Abstract
Cederström and Spicer’s short book goes a long way. In taking a comprehensive overview of the emergence of ‘wellness’ in modern Western life, the authors draw together seemingly disparate strands of corporate, civil and personal cultural phenomena, unearthing the underlying principle: to be well in body and mind is a moral imperative.
At first glance, it is hard to see what unites the fitness-obsessed young professional, reducing their life experience to a series of metrics on an iPhone app, with the overweight, unemployed single mother. But by exposing the ‘biomorality’ that equates wellness with the productive, high-achieving citizen, the authors expose how something that is intrinsically meant to make us feel better is used to police behaviours and create market value in a capitalist society.
The authors paint a vision of the citizen/employee required to maximise wellness for the benefit of the company or the state and describe the demonisation faced by those who are seen to have failed to improve their health and productivity. As though to demonstrate Cederström and Spicer’s theorem, in June this year, reports emerged that the British Department for Work and Pensions was considering placing psychologists in job centres, prompting mental health workers to protest that unemployment was being painted as a psychological disorder, rather than a consequence of the economic landscape. 1
Cederström and Spicer have made a valuable and timely contribution that can help us think critically about this new cultural norm and the power structures it enforces, and from there, what an ethical and effective policy approach might look like.
Moving away from a universalised notion of wellness
At 135 pages, The Wellness Syndrome could never have been expected to address every aspect of the topic. However, the authors could usefully have spent time on the intersectional nature and experience of wellness. Does the wellness syndrome affect a Black and minority ethnic (BME) middle-class 20-something woman in Britain in the same way as a white male 30-something banker in New York City?
Wellness as a norm interacts with other categories, such as class, age, gender and ethnicity. Some of the most interesting sections of the book briefly touch on classed and gendered interpretations of wellness (see Chapter 2)—particularly the disgust felt by the middle classes towards the stereotype of the fat, promiscuous, unemployed, working-class single mother who is seen to embody a rejection of wellness. But it lacks a conscious and sustained analysis that acknowledges the intersectional nature of their topic.
This relates to a second criticism—the relative lack of historical perspective. Cederström and Spicer are right to see wellness as a peculiarly modern syndrome that has come about in relation to a capitalist market that emphasises flexibility, impermanence and self-sufficiency. But the policing of the body as a means of exercising power is not new, and it is valuable to see the wellness syndrome as part of a longer history of the body.
By understanding that since pre-historic times women, particularly as mothers, have been situated by many societies as nurturing figures who prepare food and look after the physical wellbeing of others, we stand to gain a greater understanding of why the ‘chavette’ who fails in these duties is so demonised. 2 Likewise, between the World Wars there was an emphasis on a citizen’s duty to rebuild a shattered Europe through cultivating a healthy body and mind. 3 Did this lay the foundations for today’s wellness syndrome? These and other long-term perspectives may be productive in deepening our understanding of today’s syndrome and finding a healthier path in the future.
Wellness is not of itself a negative pursuit
The authors make clear in their introduction that their critique is not of wellbeing in itself, but of the ‘syndrome’ it becomes when transformed into a consuming ideology that causes harm rather than wellness. However, the tone of The Wellness Syndrome is fundamentally sceptical of the practices it describes, such as self-monitoring and nutritious eating.
Because the focus of the work is ‘when wellness goes wrong’, it risks dichotomising between well and not. It is easy to lose sight of the spectrum of wellness practices, from complete neglect, to mild interest, to productive engagement, to obsessive pursuit and everywhere in between.
Without endorsing a particular wellness programme, it is clear that wellbeing is not fundamentally a selfish or misplaced pursuit. It can lead to improved relationships, a cleaner planet and—yes—economic benefits.
There is also a risk of saying that because no one has yet agreed on what wellness is (as described in Chapter 3), it is pointless trying to design policies to achieve it. In reality it is not the case—we can target specific problems through actions we know produce improved physical and mental health. On a grand scale, the establishment of the welfare system in Britain after the Second World War was an implicit acknowledgement that state intervention can improve living standards, and very few people would now seek to wholly erase the National Health Service (NHS), whatever their views on reform. This is not to dispute the authors’ findings, but to suggest that while we should be wary of the syndrome, we should not discard wellness as something worthwhile.
Looking forward
By taking a more intersectional approach to wellness, policymakers stand a greater chance of success. People interact differently with the philosophy, programmes and tools of wellness. To design policy interventions, it is also necessary to understand that people are not passive recipients of wellness programmes. People resist, appropriate or modify these cultural imperatives. The fat acceptance movement (Chapter 5) is an example of how people variously reject aesthetic standards, refuse to accept the doctrine of health or seek to demonstrate that healthiness is not necessarily aligned with slimness and self-denial.
The potential harms that Cederström and Spicer identify in the pursuit of wellness allow us to take a clearer view of what civil and corporate attempts to improve health and productivity ought to do. First, companies and government bodies must be aware of the potentially manipulative nature of ‘wellbeing’ and of the underlying biomorality that Cederström and Spicer demonstrate shifts responsibility for physical and mental health onto the individual, and tend to ignore structural factors such as inequality of education, wealth and opportunity. Wellness interventions must acknowledge this and be complementary to policy changes that address structural problems head on.
Bearing this in mind, the ethical policy interventions that arise are ones that have genuine wellness for the individual as their end. Other outcomes (e.g. reduced health spending) ought to be pursued as the secondary consequence of an improved situation for the citizen/employee, rather than as the primary objective regardless of the effect it has on the individual. Second, it must be something that the individual undertakes with free will. The examples which the authors provide of companies and social security departments threatening punitive action for failing to take part in wellness schemes are unethical and fundamentally undermine the stated pursuit of health and happiness.
Conclusion
Cederström and Spicer pack an impressive punch. Perhaps most importantly, their work does that which academic work so rarely does—force the reader to interrogate their own beliefs and practices and those of the structures around them.
As my nuptials approach and I seek to look and feel my best, I question why and how I engage with the wellbeing economy. I want to look like a fox in my dress—but is that for me, for my intended, for social media or posterity? And to what lengths will I go to achieve what society tells me is the aesthetic realisation of wellness?
The Wellness Syndrome provides an excellent overview from which academics and policymakers can now address their own specific interests. Capitalism looks to be the dominant economic model in the Western world for the foreseeable future, and governments continue to look for ways to maximise tax revenue and minimise spending. Wellness is a topic that will only grow in importance.