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From International Socialism 2 : 117, Winter 2008.
Copyright © International Socialism.
Copied with thanks from the International Socialism Website.
Marked up by Einde O’Callaghan for ETOL.
Visit any high street bookshop chain in Britain and before very long you are likely to encounter one or more stands devoted solely to the subject of happiness and wellbeing. Recent titles range from Happiness: Lessons from a New Science by Richard Layard and The Pursuit of Happiness: a History by Darren McMahon at the more academic end of the spectrum to Positively Happy: Cosmic Ways to Change Your Life by game show host Noel Edmonds at the other. [1] Interest in the subject of happiness is, of course, hardly new. As McMahon shows, happiness, and its relationship with other valued goods such as freedom and justice, have been at the heart of philosophical debate for more than 2,000 years. At a less elevated level, what makes individuals happy has long been a subject of endless popular fascination. For Karl Marx, answering a quiz set for him by his daughter, happiness meant simply “to fight”, for Albert Einstein, all it required was “a table, a chair, a bowl of fruit and a violin”, while for John Lennon, happiness was “a warm gun”.
Three things, however, make current discussions around happiness different and worthy of consideration by socialists. First, over the past two decades a “happiness industry” has emerged [2], a global multi-million dollar business, one element of which is the self-help book market noted above. According to Gunnell, in the UK self-help books now generate roughly £80 million a year, while in the US they make up nearly 6 percent of the entire book market. In addition, while not the main focus of this article, counselling, therapy and, for the wealthier middle classes, life-coaching services have also expanded hugely in the UK during this period.
Second, recent years have seen the growth of serious academic interest in issues of happiness and wellbeing. The new discipline has its own peer-reviewed journal (The Journal of Happiness Studies, founded in 2001) and its own series of annual conferences (Happiness and its Causes, with the 2007 conference in Sydney attended by over 3,000 delegates). Here the central figure has been Martin Seligman, Fox Leadership Professor of Psychology at the University of Pennsylvania. Seligman’s Authentic Happiness [3] is a key text of the happiness literature and his website [4] one of the most visited on this topic. While the title, style and glossy cover of Authentic Happiness (subtitled Using the New Positive Psychology to Realise Your Potential for Lasting Fulfilment) are reminiscent of much other self-help literature, Seligman, a former president of the American Psychological Association, is by any criterion a substantial figure within US academic psychology, and the key theorist of “positive psychology”. In the UK the main role in promoting the “science of happiness” has been played by Richard Layard, professor of economics at the London School of Economics and a Labour peer in the House of Lords. Layard is also the convenor of the Happiness Forum, a group of academics, psychologists and top civil servants which meets regularly at the LSE to consider issues of happiness and wellbeing.
The third, and most significant, development, however, is the growth of interest in happiness (or “subjective wellbeing”, as it is more often called) among Western governments and policy-makers. In Britain, for example, the New Labour government has commissioned research into the influences on personal wellbeing and their application to policy-making [5], and in 2007 undertook its first national survey into the happiness of the nation. [6] At a European level, Deutsche Bank has recently commissioned research into happiness levels within OECD countries with a view to establishing the factors which contribute to the “happy variety of capitalism”. [7]
The findings both from this research and from the new psychologies
of happiness and wellbeing referred to above are already having a
major impact on public policy. Thus in the UK the “science of
happiness” has been important in directly shaping both health and
safety at work policies [8] and also
mental health policy in England and Wales. As well as being the
author of Happiness: Lessons from a New Science, Richard
Layard is the main author of the influential Depression Report
[9] published in June 2006, subtitled A
New Deal for Depression and Anxiety Disorders, which I consider
in detail below. The language of “new deals” is not accidental.
From 1997 to 2001 Layard was an adviser to New Labour and one of the
key architects of its “New Deal” and “Welfare to Work”
policies. Meanwhile, north of the border, this new interest in
happiness and wellbeing is reflected in the Scottish government’s
funding of a “Centre for Confidence and Wellbeing”, launched at a
conference in Glasgow in December 2004 with Martin Seligman the
keynote speaker. The centre, which is supported by important sections
of Scottish business including Scottish Enterprise, BT Scotland and
the Scottish CBI, has the aim of overcoming what its chief executive,
psychologist Carol Craig, has labelled “the Scots’ crisis of
confidence” in her book of the same name. This crisis includes an
alleged “dependency culture” which supposedly inhibits the growth
of the Scottish economy. [10]
The starting point for most of the happiness theorists is what Richard Layard refers to as the “paradox at the heart of our lives”:
Most people want more income and strive for it. Yet as Western societies have got richer, their people have become no happier ... But aren’t our lives infinitely more comfortable? Indeed we have more food, more clothes, more cars, bigger houses, more central heating, more foreign holidays, a shorter working week, nicer work and, above all, better health. Yet we are not happier. Despite all the efforts of governments, teachers, doctors and businessmen, human happiness has not improved. [11]
The belief that increased wealth in recent decades has not led to increased happiness is widely held by happiness theorists and appears to be supported by research evidence. According to one summary of this evidence, cited by the health epidemiologist Richard Wilkinson, “Study after careful study shows that, beyond some point, the average happiness within a country is almost completely unaffected by increases in its average income level ... Average satisfaction levels register virtually no change even when average incomes grow many-fold.” [12] Why should this be so?
