The merits of context: Unfolding mental vulnerability as category and experience

Abstract

‘Mentally vulnerable’ young people are a strong focal point in public debate and policy in Denmark at present, and a variety of cultural activities are now being offered to them. Building on ethnographic fieldwork (April 2018-August 2019) with so-called mentally vulnerable young women (aged 18-36) who meet in literature reading groups, this article seeks to connect the reading group with the phenomenon of ‘mental vulnerability’, first through a review of the historical emergence and contemporary use of the term, and second by considering what (painful) experiences the term signifies for individuals belonging to this category. This contextualization involves a discussion of literature on the role of context in anthropological analyses. The article concludes with an empirical contradiction: the reading group provides a sanctuary from everyday demands for purposefulness and productivity, but it can also be used as a strategy for navigating such demands.

Keywords

Mental illness mental vulnerability Denmark context categorization reading groups literature youth

Why context?

Maybe because we live in a society where you have to have a diagnosis before people understand that you can’t do everything in the world. Then [mental vulnerability] works well enough, but I also think everyone could end up getting that diagnosis, because nobody can stand stressing around all the time.

Vera¹ is one of my interlocutors; a Danish writer in her early twenties who has had mental health problems. To me, her quote illustrates the ambiguity of mental vulnerability [psykisk sårbarhed]: The term bears diagnostic-like traits, but can also easily be watered down – resulting in a situation in which everyone could be defined a mentally vulnerable.

In this article, I want to shed light on this widely used Danish term from two angles: First, I want to unfold its emergence. Second, I want to present the experiences of young women who had signed up for a literary reading group for ‘mentally vulnerable young people’, and thereby regarded themselves as belonging to this category. Following Crossley’s approach to the body (1996), I see the bodies of my interlocutors as simultaneously lived and inscribed from without, recognizing that outside categorization and embodied experiences of vulnerability mutually inform each other. I thus aim to describe the position of a group of young women between outside expectations and their own struggles for a good life by looking at one key term. My overall argument is that an exploration (and analytical construction) of the context for joining a reading group generates insights into what kind of space such a reading group will be. This contextualization illuminates what kinds of lives my interlocutors live and the role of literature in them.

The article is based on fieldwork (April 2018-August 2019) in shared reading groups in Denmark, for young people (18-35) who are mentally vulnerable.² Reading groups like this are established by The Danish Reading Society, which is a non-profit NGO striving to “create strong reading communities […] to strengthen the quality of life of the individual and better possibilities for taking part in society” (The Reading Society [Læseforeningen], 2019). The society is active all over Denmark and groups typically meet once a week to read aloud and discuss literary texts. The reading groups I study here were part of a larger interdisciplinary research project in collaboration with The Reading Society, with the society establishing reading groups to empower mentally vulnerable young people through shared literary experiences and possible group leader training. The aim of the anthropological research dimension was primarily to explore how these reading groups were experienced by the participants. I see our interdisciplinary project as a para-site, understood as a space that brings the ethnographer and his/her counterparts together, all with different intentions, but with a shared aim to generate critical sensibilities about certain issues they have in common (Marcus, 2000: 9). Here, the main counterparts were actors involved from The Reading Society and the group participants.

In order to fully understand the role of a reading group in the lives of its participants, I sought to broaden my knowledge of their everyday lives and life stories, and what kind of challenges they encountered. I conducted fieldwork through individual semi-structured interviews, email correspondence, workshops, document analysis and participant observation in and outside of reading groups (what happens within the reading groups is beyond the scope of this article. See Christiansen and Dalsgaard (2020). I also sought out social practices linking youth, mental health and participatory arts in Denmark.

Ethnographic fields like mine, which are ‘at home’ (Nordquest, 2007) and situated around specific social spaces, have moved radically away from the Malinowskian ideal of the local community far from home. Instead it invokes terms such as ‘multi-sited’ (Marcus, 1995), ‘experimental’ (Estalella and Criado, 2018; Roepstorff and Frith, 2012) and ‘collaborative’ (Estalella and Criado, 2018). I return repeatedly to the question of how to construct my context and make it explicit so that the reading groups are not analyzed as a phenomenon which exists in a socio-cultural vacuum. Thus, the question of context is accentuated. So, before unfolding the concept of mental vulnerability, I will briefly outline some key discussions of context within anthropology, focusing on the contributions of Roy Dilley and Marilyn Strathern.

The problem of context

With the volume The Problem of Context (1999), Roy Dilley sparked new life into methodological discussions of context. He claimed that the problem of context stemmed from the fact that anthropologists posit an essential unity of humanity while describing the particularity of each culture we study; social and cultural anthropology is “caught between the Scylla of contextual relativism and the Charybdis of ‘extreme sameness and objectivity’” (Dilley, 2002: 443). You could say that what characterizes anthropology as a discipline is exactly its concern with the construction of socio-cultural contexts. Dilley argued that for long, anthropologists had largely treated the analytical process of contextualization as unproblematic (1999: 1). After Malinowski criticized Frazer for taking things out of context, context became the natural backdrop of ethnographic interpretation. It became elastic and all-encompassing: context could be cultural, social, political, ritual, economic, ecological, interactional, systemic or historical (Dilley, 2002: 447–449). Later, with postmodernism, context moved from being the backdrop of interpretation to being something to play with deliberately. The fact that Frazer tore data out of context was rediscovered as useful inspiration for a controlled, imaginative play with context (Strathern et al., 1987).

