Social Suffering: A New Reference Framework for Economic Analysis

2.1. Social suffering is not about pain

Anderson (2013) distinguishes between physical pain (hardship), mental pain and social pain. Only the first equates pain and suffering, for example, athletes who train hard to win a competition subject their bodies to physical pain. Their suffering is physical rather than social. Mental suffering relates to both cognitive and emotional suffering, while social suffering relates to suffering generated by institutions, or as I. Wilkinson (2005) puts it, suffering generated by social forces. This is not to deny the interactions between these three forms of suffering. Organizations that pay no attention to people, for example, within their strategic planning, can influence the level of physical suffering according to the quality of the existing working conditions. They can also generate mental suffering by causing people to feel that they are not taken into consideration. The first two forms of suffering are therefore closely associated with social suffering. However, social suffering encompasses the other two forms, but is not defined by them. As Ricoeur (1994) notes, pain relates to the body and is expressed by one’s relationship with one’s own body, whereas suffering is automatically situated in the context of one’s relationships with others, even if it embraces reflexivity. By its very nature, social suffering is an expression of distress in relationships with others and society.

2.2. Social suffering is not the frustration of desire

A further argument is ripe for dismissal. In this argument, social suffering is merely evidence that certain people are incapable of entering the higher echelons of society, and in particular, of reaching a higher level of consumption. Social suffering is hence akin to the frustration associated with unfulfilled desire. However, suffering appears to be distinct from the frustration of consumption-related desires, for example, to feel frustration at being unable to acquire a certain product or novelty at a certain time is not tantamount to suffering because of the inability to consume, as in the case of someone who is “suffering” from hunger. We can appreciate the flat we are living in, even if it is not a sumptuous villa, and we can be satisfied with the goods we have bought, even if they are not designer brands. The inability to afford a luxury car or a luxury holiday does not have to deprive us of the pleasure of driving a standard model or traveling to a popular resort. Suffering is hence distinct from the frustration caused by any form of desire.

Similarly, when a depressed person is asked what she wants or prefers, her answer usually corresponds to the absence of any preference. The person loses her motivation, and desires nothing. She cannot be frustrated as she no longer has desires, but she suffers nonetheless. Desire is hence separate from suffering.

2.3. Social suffering is more than a purely subjective feeling of suffering

It is hard to dissociate social suffering from the feeling of suffering. Social suffering is a form of psychological distress (Mayerfeld 2005) that to some degree makes it subjective. It is partly subjective insofar as it relates to the person’s experience of the world. However, it should not be seen as a purely subjective feeling detached from the characteristics of the person’s environment, and three clarifications can be put forward.

2.4. Social suffering as a symptom of a socioeconomic order

Wilkinson and Kleinman (2016) insist on the idea that suffering is associated with social institutions and the global system, as they shape the context of experiences of suffering. The major work by Polanyi (1944) asserts that prior to the eighteenth century, the economic sphere functioned according to social relationships rather than the economic interest of the individual, but the latter now reigns supreme and the social sphere has gradually become its servant. The economic sphere has become disembedded from the social sphere. Current thinking on social suffering has reinvigorated this theory through the lens of globalization and its social impact on people’s lives. Globalization both transforms the social context of experiences and generates suffering. Indeed, increasing levels of rationalization and commodification change the relationships people have with each other and contribute to social suffering (Bourdieu 1993; Kleinman 1999). The dismantling of the welfare state and changes in the social order, especially in the wage-labor nexus, which occurred in the 1980s, and were later exacerbated by globalization and neoliberalism, have led to a deterioration in living conditions and social positions. Bourdieu primarily wanted to highlight the suffering among people caused by the new socioeconomic context, but he also wanted to show that socioeconomic transformations affect people's relationships with others and with their environment, hence the rise in violence and xenophobia. We are therefore looking at a more profound transformation of social relations in a context of socioeconomic transformation, which means that social suffering must be perceived as a process characterized by suffering and social factors. As Bourdieu (1993: 1453) puts it:

I am thinking of the outbursts of senseless violence, at sports events or elsewhere, about racist crimes, about the electoral successes of the prophets of doom, eager to exploit and magnify the most primitive expressions of moral suffering that—as much as and more than by the poverty and the “passive violence” of economic and social structures—are produced by all small privations and muted violence of everyday life.

