Which is worse – the experience or the stigma of mental illness?

According to Beyond Blue, it is estimated that in 1 year, 1 million Australian adults will experience depression and 2 million will experience anxiety; that 45% of Australians will experience mental health problem in their lifetime; that; and that 1 in 4 women and 1 in 6 men will experience depression.

However, anxiety, depression and sadness are only some of the difficult (or what I would call primary) emotions associated with mental illness. Those who experience it also have to deal with the stigma associated with mental illness, and with a range of secondary emotions associated – disgust, embarrassment, guilt and shame – associated with the experience of stigma. Erving Goffman described stigma as a discrepancy between a virtual and an actual social identity, where a person is “reduced in our minds from a whole and usual person to a tainted, discounted one.” Whether at work, home, school or in public, having to hide one’s condition – or suffer the indignity of being treated as a ‘tainted’ person – only compounds the difficult emotional experience of managing a mental illness.

Kathy Charmaz provides a critical sociological perspective to the problem, in arguing that our society sets up standards of normal health – a ‘core’ of healthy images and spaces – and expects people to either commit to a clear core (be consistently healthy) or accept a marginalized position outside of this (with an internalized, stigmatized, and shameful identity), but not to ‘pretend’ health or ‘exaggerate’ one’s illness, as those with mental illness are often suspect of doing. Gillian Bendelow notes that the great rise in pharmacological treatments over previous decades and that the use of anti-depressants is seen as the more socially conventional and acceptable approach to the ‘treatment’ of mental illness. Evidence of this can be seen in the fact that Australia now ranks second in the world in anti-depressant prescriptions.

Are more anti-depressants the solution? Davey and Chan (2012) challenge their effectiveness, and suggest that they should be increasingly used only in combination with psychotherapeutic approaches. However, this approach still individualises the problem, and does little to look at the social conditions and the stigma that compounds the experience of mental illness. Perhaps its time to move the focus away from the ‘core’ and towards the periphery, and do more to end the stigma associated with mental illness, anxiety and depression?

#S327UOW16 #Tut11

Do we improve mental health through more services, or restructuring our work, cities and social connections?

There has been intense investment in mental health resources and treatments over the last few decades in Australia. This includes the establishment of initiatives such as the Black Dog Institute, the headspace National Youth Mental Health Initiative (a good program, which I helped evaluate), and recently a multi-sector initiative aimed at ‘Creating Mentally health Workplaces’.

Despite these efforts, however, the expenditure on and costs of mental health issues continue to rise, and the prevalence of anxiety issues in our society remains high. Anthony Jorm, at the University of Melbourne, estimates that around 15% of Australians suffer from an anxiety disorder, but many Australians don’t understand these issues, can’t recognise the symptoms, and tend to dismiss them as ‘everyday worries’. This serves both to downplay the severity and impact of anxiety issues on the national psyche, but also – importantly – obscure the social basis to such emotions. A similar story applies to the experience of loneliness. As Adrian Franklin finds, loneliness is endemic in Australia.

There are numerous sociological explanations behind ingrained, or rising, anxiety and loneliness in our society. Certain groups are at greater risk of loneliness than others – older men for example – but sociologists such as Anthony Giddens and Zigmund Bauman point out the atomising affect of late modernity, where human relations become more individualised, and we become less invested in keeping our groups and connections together. And we are not helped by the way we structure our modern lives. Work is increasingly temporary and fractious, sending us off to all sorts of places, to work all sorts of hours, with increasing precarity. Our cities continue to sprawl into suburban ‘exopolises’, lacking natural social centres within which people can connect and socialise. And our media changes, becoming supposedly more ‘social’, but with uncertain consequences in terms of the exact impact it has on our face-to-face interaction.

The exact alchemy of factors that entrench anxiety and loneliness in modern society is unclear. However, the need to examine these factors sociologically is paramount. Do we need more expenditure on mental health services? Or is this just a Band-Aid solution? Do we instead need to examine, recognise, and cost options for making deeper, structural changes to our social, urban and media environments that impact our sense of sociability and security, and our feelings of anxiety, isolation and loneliness?

