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ISBN-13: | 9780520950481 |
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Publisher: | University of California Press |
Publication date: | 10/03/2011 |
Sold by: | Barnes & Noble |
Format: | eBook |
Pages: | 352 |
File size: | 2 MB |
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Humanitarian Reason
A Moral History of the Present
By Didier Fassin, Rachel Gomme
UNIVERSITY OF CALIFORNIA PRESS
Copyright © 2012 The Regents of the University of CaliforniaAll rights reserved.
ISBN: 978-0-520-95048-1
CHAPTER 1
Suffering Unveiled
Listening to the Excluded and the Marginalized
Efforts to reduce suffering have habitually focused on control and repair of individual bodies. The social origins of suffering and distress, including poverty and discrimination, even if fleetingly recognized, are set aside. MARGARET LOCK, Displacing Suffering
The 1995 presidential election campaign in France was dominated by the theme of "social fracture." In a context where unemployment had finally come to be recognized as a structural fact of French society rather than a temporary result of a particular set of economic conditions, as it had long been held to be, a gnawing anxiety had developed around what was termed, during the 1980s, "new poverty," and from 1990 onward, "social exclusion." During this period when sociologists asserted that society was no longer organized as a vertical hierarchy but rather divided with an inside and an outside, the idea that the old inequalities between classes had been replaced by a new and radical social line between included and excluded appeared attractive to many politicians, researchers, intellectuals, and journalists. Jacques Chirac made it the leitmotif of his campaign for the presidency, declaring, in a foundational speech on February 17, 1995: "Economic certainty and a secure tomorrow are now privileges. The young people of France are expressing their helplessness. There is a deepening social fracture, the burden of which is being borne by the nation as a whole." Many commentators saw this strategic choice as key to Chirac's victory, which was, it has to be said, unexpected, since he appeared to be trapped between two other candidates, one Conservative and one Socialist, who left him little ideological space: his success was therefore interpreted as the result of a skillful rightwing candidate campaigning on what was generally seen as a left-wing issue. Following his election, the new president kept his promises, at least nominally: the government formed by his prime minister Alain Juppé included, in addition to the traditional Ministry of Labor and Social Affairs and the by now customary Department for Emergency Humanitarian Action, a Ministry for Social Integration and against Exclusion, and a Department for Housing Projects, renamed "neighborhoods in difficulty." The most innovative measure, introduced after a cabinet reshuffle, was the establishment of support centers, which received the remarkable label lieux d'écoute (literally: places for listening). A number of reports had highlighted the new phenomenon of "psychic suffering," particularly among teenagers and young adults, whom these facilities, offering welcome and a listening ear, were intended to serve. A preliminary circular appeared on June 14, 1996: it instituted "reception centers for youth aged between 10 and 25" and aimed to "respond to teenagers' distress." It is worth noting that it was signed by both the minister for labor and social affairs, Jacques Barrot, and the secretary for emergency humanitarian action, Xavier Emmanuelli; the involvement of the latter was thus set within the context of an at least partial reorientation of the missions of the major humanitarian organizations from international causes toward the disadvantaged within French society. A second circular was published on April 10, 1997: this one related more explicitly to "listening facilities for young people and/or their parents" and sought to meet "their need to express their problems"; it was signed by the minister for urban planning and social integration, Jean-Claude Gaudin, and the secretary for urban integration, Eric Raoult; it was something of a surprise to see the latter's name at the bottom of this document as he was better known for his harsh discourses on public order issues. Thus the new support centers were the result of an unprecedented coupling of humanitarian and security concerns.
In the months that followed, these facilities proliferated throughout France. One of them, in a town of Seine-Saint-Denis—a département (that is, administrative territory) known to be especially hard hit by economic difficulties, but with a high level of social and political engagement—was led by a psychiatrist with a team of psychologists. The municipal administration had wanted the team to be based in a cité (housing project), but the mental health professionals, fearful at the prospect of spending their working days among a population with which they were not familiar, had argued for what they euphemistically called a "neutral setting." They had therefore taken possession of an elegant building in one of the town's old neighborhoods. They gained in peace of mind, but certainly lost some of their most disadvantaged clientele. Yet the activity report they submitted to their board of management suggested that the situation was worrying:
Faced with the climate of insecurity and anxiety generated by the lack of stability in work, training and family, young people with no reference points form a vulnerable group. The explosion of violence and crime among youth, and the increasingly young age of those involved, result in teenagers becoming stigmatized and provoke mistrust and even fear. How do we establish a link with these young people who, even when they are experiencing psychic suffering, cannot formulate a plea for help?
This alarming observation thus confirmed the politicians' analysis: the combination of instability and insecurity generated both the suffering that translated into violence among young people and the mistrust that developed into fear among adults, a vicious circle for which the listening center was the solution.
