the culturally dominant group men are rational and independent, women emotional and dependent, etc. The massive over-representation of young African Caribbean men in the most custodial and oppressive parts of the mental health system can be related to the ascriptions of non-rational, out of control, violent and threatening (discourses of youth and of black men ageism and racism). More frequently compulsorily, rather than voluntarily, admitted to hospital and secure units, administered excessive use of major tranquillizers, and so on the most coercive, and dehumanizing extremes of this system are the end result of being the constructed black other of racist projections of the public, the police, magistrates and mental health staff (Cope, 1989; Fernando et al., 1998; Mohan et al., 1997; Nazroo, 1997). Zizek (1993) draws attention to a further dimension of these affective dynamics when arguing that the object of racial or ethnic hatred is construed by the perpetrator as having deprived him of his satisfaction, of having stolen the possibility of his own enjoyment. Adapting Zizeks ideas to the area of social policy we can see how the racialized other is then positioned as the source of injustice and an object of grievance (theyve taken our jobs, our schools, our homes . . .), a kind of favoured child towards whom the state is seen as acting unfairly. Hurt: Sociological accounts Symbolic interactionism, from Irving Goffman to Anthony Giddens, has theorized the subjective experience of social hurt, in terms of stigma (Goffman, 1968) and shame (Giddens, 1991). Goffman, for example, whose notion of social identity is always embodied and visual, describes

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the social hurt of stigma thus: the experience of the individual who cannot produce the normal social identity required, and is aware that they do not come up to standard, is that of being discredited, of a personal failure to pass. Because the opinion formed by those making judgements does not stop at presentation, but makes moral judgements and imputes certain characteristics, the discrediting of the person impinges on the whole identity. As Goffman points out the stigmatized individual shares the same belief system as the rest of their culture so then the standards incorporated from the rest of society equip him to be alive to what others see as his failing, inevitably causing him to agree that he inevitably does fall short of what he really ought to be . . . shame becomes a central possibility . . . (Goffman, 1968: 18). Because that sense of inadequacy is internalized within the individuals own meaning system shame is experienced privately, personally and as all embracing. The individual lives the sense that they no longer fit the group they fall short of and are excluded from this possibility. Shame, then, equals serious identity damage with ramifications for various aspects of selfhood. Similarly to Goffman, for Giddens the self is embodied and the body is the mechanism and conduit through which social constructs are made personal and personal constructs, social. Shame is concern with the overall tissue of self-identity; concern about the body in relation to the mechanisms of self-identity, and crucially feeling that one is inadequate for a respected or loved other . . . trust [is] based on being known to the other where self-revelation does not incur anxieties over exposure (Giddens, 1991: 67). This connects also to Honneths (1995) work, discussed later, on recognition, as it compromises the possibilities of recognition where someone cannot show or trust exposure. The co-authors research on embodiment and identity with young women found this painfully illustrated. For example a young woman described her appearance thus:
I feel like it is something I worry about, that people can always hurt me with, if you have an experience like that [being called ugly] it is something you will never forget, and it is always there, that somebody is going to say something like that to you, and it is, it is just so humiliating. (A quoted in Frost, 2001: 158)

This is the individually experienced hurt of being called ugly the shame and pain of it, in a society in which contemporary young women are positioned by the visual imperatives of consumer capitalism