Ultimately, contextualization means connecting your phenomenon with relevant surroundings – and this connecting entails disconnecting it from other surroundings which are deemed irrelevant, Dilley noted (2002: 440). Here, he drew on Strathern’s influential work on comparison. For Strathern, drawing on Melanesian modes of thought, comparison (between societies or parts of societies) meant making specific connections either by resemblance or direct relation (1991: 53; see also Huen, 2009). Sociality could be divided and re-divided into smaller parts “like flecks of Cantor’s dust”, the same amount of society being present on all levels (Strathern, 1991: 114). Strathern conceptualized the anthropologist as a cyborg whose “writings form a kind of integrated circuit between parts that work as extensions of another […] the circuit still seems centered, however, on the perceptual tools of the anthropologist” (Strathern, 1991: 55). It is hard to avoid an arbitrariness in terms of when these contextualizing moves should stop, Dilley argued: the problem with context is that it is boundless. Connecting to one context implies that that context can be contextualized, and so on to infinite regression (2002: 446). How can we decide which connections or disconnections to make?

Dilley proposed two ways to handle this, which I will consider in this article. The first path is to consider what connections local social agents themselves perceive as relevant. The sets of connections the analyst makes are “construed as relevant to someone, to something or to a particular problem” (Dilley, 1999: 2). The second is to make connections to the interpretive practices of your discipline. Ideally, these two paths should enter into a dialogue in your work (Dilley, 1999: 38). Contextualizing is a particular form of social, performative and political action generated and negotiated by both anthropologists and social actors (Dilley, 2002: 441).

According to Candea, even though the world seems ever more seamlessly connected, increasingly multi-sited fieldwork practices still involve choices and delimitations with regard to which people, ideas and objects to trace and connect. This arbitrary limitation of one’s fieldwork context can in itself be analytically productive. The messiness of the field invites the ethnographer to reflect on conceptual entities (2007: 180). Such artificial delimitation is present in my field as well; but the connections I make (between mental vulnerability, Denmark, youth and literature reading) are perceived as relevant by actors in my field and thus not completely arbitrary. Furthermore, I seek to let these connections enter into a dialogue with the question of contextualization as interpretative practice in anthropology.

In my empirical context, literary reading groups are put forth as a solution, but this compels me to ask, what characterizes the seemingly self-evident problem group of mentally vulnerables? Dilley called for analytical and even political strategies to be adopted in order to avoid misrepresentations or acts of ‘bad faith’ (2002: 440). A methodological epoché from pre-constructed objects is needed, in order to avoid converting common-sense social problems into ‘real’ sociological problems (Bourdieu, 1991: 248–249). Based on this, I argue that it is important to explicate the empirical context of mental vulnerability, to bracket common-sense cultural ideas of this problem.

To give one last reason for focusing on context, I want to draw attention to the relationship between body and context, taking inspiration from Nick Crossley’s notion of the body. Crossley seeks to dissolve the analytical pseudo-distinction between the historically inscribed body, represented by Foucault, and embodied experience, represented by Merleau-Ponty (1996, see Scheper-Hughes and Lock, 1987: 7 for a related conceptualization). This tension between lived and inscribed body can also be seen as an exemplification of the subject-context problem that Dilley emphasized. Whereas Foucault is concerned with how long-term historical power systems constitute bodily modes of being and Merleau-Ponty is concerned with ongoing day-to-day bodily actions, emotions, and sensations, both reject mentalism and the idea of a psychological faculty outside the body (Crossley, 1996: 102--103). Analyzing mental vulnerability as a phenomenon that is both inscribed and embodied becomes possible through my contextualizing approach. As I read Crossley, there is a need to investigate exactly this tension to see how subjectivities are formed in specific historical times. I will return to this in the conclusion.

To round off this discussion, epistemologically, an understanding of people and their actions calls for an exploration of the contexts in which they exist. There is a certain arbitrariness in the delimitation of context and to reflect on context is to explicitly consider the delimitations that every anthropological analysis entail. Moving forward from problematizing context, as Dilley did, my aim is to explore the merits of context.

The most significant connection to be made and explicated with regard to the reading groups is the phenomenon mental vulnerability. This was generally seen as an urgent social problem in Denmark and a reason to establish reading groups at the time of research, and it was an issue for reflection for my interlocutors when I talked with them. With this focus, I will conversely abstain from other meaningful connections: I will for example not connect The Reading Society’s activities to the Danish tradition of civil associationalism, nor to a wider literary field in Denmark. In the rest of this article I will explore mental vulnerability in two contextualizing moves. Investigating the merits of contextualization consequently prevents me from going into any of these directions in minute detail. Following Crossley’s approach to the body, I start by looking into the historical emergence of the mentally vulnerable body in Denmark, which will lead to a section where I describe my interlocutors’ encounters with and reflections on mental vulnerability as a category. Then I will describe experiences connected to mental vulnerability. This leads to a discussion of the body as context, and the reading group as a locus where different intentions play out and subjectivity is formed.

