Introduction
the commandment to ‘be happy’ amounts to a form of insidious social control, in which we are encouraged to look inwards (and to blame ourselves) for the causes of our trouble. (Moloney, Reference Moloney2006: 27)
Social commentators and policymakers in the UK and elsewhere have, in recent times, resurrected an interest in the concept of ‘wellbeing’ (Furedi, Reference Furedi2004; Layard, Reference Layard2005; Sointu, Reference Sointu2005, Reference Sointu2006a).Footnote 1 For many, this refers to the recognition that economic growth and prosperity in advanced industrialised nations has not necessarily brought greater happiness or life satisfaction, and that a key focus for government should be to promote the wellbeing of citizens so that they are, in the words of the New Economics Foundation's (NEF) Manifesto for Well-Being, ‘happy, healthy, capable and engaged’ (NEF, 2004: 2; also, see Marks and Shah, Reference Marks, Shah, Huppert, Baylis and Keverne2005). On this basis, there has been a flurry of analyses of ‘what we know’ about wellbeing and quality of life, witnessed in policy think pieces from the Prime Minister's Strategy Unit through to government commitments to develop wellbeing indicators (see, for example, Donovan and Halpern, Reference Donovan and Halpern2002; Marks and Shah, Reference Marks, Shah, Huppert, Baylis and Keverne2005).
There are a number of implicit assumptions embodied in many of the analyses, most notably that life satisfaction is related to particular idealised forms of behaviour or ways of being (including being healthy, fit, employed and engaged in civic society), which engender positive emotional states (Helliwell and Putnam, Reference Helliwell, Putnam, Huppert, Baylis and Keverne2005; Layard, Reference Layard2005; Marks and Shah, Reference Marks, Shah, Huppert, Baylis and Keverne2005). The perceived role of a ‘politics of happiness’, then, is to minimise, or eradicate, negative emotions through interventions which seek to engage individuals, or create the conditions for them to pursue ways of living which promote wellbeing. Such an analysis may, however, ignore the significant societal barriers that particular individuals, such as disabled people, experience in participating in society as self-determining citizens and, through a reductive analysis of emotions, further stigmatise those that do not meet the wellbeing ideal (see, for instance, Furedi, Reference Furedi2004; Moloney, Reference Moloney2006).
By evaluating government policy documents and statements, this article explores the moral discourse of wellbeing and its implications in the context of disability in the UK. We argue that notions of a politics of happiness reflect the way in which governments are increasingly concerned with the management of individual emotions and behaviour, as a consequence of a ‘growing tendency to redefine public issues as the private problem of the individual’ (Furedi, Reference Furedi2004: 25). In a context where individuals are encouraged by government to take responsibility for their own contentment and self-fulfilment, social issues, and issues relating to employability and preparedness for work, become recast as emotional and/or personal ones; in this respect, the individual self (responsibility) takes precedence over social, cultural or, indeed, economic explanations of experience and/or identity (Beck and Beck-Gernsheim, Reference Beck and Beck-Gernsheim2002; Furedi, Reference Furedi2004).
This (political) orientation is, potentially, problematic for disabled people who, since the Union of the Physically Impaired Against Segregation (UPIAS) declaration of 1975, have attempted to shift interpretations of disability from individualised, biological, conceptions based on internal limitations, to ones situated within the socio-structural relations of an ableist society (see Barnes, Reference Barnes1991; Oliver, Reference Oliver1990).Footnote 2 In developing a collective politics based on this societal critique, disabled people have sought to promote their rights as active citizens, and highlight the barriers that prevent their participation in society. We suggest, however, that conceptions of wellbeing are less concerned with positive constructions of citizenship and political strategies, and more with the propagation of a consumerist ethic and/or series of practices. In this context, the extent to which disabled people are likely to develop, in policy and practice, the insights of social theoretical conceptions of disability is questionable.
In developing these views, we divide the article into three. First, we outline what the wellbeing agenda is, and situate it in the wider context of what Beck and Beck-Gernsheim (Reference Beck and Beck-Gernsheim2002) refers to as disembedded individualisation, and the restructuring of state and welfare. Second, we focus on the implications of the wellbeing agenda for disabled people, and note that it is unlikely, in its present form, to contribute to the development of UPIAS' social theoretical analysis and understanding of disablement in society. This is because of the emphasis on biologism, personality and character traits, and a policy prognosis that revolves around self-help and therapy, or individuated actions and (self) responsibilities. We conclude by discussing how the wellbeing agenda ought to be (re)connected to a material politics of disability that, after Moloney (Reference Moloney2006: 27), does not, first and foremost, propagate the idealist ways in which we see the world but, rather, addresses the way that it is.
