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Social Class and Mental Health: Methodological Issues THANASSIS ALEXIOU *

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Social Class and Mental Health: Methodological Issues THANASSIS ALEXIOU * ENCEPHALOS 54, 40-50, 2017 Social Class and Mental Health: Methodological Issues THANASSIS ALEXIOU * The question Social class and social stratification Despite the fact that the relation between social The social structure reflects the changes in the pro - class and health and its correlation to mental health is duction and the society, such as the shrinkage of the in - implicitly evidenced in various studies, there is a diffi - dustrial working class and the growth of the middle culty in explicitly correlating social class to mental classes. These changes pose the question of the extent health. However, this difficulty is rather methodological to which the concept of social class has lost its analytical in its nature. More precisely, it has to do with the ques - rigor and its methodological value. Could it be the case tion of how a concept which is mostly defined post-the - that other factors, appertaining to culture and mostly oretically can turn into a methodological category. This marking the middle classes, according to Pierre Bour - would consequently elucidate the relation between so - dieu, such as the lifestyle and the cultural capital, have cial positionality, the socio-cultural environment and assumed cardinal importance due to these changes? mental health, thus enabling its investigation. Should social stratification be determined in accordance to such factors? These questions can only be answered Keywords : social class, social stratification, mental after social class, class relations and social stratification health, habitus, Taylorism, post-fordism, humanization are clearly and analytically distinguished, so that mental of the work, socio-linguistic codes, resistance resources, health can be correlated to social class. life skills, collective action The reduction of social structure to social stratifica - tion or its reverse reduction to social relations gives way to two different paradigms of describing the problem, which in turn entail certain potential solutions. In other words, by exclusively correlating unemployment, social destitution, mental health and other social problems to social stratification, it follows that these problems can be addressed within the existing system of social rela - tions. Contrary to the subjects emerging from class re - lations, that is from social classes, social stratification engenders social subjects who display a finite number of potentials and can act where they appear: in the sphere of reproduction (distribution, consumption and so on). These subjects can affect the redeeming and re - distributional politics of the Welfare State, but they can - not interfere in the sphere of production, where social wealth is produced. That is the sphere where the social surplus is generated and social inequalities are created. Besides, welfare state politics have never questioned * Professor at the Department of Sociology/University of the ownership of the means of production. On the con - Aegean, e-mail: [email protected] trary, they have always aimed to overcome the eco - The article was commissioned in the framework of Aristeia re - nomic crisis, thus purporting to safeguard property search program “Socio-economic Inequalities in Mental (countercyclical economic politics). Conversely, if social Health: Social Conditions, Agents and the Ideologies of Pro - fessionals in Contemporary Greece” (Principal Researcher: problems are correlated to social classes and class con - Associated Professor Anastasia Zissi). flict, that is the opposition between capital-labor and class relations, the very organization of society and 41 ENCEPHALOS 54, 40-50, 2017 labor should change. Moreover, and up to the extent to and the social marginalization of large parts of the which labor constitutes the human activity par excel - population. As it is already known and analyzed in socio- lence, its conversion into a commodity by means of epidemic studies, the sense of injustice, along with un - wage, labor destitution (unemployment), as well as the employment and social destitution constitute individuals’ alienation from their labor’s creation also disorganizing forces on an individual and a social level constitute a form of anthropological destitution. Accord - (see also Townsend & Davidson 1998). ing to Sigmund Freud, this is experienced in a traumatic Consequently, as a relation of exploitation, social way, as a “discontent with civilization” (Freud 1974). On class is embedded in the very structure of the society. one hand, in conditions where part of the cost of labor Moreover, upon its emergence on the level of social force reproduction is socialized, that is to say that basic stratification, it assumes the form of unequal access to social goods are made public (Welfare State), it rightly resources and means, such as income, education, pro - seems that the recovery of the individual’s functionality fession, social status and so on. In effect, unequal ac - is prioritized and hence coercion is internalized, desires cess to resources and means also determines the are repressed and so on. However, the psychic price unequal exposure to dangers for mental health and its that needs to be paid both on an individual and on a so - recovery (see also Kahn 1981). It is no coincidence that cial level is incommensurate and involves alienation, symptoms of depression are induced by financial diffi - conformism and so on. Moreover, in the framework of culties and most importantly the loss of employment, the exploitative nature of social relations, the labor of which is mostly experienced by individuals from working the working class produces the two values needed for classes. What is more, since these affect their emotional these relations to be reproduced, that is the “needed functionality and physical condition, they render the as - labor” and the “surplus labor” as Karl Marx has put it. sumption of action even more difficult (see also Price, Thus, the conceptualization of social structures in terms Cosmides & Tooby 2002). It must be argued that social of social class directly points to when and why social in - stratification should be primarily included in class rela - equalities emerge. According to Marx (Marx 1978), labor tions and the social division of labor (social relations of produces a value that is reflected on the wage and is production) and secondarily to the technical division of consumed on the replenishment of labor force (housing, labor (professions, employment status, cultural capital alimentation and sustenance of the working class). This and so on). It is only in this way that quantitative evalu - is how the means of production of social wealth, such ation of social relations can methodologically lead to the as factories and services can work. At the same time, exploration of their qualitative dimension (class rela - though, labor also produces surplus value (surplus tions). Certain nominalist approaches identify social labor), which is the unpaid labor appropriated by the strata (professional groups, “closed groups”, “cultural owner of the means of production, so that capital accu - environments” and so on) with social classes, aiming to mulation can carry on smoothly. It follows that social re - render class absolutely accessible to empirical analy - lations are built upon the exploitation of the working sis-categorization. On the contrary, the suggested class. The pervasive social injustice that follows from methodology defines social class qualitatively, that is in exploitative relations governs the whole socio-institu - relation to other classes within the production system. tional complex, hence fueling feelings of weakness, dis - As a result, social class turns into a sociological signified appointment and futility. What complicates things even and does not constitute an empirical-statistical signifier more is the fact that despite satisfying social needs, the anymore. Consequently, the professional positions of in - means of production are not public, but individual prop - dividuals, income categories, levels of education, hous - erty. The inability of societies to fairly deal with this issue ing status, health status and so on follow from the which is directly related to human dignity and the access general position of a social class within a certain society, to material and symbolical resources and means (social in relation to the system of production, as well as to infrastructure, health and counseling services) pushes other social classes. Thus, social inequalities are not social action to the limits of social pessimism. People due to the fact that certain people have been excluded believe that the whole situation has acquired such au - from resources, or that some other people have appro - tonomy that is now simply beyond the reach of their ac - priated resources because of incommensurate relations tion. Consequently, any attempt of change is deemed of power. Nor are they nobody’s fault, as is the case with impossible and futile, which renders individuals inactive the paradigm of social exclusion. In fact, they are rather and disinterested. And yet, it is the unruly character of caused by the fact that social classes exploit each other, production, that is the production of goods without any and as a result each class’s surplus of material and consideration of the needs of the society that heavily ac - symbolic resources is missing, as it has been usurped counts for the economic crises (overproduction/under - by another class (see also Wright 1985: 239). In the consumption
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