The most influential answer to the question is that provided by Martin Seligman. Happiness, Seligman argues, is primarily a product of two main factors. First, there is your genetic inheritance, which sets the boundaries for your happiness range and accounts for roughly half of your predisposition to be happy. Crudely, if your parents and grandparents were miserable, then you probably will be too. (In fact, given the fondness of many of these theorists for the arguments of evolutionary psychology, the happiness levels of your Stone Age ancestors are probably also relevant.) There are then a number of other factors which affect your happiness levels. Chief amongst these, he suggests, are living in a wealthy democracy, not a dictatorship (“a strong effect” on happiness levels, apparently), getting married, and acquiring a rich social network. By contrast, he argues, more money, good health and education have no impact on happiness levels. Commenting on these “findings”, he notes:
You have undoubtedly noticed that the factors that matter vary from impossible to inconvenient to change. Even if you could alter all of the external circumstances above, it would not do much for you, since together they account for no more than 8 and 15 percent of the variance in happiness. The very good news is that there are quite a number of internal circumstances that will likely work for you. [13]
A focus on these internal factors is, therefore, at the core of Seligman’s “positive psychology”. As the name suggests, its central message, in the title of Cole Porter’s song, is the need to “accentuate the positive, eliminate the negative”. Thus, whereas the “old” psychology concentrated on depression, distress and mental pain, the focus in positive psychology is on the cultivation of “positive” feelings such as satisfaction, happiness and hope. [14] By cultivating these emotions, individuals can “buffer” themselves against the factors that create mental ill health, through attitude change, for example, or the practice of meditation. [15]
A second “pillar” focuses on positive traits, strengths and virtues, such as wisdom, courage and love. Happiness, Seligman argues, is based on individuals identifying their key signature strengths (mainly inherited) and building on these. Here there are obvious similarities with Aristotelian notions of happiness as “flourishing”, the realisation of one’s human faculties. For Aristotle, however, and even more so for Marx, the capacity for such realisation depends largely on the type of society in which you live. As Terry Eagleton has recently put it in his short treatise on The Meaning of Life:
If happiness is a state of mind, then it is arguably dependent on one’s material circumstances ... Happiness or wellbeing is an institutional affair: it demands the kind of social and political conditions in which you are free to exercise your creative powers. [16]
By contrast, the third pillar of Seligman’s positive psychology, “positive institutions”, identified as “democracy, strong families and a free press”, is the one which receives least attention, mainly because, as we have seen, it is the least amenable to change.
Despite his protestations to the contrary, it is difficult not to see Seligman’s positive psychology as little more than a restatement, albeit in more academic language, of earlier American self-help literature, such as Norman Vincent Peale’s 1950s bestseller The Power of Positive Thinking. Its dominant themes are individualism and an emphasis on the necessity of changing the way you see the world. This is coupled with an almost total neglect of the impact of structural inequalities on happiness and wellbeing (the term “inequality” does not even appear, for example, in the index of Authentic Happiness), mainly because he seems to share Anthony Giddens’s view that, beyond a very low level of income, “happiness and its opposite bear no relation to either wealth or the possession of power”. [17] Instead a relentless optimism about the capacity of individuals to improve their own mental health is combined with a contempt for “pessimistic” ideas or theories which suggest that this capacity might be subject to any constraints whatsoever, whether these be the effects of negative childhood experiences such as abuse or neglect (and Freud is a particular bete noir) or of structural oppressions, such as racism and sexism. An emphasis on such constraints is, he argues:
the philosophical infrastructure underneath the victimology that has swept America since the glorious beginnings of the civil rights movement, and which threatens to overtake the rugged individualism and sense of individual responsibility that used to be this nation’s hallmark. [18]
As opposed to such attitudes, he argues, what we need to cultivate is an individual psychology of “rising to the occasion”, encapsulated in what he calls “the Harry Truman effect”: “Truman, after an undistinguished life, to almost everyone’s surprise rose to the occasion when FDR died and ended up becoming one of the great presidents.” [19] (This view of Truman is perhaps less likely to be shared by the descendants of the victims of the atomic bombs dropped on Hiroshima and Nagasaki in 1945 on Truman’s orders.)
