Critique of a Book Used by Many Psychologists and Psychiatrists to Oppress Patients, Part One

Introduction

This is the first of a five-part series of posts that criticize a book that serves to oppress individuals, whether they have mental health problems or not.

As I indicated in another post (A Worker’s Resistance to the Capitalist Government or State and Its Representatives, Part Nine), I engaged in a partial critique of the book Feeling Good: The New Mood Therapy by David Burns, M.D. (1999). This book is used by many psychologists and psychiatrists as a basis for the psychological technique called “mindfulness”–and with reason since Dr. Burns defines human problems independently of social context–quite convenient for the class of employers since the economic, social and political oppressive and exploitative contexts are thereby ignored–or rather suppressed.

The reason why I read the book was that I was required to see a psychologist as a condition of receiving disability benefits from the Manitoba Teachers Society (see A Worker’s Resistance to the Capitalist Government or State and Its Representatives, Part Ten). Mr. Alan Slusky, a psychologist in Winnipeg, Manitoba, Canada, recommended the book and, in fact, it was supposed to be part of my “therapy”–bibliotherapy. According to Wikipedia:

Bibliotherapy is a creative arts therapies modality that involves storytelling or the reading of specific texts with the purpose of healing. It uses an individual’s relationship to the content of books and poetry and other written words as therapy. Bibliotherapy is often combined with writing therapy.

I refer occasionally to John Dewey’s philosophy of science, which I will look at to some extent in the fourth post but especially in the last post of this series. I also refer occasionally to my dissertation. My doctoral dissertation compared the philosophies of human nature of John Dewey (an :American philosopher of education and author of, among other books, Human Nature and Social Conduct: An Introduction to Social Psychology, Democracy and Education and Logic: The Theory of Inquiry) and Paulo Freire (a Brazilian philosopher of education and author, among other books, of Pedagogy of the Oppressed).

Critique of the Contents of the Book

Let us now turn to the contents of the book and some of my criticisms.  I do not present my criticism in the order in which I wrote it since the initial points are fairly abstract (I leave those for the fourth and fifth posts in this series). My critical comments are usually either in square brackets or separate points  as a continuation of my comments: 

    1. p.xxx: “Depression is one of the worst forms of suffering because of the immense feelings of shame, worthlessness, hopelessness and demoralization. Depression can seem worse than terminal cancer, because most cancer patients feel loved and they have hope and self-esteem. Many depressed patients have told me, in fact, that they yearned for death and that they prayed every night that they would get cancer, so they could die in dignity without having to commit suicide.”

    2. P. 9: “In fact, depression is so widespread it is considered the common cold of psychiatric disturbances.” [Would that not be evidence of a social problem for a scientist? Would not even the lay person who is curious wonder why it is so common?]

    3. Page 10: Note: “The idea that thinking patterns can profoundly influence your moods has been described by a number of philosophers [why did he not name a few?] in the past 2500 years. More recently, the cognitive view of emotional disturbances has been explored in the writings of many psychiatrists and psychologists including Alfred Adler, Albert Ellis, Karen Horney, and Arnold Lazarus, to name just a few. A history of this movement has been described in Ellis, A., Reason and Emotion in Psychotherapy.”

    4. Page 11: “2. Understanding: A clear understanding of why you get moody and what you can do to change your moods. You will learn what causes your powerful feelings; how to distinguish “normal” from “abnormal” emotions; and how to diagnose and assess the severity of your upsets.”

    5. Page 11: Self-control: You will learn how to apply safe and effective coping strategies that will make you feel better whenever you are upset. … As you apply it, your moods can come under greater voluntary control.

    6. Page 12: “The first principle of cognitive therapy is that all your moods are created by your “cognitions,” or thoughts. … You feel the way you do because of the thoughts that you are thinking in this moment. [One of the categories that he uses is “overgeneralization.” Here is a good example of overgeneralization. What is a thought? What is a feeling? What is the relationship between the two? Do feelings cause thoughts? What is the specific causal mechanism that leads from thoughts to feelings? What narrative structure, in conjunction with the descriptive structure? Furthermore, the “self” of human beings is constituted by a set of ways of acting, which are linked to how others act. Money. A set of habits is generally unconscious until a problem arises.] [Which came first? Thoughts or feelings in the process of evolution?]