Pursuing the hedonic experience: the discourse of wellbeing
The growing interest in issues of wellbeing and what ‘makes people happy’ can be witnessed in a number of different arenas, ranging from the academic to the political to the popular (see for example, programmes such as BBC's The Happiness Formula (BBC2, 3 May 2006) and Making Slough Happy (BBC2, 15 November 2005)). For some commentators, their concern with what is often termed ‘hedonics’ lies in the academic exercise of taking apart the factors that contribute to happiness and understanding how it might be measured (McAllister, Reference McAllister2005).Footnote 3 In a rather more radical step, others vigorously advocate a focus on happiness and wellbeing in government policy (Helliwell and Putnam, Reference Helliwell, Putnam, Huppert, Baylis and Keverne2005; Layard, Reference Layard2005; Marks and Shah, Reference Marks, Shah, Huppert, Baylis and Keverne2005). A research proposal by the Young Foundation (2006), for example, suggests that ‘it is now accepted that government should concern itself with happiness and well being’. Likewise, Marks and Shah (Reference Marks, Shah, Huppert, Baylis and Keverne2005: 503) note that ‘the idea that government should be concerned with people's well-being and happiness is no longer considered frivolous’.Footnote 4
The voices calling for a ‘politics of happiness’ have not gone unheard by policymakers and politicians within the New Labour government (Easton, Reference Easton2006). The focus on wellbeing is influencing government policy, most notably the sustainable development strategy Securing the Future published by the Department of Environment, Food and Rural Affairs (DEFRA, 2005). The strategy states that ‘by the end of 2006, the Government will sponsor cross-disciplinary work to bring together existing research and international experience and to explore how policies might change with an explicit well-being focus’ (DEFRA, 2005: 23). The establishment of the Sustainable Development Research Network, funded by DEFRA to develop research and indicators on wellbeing, is intended to contribute towards building this wellbeing evidence base. Likewise, the Local Government Act 2000 gives local authorities a ‘wellbeing power’; it enables them to do anything that improves the environmental, economic, or social wellbeing of their area and community.Footnote 5
Wellbeing proponents note that they have alighted on a new science that gives them a basis for understanding happiness as an objective entity (Huppert, Reference Huppert, Huppert, Baylis and Keverne2005; Layard, Reference Layard2005; McAllister, Reference McAllister2005). The development of indices and measures to test and evaluate wellbeing is a particular feature (Marks and Shah, Reference Marks, Shah, Huppert, Baylis and Keverne2005). Marks and Shah (Reference Marks, Shah, Huppert, Baylis and Keverne2005: 511) even suggest that national wellbeing accounts ought to be constructed by the government, to ‘measure what matters’ in relation to individual wellbeing. Thus, whether by asking people how happy they are in surveys (that is, assessing subjective wellbeing) or using physiological experiments that measure electrical activity in the brain, happiness has become ‘evidence-based’; it is, in Layard's (Reference Layard2005: 224) terms, ‘a real, objective phenomenon’. From here, it is a natural jump for many to suggest that if happiness exists, and we know what contributes to it, we can alter it through subjection to various forms of policy intervention.
What form this intervention might take depends on the diagnosis of the factors that contribute to wellbeing and happiness. Much of the literature on wellbeing stems from psychology and economics, and challenges the economic orthodoxy that income is the primary basis of happiness (Lane, Reference Lane2000). Analysts point to evidence that, despite improvements in material living conditions and the eradication of widespread poverty in advanced industrial nations over the past 50 years, levels of happiness have not improved, and in some cases have declined (Buonfino and Mulgan, Reference Buonfino and Mulgan2006). They highlight increased rates of crime and depression, and growing distrust in social relations as indicators of the ‘malaise’ of developed societies, and suggest that governments need to look beyond economic growth to other factors that contribute to people's wellbeing. In this sense, a contribution of the wellbeing message may be that it moves beyond the dominant economic analysis of society and individual behaviour, and recognises the value of other types of being and interaction.
Commentators agree that there are a number of interrelated factors that contribute to wellbeing, ranging from the biological to the social, including ‘physical health, income and wealth, relationships, meaningful work and leisure, personal stability and (lack of) depression’ (McAllister, Reference McAllister2005: 6).Footnote 6 Happiness is seen to have both external and internal, more personal, determinants. For example, Helliwell and Putnam (Reference Helliwell, Putnam, Huppert, Baylis and Keverne2005: 437) reinforce a view that wellbeing is connected to specific social relations that, broadly, conform to conventions of religion, nuclear family and marriage. They suggest that ‘marriage has universally been found to be a strong correlate of happiness’ (p. 437), and later note that ‘having a family enhances subjective well being, and spending more time with one's family helps even more’ (p. 448). In a different focus, on the issue of biology and genes and their relation to experience in determining happiness, Layard writes that ‘people with good genes also tend to get good experiences. Their parents are good at parenting. Their own niceness elicits good treatment from other people’ (2005: 58).
