Against Critical Thinking in Health, Social Care and Social Work: Reframing Philosophy for Professional Practice 0367642352, 9780367642358

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Against Critical Thinking in Health, Social Care and Social Work

This book stages a provocative dialogue between social work, health and social care and contemporary philosophy in order to inform theory and practice in a complex and challenging world. Today, the social world is marked by deep-rooted complexities, tensions and challenges. Health workers and social workers are constantly reminded to employ critical thinking to navigate this world through their practice. But given how many of these challenges pose significant problems for the theories that these subjects have traditionally drawn upon, should we now be critical of critical thinking – its assumptions, its basis and its aspirations – itself? Arguing that health and social work theory must reconsider its deep-rooted assumptions about criticality in order to navigate complex neoliberalism, post-truth and the relationship between language and late capitalism, it examines how the fusion of theory and practice can re-imagine critical thinking for health, social care and social work. It will be of interest to all scholars, students and professionals of social work and health and social care. Tom Grimwood  is Professor of Social Philosophy at the University of Cumbria, where he leads the Health and Society Knowledge Exchange (HASKE) within the Centre for Research in Health and Society. He is the author of The Problem with Stupid: Ignorance, Intellectuals, Post-Truth and Resistance (2023), The Shock of the Same: An Anti-Philosophy of Clichés (2020) and Key Debates in Social Work and Philosophy (Routledge, 2016).

Routledge Advances in Social Work

Using Art for Social Transformation International Perspective for Social Workers, Community Workers and Art Therapies Edited by Eltje Bos and Ephrat Huss Revitalising Critical Reflection in Contemporary Social Work Research, Practice and Education Edited by Christian Franklin Svensson and Pia Ringø The Body Politics of Glocal Social Work Essays on the Post-Anthropocentric Condition Mona B. Livholts Language Discordant Social Work in a Multilingual World The Space Between Hilde Fiva Buzungu Social Work, Social Welfare and Social Development in Nigeria A Postcolonial Perspective Mel Gray and Solomon Amadasun International Perspectives on Parenting Support and Parental Participation in Children and Family Services Edited by Carmel Devaney and Rosemary Crosse Against Critical Thinking in Health, Social Care and Social Work Reframing Philosophy for Professional Practice Tom Grimwood

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Against Critical Thinking in Health, Social Care and Social Work Reframing Philosophy for Professional Practice Tom Grimwood

First published 2024 by Routledge 4 Park Square, Milton Park, Abingdon, Oxon OX14 4RN and by Routledge 605 Third Avenue, New York, NY 10158 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2024 Tom Grimwood The right of Tom Grimwood to be identified as author of this work has been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library ISBN: 978-0-367-64235-8 (hbk) ISBN: 978-0-367-64237-2 (pbk) ISBN: 978-1-003-12358-3 (ebk) DOI: 10.4324/9781003123583 Typeset in Sabon by codeMantra

Contents

Lists of figures Acknowledgements

Introduction: against critical thinking?

1 Critical atmospheres: where are we now with facts, critique and care?

vii ix 1 23

2 The rhetoric of urgency: tensions between critique and practice55 3 Autonomy, critique, and consensus

76

4 Placing the review under review: reconciling critique with assemblage in safeguarding reviews

99

5 The power of critique: looking back and forwards with Foucault122 6 The vulnerability of critique

144

Index161

Figures

1.1 Critical thinking matrix 1.2 Post-critical thinking matrix

28 44

Acknowledgements

As with any book, the writing of this would have been impossible ­without ongoing dialogue with a wide range of people, some regarding the topic directly, others prompting changes of thought and direction without ­necessarily being aware of it. I would particularly like to thank Claire Jarvis, Sully Evans and the anonymous reviewers at Routledge for their support for the work. I would also like to thank Alan Blum, Arthur Bradley, Vicki Goodwin, Claude Haas, Martin Lang, Niall Gildea, Heather Lynch, Jamie McPhee, Thomas Marthaler, Paul Miller, Tina Wilson, Nancy Moules, Sarah Pemberton, Rebecca Robinson, Laura Snell, Robert Williams and Mark Wilson, as well as the speakers at the University of Cumbria’s Centre for Research in Health and Society’s Guest Lecture Series over 2021 and 2022; all of whom provided the necessary support and/or provocation when it was needed. As always, my biggest thanks go to Abby, Elijah and Martha for their own critical sensibilities towards the ordeals that book writing brings to our house. Some of the chapters in this book are revised and extended versions of work that has been previously published. Chapter 1 is an expanded v­ ersion of Grimwood, T. (2023). ‘Post-Critical Social Work?’ Social Work and Society, 21:1. Chapter 2 is an extended version of Grimwood, T. (2020). ‘The Rhetoric of Urgency and Theory-Practice Tensions.’ European Journal of Social Work, 25:1, pp.15–25. Chapter 3 is a revised and extended v­ ersion of Grimwood, T. (2019). ‘Autonomy and Dependence.’ In Payne, M. and ReithHall, E. (eds.), The Routledge Handbook of Social Work Theory. London: Routledge, pp.95–108. I had the pleasure of presenting a number of these arguments at ­various conferences and seminars: in particular, ‘The Rhetoric of Urgency and the Theory-Practice Binary,’ an invited keynote at the 29th Annual Conference of Réseau Européen de Formation Universitaire en Travail Social (REFUTS) at the University of Luxembourg, 4 July 2018; ‘Facts, critique and care: Where are we now, and where do we need to go?’ presented at the Social Work Futures conference, What ‘Social Work’ does the World need Now? at Glasgow Caledonian University, 28 June 2021;

x Acknowledgements and ‘A Social Ontology of Safeguarding Practice Reviews: Reconciling Assemblage with Critique’ presented at the International Social Ontology Association Annual Conference at the University of California, San Diego, 18 August 2021. My thanks to all the comments and conversations I received at, and after, these events.

Introduction Against critical thinking?

In a now often-quoted passage of his book One Way Street, Walter Benjamin writes: Criticism is a matter of correct distancing. It was at home in a world where perspectives and prospects counted and where it was still possible to adopt a standpoint. Now things press too urgently on human society. (1928 [1996], p.476) Benjamin wrote this in 1928; however, such a quote may seem even timelier in the current age. After all, today the world of welfare is marked by deeprooted complexities, tensions and challenges which disturb the notion of the ‘correct distancing’ for critical appraisal. The world remains grippled by constant urgencies: welfare crises, sparsity of resources, mounting caseloads and so on, all of which challenge not only the day-to-day delivery of care, but also the conventional models that underlie demands for critical thinking in practice. The COVID-19 pandemic saw the scene of a variety of rampant discourses which constantly negotiated certainty and speculation, modelling and pragmatism, the seemingly endless power of ‘the data’ and not only ethical dilemmas around the provision of care, but also larger meta-ethical balance between health, welfare and the economy, as well as a rhetorical emphasis on the importance of intelligence at the expense of ‘stupidity’ (Grimwood 2023) that reflected wider discussions on clinical expertise and service user decision-making. And if COVID-19 was a ‘once in a generation’ event of huge significance, it was nevertheless one of a series of events which combined the political, socio-cultural and economic aspects of the delivery of health and social care. The banking crisis of 2008 and the austerity politics implemented in its wake (see, e.g., Raj 2019), the rise of ‘populist’ leaders and increasingly complex treatments of human rights and welfare provision (see Keane 2020), the increase in the speed and mass of information passing around the globe and the subsequent rise of ‘post-truth’ and ‘fake news’ and its effect on the trust in the care professions (see, all of these events have contributed to a requestioning of the role and limits of critical thinking in professional practice). DOI: 10.4324/9781003123583-1

2  Against critical thinking? Chatzidakis et al. refer to this as a ‘current moment of rupture’ in the understanding of care in society (2020, p.97). The long-standing tensions in social care, brought to the fore during the pandemic, leads Cottam to note that ‘[d]espite decades of brilliant work: the research, the policy papers, the advocacy and the data, we are stuck’ (2021, p.3, my emphasis) and as a result ‘we see a hunger to reimagine these tensions and to think again’ (2021, p.7). Cottam is not alone: Ioakimidis et al. suggest there is a ‘profound (re) politicization of social workers’ (2014); Salvage and White argue that now ‘is the moment for nurses to shift the paradigm, to be taken seriously together and individually, when the old certainties and ways are being shaken to the core’ (2020, p.5); Papathanasiou et al. argue that in the current climate ‘we should all try to achieve some level of critical thinking to solve problems and make decisions successfully’ (Papathanasiou et al. 2014, p.285); ‘Now more than ever,’ Laskowski-Jones (2021, online) writes, ‘nurses need to draw upon their discernment abilities to aid the public in navigating the turbulent sea of health advice and differentiating high-quality information from bogus’; and Boddy and Dominelli note that the ‘[i]ntersecting discourses around power, privacy, embodiment, professionalism, authorship, and consequences’ require all of the care professions ‘to retain criticality in their practice’ (2017, p.181). Yet, the correct critical distance remains far from obvious. This is a problem. After all, a glance at the generic critical thinking literature in health, social work and social care will tell us that it is key for the development of professional skills; it is crucial for helping service users to the fullest extent possible; it allows the anticipation of service user needs; it enables openmindedness in the interpretation of evidence; it facilitates good communication and the healthy exchange of ideas around care plans, approaches and policies; it promotes safe practice and it encourages innovation. Why, then, after all these pervasive lists of reasons for engaging with criticality affirmatively in practice, would this book be called ‘Against Critical Thinking’? Perhaps the simple answer is that, within the enthusiasm for critical examinations of professional practice, it seems unclear as to what extent it is possible to be critical of critical thinking – its assumptions, its basis and its aspirations – itself. Despite the widespread changes and challenges to models of criticality across disciplines in the past 30 years or so, the models of critical thinking available to educators and practitioners in health, social care and social work remain curiously static. For sure, we can find warnings about the rise of ‘post-truth’ and ‘fake news’ affecting the delivery of care. We can read all about the problems in contemporary practice arising directly from insufficient appraisals of evidence. We can witness the danger of workplace habits and cultures overtaking user-focused services. But textbooks on the subject often present much the same processes, powers and particularities of criticality explained. The answer to the problems of post-truth, excessive information, shifting service user demographics and ever-changing systems of governance and organisation seems to ignore

Against critical thinking?  3 Benjamin’s concerns and simply apply more of the same, regardless of how effective it has been thus far. Critical tensions Of course, there is no end of ready-to-hand resources available across the care professions, not to mention education research, cognitive and developmental psychology and even in self-help and lifestyle literature regarding how to improve critical thinking, with an array of names to guide the way: Dewey, Piaget, Siegel, Freire, Watson and Glaser, Ennis and Weir, Paul and Elder and so on. More broadly, the opposition of ‘critical’ practice to ‘neoliberal’ conventions has become a standard face-off in the politics of care (Hastings and Rogowski 2015; Chapman and Withers 2019). But such a framing inevitably leads to the consolidation of certain unhelpful stereotypes: that critical thinking is a kind of monolithic entity that can be inserted ‘in’ to practice at various appropriate moments; that practice itself is uncritical until this happens. Even when such caricatures are not explicitly in play, a tendency remains for the textbook literature on critical thinking to focus on concise, reductionist accounts; think, for example, MacLean and Harrison’s ‘straightforward guides’ on theory and practice (2015) that are well into their third editions. Consequently, this can risk removing (unintended or otherwise) the very complexities that critical thinking sets out to understand, typically because such books are aimed at undergraduate students. In line with this notion of critique as a pedagogical tool, the term ‘critical thinking’ has often been enveloped by cognitive development assessments of individual competencies, where the focus is on improvements in problem solving, self-identification of personal bias or assumptions, ‘learning how to learn,’ and to act ethically and autonomously (Milner and Wolfer 2014, pp.274–276). Tom Boland summarises such a view of critical thinking ‘as a discourse that produces truth, provides an apparatus of “knowledge” and forms and governs subjects; comparable to the disciplinary tendencies of psy-sciences and social policy’ (2019, p.78). Indeed, the idea of critical thinking as a set of transferable and generic skills may be persuasive: what could be more useful, after all, than a set of tools, a process of steps or, as Elmansy suggests (2022), an abstract system to internalise until it becomes part of one’s practice? None of this really addresses the problem of correct distance that Benjamin raises. As Boland rightly argues, such tendencies present critical thinking as a form of innate or universal reason that can be unleashed with the correct training. As such, while professional practice often looks to psychological development theories for implementing critical thinking in order to reap several clear and tangible benefits, it also risks omitting the social traditions that carry (and are embodied by) such a modality of critique, and consequently undermining the ‘cultural resources for shared values and ideals that might mobilise solidarity and social renewal’ (Boland 2019, p.99). Henry Giroux

4  Against critical thinking? notes the potential problem with drawing on such limited definitions and subsequent methods: The most powerful, yet limited, definition of critical thinking comes out of the positivist tradition in the applied sciences and […] refers primarily to teaching students how to analyse and develop reading and writing assignments from the perspective of formal, logical patterns of consistency. […] While all of the learning skills are important, their limitations as a whole lie in what is excluded, and it is with respect to what is missing that the ideology of such an approach is revealed. (Giroux 1994, p.200ff) This, I think, goes beyond the more obvious problems with overtly positivist accounts of critical thinking (of which there are, of course, many). It also affects the broader critically interpretative activities at the core of relating theory and practice. For example, when Stepney and Thompson (2021) boldly argue that ‘applying theory to practice’ (which they argue is the conventional educational approach) is replaced by ‘theorising practice,’ they assert that ‘if carried out with skill and critical thinking, then theorising practice leads to informed practice’ (p.155, my emphasis). Addressing the complexities of the social world that confronts the practitioner, they argue that when ‘dealing with situations of conflict and uncertainty practitioners cannot simply draw upon their knowledge base in a direct, linear or prescriptive way, but must engage in a process of critical exploration’ (Stepney and Thompson 2021, p.154, my emphasis). What is critical thinking, though, in this sense? It is nothing more than ‘the ability to question, probe and explore beneath the surface’ (2021, p.159). In this way, even a decidedly non-positivist account retains the notion of critique as an exercise in analytic process; an unmasking or excavating act, involving a subject probing an object, and which is developed and enhanced with enough training or encouragement. Perhaps one reason that the issue pervades a range of methods and approaches is that it names a tension for the professions between criticality being understood as a form of sense-making on the one hand (which may not just be writing assignments, but more generally how effectively one is practising; or inquiring into what the salient issues are in the case before them), and on the other hand being utilised as an investment in some kind of transformative engagement. In Kathrin Thiele’s words, ‘a critical position is one that invests in its own power to transform, and it relies on active engagement with the issues it addresses so that it allows, or even more so, strives for changes to happen’ (2021, p.21). Critique is therefore often caught between the naturalistic (i.e. an account of what there really is) and the normative (i.e. an account of what really should be), and different invocations of the term will emphasise one more than the other. The tension is not resolvable by simply picking one or the other, however. This is not just because, as Michel Foucault once commented, critique implies an ‘art of not being governed

Against critical thinking?  5 quite so much,’ and, by challenging accepted practices, introduces a natural tension into professional roles where governance is vital to the safety and wellbeing of service users. The problem is also that within the contemporary cultures of care and welfare, it is precisely the notions of critique, truth and evidence that have been at the forefront of policy decisions at local, national and international levels, as well as decision-making at an individual level. Critical thinking is not simply a lens that professional practice can be approached through; it is an area that is very much in question. What is critique? Perhaps this should not be surprising. The fact that there are so many different invocations of criticality is not an accident. As McQuillan suggests, ‘the words “critique” and “critical” have been popular since the enlightenment, but they remain lexically imprecise and philosophically vague’ (2010, p.150). Critique, in the sense that is used here, can trace its roots back to the European Enlightenment. But even then, Delanty (2011) points out that the time of the Enlightenment saw at least four major concepts of criticality emerge, all of which gave rise to further elaborations and divisions as the 20th and 21st centuries unfolded. In many ways, this is because critique is itself always a practice, and any definition of it will, by necessity, be itself open to critique. As such, it seems that at least part of the current appetite for critique would invite re-assessing the role of criticality itself in the caring professions, not just in terms of the application of ‘critical thinking’ as a pedagogic tool, but more broadly in terms of how critique takes place, its limits and its possibilities, and what kind of dialogue the practices of health, social work and social care practitioners can sustain with discussions of the same questions in philosophy and social theory. If Benjamin’s issue of correct distancing is now pressing not only on theorists but also on practice education and provision, then it seems only sensible to ask whether there are alternatives to ‘critical thinking’ in the conventional way it inhabits the health and care professions. This is not just in the sense of intensifying the existing methods of critique – that is, trying harder to live up to the demands of the ideal mode of critical thinking, insisting on more references in the papers we review, demanding more clarity on the proposed changes to care delivery systems, berating ourselves further via critical reflections – but in terms of thinking outside of the more conventional frames of reference. That is, to consider critical thinking as something more than a question of being ‘objective,’ ‘evidence-based’ or ‘logical,’ and attending to the atmospheres through which critique takes place – the rhetorics and resonances of practice, and how these affect modes of justification, representation and communication – and how these inform the interpretative practices of professionals within health, social care and social work. In other words, there is a need to reframe the concepts at work in the critical practices of the caring professions.

6  Against critical thinking? It is important to clarify that ‘rhetoric’ is not used here as a pejorative term for misleading or vacuous speech, but rather to the detailed and rigorous understanding of the art of persuasion (see Crowley and Hawhee 1999); an art aimed at securing the ‘adherence of minds’ in a given audience (Perelman and Olbrechts-Tyteca 2008, p.8). In this sense, it offers a distinctive approach to how ‘the usage of words shapes the way [a] profession communicates to itself, how it coalesces, marks out and sustains a distinctive rationality’ (Garrett 2018, p.2). As such, paying attention to rhetoric involves understanding how the meaning of particular words, images or concepts is consolidated through their use and circulation around specific audiences (such as particular communities of practitioners, which are in turn formed through particular relationships between different domains of work and their respective demands). While the discipline of rhetoric carries with it a long tradition of specific methods, I agree with Melonçon and Blake Scott’s (2018) argument that it can often be more helpful to think through fields of inquiry that are guided by rhetoric but shaped by a cross-section of disciplinary knowledge and approaches. Such an account of rhetoric is not limited to words alone, but also to the materiality of practice and the ways in which persuasive forms emerge from them (see, e.g., Barnett and Boyle 2016; Enoch 2019). Hence, rhetoric’s relevance to welfare provision has been claimed by several writers for its significant re-emphasis on ‘the classical relationship between theoria and praxis through a realization of theory’s practical power’ (Parton 2000, p.461; see also Miller 1991; Rutten et al. 2010; Roets et al. 2015). It therefore suggests a strong starting point for considering the impactful relationship between criticality and practice. Post-critical thinking Such questioning of the place, power and purpose of critical thinking has led to what is sometimes termed a ‘post-critical turn.’ As with many of the ‘turns’ within the history of ideas, this does not describe a single approach but rather a collection of (sometimes opposed) trends in thought and practice. I want to consider, quickly and schematically, for the sake of introduction, three quite different ways in which the post-critical expresses itself within the contexts discussed above. These, it needs to be emphasised, are not specific and named theories, but rather collections of similar rhetorical fields regarding the place of critique. Rhetorics of exhaustion

The impact of COVID-19 has seen a marked increase in interest in reviewing and reimagining the relationship between care and society. The Care Collective concludes their manifesto with the claim that ‘the COVID-19 pandemic has certainly laid bare the horrors of neoliberalism. But it has revitalised a

Against critical thinking?  7 conversation about care, however limited it may still be’ (Chatzidakis et al. 2020, p.96). Indeed, the pandemic encouraged a small explosion of visions for both social care and public health, often positioned as critiques of the existing order (see, e.g., Cottam 2021; Dowling 2021). This is, in part, due to the lens that COVID-19 brought on to the delivery of care, the systems that became overburdened and the provision of resources it needed not only now but throughout the years of economic austerity policies across Europe. (In part, too – and this should not be overlooked – it was due to research funding available being almost exclusively focused on COVID-19.) Nevertheless, amid this renewal of visions for care, a form of post-critical sensibility also emerges. One might be reminded of Peter Sloterdijk’s (1987) term ‘cynical reason,’ which he used to describe the sense in which the exercise of critique is ‘going through the motions’ to only repeat what it already knows – including the knowledge that it will not succeed. It was undoubtedly the case that many of the critiques of care arising from the pandemic were re-treading existing critiques from throughout the past 30 years. This may not be all that surprising: as Hannah et al. noted at the time, ‘writing during a pandemic […] risks illuminating pre-established theoretical frameworks more than the unfolding events themselves’ (Hannah et al. 2020, online). In this way, while COVID-19 brought about unprecedented changes in behaviour, for many opinion pieces, research articles and monographs, it often turned out to be more like additional evidence for long-existing programmes of criticism yet to be fulfilled. Of course, the problem is not simply rooted in the timeframe of the pandemic. Even in those works with longer-term views, such as Emma Dowling’s masterful and in-depth analysis of the decline of social care in the United Kingdom, her conclusions seem somehow familiar: ‘allocating more time, money and social capacities’ and elevating the ‘undervalued political and ethical status’ of care (2021, p.195). As I discuss in Chapter 1, this raises questions about the weariness of such programmes. If the effect of an unprecedented world event such as the pandemic is simply to confirm that we already knew we were right, it would seem that either unprecedented world events are not as ‘eventful’ as we imagined, or there is something more to say about how we go about thinking critically. Likewise, if everyone already knows what’s wrong, and has a vague consensus around what needs to be done to address this, why has it not happened? For some, this would be a matter for politics and decisionmaking at the highest levels, and there is a strong case for this, given the relationship between neoliberal regimes and practices resulting in health and social inequalities (see, e.g., Collins et al. 2015; Baru and Mohan 2018). For others, neoliberalism itself is opposed to critical activities, both because the ‘hegemonic discourse of neoliberalism forecloses the usual ways critique has been raised’ (Foth et al. 2018, p.2), and the increase in health and care complexities alongside reductions in resources has led to education programmes emphasising almost exclusively practical, imminent training for professions at the expense of in-depth or conceptual education (Beedholm

8  Against critical thinking? et al. 2014). For Sloterdijk (1987), though, this turn to politics misses a more fundamental point about the underlying assumptions of politics itself. There is, he suggests, a tenet central to both the European Enlightenment and the Marxist tradition of critique, that increasing our understanding of the world will necessarily bring about social change. Cynical reason poses challenges to this view; and this is something which, while still a political issue, is also one for the nature and role of critique. Rhetorics of dataism

In stark contrast to the repetitive critiques of contemporary care systems that are (and not without good reason) well-known to us, another rhetorical field suggests the removal of criticality via a turn to different modalities. I am thinking here specifically of the turn to ‘data’ as a substitute for critical interpretation in practice. One pertinent example is Sir Simon Stevens, Chief Executive of the NHS, response to the health inequalities raised during the pandemic. Stevens wrote that it is increasingly clear that COVID-19 is having a disproportionate impact on our black, Asian and minority ethnic (BAME) patients, friends and colleagues. And this in turn has brought into stark and urgent focus the layered impacts of years of disadvantage and inequality. (Stevens 2020) Furthermore, ‘if we’re honest with ourselves, the NHS as an embedded part of society is both part of the problem and part of the solution.’ From this initially judicious and reflexive position, his response was to launch a Race and Health Observatory, which would identify challenges to inclusion and diversity. There is certainly nothing wrong with such a move in itself, and the acknowledgement of the systemic problems of race and culture within the delivery of care is fundamental to addressing inequalities in this sense. What is striking, though, is that the Observatory does not carry any of the language of critique. Unlike the discourse of, say, intersectionality approaches, which examine the overlap of certain categories precisely to challenge inequalities in service provision (see Esposito and Evans-Winters 2021), the observatory held a strict focus on data. This is not a problem with data per se, but rather the mode in which data is presented as a move beyond interpretation and, by extension, critique; it promises, instead, a ‘behaviourist theory of information that can do without discourse’ (Han 2022, p.37, emphasis original). Byung-Chul Han terms this ‘dataism,’ a mode of understanding that promises ‘a society that works without any kind of politics. […] Politics will be replaced by data-driven systems ­ management’ (Han 2022, pp.38–39, emphasis original). This broader shift regarding criticality and data crystallised during the pandemic: a certain

Against critical thinking?  9 fetishising of facts and objectivity (as figures of discourse) within what can be incredibly complex, nuanced and fundamentally interpretative contexts. Philosophically, this points towards a pre-critical model of thinking exemplified in the 16th century thinker David Hume (see Lillywhite 2017, p.25). In its more troubling form, it is seen in the increasing rise of behavioural science within health and social care policies (see, e.g., Cohen et  al. 2016; Michie et al. 2020; Ghebreyesus 2021). This approach was popularised in 2008 with the publication of Thaler and Sunstein’s book Nudge: Improving Decisions about Health, Wealth, and Happiness, and institutionalised with the creation of the Behavioural Insights Team within the UK Cabinet Office in 2010 by David Cameron, followed by similar teams in the governments of Australia, Germany, the United States and elsewhere, as well as the Joint Research Centre in the European Commission. In earlier decades, behavioural science tended to refer to crossdisciplinary studies in social, economic and physical sciences addressing causes of behaviour (see Mass 1958). More recently, though, health-based behavioural interventions have moved towards the ‘hard data’ of fact: as Holman et al. argue, the number of health behaviour interventions has grown rapidly since around 2006, and that ‘references to social science disciplines and concepts that foreground issues of social context are rare.’ In its place, the availability of large-scale data sets means that the more common concepts used are quantifiable, and those closer ‘to the complexities of social context are mentioned least’ (Holman et al. 2018, pp.389–990). The narrowing of the behavioural field to ‘data’ means that a wide number of other determinants can be obscured due to the fundamental assumptions in some behavioural approaches (Mackay and Quigley 2018). And, indeed, research suggests this dataism can be unintentionally complicit in amplifying existing inequalities (Lonne et al. 2022). This is not the place to weigh up the merits of behavioural insights with all the due diligence that would need to be paid. What I do want to draw attention to, though, is its use as a form of post-critical intervention that serves less as a dynamic response to the complexities of contemporary practice, and more as a desire for factual certainty – clear outcomes and impacts, as intervention evaluations so often call for – in a world that, in Tina Wilson’s words, has seen a definitive a ‘shift from linear human causality and progressive problem solving to constitutive complexity and an unpredictable relation with more-than-human worlds’ (Wilson 2021, p.42). Such complexities can result, somewhat understandably, in calls for relatively clear and concise ‘answers’: be this the re-tread of critical theory’s calls to arms or the emptying of interventions from any criticality in the name of behavioural patterns (so-called ‘nudges’ should be, according to Thaler and Sunstein, ‘easy and cheap’). The absence of what we might call ‘critical points’ in the general trend for evidence in practice, suggests that applying quantitative reasoning produces self-evident truths which remove the need for criticality. But following the TV detective Dragnet and asking for ‘just the facts, ma’am,’

10  Against critical thinking? seems to leave us only with the option of being, perhaps, mindful rather than overtly critical. Rhetorics of post-critique

The third example is not from professional practice, but from theoretical discussions in the humanities and social sciences. A number of philosophical discussions have arisen in the last 30 years or so which point to ways in which the practice of critique can be understood outside of simply an instrument of ‘better’ thinking. Such discussions vary in approaches and traditions: from literary realists to new materialists, affect theorists and feminist accounts, as well as those drawing on sources as diverse as the sophists of ancient Athens and the cynicism of Nietzsche. However, what links these ‘post-critical’ discussions and debates is a general sense in which the application of critique has become stale, hackneyed, and generally opposed to the very criticality it is purported to achieve. This leads, ironically, to the idea of what constitutes ‘being critical,’ of the distance between the ‘critic’ and the object of their critical analyses, and what the aim of critique should be, all relatively unchallenged. Consider how Jones-Devitt and Smith describe four commonalities across the ways in which critical thinking is established across health, social care and social work (2007, p.10): (a) the exploration of definitions, concepts and boundaries of critical thinking; (b) the relationship between knowledge and the production and ownership of knowledge; (c) questioning assumptions, considering contexts and the tensions between universal truth and multiple realities; and (d) evaluating different forms of evidence, exploring the different forms and typologies. In many senses, all of these are vital projects within both the applied professions and philosophical thinking. However, post-critical writers point to the habits that slip into what are otherwise pressing sites of interest. Rita Felski (2015), for example, suggests some common core assumptions that have come to dominate how such criticality is enacted: first, it is negative (indeed, as far back as the 1970s, Raymond Williams raised concerns that the notion of criticism has been restricted to the notion of ‘fault-finding’ (1976, p.76)); second, it is secondary (one can only be critical of something already existing); third, it is intellectual (critical thinking challenges ‘common’ sense and practice); fourth, proper critique comes from below (in the sense that it is iconoclastic, often aimed at conventional authorities and the status quo they are perceived to uphold), and finally, critique does not ‘tolerate rivals’ (it is difficult to postulate forms of criticism that do not conform to all or most of the above). One need not subscribe to Felski’s taxonomy to recognise the more general point, which Timothy O’Leary makes succinctly: ‘In a world in which even “critical thinking” has been commodified and sanitized by universities, as an employer-friendly graduate attribute, it can be difficult to maintain a focus on

Against critical thinking?  11 what it is that makes critique valuable and effective’ (O’Leary 2021, p.155). Indeed, there remains a wide discrepancy between the importance of the concept of criticality to the professionalisation of health and social care, its rooting in degree-level qualifications and the amount of time and space dedicated to exploring what this actually means. Critique is not only ‘the primary mode of practicing theory’ (Hardt 2011, p.19), but also an applied theorisation of practice. Thus, if critical thinking only produces fault-finding, it may obscure any number of useful (if less ‘neutral,’ and possibly even partial) views and approaches (see Hayes 2015). This said, a number of the post-critical arguments within this rhetorical field often appear conservative in nature, or at the least optimistic as to the transparency of the world. They are certainly opposed to more radical traditions of thought such as Marxism, the broad range of theories often labelled ‘postmodern’ or more broadly, the ‘hermeneutics of suspicion.’ Indeed, some of the approaches can seem to align comfortably with the rise of behavioural science in the design of care policies and interventions: that is to say, the very rejection of meaning (which is, it is suggested, merely subjective and individual) and its replacement with behaviours (which are easier to both analyse for patterns and shape through interventions). My view, however, is that this conservatism is a residue of theoretical skirmishes in various disciplines (Benjamin Noys has pointed out the irony that, while many post-critical thinkers emphasise the materiality and surface of practice as an anti-theoretical move, this move is in fact rooted in decidedly theoretical origins; 2017, p.298). I am less interested in these conflicts, or, indeed, endorsing a ‘position’ on one or the other side. Instead, at its most basic level, I take these post-critical moves not to be opposed to critical thinking, but rather opening up the ways in which conventions of critique self-deconstruct. As such, while we may ultimately disagree with them, postcritical viewpoints enable us to think against the dominant assumptions of criticality (in whatever tradition), precisely in order to return to the themes raised by Jones-Devitt and Smith, and in doing so answer the calls for the caring professions to attend to their critical possibilities. Whether critique appears somewhat tired and repetitious precisely at the point it is being called upon; whether it increasingly struggles to identify its uses in relation to the promises of dataism; or whether there is dissatisfaction with the various modes of critique – from positivist to postmodern – all involves thinking about how particular ways of acting and thinking have become persuasive, what models, rhetoric, images, and metaphors guide these ways, and how the debates around post-critique can illuminate the ways in which we interpret them to better respond to the challenges of critique within contemporary and future practice. Anker and Felski point out that: It is no longer just a matter of engaging in critiques of critique – thereby prolonging the very style of thinking that is at issue. Rather, influential arguments over the last two decades suggest that the language game of

12  Against critical thinking? critique may have played itself out: that there is a need not just for different kinds of thinking but for an alternative ethos, mood, or disposition. (2017, p.10) If Benjamin suggested that ‘things pressing too urgently’ troubles the correct distance that allowed for the sensible application of critique, then Anker and Felski point us towards thinking through how such distance (and its lack thereof) is felt, experienced and practised. Focusing on ethos, mood or disposition necessarily involves looking not just at the models and dictums of critical thinking literature, but also looking to the edges of what is traditionally their concern. It is impossible to separate either the disposition of criticality or its reception from cultural practices within organisations and disciplines. The importance of interpretation If we are to think beyond these fields, it seems necessary to stage a dialogical encounter between the professions and the philosophical issues which underpin the current cultural climate regarding criticality. That, therefore, is the aim of this book. Hopefully it does not sound as though this book is going to be a case of picking some theories from other disciplines and imposing them on the care professions, with all the blunt arrogance that entails. It is important to be clear that while it is true that exploring the nature of critique seems to imply an element of self-scrutiny, this is not a question asked from somewhere ‘up on high.’ This book is certainly not a philosophical judgement of the nonphilosophical. Instead, its concern is that the contexts of today point to the need for broader questions around the status of criticality in both theory and practice. The reasons for this are straightforward. As I have already suggested, it is clear that Benjamin’s call for a ‘correct distance’ of critique is problematic, and that while this reflects the changing context of care delivery, it also reflects the development of the concept and practice of criticality itself. While I see a number of resources within the debates and discussions around the notion of the post-critical, they also leave a number of questions unanswered; questions that might be, I think, answered in dialogue with practitioner research. This would include not just the ways in which dominant forms of characterising critical thinking can lead to artificially weighting concerns in practice towards certain areas over others, but also the complicity certain characteristics of critical thinking itself have been in the current malaise regarding truth, fact, meaning and purpose within the caring professions and in wider society. If the question of what critical thinking should be today extends across essential practice skills, academic literacy, theoretical exploration and the use of evidence to inform practice, then it is precisely these contexts which philosophers can learn from when considering the value of critique today.

Against critical thinking?  13 This is not to say, by the way, that I want to uphold the commonplace identification of philosophy with the ‘abstract’ and care provision with the ‘applied’ or ‘real.’ After many years of working on evaluations and research in health and social care, it seems to me that there is just as much abstraction at the front line of practices than there is in the work of the academics. Critical thinking is, in fact, an excellent example of this. If we scour the critical thinking textbooks in health, social care and social work, what we will usually find are a set of rules, tools or guidelines that are designed to apply to any (or at least most) situations in practice. In order to do this, they pick the core functions of criticality and economise them in ways that will fit more easily into the everyday demands of practice. This is, of course, an act of abstraction. We might also think of the codes of ethics for professional bodies: there is no way that codes so brief could engage in every possible moral conundrum raised at the frontline other than as a ‘principle’ interpreted in the moment. It is not about abstract versus embodied work, then, so much as the space of practice offering a distinct lens through which arguments and polemics about the role of criticality can be considered. For example, the prospect of the post-critical tends to be met with a somewhat instinctive response in many areas of philosophy, social science and the humanities: either it is dismissed as being too conservative, lacking any insight or capacity to change the world; or, it is dismissed as being flawed, because its proponents must, by necessity, be critical in order to make the case for post-critique. I do not contest these responses, as they all hold merit in some ways. My view, though, is that postcritical challenges offer a way of reinvigorating critical practice towards the nuances and complexities today. Such complexities of policy and practice are interwoven with the increased questioning of existing evidence forms. As I will argue in Chapter 1, this is not (as many conservative academic spokespersons have argued) the result of some kind of invasion of postmodern relativism degrading our rational capacities, or an infection of laziness and stupidity into decision-making, but rather a consequence or evolution of more traditional methods of ascertaining ‘truth’ in a digital media age. I also need to be clear that I am not advocating one form of critique to replace the problematic or fatigued versions discussed. In rejecting the conception of critical thinking as an instrumental exercise, we also need to reject its correlative alternatives: that is, to treat critical thinking as a ‘pure’ subject in itself (often prefaced as the ultimate transferrable skill across all disciplines, as Paul and Elder (2008) suggest), or as a ‘mixed approach’ between applied and discrete aspects of the topic (Jones-Devitt and Smith 2007, pp.8–9). If we treat critique as an abstract and separate entity, this naturally creates a distance between it and the challenges of everyday application in the contexts we have raised; this inevitably leads to a use of criticality which is more aspirational than effective. If we adopt a mixed approach, then we are simply taking both of the previous faltering paths without necessarily addressing either. In many ways, all of these approaches

14  Against critical thinking? reflect a blurring of the philosophical distinction between process and product. As Max Black once wrote, certain words are ambiguous as to whether they are one or the other: ‘science,’ for example, or ‘education.’ Of course, critical thinking can also be ambiguous: criticality is practised, but in order to produce critical thought. The problem with viewing critical thinking as a subject in and of itself is that it begins with treating criticality as a product which can then be applied to a process (e.g. care delivery). However, this omits the possibility of distinctive forms of critique emerging from care practices themselves. In some ways the interaction I propose between philosophies of critique, post-critique and practice is summarised well by Joy Higgs, when she writes of the importance of practice wisdom: Professionals are not simply third-party receivers of the knowledge and wisdom of others. Instead they are critical consumers of the knowledge of their own and other relevant fields plus the vast knowledge (as well as the lesser entity, information) that pervades the Internet and industry/professional work spaces. With these tools they are capable of using knowledge in action, to make judgements, to guide and promote human interaction, to make sense of experiences and to inform behaviour, particularly wise and moral practice such as ethical conduct, benevolence, practice decision making and the promotion of social justice. Further, they are knowledge generators, being responsible for creating and critiquing practice-based knowledge from their own practice and contributing this to their field and the wider professional knowledge base. (Higgs 2019, pp.11–12) While I find much resonance with this passage, I am nevertheless aware of not only how it expresses the relationship between knowledge and practice, but also it’s pacing in the process. ‘Criticality’ slips through rather unnoticed and is framed only in terms of the generation and consumption of knowledge. Interpretation, which forms the basis of both Aristotle and Heidegger’s philosophies that Higgs draws upon in her work, is not mentioned at all, although the notion of sense-making tools are. As such, Higgs’ summary presents an agreeable account of how philosophical questions emerge within practice. But it also highlights a particular direction in which critique is already set, as an adjective for practice-based knowledge rather than a distinct set of conceptual tensions in and of itself. This is one of the directions I want to challenge. There is often an urge to place such tensions in the centre of practice (‘otherwise, what’s the use?!’), and this, I think, presents a number of risks. Instead, I want to explore them as a hermeneutic project. That is to say, it is aimed at a dynamic space between theorisation of critique and its implementation in practice. Hermeneutics broadly refers to the philosophy of interpretation,

Against critical thinking?  15 and emphasises the situatedness of our knowledge. In my view, what links philosophical practice to that of the applied health and social care professions is – to boil it down to the absolute basics – the role of interpretation. The book, then, is not a theory of practice, but a mediating space in between. Moules et al. put this well: The kinds of discretion that are called forth in our practices are about making sense of particulars, putting them in context, assigning relevance and meaning, and acting on the implications of that meaning. This is an interpretive practice that occurs in a shifting in-between, in the middle of relationships, contexts, and particularities. As such, practitioners are brokers of understanding. For example, in nursing, there is no such thing as an uninterpreted observation. Even the measure of an elevated blood pressure is contextualized. Is the patient anxious, in pain, upset? Educators, therapists, psychologists, social workers, and nurses innately are always in the process of contextualizing, appreciating that “facts are not separate from the meaning of facts” (Walsh 1996, p.233). Understanding occurs through language and in tradition (Walsh 1996), and practice disciplines have long known this interpretive tradition. (Moules et al. 2011, p.2) This space is at odds with much of the direction of the post-critical theorists that the book encounters. Indeed, the aim of movements such as the new materialists in philosophy, or the post-critical theorists in literary and science studies, is precisely to remove the hermeneutic dimension of the world, because they often align interpretation with the conventions of traditional critique. This is often due to a tendency to reduce interpretation to a caricature of the ‘hermeneutics of suspicion’ (see Felski 2015). I do not agree with this reduction, though. As the following chapters show, I find that the challenge of post-critical thinking demonstrates the need, not to reject, but to return to the interpretative aspects of practice, although somewhat the wiser to how the conventions involved in these aspects might be reimagined. As such, I position the interdisciplinary engagement in this book as something of a two-way dialogue, in order to suggest that a closer alignment between practice-based expertise and in-depth philosophical considerations opens possibilities for reframing the provision of care for the current and future world. One way I have used to illustrate this is to imagine two lecture halls, either side of a corridor: in one, a lecture from one of the health, social care or social work disciplines, and in the other, a lecture on philosophy. If the doors at the back of each hall are left open, so that those at the back can also catch parts of the lecture across the corridor, they will find that much of the time this is just an irritating distraction. But at some points, the substance of the lectures may coincide so that the space in between the two halls

16  Against critical thinking? resonates with the potential dialogue between disciplines, not in the kind of translation exercises we frequently see in profession’s textbooks where entire traditions of thought are summarised reductively into single sentences, but instead from the flow of each discipline’s practices and reflections. As a result, I try and steer clear of any universalising claims or overviews: the chapters which follow are a journey through several different sites across the theorisation of critique and the delivery of care. All this raises some housekeeping points I need to address regarding some of the terminology and identities invoked in the book. Where are all the examples? And other questions This book covers allied health, social care and social work, as well as philosophical arguments, alongside the application of criticality in practice in sociology, science studies, literature and rhetoric. Clearly, this includes a wide range of very different roles and responsibilities, not to mention an entire world of political issues that arise when they interact with one another. In different chapters here, I will focus on some specific sites of practice, but my general aim is to also speak to more general themes around the place of critique which I find similar across these professions. Indeed, there have been suggestions that health, social care and social work too often tend to focus on differences between themselves rather than shared interests (Norman and Strømsend Sjetne 2017). In the context of critical thinking, these shared interests correlate and resonate with what Sanford Schram calls ‘timeless, fundamental questions’ which are often overlooked in the current regime of reactionary training. For Schram, writing of the political action in particular, [f]ailed attempt after failed attempt to mobilize concerted action to push back against the onslaught of reactionary policymaking must at some point force us to step back and try to understand how political change is possible in the current era. (Schram 2015, p.8) Largely for practical reasons, I will refer to allied health, social care and social work as ‘professions’ or ‘professional practice’ throughout the book. This is not to exclude those areas in, for example, social care or in the allied health support workforce, where the issue of professional identity is still unfolding in a myriad of ways (see, e.g., Snell et al. 2020). I am acutely aware of the variations between these roles, not only in terms of disciplinary scope but also history, language and pedagogies. The choice of the term ‘professions’ is far more pragmatic, in that, as I suggest in Chapter 1, the inclusion of critical thinking criteria is a standard hallmark of the degree-level qualifications required for professional roles. The issues discussed in the book are therefore likely to be more relevant to those undergoing such qualifications.

Against critical thinking?  17 I apply the same logic to describing the person, group, community or population being engaged with by the professions. There is, of course, a mass of literature discussing the proper ways to describe the ‘patient,’ the ‘client,’ the ‘service user,’ the ‘expert by experience’ and so on. Because this debate is not the subject of this book, and in awareness of how terms will change according to cultural and organisational context, I simply refer to ‘service users’ here, unless the literature discussed specifically uses a different term (such as ‘patient’) for a clear reason. During the course of the book, I use the terms ‘critical thinking,’ ‘critique’ and ‘criticality.’ There are, of course, technical differences between these, and certainly some people find these important. It is notable that there is rarely mention of ‘critique’ (as a noun) in the health and social care literature, compared to ‘critical’ (as an adjective), which appears regularly. This contrasts with work in philosophy and cultural theory, where the concept and performance of critique itself are often considered in their own right. For my part, I am not really interested in providing rigorous definitions of these terms in order eliminate rival claims. As Frieder Vogelmann rightly argues, ‘there is no single “project of critique,” just as there is no “science” (and no “politics”) in the singular. There are different sciences and humanities, different political regimes and rationalities, and different practices of critique’ (2019, p.2). In order to engage with these differences, I attempt to use what I think is the most appropriate term in the context of the discussion at hand, all the while mindful that the practice of critique is not just a technical exercise but also a commonplace expression, and as such requires some fluidity and flexibility in order to capture the number of ways it circulates within professional activities. This links to the one thing I am pushed the most on when I write on the dialogues between philosophy, health, social care and social work: ‘where are the examples?’ It needs to be emphasised that this is not a ‘how to’ book. It is, as has hopefully been apparent so far, presented as an antidote to critical thinking textbooks for health, social care and social work. This involves reframing what a discussion on critical thinking would look like: hence, I do not intend to lay out yet more abstract rules for practice regarding critical thinking here. Some readers may be disappointed to find no case studies of single-named imaginary service users conjured up for imaginary role plays. There is something interesting in itself about the constant need for abstract illustrations of theories (to ‘show how they apply’) but for which there is not the space to detail here. For sure, there is nothing wrong with illustration, but there is a particular type of example often insisted on in critical thinking textbooks that is bewilderingly presentist, insisting on a world of ‘case studies’ where issues emerge in neatly separated scenarios with only relevant information filtered in. In this way, the risk of any example is that it shifts from illustrative illumination to didactic tool, or it picks a specialism that occludes other forms of practice in a kind of ‘heresy of the paraphrase’ for professional education.