The elusive category of mental vulnerability

There is an ongoing question in Western European ideas of mental illness: is it a biological condition (and thus medically treatable), or is it a moral, social, and perhaps generational problem, a problematic interplay between an individual and her surroundings? (see Foucault, 1988; Hacking, 1998; Jenkins, 2015: 3; Nielsen, 2018: 895). The question points to a tension-filled relationship between mind and body and between biological brain and cognitive mind in Western thought (see Nagel, 1974: 435; for anthropological discussion of theories of mind see Keane, 2008). Today there is still uncertainty in psychopathology research as to what constitutes mental disorders. Some disorders such as schizophrenia are widely recognized brain disorders, while others such as ADHD are more debated (Brinkmann, 2018: 151–152). Here, I will not seek to solve the tensions between biological and environmental explanations, but merely point out the presence of both explanatory models in conceptualizations of mental illness in general, and the way mental vulnerability as a concept might be said to try to bridge biological and environmental causal explanations.

The concept of mental vulnerability [psykisk sårbarhed]³ was coined by the The Danish National Institute of Social Research, within ongoing negotiations of what mental illness is and how to approach it as a welfare state (Kühl and Martini, 1981). The intention behind this category was to identify a group in society consisting not of actual psychiatric patients, but of people who deviated in some way from what was regarded as normal mental and social function. Mental vulnerability was not a diagnostic, but a statistical category. 10 per cent of the population were found to be vulnerable in an omnibus survey (Kühl and Martini, 1981: 35–37, see Eplov et al., 2010 for a contemporary evaluation of the questionnaire). The people who were categorized as mentally vulnerable were predominantly urban dwellers, characterized by a behavioral pattern of passivity, a low threshold of sensitivity, and inappropriate reactions in situations of social conflict. “Compared with really psychically handicapped persons, the vulnerable ones are characterized by being just slightly deviant in a neurotic way” Kühl and Martini wrote (1981: 154). Mentally vulnerables were a whole new group to study, expected to benefit from preventive measures and support from the state (Kühl and Martini, 1981: 116).

I conducted a media search that showed very sporadic occurrence of the concept of mental vulnerability in Danish media after 1981. However, in 2009, it was brought to public attention by previous Social Democratic Prime Minister Poul Nyrup Rasmussen, after which the use of the term increased radically in the news media. 15 years after the loss of his daughter to suicide, Rasmussen established The Social Network, the objective of which was to improve the conditions for people with mental vulnerability. In this connection, he stated in an interview:

[when] I use the term mentally vulnerable, it is simply to signal that we all are or can be mentally vulnerable if we are under enough pressure. We are not talking about people who are different, but about how sometimes you have so much noise in your head that it becomes mental vulnerability (2011).

Rasmussen used the term mental vulnerability to underline that people with a psychiatric diagnosis were not essentially different from other people. He emphasized the social environment as a cause of mental distress, whereas in Kühl and Martini’s original characterization mental vulnerability was attributed to both socio-economic status and childhood but also personality traits and biology (1981: 116). Rasmussen wanted to abolish the idea of more or less robust types of citizens and his initiative led to a still active civil movement.

Since Rasmussen’s initiative, mental health has worsened in Denmark: the number of citizens who receive psychiatric treatment has nearly doubled from 2012 to 2017 and a growing number of young people are stressed, or struggle with anxiety or self-harm (Tidmand, 2018: 91), while the psychiatric sector is typically described as financially under-prioritized (Sørensen and Christensen, 2019). Various reasons have been suggested in the mainstream media: the use of social media, a superficial perfection culture with impossible body ideals, and a public education system that relies increasingly on tests. In a study by Sørensen et al. (2017: 29), young Danish citizens reportedly experience a hard individualization where the gap between socio-economic success and failure has widened. And they feel that they have sole responsibility as individuals to perform well if they wish to be employable ‘winners’. In an influential study, political scientist Pedersen (2011) described how the Danish state changed from a welfare state into a ‘competition state’ [konkurrencestat], re-conceptualised on the terms of a global market economy.

Studies from other countries have also shown negative effects of the globally competitive market economy. In China, middle class parents feel pressured to make their children perform well educationally, in the midst of the “stresses of urban life, the rigor of school discipline, intensification of social competition [and] the emergence of a psychological common sense”, and some children react with poor mental health (Kuan, 2015: 4). In Finland, the emergent notion of ‘burnout’ shares some traits with mental vulnerability. Here, burnout is understood as something that strikes people when they are not able to protect their own limits in their work-lives in the new neoliberal, globally competitive economy. Burn-out workers often have a sense of not being normal. They can be sent to rehabilitation centers where they can work with empowering themselves and take control of their own recovery process (Funahashi, 2013: 7). Like mental vulnerability, though a widespread term, burnout is diffuse, and not recognized by social security institutions as a primary disease category. Nevertheless, it is a source of concern for health officials (Funahashi, 2013: 6).