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(Frost, 2003). Gender and youth are the dimensions of structural oppression but the broader context, of individualization and consumerism, renders damage to all contemporary young people. Developing identity is reduced to adopting market categories shopping for subjectivities as it is conceptualized (Langman, 1992): fragile, competitive, market-led subjectivities which cannot replace traditional group affiliations and collective identifications of, for example, class and which connect to poor mental health and high stress levels in the young (Furlong and Cartmel, 1997). Hurt internalized Sociological accounts of stigma and shame draw attention to social relations which reproduce psychic injuries but they do not in themselves enable us to grasp how the subject is constituted by these experiences. A psychosocial approach focuses on the relationship between individual biographies and social processes and is therefore concerned with the mechanisms by which social relations become internalized. This is a complex issue and one we have begun to tackle in some recent research (Hoggett et al., 2006a). This brief extract from an interview with a working class woman illustrates the way in which the psychic injuries of class, mediated through the family, became constitutive of her subjectivity.
My dad was, he was an odd mixture of kind of Italian macho and being completely cowed by the world as well. He knew his place and he accepted his place and would never argue his place. And that was a real tragedy for me, I think, looking back on it, that he was kept firmly where he was because he believed in what he was taught he was. Whereas my mums attitude was completely different. Its interesting, my mum was a waitress for years and years, and my dad used to come and pick her up from work. And she said youd watch him walking through the restaurant and she said the only people who went in restaurants in those days were people in suits and people with money, you know, that was in the sixties. She said youd watch him walk through the restaurant, she said, and he was almost physically shrinking as he was walking through, because he didnt belong. (Hoggett et al., 2006a: 696)

Here we can see the way in which the identifications this woman makes with her parents constitute different aspects of herself. Interestingly enough in her case it is the masculine identification which represents the

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abjected part of the self whereas the feminine identification provides her with her internal resources for agency, something inside her that refused to accept her place, a restless desire for something better. These identifications are deeply internalized: what she elsewhere describes as that shrinking thing is discursive, affective and somatic. The example also illustrates the non-unitary nature of the self, the way in which different parts pull the person in different directions, some constraining agency, others enabling it.

Loss
Particularly during rapid social change powerless people become the objects of change rather than its agents. Deindustrialization destroys whole communities and identities, particularly those linked to masculinity. Equally the personal costs of forced migration as a result of war, famine and ecological disaster can be enormous (loss of family, friends, job, status, identity, etc.) rendering the task of making a new life extremely challenging. There is now a history of using concepts of loss, grief and melancholia to understand the experiences of those whose communities are destroyed by processes of urban modernization (Marris, 1974) or, more generally, who are the powerless objects of economic and social restructuring (Sennett, 1998). The demise of traditional working class labour has taken with it sources of pride in physical strength, manual skills, hard graft and a job well done, and communities of labouring men shored up by and shoring up such esteem and recognition (Hollands, 1990). Recently there has been an interest in understanding the role of loss in the formation of subaltern identities. Speaking of such loss Judith Butler lists the loss of humanness under slavery; the loss that is undergone with exile . . . the loss of culture that is performed by the mandatory production of the colonized subject . . . and perhaps most difficult, the loss of loss itself; somewhere, sometime, something was lost, but no story can be told about it; no memory can retrieve it (Butler, 2003: 467). Much of this literature takes Freuds seminal text Mourning and Melancholia (Freud, 1917) as its starting point and now applies it to the broader experiences of race, class and gender. Loss is constitutive of subaltern identities the loss of ones own history (as history is largely not written by the powerless), the loss of a sense of the achievements

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of ones group or class, the loss of valued role models, icons and heroes present or past, the absence of culturally desirable human qualities in the identity of black, working class, woman or queer. Thus for Butler, ungrieved and ungrievable loss constitutes the formation of what we might call the gendered character of the ego (Butler, 1997: 136). Butlers arguments illuminate aspects of identity formation of many of the subaltern groups who are welfare service users. For example, research focusing on the relation between structural oppression and old age (Dykstra et al., 2005; Jones and Moore, 1989) reveals the near impossibility of mourning or even recognizing the experience (the loss of loss). No role models, no icons, no social recognition exist for the very old; only the denigrating projections of our own terror of ageing and death. Old age in Western consumer societies is only defined as a deficit (of all things youthful the inability to approximate a youthful subjectivity). This is othering in the extreme: the denial of any worthwhile subjectivity. The terrifying experiences of physical loss of capacity and dependency and the psychic re-experiencing of powerful and primitive processes around these are lived out (impacted on and impacting on) in a social context of mass denial and denigration. This may have also some gender dimensions. For example Caroline Jackson argues physical breakdown is a terrible experience for many men because it connects the masculine body with weakness, dependency and passivity all the supposedly feminine qualities they have spent a life-time defining and defending themselves against (Jackson in Hearn, 1995: 106). But in contemporary societies where the visual is often privileged as a way of knowing, youthful bodies are adored and fetishized and bodily weakness and imperfection are reviled. The loss of a socially and psychically valued or recognized self is replaced by inhabiting a reviled subjectivity: a subjectivity that is the repository of the social terror of ageing and death, and therefore a place where ones own lived reality has to be constantly and insecurely denied. Splitting and denial are intrinsic; psychic well-being becomes very difficult to achieve. The individualization of such experiences of hurt and loss can leave individuals feeling very much alone; shame in particular can lead to a withdrawal from intimacy, networks, connectedness. This can further limit the subjects capacity to move purposively and confidently in the world and to influence, to effect, to realize. This will be considered more below.

