Tag: behaviourism

Jobcentre tells GP to stop issuing sick notes to patient assessed as ‘fit for work’ and he died.

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Abbie and her late father, James Harrison.

Julia Savage is a manager at Birkenhead Benefit Centre in Liverpool. She wrote a letter addressed to a GP regarding a seriously ill patient. It said:

“We have decided your patient is capable of work from and including January 10, 2016.

“This means you do not have to give your patient more medical certificates for employment and support allowance purposes unless they appeal against this decision.

“You may need to again if their condition worsens significantly, or they have a new medical condition.” 

The patient, James Harrison, had been declared “fit for work” and the letter stated that he should not get further medical certificates. 

However, 10 months after the Department for Work and Pensions (DWP) contacted his doctor without telling him, James died, aged 55, the Daily Record has reported.

He was clearly not fit for work.

His grieving daughter, Abbie, said: “It’s a disgrace that managers at the Jobcentre, who know nothing about medicine, should interfere in any way in the relationship between a doctor and a patient.

“They have no place at all telling a doctor what they should or shouldn’t give a patient. It has nothing to do with them.

“When the Jobcentre starts to get involved in telling doctors about the health of their patients, that’s a really slippery slope.”

Abbie said James had worked since leaving school at a community centre near his home. But his already poor health went downhill after the centre was shut down because of austerity cuts.

James had a serious lung condition and a hernia before the centre closed, and also developed depression and anxiety afterwards.

Abbie said: “He’d worked all his life. He wasn’t the kind of guy who knew anything about benefits.

“But as his health deteriorated, there wasn’t any chance he could do a job. He applied for employment and support allowance.”

James received Employment and Support Allowance (ESA), but only at the low rate of £70 a week, the same amount as jobseekers’ allowance. He was then sent to attend one of the DWP’s controversial Work Capability Assessments – and declared fit for work.

Despite that decision, Abbie said James remained in constant need of medical help and had to visit his doctor regularly.

However, the GP concerned repeatedly refused to give him a sick note, and James began to suspect the Jobcentre were to blame for this.

Abbie said: “He really needed a note. He was too ill to go to the constant appointments at the Jobcentre and he didn’t want to be sanctioned.

“He became convinced the DWP had been talking to his doctor behind his back.”

Although Abbie felt her father was confused, and didn’t think his explanation was right at the time, she later asked to see her father’s medical records. She found the letter in his file from Julia Savage, the manager at Birkenhead Benefit Centre, in James’s home city of Liverpool.

The letter was addressed to James’s GP.

Context: Government claims that work is a “health outcome”

James Harrison was very worried that his ill health interfered with his obligation to comply with the inflexible and constant conditions attached to his eligibility for welfare support, and that this would lead to sanctions – the withdrawal of his lifeline support, which was calculated to meet basic survival needs only.

The GP should have provided evidence that this was the case. The doctor was advised not to provide further fit notes by the DWP, however, unless James appealed. Yet the circumstances warranted that the GP provide a fit note. 

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Last year, the Department for Work and Pensions issued an ideologically directed new guidance to GPs regarding when they should issue a Fit Note. This was updated in December 2016.

In the document, doctors are warned of the dangers of “worklessness” and told they must consider “the vital role that work can play in your patient’s health”.  According to the department, “the evidence is clear that patients benefit from being in some kind of regular work”.

The biopsychosocial model, with a current political emphasis on the psychological element, has become a disingenuous euphemism for psychosomatic illness, which has been exploited by successive governments (and rogue insurance companies) to limit or deny access to social security, medical and social care.

Nobody would deny that illness has biological, psychological and social dimensions, however, the model has been adapted to fit a neoliberal “small state” ideology – one that rests almost entirely on Conservative individualist notions of citizen responsibility, as opposed to a rights-based approach and provision of publicly funded state support.

This approach to disability and ill health has been used by the government to purposefully question the extent to which people claiming social security bear personal responsibility for their own health status, rehabilitation and prompt return to work. It also leads to the alleged concern that a welfare system which was originally designed to provide a livable income to those with disabling health problems, may provide “perverse incentives” for perverse behaviours, entrenching “worklessness” and a “culture of dependency”. It’s worth pointing out at this point that there has never been any empirical evidence to support the Conservative notion of welfare “dependency”. 

Instead of being viewed as a way of diversifying risk and supporting those who have suffered misfortune and ill health, social and private insurance systems are to be understood as perverse incentives that pay people, absurdly, to remain ill and keep them from being economically productive.

The idea that people remain ill deliberately to avoid returning to work  – what Iain Duncan Smith and David Cameron have termed “the sickness benefit culture” – is not only absurd, it’s very offensive. This is a government that not only disregards the professional judgements of doctors, it also disregards the judgements of sick and disabled people. However, we have learned over the last decade that political “management” of people’s medical conditions does not make people healthier or suddenly able to work. Government policies, designed to “change behaviours” of sick and disabled people have resulted in harm, distress and sometimes, in premature deaths

The government have made it clear that there are plans to merge health and employment services. In a move that is both unethical and likely to present significant risk of harm to many patients, health professionals are being tasked to deliver benefit cuts for the DWP. This involves measures to support the imposition of work cures, including setting employment as a clinical outcome and allowing medically unqualified job coaches to directly update a patient’s medical record.

The Conservatives (and the Reform think tank) have also proposed mandatory treatment for people with long term conditions (which was first flagged up in the Conservative Party Manifesto) and this is currently under review, including whether benefit entitlements should be linked to “accepting appropriate treatments or support/taking reasonable steps towards “rehabilitation”.  The work, health and disability green paper and consultation suggests that people with the most severe illnesses in the support group may be subjected to welfare conditionality and sanctions.

Many campaigners have raised concerns about the DWP interfering with people’s medical care and accessing their medical files. I wrote an article last year about how the government plans to merge health and employment services and are now attempting to redefine work as a clinical outcome. I raised concerns about the fact that unemployment has been stigmatised and politically redefined as a psychological disorder, and that the government claims, somewhat incoherently, that the “cure” for unemployment due to illness and disability, and sickness absence from work, is work.

In a critical analysis of the recent work, health and disability green paper, I said: 

“And apparently qualified doctors, the public and our entire health and welfare systems have ingrained “wrong” ideas about sickness and disability, especially doctors, who the government feels should not be responsible for issuing the Conservatives recent Orwellian “fit notes” any more, since they haven’t “worked” as intended and made every single citizen economically productive from their sick beds.

It seems likely, then, that a new “independent” assessment and some multinational private company will most likely very soon have a lucrative role to ensure the government get the “right” results.”

The medical specialists are to be replaced by another profiteering corporate giant who will enforce a political agenda in return for big bucks from the public purse. Health care specialists are seeing their roles being incrementally and systematically  de-professionalised. That means more atrocious and highly irrational attempts from an increasingly authoritarian government at imposing an ideological “cure” – entailing the withdrawal of any support and imposing punitive “behavioural incentives” – on people with medical conditions and disabilities. Doctors, who are clever enough to recognise, diagnose and treat illness, are suddenly deemed by this government to be insufficiently clever to judge if patients are fit for work.

The political de-professionalisation of medicine, medical science and specialisms (consider, for example, the implications of permitting job coaches to update patient medical files), the merging of health and employment services and the recent absurd declaration that work is a clinical “health” outcome, are all carefully calculated strategies that serve as an ideological prop and add to the justification rhetoric regarding the intentional political process of dismantling publicly funded state provision, and the subsequent stealthy privatisation of Social Security and the National Health Service. 

“De-medicalising” illness is also a part of that process:

“Behavioural approaches try to extinguish observed illness behaviour by withdrawal of negative reinforcements such as medication, sympathetic attention, rest, and release from duties, and to encourage healthy behaviour by positive reinforcement: ‘operant-conditioning’ using strong feedback on progress.” Gordon Waddell and Kim Burton in Concepts of rehabilitation for the management of common health problems. The Corporate Medical Group, Department for Work and Pensions, UK. 

Waddell and Burton are cited frequently by the DWP as providing “evidence” that their policies are “evidence based.” Yet the DWP have selectively funded their research, which unfortunately frames and constrains the theoretical starting point, research processes and the outcomes with a heavy ideological bias. 

This framing simply shifts the focus from the medical conditions that cause illness and disability to the “incentives”, behaviours and perceptions of patients and ultimately, to neoliberal notions of personal responsibility and self-sufficient citizenship in a context of a night watchman, non-welfare state. 

Medication, rest, release from duties, sympathetic understanding – the remedies to illness – are being appallingly redefined as “perverse incentives” for ill health, yet the symptoms necessarily precede the prescription of medication, the Orwellian renamed (and political rather than medical) “fit note” and exemption from work duties. Notions of “rehabilitation” and medicine are being redefined as behaviour modification: here it is proposed that operant conditioning in the form of negative reinforcement – which the authors seem to have confused with punishment – will “cure” ill health. 

People cannot simply be “incentivised” into not being ill. 

The political use of the biopsychosocial model to cut costs at the expense of people who are ill will undoubtedly have further extremely serious implications. Such an approach, which draws on behaviourism and punishment (such as the threat and implementation of sanctions) is extremely unethical and makes the issue of consent to medical treatment very problematic if it is linked to the loss of lifeline support or the fear of loss of benefits.

This is clearly the direction that government policy is moving in and this represents a serious threat to the health, welfare, wellbeing and human rights of patients and the political independence of health professionals.

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Dr. Robert J. Lifton’s Eight Criteria for Thought Reform, cult thinking and neoliberalism

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Dr Robert J. Lifton is a psychologist who studied and identified the techniques of mass persuasion and groupthink used in propaganda and in cults (from political to religious). I found his interesting article about the eight criteria for “thought reform” on the International Cultic Studies Association (ICSA) site.

What struck me immediately about Lifton’s criteria is how easily they may be applied to neoliberalism – a totalising, authoritarian New Right ideology, imposed by an elite of very financially secure and powerful oppressors. Over the last few years, much of the rest of the population in the UK have experienced growing inequality and increasingly precarious socioeconomic circumstances, exacerbated by class-contingent neoliberal austerity and “small state” policies.

The neoliberal approach to public policy has become naturalised. Political theorist Francis Fukuyama, announced in 1992 that the great ideological battles between “east and west” were over, and that western liberal democracy had triumphed. He was dubbed the “court philosopher of [post-industrial] global capitalism” by John Gray.

In his book The End of History and the Last Man, Fukuyama wrote:

“At the end of history, it is not necessary that all societies become successful liberal societies, merely that they end their ideological pretensions of representing different and higher forms of human society…..What we are witnessing, is not just the end of the cold war, or a passing of a particular period of postwar history, but the end of history as such: that is, the end point of mankind’s ideological evolution and the universalisation of western liberal democracy as the final form of human government.”

I always saw Fukuyama as an ardent champion of ultra-neoliberalism, he disguised his conservatism behind apparently benign virtue words and phrases (as part of a propaganda technique called Glittering Generalities), such as “Man’s universal right to freedom.” 

He meant the same sort of self-interested “freedom” as Ayn Rand: “a free mind and a free market are corollaries.” He meant the same kind of implicit social Darwinist notions long held by Conservatives like Herbert Spencer – where the conditions of the market rather than evolution decides who is “free,” who survives, and as we know, the market is rigged by the invisible hand of government.

Fukuyama’s ideas have been absorbed culturally, and serve to normalise the dominance of the right, and stifle the rationale for critical debate.

Fukuyama’s work is a celebration of neoliberal hegemony. It’s an important work to discuss simply because it has been so widely and tacitly accepted, and because of that, some of the implicit, taken-for-granted assumptions and ramifications need to be made explicit. 

Neoliberalism requires an authoritarian approach to public administration. Rather than an elected government recognising and meeting public needs, instead, we now have a government manipulating citizens to adapt their views, behaviours and circumstances to meet the politically defined needs of the state. This turns democracy on its head. It is also presents us with a political framework that is incompatible with the UK’s international human rights obligations and equality legislation. 

Government policies have become increasingly irrational.  We have a government that has decided work is a health outcome, for example. In an absurd world where medical sick notes have been politically redefined as fit notes, sick and disabled people are apparently no longer exempt from work, which is now held to be a magic “cure”. The only way out of the politically imposed punitive and increasing poverty for those who cannot work is… to work. (See: Let’s keep the job centre out of GP surgeries and the DWP out of our confidential medical records.) 