Throughout my fieldwork, I have heard mental vulnerability used by frontline figures in welfare institutions such as job centers, politicians, and in NGOs. I have heard the term used to describe severe mental disorders, as when a 19-year-old young woman with bipolar disorder told me that her psychiatrist had said to her that she “was not ill, she was mentally vulnerable”. I have also encountered it used by a GP and a social worker to describe individuals experiencing periods of stress or various difficulties coping with the demands of modern life. The meaning of mental vulnerability is sometimes not distinguishable from mental illness, but on other occasions it is used as a way to exactly not denote illness.

With its unclear characterization and fragmentary use, the term bears a likeness to other terms in Denmark such as especially sensitive [særligt sensitiv] (Lihme, 2015) and loneliness (Mikkelsen, 2016). Such quasi-diagnoses might reflect the fact, as Danish psychologist Brinkmann points out, that modern welfare states now have a ‘diagnostic culture’ meaning that problems and life conditions are increasingly thought of in terms of different diagnoses, the number of which is still increasing (Brinkmann, 2018: 147).

In the Danish health care system, there is growing attention to the way some citizen groups, despite efforts, are left ‘vulnerable’ and experience inequality in treatment (Sodemann, 2018). Nielsen et al. have shown how vulnerable immigrant patients often struggle with barriers to health services. Here, focus is on the meeting between health care professionals and patients as the place where problems occur and vulnerability is often understood as denoting a lack of resources, demanding more skills from health care professionals (Nielsen et al., 2019: 394). In comparison, for my interlocutors, the vulnerability is seen as a general lack of agency in life, and professionals were more often in the role of helping people overcome barriers. This notion of vulnerability as an absence of agency is also present in Grøn’s (2016) study of vulnerable Danish elders.

One political strategy to alleviate worsening mental health is participatory arts interventions. Here, reading literature is often mentioned as a promising activity.⁴ In 2016, a pilot project called Culture on Prescription was initiated by the Danish Health Authority. Citizens on sick-leave were offered a variety of cultural activities such as choirs, painting and reading sessions, and visits to art museums. In one municipality, the benefits of this programme were expected to be: improved memory, better concentration, stronger social relationships, the ability to take control of your own life, and job readiness (Aalborg Kommune). Since then, cultural activities for mental well-being have mushroomed from public and non-public actors. According to Dalsgaard and Lund (2016), a general development within the cultural sector is that earlier Danish ideas about the intrinsic value of a sound cultural education have faded to some extent, and been replaced by a focus on events, participation and experience. It is within this context that the reading groups I follow were established. After this introduction to the emergence of mental vulnerability in Denmark, I will now turn to some instances where my interlocutors have encountered and reflected upon the category.

Mental vulnerability as a boundary object

The experiences of twelve female reading group members, aged 18-36, constitute the empirical basis for the rest of this article. They had been given diagnoses such as schizophrenia, personality disorder, autism spectrum disorder, psychosis, eating disorder or anxiety. Diagnoses were often a help because they opened up for financial support and practical help from the state or municipality: weekly visits from social workers, disability support, special allowances being made in the workplace, and therapy. However, receiving a diagnosis – typically after a period of intense suffering and treatment – was only one step in a long process marked by confusion and unanswered questions. According to Brinkmann, in ‘diagnostic cultures’, diagnoses are not only medical, biological or psychological, but also serve as bureaucratic, social and administrative entities. Diagnoses serve as boundary objects, allowing different communities to communicate about something designated by the category, though their understandings of it can vary (Brinkmann, 2017: 1). As an example, in many countries, health categories such as disability or infertility have led to campaigns for the recognition of group rights and respect, in a current of identity politics (Whyte, 2009: 7). To some extent, such mechanisms could also be seen with the civil movement Rasmussen initiated called The Social Network. But as previously mentioned, mental vulnerability group rights has not been established. I suggest that this is due to the ephemeral qualities of the category.

How could mental vulnerability be said to serve as a ‘boundary object’ for my interlocutors? The reading groups considered in this article were run by an NGO, which nevertheless tapped into public discourses on mental health when the group was advertised for mentally vulnerable young people. Participants did not need a referral from their GP or their social worker: to sign up, they only needed to write to Reading Society that they found themselves to be mentally vulnerable. When I met the reading group participants, they had therefore hesitantly accepted the term in order to join the group. Some of them felt that the term categorized them as vulnerable personality types when they were actually seriously ill. Others felt that they might not actually be ill, but that they were going through a difficult period in their lives – and that consequently the term categorized them as being more ill than they were.