18  Against critical thinking? Instead, by looking at the concepts of critique and bringing together philosophical concerns with those of the care professions, I use existing research and commentary from across these professions to unpack the tensions and possibilities that criticality offers in contemporary welfare culture. But it is always my intention that this book is read alongside others, bridging philosophical and practice debates without reducing either. As such, it should be clear that this is not intended as an exhaustive survey, but an exploration of ideas around the role and nature of criticality. Part of this approach involves acknowledging the partiality of the studies that follow. There will always be texts that weren’t considered, research that was not included, viewpoints that might have been relevant. There can never be a ‘final word’ on the matter – after all, would this not mean the end of criticality? – and we do not read books in isolation. If some readers find the following book too non-committal or fleeting in its presentation, then this is in large part due to it being a book about suggestions. It is not the purpose of the book, therefore, to provide didactic instructions on practice. Such an impulse has, I think, been a key driver in blunting the potential of critical thinking within the professions: to convert it into a teaching aid, or a performative mark of professionalisation, rather than a mode of transformation. Instead, I approach this book in a similar manner to how Noël Carroll describes his philosophy of criticism. Our lines of reasoning are, of course, different: he is focused on criticism within the arts, where it refers to evaluative interpretation; I am focused on the hermeneutics of practice, which is not limited to evaluative interpretation, but draws on broader understandings rooted in the practical wisdom, or phronesis, of professional contexts. He sees interpretation as an element of critical analysis; I see critique as part of a broader notion of interpretation as central to us as social, cultural and political beings. Nevertheless, I respectfully borrow his summary that this ‘is an attempt to excavate the foundations of any critical practice, whether theory driven or otherwise.’ Thus, while there is a myriad of theories of criticality, which include methods as different as cognitive tests and socio-political narratives, my concern, like Carroll’s, is ‘the nature of and constraints upon anything that we should be persuaded is an authentic interpretation, including ones that take their marching orders from theories’ (Carroll 2009, pp.4–5). References Anker, E. and Felski, R. (2017). ‘Introduction.’ In Anker, E. and Felski, R. (eds.), Critique and Post-Critique. Durham, NC: Duke University Press, pp.1–28. Barnett, S. and Boyle, C. (eds.). (2016). Rhetoric, Through Everyday Things. Tuscaloosa: University of Alabama Press. Baru, R. and Mohan, M. (2018). ‘Globalisation and Neoliberalism as Structural Drivers of Health Inequities.’ Health Research Policy and Systems, 16:91 (Online). https://pubmed.ncbi.nlm.nih.gov/30301457/

Against critical thinking?  19 Beedholm, K., Lomborg, K. and Frederiksen, K. (2014). ‘Ruptured Thought: Rupture as a Critical Attitude to Nursing Research.’ Nursing Philosophy, 15:2, pp.102–111. Benjamin, W. (1928 [1996]). Selected Writings Vol. 1. Cambridge, MA: Harvard University Press. Boddy, J. and Dominelli, L. (2017). ‘Social Media and Social Work: The Challenges of a New Ethical Space.’ Australian Social Work, 70:2, pp.172–184. Boland, T. (2019). The Spectacle of Critique. London: Routledge. Carroll, N. (2009). On Criticism. London: Routledge. Chapman, C. and Withers, A. J. (2019). A Violent History of Benevolence. Toronto: University of Toronto Press. Chatzidakis, A., Hakim, J., Littler, J., Rottenberg, C. and Segal, L. (2020). The Care Manifesto: The Politics of Interdependence. London: Verso. Cohen, I. G., Lynch, H. F. and Robertson, C. T. (eds.). (2016). Nudging Health: Health Law and Behavioural Economics. Baltimore, MA: Johns Hopkins University Press. Collins, C., McCartney, G. and Garnham, L. (2015). ‘Neoliberalism and Health Inequalities.’ In Smith, K. (ed.), Health Inequalities: Critical Perspectives. Oxford: Oxford University Press, pp.124–137. Cottam, H. (2021). A Radical New Vision for Social Care: How to Reimagine and Redesign Support Systems for this Century. The Health Foundation. Available at: health.org.uk/publications/reports/a-radical-new-vision-for-social-care Crowley, S. and Hawhee, D. (1999). Ancient Rhetorics for Contemporary Students. London: Allyn and Bacon. Delanty, G. (2011). ‘Varieties of Critique in Sociological Theory and their Methodological Implications for Social Research.’ Irish Journal of Sociology, 19:1, pp.68–92. Dowling, E. (2021). The Care Crisis: What Caused It and How Can We End It. London: Verso. Elmansy, R. (2022) ‘How to Apply Paul-Elder Critical Thinking Framework.’ Designorate. Available at: https://www.designorate.com/critical-thinking-paul-elder-framework/ Enoch, J. (2019). Domestic Occupations: Spatial Rhetorics and Women’s Work. Carbondale: Southern Illinois University Press. Esposito, J. and Evans-Winters, V. (2021). Introduction to Intersectional Qualitative Research. London: Sage Publications. Felski, R. (2015). The Limits of Critique. Chicago, IL: University of Chicago Press. Foth, T., Lange, J. and Smith, K. (2018). ‘Nursing History as Philosophy – Towards a Critical History of Nursing.’ Nursing Philosophy, 19:3, pp.1–11. Garrett, P. (2018). Welfare Words: Critical Social Work and Social Policy. London: Sage. Ghebreyesus, T. (2021). ‘Using Behavioural Science for Better Health.’ Bulletin of the World Health Organisation, 99:11, pp.755. Giroux, H. (1994). ‘Toward a Pedagogy of Critical Thinking.’ In Walters, K. S. (ed.), Re-Thinking Reason: New Perspectives on Critical Thinking. Albany: State University of New York Press, pp.199–204. Grimwood, T. (2023). The Problem with Stupid: Ignorance, Intellectuals, Post-Truth and Resistance. Winchester: Zer0 Books. Han, B.-C. (2022). Infocracy: Digitalization and the Crisis of Democracy. Trans. Steuer, D. Cambridge: Polity Press.

20  Against critical thinking? Hannah, M., Hutta, J. and Schemann, C. (2020). ‘Thinking through Covid-19 Responses with Foucault – An Initial Overview.’ Available at: https://antipodeonline.org/2020/05/05/thinking-through-covid-19-responses-with-foucault/ Hardt, M. (2011). ‘The Militancy of Theory.’ South Atlantic Quarterly, 110:1, pp.3–28. Hastings, S. and Rogowski, S. (2015). ‘Critical Social Work with Older People in Neo-Liberal Times: Challenges and Critical Possibilities.’ Practice: Social Work in Action, 27:1, pp.21–33. Hayes, D. (2015). ‘Against Critical Thinking Pedagogy.’ Arts and Humanities in Higher Education, 14:4, pp.318–328. Higgs, J. (2019). ‘Appreciating Practice Wisdom.’ In Higgs, J. (ed.), Practice Wisdom: Values and Interpretations. Leiden: Brill, pp.3–14. Holman, D., Lynch, R. and Reeves, A. (2018). ‘How Do Health Behaviour Interventions Take Account of Social Context? A Literature Trend and Co-citation Analysis.’ Health, 22:4, pp.389–410. Ioakimidis, V., Cruz Santos, C. and Martinez Herrero, I. (2014). ‘Reconceptualizing Social Work in Times of Crisis: An Examination of the Cases of Greece, Spain and Portugal.’ International Social Work, 57:4, pp.285–300. Jones-Devitt, S. and Smith, L. (2007). Critical Thinking in Health and Social Care. London: Sage. Keane, J. (2020). The New Despotism. Cambridge, MA: Harvard University Press. Laskowski-Jones, L. (2021). ‘Discerning Truth through the Fog of Fallacies.’ Nursing, 51:10, online. Available at: https://journals.lww.com/nursing/Fulltext/2021/10000/ Discerning_truth_through_the_fog_of_fallacies.1.aspx Lillywhite, A. (2017). ‘Relationality Matters: A Critique of Speculative Realism and a Defence of Non-Reductive Materialism.’ Chiasma, 4, pp.13–39. Lonne, B., Herrenkohl, T., Higgins, D. and Scott, D. (2022). ‘The Implications of Leveraging Administrative Data for Public Health Approaches to Protecting Children: Sleepwalking into Quicksand?’ International Journal on Child Maltreatment: Research, Policy and Practice, 5:6S1 (published on-line). MacKay, K. and Quigley, M. (2018). ‘Exacerbating Inequalities? Health Policy and the Behavioural Sciences.’ Health Care Analysis, 26, pp.380–397. MacLean, S. and Harrison, R. (2015). Theory and Practice: A Straightforward Guide for Social Work. Lichfield: Kirwin Maclean Associates. McQuillan, C. (2010). ‘Transcendental Philosophy and Critical Philosophy in Kant and Foucault.’ Foucault Studies, 9, pp.145–155. Mass, H. (1958). ‘Use of Behavioral Sciences in Social Work Education.’ Social Work, 3:3, pp.62–69. Melonçon, L. and Blake Scott, J. (2018). Methodologies for the Rhetoric of Health and Medicine. London: Routledge. Michie, H., Rubin, J. and Amlôt, R. (2020). ‘Behavioural Science Must Be at the Heart of the Public Health Response to COVID-19.’ The BMJ Opinion. Available at: https://blogs.bmj.com/bmj/2020/02/28/behavioural-science-must-be-at-the-heartof-the-public-health-response-to-covid-19/ Miller, G. (1991). Enforcing the Work Ethic: Rhetoric and Everyday Life in a Work Incentive Program. New York: SUNY Press. Milner, M. and Wolfer, T. (2014). ‘The Use of Decision Cases to Foster Critical Thinking in Social Work Students.’ Journal of Teaching in Social Work, 34:3, pp.269–284.

Against critical thinking?  21 Moules, N., McCaffrey, G., Morck, A. and Jardine, D. (2011). ‘On Applied Hermeneutics and the Work of the World.’ Journal of Applied Hermeneutics, 1, pp.1–5. Norman, R. and Strømsend Sjetne, N. (2017). ‘Measuring Nurses’ Perception of Work Environment: A Scoping Review of Questionnaires.’ BMC Nursing, 16:66, pp.1–15. Noys, B. (2017). ‘Skimming the Surface: Critiquing Anti-Critique.’ Journal of Cultural Research, 21:4, pp.295–308. O’Leary, T. (2021). ‘Critical Vivisection: Transforming Ethical Sensibilities.’ In Thiele, K., Kaiser, B. and O’Leary, T. (eds.), The Ends of Critique: Methods, Institutions, Politics. London: Rowman and Littlefield, pp.139–157. Papathanasiou, I., Kleisiaris, C., Fradelos, E., Kakou, K. and Kourkouta, L. (2014). ‘Critical Thinking: The Development of an Essential Skill for Nursing Students.’ Acta Informatica Medica, 4, pp.283–286. Parton, N. (2000). ‘Some Thoughts on the Relationship between Theory and Practice in and for Social Work.’ British Journal of Social Work, 30, pp.449–463. Paul, R. and Elder, L. (2008). The Nature and Functions of Critical and Creative Thinking. Dillon Beach, CA: The Foundation for Critical Thinking. Perelman, C. and Olbrechts-Tyteca, L. (2008 [1969]). The New Rhetoric: A Treatise on Argumentation. Trans. Wilkinson, J. and Weaver, P. Notre Dame, IN: University of Notre Dame Press. Raj, K. (2019). Nothing Left in the Cupboards: Austerity, Welfare Cuts, and the Right to Food in the UK. Human Rights Watch. Available at: https://www. hrw.org/report/2019/05/20/nothing-left-cupboards/austerity-welfare-cuts-andright-food-uk Roets, G., Rutten, K., Roose, R., Vandekinderen, C. and Soetaert, R. (2015). ‘Constructing the “Child at Risk” in Social Work Reports: A Way of Seeing is a Way of not Seeing.’ Children and Society, 29:3, pp.198–208. Rutten, K., Mottart, A. and Soetaert, R. (2010). ‘Narrative and Rhetoric in Social Work Education.’ British Journal of Social Work, 40, pp.480–495. Salvage, J. and White, J. (2020). ‘Our Future is Global: Nursing Leadership and Global Health.’ Revista Latino-Americana de Enfermagem, 28. Schram, S. (2015). The Return of Ordinary Capitalism: Neoliberalism, Precarity, Occupy. Oxford: Oxford University Press. Sloterdijk, P. (1987). Critique of Cynical Reason. Trans. Eldred, M. Minneapolis: University of Minnesota Press. Snell, L., Grimwood, T. and Goodwin, V. (2020). The Development of the Allied Health Support Workforce. Health Education England. Stepney, P. and Thompson, N. (2021). ‘Isn’t it Time to Start “Theorising Practice” Rather than Trying to “Apply Theory to Practice”? Reconsidering our Approach to the Relationship Between Theory and Practice.’ Practice: Social Work in Action, 33:2, pp.149–163. Stevens, S. (2020). ‘Personal Message from Sir Simon Stevens on Black Lives Matter and Health Inequalities.’ Available at: https://www.england.nhs.uk/2020/06/ personal-message-from-sir-simon-stevens-on-black-lives-matter-and-healthinequalities/ Thiele, K. (2021). ‘“After Humanism?” – Time and Transition in Critical Thinking.’ In Thiele, K., Kaiser, B. and O’Leary, T. (eds.), The Ends of Critique: Methods, ­Institutions, Politics. London: Rowman and Littlefield International, pp.19–40.

22  Against critical thinking? Vogelmann, F. (2019). ‘Should Critique be Tamed by Realism? A Defense of Radical Critiques of Reason.’ Le foucaldien, 5:1, pp.1–34. Williams, R. (1976). Keywords. Oxford: Oxford University Press. Wilson, T. (2021). ‘An Invitation into the Trouble with Humanism for Social Work.’ In Pease, B. and Bozalek, V. (eds.), Post-Anthropocentric Social Work. London: Routledge, pp. 32–45.

1

Critical atmospheres Where are we now with facts, critique and care?

Critical thinking may often appear as a relatively unchanging set of tools. Just as a tool like the hammer has had much the same shape and use since at least 30,000 BCE, the concepts involved in critique – appropriate use of evidence, clear logical sequencing and so on – are fixed for purpose and effect. However, this appearance would be misleading. Not only has critical thinking as a tool had a long and sometimes troubled history within the disciplines of health, social care and social work – that is to say, how it has been used and what it has been used for – the wider socio-cultural contexts of delivering care today present potential challenges to the effectiveness of the tool in its more traditional forms. The word critique finds its root in the Greek krisis, which also gives us the word crisis: it originally meant a ‘turning point.’ Where are we now, then, in terms of turning points? Is critique itself, if not at a crisis, at a turning point? In this chapter, I want to consider how these present potential challenges interweave with the uses of critical thinking within the professions. The challenges are constituted by a number of concerns regarding the circulation of and attitudes towards knowledge, the ownership of authority and the status of ‘critique’ and ‘facts.’ These are, in many senses, symptoms of what is called the ‘post-truth era’ (although, as we shall see, the term is contested), built upon a combination of advances in digital media and the accessibility of information, and longer-term political and philosophical issues within the applied professions themselves regarding the role of expertise and the limits of practitioner roles. But alongside these concerns, a further challenge is more philosophical in nature: this is the disparate group of views which suggests that, rather than respond to post-truth with yet more critique, critical thinking has itself stultified and become only a staged performance. It has therefore become a wellrehearsed exercise, resulting in a ‘series of rigged moves’ (Sloterdijk 1987, p.90) which does little to effect actual change on either a societal level or for individual service users. And, subsequently, there are also attempts to think through how critique is best practiced in the light of such critiques of criticality. DOI: 10.4324/9781003123583-2

24  Critical atmospheres Critical atmospheres The question of where we are now in terms of facts, critique and care thus applies to both the applied professions and philosophers alike. In that sense, when I ask where we are now in terms of critical thinking, it is important to be clear that I am not identifying any one specific model, measure or assessment. Instead, I am interested in a certain atmosphere or attitude which runs throughout exhortations of criticality, whether in theory or in practice. Literary theorist Rita Felski summarises such an atmosphere as the way that critique assumes an unchallenged place: Critique, it is claimed, just is the adventure of serious or proper “thinking,” in contrast to the ossified categories of the already thought. It is at odds with the easy answer, the pat conclusion, the phrasing that lies ready to hand. (Felski 2015, p.7) In this way, she continues, ‘rigorous thinking is equated with, and often reduced to, the mentality of critique’ (2015, p.15). Despite the marked differences between the disciplines, we nevertheless find in health and social care a similar atmosphere to what Felski describes in literary theory. These are, just as for Felski, not theoretical commitments or disciplinary limits, but distinctive atmospheres of critical thought. After all, as Kahlke and Eva have argued, while calls for enabling critical thinking ‘are ubiquitous in health professional education,’ there is nevertheless ‘little agreement in the literature or in practice as to what this term means and efforts to generate a universal definition have found limited traction’ (2018, p.156; see also Boostrom 2005; Heron 2006; Milner and Wolfer 2014). Surveying the literature we will find, for example, suggestions that ‘the best representation almost always lies beneath the surface of the given information’ (McKendree et al. 2002, p.59); that critical thinking ‘looks beneath the surface of knowledge and reason’ (Brechin et al. 2000, p.56); that it encourages ‘asking questions designed to make the invisible visible’ (Gambrill 2012, p.11); that it is rigorous thinking with a ‘purpose’ or a ‘value base’ (Facione 2013; Mason 2007; Gambrill 2012, 2018), even if the descriptions of such a purpose or value base come close to repeating the same mantras of critique itself. Indeed, it is not uncommon to find in the literature definitions which double down on the term: ‘critical thinking is the systematic application of critical thinking’ (Gibbons and Gray 2004, p.20); ‘“critical thinkers” have the dispositions and abilities that lead them to think critically’ (Hitchcock 2018, online; Paul 1995). Alongside these common definitions, the atmosphere of criticality mingles, sometimes interchangeably, with other related elements which challenge stagnancy and ossification: clarity, creativity, decision-making, evaluation, reasoning, reflection and significance. Papathanasiou et al. (2014) go as far to refer to some 28 different attributes

Critical atmospheres  25 in a single paragraph on what constitutes critical thinking in nursing. Given this range of areas, perhaps it is unsurprising that there has been little agreement on definitions. Following Felski, I would argue that while these voices may all spring from different models of critique, their themes all depend upon a similar ‘rhetoric of defamiliarisation’ (Felski 2015, p.7). While such a rhetoric facilitates the kind of ‘distance’ that Benjamin suggested in the opening quote of the Introduction, it has an added effect of positioning critical thinking in its own, exceptional, space. In other words, this rhetoric suggests that when we apply critical thinking, everything can be defamiliarised – except critique. Because critique is inherently opposed to convention, it is not subject to the same scrutiny it insists on for the everyday world of practice. As a result, Felski argues that the ‘social worth’ of critique can, it seems, ‘only be cashed out in terms of a rhetoric of againstness’ (2015, p.17, emphasis original). Critical thinking has, in her view, developed a disproportionate focus on critique and suspicion, at the expense of thinking as an embodied practice in time and space. Such againstness can be seen, for example, when Gambrill presents the hallmarks of critical thinking in health and social care as a series of binary oppositions. These include clear versus unclear, relevant versus irrelevant, consistent versus inconsistent, logical versus illogical, deep versus shallow and significant versus trivial (2012, p.11). Critical thinking, she goes on, is about revealing ‘evidentiary status’ through questions that are too often not asked, questions which take us beyond the immediacy of the decision and either back to its origin (or its evidence) or forward to its effects (who it works for and how). In doing so, this introduces a distance between the critical thinker and the object or moment of critique; and it is this distance which speaks to the exceptionalism of the critic, because it allows them to step outside of their immediate context. However, it is clear that Gambrill’s dualisms are constructed entirely from the perspective of one side: the side of the critic. That is to say, the presentation of these binaries results in a clear, consistent and logical account of how critical thinking ‘works.’ It is not so much a description of critical thinking, in that sense, but rather a description of a world shaped by the primacy of a certain mantra of detached and rational observation; or, in Sharples et al.’s definition, ‘the ability to think clearly and rationally about what to do or what to believe’ (2017, p.2234). This has implications for practice, of course, and we can mention two here. First, these dualisms position the critical thinker in a position of expertise before a single word has been uttered, an issue raised, or a symptom revealed. The alignment of a certain type of criticality with a certain type of expertise can easily create assumptions about the relative worth of As Bruno Latour points out, however, the problem with such foundational principles is that they are not designed to be challenged. For example, it is a common assumption that ‘objectivity’ defends particular critical views by providing a sound basis of evidence. But ‘as soon as objectivity is seriously challenged

26  Critical atmospheres […], it becomes desirable to describe the practice of researchers quite differently,’ because it lacks tools of defence other than repeating its own significance (Latour 2013, p.11). Hence, in presenting critical thinking in the way Gambrill does – that is, repeating the traditional view that criticality is ‘restricted to one side of the intellectual [or expert] encounter, and everyday thought is pictured as a zone of undifferentiated doxa [opinion]’ (Felski 2015, p.138) – some of its inherent problems in practice are obscured. This, I would argue, does not force us to agree that Felski’s conclusions for literary critique would equally apply to critical thinking in professional practice. But understanding the ways in which critical practice has emerged to where it is today is key to addressing some of the problems her analysis raises. Situating the critical With this in mind, we can answer our starting question regarding the role of critique in health, care and social work via the alignment of critical thought with rigorous thought. While such deployment may involve different theories and traditions, there tend to be three interlinking sites where criticality is particularly prominent: a Critical thinking as a requirement or hallmark of professionalisation. Within this dimension, criticality emerges in learning outcomes and marking rubrics, continuing professional development courses, and finds its medium in a range of texts from the basic ‘how to write an essay in health and social care’ (see, e.g., Frohman and Lupton 2020) to more in-depth analysis of, and models for, critical thinking in professional settings. For example, the 2018 Nursing and Midwifery Council (NMC) in the UK has four paragraphs referencing the need to accommodate constructive criticism within the delivery of care, largely aimed at evaluating and improving the quality of others’ practice. This aligns with the alignment of professionalisation with ‘rational, theory-based practice supported by certified training courses’ (Lorenz et al. 2010, p.33). The link between critical thinking and professionalisation goes well beyond the spheres of health and care, though: as Boland notes, across its application to ‘nursing, food science, military strategy and policing counterterrorism,’ the general narrative of critical thinking ‘neatly packages certain techniques as a “one-size-fits-all” version of reason adequate to any situation or discipline, meanwhile narrowing conceptual richness’ (2019, p.79). b Critical thinking supporting evidence-based practice and delivery innovation. Here critique forms part of the established methods for evaluating practice and policy, utilising such evaluations to inform potential changes to practice, and further evaluation of new ways of working: separating research designs according to validity and

Critical atmospheres  27 reliability, for example, or insisting on utilising current evidence to support best practice (Profetto-McGrath 2005). Glaister summarises this criticality as being ‘open-minded, reflective approaches that take account of different perspectives, experiences and assumptions’ (2008, p.9). In the context of social work, for example, this form is described by Gray et al. (2009) as a ‘broad’ account of criticality, rooted in reflection and finding alternatives while leaving the broader structure of both society and its knowledge hierarchies in place. c In contrast to the broad account, Gray et al. (2009) suggest a narrower version is an active critique of core service delivery and the link between practice, culture and politics. For all the applied professions, there is a recognition that, at least in principle, they occupy a space with the potential to effect broader social change. Social work has, at least since the 1960s, shared many of its fundamental tenets with critical theory, feminist theory and aspects of post-structural political philosophy. The more clinically-based professions have increasingly looked to critical social theories such as Freire’s to address health inequalities in society (Browne 2000; Mooney and Nolan 2006; Rozendo et al. 2017). The third critical site, then, is the use of critique to challenge domination and oppression at not just personal, case levels, but at interpersonal and structural levels as well. Critique allows the diverging forms of domination to be identified, some of which involve not just external force but also what Fook describes as ‘internal self-deception,’ a hallmark of the ‘false consciousness’ of classical Marxism (Fook 2002, p.17); Fisher and Dybicz (1999) note that the rise of critical reflection in social work, utilising the historical basis of practice including its relation to broader power structures, accompanied the a-historical rise of critical thinking in the 1980s and 1990s; likewise, Brookfield (2009) suggests that critical reflection is only really ‘critical’ if supplemented with a critical and/or social theory within it. This informs approaches such as Shor’s ‘critical pedagogy’: where learning and teaching directly engage with: habits of thought, reading, writing, and speaking which go beneath surface meaning, first impressions, dominant myths, official pronouncements, traditional cliches, received wisdom, and mere opinions, to understand the deep meaning, root causes, social context, ideology, and personal consequences of any action, event, object, process, organization, experience, text, subject matter, policy, mass media, or discourse. (Shor 1992, p.129) This is not the place to go over the various debates that inform each of these sites, or to catalogue in fine detail where each and every approach to criticality sits within them. Instead, my interest is how criticality is deployed within

28  Critical atmospheres such sites as a form of sense-making; and by exploring this to unpack the notion of what ‘post-critical’ might mean to professional practice. While these describe the primary sites where criticality is significant for professional practice, the precise form of critical thought is not as tidy to summarise. Instead, it is better to think of critical thinking as emerging in professional practice along a continuum, with its most instrumental use – as a way of improving frontline decision-making ‘in the moment,’ what was described in dimension (a) above – at one end, dovetailing into guides for good practice, and at the other end broader critiques of welfare provision and policy, those of the academic or the activist, which dovetail with the arguments of social and cultural theory and constitute critique as an endpoint rather than a means (dimension (c)) (see Figure 1.1). Across this runs another continuum indicating the concept of criticality being used, which is placed between what I term ‘transcendent’ and ‘immanent’ forms (I will explain this difference below). We can see that the furthest points of each end of both continuums are very much opposed. However, the notion of critical professionalism tends to fluctuate, necessarily, between them. Hence, some critical approaches will sit at particular points on the matrix. The more instructional textbooks on critical reasoning, for example, will tend to be found near the top right-hand corner. An approach such as Applied Critical Leadership, for example, which draws on the insights of critical race theory but remains rooted within the context of professionalisation of practice (see Aho and Quaye 2018), may sit somewhere in the upper middle of the left-hand side. The point of the diagram is not to insist on a definite position, but rather to note how this difficulty is constituted, and what contributes to it. To do this, we can explore these continuums in more detail.

Figure 1.1 Critical thinking matrix.

Critical atmospheres  29 From critical professionalism to professional criticism

It may be said, with tongue slightly in cheek, that the distinction between professional qualification – typically marked, in most countries, by a higher education degree – and vocational training is the presence of the word ‘critical’ in the learning outcomes. As McKendree et al. noted, criticality has increasingly featured in educational standards for health and social care; it is a ‘generic skill to be learned in classes and transferred from one to another’ (2002, p.57). This positions us firmly at the top of the diagram, where critical thinking is a tool for practice. At the same time, the use of critical thinking within professional learning outcomes alerts us to a dual dimension of criticality within the professions. On the one hand, criticality indicates or qualifies a certain depth of skills and knowledge which is legitimised by institutions and organisations (through qualifications, career pathways, Continuing Professional Development and research), and on the other hand criticality involves applying a depth of inquiry which, in many cases, challenges those same institutions (through theoretical exploration, particularly through critical theory, and political dimensions of practice such as the various forms of ‘critical’ social work which move from ‘critical thinking’ as a tool to something more like ‘social criticism’). The indication of skills, on the one hand, and their application, on the other, are not inherently opposed; they simply perform different functions. But it also shows that critical thinking naturally lends itself to differing, and sometimes conflicting, dimensions which are both necessary for professionalisation. For Toner and Rountree (2003), the politics of critical theory and the practicalities of critical thinking are necessarily interdependent, given that they both centre on analysis and reflection. Although noting that an awareness of broader critical theories is not necessary to be a critical practitioner, Glaister, too, situates ‘critical practice’ at the intersection of analysis, action and reflexivity; and argues that critical practice entails understanding individuals ‘in relation to a socio-political and ideological context within which meanings are socially constructed’ (2008, p.17). As such, while learning outcomes and professional requirements may sit at the top of Figure 1.1, there will always be a natural pull towards the lower elements of wider societal concern, differing only in intensity. However, it is also important not to simply role these two different dimensions into one. This is not just because of disciplinary objections, such as the criticisms of social work education for being too focused on social theory than face-to-face interventions (Narey 2014). It is, rather, important to note that both ends of this vertical continuum relate to very different aspects of professionalisation. From transcendent critique to imminent critique

Because I am grouping together a relatively varied group of practices on this continuum, it is useful to picture another continuum, running across the

30  Critical atmospheres first, this time concerning the concept of criticism being employed. Here, I use two different concepts to mark out either end: ‘transcendent critique’ on the one hand, and ‘immanent critique’ on the other. These concepts do not describe methodologies, but rather the atmospheric relationship between critique and practice in general. Transcendent critique positions the role of critical thinking as enacting a relatively unchanging set of conditions or principles; whether this is an established set of properties for factual knowledge, as utilised in Evidence-Based Practice (EBP), or a principle of reason that underlies activity such as much of the varied responses to Kant’s philosophy have provided (e.g. the later Habermas’ notion of communicative rationality). Immanent critique, meanwhile, is tasked with unpacking the hidden contradictions in the systems we use. This involves assessing a practice on its own criteria for rationality and demonstrating how it falls short of this. In this way, rather than stand outside of the world, it constitutes a form of ‘insider critique’ employed not just by those traditions influenced by Marx, Foucault, Deleuze and others, but also by applied methods such as Action Research (Pearson 2017). It is fair to say that, for a long time, ‘official’ uses of critical thinking within the professions were weighted towards more transcendent models. It was in the 1980s that, in the English-speaking world at least, critical thinking as a subject in and of itself began moving from the narrow confines of philosophy into specialist professions (Paul et al. 1997). By 1990, aware of the spread of critical thinking across different curricula, and the possible mutations this may involve, the American Philosophical Associated sponsored an analysis of the use of critical thinking across US universities to arrive at a single definition. The panel argued that critical thinking was ‘purposeful, self-regulatory judgement which results in interpretation, analysis, evaluation and inference, as well as explanation of the evidential, conceptual, methodological, criteriological, or contextual considerations upon which that judgement is based’ (Facione 1990, p.2). As definitions go, this is wide-ranging and manages to summarise a complicated set of practices. It also, however, made clear that the skills of critical thought were entirely separate from moral, political or cultural beliefs: it was entirely possible, the panel acknowledged, to utilise the tools of critical thought to produce harm. At the same time, positioning critical thinking as a tool of self-improvement required a number of just such moral, political and cultural beliefs to be at least implied. For the panel, critical thinking was ‘a liberating force in education and a powerful resource in one’s personal and civic life. While not synonymous with good thinking, [critical thinking] is a pervasive and self-rectifying human phenomenon’ (1990, p.2). As with the dyadic view of critical thought which Gambrill presented earlier, the use of language such as ‘liberation’ and ‘power’ suggests a particular world shaped by the primacy of detached and rational observation, which is intrinsically related to the cultural evolution of modernity and its selfshaping practices in Western culture. This is not to say, of course, that such a

Critical atmospheres  31 world is not needed or wanted, nor is it to suggest that Facione’s description is limited only to certain cultures. Instead, it is important to note how the general account of critical thinking is embedded in certain atmospheres in terms of the ways in which it relates to and resonates with particular aspects of practice, and the language and exercises this ‘self-rectifying’ forms take. In turn, this helps to sketch out how critical thinking becomes a core part of a professional practice curricula. One can see this more clearly in the fate of Facione’s work, which can be seen in psychological measurement tests such as the California Critical Thinking Disposition Inventory (CCTDI) or the Watson-Glaser Critical Thinking Appraisal (WGCTA), which position criticality as a purely cognitive exercise related to the virtues of individualistic selfhood. This fate will become significant when we explore the development of critical thinking within the problematic contexts of contemporary practice, and the broader socio-cultural aspects affecting this. Alongside this development in clarifying processes, methods and assessments of criticality, though, was the adoption of a wide range of methodologies across professional practices to rival the rather narrow atmospheres of reasoning present in Facione’s account. Emphases on praxis-based exploration of care delivery, utilisation of different forms of ‘data’ such as ethnographic observation or material analyses of practice, and attempts to link critical reflection to broader socio-political concepts and arguments all pushed aspects of critical practice towards immanent, embedded and embodied models of critique. As a result, critical practice is often figured somewhere between the EBP that we saw within dimension (b) above, and the more political theories informed by the critical and cultural theories of dimension (c). However, across contemporary literature there is a consistent suggestion that this ‘somewhere between’ is unsatisfactory; whether critique needs to be more robust in its objective rigour, or more aware of its implicit and explicit politics, the call to move critical practice further towards one end or the other of the continuum is difficult to ignore. Criticality in malaise Having provided a model of criticality, we can now return to the starting point of the chapter: that critique is now in question. We have already seen how critical thinking can operate as something of a floating concept within both practice and education. The reason for the apparent transferability of critical thinking skills is rooted in the fact that, rather than simply being a tool or instrument for better thought and practice, critique is typically accompanied by certain uniform habits, rituals and metaphors. It is calling attention to these habits that have led some to question the ways in which criticality is positioned. Some of these calls have come from the broader world of everyday social practices, such as the rise of the so-called era of ‘post-truth.’ Some have come from inside the health and care disciplines, arising from the tensions between traditional models of critical practice and how well these

32  Critical atmospheres apply to the specific contexts and demands of late capitalist care. Others are still drawn from theoretical conflicts and malaises, where the value of critical approaches have been called into question. Truth, facts and fake news

The idea that broader cultural movements have led to truth coming under fire has, no doubt, caused concern in the caring professions that are at least partially rooted in empirical research. The University of Michigan has even run a module on ‘Social Work Practice in the Era of Fake News.’ For this reason, it is worth looking in brief detail at the rise of the phenomena in question. In 2013, Jestin Coler founded the company Disinfomedia. His business model was, in many senses, very traditional for a media outlet. Coler created websites with news stories likely to catch attention, and generated income through paid-for advertisements. The one difference was that the stories Coler ran were deliberately false, and the websites he created were purposefully designed to look like reputable news sources. Over the next few years, Disinfomedia became one of the most powerful ‘fake news’ organisations in the world, and its hoaxes were so convincing that some led to motions put forward in the US Senate, and government issuing clarifications to dispel rumours. Coler’s activities were by no means in isolation. Some sites such as NationalReport.net or worldnewsdailyreport.com are straightforwardly satirical, often acknowledging this through disclaimers. Others deliberately set out to mislead: The Buffalo Chronicle, the News Examiner, and Peace Data make no differentiation between hoax and reality. Meanwhile, sites such as InfoWars deploy fake news alongside a host of conspiracy theories which, by their nature, are difficult to evidence as false. For all, the medium of their message is similar: fake headlines are widely shared across social media platforms before they can be verified, and suggestions and allegations can spread almost uncontrollably from any form of ‘fact-checking.’ Coler’s task, he has argued, was not to champion hoaxes and false information, but rather to call attention to how quickly such hoaxes can become embedded in the public imagination. His primary aim was not to enable extremists and populists, but on the contrary debunk them: the whole idea from the start was to build a site that could infiltrate the echo chambers of the alt-right, publish blatantly false or fictional stories and then be able to publicly denounce those stories and point out the fact that they were fiction. (Sydell 2016) In other words, the beginning of fake news was a promotion of the ways in which fake news might take place, which was inherently linked to the free circulation of information and the speed at which such information might

Critical atmospheres  33 be taken as ‘fact.’ The deployment of automated ‘bots’ operating on social media, appearing as real people, disseminating disinformation and promoting conspiratorial agendas, elevated the problem of fake news to public concerns: ‘at zero marginal cost, these robots create voices that produce a mood and thus severely disfigure the political debate’ (Han 2022, p.22). This is why, while propaganda and deliberately misleading news has been around since records began, the fake news phenomenon reached its height in 2016, when Lockie notes: In the short term at least, 2016 […] will be known as the year in which the blatant dishonesty and cynicism of political campaigns associated with Brexit, the US presidential election and quite a few others led Oxford Dictionaries to declare “post-truth” the word of the year. (Lockie 2017, p.1) However, as is so often the case, there are deeper roots to the problem of posttruth which can be easily overlooked amid the panic over disingenuous bots. The concept of a fact, for example, has a specific history in terms of its development within social history. David Hume, the 18th century philosopher, is widely credited as the first to argue that ‘matters of fact’ belonged in a separate category from necessary ‘relations of ideas.’ Relations of ideas were necessary truths: that bachelors are unmarried men, for example, or that 1 add 2 equals 3. Matters of fact, meanwhile, were contingent. Relations of ideas would lead to contradiction or paradox if they were wrong: a bachelor cannot be a married man, by definition. However, something like the inequalities in exposure to poverty experienced by different demographics (see https:// www.health.org.uk/evidence-hub/money-and-resources/poverty/inequalitiesin-who-is-in-poverty) is a fact precisely because it could be otherwise. Mary Poovey (1998) argues that, prior to Hume, the model for such matters of fact was first formed in the 15th century, with the advent of doubleentry book-keeping. This new process, used by merchants trading across an increasingly global world with the European discovery of the Americas, involved recording transactions in at least two ledgers, marking credits and debits involved in trade and ensuring the books ‘balanced.’ In this way, Poovey argues, what began as a simple way of accounting for who owed what to whom was codified into a set of rules. Now, it was the system, rather than the individual particulars, that mattered most. The systematic rules that kept facts ordered meant that they were context-independent. But because the system was borne out of real exchanges, facts were seen to be capable of being applied into ‘multiple contexts as and when they are needed’ (Davies 2021, p.32). As Davies goes on to argue, facts are supported because certain methodologies: become standardised, but then treated as apolitical, thereby allowing numbers to move around freely in public discourse without difficult or

34  Critical atmospheres challenge. In order for this to work, the infrastructure that produces “facts” needs careful policing, ideally through centralisation in the hands of statistics agencies or elite universities. (2021, pp.32–33) The problem is that the apolitical nature of such ‘policing’ has long been challenged, both philosophically, politically and practically. This is what, effectively, Coler set out to demonstrate: that trust in particular institutions regarding information and fact should not be taken for granted. When his work became profitable and utilised by political forces, it made the point better than he ever could have. Once fake news became part of regular parlance, it quickly became a way of denouncing information – whether it was actually a hoax or not. Post-truth and policy

What are the implications of this for critical thinking in practice? At the top of the decision-making tower, post-truth can be seen as a fuelling a particular mode of populist politics, as Lockie suggests, which arises from a combination of social and cultural factors combined with the technology of media communication. Such politics leads to policies which trouble the traditional modes of defining care delivery, its purpose and its principles. In a survey of 50 years of evaluation research in probation services, Peter Raynor concludes that ‘the 21st century so far shows a progression from being guided by evidence, to using evidence as a resource to support policy decisions already made, to creating evidence to support policies, and eventually to dispensing with evidence altogether’ (2018, p.70, emphasis original). This may point to a simple reversal being the answer: to return to the ‘careful policing’ that Davies mentions. But such a move is complicated by the constructive critiques of expertise that the growth of information and accessibility to political platforms has enabled within the caring professions. For example, Speed and Mannion agree that it is ‘not difficult to see that the disdain for policy experts by politicians pursuing populist policies, may result in poorly designed and implemented health policies with potentially serious dysfunctional consequences’ (2017, p.250). However, the risk of some kind of ‘return’ or reinvigoration of an evidence-base is the rise of what Isaacs and Fitzgerald (1999) once termed ‘eminence-based practice’ or following the opinions of established experts on the basis of their established expertise, rather than the evidence itself. Hence, Speed and Mannion go on to note ‘expertise is clearly widely distributed in society, with citizens expert in everything from restaurant reviews to medical advising.’ As such, the real ‘challenge in post-truth societies is to harness the potential of new technology to support more participatory styles of involvement in public affairs’ (2017, p.251). The problem is that the unquestioned establishment of the idea that critical thinking is good and necessary means that when it is challenged in this way,

Critical atmospheres  35 the response is often to simply redouble one’s efforts in being ‘critical’ in the conventional sense: without investigating the relationship between the two, or considering the questions one might raise of the notion of ‘the critical’ being employed. In an editorial of International Health Promotion, for example, Michael Sparks provides a summary of what we must now recognise as the stock response, best summarised by his section headings: the first is ‘Maintain our Research Standards’; followed by ‘Strengthen our Institutions.’ The way to combat challenges to evidence standards and critical reasoning is to simply continue to do it. Sparks here insists on a form of transcendent critique invested in scientific method to dispel disinformation and competing truth claims. The move is not uncommon: for example, writing on the history of evidence-base in the probation services, Peter Raynor concludes: ‘when post-truth policies fail, factual research on how to make probation more effective will be needed to support the necessary evidencebased reform’ (Raynor 2018, p.71). There is often a lack of attention to how the delivery and practices of ‘evidence’ may fuel post-truth, and the accounts of what constitutes post-truth are, ironically, superficial. In part, this is due to the insistence on following the rather unfortunately misinformed definition of post-truth that the Oxford English Dictionary decided upon, that was ‘relating to or denoting circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief.’ Of course, such a definition rides roughshod over the complexities of establishing ‘objective fact’ that have been subject to ongoing debate in both philosophy and professional practice (how are the facts of a service user’s condition ‘objectified’? What relations, institutions and power dynamics does this involve, and how are they, in Ken Moffat’s words, ‘entrenched within the social body’? (1998, p.219)). Identifying posttruth as the surpassing of objective facts with emotion is a misleading – if not straightforwardly false – definition, because it omits hundreds of years of scholarship on the role of both emotions and beliefs in the formation of our judgements; including the hugely significant work in feminist theory unpacking the grounds on which emotion is considered non-factual, or even dangerous to reasoning (see, e.g., Stone 2007; Grimwood 2011). It presupposes that ‘objective fact’ can, and has, been ‘influential’ – but which opens up a number of questions about how fact can influence, and what mechanisms and mediums are needed for this to happen. In short, this definition of post-truth suggests a distinction between fact and more ‘subjective’ aspects of meaning which is open to challenge in several ways. Indeed, Frieder Vogelmann suggests that post-truth should not be seen as an ‘era,’ as this suggests there was an ‘era of truth’ beforehand which is difficult to evidence. Indeed, the term ‘post-truth’ was first coined in 1992 by the playwright Steve Tesich but did not come into common parlance until the late 2010s (Vogelmann 2018, pp.19–21). As Keane makes clear: ‘“post-truth” is not simply the opposite of truth, however that is defined; it is more complicated. It is better described as an omnibus term, a word

36  Critical atmospheres for communication comprising a salmagundi or assemblage of different but interconnected phenomena’ (Keane 2018). In other words, ‘post-truth’ is a general term that is used to cover a wide range of shifts and changes in the way critical thought is applied: it is the use of a non-contingent term to cover a number of contingent practices, and in this sense, the term ‘post-truth’ is a performance of post-truth in itself. Post-truth and trust

The ambiguity and contradictions of fake news and post-truth are key to the problems they present for critical thinking. As Keane notes, ‘paradoxically, post-truth is among the most-talked-about yet least-well-defined meme words of our time’ (Keane 2018). This said, its effects on criticality in frontline decision-making are clearly a concern: whether this is through the ‘topdown’ lack of evidence-based working to inform social policy (Smith 2017; Speed and Mannion 2017), or the ‘bottom-up’ availability of information and disinformation for both service users and practitioners to challenge the basis of their support, something the recent COVID-19 crisis brought to the fore (Hopf et al. 2019; López Peláez et al. 2020). The problem emerges, though, when the same standards and institutions that Sparks insists we reemphasise might also be, in some way, complicit in the complexities of posttruth. Frieder Vogelmann has made this point clearly when he points out the paradoxes of the very idea of post-truth: those diagnosing a “post-truth era” often replace the hard work of justifying their truth-claims with appeals that we must learn to trust again […] our political elites, our fellow citizens and, most of all, our scientists. Yet which experts, which scientists, which politicians and who of our fellow citizens should we trust? Without explaining how we can discriminate between blind faith and trust, calls for a renewal of the virtue of trust turn into calls for being less critical – certainly a bad strategy if we really lived in a “post-truth era” with its reign of “fake news” and phony experts. (Vogelmann 2018, p.21) The COVID-19 pandemic provided a particular focus on the nature of fact and critique, not just with the various vaccination conspiracy theories, ‘vaccine hesitancy’ and the unprecedented expertise in epidemiology claimed by the general population, but also with the question of what to do about this, as Harambam explains: Finding out what is really the case with vaccinations requires large independent investigative research involving various kinds of experts who can assess the validity of current and historical research and enjoy trust from the different publics involved. […] Obviously, this is not a bad

Critical atmospheres  37 strategy to take when living in the complex knowledge societies of today. In fact, this is the way it works: we need to rely on experts and we need to trust epistemic authorities […] But when the issue at stake is precisely the truthfulness of established knowledge and the credibility of experts and mainstream epistemic institutions, then this strategy falls short. (Harambam 2021, p.108) For Vogelmann, the exclusive focus on a particular model of ‘truth’ – in this case, the dominance of epidemiological research informing the public health measures in response to COVID-10 – leads to the advertised risks of post-truth being remarkably shallow and ill-fitting. Rather than pursue rigorous critical activities, he suggests, we are simply asked to ‘trust’ those who have traditionally held political and epistemological authority. This would overlook, for example, the conflicts between practitioners around what constitutes ‘best practice,’ the instructive debates around how care practices should be theoretically framed, or the realities of implementing models of best practice abstracted from their original contexts. Indeed, different areas of health, care and social work are historically formed out of just such competing claims to knowledge, as can be seen even today with, for example, the continued debates over the voice of the service user in decision-making, commissioning and policymaking. Even the (almost-exclusive) attention on knowledge as the conclusion of critical thinking, though, has an important effect, in that the contexts surrounding ­ the conditions by which post-truth has become a popular term are often overlooked or downplayed. As Davies notes, there is a convincing narrative regarding post-truth: the power of dark digital forces to place fake news in front of the non-discerning public such that nobody can tell the truth from lies any longer. But this same narrative has been treated with scepticism by those who question why people would be open to such ‘alternative facts,’ and what discontent existed with existing structures of knowledge to enable the symptoms of post-truth to emerge (Davies 2021, p.11). In this context, a warning from philosopher Babette Babich highlights how the rhetoric of post-truth, and the responses of critical thinking within professional practice (as Sparks exemplifies) may interfere with the necessary reflective processes of practice: indeed, it can be hard not to wonder if the language of ‘post-truth’ itself is not a bullying tactic, […] in our era of political concern, deployed by a regime nostalgic for a single media voice and anxious to silence ­different voices. (Babich 2017, p.174, my emphasis) There is a noticeable speed by which the culprits for the post-truth age are routinely identified, and the familiarity of these enemies of facts from past debates in the 1960s up to today. It is now common, for example, to find

38  Critical atmospheres arguments that the advent of ‘post-truth’ is due to the rise of postmodernist tendencies in universities and wider culture. In turn, the excitement about post-truth has led to a nostalgic appeal to outworn approaches: perhaps most prominently, the scientistic quest for a pure and scientific truth. In this response, post-truth is cast more as ‘anti-truth,’ which can be rescued by the appropriate application of proper scientific method. One finds this in the increasingly shrill articles in the pages of the BMJ and others, where medical expertise is fiercely defended against the forces of populism and ignorance (see, e.g., Heinrich 2020). It is also present in the rise of certain behavioural analytics and uses of ‘big data’ which, as we will consider in later chapters, can involve reframing facts as separable from critique. Mistrust and the politics of identity

One reason that the institutions that traditionally policed the tools and implementation of critical thinking are not as trusted as before is the steady rise, throughout the 20th and 21st centuries, of arguments concerning their fundamental assumptions of who the ‘critical thinker’ is. Today, this rich tradition of questioning is often reduced to the catch-all term of ‘identity politics,’ which is typically held up as an obstacle to critical reflection by virtue of the perceived trenchant positioning of its advocates. Rakib Ehsan (2021), for example, argues vociferously that the ‘peddling’ of identity politics by managers simply creates divisions and conflict with health services. It has not always been the case. In 2006, Malcolm Payne was advocating for the benefits of a politics of identity in professional practice, using multiprofessional teams to promote ‘bottom-up’ specialised identities emerging from the relationship between different professions in situ (Payne 2006). In the same year, Collins Airhenbuwa’s book Healing Our Differences (2006) argued that the need to attend to individual cultural need, rather than focus on uniform or ‘apolitical’ views of healthcare, was the only way of dealing successfully with global health. Yet, in more recent times, the notion of identity politics has since come to stand for something restrictive or obstructive; quite the opposite of what the politics of identity was originally conceived to be. The association of identity politics with managerialist interventions and unnecessary workplace policies, as well as the view that it ‘cancels’ certain viewpoints or expressions, caricatures the deeper problems of identity as a critical question of procedure. For example, Jodi Dean casts those pushing identity politics as: avoiding the division and antagonism that comes with taking a political position, they displace their energies onto procedural concerns with inclusion and participation, as if the content of the politics were either given – a matter of identity – or secondary to the fact of inclusion,