Neoliberalism has become a doxa in the Western world. Here in the UK, citizen behaviours are being aligned with politically defined neoliberal outcomes, via policies that extend behaviour modification techniques, based on methodological behaviourism. Policies that “incentivise” have become the norm. This is a psychocratic approach to administration: the government are delivering public policies that have an expressed design and aim to act upon individuals, with an implicit set of instructions that inform citizens how they should be

Aversives and punishment protocols are most commonly used. Coercive welfare policies are one example of this. The recent eugenics by stealth policy entailing the restricting of welfare support to two children only is another. Both were introduced with the explicitly stated political intention of “changing behaviours” of poorer citizens. Those that cannot or will not conform are politically stigmatised and outgrouped, as well as being being further “disciplined” by state-imposed economic sanctions.

Another particularly successful way of neutralising opposition to an ideology is to ensure that only those ideas that are consistent with that ideology saturate the media and are presented as orthodoxy. Every Conservative campaign has been a thoroughly dispiriting and ruthless masterclass in media control.

Communication in the media is geared towards establishing a dominant paradigm and maintaining an illusion of a consensus. This ultimately serves to reduce democratic choices. Such tactics are nothing less than a political micro-management of your beliefs and are ultimately aimed at nudging your voting decisions and maintaining a profoundly unbalanced, pathological status quo. (See also: Inverted totalitarianism and neoliberalism.)

As a frame of analysis, Lifton’s criteria are very useful in highlighting parallels between cult thinking and how political dogma may gain an illusion of consensus; how it becomes a dominant paradigm and is accepted as everyday “common sense.” 

Kitty.

Lifton’s criteria for “thought reform” are:

  1. Milieu Control.  This involves the control of information and communication both within the environment and, ultimately, within the individual, resulting in a significant degree of isolation from society at large.

  2. Mystical Manipulation.  There is manipulation of experiences that appear spontaneous but in fact were planned and orchestrated by the group or its leaders in order to demonstrate divine authority or spiritual advancement or some special gift or talent that will then allow the leader to reinterpret events, scripture, and experiences as he or she wishes. (This can include “natural order” ideas and political doxa.) 
  3. Demand for Purity.  The world is viewed as black and white and the members are constantly exhorted to conform to the ideology of the group and strive for perfection.  The induction of guilt and/or shame is a powerful control device used here. (Stigma and political outgrouping is used to deter and exile non-conformists.)
  4. Confession.  Sins, as defined by the group, are to be confessed either to a personal monitor or publicly to the group.  There is no confidentiality; members’ “sins,” “attitudes,” and “faults” are discussed and exploited by the leaders. (Mainstream media have bombarded us with “confessions” of “scroungers”, for example. The lives and experiences of those out of work have become public moral “property.”)
  5. Sacred Science.  The group’s doctrine or ideology is considered to be the ultimate Truth, beyond all questioning or dispute.  Truth is not to be found outside the group.  The leader, as the spokesperson for God or for all humanity, is likewise above criticism. (Ties in with Conservative notions of a “natural social order”)
  6. Loading the Language.  The group interprets or uses words and phrases in new ways so that often the outside world does not understand.  This jargon consists of thought-terminating cliches, which serve to alter members’ thought processes to conform to the group’s way of thinking. (See Glittering Generalities and The Conservatives are colonising progressive rhetoric.)
  7. Doctrine over person.  Member’s personal experiences are subordinated to the sacred science and any contrary experiences must be denied or reinterpreted to fit the ideology of the group. 
  8. Dispensing of existence.  The group has the prerogative to decide who has the right to exist and who does not.  This is usually not literal but means that those in the outside world are not saved, unenlightened, unconscious and they must be converted to the group’s ideology.  If they do not join the group or are critical of the group, then they must be rejected by the  members.  Thus, the outside world loses all credibility.  In conjunction, should any member leave the group, he or she must be rejected also.  (Lifton, 1989)

*Italics in blue added by me.

Related

Nudging conformity and benefit sanctions: a state experiment in behaviour modification

The new Work and Health Programme: government plan social experiments to “nudge” sick and disabled people into work

Cameron’s Nudge that knocked democracy down: mind the Mindspace.

 

Link: The Government Communication Service guide to communications and behaviour changegcs-guide-to-communications-and-behaviour-change1


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Two key studies show that punitive benefit sanctions don’t ‘incentivise’ people to work, as claimed by the government

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Satirical Twitter response after Welfare Weekly revealed that the Department for Work and Pensions had been using fake claimants and made-up comments to justify the use of punitive welfare sanctions

 

The government’s controversial benefit sanctions regime can cause “damage to the wellbeing of vulnerable claimants and can lead to hunger, debt and destitution”, according to a damning new report which debunks Tory myths that benefit sanctions – denying people who are already struggling the only means by which support themselves and their families – “incentivise people into work.”

In a report titled Benefit Conditionality and Sanctions in Salford – One Year on, commissioned by Salford City Council in 2014, comprised of a task force of Salford’s Financial Inclusion Practitioner’s Group (FIPG), it was concluded that far from than “incentivising” people to move into work, the sanctions regime actually serves as a barrier, preventing people from engaging in appropriate training, volunteering and demotivating employment-related activities. Furthermore, the  sudden loss of income by removing benefits by imposing punitive sanctions often damages people’s mental health, create tensions within family relationships and may cause individuals to turn to crime in order to meet their basic survival needs.

The report says: “Despite the drop in numbers in Salford receiving a benefit sanction, for those who are sanctioned the impact is devastating. 

“A ‘financial shock’ such as a sanction causes both immediate and longer term impact as most people do not have the means to save, so have no safety net. This presents an emergency need for money to buy food, pay for heating and essential travel costs.”

The report also says that the rate of people being sanctioned in the area has not reduced over the previous 12 month period. But, critically, it adds: “Register sizes are decreasing and we believe this is in part due to a growing number of “disappeared“. These are claimants who drop their benefit claim or who move off benefit but do not take up employment. The Government has refused to publish destination data.”  (See also: Government under fire for massaging unemployment figures via benefit sanctions from Commons Select Committee.)

The report goes on to say: “From the wide range of responses we have received from Salford agencies working with claimants, despite the fall in sanctions, the impact of sanctions both on claimants and services within the City cannot be overstated and the harsh regime will be expected to include additional groups as Universal Credit rolls out nationally this year.”

The report follows on from an interim study, published in October 2014, which predicted that sanctioning would most likely lead to extreme material hardship, mental health problems such as depression, an increasing reliance on loan sharks. The interim report was submitted as evidence to the parliamentary inquiry into the impact of benefit sanctions.

Salford City Mayor, Paul Dennett said: “People on benefits are already struggling to afford food, heating and essential costs. They can’t save so they have no financial safety net. They live in dread of being sanctioned  which isn’t the right frame of mind for job hunting, volunteering or going back into education.” 

Rebecca Long Bailey, the Labour MP for Salford and Eccles, has said that the research “shows charities are increasingly having to step in to support claimants who are thrown into crisis due to delays and sanctions”. 

She added: “As an MP, I have seen some truly horrific cases, where the effects have been severe damage to my constituents’ mental and physical health, as well as the tragic case of David Clapson, who was found dead in his flat from diabetic ketoacidosis, two weeks after his benefits were suspended. His sister discovered her brother’s body and found his electricity had been cut off, meaning the fridge where he stored his insulin was no longer working. They must know that sanctioning people with diabetes is very dangerous but the system treats people as statistics and numbers. 

This report shows where we are in Salford today, one year on from the original report. Sadly, it illustrates the devastating impact sanctions have on the lives of people who are already struggling to make ends meet.”

Earlier this month, another collaborative research project, which is based at York university, also launched the first wave findings from an ongoing study on the effects and ethics of welfare conditionality. This project started in 2013 and will finish in 2018. The researchers, from a variety of universities across the UK, draws on data from interviews with 52 policy stakeholders, 27 focus groups conducted with practitioners, and 480 ‘wave a’ qualitative longitudinal interviews with with nine groups of welfare service users in England and Scotland.  The study includes 480 people living in Bath, Bristol, Edinburgh, Glasgow, Greater Manchester, Inverness, London, Peterborough, Sheffield and Warrington, and is aimed at determining what longer-term effects the sanctions and “support” are having.

Most respondents report negative experiences of conditional welfare interventions. Linking continued receipt of benefit and services to mandatory behavioural requirements under threat of sanction created widespread anxiety and feelings of disempowerment among claimants. The impacts of benefit sanctions are universally reported by welfare service users as profoundly negative. Routinely, sanctions had severely detrimental financial, material, emotional and health impacts on those subject to them. There was evidence of certain individuals disengaging from services or being pushed toward “survival crime”. Harsh, disproportionate or inappropriate sanctioning created deep resentment and feelings of injustice. 

A recurring theme in peoples’ experiences was that sanctions or other enforcement measures were out of proportion to the ‘offence’, such as being a few minutes late for an appointment. Many reported being sanctioned following administrative mistakes by Jobcentre or Work Programme staff. The Claimant Commitment was criticised for not taking sufficient account of individuals’ capabilities, wider responsibilities and/or vulnerabilities. Many saw Jobcentre Plus in particular as being primarily concerned with monitoring compliancy with behavioural requirements, imposing discipline and enforcement, rather than providing any meaningful support.

At the heart of welfare conditionality is an unfounded belief that it will change service users’ behaviour. Research to date in this first wave of findings has found very little  evidence of welfare conditionality bringing about positive behaviour change in terms of preparing for or finding paid work and/or ending what is assumed to be “irresponsible behaviour” (rather than a consequence of the realities of labour market and socioeconomic constraints.)

Many welfare service users challenged the notion that they did not want to work. Virtually all interviewees in this study expressed a desire to work in the future when, and if, their personal situations made this possible. 

If you want to take part in this study, please get in touch if you live in one of these areas: Bath, Bristol, Edinburgh, Glasgow, Greater Manchester, Inverness, London, Peterborough, Sheffield and Warrington. Your personal details will be kept confidential.

 

Related 

Exclusive: DWP Admit Using Fake Claimant’s Comments In Benefit Sanctions Leaflet

Benefit Sanctions Can’t Possibly ‘Incentivise’ People To Work – And Here’s Why

Nudging conformity and benefit sanctions

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The media need a nudge: the government using ‘behavioural science’ to manipulate the public isn’t a recent development, nudging has been happening since 2010

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Last year I wrote a critical article about the government’s Nudge Unit. The ideas of libertarian paternalism were popularised around five years ago by the legal theorist Cass Sunstein and the behavioural economist Richard Thaler, in their bestselling book Nudge. Sunstein and Thaler argue that we are fundamentally “irrational” and that many of our choices are influenced negatively by “cognitive bias.” They go on to propose that policymakers can and ought to nudge citizens towards making choices that are supposedly in their best interests and in the best interests of society.

But who nudges the nudgers?

Who decides what is in our “best interests”?

And how can human interests be so narrowly defined and measured in terms of economic outcomes, within a highly competitive, “survival of the fittest” neoliberal framework? The Nudge Unit is concerned with behavioural economics, not human happiness and wellbeing.

The welfare reforms, especially the increased application of behavioural conditionality criteria and the extended use of benefit sanctions, are based on a principle borrowed from behavioural economics theory – the cognitive bias called “loss aversion.” It refers to the idea that people’s tendency is to strongly prefer avoiding losses to acquiring gains. The idea is embedded in the use of sanctions to “nudge” people towards compliance with welfare rules of conditionality, by using a threat of punitive financial loss, since the longstanding, underpinning Conservative assumption is that people are unemployed because of behavioural deficits.

I’ve argued elsewhere, however, that benefit sanctions are more closely aligned with operant conditioning (behaviourism) than “libertarian paternalism,” since sanctions are a severe punishment intended to modify behaviour and restrict choices to that of compliance and conformity or destitution. But nudge was always going to be an attractive presentation at the top of a very slippery slope all the way down to open state coercion. Most people think that nudge is just about helping men to pee on the right spot on urinals, getting us to pay our taxes on time, or to save for our old age. It isn’t.

How can sanctioning ever be considered a rational political action –  that taking away lifeline income from people who are already struggling to meet their basic needs is somehow justifiable, or “in their best interests” or about making welfare “fair”?  The government claim that sanctions “incentivise” people to look for work. But there is an established body of empirical evidence which demonstrates clearly that denying people the means of meeting basic needs, such as money for food and fuel, undermines their physical, emotional and psychological wellbeing, and serves to further “disincentivise” people who are already trapped at a basic level of struggling to simply survive.