One of the difficulties of the wellbeing agenda appears to be the way that it sets up happiness as a state of being that can be achieved through particular forms of idealised behaviour, thereby reinforcing particular social norms (Furedi, Reference Furedi2004, Reference Furedi2006). Happiness is propagated as something that can be attained, as though it were a fixed ‘end state’ waiting to be discovered, although as Freud noted, happiness ‘is from its nature only possible as an episodic phenomenon’ (Reference Freud1989: 23). Meanwhile, happiness and its presumed opposite entity – misery – have been cast as dichotomous categories, along with the emotions that lead to them; thus for Furedi ‘emotions are classified into those that are positive (joy, happiness and contentment) and those that are negative (fear, anger, sadness, hate)’ (Reference Furedi2004: 31). For wellbeing proponents, the avoidance or dispelling of negative emotions that may lead to unhappiness is a key objective. Happiness becomes an individual virtue to which we should all aspire.
We would suggest, however, that these views are reductive in the way they fix fluid social states and emotions (such as happiness and misery) and also, potentially, stigmatising of certain groups or individuals in society who do not ‘measure up’ to the happiness ideal, nor engage in the types of behaviour analysts and policymakers tell us lead to happiness (whether it be participation in employment, marriage, being physically active and so on). This is particularly so with mental illness, as it is suggested by wellbeing proponents that depression is a major, and growing, cause of unhappiness in western societies.Footnote 7 Layard exemplifies this approach in stating, ‘In the West, the most miserable group of people are the mentally ill. We know how to help most of them, but only about a quarter are currently in treatment’ (Reference Layard2005: 231). He advocates that wellbeing politics and policies should focus on tackling the unhappiness created by mental illness, primarily through therapy (Layard, Reference Layard2005, Reference Layard2006).
Such analyses could appear to be indicative of an agenda in which the individual self – and their happiness – becomes a focus for government interventions. Those who are critical of the ‘politics of happiness’ see the new focus on wellbeing as a move away from a politicised public sphere to one in which the management of individuals and their behaviour is paramount. Thus, for Furedi (Reference Furedi2004, Reference Furedi2006), the wellbeing agenda is part of New Labour's ‘politicisation of emotions’, in which government is increasingly delving into psycho-social relationships, and where social problems become recast as emotional ones. Likewise, Heartfield suggests that third way politics transcends the activist formation of political will: ‘the realm of subjectivity that is politics is shrunken and diminished’ (Reference Heartfield2002: 18).
For others, the discourse of wellbeing can be related to the (continuing) process of disembedded individualisation in society, in which solidaristic social relations, and collective and community ties and identities, are dissolving (Bauman, Reference Bauman2000; Beck, Reference Beck1992; Giddens, Reference Giddens1991). In this context, the key challenge for individuals is to negotiate a path through the dilemmas of modern life, and forge self-identities and biographies that reflect a life of one's own choosing (Beck, Reference Beck1992; Beck and Beck-Gernsheim, Reference Beck and Beck-Gernsheim2002; Giddens, Reference Giddens1991). The self therefore becomes a reflexive project: the individual must decide between multiple, and often conflicting, forms of information and knowledge in deciding how to live (Giddens, Reference Giddens1991; Rose, Reference Rose1999). For some, the process of self-reflexivity has intensified as a result of the undermining of traditional forms of expertise and the rise of consumer culture, which presents individuals with ever-more diverse forms of expertise from which to choose. In this context, processes of individualisation ‘not only permit, but they also demand an active contribution by individuals’ (emphasis added) (Beck and Beck-Gernshein, Reference Beck and Beck-Gernsheim2002: 4).
Sointu (Reference Sointu2005, Reference Sointu2006a, Reference Sointu2006b) suggests that the pursuit of wellbeing can be linked to this project of self-actualisation, and forms of governance that engender self-responsibility. She notes how the meaning of wellbeing has shifted from the ‘body politic’ (expressed in discussions of the wellbeing of the economy or society) to the ‘body personal’, such that wellness has increasingly become the responsibility of the individual. In associating wellbeing with health, Sointu highlights the opening out of domains of health expertise beyond the biomedical, to include alternative health practices as a context in which individuals are ‘enjoined to freely seek out the ways of living most likely to promote their own health’ (Rose, Reference Rose1999: 86). Such strategies to promote wellbeing are notably consumerist in character; individuals exercise their autonomy, and create their ‘biography’ through the role of ‘choosing consumers’ (Sointu, Reference Sointu2005: 271, Reference Sointu2006a).
Others point to the risks associated with the self-autonomous subject, highlighting that the process of individualisation is inherently unstable and precarious. As Beck and Beck-Gernsheim note, in an uncertain world, the ‘do-it-yourself biography is always a “risk biography”, indeed a “tightrope biography”’ (Reference Beck and Beck-Gernsheim2002: 3). The flip side of self-responsibility is that failure comes to be located within the individual, the personal; social issues can be transposed into psychological ones. Thus, as Bauman states of individuals, ‘If they fall ill, it is because they were not resolute or industrious in following a health regime. If they stay unemployed, it is because they failed to learn the skills of winning an interview or because they did not try hard enough’ (2002: xvi). It is within this context that we come to see the focus on emotion and strategies of governance to manage those individuals deemed not to be meeting their obligations as active and self-responsible citizens in ensuring their own wellbeing (Rose, Reference Rose1999).
