“Struggles in (Elderly) Care”

COMMENT: This entry aims to introduce the recent book by Hanne Marlene Dahl entitled Struggles in (Elderly) Care: A Feminist View (Palgrave Macmillan 2017). This rich theoretical text provides the basis for several forthcoming entries on “theorizing care”, “theorizing ageing”, and on “gendering and de-gendering”.

Here I wish to emphasize how Struggles in (Elderly) Care [hereafter referred to as Struggles] illustrates what it means to deploy a poststructural research perspective. Throughout the book Dahl’s focus is on complexity and contingency, and on the processural nature of change. She develops a repertoire of concepts to facilitate analysis of this kind, including some that will be familiar to those working with poststructural frameworks, e.g. “assemblage”, “discourses”, “logics”, “governmentality”, among others.

The key term in the book’s title – Struggles – signals Dahl’s poststructural theoretical positioning. She challenges a view that she sees as dominant in research in the area of elderly care, where the focus is on inevitable and fixed contradictory positions (e.g. “dilemmas”; pp. 76-77). By contrast she points to tensions, conflicts and points of change that produce struggles.

Reflecting her poststructural positioning Dahl notes that her analysis targets a specific context – paid elderly care in Denmark from the 1950s to 2015. Her material is drawn from several research projects conducted over the past two decades. Dahl also specifies that her analysis reflects a critical and feminist viewpoint.

Dahl deploys a range of strategies to ensure that she focuses on a level she describes as “micro”, and that she eschews grand narratives (p. 7, 47). For example, in several places she explains the theoretical benefits of using verbs rather than nouns, e.g. neo-liberalizing rather than neo-liberalism, and gendering (p. 29). At the same time she argues for and illustrates the possibility of drawing broader insights about the nature of the place of “care” in the context of a range of social and political processes – “commodifying, professionalizing, late modernizing, de-gendering, globalizing, bureaucratizing and the advent of neo-liberalism” (p. 19).

These broader insights are linked to the notion of “logics”, drawn from Annemarie Mol’s work (A. Mol, The logic of care – Health and the problem of patient choice, Routledge, 2008; see entry on “ontological politics”, 10 December 2017). Logics are described as “different ways of viewing and providing care” (p. 7), and are treated as synonymous with “governmental rationalities” (p. 129). This key term in Foucauldian-informed analysis is discussed in the Research Hub entry, 7 January 2018. In that entry I emphasize the usefulness of problematizations (brought to attention through the WPR questions; Bacchi WPR CHART) as a way to identify rationalities/logics, clearly a key task in this form of analysis.

Dahl highlights the importance of ensuring that we do not miss important struggles, those that may well be less visible or invisible due to a range of “silencing practices” within “discursive regulation”. To bring these struggles into view, Dahl elaborates three analytic techniques: deconstruction, some comparative discourse analysis and memory work (Chapter 4).

“Buildings as proposals”

Comment: This entry is prompted by a question from a PhD student, received in late December 2017. The question had to do with a comment I made in the keynote address I delivered at the Fourth Contemporary Drug Problems Conference (“Making Alcohol and Other Drug Realities”) in Helsinki in August 2017. The keynote address can be viewed at https://ndri.curtin.edu.au/events/cdp2017/

In that address I suggest that the WPR approach can be used to critically analyze buildings and other artefacts because, in effect, such artefacts can be seen as proposals that contain problem representations. The student wants to know in what sense buildings can be seen as proposals and why WPR is a useful form of analysis to apply to these kinds of material.

First, I need to mention that part of the purpose of the Helsinki address was to indicate the variety of materials that could usefully be examined critically using WPR. Please watch the video (link above) should you want the full list of kinds of material that I offer for WPR analysis (or see Bacchi, C. (2017). Drug Problematizations and Politics: Deploying a poststructural analytic strategy, Contemporary Drug Problems, 1-12. DOI: 10.1177/009/450917748760). In each case the argument runs thus: what we propose to do about something indicates what we think needs to change and hence what is deemed to be problematic – what the “problem” is represented to be. To apply WPR beyond the policy field, therefore, we need (only) to identify forms of material that can be perceived as “proposals”.

Buildings and other artefacts can be seen as proposals in the sense that they commit to particular ways of organizing the world. It follows that it is possible to ask: “If this building [or some part of a building, e.g. a purpose-built room or facility] is a statement about how things ought to be, what is seen as needing to change and hence as ‘the problem’?” Bottrell and Goodwin (2011, p. 4) use the example of modern schools with their “uni-purpose facilities located on enclosed land, fenced and gated” and how they reflect a “hidden curriculum” that problematizes the moral and cognitive training of young people (“Contextualising schools and communities”. In D. Bottrell & S. Goodwin (Eds.), Schools, communities and social inclusion. South Yarra, Australia: Palgrave Macmillan).