The Minnesota Semistarvation Experiment for example, provided empirical evidence and a highly detailed account regarding the negative impacts of food deprivation on human motivation, behaviour, sociability, physical and psychological health. Abraham Maslow, a humanist psychologist who studied human potential, needs and motivation, said that if a person is starving, the desire to obtain food will trump all other goals and dominate the person’s thought processes. This idea of cognitive priority is also represented in his classic hierarchy of needs. 

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Maslow’s hierarchy of needs

In a nutshell, this means that if people can’t meet their basic survival needs, it is extremely unlikely that they will have either the capability or motivation to meet higher level psychosocial needs, including social obligations and responsibilities to job seek.

Libertarian paternalists claim that whilst it is legitimate for government, private and public institutions to affect behaviour the aims should be to ensure that “people should be free to opt out of specified arrangements if they choose to do so.” The nudges favoured by libertarian paternalists are also supposed to be “unobtrusive.” That clearly is not the case with the application of coercive, draconian Conservative welfare sanctions. (See Nudging conformity and benefit sanctions.)

Evidently the government have more than a few whopping cognitive biases of their own.

I have previously criticised nudge because of its fundamental incompatibility with traditional democratic principles, and human rights frameworks, amongst other things. Democracy is based on a process of dialogue between the public and government, ensuring that the public are represented: that governments are responsive, shaping policies that address identified social needs. However, policies are no longer about representing and reflecting citizen’s needs: they are all about telling us how to be.

I’ve also pointed out that nudge operates to manipulate at a much broader level, too. The intentional political construction of folk devils and purposeful culturally amplified references to a stereotype embodying fecklessness, idleness and irresponsibility, utilising moral panic and manufactured public outrage as an effective platform for punitive welfare reform legislation, is one example of the value-laden application of pseudoscientific “behavioural insights” theory. The new paternalists have drawn on our psychosocial inclinations towards conformity, which is evident in the increasing political use of manipulative normative messaging. (For example, see: The Behavioral Insights Team in the U.K. used social normative messages to increase tax compliance in 2011.) 

The paternalist’s behavioural theories have been used to increasingly normalise a moral narrative based on a crude underpinning “deserving” and “undeserving” dichotomy, that justifies state interventions imposing conditions of extreme deprivation amongst some social groups – especially those previously considered legally protected. Public rational and moral boundaries have been and continue to be nudged and shifted, incrementally. Gordon Allport outlined a remarkably similar process in his classic political psychology text, The Nature of Prejudice, which describes the psychosocial processes involved in the construction of categorical others, and the subsequent escalating scale of prejudice and discrimination.

So we really do need to ask exactly in whose “best interests” the new paternalist “economologists” are acting. Nudge is being targeted specifically at the casualties of inequality, which is itself an inevitability of neoliberalism. The premise of nudge theory is that poor people make “bad choices” rather than their circumstances being recognised as an inexorable consequence of a broader context in which political decisions and the economic Darwinism that neoliberalism entails creates “winners and losers.”

I have seen very little criticism of nudge in the mainstream media until very recently. On Monday the Independent published an article about how the Chancellor exploited our cognitive biases to secure his cuts to welfare, drawing particularly on the loss aversion theory. To reiterate, in economics decision theory, loss aversion refers to people’s tendency to strongly prefer avoiding losses to acquiring gains.

From the Independent article:

“Researchers have also found that people do not treat possible forgone gains resulting from a decision in the same way as equivalent potential out-of-pocket losses from that same decision. The forgone gains are much less psychologically painful to contemplate than the losses. Indeed, the gains are sometimes ignored altogether.

There was an apparent attempt to harness this particular psychological bias in George Osborne’s Autumn Statement. Of course the Chancellor was forced into a memorable U-turn on his wildly unpopular tax credit cuts. Millions of poor working families will now not see their benefits cut in cash terms next April. Yet the Chancellor still gets virtually all his previously targeted savings from the welfare bill by 2020.

How? Because the working age welfare system will still become much less generous in five years’ time. As research from the Institute for Fiscal Studies and the Resolution Foundation has shown, the typical low-income working family in 2020 will be hit just as hard as they were going to be before the Autumn Statement U-turn. The Chancellor seems to be calculating that the pain of future forgone gains will be less politically toxic than immediate cash losses.”

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It’s hardly a revelation that the Conservative government are manipulating public opinion, using scapegoating, outgrouping and the creation of folk devils in order desensitize the public to the plight of the poorest citizens and to justify dismantling the welfare state incrementally. As I’ve pointed out previously, this has been going on since 2010, hidden in plain view.

In the article, Ben Chu also goes on to say:

“Experiments by Daniel Kahneman, Jack Knetsch and Richard Thaler also suggest that this stealth approach fits with people’s sense of fairness. They found that in a time of recession and high unemployment most people they surveyed thought a hypothetical company that cut pay in cash terms was acting unfairly, while one that merely raised it by less than inflation was behaving fairly.

There was another exploitation of our psychological biases in the Autumn Statement. The Chancellor announced an increase in stamp duty for people buying residential properties to let. That underscored the fact that the Chancellor remains wedded to the stamp duty tax, despite pressure from public finance experts to shift to a more progressive and efficient annual property tax (perhaps an overhauled council tax).

But Mr Osborne, like all his recent predecessors, realises that stamp duty, for all its deficiencies, tends to be less resented as a form of taxing property. Why? Because of “anchoring”. When people buy a house they are mentally prepared to part with a huge sum, usually far bigger than any other transaction they will make in their lives. The additional stamp duty payable to the Treasury on top of this massive sum, large though it is, seems less offensive. People resent it less than they would if the tax were collected annually in the form of a property tax – even if, for most, it would actually make little difference over the longer term. Sticking with stamp duty is the path of least resistance.”

There is another economologist “experiment” that seems to have slipped under the radar of the media – an experiment to nudge sick and disabled people into work, attempting to utilise GPs in a blatant overextension of the intrusive and coercive arm of the state. It is aimed at ensuring sick and disabled people don’t claim benefits. I don’t recall any mention of behaviourist social experiments on the public in the Conservative manifesto.

When I am ill, I visit a doctor. I expect professional and expert support. I wouldn’t consider consulting Iain Duncan Smith about my medical conditions. Or the government more generally. There are very good reasons for that. I’m sure that Iain Duncan Smith has Dunning–Kruger syndrome. He thinks he knows better than doctors and unreliably informs us that work can set you free, it can help prevent and cure illness.  Yet I’ve never heard of a single case of work curing blindness, heart disease, rheumatoid arthritis, cerebral palsy, multiple sclerosis, cancer or even so much as a migraine. I’ve also yet to hear of a person’s missing limbs miraculously growing back. The Conservative “medical intervention” entails a single prescription: a work coach from the job centre. State medicine – a single dose to be taken daily: Conservative ideology, traditional prejudice and some patronising and extremely coercive paternalism. The blue pill.

I don’t agree with the conclusions that Ben Chu draws in his article. Whilst he acknowledges that:

“The Government has a Behavioural Insights Team (or “Nudge Unit”) whose objective is to exploit the public’s psychological biases,” he goes on to say that it’s merely “to push progressive policies, such as getting us to save more for retirement and helping us make “better choices”, perhaps by counteracting the negative impact of loss aversion. But, as we’ve seen, the Chancellor is not above exploiting our biases in a cynical fashion too.” 

Progressive policies? The draconian welfare “reforms” aren’t remotely “progressive.” In the UK, the growth and institutionalisation of prejudice and discrimination is reflected in the increasing tendency towards the transgression of international legal human rights frameworks at the level of public policy-making. Policies that target protected social groups with moralising, stereotypical (and nudge-driven) normative messages, accompanied with operant disciplinary measures, have led to extremely negative and harmful outcomes for the poorest and most vulnerable citizens, but there is a marked political and social indifference to the serious implications and consequences of such policies.

There is a relationship between the world that a person inhabits and that person’s actions. Any theory of behaviour and cognition that ignores context can at best be regarded as very limited and partial. Yet the libertarian paternalists overstep their narrow conceptual bounds, with the difficulty of reconciling individual and social interests somewhat glossed over. They conflate “social interests” with neoliberal outcomes.

The asymmetrical, class-contingent application of paternalistic libertarian “insights” establishes a hierarchy of decision-making “competence” and autonomy, which unsurprisingly corresponds with the hierarchy of wealth distribution.

So nudge inevitably will deepen and perpetuate existing inequality and prejudice, adding a dimension of patronising psycho-moral suprematism to add further insult to politically inflicted injury. Nudge is a technocratic fad that is overhyped, theoretically trivial, unreliable; a smokescreen, a prop for neoliberalism and monstrously unfair, bad policy-making.

Libertarian paternalists are narrowly and uncritically concerned only with the economic consequences of decisions within a neoliberal context, and therefore, their “interventions” will invariably encompass enforcing behavioural modifiers and ensuring adaptations to the context, rather than being genuinely and more broadly in our “best interests.” Defining human agency and rationality in terms of economic outcomes is extremely problematic. And despite the alleged value-neutrality of the new behavioural economics research it is invariably biased towards the status quo and social preservation rather than progressive social change.

At best, the new “behavioural science” is merely theoretical, at a broadly experimental stage, and therefore profoundly limited in terms of scope and academic rigour, as a mechanism of explanation, and in terms of its capacity for generating comprehensive and coherent accounts and understandings of human motivation and behaviour.

At worst, the rise of this new form of psychopolitical behaviourism reflects, and aims at perpetuating, the hegemonic nature of neoliberalism.

But for the record, when a government attempts to micromanage and manipulate the behaviour of citizens, we call that “totalitarianism” not “nudge.” 

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Related reading

A critique of Conservative notions of social research

The government plan social experiments to “nudge” sick and disabled people into work

Mind the MINDSPACE: the nudge that knocked democracy down

Nudging conformity and benefit sanctions

A critique of Conservative notions of social research

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The goverment’s archaic positivist approach to social research shows that they need a team of sociologists and social psychologists, rather than the group of “libertarian paternalists” – behavioural economists – at the heart of the cabinet office, who simply nudge the public to behave how they deem appropriate, according to a rigid, deterministic, reductive neoliberal agenda and traditional, class-contingent Conservative prejudices.

 

Glossary

Epistemology – The study or theory of the nature and grounds of knowledge, especially with reference to its limits, reliability and validity. It’s invariably linked with how a researcher perceives our relationship with the world and what “social reality” is (ontology), and how we ought to investigate that world (methodology). For example, in sociology, some theorists held that social structures largely determine our behaviour, and so behaviour is predictable and objectively measurable, others emphasise human agency, and believe that we shape our own social reality to a degree, and that it’s mutually and meaningfully negotiated and unfixed. Therefore, detail of how we make sense of the world and navigate it is important.

Interpretivism – In sociology, interpretivists assert that the social world is fundamentally unlike the natural world insofar as the social world is meaningful in a way that the natural world is not. As such, social phenomena cannot be studied in the same way as natural phenomena. Interpretivism is concerned with generating explanations and extending understanding rather than simply describing and measuring social phenomena, and establishing basic cause and effect relationships.

Libertarian paternalism – The idea that it is both possible and legitimate for governments, public and private institutions to affect and change the behaviours of citizens whilst also [controversially] “respecting freedom of choice.”

MethodologyA system of methods used in a particular area of study or activity to collect data. In the social sciences there has been disagreement as to whether validity or reliability ought to take priority, which reflected ontological and epistemological differences amongst researchers, with positivism, broadly speaking, being historically linked with structural theories of society – Emile Durkheim’s structural-functionalism, for example – and quantitative methods, usually involving response-limiting surveys, closed-ended questionaires and statistical data collection, whereas interpretive perspectives, such as symbolic interactionism, phenomenology and ethnomethodology, tend to be associated with qualitative methods, favoring open-ended questionaires, interviews and participant observation.

The dichotomy between quantitative and qualitative methodological approaches, theoretical structuralism (macro-level perspectives) and interpretivism (micro-level perspectives) is not nearly so clear as it once was, however, with many sociologists recognising the value of both means of data collection and employing methodological triangulation, reflecting a commitment to methodological and epistemological pluralism. Qualitative methods tend to be more inclusive, lending participants a dialogic, democratic voice regarding their experiences.

