Psychocentrism and Homelessness: The Pathologization/Responsibilization Paradox
DOI:
https://doi.org/10.26522/ssj.v10i1.1349Keywords:
homelessness, mental and emotional distress, mental illness, psychocentrism, neoliberalism, shamed poor, empowerment discoursesAbstract
Psychocentrism is a governing neoliberal rationality that pathologizes human problems and frames individuals as responsible for socially structured inequalities. The homeless community provides an important case study to examine the ways psychocentrism manifests among an excluded population. This paper explores the paradox whereby homeless individuals are simultaneously pathologized and responsibilized through psychocentric discourses in which their status as economically poor becomes individualized as a symptom of mental illness and/or addiction. Although medicalized understandings of mental and emotional distress pervade the homeless industry, the obligations of freedom in the neoliberal era mean that individuals alone are held responsible for their failures. The paper examines the ways individuals experiencing homelessness are compelled to embark on an entrepreneurial project of the self that requires them to accept blame for their social precariousness. Further, it deconstructs the narratives that regard social explanations as an excuse and a failure of individual accountability. I argue that the “shamed poor” adopt empowerment discourses touted by the homeless industry, which paradoxically encourage individuals to find strength in their personal failures and to work toward self-governance, devoid of historical, social, and cultural context.
References
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Bahr, H. M. (1967). Drinking, interaction, and identification: Notes on socialization into skid row. Journal of Health and Social Behavior, 8(4), 272-285.
Barreira, P., Macias, C., Rodican, C., & Gold, P. B. (2008). Choice of service provider: How consumer self-determination shaped a psychiatric rehabilitation program. Psychiatric Rehabilitation Journal, 31(3), 202-210.
Bauman, Z. (1988). Freedom. Milton Keynes, UK: Open University Press.
Bradford, D. W., Gaynes, B. N., Kim, M. M., Kaufman, J. S., & Weinberger, M. (2005). Can shelter-based interventions improve treatment engagement in homeless individuals with psychiatric and/or substance misuse disorders?: A randomized controlled trial. Medical Care, 43(8), 763-768.
Bresson, M. (2003). Le lien entre santé mentale et précarité sociale: Une fausse evidence. Cahiers Internationaux de Sociolgie, 115, 311-326.
Burstow, B., LeFrançois, B. A., & Diamond, S. (2014). Psychiatry disrupted: Theorizing resistance and crafting the (r)evolution. Montreal: McGill-Queen's University Press.
Burstow, B., & Weitz, D. (Eds.). (1988). Shrink resistant: The struggle against psychiatry in Canada. Vancouver: New Star Books.
Castel, R. (1991). From dangerousness to risk. In G. Burchell, C. Gordon & P. Miller. (Eds.), The Foucault effect: Studies in governmentality (pp. 281–298). Chicago: University of Chicago Press.
Castel, R. (2003). From manual workers to wage laborers: Transformation of the social question (R. Boyd, Trans.). New Brunswick: Transaction Publisher.
Christensen, R. C. (2009). Psychiatric street outreach to homeless people: Fostering relationship, reconnection, and recovery. Journal of Health Care for the Poor and Underserved, 20, 1036-1040.
Chunn, D., & Gavigan, S. A. M. (2004). Welfare law, welfare fraud, and the moral regulation of the ‘never deserving’ poor. Social & Legal Studies, 13(2), 219-243.
CPHI (Canadian Population Health Initiative). (2009). Mental health, mental illness, and homelessness in Canada. In J. D. Hulchanski, P. Campsie, S. Chau, S. W. Hwang & E. Paradis (Eds.), Finding home: Policy options for addressing homelessness in Canada (pp. 156-176). Toronto: Canadian Homelessness Research Network.
Cruikshank, B. (1999). The will to empower: Democratic citizens and other subjects. Ithaca, NY: Cornell University Press.
Dell, C. A., Fillmore, C. J., & Kilty, J. M. (2009). Looking back 10 years after the Arbour inquiry: Ideology, policy, practice, and the federal female prisoner. The Prison Journal, 89(3), 286-308.
Desjarlais, R. (1997). Shelter blues: Sanity and selfhood among the homeless. Philadelphia: University of Philadelphia Press.
Elias, N. (1978). The civilizing process. New York: Urizen Books.
