A Perfect „Treatment-Society’?

A Perfect „Treatment-Society’?

Niels Rosendal Jensen, The Danish University of Education Copenhagen


The Danish Minister of Social Affairs is a very eager protagonist of quality in treatment, almost searching for the “perfect“ treatment for children, youngsters, disabled, etc. Many expensive research projects dealing with quality management as well as developmental projects have been launched during the latest years in order to improve professional practice.

Within that context this article will deal with the relations between paternalism and ignorance and between pro-social behaviour and anti-social treatment in order to grasp “why professions are doing vicious things“. The main focus is concerned with the knowledge field of social pedagogy.

2        Good intentions and happiness versus tough realities

The understanding of the social pedagogical profession in Denmark concerning its own work is often characterized by words like “good intentions”, “lovely relations to clients” and “quality of life”.

The modern Danish welfare state or welfare society – which is by some foreign observers viewed as a welfare frontline state – seems to be suffering from the term “treatment“. Alcoholics, homeless, single mothers, youngsters or children in schools or residential homes are some of the target groups of such “treatment“.

Several reasons could be identified to underline the character of that understanding. Let me just in a hurry and in plain words explain that interest: first of all – there has been a shift in the general understanding of how a society reproduces itself. Up to the 1990’es the welfare state was modernized, but still based on the principles of freedom, equality and fraternity, meaning that the principle of universalism was in function. Since the middle of the 90’es universalism has been under siege – due to lack of finances and the ongoing individualization. Philosophically: Universalism seems to be substituted by “sophisticated universalism” (= social rights are based on the right to be different from any other person), or “positive selection” (= a positive discrimination of certain parts of the population (migrants, sexual minorities, etc.), or “particularism“ (= respecting the deviant, or special). The general outcome is a selective policy, focusing on the target groups in stead of broader political initiatives to develop welfare. Economically: F.i. the public costs of treatment of children and adolescents in institutions (family care, traditional social pedagogic institutions, or boarding schools) are about 1.5 Billion EURO per year. The costs are increasing – in spite of the fact that the number of “inmates“ is stable (about 1% of the total population of the young generation; in numbers 14.000).

Societal: Does the treatment help? Perhaps it helps society to get rid of some problems for a shorter or longer period. But generally speaking the percentage of residuals is rather high. Is the treatment evidence-based? The Minister would like to have a kind of fool proof manual at her desk. Secondly, I would like to emphasize that the ideal of social citizenship is the most important challenge of the 21st Century. We are facing a number of difficult problems which I prefer to summarize like this: we need to develop social rights in a way that strengthens a differentiated social integration, participation and emancipation of (potential) losers of globalization.

Looking back at Danish social policy and social pedagogy it seems obvious to moderate the optimistic views of the professions themselves. Since the middle of the 1930s sterilisation, behavioural therapy and isolation “for the good of yourself and your country” have unfortunately been rather common. This began to change in 1961 with the introduction of new legislation.

Nevertheless, it is not difficult to search and to find representatives of the professions who would still like to define “the happiness of their clients” and then carry out the necessary measures to reach that goal. Remembering our experiences of the past we should always be wary of people who would like to do good to other people – especially those who claim to know how other people should be happy. This lesson was paid several times years ago.

Usually, many pay tribute to the slogan: “Small is beautiful”. For the client, however, it does not matter whether we are talking about “big” or “small” evil. Pain might be the result of both. But is this not an exaggeration? Unfortunately, evidence points in another direction.

We have in Denmark a long history telling us the hard facts. In the early 1930s the foundations of the modern Danish welfare state were laid. The hottest issue and the pivotal hinge were a new social policy. The leading politicians were worried that the number of “Untermenschen” or “nonentities” should increase and outnumber the “useful” part of the population. The answer to this challenge included achieving a reduction in the number of “problem people“. This answer came not from the party program of the Danish Nazi Party; in fact, the majority of the “responsible” political parties were protagonists of that policy – Social Democrats, Social Liberals, Liberals, and Conservatives. The idea of securing a “social” minimum went hand in hand with the efforts of eugenics to limit the number of outcasts or “Untermenschen” (Koch 1996, 24). Social policy was a matter of supporting the lower social classes and strata (unemployed, ill, those worthy of public support etc.), at the button of society. Below that button the “societal garbage“ was discovered and interpreted as a threat against the quality of the population. Social Darwinism, Nazism, or Danish Welfare? The declared goals seem different, but the means proposed had a close proximity to each other.