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Double suffering
Some experiences threaten to go beyond our capacity to digest them because we lack the resources to symbolize and give meaning to them. They are more likely to be experiences that have been forced upon us rather than ones we have freely chosen: those we face as powerless objects rather than as active agents. If we try to eat something that we cannot digest then these items will get stuck in the system or we will evacuate them. According to the psychoanalyst Wilfred Bion (1962) so it is with noxious experiences, they get stuck in our system as psychic toxins (most vividly in terms of traumatic repetitions). It follows that if experience cannot be thought about (symbolized) then we will have an unreflexive relation to it. But why cannot some experiences be thought about? Judith Butler (1997) uses the psychoanalytic concept of foreclosure here. Jean Laplanche and Jean Paul Pontalis (1973) define foreclosure as not symbolising what ought to be symbolised . . . it is a symbolic abolition (p. 168). Butler adds the social dimension: what if society prevents us from thinking about what we ought to think about? Referring specifically to the experience of loss, Butler argues that in such situations the possibility that experience can be worked through is foreclosed because there is no public recognition or discourse through which it might be named and mourned (Butler, 1997: 139). Not only gender but ageing, for example, as considered above, would epitomize this. Butlers work, then, is part of a body of literature which deploys Freuds analysis of melancholia to explore forms of suffering which cannot be worked through psychically as there are no available means for articulating and symbolizing them (Eng and Kazanjian, 2003). The idea that social suffering has a melancholic dimension is also helpful because by drawing attention to that which cannot be worked through we are reminded of the ways in which suffering must then be somatized and embodied (an important factor accounting for the social inequalities of health), enacted (acting out under the old social pathology paradigm, repetition according to Butler) or projected (onto partners, children, neighbours, strangers, etc.). These reactions to a suffering that cannot be thought about and whose sources remain unknown have the character both of dysfunctional defences and of adaptive forms of coping. To the extent that the former dominates, like in alcoholism or drug abuse, the individuals response to suffering causes further suffering to both self and others. This is why we call it double suffering.

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Suffering enacted Experience which cannot be thought about and voiced will often find expression in action. The action may be unreflexive; the individuals suffering can speak through their behaviour. Butler (1997) recasts the concept of performativity in this way, de-rationalizing and de-intentionalizing it so that the act contains a thought which is nevertheless unrecognizable to the one who acts. As Butler puts it a thought that is unthought to itself and thus opaque, but nevertheless alive and persistent (Butler, 2003: 408) and therefore the source of what she terms a melancholic agency, an agency haunted by a past (experience) that cannot be represented. Trauma is the strong form of such unrepresentable experience and as such it demonstrates the power of enactment. There is a vast literature on the re-enactment of abuse: the way in which the victim of parental abuse often becomes in turn the perpetrator on the next generation (Faimberg, 2005). It is as if the traumatic experience becomes a psychical virus, dormant then reawakened. Some observers of the perpetrators of ethnic violence (such as the Serbs) suggest that collectively experienced trauma (military defeats, subordination by a colonizing power, genocide, etc.) can be passed on transgenerationally in a similar fashion (Volkan, 1999). Such traumas remind us of the major and ruptural events that may impact upon individual or collective lives. However, Moglen (2005) has suggested the possible value of Masud Khans concept of cumulative trauma (Khan, 1974) to describe the effects of the continuous everyday impingements, misfortunes and slights that characterize the lives of the powerless. In the current social policy world one of the most visible forms of enacted suffering is commonly referred to as anti-social behaviour. Here is a youth worker talking about some young people he has known over many years, who had just received ASBOs (anti-social behaviour orders):
Last week I saw all the shops around here have mug shots of the 10 most difficult young people and I was at a meeting of the shopkeepers and I saw these, sort of, rows of photographs and theyre a very desperate bunch. I mean, I was probably the only person in the room who knew all the kids and its very sad to see this. I know theyre dangerous . . . but there is just a feeling of, is this the right way, but I cant think of another way. You know, I cant think of another way of getting these kids out of their desperation. I mean what struck me most about them is that they are a very