Compared to Seligman, other theorists of happiness are more willing to acknowledge, albeit implicitly, some connection between the values and priorities of neoliberalism and the decline in levels of happiness and wellbeing. In his Happiness: Lessons from a New Science, for example, Layard argues that “our fundamental problem today is a lack of a common feeling between people – the notion that life is essentially a competitive struggle”. [20] He identifies the growth of individualism as one of three factors (the others being changing gender roles and the impact of television) as contributing to current levels of unhappiness. In addition, unlike Seligman, he recognises a connection between inequality and levels of wellbeing, and calls for a redistribution of wealth, based on taxing the rich. In most respects, however, Layard’s critique of individualism appears to owe more to communitarian rather than socialist ideas. Thus he argues, “The goal of self-realisation is not enough. No society can work unless its members feel responsibilities as well as rights.” An emphasis on “responsibilities” as well as rights is, of course, at the heart of New Labour ideology, including its more authoritarian aspects. It is perhaps not surprising then to find Layard, as a key New Labour adviser on welfare to work schemes, arguing that:
After a period of unemployment, benefit-recipients enter a period of grey resignation where any change can appear dangerous. Their “tastes” change. It is the role of the employment office to push people out of that state and into meaningful activity. If we could mobilise more of Europe’s unemployed, those extra employees could find jobs, and at existing rates of pay. [21]
Quite how working in dead end jobs with low rates of pay and little hope of improvement increases happiness levels is not made clear.
To a greater extent than Layard, the British psychologist Oliver James explicitly locates the roots of much current unhappiness in the “selfish capitalism” that has prevailed since the 1980s. In his book, Affluenza [22], much of which is a scathing critique of the values and policies of New Labour, James attacks “selfish capitalism” for giving rise to the “Affluenza Virus”, which he defines as:
A set of values which increase our vulnerability to emotional distress. It entails placing a high value on acquiring money and possessions, looking good in the eyes of others and wanting to be famous. Just as having the HIV virus places you at risk of developing the physical disease of Aids, infection with the Affluenza Virus increases your susceptibility to the commonest emotional distresses: depression, anxiety, substance abuse and personality disorder (like “me, me, me” narcissism, febrile moods or confused identity). [23]
The “vaccines” that James proposes to deal with the virus, consisting of maxims such as “Consume what you need, not what advertisers want you to want” or “Educate your children, don’t brainwash them”, are ones with which few socialists would disagree. Again, however, most of them involve individual lifestyle change, rather than structural change, achievable more easily by the fabulously wealthy individuals who appear to be the main victims of the Affluenza Virus in his study but more difficult for the rest of us. Thus his “vaccines” for stressed-out women are to divide the care of small children with your partner; try to find a nanny rather than using a kindergarten; and enjoy being a mother – all fairly basic and uncontentious, but still beyond the reach of many ordinary women.
Because James critiques the symptoms of neoliberal policies rather than neoliberalism itself, the valid points he makes can also easily be co-opted by those arguing for a return to more “traditional” values. So Tory leader David Cameron, speaking in Hertfordshire on 22 May 2006, argued:
It’s time we admitted that there’s more to life than money, and it’s time we focused not on GDP (gross domestic product) but on GWB – general wellbeing ... It is about the beauty of our surroundings, the quality of our culture and above all the strength of our relationships. There is a deep satisfaction which comes from belonging to some one and some place. There comes a point when you can’t keep on choosing and have to commit. [24]
Commenting on this, the critical social worker Bill Jordan suggests that “these themes resonate with social work’s concerns about quality of life rather than material consumption or the work ethic. They also contrast with New Labour’s emphasis on individual responsibility.” [25] In fact, it seems more likely that Cameron’s emphasis on the “strength of relationships” and the “need to commit” owes less to any critique of “selfish capitalism” than to his desire, expressed at the 2007 Conservative Party conference, to restore marriage to its place as “the central institution of our society”, for example, by providing tax breaks not available to lone parent families. [26]
At their best then, it is possible to discern in the writing of
some of the happiness theorists a critique of consumerism and an echo
of the central slogan of the anti-capitalist movement that “the
world is not a commodity”. Underpinning this, however, there is an
individualism that makes these theories all too compatible with the
priorities and strategies of neoliberalism, whether of the New Labour
or New Tory variety. Some policy examples of this will be considered
in the final section of this article. Before then, however, if it is
indeed the case that levels of happiness have not continued to rise
in recent decades, then perhaps it is necessary to consider some
alternative reasons as to why this might be so.
According to the theorists discussed above, as well as for researchers and governments, “average living standards” have risen in most OECD countries in recent decades, but not happiness levels. So, they conclude, income and happiness are unconnected. However, they seldom look at what else has been going on in the lives of millions of people during the same period, which broadly coincides with the implementation of neoliberal policies. [27] In this section I shall look briefly at the British experience during this period. In this country the year in which happiness levels appear to have stalled – 1975, according to Layard – is, for several reasons, rather a significant one. [28] It was the year, for example, in which the expansion of the welfare state that began soon after the Second World War, reducing insecurity and fear for millions of working class people, came abruptly to an end. The prospect of a future of huge cutbacks in health, housing and social care services was epitomised in the announcement by Anthony Crosland, minister in the Wilson-Callaghan governments and a leading Labour Party intellectual, that “the party’s over” in May that year. [29]
It was also that year that saw the introduction of Labour’s “Social Contract” which, over the next two years, resulted in the biggest fall in living standards since the Second World War. And it was the year which, following two decades of growing working class organisation, confidence and successful struggle, saw the beginnings of what Tony Cliff was later to label the “downturn” – a period when the balance of forces shifted decisively away from organised labour and in favour of the employers and government. [30] The next 20 years were to see workers suffer defeat after defeat, with the low point being the crushing of the miners’ strike of 1984–5. The impact of that long downturn in terms of working class confidence was profound, and its effects are still evident today, in the low level of strikes, for example. Finally, the monetarist policies implemented by Labour governments during the mid to late 1970s were to be the precursor of the fully fledged neoliberal policies of Maragaret Thatcher and John Major, policies which would be continued and even intensified by New Labour governments after 1997. These policies have impacted upon the lives of working class people in three main areas.