The picture presented in the facility itself was very different. Teenagers sped there enthusiastically after school for a snack before settling in small groups to play Monopoly or hang out in the IT room. There were certainly arguments and sometimes fights, but little more than one would expect on a school playground. Looking at these adolescents, it was difficult to recognize suffering, even disguised as violence. But as we have seen in the excerpt, the psychologists had a ready answer to this objection: the suffering was usually invisible to the inexperienced eye of nonspecialists; teenagers' failure to express it simply became a confirmation of its existence. Yet the statistics of the center indicated that only 6% of the youths had been referred by psychiatric services, 6% by child protection services, and 5% by education services, while at least 80% came of their own volition and often with pleasure. This did not prevent the psyche experts from imagining that they had "major problems," thus revealing much more of their ignorance of this environment, socially so distant from their own, than the after all fairly ordinary reality of the schoolchildren: "When you arrive here, it feels like another planet," admitted one of the support workers, unfamiliar with the verbal and corporeal expressions of these teenagers. But over and above this gap between psychologists belonging to the Parisian upper middle classes and the adolescents of immigrant descent from the disadvantaged neighborhoods of Seine-Saint-Denis, what interests me here is the form of government that translates social inequalities in terms of psychic suffering and proposes listening to the distress of working-class people as a response to their social difficulties.
Toward the end of the twentieth century a new language emerged in France to describe social problems, their effects on individuals, and the possible solutions for them. The problems were related to exclusion, the effects were interpreted in terms of suffering, and the solutions put forward revolved around the activity of listening. We could describe a set of notions that are constructed together and complement one another in order to account for a social reality, as a semantic configuration. "Exclusion," "suffering," and "listening" constitute just such a semantic configuration for the 1990s, one which we might qualify as compassion based. These notions make it possible to articulate what sociologists have called a "new social question"—that is, both what causes "the social" to exist as a problem, between economics and politics, and how it is constituted as an "issue" through a problematization that is specific to a moment in history. Every historical period can be characterized by the semantic configuration that best expresses the way the social question is understood at that moment: in the 1970s, for example, the problem, its consequence, and its solution were articulated respectively in terms of "maladjustment," "poverty," and "integration," in a context where the great political themes that are familiar to us today, such as unemployment, immigration, and insecurity, were yet to be fully formulated. But in any given period, a number of semantic configurations may develop in parallel, finding resources in different spaces and sometimes even competing to become established as the legitimate definition of the social question. Thus in the 1990s a set of ideas constituted around "housing projects," "urban insecurity," and "zero tolerance" gradually emerged until at the beginning of the following decade this new semantic configuration, which can be described as security focused, became overwhelming during the subsequent decade. It is therefore essential to consider these commonplaces that characterize a period as fluid and dynamic networks.
But a semantic configuration does not appear out of nowhere. It originates in a specific social world—professional, institutional, cultural—which at a given moment becomes to some extent recognized as an authorized describer of social facts and a competent provider of social responses. In France during the 1990s, the field of mental health played this role. It found the words to articulate social disarray. Society, or at least major elements within it that were involved in addressing the new economic realities, from government officials to social workers in poor neighborhoods, adopted the vocabulary of mental health to implement policies around inequality and deviance, poverty and crime—issues that were now seen more in terms of exclusion and suffering that called for assistance and listening. In emphasizing this development, I am not suggesting that the traditional tools of the state were dismissed: welfare services were maintained and sometimes expanded, technologies of repression were used and even refined, but other responses also appeared, responses to which psychiatrists and psychologists contributed their theoretical and practical tools, which proved all the more efficacious because the ground had been prepared for them by the social sciences, various politicians, and the media. What I am attempting to grasp here is the social innovation introduced in and by the world of mental health, understood both as a body of professionals and as a body of knowledge. The analyses frequently advanced that see this phenomenon in terms of psychologization, or even psychiatrization, of the social give only a very partial account of it. Once we go beyond official statements to examine discourses and practices as implemented in national and local policies, particularly the policy promoting these listening centers, we find that rather than a unilateral determination of direction and emphasis, what we are witnessing is a crystallization of representations and ideas around a series of words and notions.
THE EMBODIMENT OF THE SOCIAL
On October 15, 1999, in a fringe meeting at the Sixth Bayeux International Festival of War Correspondents and Photographers, a French journalist, commenting on changes in the market for reports and images that relate and illustrate the world's events, observed: "I think we have gone beyond the stage where it had to be bodies and blood. What is required today is suffering—particularly the suffering of women and children, because it moves and mobilizes people more easily." The host of the radio program Pot-au-feu, interviewing this journalist for the France Culture channel, commented soberly: "The Pietà rather than the Crucifixion, then." A striking formulation indeed. This shift was starkly illustrated by the controversy around the tragic photograph of the desperate Algerian mother who, on the morning of September 23, 1997, learned that her eight children had been massacred the day before in Benthala, along with four hundred other people. What the global press published on their front pages about the slaughter was not the image of the lifeless or mutilated bodies of the victims, but the representation of this woman's pain. Thus the reader became a spectator of suffering rather than of violence, and the emotion to be felt was compassion rather than terror.