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unloved group, but all we offer them is disciplinary, um, sort of measures against them . . . My main feeling is, yes, they just have absolutely no love in their lives and all were doing is punishing them more and more.

The youth worker, who had worked on that same estate for over 20 years (and had worked with many of the parents of these kids when they themselves were young) knew the vulnerability in their violence and could see the suffering within their badness. He was both angry for them and angry with them. Holding these contradictions in mind is part of what we refer to as the dilemmas of welfare work (Hoggett, Mayo and Miller, 2008). This youth workers thoughts about the absence of love link to Majid Yars (2008) suggestion that the anti-social can be conceptualized in terms of failures of recognition. Such failures in early life, compounded by experiences in school and the labour market, convince the young adult that the environment is untrustworthy. Consequently they provoke the environment believing it will ultimately let them down, a kind of self-fulfilling prophecy. Denied recognition in home, school and work some people find recognition in drugs, in gang life, in the projection of hardness and in the enactment of physical and sexual violence. Through the enactment of their suffering powerless subjects assert an unreflexive agency and this wounded and unpremeditated response, when collectively undertaken, becomes interpreted by the media and policy makers as a social problem. This in turn may kick-start a variety of repressive and/or ameliorative actions, including policy changes at state or local level. Enactment, then, has the capacity to set in motion a powerful reaction with undeniable impact. Suffering embodied As we have seen, the stress and coping literature uses stress as a biopsychosocial category, in which the psychological aspects of suffering undergo conversion into a physical symptomatology. Stress then refers to the realm of the psychosomatic or, more properly, the social psychosomatic. To the extent that shame and grief can only be thought about in individualized terms, as further proof of inadequacy, or cannot be thought about at all, then these affects become embodied in psychosomatic illnesses or become carved onto the body in terms of posture, facial gestures, pallor and so on.

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The literature of health inequalities has evidenced the direct link between all forms of social oppression and ill health. The Black Report, undertaken for a Conservative government in 1980, charts the extent to which not just psychosomatic illness but virtually all forms of morbidity and higher mortality rates apply to working class people more (Townsend and Davidson, 1988). The class difference is enduring and ubiquitous; evident across almost any health measure. In relation to such seemingly different kinds of phenomena as ischaemic heart disease in men and mental health problems in children, for example: in men aged 3565, in social class I there were 90 deaths per 100,000 a decade ago, and 167 in social class V; the incidence of childrens mental health problems was twice as great in households earning less than 200 per week compared to those with 500 plus in 1999 (White et al., Meltzer and Watwood, in Graham, 2007). Poverty, and the inequalities which are associated with it (not just class but gender, race, physical disability and age) guarantee that these populations are more likely to experience more physical and psychological suffering, from toothache to suicide. The social and biological processes which explain health inequalities are a source of debate. Government policy initiatives which attempt to locate the causes of such difficulties in poor health choices (smoking, alcoholism and obesity all feature more in social class V) have been contested, and the environments in which people work and live have been studied. Poor conditions, gruelling physical demands and long hours characterize working class jobs more than middle class ones. However, it is clear from the research that environmental explanations are limited. For example, the much cited Whitehall Studies demonstrate that within an identical work environment (Civil Service), senior administrators had much better rates of morbidity and lower rates of mortality (including suicide) than did clerical and other junior staff (Cockerham, 2007). Cockerham accounts for this by the power of class and uses what is essentially a psychosocial framework to understand the process, listing factors such as self esteem, status difference, self-direction at work, control in ones environment, social capital and sources of social support as the key variables which decline in strength as one descends the social ladder (Cockerham, 2007: 94). Social suffering is inscribed on the body: the low self-esteem, low status, lack of social capital and lack of power to direct ones life. Lack of recognition (see above) offers a framework for understanding such states, which, as experienced, can be understood as not feeling good enough