Critical atmospheres  39 which makes the outcome of political struggle less significant than the process of struggle. (Dean 2011, pp.56–57) As with post-truth, the issue here is that the term ‘identity politics’ is often utilised to describe a very narrow and limited set of activities, while being ascribed to such a wide range of contexts it cannot help but become something of a ‘straw man’ position. Daniel Béland (2016) argues, for example, that ‘how actors understand themselves and are seen by others’ is a key aspect of any public policy analysis or implementation. But once such understanding is framed as an obstruction to implementing policy, or to delivering what may seem to be common-sense or ready-to-hand interventions as forms of care, it creates a problem for situating a critical perspective. Tensions within critique In summary, then: a number of the perceived threats to critical thinking are, on closer inspection, not the binary opposites that Gambrill suggested in her definition of ‘good’ thinking from bad earlier in the chapter. Rather, it is more complicated, because in many cases, such threats appear inherently connected to the activity of critical thinking, even if they end up appearing to oppose or problematise it. How do these malaises affect the matrix presented in Figure 1.1 earlier? In many senses, it remains very similar in terms of the available coordinates for situating criticality in practice. At the same time, there is a sense in which each end of the continuum has mutated into something curiously at odds with the notion of critical thinking. This, as the chapter began by noting, is not necessarily a mutation caused by shifts in reasoning or method, but rather the atmosphere in which critical thinking takes place. In terms of critical thinking in practice, one atmospheric aspect is made manifest when the responses to post-truth, and the recommendations on what should be done, appear to reflect many ‘felt’ or ‘instinctive’ truths on the side of theorists and practitioners alike. For example, writing on the MacMillan International Higher Education blog, Louise Katz writes of the problem with ‘critical thinking’ becoming a buzzword. While ‘the most commonly presented argument for the importance of teaching critical thinking at university is that it is an indispensable tool for sorting through the roar of ideas with which we are inundated daily,’ Katz suggests a need for students and practitioners to go further: In order to think critically, we have to be willing to question ourselves, our motivations, and our belief systems; in other words, we have to attempt to step outside ourselves and work out why it is that that we believe what we believe. Only then can we begin to approach an idea

40  Critical atmospheres or an issue with clear eyes. […] This means exercising a desire to see to the truth of a matter. We have to desire truth. (Katz 2019) Katz’s argument is one of many examples where particular tropes and images of critique are employed to enhance their persuasiveness: notably, the need to look behind or beyond the immediate circumstances (‘steeping outside ourselves’) which implies that clarity can only be achieved via detachment. Notably, Katz draws on the image of desire – we can’t just want truth, we have to desire it! – which suggests a far more intimate connection, deeply ingrained in selfhood; but also an image which seems at odds with the prior command to step away from the immediacy of our ‘self.’ Tensions within transcendent critique

I call attention to this, not for the sake of criticising Katz, but rather to note how this tension sits within the premise of transcendent critique when it is challenged by deceptively complex terms such as ‘post-truth.’ Indeed, it is noteworthy that the pervading image of this ‘stepping outside’ of practice in a form of objective separation is not reflected in the roots of contemporary EBP. Archie Cochrane’s (1971) evaluation of the National Health Service in England, Effectiveness and Efficiency: Random Reflections on Health Services, promoted the use of the Randomised Control Trial (RCT) and subsequently gave rise to the Cochrane Collaboration Tool for systematic reviews of current available research on a given health topic, reviews which now form the bedrock of EBP across the allied health professions. In social work, meanwhile, a number of papers appeared challenging the evidence base of social work interventions around the same time (see Fischer 1973; Pincus and Minahan 1973). Cochrane’s original book makes for an interesting read when compared to the industry that EBP has since become: he approaches the topics of effectiveness and efficiency by freely admitting his own biases, including his emotional investment in health provision; he situates the state of medical treatment within a narrative history which includes his own experience in prisoner of war camps; he summarises the expectations and beliefs of ‘the layperson’; and he includes an astute observation on the role of the Medical Research Council in ignoring applied research in favour of ‘pure’ and how this contributes to the effectiveness of care. This is in some ways an incidental observation, and I do not want to revisit the EBP debate in its entirety. I raise it instead to make the simple point that the presentation of the case for EBP – its rhetoric, in effect – has always depended upon elements which are effectively outside of its own processes. This is because the basis of transcendent critique is that it takes place from a position outside of a given ‘real world’ (hence transcends the immediacy of

Critical atmospheres  41 the real in a kind of Archimedean view from nowhere), but it is also why it insists on the need for ‘trust’ in institutions to work effectively. The key concern for us here is the way in which it incorporates particular atmospheres of critical thinking, and in this context, we will only note that the primacy of EBP has been troubling for many within the applied professions on both theoretical and practical grounds. In theoretical terms, it is troubling because of its basis in positivist epistemologies which can be considered ill-suited to the types of knowledge involved in certain aspects of practices of care. A fundamental principle of EBP is the hierarchical pyramid system for valuing evidence with the most ‘objective’ (systematic reviews of RCTs), down to the most ‘subjective’ (background information and expert opinion) (Hoffman et al. 2013). As Susan Haack remarks, clearly EBP is a positive thing – ‘Who wouldn’t prefer to know before they take it that this medicine will make them better, and won’t kill them in the process?’ – but this does not remove its rhetorical activities. After all: evidence-based medicine is a good thing – if “evidence-based” means “taking into account all the relevant evidence we have, or can obtain.” But things go wrong when the entirely reasonable idea that we should prefer medical treatment which there is evidence to believe is both effective and safe is covertly transmuted into the much less reasonable idea that we should prefer medical treatments supported by a restricted kind of evidence – epidemiological studies and clinical trials. This is classic bait-and-switch: first appeal to our sense that evidence matters, and then covertly allow only evidence of certain preferred kinds. (Haack 2015, p.9) It is not just a case of preferential choice, however. True, EBP has been rightly criticised for being too simplistic, overlooking the role of interpretative and analytic strategies (Dechartres et al. 2014; Murad et al. 2016). But additionally, when EBP becomes the basis of critical practice, its model requires that critique is also supported with a clear distinction between the object and the subject, just as clinical trials are. The character of this distinction is important, particularly in terms of how criticality is rhetorically situated within practice. Loversidge and Zurmehly make this clear in their introduction to the topic: while healthcare professionals may utilise ‘time, experience and trial and error’ for mentoring those new to the work, they note that: today’s healthcare environment is so complex that trial, error, and opinion are insufficient for developing informed policy. It is therefore incumbent upon educated health professionals to press for the judicious use of science and evidence in policymaking. To do that, we must arm ourselves not only with the best evidence but with a full and realistic

42  Critical atmospheres understanding of the political processes that are part and parcel of policymaking. (Loversidge and Zurmehly 2019, p.2) Framed in this way, EBP takes the form of a miniature Enlightenment: whereas in the past medical practice was based on tradition, now ‘we’ (who are, as the next sentence suggests, the ‘educated’) must take it upon ourselves to move away from this base. Just as, in the 18th century, Immanuel Kant encouraged his cosmopolitan readership to grow out of their self-inflicted immaturity, so here Loversidge and Zurmehly position EBP as a job for the grown-ups. They also inherit from the Enlightenment language the antagonism of such a move: EBP is not just a practice, but a weapon to ‘arm ourselves’ with. This arming is important, because their account that follows essentially points out the partiality of political viewpoints, which is fundamentally at odds with the objective findings of EBP. In other words, the case for scientific evidence guiding policy is not necessarily a scientific one; and this is perhaps necessary given that, as Little notes, ‘“Evidence-Based Policy” is now far too long in the tooth to be treated entirely credulously, and people tacitly understand that it often involves a lot of “policy-based evidence”’ (Davies 2021, p.33). Tensions within immanent critique

The opposite end of the continuum, meanwhile, which insists on the immanent critique of existing systems, searching for the concealed contradictions and structural tensions that uphold oppressive contexts for service users, can also be said to have reached a point of malaise. Across different disciplines, theorists have suggested critical thinking has itself stultified and become only a staged performance. It has therefore become a well-rehearsed exercise, resulting in a ‘series of rigged moves’ (Sloterdijk 1987, p.90) which does little to effect actual change on either a societal level or for individual service users. We have already seen this risk in our earlier discussion of textbook uses of critical thinking, a tension which was taken up by Bruno Latour, in a now-famous paper which asked ‘Why Has Critique Run out of Steam?’ Here, Latour presents critique as a form of self-knowledge, set against the naïve optimism of the Enlightenment that knowledge alone will simply expand for the better. However, while this calling out the problems of positivist and scientific assertions of the primacy of ‘facts,’ he argues that this form of critical selfknowledge falls into traps of its own design. It produces what amounts to an endless cycle of critique – adding ‘iconoclasm to iconoclasm’ and practising a form of ‘instant revisionism’ (2004, p.228) where every fact must be doubted – risks leaving intellectual pursuit as ‘like those mechanical toys that endlessly make the same gesture when everything else has changed around them’ (p.225). A non-reflexive blindness, Latour argues,

Critical atmospheres  43 has been built into the suspicions of critique, which unwittingly creates a set of mechanical clichés; undertaking critique is simply ‘to go through the motions’ (p.226). If the task of critical thought has become institutionally embedded as debunking reality as a sign or mask of something else (complexity, ideology, power, hegemony etc.) then, Latour points out, these principles manifest themselves in contemporary culture in the form of conspiracy theories. In their ‘mad mixtures of knee-jerk disbelief, punctilious demands for proofs, and free use of powerful explanation from the social Neverland,’ they deploy the same ‘weapons of critique’ – distrust, suspicion, the need to unmask and expose – which were meant to protect us from just such fantastical arguments (p.230). As a result, Latour finds something troublingly similar in the structure of the explanation, in the first movement of disbelief and, then, in the wheeling of causal explanations coming out of the deep dark below. What if explanations resorting automatically to power, society, discourse had outlived their usefulness and deteriorated to the point of now feeding the most gullible sort of critique? (Latour 2004, pp.229–230) Latour is being deliberately polemical, but his point is worth considering. Consider, for example, how in 2019 the World Health Organisation ranked ‘vaccine hesitancy’ as one of the ten most significant threats to global health. While the stock response to such hesitancy is an appeal to evidence-bases, better information campaigns and terms like the ‘restoration of trust’ in scientific authority, this can overlook the more ingrained practices of suspicion that are embedded within the traditions of critical thinking and its pedagogy. Simply refer back to the definitions the chapter began with, and the emphasis on ‘looking beneath the surface,’ ‘making the invisible visible’ and so on. Another example. Just as there are the well-known and powerful figures of post-truth – the policymaker motivated by economic cost-cutting rather than real, existing welfare; the ill-informed service user voting for cuts to their own provisions, and so on – there are similar figures on the side of the critical social worker, or the activist clinician: the ‘subversive caseworker’ or the transgressive practitioner, operating in between the lines of panoptical human services management (see Schram 2015). Tina Wilson refers to the ‘reproduction of […] justice cultures in social work’ after what she identifies as a collapsing of left-wing progress narratives: that is, ‘the repetition of a narrative that insists that, if we think right and work right, the future will be more just than the past’ (Wilson 2017, pp.1311–1312). What I am suggesting here is that, in at least some way, these figures of malaise are products not just of the politics of professional practice, but also of the worn-out models of criticality that it employs, wherever such models sit on the matrix above.

44  Critical atmospheres We can simplify this to two problems, then. On the one hand, there is an excess of critique at work in the post-truth manifestations, which includes both the laboured suspicion of authority, sense and evidence, and the insistence on a naïve return to scientific method and objective knowledge. On the other hand, there is a dual resignation at work both in the weary alignment of critical thinking with training processes – the succumbing to textbook criticality – and the cynical sense of the ineffectiveness of broader social critique. Once again, we find that the problems facing critique are not inherently opposed to the practice of critical thinking, but arise from various applications of the process itself. In particular, I would argue, they arise from a fetishising of the notion of critique outside of the broader context in which it takes place, whether this is in terms of how EBP developed from Cochrane’s original observations, or whether it is critical theory’s dependence on suspicion as a clichéd version of practical engagement. Post-critical care? Taking the previous discussion in its entirety, we can revisit our original matrix of critical thought in the professions and present a more view perhaps more in keeping with the times (Figure 1.2). Here, far from offering the liberatory qualities of clarity, creativity, decision-making, evaluation, and all the other benefits encountered at the beginning of the chapter, the prospect of critical thinking suggests instead a number of problematic cul-de-sacs. It is clear, then, that in order to move beyond such a malaise, we need more than simple repetition of the same critical thinking that got us here.

Figure 1.2 Post-critical thinking matrix.

Critical atmospheres  45 But this raises the obvious question: how do we go about criticising critique, without being caught up in an endless cycle of criticism? I am not going to provide a golden answer to this: whether for practitioners (as I am not one), or for theorists (as this would simply be adding one more set of theories to the ‘theory supermarket’ where we can pick and choose what we want; itself an extension of neoliberal ‘choice’ (Grimwood 2016, pp.132–133)). Instead, as a starting point for considering what kind of dialogue between practice and post-critical thinking might have on these issues, I want to conclude the chapter by highlighting certain tenets of the post-critical which are particularly relevant for how criticality is deployed within practice and practice education. Not just matters of fact, but matters of concern

Latour concludes his deconstruction of critique by suggesting the key problem is an almost relentless prioritising of facts; a prioritising which can also be seen in the numerous texts that respond to post-truth by insisting on a renewed emphasis on scientific method. It can also be identified in the relationship between social work and ‘data gathering,’ particularly the role of data and case management systems. Following Latour, it can be seen that there is nothing inherently wrong with a ‘matter of fact’; and, indeed, the recommendations of organisations such as the American Academy of Social Work and Social Welfare’s report Harnessing Big Data for Social Good (2015) demonstrate ways in which sharing information can lead to better outcomes. The problem is when facticity becomes the dominant figure of critical thought: when ‘information’ displaces the very relational aspects that made that information worthy of gathering in the first place. When this happens, critical thinking is shaped towards certain activities, postures and distances at the expense of others. Latour suggests that matters of fact are only one subset of a broader category of matters of concern. These are ‘gatherings’ of ideas, forces, figures and sites in which ‘things’ (rather than ‘facts’) emerge and persist, precisely because they are cared for or worried over. He concludes optimistically that the future critic must be ‘not one who debunks, but the one who assembles […] not the one who lifts the rugs from under the feet of the naïve believers, but the one who offers the participants arenas in which to gather’ (2004, p.246) Criticality, in this sense, is an awareness of how something has been made ‘provides a rare glimpse of what it is for a thing to emerge out of inexistence’ (Latour 2005, p.89), and as such the question we ask is not whether it’s constructed or not – clearly, things in the world are made, whether by humans or other forces – but rather if it’s constructed well or badly. While he notes that it has become more common in both the social and natural sciences to equate ‘constructed’ with ‘not true,’ and, subsequently, this leads to a ‘most absurd’ command: ‘Choose! Either a fact is real or it’s fabricated!’ (Latour 2005, pp.90–91). This is a false dichotomy: after all, proving facts in

46  Critical atmospheres clinical interventions depends upon carefully constructed methods and data collection systems. What do we replace this dichotomy with, though? William Mazzarella muses on how he was taught at graduate school that the purpose of academic conversation was to build better arguments than others, so that they could be corrected in some sense, and come around to agreeing with you. But, as he goes on to note, this is not what happens: It’s never really about finding the perfect way to argue a point or defend a position. Instead, people – I, you, we, all of us – are attached to certain arguments not because we agree with them, but rather because they are extensions of worlds in which we find it agreeable to live. (Mazzarella 2022, p.259) This is, it’s important to note, not simply saying that arguing is a matter of going with what you feel is right. This would be the caricatured position of ‘post-truth,’ after all, casting a figure that values emotional response over and above evidence. Instead, Mazzarella is doing something else: first, describing a more realistic account of how criticality plays out in practice (regardless of the methods used), which involves attachment and agreement in ways that are not always noted; and secondly, suggesting the need for attunement to these factors for critique to be convincing. In this sense, what constitutes critical thinking is not only an act or interrogation, but also a network or pattern of attachments and relationships that can form as much a part of a critical moment than the more overt aspects. Hence, Latour concludes: The critic is not the one who lifts the rugs from under the feet of the naïve believers, but the one who offers participants arenas in which to gather. The critic is […] the one for whom, if something is constructed, then it means it is fragile and thus in need of great care and caution. (2004, p.246) The performance of knowledge

In her famous essay subtitled ‘You’re so paranoid, you probably think this Introduction is about you,’ feminist critic Eve Kosofsky Sedgwick notes that ‘knowledge does rather than simply is.’ Rather than using critical thinking to support a reliable knowledgebase, she suggests that the real interest in knowledge should be what ‘the pursuit of it, the having and exposing of it, the receiving-again of knowledge of what one already knows,’ because this is more meaningful in our localised decision-making (Sedgwick 1997, p.4). Such an observation that knowledge does things in specific situations is not radical (see Dore 2018a for a reflection on how this emerges in social work practice via forms of epistemic injustice). However, Sedgwick argues

Critical atmospheres  47 that understanding knowledge as something that ‘happens’ in local contexts is blunted by the deployment of critical thinking as a mode of suspicion. While in the humanities this alignment is rooted in a particular tradition of radical thought – Nietzsche, Marx and Freud are usually cited as the forebears of the ‘hermeneutics of suspicion’ – it can likewise be seen in the straightforward injunctions in critical thinking manuals to ‘look beyond the surface’ for the reality of a situation, whether this reality be the power structures of neoliberal late capitalism in welfare provision, or merely a more rigorous solution to a problem that is not immediately self-evident. Sedgwick’s point is that while there is clearly much to be gained from this approach, such a mentality has become so habitual, though, it ‘may have made it less rather than more possible to unpack the local, contingent relations between any given piece of knowledge and its narrative/epistemological entailments for the seeker, knower, or teller’ (1997, p.5). This is because, Sedgwick argues, suspicion becomes a form of paranoia: it is anticipating difference between the surface and depth, and in doing so investing its power in exposing something behind an appearance. We risk being left with Jacques Ranciere’s pithy statement on the often-unacknowledged side of critique: ‘where one searches for the hidden beneath the apparent, a position of mastery is assumed’ (2004, p.49). The problem with this, which Sedgwick identified in 1997 but has become more and more prevalent in contemporary thought, is not only the assumption that those who are not suspicious enough are naïve – those who will be shocked by the exposing – but that some formations that care professionals face, engage with and seek to overcome are, in fact, premised on their visibility, rather than their hidden-ness. There is, after all, no need to identify hidden power structures in a van driving around London telling illegal immigrants to go home, as the Conservative government piloted in 2013, and in Welfare Words (2019), Paul Michael Garrett has tracked the shifts in policy discourse to overtly vilify terms such as welfare dependency and anti-social behaviour. Likewise, exposing the hidden neoliberal agendas of the care system may do little to inspire students who are then told on placement that this is ‘simply how it is done here’ regardless of the currency of evidence. Instead, Sedgwick argues for a ‘reparative’ approach to critique: one that, rather than adopting an interrogative posture that seeks to outsmart through critical distance, to look instead at what knowledge does in terms of its innovations, localised empowerment and social changes, however small. As Tina Wilson summarises, ‘paranoid work tends to position itself as an insightful critique located outside of the problem it identifies, while reparative work typically reads itself into the inevitable failures of the world.’ In practice this involves, in Wilson’s words, directing greater care and attention towards living on amid the limits and failures of our justice projects, the conflicting investments and structures of

48  Critical atmospheres feeling at play in our declining welfare states, and towards the impossibility of acting in the world without ever causing harm. (Wilson 2017, p.1317) Surfaces, mood and method

Much of the literature on post-critique has argued for more attention to the surface of experience, or a more affirmative approach which moves us away from the ‘hermeneutics of suspicion’ or emphasis on a negative form of ‘unmasking’ that has tended to dominate critical theory as well as the application of critique into practice. Sharon Marcus and Stephen Best (2009), for example, argued that critique was overly-dominated by ‘symptomatic reading,’ which carried with it an assumption of hidden depths to any surface – depths which the critic is expected to retrieve, clarify, and re-present, usually to make a political point of some kind. Instead, they argue, critics should focus on surfaces, which they define as ‘what insists on being looked at rather than what we must train ourselves to see through’ (2009, p.9, emphasis original). While the context of their argument is literary theory, one might think here of the broader symptomatic interpretations that might take hold of ‘critical practitioners’: the social worker visiting a service user’s home who conducts a kind of forensic inquiry: detecting particular signs (unwashed laundry in a client’s house? out of date food in their fridge?) and interpreting these as a specific form of living (are they a neglectful parent?); the healthcare worker talking to an unkempt patient and wondering if they are really serious about improving their HbA1c, and so on. Of course, these are clearly problematic (and unethical) uses of suspicion; just as Marcus and Best’s own account of symptomatic reading is something of a straw man. Like much of Felski’s work, Marcus and Best’s account is fundamentally conservative: they simply replace ‘depth’ with ‘surface,’ adopt a ‘what you see is what you get’ approach. This, in effect, returns us to Latour’s matters of fact, the very thing we were trying to avoid. Rather than opening up the critical scene to the flows of contemporary practice, they seek to return to some sense of descriptive clarity. As Ellen Rooney has pointed out, this approach ‘celebrates obviousness’ (2010, p.116) and overlooks the necessity for critical interpretations to go beyond the immediate. Yet, Marcus and Best’s challenge is still worth considering. Not because it is persuasive, but rather because it asks what we might call post-critical care to explore the meaning of surfaces as surfaces. This would involve the banal, the ritualised and the ever-present but forgettable aspects of approaches to conceptualising care: not simply the ‘evidence’ in play, but the relationship between evidence and the contexts in which it is used in dialogue, where that dialogue takes place, what else is in that place (be it a consulting room, a service user’s house, an office, etc.), the ordering of the objects within … in other words, surfaces are not simply obvious and ‘flat’ representations, but

Critical atmospheres  49 rather interact with each other in a host of interesting ways, all of which might affect the ways in which criticality is employed in practice. They constitute an active process of knowing that is, after all, precisely what knowledge in practice does (see Dore 2018b) (amongst other things, this may help to explain, for example, why in the healthcare domain, research articles containing ‘critical thinking’ in the title are predominantly from fields of nursing, rather than medicine (Sharples et al. 2017)). This requires a shift in the register of critical thinking, not to simply swap depth and surface around (which risks simply replacing critical suspicion with wilful naivety), but rather focusing on the rhetorical and affective aspects of critical reflection that surrounds both. When Felski refers to a ‘rhetoric of defamiliarisation’ accompanying critique, she is using rhetoric in a rather disparaging way. However, rhetoric is not necessarily a benign evil, but is instead the study of what makes things persuasive. Indeed, the defamiliarisation that Felski refers to is a legacy of the notion that critique must be rationalist and requires holding a critical ‘position’ (similar to what Gambrill described earlier), which often obscures or neglects mood, emotion or disposition. In other words, paying attention to the surface means understanding the moods of critical thought, and how these affect its performance within practice. Such an understanding does not do away with suspicion altogether, as Marcus and Best suggest. Rather, it brings to light aspects of sense-making and localised criticality that may otherwise be dismissed. Lauren Berlant (2011), for example, writes of the significance of affective attachments in structuring fantasies of upward mobility, job security, and political equality for those in poverty; a ‘cruel optimism’ that is central to the premise of late capitalist society. These attachments lack depth in the traditional sense; they are superficial, often clichés rather than firmly rooted relationships. At the same time, the superficiality of cruel optimism is precisely its strength. Rather than judging this as a form of ignorance, given the raft of conventional evidence against such optimism, the more pressing question is what allows it to remain as such a central premise to social relations. This requires a more direct engagement with the superficial, rather than dismissing it as ‘uncritical.’ Re-energising understanding

Faced with the prospects of a post-truth age or the problematic issues sparked by identity politics, newly prescribed academic orthodoxies or the spirit of welfare remaining under the auspices of neoliberal managerialism, it is perhaps unsurprising to find calls for the revival of the critical and vocal spirit that has been part of the history of many of the caring professions (see, e.g., Fenton and Smith 2021). But it is important to be vigilant as to the ways in which a critical spirit has itself, and can continue to, contribute to malaise. In such cases, the repetition of such a spirit is likely to lead only to dead ends in social, professional and political thought.

50  Critical atmospheres However, engaging in a dialogue with the debates around post-critique on the one hand, and the applied and localised practices of care on the other, provides sites with the potential to think and act through such a critical malaise. The point of such a dialogue is not to simply replace one set of critical practices directly with another, as Marcus and Best propose. Nor is it to be satisfied with the empathetic but somewhat idealistic image of the concerned critic that Latour proposes, as this is not so much a new model but rather an encouragement to engage in the relations of concern that ground any ‘critical’ aspect of critical practice. In this way, appealing to the atmospherics of practice is not the same as recommending yet another new kind of model of delivering services, or a brand new theory from which to choose off the ever-burgeoning shelves of the humanities and social sciences. Instead, the challenge to the caring professions of post-critique, no less than the challenge of post-truth, is to re-energise the role of interpretation within their practice, to apply a critical lens to critical thinking and to reflect on the ways in which certain models of critique are more persuasive than others, and to think through whether such persuasiveness makes them more or less effective. This means considering what elements, tropes, and habits are at work in the idea of a critical practitioner, and whether these are fitting for the atmosphere of critique in today’s provision of care. Having considered the broader atmospheric pressures surrounding critical thinking in this chapter, the next chapter examines a more specific and immediate pressure on the care practitioner: the atmosphere of time. References Aho, R. E. and Quaye, S. J. (2018). ‘Applied Critical Leadership: Centering Racial Justice and Decolonization in Professional Associations.’ Journal of Critical Scholarship on Higher Education and Student Affairs, 3:3, p.2. Airhenbuwa, C. (2006). Healing our Differences: The Crisis of Global Health and the Politics of Identity. London: Rowman & Littlefield International. American Academy of Social Work and Social Welfare. (2015). Harnessing Big Data for Social Good: A Grand Challenge for Social Work. Available at: https:// grandchallengesforsocialwork.org/wp-content/uploads/2015/12/WP11-with-cover. pdf Babich, B. (2017). ‘Hermeneutics and its Discontents in Philosophy of Science: On Bruno Latour, the “Science Wars”, Mockery and Immortal Models.’ In Babich, B. (ed.), Hermeneutic Philosophies of Social Science. Berlin: De Gruyter, pp.163–188. Béland, D. (2016). ‘Identity, Politics and Public Policy.’ Critical Policy Studies, 11:1, pp.1–18. Berlant, L. (2011). Cruel Optimism. London: Duke University Press. Boland, T. (2019). The Spectacle of Critique. London: Routledge. Boostrom, R. (2005). Thinking: The Foundation of Critical and Creative Learning in the Classroom. New York: Teacher’s College Press. Brechin, A., Brown, H. and Eby, M. (2000). Critical Practice in Health and Social Care. London: Sage.

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Critical atmospheres  53 Milner, M. and Wolfer, T. (2014). ‘The Use of Decision Cases to Foster Critical Thinking in Social Work Students.’ Journal of Teaching in Social Work, 34:3, pp.269–284. Moffat, K. (1998). ‘Surveillance and Government of the Welfare Recipient.’ In Chambon, A., Irving, A. and Epstein, L. (eds.), Reading Foucault for Social Work. New York: Columbia University Press, pp.219–246. Mooney, M. and Nolan, L. (2006). ‘A Critique of Freire’s Perspective on Critical Social Theory in Nursing Education.’ Nursing Education Today, 26:3, pp.240–244. Murad, M., Asi, N., Alsawas, M. and Alahdab, M. (2016). ‘New Evidence Pyramid.’ Evidence Based Medicine, 21:4, pp.125–127. Narey, M. (2014). ‘Making the Education of Social Workers Consistently Effective.’ Department for Education. Available at: https://www.gov.uk/government/ publications/making-the-education-of-social-workers-consistently-effective Papathanasiou, I., Kleisiaris, C., Fradelos, E., Kakou, K. and Kourkouta, L. (2014). ‘Critical Thinking: The Development of an Essential Skill for Nursing Students.’ Acta Informatica Medica, 4, pp.283–286. Paul, R. (1995). Critical Thinking: How to Prepare Students for a Rapidly Changing World. Santa Rosa, CA: Foundation for Critical Thinking. Paul, R., Elder, L. and Bartell, T. (1997). California Teacher Preparation for Instruction in Critical Thinking: Research Findings and Policy Recommendations. Santa Rosa, CA: Foundation for Critical Thinking. Payne, M. (2006). ‘Identity Politics in Multiprofessional Teams.’ Journal of Social Work, 6:2, pp.137–150. Pearson, J. (2017). Who’s Afraid of Action Research? The Risky Practice of Immanent Critique.’ The Language Scholar Journal, 1, pp.1–21. Pincus, A. and Minahan, A. (1973). Social Work Practice: Model and Method. Itasca, IL: Peacock. Poovey, M. (1998). A History of the Modern Fact: Problems of Knowledge in the Sciences of Wealth and Society. Chicago, IL: University of Chicago Press. Profetto-McGrath, J. (2005). ‘Critical Thinking and Evidence-Based Practice.’ Journal of Professional Nursing, 21:6, pp.364–371. Ranciere, J. (2004). The Politics of Aesthetics. London: Continuum. Raynor, P. (2018). ‘From “Nothing Works” to “Post-truth”: The Rise and Fall of Evidence in British Probation.’ European Journal of Probation, 10:1, pp.59–75. Rooney, E. (2010). ‘Live Free or Describe: The Reading Effect and the Persistence of Form.’ Differences, 21:3, pp.112–139. Rozendo, C., Santos, A. and Cameron, B. (2017). ‘A Critical Review of Social and Health Inequalities in the Nursing Curriculum.’ Nurse Education Today, 50, pp.62–71. Schram, S. (2015). The Return of Ordinary Capitalism: Neoliberalism, Precarity, Occupy. Oxford: Oxford University Press. Sedgwick, E. K. (1997). ‘Paranoid Reading and Reparative Reading; Or, You’re So Paranoid, You Probably Think This Introduction is About You.’ In Sedgwick, E. K. (ed.), Novel Gazing: Queer Readings in Fiction. Durham, NC: Duke University Press, pp.1–37. Sharples, J., Oxman, A., Mahtani, K., Chalmers, I., Oliver, S., Collins, K., AustvollDahlgren, A. and Hoffmann, T. (2017). ‘Critical Thinking in Healthcare and Education.’ BMJ, 357, p.2234. Shor, I. (1992). Empowering Education: Critical Thinking for Social Change. Chicago: University of Chicago Press.

54  Critical atmospheres Sloterdijk, P. (1987). Critique of Cynical Reason. Trans. Eldred, M. Minneapolis: University of Minnesota Press. Smith, K. (2017). ‘Beyond “Evidence-based Policy” in a “Post-truth” World: The Role of Ideas in Public Health Policy.’ In Hudson, J., Needham, C. and Heins, E. (eds.), Social Policy Review 29: Analysis and Debate in Social Policy. Bristol: Policy Press. Speed, E. and Mannion, R. (2017). ‘The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy.’ International Journal of Health Policy Management, 6:5, pp.249–251. Stone, A. (2007). An Introduction to Feminist Philosophy. Cambridge: Polity Press. Sydell, L. (2016). ‘We Tracked Down a Fake-News Creator in the Suburbs. Here’s what we Learned.’ National Public Radio, Available at: https://www.npr.org/sections/ alltechconsidered/2016/11/23/503146770/npr-finds-the-head-of-a-covert-fakenews-operation-in-the-suburbs Toner, J. and Rountree, M. (2003). ‘Transformative and Educative Power of Critical Thinking.’ Inquiry: Critical Thinking Across the Disciplines, 23, pp.81–85. Vogelmann, F. (2018). ‘The Problem of Post-Truth: Rethinking the Relationship between Truth and Politics.’ Behemoth: A Journal on Civilisation, 11:2, pp.18–37. Wilson, T. (2017). ‘Repairing What’s Left in Social Work, or, When Knowledge No Longer Cuts.’ British Journal of Social Work, 47, pp.1310–1325.

2

The rhetoric of urgency Tensions between critique and practice

‘Situating critique in history, as an emergent and contingent form of discourse, is a vital task,’ Tom Boland writes, ‘because without history, critique appears as a natural mental capacity or automatic response to social crises’ (2019, p.53). Not only this, but the application of critical practices – understanding the arguments and processes behind decisions – is fundamentally embedded within time; the temporal aspect of critique separates it from merely describing something outside of its practical context (Scott 2020). It could well be said, though, that in contemporary professional practice, the opposite is in effect. For here, we frequently find critical thinking applied in ahistorical ways, placed within settings where the problem of time is a preventative, rather than an enabler, of its deployment. Indeed, it seems that in professional practice today, whichever way one turns a sense of urgency is prevalent: whether the persistent time pressures exerted in day-to-day practice, or the recurrent themes of impending crisis confronting the professions themselves. Frequently, these strains on time and resource perpetuate a particular relationship between ‘theory’ and ‘practice.’ In some cases, this is simply a re-assertion of the view Stephen Hicks describes as theory being a ‘problem to be resolved’ (2016, p.399), an accompaniment to practice which nevertheless ‘won’t get you through the door’ (Garrett 2013, p.1), or the consequence of employer-led education which focuses on getting the job done first and foremost (Green 2006; Tanner 2010; Houston 2014). But there is also a sense in which, under the neoliberal governance of social provision, urgency has become far more of an inherent feature of practice. Lauren Berlant once described a ‘crisis ordinariness’ in late capitalist culture, whereby crisis is not a rare exception but instead a fundamental structure of our experience of the present (2011, pp.81–82). Likewise, there are a myriad of ways in which practitioners, on a personal level, identify their own work in terms of its relationship to time, and in particular the absence of it in the face of growing service demands. When Kumagai and Naidu assert that ‘there’s simply never enough time’ in care contexts (2020, p.512), this is not simply a reflection on what tasks can and cannot be done during the length of a shift, but also a core premise of what it is to be a practitioner in DOI: 10.4324/9781003123583-3

56  The rhetoric of urgency: tensions between critique and practice the 21st century: to have no time is, effectively, to be working normally (or, as working normally has now become synonymous with, ‘working hard’). This has obvious knock-on effects on criticality in practice and, as such, there is a need to re-think the ways of acknowledging and representing this urgency, the problem of time that underlies the relationship between practice and theoretical inquiry, and the models of critique that can be applied to it. In this way, and however paradoxical it may seem, it makes sense to take some time to consider the impact of urgency, and its association with resource pressures and lack of time for critical discussion or reflection. Rather than present an exhaustive survey of literature on the topic of time pressures, I want instead to re-read the individual, contextualised sites of research in order to explore how, as well as being demanding and immanent, urgency is also something which is persuasive, and therefore a need to interrogate how this persuasiveness is structured and formed in its mobile, dynamic, and multi-layered ways. That is to say, there is something rhetorical about urgency that needs addressing if we are to take seriously the relationships it perpetuates between theory, practice and critique. By doing this, I want to suggest that the form of time most utilised in the discussions of urgency is more concerned with the division of space than it is with temporal concerns, and that this in turn shapes approaches to critical thinking. Time, space and crisis It is difficult to ignore how embedded the language of urgency has become within the discourses of care. This has both long-term and more recent history. The fate of social welfare, at least when positioned within state-funded delivery in Western countries, has been inextricably tied to broader social and economic crises since the 1970s (Jopkke 1987; Banks 2012; Donovan et al. 2017; Houston 2019). Across Europe, following the financial crisis of 2008 public sector social work was reframed in terms of disciplinary and punitive measures of austerity (Ferguson and Lavalette 2013; Palese et al. 2014; Gea-Sánchez et al. 2019). It is not surprising, then, that social work, social care and health delivery finds itself on the knife edge of urgent state responses. But even outside of global disasters, the sense of impending crisis has been a recurrent feature in the literature of these professions, not just in the UK but in ‘many other countries’ (Asquith et al. 2005, p.9). ‘In medical education these days,’ Kumagai and Nadau comment, ‘time is not on our side’ (2020, p.512). The literal meaning of crisis is a time of intense difficulty or danger; a time when a difficult or important decision must be made (from the Greek Krisis, decision). As such, it is striking that in Asquith et al.’s survey of literature on the role of the social worker in the 21st century, we find distinctly spatial or territorial explanations of what is, fundamentally, a temporal figure. Their report lists examples of crisis as the erosion of professional boundaries; the

The rhetoric of urgency: tensions between critique and practice  57 fact that much ‘social work’ is being carried out by non-qualified workers/ carers; the failure to recruit and a shortage of qualified social workers; the lack of recognition amongst other professions; working conditions and the lack of resources necessary to allow social work to be effectively practised. Crisis is here represented through the lack of bodies-in-space (failure to recruit, high turnover rates, lack of resources), or the lack of bodies to fill space (the space of social work intruded upon, the collapsing of boundaries between the social worker and other professionals or para-professionals). While the operational aspects of urgency have clearly changed, the conceptual themes raised in 2005 remain pertinent in 2023, and not just in social work, as Borneo et al.’s (2022) report on the UK nursing workforce demonstrates. If the impact of austerity prompted new urgencies for health, care and social workers to respond to, the language of crisis remains focused on lack of resources, a consequent lack of time and wrongly placed practice (UNISON 2019); problems brought all the more to light by the impact of COVID-19 on adult social care (Carter 2020). In some senses, this articulation of practice in spatial (rather than temporal) terms is neither false nor surprising. The very fact that social work (or indeed, any of the caring professions) is, in McBeath and Webb’s words, a ‘contingent non-linear task’ of ‘complex indeterminate work’ (2002, p.1018) means that its expertise is structured, at least in part, by its situated locality. Social work is a practice, and practice is identified through place, or ‘an appreciation of their own structural location and the associated “baggage” which exercises significant influence on both the opportunities available to them and the constraints which they experience’ (Smith, 2008, p.193). It follows that the role of time typically emerges as a consequence of the spatialising or ‘placement’ of practice. For example, the name of the British Association of Social Work’s ‘80/20’ campaign in 2018 derived from the discovery that children’s social workers spent 80% of their time on administrative tasks and 20% in direct contact with service users provides one example of this. The spatial constraints of administrative work means that there is not enough time for the location of practice to be realised. At the same time, there is more to say about this emphasis on the spatiality of practice, and in particular how this shapes the relationship between practice and critique. This, in turn, links to broader discussions on the necessity of critique within day-to-day practice, however persuasively it seems unnecessary in the face of urgency. The political theorist Wendy Brown argues that criticality: is essential in dark times not for the sake of sustaining utopian hopes, making flamboyant interventions, or staging irreverent protests, but rather to contest the very senses of time invoked to declare critique untimely. If the charge of untimeliness inevitably also fixes time, then disrupting this fixity is crucial to keeping the times from closing in on

58  The rhetoric of urgency: tensions between critique and practice us. It is a way of reclaiming the present from the conservative hold on it that is borne by the charge of untimeliness. (Brown 2005, p.4) In other words, Brown argues that because critical thinking is seen as untimely – in the sense that it is often theoretically based, ‘outside’ of everyday pressures, and appears to have no natural home in the applied professions (outside of certain, highly specific contexts) – one of its main tasks is to challenge the way in which time is presented in this way. For this reason, a key resource for doing this is exploring the rhetorical dimensions of such urgency. Here, I take my lead from Barbara Cassin’s work on the distinction between chronological time and kairotic time. Cassin (2014) argues that within the dominant modes of European thought – and, I shall argue, within neoliberal economies of care specifically – matters of time are modelled and reduced to issues of space. To demonstrate this, I will break down the different aspects of urgency in this context, in order to explore how urgency is not simply the absence of time, but also a mode of decision-making (a rhetoric of logos, or rational proof), a sense of insecurity derived from the complexities of neoliberal care systems (a rhetoric of pathos, or emotional proof), and a particular form of self-creating discipline (a rhetoric of ethos, or proof based on character). Reviewing these rhetorics suggests ways in which the problem of time can be reconceived, not as a linear form of chronological time which is forever receding from the social worker’s grasp, but as a form of opportunity, or kairotic time, which suggests alternative ways of theorising urgency. Urgency and logos: decision-making Perhaps the most straightforward way of understanding urgency within a practice context is to align it with decision-making. Decision-making involves a complicated interaction between theory and practice, through which the latter supersedes the former. In an interview discussing the social analysis of neoliberalism since 1989, postcolonial theorist Dipesh Chakrabarty suggests that when a decision is made, ‘the world intrudes into our thinking as a question of urgency’ (2017, p.90). The more urgent the decision to be made is, the more abrupt this intrusion is. Urgency can ‘cut short’ thinking, Chakrabarty remarks, even if where it stops may be quite arbitrary. For example, in the Health and Care Professions Council (HCPC), which regulates allied health professionals in England (including social workers until the end of 2019), mentioned urgency in its social work education framework only once, under ‘assessment’: a core social work skill is to assess the urgency of a case and prioritise accordingly. In this context, the arbitrariness Chakrabarty mentions is due to urgency being an imposition on a varied and multiple number of questions a social worker could be asking about their assessments: what factors of the client’s context, actions and relationships they have considered out of the infinite differences within

The rhetoric of urgency: tensions between critique and practice  59 practice (a point that Aristotle first made in the Nicomachean Ethics). There is no clear stopping point where theoretical reflection naturally reaches a decision by itself, because there will always be other perspectives to consider, alternative meanings, histories, translations, genealogies and so on. But what is the nature of this imposition of practice into theory? Clearly, urgency does not just impose the recognition of a lack of time, or limited time. Rather, Chakrabarty’s point suggests that the force of urgency is better understood as a specific distance imposed between, on the one hand, assessment decisions made, and on the other, critique or reflection. Understanding urgency in this way moves the discussion beyond any unhelpful equivocation of urgency with simply ‘lack of time.’ Contrary to Chakrabarty’s claim, though, decision-making does not stop theorising altogether; rather, the notion of urgency as a forced decision compels us rather to adopt a certain model of thinking, and agency, which is itself based on perpetuating a certain distance between theory and practice. Perhaps the best illustration of how this distance is produced and maintained can be seen with the application of particular time- and risk-management strategies to local practice, explicitly in order to deal with stress and anxiety borne from an oversaturation of urgency. For example, an article in the online social work magazine Community Care talks about dealing with stress through the management of time. It does this by using the ‘Eisenhower distinction’ between activities which have an outcome that leads to us achieving personal or professional goals (which are ‘important’ activities), and those which demand immediate attention, usually around achieving someone else’s goals (which are ‘urgent’ activities, because the consequences of not doing them are more clearly visible): Go back to understanding “how much” time you can spend on resolving the issue that comes up unexpectedly. Importance and urgency are different and they love to compete. My advice? Manage urgency effectively (i.e. what CAN you do?) and focus on importance (Betts 2015, online). The article makes it clear that urgency is something to be managed, whereas importance is more intuitive: what is ‘important’ is for you to decide (even if the conditions of urgency are rarely the responsibility of the individual). The persuasiveness of this claim is fundamentally rooted in its appeal to an implicit binary between the subject and the object of the discourse. The objective technicalities of the urgent are managed by the subjective appraisal of what is important ‘to you’ (the non-technical, human social worker). In this way, the representation of urgency here draws upon and maintains a familiar set of dichotomies, where one side is privileged as more valuable than the other: object-subject, technical-human, bureaucratic-relational. There are two points of interest around this binary representation of urgency as a form of decision-making. Firstly, the alignment of the urgent with the bureaucratic and technical and the important with the personal risks what political theorist Wendy Brown calls a ‘depoliticisation’ at work in the

60  The rhetoric of urgency: tensions between critique and practice substitution of ‘emotional and personal vocabularies for political ones in formulating solutions to […] problems’ (2006, p.16). Replacing questions of social justice – why does the social worker have to decide between urgent and important in the first place? What resources have been taken away to prompt the decision? – with a therapeutic or behavioural one provides both a rhetoric of empowerment through individualisation, and a consolidation of responsibility on the individual alone. Secondly, and more importantly to the topic at hand, the association of ‘urgent’ issues with measurable, objective markers risks overstating the capacity one has to differentiate ‘urgency’ from ‘importance.’ To put it another way, the distance between decision and critique which this rhetoric insists upon seems to also imply a certain timelessness of critique. The distinction between the urgent and the important heavily implies that the former is allied to time demands, while the latter escapes those demands (and hence, ‘important’ is something distinct from ‘urgent’). If urgency imposes time restrictions, then this can be ‘managed,’ but managed in what time? This implicit binary is often seen in the promotion of theoretical inquiry in practice more generally. The lack of time pressure is promoted, quite rightly, as one of the benefits of theorising. Gray and Webb argue, for example, that the ‘joy of “thinking social work” is in creating alternative modes of understanding through critical engagement with competing perspectives’ (2013, p.7). The problem, however, is that without a clear sense of time at work in critical reflection – conducted in the contexts such as supervisions or university modules, where scenarios can be replayed and revisited, or through the traditional ‘case study’ text-box – we stop paying attention to what we might in fact be bracketing when we bracket time. Indeed, a range of social, material, interpretative and temporal considerations are likely to be ignored in this model of ‘timeless’ case studies. For example, Smith (2008) relates how power in social work can be framed entirely by the notion of ‘lateness,’ and the ways in which this is defined, experienced and justified. Power relations are expressed in the differing ways in which ‘being late’ is dealt with in transactions between agencies, practitioners and service users – who is held accountable, for example. In this way, removing the temporal aspects of an example can lead to a deceptively uncritical analysis, precisely because time can be the hidden carrier of materialities of practice. There are important reasons for understanding these everyday, often fleeting materialities. If there is a distance between the decision and critique or reflection, then the main tool of decision becomes technical, rather than critical or reflective. The routes to ‘managing’ the pressures of urgency are found in assessment tools, decision-making frameworks and so on. As a result, the persuasiveness of this urgency is not as straightforward as a manager telling a social worker to make a decision, or the needs of the service user determining a quick response. Instead, its rhetorical power is embedded within the technological and bureaucratic regimes that allow decisions to be made. The landmark Munro Review of Child Protection in England