For example, the problems of particular groups deemed to be excluded and dependent – the unemployed, lone parents, disabled people – are frequently being associated with a lack of self-esteem by the New Labour government. In the context of employment, for example, a National Employment Panel report commissioned by the government recommended that lone parents who were out of work required ‘an intensive period to build self-confidence and explore alternative lifestyles’, to enable them to move nearer to the labour market (Verwaayen, Reference Verwaayen2003: 3). Meanwhile, activities such as confidence building, counselling and mentoring are increasingly seen as appropriate interventions to improve the employability of particular groups (DWP, 2006).
For several authors, such interventions are evidence of the growing emphasis in welfare policy on therapeutic tactics, and not just in the context of employment but also parenting and addressing ‘anti-social’ behaviour (Dean, Reference Dean1999; Furedi, Reference Furedi2004; Rose, Reference Rose1999). Yet while therapeutic intervention is often presented as an opportunity for self-discovery, Furedi (Reference Furedi2004) argues that it may serve to reinforce individual vulnerability and dependency on a new cadre of ‘psy’ experts. Seen from this perspective, there is a danger that wellbeing politics – and its accompanying evidence base, which arguably leads to the invention of new categories or problematisations that give government a mandate to ‘act’ – may be less about individual autonomy and more about exercising subtle forms of social control to responsibilise those groups not deemed to be actively engaged in society.
Disabled people and the wellbeing agenda
In the rest of the article, we evaluate the implications of the wellbeing agenda in relation to the lives of disabled people, and to the development of a politics of disability. We do so by exploring UK government policy documents and statements promoting wellbeing (for instance, see DH, 2005; DWP, 2006; LGA, 2003). One of the most detailed documents about the characteristics and determinants of wellbeing and the implications for public policy is Donovan and Halpern's report for the Prime Minister's Strategy Unit, Life Satisfaction: The State of Knowledge and Implications for Government (Reference Donovan and Halpern2002). While claiming not to be a statement of government policy, it has formed the basis for further work within the Cabinet Office on developing the wellbeing agenda (Easton, Reference Easton2006). As such, it is an authoritative source of information and opinion, and held in high regard by ministers and others seeking to develop wellbeing policy.
We also draw on documents from sources outside government, including the New Economics Foundation's Well-being Manifesto for a Flourishing Society (NEF, 2004; see also Marks and Shah, Reference Marks, Shah, Huppert, Baylis and Keverne2005, and Layard's, Reference Layard2005, Reference Layard2006, work on happiness, most recently expressed in ‘The depression report: a new deal for depression and anxiety disorders’). In so doing, we recognise the diversity of these sources. We do not suggest that the wellbeing agenda currently represents a coherent set of operationable policy objectives on which government and other agencies agree; some take a more radical stance in their propagation of what a wellbeing society should look like. However, there are a significant number of areas of congruence between the documents, developing out of a context in which influential policy advisers, such as Layard (who has been awarded the rather dubious title of ‘happiness czar’), have the ear of government.
In developing our analysis, our concern in the rest of the article is less with considering the factors that contribute to disabled people's happiness, but rather with exploring some of the ‘wider norms and values imbuing the rise of the ideal of well being’ as they are set out in the documents, and their implications for disabled people (Sointu, Reference Sointu2005: 256). We divide the rest of the section into two. First, we consider the documents' ‘diagnosis’ of what constitutes wellbeing in the context of disabled people, and the ways in which disability, where it is addressed, is conceived of and understood. We argue that one issue is the focus, almost exclusively, on the individual (and their pathology), and the use of a deficit paradigm or understanding of disablement in society. This is overlain by the propagation of a biological determination, in which health status, and physiological and genetic factors, are perceived to be core in influencing much of (disabled) people's life satisfaction.
Second, we explore the documents in the context of arguments that the wellbeing agenda is tied to forms of ‘therapeutic governance’ and strategies which seek to engage individuals in taking (self) responsibility for ‘acting upon oneself to overcome dissatisfactions, realize one's potential, gain happiness and achieve autonomy’ (Rose, Reference Rose1999: 90). Such governance appears, however, to be focused narrowly around utilitarian objectives relating to the reshaping of welfare, and connecting notions of personal wellbeing to active participation in the labour market. In this respect, one interpretation of the wellbeing agenda is to suggest that it is part of broader, structural, changes in economy, employment, and state, or part of the conjoining of welfare to workfare, and forms of intervention to enhance the employability of particular groups, such as disabled people. Wellbeing, in this view, is the connectivity between the (responsible) self and other forms of sociability.
