Adversity, Ambivalence, and Mental Health: The Emotional Costs of Severe Deprivation

Abstract

This dissertation uses small-scale ethnographic fieldwork to examine the affective underside of severe deprivation and its institutional management. Chapters 1-3 draw on three years of participant observation in a low-income network. Chapter 1 outlines the key research participants’ trajectories and illustrates the proliferating nature of poverty’s trials. Chapter 2 traces some consequences of cumulative adversity by focusing on the on-again, off-again quality of several relationships in my participants’ network. Dispossession increased participants’ reliance on each other, not only materially, but for emotional nurturance. However, poverty also made it more difficult to meet each other’s needs. Disappointment and sometimes violence ensued, breaking up social ties. Nevertheless, at the next crisis, people found themselves rekindling their relationships for lack of a better alternative. The travails of chronic scarcity thus worked both as strains on relationships and sometimes as traps that brought people back together under the pressure of necessity. This resulted in relationships marked by deep ambivalence. A stronger institutional safety net would free poor people from having to negotiate emotional fulfillment under the pressures of economic survival. Given the distress documented in chapters 1 and 2, however, it is also reasonable to consider psychological and therapeutic interventions. Chapters 3 and 4 examine uses of mental health services as institutional responses to suffering. I argue that treatment and counseling, when nested within structures of poverty governance, present a troubling fusion of care with control and mistrust. Chapter 3 focuses on a mother and her five-year old son’s experiences with counseling services and psychiatric treatment. Chapter 4 investigates an incipient development in social service delivery: the rise of “trauma-informed care”. This chapter introduces a new set of data, collected during eight months of visits to a social service agency. In both case studies, being labeled as mentally disordered brought benefits, e.g. disability income or the chance to escape incarceration. The wages of mental illness, however, were problematic in two ways: Offered against the backdrop of punishing alternatives, they could be considered coercive. Second, they came at significant costs: increased distrust of healthcare providers, exposure to potentially serious side-effects, and a loss of credibility.