The policy - adopted by the Danish parliament - was implemented in a 3-legged strategy:

1.       Negative eugenics (segregation, sterilisation or castration)

2.       Positive eugenics (information, tax reduction and/or wage policy for the best genetic heritage)

3.       Prophylactic eugenics (legislation on marriage, prohibition of „mixing races“ etc.)

During the years 1928-1935 efforts were made in all categories. As already emphasized, the policy was not based on fascism or extremism, it was strictly scientifically based. Danish and German researchers were the pioneers of a new science on controlling the population. There was one important difference - the Danish Labour Party was never a racist party, it did not support such initiatives on a racist platform. In fact it condemned the racism of Hitler as developed in “Mein Kampf” and in the ideology of “Blut und Boden”. The guidelines of the eugenic argument were not racial, but social – a sort of “eugenics with a socialist and human face”. At least socialist eugenics served the preservation of a “sound social body” (metaphorically speaking) , especially the moderating the capitalist exploitation of the working classes against the degenerated “Lumpenproletariat”. In that perspective eugenics was an ambitious collective program of modernization for the whole population or at least its vast majority.

To jump from the past to the present, what can be learned about the modern “treatment-society”? We do not have legislation like in the 1930s. Nevertheless, Danish and Nordic disability research (Kirkebæk 1993, 1997; Sætersdal & Heggen 2004) is able to prove how humiliating and offending forms of treatment can be as a natural consequence of the professional stance of dealing with ”otherness“. The research does offer two lines of explanation, structural and ontological.

1.       According to the structural explanation, which underlines bureaucracy, administration, procedures, etc., professionals are behaving “badly” because they have to obey decisions, regulations, or orders from an authority. This goes for the German guard in Auschwitz, the American soldier in Guantanamo or even the Iranian terrorist in Al-Quaeda. But it might do as well for the teacher, the pedagogue, or the nurse who is acting on behalf of prescriptions stated by their superiors or based on the “conscience collectif” (Durkheim 1893) of the professional community/the community of practitioners. In brief: both types of action are based on knowledge derived from approved research. And it might do, too, for parents following the advices of the experts on child rearing, training of dogs or treatment for their senile mothers and fathers. This means that persons involved are acting in accordance with the premises of “best practice”.

2.       The ontological explanation points out that some people enjoy the pain of others. We are all vulnerable. In order to protect our selves and control our own vulnerability we transfer that vulnerability to other human beings. This category has nothing to do with orders; it has to do with joy – I am enjoying the misfortune or the pain of him or her. I am getting more powerful in contrast with their powerlessness. Or I do not understand or accept their world, because mine is much better, cleaner and true.

Most professionals understand the structural explanation to such an extent that they reject the ontological one. It is hard to have to accept that one’s esteemed co-workers are abusing their power. And: Why? Because it is difficult to understand that normal people are doing horrible things. We should never forget that such interventions were legal in Hitler Germany and in Denmark. People acted like loyal administrators of given legislation.

Even if I have to accept the above mentioned rationalization, I still do not accept that scientists in Germany or Denmark did research not only the genetic heritage, but as a parallel developed treatment methods of dubious character in prison-like institutions, invented gas chambers or conducted medical experiments in KZ-camps. In Germany as in Denmark the task was to preserve the best possible quality of the genetic material. KZ-camps are then to be seen as a giant laboratory of living human material, and “die Endlösung” (the final solution of the Jewish question) interpreted as a medical operation to protect the German people. Therefore, seen in this light, this was not a crime, but a medical necessity. In Denmark as well as Germany, eugenics was an objective and respectable science, supported by the belief that the results of science were implemented for the sake of a supreme and just cause (the survival of the healthy Danish people or the pure blood of the German Arian race). In brief: Eugenics was based on truth.

Those matters were intensely discussed in the aftermath of the Second World War (Sartre 1946, Adorno et al. 1950, Arendt 1964).

3        Where is it rooted?

But is this not just a German, or Jewish, or at least a historical matter?

Michel Foucault’s writings enrich our understanding as they are the essence of a life-story of struggles against the Platonic monopoly of truth. Foucault’s work traced parts of the history of truth as the “history of insanity in the age of reason”. Such a “production of truth” or “production history of truth” acquires its political explosiveness from the fact that it describes truth in its emergence. What is acknowledged as normal (e.g. eugenics of the 1930s) is alienated through the revelation of its origins. Foucault underlines, that the genealogies as „anti-sciences“ should not establish any new “truths”, but demonstrate ways towards the transformation of the earlier ones (Foucault 1994, III, 165). In a way Foucault was bound for a fundamental task corresponding with the Nietzschean dictum “Umwertung aller Werte” (revaluation of all values). This task has to do with an attempt to pursue science not simply as a „discovery of truth“, but rather as a sort of “politicising“ the role of the intellectual or scientist. In his last works the ethics of existence was strongly emphasized. The intellectual or the scientist should neither prescribe nor prophesy. He should rather be a “destroyer of evidences and universalities” (op. cit., 268). Foucault in his works shows how truths are created, and exactly for that reason they can be criticized and changed. He tries to show us “the arbitrariness of institutions and which space of freedom we can still enjoy and how many changes can still be made” (Foucault 1988, 11).