When I asked them what mental vulnerability meant in their lives, my interlocutors most often answered that some special considerations were needed, in order for them to be able to actively take a role in an internship, job or social activity. For example, to be able to put on headphones or go for a walk during the workday allowed Frida to have an internship in spite of her vulnerabilities. Caroline had had difficult experiences when she attended a regular reading group and found it easier to be in this one with equals. For her, mental vulnerability denoted someone who just “functioned differently”; had difficulties taking initiatives, difficulties being extroverted in social situations, “not having that natural drive like others”; and not always being met well or helped along, by one’s surroundings. As she said: “This thing about being in the world … It is difficult being normal, because we can’t take part on normal premises and often end kind of on the periphery”.

On one occasion, mental vulnerability served as a direct way to gain access to help from the municipality. After having been sent back and forth between her job center and GP, Sandra’s GP had signed a note granting her sick leave, stating that the causes were “stress and mental vulnerability”. The category thus gave Sandra access to monetary support from the municipality without having to seek jobs, at a time where a specific diagnosis had not yet been reached. Telling me about this, Sandra said that mental vulnerability was a box covering many different diagnoses that people moved in and out of – that it was a useful “super-category”. However, it had also caused some confusion when she saw it on the ad for the reading group:

I also looked at [the term] and thought, what do you mean? Am I qualified for that? It’s a bit difficult to know […] but considering that I’m on sick leave […] and in the process of figuring out what other stuff lies behind, that keeps returning, that I have problems with. […] At first, I didn’t know what mental vulnerability meant, so I sat down and tried to look it up. It feels like a term that has not been defined. I think for me, well, I feel like it’s that you’re more sensitive, mentally, in various situations.

When I asked Ida what she thought of the term, she had been similarly puzzled by its undefined quality:

Mental vulnerability was one of the things that puzzled me. I remember I talked about it with a friend, and asked “when is someone mentally vulnerable?” and she’d had some stress and anxiety at one point, but she hasn’t been like, hospitalized, and she said “I think I could call myself mentally vulnerable”. […]

But I’ve still thought sometimes that I would find it hard to tell people what I was doing in the reading group: Well, I’m in this group for young mentally vulnerable adults. […]then again, I don’t know what else you should [call it] … It’s a bit softer.

She told me of her unease with the concept, but also said that she was happy that the group was designated as being only for people in the same situation as herself – and she was aware of this contradiction. Similarly, Frida said:

I think it’s an expression that is hard to work with. Because it’s everything in a way. It’s like saying ‘rock music’ or something right? I think personally it is odd to call yourself vulnerable right? But I think it’s such a thing that I’ve always been.

Here is a last quote from Yvonne, illustrating some of the negative stigma connected to the term:

Now I’m on terms with the expression, though I wouldn’t present myself as mentally vulnerable. I told my dad’s wife that I was joining this group, and I could tell it was a kind of shock to her. That it was hard for her that I needed to do this. That provoked me […] She thought it would be hard for me listening to other people’s fates. I told her it was not about [mental vulnerability], but about reading literature.

I hope these examples illustrate that mental vulnerability was useful as a kind of labelling quasi-diagnosis. You could define the category on your own terms and it could be a more permanent description in a situation where most of my interlocutors had moved between several different diagnoses. To me, these quotes also illustrates the identity turmoil that accepting such a label could entail. Joining a group for mentally vulnerables turned it into a public category that for some was difficult to label yourself under. Many participants noted that they would only attend a group for people with mental vulnerabilities, because it felt safer to be with peers. However, they also appreciated that the group was about reading literature and not sharing their difficult life situations: Sandra had attended a group for people who struggled with loneliness. She experienced the atmosphere there much “heavier”, with pressure to tell your personal story. In contradiction, the reading group was a cheerful experience.

To sum up, mental vulnerability worked as one among an array of boundary objects that my interlocutors moved in and out of. Mental vulnerability could sometimes serve as a foundation for gaining help and taking control of your situation, for example to gain special considerations, enabling you to participate in a job or reading group on tolerable premises, and in this way regain some power and agency in your life. But it was also perceived as confusing in terms of self-perception. The fuzzy borders of mental vulnerability may well be an advantage, enabling individuals to decide if they belonged to this particular category. But its fuzziness also made its consequences, the rights or duties that accompanied it, unclear. I will now move on to some of the specific sensory and emotional experiences connected to mental vulnerability.

Unruly bodies and perforated boundaries

It was “palpitation” and “feeling suffocated” on her way to classes, Olga, one of the members of the reading group, said when I asked her to describe her life up until she got help. In those days she did not shower or sleep – she could not even manage to brush her teeth. Her emotional state was marked by shame: shame about not being well, because people in other parts of the world had to face much more difficult problems – but when she was doing better, she also felt a sense of shame about that. She was distrustful of other people and afraid to talk to them. Olga described a sense of unmanageable emotions and thoughts when she talked about some of the worst days: “I was in a kind of existential crisis, but I couldn’t focus on it. I couldn’t emotionally break away from the feeling of being inadequate. And I was so ashamed of it”. Eventually, her sister assisted her in seeking help and Olga found out that her experiences were signs of anxiety.

