Austerity and identity formation: How welfare cutbacks condition narratives of sickness, 2022, Altermark and Plesner

Abstract

In recent years, Swedish sick insurance has become more restrictive. In this article, we analyse how people not being granted payments, despite being seriously ill, are affected. Scholarship on identity formation and sickness stress the importance of constructing narratives in order to come to terms with one’s situation. Our analysis of 30 qualitative interviews with people diagnosed with ME/CFS shows that workfare politics conditions such identity formation and often prevents it from taking place. Interviewees describe extreme stress as a result of their contacts with the Social Insurance Agency (SIA), which results in a perpetual crisis that is renewed with each new denied application. In particular, the sense of not having a future means that it is hard to construct narratives to make sense of one’s situation. To escape the perpetual crisis, some people have politicised their situation, constructing a narrative about themselves as suffering from oppressive politics. Others have escaped by not applying for sick insurance or other social insurances. But generally speaking, the most common effect of being denied sick insurance is an ongoing crisis that leads to deteriorating health.

Open access, https://onlinelibrary.wiley.com/doi/10.1111/1467-9566.13545

 

Uh, yes, but not the people they're thinking of here. Those people keep talking about being bullied and threatened by people who can barely walk, of being persecuted, even though they are in full control of our lives and literally face nothing despite their massive failures. Truly unhinged stuff.

Well maybe they shouldn't stress about irrelevant things, then. I could not care less about this nonsense about narratives and identity.

Oh, for sure there are sticking it to the man by refusing to apply. They're totally making a political point. Just like it's soooo common for abortion advocates to have abortions just for fun. Totally a real thing. Also kids are eating Tide pods these days. And that reefer? Total madness, turns people into raging psychopaths after a single puff.

When people don't have arguments they just make stuff up. This is making stuff up. For politics. Double irony.

 

Warning: this is not a fun read, this content might be distressing for some patients.

Some quotes from the study:

"interviewees were recruited with the aid of the leading Swedish patient organisation RME (National Patient ME-association) [...] All participants in this study have been denied sickness payments even though their doctors consider them to be unable to work."

"Many of the participants recount that they have tried to work and how their health worsened. The crushed expectation of social security support triggers a crisis that in a majority of our interviews appears as more serious and harder to deal with than becoming ill and being diagnosed in the first place"

"As interviewees experience themselves as unable to work, the withdrawal of social insurance payments means that the state fails to meet its obligations. As a consequence, the crisis of being denied sick insurance triggers at least two additional crises: one of personal finances and one of general trust in society"

"Interviewee 6: Social services won’t allow any assistance unless we sell the house and run out of assets. So, we’re about to be kicked out with children due to all of this. (…) The emergency solution we’re going to go with is getting a divorce. We think that my wife can manage the mortgage and the children on her wages, but not my debts..."

"Often, their lives are dominated by applying for sick insurance, overruling the denials of the SIA, whilst also trying to understand why they are being denied."

"People describe a form of day-to-day living of great pressure, where a common coping strategy is to not think about the future at all. [...] Several respondents stress that depression was not part of their clinical symptoms until they were declared fit to work"

"While our research design does not allow for estimations of the prevalence of suicidal thoughts among people with ME/CFS that are not granted sick insurance, we want to stress that the theme of suicide emerged alarmingly often: even though the interviewer never introduced the topic, respondents brought it up in about half of the interviews"

"all interviewees state that their health has deteriorated as a consequence of the contacts with and decisions of the SIA. The permanent stress introduced by lacking control over the future makes pacing and rest, which is fundamental for ME/CFS-patients, almost impossible"

"Seeing one’s individual hardships as part of a wider struggle against the SIA helped create some analytical distance towards one’s own situation"

"In summary, our interviews show that being denied sick insurance creates a crisis where it becomes very hard to create meaning and understanding through self-narration. This results from the fact that participants face economic crisis, a disease that may worsen as a result of stress and a strong sense of powerlessness. In this situation, it is common to express that one has no future. Almost all participants have found themselves in this situation."​

 

I think it is useful that this study highlights these problems and how hard it affects people lives.

Bit unfortunate that these scientific papers in sociology always have to frame their results inside a larger theoretical framework and focus on meaning, narratives etc. They all want to quote Foucault for some reason.

I think it would be much more valuable to leave all that theory and vocabulary behind and just research and describe the situation without any presumptions, much like a journalist would.

 

It's Foucault vs Hayek atm in these areas (it's sort of not whole subjects but the intersection of the specific part of a number of them) and is about neoliberalism. So tbf if it is in that are it will get them read by those who are into that.

My biggest frustration is the not linking them to real-life actions particularly - almost as if that sullies the exploit of researching it in itself. Which perhaps makes it more about 'social movements' as an end-game than the specific issue . And I'm not sure that this one is - it might be an example, but it isn't caused by one system over the other, it's both systems who were happy to cast off a few as an example and make them low-hanging fruit. One has to remark at how they've managed to pick some of the illest people when doing this, thereby easiest to prevent from accessing by hoop-jumping, and whether that is coincidence. And now I've said it.

EDIT ie doubt the result sought is ME (or other specific illnesses) specific, just us as an example for 'change' that mightn't pull us up/fix that issue with its rising tide given our specific needs might still fall through the cracks of that