Another famous theoretician, Zygmunt Bauman, points out that while seeking and protecting safety in an insecure world we have to drop freedom and vice versa. Safety without freedom seems to be slavery. The interesting point in Bauman’s analysis concerns the fact that safety which is given up in the name of freedom as well as freedom given up in the name of safety tend to concern the safety and freedom of the other person (Bauman 1989). This leads to a contradiction between “good“ and “evil“ in the professional space – a space, where dependence and difference in the relations between humans is at their high noon.

Bauman sums up his view in the following statement:

“Moral responsibility is the most personal and inalienable of human possessions, and the most precious of human rights. It cannot be taken away, shared, ceded, pawned or deposited for safe keeping. Moral responsibility is unconditional and infinite, and it manifests itself in the constant anguish of not manifesting itself enough. Moral responsibility does not look for the reassurance for its right to be or for excuses not to be. It is there before any reassurance or proof and after any excuse or absolution“ (Bauman 1993, 250).

Through this statement Bauman underlines that Holocaust is not just a Jewish or German question but a general problem of modernity. In other words: evil does not require evil actors, i.e. people planning to be evil. Evil could be understood as resulting from institutional structures, fragmentation of responsibility, extreme specification of items, lack of overview, etc. Such factors might explain why people are capable of doing (very) bad things with innocence and pure conscience. Bureaucracy, technology, and an instrumental mentality widen the distance to the human beings we are responsible for. When the distance increases, evil tends to increase, too. This is what Milgram (1969) tried to demonstrate. Later interpretations of Milgram’s experiments point in other directions – not at the external factors, rather at the internal ones, i.e. the human beings themselves. To be a human being is to be vulnerable, insecure and mortal. To be mortal is to be alive. This further means that we need to be in control of the situation. An important form of control is a kind of projection of one’s own vulnerability upon other persons. When other persons show their pain and vulnerability, my own decrease. One might even get the impression of being a ruler on life and death of others. Such reflections might make accessible the field of injustice, assault and even atrocity towards clients.

Following the considerations of Bauman, which have had a great impact on the contemporary understanding of Nazism and Fascism or of the recent Yugoslav civil war, evidence seems to point at the fact that evil is an inherent part of modernity or the project of Enlightenment. Reflecting upon these matters one could ask: What is the link between Holocaust and everyday life in a public institution (school, day care, home for elderly people, residential home for youngsters or hospital)?

A similar kind of reflection exists in the work of Foucault. Due to his research in medicine, psychiatry, punishment and other areas, he was able to label the discourses “truth games“. As an answer to many misunderstandings he stated: “Power is not evil. Power is strategic games“ (Foucault 1994, IV, 727). Foucault’s ardent question is “What is Enlightenment?“ (Foucault 1976).

4        What can be done about it?

The conclusion might be pessimistic about our common future. What is to be done? Should we give up? At least Bauman appeals to reason. He is an optimistic observer and believes that reason might convince us not to replay the tragedy of the 20th Century. Influenced by this optimism it seems possible to develop pro-social behaviour. This is certainly no easy assignment, but a very necessary one.