Disability and the reductive nature of the wellbeing agenda
Much of the discussion about wellbeing is based on the assumption that happiness is a subjective sense of self that is primarily related to, or conditioned by, genetics and personality, with social or structural circumstances of lesser importance. The NEF report, for instance, reports the oft-quoted statement that people are genetically predisposed ‘to a certain level of happiness . . . it explains about 50% of the variation in people's current happiness’ (2004: 5; see also Helliwell and Putnam, Reference Helliwell, Putnam, Huppert, Baylis and Keverne2005; Huppert, Reference Huppert, Huppert, Baylis and Keverne2005; Layard, Reference Layard2005). This type of statement is characteristic of much of the wellbeing debate in which a preoccupation with reductive frames of reference, such as personality traits and individualising behaviour and contexts, is centre stage. Thus, Marks and Shah note that wellbeing ‘includes being engaged in life, curiosity . . . personal development and growing autonomy, fulfilling potential, having a purpose in life’ (Reference Marks, Shah, Huppert, Baylis and Keverne2005: 505).
A focus on the (reductive) self is also an undercurrent of Donovan and Halpern's (Reference Donovan and Halpern2002) writings. In equating disability to health status, they see disability as a form of interesting anomaly; ‘against all odds’, disabled people have been shown to adapt to the adverse circumstances of their impairment to demonstrate a certain level of happiness. In stating that ‘Research on paralysed accident victims found that their levels of life satisfaction were significantly lower than a control group’ (p.24), they draw on a frequently cited piece of research carried out by Brickman et al. (Reference Brickman, Coates and Janoff-Bulman1978) which explored how lottery winners (presumed to experience extreme happiness) and paralysed accident victims (presumed to experience extreme unhappiness) ‘adapted’ to their situations in terms of happiness levels. While levels of life satisfaction for recent accident victims were found to be lower than for a control group initially, in the longer term they returned to their ‘basal’ level of happiness (see also Delle Fave and Massimini, Reference Delle Fave, Massimini, Huppert, Baylis and Keverne2005; Huppert, Reference Huppert, Huppert, Baylis and Keverne2005).
What becomes apparent here is an individualised interpretation of disability that places biological impairment at the root of the ‘problem’ in disabled people's quest for wellbeing. Even discussions of disabled people's wellbeing, which seek to focus on their ‘resources and abilities instead of weakness and deficits’ (Delle Fave and Massimini, Reference Delle Fave, Massimini, Huppert, Baylis and Keverne2005: 379), and pay some recognition to the social and cultural contexts which impact on disability, seem to focus on individual coping strategies and behaviour in response to biologically derived deficits. For example, Delle Fave and Massimini's study of the subjective wellbeing of disabled people states that people with disabilities ‘have to cope with the constraints derived from biological impairments’, and concludes that they ‘can successfully achieve developmental goals, social integration and a good quality of life despite severe biological constraint’ (Reference Delle Fave, Massimini, Huppert, Baylis and Keverne2005: 385, emphasis added). In such analyses, it seems wellbeing can be achieved if disabled people overcome or internally adapt to their own individual limitations.
This emphasis is repeated in much of the research on disability and wellbeing, in which personal attitudes and/or feelings are conceived of as a function of impairment or the medical condition. For instance, Mehnert et al.'s study (Reference Mehnert, Krauss, Nadler and Boyd1990) of 675 adult disabled people in the USA compared the relationship between types of impairment and disabled people's subjective definitions of life satisfaction, and concluded that people with sensory impairments had ‘highest satisfaction’. Likewise, Uppal's research of disabled people in Canada notes ‘that happiness or well-being is negatively related to the severity of disability’ (Reference Uppal2006: 536). His prognosis is bodily rehabilitation or measures to overcome bodily limitations. As Uppal suggests, ‘providing the disabled with assistive devices or modifying structures would help obviate the effects of disability and thus reduce severity. This in turn would lead to an increase in their well-being’ (Reference Uppal2006: 536).
The language of the individual, the biological, and disabled people's ability to ‘adapt’, also permeates government policy documents in relation to health and wellbeing. For instance, a ministerial statement in the government strategy, Health, Work, and Well being, suggests that policy ought to contribute to building ‘a world that rehabilitates rather than rejects people when they experience illness or disability. In this way we can support people to fulfil their potential in contributing to society’ (Blunkett and Hewitt, Reference Blunkett and Hewitt2005: 3). The ‘supporting agenda’ is part of the social care Green Paper, Independence, Well-being and Choice (DH, 2005) that is, so it alleges, committed to breaking down paternalist forms of care and creating individual budgets and contexts for independent living. Yet, as some commentary suggests, it is not really seeking to change fundamentally ‘symptom management’ or the power of the medical professions, and as Glascott says, ‘this isn't all new and innovative. Believe it or not we've heard lots of this before’ (Reference Glascott2005: 3).
