Enclosing the 'psyCommons'
A good way of thinking about how we currently understand psychological healing is to start with the idea of a ‘therapeutic culture’. Furedi suggests that recent history in the West has seen a ‘therapeutic turn’ that has encouraged victims of past wrongs to frame their claims within the language of psychology.4 We now live in a therapeutic culture that is so powerful that it provides the coordinates that we use to make sense, not only of our distress and the distress of others, but also of our day-to-day experiences in the world. He suggests that it disposes many to interpret emotional problems through the disease metaphor and means that distressed people and their loved ones come to regard themselves as objects of passivity to be fixed and changed rather than as subjects of their destiny.4 If this is the case, how has this come to pass?
Exploring this requires us to reflect on the idea of ‘the commons’. The commons is the great variety of natural, physical, social, intellectual and cultural resources that make our everyday survival possible.5 They are assemblages, groups and ensembles of resources that human beings hold in common and that we draw upon for our everyday living. The social commons is often organised around access by users to social resources created by specific kinds of human labour. Caring for the sick and educating children are examples of social commons, and all polities have some variety of social commons. Many social resources, as commons, are organised around family, kin and local affiliations. However, what can be understood as ‘common resources’ is also fiercely contested. There are conflicts not only about control of common material resources but also for control of the cultural meanings. Here common property can be distinguished from state or private property.
Denis Postle has discussed the ‘psyCommons’ as the universe of rapport and relationships between people that we draw from to navigate through our daily lives.6 It describes the beliefs, preconceptions and the learning and experience that we all use routinely when we interact with other people. The psyCommons is a living, growing multitude, a rich ecology of negotiations, conversations, meetings with family, friends and co-workers—the myriad conversations of 60 million people in the UK. Herein lies a rich source of ordinary wisdom, insights and understandings on a whole range of ‘issues of living’, from growing up, to caring for people to supporting neighbours in difficulty, and together they make up this psyCommons, the rich stock of psychological knowledge to which people have access.
One of the messages in this book is that the psyCommons, like many other forms of commons, has been encroached upon and enclosed. In this case, largely by the psy professions of psychiatry, psychology, counselling and psychoanalysis. These professional institutions have, through their privileged discourses, legitimising systems of professionalisation, and forms of evidence, fenced off and claimed ownership of an increasing proportion of the psyCommons. They have extracted value from them through developing services and charging for them. Indeed the pursuit of privileged status through professionalisation has protected and strengthened these enclosures.
While distress is a very real and embodied state, the social category ‘mental illness’ is a product of the professional psychological enclosures that are reproduced through the 200,000 psy practitioners in the UK who engage in the practice of enclosing ordinary wisdom. This can be framed through the commons lens as a systematic encroachment where dominant cultural narratives are established that extend the psy terrain that ‘belongs’ to psy experts. These boundaries and limitations of conduct are constantly negotiated and renegotiated through time and within cultures. The right of some sections of society to use a given resource can be revoked as the resource is removed into the realms of a given professional practice. Through this perspective, therapy can be understood as the enclosure and formalisation of empathy and positive regard towards those experiencing distress. The assumption from within the enclosing institution would be that such enclosure practices would lead to greater outcomes for those now understood as clients. However, evidence, even the kind of evidence that Psy researchers and policy makers draw on, to support this assertion is equivocal.7,8
We would contend that many of the inherent problems of the psy institutions touched upon in the previous chapter—both in the making of embodied experiences of psychosocial distress into disorders and in the formalisation of treatments for these disorders—are driven by, and indeed drive and sustain, these practices of professional enclosure.
One of the major casualties of the activities, technologies and enclosures of the traditional psy disciplines has been our collective responsibility and capacity to heal and support ourselves and others simply as human beings. The psy disciplines have, in the process of privileging professional understandings of distress, potentially facilitated a corrosion of the dignity of ‘lay’ human selfhood 9 where human beings in the West no longer have any sense of public agency in the understanding and amelioration of their distress. The exclusion of non-professionals from the care of the hurt or sick has resulted in new demands for medical services, and it has become almost impossible for non-professional people to be officially understood as having expertise in psychological care.10
The dominance of psychiatric enclosures has meant that psychiatric remarks have become the preserve of the traditional psy professions despite ‘ordinary people having perfectly sufficient descriptions of themselves’.9 Instead, actively constituted subjects (people) come to know themselves through the potentially problematic diagnoses reproduced and regulated by traditional psy practitioners. The dominant cultural narrative around distress has it that these necessary practices have enabled processes of recovery for people and their families who are experiencing the most pronounced suffering. For some service users and their loved ones, this is undoubtedly how they have been experienced. However, this has led in many cases to the removal of people from socially valued sources of support.11 Furthermore, there has been a diminution of support networks in the community that work to prevent the existence and escalation of crises, and that hold people until de-escalation without medication or violence.12
For some, this casualty of our collective commons is simply too much and they question whether the profession of medicine has any legitimate role at all to play in human misery.13 In this chapter we wish to explore the ways in which new vocabularies of helping, often divested of much (although not all) of the emotion talk enclosed by psy institutions, operate around the fringe of these enclosures and have considerable impacts on people’s distress. We explore the informal landscapes, settings and spaces that exist to some degree beyond the psy enclosures. Only to a degree because psy discourse on emotions and therapy is so all-pervasive in the twenty-first century that one would have to have lived under the ocean to truly escape it.
In such settings and spaces it is quite possible for distress and suffering to be understood as everyday artefacts of modern life that do not require institutions of expertise to legitimate certain states of being at the expense of others. Moreover, they often require no central reliance on a system of pharmaceutical treatments or therapeutic techniques to radically alter the way that distressed people feel and think about the world. Such settings do not share with the dominant discourses of the psy sciences the requirement for people feeling distressed to be categorised and subject to the symbolic and material practices of othering that mental health service users often experience and that can reinforce discrimination, marginalisation and stigma.9 To make sense of these settings requires a focus not on the therapeutic but on the helpful.