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(as good as others). For theorists such as Wilkinson, class inequalities are in themselves unhealthy, not just because of the differing access to the good life. He argues that high levels of inequality damage social cohesion, and peoples sense of relative deprivation, insecurity and relative powerlessness impacts badly on their health (Wilkinson, 1996 in Busfield, 2000). According to Busfield, the unemployed do not become ill because they cannot feed themselves, but because . . . their sense of self-worth is diminished, and they become more isolated. The mediation is psychosocial, rather than material and bodily (Busfield, 2000: 57). Their socially inflicted suffering isolates them from society double suffering as we have described it. Suffering projected Heres that youth worker again. Hes referring to a recent incident in which some youths trashed his club and then three of them two brothers and their friends cousin turned on each other. The younger brother is known to be dangerous and has used knives in the past.
The younger brother and the other protagonist were just yelling abuse at each other. And they just sounded so hysterical, fragile and upset, I mean that was quite upsetting, because they were both saying really hurtful things to each other. I mean when I find this, all of them have actually got quite a lot of pain in their backgrounds and they scratch at each others pain, they dont let it, they dont show solidarity for other people. On these situations they actually pull at the scabs you know, yelling awful things about their parents, the majority of which were true, you know.

The concept of projection can help illuminate the lack of solidarity, the scratching at the others pain. What I cannot bear in myself I can always locate in the other, hence the relief and satisfaction to be gained from racism, homophobia, etc. Coping strategies are also mechanisms of defence suffering can be dealt with by splitting, projection, idealization and denigration just as it is by alcohol, drugs or other addictions. As well as agents and victims, the more we suffer the more we may also adopt the subject position of our own worst enemy or others worst enemy (Hoggett, 2001). Subjects of social suffering may not draw easily upon our compassion if they do not present themselves as innocent victims but as aggressive, resentful or suspicious people whose hurt and loss is directed at others rather than at themselves (Hoggett, 2006).

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A further form of double suffering accrues then: the person becomes disliked perhaps avoided; unwelcome in social groups, struggling to form friendships or to find personal love and esteem. Hurt in this way produces more hurt: rejection and dismissal, more loss and more suffering. Intimate relations and broader social bonds can become hard to sustain, and the person caught up in this may become atomized, anomic and lonely. Honneth argues that there is a primary need for social recognition: for love, respect, esteem, and a need for relations of mutual recognition as a precondition of self-realisation essential for the development of a persons identity (Honneth, 1995: xi). Anomie reduces the possibilities for mutual recognition and for securing identity. That loneliness can be damaging and negating is well documented. For example as research literature in relation to many oppressed groups evidences, the rupturing of social networks and of friendship, a lack of inclusion and opportunities for social valuing, can cause lack of mental well-being and illness (Goodyer et al., 1990; Kawachi and Berkman, 2001; Silviera and Alleback, 2001). This is not just social but psychosocial. For example research in a Somali community in Melbourne connects loss with loneliness and depression: partly because of the lived experience of fracturing of bonds, but also because what cannot be mourned is fantasized as a lost ideal of social networks/communities (MacMichael and Manderson, 2004). And as the authors found when researching children making the transition from primary to secondary school, the most feared scenario was being friendless, and it was the loss of old friends that was most mourned (Frost, 2004). The primal, fantasized, abandoned self exerts continuing influence.