Other authors have drawn attention to the cultural and hence meaning-filled dimensions of buildings (see Woolgar and Jezaun 2013. “The wrong bin bag: A turn to ontology in science and technology studies?” Social Studies of Science, 43, 321–340). The question becomes: how are we to engage critically with artefacts of this kind? WPR, through its seven forms of questioning and analysis (see Bacchi WPR CHART), makes available a critical analytic strategy to interrogate buildings and other artefacts as to their presuppositions and limits, producing useful political analysis of a wide range of materials.

“political rationalities”

Comment: This entry is prompted by a question from a PhD student received mid-December 2017. The question concerns how to link identified problem representations to particular political rationalities. Using a WPR analysis, problem representations are identified through examining how specific policies produce or enact “the problem” (see Bacchi, Analysing Policy, Pearson Education, 2009). But how, I am asked, can you take the next step and draw links between these representations and particular political rationalities, such as neoliberalism? The short answer is that specific ways of representing “the problem” – e.g. who is held responsible, what is deemed to be the proper domain of government, how relations between governments and business activities are conceptualized, etc. – link to ways of thinking (“political rationalities”) that have a certain coherence (such as social liberalism, neoliberalism, etc.).

A longer reply requires two steps: first, elaborating what is meant by political rationalities; second, showing how these rationalities are linked to problematizations and hence to problem representations.

Rationalities, as used in governmentality studies, have nothing to do with being rational in the conventional sense of the term. Rather, rationalities are rationales, the logics or ways of thinking that make particular modes of government intelligible and hence acceptable. They are not ideologies; nor do they translate into policy in a direct fashion (see Larner, W. [2000]. “Neo-liberalism: Policy, ideology, governmentality”, Studies in Political Economy, 63, 5-25). Instead, based upon forms of knowledge that characterize our intellectual heritage, they underpin contingent routine and mundane governing practices (see Bacchi and Goodwin, Poststructural Policy Analysis, Palgrave Macmillan, 2016, p. 43).

The best way to characterize a political rationality is to note that it is a style of problematization (Dean, Mitchell and Hindess, Barry (1998) Governing Australia: Studies in Contemporary Rationalities of Government. Cambridge: Cambridge University Press, p. 9). As suggested in the short answer above, we can best identify a political rationality by considering how aspects of social relations are problematized. For example, a neoliberal mode of rule is commonly associated with governmental practices that presume self-regulation and an entrepreneurial spirit as desirable human traits. In this rationality/rationale, individuals themselves are held to be responsible should their economic or health status fail to meet expected standards. If one observes a pattern within targeted policies that problematizes political subjects in this way, holding them responsible for “failings” – a stance often described as “responsibilization” – one can say that a neoliberal rationality is in evidence. So too, one can examine how social relations more broadly are problematized. For example, considering social relations purely in economic terms can also be linked to a neoliberal rationality (see Calişkan, K. and Callon, M. (2009) Economization, Part 1: Shifting attention from the economy towards processes of economization, Economy and Society, 38:3, 369-398; and Birch, K. and Siemiatycki, M. (2016) ‘Neoliberalism and the geographies of marketization: The entangling of state and markets’, Progress in Human Geography, 40(2): 177-198).

The analytic task involves offering ways to interrogate and critique political rationalities that have possible deleterious effects. Here, WPR provokes reflection on the limits in particular ways of conceptualizing governmental and social relations by asking what is not problematized in specific practices and their underlying knowledges (Question 4 on Bacchi WPR CHART). It also directs attention to the forms of subject presumed and hence elicited through practices that produce individuals as responsible for their own health and welfare (Question 5 on Chart).

“Declaring war on ‘problems’ #2”

Comment: In the last entry [25 December 2017] I forecast that I would be considering alternative terminology to “problems”, a concept that I consider vague and, in some cases, dangerous [https://ndri.curtin.edu.au/events/cdp2017/]. To anticipate my argument, I suggest that any term we decide to use to identify the target of our analysis (e.g. “problem”, “issue”, “matters of concern”) needs to be put in question. I contrast a form of thinking that interrogates presumed starting points for analysis to a form of thinking that takes such starting points for granted. I wish to contest the latter form of thinking – that which takes designated starting points for granted. This form of thinking is most readily observed in the problem-solving paradigm; hence, my “declaration of war” on the concepts “problem” and “problems” (Bacchi Declaring War abridged).

The previous entry (25 December 2017) ended by noting that all concepts need to be considered within the projects to which they are attached. I accept Tanesini’s argument that concepts have no fixed meaning but are “proposals about how we ought to proceed from here” (see Tanesini, A. 1994. Whose language? In K. Lennon & M. Whitford, Eds. Knowing the difference: Feminist perspectives in epistemology. NY: Routledge, p. 207). Proposals are not necessarily intentional; rather, they represent the logic of an approach. The task here becomes sorting through the form of proposal associated with the uses of adopted concepts.