    7. You create those feelings [feelings are products of the self—the environment plays no part for Burns. The subject of the action of creating feelings is “you”—apparently, you do not consist of feelings—they arise out of thin air. You are feelingless, and the feelings then are magically produced by something completely different from the feelings—thoughts.” Does Burns explain anywhere how people create feelings? Unlikely. This is mysticism, not science, or rather it is mysticism parading as science. How do thoughts “create” feelings? What is the difference between thoughts and feelings?] by the dialogue you are having with this book. [Presentation of the individual self as purely internal. There is no relation to an environment. Feelings are purely internal as are thoughts. But if both are purely internal, are they not the same in some way? This is idealist—and subjective idealism at that—by reducing the individual to purely internal processes. Anti-evolutionary.] [Burns is inferior to anything that Dewey has to offer. Burns assumes the “you” without inquiring into what he means by the “you” Does he mean the person or the body? The formation of the human person? If the “you” is itself a social process that has its focal point in an individual who becomes conscious of processes between the environment and the living being, then this “you” is itself a product and a cause. This one-sided reduction of the “you” to pure thought cannot begin to grasp the complexity of the nature of human beings. Burns does not even reflect on the use of his terms—a lack of critical thinking.]

    8. If “you” are a product of a social process, what then is the relation between the “individual” and the “social”? Burns does not even try to determine the relation since he reduces human nature to the isolated individual who is already formed—and assumes that this isolated individual is the point of departure.

    9. He assumes, in effect, that the human individual is a formed individual, and simply ignores the environmental conditions that contribute to the construction of the “you.”

    10. From Burns’ point of view, prehistoric people merely had to change their way of thinking and they would be like us.

    11. Is not the “you”—and thoughts and feelings—linked to the kind of society in which we live? Would Burns have the you that he does without the Gutenberg press?

    12. Your emotional reaction is generated not by the sentences you are reading but by the way you are thinking. Your thought actually creates the emotion. [creates? How? There is an organic aspect to all reactions, and that organic aspect, when grounded in the cns (central nervous system), can be called feeling. Feeling becomes emotion (something with an object attached to it. Feeling has organic roots and is quite independent of “thought.” Let us see whether this “scientist” explains how thought “creates ”emotion.”]Thought does not create emotion; it is a necessary condition for emotion to arise, but then so too is the environment. This person is an idealist and so too is his theory—despite the “scientific research” he claims. As for science, if thoughts “cause” feelings—in a real scientific sense and not in his pseudo-scientific conception of science, then he should be able to link up the “cause” with the “effect” in one narrative structure such that the beginning and the end form a history. See my dissertation.]

    13. The second principle is that when you are feeling depressed, your thoughts are dominated by a pervasive negativity.” Really? Such a generalization independent of context? His principle must be a physical principle since only physic-chemical principles are universal. Even if it were true—and? The implication is that “negativity” is an unreasonable or unjustifiable response to conditions. Such an assumption is unjustifiable. See the article on justifiable depression.] Social science that pretends to be universal is ideological—except for a few generalities that cannot grasp any definite, concrete relation (cannot exist independently of determinate, concrete relations).

    14. p. 13: “This feeling is absolutely illogical, but it seems so real that you have convinced yourself that your inadequacy will go on forever.” [Does this person live on this planet? There are many individuals who live in hopeless situations. How many children die each year throughout the world from malnutrition and starvation? Should their parents not be depressed? Has he ever experienced depression? This “scientist” becomes ever more pompous and lacks any depth of understanding of what people in this world experience.] [In any case, his statement that it is “absolutely illogical” is itself illogical. No rational scientist would make such a categorical statement independently of circumstances. [Watched a movie recently called “Guilty,” in French. The man was accused falsely of sexual abuse; he was imprisoned; his children were taken away from him (his children were his life); his wife eventually was let go, but she began seeing another man. His mother died while he was in prison. He stayed in prison for almost two years. Despite the recantation of the woman who accused him of sexual abuse, the judges condemned him to 18 months of probation. He tried to kill himself several times. Was it his negative thoughts that led to his depressed feelings? Was it the total situation? “Negative thoughts” may be a contributing determinant of depression, but to reduce depression to just this aspect is a fallacy—a fallacy of reducing a total process and situation to one event within the process or one aspect of it.]