Fairclough, N. (1985). Critical and descriptive goals in discourse analysis. Journal of Pragmatics, 9(6), 739-763.
Feldman, L. C. (2004). Citizens without shelter: Homelessness, democracy, and political exclusion. Ithaca, NY: Cornell University Press.
Fischer, S., Shinn, M., Shrout, P., & Tsemberis, S. (2008). Homelessness, mental illness, and criminal activity: Examining patterns over time. American Journal of Community Psychology, 42(3), 251-265.
Foucault, M. (1961/1977). Discipline & punish: The birth of the prison (A. Sheridan, Trans.). New York: Vintage.
Foucault, M. (1979/1988). Madness and civilization: A history of insanity in the age of reason (R. Howard, Trans.). New York: Vintage Books.
Gaetz, S., Donaldson, J., Richeter, T., & Gulliver, T. (2013). The state of homelessness in Canada: 2013. Toronto: Canadian Homeless Research Network Press.
Goering,P., Veldhuizen, S., Watson, A., Adair, C., Kopp, B., Latimer, E., . . . Aubry, T. (2014). National at home/chez soi final report. Calgary: Mental Health Commission of Canada.
Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Englewood Cliffs, New Jersey: Prentice-Hall.
Greenberg, G. A., & Rosenheck, R. A. (2008). Jail incarceration, homelessness, and mental health: A national study. Psychiatric Services, 59(2), 170-177.
Hamer, D., & Copeland, P. (1994). Science of desire: The gay gene and the biology of behavior. New York: Simon & Schuster.
Hannah-Moffat, K. (2000). Re-forming the prison: Rethinking our ideals. In K. Hannah-Moffat & M. Shaw (Eds.), An ideal prison? Critical essays on women's imprisonment in Canada (pp. 30-40). Halifax, NS: Fernwood Publishing.
Insel, T. R. (2008). Assessing the economic costs of serious mental illness. American Journal of Psychiatry, 165(6), 663-665.
Katz, M. B. (2013). The undeserving poor: America's enduring confrontation with poverty. New York: Oxford University Press.
Kendall, K. (2000). Psy-ence fiction: Inventing the mentally-disordered female prisoner. In K. Hannah-Moffat & M. Shaw (Eds.), An ideal prison? Critical essays on women's imprisonment in Canada (pp. 82-93). Halifax, NS: Fernwood Publishing.
Kilty, J. M. (2012). ‘It's like they don't want you to get better’: Practicing ‘psy’ in the carceral context. Feminism & Psychology, 22(2), 162-182.
Laing, R. D. (1960). The divided self. New York: Pantheon Books.
Lofland, J., Snow, D. A., Anderson, L., & Lofland, L. H. (2006). Analyzing social settings: A guide to qualitative observation and analysis (4th ed.). Belmont, CA: Wadsworth/Thomson Learning.
Lupton, D. (1995). The imperative of health: Public health and the regulated body. London: Sage Publications.
Lyon-Callo, V. (2000). Medicalizing homelessness: The production of self-blame and self-governing within homeless shelters. Medical Anthropology Quarterly, 14(3), 328-345.
Lyon-Callo, V. (2004). Inequality, poverty, and neoliberal governance: Activist ethnography in the homeless sheltering industry. Peterborough, ON: Broadview Press.
Maidment, M. R. (2006). Doing time on the outside: Deconstructing the benevolent community. Toronto: University of Toronto Press.
Maruna, S. (2001). Making good: How ex-convicts reform and rebuild their lives. Washington: American Psychological Association.
Maté, G. (1999). Scattered minds: A new look at the origins of healing attention deficit disorder. Toronto: Vintage Canada.
Maté, G. (2008). In the realm of hungry ghosts: Close encounters with addiction. Toronto: Vintage Canada.
Mathieu, A. (1993). The medicalization of homelessness and the theater of repression. Medical Anthropology Quarterly, 7(2), 170-184.
McNaughton, C.C. (2008). Transitions through homelessness, substance use, and the effect of material marginalization and psychological trauma. Drugs: Education, Prevention, and Policy, 15(2), 177-188.
Mosher, J. (2002). The shrinking of the public and private spaces of the poor. In J. Hermer & J. Mosher (Eds.), Disorderly people: Law and the politics of exclusion in Ontario (pp. 41-53). Halifax, NS: Fernwood Publishing.