Ontology – A branch of metaphysics concerned with the nature of reality and being. It’s important because each perspective within the social sciences is founded on a distinct ontological view.

Positivism – In sociology particularly, the view that society, like the physical world, operates according to general laws, and that all authentic knowledge is that which is verified. However, the verification principle is itself unverifiable.

Positivism tends to present superficial and descriptive rather than in-depth and explanatory accounts of social phenomena. In psychology, behaviourism has been the doctrine most closely associated with positivism. Behaviour from this perspective can be described and explained without the need to make ultimate reference to mental events or to internal psychological processes. Psychology is, according to behaviourists, the “science” of behaviour, and not the mind.

Critical realism – Whilst positivists and empiricists more generally, locate causal relationships at the level of observable surface events, critical realists locate them at the level of deeper, underlying generative mechanisms. For example, in science, gravity is an underlying mechanism that is not directly observable, but it does generate observable effects. In sociology, on a basic level, Marx’s determining base (which determines superstructure) may be regarded as a generative mechanism which gives rise to emergent and observable properties.

Randomised controlled trials (RCTs) – RCT is a positivist research model in which people are randomly assigned to an intervention or a control (a group with no intervention) and this allows comparisons to be made. Widely accepted as the “gold standard” for clinical trials, the foundation for evidence-based medicine, RCTs are used to establish causal relationships. These kinds of trials usually have very strict ethical safeguards to ensure the fair and ethical treatment of all participants, and these safeguards are especially essential in government trials, given the obvious power imbalances and potential for abuse. A basic principle expressed in the Nuremberg Code is the respect due to persons and the value of a person’s autonomy, for example.

In the UK, the Behavioural Insight Team is testing paternalist ideas for conducting public policy by running experiments in which many thousands of participants receive various “treatments” at random. Whilst medical researchers generally observe strict ethical codes of practice, in place to protect subjects, the new behavioural economists are much less transparent in conducting research and testing public policy interventions. Consent to a therapy or a research protocol must possess three features in order to be valid. It should be voluntarily expressed, it should be the expression of a competent subject, and the subject should be adequately informed. It’s highly unlikely that people subjected to the extended use and broadened application of welfare sanctions gave their informed consent to participate in experiments designed to test the theory of “loss aversion,” for example.

There is nothing to prevent a government deliberately exploiting a research framework as a way to test out highly unethical and ideologically-driven policies. How appropriate is it to apply a biomedical model of prescribed policy “treatments” to people experiencing politically and structurally generated social problems, such as unemployment, inequality and poverty, for example?

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The increasing conditionality and politicisation of “truths”

The goverment often claim that any research revealing negative social consequences arising from their draconian policies, which they don’t like to be made public “doesn’t establish a causal link.”  Recently there has been a persistent, aggressive and flat denial that there is any “causal link” between the increased use of food banks and increasing poverty, between benefit sanctions and extreme hardship and harm, between the work capability assessment and an increase in numbers of deaths and suicides, for example.

The government are referring to a scientific maxim: “Correlation doesn’t imply causality.” 

It’s true that correlation is not the same as causation.

It’s certainly true that no conclusion may be drawn regarding the existence or the direction of a cause and effect relationship only from the fact that event A and event B are correlated. Determining whether there is an actual cause and effect relationship requires further investigation. The relationship is more likely to be causal if the correlation coefficient is large and statistically significant, as a general rule of thumb. (For anyone interested in finding out more about quantitative research methods, inferential testing and statistics, this is a good starting point – Inferential Statistics.)

Here are some minimal conditions to consider in order to establish causality, taken from Hills criteria:

  • Strength: A relationship is more likely to be causal if there is a plausible mechanism between the cause and the effect.
  • Coherence: A relationship is more likely to be causal if it is compatible with related facts and theories.
  • Analogy: A relationship is more likely to be causal if there are proven relationships between similar causes and effects.
  • Specificity: A relationship is more likely to be causal if there is no other likely explanation.
  • Temporality: A relationship is more likely to be causal if the effect always occurs after the cause.
  • Gradient: A relationship is more likely to be causal if a greater exposure to the suspected cause leads to a greater effect.
  • Plausibility: A relationship is more likely to be causal if there is a plausible mechanism between the cause and the effect.

Hill’s criteria can be thought of as elements within a broader process of critical thinking in research, as careful considerations in the scientific method or model for deciding if a relationship involves causation. The criteria don’t all have to be met to suggest causality and it may not even be possible to meet them in every case. The important point is that we can consider the criteria as part of a careful and relatively unbiased research process. We can also take other precautionary steps, such as ensuring that there are no outliers or excessive uncontrolled variance, ensuring the populations sampled are representative and generally taking care in our research design, for example.

However, it is inaccurate to say that correlation doesn’t imply causation. It quite often does.

Furthermore, the government are implying that social research is valid only if it conforms to strict and archaic positivist criteria, and they attempt to regularly dismiss the propositions and research findings of social scientists as being “value-laden” or by implying that they are, at least. However, it may also be said that values enter into social inquiry at every level, including decisions to research a social issue or not, decisions to accept established correlations and investigate further, or not, which transforms research into a political act. (One only need examine who is potentially empowered or disempowered through any inquiry and note the government response to see this very clearly).

It’s noteworthy that when it comes to government claims, the same methodological rigour that they advocate for others isn’t applied. Indeed, many policies have clearly been directed by ideology and traditional Tory prejudices, rather than valid research and empirical evidence. For example, it is widely held by the Conservatives that work is the “only route out of poverty”. Yet since 2010, the decline in UK wage levels has been amongst the very worst in Europe. The fall in earnings under the Tory-led Coalition is the biggest in any parliament since 1880, according to analysis by the House of Commons Library, and at a time when the cost of living has spiralled upwards. Many people in work, as a consequence, are now in poverty, empirically contradicting government claims.

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So what is positivism?

Positivism was a philosophical and political movement which enjoyed a very wide currency in the second half of the nineteenth century. It was extensively discredited during the twentieth century.

Auguste Comte (1798-1857,) who was regarded by many as the founding father of social sciences, particularly sociology, and who coined the term “positivism,” was a Conservative. He believed social change should happen only as part of an organic, gradual evolutionary process, and he placed value on traditional social order, conventions and structures. Although the notion of positivism was originally claimed to be about the sovereignty of positive (verified) value-free, scientific facts, its key objective was politically Conservative. Positivism in Comte’s view was “the only guarantee against the communist invasion.” (Therborn, 1976: 224).

The thing about the fact-value distinction is that those who insist on it being rigidly upheld the loudest generally tend to use it the most to disguise their own whopping great ideological commitments. In psychology, we call this common defence mechanism splitting.  “Fact, fact, fact!” cried Mr Thomas Gradgrind. It’s a very traditionally Conservative way of rigidly demarcating the world, imposing hierarchies of priority and order, to assure ontological security and maintain the status quo, regardless of how absurd this shrinking island of certainty appears to the many who are exiled from it.

Perhaps unsurprisingly, Comte’s starting point is the same as Hayek’s, namely the existence of a spontaneous order. It’s a Conservative ideological premise, and this is one reason why the current neoliberal Tory government of self-described “libertarian paternalists” embrace positivism without any acknowledgement of its controversy.

However, positivist politics was discarded half a century ago, as a reactionary and totalitarian doctrine. It’s is true to say that, in many respects, Comte was resolutely anti-modern, and he also represents a general retreat from Enlightenment humanism. His somewhat authoritarian positivist ideology, rather than celebrating the rationality of the individual and wanting to protect people from state interference, instead fetishised the scientific method, proposing that a new ruling class of authoritarian technocrats should decide how society ought to be run and how people should behave. This is a view that the current government, with their endorsement and widespread experimental application of nudge theory, would certainly subscribe to.

Science, correlation and causality

Much scientific evidence is based on established correlation of variables – they are observed to occur together. For example, correlation is used in Bell’s theorem to disprove local causality. The combination of limited available methodologies has been used together with the dismissing “correlation doesn’t imply causation” fallacy on occasion to counter important scientific findings. For example, the tobacco industry has historically relied on a dismissal of correlational evidence to reject a link between tobacco and lung cancer, especially in the earliest stages of the research, but there was a clearly and strongly indicated association. 

Science is manifestly progressive, insofar as over time its theories tend to increase in depth, range and predictive power.

Established correlations in both the social and natural sciences may be regarded, then, as a starting point for further in-depth and rigorous research, with the coherence, comprehensiveness and verisimilitude of theoretical propositions increasing over time. This is basically a critical realist position, which is different from the philosophical positivism that dominated science and the social sciences two centuries ago, with an emphasis on strictly reductive empirical evidence and the verification principle (which is itself unverifiable).

Positivist epistemology has been extensively critiqued for its various limitations in studying the complexities of  human experiences. One critique focuses on the positivist tendency to carry out studies from a “value-free” outsider perspective in an effort to maintain objectivity, whilst the insider or subjective perspective is ignored. There is no mind-independent, objective vantage point from which social scientists may escape the insider. A second critique is that positivism is reductionist and deterministic. It emphasises quantification and ignores and removes context, meanings, autonomy, intention and purpose from research questions by ignoring unquantifiable variables.

It therefore doesn’t extend explanations and understanding of how we make sense of the world. A third critique is that positivism entails generalisation of data which renders results inapplicable to individual cases; data are used to describe a population without accounting for significant micro-level or individual variation. Because of these and other problems, positivism lost much favour amongst sociologists and psychologists in particular. 

Verification was never the sole criterion of scientific inquiry. Positivism probably lost much more methodological and epistemological currency in the social sciences than the natural sciences, because humans cannot be investigated in the same way as inert matter. We have the added complication of consciousness and [debatable] degrees of intentionality, so people’s behaviour is much more difficult to measure, observe and predict. There’s a difference between facts and meanings, human behaviours are meaningful and purposeful, human agency arises in contexts of intersubjectively shared meanings. But it does seem that prediction curiously becomes easier at macro-levels when we examine broader social phenomena, mechanisms and processes. (It’s a bit like quantum events: quite difficult to predict at subatomic level, but clarifying, with events apparently becoming more predictable at the level we inhabit and observe every day.)

Now, whilst correlation isn’t quite the same as “cause and effect”, it often strongly indicates a causal link, and what usually follows once we have established a correlation is further rigorous research, eliminating “confounding” variables and bias systematically (we do use rigorous inference testing in the social sciences). Correlation is used when inferring causation; the important point is that such inferences are made after correlations are confirmed as real and all causational relationships are systematically explored using large enough data sets.

The standard process of research and enquiry, scientific or otherwise, doesn’t entail, at any point, a flat political denial that there is any relationship of significance to concern ourselves with, nor does it involve withholding data and a refusal to investigate further.

Positivism and psychology

Positivism was most closely associated with a doctrine known as behaviourism during the mid-20th century in psychology. Behaviourists confined their research to behaviours could be directly observed and measured. Since we can’t directly observe beliefs, thoughts, intentions, emotions and so forth,  these were not deemed to be legitimate topics for a scientific psychology. One of the assumptions of behaviourists is that free-will is illusory, and that all behaviour is determined by the environment either through association or reinforcement. B.F. Skinner argued that psychology needed to concentrate only on the positive and negative reinforcers of behaviour in order to predict how people will behave, and  everything else in between (like what a person is thinking, or their attitude) is irrelevant because it can’t be measured.

So, to summarise, behaviourism is basically the theory that human (and animal) behaviour can be explained in terms of conditioning, without appeal to wider socioeconomic contexts, consciousness, character, traits, personality, internal states, intentions, purpose, thoughts or feelings, and that psychological disorders and “undesirable” behaviours are best treated by using a system of reinforcement and punishment to alter behaviour “patterns.”

In Skinner’s best-selling book Beyond Freedom and Dignity1971, he argued that freedom and dignity are illusions that hinder the science of behaviour modification, which he claimed could create a better-organised and happier society, where no-one is autonomous, because we have no autonomy. (See also Walden Two1948: Skinner’s dystopian novel).

There is, of course, no doubt that behaviour can be controlled, for example, by threat of violence, actual violence or a pattern of deprivation and reward. Freedom and dignity are values that are intrinsic to human rights. Quite properly so. All totalitarians, bullies  and authoritarians are behaviourists. Skinner has been extensively criticised for his sociopolitical pronouncements, which many perceive to be based on serious philosophical errors. His recommendations are not based on “science”, but on his own covert biases and preferences.

