‘Working Through’: An Inquiry into Work and Madness

Abstract

This interdisciplinary doctoral thesis represents the weaving together of several partially independent strands of research conducted by the author between 2008 and 2011 in the field of madness, work and recovery. The purpose of the thesis is, to borrow from Freud, to ‘work through’ some of the rich and diverse links between work and mental health as they appear throughout time and space, and in particular in a climate where getting people with mental health problems back to work is a central political priority. The first stream of the thesis is dedicated largely to an historical and philosophical analysis of the relation between work and madness, and especially the therapeutics of work. Next, voices from contemporary mental health service-users—drawn both from ethnographic work in spaces of ‘sheltered’ employment and narrative research with individuals in mainstream paid employment—are introduced to offer a series of disruptions to common understandings of what it means to be mad at work. Finally, the thesis turns to policy and to an examination of the ‘what works’ agenda in getting people with mental health difficulties back into paid employment. Rather than add further to this evidence base, the thesis seeks instead to describe what may be lost when ‘what works’ becomes the only way of thinking about recovery. Recurring themes in the thesis include the tensions between therapeutic work and damaging work; between curing madness and embracing it; between the complex relations between work, employment and activity and their role in recovery; and between the competing epistemological positions of service-user centred perspectives and critical hermeneutics in understanding the relation between work and mental distress. At their simplest, conclusions point to the need for a rich and plural theoretical landscape of work and mental health and to the need to resist overarching and inflexible policy interventions.