Muir-Cochrane, E., Fereday, J., Jureidini, J., Drummond, A., & Darbyshire, P. (2006). Self-management of medication for mental health problems by homeless young people. International Journal of Mental Health Nursing, 15(3), 163-170.
Nussbaum, M. (2006). Hiding from humanity: Disgust, shame, and the law. Princeton, NJ: Princeton University Press.
O'Grady, B., Gaetz, S., & Buccieri, K. (2011). Can I see your ID? The policing of youth homelessness in Toronto. Toronto: JFCY & Homeless Hub.
Olin, J. S. (1966). ‘Skid row’ syndrome: A medical profile of the chronic drunkenness offender. Canadian Medical Association Journal, 95(5), 205-214.
Paradis, E. K., & Stermac, L. (2001). Homeless women and victimization: Abuse and mental health history among homeless rape survivors. Resources for Feminist Research, 28, 65-80.
Pollack, S. (2009). ‘You can't have it both ways’: Punishment and treatment of imprisoned women. Journal of Progressive Human Services, 20(2), 112-128.
Rimke, H. (2000). Governing citizens through self-help literature. Cultural Studies, 14(1), 61-78.
Rimke, H. (2003). Constituting transgressive interiorities: 19th century psychiatric readings of morally mad bodies. In A. Arturo (Ed.), Violence and the body: Race, gender and the state (pp. 403-428). Bloomington, IN: Indiana University Press.
Rimke, H. (2010). Consuming fears: Neoliberal in/securities, cannibalization, and psychopolitics. In J. Shantz (Ed.), Racism and borders: Representation, repression, resistance (pp. 95-113). New York: Algora Publishing.
Rimke, H. (2011). The pathological approach to crime: Individually based theories. In K. Kramar (Ed.), Criminology: Critical Canadian perspectives (pp. 78-92). Toronto: Pearson Education Canada.
Rimke, H. (2016). Pathologizing resistance and promoting anthropophobia: The violent extremism risk assessment (VERA) as case study. In H. Ramadan & J. Shantz (eds.) Manufacturing phobias: The political production of fear in theory and practice (pp. 17-26). Toronto: University of Toronto Press.
Rimke, H., & Brock, D. (2012). The culture of therapy and psychocentricity in everyday life. In M. Thomas, R. Raby, & D. Brock (Eds.) Power and everyday practices (pp. 182-202). Toronto: Nelson Press.
Rimke, H., & Hunt, A. (2002). From sinners to degenerates: The medicalization of morality in the 19th century. History of the Human Sciences, 15(1), 59-88.
Rose, N. (1999). Powers of freedom: Reframing political thought. Cambridge: Cambridge University Press.
Rose, N. (2007). The politics of life itself: Biomedicine, power, and subjectivity in the twenty-first century. Princeton, NJ: Princeton University Press.
Schnittker, J. (2008). An uncertain revolution: Why the rise of a genetic model of mental illness has not increased tolerance. Social Science & Medicine, 67, 1370-1381.
Sedgwick, P. (1982). Psychopolitics: Laing, Foucault, Goffman, Szasz and the future of mass psychiatry. New York: Harper & Row Publishers.
Shamrat, I. (1997). Call me crazy: Stories from the mad movement. Vancouver: Press Gang Publishers.
Shamrat, I. (2013). The tragic farce of ‘community mental health care’. In B. A. LeFrancois, R. Menzies & G. Reaume (Eds.), Mad matters: A critical reader in Canadian mad studies (pp. 144-157). Toronto: Canadian Scholars Press.
Snow, D. A., Baker, S. G., Leon, A., & Martin, M. (1986). The myth of pervasive mental illness among the homeless. Social Problems, 33(5), 407-423.
Sylvestre, M. E. (2010). Policing the homeless in Montreal: Is this really what the population wants? Policing and Society, 20(4), 432-458.
Szasz, T. (1974). The myth of mental illness: Foundations of a theory of personal conduct. New York: Harper & Row.
Tew, J. (2005). Core themes of social perspectives. In J. Tew (Ed.), Social perspectives in mental health: Developing social models to understand and work with mental distress (pp. 13-31). London: Jessica Kingsley Publishers.
van Dijk, T. A. (1993). Principles of critical discourse analysis. Discourse & Society, 4(2), 249-283.