First, there is poverty. As noted above, poverty hardly figures in the happiness literature. In part, this is because it is seen as a residual issue, affecting relatively small numbers of people. This complacent attitude is evident, for example, in the Deutsche Bank study referred to earlier: “Nearly every OECD country has achieved a high level of material prosperity. The questions now facing individuals and societies are which priorities to set for the future”. [31]
The reality is very different. A number of major studies have painted a comprehensive picture of poverty in Britain just under a decade after New Labour first came into office. [32] Thus, in 2003/4, 12 million people in Britain, about one in five, were living in income poverty. This is nearly two million fewer than in the early 1990s. It is still, however, nearly twice as many as when the Conservatives came into office in 1979. In fact, since New Labour was first elected, poverty levels have declined only among two groups: families with children (down from 32 percent to 29 percent) and pensioners (down from 27 percent to 22 percent). By contrast, the proportion of working age adults without dependent children in income poverty has actually increased by 400,000 since the late 1990s. [33]
A second reason why the literature ignores poverty is because, as we have seen, above an extremely low level income and wealth are considered to have little relationship with happiness and wellbeing. In fact, “overall, there appears to be reasonably robust evidence that individual or household income has a positive but non-linear effect on life satisfaction”. [34] Similarly, the main finding of the happiness survey conducted by the Department of the Environment in 2007 was that a skilled job, good health and financial security were the keys to happiness. [35] In other words, in general people with a decent income tend to be happier, although obviously this can be affected by other factors. Conversely, the link between class, poverty and every form of mental ill heath is very well established. In their classic study of depression published in 1978, for example, Brown and Harris found that working class women were four times more likely to experience depression than middle class women. This was not simply about income, but about their whole life experience, including their employment experience, social supports and, above all, self-esteem. There is, therefore, something rather distasteful in being told by so many wealthy professors, politicians and researchers that money does not bring happiness. Ruth Levitas’s reproduction of a 19th century poem seems apt:
|
Plain living may be wholesome and wondrous virtues may |
Then there is the issue of inequality. The literature emphasises how “we are all better off”. Its focus on the rise in average income obscures the extent to which some of “us” have actually become much better off than others. Inequality has increased over the past decade, not only in the US but also in the UK. In his study of Rich Britain Lansley found that:
Britain has been slowly moving back in time – to levels of income inequality that prevailed more than half a century ago and to levels of wealth inequality of more than 30 years ago. [37]
According to a report published in 2004 by the Office for National Statistics, the wealth of the super-rich has doubled since 1997. Nearly 600,000 individuals in the top 1 percent of the UK wealth league owned assets worth £355 billion in 1996, the last full year of Conservative rule. By 2002 that had increased to £797 billion. Part of the increase was due to rising national prosperity, but the top 1 percent also increased their share of national wealth from 20 percent to 23 percent in the first six years of the period. Meanwhile the wealth of the poorest 50 percent of the population shrank from 10 percent in 1986 to 7 percent in 1996 and 5 percent in 2002. On average, each individual in the top 1 percent was £737,000 better off than just before Tony Blair arrived in Downing Street. [38]
More than any other single theorist, the social epidemiologist
Richard Wilkinson has demonstrated the ways in which such inequality
impacts on every aspect of our health, wellbeing and relationships.
Wilkinson cites Frank’s reporting of the “consistent finding”
of analyses of “how subjective wellbeing varies with income within
a country ... richer people are, on average, more satisfied with
their lives than their poorer contemporaries”. [39]
In addition, as Wilkinson shows, factors such as the level of trust
in fellow citizens, cited in most studies as a key determinant of a
“happy society”, is inversely related to the degree of inequality
in any society.
If the impact of poverty and inequality on the happiness and wellbeing of millions is neglected within the literature, neither is there much recognition of the other ways in which the daily lives of ordinary people have been transformed by the impact of neoliberal policies over the past three decades. As Bourdieu notes:
Using material poverty as the sole measure of all suffering keeps us from seeing and understanding a whole side of the suffering characteristic of a social order which, although it has undoubtedly reduced poverty overall (though less than often claimed), has also multiplied the social spaces ... and set up the conditions for an unprecedented development of all kinds of ordinary suffering. [40]
One such form of social suffering is the insecurity arising from the increasing withdrawal of the state from areas such as housing and pensions. Another is the growing level of debt experienced by young people in particular. But perhaps the biggest change for many people has been in their experience of work. And it is also in the area of work that the real limitations of happiness and wellbeing strategies are most evident.