While the propagation of a reductive understanding of disability and wellbeing is not a surprise, it does, however, have dangers in missing the point about the lives of disabled people in relation to material disadvantage and structured inequalities. In particular, much of the wellbeing agenda is based in part on the premise that once basic material needs have been met, then what counts is the development of interpersonal relationships and socialisation. Thus, the NEF (2004) report implies that administering to the ‘income poor’ ought not to be the point or purpose of a wellbeing agenda, and notes that there are diminishing returns in relation to consumption. As it states, ‘Many policies tend to focus on enhancing people's incomes by growing the economy. This has only a small effect on well-being’ (p.2). For NEF, the government's concern should be directed to the main components of (subjective) wellbeing: that is, life satisfaction and personal development.
This view is also based on the observation by Marks and Shah that ‘factors such as income, material possessions . . . explain only 10% of the variation’ in an individual's wellbeing (Reference Marks, Shah, Huppert, Baylis and Keverne2005: 506–7). It is difficult to believe Marks and Shah's observation, although the authors may well have reached a different conclusion if disabled people's perilous income status had been to the fore in the figures and/or their analysis. Similarly problematic is Donovan and Halpern's (Reference Donovan and Halpern2002: 4) review of wellbeing, in which they argue that ‘income is far less important than marital status, unemployed status and health’. Much disability research suggests that this is not necessarily the case (Barnes, Reference Barnes1991; Oliver, Reference Oliver1990). Income may also be related to health and/or impairment and (un)employment status, and to broader social and situational contexts, so to separate one off from the other, as implied by Donovan and Halpern's observation, is problematical and not likely to lead to useful or appropriate analyses of the interrelationships between disability and wellbeing.
The apparent demotion of income and material issues by the wellbeing agenda has led some commentators, such as Landhauber and Ziegler (Reference Landhauber and Ziegler2005), to suggest that this is dangerous for marginal groups because it is part of a conceptual (re-)orientation by government, in which poverty and inequality are no longer regarded as prime targets or objects of policy. Instead, the emergent politics (of wellbeing) revolves around personal, often psychological, development or, as the NEF report states, ‘positive and happy people are more likely to overcome their problems’ (2004: 3). Influential American writers such as Vaillant go further in suggesting that personal development is a basis for ‘health, longevity, resilience and ability to cope’ (Reference Vaillant2002: 17). For disabled people, the message might be understood as one whereby the social and structural disadvantages of disablism are best addressed by policies that promote, first and foremost, character and personality development.
The focus on subjective wellbeing is also one that is concerned more with individuals' aspirations and, arguably, less with their actual life circumstances. In other words, it is concerned with what people would like, or feel that they need, to enhance their (subjective sense of) wellbeing. As NEF suggests, ‘subjective quality of life is very important, as it is the felt experience’ (2004: 29). However, as Easterlin suggests, there is nothing benign or politically neutral about people's aspirations, and ‘there is evidence that aspirations appear to grow commensurably with household wealth’ (Reference Easterlin2003: 1). Thus, to promote government policy based on self (or subjective) assessments of wellbeing, or what a person aspires to as part of their wellbeing status, may do no more than reproduce existing inequalities of aspirations that in turn reflect systemic social and economic inequalities in society (that themselves are not the target or object of policy).
Likewise, the development of a coherent social policy around both the individual and collective needs of disabled people is potentially problematical given its focus on subjective measures, individual wants and desires. Bauman's analysis of individuation is instructive in suggesting that the (wellbeing) policy focus on the subjective and aspirational is likely to lead to the ‘slow disintegration of citizenship’ (Reference Bauman2000: 36). For Bauman (Reference Bauman2000, Reference Bauman, Beck and Beck-Gernsheim2002), individuated social relationships have the potential to erode the public sphere and collective consciousness and/or action, and lead to the trivialisation of everyday life. In this respect, it may be that the notion of wellbeing, and its focus on the individualised private sphere leads to an ‘emptying out’ of the public sphere, and represents a de-politicisation that shifts the emphasis away from issues such as equality, and on to individual emotions.
‘Help yourself’: personal responsibility and the therapy state
Historically, the relationship between disabled people and the institutions of the state has been one in which paternalistic and charitable attitudes have dominated. In the realm of social care, a brigade of professionals – from social workers to doctors to occupational therapists – brought their expertise to bear on disabled people through the bureau-professionalism of the welfare state. Since the 1970s, organisations such as UPIAS, the British Council of Disabled People (BCODP) and others in the independent living movement have sought to challenge this professional dominance by articulating a discourse in which disabled people have been encouraged to define their own needs and wants, particularly through forms of self-organisation (Oliver, Reference Oliver1996).Footnote 8 For Giddens (Reference Giddens1991), this is part of the emergence of sub-politics based on self-emancipation that is more broadly reflective of the processes of individualisation and the search for self-identity in late modern society.
