صحنه و فضاهای اضطراب: تجسم عبارات و اصطلاحات پریشانی در مجامع عمومی و خصوصی

Psychological treatments of mental health issues have acquired a justifiable notoriety for their tendency to engage in generalisation and reductionism. By contrast, the emergent geographies of exclusion make visible the fine-grain material and spatial contours of the lives of individuals who experience mental health difficulties and distress. However, this can come at the cost of a relative neglect of the psychological. In this paper we propose a set of concepts for facilitating the study of intersecting planes of experience, which demonstrates the interdependency of the spatial, the psychological and the technological. Drawing on empirical work with participants who live with persistent anxiety, we demonstrate how online support networks mediate – that is transduct, intersect and transform – how experiences of anxiety are lived out. Attention to endogenous ‘tactics’ or ‘modes of normativity’ provides an interesting agenda for the emergent engagement of social psychology with social/cultural geography.

The conceptualisation and treatment of mental distress have long served as a fault line in psychology, the source of heated and bitter ideological, philosophical and political debate. At stake is the question of the normal and the pathological, and the relationship between these two highly contested terms. As Canguilhem (1980) once proposed, these terms are greatly misunderstood in psychology. In biology and medical science, Canguilhem argued, the normal denotes not a fixed constant, but rather a continuous struggle of the organism to adapt its functioning in response to the challenges of the environment (for example, increases and decreases in neurotransmitter sensitivity in response to exposure to pharmacological stimulants). Norms are then mobile, changing and subject to ongoing revision. The pathological is not opposed to the normal, but typically represents a special instance of the norm where the scope for changes in responses becomes limited (see Canguilhem, 1991). It is when the organism cannot respond ‘normally’ (i.e. adaptively, flexibly, and provisionally) that we speak of pathology. This is a point that has been raised by many psychologists and allied professionals working within the mental health field. The dimensional approach, as it is mainly referred to, aims to understand mental health difficulties as continuous with human experience as opposed to discrete categories of disorder. However, the remaining danger in any psychological study of mental health is that it risks falling back into the error Canguilhem identifies. There are two forms this tendency typically takes. The first is the practice of reducing mental health to a single domain of expression (see Cromby et al., 2007). For example, mainstream psychology generally takes a cognitive approach to distress, where individual thoughts are the major focus of concern, leading to treatment approaches that emphasise the individual's responsibility to change (Smail, 2005). Although cognitive approaches acknowledge the importance of others in the development of individual interpretation and belief, the scope of enquiry nevertheless remains centred on the individual's processes of thought, systems of belief and errors in information processing (Bentall, 2003). Conversely, radical or critical psychology locates the source of distress firmly in the structures of society that lead to oppression and concerns itself with proposing interventions aimed at preventing these from occurring (see Hare-Mustin and Maracek, 1997, Newnes et al., 2000, Newnes et al., 2001 and Strakowski et al., 1995). That the one position is a structural inversion of the other is clear: wherein both contain the danger of returning to the same kind of reductive gesture. The second danger consists in wanting to move as rapidly as possible from the particular to the general. The experience of ongoing anxiety, for instance, is subsumed within the overall diagnostic rubric of ‘neurotic disorders’ that include generalised anxiety disorder (GAD), obsessive compulsive disorder (OCD), panic disorder and social phobia (see APA: DSM-IV-TR, 2000 and WHO: ICD-10, 1992). The difficulty with this rush to generalisation is that since it washes out the particular at an early stage, it creates problems of differentiation and logical puzzles at a higher order. For example, although neurotic disorders are the UK's most common psychiatric diagnoses, affecting 16% of women and 11% of men (ONS, 2003), high levels of co-morbidity (co-existence of more than one mental health problem) have been found between different anxiety disorders (e.g., Magee et al., 1996 and Yonkers et al., 1996) as well as with other psychiatric diagnoses, including depression, Tourette's syndrome, schizophrenia and eating disorders (Rasmussen and Eisen, 1992). Anxiety then seems to be everywhere and connected to everything precisely because the particularity of anxious experiences has been erased in their recognition and classification by psychology and psychiatry (Bentall, 2003). How then can we speak of anxious experiences in a psychological framework without lapsing into reductionism or generalisation? In this paper we will argue that despite the many attendant problems in doing so, it is possible to envisage a form of psychological analysis that is capable of doing justice to the particularity of distress and, in our particular case, anxious experience. At the heart of this analysis is the notion, popularised in recent Deleuzian scholarship (e.g., Ansell-Pearson, 2004 and Massumi, 2002) that experience is best grasped as a form of multiplicity. Whilst it is relatively straightforward to understand the contents of experience as multiple and possibly contradictory, it is considerably more challenging to see that experience is equally affective, spatial, embodied, material, technological and so on, and that what is usually called the psychological narrowly refers to only one set of planes of experience. The term ‘plane’ is derived from the philosophy of Henri Bergson and elaborated further by Gilles Deleuze. Amongst the several meanings of the term are the notions of a ‘slice’, a ‘cut’ or a particular perspective on the entirety of one's experience; a ‘plan’ or organisational principle at work in a particular mode of experience; and a grounding of experience in non-transcendental, immanent relations that cut across subject and object and are as such experienced without becoming directly a matter for consciousness (see Bergson, 1991, Deleuze, 1991 and Deleuze and Guattari, 1988). Out of this heady brew we draw the particular meaning that experience is divided up into differing modes (e.g., the psychological, the affective; the technological) each of which have their own logic and patterning of relations, and are irreducible to one another. The difficulty is to keep this multiplicity – both difference and irreducibility – central to the analysis without prioritising one set of planes over another. In order to provide a check against this, we will use the term mediation to refer to the interdependency of one plane with another (e.g., the psychological with the spatial, the technological with the social). As we will go on to argue, the idea of experience as multiply mediated demands particular kinds of methodological responses.

