Rehabilitating antisocial personalities: treatment through self-governance strategies

Offenders with antisocial personality disorder (ASPD) are widely assumed to reject psychotherapeutic intervention. Some commentators, therefore, argue that those with the disorder are better managed in the criminal justice system, where, following the introduction of indeterminate sentences, engagement with psychological treatment is coercively linked to the achievement of parole. By comparison, National Institute of Clinical Excellence guidelines on the management and treatment of ASPD recommend that those who are treatment seeking should be considered for admission to specialist psychiatric hospitals. The rationale is that prison-based interventions are underresourced, and the treatment of ASPD is underprioritised. The justification is that offenders with ASPD can be rehabilitated, if they are motivated. One problem, however, is that little is known about why offenders with ASPD seek treatment or what effect subsequent treatment has on their self-understanding. The aim of this paper is to address these unresolved issues. It draws on the findings of Economic and Social Research Council (ESRC) funded qualitative study examining the experiences of sentenced male offenders admitted to a specialist personality disorder ward within the medium secure estate and the medical practitioners who treat them. The data are analysed with reference to Michel Foucault’s work on governmentality and strategy in power relations. Two arguments are advanced: first, offenders with ASPD are motivated by legal coercive pressures to implement a variety of Foucauldian-type strategies to give the false impression of treatment progress. Second, and related, treatment does not result in changes in self-understanding in the resistive client with ASPD. This presupposes that, in respect of this group at least, Foucault was mistaken in his claim that resistive behaviours merely mask the effectiveness of treatment norms over time. Nevertheless, the paper concludes that specialist treatment in the hospital setting can effect changes in the resistive offender’s self-understanding, but not if the completion of treatment results, as is commonplace, in his prison readmission

Ethical Subjectivity and Politics in Organizations: A Case of Health Care Tendering.

This paper examines the relationship between ethics and politics in organizations with a specific focus on ethical subjectivity - that is, how people at work constitute themselves as subjects in relation to both their conduct and their sense of ethical responsibility to others. To investigate this we consider those ethics that were politically mobilized when five clinical partners tendered to buy out the medical practice in which they worked. We provide a detailed reading of a letter of complaint written by one of the partners and sent to their employer - a letter we consider to be a deliberate, political, ethically motivated and overt act of resistance. Drawing on the ethical philosophy of Emmanuel Levinas we argue that the practice of ethics is characterized by a tension where ethical commitments and realpolitik come crashing together. The implication we draw from this is that in organizations the ethical subject is always a political subject; the one who takes action in response to the call of the ethical demand. It is answering the call to political action by the ethical subject - a subject prepared to act in response to the experience of injustice while not resting easy on their own ethical righteousness - that provides an affirmative possibility for researching and theorizing ethics within a critical framework.21 page(s

Accumulation by Conservation

Following the financial crisis and its aftermath, it is clear that the inherent contradictions of capitalist accumulation have become even more intense and plunged the global economy into unprecedented turmoil and urgency. Governments, business leaders and other elite agents are frantically searching for a new, more stable mode of accumulation. Arguably the most promising is what we call 'Accumulation by Conservation' (AbC): a mode of accumulation that takes the negative environmental contradictions of contemporary capitalism as its departure for a newfound 'sustainable' model of accumulation for the future. Under slogans such as payments for environmental services, the Green Economy, and The Economics of Ecosystems and Biodiversity, public, private and non-governmental sectors seek ways to turn the non-material use of nature into capital that can simultaneously 'save' the environment and establish long-term modes of capital accumulation. In the paper, we conceptualise and interrogate the grand claim of AbC and argue that it should be seen as a denial of the negative environmental impacts of 'business as usual' capitalism. We evaluate AbC's attempt to compel nature to pay for itself and conclude by speculating whether this dynamic signals the impending end of the current global cycle of accumulation altogether