The rhetoric of urgency: tensions between critique and practice  61 (2011) identified the way in which a managerial preoccupation with timeliness, recording, procedural compliance, standardised assessment, productivity measurement and risk aversion was detracting from the ‘quality decision-making informed by a relational approach to knowing and doing in social work practice.’ More recently, Madeleine Bunting’s work has argued that the root of the crisis in care lies in a fundamental misunderstanding of what care is, and the efforts to manage it via bureaucratic measures (Bunting 2020). Such technical tools frequently privilege certain kinds of knowledge over and above others: knowledge which serves certain models of government and state control and devalued other possible models of expertise rooted in the ‘ground-level’ workings of everyday wisdoms (Fook 2012). Parton and O’Byrne famously identified this as a distinction between the ‘technical-rational’ and the ‘practical-moral’ approaches to practice (2000, pp.30–31). Healy points out that the ‘dominant discourses’ governing the technical-rational approach to social work, broadly construed – biomedicine, economics and law – are all ‘strongly aligned with Enlightenment ideals of objectivity, rationality, individualism and linear notions of progress. In many health and welfare institutions, these discourses profoundly influence what counts as true, right and rational ways of proceeding’ (Healy 2005, p.18). In this way, it is less the content of the individual tools themselves, and more the epistemological assumptions contained within such techniques of decision-making which shape urgency in practice. This includes, as Healy notes with the ‘linear notions of progress,’ a particular preference for time as abstract chronology. The expectation that objective and rationally progressive techniques would enhance the predictability of outcomes at first appears to help social workers deal with urgency. But as the Munro review demonstrated, in many cases it has ironically promoted another form of urgency as a consequence: that is, they produce an accelerated expectation that the ‘right’ decision will be made. Thus, if the urgency of decision-making imposes a distance between practice and critique, it would seem that the specific distance utilised by technical-rational approaches result in uncertainty, rather than the completion they promise. Correspondingly, there seems to be a link between the need to manage urgency – to keep things moving on time, and to keep social work technically efficient – and the very prevalence of urgency and, indeed, crisis. Urgency and pathos: complexity This leads us on to the next rhetoric of urgency: urgency which emerges as part of the complexity of situating social care in the global world today. Such a rhetoric is a key component of neoliberal care policies, and the effects it has had on social work and social care to date. It should be noted that neoliberalism has become a term denoting the bogeyman of social policy, despite widespread ambiguity over its precise

62  The rhetoric of urgency: tensions between critique and practice meaning. As Andrew Whelan notes, ‘neoliberalisation is not a coherent and tangible force in the world; it is a label ascribed to an unpredictable array of such forces in unpredictable motion’ (2015, p.8). This is not simply a result of academic laziness ascribing everything distasteful about contemporary welfare delivery to the shadowy triumph of something named neoliberalism (although this can certainly happen at some points). Rather, the mutation of classical liberalism into what is now called neoliberalism has taken place by the embracing of deliberate ambiguities. In principle, liberalism is a utilitarian method, and lends itself to utilitarian ethics: rational and calculative based on the ends justifying the means. While liberal capitalism applied economic rationality to markets, neoliberalism applies it to all aspects of life, with the knock-on effect being an assumption – necessary for any economic rationality to make sense – that resources are scarce in all such areas. As a result, if liberalism was laissez-faire, leaving the markets to themselves to be corrected by ‘the invisible hand’ of economic forces, neoliberalism makes specific demands on government – through law, policy and social norms – to enforce the primacy of economic rationality. This, in turn, shapes the individual as an ‘entrepreneurial actor in every sphere of life’ (Brown 2005, p.42), which requires a fundamental state of inequality to exist in order that such entrepreneurial actions can be undertaken successfully. However, late modern capitalism is paradoxically characterised by an excess of anti-rational, anti-utilitarian actions. Risk and short-termism are prioritised over the retreat of government into administration; steadfast growth is replaced with chaos and abrupt change; and, Franco Berardi argues, ‘conditions of info-acceleration and hypercomplexity’ (2012, p.12) mean that the epistemology of prediction and certainty – the technicalrational methods – become dysfunctional within neoliberal governed social care. While the results of this have been documented in hundreds of publications across health, social care and social work research, a further result is that the very term ‘neoliberalism’ has become something of an ogre: it can be invoked to explain so many areas of practice, from managerialism to budgetcutting, from service user complaints to pay freezes, and so on, that it can – and in many cases, has – become a word that simply describes everything that’s not likeable about contemporary care provision. As the anthropologist James Laidlaw argued in a roundtable paper: Neoliberalism also apparently explains changing patterns of parenting in the Caribbean, the sale of fake branded headscarves in various places where Islamism is on the rise, Malay marginalization in Singapore, antihomosexual legislation in Uganda, and educational policy in Morocco. […] So, apparently, everywhere, everything is neoliberal. Obviously this is pretty hopeless. Any concept or theory that purports to explain everything can only be explaining nothing. (Venkatesan et al. 2015, p.912)

The rhetoric of urgency: tensions between critique and practice  63 While we should be careful about dropping the ‘n’ word too freely, at the same time there is a sense in which the complexities of neoliberal economics encourages such a loose rhetoric. If the previous account gives a sense of neoliberalism as an aggressive evolution from the liberalism it followed, the financial crisis of 2008–9 had an acute effect on this. By all accounts, the crisis – which saw an array of austerity measures and cuts to welfare provision introduced across the global north and beyond – should have heralded severe questions of neoliberal mantras. Instead, the opposite happened. Indeed, Mitchell Dean has described the post-2008 forms of capitalism as ‘a rogue neoliberalism’: unanchored from the bases of its own legitimacy by financial crisis, inequality, and rapacity, but somehow drawing upon a well of deep theological resources. […] In terms of cultural diagnostic and imagery, the Weberian “soulnessness” of the Fordist industrial welfare state has been replaced by a low-level confessional civil war between progressivist and fundamentalist neoliberalisms. (Dean 2019, p.327) Here, Dean is arguing that the rogue nature of contemporary neoliberalism means it no longer has a basis, as liberalism did, in the legitimate success of economic rationality (in short, the 2008 crash showed that it is neither costeffective nor does it lead to less governmental interference in our everyday lives). Instead, it relies on rhetorically persuasive terms – the ‘theological resources’ Dean alludes to – which shape discussion and debate about welfare in terms of sacred (thus unchallenged, but also unspecified) terms. In terms of care provision, such terms would include the assumed importance of ‘competition’ amongst care deliverers or ‘efficiencies’ in welfare spending, as well as the language of purity and deservedness that underline fears of, say, immigrants taking up hospital spaces, ‘welfare tourism’ or feckless timewasters taking up sparse resources (see, e.g., Garrett 2018). This translates into a complex urgency on a ground level, as Vassilus Karagkounis (2017) demonstrates. In his work on the post-2008 austerity measures in Greece and its effects on social work, Karagkounis argues that the effects of austerity highlight the shortcomings of medical or functional models of casework at an individual and family level. This, he argues, has fallen short for two reasons. First, the limits are reached when more than a set number of individuals need help (as there is not enough time or resource). Second, the complexity of the broader problems, and the necessity of linking personal welfare with wider economic policies, means that the shortcomings of casework are exposed by austerity measures. While casework may still be helpful for alleviating short-term problems for service users, Karagkounis suggests it is shown up for its shortcomings. Despite these inevitable variations [of austerity], the impact of neoliberal policies poses a significant challenge to social workers in terms

64  The rhetoric of urgency: tensions between critique and practice of effectively responding to rapidly changing socioeconomic conditions and to complex and deepening problems that many individuals, families and communities face. (Karagkounis 2017, p.652) Urgency thus manifests itself in two ways beyond a mere lack of resources. Firstly, individual ‘cases’ are harder to separate from the broader changes around them. As the economies of states become increasingly interdependent, Stanford (2010) has argued that risk is used within neoliberal societies to mobilise fear as an emotive medium for advancing the values of safety and security. As a result, how social workers view themselves: has become dominated by the legions of polarised identities that cumulate around notions of risk—dangerousness and vulnerability, independence and dependence, responsibility and irresponsibility, trustworthiness and untrustworthiness, culpability and innocence. Within this analysis, overwhelming fear operates as a core constituent for defining the personal experience of risk within contemporary society. (Stanford 2010, p.1066) Secondly, the almost unfathomable complexity of the neoliberal economic field results in a range of competing insecurities which effectively hold up and support the delivery of government. This prompts a rhetorical sense of urgency specifically rooted in how social movements have attempted to respond to the current world economic order. That is the need for a noncomplex, often binary response: the good versus the bad. In short: urgent situations call for urgent answers, and complexity can often slip. On a broader scale, Berardi argues that the more complex the world, the more urgent the desire to see a really good good guy, or really bad bad guy; an aggressive desire for identity to fill the void where traditional heroism has been unable to sustain itself in late capitalism (Berardi 2015, p.5). The pathos of this rhetoric has a knock-on effect for the relationship between theory and practice in Karagkounis’ work, where he argues that the return to critical social work, or the Global Social Work Agenda, is the only route to resist austerity. But the point of ‘urgent complexity’ is precisely that a clear practical solution will not simply appear in neat and representative ways, however ‘critical’ they may be. The urgent need for a ‘good’ response risks falling into the trap of what I once termed the problematic need for ‘answers’ in social work theory (Grimwood 2016, p.185), whereby the expectation of single theories to provide both critique and solutions, in isolation from other theories and views, creates an artificial ‘view from everywhere’ which leaves the distillation of theories through everyday temporality, and the role of this in the persuasiveness of urgency, to one side.

The rhetoric of urgency: tensions between critique and practice  65 Urgency and ethos: discipline What is at stake in leaving this to one side, though? In his later work, Foucault (1997, 2008) uses the ancient Greek term askēsis to discuss how the self is exercised and trained and, through such training, transformed. For Foucault, this ancient emphasis on ‘taking care of oneself’ has been superseded by the drive to ‘know oneself’ (McGushin 2007, p.31), resulting in the taking for granted of relationships between power, subjectivity and truth. However, it could well be argued that this originary notion of an ethical transformative ‘training’ of the self has been core to health and social care throughout its history. This can be seen perhaps most directly in social work: before the advent of the welfare state, health and social care was based on voluntary provision, and the development of a service user’s ‘character’ as a temporal unfolding was fundamental to the moral idealism of the Charity Organisation Societies of the late 19th century in England. Working with the hidden depths of the self was key to the shift to psychoanalytic approaches to social work in the interwar period, alongside the growth of the ideas of rehabilitation (rather than maintenance) of the elderly and disabled. In the 1970s, enabling ‘self-actualisation’ was a key mantra of the therapeutic turn in social work, alongside the move towards enabling independent living over and above domiciliary care in the social care sector generally. Today, the space for self-shaping is seen in the longstanding tension between personcentred practice and models of casework, often in conflict with ecological and intersectional approaches that draw on critical engagements with the wider structures of society. The neoliberal context in which these models compete is itself built less on an explicit ideology, and more on a number of techniques of self-shaping which model service users and service delivers as economic agents. Foucault famously talks of the neoliberal subject emerging as an ‘entrepreneur of himself’ (2008, p.226), through the practices of ‘normative reason’ embedded within neoliberal policies (Brown 2015, p.30). Understanding these as fundamentally ethical practices – that is to say, contributing to a persuasiveness based on the ethos or ‘self’ within an argument – provides a ground on which to consider the ways in which the theory-practice division manifests itself within the current context of neoliberal social care. In 1981 Margaret Thatcher ominous declared that: ‘economics are the method; the object is to change the heart and soul.’ (Butt 1981) The effects of this change on hearts and souls is documented by Berardi, who notes that social psychology has ‘remarked that two pathologies are of great actuality in these last decades of liberalist hyper-capitalism: panic and depression’ (2009, p.100). Once, the problem of social relations was alienation. Now, Berardi argues, the problem is over-connection. Along similar lines, the psychologist Jeff Sugarman has worked specifically on the ways in which the urgency of neoliberalism affects the psyche. He writes:

66  The rhetoric of urgency: tensions between critique and practice In neoliberalism, governing occurs by providing individuals with choices and holding them accountable for the choices they make. However, many of the life choices with which individuals are now faced are the result of reduced government services that, in effect, transfers risk from the state to individuals. Risk and uncertainty are nothing new. But, in the climate of neoliberal economics, there is less and less separating those who pursue risk intentionally for profit, from the rest of us for whom it is being woven ideologically into the fabric of everyday life, whether it is matters of personal health, the care and education of our children, the increasing unpredictability of employment, or dignity in old age. Along with increased risk, the current emphasis on choice, autonomy, and self-reliance insinuates failure as self-failure, for which one is expected to bear sole responsibility. There is diminishing appreciation that individuals’ predicaments are a product of more than simply their individual choice, and include access to opportunities, how opportunities are made available, the capacity to take advantage of opportunities offered, and a host of factors regarding personal histories and the exigencies of lives. (Sugarman 2015, p.105) This collapsing of the private and public self suggests that we cannot simply turn to practice or reality to escape what urgency does to theory. As Matko Krce-Ivančić argues, ‘anxiety relentlessly reminds the neoliberal subject that she has not yet done enough on herself,’ (2018, p.263) and as such is not simply a side effect of the disciplinary processes, but is in fact key in establishing what he terms ‘neoliberal subjectivity’ (p.274). Individuals are left to themselves, but are still ‘overseen’ through the establishment of fields of power and practice. In the UK, this has been seen profoundly with the personalisation agenda, whereby service users are given private budgets to have autonomy over their care. But the problem is that the time it takes for state services to be withdrawn is quicker than new services take to be created; hence Burton comments that ‘“Personalisation” is a bureaucratic word for a bureaucratic response to the political failure of social care’ (Burton 2010, p.301). In such cases, the chronology of self-development forms a core part of the disciplinary persuasiveness of the entrepreneurial self; a sense of time which is, however, impossible to fulfil. Hence, for Ehrenberg depression develops ‘after the disciplinary behavioural models and the rules of authority… that assigned a destiny to social classes and gender collapsed faced with the new norms pushing each and everyone to individual action, forcing individuals to become themselves.’ He goes on: ‘the responsibility of our lives is now fully assigned to each of us. Depression manifests itself as pathology of responsibility, dominated by the feeling of inadequateness’ (cited in Berardi 2009, p.99). The issue is not simply responsibility but, as Burton’s point illustrates, the erosion of the time in which to carry out these responsibilities. This also carries through to the capacity of professions to ‘think critically’ in the conventional

The rhetoric of urgency: tensions between critique and practice  67 senses in which the more canonical representatives of the Frankfurt School or radical social theorists proposed. In his final lectures before his death, Mark Fisher discusses this in terms of the command of critical theory to ‘raise consciousness’ about (and against) the systems surrounding our social actions. Raising consciousness requires time (Fisher suggests universities traditionally provided this time), but neoliberalism thrives on what he refers to as forms of ‘time poverty,’ a scarcity of energy and resource that is easily relatable: Say you’ve done your day of work and then you go home. Are you going to leave the house now? I’m tired! Then you’ve done a double day of work – you’ve done a full day of work and then you’ve done domestic work on top of that, which is still overwhelmingly done by women more than men. So, you’ve done that, then do you want to go out and raise your consciousness? Yeah, OK, but… I’m kind of tired… (Fisher 2021, p.132, emphasis original) We might add to Fisher’s observation that the time poverty is not just the result of neoliberal working practices; there is also a certain panic inspired by the sense of a need to act responsibly, to be critical, to find solutions to the systems undermining those thinking processes. In such cases, reaffirming the mantras of critical theory – that neoliberalism suppresses critical consciousness, for example – can be equally problematic. Rethinking time: from chronos to kairos The point of this chapter is not, however, to repeat the well-worn critiques of neoliberal self-shaping. Rather, its analysis has pointed to three rhetorical dimensions of urgency. These have been aligned schematically with three forms of persuasion (rational, emotional and character-led). These are, of course, frequently interlinked: Sugarman and Berardi demonstrate how neoliberal disciplining interweaves rationality, emotional response, and models of the self. For example, the requirement on a social worker for meeting targets may appear to be the domination of a logical argument; however, it tends to elicit both pathos responses and ethos (as the BASW 80/20 report found, the space in which the social worker has to complete bureaucracy requires a change in character, or change in assumption of self). But linking all of these dimensions of urgency is the conception of time as chronological, and its centrality to the tensions these forms of persuasion reveal. In summary, discourses of urgency are dominated by a linear form of time that can be measured and quantified, such that the demands of time rest within corresponding forms of knowledge and practices of knowing; which, in turn, conflict with the everyday mediation of time in practice which is often obscured. Classical rhetoric employed two concepts of time: chronos, which was linear, measurable time, and kairos, which was a more situational kind of time, perhaps close to ‘opportunity’ or ‘opening’ in English.

68  The rhetoric of urgency: tensions between critique and practice A Kairos-based discourse does not seek certainty prior to writing, but rather views writing and speaking themselves as opportunities for exploring issues and making knowledge. A rhetoric that privileges Kairos as a principle of invention does not present a list of rules… but rather… is not only attuned to the history of an issue (chronos), but is also aware of the more precise turns the arguments surrounding an issue have taken and when they took these turns. (Crowley and Hawhee 1999, p.35) Kairos thus refers to a ‘timely or appropriate moment.’ This concept was largely neglected in the European Enlightenment, as it was not well-suited to the rational and predictable grounding of modern knowledge. A ‘passing instant’ is not teachable, and at odds with the planning, strategising and management of technical processes; the ‘rupture’ of a situation, the sudden emergence of a ‘right’ or ‘wrong’ time defies the predictability of systems and logical explanations. The space-time configuration of kairos offers a different lens for thinking about urgency. The idea of opportunity or moment seems perhaps one way of countering the urgency of calculation and measured chronos, without relying on a disciplinary territorialism built upon binary oppositions – social worker/health worker, theory/practice and so on. Too often, this binary opposition is implicit in the call for a more embodied and dynamic model of social work – such as the ‘technical rational’ versus the ‘practical moral’ of Parton and O’Byrne – which, I have argued, can bracket temporal issues that obscure some important material aspects of practice. Two examples may help to suggest how kairotic time translates into social work, in light of the previous three ways in which urgency is persuasive in determining the relationship between theory and practice. 1 Ian Hyslop proposes the idea of social work offering an ‘in-between’: social work provides a ‘socially configured understanding’ arising ‘from the practice of social work in the space between the poor and the powerful’ (2018, pp.20–21). This knowledge, Hyslop argues, furnishes social work with a distinctive ‘identity claim.’ As an example of this in action, Hyslop cites ‘a very experienced and inter-personally flexible hospital social worker who spoke of working with multiply disadvantaged people so that they are not “lost”, [and] described explaining the need to record social history with a client in order to humanise individuals within the wider clinical system.’ The social worker said: …we’re doing this because it’s really important in the hospital notes that you’re not seen as just a diagnosis or a number – that you’re seen as a person who’s got kids and that…It always works, but I do mean it genuinely. This is one example of what Hyslop argues shows ‘social work occupies an intermediate location’ (p.27); a focus on juggling, balancing, bridging and relationships, within the confines of systems built on the urgent

The rhetoric of urgency: tensions between critique and practice  69 requirement to increase efficiency. While Hyslop – as other writers have – insists on the intermediacy of location and spatiality, this invocation of historical time opens up an important aspect of the in-betweenness he describes. 2 As we have seen, in his work on austerity in Greece, Karagkounis argues that his preferred response is to ‘revive the radical tradition of social work.’ He argues that this is ‘a necessity of our times; social work owes it as much to itself and its foundational values of equality and justice as it does to its citizen clients’ (2017, p.652). Here, Karagkounis follows a general characteristic of critical social work writing, by calling on particular histories of social work: not simply as a descriptive account of how we got to be where we are, but also as a motivational device to inspire the ‘critical’ aspect of social work practice (one sees something similar in Ioakimidis et al.’s work comparing austerity in Greece, Portugal and Spain (2014); or more broadly in Michael Reisch’s historical accounts of social work (2002), which has been criticised precisely for its over-emphasis on social work’s radical contribution to society at the expense of its more humdrum, or less effective, components). While these are both examples of social work using temporal stories – of the client, or of the profession – the point of their success is not their chronological rhetoric. Simply reminding a hospital that a client has a history is not effective in itself, and neither is Reisch’s history always accurate. The point is not that they are temporal, but that they are timely. This timeliness – knowing when to speak of the radical history of social work, knowing when to insert the client’s social history into their hospital management – seems to be key to the in-between-ness that Hyslop describes; but also something that does not necessarily commit the social worker to a ‘practical-moral’ position outside of the technicalities of assessment and so on. It is view of time that is about opportunity and meeting in the moment – time in the form of kairos – rather than simply escaping the ordered and functional demands of time. Kairos and critique The principle of a kairotic care does not, of course, provide immediate answers to the multiple problems that the rhetoric of urgency poses in and of itself. As the rhetorician Kelly Myers notes: Teaching kairos […] poses many challenges, as the concepts tend to operate in non-rational, mind-body spaces that vary from person to person and moment to moment. Guidelines can be established for navigating opportunity and learning from regret, but the [concept] of kairos […] [loses its] force when removed from the context of a specific moment of action. (2011, pp.10–11)

70  The rhetoric of urgency: tensions between critique and practice For sure, there have been advocates for kairotic approaches to health and care practice that sometimes appear as textbook practice guides. Take Tsang’s insistence, for example, that practitioners ‘need to work with “time within time”, be conscious of clients’ sense of time, know what to do as well as what not to do at the appropriate time’ (2008, p.131). This all sounds great, and Tsang’s argument on the importance of time for practice wisdom is well-made. But the natural question it raises is whether this simply amounts to ‘doing the right thing’ without attending to the other commitments this might involve: not just the time of the client, but the time of the professional, of the profession, of the manager, and the different ways in which all of these are attuned to each other via different relationships, media, voices and surfaces. In other words, the problem remains as to how such ‘time within time’ critically accounts for itself, without collapsing into simply feeling good about something one has done. The error of drawing on kairos for a kind of instructional mode is that it risks perpetuating the problem of time we began with. If the need for an immediate answer to the question ‘how is kairotic time incorporated into critical thinking?’ stems from a rhetoric of urgency which already pushes the answers towards certain divisions between theory and practice, or management and delivery, this is precisely where more time needs to be taken to consider what kind of ‘answer’ is appropriate. There is a need to separate, on the one hand, timeliness as something that draws more attention to the material impacts of, and impacts on, the sense of time in care delivery; from, on the other hand, simply a sense of ‘being in the moment’ without any critical attention to how such a moment is constructed. What kind of criticality does kairos offer, then? On the one hand, the kairotic moment is by default a critical moment, given that it interrupts the present as a present. Kumagai and Naidu refer to kairos as a ‘critical moment’ within medical education, and they employ a fairly traditional model of what this ‘criticality’ looks like: placing one’s ‘taken-for-granted beliefs, and unconscious biases under a penetrating gaze that allows for a clearer perception of what is truthful or just’ (2020, p.516). But, on the other hand, they also acknowledge that this is not a competence-based criticality, and rather a ‘sensibility’ that ‘exists in the space in between knowledge, skills, observable acts, values, and competencies’ (p.516). This is a significant observation, I think, for two reasons. First, the idea of a sensibility (rather than a skill, competency, or some other training method) is reflective of many arguments within the post-critical turn described in Chapter 1. Following these arguments, it is important to draw a distinction between how one critically recognises unconscious bias or beliefs in a kairotic moment from the more standard ‘critical’ approaches. The latter tends towards logical sequencing of representative categories, which are usually very obvious when framed in that form. Every professional, after all, knows that it is wrong to be racist. But this does not stop less obvious manifestations of bias forming in the day-to-day flow of practice. The kairotic moment, as

The rhetoric of urgency: tensions between critique and practice  71 we have seen, can provide an opportunity to question the flows of practice that would otherwise leave such biases unquestioned. It is a reorientation of the self (Cassin 2014, p.88), based on an opportunity that may arise accidentally from a conversation, a feeling of unease, a reaction to a decision made, or other forms of intuition that open up a moment as significant to those involved, but are not typically included in critical thinking methods. The second significant point about Kumagai and Naidu’s observation is their emphasis on dialogue as a way of uncovering the kairotic aspects of practice. Examples from practice often involve verbal conversation – finding the route ‘in’ to understanding a service user perspective that manages to bridge the urgencies of practice with the urgencies, dependencies or banalities of the life of the service user (see, e.g., Natland 2015; Cabiati and Levy 2020). Hence, Kumagai and Naidu write of finding ways to explain about chronic care using aspects of the service user’s life that are meaningful to them, but may not be obvious without open and creative conversation (their example is exploring blood-testing with Type 1 diabetics: where a kairotic dialogue may focus on the rhythm of blood-testing to a diabetic jazz musician, whereas for an engineer it may involve talking through the technology of data capture). While dialogue is key to the kairotic encounter, there is a risk here of slipping away from the significance of the ‘critical moment.’ For, as we have already seen, we are in constant dialogue, not only with the person in front of us, but with a whole range of urgencies, pressures and persuasions that are rooted in the very identity of the professional. Kairos, according to Hawhee, marks the ‘emergence of a pro-visional subject, one that works on – and is worked on by – the situation’ (2002, p.19). So it is not just a moment which ‘we’ seize – in the classic neoliberal mantra – but rather one that mediates subject and context, time and place. Or, in Flanagan’s words: Rather than being limited to the commonplaces [topoi] by which someone might be required to speak if they seek to ‘fit-in’, these grounds might instead be oriented by or extended to considerations of the ‘stand-out’ decisive moment [kairos] where something is in fact said. (Flanagan 2022, p.759) As such, it is important to be careful that the potential benefits of dialogue do not replicate the same ideas of who or what the individuals involved in those conversations are (as Flanagan puts it, the ‘commonplaces’ of conversation). As we have seen, neoliberal chronology emphasises the crisis of individual decision regarding the distribution of time within space. Kairos, meanwhile, focuses on the broader fluctuating interactions between individual and context that disrupt such a spatial emphasis. This is not a therapeutic ‘escape’ from the spatialised temporality of practice, which suggests the construction of some new space ‘outside’ the present. Rather, it is a momentary opportunity in which the organisation of space and territory within

72  The rhetoric of urgency: tensions between critique and practice practice is ruptured and opens up alternative configurations of significance, if only in passing. Reconceptualising the persuasiveness of urgency in terms of the timeliness of moments is a step towards avoiding the distancing of critique and practice in the way the conventional chronological sense of time provokes, especially in contexts of urgency. Furthermore, it offers a route into a number of conceptual approaches that might continue a constructive dialogue between the  care professions and rhetoric. But this also raises other questions for the prospect of post-critical thinking in practice: specifically, how we situate the individual within those encounters, and how important the concept of individual autonomy is to the practice of criticality. References Asquith, S., Clark, C. and Waterhouse, L. (2005). The Role of the Social Worker in the 21st Century: A Literature Review. Report commissioned by the Scottish Executive. Banks, S. (2012). Ethics and Values in Social Work Practice. Basingstoke: Palgrave MacMillan. Berardi, F. (2009). The Soul at Work: From Alienation to Autonomy. Trans. Cadel, F. and Mecchia, G. Los Angeles, CA: Semiotext(e). ———. (2012). The Uprising: On Poetry and Finance. Los Angeles, CA: Semiotext(e). ———. (2015). Heroes: Mass Murder and Suicide London: Verso. Berlant, L. (2011). Cruel Optimism. London: Duke University Press. Betts, Z. (2015). ‘“Clarity from the Chaos”: Tips for Time Management in Social Work.’ Community Care. Available at: https://www.communitycare.co.uk/2015/07/28/ clarity-chaos-tips-time-management-social-work/ Boland, T. (2019). The Spectacle of Critique. London: Routledge. Borneo, A., Castro-Ayala, A., Dalrymple, A., Knape, J., Maynard, E., McIlroy, R. and Turnbull, L. (2022). UK Staffing for Safe and Effective Care: State of the Nation’s Nursing Labour Market. Royal College of Nursing Biannual Report. Available at: https://www.rcn.org.uk/Professional-Development/publications/ staffing-for-safe-effective-care-labour-nursing-market-2022-uk-pub-010-108 Brown, W. (2005). Edgework. Princeton: Princeton University Press. ———. (2006). Regulating Aversion: Toleration in the Age of Empire. Princeton: Princeton University Press. ———. (2015). Undoing the Demos: Neoliberalism’s Stealth Revolution. London: Zone Books. Bunting, M. (2020). Labours of Love: The Crisis of Care. London: Granta. Burton, J. (2010). ‘“Call It Personalisation If You Like”: The Realities and Dilemmas of Organising Care in a Small Rural Community.’ Journal of Social Work Practice, 24:3, pp.301–313. Butt, R. (1981). ‘Economics are the Method: The Object is to Change the Soul: Interview with Margaret Thatcher.’ The Sunday Times, 3rd May. Available at https://www.margaretthatcher.org/document/104475 Cabiati, E. and Levy, S. (2020). ‘“Inspiring Conversations”: A Comparative Analysis of the Involvement of Experts by Experience in Italian and Scottish Social Work Education.’ British Journal of Social Work, 51:7, pp.487–504.

The rhetoric of urgency: tensions between critique and practice  73 Carter, C. (2020). ‘Budget: £5bn for Coronavirus will Help Social Care but Government Criticised for Lack of Sector Funding.’ Community Care. Available at: https://www.communitycare.co.uk/2020/03/11/budget-5bn-coronavirus-includessupport-social-care-government-criticised-lack-action-sector-funding/ Cassin, B. (2014). Sophistical Practice: Toward a Consistent Relativism. New York, NY: Fordham University Press. Chakrabarty, D. (2017). ‘Postcolonial Criticism after 1989: A Conversation with Gal Kirn and Marian Burchardt.’ In Burchardt, M. and Kirn, G. (eds.), Beyond Neoliberalism: Social Analysis after 1989. Basingstoke: Palgrave MacMillan, pp.83–93. Crowley, S. and Hawhee, D. (1999). Ancient Rhetorics for Contemporary Students. London: Allyn and Bacon. Dean, M. (2019). ‘Rogue Neoliberalism, Liturgical Power, and the Search for a Left Governmentality.’ The South Atlantic Quarterly, 118:2, pp.325–342. Donovan, J., Rose, D. and Connolly, M. (2017). ‘A Crisis of Identity: Social Work Theorising at a Time of Change.’ British Journal of Social Work, 47:2, pp.2291–2307. Ferguson, I. and Lavalette, M. (2013). Crisis, Austerity and the Future(s) of Social Work in the UK. Bristol: Policy Press. (2021). Post Capitalist Desire. London: Repeater Books. Flanagan, T. (2022). ‘Standing-out and Fitting-in: The Acoustic-Space of Extemporised Speech.’ Journal of Intercultural Studies, 43:6, pp.758–772. Fook, J. (2012). Social work: A Critical Approach to Practice. London: Sage. Foucault, M. (1997). Ethics: Subjectivity and Truth. New York, NY: The New Press. ———. (2008). The Birth of Biopolitics: Lectures at the College de France. Trans. Burchall, G. Basingstoke: Palgrave Macmillan. Garrett, P. (2013). Social Work and Social Theory. Bristol: Policy Press. ———. (2018). Welfare Words: Critical Social Work and Social Policy. London: Sage. Gea-Sánchez, M., Briones-Vozmediano, E., Legido-Quigley, H., Muntaner, C., Rocaspana, M. and Blanco-Blanco, J. (2019). ‘The Resistance of Nurses to Austerity Measures in the Health Sector during the Financial Crisis in Spain.’ Gaceta Sanitaria, 35:1, pp.42–47. Gray, M. and Webb, S. (2013). ‘Introduction.’ In Gray, M. and Webb, S. (eds.), Social Work Theories and Methods. London: Sage, pp.1–10. Green, L. C. (2006). ‘Pariah Profession, Debased Discipline? An Analysis of Social Work’s Low Academic Status and the Possibilities for Change.’ Social Work Education, 25:3, pp.245–264. Grimwood, T. (2016). Key Debates in Social Work and Philosophy. London: Routledge. Hawhee, D. (2002). ‘Kairotic Encounters.’ In Atwill, J. and Lauer, J. (eds.), Perspectives on Rhetorical Invention. Knoxville: University of Tennessee Press, pp.16–35. Healy, K. (2005). Social Work Theories in Context: Creating Frameworks for Practice. Basingstoke: Palgrave. Hicks, S. (2016). ‘Theory and Social Work: A Conceptual Review of the Literature.’ International Journal of Social Welfare, 25:4, pp.399–414. Houston, S. (2014). ‘Meta-Theoretical Paradigms Underpinning Risk in Child Welfare: Towards a Position of Methodological Pragmatism.’ Children and Youth Services Review, 47:1, pp.55–60.

74  The rhetoric of urgency: tensions between critique and practice ———. (2019). ‘Theorizing Social Work in the Domains of Culture, Politics and Society.’ In Payne, M. and Reith-Hall, E. (eds.), The Routledge Handbook of Social Work Theory. London: Routledge, pp.55–67. Hyslop, I. (2018). ‘Neoliberalism and Social Work Identity.’ European Journal of Social Work, 21:1, pp.20–31. Ioakimidis, V., Cruz Santos, C. and Martinez Herrero, I. (2014). ‘Reconceptualizing Social Work in Times of Crisis: An Examination of the Cases of Greece, Spain and Portugal.’ International Social Work, 57:4, pp.285–300. Jopkke, C. (1987). ‘The Crisis of the Welfare State, Collective Consumption, and the Rise of New Social Actors.’ Berkeley Journal of Sociology, 32, pp.237–260. Karagkounis, V. (2017). ‘Social Work in Greece in the Time of Austerity: Challenges and Prospects.’ European Journal of Social Work, 20:5, pp.651–665. Krce-Ivančić, M. (2018). ‘Governing through Anxiety.’ Journal for Cultural Research, 22:3, pp.262–277. Kumagai, A. and Naidu, T. (2020). ‘On Time and Tea Bags: Chronos, Kairos, and Teaching for Humanistic Practice.’ Academic Medicine, 95:4, pp.512–517. McBeath, G. and Webb, S. (2002). ‘Virtue Ethics and Social Work: Being Lucky, Realistic and Not Doing One’s Duty.’ British Journal of Social Work, 32, pp.1015–1036. McGushin, E. (2007). Foucault’s Askesis: An Introduction to the Philosophical Life. Evanston, IL: Northwestern University Press. Munro, E. (2011). The Munro Review of Child Protection: A Child-Centred System. Report commissioned by the Department of Education, British Government. Myers, K. (2011). ‘Metanoia and the Transformation of Opportunity.’ Rhetorical Society Quarterly, 41:1, pp.1–18. Natland, S. (2015). ‘Dialogical Communication and Empowering Social Work Practice.’ Journal of Evidence-Informed Social Work, 12:1, pp.80–91. Palese, A., Vianello, C., Cassone, A., Polonia, M. and Bortoluzzi, G. (2014). ‘Financial Austerity Measures and their Effects as Perceived in Daily Practice by Italian Nurses from 2010 to 2011: A Longitudinal Study.’ Contemporary Nursing, 48:2, pp.168–180. Parton, N. and O’Byrne, P. (2000). Constructive Social Work: Towards a New Practice. Basingstoke: Palgrave. Reisch, M. (2002). The Road Not Taken: A History of Radical Social Work in the United States. London: Routledge. Scott, B. (2020). ‘Argumentation and the Challenge of Time: Perelman, Temporality, and the Future of Argument.’ Argumentation, 34, pp.25–37. Smith, R. (2008). Social Work and Power. Basingstoke: Palgrave MacMillan. Stanford, S. (2010) ‘ “Speaking Back” to Fear: Responding to the Moral Dilemmas of Risk in Social Work Practice.’ British Journal of Social Work, 40:4: pp.1065–1080. Sugarman, J. (2015). ‘Neoliberalism and Psychological Ethics.’ Journal of Theoretical and Philosophical Psychology, 35:2, pp.103–116. Tanner, C. (2010). ‘Transforming Prelicensure Nursing Education: Preparing the New Nurse to Meet Emerging Health Care Needs.’ Nursing Education Perspectives, 31:6, pp.347–353. Tsang, N. (2008). ‘Kairos and Practice Wisdom in Social Work Practice.’ European Journal of Social Work, 11:2, pp.131–143. UNISON. (2019). Social Work at Breaking Point. Available at: https://www.unison. org.uk/content/uploads/2019/06/Social-work-at-breaking-point.pdf

The rhetoric of urgency: tensions between critique and practice  75 Venkatesan, S., Laidlaw, J., Eriksen, T. H., Martin, K. and Mair, J. (2015). ‘The Concept of Neo-liberalism has Become an Obstacle to the Anthropological Understanding of the Twenty-first Century.’ Journal of the Royal Anthropological Institute, 21:4, pp.911–923. Whelan, A. (2015). ‘Academic Critique of Neoliberalism.’ SITES: New Series, 12:1, pp.1–25.

3

Autonomy, critique and consensus

Traditionally, autonomy is not only a significant aspect of decision-making in practice for both service users and practitioners, but also a core aspect of the ‘self-rectifying’ core of many models for critical thinking. As Mejía and Molina suggest, while a range of approaches to critical thinking have emerged over the past few decades, the criticality idea is inevitably entwined with that of autonomy, even if only in a partial, fragmented, or relative way […]. Criticality will presumably help us not to be compelled to believe or act in particular ways defined not by ourselves but by others – or by no one in particular – by making us aware of alternative ways of believing or acting and their implications. (2007, pp.409–410, emphasis original) Where does the malaise of critical thinking leave the concept of autonomy, then? This is not a straightforward question to answer, because the concept of autonomy in the context of health, social care and social work is rarely based on a single definition. Instead, it is constructed from several interlinking aspects. Politically, to exercise autonomy is to claim authority over one’s own actions; it is a right to self-determination and self-governance, rooted in the Greek autos (self) and nomos (laws). Physically, to exercise autonomy is the freedom to initiate one’s own actions; an independence from the constraints or supports of others. Morally and intellectually, autonomy is crucial to the capacity not only to act according to one’s own reasoning, and not under external influence, but also, in the Kantian tradition of moral philosophy at least, to follow rational, universal moral laws. In professional practice, all three are realised, and in being realised in practice, the key point is that autonomy does not simply describe particular actions, behaviours or choices made, but rather a particular way in which the authority to act, behave and choose is exercised. More importantly, these ways are not necessarily supported by consistent, or even coherent, conceptual grounding. Therefore, while we might find a plethora of debates on the meaning of autonomy within bioethics, those arguments are typically based on legal or moral cases DOI: 10.4324/9781003123583-4

Autonomy, critique and consensus  77 for whether an individual has autonomy under that definition, rather than how autonomy relates to critical thinking as an aspect of practice itself. While this means that the concept of autonomy will always be to some extent dependent on the professional context it is invoked within, it also means that the concept itself (as deployed in practice) is an assemblage of different gears and mechanisms, some rooted in practice-based contexts, some rooted in the broader philosophical history of the term. In some traditions, this might be seen as a consequence of the ‘hybrid’ or ‘interest-driven knowledge’ of professional practice (Wilson et al. 2019, p.86), whereby partially-realised concepts are picked up and used in response to specific situations. As a result, this dynamic use of autonomy – core to practice, yet elusive to define  – gains its validity from an interpretative consensus that gives it meaning as a recognised commonplace. Indeed, in such cases, this consensus approach to practice-based concepts of autonomy is entirely fitting. This is less because, as Saad (2018) argues, a fully-fledged philosophical treatment of autonomy brings potentially unwarranted complex baggage, but more because, as we will see, critical autonomy emerges from sets of specific relations, and as such it is important that the concept is somewhat mobile to allow for the shifting dynamics of those relations (rather than insisting on, say, the walled-up categories of ‘liberal humanism,’ ‘emancipatory individualism’ and so on for the sake of textbook tidiness). At the same time, though, the current mobility of the concept, and its invocation in much of the professional literature, can have unhelpful or obscurant rhetorical effects. For example, while humanist, individualist conceptions of critical thinking are often positioned as an alternative to biomedical perspectives (Kahlke and Eva 2018, p.160), there are broader socio-political emphases on the value of autonomy which can affect the extent to which the social dimensions of care can be identified and understood. Walter Lorenz has noted that prioritising individual decision-making reflects the prevailing neoliberal policies in welfare, which leads to the decline of what he calls ‘the social question’ of care (Lorenz 2016). More than just decision-making, Duschinsky et al. argue that such individualism dominates the notion of practitioner thinking as a whole: Though there are some exceptions […], an overemphasis on individual, objectifying reflexivity as the primary kind of thinking for practitioners can be seen in many books and texts written for practitioners. Yet this may support a divide between feelings of helplessness in everyday practice and fantasies of reflexivity as holding out power and solutions. (Duschinsky et al. 2016, p.45) Whereas in some educational literature autonomy is directly linked to the ability of the practitioner to think critically in order to take actions related to a service user’s care, the inevitable entwining that Mejía and Molina describe means that this criticality cannot – and should not – be separated

78  Autonomy, critique and consensus from the broader rhetorics of practice, and the ways in which these shape the exercising of authority. As such, in this chapter I want to sketch out a narrative regarding the relationship between autonomy and critique that underlies the more prominent discussions on autonomy as a right or principle, and explores how this might be reimagined in terms of a reinvigorated approach to interpretative critique. A loose consensus: autonomy as ‘good’ On some definitions autonomy is defined as ‘self-rule’ (Dworkin 1989), meaning the independence of choice, free from the manipulation of others, and the capacity, physically and mentally, to rule oneself. While all three of these aspects link autonomy with independence, the two are not the same. Technically, the opposite of autonomy is heteronomy (subjection to another), whereas the opposite of independence is dependence (which refers to a relationship of need) (see Rasmussen 2011). However important the autonomy of an action or decision, in the context of health and social care it is always positioned in a context of dependency: a set of relations that either provide the need for the act or decision to be made in the first place or the consequences of such an act on a range of relations. This can be seen most clearly in the ways in which professional bodies identify autonomy: the British Medical Association suggests ‘autonomy is usually expressed as the right of competent adults to make informed decisions about their own medical care’ (2020). Autonomy is one of the four main ethical principles of clinical ethics, where ‘disclosing medical information and treatment options’ are core to ensuring a service user’s ‘self-determination’ (Varkey 2021, p.19). The Social Care Institute for Excellence (SCIE) defines autonomy as ‘making your own decisions – big and small – about your own life. By extension, it means being supported (if you need and want support) and informed (if you need and want information); but not influenced, manipulated, ignored or bullied.’ Social Work England’s professional standards emphasise the importance of working with people to ‘enable full participation in discussions and decision making,’ a continuation of the earlier British Association of Social Worker’s code of ethics that social workers should ‘support people to reach informed decisions about their lives and promote their autonomy and independence, provided this does not conflict with their safety or with the rights of others’ (BASW 2012, p.12). As excerpts from professional standards, these statements intend to be broad in scope. Nevertheless, there is still something instructive about the way in which they merge together ‘informed decisions,’ ‘autonomy,’ ‘independence’ and ‘safety.’ Running autonomy and independence together utilises two different concepts: positive freedom, the right to nurture and grow self-determination, and negative freedom, independence within the limits of encroaching on other’s self-determination. But this is not the only balancing act at work in the space of professional autonomy. Implicit in these

Autonomy, critique and consensus  79 professional uses is a further idea of autonomy, which reflects the practitioner’s ability to act on such values in the first place. Indeed, the importance of autonomy as a social work value emerges from the professional status of the role. For example, in Robison and Reeser’s Ethical Decision-Making and Social Work (2000), autonomy appears as a kind of brokering skill between the social worker’s duties to an employer (the state, the agency, etc.) and the duties to the service user, which may conflict in ways more pronounced than other health professions (Carpenter et al. 2003). For Parrott, more generally ‘professional autonomy remains important […] as social workers have to apply and interpret policy in relation to individual cases’ (2014, p.46). In this context, it is perhaps no surprise that autonomy often figures in social work literature in discussions of supervision; both Munro (2011) and the Social Work Reform Board (2012) in the UK looked to professional supervision to protect the reflective space necessary for practitioners to assess their ‘critical consciousness’ (Bransford 2011). This relationship between a professional’s autonomy in the field, and the management of risk accompanying this reflects a tension between the selfgovernance a practitioner has in order to make informed and immediate judgements, and the broader institutional and legal governance their practice sits within. It is of note that this complex sense of autonomy is largely articulated in terms of its loss. Fook, for example, argues that the ‘autonomy of all professionals is challenged in the current context. Increased managerialism and changed funding arrangements effectively place more control of professional practice within the hands of managers or bureaucrats’ (Fook 2012, p.28). Gray and Webb likewise align ‘managerial control’ and ‘the undermining of practitioner discretion’ with ‘loss of professional autonomy,’ and criticise the ‘surrender’ of ‘“technical” and “ideological” autonomy within the rationalised care management process’ (2012, pp.12–13). For Lawler, professional knowledge is undermined by ‘management principles and practices [which have] trumped professional autonomy, knowledge and judgement.’ The perceived ‘objectivity’ of ‘management efficiency’ is thus ‘the main measure of effectiveness’ (2012, pp.102–103). Murdach (2011), too, suggests that the loss of self-determination as a value in social work is linked to the rise of ‘verification’ measures in practice. Conversely, Evans (2013) has argued that the imposition of more procedures and guidelines for practice may, in fact, increase the amount of discretion surrounding professional decision-making, for example, if practitioners find themselves working with contradictory guidelines, or overly-bureaucratic processes, and the fluidity this creates is not necessarily a good thing, as it can lead to inconsistent service delivery. In contrast, other views of autonomy explicitly challenge the association of autonomy with independence. Jordan, for example, argues that social work should not simply defend a service user’s ‘negative liberty,’ but should instead be based on the value of emancipation, which translates as ‘increasing autonomy and opportunity.’ But he clarifies:

