On 30 November 2011, Britain witnessed its largest strike in nearly three decades as an estimated two million public- sector workers protested against the degradation of their pensions. One day later, the Office for National Statistics released the results of the first official British ‘happiness survey’, which showed that 76 per cent of the British population rated their life satisfaction with a score of seven out of ten or above.
The disparity between these events was widely remarked upon. While some argued that the index revealed the fundamental contentment of the population, others questioned the methodological basis of the findings. Few, however, commented on the more fundamental tension revealed over these two days. The strike and the happiness index brought into sharp relief the disparity between two forms of politics that now coexist in Britain. The strike was played out across a traditional terrain on which the principles of action are established through reference to rights, expectations and duties.
The happiness index, by contrast, describes a very different world in which the principles of action are established through reference to the inner feelings or psychological well-being of the population.
I am examining the rise of this new form of politics through a study of the history of psychiatric epidemiology in Britain. Psychiatric epidemiology is a rather modest and often fiercely self-critical discipline. In the UK, under the guidance of Aubrey Lewis, Michael Shepherd, David Goldberg and others, it has avoided political grandstanding and has largely concerned itself with the refinement of diagnostic systems and planning service provision.
Yet at the same time the language of epidemiology, and that of psychiatric epidemiology in particular, has been seized upon by proponents of the ‘happiness agenda’. In the writings of the economist Richard Layard and Tony Blair’s former Downing Street Policy Director Geoff Mulgan, the emotions are held up as the new benchmarks of political life. David Cameron has enthusiastically embraced this new rhetoric, declaring that the pursuit of ‘gross domestic product’ should be supplemented by a search for ‘gross national happiness’. The fact that our inner feelings may now be captured and represented through epidemiological techniques is seen as making possible a new kind of political dispensation.
Some of course will argue that the happiness agenda is mere window- dressing and that reference to the population’s happiness has formed a staple of philosophies of government from Plato’s Republic through to Mill’s Utilitarianism. But the combination of these ‘psychological goods’ with epidemiological techniques marks a new departure. It is part of a shift towards ‘evidence-based politics’, a phenomenon that first began to take shape just before World War II.
New theories of psychosomatic illness were then used to interrogate the sickness returns made available through the administration of national insurance schemes. Changing patterns of morbidity could be read as an index of the psychological health of the population. In the writings of insurance investigator James Halliday and the psychiatrist-turned-politician Stephen Taylor, factors as diverse as the decline of breastfeeding and suburbanisation were blamed for a national rise in the rates of asthma, ulcer, hyperthyroidism and related anxiety disorders.
By the end of the 1930s, such epidemiological insights had begun to play a central role in political and industrial disputes. The Coronation Bus Strike of 1937 (pictured right), in which 27,000 London transport workers protested against their intensified working conditions, was only resolved through reference to Austin Bradford Hill’s study on the relative rates of gastric disorders in busmen and tramwaymen.
Knowledge of the population’s emotions became central to national planning during the War. Stephen Taylor was appointed Director of Home Intelligence in the Ministry of Information and, with colleagues, devised a number of measures for assessing levels of anxiety on the home front. These measures of popular anxiety underpinned the rhetoric of the welfare state. As Aneurin Bevan argued, the provision of social security was a crucial element in the nation’s pursuit of “serenity”. Psychiatric epidemiology and the language of stress and insecurity worked to sustain the postwar political settlement.
It is striking that these concepts of anxiety and serenity are largely absent from the new psychological politics promoted by the happiness agenda. We are no longer concerned with rising rates of insecurity but national levels of depression. The reasons for this substitution are complex and deserve further investigation. It seems to be bound up in part with the rise of new forms of psychopharmaceutical intervention.
But the change is significant. In the writings of some of the most interesting contemporary epidemiologists, including Michael Marmot and Richard Wilkinson, depression has been presented as a pathology determined by problems of autonomy and social rank. Such theories embody a new vision of social justice – an egalitarian vision that, although it has yet to be realised, informs current health programmes and early-years schemes. It is a vision made possible not through philosophical authority but through a diverse range of elements from cortisol assays to evolutionary psychiatry. Disentangling the political uses of affect and the complex interrelationship between biological, psychological and classical forms of politics now operating in modern Britain is an urgent task as much for political historians as for historians of emotion.
This article originally appeared in Wellcome History magazine.