#S327UOW16 #Tut10

Managing emotions – how, when, and whose?

We all know what its like to feel the wrong thing at the wrong time. Boredom when you’re meant to be interested (or at least look interested) in that lecture, anxiety when you’re meant to be happy with friends, tiredness when you’re playing with children, and frustration and stress at work. We all know what it means to feel the wrong thing, and then have to pretend – or display – a different feeling, or even somehow make ourselves feel something altogether different. We call this ‘emotion management.’

But how do we manage our emotions? When should we manage them? Should we always try to think happy thoughts – is sadness just bad and troublesome? Or are there social rules about how and when we should do this? Arlie Hochschild suggests that society has ‘feeling rules’ about how we are allowed to feel in given situations – particularly at work – and that these rules impact differently on men and women, with women still doing the bulk of the ‘emotional labour’ involved in care jobs in most countries.

Do you manage your emotions most of the time at work? Or in other areas of life? Does your gender affect this?

#S327UOW16 #Tut6

What do we feel when we do ‘bad’ things?

Why do people do ‘bad’ things? Is it because they feel bad – or because those bad things feel good? It’s not hard to find instances of terrible, scary things in popular media – youth gone wild, health epidemics, crime waves, etc. Sometimes these are beat-ups and moral panics; and sometimes they are more common than we think, or even unbelievably real. Nasty incidents of online trolling and attacks are commonplace, and mass gatherings channeling anger and even hatred occurred as recently as just over ten years ago Australia in the form of the Cronulla Riots.

But why do these things happen? What are the emotions that drive these acts? There can be a simple thrill or joy in doing the wrong thing – what Jack Katz calls the ‘seductions of crime’ – that tricks and compels some people into committing anti-social acts, but are these secretive, individualized compulsions not shaped by how we relate – or fail to relate authentically – to the people around us? Do we not deviate because we feel (and often hide) a sense of deviance, and maybe even shame? Is it shame and fear of the challenge to identities – to conventional masculine dominance, or the threat of job loss from globalization – that compels some young men to anger and violence, as Ghassan Hage has argued occurred on Cronulla Beach eleven years ago? How do all these feeling mix and feed off each other – fear, shame, repression, thrills, and anger – in the dynamics of deviance?

#S327UOW16 #Tut9

How much would you change your body to ‘look better’?

Have you ever wanted to change how you look? Perhaps you’ve admired the way someone else looks – or the way certain types of people in general can look – and it’s something you want to try, or experiment with? Not just in terms of how you dress, but how you might alter your body? For example, a lot of people exercise and work out to make their bodies look and feel healthier, and some argue that tattoos and piercings help people express difficult individual feelings in a uniquely public way. Some people undertake cosmetic surgery in order look different – younger, slimmer, tighter, bigger, or just to adjust certain features of face or body – so they can feel ‘more like the person they were always meant to be’. For them, body modification is an expression of individuality and authenticity.

However, an important question is just how unique are these looks and feelings to us as individuals? Do we work out, tattoo, pierce, or undergo surgery to look more like our real, genuine selves? Or to look more like how we think others want us to look – and will admire us for looking – which often makes us look like everyone else?

Admiration is not the only emotional motive for changing our bodies. Many of us worry about the way our bodies look. Sometimes we feel pressure and anxiety to fit in and look ‘good enough’, and sometimes we might even be driven to copy or look better than someone else through a sense of low status or envy. Gordon Clanton argues that if you find yourself “thinking the other does not deserve the good fortune or wishing that the other would lose his or her advantage or otherwise suffer, that is a measure of your envy”. Have you ever thought that someone you know has it too easy because they are just lucky enough to be good-looking? If you told someone else about your feeling of envy, what would be the most likely response – would they agree, would they tell you off for being ‘too envious,’ or would they encourage to ‘embrace your envy,’ and work harder to look better? Cas Wouters argues that as a society we are becoming increasingly competitive over status, and the management of emotions is a key part of this. Do we modify our bodies to manage our envy?

