Agency as a structuring principle

This issue of Nordic Studies on Alcohol and Drugs invites the reader to ponder how people negotiate their own and others’ substance use and gambling. This is a classic scope of lifestyle and addiction research – a perspective from within the meaning-making of practice. Why do people do what they do? What differentiates their particular use of substances from what is considered common or desirable? Such research ideally converses with cultural and social theory on the circumstances and logics of people’s being in the world.

A key concept here is agency. This classic philosophical concept has come to entail a social scientific core connotation pertaining to individuals’ abilities and capabilities to make independent, enlightened, and good choices, and to realise them with intended effect.

Maria Heiskanen’s qualitative analysis on problem gamers’ conceptualisation of money use exposes the principles that order their gambling strategies (Heiskanen, 2017). Money is a goal and a part of the action’s sense-making, but also a justification. The practices and meanings that problem gamblers assign to money are entangled with and driven by the idea of agency. To adjust money use to economic realities but to still play along with the fantasies of winning belongs to gamblers’ necessary competences. Different levels and dimensions of control and likelihood of success are intertwined in their overall reason-making strategies.

The study by Andersson, Otterholt, and Gråwe, (2017) on patient satisfaction with treatments and outcomes in residential substance use institutions shows that confidence in staff competence is most strongly associated with the outcome score. Patients are also more likely to report a positive outcome when they are actively involved in the treatment. To have an effect on where the treatment is headed is part of control over self and life path. Agency is an important meaning-making rationale in treatment for addiction; a state that in itself connotes lack of agency.

Is it, then, not obvious that the capability of self and others is emphasised in these studies as a desirable way of succeeding? One could argue that all inquiries must necessarily come to this conclusion, as agency is a structural principle of human life. According to the governing Western ideals, nobody has to be destined to be anything inherently. Instead, people are encouraged to take control and to orient their own lives in the desired direction in line with the American dream of hard work and capacity fulfilment.

Why should it be so important for research to continue to empirically reproduce the fact that so much depends on the measure of capacity? My own view is that the emphasis on agency may be a double-edged sword in our understanding of society. It has undoubtedly paved the way for an empathic ontology of the structures and logics interacting with people’s needs on, for example, meaning-making of money as upholding their habit of gambling (Heiskanen, 2017) or their trust in treatment personnel’s capacities for their own successful recovery (Andersson et al., 2017). But the agency emphasis may also imply a larger cultural “win or lose” mentality. According to this agency-based stratification principle you are either in or you are out.

Finding the right amount and sort of support to people for enhancing their wellbeing and good health is at the heart of the current restructuring of social and health care. The main ideological question pertains to where to draw the line for the help structures. What will encourage people to be active as citizens and as clients of the services? In times when the welfare state’s resources are tight, it seems that individuals’ capacities to “pull themselves together” (showing strong agency) instead of straining the public sector is an easily available path of reasoning.

Belackova, Janikova, Vacek, Fidesova, and Miovsky’s (2017) article on the responses among alcohol drinkers to an outbreak of methanol poisonings and partial alcohol prohibition in the Czech Republic concludes that more help is needed for marginalised alcoholics affected by the poisonings. This includes “increased access to brief interventions, addressing the strategies that alcohol consumers adapt to prevent the risks, and, in general, helping consumers make informed choices to prevent further fatalities” (Belackova et al., 2017, p. 386). The solutions need to be more exhaustive and comprehensive, yet the actual individual help structure must be modified in smaller contexts. This macro–micro interplay that is so essential for well-functioning addiction policies and treatment is often claimed to be costly for societies.

Alexanderson and Näsman (2017) study children’s strategies for coping with adults’ substance use within a specific tradition of research on agency. Childhood sociology has traditionally emphasised actorship and agency in the making. By studying children’s experiences of living with adults who abuse substances and by conducting a symbolic interactionist micro analysis, this study uncovers meaning-based social interaction.

The symbolic interactionist grasp has been described as striving beyond a “structure-destined” and “structure-interactive” variant of agency ontology that has come to guide investigations connecting harmful behaviour and its circumstantial configurations. Symbolic interactionism has been seen as an alternative to the governing critical academic aetiology underpinned by the idea of a structural enabling of lifestyle-related behaviour. However, I cannot help but wonder if there might be some way of shifting the ontology of agency still further. Rather than viewing it as a dimension in circumstantial inquiries or an object-phenomenon upon which people interact and whereby they understand themselves and others, agency could maybe be studied as an independent sense-making force on its own. A force that divides people according to capability.

Students’ drinking habits are investigated in two articles. Erevik, Pallesen, Vedaa, Andreassen, and Torsheim (2017) have studied alcohol use among Norwegian students, and Podstawski, Wesołowska, and Choszcz (2017) analyse trends in alcohol drinking among university students at the Polish University of Warmia and Mazury in Olsztyn. While quantitative and descriptive, both analyses identify agency aspects through certain key factors: by recognising the typical student drinker we can also see the circumstances that correlate with capabilities to disrupt or resort to these typical drinking trends. Drilling deeper into register data and looking for unexplored circumstances have taken us a step forward. Whether this will help us further understand the dimensions upholding and disrupting agency will perhaps be something we will know more about in the future. For now, I think we need to remember the importance of discovering new approaches and perspectives on agency as a phenomenon. We might need to start with basic questions, such as what the concept really means and implies for our everyday lives.

People who are heavy substance users, have mental health problems, are paperless, or who suffer from poverty and lack of social networks are among the most marginalised in current societies. If they are marginalised due to their lack of agency, should we not explore the agency-based stratification in research as a phenomenon in itself?