Rethinking the object of social policy


In Western-type democracies the welfare state and welfarism arose as a consequence of the existence of suffering, particularly social suffering. Much of this system concerns relationships with disadvantaged communities (including racialized minorities) and excluded groups. We suggest that one of, what Claus Offe (1984) once termed, the contradictions of the welfare state is that modern democracies are concerned as much with the management of social suffering as they are with its alleviation. Not just an issue of resources and demands, this more fundamentally gives expression to both a cultural and a political problem. Politically, the existence of

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social suffering reminds us of the continued existence of social inequality, inequalities which are proving impervious to government intervention even whilst there is unprecedented affluence for some (Institute for Fiscal Studies, 2007). Culturally suffering is itself the Other to modernity. Suffering gives expression to the passive rather than active voice, to the self as object, and to what is often chronic and enduring rather than what is open to social engineering and quick fixes. So, for both political and cultural reasons Western-style democracies are partly in flight from suffering and those who are the subjects of suffering become the Othered of an achievement oriented, change-embracing modernity. It seems possible then that by adding psychoanalytic insights to Bourdieus concept of social suffering a new way of thinking about the proper object of welfare practice can come into view. This, then, would be a perspective which could at last do justice to peoples lived experience of powerlessness and material scarcity but in a non-idealized way. We believe that what we are proposing is a realist perspective. However, we are aware that for some it may seem that our perspective is more properly deemed miserabilist rather than realist. By focusing upon abjection we recognize that we are deliberately accentuating negative elements from the complex matrix of internal and external relations that make up the self: a non-unitary self with parts which refuse, resist, subvert and seek to change. We believe the negative has an important place, particularly for a critical social policy. We seek to draw attention to what subaltern groups in society have to endure not as a recipe for despair but to illuminate the ugliness of social injustice and to illustrate just how deeply it affects human experience. For many practitioners it is this lived reality of suffering that fuels their anger at injustice and sustains their commitment to their work (Hoggett, Mayo and Miller, 2006b). For the practitioner, this demands what Raymond Williams (1977) called felt thoughtfulness a capacity both to feel the pain of the other, even in their angry, violent or selfdestructive enactments, and to think critically about the injustices that produce it. This would be equally useful in terms of policy making, community support and development, and practice with individuals. The tragedy is that none of us automatically responds to hardship, humiliation or the abusive exercise of power through noble resistance, we are just as likely to turn our sense of grievance upon ourselves or innocent others. This is suffering turned upon itself and it is this double suffering which is often the object of professional practice in welfare work.

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Frost, L. (2004) Adult Anxieties and Betweenager Lifestyles, unpublished paper presented at Resilience in Childhood: Interdisciplinary Perspectives conference, University of the West of England, July. Frost, L. (2008) Why Teach Social Work Students Psychosocial Studies?, Social Work Education 27(3): 24361. Furlong, A. and Cartmel, F. (1997) Young People and Social Change: Individuation and Risk in Late Modernity. Buckingham: Open University Press. Giddens, A. (1991) Modernity and Self-identity. Cambridge: Polity. Goffman, I. (1968) Stigma: Notes on the Management of Spoiled Identity. Harmondsworth: Pelican. Goodyer, I., Wright, C. and Altham, P. (1990) The Friendships and Recent Life Events of Anxious and Depressed School-age Children, British Journal of Psychiatry 156: 68998. Graham, H. (2007) Unequal Lives: Health and Socioeconomic Inequalities. Buckingham: Open University Press. Hearn, J. (1995) Imaging the Ageing of Men, pp. 97115 in M. Featherstone and A. Wernic (eds) Images of Aging: Cultural Representations of Later Life. London: Routledge. Hoggett, P. (2001) Agency, Rationality and Social Policy, Journal of Social Policy 30(1): 3756. Hoggett, P. (2006) Pity, Compassion, Solidarity, pp. 14561 in S. Clarke, P. Hoggett and S. Thompson (eds) Emotion, Politics and Society. Basingstoke: Palgrave Macmillan. Hoggett, P., Beedell, P., Jimenez, L., Mayo, M. and Miller, C. (2006a) Identity, Life History and Commitment to Welfare, Journal of Social Policy 35(4): 689704. Hoggett, P., Mayo, M. and Miller, C. (2006b) Private Passions, the Public Good and Public Service Reforms, Social Policy and Administration 40(7): 75873. Hoggett, P., Mayo, M. and Miller, C. (2008) The Dilemmas of Development Work. Bristol: Policy Press. Hollands, R. (1990) The Long Transition: Class, Culture and Youth Training. Basingstoke: Macmillan. Hollway, W. and Jefferson, T. (2000) Doing Qualitative Research Differently. London: SAGE. Honneth, A. (1995) The Struggle for Recognition: The Moral Grammar of Social Struggles. Cambridge: Polity. Institute for Fiscal Studies (2007) Poverty and Inequality in the UK: 2007. IFS Briefing Note, BN 73. London: Institute for Fiscal Studies. Jones, W. H. and Moore, T. L. (1989) Loneliness and Social Support, in M. Hojat and R. Crandall (eds) Loneliness, Theory, Research and Applications. London: SAGE.