Case and Deaton (2020) also underline the strong links between social suffering and current forms of capitalism. ¹

I. Wilkinson (2005) notes that suffering provides an opportunity to reconsider public policies that set out to reduce suffering, or at least improve well-being. Over and above the impact of economic systems, policies that have been designed to remedy any negative effects—or more precisely, the absence of such policies—add to the experience of this social suffering because the inability to counteract social suffering is also a form of suffering in itself. Case and Deaton (2020) clearly show that health policies in the United States are a significant factor in the current level of social suffering. As Renault (2008: 138) observes:

The idea of social suffering is therefore understood both in the positive sense of the social production of specific constraints, and in the negative sense of the absence of social resources to cope with them. Everything seems to indicate that these two forms of suffering continue to characterize capitalist societies in general, to varying extents and in various forms.

3.1. A political use that does not reflect the reality of people’s living conditions

One way to dismiss suffering could be to state that it is a discourse developed by professionals, such as occupational physicians (Salman 2008) and humanitarians (Calain 2013) who work with “sufferers.” Suffering has hence become a catch-all term that is passed on to sufferers who would be unlikely to naturally use it themselves, and who end up internalizing it without understanding its political connotations (Fassin 2004). This argument assumes that low-income populations do not use this term spontaneously, which is not always the case (Jamoulle 2002).

3.2. The neutralization of political issues

In sharp contrast to the previous criticism, some might claim that “suffering” cancels out the political dimension by transforming sufferers into victims, such as sufferers of injustice who feel more like they are in need of rescuing rather than actors in diminishing this injustice (Fassin and Rechtmann 2007). Suffering is said to embody a form of victimization that could overshadow the political dimension of the battle against injustice. This objection seems quite groundless. On the one hand, high profile cases, such as the prosecution of France Télécom for creating the conditions that led to the workplace suicides, showed that, on the contrary, the term “suffering” managed to unite people from different backgrounds (employees, trade unionists, doctors, lawyers) in the same struggle against a management approach that was described during the trial as “institutional moral harassment,” ² and that could be more generally described as a reflection of the discourse found in contemporary capitalism. On the other hand, and more generally, Putnam (2002) has clearly demonstrated that the terms used to describe a situation offer scope for evaluating that situation. He cites the “cruelty” as an example. It both describes a situation and is judgmental of that same situation, as in the expression: “this political regime is very cruel.” In addition to describing the political regime, the expression expresses a value judgment about it.

Suffering is indeed one of those terms that convey both a description and a value judgment, and this is not simply via a form of victimization. Even though sufferers can be described as victims, they are also the victims of an unjust social order that has created the conditions for the suffering (Bourdieu 1993). Therefore, this type of social order should be exposed, and denounced. Suffering does not eliminate all forms of a person’s agency (Frost and Hoggett 2008) and the term has sufficient force to drive us toward moral investigation and political engagement (I. Wilkinson 2004).

3.3. It is a categorical rather than a general phenomenon

Another objection is to deny any possibility that the term social suffering describes a general social phenomenon that is linked to the functioning of the capitalist system in its present form. In this way, opponents of the term can argue that although categorical social pathologies do exist, they are clearly documented and can be treated as categorical dimensions, which avoids any criticism of the functioning of the economic system as a whole. We now discuss this objection by considering three examples.

But using material poverty as the sole measure of all suffering keeps us from seeing and understanding a whole side of the suffering (our italics) characteristic of a social order which, although it has undoubtedly reduced poverty overall (though less than often claimed) has also multiplied the social spaces… and set up the conditions for an unprecedented development of all kinds of ordinary suffering (petite misère).

The poorest people suffer, but many others in the population also suffer because of the functioning of the current capitalist system. Bourdieu (1993) illustrates this phenomenon perfectly through the accounts and testimonies of numerous people worldwide, including, and especially, wage earners and employees who do not come under the category of extreme poverty. This is illustrated by Case and Deaton (2020), who have determined that the social category most severely affected by the increase in social suffering has been the working-class whites’ category.