These ideas raise important sociological questions. Is envy a useful driver towards seeking the higher status that comes with ‘looking better’? Do modified bodies bring us the joy of authenticity, or the thrill of elevated social status (and the relief of reduced envy?) Is there a body-industry out there helping us to conflate authenticity and status? How much is society, the media, and the body-industry telling us – and selling us on – how to look? And how to treat others based on how they look?

#S327UOW16 #Tut8

‘Late Modern’ Love and the Transformation of Intimacy

Isn’t it nice to be in love? Isn’t the feeling of love wonderful? But wait – are we talking about the enticing, heart-pounding, sexualised passionate form of love, or the steady-as-she goes companionate form of love we feel for friends, families and partners we’ve known a long time? Or are we talking about something else? Should love be overwhelming or considered? Perhaps it depends on our social context.

The experience and structures of love and intimacy in society have changed over time. Love in the Victorian Era involved published etiquette-based rules of courtship, and considerations of many things besides how one simply felt – there was one’s gender, class, finances, and the social respectability that came with marriage and family to keep in mind. Moving into contemporary times, Anthony Giddens describes the ‘transformation of intimacy’ in the later 20th century ‘late modern’ period, which continues today. We have so much more independence now from the constraints of traditional family and gender roles, that we can (and do) seek love and the ‘pure relationship’ in any number of forms. And Eva Illouz argues that this has created a society of commitment shy people – men in particular – and new inequalities in gender and intimacy.

What do you think? Has love changed? Is ‘all fair’ in love and sex these days?

#S327UOW16 #Tut5

How many emotions are there? Is our society building new, complex emotions?

When was the last time you felt something ambiguous? A feeling that you couldn’t name? Was it perhaps a mixture of two, three, or many other more familiar emotions? Are there basic emotions that everyone feels and understands? The evidence seems to suggest that there are at least four to six universal basic emotions, based on Paul Ekman’s analysis of facial expressions across cultures. These have a genetic basis, and are experienced by all humans. The great majority of emotions seem to be more complex amalgams of these basic emotions. Indeed, in 1980, the psychologist Robert Plutchik developed a fascinating ‘colour wheel’ of emotions to depict the various possible combinations and intensities of basic emotions and their resulting ‘complex emotions’.

However, many of the psychological studies into basic and complex emotions do not account for the inherently social way in which emotions are combined and experienced. Norbet Elias’ Civilizing Process, and Michel Foucault’s studies of discipline and punishment (compounded in the construction of Jermeny Bentham’s famous Panopticon as a vehicle for moral reform) are historical examples of how society engenders complex, socially constituted emotions such as shame and guilt to maintain social order and police the boundaries of class and status. Think about how the modern institutions of society – work, family, church, government, market, media, social networks – shape and assemble your emotions in ever more complex forms.

Reflect on your feelings right now. Are they basic or complex? Individual or social?

#S327UOW16 #Tut3

Can we change society? Do we have ‘social agency’?

So how do we change things? Our lives and our society? We learnt last week how there are social structures all around us, determining so much of what we do. How can we resist them, or change them? Don’t we have agency? Sure we do. Classic interactionist sociologists such as Peter Berger and Thomas Luckman, or dramaturgists such as Erving Goffman helped us understand that social life is improvised. We aren’t robots. Our lives aren’t totally determined by the big ‘social structures’ in our lives – gender, class, race etc. We joke, and laugh, and burp, and dance; we start music subcultures or pop-up cafes in old factories, carparks, or online; we cross-dress and come out as gay politicians and church ministers; we run marathons at 60, 70 and 80, or ski with a disability; we successfully manage companies as women and successfully raise children as men, we drop out of the capitalist market and make and swap our own clothes and food;we buy ethical products, and we build amazing tiny houses because the big ones have become too expensive. We improvise and play around every time we interact with others, and this gives us agency. We can change ourselves. We can change others. We can change society.

But it takes time.