    15. P.13: “The third principle is of substantial philosophical and therapeutic importance. Our research has documented that the negative thoughts which cause your emotional turmoil nearly always contain gross distortion. [Why the emphasis on “always.” Obviously because negative feelings have no real basis—always. But what happens if they do have a basis in reality, but that Burns and company have neglected to determine this in a scientific manner? Do they consider the context in which people live? That is to say, the environment? Or do they act like pre-evolutionary scientists and pretend that human beings are isolated monads, cut off from their environment?] [Who determines what constitutes gross distortions? Burns has such a grip on reality that he does not live in a distorted world? If capitalist society is by its very nature a distorted world, then what are the implications, psychologically?] Although these thoughts appear valid, you will learn that they are irrational or just plain wrong and that twisted thinking is a major cause of your suffering.” [If so many people have twisted thoughts—at the beginning, Burns claims that depression is like the common cold for psychiatrists since it is so prevalent a problem for them, then is not the educational system a possible cause for such twisted thinking? Is not education supposed to teach people how to think? See John Dewey, How We Think: A Restatement of the Relation of Reflective Thinking to the Education Process—the need for reflective thinking (not rationalism as usually defined as pure reason independently of context. Would it not be rational for a person who finds that depression is common to inquire into the conditions of its emergence? But Burns has the magic answer in his cap—negative thoughts. Why so many people have negative thoughts never enters his “scientific” mind, which seems to involve a curious lack of desire to inquire into anything that may contradict his theory. If schools contribute to the lack of a capacity to think, then individual solutions of “changing” thoughts will not do. Burns will have none of that, of course.] [It can be concluded that Burns’ theory ‘nearly always contain[s] great distortions.]

    16. : “Some of the major symptoms include… the conviction that external forces are controlling your mind or body….” [There are—necessarily—in a society characterized by commodity production—a lack of control over forces that determine our body and mind.]

A Worker’s Resistance to the Capitalist Government or State and Its Representatives, Part Ten

Introduction

This is a continuation of previous posts.

I went on sick leave in February 2012 after having been a French teacher for Lakeshore School Division in Ashern, Manitoba, Canada, for three and a half years. (For details of my decision to go on sick leave, see A Worker’s Resistance to the Capitalist Government or State and Its Representatives, Part Eight  and  A Worker’s Resistance to the Capitalist Government or State and Its Representatives, Part Nine). 

In order to receive at first short-term disability benefits and then long-term disability benefits provided by the Manitoba Teachers’ Society (MTS), if the issue is not purely physical, it is presumably necessary to be subject to psychiatric evaluation and then psychological “care” (provided the psychiatrist furnishes an assessment, I assume, that justifies not being able to work for an employer). To receive such benefits, the worker must “agree” to both the evaluation and the care. 

But what is the Manitoba Teachers’ Society? Its Facebook page indicates the following:

About

 

 

 

The Manitoba Teachers’ Society is the collective bargaining and professional development organization for all of Manitoba’s 15,000 public school teachers.
 
Additional information

 

 

 

Founded in 1919, the Society provides assistance to local associations in collective bargaining, offers professional development workshops and lobbies government on legislation that affects education, students and teachers.

 

As well, MTS provides a range of wellness services including the Disability Benefits Plan and Educator Assistance Program.

 

It also provides publication services for teacher organizations such as Special Area Groups and publishes the teachers’ newsletter, the annual handbook, annual report and an extensive range of brochures and other handbooks
 

MTS is thus not a union as such, but it is more like a union of unions; it provides services to specific teachers’ associaitons and, through them, to the members of the specific teachers’ association. 

In my last post in this series (A Worker’s Resistance to the Capitalist Government or State and Its Representatives, Part Nine), I showed how I found that Ms. Morier, a psychiatrist, had oppressed me during her assessment of me–an assessment required by MTS. This time I will outline how I felt about how another psychologist, Alan Slusky, oppressed me; I was obliged by the protocols of the Disability Benefits Plan of MTS, to attend “psychological counselling.” Indirectly, then, MTS also oppressed me. 

The social-democratic or reformist left, in general, simply ignore the various forces and professions that reinforce the power of employers as a class and that lead to the oppression (and exploitation) of workers in various ways. It thereby often underestimates the difficulty of overcoming the power of the class of employers or overestimates its own reformist power. 

So far, in this series of posts, various professionals have been involved in oppression: 

  1. social workers
  2. Winnipeg Child and Family Services
  3. Manitoba Ombudsman
  4. Institute of Regiserted Social Workers of Manitoba
  5. Anishinaabe Child and Family Services
  6. the Royal Canadian Mounted Police (RCMP)
  7. A principal at a school
  8. A superintendent in a school division
  9. Probably the Minister of Education
  10. Probably the Minister of Justice
  11. Perhpas the New Democratic Premier of Manitoba, Greg Selinger
  12. Manitoba Teachers’ Society Disability Benefits Plan
  13. A psychiatrist, Gisele Morier

Given all these professionals and institutions who, directly or indirectly reinforce the class power of employers, it is hardly surprising that the social-democratic or reformist left run around in circles claiming to seek justice all the while failing to organize systematically and in a unified fashion to oppose such oppressive social structures and oppressive professionals. 