Behaviourism also influenced a positivist school of politics that developed in the 50s and 60s in the USA. Although the term “behavouralism” was applied to this movement, the call for political analysis to be modeled upon the natural sciences, the preoccupation with researching social regularities, a commitment to verificationism, an experimental approach to methodology, an emphasis on quantification and the prioritisation of a fact-value distinction: keeping moral and ethical assessment and empirical explanations distinct, indicate clear parallels with the school of behaviourism and positivism within psychology.

The political behaviouralists proposed, ludicrously, that normative concepts such as “democracy,” “equality,” “justice” and “liberty” should be rejected as they are not scientific – not verifiable or falsifiable and so are beyond the scope of “legitimate” inquiry. 

Behaviourism has been criticised within politics as it threatens to reduce the discipline of political analysis to little more than the study of voting and the behaviour of legislatures. An emphasis on  the observation of data deprives the field of politics of other important viewpoints – it isn’t a pluralist or democratic approach at all – it turns political discourses into monologues and also conflates the fact-value distinction.

Every theory is built upon an ideological premise that led to its formation in the first place and subsequently, the study of  “observable facts” is intentional, selective and purposeful. As Einstein once said: “the theory tells you what you may observe.”

The superficial dichotomisation of facts and values also purposefully separates political statements of what is from what ought to be. Whilst behavouralism is itself premised on prescriptive ideology, any idea that politics should include progressive or responsive prescriptions – moral judgements and actions related to what ought to be – are summarily dismissed.

Most researchers would agree that we ought to attempt to remain as objective as possible, perhaps aiming for a relative value-neutrality, rather than value-freedom, when conducting research. It isn’t possible to be completely objective, because we inhabit the world that we are studying, we share cultural norms and values, we are humans that coexist within an intersubjective realm, after all. We can’t escape the world we are observing, or the mind that is part of the perceptual circuit.

But we can aim for integrity, accountability and transparency. We can be honest, we can critically explore and declare our own interests and values, for example. My own inclination is towards value-frankness, rather than value-freedom – we can make the values which have been incorporated in the choice of the topic of research, and of the formulation of hypotheses clear and explicit at the very outset. The standardised data collection process itself is uncoloured by personal feelings (that is, we can attempt to collect data reliably and systematically.) However, the debate about values and the principle of objectivity is a complex one, and it’s important to note that symbolic interactionists and post modernists, amongst others, have contended that all knowledge is culturally constructed. (That’s a lengthy and important discussion for another time.)

Nudge: from meeting public needs to prioritising political needs

The idea of “nudging” citizens to do the “right thing” for themselves and for society heralds the return of behaviourist psychopolitical theory. Whilst some theorists claim that nudge is premised on notions of cognition, and so isn’t the same as the flat, externalised stimulus-response approach of behaviourism, my observation is that the starting point of nudge theory is that our cognitions are fundamentally biased and faulty, and so the emphasis of nudge intervention is on behaviour modification, rather than on engaging with citizen’s cognitive or deliberative capacities.

In other words, our tendency towards cognitive bias(es) render us incapable of rational decision-making, so the state is bypassing democratic engagement and prescribing involuntary and experimental behavioural change to “remedy” our perceived cognitive deficits.

Behaviourists basically stated that only public events (behaviours of an individual) can be objectively observed, and that therefore private events (intentions, thoughts and feelings) should be ignored. The paternal libertarians are stating that our cognitive processes are broken, and should be ignored. What matters is how people behave. It’s effectively another reductionist, instrumental stimulus-response approach based on the same principles as operant conditioning.

Nudge is very controversial. It’s experimental use on an unconsenting population has some profound implications for democracy,  which is traditionally based on a process of dialogue between the public and government, ensuring that the public are represented: that governments are responsive, shaping policies that address identified social needs. However, Conservative policies are no longer about reflecting citizen’s needs: they are increasingly all about instructing us how to be.

The context-dependency and determination of value-laden nudge theory

Libertarian paternalists are narrowly and uncritically concerned only with the economic consequences of decisions within a neoliberal context, and therefore, their “interventions” will invariably encompass enforcing behavioural modifiers and ensuring adaptations to the context, rather than being genuinely and more broadly in our “best interests.” Defining human agency and rationality in terms of economic outcomes is extremely problematic. And despite the alleged value-neutrality of the new behavioural economics research it is invariably biased towards the status quo and social preservation rather than progressive social change.

At best, the new “behavioural theories” are merely theoretical, at a broadly experimental stage, and therefore profoundly limited in terms of scope and academic rigour; as a mechanism of explanation and in terms of capacity for generating comprehensive and coherent accounts and understandings of human motivation and behaviour.

Furthermore, in relying upon a pseudo-positivistic experimental approach to human cognition, behavioural economists have made some highly questionable ontological and epistemologial assumptions: in the pursuit of methodological individualism, citizens are isolated from the broader structural political, economic and sociocultural and established reciprocal contexts that invariably influence and shape an individuals’s experiences, meanings, motivations, behaviours and attitudes, causing a deeply problematic duality between context and cognition.

Yet many libertarian paternalists reapply the context they evade in explanations of human behaviours to justify the application of their theory in claiming that their “behavioural theories” can be used to serve social, and not necessarily individual, ends, by simply acting upon the individual to make them more “responsible.” But “responsible” is defined only within the confines of a neoliberal economic model. (See, for example: Personal Responsibility and Changing Behaviour: the state of knowledge and its implications for public policyDavid Halpern, Clive Bates, Geoff Mulgan and Stephen Aldridge, 2004.)

In other words, there is a relationship between the world that a person inhabits and a person’s perceptions, intentions and actions. Any theory of behaviour and cognition that ignores context can at best be regarded as very limited and partial. Yet the libertarian paternalists overstep their narrow conceptual bounds, with the difficulty of reconciling individual and social interests somewhat glossed over. They conflate “social interests” with neoliberal outcomes.

The ideological premise on which the government’s “behavioural theories” and assumptions about the negative impacts of neoliberalism on citizens rests is fundamentally flawed, holding individuals responsible for circumstances that arise because of market conditions, the labor market, political decision-making, socioeconomic constraints and the consequences of increasing “liberalisation”, privatisation and marketisation.

Market-based economies both highly value and extend competitive individualism and “efficiency”,  which manifests a highly hierarchical social structure, and entails the adoption of economic Darwinism. By placing a mathematical quality on social life (Bourdieu, 1999), neoliberalism has encouraged formerly autonomous states to regress into penal states that value production, competition and profit above all else, including attendance to social needs and addressing arising adverse structural level constraints, the consequences of political decision-making and wider socioeconomic issues, such as inequality and poverty.

As a doxa, neoliberalism has become a largely unchallenged reality. It now seems almost rational that markets should be the allocators of resources; that competition should be the primary driver of social problem-solving, innovation and behaviour, and that societies should be composed of individuals primarily motivated by economic conditions. Despite the Conservative’s pseudo-positivist claims of value-neutrality, the economic system is being increasingly justified by authoritarian moral arguments about how citizens ought to act.

The rise of a new psychopolitical behaviourism reflects, and aims at perpetuating, the hegemonic nature of neoliberalism.

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Image courtesy of Tiago Hoisel

 

Nudging conformity and benefit sanctions: a state experiment in behaviour modification

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“Behavioural theory is a powerful tool for the government communicator, but you don’t need to be an experienced social scientist to apply it successfully to your work.”
Alex Aiken
Executive Director of
Government Communications

Normalising state punishment 

Conservative anti-welfare discourse excludes the structural context of unemployment and poverty from public conversation by transforming these social problems into individual pathologies of “welfare dependency” and “worklessness.” The consequence is an escalating illogic of authoritarian policy measures which have at their core the intensification of punitive conditionality. These state interventions are justified by the construction and mediation of stigma, which is directed at already marginalised social groups that the policies target. The groups, which include sick and disabled people, people who are unemployed, are painted with a Malthusian brush, as a  “burden on the state” and a drain on what are seen as scarece resources in an era of austerity. Political processes of scapegoating, stigmatisation and outgrouping have been amplified by a largely complicit   UK corporate media. 

Such policies and interventions are then rationalised as innovative and new political and economic responses. Behavioural economics theories, which “nudge” is a part of, for example, are aimed at “changing the behaviours” of citizens perceived to “make the wrong choices” – ultimately the presented political aim is to mend Britain’s supposedly “broken society” and to restore a country that “lives within its means”, according to a narrow, elitist view, bringing about a neoliberal utopia built on “economic competitiveness” in a “global race.”  

Disadvantage has become an individualised, private matter: it has been politically reduced and is explained as a private characteristic of disadvantaged individuals, rather than it being an inevitable feature of a socioeconomic form of organisation founded on competitive individualism. This allows the state to depoliticise it, making disadvantage the private responsibility of citizens, whilst at the same time, justifying a psychopolitical approach to changing citizen’s behaviours to fit with neoliberal outcomes. 

Institutions structure political struggles, they provide models, schemas and scripts for citizen’s behaviours. Bureaucratic norms within the welfare state have become increasingly about moral rectification. Debate about addressing  structural inequality and poverty has been reduced to political rhetoric about behavioural incentives.

Welfare dependency is now a synonym for poverty, with its perceived dimensions of moral/psychological dependency accepted as a character “trait” or a “personality disorder.”  The sociopolitical relations of subordination and economic organisation that were hidden within the discourse of “dependency” have completely disappeared from conversations about poverty. 

Context

Narratives about social security in the UK that emphasise a deepening of neoliberalisation became particularly virulent in the context of the global economic crash, which raised threats to the New Right neoliberal hegemony.

In August 2008, James Purnell, then Work and Pensions secretary, ordered a review of welfare to cut costs. The review explored how behavioural economics (nudge) may be used to “motivate” those claiming  welfare support and to establish what the “right conditions” are for the long-term unemployed or to deal with those thought to be “abusing the system.”

The review also addressed issues such as how people’s aversion to loss could be used to reduce the claimant count, which included consideration of the loss of high regard in the community; respect for legitimate authority; reciprocity – including a sense of obligation to give something back – and finally, “social proof” (using normative setting) – responding to the behaviour of others, such as their successful search for work.

Following some targeted survey work carried out by the Department for Work and Pensions, it was claimed that more than half of claimants say they are more likely to look for work because of the threat of sanctions. It was also suggested that attaching more stringent conditions to welfare could draw on the then latest British interest in nudge economics, and the “hidden art of persuasion.” This took place in a context of other European countries and the US exploring similar radical welfare reforms. (See also: Experiments on Unemployment Benefit Sanctions and Job Search Behaviour, 2004).

However, the direct evidence on the impact of sanctions largely concerns how it affected the compliance; rule-following job seeking behaviour and employment rates of those who have actually experienced or been formally warned of a sanction. However, how “employment rates” are actually measured poses a problem, as, in the UK, an outcome of employment is assumed if someone’s claim is closed.

Several US studies have used high quality designs to analyse differences in post-welfare outcomes and found that, on average, those who are sanctioned out of the welfare system are less likely to enter employment than those who leave for other reasons. Sanctioned welfare leavers are more likely to experience severe hardship and some become disconnected from income and other support systems.

Purnell resigned in 2009, as Gordon Brown refused to implement his neoliberal welfare proposals. The Nudge Unit was established and formally instituted as part of the Cabinet in 2010, under Cameron’s coalition government.

I’ve written more than one critical piece about the Government’s part-privatised Nudge Unit – the Behavioural Insights Team – particularly its insidious and malevolent influence on the range of psychocratic policies aimed at “behavioural changes” which are now being imposed on the poorest citizens. 

From the shrinking category of legitimate “disability” to forcing people to work for no pay on exploitative workfare schemes, “nudge” has been used to euphemistically frame punitive policies, “applying the principles of behavioural economics to the important issue of the transition from welfare to work.” (See: Employing BELIEF:Applying behavioural economics to welfare to work, 2010.)

The Conservatives have claimed to make welfare provision “fair” by introducing substantial cuts to benefits and harsh conditionality requirements regarding eligibility to social security, including the frequent use of extremely punitive benefit sanctions as a means of “changing behaviours,” and “incentivising” people to find work, highlighting plainly that the Conservatives regard unemployment and disability as some kind of personal deficit on the part of those who are, in reality, simply casualties of structural constraints; labor market conditions, exclusion from acceptable living standards because of cuts to income and rising living costs, bad political decision-making and subsequent policy-shaped socioeconomic circumstances.