Anthropological studies of mental illness have shown that mental suffering is a clinical fact, as well as embodied experiences and culturally conceptualized (Dumit, 2003; Good et al., 2007; Jenkins, 2015). For example, in an American context, Csordas and Jenkins (2018) have shown how self-cutting can be a mediation of a crisis of agency between body and the world and Desjarlais (1996) has shown how regular conceptualizations of human modes of being in the world, such as experience, do not necessarily apply to individuals living with mental distress.

Most of the reading group members experienced their distress as both corporeal and psychological. They had often found the reading group after the worst of their crises had worn off, although symptoms did return. Their specific problems varied, but generally involved too much stress, in terms of disturbing and negative thoughts, emotions and bodily reactions to have the energy for everyday demands in their lives. They struggled with overheated bodies, tired bodies, not being able to find sleep or sleeping many hours a day; hearts beating too fast, not eating, and taking in all sensations and stimuli such as sharp light or loud noises or not being able to distinguish between them. They developed mysterious rashes, sudden allergies, cysts, burns and bad teeth. For instance, a couple of years ago, Bea’s body had suddenly begun to develop rashes and allergies that recurred from time to time. She thought the problem was caused by mercury implants in her teeth combined with some chaotic years in her life. My interlocutors could feel apathic, sedated, or overstimulated and these bodily reactions resulted in a need to take breaks, often by moving their bodies away from the everyday bustle of work, school or the streets.

“It was really hard to be in my mind, and my body and my thoughts. It was really unendurable,” Cindy said, when she told me what it was like in the weeks before she moved away from her family to a crisis centre:

It’s like I couldn’t feel anything. Apart from what was going on in my head. I lost the connection. I smoked a lot of cigarettes, but that actually made me feel worse. Just felt bad inside. It was just hard to be me, to be in this body […] with anxiety, the heart, it’s like it’s all cold inside, it’s like you don’t have anybody.

As another example of experiences of both apathy and over-sensitivity, Yvonne had been in a physical accident when she was younger, and now her long-term memory was flawed. Her heart pounded too fast and she got very tired and had to sleep a lot in the afternoon. She was very fond of physical exercise because it helped her gain control of her body. Edith’s body also overheated sometimes and exercises in hot water helped her body calm down. She told me about a more metaphorical exercise she was doing with her emotional musculature: “I need to learn how to expand my emotional container. The musculature is collapsed when you are mentally ill. If you ignore some feelings such as anger or sadness, all emotions are left out […]”.

To me, these accounts illustrate how mental vulnerability was connected to situations where the boundary between one’s body and the surrounding world had shifted or been perforated. Senses and emotions were unreliable and troublesome and one’s reactions were not always under control. I will broaden the perspective from these corporeal experiences to the life situations of my interlocutors.

Stuckness: Falling out of time

The life situations of my interlocutors were characterized by a sense of ‘stuckness’⁵ – as if their as if their everyday lives had been placed temporarily on hold. When they joined a reading group, ten of twelve participants had had to take a break from work or school. Most of them were in a process of healing and returning to their old lives during the months and years they were in the reading group, and they could manage to take the bus or bike to the group every week; one had left her previous life more permanently. For half of them, their crisis had appeared after a short period of high pressure. For the other half, it had been a gradual development with years of messy family structures and upbringing. More than one-third told me that one or both parents were deceased, or that they had lost contact. In a podcast she had made on the subject, Frida described how her father’s mental illness, wanderlust and death were surrounded by mystery, and she feared and reflected on the risk of becoming like him. She remembered how reading literature was what “saved her”, growing up in a conflictual family environment.

During my fieldwork we set up a workshop to discuss the term mental vulnerability. One of the participants told me about the relationship between mental illness, age peers and life stages:

People with mental illness often have a displaced relationship to their age. They are young for a longer period in their lives. If you have been in a psychiatric ward for five years, and you come out when you are 30, it’s not like you don’t need to live those five years of youth anymore. You still need those years of youth, so when you’re 30, you act like you’re 25.

Her quote illustrates the situation for most of my interlocutors: even though their day-to-day lives were sometimes quite volatile, their struggles had brought their overall life narratives to a halt. In this context, life narrative is taken to mean the way individuals understand themselves as the protagonist of their own life moving through childhood to old age, with a range of interrelated stories, events and actions (Garro and Mattingly, 2000: 10). In Denmark, the transition into adulthood is marked by education and a job – these are some parameters by which the Danish welfare system also measures how its individuals are ‘welfaring’ (Højlund et al., 2011). Christiansen et al. (2006) have explained how failing to obtain the social markers of adulthood can hold you in the generational category of youth for longer.

Having left or taken a break from school or work, my interlocutors often experienced a displacement between their life situations and what they considered they should be doing to follow their age peers. To some extent, work and education was a field of limitations and stress to which it was hard to gain access. For instance, Bea was taking a break from her university studies when she started in the group. She was still living in a student hall of residence, but was starting to feel like “the old one” as she said. One week I saw her full of energy, putting on nice clothes and make-up and seeing friends, while the next week she could have a setback and not even manage food and sleep, staying in, watching series. Edith told me about her difficulties getting a job during an interview in her home on the outskirts of Aarhus:

It’s an enigma to me, that it can be so difficult for me to get a foothold in the regular job market. In some ways I feel like society is making me even more ill. I can’t stand to be a stay-at-home wife. My husband has a brother who is physically disabled. It’s easier for him to get a job than me, even though I’ve made so much progress with my illness.