Let me add one more professional trade to the list: psychology. 

From a Helping Profession to an Oppressive Profession: The Real World of Psychology 

Initially, Mr. Slusky did help me. My heart was still racing every day, and he taught me, through breathing exercises, to reduce the intensity of my pounding heart. I could sleep better–although my heart still raced every day. There were limits to the efficacy of this technique.

I started to feel oppressed by Mr. Slusky, though, especially after I had been “assessed” by the psychiatrist, Ms. Morier, in November 2012 (see my critique of her assessment in the earlier post    A Worker’s Resistance to the Capitalist Government or State and Its Representatives, Part Nine). Mr. Slusky attempted to justify Ms. Morier’s assessment, and such a persistent justification led me to feel oppressed. Mr. Slusky persistently used such “post-modernist” phrases after that time as “It is a question of interpretation,” or “It depends on your point of view.” Mr. Slusky persistently tried to convince me–without success–of the accuracy of Ms. Morier’s assessment.

Ironically, Mr. Slusky did not, however, consider everything, at a practical level, to be just “a question of interpretation.” Either in late July or in August 2012, before the psychiatric assessment by Ms. Morier, he had sent me a stapled bill for July and August, 2012 (I still have the bills) since MTS had not yet paid him. When it comes to money, apparently, it is not a question of interpretation–but that is what Marxists say too. What is sauce for the goose is not, apparently, sauce for the gander.

Mr. Slusky had tried the usual psychological pablum called “cognitive behavioural therapy” (CBT) or mindfulness, which has as one of its roots the book by David Burns (1999): Feeling Good: The New Mood Therapy. In fact, I had started attending voluntarily counselling sessions under the MTS Employee Assistance Plan (EAP) while still working as a teacher, and Degen Gene, an EAP  counsellor, used the same approach.

This approach seems to be standard for many psychologists, without any concern for the underlying power structures and relations that give rise to stress when working for an employer.

As I indicated, the breathing exercises suggested by Mr. Slusky did help–but within limits. 

Ultimately, Mr. Slusky attempted to change my “approach” to people by getting me to be more “flexible”–a code word for not criticizing bourgeois ideology as expressed by various individuals in various areas of life.

Below, I quote Mr. Slusky’s “initial progress report,” dated September 24, 2012:

Please accept this as an initial progress report on my psychotherapy contacts with Mr. Harris. Since your referral of Mr. Harris to me, I have met with him on the following occasions: April 27, May 18, June 1, 14 & 28, Jluy 27, and August 16 & 24, 2012. Over the course of these 8 meetings Mr. Harris has attended for all of his sessions punctually and has presented in an open fashion. For the most part Mr. Harris presents in a farily serious, stoic manner, displaying little range in effect. No evidence of psychomotor agitation is demonstrated by Mr. Harris and despite his ongoing complaints of “a pounding heart” he displays no overt signs of anxiety. Mr. Harris has on occasion come to session with his computer, occasionally working in the waiting room, prior to our sessions. Mr. Harris has also brought research with him which speaks to his political and philosophical beliefs and their impact on his philosophy of education. I have thanked Mr. Harris for providing me with copies of this information, and at times this has formed the basis for some of our discussions. Mr. Harris’ attention and concentration over the course of our meetings has been good, his speech has been articulate and fluent, and at no time has he evaded or refused to answer any of my questions.

As you are aware Mr. Harris was referred to me for cognitive behavioural therapy to address his ongoing difficulties with anxiety. In this regard I have provided Mr. Harris with instruction in diaphragmatic breathing, relaxation exercises, and mindfulness meditation. The latter of these strategies has been presented to Mr. Harris both through psycho-education in session as well as through (at his request) copies of peer reviewed primary journal articles which speak to the efficacy of this approach in managing anxieties and preventing relapses of depression. I have never before had a client ask me for peer reviewed journal articles which speak to the efficacy of the treatments offered to them and while one certainly does admire Mr. Harris’ efforts to be a “wise consumer,” this is also in keeping with his critical approach to concepts and information delivered to him. I will speak more on this below, and the impact I believe that this style is having on Mr. Harris’ recovery. Mr. Harris has indicates that he has practiced the aforementioned strategies but found them to be only of limited value. The relaxation audio CD provided to him was described as helpful however and I commended Mr. Harris for his efforts in persisting with this approach. While this behavioural technique has been of assistance, Mr. Harris does acknowledge that “focusing on my heart doesn’t help.” As such, approaches to assisting Mr. Harris need to be more than behavioural, leading us to a discussion of the cognitive work that we have done together.