The word “fair” originally meant “treating people equally without favouritism or discrimination, without cheating or trying to achieve unjust advantage.” Under the Conservatives, we have witnessed more than one manipulated semantic shift, words like “fair” , “support” , “reform” , “responsibility”, “opportunities” and “help” , for example, have become embedded in a narrative of superficial  Glittering Generalities – part of a lexicon of persuasion and precarious psychosemantics that simply prop up Tory ideology  – an idiom of belief – in an endlessly erroneous, irrational and self-referential way.

The problem is that the power of a system of such implicit beliefs to defeat valid objections one by one is entirely due to the circularity  and self-perpetuating nature of such systems, as Iain Duncan Smith, who stands firmly within this idiom, consistently demonstrates only too well. After being rebuked by the UK Statistics Authority (ONS) for his claim that his policies have “forced 8,000 benefit claimants back into work” in 2013, he was informed politely that this wasn’t empirically evidenced – his claim could not be proven with his statistics. His response was: “I have a belief that I am right […] you cannot disprove what I said.” His “theory” tells him what he may observe.

There is a gulf between the rhetoric and empirical evidence on benefit sanctions. The evidence base is both small and limited in its scope, and it does not accommodate the differing approaches to preventing poverty and promoting opportunity that arise in international policy design. Increased welfare conditionality and sanctions are too narrowly based on a rhetoric of moral(ising) philosophy, and takes a highly selective approach evidence.

Iain Duncan Smith is the expert Tory pop-psychologist, fluent in psychobabble words like “incentivise” and “behavioural change” and whilst he demands rigorous research standards from academics and his critics, he doesn’t ever uphold those same standards himself.

If you “just know” you’re right, then does it matter if you regularly make up the evidence to support your mighty powers of New Right and very neoliberal intuitions?  It ought to, and it would if Conservative policy was genuinely based on meeting public needs, evidence and objective measures of effectiveness, rather than being based on prejudice and political expediency.

Words like “fair” and “help” now signpost an intentionally misleading Conservative discourse. Nudge permeates language, prompting semantic shifts towards bland descriptors which mask power and class relations, coercive state actions and political intentions. One only need to look at the context in which the government use words like “fair”, “support”, “help” “justice” and “reform” to recognise linguistic behaviourism in action. Or if you prefer, Orwellian doublespeak.

The Conservatives have orchestrated semantic shifts which reflect neoliberal values and reference a distinctive New Right ideological repertoire, from which is constructed basic pseudo-scientific justification narratives, asserting that people claiming welfare do so, as I said previously, because of “faulty” personal characteristics and various types of cognitive incompetence and laziness. In short, the government have pathologised and stigmatised unemployment, redefining it as a psychological disorder.

The government have also problematised welfare, based on the absurd New Right idea that financial support when people really need it somehow creates problems, rather than it being an essential mechanism aimed at alleviating poverty, extending social and economic support, justice and opportunities: social insurance and security

The government have adopted a strongly disciplinarian approach to structural problems such as poverty, using narratives that are strikingly reminiscent of the attitudes and values that shaped the extremely punitive and ill-conceived 1834 Poor Law amendment act.

The post-war welfare state is founded on the idea that government plays a key role in ensuring the protection and promotion of the economic and social well-being of its citizens. It is based on the principles of equality of opportunity, equitable distribution of wealth, and both political and social responsibility for those unable to avail themselves of the minimal provisions for health and wellbeing.

Restricting choices to “choice”

The increased use and rising severity of benefit sanctions became an integrated part of welfare “conditionality” in 2012. Sanctions are based on a principle borrowed from behavioural economics theory – a cognitive bias called “loss aversion.” It refers to the idea that people’s tendency is to strongly prefer avoiding losses to acquiring gains. The idea is embedded in the use of sanctions to “nudge” people towards compliance with welfare rules of conditionality, by using a threat of punitive financial loss, since the longstanding, underpinning Conservative assumption is that people are unemployed because of behavioural deficits.

I’ve argued elsewhere, however, that benefit sanctions are more closely aligned with operant conditioning (behaviourism) than “libertarian paternalism,” since sanctions are a severe punishment intended to modify behaviour and restrict choices to that of compliance and conformity or destitution.

Libertarian paternalists claim that whilst it is legitimate for government, private and public institutions to affect behaviour the aims should be to ensure that “people should be free to opt out of specified arrangements if they choose to do so.” The nudges favoured by libertarian paternalists are also supposed to be “unobtrusive.” That clearly is not the case with the application of coercive, draconian Conservative welfare sanctions.

Last year I wrote about the connection between the Nudge Unit’s pseudoscientific obsession with manipulating people’s decision-making by utilising various cognitive bias theories – in this case, particularly, the behavioural economic theory of loss aversion and the increased use and severity of benefit sanctions. Though most people succumbing to the Nudge Unit’s guru effect (ironically, another cognitive bias) think that “nudging” is just about prompting men to pee on the right spot in urinals, or about persuading us to donate organs and to pay our taxes on time. Nudge is at the very heart of the New  Right’s neo-behaviourist turn, which entails the application of operant conditioning to individualise and privatise social problems such as inequality and poverty. 

When it comes to technocratic fads like nudge, it’s worth bearing in mind that truth and ethics quite often have an inversely proportional relationship with the profit motive. It’s a cognitive bias, if you will.

For anyone curious as to how such tyrannical behaviour modification techniques like benefit sanctions arose from the bland language, inane, managementspeak acronyms and pseudo-scientific framework of “paternal libertarianism” – nudge – read this paper, focused almost exclusively on New Right small state obsessions, paying particular attention to the part about loss aversion, on page 7.

And this on page 18: The most obvious policy implication arising from loss aversion is that if policy-makers can clearly convey the losses that certain behaviour will incur, it may encourage people not to do it,” and page 46: “Given that, for most people, losses are more important than comparable gains, it is important that potential losses are defined and made explicit to jobseekers (e.g.the sanctions regime).”

The recommendation on that page: We believe the regime is currently too complex and, despite people’s tendency towards loss aversion, the lack of clarity around the sanctions regime can make it ineffective. Complexity prevents claimants from fully appreciating the financial losses they face if they do not comply with the conditions of their benefit.”

The Conservatives duly “simplified” sanctions by extending them in terms of severity and increasing the frequency of use. Sanctions have also been extended to include previously protected social groups, such as disabled people.

The paper was written in November 2010, prior to the Coalition policy of increased “conditionality” and the extended sanctions element of the Tory-led welfare “reforms” in 2012.

Sanctioning welfare recipients by removing their lifeline benefit – originally calculated to meet the cost of only basic survival needs – food, fuel and shelter – isn’t about “arranging choice architecture”, it’s not nudging: it’s operant conditioning. It’s a brand of particularly dystopic, psychopolitical behaviourism, and is all about a totalitarian level of micromanaging people to ensure they are obedient and compliant to the needs of  the “choice architects” and policy-makers. Nudge in this context is nothing more than a prop for austerity, neoliberalism and social conservatism.

It is all-pervasive, nudge permeates political rhetoric and discursive practices. Words like “help” and “support” disguise coercive and punitive state actions. Bland language is used to normalise inequality and discriminatory political practices. The word “incentivise,” for example, is used a lot by the Conservatives, but to wealthy people, it means financial privileges in the form of tax cuts and privatised wealth, and to poor people, it means having lifeline income taken away by the state. 

Deploying behavioural modification techniques (and without the public’s consent) marginalises political discussion, stifles public debate, sidesteps democratic dialogue, problem-solving, criticism and challenges and forecloses the possibility of social justice considerations.

Furthermore, an individual’s autonomy, which is also the basis of his or her dignity, as a person, is worthy of protection and should not be interfered with by any kind of behavioural modification, “nudge” or otherwise. Nor should removing people’s lifeline income designed to meet only basic survival needs ever be withdrawn as a state “correction” and punishment.

Nudge operates at a much broader level, too. The intentional political construction of folk devils and purposeful culturally amplified references to a stereotype embodying fecklessness, idleness and irresponsibility, utilising moral panic and manufactured public outrage as an effective platform for punitive welfare reform legislation, is one example of the value-laden application of pseudoscientific “behavioural insights” theory. The new paternalists have drawn on our psychosocial inclinations towards conformity, which is evident in the increasing political use of manipulative normative messaging. (For example, see: The Behavioral Insights Team in the U.K. used social normative messages to increase tax compliance in 2011.) 

The paternalist’s behavioural theories have been used to increasingly normalise a moral narrative based on a crude underpinning “deserving” and “undeserving” dichotomy, that justifies state interventions imposing conditions of extreme deprivation amongst some social groups – especially those previously considered legally protected. Public rational and moral boundaries have been and continue to be nudged and shifted, incrementally. Gordon Allport outlined a remarkably similar process in his classic political psychology text, The Nature of Prejudice, which describes the psychosocial processes involved in the construction of categorical others, and the subsequent escalating scale of prejudice and discrimination

In the UK, the growth and institutionalisation of prejudice and discrimination is reflected in the increasing tendency towards the  transgression of international legal human rights frameworks at the level of public policy-making. Policies that target protected social groups with moralising, stereotypical normative messages, accompanied with operant disciplinary measures, have led to extremely negative and harmful outcomes, but there is a marked political and social indifference to the serious implications and consequences of the impacts of such policies .

The theory tells you what you may observe

There is no evidence that welfare sanctions improve employment outcomes. There is no evidence that sanctions “change behaviours.” There is, in any case, a substantial difference between people conforming with welfare conditionality and rules and gaining appropriate and secure employment.

One difficulty is that since 2011, Job Centre Plus’s (JCP) primary key performance indicator has been off-flow from benefit at the 13th, 26th, 39th and 52nd weeks of claims. Previously JCP’s performance had been measured against a range of performance indicators, including off-flows from benefit into employment.

Indeed, when asked for evidence by the Work and Pensions Committee, one minister, in her determination to defend the Conservative sanction regime, regrettably provided misleading information on the destinations of JSA, Income Support and Employment Support Allowance claimants from 2011, that pre-dated the new sanctions regime introduced in 2012, in an attempt to challenge the findings of the University of Oxford/LSHTM study on the effects of sanctions on getting JSA claimants off-flow. (Fewer than 20% of this group of people who were no longer in receipt of JSA were recorded as finding employment.) Source: Benefit sanctions policy beyond the Oakley Review – Work and Pensions.

Studies have shown that being “treated” by at least one “stick” (punitive measure) significantly reduces an individual’s earnings after periods of unemployment; on the other hand, participating in a supportive programme affects earnings positively.

 Treatment and policy regime effects of Carrots and Sticks, in % of average earnings

 Effects are expressed in percent of average monthly earnings within 3.5 years after unemployment (3547 CHF = 3290 EUR = 3575 USD in sample). Treatment effects: effects of being exposed to at least one carrot (job search assistance, training) or stick (sanction, workfare programme).

Source: Arni, P, Lalive, R, and G J van den Berg (2015) “Treatment versus regime effects of Carrots and Sticks”, IZA Discussion Paper 9457.

It’s remarkably difficult to reconcile state imposed responsibilities that illiberally target only one social group, with democracy and universal human rights, which are based on core principles like dignity, fairness, equality, respect and autonomy.

We ought to question the claim that the manipulation of public decision-making to cut costs to the state is in our “best interests.” Who is nudging the nudgers, and  clearly they have their own whopping great “cognitive biases.”

Behavioural modification techniques are particularly prone to abuse because they are very effective – all tyrants and bullies are behaviourists – and such techniques represent, because of the range of subtle to threatening methods in which they exercise control and can elicit compliance, a political tool that is difficult to observe, challenge and control.

It’s also worth noting that the application of nudge is entirely experimental and nonconsenusal. For the record, when a government in a so called first world liberal democracy – that are generally expected to recognise and address public needs – decides to act upon citizens to change their behaviours to meet partisan, ideologically directed outcomes, we tend to call that authoritarianism, not nudge.

If it wasn’t for this government’s “behaviourist turn” and psychosemantic approach to the inequality and poverty that their policies tend to extend, the Department for Work and Pensions would have been renamed “The Department for Punitive State Correction and Neoliberal Behaviour Modification Experiments.” 