Wasserman, J. A., & Clair, J. M. (2010). At home on the street: People, poverty and a hidden culture of homelessness. Boulder, CO: Lynne Rienner Publishers.
Wasserman, J. A., Clair, J. M., & Platt, C. (2012). The homeless ‘problem’ and the double consciousness. Sociological Inquiry, 82(3), 331-355.
Wolfinger, N. H. (2002). On writing fieldnotes: Collection strategies and background expectancies. Qualitative Research, 2(1), 85-95.
Bahr, H. M. (1967). Drinking, interaction, and identification: Notes on socialization into skid row. Journal of Health and Social Behavior, 8(4), 272-285.
Barreira, P., Macias, C., Rodican, C., & Gold, P. B. (2008). Choice of service provider: How consumer self-determination shaped a psychiatric rehabilitation program. Psychiatric Rehabilitation Journal, 31(3), 202-210.
Bauman, Z. (1988). Freedom. Milton Keynes, UK: Open University Press.
Bradford, D. W., Gaynes, B. N., Kim, M. M., Kaufman, J. S., & Weinberger, M. (2005). Can shelter-based interventions improve treatment engagement in homeless individuals with psychiatric and/or substance misuse disorders?: A randomized controlled trial. Medical Care, 43(8), 763-768.
Bresson, M. (2003). Le lien entre santé mentale et précarité sociale: Une fausse evidence. Cahiers Internationaux de Sociolgie, 115, 311-326.
Burstow, B., LeFrançois, B. A., & Diamond, S. (2014). Psychiatry disrupted: Theorizing resistance and crafting the (r)evolution. Montreal: McGill-Queen's University Press.
Burstow, B., & Weitz, D. (Eds.). (1988). Shrink resistant: The struggle against psychiatry in Canada. Vancouver: New Star Books.
Castel, R. (1991). From dangerousness to risk. In G. Burchell, C. Gordon & P. Miller. (Eds.), The Foucault effect: Studies in governmentality (pp. 281–298). Chicago: University of Chicago Press.
Castel, R. (2003). From manual workers to wage laborers: Transformation of the social question (R. Boyd, Trans.). New Brunswick: Transaction Publisher.
Christensen, R. C. (2009). Psychiatric street outreach to homeless people: Fostering relationship, reconnection, and recovery. Journal of Health Care for the Poor and Underserved, 20, 1036-1040.
Chunn, D., & Gavigan, S. A. M. (2004). Welfare law, welfare fraud, and the moral regulation of the ‘never deserving’ poor. Social & Legal Studies, 13(2), 219-243.
CPHI (Canadian Population Health Initiative). (2009). Mental health, mental illness, and homelessness in Canada. In J. D. Hulchanski, P. Campsie, S. Chau, S. W. Hwang & E. Paradis (Eds.), Finding home: Policy options for addressing homelessness in Canada (pp. 156-176). Toronto: Canadian Homelessness Research Network.
Cruikshank, B. (1999). The will to empower: Democratic citizens and other subjects. Ithaca, NY: Cornell University Press.
Dell, C. A., Fillmore, C. J., & Kilty, J. M. (2009). Looking back 10 years after the Arbour inquiry: Ideology, policy, practice, and the federal female prisoner. The Prison Journal, 89(3), 286-308.
Desjarlais, R. (1997). Shelter blues: Sanity and selfhood among the homeless. Philadelphia: University of Philadelphia Press.
Elias, N. (1978). The civilizing process. New York: Urizen Books.
Fairclough, N. (1985). Critical and descriptive goals in discourse analysis. Journal of Pragmatics, 9(6), 739-763.
Feldman, L. C. (2004). Citizens without shelter: Homelessness, democracy, and political exclusion. Ithaca, NY: Cornell University Press.
Fischer, S., Shinn, M., Shrout, P., & Tsemberis, S. (2008). Homelessness, mental illness, and criminal activity: Examining patterns over time. American Journal of Community Psychology, 42(3), 251-265.
Foucault, M. (1961/1977). Discipline & punish: The birth of the prison (A. Sheridan, Trans.). New York: Vintage.