In this paper we have been concerned with how to address mental health in a social psychological framework without reproducing the reductive and generalising tendencies that often accompany such an ambition. Our aim thus is to explore the radical specificities of participants' experience, rather than to verify or expand on pre-existing and generalised professional (often diagnostic and medicalised) categories. This problem is explicitly addressed by adopting a memory work approach that begins with the texture of particular experiences, rather than through responses to interview questions, set by a researcher. By allowing participants to generate accounts that contain rich descriptions of the actual spaces, embodied feelings and sensations that their experience comprise, a departure from a static narrative of pathology and normality can, to some extent, be avoided ( Campbell, 1996). The particular instances documented in this paper on anxiety, we would argue, could be viewed as a means of providing an alternative methodological framework for research on a variety of topics relating to emotion, embodiment and space. This is an approach, which potentially resists pre-fixed or dominant categories and fixed research agendas that define the object of concern before participants have even began to speak. Following Canguilhem, we have not wanted to make mental health appear as a fixed norm around which the lived experiences of mental health services users can only appear as ways of perpetuating the conditions (whether considered as biological or societal) that underpin their distress. What we have seen is that our participants engage with experiences, many of which have a technological basis, that create interesting potentials for living. Whilst Segrott and Doel (2004), following de Certeau, would identify these as endogenous ‘tactics’, we would see them, extending Canguilhem, as modes of normativity: adaptive practices which expand the potentials for lived experience, in this case the experience of distress. The value, as we see it, of adopting a vocabulary of intersecting planes of experience is twofold. First of all it forces us to recognise that the diversity amongst forms of experience is irreducible. Spending time on the internet is not the same thing as moving through public space. Similarly, what is being done when Anne wears her baggy jumper in her house is not of the same order of experience as what she does when she plays her walkman whilst on the train. Saying that the former belongs to a variety of psychological experience and the other to a form of spatial experience is not an attempt to purify the two acts. Doubtless there is something of the psychological in the spatial and vice versa, but the provisional separation of the two reminds us constantly to return to the specific, the concrete, and to reign in an impulse to generalisation. Secondly, by referring to planes of experience we are drawn back to the idea that as ‘processes of engagement’, the practices and activities corresponding to each plane are open-ended, in a continuous process of change and evolution, which follows its own rhythm (for example, the time of interaction on the internet vs. the time of interaction spent waiting for a train). Moreover, these rhythms intersect to produce all manner of interesting counterpoints in experience (see Middleton and Brown, 2005). We see this clearly in Anne's description of the preparation work she does in her domestic space to facilitate her engagement in virtual space. Massumi (2002) resurrects William James' notion of ‘radical empiricism’ to propose a turn towards the concrete particularities of living that is able to entertain differences – for example, between the psychological and the spatial – whilst recognising that these differences are not necessarily given in nature. Rather they are emergent differences that occur through the myriad forms of engagement that multiplicities (collective, human, animal, inorganic) create and sustain with one another. We would like to situate the engagement of (social) psychology with (social and cultural) geography in these terms. It is not that one discipline augments or corrects the other, rather that their recent conjunction opens up some planes of experience that are ripe for development.