Nudge. It’s become another clever little euphemism. 
gcs-guide-to-communications-and-behaviour-change1From the Ministry of euphemism and semantic thrifts, 1984th edition

I wrote much of this as part of a considerably longer piece, but felt that this particular point and the evidence regarding the intensification of sanctions was lost in the weight of other important issues raised in the original article: The government plan social experiments to “nudge” sick and disabled people into work

Related

The benefit cap, phrenology and the new Conservative character divination

Man with diabetes had to have his leg amputated because of benefit sanctions

Cases of malnutrition continue to soar in the UK

Two key studies show that punitive benefit sanctions don’t ‘incentivise’ people to work, as claimed by the government


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The new Work and Health Programme: government plan social experiments to “nudge” sick and disabled people into work


Illustration by Jack Hudson

The government’s Nudge Unit team is currently working with the Department for Work and Pensions and the Department of Health to trial social experiments aimed at finding ways of: “preventing people from falling out of the jobs market and going onto Employment and Support Allowance (ESA).”

“These include GPs prescribing a work coach, and a health and work passport to collate employment and health information. These emerged from research with people on ESA, and are now being tested with local teams of Jobcentres, GPs and employers.”

This is a crass state intrusion on the private and confidential patient-doctor relationship, which ought to be about addressing medical health problems, and supporting people who are ill, not about creating yet another space for obsessive political micromanagement. It’s yet another overextension of the coercive arm of the state to “help” people into work. Furthermore, this move will inevitably distort people’s interactions with their doctors: it will undermine the trust and rapport that the doctor-patient relationship is founded on.

In the current political context, where the government extends a brutally disciplinarian approach to basic social security entitlement, it’s very difficult to see how the plans to place employees from the Department for Work and Pensions in GP practices can be seen as anything but a threatening gesture towards patients who are ill, and who were, up until recent years, quite rightly exempted from working. Now it seems that this group, which includes some of our most vulnerable citizens, are being politically bullied and coerced into working, regardless of the consequences for their health and wellbeing.

Of course the government haven’t announced this latest “intervention” in the lives of disabled people. I found out about it quite by chance because I read Matthew Hancock’s recent conference speech: The Future of Public Services.

I researched a little further and found an article in Pulse which confirmed Hancock’s comment: GP practices to provide advice on job seeking in new pilot scheme.

Hancock is appointed Minister for the Cabinet Office and Paymaster General, and was previously the Minister of State for Business and Enterprise. He headed David Cameron’s “earn or learn” taskforce which aims to have every young person earning or “learning” from April 2017.

He announced that 18 to 21-year-olds who can’t find work would be required to do work experience (free labour for Tory business donors) as well as looking for jobs or face losing their benefits. But then Hancock is keen to commodify everyone and everything, including public data.

However his references to “accountability and transparency” don’t stand up to much scrutiny when we consider the fact that he recently laid a statement before parliament outlining details about the five-person commission that will be asked to decide whether the Freedom of Information act is too expensive and “overly intrusive.”

He goes on to say: “And this brings me onto my second area of reform: experimentation. Because in seeking to improve our services, we need to know what actually works.”

But we need to ask for whom services are being “improved” and for whom does such reform work, exactly?

And did any of the public actually consent to being experimented upon by the state?

Or to having their behaviour modified without their knowledge?

Now that the nudge unit has been privatised, it is protected from public scrutiny, and worryingly, it is also no longer subject to the accountability afforded the public by the Freedom of Information Act.

The Tory welfare “reforms” are a big business profiteering opportunity, whilst lifeline benefits are being steadily withdrawn: policy context

The current frame of reference regarding Conservative welfare policies is an authoritarian and punitive one. It’s inconceivable that a government proposing to continue cutting the lifeline income of sick and disabled people, including a further £120 a month to those people in the ESA Work Related Activity group (WRAG), will suddenly show an interest in actually supporting disabled people. There are also proposals to further limit eligibility for Personal Independence Payments (PIP) for sick and disabled people. 

From the shrinking category of legitimate “disability” to forcing people to work for no pay on exploitative workfare schemes, “nudge” has been used to euphemistically frame punitive policies, “applying the principles of behavioural economics to the important issue of the transition from welfare to work.” (From: Employing BELIEF: Applying behavioural economics to welfare to work, 2010.)

And guess who sponsored the “research” into “nudging” people into workfare? Steve Moore, Business Development Director from esg, which is a leading welfare to work and vocational skills group, created through the merger and acquisition of four leading providers in the DWP and LSC sector.” How surprising.

It’s even more unsurprising that esg was established by two Conservative donors with very close ties to ministers, and were subsequently awarded very lucrative contracts with the Department for Work and Pensions. I think there may have been a “cognitive bias” in operation there, too. But who is nudging the nudgers?

Of course the “aim” of the “research” is: “breaking the cycle of benefit dependency especially for our hardest to help customers, including the “cohort” of disabled people.”

However, there’s no such thing as a “cycle of benefit dependency”, it’s a traditional Tory prejudice and is based on historically unevidenced myths. Poverty arises because of socioeconomic circumstances that are unmitigated through government decision-making. In fact this government has intentionally extended and perpetuated inequality through its policies.

2020health – Working Together is a report from 2012 that promotes the absurd notion of work as a health outcome.  This is a central theme amongst ideas that are driving the fit for work and the work and health and programme. Developing this idea further, Dame Carol Black and David Frost’s Health at Work – an independent review of sickness absence was aimed at reviewing ways of “reducing the cost of sickness to employers, ‘taxpayers’ and the economy.” Seems that the central aim of the review wasn’t a genuine focus on sick and disabled people’s wellbeing and “health outcomes,” then. Black and Frost advocated changing sickness certification to further reduce the influence of GPs in “deciding entitlement to out-of-work sickness benefits.”

The subsequent “fit notes” that replaced GP sick notes (a semantic shift of Orwellian proportions) were designed to substantially limit the sick role and reduce recovery periods, and to “encourage” GPs to disclose what work-related tasks patients may still be able to perform. The idea that employers could provide reasonable adjustments that allowed people who are on sick leave to return to work earlier, however, hasn’t happened in reality.

The British Medical Association (BMA) has been highly critical of the language used by the government when describing the fit for work service. The association said it was “misleading” to claim that fit for work was offering “occupational health advice and support” when the emphasis was on sickness absence management and providing a focused return to work.

The idea that work is a “health” outcome is founded on an absurd and circular Conservative logic that people in work are healthier than those out of work. It’s true that they are, however, the government have yet again confused causes with effects. Work does not make people healthier: it’s simply that healthy people can work and do. People who have long term or chronic illnesses often can’t work. The government’s main objection to sick leave and illness more generally, is that it costs businesses money. As inconvenient as that may be, politically and economically, it isn’t ever going to be possible to cure people of serious illnesses by cruelly coercing them into work.

The government’s removal of essential in-work support for disabled people – such as the Independent Living Fund, and the replacing of Disability Living Allowance  with Personal Independence Payment in order to reduce eligibility, cut costs and “target” support to those most severely disabled, and the cuts to the Access To Work scheme – means that it is now much more difficult for those disabled people who want to work to find suitable and supported employment.

The politics of punishment

There’s a clear connection between the Nudge Unit’s obsession with manipulating “cognitive bias” – in particular, “loss aversion” – and the increased use, extended scope and severity of sanctions, though most people succumbing to the Nudge Unit’s guru effect (ironically, another cognitive bias) think that “nudging” is just about prompting men to pee on the right spot in urinals, or persuading us to donate organs and to pay our taxes on time.

When it comes to technocratic fads like nudge, it’s worth bearing in mind that truth and ethics quite often have an inversely proportional relationship with the profit motive.

For anyone curious as to how such tyrannical behaviour modification techniques like benefit sanctions arose from the bland language, inane, managementspeak acronyms and pseudo-scientific framework of “paternal libertarianism” – nudge – read this paper, focused almost exclusively on New Right obsessions, paying particular attention to the part about “loss aversion” (a cognitive bias according to behavioural economists) on page 7.

And this on page 18: The most obvious policy implication arising from loss aversion is that if policy-makers can clearly convey the losses that certain behaviour will incur, it may encourage people not to do it,” and page 46: “Given that, for most people, losses are more important than comparable gains, it is important that potential losses are defined and made explicit to jobseekers (e.g.the sanctions regime).” 

The recommendation on that page: We believe the regime is currently too complex and, despite people’s tendency towards loss aversion, the lack of clarity around the sanctions regime can make it ineffective. Complexity prevents claimants from fully appreciating the financial losses they face if they do not comply with the conditions of their benefit.”

The Conservatives duly “simplified” sanctions by extending them in terms of severity, frequency and by broadening the scope of their application to include previously protected social groups.

The paper was written in November 2010, prior to the Coalition policy of increased “conditionality” and extended sanctions element of the Tory-led welfare “reforms” in 2012.

Sanctioning welfare recipients by removing their lifeline benefit – originally calculated to meet the cost of only basic survival needs – food, fuel and shelter – isn’t about “arranging choice architecture”, it’s not nudging: it’s operant conditioning. It’s a brand of particularly dystopic, psychopolitical neobehaviourism, and is all about a totalitarian level of micromanaging people to ensure they are obedient and conform to meet the needs of the “choice architects” and policy-makers.

Nudge even permeates language, prompting semantic shifts towards bland descriptors which mask power and class relations, coercive state actions and political intentions. One only need to look at the context in which the government use words like “fair”, “support”, “help” “justice” and “reform” to recognise linguistic behaviourism in action. Or if you prefer, Orwellian doublespeak.

It’s rather difficult to see how starving people and threatening them with destitution can possibly improve the well-being of many socially excluded people, and help to bring them to inclusion.”

The conclusion that Ancel Keys drew from the Minnesota Starvation Experiment in the the US during the 1940s, (which explored the physical and psychological effects of undernutrition, and stressed the dramatic, adverse effect that starvation had on competence, motivation, behaviour, mental attitude and personality) was that “democracy and nation building would not be possible in a population that did not have access to sufficient food.”

No amount of bland and meaningless psychobabble or intransigent, ideologically-tainted policies can legitimize the economic sanctioning of people who are already poor and in need of financial assistance.

Apparently, citizenship and entitlement to basic rights and autonomy is a status conferred on only the currently economically productive. Previous employment and contributions don’t count as “responsibility,” and don’t earn you any rights – the government believes that citizens owe a perpetual debt of unconditional service to the Conservative’s steeply stratified economy. Not much of a social contract, then. Cameron says he wants to “build a responsible society” by removing people’s rights and reducing or removing their lifeline income. Presumably, free invisible bootstraps are part of the deal.

Government decision-making has contributed the most significant influence on “health outcomes.” Conservative policies have entailed a vicious cutting back of support and a reduction of essential provision for sick and disabled people. In fact this group have been disproportionately targeted for austerity cuts time and time again, massively reducing their lifeline income. It’s not being “workless” that has a detrimental impact on people’s health and wellbeing: it is the deliberate impoverishment of those requiring state aid and support, funded from the public purse, (including contributions from those who now need support), which is being dogmatically and steadily withdrawn.

Making work pay for whom?

If work truly paid, then there would be no need to incentivise” almost 1.2 million low-paid workers claiming the new universal credit with the threat of in-work benefit sanctions if they fail to “take steps to boost their earnings.”

It’s very difficult to see how punishing individuals for perhaps being too ill to work more that a few hours, or those working for low pay or part-time in the context of a chronically weak labour market, depressed wages and with little scope for effective negotiating and collective bargaining can possibly be justified. It’s an utterly barbaric way for a government to treat citizens.

Surely if the government was genuinely seeking to increase choices and to widen access to the workplace for sick and disabled people, it would not be cutting the very programmes supporting and extending this aim, such as the Access to Work scheme  – a fund that helps people and employers to cover the extra living costs arising due to disabilities that might present barriers to work – and the Independent Living Fund.

This government has pushed at the public’s rational and moral boundaries, establishing and attempting to justify a draconian trend of punishing those unable to work, and what was previously unthinkable – stigmatising and punishing legally protected social groups such as sick and disabled people – has become somehow acceptable. We are on a very slippery slope, clearly mapped out previously by Allport’s scale of prejudice.

People’s needs don’t disappear just because the government has decided to “pay down” an ever-growing debt and build a “surplus” by taking money from those that have the least. Or because the government doesn’t like “big state interventions.”