As an example, elsewhere [see above “Declaring War Abridged”] I note the recent tendency to argue that people face “challenges” rather than “problems”. Here “problems” are conceptualized as entailing some intrinsic difficulty. Turning them into “challenges” can imply that a person is to take charge of a situation, regardless of how difficult it may be, always remembering the importance of context. I find this usage of the term “challenges” worrying because it appears to depoliticize complex situations, turning it all back onto individuals. Hence, I actually prefer “problems” to “challenges” in such cases.

However, in the main, the terms “problem” and “problems” are themselves depoliticizing. “Problems” are presumed to simply exist. They are taken-for-granted conditions that need to be “solved”, denying the politics that goes into their shaping.

I have been asked if the term “issues” would be preferable to “problems”. It certainly appears to be a better choice since it does not carry the negative weight and hence judgment associated with “problems”. In Science and Technology Studies (STS; see Callon, M. 2009. “Civilizing markets”, Accounting, Organizations and society, 34: 535-548), a distinction is drawn between issues – called “stem issues” – and “problems”. “Stem issues” are described as “situations of initial shock” (p. 542), which are gradually “split into a series of distinct problems” (p. 543). STS theorist, Michel Callon, reserves the term “problematization” for the process of transforming “unsolvable [stem] issues into solvable problems” (p. 547; emphasis added).

I would clearly have difficulty with the second part of this argument since it adopts the very “problem-solving” logic I have challenged in Analysing Policy (2009) and elsewhere. However, I can also see reasons to object to the notion of “stem issues”. The question I am prompted to ask is – who decides what is a stem issue? I am wary of Bruno Latour’s “matters of concern” for similar reasons (see “Why Has Critique Run out of Steam? From Matters of Fact to Matters of Concern”, Critical Inquiry, 30: 225-248). Callon (2009, p. 536 and throughout) treats “matters of concern” as synonymous with “stem issues”, indicating their conceptual affinity.

Clearly Latour’s sophisticated challenge to “matters of fact” and his endorsement of “matters of concern” requires more attention that I can give to it here. However, it seems to me that the term “matters of concern” still invites the question – who gets to decide what “matters of concern” involve? As I forecast at the outset, I wish to contrast a form of thinking that interrogates presumed starting points for analysis (including “issues” and “matters of concern”) to a form of thinking that takes such starting points for granted. I believe that interrogating the “problems” or “challenges” or “issues” or “matters of concern” set by others (using the WPR questions; Bacchi Chart) marks an important step towards critical thinking.

“Declaring war on problems #1”

Comment: On 21 October 2017 I gave a short address at the University of Umeå where I was awarded an Honorary Doctorate. The full title of the address is: “Declaring war on problems: A call to rein in the concept”. In this entry I provide a brief summary of the argument and also attach an abridged version of the talk in Umeå [Bacchi Declaring War abridged]. I have labeled this entry #1 because I intend to follow it up in a week’s time with a second entry that considers the questions – “if we are not to refer to problems, are there alternative terms that are preferable? What about ‘issues’? ‘challenges’? ‘matters of concern’?” The goal in that second entry will be to identify what is at stake in selecting one of these options and why I recommend avoiding all of them!

I start the Umeå paper by explaining that the title – “Declaring war on problems” – does not imply that I am crusading against conditions commonly labeled as “problems”, for example, homelessness, discrimination, violence against women, etc.

Rather, I am declaring war on the concepts “problem” and “problems”. I proceed to list five reasons for my disquiet with these terms.

First, I am concerned by the ubiquity of the terms. Almost every discussion of government policy, by politicians and in the media, is peppered with references to “problem” and “problems”. Have a listen and see if you agree!

Of course, if it were clear what was intended by the usage of the terms, I would be happier about the situation. However, I suggest that the terms are at best vague and at worst meaningless – my second qualm!

Third, I note the worrisome negative valence attached to the terms, seen in the common association with the notion of “social problems”.

Fourth, I turn to the policy domain and the common characterization of policy as reacting to and solving problems. I proceed to offer the “What’s the Problem Represented to be?” (WPR) approach as a new way to think about how policies do their work.

Fifth, I turn my critical gaze to “problem-solving” as a paradigm dominating the intellectual and policy landscape. My examples are the “evidence-based” movement and education. Here I challenge the view that “problem-solving” is the basis of critical thinking.

I end the paper by noting that, as with all concepts, “problem” and “problems” need to be considered within the projects to which they are attached. Hence, the argument is not to eliminate the terms but to rein them in.