From these three illustrations, we can conclude that suffering is not an exclusively categorical phenomenon, although it does affect certain categories of people more than others. As Renault (2008: 27) observes: “Like violence, suffering is one of the phenomena that immediately raises the question of the legitimacy of the social order in which it develops.” Therefore, to recognize suffering is to admit that the existing economic order is not functioning properly. He later adds (Renault 2008: 143): “the term suffering does not only designate psychological difficulties; it also claims to describe their contexts and social consequences.”

4.1. The hypothesis of symmetry

There are two versions of the hypothesis of symmetry. The first is based on the hedonistic illusion that an increase in well-being goes hand-in-hand with a reduction in suffering. This hypothesis was put forward by Pantaleoni (1889), whose assimilation of well-being into utility, and its opposite, disutility, led to the belief that disutility automatically diminishes as well-being increases. The shift from notions of pleasure and pain to those of happiness and suffering retains the idea of inversion. This hypothesis, which we refer to as the hypothesis of mechanical symmetry—an increase in one person’s happiness automatically reduces that same person’s suffering—is highly questionable when happiness and suffering are divergent fields. Indeed, surveys show that people who state how happy they are with certain aspects of their lives also state how much they suffer because of other aspects (Stone and Mackie 2013). A simultaneous state of happiness and suffering is not incompatible. Happiness in certain life domains does not reduce the suffering in others.

The second version claims that one person’s happiness compensates for another person’s unhappiness (or suffering) as happiness and suffering are comparable. This makes the pursuit of overall happiness sufficient, since any increase in happiness will compensate for overall suffering. Henry Sidgwick (1907: 413) summarizes this view perfectly:

the greatest possible surplus of pleasure over pain, the pain being conceived as balance against an equal amount of pleasure, so that the two contrasted amounts annihilate each other for purpose of ethical calculation.

We refer to this assumption as the hypothesis of moral symmetry. This hypothesis differs from the first because it does not assert that improved happiness automatically reduces suffering, but that this improvement compensates for suffering, and from a moral standpoint, the symmetrical dimension makes the pursuit of happiness sufficient.

The hypothesis of symmetry between happiness and suffering was challenged more than a century ago by Moore (1903: 222):

the study of Ethics would, no doubt, be far simpler… if… pain were an evil of exactly the same magnitude as pleasure is a good; but we have no reason whatever to believe that the Universe is such that ethical truths must display this kind of symmetry.

Karl Popper was even more skeptical, noting the asymmetry between happiness and suffering:

I believe that there is, from the ethical point of view, no symmetry between suffering and happiness, or between pain and pleasure. Both the Utilitarians and Kant seem to me (at least in their formulations) fundamentally wrong in this point…. In my opinion human suffering makes a direct moral appeal namely, the appeal for help, while there is no similar call to increase the happiness of a man…. (1945: 241, volume 1, note 2 of chapter 9)

This footnote, which is relatively insignificant in the context of the book as a whole, prompted an extremely virulent reaction within the utilitarian movement, and triggered a debate that would give rise to negative utilitarianism (Smart 1958). While the hypothesis of symmetry may have gained the upper hand for a few decades, the hypothesis of asymmetry has made a strong comeback in more recent years (Mayerfeld 1999; Hurka 2010).

In the following section, we first examine the rejection of suffering as being relevant in steering policy, before discussing both the strong and weak versions of the hypothesis of asymmetry between suffering and happiness. We conclude that there is a need to seek complementarity between greater happiness and diminished suffering.

4.2. Suffering should not influence public action

The utilitarian philosopher Roderick N. Smart (1958) considers that suffering should not influence public policy and is irrelevant as a specific criterion. Otherwise, as he tells us, the easiest way to reduce people’s suffering would be to kill them all. He mentions the following case:

Suppose that a ruler controls a weapon capable of instantly and painlessly destroying the human race. Now it is empirically certain that there would be some suffering before all those alive on any proposed destruction day were to die in the natural course of events. Consequently, the use of the weapon is bound to diminish suffering, and would be the ruler's duty on negative utilitarianism grounds. (Smart 1958: 542)

Policies must therefore focus on people’s happiness, as this absurd reasoning disqualifies suffering. His objection can be dismissed in two ways.