So the recent proposed cut to ESA – and this is a group of sick and disabled people deemed physically incapable of work by doctors – is completely unjustified and unjustifiable. No amount of pseudo-psychology and paternalist cruelty can motivate or “incentivise” people who are medically ill.

It’s for disabled individuals and their doctors – professionals, specialists and experts – to decide if a person can work or not, it’s not the role of the state, motivated only by a perverse economic Darwinist ideology. Maslow taught us that we must attend to our physiological needs before we may be motivated to meet higher level psychosocial ones.

Iain Duncan Smith is a zealot who actually tries to justify further punitive cuts to disabled people’s provision by claiming that working is “good” for people and is the only “route out of poverty.”

Presumably he believes work can cure people of the serious afflictions that they erroneously thought exempted them from full-time employment. 

He stated: “There is one area on which I believe we haven’t focused enough – how work is good for your health. Work can help keep people healthy as well as help promote recovery if someone falls ill. So, it is right that we look at how the system supports people who are sick and helps them into work.”

Duncan Smith undoubtedly “just knows” that his absurd claim is “right.” He’s never really grown out of his “magical thinking” stage, or transcended his dereistic tendencies. His department had to manufacture “evidence” recently in a ridiculous attempt to support Iain Duncan Smith’s imaginative, paternalist claim that punitive sanctions are somehow “beneficial” to claimants, by using fake characters to supply fake testimonials, but this was rumbled and exposed by a well-placed Freedom of Information request from Welfare Weekly.

Recent research indicates that not all work serves to “keep people healthy” nor does it ever “promote recovery.” This assumption that work can promote recovery in the case of people with severe illness and disability – which is why people claim ESA – is particularly bizarre. We have yet to hear of a single case involving a job miracle entailing people’s limbs growing back, vision being restored, or a wonder cure for heart failure, cerebral palsy, multiple sclerosis and lupus, for example.

The government’s Fit for Work scheme is founded on exactly the same misinformative nonsense. It supports profit-making for wealthy employers, at the expense of the health and wellbeing of employees that have been signed off work because of medically and professionally recognised illness that acts as a real barrier to work.

Furthermore, there is no proof that work in itself is beneficial. Indeed much research evidence strongly suggests otherwise.

And where have we heard these ideas from Iain Duncan Smith before?

Arbeit macht frei.

If work really paid then surely there would be no need to “nudge” people by using sanctions, regardless of whether or not they are employed. “Making work pay” is all about reducing support for those who the government deems “undeserving,” to “discourage welfare dependency” by making any support as horrible as the workhouse – founded on the principle of “less eligibility”, where conditions for those in need of support were punitive and kept people in a state of desperation so that even the lowest paid work in the worst of conditions would seem appealing.

The public/private divide

For a government that claims a minarchist philosophy, remarkably it has engineered an unprecedented blurring of public/private boundaries and a persistent violation of traditionally private experiences, including thoughts, beliefs, preferences, autonomy and attitudes via legislations and of course a heavy-handed fiscal conflation of public interests with private ones.

This also caught my attention from Matthew Hancock’s speech transcript:

“My case is that we need continuous improvement in public services. And for that we must reform the relationship between citizen and state. [My bolding]

“The case for reform is strong. Because people have high and rising expectations about what our public services should deliver. Because budgets are tight, and we have to make significant savings for our country to live within her means.”

Basically, the “paternalistic libertarian” message here is that we will have to expect less and less from the state, as the balance between rights and responsibilities is heavily weighted towards the latter, hence requiring the “reform” of the relationship between citizen and state.

However, surely it is active, democratic participation in processes of deliberation and decision-making that ensures that individuals are citizens, not subjects.

Social democracy evolved to include the idea of access to social goods and improving living standards as a means of widening and legitimizing the scope of political representation.

Political policies are defined as (1) The basic principles by which a government is guided. (2) The declared objectives that a government  seeks to achieve and preserve in the interest of national community. As applied to a law, ordinance, or Rule of Law, it’s the general purpose or tendency considered as directed to the welfare or prosperity of the state or community.

Once upon a time, policy was a response from government aimed at meeting public needs. It was part of an intimate democratic dialogue between the state and citizens. Traditional methods of participating in government decision-making include:

  • political parties or individual politicians
  • lobbying decision makers in government
  • community groups
  • voluntary organisations
  • public opinion
  • public consultations
  • the media

Nowadays, policies have been unanchored from any democratic dialogue regarding public needs and are more about monologues aimed at shaping those needs to suit the government. 

Nudge does not entail citizen involvement in either its origin or design. The state intrusions are at such an existential level, of an increasingly authoritarian nature, and are of course reserved for the poorest, who are deemed “irrational” and incapable of making “the right decisions.”

Yet those “faulty decisions” are deemed so from the perspective of the Behavioural Insights Team, (the “Nudge Unit”) who are not social psychologists: they are predominantly concerned with behavioural economics, decision-making and how governments influence people – “economologists”, changing people’s behaviours, enforcing compliance to fulfil political aims. That turns democracy completely on its head.

The Nudge Unit gurus claim that we need help to “correct our cognitive biases”, but those who make policies have their own whopping biases, too.

Nudge is the new fudging

Nudge is a prop for New Right neoliberal ideology that is aimed at dismantling a rights-based society and replacing it with an insidiously nudged, manipulated, compliant, and entirely “responsible”, “self-reliant” population of divided, isolated state-determined individuals who expect nothing from their elected government.

The Conservatives are obsessive about strict social taxonomies and economic enclosures. The Nudge Unit was set up by David Cameron in 2010 to try to “improve” public services and save money. The asymmetrical, class-contingent application of paternalistic libertarian “insights” establishes a hierarchy of decision-making “competence” and autonomy, which unsurprisingly corresponds with the hierarchy of wealth distribution.

So Nudge inevitably will deepen and perpetuate existing inequality and prejudice, adding a dimension of patronising psycho-moral suprematism to add further insult to politically inflicted injury. Nudge is a fashionable fad that is overhyped, trivial, unreliable; a smokescreen, a prop for neoliberalism and monstrously unfair, bad policy-making.

As someone who (despite the central dismal and patronising assumptions about the irrationality of others that king nudgers have as a central cognitive bias and the traditional prejudices that Tory ideology narrates,) manages to make my own decisions relatively without bias, intelligently, rationally, critically, carefully and coherently, and that, along with my professional and academic background, I can and will conclude that no matter how you dress it up, nudge is a pretentious, cringeworthy pseudo-intellectual dead-end.

 A Nudge for the Conservatives from history

The more things change for the Tories, the more they tend to stay the same.

In the 1870s, England had a recession and the Conservatives launched a Crusade of cuts to welfare expenditure to diminish “dependency” on poor law outdoor relief – non-institutional benefits called “out-relief” because it was paid to the poor in their own homes from taxation, rather than their having to go into the punitive “deterrent” workhouses.

The Crusade included cutting medical payments to lone mothers, widows, the elderly, chronically sick and disabled people and those with mental illness. The 1834 Poor Law amendment was shaped by people such as Jeremy Bentham, who argued for a disciplinary, punitive approach to social problems and particularly poverty, whilst Thomas Malthus focused attention on overpopulation, and moralising about the growth of illegitimacy. He placed emphasis on moral restraint rather than poor relief as the best means of easing the poverty of the lower classes. 

David Ricardo argued that there was a problem with poor relief provision “interfering” with an iron law of wages. Ricardo claimed that aid given to poor workers under the old Poor Law to supplement their wages had the effect of undermining the wages of other workers, so that the Roundsman System and Speenhamland system led employers to reduce wages, and needed reform to help workers who were not getting such aid and rate-payers whose poor-rates were going to subsidise low-wage employers. Yet we found, despite Ricardo’s pet theory, that the poor law deterrent element served to push wages down further.

The effect of poor relief, in the absurd view of the reformers, was to undermine the position of the “independent labourer.” They also wanted to “make work pay.” And end the “something for nothing” culture. But much subsequent evidence shows that reducing support for people out of work actually drives wages and working conditions down.

Neither the punitive poor law amendment act of 1834 or the Crusade “helped” people into work or addressed the lack of available paid work – that’s unemployment, not the made-up and intentionally stigmatizing word “worklessness”.

And its utter failure as a credible account of poverty – the-blame-the-individual narrative and the notion that relief discourages “self-reliance” – fuelled the national insurance act of 1911 and the development of the welfare state along with the other civilising and civilised benefits of the post-war settlement. 

The Conservatives inadvertently taught us as a society precisely why we need a welfare state.

We learned that it isn’t possible to be “thrifty” or help ourselves if we haven’t got the means for meeting basic survival needs. Nor is it possible to be nudged out of poverty when the means of doing so are not actually available. No amount of moralising and pseudo-psychologising about poor people actually works to address poverty, and structural socioeconomic inequalities.

The government’s undeclared preoccupation with behavioural change through personal responsibility is simply a revamped version of Samuel Smiles’s bible of Victorian and over-moralising, a hobby-horse: “thrift and self-help” – but only for the poor, of course. Smiles and other powerful, wealthy and privileged Conservative thinkers, such as Herbert Spencer, claimed that poverty was caused largely by the irresponsible habits of the poor during that era. But we learned historically that socioeconomic circumstances caused by political decision-making creates poverty.

Conservative rhetoric is designed to have us believe there would be no poor people if the welfare state didn’t somehow “create” them. If the Tories must insist on peddling the myth of meritocracy, then surely they must also concede that whilst such a system has some beneficiaries, it also creates situations of insolvency and poverty for others.

In other words, the same system that allows some people to become very wealthy is the same system that condemns others to poverty.

This wide recognition that the raw “market forces” of the old liberal laissez-faire (and the current starker neoliberalism) causes casualties is why the welfare state came into being, after all – because when we allow such competitive economic dogmas to manifest, there are invariably winners and losers.

That is the nature of “competitive individualism,” and along with inequality, it’s an implicit, undeniable and fundamental part of the meritocracy myth and neoliberal script. And that’s before we consider the fact that whenever there is a Conservative government, there is no such thing as a “free market”: in reality, all markets are rigged for elites.

Public policy is not an ideological tool for a so-called democratic government to simply get its own way. Democracy means that the voices of citizens, especially members of protected social groups, need to be included in political decision-making, rather than so frankly excluded.

We elect governments to meet public needs, not to “change behaviours” of citizens to suit government needs and prop up policy “outcomes” that are driven entirely by traditional Tory prejudice and ideology.

And by the way, we call any political notion that citizens should be totally subject to an absolute state authority “totalitarianism,” not “nudge.”

demcracy
Courtesy of Robert Livingstone

Update: The government have since announced the introduction of a number of “policy initiatives” aimed at reducing the number of people claiming Employment and Support Allowance (ESA). These initiatives are currently still at a research and trialing stage. Health Management, a subsidiary of MAXIMUS are to deliver the fit for work programme, which was set up based on recommendations from the Health at Work – an independent review of sickness absence report by Dame Carol Black and David Frost. The review was aimed at “reducing the cost of sickness to employers, ‘taxpayers’ and the economy.”

Fit for Work occupational health professional will have access to people’s diagnoses from their fit notes, the fit note end date and any further information that the GP considers relevant to their absence from work or current treatment (at the discretion of the GP). The primary referral route for an assessment for the Maximus programme will be via the GP.

The government is cutting funding for contracted-out employment support by 80%, following the Spending Review. The Department for Work and Pensions has indicated that total spending on employment will be reduced, including not renewing Mandatory Work Activity and Community Work Placements, the new Work and Health Programme will have funding of around £130 million a year – around 20% of the level of funding for the unsuccessful Work Programme and Work Choice, which it will replace.

Iain Duncan Smith says: “This Spending Review will see the start of genuine integration between the health and work sectors, with a renewed focus on supporting people with health conditions and disabilities return to and remain in work. We will increase spending in this area, expanding Access to Work and Fit for Work, and investing in the Health and Work Innovation Fund and the new Work and Health Programme.” 

Meeting the Government’s goal of halving the employment gap between disabled and non-disabled workers – moving around one million more disabled people into work – will be no easy task. Not least because despite Iain Duncan Smith’s ideological commitments, and aims to “reduce welfare dependency,” most disabled people who don’t work (and claim ESA) can’t do so because of genuine and insurmountable barriers such as incapacitating and devastating, life-changing illness. No amount of targeting those people with the Conservative doublespeak variant of “help” and nasty “incentivising” via welfare sanctions and benefit cuts will remedy that.