80  Autonomy, critique and consensus I take autonomy to include choice, and acknowledge that the choices most important for most agents in the present-day world are made in markets […]. However, the notion of emancipation also includes collective action […] and has no associations of rational egoism or possessive individualism. (Jordan 2004, p.6) In this case, achieving the benefits of autonomy may well involve dependence on other people, groups or structures; in which case, treating autonomy and independence as similar would risk being short-sighted (see MacKenzie 2014). Regardless, Jordan notes that this alignment of autonomy and dependence produces an irony for social work as an emancipatory project in the 21st century: In local authorities and other statutory agencies it is charged with motivating and cajoling […] service users towards projects of autonomy and self-development, while controlling the deviant and destructive aspects of resistance strategies (crime, drugs, benefit fraud, self-harm, mental illness). It becomes both more demanding (“tough love”), more controlling, and more coercive. It focuses on the assessment of resources and risks, despite the rhetoric of empowerment and inclusion. It also, in the process, becomes more impersonal, arm’s length and office-bound. (Jordan 2004, p.10) This irony is important, as this quotation encapsulates the different levels at which tensions surrounding autonomy emerge for professional practice today, and its relationship to criticality. In clinical practice, there is a widely accepted division between individual and clinical autonomy (e.g. accountable decision-making in day-to-day practice), organisational autonomy (e.g. contribution to and control over policy and strategy), and professional autonomy (e.g. the autonomy of the profession to move in particular directions as a group) (see Kramer et al. 2006; Gagnon et al. 2010). Likewise, in social work one can detect a micro-level around the autonomy of the service user (their rights as individuals, legally, socially and morally); a mesolevel concerning the autonomy of the practitioner in the field (the role of autonomy in the values, ethics and decision-making of practice, as well as the organisational and structural autonomy of practice which facilitates and mediates these), and a macro-level regarding the autonomy of the care professions themselves, embedded within society as a whole. The reality is, alas, far less tidy than these three tiers initially suggest. As Gagnon et al. (2010) argue, while individual, clinical, organisational, and professional autonomies have been identified in the literature, they are often used interchangeably. In part, this is because autonomy often emerges as a presupposition of practice, rather than a specific theory within it. As

Autonomy, critique and consensus  81 such, the technical specificity of the concept itself can be difficult to articulate distinctly from the concepts it is so frequently aligned with, such as independence, freedom and determination. Furthermore, this specificity is frequently obscured in much of the current and past health, care and social work literature, which is enthusiastic to reference autonomy but reluctant to embed it within a clear theoretical context. For example, the narrative of increased managerialism and neoliberal marketisation leading to a loss of professional autonomy is by now well-established (Lavalette 2011; Barnett and Bagshaw 2020), and suggestions that moving away from centralised services towards community or third-sector services provides ‘more autonomy’ as a benefit (see, e.g., Preece 2012; Greaney and O’Mathúna 2017) can be carried without question. In their critique of the discourse of ‘wellbeing’ as a measure of service user needs, Simpson and Murr argue that ‘this continues to include autonomy and self-determination,’ but that ‘this is focused primarily upon the narrower concepts of independence and choice’ (Simpson and Murr 2014, p.891, my emphasis). However, if we find autonomy referenced alongside independence, self-determination, self-esteem, professional integrity, freedom of choice, and so on, then what differentiates autonomy from these things, in the context of the delivery of care or the practice of social welfare? If it is something broader than independence and choice, what then renders it specific enough to be still meaningful in practice? There are not clear answers to these questions, but rather a series of tensions that accompany the general consensus that (a) autonomy exists, whether potentially or actually, in professional practice; (b) autonomy is a good thing to have, (c) part of its value is its relationship to independent judgement and action. Such tensions require careful thinking through, if the use of the concept of autonomy is not to become, at best, a meaningless stock phrase of practice, or, at worst, actively complicit in the concealment of oppressive ideologies of practice. Surprisingly little work has been devoted to unpacking the limits and substance of both what autonomy ‘is,’ and in what sense it is ‘good’ (Oshodi et al. 2019): under what measures, and in what context; leaving much of its meaning based on implicit interpretations rooted in the general points of agreement just listed. Indeed, Murdach has argued that ‘in contrast with other values such as social justice and confidentiality, there today appears to be little interest in […] exploring the value of self-determination’ (2011, p.371), at least as a site of contestation. As I have argued elsewhere, the moment that an ethical basis or legal framework ceases to be questionable – either by virtue of becoming “just common sense”, or by standing atop unassailable moral heights – is the same moment that we lose the ability to critically discern appropriate use from inappropriate. (Grimwood 2016, p.83)

82  Autonomy, critique and consensus Autonomy from Kant to Habermas From where might this critical discernment about the nature of autonomy be made, if critique depends upon autonomy? To address this, we need to look more closely at the historical development of autonomy as a ‘good,’ and its critical value. Within the history of ideas, the concept of autonomy takes on a principal moral and political role in the European Enlightenment, and the development of a secular humanist modernity which followed. Whereas the notion of self-sufficiency is valued as far back as the Ancient Greeks (Aristotle notes the highest value in life is to need nothing, but that this would also require a large amount of dependency on sustenance, friendships, and other supporting goods), modern autonomy arises from a context where, as the critical theorist Marcuse describes, reason took the form of rational subjectivity. Man, the individual, was to examine and judge everything given by means of the power of his knowledge. […] Self-sufficiency and independence from all that is other is the sole guarantee of the subject’s freedom. (1992, pp.6–7) This principle of autonomy as self-sufficiency within modern moral philosophy is chiefly associated with the work of Immanuel Kant. For Kant, modernity required man [sic] to emerge from ‘his self-incurred immaturity,’ which he defined as ‘the inability to use one’s own understanding without the guidance of another’ (Kant 1996, p.11). Autonomy was, therefore, the key to understanding moral authority in the modern age, once the older structures and systems of moral authority, such as the Feudal system and the influence of the Church, had dissipated. Freedom to choose, for Kant, was not simply the absence of restrictions (the ‘negative liberty’ espoused by utilitarian and liberal thinkers such as J. S. Mill), but rather the ability to reflect, critique and validate moral laws which individuals themselves arrived at rationally. In this way, Kant uses autonomy to mean critical self-sufficiency: independence from others, specifically in terms of the capacity to reason: the good will is good not because of what it performs or effects, not by its aptness for the attainment of some proposed end, but simply by virtue of the volition – that is, it is good in itself and considered by itself is to be esteemed much higher than all that can be brought about by it in favour of any inclination. (Kant 1998, p.279) Kant’s focus on rationality is also key to his model of critical autonomy: we cannot, he argues, choose our ‘inclinations,’ such as our emotions, our relationships, our social circumstances, and therefore should be wary of using them in our moral decision-making. We can, though, choose between

Autonomy, critique and consensus  83 following our inclinations and following our duties. Such duties are to moral laws; laws which are decided upon by the application of reason to moral dilemmas. Because these laws are fundamentally rational, and therefore universal, then our duty to them is absolute. In this sense, the moral autonomy he describes is both highly individualistic (we can only decide what is right and wrong for us to do) as well as overwhelmingly universal (if we follow rational principles, what Kant terms the categorical imperatives, then as individuals we will all arrive at the same outcome). Hence, the fundamental duty of Kant’s moral system is to act only in respect of others’ autonomy: treat other people as ends in themselves, never as means to an end. Autonomy, for Kant, is difficult to achieve, and part of our development as critically reflective individuals; but it is nevertheless the cornerstone of moral values. While it is common to find Kant’s account of autonomy listed in health and social care textbooks on ethics, typically as one of the ‘big three’ ethical theories (utilitarianism, deontology and virtue ethics), it is more interesting to reflect on the ways in which the rhetoric of Kantian autonomy affects the critical aspects of practice. This is most clearly seen in the case of social work, where there is a clear lineage between the kind of moral society envisaged by Kant that was, via the work of Fichte, subsequently applied to early social contexts. This is primarily seen in the work of British philosopher T.H. Green, and the work of the early forms of social work practice – most notably, the Charity Organization Society (COS) and the Settlement House Movement in the United Kingdom and the United States – who were heavily influenced by these ideas (see Pierson 2011). But while Kantian ethics decreed that the moral actor ‘utters moral commands only to himself’ (MacIntyre 2002, p.147), the influence of social reform agendas, married with the moralistic hubris of idealism, led to a widening of the remit of autonomy as a tool for a specific form of ‘emancipation.’ As Harris notes, in these early forms of social work, ‘poor people were not seen as at the mercy of […] social and economic processes and were not regarded as requiring sympathetic intervention’ (Harris 2008, p.664). Instead, they took Kant’s view of a ‘self-incurred immaturity’ quite literally: ‘caseworkers stressed the importance of isolating the causes of individual difficulties and locating people’s problems within themselves in order to intervene more directly in their lives’ (Harris 2008, p.666). This resulted in a discourse which merged ‘individual help for the deserving, […] with the Poor Law in an overarching welfare regime’ which in turn refashioned people ‘in accordance with the requirements of the new capitalist society’ (Harris 2008, p.666). In clinical practice, meanwhile, the influence of Kant’s account of autonomy remains widespread, although, as Saad rightly notes, ‘Kant’s autonomy is much more demanding than some [medical] theories of autonomy which call themselves Kantian. The moral autonomy is watered down, while the individualism is preserved’ (Saad 2018, p.7). In this way, while ostensibly Kantian principles are preserved in discussions of clinical decision-making, it is typically collapsed into a more basic norm of non-interference with an

84  Autonomy, critique and consensus individual’s choice. In this way, Saad suggests, ‘the authority of reason is replaced by the authority of permission’ (Saad 2018, p.130). From its very inception, then, the notion of autonomy has never been a tidy one within applied practice, even when the ‘paternalist’ strategies of the COS fell from fashion, at least for a time, during the 20th century (although Mead (1997) has described a ‘New Paternalism’ arising within social policy, whereby traditional values are reasserted at the core of welfare directives – such as the need to work, the centrality of the nuclear family, and so on – despite these being arguably unsustainable in post-industrial society). Nevertheless, the normative value of autonomy retains echoes of Kant’s model: not only in the more overt uses – such as Biestek’s assertion (1974) that client self-determination was a ‘natural right,’ and the highest value of social work – but also in the implicit Kantian requirements of a developed sense of rational self-sufficiency. As Singh and Cowden note, ‘historically’ the notion of autonomy refers to the control professionals have over their own practice, in their role as ‘experts’ who are able to ‘make independent judgements free of political interference,’ on the basis of ‘an absolute commitment to ethics’ (2013, p.81). Yet, the relics of Kantian philosophy underlying this are more likely to be found within the health and care discourses of one’s ‘duty’ to deontological principles, than in critical self-appraisals. One exception to this can be found in those social work theorists who have turned to the thinking of Jürgen Habermas (see Lovat and Gray 2008; Houston 2013). Habermas retains the Kantian principle that rational autonomy is still a value to celebrate, and heteronomy a threat to avoid. But he argues that this needs to be separated from a straightforward subject-object ontological distinction, which is found not only in Kant, but in the structure-agency debates of 20th-century sociology. Instead of seeing autonomy as being tied to the individual subject, Habermas locates it in the use of a particular form of critical reasoning, which is not monological, but dialogical (Habermas 1984). Both modern scientific and social knowledge, he argues, has come to use almost exclusively a monological, ‘instrumental’ form of rationality, subservient to particular ideologies which shape our practices. This enforces a separation between individuals and the communities and relationships around them, and, subsequently, the value of autonomy becomes aligned with the value of the individual over and above their social context. But to be truly critical, reasoning must be dialogical. This is because, for Habermas, a human being can only develop their reason, and therefore their autonomy, in dialogue with others. We are not born with a sense of autonomy but learn it through our cultural upbringing. Hence, the oft-cited distinction between the value of autonomy in ‘Western’ and ‘Eastern’ cultures (even if the reality is perhaps more complicated – see Chirkov 2004). As such, every genuine attempt to communicate involves an attempt to create consensus, as this is the basis of any further conversation (Habermas 1996). This suggests an ‘ideal speech situation’ which is created when such a consensus is fully realised. That is to say, communication

Autonomy, critique and consensus  85 should aim to create the conditions that allows for all interlocutors to both communicate and challenge one another, using only rationality and evidence, without the coercion of force or ideology. This suggests that ‘the ideal speech situation creates the possibility of decisions not merely reflecting pre-held positions’ (Spratt and Houston 1999, p.320); ergo, a form of autonomous critical thinking. Habermas’ approach has been employed in health care, as a way to critically analyse performance management techniques within organisations (Hewko and Cummings 2016), as well as in social work (Houston 2013), whereby his model of autonomy allows practitioners to address the broken and dysfunctional relations they are often called to address. The practitioner can accept that autonomy is not, in fact, possible for service users within specific regimes of power (e.g. benefits systems, social care bureaucracy and austerity measures; see Narotzky 2021). But, precisely because of this, they can also insist on the ideal of autonomy as the basis for effective intervention. Relational autonomy in perspective Let’s take stock of this highly schematic survey so far. We have considered how the invocations of autonomy within professional practice circulate around some core themes, and how these often tend to bleed into one another when defined explicitly. Instead, they revolve around a general yet often implicit consensus regarding the benefits of autonomy to practice. We have seen that, at least in part, this can be linked back to the Kantian concept of autonomy which forged together critical reasoning and morality, and how in the work of critical theorists such as Habermas this develops into an explicit emphasis on the significance of dialogical consensus for autonomy to be effective. At this point, then, we might conclude that a practice-based concept of autonomy depends for its critical value on some form of either implicit or ideal agreement. But when we consider the relationship between professional accounts of autonomy and critical thinking, we might question the alignment of autonomy with independence or, indeed, the uncoerced reasoning of Habermas’s ideal speech situation. This is because both of these raise a key question over the extent to which this overlooks the physical and emotional relationships already in existence around the exercise of autonomy, and the ways in which these relationships are recognised and maintained: what Lynn refers to as the ‘person-in-the-situation’ of care work (2006, p.110), or what Garrett describes as the ‘fleshiness’ (2013, p.166) of working with others to address disadvantage. In short: the associations out of which the need to appraise the value of critique might emerge. One of the issues here is that, in general parlance, autonomy is frequently explained in terms of its political meaning, translating the ‘self-rule’ of the body politic into the freedom of choice for the body personal (Murdach 2011, p.372), and the legal standing that follows from this; models of autonomy for those without the mental capacity to make decisions, for example, for which

86  Autonomy, critique and consensus there is a wealth of debates in the research. This is problematic, though, given that the ‘political’ in question is frequently rooted in European liberalism, when those engaged in the political were assumed to be (for want of a more nuanced description) white, male and bourgeois whose autonomy is a natural ability to act rationally, by virtue of his capacities to master and possess the world around him (see Lorey 2015). But as Carol Gilligan (1993) argued in the classic feminist work In a Different Voice, an emphasis on the self as a representative of, or in relation to, the state is a poor analogy, as it overlooks the attachments to others that an individual has (which do not correlate to any relationship between states). Furthermore, it overlooks what Bourdieu has termed the ‘symbolic violence’ of the body politic itself in prescribing the ‘practical schemes of perception, appreciation and action’ which frame such relationships (2000, p.175), and legitimise current structural social inequalities. As such, one of the main criticisms of autonomy as a professional value is that it imposes a specifically gendered, classed and cultured view of the individual, modelled on the most politically powerful in society, which overlooks the tangible relations these are embedded within. A good example here is the difference between literature on critical thinking and autonomy in professional practice, and the way that it sits very separately to literature on the critical approaches of the service user. If the former focuses on attention to self-sufficient – good practice, avoiding clinical error, thinking through alternative forms of intervention and so on – the latter tends towards finding agreement and cohesion between service user and professional. For example, in their chapter on patient autonomy and nursing ethics, Anna-Marie Greaney and Dónal O’Mathúna identify a core tension arising when ‘patient choice conflicts with professional advice, policy and best available clinical evidence’ (2017, p.93). This reflects the idea of viewing autonomy through the lens of ‘health literacy’ (Parker 2006), whereby the critical faculties of the service user are defined by the extent to which they understand the information regarding the service they are receiving (medication, benefits, care plans, etc.). Such an example makes a clear link between autonomy and critical thinking, although to different ends: whereas the critical practitioner uses their discretion to disseminate advice and guidance, the service user’s autonomy is essentially the freedom to make mistakes. In short: unlike the professional, service user autonomy is implied to be opposed to critical thinking. This, of course, assumes a certain coherence between advice, policy and evidence, which – as we discussed in part in Chapter 1 – is not necessarily always the case. Furthermore, Bailo et al. note that assuming a more informed patient will agree with the clinician just because he [sic] can better understand the medical reasoning underlying the decision-making process does not take into consideration that the patient’s priorities and preferences may not be the same as the clinicians. (2019, p.3)

Autonomy, critique and consensus  87 What perpetuates this division between the critical practitioner and critical service user is not always as simple as one falling short on an objective measure of some kind. Instead, service user autonomy more often highlights the ways in which the concept is embedded within a particular set of relations, which in turn define the consensus regarding autonomy’s meaning for criticality. As Jacques Rancière has long argued, ‘consensus means precisely that the sensory is given as univocal’ (2010, p.149): in other words, agreement pushes us towards using familiar or ready-to-hand language, tropes and measures. In the 1980s, Gilligan’s work laid a significant foundation for criticising Kantian accounts of personal development, notably that of Lawrence Kohlberg. His work, in line with its Kantian tradition, suggested that rational and objective autonomy is the highest level of moral development. This account, Gilligan argued, reflects a gendered account which privileges what have been traditionally masculine characteristics and values. Relational aspects of identity, such as caring, have traditionally been viewed as secondary, or obstructive, to more ‘male’ aspects such as autonomy, objectivity, and universality. Hence, while the Kantian model of autonomy remains the norm, Barnes notes that ‘choice and control’ for service users is typically framed as the ideal for interventions, with ‘care and protection’ only the ‘booby prize’ (Barnes 2011, p.160). Such views, and their subsequent development in feminist ethical theory (e.g. Noddings 1984; Held 2006) have thus formed the launching pad for a number of variations of a ‘care ethics’ across health, social care and social work, which challenges the idea that autonomy equates to a substantive independence, and suggests instead that mutually caring relations allow for genuine personal transformation and actions which address actual needs (see Hugman 2005; Lachman 2012; Reamer 2016; Gallagher 2017). This does not do away with the notion of autonomy altogether, however. When viewed in the context of relationships, rather than atomistic individuals, Gilligan herself suggests that autonomy can still be a worthy ideal, both practically and psychologically. Using the relational account of development employed by Loevinger and Wessler (1970), Gilligan argues that, while Kohlberg’s account of development uses autonomy as a means to arrive at an ‘objectively fair or just resolution to moral dilemmas upon which all rational persons could agree,’ relational autonomy ‘focuses instead on the limitations of any particular resolution,’ as well as their conflicts (1993, pp.21–22, my emphasis). Autonomy is thus redefined, somewhat poetically, as ‘modulating an excessive sense of responsibility through the recognition that other people have responsibility for their own destiny’ (Gilligan 1993, p.21). The subsequent development of this notion of relational autonomy has taken root in many health discourses, particularly around the topics of patient and service user empowerment (see, e.g., Walker and Ross 2014; Wardrope 2015), as well as areas of social work (Banks 2012, p.93). As with many of the discussions of autonomy in these contexts, however, it remains

88  Autonomy, critique and consensus a broad umbrella term, rather than a clearly defined theory (MacKenzie and Stoljar 2000, p.4). The persuasiveness, or usefulness, of relational autonomy as a guiding value for critical practice largely hinges on what role relationships play in autonomous acts. For example, some theorists, such as Nedelsky, suggest this is a causal relationship, because ‘if we ask ourselves what actually enables people to be autonomous, the answer is not isolation, but relationships  – with parents, teachers, friends, loved ones’ and, presumably, practitioners and/or their clients (Nedelsky 1989, p.12, my emphasis). Conversely, the absence of such enabling relationships can prevent a person from asserting autonomy, whether personally, as in the case of domestic abuse (Friedman 2003), or at a broader social or historical level, as in the case of displaced persons (Watts and Hodgson 2019). The relationship between relational autonomy and critique would, therefore, be constituted by assessing and addressing the ‘gaps’ required to enable the former to occur. Autonomy as a neoliberal apparatus This linking of autonomy and responsibility made by Gilligan and others seems to be a promising route towards rethinking criticality. However, for the moment, it seems to depend upon localised contexts for its effectiveness: that is, the relations of individuals to other individuals, and their immediate circumstances. The risk in play here is to ignore the wider discourses of autonomy that provide broader, perhaps ideological apparatus to frame these localised contexts. This was, of course, precisely what Habermas aimed to dispel via his ideal speech situation. For Elisabeth Anker, the grounding for a relational critique is about insisting on ‘different measures of trust and knowledge’ (2023, p.203) to those which the more traditional approaches to autonomy have in the past. However, Dean and Zamora note that the very idea of ‘autonomy’ has become the determining field of social change, while at the same time aligning self-mastery with neoliberal consumer culture. This has led to something of a monopoly on the term that may limit how many ‘measures of trust and knowledge’ remain available for the discerning practitioner: From management guru Peter Drucker’s call to “manage oneself” to Canadian psychologist Jordan B. Peterson’s “rules for life,” the success of the trope of personal development has relied on the slow “interiorization,” beginning in the late sixties, of the social, which is increasingly problematized from within the subject rather than as the outcome of institutional and socio-economic structures. In an enlarged definition of politics, in which “everything is political” and “the personal is political,” the self has gradually become the privileged battlefield of contemporary politics. By the late seventies, intellectuals announced the

Autonomy, critique and consensus  89 end of revolution and the advent of an age where transforming the self became the most popular conception of social change. Far from freeing the subject from any kind of therapeutic normativity, this shift sought to displace the individualized expertise of the professionally accredited therapist by the participatory services offered by cultural entrepreneurs on a competitive market. (Dean and Zamora 2023, p.83) This saturation of autonomy is enabled, in at least some senses, by its use of the concept as utilised by the liberal development of Kantian thought. Rather than attempt to map the content of autonomous acts, in the sense that theories of relational autonomy do, theorists such as John Rawls developed Kant’s model in the opposite direction, by theorising a distinctly procedural account of autonomy in order to protect the basic freedoms of the individual (Besthorn et al. 2016, pp.148–149; Waldron 2017). Instead of specifying the moral norms which autonomy entailed, it concentrated on establishing the minimal conditions by which an individual’s autonomy could be maintained. The liberal view begins from the idea of a self-interested individual, who must reconcile their own self-interested activities with that of other self-interested individuals through some kind of social contract (see Grimwood 2016, pp.40–46). As such, in a pluralistic society and even more clearly in a pluralistic world, we cannot agree on our visions of the good life […] but we can hope to agree on the minimal conditions for justice, for coexistence within a framework allowing us to pursue our visions of the good life. (Held 2006, p.338, my emphasis) This model is present in the development of liberal economic visions for society, of economists like Hayek and Friedman, for which autonomy could be said to roughly equate to ‘consumer-power,’ and the autonomy of the service user to their enablement as a ‘citizen-consumer’ (Clarke et al. 2007). As Saad summarises: in political liberalism […] the duty derived from autonomy falls upon others: autonomy is not something to obey or honour for oneself, but something to be respected (not interfered with) by others. Autonomy is now no longer a privilege (Rousseau) or a duty (Kant), but a right. (2018, p.136) Indeed, Saad suggests that this comes to its most prominent fruition in Beauchamp and Childress’ seminal Principles of Bioethics, which completely removes the moral aspect of autonomy and replaces it with a purely descriptive principle of non-interference. In such a case, the relationship between autonomy and critique is nothing more than that which enables self-directed

90  Autonomy, critique and consensus choice. Consequently, critical autonomy is not about dissent or challenge, but affirmation of formal rights. As mentioned above, in the Habermasian or Critical Theory tradition, this might be accounted for as the ‘ideology’ of neoliberalism (and therefore a cloud to critical judgement). Within the provision of care, however, this is not always a useful move to make. Celikates names this ‘the ideology diagnosis,’ which ‘indicates that agents, for structural reasons, do not know what they are doing. It seems that this diagnosis can only be made from an epistemologically privileged observer perspective, that is, from a standpoint beyond the ideological context’ (2018, p.3). However, while such a diagnosis might reinstate the role of critique as an unmasking or enlightening mode, the manner in which autonomy is mutated within neoliberal care practices renders this somewhat less than useful. After all, the ideology of neoliberal welfare is far from concealed. Beginning in the late 1980s and 1990s, autonomy developed a specific value related to the rise of what Cannan described as ‘enterprise culture’ in the United Kingdom: embodied by ‘a self characterised by autonomy, responsibility, initiative, self-reliance, independence and willingness to take risks, to “go for it”’ (1994, p.7). Alongside this was a shift in social care towards quasi-markets for personalised service user budgets, using the logic of neoliberal economics to counter the perceived ‘dependency culture’ of social security which ‘“produces” the poor’ (Cree 2013, p.147), seen prominently in legislation such as the 1996 Personal Responsibility and Work Opportunity Reconciliation Act in the United States (Schram 2000). Because the autonomy of personalisation remains fundamentally focused on a ‘floating self’ which grounds liberalism and neoliberalism, this procedural autonomy can overlook the importance of physical and relational dependencies. Thus, while Leece and Peace (2010) argue that service users in the United Kingdom have valued the extent to which personalisation provides enhanced levels of ‘independence’ and ‘autonomy,’ Lymbery argues that personalisaton exposes an enduring form of inequality: if we take into account the physical and cognitive frailties of many people in need of services, there are apparent limitations on their ability both to exercise choice and to have that choice turned into positive action. This is problematic, given that social work values are premised on supporting ‘people who have the lowest levels of capacity to act as self-actualising consumers’ (Lymbery 2012, p.788). Indeed, Chatzidakis et al. point out that a structural feature of neoliberal capitalism is to remove ‘care’ as a core part of individual existence while ‘rolling back […] public welfare provision and resources’ (2020, pp.10–15). As such, the problematic framing of autonomy as a form of consumer choice creates a paradox whereby, Schram argues,

Autonomy, critique and consensus  91 there is a return to ‘personal responsibility’ narratives (2000, p.27) within the delivery of social care: In the liberal contractual society that particularly valorizes choice, “personal responsibility” is […] especially paradoxical. It implies being willing to take responsibility for what the dominant culture has already assigned as one’s responsibility, and on terms predetermined by the culture. (Schram 2000, p.31) While there are a number of political and economic causes for this paradox, for our purposes we need to note that in part, these anachronistic categories arise from the shifts from the classical liberal model of autonomy found in philosophers such as Rawls, and the neoliberal policies which have dominated Western social policies. Neoliberalism requires a focus on economic self-determination to be ‘directed, buttressed, and protected by law and policy as well as by the dissemination of social norms’ (Brown 2005, p.41); as such, procedural accounts of autonomy are merged with substantive cultural assumptions, and the concept slips into a dangerous double-edged meaning. Fraser has termed this the ‘Juridical-Administrative-Therapeutic apparatus’ (Fraser 1989, p.154), whereby ‘a form of bureaucratic “needs talk” […] imputes to welfare recipient’s personal deficiencies that need to be treated if they are to leave welfare for a life of “self-sufficiency”’ (Schram 2000, p.72). In this sense, the concept of autonomy, far from liberating, can instead become a mode of cultural disciplining of the disempowered. This is also, though, why identifying the neoliberal saturation of autonomy as ‘ideology’ is less than useful, if it serves only to reinforce a particular critical autonomy that those under the false consciousness of ideological pressures are unable to understand. It also rests on the assumption, or ideal, of an ideologically-free space for such a critique to take place (we think again of Habermas’ ideal speech situation). But care providers are necessarily embedded within spaces that are permanently under political, legal and moral demand. In this way, it does not address the paradoxes raised by Schram so much as risk reproducing them. Rethinking criticality and autonomy I began this chapter by noting that there were reasons for appreciating the use of autonomy as an assemblage of different accounts and interests, loosely held together by a consensus regarding its value. While there are certainly reasons to critique this consensus (as it currently stands), the more salient point to note is how this shows the relationship between autonomy and critique manifests itself in rhetorical ways – that is, shared agreements within a given context – as much as rigorously conceptual ways. Borrowing a term

92  Autonomy, critique and consensus from Timothy O’Leary, we might say that autonomy invokes a sensibility which interlinks ‘feeling/sensing, perceiving/knowing, and valuing/judging’ (O’Leary 2021, p.150), developed from one’s training, occupational history, and sense of professional identity. This would not just include directives on what is right and wrong in a practice situation, or good or bad in terms of evidence, but also the ways in which these are themselves spoken about; the way in which each profession uses words in ways particular to itself, and likewise uses certain tropes and metaphors to express right from wrong, and good from bad. In other words, the very way in which autonomy is discussed and rendered a persuasive part of professional practice presents a problem for critical autonomy as a separate, decisive judgement. It is this aspect of autonomy which produces a fracture, not only between the individualist sense of self-sufficiency described in the previous section, and the relational account discussed before it, but also within the three conventional pillars of autonomy’s definition (political, physical and moral/legal). But if this fracture struggles to close via appeals to either concise philosophical concepts or references to ideology, how should it be theorised in terms of critical thinking? One potential route is highlighted by Chatzidakis et al., when they note the repeated arguments of disability rights activism for ‘the strategic centrality of self-determination, or forms of “independence”, in which autonomy and control over their lives are key, precisely despite and because of their distinct needs’ (2020, p.29, emphasis original). This notion of a strategic autonomy retains much of the traditional language and emphases of practicebased discourses, while at the same time, and with appropriate reservation, pulling at the loose consensus of meaning to draw attention to its wider possibilities. In other words, rather than reduce autonomy to its bare minimum, Chatzidakis et al. suggest acknowledging and celebrating the multiple and myriad connections required for autonomy to be – ‘strategically’ – realised. In this way, unlike Mejía and Molina’s suggestion that criticality helps to separate ourselves from others – that is, we are not ‘compelled to believe or act in particular ways defined […] by others’ – a strategic prioritisation of autonomy would in rather help criticality highlight the interdependencies between ourselves and others. In the case of professional practice, renewing the idea of critical autonomy in this way would be to question the prominence of legalistic rights and requirements, and focus instead on the relations of care that enable and support professional identity. A more radical approach is documented by Ludovica D’Alessandro (2022), in her work on localised solidarity practices and ‘counter-care’ collectives during the COVID-19 pandemic. D’Alessandro questions whether, given the deep-rooted conceptual complicity of autonomy with both individualist politics and neoliberal economics, it is possible ‘to practice and account for autonomous forms of reproduction and care which – even temporarily – interrupt and/or resist the ties among capitalist […] regimes of production and exploitation?’ (p.20) She argues that it is possible by moving

Autonomy, critique and consensus  93 away from the understanding of autonomy as a right, and instead as a condition of ‘affect-ability’; or the ability of every person to affect and be affected by others, often in indeterminate ways, across ‘non-neutral fields of power across unequal and inequitable regimes’ (2022, p.21). For D’Alessandro, this allows for a theorisation of how, during the pandemic, a number of spontaneous (and ‘autonomous’) community activities emerged, including food distribution, mental health support and theatre performance. These directly challenged the saturation of autonomy with the neoliberal consumerism, given that these self-formed sites of ‘resistant care’ challenged the dominant narrative that linked health, care and finance inextricably together. In this way, ‘autonomous rearticulations of care, such as those enacted by social movements during the pandemic, propose an actualisation of “autonomy” resistant to […] imaginaries of freedom through external prescription and individual self-formation’ (D’Alessandro 2022, p.25). In both of the examples listed, autonomy takes on a different role via its critical sensibility. In such cases, the concept of autonomy emerges as a distinct opportunity for re-appraising the delivery of care. While D’Alessandro appeals to a ‘flat ontology’ which is better discussed in Chapter 4, here I want to highlight the key move in her argument whereby autonomy shifts away from ‘self-formation’ as an individualistic enterprise, and towards formation as an ability to affect and be affected. Just as Chatzidakis et al. do with the idea of ‘strategic self-direction,’ this move is not so much a formal redefinition of autonomy, but rather a shift in focus: a pulling to the fore of one of the principles inherent to its use within the care professions. Autonomy entails a relationship with others, and while the relational autonomy theorists discussed above phrased this in terms of responsibility to others (as well as, in Gilligan’s words, ‘the recognition that other people have responsibility for their own destiny’), the fluidity of the concept of autonomy – its dependence on rhetorical consensus and sensibilities within everyday practice – entails that these relationships will never be easily mapped or decisively marked out. Instead, it must also possess an opportunistic aspect: opportunity that arises precisely from the tensions that exist between the rhetorical power of the term (a power based on where it appears in regulations and guidance; how it has historically been treated as fundamental in political and moral discussions) and the context-dependence of its invocation. In this sense, the loose consensus identified at the start of this chapter as to what autonomy actually is less a frustrating ambiguity, and rather the site for potentially rethinking the different ways in which it can be imagined, and in doing resisting the consumer culture that creates paradoxes for service users, as well as the assumptions around the extent to which a service user might ‘have’ autonomy or not. This is not to say the loose consensus needs leaving as it is, of course. The importance of the role of consensus is not in describing intuitive or unthought-out agreement, because agreement, in this sense, would simply be a reduction of the term in the way Rancière warned

94  Autonomy, critique and consensus against). Rather, the significance of consensus is precisely how it holds several interlinking and sometimes competing ideas together. I raise this to highlight where the relationship between criticality and autonomy becomes so important. It can be seen, I would argue, by pulling at another thread in the rhetorical consensus of autonomy’s worth. If we return to the root of the concept in Kant’s philosophy, it is clear that – bracketing, for the moment, his emphasis on rationality at the expense of intuitions, empathies and other things he suspected us to have no control over – the fundamental task of autonomy was to understand. This was necessary, because Kant took this task up at a time when traditional moral values and practices were under question, and in order to postulate the value of autonomy (which was, in his case, almost synonymous with Enlightenment), there was first the need to examine what it could and could not do. We have come a long way since then, and the mutation of reason into a minimalist procedural logic has shown itself to be ill-fitting for care practices. What was also lost in that mutation, though, was the task of understanding inherent to autonomy itself. To the extent that autonomy became a self-evident feature of liberal discourse – and, as I have suggested, this is one of the reasons that a clear definition in professional practice is so difficult to arrive at – its requirement to first understand its role and purpose (within the demands of a given context) was obscured to the point of disappearance. The examples given above suggest ways of reclaiming this aspect of criticality within the concept of autonomy. That is to say: the ‘inevitable entwining’ of autonomy and critique lies not in an individualistic capacity to undertake choice or action, but the necessary prerequisite requirement of understanding at work in any moment of opportunity. In other words, the strategic basis of autonomy is not rooted in the right to self-direction, judgement and appraisal, but rather its role in response to, and with responsibility for, the embedded demands of practice. In this way, the question of critique is fundamental to the question of autonomy: it lies in the capacity to understand a context, to the best ability, including the different ways in which that context affects and is affected others. But to consider this in more detail, we need to first think through how such ‘embedded demands’ of practice might be conceptualised. The next chapter provides a specific example of such a demand, in the form of the safeguarding review. References Anker, E. (2023). ‘Plan B: Weapons of Feminist Criticism.’ Political Theology, 24:2, pp.204–208. Bailo, L., Guiddi, P., Vergani, L., Marton, G. and Pravettoni, G. (2019). ‘The Patient Perspective: Investigating Patient Empowerment Enablers and Barriers within the Oncological Care Process.’ E-Cancer Medical Science, 13, p.912. Banks, S. (2012). Ethics and Values in Social Work Practice. Basingstoke: Palgrave MacMillan.

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Autonomy, critique and consensus  97 Leece, J. and Peace, S. (2010). ‘Developing New Understandings of Independence and Autonomy in the Personalised Relationship.’ British Journal of Social Work, 40, pp.1847–1865. Loevinger, J. and Wessler, R. (1970). Measuring Ego Development. San Francisco, CA: Jossey-Bass. Lorenz, W. (2016). ‘Rediscovering the Social Question.’ European Journal of Social Work, 19:1, pp.4–17. Lorey, I. (2015). State of Insecurity: Government of the Precarious. Trans. Derieg, A. London: Verso Futures. Lovat, T. and Gray, M. (2008). ‘Towards a Proportionist Social Work Ethics: A Habermasian Perspective.’ British Journal of Social Work, 38, pp.1100–1114. Lymbery, M. (2012). ‘Social Work and Personalisation.’ British Journal of Social Work, 42, pp.783–792. Lynn, M. (2006). ‘Discourses of Community: Challenges for Social Work.’ International Journal of Social Welfare, 15:2, pp.110–120. MacIntyre, A. (2002). A Short History of Ethics. London: Routledge. Mackenzie, C. (2014). ‘Three Dimensions of Autonomy: A Relational Analysis.’ In Veltman, A. and Piper, M. (eds.), Autonomy, Oppression, and Gender. Oxford: Oxford University Press, pp.15–41. MacKenzie, C. and Stoljar, N. (2000). ‘Refiguring Autonomy.’ In MacKenzie, C. and Stoljar, N. (eds.), Relational Autonomy: Feminist Essays on Autonomy, Agency and Social Self. Oxford: Oxford University Press, pp.3–33. Marcuse, H. (1992). ‘Philosophy and Critical Theory.’ In Ingram, D. and SimonIngram, J. (eds.), Critical Theory: The Essential Readings. New York, NY: Paragon House. Mead, L. (1997). The New Paternalism: Supervisory Approaches to Poverty. Washington, DC: Brookings Institution Press. Mejía, A. and Molina, A. (2007). ‘Are We Promoting Critical Autonomous Thinking? A Discussion on Conversational Genres and Whether They can Help Us Answer This Question.’ Cambridge Journal of Education, 37:3, pp.409–426. Munro, E. (2011). The Munro Review of Child Protection: A Child-Centred System. London: Department for Education. Murdach, A. (2011). ‘What Happened to Self-Determination?’ Social Work, 56:4, pp.371–3. Narotzky, S. (2021). ‘The Janus Face of Austerity Politics: Autonomy and Dependence in Contemporary Spain.’ Focaal—Journal of Global and Historical Anthropology, 90, pp.22–35. Nedelsky, J. (1989). ‘Reconceiving Autonomy: Sources, Thoughts and Possibilities.’ Yale Journal of Law and Feminism, 1:1, pp.7–36. Noddings, N. (1984). Caring: A Feminine Approach to Ethics and Moral Education. Berkeley: University of California Press. O’Leary, T. (2021). ‘Critical Vivisection: Transforming Ethical Sensibilities.’ In Thiele, K., Kaiser, B. and O’Leary, T. (eds), The Ends of Critique: Methods, Institutions, Politics. London: Rowman and Littlefield, pp.139–157. Oshodi, T. O., Bruneau, B., Crockett, R., et al. (2019). ‘Registered Nurses’ Perceptions and Experiences of Autonomy: A Descriptive Phenomenological Study.’ BMC Nursing, 18: 51. Parker, R. (2006). ‘What an Informed Patient Means for the Future of Healthcare.’ Pharmacoeconomics, 2, pp.29–33.

98  Autonomy, critique and consensus Parrott, L. (2014). Values and Ethics in Social Work Practice. London: Sage. Pierson, J. (2011). Understanding Social Work: History and Context. Berkshire: Open University Press. Preece, H. (2012). ‘More Client Time and Autonomy: Life in a Social Work Practice.’ Community Care. Available at: http://www.communitycare.co.uk/2012/05/01/ more-client-time-and-autonomy-life-in-a-social-work-practice/ Rancière, J. (2010). Dissensus: On Politics and Aesthetics. Trans. Corcoran, S. London: Continuum. Rasmussen, C. (2011). The Autonomous Animal: Self-Governance and the Modern Subject. Oxford: Oxford University Press. Reamer, F. (2016). ‘The Ethics of Care.’ Social Work Today. Available at: http://www. socialworktoday.com/news/eoe_0916.shtml Robison, W. and Reeser, L. (2000). Ethical Decision Making in Social Work. Boston, MA: Allyn and Bacon. Saad, T. (2018). ‘The History of Autonomy in Medicine from Antiquity to Principlism.’ Medicine, Health Care and Philosophy, 21, pp.125–137. Schram, S. (2000). After Welfare: The Culture of Postindustrial Social Policy. New York: New York University Press. Simpson, G. and Murr, A. (2014). ‘Reconceptualising Well-Being: Social Work, Economics and Choice.’ Culture Unbound, 6, pp.891–904. Singh, G. and Cowden, S. (2013). ‘The New Radical Social Work Professional?’ In Parker, J. and Doel, M. (eds.), Professional Social Work. London: Sage, pp.81–97. Social Care Institute for Excellence (SCIE). (n.d.). ‘Freedom to Choose and Dignity in Care.’ Available at: https://www.scie.org.uk/dignity/care/freedom Social Work Reform Board (2012). ‘Building a Safe and Confident Future.’ Department of Education. Available at: https://assets.publishing.service.gov.uk/government/ uploads/system/uploads/attachment_data/file/175947/SWRB_progress_report_-_ June_2012.pdf Spratt, T. and Houston, S. (1999). ‘Developing Critical Social Work in Theory and in Practice: Child Protection and Communicative Reason.’ Child and Family Social Work, 4, pp.315–324. Varkey, B. (2021). ‘Principles of Clinical Ethics and Their Application to Practice.’ Medical Principles and Practice, 30, pp.17–28. Waldron, J. (2017). One Another’s Equals: The Basis of Human Equality. Cambridge, MA: Harvard University Press. Walker, J. K. and Ross, L. F. (2014). ‘Relational Autonomy: Moving Beyond the Limits of Isolated Individualism.’ Pediatrics, 133:1, pp.16–23. Wardrope, A. (2015). ‘Relational Autonomy and the Ethics of Health Promotion.’ Public Health Ethics, 8:1, pp.50–62. Watts, L. and Hodgson, D. (2019). Social Justice Theory and Practice for Social Work: Critical and Philosophical Perspectives. Singapore: Springer. Wilson, T., Todd, S., Occhiuto, K. and Garrod, J. (2019). ‘Social Workers as Double Agents: Critical Inquiry, Social Work Education, and the Youth Question.’ Social Work Education, 39:1, pp.85–96.

4

Placing the review under review Reconciling critique with assemblage in safeguarding reviews

As the discussion in Chapter 3 suggested, the alignment of criticality with autonomy can lead to an over-emphasis on the idea that independent thought is a hallmark – if not the hallmark – of critical practice. This can risk overlooking collective and cultural aspects of critique, along with the atmospherics that we discussed in Chapters 1 and 2. As researchers have found, aspects like the critical abilities of an educator (Boso and Gross 2015; Raymond et al. 2018) or the culture of the workplace (Brookfield 1993; Tripathy 2020) also have huge effects on the delivery and development of critical thinking, as well as the form and tone by which it happens. Framing this collective aspect of critique, though, is a broader recurrent tension in professional practice. On the one hand is a world of systems and infrastructures that include not only organisation-specific practices, but also framing policy documents, governance configurations, abstract models of integrated care, procurement rules and so on. On the other hand, there is the world of imminent experience that can often find itself at odds with the very ‘systematic’ nature of the systems such experience is placed within. This broader framing of the embedded demands of practice is not always a productive one, given that it can lead to oppositions that sediment the notion of critique as an individual enterprise, an exercise separate (or separable) from the machinations of practice. In social work, for example, the now rather clichéd distinction between the ‘technical-rational’ and the ‘practicalmoral’ approaches can form a parochial vision of well-meaning individuals hampered by overly bureaucratic ‘management’ structures. This, in turn, will shape the ways in which critique itself is not only figured, but also expected to reveal itself, and to effect action. In this chapter, I want to explore such tensions emerge within the sites of safeguarding reviews. I will look at some possibilities for framing the collective aspect of critique, based on the debates that have taken place around the effectiveness of safeguarding reviews as a critical exercise. I do this in three stages. Firstly, I consider the ways in which more conventional models of critique lead to an impasse regarding the value of the safeguarding review. Secondly, I draw on the recent ‘ontological turn’ in philosophy, and in particular the assemblage theory of Manuel DeLanda, to consider alternative DOI: 10.4324/9781003123583-5

100  Placing the review under review ways of conceptualising the relationship between actions, systems and critical reflection, to unpack the impasse on the nature of responsibility and critical judgement. This provides a way of considering how critique might be refigured in terms of the interrelationships, not just between individuals and, say, workplace culture, but between all the material and expressive components in play. The review process In the years since their first implementation in the United Kingdom under the Children Act (2004), there has been much discussion on the role and effectiveness of safeguarding reviews. Following the Wood Review (2016), Safeguarding Practice Reviews (SPRs) and Rapid Reviews replaced Serious Case Reviews (SCRs) as processes for local safeguarding boards to examine cases where a child or vulnerable adult died, and abuse or neglect is known or suspected. While the SPR processes are specific to the UK, aimed at correcting some of the shortfalls of the previous system, they nevertheless reflect safeguarding reviews conducted in health, social care and social work in most late-capitalist welfare systems across the world. In this way, all forms of serious review share core aspects. Most immediately, of course, they share the aim that, if there has been a serious breach in safeguarding with a child or a vulnerable adult, the review should not only ascertain what happened, but also how multi-agency working can be improved to ensure it doesn’t happen again. Safeguarding reviews are intended as a system-wide learning and improvement exercise; this separates them from the legal prosecution of individuals guilty of serious misconduct. As a public enquiry, they are focused on the local level of care delivery, aiming to establish learning for agencies and professionals to improve the way that they work together to safeguard effectively. In many senses, then, they embody the application of criticality as a tool for practice. Reviews are a process-driven operation, and this involves the application of several modalities of critical inquiry: 1 Information and causal determinism. Reviews attempt to ascertain what happened and when, rationales for decision-making regarding what happened, and reasons for actions or inaction taking place. 2 Data systems and documentation. Reviews involve the analysis of formal records, policy and procedure documents, and the ICT systems used. 3 Cultural codes. In addition, reviews examine who was involved in terms of their expected roles, from practitioners and managers to family members and acquaintances; they look at what current practice roles are, and what expectations of ‘normal’ behaviour are within and across organisations. This procedural modality has produced somewhat uniform results of such reviews not only across local areas in the United Kingdom, but also across

Placing the review under review  101 the United States, Australia, New Zealand and elsewhere. Reviews typically find, for example, poor quality assessments, reviews and care plans, and a lack of implementation or adjustment; poor management involvement in complex cases and lack of attention to how practitioners are supervised during such cases; poor documentation and ignorance of chronologies; poor interaction between professional services, particularly around information-sharing; and the absence of ‘concerned curiosity or challenge’ at the heart of service delivery. At the same time, one of the more fundamental criticisms of SCRs was, specifically, the status of criticality within them. A national evaluation of 50 SCRs conducted in England in 2007–8, Learning Lessons Taking Action, reported that individuals on the review panel were often from agencies involved in the case, who were themselves responsible for preparing reports on that involvement. This meant, the evaluation noted, that it was ‘less likely’ that panels would ‘critically examine’ the practice of individual staff and managers. This was, indeed, something brought to light in the wake of the Baby P scandal, where the initial review had to be reconducted with a more ‘independent’ chair appointed. Beyond the aversion to self-criticism identified in SCRs is a second problem for the role of criticality. The procedural nature of the review means that the lessons learned from such critical inquiries are typically – and consequently – focused on procedural issues. Problems are raised, for example, with cases being closed too early; uncertainty and ambiguity about the application of thresholds for social work involvement; and practitioners viewing their own roles too narrowly (Sidebotham et al. 2016). This has remained prevalent even after SCRs were changed: in their analysis of SPRs and rapid reviews, Dickens et al. note that, overall, ‘reviews rarely address why things happen, why practitioners make certain decisions or why children and families may respond negatively to interventions’ (2021, p.6). As such, questions have been raised in both research and practice settings about the actual effectiveness of such reviews, particularly in relation to broader organisational critique and meaningful change. In other words, the procedural focus was leaving certain processes – those that framed or contextualised the processes that were scrutinised – untouched. Criticising reviews: familiar themes Unsurprisingly, then, reviews have come under a critical lens in research articles and opinion pieces alike. And if reviews tend to produce remarkably similar findings, they are met – and perhaps consequently – with a set of similar critiques of reviews themselves within research literature. In his discussion of the Wood Review, Preston-Shoot (2018) observes that there are remarkably persistent critical themes across the different forms of safeguarding analysis, which can be organised under five headings: 1 Reviews are insufficiently systematic. 2 Reviews produce repetitive findings and recommendations.