One interpretation of this is that ‘self-emancipated subjects’, such as disabled people, have also become the site of strategies of advanced liberal governance, albeit with some modification (see Dean, Reference Dean1999; Foucault, Reference Foucault1977; Rose, Reference Rose1999). Dean notes how calls for autonomy from social movements have been deployed within neo-liberal critiques of the welfare state and, in doing so, have been subject to a ‘displacement’ that reveals ‘a conception of freedom that moves away from the emancipatory aspirations of social movements towards the virtuous, disciplined, and responsible autonomy of the citizenry’ (Reference Dean1999: 151). In this context, strategies of governance involve shaping and regulating the conduct of the individual to render them capable and responsible of exercising freedom – although this is often freedom on the government's terms (Dean, Reference Dean1999). In so doing, they seek to create ‘active citizens’ who manage and take responsibility for their own risk.
Arguably, the wellbeing agenda can be linked to practices of governance that stress notions of the self-responsible active citizen. The NEF document counterposes active versus passive forms of behaviour, and their link to wellbeing: ‘For people to lead truly flourishing lives they need to feel they are personally satisfied and developing, as well as functioning positively in society. Unfortunately, too many people are languishing – living unhappy, unfulfilled lives as well as lacking social and community engagement’ (2004: 5). In addressing the ‘languishing’ segment of society, we have already suggested that strategies that promote personal responsibility are evident in policy documents, and one of the clearest is in relation to unemployment and worklessness. Donovan and Halpern (Reference Donovan and Halpern2002: 37) note that unemployment is a significant cause of unhappiness, as do NEF (2004: 2), who stress the scale of hidden unemployment in the UK and its detrimental effect on wellbeing.Footnote 9 They highlight the number of those claiming incapacity benefits who are ‘able and willing to work’, and state that ‘the Government needs to help these often hard-to-reach groups to find meaningful work’ (ibid.).
The agenda to encourage greater participation of disabled people in the labour market is a significant if not uncontroversial one. Many disability organisations and people note that enabling disabled people to work is a crucial step in furthering their participation and equality in society as a whole. However, others have raised questions about what disabled people will gain from the current labour market in terms of type of work and job stability, as well as the orthodoxy behind current government strategies to address worklessness (Roulstone, Reference Roulstone2002). For many, Labour's active welfare policies are strongly tied to their focus on ‘no rights without responsibilities’, something that is clearly evident in the government's proposals to address getting sick and disabled people back into the workforce. For example, the Green Paper, A New Deal for Welfare: Empowering People to Work, states that citizens need to ‘meet their responsibility to take the necessary steps to re-enter the labour market when they have a level of capacity and capability that makes this possible’ (DWP, 2006: 2).
Seeing work as crucial to health and wellbeing, these proposals to reform incapacity benefit and increase labour market participation build on the established formula of personal advisers, and the engagement of disabled people in continuous activity to move them nearer or into the labour market (DWP, 2006). These include work-focused interviews and the preparation of personal action plans, including activities to improve employability, to manage health in work through ‘condition management programmes’, and even activities designed for ‘stabilising life’ (cognitive behavioural therapy is suggested as an example of this for people with mental health problems) (DWP, 2006: 43).
While these interventions form one part of a range of initiatives which the government has introduced to promote more flexible employment practices for disabled people (such as the Access to Work scheme which provides grants to pay for extra costs arising from a person's disability in the workplace), the emphasis they place on enjoining the individual to manage their personal condition is clearly apparent. In Dean's terms, such interventions ‘illustrate(s) how government is crucially concerned to modify a certain space marked out by entities such as . . . the personality, character, capacities, levels of self-esteem and motivation the individual possesses’ (Reference Dean1999: 12). They place less emphasis, however, on many of the socio-structural barriers that hinder disabled people's participation in the labour market, including the discriminatory attitudes of employers and other barriers such as transport to work and educational opportunities (BCODP, 2006).
The promotion of such therapeutic interventions is evident in other contexts in the wellbeing policy documents. For example, in noting the link between life satisfaction and social relationships, Donovan and Halpern suggest that a less controversial implication would be for government to support ‘policies that help to bolster and support successful long-term personal relationships, such as marriage counselling’ (Reference Donovan and Halpern2002: 37). In a more controversial step, therapy has been advocated as the answer to the UK's growing problem of mental illness, which is seen by many proponents of a politics of happiness as a key barrier in creating wellbeing at the individual and societal level. Layard's (Reference Layard2006) report, ‘The depression report’, which has emerged from a Mental Health Policy group established under the Centre for Economic Performance at the London School of Economics, states that ‘when psychologists study how different types of disability affect a person's subjective wellbeing, they regularly find that mental illness is the single most powerful predictor of distress’ (Reference Layard2006: 5).
