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A comprehensive approach to “attitudes towards contingency” in liberal-individualistic societies : the case of mental health problems hindering autonomy

Final Report Summary - ATCMENTALHEATH (A comprehensive approach to “attitudes towards contingency” in liberal-individualistic societies : the case of mental health problems hindering autonomy)

What does it mean to live an autonomous life, especially when you are suffering from mental illness? The project focuses on contemporary “attitudes towards contingency” (ATC), i.e. the ways people make life go on, both on the operative and symbolical levels, after suffering from a disruption (e.g. a mental illness or a psychological distress). The project intends to address the ATC that are particular to the very specific context of the liberal-individualistic (LI) societies.
If the societies we are currently living in can be called “individualistic”, it is because the “individual” as a moral category has become the supreme value, where the “group” held that position in “holistic” societies. Consequently, the notion of autonomy (as the ability for a person to determine one’s own goals and way of life) has known a great success in different social spheres. In such societies, autonomy is a quality granted to almost every person. Consequently, an autonomous behavior is no longer something one can yearn for, but an expectation, a requisit that every human being has for themselves or for the others. Here is what characterizes societies in which autonomy has become a condition or a status: first, an unprecedented emphasis on efficient activity (one is expected to be active, to struggle, search for solutions, be one’s own entrepreneur, i.e. not to be passive or a victim), which corresponds to the valorization of the ability to “help oneself”. Second, the extremely frequent reference to one’s interiority (as a sanctuary located in each person’s innermost and considered as a resource for one’s identity and actions), which corresponds to the valorization of the ability to “be oneself”. Third, the importance of being correctly socialized (i.e. showing empathy, controlling ones’ emotions, etc.), which corresponds to the valorization of the ability to “be correctly affected” – somewhere between indifference and hypersensitivity. According to these characteristics, mental health has become an evaluator of paramount importance to assess the quality of an individual as well as that of their life.
Our hypothesis was that the practice of what we call the “rule of autonomy” in everyday life can be observed when people are confronted to a breach or a crisis (in the form of a more or less tragic event, a change in their routine, a vague unease, etc.) consequent to a contingency in their life. It is interesting then to observe what people do in such moments when disquiet has invaded the scene in order to overcome misfortune, evil or injustice, both on a symbolical and operative level.
Therefore, the project focused empirically on the mental health field, which is currently undergoing profound modifications, a characteristic that makes it a extremely salient analyzer of this new social context, with as question : “Which kinds of ATC do mentally diseased or psychologically distressed people resort to in societies where autonomy is a requisit?”.
Having obtained the necessary ethical clearances, the project implied fieldwork in two psychiatric institutions in France and Belgium, with no less than 6 months of observations of everyday life, and 50 interviews with people suffering from mental illness.
This material helps understanding how mentally diseased and psychologically distressed people make use of and entangle different language games in order to gain symbolic and operative resources to allow life to go on after a disruption. In the same way, they summon different entities in an attempt to explain what is happening to them (i.e. the brain, their childhood, more enchanted entities, etc.). The different configurations produce various ATC, which though being diverse all put the emphasis on an autonomous behavior as was sketched above. Asking the service users about the way they imagine what their future life made it clear that - In this social and normative environment, people suffering from mental health distress/illness assess their recovery not (only) in view of the disappearance of their trouble, but (also) considering their ability to gain back some symbolic and operative abilities that enable them to lead what is considered as an autonomous life. More generally, this research showed on the one hand how mental health problems are evoked in the light of how they jeopardize the three abilities (being oneself, being active and being correctly socialized) that are highlighted in a society where autonomy is a condition, and, on the other hand, how nowadays a line is symbolically drawn between “good” diseased people who deserve recovering and “bad” diseased people, whose behavior doesn’t fit the prestigious characteristics of ATC.
The project led to several scientific and generalist publications (books, papers), talks and press interviews. An international symposium “Normal or ordinary, achieved or autonomous? Life and the various forms it can take for people suffering from a chronic mental disorder, in and after psychiatry » at Université Saint-Louis (Brussels), September 8, 9 and 10, 2016. All the information are here :
The results of the project are not only groundbreaking for the sociology of mental health, but also prove particularly interesting for mental health experts and practitioners, as well as for people suffering from mental illness themselves.

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