Our interactions can free us, but they can also reinforce what is already there. The French sociologist Pierre Bourdieu observed that even our improvised habits are structured by society, and form a system of conscious and unconscious prescribed actions he called a habitus. How to say hello, whether to burp, or when to observe the etiquette of sitting at a table or driving a car; we collectively shape, reinforce and build these habitus through repeated interactions with each other. They eventually become the norms and even institutions (or structures) of our society. However, Bourdieu stresses the collectively improvised origins of these structures means that they are always at least a little bit flexible, and they can change over time.

It’s like a river flowing through a desert. A billion water droplets have no choice but to flow through the pre-existing path of the riverbed. However, over time, some of those droplets will spill this way and that, carve out new rivulets and channels, and eventually change the entire path of the river altogether. We can change society, and help each others to change it, a little bit every day – but only a little bit.

And it is important that we think and reflect on what we do. Unlike water, we have the capacity to be aware of where we flow as a human river, and to try and alter the path deliberately, adjusting for the influences and fluctuations in the social structures around us. The British sociologist Anthony Giddens describes this as reflexivity, or taking account of how society affects us in trying to change it (and ourselves), rather than ignoring or disregarding its influence. He is optimistic that this gives us the greatest agency in leading our lives and changing society.

What do you think? How much agency do you have? Can you change yourself? Can you change society?

#S103UOW16 #Tut4

Is mind superior to body and emotion?

We have long conceived of a separation between mind and body in western society, with supremacy of mind over body. This basic idea that reason should dominate is captured in the classic statement by Descartes ‘cogito ergo sum’, ‘I think, therefore I am’. However, if your thoughts are affected by your bodily feelings, or even your perceptions of how the society around you sees you, then what are you? What are your thoughts? Are they really separate from your body and your feelings? And do we have a better understanding of the relationship between reason and emotion as a society today? Compare Disney’s take on the role of emotions in human action in 1943 and in 2015 (and note that the producers of the 2015 ‘Inside Out’ film considered including ‘logic’ as an emotion, but later decided to drop it). Which of these depictions makes more sense to you?

#S327UOW16 #Tut2

How do you rate your chances of a good life in this society?

How do you rate your chances of a good life in this society? You might think that you can do anything in life if you work hard enough, and there’s a good chance that you can (you made it to university after all!) However, have you considered how the structures of our society might enable or constrain your chances? Or those of the people around you? Social structures include norms of culture, gender, race, class, ethnicity, age; policies and legal frameworks; and the operation of big, bureaucratic institutions like the government and corporations, and big systems like global political, financial, and technological systems and networks. We call these things structures because they are quite solid (they persist over time), they work in fairly systematic (structured) ways, and because they ‘structure’ our lives. They constrain what we can do, and they shape who we become.

Take a few examples. In Australia, the way that family, care and work life is structured means that full-time working women on average earn 17.9% (or $284 per week) less than similar men, and the way that indigenous health, education, housing and government support are structured mean that even in 2015, non-indigenous people are likely to live ten years longer than indigenous people. Internationally, the way colonial history and modern global finance are structured mean that the richest 1% of people in the world receive 14% of its income, while the poorest 20% receive 1% of its income. This is not just a failure of government policy. Social structures incorporate social, cultural, political and economic aspects that entrench inequalities over time and space.

The recent best-selling ‘Capital in the Twenty First Century’ by Thomas Pickety argues that rising inequality both between and within countries is inevitable in modern capitalist society. Labor MP and former Economics Professor Andrew Leigh points out that Australia has certainly seen inequality rising again, after falling in the post-war period, and research released last week by UOW economists shows that inter-generational mobility in Australia is not nearly as good as we thought it was. Inequality and the division between rich and poor seems to be a core structural feature of modern societies and economies – something pointed out by Karl Marx over 150 years ago – and it means that you are likely to prosper more quickly if you are born with resources, and less quickly (or not at all) if you are not.

So how will these social structures affect you? How will they affect others? What can you do as an individual to change them? What can we do together, collectively, to change them? Can we shape the structures of our society to serve us instead of the market, or instead of the entrenched interests of the powers that be?

#S103UOW16 #Tut2