With respect to cognition, Mr. Harris is certainly a bright and articulate individual. In conversation he is able to reference articles and works that he has read many years prior, and weave them into cogent and coherent arguments for his positions on various issues. The concern that I have is the degree to which Mr. Harris adopts this “critical” or argumentative approach in his discussions. On the one hand one admires an individual who is true to their principles and beliefs. On the other hand when those beliefs and principles are misunderstood by others and create defensive attitudes on their part, a different approach/style may then be called for, to effectively communicate one’s beliefs and needs. It is my opinion that it is most likely in this realm that Mr. Harris struggles. Likely as a result of early experiences in his life as well as his considerable education, Mr. Harris has developed some very well thought out positions on issues of social policy and education. It is my understanding that both in the past and currently, Mr. Harris takes the initiative to inform others of his beliefs. While Mr. Harris may be engaging in criticism from an academic/intellectual perspective, others I suspect interpret this as argumentative and resistant behaviour, and it is here I believe that Mr. Harris has struggled with respect to his success in “getting along” in a variety of different situations.

On a positive note, Mr. Harris and I recently discussed the impact of his style on his comfort level in his volunteer position at the Social Planning Council. Mr. Harris again had some very strong beliefs about the research being undertaken by this organization and in session he and I have worked hard to reframe his participation there, such that he is able to tolerate the differences between his opinions and the approach that this organization is taking in its research and work. Mr. Harris has shown some growth here, principally in his approach to the organization’s Executive Director, adopting a “softer” style in expressing his beliefs to her. Whereas in the past I suspect that Mr. Harris would have led quite strongly on this, he has I believe, gained some appreciation for the need for balance in the ways in which he expresses his opinions. In part as well I suspect that the requirement for him to continue in a volunteer position has provided further impetus for his willingness to be flexible here. Whatever the case may be, Mr. Harris has here demonstrated an ability to be flexible in his approach/style and I am encouraged by this. [my emphases]

In addition to anxiety, Mr. Harris does at times present with significant anger. This is nowhere more evident than when he discusses his situation with his ex-wife and daughter, and both the allegations made against him in the past, as well as his daughter’s current situation and their relationship. Mr. Harris indicates quite clearly that it is only because of his daughter that he is remaining in Manitoba, indicating that he does not feel like he “fits in” here, expressing a strong desire to move to Toronto where there are others who are more “like minded.” As such, on many fronts, Mr. Harris I believe is experiencing of being pulled in several directions, and this too is likely contributing to his subjective sense of anxiety.

As Mr. Harris has reported that the strategies provided to him to date have not been as helpful as he had hoped, he has begun now to express a willingness to entertain medication as an adjunctive treatment. For my part I fully support Mr. Harris’ thoughts in this regard. Not only will the appropriate medication provide Mr. Harris with a more immediate reduction in his anxiety symptoms, it is my hope that this will come a “loosening” or “softening” in Mr. Harris’ thinking and willingness to be slightly more circumspect in his expression of his political beliefs [my emphasis]. I have no doubt that Mr. Harris can be an excellent teacher, as he is quite intelligent. It is his “emotional intelligence” (i.e., his ability to appreciate the impact of his actions on others) that I believe is more problematic and I am hopeful that with appropriate medication and ongoing psychotherapy, Mr. Harris can come to a fuller appreciation of this, and demonstrate additional flexibility, above and beyond that already noted.

It is also my understanding that you are contemplating a referral to a psychiatrist to assess Mr. Harris’ readiness to return to teaching. I would respectfully recommend that this assessment also incorporate an evaluation of Mr. Harris’ readiness to accept medication treatment, and recommendations for same. Without this additional therapeutic aide I believe that Mr. Harris will considerably struggle in becoming ready to return to gainful employment as a teacher [my emphasis].

Thank you for your support in my work with Mr. Harris to date. I trust the above is of assistance to you. In the interests of therapeutic openness and transparency, I will be providing Mr. Harris with a copy of this report. Please feel free to contact me should you have any further questions or concerns regarding my work with this claimant to date.

Sincerely,

Alan Slusky, Ph. D., C. Psych.’
Registered Psychologist

Mr. Slusky, indirectly, points out that his frequent repetition of the phrase “its a question of interpretation” is an ideological cloak for his own reformist views . He wrote above:

I suspect that the requirement for him to continue in a volunteer position has provided further impetus for his willingness to be flexible here. 