According to the economist Frances Green, the past two decades have been, in his words, a “hard day’s night” for many of those in work. [41] Among his findings are that more people are working long hours and that hours have become concentrated in households, with the average two-adult household working an extra seven hours compared with the early 1980s. No less importantly, Green argues, there has been an intensification of work since the early 1980s. For example, in his research the proportion of workers who strongly agreed that their job required them to work very hard rose from 32 percent to 40 percent in just five years from 1992. The proportions working at very high speed all or almost all of the time rose from 17 percent to 25 percent in the five years from 1991. During this period work intensification was faster in Britain than anywhere else in Europe due, Green argues, to falling union power.
A further aspect of neoliberalism has been the application of managerial policies and priorities to the public sector. For groups such as teachers, nurses and social workers, this has often meant that the values and motivations that brought them into the job in the first place have had to take second place to the overriding demands of saving money and rationing services. Some sense of the unhappiness to which this increased bureaucracy and managerialism gives rise is evident in the following quote from a social worker interviewed as part of Chris Jones’s research into front-line social work:
I feel so deskilled because there are so many restrictions over what I can do. Yes I go out and do assessments, draw up care plans, but then we aren’t allowed to do anything. I can’t even go and organise meals on wheels for somebody without completing a load of paperwork, submitting a report to a load of people who would then make the decision as to whether I can go ahead and make the arrangements. I just wonder why I am doing this. It’s not social work. Many of my colleagues in the adult team are looking to get out of social work altogether. They say they don’t want to take this garbage any more. That’s how they feel. The will to do social work is still there. They are still committed to work with people in distress. That heartfelt warmth has not gone away, but the job is so different. [42]
More generally, work is one of the major contributors to all the UK’s major killers – cancer, heart disease and obstructive lung disease. The same goes for the major causes of long term sick leave, including mental illness and back pain. The UK government’s own figures show that workplace sickness absence costs £12 billion a year, with 40 million days lost to occupational ill health and injury, and 2.7 million people currently claiming incapacity benefit. [43]
Rather than seeking to address the structural issues underpinning this huge pool of ill health, however, the government’s 2005 strategy paper Health, Work and Wellbeing – Caring for our Future mirrors the individualistic assumptions of the happiness and wellbeing literature in emphasising lifestyle change and health promotion. According to a review of the strategy document in the independent Hazards magazine (entitled, appropriately enough, Futile Exercise):
The government’s health, work and well-being strategy
evangelises about the personal health side of the equation, and is
encouraging initiatives like Well@Work to promote exercise, smoking
cessation and healthy diets. It is also pushing measures to get the
sick and injured back to work, through sickness absence management
and vocational rehabilitation. Where it falls flat is in prevention
of the poor working environments and the work pressures that drive
many of us to drink, or that leave us no time or energy for exercise
and neither the time nor the cash to make healthy choices about diet.
Low pay is a health issue; long work hours are a health issue;
hazards at work are a health issue. Telling employees to clean up
their act while the workplace and the work remain unchanged is a
patently suspect and potentially unhealthy recipe. [44]
It is, however, in relation to issues of mental health and the drive to get people with mental health problems back into the workplace that the limitations of the analysis and prescriptions of the “science of happiness” are most evident . Nowhere is this clearer than in the Depression Report, written by Layard and others and published in 2006, which is already having considerable influence on government mental health policy.
The report’s starting point – that “crippling depression and chronic anxiety are the biggest causes of misery in Britain today” – is one with which few could dissent. Quoting the Psychiatric Morbidity Survey, Layard and his colleagues note that one in six of us will be diagnosed as having depression or chronic anxiety disorder, which means that one family in three is currently affected. In itself, the desire to alleviate mental and emotional suffering on this scale is clearly a laudable one.
However, while similar findings about the extent of depression almost 30 years ago led George Brown and Tirill Harris to pose hard questions about the kind of society that gives rise to such levels of misery [45], no such concerns trouble the authors of this report. Instead their second finding – the “good news” as they call it – is that most of this misery is totally unnecessary and avoidable since “we now have evidence based therapies that can lift at least half of those affected out of their depression or chronic fear”. [46] Foremost among the evidence based therapies is cognitive behaviour therapy (CBT), the central notion of which is that mental ill health is the product of people holding faulty or irrational ideas about themselves (such as “I am a worthless person”). The role of therapy therefore is to help people challenge these ideas and help them develop a more accurate view of themselves and their relationships.