In our subsequent correspondence, mostly by e-mail, she reported in a desperate tone all the different things that the municipality required her to do when searching for a job. The process involved working without pay in a job training scheme for several months and then being offered the same job for less than the minimum wage, while attending several meetings with doctors and psychiatrists in one week. “I can continue working for free and without the paper work being in order. Sigh!! I am sad”, she ended one of her last messages to me. After some years of non-permanent housing, Edith now lived in the city with her husband, but she often felt that she did not fit in, especially in the summer when everything closed down, and that she could not afford to live in the city. For several others, staying in the city was difficult financially and sometimes emotionally.

Lola, a participant in her early twenties, told me about how her family was well educated, and she “had not even finished secondary school”. She was in her own words a “straight-A-student” until everything unravelled suddenly in her late teens and she began to show symptoms of mental illness. Since then she had been on a slow road of acceptance. Her everyday life consisted of weekly check-ups at the hospital, and going to classes and various hobbies, as well as seeing her friends from both before and after her illness started. It was hard getting out of bed in the morning, and falling asleep in the evening. She longed for the day she would no longer be on social support: “I am trying to tell myself that everything is possible, that there will be a place for me out there. But I am also aware that this might be something that I will never completely extinguish,” she said. In a later talk, when we returned to the subject, I suddenly blurted out in that she might finish school in some way or another. But she answered that this would never happen. Sometimes I found it more difficult than my interlocutors to accept the culs-de-sac in which they felt they had ended up – for instance when they told me they would probably not have children.

The situation of stuckness was connected to a sense of uncertainty as to what to do next: Yvonne, on sick leave due to anxiety attacks, asked me in an interview: “How do you know when you’re ready to move on and try to go back to an education again? What if you’re not, and it’s a complete failure, and you’re pushed even further back?”. Olga, who was still an outpatient but attended university, said something similar: “I can’t get on with my life. I’m still out here, tied to psych[iatry], can’t get free of it. I want to, but have to be careful not to fly too high too early”. Participants were careful not to push their boundaries back to a breaking point.

Mental illness is best conceptualized as an extraordinary condition that generates existential precariousness, Janis Jenkins has suggested. She compares it to situations of war, catastrophe and natural disasters, and writes that experiences of mental illness are better characterized as a struggle than as medical symptoms (2015: 249). Her ethnographic study in the US, of individuals with schizophrenia and schizoaffective disorders showed that their experiences are characterized by social stigma and working with controlling oneself. This involves negotiations and reflections on what is self, illness, and drugs and how agency is distributed between these three (Jenkins, 2015: 52). Schizophrenia can lead to new experiences of self, self understood as “not a discrete entity but […] a configuration of processes by which people orient themselves to their own being, to others, and to the surrounding world” (Jenkins, 2015: 24). In a Danish context, Grøn’s (2016) study of vulnerability among elderly, showed how it was also here a highly fuzzy term, denoting a fractured relationship between an individual and the surrounding society.

Similarly, in my fieldwork, mental vulnerability represents specific experiences of loss of control and agency, and recurring crises. This has informed and demanded negotiations of the way my interlocutors are in the world and relate to others and their surroundings; being more careful for themselves. In this situation, the reading group appeared as desirable to step into. Several participants had attended other reading clubs and they chose to join primarily out of an interest in literature. For example, this quote from Olga shows such interests:

I was on Facebook and saw that the advert had been shared […] it sounded interesting […] I read a bit about The Reading Society, what that was. And then I thought, that sounds nice, I like to read and I have some spare time this fall so I applied right away […] it appeals to me because I love to read, you know. I have this experience that when I read, I grow. I guess that’s what this is about. […] it’s a reading group for mentally vulnerables, right? Because I think that appeals to me too. I’ve had an illness for many years, that I’m leaving now.

Later, Olga told me she joined because she felt a need to do something different, to remember the dimensions or colors of life that literature represented to her - something in her life that did not have an outright rational purpose, but which gave her food for thought. Similarly, Frida said she applied, because she wished to read in a non-academic way, that sometimes it was nice just to “read something and feel something”. Lola said she missed something to immerse herself in, to ponder and reflect on things, without being result-oriented.

For Sandra, reading literature could not be replaced by flower arrangement for example, because it was not just a question of doing something. For her, literature had specific qualities, in its ability to take you places, to let you move in a direction when your own condition holds you in a standstill, she said. Reading fiction let her live through emotions, and move away from being self-occupied, she told me. Generally, the group was seen as a community of interest, without demands of rational purposes, while attending it formed a brick in the everyday lives, group members were rebuilding for themselves.