Foucault, M. (1979/1988). Madness and civilization: A history of insanity in the age of reason (R. Howard, Trans.). New York: Vintage Books.
Gaetz, S., Donaldson, J., Richeter, T., & Gulliver, T. (2013). The state of homelessness in Canada: 2013. Toronto: Canadian Homeless Research Network Press.
Goering,P., Veldhuizen, S., Watson, A., Adair, C., Kopp, B., Latimer, E., . . . Aubry, T. (2014). National at home/chez soi final report. Calgary: Mental Health Commission of Canada.
Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Englewood Cliffs, New Jersey: Prentice-Hall.
Greenberg, G. A., & Rosenheck, R. A. (2008). Jail incarceration, homelessness, and mental health: A national study. Psychiatric Services, 59(2), 170-177.
Hamer, D., & Copeland, P. (1994). Science of desire: The gay gene and the biology of behavior. New York: Simon & Schuster.
Hannah-Moffat, K. (2000). Re-forming the prison: Rethinking our ideals. In K. Hannah-Moffat & M. Shaw (Eds.), An ideal prison? Critical essays on women's imprisonment in Canada (pp. 30-40). Halifax, NS: Fernwood Publishing.
Insel, T. R. (2008). Assessing the economic costs of serious mental illness. American Journal of Psychiatry, 165(6), 663-665.
Katz, M. B. (2013). The undeserving poor: America's enduring confrontation with poverty. New York: Oxford University Press.
Kendall, K. (2000). Psy-ence fiction: Inventing the mentally-disordered female prisoner. In K. Hannah-Moffat & M. Shaw (Eds.), An ideal prison? Critical essays on women's imprisonment in Canada (pp. 82-93). Halifax, NS: Fernwood Publishing.
Kilty, J. M. (2012). ‘It's like they don't want you to get better’: Practicing ‘psy’ in the carceral context. Feminism & Psychology, 22(2), 162-182.
Laing, R. D. (1960). The divided self. New York: Pantheon Books.
Lofland, J., Snow, D. A., Anderson, L., & Lofland, L. H. (2006). Analyzing social settings: A guide to qualitative observation and analysis (4th ed.). Belmont, CA: Wadsworth/Thomson Learning.
Lupton, D. (1995). The imperative of health: Public health and the regulated body. London: Sage Publications.
Lyon-Callo, V. (2000). Medicalizing homelessness: The production of self-blame and self-governing within homeless shelters. Medical Anthropology Quarterly, 14(3), 328-345.
Lyon-Callo, V. (2004). Inequality, poverty, and neoliberal governance: Activist ethnography in the homeless sheltering industry. Peterborough, ON: Broadview Press.
Maidment, M. R. (2006). Doing time on the outside: Deconstructing the benevolent community. Toronto: University of Toronto Press.
Maruna, S. (2001). Making good: How ex-convicts reform and rebuild their lives. Washington: American Psychological Association.
Maté, G. (1999). Scattered minds: A new look at the origins of healing attention deficit disorder. Toronto: Vintage Canada.
Maté, G. (2008). In the realm of hungry ghosts: Close encounters with addiction. Toronto: Vintage Canada.
Mathieu, A. (1993). The medicalization of homelessness and the theater of repression. Medical Anthropology Quarterly, 7(2), 170-184.
McNaughton, C.C. (2008). Transitions through homelessness, substance use, and the effect of material marginalization and psychological trauma. Drugs: Education, Prevention, and Policy, 15(2), 177-188.
Mosher, J. (2002). The shrinking of the public and private spaces of the poor. In J. Hermer & J. Mosher (Eds.), Disorderly people: Law and the politics of exclusion in Ontario (pp. 41-53). Halifax, NS: Fernwood Publishing.
Muir-Cochrane, E., Fereday, J., Jureidini, J., Drummond, A., & Darbyshire, P. (2006). Self-management of medication for mental health problems by homeless young people. International Journal of Mental Health Nursing, 15(3), 163-170.
Nussbaum, M. (2006). Hiding from humanity: Disgust, shame, and the law. Princeton, NJ: Princeton University Press.
O'Grady, B., Gaetz, S., & Buccieri, K. (2011). Can I see your ID? The policing of youth homelessness in Toronto. Toronto: JFCY & Homeless Hub.