This, they argue, is good news for two groups of people. Most obviously, it is good news for those who are currently experiencing mental distress. It is also, however, good news for a New Labour government which is currently seeking to slash spending on Incapacity Benefit. For, as the report reminds us, as well as such mental ill health being a waste of people’s lives:
It is also costing a lot of money. For depression and anxiety make it difficult or impossible to work, and drive people onto Incapacity Benefit. We now have half a million people on Incapacity Benefits because of mental illness – more than the total number of people receiving unemployment benefit.
A key objective, then, of the report is to find ways of reducing the number of people with mental health problems currently claiming Incapacity Benefit.
How are these objectives to be achieved? The solution which the report proposes is the recruitment of many more CBT therapists – 10,000, to be precise – of whom 5, 000 would be clinical psychologists and another 5,000, including nurses, occupational therapists, counsellors and social workers, who, on the basis of part-time training over one or two years, would become “psychological therapists”. These would be trained and recruited over the next seven years, with the aim being that by 2013 there would be some 250 teams in place in England and Wales with around 40 therapists in each.
On the all-important question of costs, by 2013 the gross costs of the service would have reached about £600 million a year, with an additional annual training cost of around £50 million. However, the report’s authors suggest, these costs would be “fully offset, of course, by rapid savings to the Department for Work and Pensions and HM Revenue and Customs”.
How should we respond to these proposals? On an individual level, there is clear evidence that many people find CBT, and “talking therapies” more generally, a better way of addressing their mental health problems than taking prescribed drugs. For that reason alone, the extension of talking therapies on the NHS should be welcomed. There are, however, a number of problems with the notion proposed by Layard and his colleagues that, as an “evidence-based” approach, CBT should become the primary, if not the sole, form of therapy on offer, at the expense of all other approaches including person-centred and psychoanalytic approaches.
First, there is the uncritical acceptance of positivist notions of science and of what constitutes evidence. The fact that CBT, like other behavioural approaches, lends itself more easily than other therapies to quantitative methods of evaluation is not the same as saying that it is necessarily more effective.
Second, while there is research evidence to show that CBT can be effective for people with simple, uncomplicated, mild depression, there is less evidence for its effectiveness in helping people with more complicated or prolonged depression, including depression arising from early trauma. To state the obvious, different approaches are likely to work for different people. [47] In this respect, there is a particular irony in a New Labour government, which in its promotion of a choice agenda in education and social care is continually lambasting a “one size fits all” approach, promoting precisely such an approach in the field of mental health policy.
Third, despite frequent references to evidence-based practice, there is very little discussion in any of this literature (and none whatsoever in the Depression Report) of what by any criterion must be considered one of the most strongly established links in any body of social science research anywhere, namely the link between poverty, inequality and mental ill health. [48]
However, the main reason for being sceptical about these ideas relates to the intellectual and political climate in which they are being proposed and the uses to which they are already being put. For, whether it be Layard’s insistence that CBT can reduce the number of people with mental health problems on Incapacity Benefit by half or Carol Craig’s view that the roots of Scotland’s problems lie in its dependency culture, the key themes of the science of happiness fit like a glove with the dominant ideas and policies of the New Labour government in Britain and of neoliberalism more generally: notions of health as individual responsibility; rejection of poverty and inequality as explanatory frameworks; an abhorrence of dependency in any form; and of course the very specific policy, announced by the works and pensions secretary John Hutton in July 2006, to save billions of pounds by removing one million people from Incapacity Benefit. [49]
In this context, should Layard’s plans be implemented (and ten
pilot schemes have already been set up across England and Wales), one
can only feel concern for those with mental health problems who, for
whatever reason, have failed to attain good mental health after the
prescribed 16 weeks of CBT.
Thirty years ago Brown and Harris concluded their groundbreaking study of the social origins of depression by arguing that social factors shaped every aspect of depression, from the likelihood of its onset to the ways in which people interpreted their life experiences. The results as a whole, they concluded, focused attention on the importance of understanding early childhood attachments for the understanding of depressive phenomena. But they went on:
This does not mean, of course, that they just have implications in terms of individual psychology. The social class differences have much wider implications. [50]
That approach allowed them to explicitly envisage a different kind of society in which very few people would experience depression. It is perhaps a tribute of sorts to the triumph of neoliberalism that, despite equally high levels of mental ill health today, few, and even fewer happiness theorists, are capable of envisaging such a systemic alternative. Even the best of them, such as Oliver James, who rails eloquently against the “greed is good” values of neoliberalism and the ways in which they produce mental ill health, ends up protesting that “I am not against capitalism, which does not in itself cause Affluenza”. [51]
For the most part, despite nods in the direction of the need to reduce inequality, their unwillingness to address the structural factors which produce so much physical and emotional misery means in practice that achieving happiness becomes, for them, both an individual task and an individual responsibility. In that sense, Layard’s vision of “mass” CBT fits perfectly with welfare to work policies. For if phase one was about equipping individuals with the practical and technical skills to survive in a globalised workplace, then arguably phase two is about providing them (and particularly those with poor mental health) with the emotional and psychological skills to do so.