Firstly, it is possible to find situations in which the pursuit of happiness and the associated policies are clearly meaningless. Philippa Foot (2002) describes the case of a prefrontal lobotomy patient who spends his days collecting leaves from trees in the grounds of the psychiatric clinic where he is staying. In the opinion of his doctor, the patient is very happy while engaged in this activity, and therefore spends his entire days in a state of undeniable well-being. Foot then asks us whether we can imagine a loving father deciding to subject his child to a prefrontal lobotomy for the sake of his child’s happiness. He then buys large numbers of toys, or even collects leaves, so that the child can enjoy a very happy life picking up leaves or toys all day. Accepting the desirability of such a life for the child could, by generalization, lead us to conclude that in the pursuit of a policy to ensure the happiness of its citizens, a government should simply implement a widespread program of lobotomization. This is clearly nonsensical. The absurd reasoning proposed by Smart makes suffering irrelevant, but the same type of reasoning also discredits happiness.

Secondly, the example proposed by Smart suggests that suffering should be eliminated, both in the present and in the future. Yet while future suffering is inevitable, eliminating people to reduce their future suffering will also put an end to current and future happiness. The hypothesis of asymmetry between happiness and suffering does not claim that suffering should be totally eliminated. It only states that it should be reduced and avoided as far as possible, as the reduction of suffering takes priority over the pursuit of happiness. Acton (1963) clearly points out that eliminating suffering altogether is not the same as reducing it or attaining the lowest possible level. Again, we could reverse Smart’s argument by stating that under the hypothesis of symmetry, increasing happiness is not the same as maximizing it. Otherwise, our example of generalized lobotomization would be the best way to maximize happiness. Indeed, despite striving for happiness, it is obvious that people suffer, and that their suffering reduces their overall happiness (by symmetry). A simple way to maximize happiness would be to remove the risk of psychological suffering, which is the purpose of the generalized lobotomization mentioned in our example. The hypothesis of symmetry hence involves lobotomization. We could also state that if happiness is superior to suffering, which implies the acceptance of a form of inverted asymmetry, as undoubtedly defended by Smart (1958), then generalized lobotomization is all the more important, since a small increase in happiness is largely preferable, even at the cost of greater suffering. Lobotomization guarantees this small increase in happiness.

Asserting that suffering is of no interest to policy makers seems problematic, as this would mean admitting that happiness is equally devoid of interest. We can easily agree with Walker (1974: 428) that it makes sense to give precedence to suffering, since “a mechanic would think he ought to repair the faults in an engine before improving the performance of those parts which already functioned satisfactorily.” Morality implies that we reduce suffering before we improve happiness.

4.3. Strong asymmetry and weak asymmetry

James Griffin (1979) is one of the utilitarian philosophers who have dismissed the idea that suffering is asymmetrical to happiness and that it should be given special consideration in any analysis. In order to bolster his point of view, Griffin distinguishes between several versions of the hypothesis of asymmetry, which he prefers to deny: a strong version according to which “promoting happiness is not morally obligatory at all,” a weak version which states that “promoting happiness is a slighter obligation than eliminating suffering,” and a very weak version based on the idea that “eliminating suffering is granted more weight than promoting happiness on practical grounds,” because in practice, it is generally easier to reduce suffering than to promote happiness. However, Griffin does not discuss the hypothesis of very weak asymmetry, as this is based on practical considerations, whereas the strong and weak versions hinge on moral considerations, and he deems it important to establish a moral rule that serves as a guide for action, irrespective of whether or not the different actions are easily achievable.

The difference between strong and weak asymmetry lies in the role of happiness. In the hypothesis of strong asymmetry, only suffering counts and must be reduced; in the hypothesis of weak asymmetry, both count but are weighted by a factor that gives more emphasis to suffering than to happiness. The hypothesis of strong asymmetry is therefore an extreme case of weak asymmetry in which the weight of suffering tends toward infinity and that of happiness tends toward zero.