Indeed, the requirement that I volunteer in order to continue to receive disability benefits from the Manitoba Teachers’ Society was economic coercion [a phrase that John Clarke, a radical social democrat here in Toronto has used on a couple of occasions while ignoring its economic, political and social implications). Had I not “agreed” to “volunteer,” I could have been cut off from disability benefits. Mr. Slusky’s reference to ‘flexibility” in effect admits that economic coercion involves forcing a person to alter their will in order to receive money required to live. 

Mr. Slusky did not even recognize that my “flexibility” was involuntary–that I was “flexible” because I was obliged to be so in order to continue to receive disability benefits. This lack of consideration of the factual economic coercion that obliged me to “volunteer” in the first place and to be “flexible” in the second place is characteristic of all social reformers and social democrats. 

Like Mr. Clarke, though, he simply ignored the social, political, emotional and psychological implications of such economic coercion. 

I felt so oppressed by Dr. Slusky that it formed one of the reasons for my decision to leave Winnipeg in favour of Toronto, Ontario (it was not, however, the only reason). I dreaded going to his sessions. To have to attend such sessions from a person who tried to justify the Gisele Morier’s abuse when she was evaluating me (as well as her biased assessment) was oppressive, and my heart would race because of such oppression. 

I am glad that I left Winnipeg–despite leaving behind my daughter, Francesca; I would have likely had a heart-attack if I did not leave. 

I still had to attend sessions with a psychologist in Toronto, but at least I was free from Mr. Slusky’s oppressive practice and attempt to justify the abusive evaluation made by Ms. Morier. 

For further information about Mr. Slusky, see     or https://mps1.wildapricot.org/Sys/PublicProfile/25307229/1789964  or    https://www.jewishpostandnews.ca/local/1074-for-dr-alan-slusky-building-relationships-is-an-essential-part-of-psychology-practice

A follow-up post will continue with a description of my experiences with a psychologist here in Toronto. 

A Private Employer’s “Humanism” in Sweden: The Dream of Social Democrats Everywhere

As I pointed out in my critique of Jane McAlevey’s reference to Sweden’s so-called ‘leveling of the playing field for children’s opportunity for success from birth onward,” (see   Review of Jane McAlevey’s “A Collective Bargain: Unions, Organizing, and the Fight for Democracy”: Two Steps Backward and One Step Forward, Part Two), social democrats tend to idealize the Scandinavian countries. I began to more directly debunk this social-democratic myth in the post  A Short List of the Largest Swedish Employers by the Number of Employees, Profits and the Profits per Worker ).

Let us look at the behaviour of one private employer in Sweden, which supposedly instituted humanistic methods for helping workers to become more healthy: the private employer Scania, a multinational capitalist manufacturing firm (from page 140, Christian Maravelias, Torkild Thanem, Mikael Holmqvist. “March Meets Marx: The Politics of Exploitation and Exploration in the Management of Life and Labour”. Published online: 2012; pages 129-159):

Scania is an internationally leading manufacturer of heavy trucks, buses and coaches, and industrial and marine engines. It operates in some 100 countries with approximately 34,000 employees [in another source, it says 45,235].. Scania was founded in the late nineteenth century and has built and delivered more than 1,500,000 trucks, buses and engines.

Scania is well known both for its products and for its stable and long-term strategic focus. It has grown organically, primarily through internal financing, and it has remained in the same product category for more than 80 years. This conservatism has been successful, yielding annual profits for more than seven consecutive decades and helped avoid regular lay-offs since the 1940s. Today Scania is regarded a stable and attractive employer known for combining continuous improvement in production with safe and professionally stimulating working conditions.

Workers in Scania were subject to a scientific management system, with a top-down management style. As a consequence, (page 145):

the previous system was associated with high levels of personnel turnover (30%) and illness absenteeism (25%),

To deal with this problem, the union pressured for the development of a lean production model in the style of Toyota (pages 145-146):

the union was able to exercise considerable bargaining power, almost forcing the firm to accept a version of lean production that was aligned with principles of health and well-being.

However, Scanian management turned the situation to its advantage by coopting the process of a move towards  so-called health and wellness:

Like many lean production initiatives, Scania’s turn to this kind of system in the 1990s implied an emphasis on self-managing teams, continuous improvement and individual responsibility (see, e.g. Adler, 1993; Adler, Goldoftas, & Levine, 1999; Delbridge, 1995; Delbridge, Turnbull, & Wilkinson, 1992). Despite an emerging concern with well-being, the most apparent aspect of this related to the objective dimension of exploiting labour. As new tasks and responsibilities were added to all factory jobs, Scania was able to extract more value from the salary they paid workers. Making workers take individual responsibility for constantly improving the production process intensified work, as it meant that they had to do more for the same salary: in addition to take responsibility for executing predefined tasks, workers in self-managing teams were expected to set goals and find ways of reaching these goals.