Fortunately, there is both a theoretical and a political alternative. The theoretical alternative is rooted in a Marxism which argues that human happiness, wellbeing and – importantly – individuality can only be fully realised in a society free of exploitation and oppression, a genuinely socialist society where people are free to develop their unique abilities and potential. This is a million miles away from Stalinist notions of prescribed “happiness from above” (where rumour has it that a favourite official slogan in the depths of the terror was “Life is better and merrier than ever before” [52]). By contrast, as Marshall Berman has argued, a core value of the young Marx was the notion of bildung, which Berman translates as meaning “self-development” or “becoming who you are”, whereas, Marx argued in his early writings, the dominance of money meant “the overturning of all individualities”. [53] More recently Terry Eagleton has argued:
We are, by nature, sociable animals who must cooperate or die; but we are also individual beings who seek our own fulfilment To be individuated is an activity of our species-being, not a condition at odds with it. We could not achieve it, for example, were it not for language, which belongs to me only because it belongs to the species first. [54]
As an example of this interaction between group and individual, he cites the example of a jazz group with “the free musical expression of each member acting as the basis for the free expression of the others” (though presumably in a genuinely socialist society there would also be space for lovers of folk music). [55]
The political alternative is rooted in a different critique of consumerism, that provided by the anti-capitalist movement that emerged out of the demonstrations against the World Trade Organisation in Seattle in 1999. [56] In common with some happiness theorists, the starting point for that movement was a rejection of the notion that our lives, our relationships and our world are simply commodities. Unlike them, however, rather than exhorting us to change the way we see the world, movement activists argued that “another world is possible”. For all its current debates and disagreements [57], it is that movement and that critique, rather than the individualist prescriptions of the “science of happiness”, which point the way out of the material and emotional misery that continues to blight the lives of millions.
1. Layard, 2005; McMahon 2006; Edmonds, 2006.
2. Gunnell, 2004.
3. Seligman, 2002.
4. www.authentichappiness.com.
5. Dolan, Peasgood and White, 2006.
6. Laurance, 2007.
7. Bergheim, 2007.
8. DWP, 2005.
9. CEPMHPG, 2006.
10. Craig, 2003.
11. Layard, 2005, pp. 3–4.
12. Cited in Wilkinson, 2005, p. 294.
13. Seligman, 2002, p. 61.
14. For those unfortunate enough to suffer from more serious mental illnesses, Seligman, like Richard Layard, appears to believe that biomedical psychiatry and drug treatments have the answers, despite very considerable evidence to the contrary. See Healy, 2001.
15. As the emphasis on meditation suggests, there is considerable overlap and interchange between the ideas of the “science of happiness” and Buddhist ideas, with Buddhist speakers figuring prominently, for example, in the Happiness and Its Causes conferences. Layard similarly recommends Happiness by Buddhist monk Matthieu Ricard (2007), saying, “If you want to be happier and better, this is the book you should read.”
16. Eagleton, 2007, pp. 151–152.
17. Cited in Levitas, 2000.
18. Seligman, 2002, p. 68.
19. Seligman, 2002, p. 12.
20. Layard, 2005, p. 163.
21. Layard, 2005, p. 174.
22. James, 2007.
23. James, 2007, p. vii.
24. Cited in Jordan, 2007, p. x.
25. Jordan, 2007, p. x.
26. Cameron, 2007.
27. One study which does look at this is The Weight of the World, by Pierre Bourdieu (1999), a massive study of “social suffering” in France, which has not been replicated elsewhere.
28. Layard, 2005, p. 29.
29. Cited in Timmins, 1996, p. 313.
30. Cliff, 1979.
31. Bergheim, 2007, p. 1.
32. See, for instance, Palmer, Carr and Kenway, 2005; Hills and Stewart, 2005; Pantazis, Gordon and Levitas, 2006.
33. Palmer, Carr and Kenway, 2005.
34. Dolan, Peasgood and White, 2006.
35. Laurance, 2007.
36. John Bruce Glasier, cited in Levitas, 2000, p. 206.
37. Lansley, 2006, p. 29.
38. Office for National Statistics, 2004.
39. Wilkinson, 2005, p. 294.
40. Bourdieu, 1999, p. 4.
41. Green, 2000.
42. Jones, 2004.
43. Cited in Hazards 93, p. 2.
44. Hazards 93, p. 4.
45. Brown and Harris, 1978.
46. CEPMHPG, 2006, p. 1.
47. Holmes, 2002; McPherson, Richardson, and Leroux, 2003; Plumb, 2005.
48. For reviews of the literature, see Rogers and Pilgrim, 2003, and Ramon, 2007.
49. The Guardian, 5 July 2006.
50. Brown and Harris, 1978, p. 289.
51. James, 2007, p. 329.
52. That’s Enough Happynomics, the Economist Free Exchange blog.
53. Berman, 1999, pp. 9–10.
54. Eagleton, 2007, pp. 167–168.
55. Eagleton, 2007, pp. 171–172.
56. Harman, 2000.
57. For a discussion of these, see Callinicos and Nineham, 2007.
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Berman, Marshall, 1999, Adventures in Marxism (Verso).