102  Placing the review under review 3 Lessons from reviews are not learned. 4 Reviews fail to engage practitioners. 5 Reviews are conducted with inadequate process. It is immediately clear that these themes all cover similar ground, ground upon which the tensions between systematic reconstructions of systemsat-work readily sit. For example, safeguarding reviews are systematic in the principles of their approach, but many critiques suggest that they are effectively not systematic enough. That is to say, while reviews can identify errors, they tend to leave out wider systems and organisations in play beyond the immediate interactions of the individuals involved. As such, they typically do not deal with bigger (systemic) questions of why something happened. A common criticism of reviews is that they overlook the economic and political aspects of poor performance, underfunding, broader community issues and so on, that may not provide a complete causal explanation of the safeguarding error, but nevertheless provide an important and affective context to the events that happened (Peckover and Smith 2011). Indeed, writing after a different but related inquiry into the Mid Staffordshire Hospital Trust (Francis 2013), Dekker and Hugh highlight that, for such reviews to be effective in changing practice longer-term, they must be ‘sensitive to the political, economic and demographic complexities of getting healthcare delivery “right” in a mature democracy,’ and understanding ‘that the risk of error and failure is the inevitable byproduct of pursuing success in a resource-constrained, goal-conflicted world’ (2014, p.3). It could be objected that such a criticism would risk moving safeguarding reviews away from their procedural focus of explanation, and towards a more political or normative account. While this is certainly worth considering, it nevertheless leaves to one side the more pressing question of how one identifies the limits of what ‘systematic’ means – which is not necessarily just a simple procedural question. For example, Dickens et al. note in their analysis that a number of reviews found services worked at too superficial a level with their clients, such that a ‘lack of “professional curiosity” is a cliché used by reviewers’ throughout SPRs, and as a result, ‘work with adolescents, babies, fathers and men in families, and families from diverse cultures often showed the impact of stereotypes and assumptions that left issues unexplored.’ At the same time, though, ‘further inquiry [by the SPR] into why practitioners did not always ask “the second question” was usually missing’ (2021, p.6, my emphasis). Because the findings and recommendations of reviews are almost always procedural in nature, they are typically directed at better management of services. This can lead to top-down recommendations, that can overlook what Taylor et al. (2017) identify as the interpretative and relational work that is core to the effectiveness of professional safeguarding roles. Furthermore, such recommendations tend to be very repetitive. Indeed, the Wood Review

Placing the review under review  103 noted in particular that SCRs were too often focused on allocating blame rather than improving practice, which led to predictable and banal recommendations. There may be good reason for repetitive findings, of course: as Dickens et al. note, ‘lessons always have to be re-learned’ (2021, p.48). And indeed, Preston-Shoot points out that ‘just because findings and recommendations appear repetitive does not necessarily mean that nothing has been learned’ in between each review (Preston-Shoot 2018, p.21). Nevertheless, Ofsted’s 2007–8 review of SCRs, Learning Lessons and Taking Action, notes that the practice issues raised in reviews – ‘failure of staff to identify and report signs of abuse; poor recording and communication, and poor knowledge, and application, of basic policies and procedures’ – had not changed from a similar review five years previous (Ofsted 2008, p.6), and the lack of ‘why’ something had happened alongside the ‘what’ seems to be a perennial problem (see Ahmed 2008). However, it is highly notable that recommendations from reviews almost always require ‘more training’ of some kind. This is, admittedly, not a problem faced by reviews alone; a vast amount of research papers in health, social care and social work will conclude with the call for better education or improved training on particular issues. Rarely, though, are the principles of training as a form of meaning-making challenged. In other words, while the content of training is frequently addressed and updated, the idea of what constitutes training, and whether training is a suitable format for initiating learning in the applied professions, is not. In other words, ‘training’ has become a de facto procedural answer to procedural issues. As a result, it is perhaps unsurprising that calls for ‘more training’ often do not successfully embed itself in the longer term of practice (Rose and Barnes 2008). After all, the outcomes of training interventions across health and care are notoriously under-evidenced (Melender et al. 2016; Kerr et al. 2020), and some research suggests interaction and learning context affect outcomes far more than simply transferring knowledge from trainer to trainee (MalmbergHeimonen et al. 2016). There are other reasons raised as to why lessons aren’t always learned. Typically, the views of the practitioners themselves are framed by the lenses of the commissioner, who is, after all, investigating how often horrific cases have occurred. It is not surprising, then, to find practitioner voices often being defensive or protective. As Rawlings et al. (2014) noted in their report for the UK government, an ‘ethos of “blame”’ within review processes, and a lack of sensitivity to local contexts surrounding cases. There are somewhat forgivable sensitivities to anything that might be perceived as an accusation or an apportioning of blame, however much of learning process the review is supposed to be, especially when one considers what Dekker and Hugh call hindsight and outcome bias: ‘knowledge of outcome affects our evaluation of the quality of decisions, whereas hindsight increases retrospective estimates of the foreseeability of the outcome’ (2014, p.1).

104  Placing the review under review In effect, what all these points taken together suggest is that the very things that reviews are meant to address are also a point of contestation. The review is process-driven, but because of the different modalities of understanding involved, a diverse range of approaches and methodologies are used without an agreement on how they should be put together. The review is independent, but often questions are raised regarding ‘independent from what?’ Learning Lessons and Taking Action found that most serious case review panels ‘consisted solely or mainly of representatives from agencies that were also responsible for preparing individual management reviews,’ which called into question ‘their independence and ability to adequately challenge the quality of individual management reviews’ (Ofsted 2008, p.6). Reviews are meant to avoid repeating mistakes, yet the findings are themselves often repetitive. A critical impasse At this point, then, I want to proceed via something of a side-route to the more obvious and well-trodden dimensions of this discussion, and instead focus more on the idea of criticality at work in these dilemmas of context. This, it should be said, is not to disparage the efforts of any of the previous works mentioned. It is rather to point to the problem that, while the procedural modality of the review should provide systematic certainty, it leaves us instead with an interpretative problem that such a procedural emphasis should, in principle, avoid. The question is whether it is possible to rethink the concepts underpinning the critical disputes themselves and ask what is at stake in terms of knowledge, expertise and critical judgement in ­philosophical terms. The question arises primarily because, if we were to summarise the work of safeguarding reviews through the lens of critique, we might see a familiar pattern of activities: Policy and process ↓ (interrogated by) ↓ Established modes of critique ↓ (which leads to) ↓ Distrust of current practice – ‘we need more training!’ (or) New processes If we apply this to the criticisms of these processes, which we have already noted are remarkably uniform, we find something like this:

Placing the review under review  105 Policy and process ↓ (challenged by) ↓ Established modes of critique ↓ (which leads to) ↓ Distrust in current processes – ‘we need more research!’ (or) New processes As with any diagram, this is necessarily schematic. Clearly one will find individual examples that do not follow this logic, and other summaries are, of course, available. The point, though, is that considered in general, when presented in this way we can see that both the reviews and their criticisms seem to utilise similar terms and invoke similar authorities. For both, policy and procedure are subjected to criticism – are you doing what you are meant to be doing? Are you representing what you claim to represent? Is your method coherent? – and only the end result differs. From a critical perspective we thus reach something of an impasse. On the one hand, there is the need for reviews to take place, and the persistence of their findings. On the other hand, there are the criticisms of review processes and the persistence of their conclusions. How, then, do we move beyond such an impasse? A standard response is to begin by recognising the complexity of reconstructing, in a systematic way, inter-related but not always connected systems and decisions. For Preston-Shoot, interventions such as the Wood Review ‘represents another example of a belief in quick solutions rather than a more rigorous examination of why some wicked problems persist’ (2018, p.21). Dickens et al., meanwhile, acknowledge that: the work is desperately difficult, with competing imperatives: safeguarding children and supporting families; investigative duties and powers versus family autonomy; providing an excellent service for this family and saving time and resources for work with all the other families, and so on – all the well-known dilemmas. The new practice review system has not changed that, so it is unlikely to find any new solutions. If it were easy to do it, it would have happened a long time ago. That is not to suggest defeatism, but rather realism, and everyone working in the field deserves the recognition of how difficult it is. (Dickens et al. 2021, p.48) Both Preston-Shoot and Dickens et al. therefore point to the perpetual dilemmas of practice embedded within contextual difficulties and complexity. As such, the procedural approach of the review always risks reducing or

106  Placing the review under review obscuring these difficulties and complexities, and in doing so leaving them to continue to expand. We should perhaps be wary of settling on a judgement that ‘context matters’ here, however much this has become a common mantra for health and social care education, particularly within discussions of appropriate knowledge forms and interventions relative to service user circumstances, culture and demographics (see, e.g., Graham et al. 2012; Nadan et al. 2015). Felski suggests that context is too often used as a kind of container to ‘hold fast’ that which is under scrutiny (2015, p.155), and ‘context’ can be used as a short-hand way of closing a discussion down, rather than remaining as open to interrogation as whatever it is being contextualised. It is, of course, undeniable that certain complexities are persistent in the delivery of care, but this is not to say that more can’t be said of it. With this in mind, governing the procedural approach of the review is a set of shared philosophical assumptions regarding the ontological basis of its critical faculties. Here, ontology refers to the nature of being, what the world is and what it consists of (Paleček and Risjord 2013). The systematic approach of reviews, as well as critiques of reviews, draws upon this ontological basis by stressing certain aspects of a care system. We have already listed these at the start of the chapter: data systems, information, and cultural codes, linked together in causally deterministic ways. These form the basis of the ‘reality’ of the events being investigated; they constitute the reality of a ‘system’ and a ‘process.’ The problem is whether this is sufficient grounding for the kind of difficulties and complexities that the critics of the reviews describe. Indeed, complexity has become a somewhat misused term in contemporary care, often being used as a substitute for ‘complicated.’ I follow Patricia Rogers’ (2008) distinction between the two: complicated interventions involve multiple strands (different sites, stakeholders, outcomes and so on), whereas complex interventions involve these strands interacting in often unpredictable ways. The significance of the latter is precisely in the way that it relates to accounts of causality. As Ray Pawson notes, mistaking complexity for complication, as he argues the Medical Research Council does in its guidance on complex interventions, results in ‘missing […] any notion of emergence, of internal, adaptive, self-generated, or historical change’ (2013, p.49). In complex systems, causality is recursive (where high-level outcomes are produced by a number of interactions between lower-level outcomes) and emergence (where the shape of outcomes emerges only during the implementation, or through negotiations between different organisations). In this way, complex systems see ‘relatively simple functional structures’ emerge from ‘complex interchanges of the component parts of a system’ (Protevi 2006, pp.21–22); interchanges which are necessarily separable from the system as a whole. Perhaps this is one reason why changing systems for the better is so difficult.

Placing the review under review  107 Complex ontologies For a certain time, the space for theorising complexity within the governance of professional practice was filled by versions of systems theory. This was (and still is in some areas) proffered as a means to address the naivety of viewing the management in the health and care sectors as a simple linear process, whereby each ‘adverse event’ can be ascribed ‘an identifiable, antecedent cause’ (Anderson 2016, p.594). Indeed, Munro (2011) advocated a need for a systems approach to counteract the blame culture and singling out individuals in the course of safeguarding reviews. But even back in 1975, theorists such as LaPorte were arguing that systems approaches presents only ‘a premise rather than a theory, and to have substance, its constructs must extend to other notions: the mechanistic equilibrium of the machine, the homeostatic equilibrium of the ecological niche, the adaptive dynamics of organic species’ (LaPorte 1975, p.19). In other words, while the claim that the events within a safeguarding review operated within micro, meso and macro structures was a fine starting point, it implemented these only while leaving other aspects of human existence as relatively fixed and unchanging, and certainly not as responsive to interrelations with other aspects as we can observe they are. As a result, its application to the caring professions – perhaps the most prominent, in the United States at least, being the Institute of Medicine report To Err is Human: Building a Safer Health System (2000) – is as a corrective, rather than an appreciation of the necessarily complex aspects of practice: ‘the systems approach in medicine has come to include a multiplicity of standardisation techniques to correct defects: checklists, protocols, rules and data collection routines’ (Levitt 2014, p.1051). A further issue arises from the ways in which interlinking processes and organisations relate to one another, particularly in the drive towards integrated care systems that bring together primary, acute, social and community care. Attempts to map such processes as a system can often create figures that do not so much explain complexity as create yet more of it. A fantastic example of this problem is presented in Alexander Galloway’s book The Interface Effect. Galloway uses the example of a PowerPoint slide from a meeting between military and government officials, which attempted to depict the US military strategy in Afghanistan. It is a mass of words in different fonts, representing one hundred and twenty nodes, lines connecting them with sweeping curves and minute arrows. As Galloway comments, ‘it is unclear exactly what the slide is meant to convey or indeed if it is meant to convey anything at all. “When we understand that slide, we’ll have won the war,” General McChrystal dryly remarked’ (2012, p.78). Safeguarding reviews, of course, are not so concerned with foreign invasions. But more than enough systems map of integrated care models and ever-restructured social services present the same problem: either they are too simplistic to account for the ways in which information, influence and

108  Placing the review under review prevailing urgencies pass through it (see, e.g., Bussu and Marshall 2020); or they are so detailed that they raise more questions than they answer. This has led some to argue that health and care is simply too complex to apply rigorous systematic theorisation to (Straub 2013). But the problem suggests, I think, more of an issue with the notion of a ‘system’ than it does the complexity of organisations. In part, as I have argued elsewhere (Grimwood 2019), this is because systems approaches tend to assume a relatively consistent, singular meaning for each part of an organisation (‘line manager,’ ‘safeguarding protocol’ and so on). But in reality, key components of care systems depend on ‘tactical interpretations at the more local levels of delivery’ that reshape and change the ways in which these parts are understood and able to act (Grimwood 2019, p.212). This is due in part to the ways in which such systems are rarely designed on a blank sheet of paper, but rather assembled in a context of resource limits, existing and previous systems, and performance indicators. As a result, systems don’t simply work because they connect parts together. They work because such connections produce adherence, which in turn depends on those involved within the systems being suitably persuaded that relevant components work with each other effectively and meaningfully. In short, a successful system will require a contingent and rhetorical system to render it understandable and persuasive. This returns us to the problem of ‘competing imperatives’ that Dickens et al. raised in the previous section. This is what might be termed, borrowing from Brian Massumi, a problem of ‘positionality,’ whereby embedded standpoints – safeguarding children and supporting families, investigative duties versus family autonomy and so on – are set at odds with each other. It is of note that the dilemmas Dickens et al. mention specifically are largely policy-related; that is, established through documentation and professional discourses. The result of this can be to imagine these positions as solidified and, at least within their summary of safeguarding reviews, relatively fixed as a consequence of the discourses welfare services operate within. But as Massumi points out, this has the effect of freezing the dynamics of such dilemmas. The idea of positionality begins by subtracting movement from the picture. This catches the body in a cultural freeze-frame. […] After all is signified and sited, there is the nagging problem of how to add movement back into the picture. (Massumi 2002, p.7) But given that there is clearly movement at work between these positions within reviews and their criticisms, a better question perhaps is that given the mass complexity of today’s care systems, how do they hold their stability? How do they constitute a ‘system,’ even when we frequently hear that the system is broken, whether ‘nearing collapse’ as a totality (see, e.g., Simmons

Placing the review under review  109 2022; Gregory and Campbell 2022), or inflicting harms on an individual level (as would warrant a safeguarding review)? Such a question takes us back to the ontology at work in the notion of both a system under review, and a systematic review of that system. It is here that considering the idea of ontological assemblages may provide one route through the impasse. Assemblage in the sense it is deployed here is based on a translation of a term used by Deleuze and Guattari, agencement. While assemblage has become the most common translation of this word, it could also be read as ‘arrangement,’ ‘layout’ or ‘ensemble’ (in the sense of a musical arrangement), the key to the term being the movement and contingency of any event. Approaches and theories of assemblage are not only interested in how such arrangements are produced, but also how they are held together or, indeed, changed, weakened, or improved (Baker and McGuirk 2017, p.431). Indeed, Deleuze argued that we should look less at apparatuses of systems, and instead more on the physical systems of power that such apparatuses bring into play. Apparatuses, he claimed, are in this way composed of lines of visibility and enunciation, lines of force, lines of subjectification, lines of splitting, breakage, fracture, all of which criss-cross and mingle together, some lines reproducing or giving rise to others, by means of variations or even changes in the way they are grouped. (1992, p.162) What does this mean in practice, though? In his work with Vicki Singleton conducting research in an alcohol advice centre, John Law notes that it was not simply the people – the social workers, the administrators, the researchers and, of course, those with alcohol-related problems – that constituted the delivery of care, but the layout of the building (a long staircase led up to the main room; there was no suitable space for a meeting area and a lack of space in general) and what they describe as a ‘chaos of leaflets’ and other ‘messy’ aspects of the centre. In this way, Law suggests, ‘the building reflected, witnessed, or condensed a wider state of disorganisation.’ But importantly, ‘this also enacted the interrupted flow between the tighter biomedical realities of the consultants in the hospital and their less bounded, psychiatric and social (but also medical) alternatives being crafted elsewhere’ (Law 2004, p.87). In this way, what Law and Singleton refer to as ‘chaos’ or ‘mess’ is not a criticism of practice. Rather, it is an observation that the sheer number of leaflets from multiple sources constitute a form of meaning outside of language or traditional models of representation, at least within the conventions of clinical treatments. The contents assembled on a single shelf reflected ‘the criss-crossing plethora of locations, organisations, facilities, and policies that were all, somehow or other, more or less relevant to the issue of alcohol abuse in the district, yet didn’t quite fit together either’ (Law 2004, p.87). In such a situation, it makes little sense to try and allocate a leaflet, a coffee mug or a shelf attached to a supporting wall into distinct ‘micro systems.’ To do

110  Placing the review under review so would necessarily involve deciding the importance of individual objects, and the unimportance of others. Law’s argument is that, in challenging the limitations of more traditional representational practice, chaos and mess are significant precisely because they resist being separated: they become meaningful only as a ‘mess,’ rather than a separable collection of objects. He thus argues that ‘to try to shoehorn non-coherent realities into singularity by insisting on direct representation and Othering whatever does not fit is […] to miss the point. It is to (try to) enact a particular version of ontological politics.’ In other words, the system they encountered did not operate in one singular ‘world’ of reality, but nevertheless different aspects of the workplace, the workers, the service users and the objects and attitudes they all used affected the outcomes of the service. This requires what is sometimes called a ‘flat ontology’: that is, an understanding of ontology that does not impose hierarchies of value on to the reality it describes. Assemblage approaches, such as Law proposes, ‘softens and plays with the boundaries between what is Othered and what is made manifest,’ and in doing so ‘discovers – and enacts – new and only partially connected realities’ (Law 2004, p.93). Assemblage theory: against the organism The idea of ‘softening and playing’ with boundaries when it comes to serious case reviews, no less than alcohol advice centres, may not be immediately appealing; callous, even. After all, assemblage theories seek to replace these abstract notions with aggregates of elements, contingent upon situational relations. In doing so, assemblages directly oppose the kinds of deterministic reasoning, whereby causes are attributed linearly to outcomes, at work not only in much research but often in case reviews themselves. However, it is also the case that assemblage approaches offer a way of interpreting complex contexts of practice, and in doing so potentially provide a way of thinking through the critical impasse we encountered earlier. To do this, I draw primarily on the work of Manuel DeLanda. DeLanda’s use of assemblages to describe social phenomena is directly opposed to the ‘organismic metaphors’ which has governed more traditional approaches to events and organisations. Organismic metaphors suggest that the parts and the whole of a phenomena are seen as analogous to organs within a body. Such a metaphor, according to DeLanda (2006, p.8), frames the part-whole relationship as though they follow an inherent, internal logic. The organistic metaphor is, indeed, often key not only to some of the more well-used cognitive developmental theories such as Piaget, Rogers or Maslow, but also within some systematic accounts of care delivery (where different organs of the body are metaphors for different departments or directorates of an organisation). In the case of safeguarding reviews, this logic is assumed to be one of systematic self-correction: that through the review process the weak, missing

Placing the review under review  111 or dysfunctional parts will emerge, and either addressed or replaced. By asking ‘where’ the mistakes happened is a matter of how things – information flow, data systems, and cultural codes – relate together in terms of an overall single logic. The critiques of reviews often double down on this: the question now is where did the mistakes happen in the process of the review itself. For both, the answer is fundamentally topological. Space – as we saw in Chapter 2 – dominates the imaginary of the delivery of care. The core issue is that the organismic metaphor insists on parts effectively representing the whole, and vice versa. But within this prism of representation, we have seen that the outcomes of safeguarding reviews can produce a reality which does not match with the lived experience of either practitioners or service users. In part this is because the organismic metaphor does not account for the autonomy of the component parts of an assemblage: that the relationships are effective and embedded, but nevertheless contingent. Just as several critiques of reviews have highlighted, its component parts are not defined by the review itself – a social worker is a social worker, whether involved in a review or not – but are effectively ‘unplugged’ from one assemblage and plugged into another, which affects the role they perform. In Law’s discussion of the inquiry of the Ladbroke Grove rail crash, he notes the ontological assumptions of the exercise are embedded within what he calls ‘the framing assumptions of Euro-American metaphysics.’ A key consequence of this is that in assembling an inquiry, certain interpretative commitments are made in order to make sense of the myriad of complexities that might have happened in the throes of multi-agency and multi-service user practice: In particular, reality is taken to be definite, singular, prior, and independent – and is made that way. […] A coherent account of the world is possible even at moments when things have gone dreadfully wrong. The inquiry […] thus denies the possibility of non-coherence, multiplicity, priority, and all the rest. (Law 2004, p.96) This framing, however, presents forms of reductionism, in both micro- and macro-level ways. What DeLanda terms ‘micro-reductionism’ identifies a whole (event, organisation, policy etc.) as made up only by the sum of its parts. Macro-reductionism, on the other hand, sees the parts as the product of the whole, the ‘organs’ existing essentially only to serve that particular body and having no identity outside of it. The critiques of safeguarding reviews serve as examples of why such reductionism should be avoided. We can see, for example, that the ‘systematic’ nature of the review does not simply arise from the aggregate of its parts. While one might argue that the review is essentially a summary of the voices involved (for SCRs, all agencies who had a role and responsibility for the case in question was required to contribute an individual management report to the review), and as such they

112  Placing the review under review all utilise the same ontological ‘reality,’ we have already seen that reviews involve a range of different modalities regarding information, documentation and cultural practice, as well as distinct filters around what voices are represented and to what purpose. Likewise, there is a danger in reviews applying a macro-reduction by placing a single event – typically, the consequences of the safeguarding errors – as a kind of sum point of all actions leading up to it (as Law critiques the Ladbroke inquiry for). In this way, the parts of the review are effectively summoned into existence by the whole, precisely with the kind of outcome or hindsight bias that Dekker and Hugh warned of. Territorialisation and practice In fact, all of the component parts have only what DeLanda calls a relation of exteriority to each other: the assemblage’s only unity, as Deleuze once wrote, is that of co-functioning as alliances, rather than filiations, the assemblage is not a body or a machine (in the way a car is made up of distinct parts that hold a logically necessary relation to each other in order to make the car work); nor are they a random mess that happen to be in the same place. Instead, they hold strategic relationships with each other. In Glenn Savage’s words, these are ‘contingently obligatory relations that are always evolving in form’ (2020, p.325). Such relations come together through what DeLanda, borrowing from Deleuze and Guattari, calls territorialisation. Anything that gives a social interaction a set of boundaries, a sense of ‘place’ (which may be physical, temporal, discursive or otherwise) is a territory. This situates a set of dependencies within a particular closed assemblage. Thus, safeguarding processes are dependent on practitioners carrying them out (and vice versa); in turn, practitioners are dependent on particular spaces and materials being available to them within their work (and vice versa – an office depends on its occupant as much as the other way around); the order of things within an office will also have a dependency on their use, expectation and currency; and one of those things may be the physical documents of the safeguarding processes themselves. We could go on mapping each relation of dependency at work within any territory of welfare delivery: the intensive care unit, the care home, the multi-disciplinary team conference, and so on. As a result, once an assemblage is formed it immediately begins to create emergent properties, both constraining and enabling. In this way, the question is no longer the systems question of how different parts relate to each other, but rather how such parts can be defined as elements of the whole in the first place: what DeLanda calls a move from the interiority to the exteriority of relations (2006, pp.11–12). Territorialising is a useful way for thinking about the case of safeguarding reviews. In the first instance, a review takes place because the accepted processes have gone wrong (there has been a problem with safeguarding). The review attempts to assemble the component parts into a re-territorialised

Placing the review under review  113 understanding, in order to enhance what DeLanda calls the coding of the territory. Territories, as previously discussed, are made up of components: people, protocols, buildings, rooms and so on. But simply placing all these things together would not produce a welfare service. Alongside this, there is also an assemblage of expressive aspects: in this case, the principles of welfare provision underlying the service, the societal motifs of care for the vulnerable, the expected standards of a professional practitioner; as well as the managerialist discourse or the language of blame and judgement, but also rituals, non-verbal communication and behaviours often attributed to organisational culture (Savage 2020). Coding here thus refers to the expressive components of an assemblage, such as naming, classification, mapping, and valuation (DeLanda 2016, p.22), and the more formalised the assemblage, the higher order of coding there is. That is: the more components will act together in similar ways, owing to their shared expressions. Coding is also a way of achieving integration into an assemblage, by enforcing a particular set of expressions onto its component parts (something at work, perhaps, when reviews are criticised for not adequately allowing the voice of the victim or victim’s family to be heard). Conversely, deterritorialisation (taken from the geopolitical sense of removing control and order from a territory) pulls assemblages apart. There are, at least for Deleuze and Guattari, three forms of deterritorialisation (or ‘lines of flight’ away from territories): negative, relative and absolute. Negative deterritorialisation involves changing component parts of a territory, but such that it stays the same (the replacement of one member of staff with another may cause some ripples in an organisation, but in general won’t change it dramatically). Relative deterritorialisation attempts to bring about change, but does so in a partial and reactive way. Therefore, it never fully removes itself from reterritorialisation. Finally, absolute deterritorialisation creates a completely new beginning, without any of the old territorialisation left. These different lines of flight map onto many of the conclusions of wholescale safeguarding reviews: the removal of ‘bad apples’ from an organisation would constitute negative deterritorialisation (this was seen, e.g., with the case of London’s Metropolitan Police Force’s response to multiple cases of serious misconduct (see Delgado 2022)). Relative deterritorialisation may be seen in the numerous recommendations for better training, where, without attending to broader social, cultural, political and economic conditions, they are often reactive rather than resulting in widespread change to practices (Dickens et al. 2021, p.111). At the same time, while a complete reimagination of the review system is suggested every so often, the enormity of such a task is all too apparent. The purpose of this chapter, though, is not to simply reorient safeguarding reviews towards different ontological descriptions. The problem we are addressing is not the review per se, but rather the ontology of critique, as manifested in the impasse between reviews and their critics. To this end,

114  Placing the review under review thinking through reviews as assemblages is only a step towards our more formal question, which is how we might think of critique itself as an assemblage. An ontology of critique? To this end, our foray into assemblage theory has served to highlight that the critical methods of the reviews are geared towards specific territorialisation and coding practices. In short, the reviews seek, like Delanda’s assemblage, ‘to name a unity across difference, i.e. for describing alignments or wholes between different actors without losing sight of the specific agencies that form assemblages’ (McFarlane and Anderson 2011, p.162). At the same time, there is an intriguing repetition at work: the review is re-assembling a territory for which the nature of its deterritorialisation is not always clear. In turn, the critiques of reviews are deterritorialising in order to present a further assemblage, which is, for want of a less clumsy term, the ‘reviewas-critiqued.’ On the one hand, this illustrates what DeLanda describes as a paradox of assemblages, whereby they are both stable entities – ‘enduring states defined by properties that are always actual, existing in the here and now’ (DeLanda, 2016, p.108) – and in a constant process of contingency, given they depend upon multiple ontologies in order to work. However, as Ian Buchanan (2015) has noted of DeLanda’s work, this could be tantamount to just mapping out various parts and activities and saying ‘well, it’s even more complex than you think!’ We would only be left with the same conclusion that Preston-Shoot reached, just arriving from a different direction. In turn, this wouldn’t be that different to understanding the lack of embedded learning and the repetition of safeguarding failures in terms of the ongoing tensions between, for example, practice wisdom and codified programmes in health, social work or social care delivery. And as we began this chapter by reminding ourselves, everybody knows that already. We can, of course, use DeLanda’s insights to suggest that the contingency of what serious reviews critically examine is ill-served by its assumptions of a single logic of critique. Likewise, we can suggest that it is the ontology of the review lends itself to the forms of managerialism which social workers in practice typically resist, leading to an over-coding that closes down other possible assemblages in working practice. This would, I should add, in no way commit us to some kind of glib social constructionism regarding safeguarding. For DeLanda, social theories which treat society as a ‘construction’ fall into unwanted idealism (2006, p.5), and in doing so fail to successfully capture the real history and internal dynamics of social entities. Instead, as Law explains: [T]he absence of singularity does not imply that we live in a world composed of an indefinite number of disconnected bodies […]. It does not imply that reality is fragmented. It instead implies something much more complex. It implies that different realities overlap and interfere

Placing the review under review  115 with one another. Their relations, partially coordinated, are complex and messy. (Law 2004, p.61) On a very superficial level one can see this in any inter-professional learning set, of course: the occupational therapist world is different to that of the physiotherapy, the radiographer, the HPA and so on. Indeed, the balance of professions and the ways in which they interact is key to the success of failure of any form of multi-disciplinary team, and this can be done without any charges of moral relativism being made, inside the meeting or out. The question is, though, can such messiness also be found in the ontology of critique itself? It should be noted that, even with much assemblage literature, critique is often used as a tool to apply to the framing of relations, rather than inherently embedded within them. Building off his work on networks and assemblages, Latour (2004) ascribes this problem to the legacy of Kant’s model of critique, which enforces a distinction between the knowing subject (who does the critiquing) and the passive object (which is subjected to critique). This has the effect, as Michael Thompson (2016) argues, of separating critical reason, as a capacity of cognition, from the world, as an object of cognition. This is certainly one way of looking at it; but, as we have explored throughout this book, critique also carries with it its own set of coding, and its own territorialising practices. As such, it makes sense to think through what components of critique are at work in the impasse we raised earlier in the chapter, and how understanding them as assemblages – assemblages which become a component part of the larger assemblage of the review and/or the review’s criticism – might open further possibilities for analysis. Here, I suggest two are of particular note: credibility and suspicion. Much of the critical discussion around reviews are centred on the objectivity or potential bias of the panels. But it also seems that the issues raised are not fully explained by the cognitive notions of objectivity or disinterest. Instead, reviews have to manage what we might call an economy of credibility, which involves balancing the intricacies of professional demands with the ‘very public nature of safeguarding’ expressed through the media and the general public (Elsley 2010, p.12). The fluidity of these demands, clearly, goes beyond standard measures of validity or coherence. Credibility in this case is not like a threshold to be reached by due diligence and impartial inquiry (although these are fundamental to the effectiveness of the review), because the objectivity and procedural emphases of reviews instead offer a gesture of closure on a case which it ultimately cannot fulfil; precisely because such objectivity is created only by holding together a number of contingent parts to support its conclusions. This, it should be clear, does not undermine a review’s findings. It is, rather, simply to acknowledge that there is no way of providing anything more ‘objective’ than a particular coding apparatus, due to the multiple ontologies any multi-agency, complex case involves.

116  Placing the review under review This becomes important when questions are raised as to what the expressive components of a review refer to. For example, earlier in the chapter we considered why the value of ‘independence’ in a review was sometimes misinterpreted or ignored; in such cases, one could suggest that while certain procedural components were in place, they lacked sufficient coding to also incorporate the expressive and territorial aspects of credibility, and as such could not hold the assemblage together. Conversely, in cases where the emphasis on procedural process is argued to omit the messiness of practice around it, this can result in over-coding. In such cases, the assemblage holds and is able to take up a line of flight: professionals find themselves reterritorialised into revised structures or policy assemblages. But the effectiveness of such an adjustment will depend on whether the parameters of credibility were acknowledged in the original over-coding; or, to put it another way, to what extent the necessity of ‘messiness’ was plugged into the original coding. The point is that credibility, as a component of any deterritorialising practice, needs to be assembled for each case, rather than considered a neutral or third-party element. This requires a shift in how the credibility of critique is considered. In her work on the multiplicity of reality in clinical practice, Anne-Marie Mol comments that ‘philosophy used to approach knowledge in an epistemological way. It was interested in the preconditions for acquiring knowledge.’ But after the ontological turn, ‘knowledge is not understood as a matter of reference, but as one of manipulation. The driving question is no longer “how to find the truth?” but “how are objects handled in practice?”’ (Mol 2002, p.5). Credibility is one assemblage at work in the structure of critique that involves thinking through how different components – the interests of the family, the morale of the workforce, the interest of the media, the concern of the general public and so on – are handled rather than described or positioned. This is important because, as Buchanan notes, any deterritorialising effort – which critique in this context inevitably leads to – will always carry distinctive risks. As an assemblage in, or in a discussion of, a safeguarding review, three risks are particularly pertinent: fear, clarity and power. Fear, Buchannon explains, relates to our discomfort with losing the security of what ‘we have grown accustomed to, which define the very order of things.’ This results in resistant to change via appeals to ‘the old days and call for a return to the way things were – the fantasy of lost certainties.’ Clarity, on the other hand, ‘is the feeling of knowing everything, of seeing through everything, of being taken in by nothing.’ It resists change by insisting that everything is already known, and needs no adjustment; albeit, clarity brings with it ‘a multitude of microparanoias’ as damaging as the fear of lost certainty, producing the kind of self-appointed administers of justice based on ‘common sense’ (‘isn’t it obvious what’s gone wrong here…?’). Power, meanwhile, ‘moves between these two points of view’ (Buchanan 2021, pp.89–90). In this way, assembling the parameters of credibility need to be alert to all three

Placing the review under review  117 risks, in ways that reductive or overly-procedural approaches to critique do not always allow for. In part, this is because of the role of suspicion that underlies traditional uses of credibility. The importance of questioning previous practices and processes is, of course, fundamental to any form of welfare delivery. But in the critical impasse we encountered before, it seemed that both reviews and their critics deployed similar models of suspicion, which was a sense that there was more to find than conventional reflective or supervisory practices allowed for. But suspicion shows a notable mobility across the impasse. In its harsher forms, it is a threat to be avoided: for example, the judgement of a review should be independent and unbiased; otherwise, the suspicion of some kind of organisational cover up of failure is difficult to defend. In more conventional ways, the understanding that there might be initially-unseen faults in a system is precisely why one conducts a review in the first place. Of course, we have seen already in Chapter 1 how the charge that the idea of criticality has developed a disproportionate focus on distance and suspicion, at the expense of thinking as an embodied practice in time and space. The key here, then, is not to view suspicion as an attitude or disposition, as well as not necessarily a negative or destructive part of critique (i.e. the assumption that to suspect is to automatically cast everything under mistrust, and to tear down the surfaces of practice until a ‘truth’ is revealed). In this sense, suspicion is not outside of the assemblages under consideration, but rather an activation of their power to affect change. Buchanan notes that in its origin in the work of Deleuze and Guattari, assemblage theory ‘was always concerned about questions of power,’ even though this is often forgotten: ‘making the assemblage seem as though it is merely another way of saying something is complicated’ (2015, p.382). Power, in this sense, is a matter of association: it is the effect of coding such that component parts of a given assemblage – be they workers, IT systems, service users or others – adhere to each other, and become effectively allied. In this way, power (and truth) can only reach as far as the weakest point in the assemblage; and in this way both power and truth are always at risk in any given territorialisation. Suspicion is therefore a performative element based on the fact that truth can never be fully explicit or present so long as we live in contingent states of affairs. If there is a critique to make of the critical impasse regarding reviews – a critique of the critique of the critical act, in effect – then it would be that, first, the role of credibility and suspicion are not fixed parameters of critique, but rather open up the constructive contingency of each case; and second, that without this too much is made of the repetition at work in the findings of both review and criticisms, without looking at the ways in which this repetition is iterative and cyclical processes of territorialisation and deterritorialisation. In particular, the over-coding of the reviews often results in a reterritorialising of practice that is far smaller and functionalist than optimal, and the result of this is the often-limited focus on ‘better training’ and

118  Placing the review under review restrained forms of retributive justice. But part of this over-coding comes, I suggest, from utilising concepts of critique that occludes the importance of their relations to other terms within a gathered assemblage; what DeLanda describes as the ‘reification’ of particular terms. In contrast to this, understanding criticism and its component parts existing dynamically in an ecosystem of case, knowledge, expertise and self-identity offers at least the potential of alternative paths through this highly charged field. As Brown and Tucker remind us, philosophical changes cannot be simply ‘transposed’ into the world of practice and attempts to do so ‘typically show blithe disregard for the particularities’ at work in different fields (2010, p.248). Aware of this, I conclude simply with the suggestion that assemblage theory provides some resources for exploring the ways in which critical approaches within practice relate can be both contingent and essential. Unpacking the contingencies of context – including components such as credibility and suspicion that authorise critical practice – is a way to enhance the understanding of critique at work in a given situation. References Ahmed, M. (2008). ‘What’s Wrong with Serious Case Reviews?’ Community Care. Available at: https://www.communitycare.co.uk/2008/12/09/whats-wrong-withserious-case-reviews/ Anderson, B. (2016). ‘Improving Healthcare by Embracing Systems Theory.’ Journal of Thoracic Cardiovascular Surgery, 152:2, pp.593–594. Baker, T. and McGuirk, P. (2017). ‘Assemblage Thinking as Methodology: Commitments and Practices for Critical Policy Research.’ Territory, Politics, Governance, 5:4, pp.425–442. Boso, C. and Gross, J. (2015). ‘Nurse Educators’ Perceptions of Critical Thinking in Developing Countries: Ghana as a Case Study.’ Advances in Medical Education and Practice, 6, pp.555–560. Brookfield, S. (1993). ‘On Impostorship, Cultural Suicide, and Other Dangers: How Nurses Learn Critical Thinking.’ The Journal of Continuing Education in Nursing, 24:5, pp.197–205. Brown, S. and Tucker, I. (2010). ‘Eff the Ineffable: Affect, Somatic Management, and Mental Health Service Users.’ In Gregg, M. and Siegworth, G. (eds.), The Affect Theory Reader. Durham, NC: Duke University Press, pp.229–249. Buchanan, I. (2015). ‘Assemblage Theory and Its Discontents.’ Deleuze Studies, 9:3, pp.382–392. ———. (2021). Assemblage Theory and Method. London: Bloomsbury. Bussu, S. and Marshall, M. (2020). ‘(Dis)Integrated Care? Lessons from East London.’ International Journal of Integrated Care, 20:4, pp.1–10. Dekker, S. and Hugh, T. (2014). ‘A Just Culture after Mid Staffordshire.’ BMJ Quality and Safety, 23:5, pp.356–358. DeLanda, M. (2006). A New Philosophy of Science: Assemblage Theory and Social Complexity. London: Bloomsbury. ———. (2016). Assemblage Theory. Edinburgh: Edinburgh University Press. Deleuze, G. (1992). Michel Foucault, Philosopher. Trans. Armstrong, R. London: Routledge.

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120  Placing the review under review Mol, A. (2002). The Body Multiple: Ontology in Medical Practice. London: Duke University Press. Munro, E. (2011). The Munro Review of Child Protection: A Child-Centred System. Report commissioned by the Department of Education, British Government. Nadan, Y., Weinberg-Kurnik, G. and Ben-Ari, A. (2015). ‘Bringing Context and Power Relations to the Fore: Intergroup Dialogue as a Tool in Social Work Education.’ British Journal of Social Work, 45:1, pp.260–277. Ofsted. (2008). Learning Lessons, Taking Action: Ofsted’s Evaluations of Serious Case Reviews 1 April 2007 to 31 March 2008. Available at: https://dera.ioe. ac.uk/324/1/learninglessons_scr.pdf Paleček, M. and Risjord, M. (2013). ‘Relativism and the Ontological Turn within Anthropology.’ Philosophy of the Social Sciences, 43:1, pp.3–23. Pawson, R. (2013). The Science of Evaluation: A Realist Manifesto. London: Sage. Peckover, S. and Smith, S. (2011). ‘Public Health Approaches to Safeguarding Children.’ Child Abuse Review, 20:4, pp.231–237. Preston-Shoot, M. (2018). ‘What is Really Wrong with Serious Case Reviews?’ Child Abuse Review, 27, pp.11–23. Protevi, J. (2006). ‘Deleuze, Guattari and Emergence.’ Paragraph, 29:2, pp.19–39. Rawlings, A., Paliokosta, P., Maisey, D., Johnson, J., Capstick, J. and Jones, R. (2014). A Study to Investigate the Barriers to Learning from Serious Case Reviews and Identify Ways of Overcoming these Barriers. Department for Education Research Report. Available at: https://assets.publishing.service.gov.uk/government/uploads/ system/uploads/attachment_data/file/331658/RR340.pdf Raymond, C., Profetto-McGrath, J., Myrick, F. and Strean, W. B. (2018). ‘Balancing the Seen and Unseen: Nurse Educator as Role Model for Critical Thinking.’ Nurse Education in Practice, 31, pp.41–47. Rogers, P. (2008). ‘Using Programme Theory to Evaluate Complicated and Complex Aspects of Interventions.’ Evaluation, 14:1, pp.29–48. Rose, W. and Barnes, J. (2008). Improving Safeguarding Practice. Study of Serious Case Reviews 2001–2003. Department for Children, Schools and Families. Available at: https://www.scie-socialcareonline.org.uk/improving-safeguarding-practice-studyof-serious-case-reviews-2001-2003/r/a11G00000017xUnIAI Savage, G. (2020). ‘What Is Policy Assemblage?’ Territory, Politics, Governance, 8:3, pp.319–335. Sidebotham, P., Brandon, M., Bailey, S., Belderson, P., Dodsworth, J., Garstang, J., Harrison, E., Retzer, A. and Sorensen, P. (2016). Pathways to Harm, Pathways to Protection: A Triennial Analysis of Serious Case Reviews 2011 to 2014. Department for Education. Available at: https://assets.publishing.service.gov.uk/government/ uploads/system/uploads/attachment_data/file/533826/Triennial_Analysis_of_ SCRs_2011-2014_-__Pathways_to_harm_and_protection.pdf Simmons, M. (2022). ‘The NHS Is Collapsing. These Figures Prove It.’ The Spectator, 11th August. Available at: https://www.spectator.co.uk/article/the-nhs-is-collapsingthese-figures-prove-it/ Straub, R. (2013). ‘Why Managers Haven’t Embraced Complexity.’ Harvard Business Review, May 6. Available at: https://hbr.org/2013/05/why-managershavent-embraced-c#:~:text=Complexity%20wasn%E2%80%99t%20 a%20convenient%20reality%20given%20managers%E2%80%99%20 ­ desire,created%20models%20and%20mechanisms%20that%20wish%20it%20 away

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5

The power of critique Looking back and forwards with Foucault

‘We are drowning in misinformation,’ states a critical thinking blog called Thinking is Power (https://thinkingispower.com/floater-a-tool-kitfor-evaluating-claims/). Offering an article entitled ‘A Life Preserver for Staying Afloat in a Sea of Misinformation,’ it suggests that to aid us against such a sea, understanding ‘the process of science and how to draw reasonable conclusions from the available evidence can empower [us] to make better decisions and protect them from being fooled or harmed’ (TrecekKing 2022). But knowledge on its own, the Thinking is Power blog claims, is not enough: critical thinking is the key to turning knowledge into empowerment. In many ways, this sentiment is persuasive. The formula is straightforward enough: more information, critically understood, enables active engagement and therefore shifts the power balance of the welfare relationship. In this way, the power of critique is clear: in Lack and Rousseau’s words, ‘knowledge cannot be separated from power – having knowledge confers power, and lacking knowledge removes it and creates vulnerability’ (2015, p.3). This can be seen in the shifts in welfare provision towards patient or serviceuser empowerment that is rooted in ‘the use of technology that facilitates increased patient access to information via the Internet, peer-to-peer sharing, consumer health devices, and mobile apps’ (Ennis-O’Connor 2018). In such a context, patient or service-user empowerment is clearly at odds with more traditional ‘compliance’ models of care, which sees the patient’s role as a passive recipient, whereas ‘empowerment’ models make the patient an active part of the care process (Cutica et al. 2014). The aim of guides such as Thinking is Power is therefore to provide the right critical methods allows sense to be made of the array of potential information, and the useful to be separated from the misleading. Criticality is, then, a process of reducing or economising information into knowledge. This is supported by the recitation of highly traditional motifs of critical thinking: we find in the ‘Life Preserver’ standard rules of logic, common fallacies to avoid, and the familiar use of water-based imagery to separate reason from unreason. DOI: 10.4324/9781003123583-6

The power of critique: looking back and forwards with Foucault  123 The allusions to drowning in seas of misinformation is, as Michel Foucault once noted, common to the Western imagination. Throughout a myriad of philosophical treatises, reason is represented by the image of terra firma, an island or a continent, capable of stalwartly repelling the unreason of water and its secret, hidden depths. The benefit of such an image is that it separates reason and unreason into two identifiable spaces, with one clearly preferable to the other. After all, unlike the sea, the land is something one can hold, divide and organise. Thus, on the one hand, the sense of empowerment promised by critical thinking is the straightforward idea that, with the right tools, knowledge will be used – that is, held, divided and organised – correctly, and fact will be separated from fake news or post-truth. On the other hand, it also invokes specific images that frame empowerment with a reduction of the complications of the world into two distinct positions, the rational and the irrational; an economising either/or echoed by The Lancet editor Richard Horton when he once claimed that in a post-truth world ‘a rigorous quest for fact is all that separates us from chaos and damnation’ (2017, p.1282, my emphasis). There is obviously nothing wrong with wanting some clarity in the complex and often-contradictory world of the caring professions (even if we might hesitate before accepting such a stark drop-off; after all, is that really all that separates us?). Likewise, conducting any form of critique without the possibility of it bringing about change in some way would only be a paper exercise, and as such there must be a sense in which critique holds a form of power to bring about such changes. But metaphors are also powerful, and we should not be too quick to accept the premise that the power of critical thinking rests on a binary separation of the world into the rational on the one side and the irrational on the other, in the way that tropes of watery unreason do. As we have seen in previous chapters, the complexities of contemporary care render these binaries unhelpful, if not debilitating, for critical activity. If critical thinking is key to empowerment, we need to step away from the rather simplistic notions of both criticality and power that the Thinking is Power blog references. How, then, might we rethink the relationship between knowledge, power and critique? For this, the work of Foucault can be particularly instructive for thinking through the more simplistic and problematic assumptions that informed critical thinking leads to empowerment in the domain of care. By examining Foucault’s approach to critique – a particular form of ‘looking back’ at the genealogy of practice – different accounts of critical empowerment can emerge. But at the same time, as this chapter will argue, there is a risk that the radical nature of Foucault’s approach to criticality becomes somewhat familiar and toothless due to shifts in the regimes of care he described. For this reason, as well as looking back, we also need to look forward to what a post-Foucauldian analysis of critique and empowerment – taking into consideration such regime shifts – would look like.