Olin, J. S. (1966). ‘Skid row’ syndrome: A medical profile of the chronic drunkenness offender. Canadian Medical Association Journal, 95(5), 205-214.
Paradis, E. K., & Stermac, L. (2001). Homeless women and victimization: Abuse and mental health history among homeless rape survivors. Resources for Feminist Research, 28, 65-80.
Pollack, S. (2009). ‘You can't have it both ways’: Punishment and treatment of imprisoned women. Journal of Progressive Human Services, 20(2), 112-128.
Rimke, H. (2000). Governing citizens through self-help literature. Cultural Studies, 14(1), 61-78.
Rimke, H. (2003). Constituting transgressive interiorities: 19th century psychiatric readings of morally mad bodies. In A. Arturo (Ed.), Violence and the body: Race, gender and the state (pp. 403-428). Bloomington, IN: Indiana University Press.
Rimke, H. (2010). Consuming fears: Neoliberal in/securities, cannibalization, and psychopolitics. In J. Shantz (Ed.), Racism and borders: Representation, repression, resistance (pp. 95-113). New York: Algora Publishing.
Rimke, H. (2011). The pathological approach to crime: Individually based theories. In K. Kramar (Ed.), Criminology: Critical Canadian perspectives (pp. 78-92). Toronto: Pearson Education Canada.
Rimke, H. (2016). Pathologizing resistance and promoting anthropophobia: The violent extremism risk assessment (VERA) as case study. In H. Ramadan & J. Shantz (eds.) Manufacturing phobias: The political production of fear in theory and practice (pp. 17-26). Toronto: University of Toronto Press.
Rimke, H., & Brock, D. (2012). The culture of therapy and psychocentricity in everyday life. In M. Thomas, R. Raby, & D. Brock (Eds.) Power and everyday practices (pp. 182-202). Toronto: Nelson Press.
Rimke, H., & Hunt, A. (2002). From sinners to degenerates: The medicalization of morality in the 19th century. History of the Human Sciences, 15(1), 59-88.
Rose, N. (1999). Powers of freedom: Reframing political thought. Cambridge: Cambridge University Press.
Rose, N. (2007). The politics of life itself: Biomedicine, power, and subjectivity in the twenty-first century. Princeton, NJ: Princeton University Press.
Schnittker, J. (2008). An uncertain revolution: Why the rise of a genetic model of mental illness has not increased tolerance. Social Science & Medicine, 67, 1370-1381.
Sedgwick, P. (1982). Psychopolitics: Laing, Foucault, Goffman, Szasz and the future of mass psychiatry. New York: Harper & Row Publishers.
Shamrat, I. (1997). Call me crazy: Stories from the mad movement. Vancouver: Press Gang Publishers.
Shamrat, I. (2013). The tragic farce of ‘community mental health care’. In B. A. LeFrancois, R. Menzies & G. Reaume (Eds.), Mad matters: A critical reader in Canadian mad studies (pp. 144-157). Toronto: Canadian Scholars Press.
Snow, D. A., Baker, S. G., Leon, A., & Martin, M. (1986). The myth of pervasive mental illness among the homeless. Social Problems, 33(5), 407-423.
Sylvestre, M. E. (2010). Policing the homeless in Montreal: Is this really what the population wants? Policing and Society, 20(4), 432-458.
Szasz, T. (1974). The myth of mental illness: Foundations of a theory of personal conduct. New York: Harper & Row.
Tew, J. (2005). Core themes of social perspectives. In J. Tew (Ed.), Social perspectives in mental health: Developing social models to understand and work with mental distress (pp. 13-31). London: Jessica Kingsley Publishers.
van Dijk, T. A. (1993). Principles of critical discourse analysis. Discourse & Society, 4(2), 249-283.
Wasserman, J. A., & Clair, J. M. (2010). At home on the street: People, poverty and a hidden culture of homelessness. Boulder, CO: Lynne Rienner Publishers.
Wasserman, J. A., Clair, J. M., & Platt, C. (2012). The homeless ‘problem’ and the double consciousness. Sociological Inquiry, 82(3), 331-355.
Wolfinger, N. H. (2002). On writing fieldnotes: Collection strategies and background expectancies. Qualitative Research, 2(1), 85-95.
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2016-08-11
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