Bourdieu, Pierre, 1999, The Weight of the World: Social Suffering in Contemporary Society (Stanford University).
Brown, George, and Tirril Harris, 1978, Social Origins of Depression: A Study of Psychiatric Disorder in Women (Tavistock).
Callinicos, Alex, and Chris Nineham, 2007, At an Impasse: Anti-capitalism and the Social Forums Today, International Socialism 2 : 115 (Spring 2007).
Cameron, David, 2007, Closing Speech to Conservative Party Conference, 3 October 2007.
CEPMHPG, 2006, The Depression Report: a New Deal for Depression and Anxiety Disorders (Centre for Economic Performance’s Mental Health Policy Group, LSE).
Cliff, Tony, 1979, The Balance of Class Forces in Britain Today, International Socialism 2 : 6 (Autumn 1979).
Craig, Carol, 2003, The Scots’ Crisis of Confidence (Big Thinking)
Department for Work and Pensions, Department of Health and the Health and Safety Executive, 2005, Health, Work and Wellbeing – Caring for our Future: A Strategy for the Health and Wellbeing of Working Age People (The Stationery Office)
Dolan, Paul, Tessa Peasgood and Matthew White, 2006, Review of Research on the Influences on Personal Wellbeing and Application to Policy Making (Defra).
Eagleton, Terry, 2007, The Meaning of Life (Oxford University).
Edmonds, Noel, 2006, Positively Happy: Cosmic Ways to Change Your Life (Random House).
Green, Francis, It’s Been a Hard Day’s Night but Why? An Exploration of Work Intensification in Britain, Public Lecture, 23 June 2000, University of Kent at Canterbury.
Gunnell, Barbara, 2004, The Happiness Industry, New Statesman, 6 September 2004.
Harman, Chris, 2000, Anti-capitalism: Theory and Practice, International Socialism 2 : 88 (Autumn 2000).
Healy, David, 1998, The Psychopharmacologists (Hooder Arnold).
Hills, John, and Kitty Stewart (eds), 2005, A More Equal Society? New Labour, Poverty, Inequality, and Exclusion (Policy Press).
Holmes, Jeremy, 2002, All You Need is Cognitive Behaviour Therapy?, British Medical Journal 324.
James, Oliver, 2007, Affluenza (Vermillion).
Jones, Chris, 2004, The Neoliberal Assault: Voices from the Front-line of British Social Work, in Iain Ferguson, Michael Lavalette and Elizabeth Whitmore (eds.), Globalisation, Global Justice and Social Work (Routledge).
Jordan, Bill, 2007, Social Work and Wellbeing (Russell House).
Lansley, Stewart, 2006, Rich Britain: The Rise and Rise of the Super-wealthy (Politico’s).
Laurance, Jeremy, 2007, “Health, Wealth and a Skilled Job is the Way to Happiness”, The Independent, 28 July 2007.
Layard, Richard, 2005, Happiness: Lessons from a New Science (Penguin).
Levitas, Ruth, 2000, Discourses of Risk and Utopia, in Barbara Adam, Ulrich Beck and Joost Van Loon (eds.), The Risk Society and Beyond: Critical Issues for Social Theory (Sage).
McMahon, Darren M., 2006, Happiness: A History (Grove).
McPherson, Susan, Phil Richardson and Penny Leroux (eds.), 2003, Clinical Effectiveness in Psychotherapy and Mental Health: Strategies and Resources for the Effective Clinical Governance (Karnac).
Office for National Statistics, 2004, Focus on Social Inequalities (The Stationery Office).
Palmer, Guy, Jane Carr and Peter Kenway, 2005, Monitoring Poverty and Social Exclusion in the UK (Joseph Rowntree Foundation).
Pantazis, Christina, Dave Gordon and Ruth Levitas (eds.), 2006, Poverty and Social Exclusion in Britain: the Millennium Survey (Policy Press)
Plumb, Sally, 2005, The Social/Trauma Model: Mapping the Mental Health Consequences of Childhood Sexual Abuse and Similar Experiences, in Jerry Tew (ed.), Social Perspectives in Mental Health (Jessica Kingsley).
Ramon, Shulamit, 2007, Inequality in Mental Health: The Relevance of Current Research and Understanding to Potentially Effective Social Work Responses, Radical Psychology, Vol. 6, No. 1.
Ricard, Matthieu, 2007, Happiness: a Guide to Developing Life’s Most Important Skill (Atlantic Books)
Rogers, Ann and David Pilgrim, 2003, Mental Health and Inequality (Palgrave Macmillan).
Seligman, Martin E.P., 2002, Authentic Happiness (Simon and Schuster).
Timmins, Nicholas, 1996, The Five Giants: a Biography of the Welfare State (Fontana).
Wilkinson, Richard, 2005, The Impact of Inequality: How to Make Sick Societies Healthier (The New Press).
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Last updated on 31 January 2017