124  The power of critique: looking back and forwards with Foucault Usefulness, discipline and power For a long time now, to speak about power in social research is to speak about the work of Foucault (Bevir and Blakely 2018). His critical interventions in history, sociology and philosophy allowed power to be understood less as a ‘thing’ which is held, owned or wielded by individuals, and rather a set of relations which are produced and performed. As such, Foucault’s shadow casts itself a long way over contemporary social science, theory and applied professions. On the one hand, this is to be welcomed. Foucault’s work lends itself to problems of practice because of his interest in the way that the body – particularly the sick, deviant or deprived body – is a complex site where socio-cultural norms are played out. According to Foucault, the body has historically been ignored or obscured within philosophical traditions that focus far more on thought and mind. As a result, Foucault turns to the body as a site of critical resistance against such traditions. He does this by following a ‘genealogical’ approach, which traces the histories of terms, names and concepts which we might otherwise assume are universal, natural or timeless. Instead, in works such as Madness and Civilisation, Discipline and Punish and The Birth of the Clinic, he demonstrates how terms such as ‘madness’ or ‘deviance’ are contingent, shifting and changing according to the interrelationship of power and critique. These demonstrations have been vital in challenging practitioners to reopen questions such as: what constitutes a ‘patient’? How does ‘medicalised’ knowledge, informed by various rules for collecting, analysing and distributing research, come to create the subject of medicine – the patient, the service user, the clinician, the expert? How does the organisation of space, place and population create and perpetuate social inequalities as much as address them? And so on. In the words of Adrienne Chambon, ‘historicizing our understanding of reality by retracing how particular practices and forms of knowledge have been created and adopted over time and treating these as results and not as truths’ encourages the exploration of how different voices and circumstances are produced though the materials of professional practice such as patient notes or case files (Chambon 1999, p.78). In doing this, Foucault interrogates the historical construction of concepts otherwise thought to be fixed and unchallengeable is a key activity of critical thinking. He aims specifically at the forms of knowledge which claim unchanging truths, and deny that their claims may be situated, contextual and necessarily limited. In their work using history as a critique of contemporary nursing, Foth et al. draw on that Foucault’s approach which: rests on analysis of historical documents to understand how they contributed to the constitution of past and present realities – how truth and particular forms of knowledge were solidified in the past, and how realities in the present are formed […]. It is about concentrating on the “surface,” which is a critique of the historical material and takes the

The power of critique: looking back and forwards with Foucault  125 materiality seriously. The concept of discourse invites us to observe the text closely to uncover unexpected prejudices and reservations. Beneath the text lies a kind of collective intelligence determined by practices and systems of differentiation that operate underneath any “conscious” statement or logic of ideas. (Foth et al. 2018, p.5) Foucault’s early work asked questions of this ‘collective intelligence’ that were, in many senses, the opposite of theorists before him. For political philosophers of the past such as Hobbes or Rousseau, and traditional sociologists such as Durkheim and Weber, the question to as was ‘what holds society together?’ Foucault, far more interested in prisons, hospitals and social workers than ideal models of society, turned this question into ‘how are certain people excluded from society?’ But as his research developed, this question changed again, as he began to see that ‘exclusion’ – whether the placing of someone in prison, the sectioning of someone with mental health issues, or the deprivation of somebody’s benefits – was in fact a technique for sustaining particular models of society. What appeared at first to be a separation of populations into those who were ‘normal’ and those who were deviant, ill, or criminal, served to define what ‘normality’ should be. Hence, while people might be locked up in prisons or asylums, and sick people might be separated from the healthy by staying in a hospital, Foucault notes that these buildings were nevertheless always visible (asylums, e.g., were typically built on hills; prisons, at least before the 20th century in Europe, were often built in the middle of towns). In this way, such techniques were interpreted by Foucault as the operation of a specific form of power. There is no one form that this power takes, but Foucault draws attention to three in particular: discursive (e.g., the way our language implicitly sets out accepted and unaccepted practices; just as Thinking is Power drew on the metaphors of water to indicate the threat of unreason), disciplinary (the ways in which we classify individuals according to a set of norms such as ‘sick’ or ‘mad,’ and use this as a basis for ‘correcting,’ ‘fixing’ or ‘curing’ them), and biopower (the ways in which society is described in terms of quantitative analyses of population health and demographic data). Hence, disciplinary power applies to individuals, whereas biopower emerges from technologies focused on social, economic, and environmental factors. In the pre- and early modern age, Foucault suggests, power equated with the power to kill or harm. This was the power of the king or sovereign, which remains a commonplace for many discussions of power as a form of invasive force. But from the 18th century onwards in Europe, Foucault suggests that this model of power is replaced with an emphasis on regulation – separating, categorising and dividing populations in various different ways – rather than exclusion per se. Now, the purpose of power was to promote usefulness (Ahmed 2019, p.104), whether the usefulness of the individual or that of the deviant. The goal was not correction or punishment, but rather a form of

126  The power of critique: looking back and forwards with Foucault training that produces ‘useful and obedient individuals’ (Lemke 2019, p.63), often in the most everyday and banal practices. These forms of power mark a shift from the traditional models of power as form of force, towards power as a technique or technology: a set of relations, rather than thing one person or group can ‘possess.’ In keeping with his focus on the body, Foucault was particularly interested in the ways in which techniques and technologies of power shaped and moulded it into acting and thinking in particular ways such that they are ‘normalised.’ As David Couzens Hoy explains, such processes are not about destroying an individual, but rather producing one. In this way, ‘individuals are complicit in the process of their self-formation and they learn to normalize themselves. […] However, what it is to be an individual changes once the disciplinary regime colonizes and supplants the older, juridical regime’ (Hoy 2004, p.65). In modern disciplinary society, there is no one all-seeing power. According to Moffat, a number of rationalities can function within any social welfare agency. It cannot be assumed, however, that they are constructed according to a master plan nor that they create a cumulative effect. But an interplay does exist between the various technologies related to the exercise of power. (1999, p.220) Instead, Foucault argues that the judges of normality are everywhere. We are in a society of the teacherjudge, the doctor-judge, the educator-judge, the “social-worker”-judge; it is on them that the universal reign of the normative is based; and each individual […] subjects to it his body, his gestures, his behaviour, his aptitudes, his achievements. (1979, p.303) Ken Moffat provides a concise illustration of this aspect of Foucault’s concept of power with his analysis of a social assistance office in North America, where he pays particular attention to the role of ‘the examination’ conducted by the welfare officer on the service user. As Moffat explains, ‘minor procedures and modest methodologies’ work best to instil an economy of power which ‘combines hierarchical observation with normalising judgement’ (Moffat 1999, pp.221–222). In any health or welfare service, documentation – whether digital or material – is instrumental to its delivery. Permission papers to share personal information, medical records or case files all provide the crucial links that form the continuity of service in its various stages. At the same time, documentation frames interactions by privileging certain information at the expense of others, while also acting as a form of surveillance. In the case of the examination, the individual is created – that is, they

The power of critique: looking back and forwards with Foucault  127 become the ‘client’ – via a range of documents that they are to sign in order to become recognised as a potential welfare recipient. If they fail to sign the prerequisite documents, then while they still exist as a person, they serve ‘no useful purpose within the system of power relations’ (p.222). In Discipline and Punish, Foucault famously discusses Jeremy Bentham’s plans for a panopticon prison. This prison – designed for overseeing a maximum amount of prisoners with minimal staffing – consisted of a ring of individual prison cells built around a watchtower. The prisoners are unable to see each other or know whether they are being watched or not. As a result, in Bentham’s view, this would achieve a retraining of the prisoner through their own mental retraining to act as if they are always being watched, and in doing so internalise the merits of right and wrong. In this way, power is always visible, but unverifiable. The principle of the panopticon can be seen in the disciplinary combination of surveillance and judgement that Moffat identifies. Once the idea that our activities are under surveillance – from who, we may not be fully cognisant – our actions will adjust to be more ‘useful.’ This explanation of power within welfare delivery is supported by an essential relation to critique, which appears as the arbiter of whether a service user is ‘useful’ within the system – that is, qualifying for support, engaged in services, etc. – or not. In Moffat’s example, every surveillance operation requires the worker to sit ‘in judgement of the client’s eligibility’ (Moffat 1999, p.223). As Moffat argues, while this judgement takes the form of constant verification procedures to affirm that the client is who they say they are, and that they are working towards the appropriate goals to continue their support, the welfare workers themselves are also under surveillance from supervisors, who are in turn watched by managers above. In this sense, the answer to our original question regarding the power of critique now goes beyond our original and slightly glib account of a tool to economise information into knowledge. For a Foucauldian reading, what constitutes ‘knowledge’ is rooted in techniques and technologies for normalising (in the case of Moffat’s example, we might say rendering the service user ‘useful’) rather than the application of criticality per se. Situating critical thinking in this therefore needs more investigation. The centrality of critique In one sense, Foucault’s focus on the body as a site or practice, and his calling into question the authority of widely accepted bodies of knowledge, suggests his work is a form of anti-intellectualism; or, at least, opposed to the traditions of ‘proper thinking’ that valued cognitive abilities over and above the physical. But rather than simply reject the intellectualist account of the body – a rejection we often find in those arguments railing against degreelevel education for the caring professions because ‘it’s no replacement for real experience’ and therefore of little use in the applied world – Foucault wanted to understand the disciplinary techniques that enable some bodies to

128  The power of critique: looking back and forwards with Foucault be recognised and others not. In other words, he was less interested in what was ‘useful,’ and more how ‘usefulness’ is itself a technique for shaping the spaces where critical practice can and can’t take place. This is not so that he can, in his own words, simply ‘mark out impossible boundaries or describe closed systems.’ Instead, understanding such techniques ‘brings to light transformable singularities. These transformations could not take place except by means of a working of thought upon itself; that is, the principle of the history of thought as critical activity’ (Foucault 1984, p.335). What is meant by this? The suggestion here is that critical thinking in its traditional form would constitute yet another form of disciplinary training (hence, it simply describes ‘closed systems’). To put it bluntly, according to Foucault, one does not use critical thinking (as one uses a life preserver) because it is useful; instead, critical thinking itself creates a useful subject. Indeed, traditional critical thinking appears to be an exercise in judging and condemning, and as such its links to the professionalisation agenda of the caring professions – that is, the creation of authoritative caregiving – makes perfect sense. For Foucault, such critical practices are primarily judicial, and characterised by three aspects (Lemke 2011): 1 Deficit. Criticality focuses on lack of knowledge and errors of practice, with the aim of correction. 2 Dependency. Critical thinking has no core existence; it is dependent on that which it critiques, but also promises a (better) future – without errors of practices – that does not yet exist. 3 Distance. In order to be critical, there must be a distance between one who knows and one who does not; those who are in charge and those who are not; those who are specialist and those who are not. The ‘disciplining effect’ of such practices can be seen straightforwardly enough in a majority of textbook approaches to critical thinking in health, social care and social work. Take Frohman and Lupton’s study skills book (2020), for example. They begin with an acknowledgement that there is no single definition of critical thinking, before listing a number of suggestions for what it might be. They then ‘define critical thinking as applying all of those thinking skills listed above in order to come to a judgement on an argument or idea’ (Frohman and Lupton 2020, p.6). The main focus of the book is, somewhat unsurprisingly for a study skills text, identifying the gap between subjective opinion and well-evidenced argument, in order to develop the skills for ‘building rapport, delivering high-quality safe care and developing professional standards’ (p.151). In line with Foucault’s account, we can see here that criticality here points to deficits (in this case, in the student’s unfamiliarity with academic and professional standards); its usefulness is premised on better practice in the future (in particular, the authors emphasise the link between critical thinking and safety in the workplace); and it emphasises the need for ‘high-quality’ evidence

The power of critique: looking back and forwards with Foucault  129 to be deployed in the student’s writing, the distance between informal and formal statements, and, perhaps more subtly, the need to ‘build rapport’ between the non-expert and the expert in the field. Not only does this have a disciplining effect on anyone applying critical thinking, who is trained to incorporate these three aspects into any exercise of critical thought, but it also implies critique must be negative (focused on errors and mistakes). Consider, similarly, Brian Sheldon’s well-used definition: ‘Evidence-based social care is the conscientious, explicit and judicious use of current best evidence in making decisions regarding the welfare of those in need’ (Sheldon and Chilvers 2002, p.6). As Celia Keeping notes (2008), such a definition is significantly abstract. First, in terms of ignoring the involved role of the practitioner (only externally verified evidence counts, which involves shaping practice to standardised interventions at the expense of the ‘skill and wisdom’ of the practitioner; in other words, this definition is core to the disciplinary techniques of professionalised social work. Second, it addresses critical evidence in a one-way direction regarding the definition of ‘those in need’ who, one assumes, do not, or cannot, apply critical thinking in the same way. On this reading, then, the power of critique is not a normative judgement on information, based on rigorous and validated methodologies (as Thinking is Power has it), but rather one of several technologies for shaping relations, hierarchies and values. Looking back: thinking critically with Foucault If there is no shortage of critical thinking texts performing this disciplinary role for knowledge in practice, it is perhaps not surprising that Foucault’s account of disciplinary power has become a go-to resource for those who question the forms and hierarchies of knowledge within health, social care and social work. After all, in organisational cultures seemingly driven by targets and outcome metrics, it is never too difficult to find examples of how such techniques affect both behaviours and meanings of practice, shaping the growth and development of practitioners. For sure, this can warn us of the naivete of claims such as Thinking is Power, and that assessing knowledge in terms of its logical sequencing can overlook a whole range of techniques at work in assuring such sequencing seems obvious and correct. At the same time, though, there is an accompanying risk, particularly in health and care disciplines, that a kind of institutionally-safe, textbook-reductive Foucault emerging: a readymade figure that stands for catch-all phrases and doesn’t really get us anywhere as a result. The lingering summary of Foucault as simply a ‘social constructionist,’ for example, can be misleading and unhelpful, and the claim that ‘knowledge is power,’ powerful as it may appear, can lead us down a dead end without a sense of how to move beyond it. Consider, for example, how during the onset of the COVID-19 pandemic, Richard Horton of The Lancet turned to Foucault to make this point precisely. Recognising that ‘medicine and public

130  The power of critique: looking back and forwards with Foucault health are being co-opted into a political programme of population control,’ and by extension to ‘protect the power of the modern neoliberal state,’ this did not take away from health and care practitioners’ ‘obligation to question power and its effects on truth, and truth and its effects on power’ that arose as a necessary part of what he described as ‘the struggle for health’ (Horton 2020). Yet, this is the same Horton who also advocated a redoubling of existing methods of research to counter post-truth; ignoring their potential complicity in both the distrust of institutions, and, here, the relations between power and truth. Foucault makes good as a reference, in such instances, but we should be asking for more than this. In particular, we should be wary of this when problems with applying Foucault’s ideas to service delivery are raised. Borg, for example, recounts the common accusation that ‘by exaggerating the pervasiveness and intricacy of disciplinary mechanisms and power relations, Foucault overlooked – and even considered as an extension of the workings of power – individual agency’ (Borg 2015, p.2). Chambon likewise notes that Foucault’s emphasis on the ‘subject,’ rather than the ‘individual’ which is more commonly invoked across health and social care, can be problematic, especially in professions such as social work or occupational therapy which have historically valorised humanistic notions of ‘personality, motivation, autonomy, and self-determination’ (Chambon 1999, p.58). This becomes particularly problematic when we attempt to think of criticality as anything beyond yet another disciplinary technique – that is, to reduce criticality to knowledge – as this seems to surrender any ability to question or challenge such processes. Some have identified a certain ‘neutralisation of critique’ in the Foucauldian approach (Delanty 2011, p.87). It is true that Foucault criticises the notion of autonomy as straightforward self-rule by exploring the notion of ‘governmentality’: that is, the techniques and technologies which shape the way individuals govern themselves. In this way, contra the more deterministic views of Marxism, ‘the subject constitutes itself in an active fashion through practices of the self,’ but ‘these practices are nevertheless not something invented by the individual himself [sic].’ They are instead ‘proposed, suggested, [and] imposed upon him by his culture, his society, and his social group.’ (Foucault 2003a, p.34). There can, then, be no self-sufficient autonomy, as the rationality this depends upon is itself a technique of governmentality. Furthermore, if critical thinking is, on Foucault’s reading, nothing more than a form of disciplining the other, then surely (the objection goes) his own project cannot simply repeat the same act of judicial critique. However, many of these concerns end up dealing too much with what I earlier termed Foucault’s shadow, rather than his own proposed model of critical thinking. Outlining this model will help to address the problems raised above; although, as we shall see, it will also raise some issues of a different order. It is important to note that Foucault’s aim was not to critique power in the same sense that Thinking is Power critiques misinformation. His account of

The power of critique: looking back and forwards with Foucault  131 biopower in fact stresses the point that issues such as population health, family structures, improvements in hygiene and nutrition, the welfare state and so on are all positive aspects of state activity. In Foucault’s view, these positive aspects are not simply a list of rules (i.e. ‘be healthier!’), but structural and discursive ways of ensuring that certain forms of healthy circulation are promoted (be this fresh air, viral immunity, or goods and money), whereas others are prevented from circulating (such as transmissible diseases). As such, Foucault’s alternative to the judicious application of critique is not to reject criticality completely, but rather to emphasise its transformative capacities, rather than its inherent support for the way things are currently ordered and discussed. His phrase ‘transformative singularities’ refers to specific arrangements and organisations of activities that could be otherwise. It can be helpful, following Lemke (2011), to think of Foucault’s engagement with criticality as a two-step process. The first step is the aforementioned genealogical approach, which is perhaps the more well-known aspect of his work, at least in fields of health and care. The second, which he describes above as ‘a working of thought upon itself,’ is to attempt to understand, if universal truths and concepts are actually contingent and changing, why they are accepted as universal in the first place. Hence, for Foucault: critique is not a matter of saying that things are not right as they are. It is a matter of pointing out on what kinds of assumptions, what kinds of familiar, unchallenged, unconsidered modes of thought the practices that we accept rest. […] Criticism is a matter of flushing out that thought and trying to change it: to show that things are not as selfevident as one believed, to see that what is accepted as self-evident will no longer be accepted as such. Practicing criticism is a matter of making facile gestures difficult. (Foucault 1988, pp.154–155) This point enables us to see why the potential discomfort practitioners might feel with Foucault’s apparent rejection of the autonomous individual are perhaps misplaced. Foucault’s interest in the subject (as opposed to the individual) is part of an effort to understand the experience of the body placed within systems of ‘care’ or ‘governance’ (hospitals, prisons, schools, etc.), and this necessarily requires disconnecting ‘the unquestioned continuities by which we recognise, in advance, the discourse that we are to analyse’ (Foucault 1969 [2002], p.27). As such, he criticises the notion of autonomy as straightforward self-rule by exploring the notion of ‘governmentality,’ that is, the techniques and technologies which shape the way individuals govern themselves. In this way, contra the more deterministic views of Marxism, ‘the subject constitutes itself in an active fashion through practices of the self,’ but ‘these practices are nevertheless not something invented by the individual himself [sic].’ They are instead ‘proposed, suggested, [and] imposed upon him by his culture, his society, and his social

132  The power of critique: looking back and forwards with Foucault group.’ (Foucault 2003a, p.34). There can, then, be no self-sufficient autonomy, as the rationality this depends upon is itself a technique of governmentality. However, an individual does have agency. They are still concrete individuals in concrete social contexts, of course, and while these contexts are created through various arrangements of power relationships, Foucault argues that governmentality is ‘always a versatile equilibrium, with complementarity and conflicts between techniques which assure coercion and processes through which the self is constructed or modified by himself’ (Foucault 1993, pp.203–204). He thus reframes autonomy as the ‘permanent creation of ourselves’ within our domains of practice (2003b, p.52), which is not an isolated effort but rather created through ‘the interplay of care of the self and the help of the other’ which ‘blends into pre-existing relations, giving them a new coloration and greater warmth.’ Or, as Powell puts it, ‘on the one hand, professional surveillance restricts practice while, on the other, complexity opens up the space for resistance and new formulations of power relations’ (2013, p.51). In this way, Lemke suggests that: critique does not move in simple opposition, or reaction, to intensified practices of government. Instead, it functions as an element within them. Inasmuch as government represents a form of power that structures the field of subjects’ possible actions through the production of truth, it must constantly confront the question of its principles, scope and aims. (2019, pp.364–365) In other words, there is a need to suspend what is ‘accepted without question,’ precisely in order to ask: how is this accepted without question? This does not mean that Foucault wants to place everything in doubt (as early modern philosophers like Descartes did) or assume some kind of position outside of the discourses and practices in question (the kind of ‘view from everywhere’ that was apparent in, for example, Sheldon and Chilvers’ use of abstraction in their definition of critical thinking). Instead, he is clear that the accepted continuities of practice ‘must not be rejected definitively […] but the tranquillity with which they are accepted must be disturbed’ (Foucault 1969 [2002], p.28, my emphasis). This links critique firmly to acts of change and displacement, or, in his own words, resistance: Critique doesn’t have to be the premise of a deduction which concludes: this then is what needs to be done. It should be an instrument for those who fight, those who resists and refuse what is. Its use should be in processes of conflict and confrontation, essays in refusal. It doesn’t have to lay down the law for the law. It isn’t a stage in a programming. It is a challenge directed to what it is. (Foucault 1980 [1991], p.84)

The power of critique: looking back and forwards with Foucault  133 Looking forward: post-disciplinary care It might be tempting to conclude the chapter at this point, given that we have arrived at an answer to the question of how critical thinking relates to power. But as I mentioned before, this raises a slightly different set of questions. These would be: how do we know that we are disturbing tranquillities, while remaining within the continuities that constitute ‘critical practice’? What kind of power does this critical thinking have? The need for this question was first highlighted by the theorist Jean Baudrillard, in his controversial work Forget Foucault. Baudrillard acknowledged that Foucault’s work offered a perfect explanation and analysis of power. But an analysis of such perfection could only take the place if what was under scrutiny was already finished, over, and no longer a live issue. ‘The very perfection of this analytical chronicle of power is disturbing,’ Baudrillard notes. [I]f it is possible at last to talk with such definitive understanding about power, sexuality, the body, and discipline, even down to their most delicate metamorphoses, it is because at some point all this is here and now over with. (Baudrillard 1977 [2007], p.30, emphasis original) In other words, the account of disciplinary power is so persuasive that it can become an all-encompassing explanation of just about everything, which is only possible if the world it describes is fixed and unchanging – or doesn’t exist anymore. One does not have to accept Baudrillard’s provocation to consider a problem it raises with Foucault’s account of criticality. By positioning himself against the normative-judicial model of critical thinking and emphasising a more performative and disruptive version in its place, Foucault may well appear to present critique as a form of ‘permanent self-creation’ which seems to resemble, in many ways, the neoliberal mantras of personal autonomy that we encountered in Chapters 2 and 3. This arises from the distinctive changes brought about under neoliberal regimes in the work of disciplinary techniques, as Mitchell Dean explains in a long passage: Previous health, welfare, and education systems sought to produce particular kinds of subjects. Domination had not proceeded by the objectification of what was truly human […] but by the creation of a certain kind of subject – docile, useful, and self-responsible. Social work, criminal anthropology, and child psychology, among the other disciplines of the human sciences, had conspired in the production of the “modern soul.” Neoliberalism, in direct contrast, would move to the side of the subject and its choices and seek to govern conduct not by the oppressive imposition of subjectivities (the criminal, the recidivist,

134  The power of critique: looking back and forwards with Foucault the homosexual, the underclass, etc.) but by acting on the conditions of choice, with the minimal supposition that choice was simply a nonrandom phenomenon. It would proceed by changing the rules of the game rather than supervening upon the individual. Neoliberalism didn’t so much aim to produce subjects as to cultivate desirable attributes of enterprise and competition by acting on the environment of individuals and their field of choice. (Dean 2019, p.329) As such, neoliberal welfare is less about the creation of individuals within established disciplinary systems (hospitals, care homes, prisons and so on), but rather about intensive processes of self-individualising. The problem, then, is that the characteristics of strong critique – challenging assumptions, questioning power relations and so on – are absorbed within narratives of neoliberalism. As such, Amselle notes that far from offering resistance to the current welfare regimes, Foucault’s account ‘can be seen as extremely conservative techniques for psychological maintenance, in the sense that they refer individual expression or grievances back to individuals themselves, thus averting any condemnation of the society in which they live’ (2016, p.165). This is far from a settled argument. For many, the neoliberal condition is best addressed with a doubling down of Foucault’s genealogy of disciplinary techniques. For philosophers such as Roberto Esposito (2020), the COVID19 pandemic provided a clear example of how the disciplinary techniques of medical knowledge were imposed upon the political regime. Such interpretations utilised immunological metaphors to describe the ways in which society is governed and directed to act: society as an (otherwise healthy) body, framed as in need of defending from the threat of the infection of the ‘other’ – which was not just the COVID-19 virus itself, but also the those who might be carrying it entering society’s borders, those who rejected government guidance, those who refused vaccines and so on. In turn, this positioned a particular form of knowledge as primary: the data produced by the scientist in the laboratory; at the expense of the more complex expertise from public health research. This would serve, under a Foucauldian reading, as a clear example of disciplinary power in action, with the fault-lines of judicial critique (the judgement of the ‘other’) in clear view. The problem that emerges from such an interpretation, though, is this: such is the usefulness of Foucault’s analytic toolkit, it becomes tempting to frame the mutation of disciplinary techniques using what amounts to the same disciplinary model. The risk, then, to utilise a Foucauldian analysis in much the same way that the Thinking is Power blog did: i.e., as a judicial corrective to the irrationalities of government responses, as a way of translating the sense of neoliberal welfare into something far more solid and predictable than it perhaps is. This is also notable within the application of Foucauldian critique in practice-based research. Consider, for example, Springer and Clinton’s (2015)

The power of critique: looking back and forwards with Foucault  135 paper on the use of Foucault in nursing studies, where they emphasise discuss the importance of ‘doing,’ as opposed to the ‘learning from’ or ‘training in’ that dominates nursing education. This, they suggest, offers a way of challenging the spread of uncritical reproductions of neoliberal concepts within healthcare. While an excellent introductory paper, there remains a constant pull throughout between emphasising the slippery aspects of Foucault’s own methodological position, while also describing a particular static theory, Foucauldian Discourse Analysis, as a method that might be replicated (or perhaps learned from or trained in?) across different practitioners (2015, p.88). One might suggest the paper is caught between the inspiration of Foucault’s writing and the problematising of key terms it brings, and the necessities of professional critical thinking which demands a named method and a set of regulations to follow. The result is that when the paper argues that ‘specifically, the Foucauldian scholar engages critically with the complexities of discourse, its immediacy, its endurance, its shifting content and contexts, its interrelationships, and its contingencies’ (p.88), what is actually ‘specific’ about this is somewhat lost. It leaves us only with a certain speculative hope in the idea that identifying or unmasking the workings of neoliberal care will provide the kind of future ‘refusal’ or ‘conflict’ that Foucault wrote of. At the root of both of these examples is, I think, a similar concern. Because the empowerment involved in the Foucauldian form of criticality is rooted in its narration or description of particular disciplinary techniques, its real power lies in its ability to present a coherent and persuasive body of work: whether this ‘body’ concerns the ‘other’ (the service user, the prisoner, the patient) or the mechanisms of ‘othering’ (the social services examination, the prison, the hospital). Baudrillard refers to this when he suggests that ‘Foucault’s is not […] a discourse of truth but a mythic discourse in the strong sense of the word’ (Baudrillard 1977 [2007], p.30), ‘When one talks about power, it’s because it can no longer be found anywhere’ (p.64). This point has been raised regarding the prominence of particular metaphors (no less than the notion of reason and unreason as dry land and sea that we encountered at the start of the chapter), most notably the idea of a disciplinary society being based on an immunological model. Byung-Chul Han, for example, has pointed to the problematic role of immunology as a framework for interpretation of contemporary society. The fundamental category of immunology is the Other, and this provides an interpretative language: a set of metaphors and allegories which links together otherwise disparate concerns in medicine, politics and technology. ‘The past century was an immunological age,’ he argues. ‘The epoch sought to distinguish clearly between inside and outside, friend and foe, self and other […]. The object of immune defense is the foreign as such’ (2015, pp.1–2). While this may work well for supporting Foucauldian analyses of power, for Han this immunological model is insufficient to describe the workings of 21st century late capitalism with its globalised information networks and dissolution of boundaries. If the model of immunology leads to disciplinary responses – the type of

136  The power of critique: looking back and forwards with Foucault organisational control which was described so well by Foucault’s account of institutions – for Han we now live in an achievement society. Here, the negative trope of control is replaced by an excess of positivity: ‘prohibitions, commandments, and the law are replaced by projects, initiatives, and motivation’ (2015, p.9). The problem is no longer an external Other, but rather the demands of self-fulfilment, demands which require our (metaphorical and literal) immune responses to be suppressed ‘so that information will circulate faster and capital will accelerate’ (2017, p.83). Reconsidering power, knowledge and critical thinking It is not accidental that Han names the circulation of information as a key feature of the achievement society. We began this chapter with Thinking is Power’s appeal to critical thinking to counter the growth of misinformation. But this growth is only possible due to the rise in information (mis- or otherwise), that is a hallmark of both late capitalist culture and the welfare systems within it. Back in 2002, McKendree et al. were pointing out that the rise of critical thinking in health and social care from the 1980s onwards could be attributed to ‘the information overload that accompanies the growth of electronic networks’; this meant that ‘being able to think critically is essential to be able to respond appropriately to rapid and complex changes in modern society’ (2002, p.58). Likewise, Gray and Schubert note a need for critical thinking because ‘more knowledge is produced than ever makes an impact on practice, and even when it does, there tends to be a huge time lag between the generation and use of knowledge’ (2012, p.203). Such an investment in critical thinking in its traditional forms overlooks how, as Bunz has argued, the shift towards new forms of information means that ‘the power mechanisms at work in digital technologies are structured in profoundly different ways from older forms of power’ (2021, p.195). Indeed, what Rouvroy (2013) terms the ‘computational turn’ in government (i.e. ‘the practice of framing the fields of actions of others’ with data insights) should not be seen as a trivial one. Such a ‘turn’ is not simply an enhanced form of decision-making, but also redefines knowledge, data and information as given facts which remove any need for interpretation or critical analysis. In other words, the implementation of ‘algorithmic rationality’ and data modelling fundamentally change the nature of what a ‘fact’ is. This has consequences for the prospect of critical engagement, given that the advent of a data-driven ‘knowledge society’ and its accompanying practices of behavioural insights, subtly shifts who or what would have the capacities to effect change. The discursive shift, most notable during the COVID-19 pandemic, from ‘facts’ to ‘data,’ for example, has profound effects on the ways in which critique can be formulated, shifting from ‘trusted measures and methodologies being used to produce numbers,’ to ‘a dizzying array’ of information ‘to be mined, visualised, analysed and interpreted’ (Davies 2021, p.33); and from concerns with the objective to an increasing concern

The power of critique: looking back and forwards with Foucault  137 with ‘sentiment analysis’ and other deeper aspects of human behaviour. As Nicotra argues: [t]he material changes in our communication technologies have altered our habits of perception such that the suasive force of the material has simply become more obvious. […] From mobile computing to social media, it is clear even to the casual observer that these technologies have had profound, material effects on the way we think, communicate and organise our lives. (Nicotra 2016, p.186) The rise in information and communication is inherently linked to neoliberal forms of capitalism. This is rooted in the shift to the post-industrial knowledge society in the global north during the late 1960s and 1970s, a shift marked by ‘technological transformations’ which ‘displaced the focus from the sphere of the production of material goods towards the sphere of semiotic goods: the info-sphere’ (Berardi 2009, p.44, my emphasis). According to Franco Berardi, it was at this point that capitalism in its historical sense of the production and exchange of material goods, was replaced with semiocapitalism: the production and exchange of signs. Under such conditions: Both labour and capital […] no longer have a stable relation to territory or community. Capital flows in the financial circuits, and enterprise is no longer based on territorialised material assets, but on signs, ideas, information, knowledge, and linguistic exchange. Enterprise is no longer linked to territory and the work process is no longer based on a community of workers […] but instead takes the form of an ever-changing recombination of time fragments connected in the global network. (Berardi 2012, pp.117–118) As Deleuze once noted, the disciplinary regimes that Foucault described were long-standing, based on a fixed gold-standard of value; the neoliberal economy is based on ‘floating exchange rates’ which lead to necessarily ‘shortterm and rapidly shifting’ transactions of power (1995, p.180). Whereas for Moffat earlier the process of interviewing service users was the basis for disciplinary control, the regime of semiocapitalism multiplies the fields through which this transfer of information affects and shapes services. In other words, service-user data is not simply an off-shoot of better notetaking by practitioners, but rather a key source of value in the subject of a neoliberal welfare regime. Information and communication have become the main sites of power relations in the context of contemporary welfare, with clear effects on the ways in which health and social services are delivered and appraised; whether in the spread of data from service provision to research use to commercialisation prospects, or in drives to improve user-centred health and social care services using health informatics (Loader et al. 2008), or in the

138  The power of critique: looking back and forwards with Foucault attempts to rethink how social and health services are funded and delivered, given the knock-on effect of information and communication technologies on the labour market (Pasi and Misuraca 2020). In terms of our purposes here, there are two ways in which the notion of semio-capitalism might effect our critical practices, and discern whether this rise in information provides positive or negative effects. Firstly, the disciplinary model of society is premised on controlling the distribution of and access to information. It was reflected in social theory’s concern with who was excluded or alienated as ‘other’ by this control, and the ‘relational discomfort’ of ‘incommunicability’ it produced (Berardi 2009, p.30). But in the neoliberal information society, alienation is replaced with saturation. ‘Not silence, but uninterrupted noise […], a cognitive space overloaded with nervous incentives to act: this is the alienation of our times’ (Berardi 2011, p.108). The result of this is to once again fundamentally problematise the notion that critique depends upon the idea of exclusion and the Other: the accessibility of information today, and the digital technologies which enable it, are after all substantively different to those of the panopticon or the asylum. Secondly, the excess of information at the very heart of power brings with it a core irrationality to the application of economic logic in its neoliberal guise. This irrationality is not so much problematic to it as fundamental. Lemley (2022) points to the fundamental paradoxes at work in introducing the notion of the ‘marketplace customer’ into healthcare delivery; Weeger et al. (2021, p.689) note contradictions in ‘improving patients’ health status versus improving hospital productivity, or time devoted to administrative efforts versus time dedicated to patient care. Foth et al. point to another easily recognisable example: To break what [has been] called “welfare dependency,” governments have systematically rolled back support for the vulnerable, and healthcare services have increasingly been privatized. […] The work environment for nurses has also changed dramatically with the implementation of different managerial technologies embodied in neoliberalism. It is claimed that these technologies will make nurses’ work more efficient, but often they lead to the intensification of nursing work. (Foth et al. 2018, pp.1–2) Perhaps the biggest contradiction, though, is the fact that ‘the neoliberal celebration of identity and self-making is mired in the authoritarian practices it generates’ (Dean 2019, p.335). In other words, the technologies of discipline do not disappear within Han’s achievement society; they are rather refigured, carried under different signs and systems while typically retaining the rhetorical fields from which they first operated, such as the metaphors they employ (think of the Victorian notion of the ‘deserving’ and ‘undeserving’ poor, which remains at work in many welfare policies involving the removal of benefits or opportunities). Indeed, the very dependence on the circulation

The power of critique: looking back and forwards with Foucault  139 of what Berardi identified as ‘signs, ideas, information, knowledge’ enable these contradictions to be not obstructive, but actually form the core of contemporary service delivery. Hence, while Foth et al. utilise Foucault’s writing to emphasise the technologies for implementing such paradoxical regimes of care, what they perhaps miss are the ways in which such contradictions nevertheless make some form of sense to those involved in the delivery. This is because, as Dean suggests, these forms of neoliberalism involve the loss of the ‘monopoly on truth’ that institutions previously enjoyed – be they institutions of health, welfare, science or media. And if this is the case, then ‘the relations of power and possibilities of manipulation run much deeper than the surveillance society with its increased digital panoptism and even algorithmic governmentality can allow’ (2019, p.338). Is critical thinking powerful? How, then, should we consider the power of critique? I will conclude with three summary points. First, the normative-judicial model that we find so often within critical thinking textbooks will always find itself struggling to make sense of neoliberal welfare regimes, given their fundamental irrationality. Not only this, positioning critical thinking as a ‘life preserver’ against misinformation will be problematic, if the vast array of information in the sphere of care delivery requires a certain amount of misinformation, misuse of data, poorly collected or unnecessary data. These are not accidents; they are a consequence of the growth of information. No amount of critical thinking will relieve current care systems from them. They are there to be negotiated, and such negotiation requires careful consideration of how information is being framed discursively, what position it holds in the rhetoric of care delivery, and to which audiences it is being applied. Second, as an alternative to the redundant normative-judicial model of critical thinking, Foucault’s insights are invaluable. But there are risks of utilising these insights as a supplement to the judgemental models: whereby, all-powerful narratives of disciplinary systems are deeply persuasive for a critical perspective, but may forsake accurate articulation of the complex realities of practice for the sake of narrative coherence. This is not to ignore the significance of narrative coherence; as I suggested at the end of Chapter 2 it can be incredibly powerful in kairotic moments of practice. However, it is important to note the distinction between the power and persuasiveness of a narrative (such as the disciplinary account of power, or neoliberalism as a doubling-down on disciplinary techniques), and the power of critique itself. This is why many of the imminent critiques rooted in Foucauldian analysis can often fall either into a supplement for the same normative-judicial techniques they were supposed to replace, or into a certain descriptiveness that leaves the actualities of critique as somewhat idealistic or speculative.

140  The power of critique: looking back and forwards with Foucault The third point is made by way of a brief analogy. In his book After Virtue, Alasdair MacIntyre argues that ethical theories arose from particular shared contexts, whereby specific communities had a clear sense of direction to improve towards. The purpose of ethics, then, was to help that community adapt its practices in order to move closer to a more ideal way of living through a group of particular values or moral rules. We can see this as a three-stage process: first, the community in a state of need; second, the rules and principles to follow; and third, the ideal point at which community need is met. Over the years, MacIntyre argues, this first stage, the original context, has disappeared. The small communities of the classical period that first posited ethical ideals were long gone by the time of modernity. Now, communities are shaped by working practices, state policy, job opportunities, migration, access to infrastructure and so on. Yet, the ethical ideals, and the means by which they should be realised, remained in place. What this meant, MacIntyre concludes, is that ethics has come to be limited to the second and third stage of the list above: that is, a set of abstract rules to follow and a vague sense of an unrealisable future that bears little to no relation to the present. If the accounts of neoliberalism such as Dean’s or Berardi’s that we have considered briefly are persuasive, then we can see how a similar narrative can be made about critical thinking. In this case, the shift from disciplinary processes into an emphasis on self-formation effectively turns the normative-judicial model of critical thinking into an abstract and dislocated tool; an abstract dislocation so obviously present in the textbook, neo-positivist brands of critical thinking, as well as the psychological metrics approach. Indeed, disciplinary power is still alive and well in professional training, as well as policy development and rhetorics of welfare distribution. However, it always struggles to locate itself in the information-saturated spheres of health and care delivery. Foucault’s insights re-introduced the significance of the historical development of the conditions of critical thinking; an invaluable way to understand the ways in which certain critical practices were valued over and above others. But in doing so, there is a risk of reconstructing the original contexts for critical thinking without offering a viable alternative – in other words, by reassembling the first stage and explaining how the second stage followed from this, the significance of the third stage is lost. This leads to the criticisms, exemplified by both Baudrillard and Han, that Foucauldian critique only works as a descriptor of systems too closed and static to apply to contemporary contexts. While much ink continues to be spilled on whether this is the case or not, or indeed whether Foucault offers a critique of neoliberal care or an ambiguous endorsement, the focus of our concern should perhaps be guided by this analogy with MacIntyre’s process. That is to say, having considered the power of critical thinking in terms of both its emerging contexts, as well as the procedural rules it procures, at this point our attention may well turn to the third stage of MacIntyre’s process: that is, to look more closely

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The power of critique: looking back and forwards with Foucault  143 O’Leary, T. (2021). ‘Critical Vivisection: Transforming Ethical Sensibilities.’ In Thiele, K., Kaiser, B. and O’Leary, T. (eds.), The Ends of Critique: Methods, Institutions, Politics. London: Rowman and Littlefield, pp.139–157. Pasi, G. and Misuraca, G. (2020). ‘Welfare 2.0: Future Scenarios of Social Protection Systems in the Digital Age.’ Policy Design and Practice, 3:2, pp.163–176. Powell, J. (2013). ‘Michel Foucault.’ In Gray, M. and Webb, S. (eds.), Social Work Theories and Methods, 2nd ed. London: Sage, pp.46–62. Rouvroy, A. (2013). ‘The End(s) of Critique: Data Behaviourism Versus Due Process.’ In Hildebrandt, M. and de Vries, K. (eds.), Privacy, Due Process and the Computational Turn: The Philosophy of Law Meets the Philosophy of Technology. London: Routledge, pp.143–167. Sheldon, B. and Chilvers, R. (2002). ‘An Empirical Study of the Obstacles to EvidenceBased Practice.’ Social Work and Social Sciences Review, 10:2, pp.63–81. Springer, R. and Clinton, M. (2015). ‘Doing Foucault: Inquiring into Nursing Knowledge with Foucauldian Discourse Analysis.’ Nursing Philosophy, 16, pp.87–97. Trecek-King, M. (2022). ‘A Life Preserver for Staying Afloat in a Sea of Misinformation.’ Skeptical Inquirer, 46:2. Available at: https://skepticalinquirer. org/2022/02/a-life-preserver-for-staying-afloat-in-a-sea-of-misinformation/ Weeger A., Wagner, H.-T., Gewald, H. and Weitzel, T. (2021). ‘Contradictions and Interventions in Health IS.’ Business & Information Systems Engineering, 63, pp.689–710.