Mental illness, the report argues, not only causes individual distress but also creates a significant economic cost to society and the taxpayer. The response to this, it is argued, is the provision of more cognitive behavioural therapy (CBT) and therapists, and a new therapy service to which GPs, occupational therapists and Job Centres could refer. A clear argument in the report appears to be the promotion of CBT as a ‘cost effective therapy’ (p. 7), which will engender cost savings through reducing the time that people spend on incapacity benefit, and their reliance on the health service. Thus, as it states ‘one course of CBT is likely to produce 12 extra months free of depression. This means nearly two months more of work. And, if treatment is combined with the extra employment advice which government is planning, we can expect a much bigger response in terms of work’ (p.8). Interestingly, reducing individual distress appears last on a list of the benefits that CBT can bring.
It would be hard to disagree with the report's call for greater attention and expenditure on the area of mental health. However, such pronouncements about the role of therapy – and its obvious linkages to economic imperatives – run the risk of stigmatising further a group that already experiences considerable societal prejudice (Sayce, Reference Sayce1999) and negating the complexity of mental illness. Aside from questions about the proven effectiveness of CBT itself (for a discussion on this, see Pidd, Reference Pidd2006), the report locates the ‘problem’ of mental health and its solution within the individual; it places the responsibility on the individual to engage in therapy to make themselves well ‘for the good of society’. Yet for someone who experiences mental illness, what does it mean if treatment is unsuccessful, or only successful on a periodic basis? Will those who do not wish to engage in treatment be deemed irresponsible? If conceived in such reductive terms, calls to end the misery of mental illness may amount to little more than a ‘blame the victim’ approach.Footnote 10
Such individualised, therapeutic, forms of intervention, which are encouraged by aspects of the wellbeing agenda, arguably promote forms of paternalistic governance in which policymakers know what is best for individuals – and particularly those who are not being responsible in living up to the wellbeing ideal. Dean notes that one of the dangers of advanced liberal governance is that ‘it cedes responsibility to paternalism for those who, for whatever reason, cannot or do not exercise responsible choices’ (Reference Dean1999: 207). There is an expectation (or even obligation) that individuals take up forms of offered assistance: in the new proposals on welfare reform, for example, disabled people will be penalised (by a reduction in benefit) if they fail to ‘continuously engage’ in some kind of work-based activity (DWP, 2006). In setting up such a dependent and potentially coercive relationship, it is possible that the wellbeing agenda will lead to policy strategies that undermine disabled people's capacity for independent and/or autonomous forms of living.
Conclusions
Since the mid-1970s, many disabled people have sought to politicise disability through the context of the social model of disability. The UPIAS declaration of 1976 represented a break point, and various political struggles have, since then, done much to develop understanding of the social and structural relations and processes that undermine disabled people's search for equality of opportunity. Our assessment of the wellbeing agenda would seem to suggest that despite the positive developments in policy and legislation, which have sought to promote disabled people's independence and equality in the UK, the focus on a ‘politics of happiness’ has the potential to be a retrograde step. This is not just in the way disability is likely to be interpreted and defined by proponents of the wellbeing agenda, but also in the forms of idealised behaviour it seeks to inculcate in individuals through the promotion of particular strategies and modes of governance.
Such strategies conceive of citizenship and subjects in ways that emphasise, first and foremost, personal responsibility and self-care as the means to attain wellbeing and personal happiness. This, though, is wedded to broader government objectives to manage personal dispositions towards (the exercise of) self-responsibility, and in this respect the wellbeing agenda can be understood as part of broader government programmes ‘to manage’ disabled people and other subjects (of welfare). It is not surprising, then, that the wellbeing agenda is closely aligned to labour market and employment policies, or that a recent workshop held at the Treasury concluded ‘that happiness is good economics’ (Sustainable Development Commission, 2004: 3). Similar pronouncements from industrialists, the Confederation of British Industry (CBI), and supranational institutions like the United Nations, are evidence of a close interlinking between the wellbeing agenda and utilitarian and/or economic goals and objectives.
However, how far should increasing people's subjective wellbeing be an objective of government? It is hard to argue against the notion that most people want to be happy. Yet as Lane (Reference Lane2000) suggests, it is extremely difficult to see how one can base a political theory or philosophy on subjective wellbeing alone. As he states, ‘If we identify a high quality of life exclusively with happiness, we jeopardize values that we cherish, not only justice and human development, but also such instrumental values as freedom and human rights’ (Lane, Reference Lane2000: 277). Lane does not disregard the notion of wellbeing completely, but rather suggests it must be one of a plurality of ‘goods’ in society. For disabled people, claims to justice and rights expressed in changes in the social and structural relations of society are where progress towards disabled people's equal status and participation are likely to be made. As it stands, the wellbeing agenda may offer little to disabled people and the development of disability politics.
Acknowledgements
We would like to thank Mariela Gaete Reyes, Marian Hawkesworth, Mike Raco, and two referees for useful and constructive comments about an earlier draft of the paper. Our thanks, in particular, to participants at the Disability Studies Conference, University of Lancaster, September 2006, for feedback that they gave to an earlier draft of the paper.
