Take up thy bed and Work

The first time I heard the term ‘worklessness’ I remember a shiver running down my spine- it was the way in which it was being used to describe an apparent ‘human condition’ in which there was a sense of this being a lifestyle choice. We were told that it meant not simply being ‘unemployed’ but not actively seeking and/or being available for work; but it was not applied to the idle rich or others members of society, myself now included, who have concluded that work is not particularly good for their health but do not need to claim benefits (although my University Pension, funded partly through the state is still a benefit). At a time when the drive towards viewing employment as the desired outcome for people with mental illness was beginning to take precedence over other more used-centred outcomes it was a prescient warning of changes about which we are now only too aware- the move to treat people with physical but also particularly mental health problems as essentially capable of taking up their own beds and walking to the Job Centre, regardless of their condition.

I’m very suspicious of terms that are used by governments to describe those who do not comply with what is expected of them in our societies. As a psychiatrist I have been accused of being an agent of the state on more than one occasion, but the role played by British psychiatrists is a long way from that which was played by Nazi psychiatrists in the Third Reich who colluded in ‘euthanasia’ or by the psychiatrists in the Soviet Union who were willing to label political dissidents with the diagnosis of ‘sluggish schizophrenia’- which resulted in the expulsion of their organization from the World Psychiatric Association. The use of diagnoses to both label and treat dissident citizens continues to this day- for example in the controversial treatment in China of the practitioners of the Falun Gong meditation movement who are deemed to be psychotic and undergo ‘treatment’. We have also recently seen the notorious collusion between psychologists in the USA and torture of detainees at Guantanamo Bay. Professionals who were willing to behave unethically in the service of the state for payment.

You may say these are extreme examples, but I think we should be concerned when political and social issues are described in terms which a) infer that the problem lies within the individual rather than society b) dresses this up in pseudo-psychological terminology and c) infers that there is a treatment, psychological and/or physical for this.

The report this week from Birkbeck College highlighted the way in which being unemployed is increasingly described in policy documents as a problem of the individual, who lacks motivation or the ‘right attitude’ to obtain a job. This is deemed to be ‘treatable’, although for a professional to engage in such enforced treatment, without which a person will lose his or her benefits has been described as ‘not only unethical but probably illegal’.

It’s difficult to see how a person with severe mental illness would be capable of acquiring the ‘right attitude’ when they are still struggling with the everyday tasks of life. Yet there are people in our government who clearly think this is possible, which is not only senseless but very, very scary. It reminds me of the attitude of some of the people I worked with over the years, who truly seemed to believe that mental illness is itself a ‘lifestyle choice’, which the person suffering not only had power over, but could choose to change if only they wanted to do so. An attitude which not only lacks basic empathy, but has a seductive simplicity which has emerged recently in the imperative to declare oneself ‘well’ and ‘recovered’, and has been around for many years in some so-called ‘self-help books which tell you that you can ‘climb out of your prison’ without any help in unlocking the door.

It’s a worrying trend in a society, which seems not only to care less than ever for those who have disabilities but to declare that a person has, within him or herself, the power to overcome their problems, if they choose to, and obtain a job with or without the aid of some motivational therapy. And what happens if they don’t take up their beds and work? The Rt Honourable Ian Duncan Smith would seem to believe they must work, because it is in itself a form of treatment. For as it famously said on the gates of Auschwitz, Arbeit macht frei ‘Work Sets You Free.’

3 thoughts on “Take up thy bed and Work”

  1. depression over the past 30 years has robbed my ability to work prior to this i ran two businesses served as a police officer and served an apprenticeship.I always wanted to work but depression i can only describe blocked my ability to do so.I had no choice over this it was like a power greater than my own will, ive had recurrent severe episodes often suicidal im out of the worst at present
    but will it happen again? work would surely cure this? i think not………

  2. This article has provoked a very strong reaction in me. I too have suffered several bouts of severe depression, and am not too good right now. I am of Anglo-German extraction, and have through formal academic study of the Second World War a wide and deep knowledge of the way in which Germany and Germans went so badly wrong in human terms. I have suffered untold agonies at the knowledge that my mother, though not an active participant in any cruelty, supported through her role as a Flak auxiliary that terrible regime. How chilling, then, to see you use, so accurately, the term ‘Arbeit Macht Frei’ in connection with current policies towards ill individuals. Especially as I watch one of my children, a vulnerable adult with some learning difficulties and bipolar disorder, maltreated through ATOS by a care-less state. I discovered your book, and read it avidly. I recognised myself in so much of it, it was very helpful. But what can one do in the face of such odds? My father brought me up with socialist values of caring and sharing, but now I find these are of little use. Nonetheless, I thank you for your insightful work.

  3. Dear Ingrid
    I am sorry to take so long to reply. I was anxious about using that phrase, but it has been used, I think, by a member of the government to support pushing people into work. I’m very sorry to hear about your family member’s problems with this inhumane system. There are still so many people around who do care. We continue to try and support each other. My very best wishes

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