In this fourth blog on Archer’s work on reflexivity I posit an ideal type of the vulnerable fractured reflexive. While the focused autonomous reflexive and the dedicated meta-reflexive characterize significant players around the contestable nature, ownership and use and abuse of wealth and power, the vulnerable fractured reflexive is more accurately portrayed as a non-player. The vulnerable fractured reflexive, I contend, is primed for sickness and a life prematurely cut off.
Archer assesses the fractured reflexive in The Reflexive Imperative in Late Modernity along six dimensions. Her conclusions are broadly as follows:
- natal background:
they have experienced severely disruptive life-events, for example impaired health, redundancy, marital breakdown;
- home friends:
they lack longstanding solidary friendship networks, characterized by inclusiveness, reciprocity and trust, that incorporate confidants;
- new friends:
new friendships, or acquaintanceships, are typified by ‘dependency’;
- career drivers:
their work motivations are ‘ephemeral’, suggesting the lack of any clear mission and specific criteria of worth or accomplishment;
- career aspirations:
they lack any tangible sense of just what type of job they want, where and why;
- situational logic of opportunity:
they are above all ‘passive’ in their orientation, within and without the labour market.
She rejects any notion that her delineation of types of reflexive is essentially a matter of and for psychology. Fractured reflexives do not just exhibit an external locus of control; rather, modes of reflexivity are ‘conditioned’ both structurally and culturally.
So, who precisely are the members of my sub-type of ‘vulnerable fractured reflexives’, and how does their membership pertain to the sociology of health inequalities? To take the first question first, they present as:
HARRANGUED BY THE LIFEWORLD
Sucked in and (almost) dry by the routines and demands of the private sphere or household. The everyday business of getting by (almost) asks too much.
‘SHIPS WITHOUT ANCHOR’
They lack bearings, drifting, at the beck-and-call and mercy of Lyotard’s (1971) ‘petit’ narratives. There is no core to who they are or why and what this might amount to: it has been nibbled away by the cut and thrust of conditioned circumstance.
SWAYED BY OTHERS’ LEADS
In need of rescue or guidance, they await the arrival of either the cavalry or an autonomous or meta-reflexive (the latter in particular should take out insurance); but they wait without real hope or expectation.
SUBSERVIENT TO FLEETING EPHEMORA
With no set compass and disorientated, they attach themselves to fads, fashions and the discourses of the moment, but without conviction or commitment; rather they are appendages or ‘hangers on’ to the convictions and commitments of others.
LACKING PERSONAL PROJECTS
They are characterized by passivity: they are Sartrean ‘objects-for-others’, underplaying any causal efficacy for want of personal aspiration or ambition.
Expanding on Marx’s classic exegesis, they are alienated in line with each of Seeman’s (1959) dimensions: powerlessness, meaninglessness, normlessness, isolation, and self-estrangement.
OF LOW SELF-WORTH AND ESTEEM
Following on from their natal backgrounds and early life-events, impoverished sense of self, plus the ‘self-fulfilling prophecy’, they hold themselves of little account. Their outlook is informed by ‘felt stigma’ and/or ‘felt deviance’, a sense that they are either imperfect, inadequate or both.
Why might those exhibiting the features of the vulnerable fractured reflexive be ‘set up’ for impaired health and even a shortened life expectancy?
There is an extensive literature on the social determinants of health/health inequalities, much of it made available through socio-epidemiological research. I have long maintained that we sociologists have not pulled our weight. So how might this application of Archer’s theories help? There is one obvious way. I have referred elsewhere to the salience for health of a psychological asset flow. Individuals can be demonstrably ‘vulnerable’ or ‘resilient’; and it is axiomatic that these attributes are in part down to natal and social background, to our ‘involuntary placement’ as well as to contingency and to happenstance, and therefore do not simply reduce to psychological precepts. Agency is structured but not structurally determined. Who we (think we) are and how we evaluate ourselves impacts on our lives and our health. This assertion is at least consonant with a vast body of research.
But I suggest that the ideal type of the vulnerable fractured reflexive offers more to the sociology of health inequalities than this. First, it has synthesizing potential. Revisiting the sixth item in the ideal type of vulnerable fractured reflexive above – namely, ‘alienation’ – and Seeman’s 1950s breakdown via powerlessness, meaninglessness, normlessness, isolation and self-estrangement, affords a clue. Yuill has reminded us that Marx’s original fourfold concept of alienation has been neglected by medical sociologists. But Marx’s remarkable analysis of capitalism and the purchase of his explication of alienation alike require revision 150 years later. My suggestion is that the vulnerable fractured reflexive constitutes an absent presence in the postmodern or ‘relativized culture’ of financial capitalism.
Vulnerable fractured reflexives, found in all classes but, I conjecture, in inverse relation to SEG/S, only become visible when sought. They live their lives below the radar. To today’s oligarchs they make up the numbers. They are not floating voters in general elections: they may vote with the tabloids or, most likely, not at all. If they can be summed up in a phrase, then disconnected fatalists might suffice. They are disconnected in Castells’ increasingly networked or connected world. My general hypothesis is that their overriding characteristic – disconnected fatalism – constitutes a socially structured subjectivity that predisposes to risk behaviours for health and longevity. It is a hypothesis that subsumes two more specific contentions since the concept of ‘risk behaviours’ deployed here goes round and beyond that conventionally deployed.