Danish society has to a certain degree lost its coherence. Hegel is his „Philosophy of Law“ ([1821]1997) argues that three integrating mechanisms are important for the individual in order to become an integrated member of the national society. The ethical code is transmitted in three contexts: that of the family, of civil society and of the state. The family is the basis of spontaneous learning processes such as work, standards of living, love and care all based on closeness, relationship and kinship. The civil society comes next with trade, economic and industrial life (today labelled as the market), local groups, all sorts of communities. At the end comes the national state transforming legitimate law into legal law. This tri-partition is today in crisis: Families have difficulties in raising the young generation; civil society seems to be disintegrated; the national state is under siege. In brief: The “winners“ of sharpened global competition and the outsourcing of jobs and work places are not interested in the fate of the “losers“. More and more youngsters are experiencing themselves to be dumped by modernization. They are victims of social marginalisation, are expelled and useless. It is difficult for them to gain a foothold on the processes of economic production. Their life is a life marked by social poverty. Not only their social position is at risk, but their lives are at the same time accompanied by feelings of uncertainty, a lack of basic trust, incompetence as well as uselessness (Bauman 2003). This dark side of today’s situation calls for the containment of useless youngsters in prisons or secure institutions. The middle class is less committed to “Gemeinschaft“ (community) and “Gesellschaft“ (association) (Tönnies 1887). The coherence was until recently a part of a national bargaining. The nation state was formerly characterized by specialised institutions, partly functioning in their own right as societal differentiation – and partly balanced by reciprocally aiming at preserving or establishing the social order through integration. At a global level we cannot find such integration. If we seek, we find chaos and anarchy. But at regional or local level social life still goes on at workplaces, schools, kindergartens or youth institutions and families and in direct face-to-face-relations with peers, friends, family members etc.

This constitutes a relevant discourse for the social pedagogical profession in Denmark as well as the societal discourse on social capital. Given the fact that contradictions in explanations do exist (the structural vs. the ontological) are we then able to define or locate factors or effects upon the community of practitioners, which are stimulating or even creating humiliations? Are patterns of values available which create „order“? Should the young man or woman not simply address their unemployment by intensifying their efforts to compete with other youngsters? Such trivial questions must be asked, if we are to collect knowledge about the content of concrete everyday practice.

Still the discourse of the social pedagogical profession on this subject is very tacit. This tells us that the reformers and practitioners are dealing with a severe problem: How to handle obvious inequalities between people? Do social pedagogues have the right to influence other people’s life courses? And if we do (in casu: confronting unemployed youth), is it possible then to “save“ everybody? Can we continue “saving souls“? And how do we go on with our work, when our good intentions fail? Or when they are re-interpreted in slogans like „don't worry, be happy“? Such basic questions on a philosophical meta-level have to do with normative and ethical issues concerning the assumptions for intervening in people’s lives in order to help them and better their everyday life conditions. The fact that social pedagogy has often been forced to legitimate its position explains some of the interest in philosophical, meta-level analysis. As for the profession as such the wider range is lacking. We rarely hear about working conditions, wages or frame conditions. This tends to individualize and privatise experiences with neo-liberalist social policy.

To answer the leading question: What is the link between the Holocaust and everyday life in a public institution? – I would like to summarize: Bauman shows us that without personal responsibility “anything goes“. At the end of the line after all our misdeeds we might be cross-examined. We are then free to explain: I just carried out orders. But the explanation will not save us or free us from personal responsibility. Foucault furthermore excavates how truth is born, and how we forget its origins, understand it as a universal truth and act as if it was the one and only truth. Foucault is seeking a genealogy of the critical attitude in Western philosophy. Why are certain forms of behaviour classified as “madness“ at this point of history when similar forms are completely neglected at another time? The genealogy of a given problem is the comprehensible history of an answer. The lesson to be drawn is that researchers and practitioners should intensify their common efforts to develop a code for sustainable practice. Are we able to learn from history?

Elements of a possible answer:

·         Scientists and practitioners are always able to choose within existing possibilities. We cannot excuse ourselves by saying that „eugenic researchers were children of their time“ or that nurses, teachers or professionals just did their duty. Of course they were products of circumstances, but even so one must never forget that human beings are capable of changing their circumstances. Different decisions or personal choices are possible.

·         It is important to recognise the basis of power in research intentions. For example the majority has always used research against the minority. This means that research as well as practice might be repressive.

·         Science is often seduced or carried away by its own success and claims to have a privileged position on knowledge far beyond the real contents and range of the scientific findings.

·         Scientific research seldom takes place in a vacuum without ideology or power.

And the professions - are they able to conquer new experiences? Of course, not overnight, but as starting point they might reflect on possible expansions of the forms of legitimate control. Max Weber emphasized three forms: the legal, the traditional, and the charismatic (Weber 1922). Why not a fourth form? A suggestion is to expand the range by incorporating the democratic form of control based on mutual dialogue. Not only professionals, but also clients have the right to problematisize everything. Any decision can be debated. This means that the administration of the (loyal) administrator can be called into question not only by his/her superior, but also by any citizen. The outcome of this would be that ethical conflicts at administration and street level bureaucracy become open to debate. That is why the democratic form of interaction is a genuine alternative to authoritarian forms.


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Author's address:
Associate Prof Niels Rosendal Jensen
The Danish University of Education
Emdrupvej 101
DK-2400 Copenhagen NV
Tel.: +45 8888 9850