The body and the reading group: Natural amalgams

This article has been a (political) performance, an overt contextualization of a reading group in Denmark, with a view to studying the seemingly natural connection between the problem of mental vulnerability and the solution of reading groups. These contextualizing moves have also illustrated Dilley’s observation that contextualization is never-ending. By connecting a reading group to mental vulnerability, I have connected mental vulnerability primarily to notions of the body, but also to diagnostic categories, to the idea of culture on prescription, and to a discussion of context. I have made not one, but many connections – and abstained from others. This analysis revealed certain insights with regard to agency and subjectivity and a range of empirical tensions.

Following Crossley’s approach to the body (1996) I looked at the mentally vulnerable body as both lived and suspended in historical structures. While Merleau-Ponty emphasizes the body-subject as something which creatively reacts and conducts itself in a specific present, Foucault’s focus is on the body as a product of history and how measures to control bodies are made. But in the writings of both, “the body is both active and acted upon: a locus of action and a target for power” (Crossley, 1996: 104). For Foucault, space is where political control and power can be exerted over the individual and where resistance can be made. Body-power is this political use of space – but as Crossley makes clear, you cannot exert power over an individual that does not have some bodily mastery of herself. Thus, the body is at once mastered and self-aware, and the self-awareness is mediated by its engagement in a cultural world. It is in these tensions between lived and inscribed body, its way of positioning and being positioned, that subjectivity is formed (Crossley, 1996: 114). The functionality of space, embodied human action, and power are all constituted in one single moment (Crossley, 1996: 107), though performing a contextualization can separate the moment into different parts.

The reading group can be seen as a specific space that brings together broader notions and expectations of mental vulnerability, but also where embodied action unfolds creatively, new ways of relating to oneself and others can be consolidated, and resisting moves can be made. It was in the bodies of my interlocutors that mental vulnerability appeared, for example as apathy or pain. It was the bodies who reacted to too stressful circumstances with palpitating hearts or an overwhelming need to sleep. It was also through bodily actions my interlocutors sought to gain a sense of control; often through moving the body to other more desirable spaces or arranging work or educational spaces to be more tolerable. With articulations of wishes to gain space for emotions and the interest in reading because of its possibility for readers to ‘live through emotions’ in the reading group, the reading groups provided hope for a more emotionally fertile space where your way of experiencing yourself and others could be less painful. A space where they might regain some agency and the perforated boundaries between body and world might be restored.

My interlocutors were active agents when choosing to join a reading group. But the choice was dependent on the existence of a reading group that could be perceived as a desirable space to step into. The choice appeared logical in a historical context involving specific ideas of literature, mental health and youth: Danish welfare institutions and NGOs are grappling for new solutions for the growing number of citizens with poor mental health. Here, cultural activities are increasingly seen as having health benefits. Youth is increasingly perceived as a period during which you either succeed and become a productive part of society, or fail, and mentally vulnerable young people are perceived as being at risk of failing.

I will end this conclusion with some empirical tensions and contradictions. In Denmark, mental vulnerability both indicates that we are all vulnerable to pressure or stress and designates certain people with mental disorders who need special psychiatric care. Reading group participants like the idea of reading with people who, like themselves, have experienced crises and mental distress, but at the same time, most of them are not completely comfortable about categorizing themselves as mentally vulnerable. Shared reading is offered to a group of people who are perceived as vulnerable, at risk, and in need of desirable futures and thus it could be said that the reading group is expected to provide the opposites: resilience, safety and goal orientation. However, the choice to join a reading group is primarily based on a wish for a sanctuary away from everyday demands of direction and the joy of reading literature, experienced as an opening up non-rational imaginative spaces. But inevitably, the reading group becomes part of an overall process of getting better and learning to cope with everyday demands. The Reading Society is very aware of this mechanism and its daily leader calls it “the unintended therapeutic effects”. The reading group is a space with a lot of expectations attached to it. Performing an overt contextualization has untangled relationships that might look contradictory and messy analytically. However, in the everyday life the reading group composes a natural amalgam of a myriad of intentions, bodies and ideas.

Footnotes

Acknowledgements

I would like to thank my informants for so generously and patiently sharing their experiences and perspectives with me. I would also like to thank Anne Line Dalsgaard, Karen Waltorp and Nicolai Ladegaard for helpful reviews of earlier drafts, and Adam Reed and all my colleagues in the project Shared Reading: A human scientific laboratory for literature and social intervention for fruitful analytical discussions. Lastly, I would thank the three anonymous reviewers for helping me nuance and sharpen the argument of the article. All errors are my own.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This article is based on research that was made possible by generous funding from the Velux Foundation's HUMpraxis program.

ORCID iD

Charlotte Ettrup Christiansen

Notes

Author Biography

Charlotte Ettrup Christiansen is a PhD candidate at the Department of Anthropology, Aarhus University, Denmark. She takes part in the interdisciplinary research project Shared Reading: A human scientific laboratory for literature and social intervention (2018-2021). Her PhD project investigates experiences and subjectivity formation among young people in Denmark (18–35 years) who participate in different aesthetic interventions.

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