As something of an aside, its a shame that even in this supposedly 
enlightened forum the term 'academic' can seem to signify issues that 
are deemed irrelevant or trivial. But in any case, these are not merely 
'academic' issues. David F's post - and the responses to it - point to a 
difficult pair of dilemmas that, it seems to me, frame the efforts of 
all progressively minded professionals in human and social services. In 
the various posts they're bound together but I think its helpful to 
separate them out.

The first dilemma is to do with how we conceive of service users. On the 
one hand, we can view them as those who are merely labelled e.g. as 
having emotional and behavioural difficulties. In this instance its 
almost as though the people who occupy this position come to do so 
entirely contingently. It is as though the fact that they (and not some 
other individuals from disadvantaged backgrounds) became service users 
is random, contingent, and hence meaningless. From this perspective 
what's important instead is that we critique their discursive 
positioning, their arbitrary subjection to disciplinary practice.

On the other hand, we can explicitly make the links between social and 
material inequality and their inevitably toxic effects upon those who 
find themselves at the bottom of the pile. Provided this is done in a 
sufficiently thorough, sensitive, nuanced manner, in a way that engages 
with the meaning of people's distress as well as with its manifestation 
as 'symptoms' or 'deficits', it has much to offer. But it seems to come 
at the cost of marking some people out, temporarily at least, as 
different to others, of agreeing that service users are not 'randomly' 
produced.

The second dilemma highlighted by David's message concerns the value and 
efficacy of any intervention people might receive. On the one hand, 
interventions can be seen as mere figleaves, a matter of changing 
deckchairs on the Titanic or sticking plasters onto the stumps of 
missing limbs: too little, too late, addressing only the symptoms rather 
than the causes and so, fundamentally, helping to shore up the status 
quo rather than progressively transform it.

On the other hand, people providing services - particularly, in this 
context, progressive, community psychological services - see that their 
efforts do seem to make a difference, that service users respond to and 
ask for more of what they have to offer, and that some lives do seem to 
be transformed - or at least improved - because of their efforts. As 
Gareth says, to dismiss these improvements as illusory or trivial is not 
only insulting to those doing the work, it also may actually further the 
contemporary neoliberal assault on working people.

All of us trying to work progressively at the moment (whether as 
academics, like me, or in hands-on work like most others on the list) 
encounter versions of these dilemmas - these discursive regimes, if you 
prefer. And, as is the way with discursive resources, we all tend to 
draw on them flexibly: sometimes talking up the value of interventions, 
sometimes emphasising their 'drop in the ocean' character, sometimes 
emphasising the skills and abilities of service users but sometimes 
emphasising their vulnerability, and so on. Indeed, there are 
potentially elements of these contradictory positions both in David's 
post (which talked about discourses, but also talked about Wilkinson's 
work) and in Jacqui L's post (which rejected David's critique whilst 
also agreeing with the politics behind it).

So I think its helpful both to tease these issues apart, and to remember 
that most (if not all) of us do position ourselves differentially with 
respect to the problems they highlight. Doing this may also help us to 
identify and focus on the more important questions raised by these 
important posts. In my view these questions might include:

*why do some disadvantaged people, and not others, become service users?

*how can we avoid labelling people whilst at the same time recognising 
how the toxic conditions of their lives have led them to suffer?

*how can we avoid e.g. 'mother blaming' whilst simultaneously 
recognising that some people are less able to

*are all interventions necessarily reformist, simply supportive of the 
status quo, or can they also sometimes help to foment progressive change?

J.
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John Cromby
Department of Human Sciences
Loughborough University
Loughborough, Leics
LE11 3TU England
Tel: 01509 223000
Email: [log in to unmask]
Personal webpage: http://www-staff.lboro.ac.uk/~hujc4/
Co-Editor, "Subjectivity": www.palgrave-journals.com/sub
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