reconstruction, like the resolution of personal and marital tensions at midlife, demanded the realignment of individual, domestic, occupational and social selves and a reconfiguration, or rebalancing, of the needs of self and others in a climate of aggressive individualism.
Self-help books and marriage guidance literature also reveal how the boundaries of middle age and the parameters of the midlife crisis were fluid and ambiguous, constructed by shifting configurations of the life course and prominent Western emphases on
Balance, malleability and anthropology: historical contexts
retreat of the state from responsibility for health.
Nicos Kefalas's argument about the rise of self-care is similarly charged with contemporary relevance, and he talks explicitly about the embrace of ‘the notion of self-reflective, self-governing individualism’ and links it to ideas of ‘efficiency’. The contemporary relevance of this – to us now in 2019 – is left largely unsaid. Awareness of the contingency of the methodological tools we wield in the present, in pursuit of present objectives, according to our present resources, capacities and
Visualising obesity as a public health concern in 1970s and 1980s
composition and visual arrangement of these documentaries revealed alternative notions regarding the role of individualism in the disease prevention process. They provided a counternarrative, emphasising how televisual media were engaging with broader health and social equality issues that impacted on health outcomes. Examining the structural and economic barriers to health was one part of this counternarrative, with poverty, environment, service delivery and healthcare access all contributing to the construction of another type of self – anyone unable to achieve balanced
and conformity; individualism and incorporation; static and dynamic; and, as Hobsbawm pointed out, losers and winners.
Hobsbawm recognised that extreme social conditions or political positions were not necessarily unbalanced or labile. Opposing forces – such as capitalism and communism during the Cold War – could be inherently stabilising, serving to preserve a precarious balance of power.
According to some post-war Western
effective medical therapies, they are preferable to extreme and dangerous therapies.
The Fowlers’ negotiation of medicine and modernity was decidedly uneven. While not denying the diseases of modern life or the evolutionary correlation between progress and pathology, the Fowlers offered a medical paradigm and system of treatments that lessened the weight of modernity upon the individual. They triumphed in the modern arenas of market capitalism and information dissemination, advocating a radical individualism that promised greater agency in modern
professionals themselves in creating managerial structures. Whilst undoubtedly aligned with projects to reduce state expenditure and ensure resource efficiency, healthcare governance also continues to be the product of negotiation between visions of how to manage the medical profession. 68 It should be stressed, moreover, that scholars over the past two decades have highlighted a range of ways in which doctors could ameliorate pressures for conformity. Into the present century, doctors appealed to traditional forms of therapeutic individualism – the idea that familiarity
, self-regulation and individualism.
Anon., ‘The Kallang Inquiry’, Flight International , 19 November 1954, p. 754.
The National Archives, London (hereafter TNA) BT/248/110, extract from the Kallang Accident Inquiry Report, 1954, p. 1
their personal knowledge of patients and their ability to build relationships over time. 89 One well-regarded practitioner considered this longitudinal bond to be so strong that, he suggested: ‘the GP alone can offer the patient, and his family continuity of medical care over the years. They alone can know the family environment. And they alone can learn what is normal for the individual patient.’ 90
Appeals to personalised practice continued into the 1970s, and medical individualism underpinned claims about general practice diabetes care in
innovative procedures, whilst hospitals might deploy their own documentary aids to help practitioners to tailor observation or therapeutic practices. 104 However, ‘the right of private judgement’ and clinical individualism were highly prized, and professional action was rarely subject to codified criteria of proper practice, temporal regulation, or recording. 105
Taken together, therefore, recall systems, specialist records, and care protocol added new local structure to professional action. As discussed in Chapter 5 , this structure emerged at a
the policies and rhetoric of Thatcher's subsequent administrations (1979–90) as an ‘end of consensus’. This work suggested that, after 1979, retrenchment and a policy dedication to individualism and free market economics replaced a cross-party, cross-Whitehall policy paradigm which had been forged after the Second World War, built around state intervention in industry and a Keynesian commitment to full employment, as well as generous support for a social wage and the welfare state. 70 Such assessments were consciously put forward by Margaret Thatcher herself, and