This meant that each team member had dual roles: both as an operator and as a reflective practitioner. As operators, team members carried out more or less pre-defined tasks according to standard operating procedures. As reflective practitioners, they stepped out of these same processes and observed them from a distance to identify opportunities for improvement.

As reported through previous studies of lean production (e.g. Delbridge, 1995; Delbridge et al., 1992; Parker & Slaughter, 1990), the enhanced exploitation of labour and consequent work intensification was deeply related to speed, posing production speed in a tight relationship to production error.

The shift from strictly hierarchical managerial structures to more horizontal managerial structures (with, of course, the hierarchical managerial structure still prevailing “in the last instance”) led to the employer engaging in the exploration of new organizational structures to exploit its working force, a feature characteristic of capitalist firms as they are subject to the dual constraint of the need to exploit their working force while being subject to competitive rivalry from other capitalists (page 132):

The basic problem facing firms subject to increasing competitive pressures is to balance exploitation, which is incremental and may facilitate short-term competitiveness, with exploration, which is radical and might enable long-term competitiveness. The reason for this balancing act is that exploitative pursuits tend to undermine explorative pursuits.

This exploration of new ways of exploiting labour led to a focus on managing the health of workers (page 140):

To deal with problems of high costs and accident levels as well as high levels of production error, illness absenteeism and employee turnover, Scania decided to implement a lean production system inspired by the justin- time and total quality management principles of Toyotaism. This was later combined with investments in health promotion, and it is the emphasis on health in particular which makes this case distinct from previous studies of lean production.

The exploration of control over the health of the workers led, on the one hand, to attempts to control their subjectivity (their “mind set” or their “attitude”) (page 142):

Having the right job skills was only seen to constitute one part of this. Perhaps more reminiscent of previous research on service work (e.g. Callaghan & Thompson, 2002), high performance was just as much about having the right mind-set, that is having the motivation to be an active, committed and ambitious employee. It was acknowledged by managers and workers that this was not an easy task, because a partly new type of employee was required for the lean production system to work properly. Since working the production line was hard work, workers needed to be in
good shape. But since this also involved efforts to enhance output and quality, it required a particular person who was motivated and committed to change and improvement.

On the other hand, the attempt to control the subjectivity of the worker also led to attempts to control life after work through what programs that seemed to benefit workers (pages 142-143):

This approach blurred the boundaries between work and life. In the words of one team leader, ‘being active and motivated is not a capacity you can switch on and off, [y] it comes down to who you are and how you live your life’. Hence, workers were expected to go far in adapting to the system. But if Scania was to live up to its goal of being a ‘responsible and caring employer’ as well as a lean firm, this obliged them to make far-reaching adaptations, which go beyond what has been reported in previous studies (e.g. Adler, 1993; Adler et al., 1999; Delbridge, 1995; Delbridge et al., 1992). The mutual responsibilities of employees and employer were expressed through two company programmes known as the Employeeship and the 24 Hour Employee. These programmes were also pinnacles in the firm’s integration of lean production and health promotion, involving anything from safe machinery to helping employees lose weight.

These programs were not just window dressing; workers were conceived as resources in a similar fashion to the machines and buildings that Scania owned; workers were expected to take care of themselves outside work and inside work in order to increase the productivity of the company, and if they did not productivity would suffer (page 143):

Scania’s objective exploration of labour, which was aimed to enhance productivity, improve quality and increase profits, required them to re-socialise workers by subjectively exploring their lives, bodies and personalities and what potential they offered in terms of being exploited as labour. This was expressed in rather explicit expectations and norms concerning employee lifestyle. To be physically, mentally and technologically equipped to handle their work, one nurse emphasised that workers were expected to keep themselves in a ‘healthy workable condition’ and
show competence in ‘health-related things such as physical fitness [and] mental strength’.

Although there was no formal right for Scania to control the workers’ lives outside work, on a practical level the two programs did lead to pressure to conform to the requirements of Scania to exploit the workers (page 144):

Of course, Scania had no formal right to interfere with what workers did in their spare time, but when a worker’s private life started to impact
negatively on their work, the firm was able to intervene in the opposite
direction, subordinating life to labour. As argued by one line manager:

If one of my employees doesn’t get enough sleep because he plays poker all night, it is his own business – as long as it doesn’t affect his ability to work. But if it  does  […] – and most likely it will – it is not just his business but my business as  well.