6

The vulnerability of critique

‘Critical thinking,’ Kathrin Thiele writes ‘is all about imagining things differently, and most of the time it projects them into a future, as something to come, to achieve – a hope.’ Consequently, no application of criticality ‘can fully avoid the dangers of a belief in progress and from there also the production of overgeneralising truth claims’ (Thiele 2022, p.21). What Thiele names here is a kind of vulnerability of critique. This vulnerability is, on the one hand, problematic for implementing critical thinking into professional practice. Its commitments to change can invite spurious mutations (the never-ending celebration of ‘innovation’ amongst academic health experts, for example), not to mention cementing clichés around the wealth of benefits critique will – at least in theory – provide, that we so often find at the beginning of critical thinking textbooks. It is such a vulnerability that has led, as Chapter 1 argued, to a series of malaises in critical theory and practice, typically when it encountered the complexities of contemporary culture and found to be wanting in delivering on its promises. It is also what the numerous post-critical approaches in philosophy, science studies and the humanities have engaged with, some of which we have considered in previous chapters. On the other hand, Thiele suggests that this vulnerability is not some unfortunate off-shoot, but rather a core part of critical thinking. Anyone who has ventured to speak critically in management committees, raise issues with organisational policy, or speak to concerns about the culture of a workplace will know that this vulnerability can be felt as an acute emotion: to suggest alternatives to the seeming inevitability of the present is, after all, to invite backlash and place oneself ‘above the parapet,’ as the saying goes. But while this may be the case, the act of critique is necessarily vulnerable in order to be effective. Without a certain idealism, a certain naïve hope in the capacity to transform services in even the smallest ways, there is no criticality to critical thinking. This, as Athanasiou points out, places critique in a state of ambivalence within todays’ neoliberal context of care: It has become commonplace for mainstream analysts of the neoliberal and neoconservative right to argue that any attempt to change our DOI: 10.4324/9781003123583-7

The vulnerability of critique  145 present social milieu, marked by injustice and inequality, is utopian, and by “utopian” they mean naive, impractical, impossible. On the other hand, the notion of utopia, as it is implicit – and has been historically imbricated – in colonialist, imperialist, and nationalist projects, is often posited in essentialist terms, as a means of attaining all-encompassing ideals of a “true” and “full,” “newly-founded,” and “wellordered” society. (Athanasiou 2020, p. 251) We could go further and suggest that the vulnerability of critique is what separates it from the apparent certainty of factual or data-driven knowledge. Nicholas Smith points out that the certainty of knowledge is often at odds with the reality of ‘hope,’ and as such tends to be left to one side or covered over. Hope lacks the justification that self-respecting theorists demand of their convictions and beliefs. The realm of hope is vague and imprecise, and for that reason uninteresting. […] [H]ope seems to mark the threshold of ability: a player, as much as an actor, musician or writer, starts to hope as she approaches and crosses (what she believes to be) the limits of her powers. (Smith 2006, pp.46–47). This is not to say that data-driven knowledge is not without its own set of hopes, of course. The mantra that ‘there can never be too much data’ can easily be reversed without losing its meaning into ‘there will never be enough data collected’; and the full effects of large datasets to health and social care are typically wrapped in promises of better alignment of systems and real-time collection, all of which are well-documented as a struggle to achieve. As Hajduk et al. note, despite decades of aspiration, ‘sharing of health data in a meaningful manner is neither straightforward nor commonplace’ (2019, p.1). Furthermore, discourses of data-driven knowledge often utilise rhetorical generalities, where ‘data’ itself shifts between its technical meaning (embedded within information technology systems), and the more general sense of ‘information’ or ‘evidence.’ This enables such discourses to frame the use of hope in a particularly strategic way, whereby precisely where the limits of what is possible are ‘approached and crossed,’ as Smith puts it, are always slightly ambiguous; they are instead more like to talk of ‘unfathomable potential’ and ‘untapped resources’ of data already there (Goldacre and Morley 2022, p.9), and in some cases being used, that could be improved upon. Another example of hope underlying criticality would be the responses to the growth of misinformation and ‘post-truth’ in and around health and care, as was discussed in Chapter 1. Here, the hope is more nostalgic than forward-looking (Grimwood 2023), typically insisting upon the return to the

146  The vulnerability of critique certainty of methods and approaches for discerning right from wrong. This is what we might think of as the standard textbook critical thinking. Yet, as we have seen in several chapters, these approaches depend on reductive and somewhat idealistic reconstructions and representations of the realities of practice. The difference between these latter two examples and Thiele’s idea of transformative critique is captured well by Richard Rorty, when he suggested that ‘the best way to expose or demystify an existing practice would seem to be by suggesting an alternative practice, rather than criticizing the current one’ (1994, p.227). The promise of dataism and/or the certainty of scientific method may be speculative, but they nevertheless offer what Rorty terms a ‘direct solution,’ free from the ‘mediation’ of criticism. Critique is always at risk of accusations of muddying waters unnecessarily, when its results remain too far in the distance. This vulnerability of critique lies at the roots of many of the obstructions to critical thinking in practice, as well as the basis upon which any model of criticality should be based on to be effective. In this way, it highlights the shortcomings that the alignment of conventional critical thinking with the kind of normative-judicial negativity that Foucault identified – that is, critique equating to saying: ‘not like that!’ – presents when it comes to addressing its vulnerabilities. To this end, I want to explore in this chapter two potential philosophical resources for reconciling the necessity of hope with the practice of critique. The first, that of non-ideal theory, approaches the problem from the starting point of classical rationality. The second, that of cultural hermeneutics, approaches the problem from the necessary incompleteness of any critical judgement, and the ‘messiness’ of critical practice. Managing vulnerability: non-ideal theory Non-ideal theory refers to a loose group of approaches developed in political philosophy. These all stemmed from the acknowledgement that the dominant paradigms of the discipline – most notably, the philosophy of John Rawls and his legacy, but also the Habermasian model of the public sphere at work in critical theory – were largely ineffective in ‘real world’ politics. For Rawls, the best way to distribute welfare in a society was based on a thought experiment, whereby any judgement must be made from behind a ‘veil of ignorance’ which prevented one from seeing whether one profited or lost out from such a distribution. For Habermas, political engagement should aim towards the ‘ideal speech situation’ where participants would be able to assess the value of other’s arguments on the basis of reason and evidence, free from coercion. As Levy explains: The Rawlsian assumption of consensus generalizes to other models that try to derive fundamental normative truths about politics by denying the basic, dissensual, character of political life. The Habermasian school of democratic theory and its offshoots in deliberative democratic

The vulnerability of critique  147 theory – indeed any account that derives principles of democracy from an initial idealization of universal agreement – normally offers another instance of ideal theory: democratic politics without the politics, without friction. (Levy 2016, p.315) There is, of course, a logic at work for both. As Levy acknowledges, to theorize is to engage in simplification and abstraction – that is, in idealization. And to have a normative vision is to be in at least some small degree idealistic: we imagine that in at least some way, the world might be other than, and better than, it is. (Levy 2016, p.314) Perhaps for these visions of the ways in which the world might be better than it is, both Rawls and Habermas have enjoyed significant influence on politics and policy. In North American social work, Rawls’ theory has traditionally been a touchpoint for concepts and definitions of social justice (Banerjee 2005, p. 36). Similarly, it has been used to justify antipoverty transfer programmes (or ‘social assistance’) in middle-income countries (Barrientos 2016). Indeed, the very fact that Rawls in particular works through ideal situations in order to determine the most justifiable distribution of wealth in society means that his model of welfare is not based on perceived ‘needs’ – in the sense that a more socio-historical account might – but on what he calls ‘primary goods.’ The problem, though, is that while philosophers in these traditions could discuss the reasoning and consistency at work in normative claims regarding society – that is, they could argue what society ought to be like – there was often a gap between the ‘ought’ and the ‘is.’ As Charles Mills puts it in a famous essay on the topic, ‘what distinguishes ideal theory is the reliance on idealization to the exclusion, or at least marginalization, of the actual’ (Mills 2005, p.168). With this in mind, there has been a move in recent years to develop forms of non-ideal theory. Valentini (2012) notes that there are at least three senses in which such theories are positioned in relation to their ideal forebears. Nonideal theory can be considered as ‘partial compliance’ with the principles of a theory. Rawls proposed a theory of justice, based on the fair distribution of resources to all members of society. However, in making this argument, Rawls acknowledges that while his theory provided principles for defining what justice was, these principles were based on the assumption that, first, all agents involved complied with the principles, and second, that society is economically and historically able to conform to this kind of resource distribution. For one version of non-ideal theory, then, the critical task is to establish what a form of justice would look like that is only partially compliant with these conditions. In their review of literature on the dignity of people marginalised by mental illness, substance abuse, Schmidt et al. (2020) note

148  The vulnerability of critique that conventional norms for dignity such as ‘treatment as unique individuals’ and ‘maintaining a positive identity’ belong in the realm of ideal theory. Instead, they suggest that non-ideal is more constructive for practitioners, and to demonstrate this they identify ‘building blocks for a non-ideal theory of dignity.’ These emphasise the balance needed to promote dignity, the recognition that contradictory norms and organisational constraints may make it impossible, and avoiding its violation can be better than promoting it. Non-ideal theory can also represent a demand for factual constraints being placed upon theories of justice. This might be described as ‘realistic theories’ of justice, positioned against ‘utopian’ theories. Sreenivasan (2007), for example, draws on non-ideal theories of this type to argue that understanding well-being in terms of an individual’s health status, using existing data, strengthens the case for rich countries having an obligation to transfer 1% of their GDP to poor countries. The introduction of factual constraints to what has previously been advocated as an ideal norm, Sreenivasan suggests, renders it a less demanding proposal, especially when considered against individual well-being. In this way, a hopeful ideal will guide the argument, but the use of factual evidence from the non-ideal reality provides a way of moving towards that hope. This then reflects another form of non-ideal theory, which is to put forward critical arguments as ‘transitional’ theories, which are steps to be taken on the way to the kind of ‘end-state’ theory found in Rawls or Habermas. All of these approaches offer a reconciliation between the hope of critique and its application. In doing so, the vulnerability that criticality is open to becomes either (a) managed, by being clear on the expectations and empirical data backing up its suggestions for change, or (b) post-poned, by acknowledging its ideality and taking steps to reduce the vulnerability this creates. This would be of particular importance in the limited time and space available for critical activities in professional practice (Robeyns 2008, p.360) and hence, a persuasive way for developing practice within the confines of the organisational, political and economic pressures that health and welfare services face. Ideals in practice However, these approaches still begin from the assumption that full compliance with an ideal theory can, at least in principle, be reached. In this way, despite its idealism, ‘a theory designed under conditions of full compliance can take us very far in understanding what is required of us in conditions of partial compliance’ (Valentini 2012, p.656, my emphasis). This would suggest that the vulnerability of ideals at work in critical discourses are nevertheless key to their organisation and direction. Indeed, Callinicos argues that ideals are necessary for any social critique to take place, and it is the abandonment of these (via ‘postmodern’ approaches) that has both weakened critique by removing its feasibility as a transcendental position. But, Callinicos continues,

The vulnerability of critique  149 ‘social critique requires free-standing, substantive principles of justice’ (2006, p.218). Otherwise, we are left with simply a politics of description, rather than any grounds upon which to ask for alternatives. While raised in the context of political theory, this argument nevertheless brings to mind a point that we have frequently come back to during this book. That is, the idea that professional practice presents a tangible and substantive case for rethinking certain philosophical pronouncements on criticality. This is particularly the case when we consider the specific investments at work in practice that are not always considered in discussions of critical thinking. For example, the open-ness to kairotic opportunity in Chapter 2; the commitment to the embodied ‘person-in-situation’ in Chapter 3; or the inherent ‘messiness’ of practice in Chapter 4. In each case, we are invoking a certain value, and to some extent a ‘free-standing’ value, to use Callinicos’ term. Indeed, the entire idea behind this book – a dialogue between health, social care and social work practice and philosophy – is premised on the existence of some form of argument or persuasive emerging from those sites of practice. These, we might speculate, require some ideal to bind them together, otherwise we would not be dealing with ‘practice’ in the sense we employ it, but a random collection of actions. Somewhat ironically, then, the appeal to professional practice as something concrete and tangible might itself depend upon a certain idealisation: an idealisation that provides the basis of its value as an interlocutor with the more theoretically-based arguments around critique. I do not for one moment think that this idealisation is as simple to describe as a set of professional principles, ethical guidelines or legal parameters. To locate the ideal anchoring ‘practice’ in this way would create something of a paradox, whereby on the one hand there was ‘real practice,’ typically described as positive terms of practice – that is, the transformative, supportive and caring aspects – and on the other hand the ‘realities’ of practice, reflecting increased managerialism, neoliberal welfare policies and so on. Instead, this ideal of ‘frontline practice,’ however much it stands as a stable reference point for different forms of practical activities and dilemmas, can perhaps be thought of as something more like an expressive component of coded assemblages, the likes of which was sketched out in Chapter 4. Indeed, many of the ideas put forward by assemblage theory and its appeal to ontology over epistemology provide ways of understanding how the two forms of ‘real practice’ can exist in the same spheres of life, often at the same time. The problem is not with the ideal, in these cases. The problem is, instead, the alignment of transcendent ideals with transcendent critique. In other words, using critique as an exercise in ideal standards – that is, critique as a judgement of the world before us against the criteria of idea consistency and rationality – narrows criticality into the kind of judicial exercise of power which Foucault warned us of in Chapter 5. This is where, I would argue, most non-ideal theories come unstuck: because for all of its awareness of the incompleteness of the normative arguments it puts forward, non-ideal

150  The vulnerability of critique proponents routinely use an ideal form of reason to assess the strengths and weaknesses of those arguments. A good example of this is Jason Stanley’s book How Propaganda Works, a pertinent work for us given that it is both an exemplar of non-ideal theory (of the ‘transitional’ type), and an analysis of the kinds of misinformation and fake news that prompted concerns with the state of critique at the start of this book. Stanley argues that there has been a distinct lack of scholarly interest in these issues, because of political philosophy’s overriding concern with ‘the normatively ideal components of an ideal liberal democratic state’ (2015, p.28). In such ideal states, there would, of course, be no thorny issues with misinformation, and no requirement for propaganda. In response to this, Stanley begins from the starting point of our actual society, complete with its inequalities, exploitation and multiple sources of misleading information. To do this, he necessarily adopts a morally neutral view of propaganda, in order to understand its nature (over and above its rightness or wrongness). However, his framework for assessing its nature is Kantian rational deliberation, as employed by both Rawls and Habermas. This creates a contradiction whereby the non-ideal status of propaganda and misinformation are assessed in terms of the ideal conditions of rational communication. Or, as van Tunen puts it, ‘he aims to defend the ideals of liberalism and democracy by warning of the threat posed by harmful propaganda […], which in turn is being warned about by appealing to the ideals of liberalism and democracy’ (2022, p.148). A somewhat blunter example can be seen in an early effort to synthesis philosophy and social care, in Plant et al.’s book Political Philosophy and Social Welfare (1980). Here, the authors attempt to find some universally agreed, ‘morally neutral’ sets of human needs which a rational philosophy of welfare can proceed from. While their survey of philosophical arguments finds that it is at least possible to identify such a set, the set is small. In fact, it consists of only two needs: “survival” and “personal autonomy.” But is this surprising that these are the only two agreed principles? In fact, they relate directly to the methods underlying the approaches to the philosophy of welfare surveyed. Because such an approach values rational deliberation means that they necessarily require both survival (after all, in order to deliberate, one must be alive), and the autonomy to think otherwise: that is, to at least imagine that we can “step outside” of our immediate experiences and re-constitute them according to rational principles. As such, we have as much discovered universally agreed human needs, as engaged in circular and self-confirmatory thinking facilitated by the methods of interpretation. While this is perhaps a more extreme example than the (otherwise in-depth and interesting) study by Stanley, it points to the ways in which the performance of critique can in itself create what we termed in Chapter 1 an atmospherics of critical thinking, and this can at best narrow down its possible uses, and at worst create questionable results.

The vulnerability of critique  151 In order to avoid this kind of circularity, without losing the necessary idealistic elements of considerations of critical thinking, there is a need to take a step back: that is, to separate the act of critique from the hope it depends upon, and to consider its emergence within such (non-ideal) situations. To do this we need, for a final time, to return to the topic of interpretation. Embracing vulnerability: hermeneutic critique For some time, the philosophical tradition known as hermeneutics, and particularly that part of the tradition that grew from the work of HansGeorg Gadamer, has been considered conservative in nature. At first glance, this seems plausible. David Vessey notes that Gadamer offers an epistemology which defends three claims: (1) our beliefs are shaped by the traditions to which we belong, (2) we are incapable of becoming reflectively, and therefore critically, aware of all the effects of tradition on our beliefs, and (3) nonetheless our beliefs may be justified. (Vessey 2022, p.117, my emphasis) However, recent work has served to highlight how critical engagement is not only part of the hermeneutic task, but actually fundamental to it. In this case, the vulnerability of critique is not something to be managed, as with non-ideal theory, but carefully balancing its normative demands with the restrictions of ‘actual’ practice. Rather, it is something that is core to the interpretative process. To make this case, we should remember that in the hermeneutic tradition, all of our understanding is formed through a process of interpretation. There is no neutral or transcendent position to assess the ‘truth’ of a situation – no ‘ideal’ position, as with Rawls or Habermas – because any understanding is bound to particular traditions of knowing, or what Gadamer calls our ‘effective-historical consciousness.’ Understanding is always situated, then, within the horizon of this consciousness: a ‘range of vision that includes everything that can be seen from a particular vantage point’ (Gadamer 1975 [2004], p.301). Our horizons are not simply operational knowledge of the world, but also our expectations, projections and hopes of the world – including the images of welfare and society which frame our critical appraisals. Or, borrowing the words of de Sousa Santos in his argument against the primacy of Eurocentric reasoning in accounts of critical thinking: All knowledges are incomplete: the broader the knowledge of the diversity of knowledges, the deeper the awareness of the incompleteness of them all. A better understanding of the diversity of knowledges circulating in the world carries with it a better understanding of their

152  The vulnerability of critique limits and of the ignorance they produce. […] [T]here is no knowledge in general, just as there is no ignorance in general. (de Sousa Santos 2018, p.45) This does not, however, entail some kind of relativist position whereby the incompleteness of knowledges lead to there being no decisive evidence or position of authority. This, as de Sousa Santos rightly picks up on, would be to suppose there is still some kind of ‘knowledge in general’ that can assess all knowledge claims from a single, transcendent position, somewhere ‘outside’ of the localities of knowledge production. This is, in many ways, the problem with the more knee-jerk responses to ‘post-truth’ or ‘mis-information’ discussed in Chapters 1 and 5: the fear of relativistic positions regarding the facts of caring practices – vaccine hesitancy, for example – leads to an appeal to objective or transcendent authorities (e.g., ‘scientific method’) in order to assert the truth of delivery. But this risks overlooking the local production and implementation of facts; including the effective-historical consciousness, or traditions of knowing rooted in social and cultural circumstances, that render certain facts persuasive and others not (Grimwood 2021). For Gadamer, this situated-ness is not an obstacle to understanding; it is, rather, a condition of understanding itself. While this enables our understanding, it also necessarily limits it to the effective history or traditions we carry with us. As such, this frame of reference is shaped and changed by the limits of our historical situation and knowledge, and the ways in which such knowledge is significant to us. To ‘understand’ is to understand oneself in the subject matter of what is being interpreted (Gadamer 1975 [2004], p.294). This means that understanding is essentially being open to expanding our horizons, not by simply accepting an other perspective without question, but rather by ‘fusing’ their horizons with ours on particular concerns we share. The charges of conservatism, or the lack of critical possibilities within understanding, stem from the prominence of effective-historical consciousness at work in the hermeneutic approach. To continue the previous example, appreciating the circumstances under which certain people may be suspicious of medical evidence (consider, for example, the ongoing discussion concerning the role of race and ethnic demographics in vaccine uptake), professionals may nevertheless want to engage critically with vaccine hesitancy (Razai et al. 2021; Willis et al. 2021). However, it is worth noting that Gadamer’s work is premised on, much like the work of the assemblage theorists in Chapter 4, on an ontological turn; even if his starting point is very different to that of DeLanda. The ontological element, in this case, is precisely the role of traditions that we necessarily speak, listen and read from: interpretation is not simply an exercise we take part in at specific moments – reading case notes, responding to example exercises, making sense of test results and so on – but rather the condition of our very existence.

The vulnerability of critique  153 Given the complexities of a world in which welfare is needed, and the complexities of the history of previous welfare efforts before it, it makes sense that our entire thinking is always a process of interconnected interpretations, over and above explanation or an objective ideal. Hence, Lincoln notes that studies comparing populations rather than examining their interpretative engagement often ‘obscure heterogeneity within populations [which] limits the ability to identify subpopulations of older adults with varying risk profiles’ (2020, p.7). In this way, Gadamer’s ‘traditions’ are not the same as the closed social determinants of population demographics, but a way of opening up understanding to different forms of diversity. This is not a case of simply identifying, describing or acknowledging other horizons of understanding, though. Rather, it is because of the complex facticity of effective historical consciousness that we are able to adapt and develop what Gadamer terms our ‘prejudices,’ and in doing so widen our horizon of understanding. Understanding is a dialogue, or, in Gadamer’s celebrated phrase, a fusion of horizons: a joining together of the different horizons of interpreter and interpreted. As Theodore George reminds us, this is rooted in a concern for ‘factical life,’ which goes beyond the interpretation of individual events or problems – the kind of ‘case study’ often found in critical thinking literature – and instead incorporates the historical, present and future we interpret within. Gadamer seeks to rehabilitate the term ‘prejudice’ from its negative connotations and uses it more in terms of the necessary expectations we have in order to understand anything. This facticity of life, therefore, operates via a hermeneutic circle, whereby we must already be in the process of understanding before we embark on interpretation (Grimwood 2016, p.26), while also acknowledging that encounters with other horizons ‘will emerge from a distinctive kind of dialogue whose vocabulary does not fully precede the dialogue itself’ (Simpson 2021, p.61). Interpretative experience, ‘because it is conditioned by the fore-structure of prejudice, is never freed from historically inherited meaning.’ It therefore ‘makes possible, as well as limits, every effort to understand’ (George 2020, p.52). Consider the case of vaccine hesitancy once more, then. Dembowsky (2021) reports that many commentators and some health academics attributed the apparent reluctance of black communities to the legacy of the Tuskegee syphilis study, where poor black communities were misled into participating in a testing programme and refused a cure for the disease they carried. However, this relation does not stand up to scrutiny (for a far more detailed account of the relationship, see Katz and Warren 2011); and, indeed, a number of researchers found that the low vaccine uptake had more to do with health and social inequalities, limited access to appointments, gaps in pharmacy provision and broader distrust in government testing. Thus, while there may be a critical imperative to increase the uptake of vaccines (be they COVID-19 or otherwise), there remains a high risk of approaching

154  The vulnerability of critique this criticality in what we described in Chapter 5 as a normative-judicial way. The dialogical approach to understanding highlights how different effective histories, not to mention pressing social contexts, both create and challenge our interpretative horizons. Critical thinking as displacement… Where, then, does the vulnerability of critique fit into this account? Rather than emerging as a risky hope for change, as in non-ideal theory, within hermeneutics vulnerability is embedded within the act of interpretation via what George calls ‘displacement.’ This arises from what George calls the ‘predicament of the exception’ (2020, p.47). By this, he refers to the consequence of the hermeneutic account of understanding, which is that while every situation or event demands that we interpret and understand it, each situation will be exceptional because, due to the complex forms of effective historical consciousness we have just described, ‘every situation is […] factically different from any other possible situation’ (George 2020, p.47). It follows from this that every situation that concerns us demands an interpretation, which is to say a form of dialogical (or polylogical) engagement. This demand is not for an engagement in the sense of reaching an agreement with another horizon (in the sense that we discussed the role of consensus in Chapter 3), but to be open to the possibility of our own horizon being in need of adjustment or expansion. In other words, the ability to understand involves ‘the capacity to become interpretatively open by putting ourselves into question […] in the face of the challenge it poses to even our deepest prejudices’ (p.47). As such, while our interpretations carry with them the necessary prejudices of our effective historical consciousness, the ability to understand is premised on our openness to being wrong – to being displaced, hermeneutically. That is to say, one of the first elements of engaging our own horizons with another’s is to effectively displace ourselves, to place our horizon in question in response to coming across something that demands interpretation. ‘The capacity for displacement,’ Young writes, ‘constituted by prejudice and undogmatic openness, is a condition of the “fusion of horizons.” Such a fusion takes place when genuine understanding between the speakers is reached’ (2022, p.5). If this sounds quite technical, George summarises it straightforwardly as the basic act of interpretative listening. To listen means to be open, in the sense that we are freed by our encounter with the other enough to put aside our self-absorption and genuinely entertain the possible validity of the other’s claim. Such entertaining can, perhaps, be described as a free suspicion of our self-absorption, one that is held open by the tension of a challenge posed and a promise elicited by the other. Openness to the possible validity of the other’s claim poses a challenge because it requires us to consider that

The vulnerability of critique  155 the other’s claim may be right and that we may therefore have to change our minds, and even ourselves. This challenge is at the same time a promise, however, because the possibility that the other’s claim may be right is likewise the opportunity for a deeper, richer understanding and transformative growth. (George 2020, p.109) It is important to note that this is not simply a restatement of the kind of ‘active listening,’ ‘motivational interviewing’ or other practice-rooted techniques that practitioners may be well used to. Such techniques are ultimately epistemological processes, an issue we encountered in Chapter 2 with the dialogical element of kairotic opportunity. There, we noted that the structure of dialogue – that is, the open-ness to another horizon – needed to resist being reduced to a simple conversation between fully-formed individuals, because the power of the kairotic moment was to place the boundaries of self and other in question. In other words, the ‘dialogue’ in question, while illustrated well by the image of conversation, is an ontological position inherent to interpretative beings. The ‘we’ that George refers to are not isolated individuals, in this respect, but assembled horizons of multiple traditions, prejudices and open-ness to future encounters. This may, of course, sound idealistic, abstract or aspirational. To many extents, of course, it is. Conventions regarding the parameters of critique, as well as structural and experiential challenges to everyday practice that we have discussed in the previous chapters, all work against this open-ness. As Lorenzo Simpson points out, many cases of what is now commonly called epistemic injustice exist in the social sphere that ‘arbitrarily [restrict] our ability to interpret reality in empowering ways’ (2021, p.102). In such cases, as ‘a result of social hierarchies distorting social knowledge through the enforcement of skewed epistemic resources’ (Young 2022, p.6), the opportunities for dialogical understanding and horizon fusing are limited, as Simpson argues: it can limit our ability to name the wrongs that demand our response, and it can circumscribe our capacity to name the ways of being or the self-description we can “own.” It threatens our ability to name both what we are against and what we are for, what we want to be. (2021, p.102) In short, Simpson suggests that hermeneutic limitations on agency affect our ability to be critical. This is precisely why, I would argue, the aspirational quality of displacement is where we find the vulnerability of critique emerging within the hermeneutic approach. Rather than positing itself as an ideal to be reached, whether fully or partially, in some kind of future (as in non-ideal theory), for hermeneutic approaches the moment of critical vulnerability precedes understanding the situation at all; instead, it opens up the

156  The vulnerability of critique situation to the possibilities of critical challenge. Such vulnerability does not emerge after the ‘actualities’ (as Mills had it) are identified. Interpretation is not epistemological – that is, concerned with the examination of knowledge – but, as Gadamer argued, ontological – that is, concerned with the conditions through which we understand something as knowledge. This is why, for both Simpson and George, enabling this vulnerable moment of interpretation is key to the advancement of justice. In Simpson’s words, ‘the bureaucratic colonization of the lifeworld and the merely procedural legitimacy of laws can be contested by protecting a space for the risk of the unpremeditated outcomes of genuinely dialogical communicative participation and contestation’ (Simpson 2021, p.164). Indeed, the closure of such interpretative spaces was at work in the models of critical thinking examined as disciplinary techniques in Chapter 5, procedural critical methods in Chapter 4, or spatialised rhetoric in Chapter 2. Thus, for Simpson, the normative element of critical thinking is not the ideal of justice to be reached, but preserving the capacity to form interpretations that may construct those future ideals. In a related vein, George writes of the need to attend to the importance of professional practice as an interpretative act. The nature of practice, according to George, ‘cannot unfold as a mindless reiteration of and thus adherence to tradition.’ Instead, ‘it involves an interpretative distance opened up by our attempts to apply the tradition in a new way, one that is prescient for and response to the requirements of a specific situation’ (George 2020, p.118). This, then, constitutes a critical space – as well as a vulnerable one. …and as a responsibility I began this book by deliberately avoiding presenting any definition of criticality, choosing to approach it instead as a plurality of approaches and practices. Part of the argument of the book overall, indeed, has been to attend to this plurality, rather than employ singular and reductive models within health, social care and social work. But at this point I do want to add a final suggestion for how critical thinking might be defined. Throughout the book we have encountered arguments against the idea of critical thinking being a form of normative judgement, excavation or colonisation of experience. Instead, there have been calls for disruption, including disrupting our assumptions of what criticality is and how it would look like in practice. In Chapter 1, we identified ways in which criticality could be considered as a matter of concern, embedded within atmospheres as well as evidence. Chapter 2 pointed to the significance of timeliness and opportunity to critical intervention. Chapter 3 explored the ways in which critical autonomy emerged in response to complex contexts of practice. In Chapter 4, the ontological significance of such contexts was analysed in order to show the necessary dynamics and mobility of the language of critique. Chapter 5 raised the problem of celebrating disruption without articulating how we would know if we had disrupted what we intended, and, given the instabilities

The vulnerability of critique  157 of neoliberal care as a concept and a practice, to what effect it might be successful. In this final chapter, then, I have suggested that the disruption which critical thinking might cause does not arise, in the first instance at least, from ideals provoking transformation, from assertions of authority or from any post-epistemic position. Instead, the core disruptive element of critical thinking is rooted in hermeneutic displacement, or, in George’s terms, a certain responsibility to listen. At the beginning of this chapter Thiele argued that critical thinking involves ‘imagining things differently […] as something to come, to achieve – a hope.’ We can now suggest that this hope may well manifest itself as something to come in the future, but it actually emerges in the first instance at the beginning of interpretation. As such, it makes sense to me to see critical thinking as a form of interpretative and opportunistic (i.e. responsive) understanding. By understanding, I do not mean simply describing, spatialising or limiting, but rather in the hermeneutic sense of a transformative moment where our horizons fuse with others and expand. Criticality may, in this case, be a specific form of understanding alongside others; but it is nevertheless inextricable from the work of understanding. Perhaps this has been self-evident all along. But it follows, I think, that if this is the case, then critical thinking is not just a professional requirement, useful for decision-making, a tool that supports service user safety or a way of discerning evidence from misinformation. It is, instead, a responsibility which forms part of the interpretative commitment of health, social care and social work to the world. As I have suggested throughout this book, the challenges of post-critical arguments amid the complexities of contemporary care call for a re-energisation of interpretation, not only in frontline practice but in policy, evidence and theory. And following from this, such a re-energising should be done in the light of David Couzens Hoy’s words that any interpretation ‘must involve both the attempt to construct a comprehensive totality and a healthy scepticism about the possibility of complete success in doing so’ (Hoy 2004, p.44). Such is the vulnerability of critical thinking. The partial and incomplete nature of its interventions are the best form of response to the demand for understanding that the context of contemporary care places on us. Perhaps, through cross-disciplinary dialogues or other routes, following this responsibility to listen can reimagine critical thinking to resist the techniques of judgement and excavation, and instead provide opportunities for concerned engagement. References Athanasiou, A. (2020). ‘At Odds with the Temporalities of the Im-possible; of, What Critical Theory Can (Still) Do.’ Critical Times, 3:2, pp.249–276. Banerjee, M. (2005). ‘Applying Rawlsian Social Justice to Welfare Reform: An Unexpected Finding for Social Work.’ The Journal of Sociology and Social Welfare, 32:3, pp.35–47.

158  The vulnerability of critique Barrientos, A. (2016). ‘Justice-Based Social Assistance.’ Global Social Policy, 16:2, pp.151–165. Callinicos, A. (2006). The Resources of Critique. Cambridge: Polity Press. Dembowsky, A. (2021). ‘Stop Blaming Tuskegee, Critics Say. It’s Not An “Excuse” For Current Medical Racism.’ NPR/Kaiser Health News. Available at: https://www.npr. org/sections/health-shots/2021/03/23/974059870/stop-blaming-tuskegee-criticssay-its-not-an-excuse-for-current-medical-racism Gadamer, H.-G. (1975 [2004]). Truth and Method. Trans. Weinsheimer, J. and Marshall, D. London: Continuum. George, T. (2020). The Responsibility to Understand: Hermeneutical Contours of Ethical Life. Edinburgh: Edinburgh University Press. Goldacre, B. and Morley, J. (2022). Better, Broader, Safer: Using Health Data for Research and Analysis. A Review Commissioned by the Secretary of State for Health and Social Care. Department of Health and Social Care. Available at: https://assets. publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/ file/1067053/goldacre-review-using-health-data-for-research-and-analysis.pdf Grimwood, T. (2016). Key Debates in Social Work and Philosophy. London: Routledge. ———. (2021). ‘On Covidiots and Covexperts: Stupidity and the Politics of Health.’ Journal of Applied Hermeneutics, 11, pp.1–15. ———. (2023). The Problem with Stupid: Ignorance, Intellectuals, Post-Truth and Resistance. Winchester: Zer0 Books. Hajduk G., Jamieson N., Baker B., Olseon, O. and Lang, T. (2019). ‘It Is Not Enough that We Require Data to be Shared; We Have to Make Sharing Easy, Feasible and Accessible Too!’ BMJ Global Health, 4:4. Hoy, D. (2004). Critical Resistance: From Poststructuralism to Post-Critique. London: The MIT Press. Katz, R. and Warren, R. (eds.). (2011). The Search for the Legacy of the USPHS Syphilis Study at Tuskegee: Reflective Essays Based upon Findings from the Tuskegee Legacy Project. London: Lexington Books. Levy, J. (2016). ‘There is No Such Thing as Ideal Theory.’ Social Philosophy and Policy, 33:1–2, pp.312–333. Lincoln, K. (2020). ‘Race, Obesity, and Mental Health Among Older Adults in the United States: A Literature Review.’ Innovation in Aging, 4:5, pp.1–10. Mills, C. (2005). ‘“Ideal Theory” as Ideology.’ Hypatia, 20:3, pp.165–183. Razai, M., Osama, T., McKechnie, D. and Majeed, A. (2021). ‘Covid-19 Vaccine Hesitancy among Ethnic Minority Groups.’ BMJ 372, pp.1–2. Robeyns, I. (2008). ‘Ideal Theory in Theory and Practice.’ Social Theory and Practice, 34:3, pp.341–362. Rorty, R. (1994). ‘Feminism, Ideology, and Deconstruction: A Pragmatist View.’ In Žižek, S. (ed.), Mapping Ideology. London: Verso Books, pp.226–234. Schmidt, J., Trappenburg, M. and Tonkens, E. (2020). ‘Social Dignity for Marginalized People in Public Healthcare: An Interpretive Review and Building Blocks for a NonIdeal Theory.’ Medicine, Healthcare and Philosophy, 24:1, pp.85–97. Simpson, L. (2021). Hermeneutics as Critique: Science, Politics, Race, and Culture. New York, NY: Columbia University Press. Smith, N. (2006). ‘Hope and Critical Theory.’ In Sinnerbrink, T., Deranty, J-P., Smith, N. and Schmiedgen, P. (eds.), Critique Today. Leiden: Brill, pp.45–62.

The vulnerability of critique  159 de Sousa Santos, B. (2018). The End of the Cognitive Empire. Durham, NC: Duke University Press. Sreenivasan, G. (2007). ‘Health and Justice in our Non-Ideal World.’ Politics, Philosophy & Economics, 6:2, pp.218–236. Stanley, J. (2015). How Propaganda Works. Cambridge, MA: Harvard University Press. Thiele, K. (2022). ‘  “After Humanism?” – Time and Transformation in Critical Thinking.’ In Thiele, K., Kaiser, B. and O’Leary, T. (eds.), The Ends of Critique: Methods, Institutions, Politics. London: Rowman and Littlefield, pp.19–40. van Tunen, M. (2022). ‘Propaganda, Politics, Philosophy: A Critical Review Essay on Jason Stanley’s How Propaganda Works (2015) and How Fascism Works (2018).’ Krisis: Journal of Contemporary Philosophy, 42:1, pp.144–152. Valentini, L. (2012). ‘Ideal Vs. Non-Ideal Theory: A Conceptual Map.’ Philosophy Compass, 7:9, pp.654–664. Vessey, D. (2022). ‘Gadamer on Tradition.’ In George, T. and van der Heiden, G. (eds.), The Gadamerian Mind. London: Routledge, pp.117–126. Willis, D., Andersen, J., Bryant-Moore, K., Selig, J., Long, C., Felix, H., Curran, G. and McElfish, P. (2021). ‘COVID-19 Vaccine Hesitancy: Race/Ethnicity, Trust, and Fear.’ Clinical and Translational Science, 14:6, pp.2200–2207. Young, H. (2022). ‘Developing Gadamerian Virtues against Epistemic Injustice: The Epistemic and Hermeneutic Dimensions of Ethics.’ Journal of Applied Hermeneutics, 12, pp.1–10.

Index

Note: Italic page numbers refer to figures. After Virtue (MacIntyre) 140 Airhenbuwa, C. 38 Anker, E. 11–12, 88 Applied Critical Leadership 28 Asquith, S. 56 assemblage theory 99, 109–112, 114, 117–118, 149 Athanasiou, A. 144–145 autonomy 76–78; good 78–81; Habermas 82–85; neoliberalism 88–91; relational 85–88 Bailo, L. 86–87 Baudrillard, J. 133 Béland, D. 39 Benjamin, W. 1, 3, 5, 12, 25 Berardi, F. 64–65, 67, 137, 139 Berlant, L. 49, 55–56 Best, S. 48–50 Black, M. 14 Blake Scott, J. 6 Boddy, J. 2 Boland, T. 3, 26, 55 Borneo, A. 57 Bourdieu, P. 86 British Association of Social Worker (BASW) 78 British Medical Association 78 Brookfield, S. 27 Brown, W. 57–60, 118 Buchanan, I. 114, 116–117 Bunting, M. 61 Bunz, M. 136 Burton, J. 66–67

California Critical Thinking Disposition Inventory (CCTDI) 31 Callinicos, A. 148–149 Cannan, C. 90 capital 137 capitalism 47, 62–65, 90, 135, 137 Carroll, N. 18 Cassin, B. 58 Chakrabarty, D. 58–59 Chambon, A. 124, 130 Charity Organisation Society (COS) 83–84 Chatzidakis, A. 2, 90, 92–93 Children Act (2004) 100 Chilvers, R. 132 chronos 67–68 Clinton, M. 134–135 Cochrane, A. 40 Cochrane Collaboration Tool 40 coding 113–117 Coler, J. 32, 34 correct distancing 1, 5 Cottam, H. 2 COVID-19 pandemic 1, 6–8, 36–37, 57, 92, 129, 134, 136, 153–154 Cowden, S. 84 credibility 37, 115–118 crisis 56–57 crisis ordinariness 55 critical: atmospheres 24–26; impasse 104–106; pedagogy 27; practice 3, 5, 13, 18, 26, 29, 31, 41, 50, 55, 88, 99, 118, 128, 133, 138, 140, 146; professionalism 28–29; tensions 3–5

162 Index criticality 2, 4–6, 13–14, 18, 27–28, 45–46, 49, 57–58, 70, 101, 122–123, 133, 149, 157; and autonomy 91–94; dimension of 29; in malaise 31–40; removal of 8 critical thinking 3–5, 10, 12–18, 23–26, 123–124, 128, 136, 139–140, 144, 146; and autonomy 86; as displacement 154–157; malaise of 76; matrix 28, 28, 44, 44; professional criticism 29 critique 5–6; centrality of 127–129; immanent 42–44; imminent 29– 31, 139; tensions within 39–40; transcendent 29–31, 35, 40–42, 149; vulnerability of 144–157 cruel optimism 49 cultural codes 100 cynical reason 7 D’Alessandro, L. 92–93 data systems and documentation 100 Davies, W. 33–34, 37 Dean, J. 38–39, 88 Dean, M. 63, 133, 139 decision-making 1, 5, 13, 24, 28, 34, 36–37, 44, 46, 58–61, 76–77, 79–80, 82–83, 86, 100, 136, 157 deficit 128 Dekker, S. 103, 112 DeLanda, M. 99, 110–114, 118, 152 Delanty, G. 5 Deleuze, G. 30, 109, 112–113, 117, 137 Dembowsky, A. 153 dependency 128 depoliticisation 59–60 depression 66 De Sousa Santos, B. 151–152 deterritorialisation 113–114, 117 Dickens, J. 101–103, 105, 108 disciplining effect 128 Disinfomedia 32 displacement 154–157 distance 128 Dominelli, L. 2 Dowling, E. 7 Duschinsky, R. 77 Dybicz, P. 27 Ehsan, R. 38 ‘80/20’ campaign 57 Eisenhower distinction 59

Elmansy, R. 3 emancipation 79–80, 83 enterprise culture (Cannan) 90 epistemic injustice 155 Esposito, R. 134 Ethical Decision-Making and Social Work (Robison and Reeser) 79 Eva, K. 24 Evans, T. 79 Evidence-Based Practice (EBP) 30–31, 40–42, 44 factical life 153 facts 32–34 fake news 1–2, 32–34, 36–37, 123, 150 Felski, R. 10–12, 24–26, 48–49, 106 Fisher, M. 67 Fisher, R. 27 Fitzgerald, D. 34 Flanagan, T. 71 flat ontology 110 Fook, J. 27 Forget Foucault (Baudrillard) 133 Foth, T. 139 Foucault, M. 4–5, 65, 123–141; askēsis 65; critical practices 128–129; Discipline and Punish 127; Thinking is Power 122–123, 125, 129–130, 134, 136 Frohman, R. 128 Gadamer, H. -G. 151–153, 156 Gagnon, L. 80–81 Galloway, A. 107 Gambrill, E. 25–26, 30, 39 Garrett, P. M. 47, 85 genealogical approach 124 George, T. 153–157 Gilligan, C. 86–88, 93 Giroux, H. 3–4 Glaister, A. 27, 29 Gray, M. 27, 60, 79, 136 Greaney, A. -M. 86 Green, T. H. 83 Guattari, F. 109, 112–113, 117 Haack, S. 41 Habermas, J. 82–85, 88, 90–91, 146–148, 150–151 Hajduk, G. 145 Han, B. -C. 135–136 Hannah, M. 7 Harambam, J. 36–37

Index  163 Harnessing Big Data for Social Good (2015) 45 Harris, J. 83 Harrison, R. 3 Healing Our Differences (Airhenbuwa) 38 Health and Care Professions Council (HCPC) 58 Healy, K. 61 hermeneutics 11, 14–15, 18, 47–48, 146, 151–154 Higgs, J. 14 Horton, R. 123, 129–130 How Propaganda Works (Stanley) 150 Hoy, D. C. 126, 157 Hugh, T. 103, 112 Hume, D. 9, 33 Hyslop, I. 68–69 idealism 65, 83, 144, 148–151 ideal speech situation (Habermas) 84–85, 88, 91, 146 identity politics 38–39 immanent critique 42–44 imminent critique 29–31, 139 In a Different Voice (Gilligan) 86 incommunicability 138 independence 76, 78–82, 85, 87, 90, 92, 104, 116 information: and causal determinism 100; and communication 136–138 InfoWars 32 The Interface Effect (Galloway) 107 interpretation 12–16 interpretative listening 154–155 interpretative understanding 157 Ioakimidis, V. 2 irrationality 138–139 Isaacs, D. 34 Jones-Devitt, S. 10–11 Jordan, B. 79–80 Kahlke, R. 24 kairos 67–72 Kant, I. 30, 42, 76, 82–85, 87, 89, 94, 115, 150 Karagkounis, V. 63–64, 69 Katz, L. 39–40 Keane, J. 35–36 Keeping, C. 129 Krce-Ivanèi, M. 66 Kumagai, A. 55–56, 70–71

labour 44, 137–138 Lack, C. 122 Laidlaw, J. 62 The Lancet (Horton) 123, 129 LaPorte, T. R. 107 Laskowski-Jones, L. 2 Latour, B. 25, 42–43, 45–46, 48, 115 Law, J. 109–111, 114–115 Learning Lessons and Taking Action 103–104 Leece, J. 90 Lemke, T. 131–132 Lemley, D. 138 Levy, J. 146–147 liberalism 62–63, 86, 89–90, 150 Lincoln, K. 153 Lockie, S. 33–34 Loevinger, J. 87 Lorenz, W. 77 Loversidge, J. M. 41–42 Lupton, K. 128 Lymbery, M. 90 Lynn, M. 85 MacIntyre, A. 140–141 MacLean, S. 3 macro-reductionism 111 Mannion, R. 34 Marcuse, H. 82 Marcus, S. 48–50 Marxism 11, 27, 130–131 Massumi, B. 108 Mazzarella, W. 46 McBeath, G. 57 McKendree, J. 29 McQuillan, C. 5 Mead, L. 84 Mejía, A. 76–77, 92 Melonçon, L. 6 micro-reductionism 111 Mills, C. 147 Moffat, K. 35, 126–127 Mol, A. -M. 116 Molina, A. 76–77, 92 Moules, N. 15 Munro, E. 79, 107 The Munro Review of Child Protection (Munro) 60–61 Murdach, A. 79, 81 Myers, K. 69 Naidu, T. 55–56, 70–71 Nedelsky, J. 88

164 Index neoliberalism 6–7, 58, 61–63, 65–67, 90–91, 133–134, 138–140 neoliberal subjectivity 66 New Paternalism (Mead) 84 Nicotra, J. 137 non-ideal theory 146–151, 154–155 Nursing and Midwifery Council (NMC) 26 O’Byrne, P. 61, 68 O’Leary, T. 10 O’Mathúna, D. 86 One Way Street (Benjamin) 1 ontology 106–110 opportunistic understanding 157 Papathanasiou, I. 2, 24–25 Parrott, L. 79 partial compliance 147–148 Parton, N. 61, 68 Pawson, R. 106 Payne, M. 38 Peace, S. 90 performance of knowledge 46–48 personal responsibility 91 Peterson, J. D. 88 Poovey, M. 33 positionality 108 post-critical thinking 6–12, 44–50 post-critique 10–14, 48, 50 post-truth 1–2, 23, 31, 33, 39–40, 43–46, 49–50, 123, 130, 145, 152; and policy 34–36; and trust 36–38 Powell, J. 132 power 30, 43, 47, 66, 117, 122–140; power relations 60, 132, 134, 137 Preston-Shoot, M. 101, 103, 105, 114 professional criticism 29 professionalisation 11, 18, 26, 28–29, 128–129 Ranciere, J. 47, 87, 93–94 Randomised Control Trial (RCT) 40 Rawlings, A. 103 Rawls, J. 89, 146–147, 150 Raynor, P. 34–35 Reeser, L. 79 Reisch, M. 69 reparative approach 47 resistance 132 reviews process 100–101; criticisms of 104–105; critiques of 101–104

rhetoric: of dataism 8–10; of defamiliarisation 49; of exhaustion 6–8; of post-critique 10–12 Robison, W. 79 Rogers, P. 106 Rooney, E. 48 Rorty, R. 146 Rountree, M. 29 Rousseau, J. 122, 125 Rouvroy, A. 136 Saad, T. 77, 83–84, 89 safeguarding 99–116 Safeguarding Practice Reviews (SPRs) 100, 102 Salvage, J. 2 Savage, G. 112 Schmidt, J. 147–148 Schram, S. 16, 90–91 Schubert, L. 136 Sedgwick, E. K. 46–47 self-actualisation 65 self-rule 78 self-sufficiency 82, 84, 91–92 semio-capitalism 137–138 Serious Case Reviews (SCRs) 100–101, 103 Settlement House Movement 83 Sheldon, B. 129, 132 Shor, I. 27 Simpson, L. 155–156 Singh, G. 84 Singleton, V. 109 Sloterdijk, P. 7–8 Smith, L. 10–11 Smith, N. 145 Smith, R. 60 Social Care Institute for Excellence (SCIE) 78 social work 57 Social Work Reform Board 79 Sparks, M. 35–36 Speed, E. 34 Springer, R. 134–135 Sreenivasan, G. 148 Stanford, S. 64 Stanley, J. 150 Stepney, P. 4 Stevens, S. 8 straightforward guides 3 Sugarman, J. 65–67 symbolic violence 86

Index  165 Taylor, J. 102 territorialisation 112–114, 117 Thatcher, M. 65 Thiele, K. 4, 144, 146, 157 Thompson, M. 115 Thompson, N. 4 time poverty 67 Toner, J. 29 training 3–4, 7, 16, 26, 29, 44, 65, 70, 92, 103, 113, 126–128, 135, 140 transcendent critique 29–31, 35, 40–42, 149 truth 32–33 Tsang, N. 70 Tucker, I. 118 urgency: and ethos 65–67; and logos 58–61; and pathos 61–64 vaccine hesitancy 36, 43, 152–153 Valentini, L. 147 Vessey, D. 151

Vogelmann, F. 17, 35–37 vulnerability: of critique 144–157; hermeneutics 151–154; of ideals 148–151; management 146–148 Watson-Glaser Critical Thinking Appraisal (WGCTA) 31 Webb, S. 57, 60, 79 Weeger, A. 138 welfare dependency 47, 138 Welfare Words (Garrett) 47 Wessler, R. 87 Whelan, A. 62 White, J. 2 Williams, R. 10 Wilson, T. 43, 47–48 Young, H. 154 Zamora, D. 88 Zurmehly, J. 41–42