But suffering was not only portrayed in pictures, it was also put into words. By the end of the 1990s it had become ubiquitous in the world of work. A magazine, reporting on the proliferation of protest movements, ran the headline: "Suffering Comes Out onto the Streets." A sociologist, Danièle Linhart, explained: "Social workers and occupational physicians stress how badly people who work are doing in many sectors. Before, colleagues used to pass on union cards; now they exchange antidepressants." She went on to deplore this development: "There is more talk about suffering, but it is still often expressed in individual terms.... Listening to one another, sympathizing with one another's troubles, identifying with their suffering is one thing. The issue is in coming back to a collective focus." Social relations in industry and changes in the organization of production were increasingly described in the vocabulary of psychopathology. "Changes in Working Conditions Generate New Kinds of Suffering" ran the headline in one national daily newspaper, above a long article commemorating the centenary of the law on accidents at work that quoted a number of psychoanalysts and psychologists at length. Their account was unequivocal, summed up by Damien Cru, a specialist in occupational psychopathology: "Previously, suffering was confined to the workers, and they kept quiet about it. Now these phenomena affect all professional categories, including managers and researchers." In other words, whereas previously the worker was championed, now everyone in the world of work, even the most privileged, was pitied. Above all, what was previously stated in terms of economic exploitation was now expressed in the vocabulary of mental health. Where before trade unionists condemned the conditions in which professional activity was exercised, now the occupational physician cared for psychic distress. Of course, this development should not be overstated, as the earlier language was not entirely replaced by the newer, but almost more significantly and somewhat ironically, the discourse of protest began to find its most effective resources in the lexicon of suffering.
Moreover, suffering was starting to become contagious. In other words, people were affected not only through their own situation but also because they were faced with the condition of others. Empathy itself was becoming pathogenic. This contagion could be direct, in face-to-face encounters with the person suffering, or indirect, via the mediation of images or words that expressed suffering. In the first case, health care and social welfare professionals were obviously the most at risk. The Society for Therapeutic Training of General Practitioners, for example, introduced a program for doctors on "the limits of care or compassion." The organizers asked "why the suffering of health professionals is so disregarded," and invited public authorities to "instigate assessments for stress, not just skills." To help participantsrecognize"thedoctor'ssuffering"theydistributedaself-assessment questionnaire among the group, the "Malasch burn-out inventory," helping them to establish whether they were indeed affected by "professional exhaustion" or even "depersonalization." Indirect contagion seemed particularly to put television viewers to the test. A study by the Public Debate Observatory on the reception of news as distilled on television each evening and watched by an average of twenty-three million individuals revealed that "French people experience their television news as suffering." According to the director of this marketing research organization, "Watching a television news broadcast is a psychological and physical ordeal that produces a sort of vertigo, deriving from both quantity and diversity, which becomes a source of anxiety." The editorial work of the presenters is then to act as "psychological counterweight," helping to "attenuate the disaster"; through their commentary, which "reassures even as the images raise anxiety," they "make it possible for the viewer to stay present with all this horror." Instead of Hannah Arendt's opposition between compassion with those close to one and pity felt at a distance, here we have a form of generalized closeness to suffering that allows empathy to be expressed almost identically whether one is face to face with the person or thousands of miles away.
(Continues...)
Excerpted from Humanitarian Reason by Didier Fassin, Rachel Gomme. Copyright © 2012 The Regents of the University of California. Excerpted by permission of UNIVERSITY OF CALIFORNIA PRESS.
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Table of Contents
Preface to the English EditionAcknowledgments
Introduction: Humanitarian Government
PART I. POLITICS part
1. Suffering Unveiled
Listening to the Excluded and the Marginalized
2. Pathetic Choice
Exposing the Misery of the Poor
3. Compassion Protocol
Legalizing Diseased Undocumented Immigrants
4. Truth Ordeal
Attesting Violence for Asylum Seekers
LIMEN. FONTIERS
5. Ambivalent Hospitality
Governing the Unwanted
PART II. WORLDS
6. Massacre of the Innocents
Representing Childhood in the Age of Aids
7. Desire for Exception
Managing Disaster Victims
8. Subjectivity without Subjects
Reinventing the Figure of the Witness
9. Hierarchies of Humanity
Intervening in International Conflicts
Conclusion: Critique of Humanitarian Reason
Chronology
Notes
Glossary
Bibliography
Index
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