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Townsend, P. and Davidson, N. (1988) The Black Report. Harmondsworth: Penguin. Turner, J. and Lloyd, D. (1999) The Stress Process and the Social Distribution of Depression, Journal of Health and Social Behaviour 40: 374404. Volkan, V. (1999) Bloodlines: From Ethnic Pride to Ethnic Terrorism. Boulder: Westview Press. Walkerdine, V., Lucey, H. and Melody, J. (2001) Growing Up Girl: Psychosocial Explorations of Gender and Class. Basingstoke: Palgrave. Wilkinson, R. G. (1996) Unhealthy Societies: The Afflictions of Inequality. London: Routledge. Williams, F. and Popay, J. (1999) Balancing Polarities: Developing a New Framework for Welfare Research, in F. Williams, J. Popay and A. Oakely (eds) Welfare Research: A Critical Review. London: UCL Press. Williams, R. (1977) Structures of Feeling, in Marxism & Literature. Cambridge: Cambridge University Press. Yar, M. (2008) And Every Cruelty Will Cloud It: On Love, Damaged Selfhood and Criminal Harm, Paper to ESRC Seminar Recognition as Love and Care, University of the West of England, January. Yeatman, A. (2007) Varieties of Individualism, pp. 4560 in C. Howard (ed.) Contested Individualization. Basingstoke: Palgrave Macmillan. Zizek, S. (1993) Tarrying with the Negative. Durham, NC: Duke University Press. Liz Frost is principal lecturer in the School of Health Community and Policy Studies at the University of the West of England. She teaches, researches and writes in the following areas: firstly, psychosocial studies, developing a curriculum and publication in psychosocial theory for social work (Frost, L. (2008) Why Teach Social Work Students Psychosocial Studies?, Social Work Education: The International Journal 27(3): 24361). Secondly, young people in consumer societies, producing work on appearance issues (Frost, L. Young Women and The Body, Palgrave, 2001) and on children in transition (Childhoods in Consumer Society: Psychosocial Approaches, Palgrave, forthcoming). Thirdly, European social work development, producing education/publication projects, e.g. Frost, E. and Freitas, M. J., eds Changing Social Work Education in Europe, Rome: Carroci, 2007. Address: Faculty of Health and Life Sciences, University of the West of England, Glenside Campus, Blackberry Hill, Bristol BS16 1DD, UK. email: Elizabeth.Frost@uwe.ac.uk

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Paul Hoggett is professor in the Centre for Psycho-social Studies at the University of the West of England. He started out as a community mental health worker in the 1970s and is now a trained and practising psychotherapist. His research in public and social policy stretches over 25 years and includes work on radical decentralization initiatives in the 1980s and critiques of public service modernization since the early 1990s. With Marj Mayo and Chris Miller he recently completed an ESRC (Economic and Social Research Council) project exploring how regeneration workers negotiate the ethical dilemmas of their jobs The Dilemmas of Development Work (Policy Press, 2008). He has a long-standing interest in applying insights about our affective life to political issues and his latest book in this area, Politics, Identity and Emotion (Paradigm Publishers) will be published in 2008.

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