Workers were somewhat ambivalent about how they experienced this. In the words of an IT specialist:

a couple of years ago I went through a divorce. I started drinking a little bit too            much and somehow my boss found out about this. At first, he didn’t say  anything,  but after some time he did, and he also explained that he had spoken to a counsellor at the Health Office who he wanted me to contact. I did, and the therapy helped. But it was somewhat creepy to see how my family problems  were turned into a work problem.

This worker’s life, then, was subjectively re-socialised and explored to fit the new organisation of production which Scania was objectively exploring in the interest of more intensely exploiting labour.

The far-reaching nature of the employer–employee contract, their shared responsibilities and the blurring of the objective exploration of labour contra the subjective exploration of life was further reflected in the 24 Hour Employee programme. More specifically, this involved a mutual sense of caring, where the programme aimed to show how much the firm cares for its employees, on and off the job, by helping them live healthier. However, this programme also emphasised how workers were expected to take care of themselves during and after working hours. Workers did not necessarily view this contract as consensual, and some workers called it ‘a give-and-take thing’. While Scania promised a safe work environment and helped workers take care of themselves, the firm was seen to expect ‘an awful lot’ in return – that workers ‘live in accordance with its standards’.

Lean production did result in some workers feeling stressed out, but rather than attributing the problem to lean production itself (and the nature of the capitalist firm as capitalist firm), the problem is identified as an individual problem (a similar approach is the current psychological fad called “mindfulness”–a variant of the ancient Stoical philosophy of disregarding the real objective social constraints on our lives); used by management, this led to manipulation (pages 148-149): 

Through a therapeutic and reflective approach, the Health School sought to help workers gain better self-knowledge, set limits and prioritise. Again, this was anchored in an emphasis on individual responsibility, where participants had to accept responsibility for their own life and work. This was important since many participants initially tended to associate stress with outside factors, such as their job being too demanding or managers expecting too much. Hence, the therapeutic process was embedded in a somewhat contested terrain where therapists and participants tried to allocate responsibility and blame in opposite directions. Although therapists sometimes relaxed the responsibilities and performance targets for individual workers in the short term, there was never any doubt that participants were required to adapt to the system should they continue to work for the firm. Indeed, therapy made most participants accept individual responsibility for adapting to the system, who thereby ended up subjectively participating in their own exploitation (cp. e.g. Burawoy, 1979; Delbridge, 1995; Thompson, 1989).

The first step in the therapeutic process was to establish a trustful atmosphere where participants were ready to accept and commit to ‘the fact’ that they have a problem with stress. The second step involved mapping out the daily routines of individual participants and their colleagues. Participants were then taught how to become more aware and reflective about their own behaviour and attitudes, and taught to think in more strategic terms about all parts of their lives. While the integration of lean production and health promotion blurred the work–life boundary, this particular task encouraged participants to make distinctions between work, self and private life, and to define goals for all three areas. According to one health coach, this mindset was pursued in the spirit of helping participants gain control over their lives and ‘feel that their lives were the result of their own conscious and informed choices’ rather than forces beyond their control.

Failing to cope, then, was seen as an outcome of limited self-management skills. Incidentally, life became just a bit more like work. Although this might be seen as an example of skill expansion, we would argue that this chimes less with Adler’s (2007) upgrading thesis than with Thompson’s (2007) argument that multi-skilling does not necessarily lead to up-skilling. Here, the subjective exploration of life did not unequivocally make work more varied, diverse and interesting; it also involved a division, simplification and management of life to make it more appropriate for work.

It should be evident now that working for Scania is a double-edged sword since workers’ health, which involves the whole life of workers and not just the working part of their lives, is used as a means for enhancing the company’s bottom line. Ultimately, Scania follows the same process of subordinating workers’ lives to the pursuit of  more money on an ever increasing scale (see The Money Circuit of Capital).

The idealization of the Scandinavian countries by Ms. McAlevey and other social democrats thus does not stand up to scrutiny. Even on the assumption that children have equal opportunity at birth (as Ms. McAlevey claims–without further evidence), when they grow up many become employees–and as employees, they are used by employers as things for obtaining more and more money.

Working lives may in some ways be better in Sweden but in many ways they also may be worse under the social-democratic approach that co-opts workers’ own subjectivity.

This case also illustrates the importance of ideological struggle since employers have many resources to co-opt workers into their own schemes. Organizational struggle in itself is insufficient; it is necessary to engage in a simultaneous struggle both organizationally and ideologically.