Griffin (1979) adopts Smart’s argument to reject the hypothesis of strong asymmetry. We have seen that this argument is not robust. We can postulate that the rejection of happiness would coexist with the rejection of suffering on the same grounds that the rejection of suffering would eliminate happiness. They are two sides of the same coin, and it is not possible to accept one side without accepting the other. However, it is possible to attach more importance to one side than the other. We can hence focus on the hypothesis of weak asymmetry insofar as strong asymmetry is merely a special case.

Although Griffin discusses several versions of weak asymmetry, which he systematically rejects, we now examine the most obvious hypothesis—that of the weighting of suffering and happiness—which the author refers to as the “calculus version.” This relates to the possibility of using a scale of measurement to compare suffering and happiness, where rather than an amount n of suffering being equivalent to an amount n of happiness, the equivalent is an amount n+m of happiness (with m > 0). In other words, the action must take into account the potential effects of suffering and happiness by applying weightings that reflect the equivalence between n and n+m.

Griffin proposes an intuitive argument to dismiss this hypothesis. Imagine that a doctor has two alternative treatments for a patient. The first treatment reduces the suffering immediately but does not lead to the patient’s complete recovery. The second treatment does not immediately reduce the suffering (it may even potentially increase it), but it can cure the patient definitively and will thus eventually end his or her suffering completely. What would the doctor’s choice be? And the patient's choice? The answer, according to Griffin, is that the second treatment is better, despite causing more suffering, and should be chosen for this very reason.

There are two responses to this argument. First, we could agree with Parfit (1984) that there is already a substantial degree of happiness, and hence, the marginal utility of increasing happiness is lower than the marginal utility of reducing suffering. This is confirmed by the Easterlin Paradox (1974).

Second, many people consider that this argument corresponds to a necessary sacrifice. Peter Berger (1974) strongly insists that this is an almost mystic doctrine. Drawing on the metaphor of the Great Pyramid of Cholula in Mexico, upon which the Aztec people performed human sacrifices, he describes this doctrine as a theory based on a belief in the need for “sweat and blood,” that is, the belief that God must be fed human blood on a regular basis to keep the universe from collapsing. This belief continues to exist to this day with the idea that sacrifices are necessary to ensure a “brighter tomorrow.” It is also interesting to note that Griffin develops his argument using the example of a generation of people who have to accept a degree of suffering for the sake of substantial future economic benefit. The case of the doctor and the patient has already raised serious doubts about the “calculus version,” but its generalization (including in the field of economics) is even more problematic. Convincing people to accept suffering by promising a better future is dubious rhetoric, such as that used in the 1980s through to the 1990s to justify structural adjustment plans. The implementation of these plans led to human misery; they continue to be used to justify all postcrisis adjustment mechanisms, and consequently, cause the same litany of suffering (Stuckler and Basu 2014). We can endorse the position adopted by Amartya Sen (1997), as encapsulated in the acronyms, BLAST and GALA, which illustrate two contrasting visions of economic reasoning. BLAST (“blood, sweat, and tears,” an expression attributed to Winston Churchill) is based on the idea of the need for sacrifices to achieve a better future, whereas GALA (“Getting by with a little assistance,” adapted from a phrase in a Beatles song) is based on the idea that improving quality of life does not require sacrifices but presupposes the pursuit of complementarity between the means of economic development and the ultimate aim, that is, a better quality of life. As soon as the means become instruments that result in human fulfillment, the doctrine of the indispensable sacrifice loses its relevance.

According to this logic, we can revise the hypothesis of asymmetry between suffering and happiness in the following manner: The priority must be to implement policies that simultaneously reconcile an improvement in happiness with a reduction in suffering. When this is not possible, the reduction in suffering must take precedence over the improvement in happiness. This hypothesis does not espouse symmetry because, on the one hand, there is nothing automatic about the inverse relationship between happiness and suffering, and on the other hand, it does not authorize any compensation between the suffering of some and the happiness of others. Our new version of the hypothesis of asymmetry between happiness and suffering is hence composed of two rules, with the second—the rule of asymmetry—being subordinated to the first, that of complementarity.