Cure and mental illness. A short reflection on the conceptual analysis of the neoliberal characterisation of ‘cure’ in mental health

What it means to be ‘cured’ from mental illness has undergone significant changes in the past century. This involved not just changing ideas about what to recover from but also of what to recover to, what it means to be a ‘healthy’ human being. Where the World Health Organisation (WHO) in its early 1948 charter defined being healthy as a ‘state of complete mental and social wellbeing and not merely the absence of disease or infirmity’, a decade ago this changed to being able to ‘adapt and self-manage in light of the physical, emotional and social challenges of life’.[1] In the past years, political theorists, philosophers and historians have increasingly studied these changes and placed them in the historical context of the rise of neoliberal ideology in Western governmentality and health care logic since the 1980s. The short essay will look at the rise of a neoliberal concept of ‘cure’ and how this can be studied. More than answering, it further poses the question to what extend an conceptual analysis like this requires or presupposes one to formulate their own ideological position? 

One of the major problems that the conceptual analysis of the rise of neoliberal thinking in any topic, including mental health, involves is that nobody describes her or himself as a neoliberal thinker. Some have argued that the word therefore is merely a ‘buzzword’ for something unwanted, ‘a slur’ that rather identifies the political background of who uses it, then what it is applied on.[2] Where Michael Freeden and Jan-Werner Muller have argued that a large problem in analyzing conservatism is that ‘it is mainly conservatives who write about conservatism’, in the case of neoliberalism it is indeed paradoxically that its solely critics of neoliberalism that write about, but more importantly denominate what ‘classical’ neoliberal texts and thinkers are.[3] This leads to the famous dilemma for historians and philosophers of ideas that Quentin Skinner posed: can we credit a ‘doctrine’, a set of ideas; an ideology, to the words or texts of someone who ‘failed to articulate the doctrine with which they are being credited’? Can we reconstruct any ‘implied intentions from guesses or vague hints’ or would we merely fill this in with our own, ideological, ‘expectations about what she or he must be saying’?[4]

Luckily, Skinner also posed the solution for this dilemma by making use of one of the few things the Austrian philosopher Ludwig Wittgenstein was right about, namely, that ‘rather than studying the supposed meaning of words we should look at how they are used’.[5] To study neoliberal thinking in mental health thinking and policy, it is therefore useful to follow David Harvey’s (2007) conceptualization of neoliberalism as a ‘theory of political economic practices’ that idealizes the market as a natural framework of human interactions and, as Trent Hamann argues, ‘compels individuals to assume market-based values in all of their judgments and practices’.[6] Or, as Ulrich Bröckling summarizes, a logic that urges people to ‘self-conceptualize as an entrepreneurial self’ that is constantly ‘self-improving’ and takes ‘self-responsibility rather than being depended on others’.[7]

With that in consideration, the increasingly neoliberal conceptualization of ‘curing from mental health’ from the 1990s can be seen in that both government and some people with mental illness began defining themselves as ‘consumer’, that rationally, in an act of self-responsibility, searches for the best options for treatment on the market. At the same time, my research on the Decade of the Brain (1990-2000) has shown that neuroscientists in an attempt to get governmental attention and funding, in this period increasingly began defining the necessity of treatment in purely economic terms; as the relieve of an ‘economic burden’ by letting ‘people with mental illness return to the labor market’. Thus, as neuroscientific research of a ‘cure’ became interwoven with an promise allowing people to ‘return to the work floor’, making that symptoms of mental illness were increasingly defined as inabilities to ‘function’ on the job market and being healthy as being an working entrepreneurial-self.[8] As my thesis shows, this meant that recovery from mental illness not just became an market-interaction but more so, framed as an necessary act of ‘self-improvement’. Indeed presupposing that mental health treatments should be chosen, and that this can be either be a good or bad purchase, but at all times one that is reflective of the individual, rather than society. 

Wessel de Cock

[1] See for instance: Sahoo, M., ‘The Effects of Neoliberal Practices on Public Health’, in: The Public Health Advocate (dec 2018)

[2] Borders, M., ‘Neoliberalism. Making a Boogeyman Out of a Buzzword’, in: Foundation for Economic Education (FEE) (26-06-2015)

[3] Muller, J.W., ‘Comprehending conservatism. A new framework for analysis, Journal of Political Ideologies’ 11:3 (2006) 359-365.

[4] Skinner, Q., ‘Meaning and Understanding in the History of Ideas’, in: History and Theory 8.1 (1969) 3-53, 6, 10.

[5] Skinner, Q., ‘Meaning and Understanding in the History of Ideas’ 37.

[6] Hamann, T.H., ‘Neoliberalism, Governmentality and Ethics’ in: Foucault studies 6 (February 2009) 37-59, 38.

[7] Brenner, N., Peck, J., and Theodore, N., ‘Variegated Neoliberalization. Geographies, modalities, pathways’, in: Global Networks 10.2 (2010) 182-222, 185.

[8] Bröckling, U., The Entrepreneurial Self. Fabricating a New Type of Subject (2015).

One thought on “Cure and mental illness. A short reflection on the conceptual analysis of the neoliberal characterisation of ‘cure’ in mental health

  1. Pingback: Cure and mental illness. A short reflection on the conceptual analysis of the neoliberal characterisation of ‘cure’ in mental health – The Dog Walks

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