The first of these contentions is readily compatible with the behavioural model of health inequalities. It is that vulnerable fractured reflexives are more likely than others to engage in acts, and to acquire and sustain habits, known to be injurious to health. Included here are well-researched patterns of (neo-liberals would say ‘irresponsible’ or ‘mis-‘)behaviour like cigarette and excessive alcohol and fatty food consumption and the under-use of health and social services.
But the second contention introduces a different kind of behaviour. Archer notes that fractured reflexives are prone to social immobility. In this vein I would argue that vulnerable fractured reflexives are less likely than others to be proactive, or even active, in challenging of the weakening of those asset flows known to be salient for positive for health and longevity (most significantly, the flow of material assets). If I am right, then it follows that disadvantage down to involuntary placement, early childhood and so on has special significance for this group. They are as unlikely to envisage or anticipate improved wellbeing as they are to take steps to achieve it. Life slips by. An inherited firm goes bust under their lackluster management; they forego opportunities for promotion or advancement, judging themselves fortunate to be in paid work at all; they did not buy their council house; the present recession is a fact of life; universal credit represents an reasonable assessment of their worth.
But there is more and deeper here for the sociologist of health inequalities. This is not just about the social determinants of disease, interruptions to wellbeing and shortened life expectancy. The lot of the vulnerable fractured reflexives can only be grasped ‘against’ the strategic behaviours of the focused autonomous reflexives. The former are in a sense an ongoing strategic accomplishment of the latter. It is not being suggested, of course, either that the strategic acts of the oligarchy are the sole reason for the existence, attributes and lot of the vulnerable fractured reflexives, or that the circumstances of the latter can be sufficiently characterized as the by-product of (class-based) exploitation and (command-based) oppression; nor are dedicated meta-reflexives lined up on the horizon, ready and willing to ride to the rescue. But it is mooted that exploitation and oppression are basic to their enduring disadvantage (that is, for any clustering and restriction of those asset flows salient for health and wellbeing).
Using a terminology deployed elsewhere, relations of class and command are likely to be ‘categorical’ for vulnerable fractured reflexivity in the ‘figuration’ or context of the nation state; but may well be ‘derivative’ (of other relations: for example of gender, ethnicity, age, stigma or deviance), or even annulled by them, in other more local or specific figurations. Nor are mechanisms outside of the social irrelevant. Biological and psychological mechanisms are also and continuously at play, as indeed are serendipity and contingency and those socially unpredictable exigencies of ‘free will’. So the claims here are modest in the face of the complex dynamics of human sociability.
I have argued elsewhere that acts emanating from the oligarchy should be re-framed as risk behaviours for the health of others, most obviously for vulnerable fractured reflexives. Maybe this is to extend courtesy too far: Engels and Virchow wrote of murder in comparable circumstances. Analyses of the backgrounds, interrelations and projects of the wealthy and powerful, and of the social structures they ‘surf’ to their personal advantage, are conspicuous by their absence in the sociology of health inequalities. A British study after the manner of C Wright Mills’ ‘Power Elite’, but focusing on structured agency and the ‘whys’ as well as the ‘hows’ of the oligarchy’s effective regime of impairment and manslaughter in financial capitalism, is long overdue.
Blogs two and three in this series offered ideal types of key players in the production, reproduction and durability of, plus resistance to, health inequalities: these were the focused autonomous reflexives and the dedicated meta-reflexives respectively. In this fourth blog I have singled out a species of non-player, the vulnerable fractured reflexive. It is a more difficult case to make. The degree of difficulty is a function of: (a) a lack of sharpness in the contours of fractured reflexivity in general and the profile of its vulnerable constituents in particular (they are defined in terms of what they are not rather than what they are); and (b) the sheer audacity of the claim that vulnerable fractured reflexivity captures something of a socially-or structurally-induced, post-alienated and post-anomic cast of mind – epitomized in the concept of disconnected fatalism – with the potential to synthesize much of sociology’s input into the social determinants of health and health inequality.
A sequence of questions might be posed, each one in need of rigorous conceptual and/or empirical scrutiny:
- how credible is it to identity an ideal type of the vulnerable fractured reflexive?
- to what extent does this ideal type carry a potential to synthesize the sociology of susceptibility to poor health and premature death?
- does the ideal type offer a sociological qualification or ‘corrective’ to the psychology of vulnerability/resilience?
- does the concept of disconnected fatalism adequately represent a mind-set beyond Marxian alienation and Durkheimian anomie that nails a negativity peculiarly damaging for health?
- how might disconnected fatalism cut across and restrict which asset flows known to be important for health, wellbeing and life-expectancy?
- might all this add up to a sociology of subjectivity missing from but critical for a sociology of health inequalities?
Might it be – a final query – that fractured reflexivity in general, and vulnerable fractured reflexivity in particular, are becoming prevailing modes of thought and action for those falling or left behind in financial capitalism (what Archer calls ‘late’ and I prefer to call ‘high’ modernity? Are we seeing the emergence of a cast of mind specific to our changing social scene that lends itself directly to impoverishment of life and health and indirectly to a widening and deepening of health inequalities?