Power-Mappingði. Background and Basic Methodology: Correspondence To: D. Smail
Power-Mappingði. Background and Basic Methodology: Correspondence To: D. Smail
7, 257±267 (1997)
ABSTRACT
Clinical and community psychology have yet to work out the full implications of taking
seriously the structuring by power of the individual's social environment. Even the factor of
social class has received little more than superficial attention. Some suggestions are offered as
to why this might be so, and a theoretical framework for understanding psychological distress
strictly as the result of the operation of social power is developed. A simple technique of
`mapping' power is outlined as a means for furthering such an understanding. # 1997 by John
Wiley & Sons, Ltd.
Key words: power-mapping; psychological distress; social class; social environment; social
power
INTRODUCTION
It has been argued in previous work (Smail, 1990, 1991) that an essentially
materialist understanding of the workings of power is central to an adequate account
of psychological distress, and a detailed attempt to develop the theoretical
foundations of such an understanding has been constructed (Smail, 1993a). While
we shall not be rehearsing those arguments in full in this paper, we feel that some re-
statement and elaboration of them is a necessary precursor to our central aim, which
is to suggest ways in which the somewhat abstract concept of `power' may be treated
as a concrete factor in the development of individual distress. Power, we argue, is as
much the fundamental key to `mental health' problems as it is to the workings of
society as a whole, and as a way of getting to grips with its operation in the
individual case we have developed a method of `mapping' power to be presented
below.
Insofar as there has been a `regnant paradigm' in clinical and therapeutic
psychology, it has depended in one form or another on the idea that mental contents
can be rearranged in such a way as to release (presumably through the operation of
`will-power') the individual's ability to take charge of his/her own conduct. Whether
through insight gained in dynamic psychotherapy or attitude changes brought about
by cognitive analysis, it is assumed that people will be able, through therapy, to
release powers from within themselves to make a difference to their circumstances.
Even the more environmentalist behavioural approaches pay only the most cursory
attention to the actual operation of social power beyond the individual's most
immediate, `proximal' world.
Community psychology is perhaps the only approach to take the matter of
social power seriously (see, e.g., Williams and Lindley, 1996; Davey, 1996), but
even in this field the material nature of power is too often substituted by a
notion of `empowerment' as a psychological characteristic which can somehow
be released within anyone by appropriate stimulation (see Smail, 1994).
However this may be, community psychology is itself treated as marginal
within clinical psychology as a whole, which continues both in its literature and
its training programmes to disregard the issue of power almost entirely. Why
should this be so?
There is no doubt that the view that emotional distress is brought about both by
the operation on the individual of damaging social forces and by the individual's lack
of the appropriate powers and resources to affect his/her predicament has political
implications which may make psychologists uncomfortable. Quite apart from the
general cultural belief that `politics and religion' are contentious matters to be kept
out of civilized discourse, there are real dangers in becoming involved in political
questions for professional workers whose livelihood may depend on their not
challenging the ideology of their paymasters.
As a corollary of this, clinical psychologists, a small and vulnerable group within
the NHS in the UK at least, have had to protect their professional security by
borrowing theoretical and conceptual tools from neighbouring disciplines
commanding either powerful social standing or respected `cultural capital'
(Bourdieu, 1984). In this way, both the received view of `dysfunction' in
psychiatry and the philosophy of personal responsibility in dynamic and
humanistic therapeutic approaches are to be found within clinical psychology, not
because they are true but because they are useful (see Smail, 1993b, 1995).
A further impediment to taking power seriously in the clinical field may be a sense
that the material nature of the kinds of powers and resources which we consider
central to the causes of distress are somehow not legitimate objects of psychological
concern. Such a worry would certainly conform with the `postmodern' Zeitgeist, but
in fact psychology has a long and honourable association with the view that states of
mindÐif indeed such are considered to existÐare dependent on environmental
factors which cannot simply be imagined away. This is an aspect of the behaviourist
legacy which we would be wise not to abandon, however much we might object to
the crude objectivism and the simplistic view of conditioned learning with which it is
associated.
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Power-mapping I: basic methodology 259
The closest mainstream research in mental health has come to taking seriously the
question of power is perhaps in investigating the effects of social class. Lower class
membership is found to be related to higher incidence in a whole range of disorders
(Whitehead, 1987; Jarman et al., 1992; Goldberg and Huxley, 1992). The two
competing hypotheses which have been discussed to account for these phenomena
are social drift (the less competent end up in the lowest strata) and trauma-based
explanations (those subject to chronic life stress due to low class membership develop
mental health problems in response). Despite evidence supporting the latter
hypothesis (see, e.g., Bruce, Takeuchi and Leaf, 1991, in the USA; Gunnell et al.,
1995, in the UK), and the recommendation of Attkisson et al. (1992) that, in relation
to schizophrenia, attention be given to `the potential etiological significance of the
life conditions of poverty', the latter then go on to focus on biological factors which
could account for the link, such as poor maternal care, head trauma from child
abuse, and exposure to environmental toxins. Chronic life stress in the form of poor
economic conditions is not so clearly spelt out. Few writers in psychology have
anything to say about the experience of being born into poverty and finding oneself
in a world in which all of forms of power enabling the development of a sense of
dignity are strictly limited or denied.
In relation to severe depression, the evidence of an important link with
unemployment mounts, while arguments about causation continue, reluctantly
concluding that job loss does adversely affect mental health even when psychological
status prior to unemployment is considered (see Dew, Penkower and Bromet, 1991).
To see how and why this is the case requires a more direct focus on power and the
way in which depriving someone of their livelihood may remove at a stroke their
access to many other important sources of power.
Morbidity patterns reveal that mental health services deal with a majority of lower
social class members and a disproportionate number of people from ethnic minority
groups, yet little if any explicit attention is given to the exact nature of their socio-
economic difficulties. In the case of social injustice and the maintenance of poverty,
the central issue of power and powerlessness leading to serious distress seems to
become lost in researchers' preoccupation with complex arrays of interrelated
variables.
The `internalization' of deprivationÐwhat one might call the moralizing of power
and powerlessnessÐmeans that people hesitate long and painfully before
acknowledging what they (and others) see as their forfeiture of the right to be
respected, to be considered self-sufficient, `well' and coping. In a recent community
survey assessing mental health needs (Hagan and Green, 1994) it was clear that
people will wait until there is no alternative before admitting such social failure. The
data also showed that those scoring as most in distress (i.e. scoring as `cases' on the
General Health Questionnaire), were also those who had the most demands on them
and the least resources with which to cope. These were carers, women, the
unemployed, those unable to work, physically disabled, lower social class members
and those who were widowed, divorced or separated.
Sennett and Cobb (1993) show how people are encouraged to feel a sense of
personal responsibility for their social position. Many people are therefore forced to
live with a sense of shame for their relative failure. The facts of existence for many
#1997 by John Wiley & Sons, Ltd. J. Community Appl. Soc. Psychol., Vol. 7, 257±267 (1997)
260 T. Hagan and D. Smail
are constantly overlooked: men's power to stay in work, for example, is as much out
of their hands as ever, but they are still likely to blame themselves for perceived
failure.
The badges of inner ability people wear seem, in sum, unfairly awardedÐyet hard to
repudiate . . . [T]hat is the injury of class in day-to-day existence. The terrible thing
about class in our society is that it sets up a contest for dignity. All of the experience,
which has to do with the structure of class, had presented itself to them as a problem in
the structure of their own characters . . . and so there lay an unspoken distrust of
themselves below the surface, a feeling of doubt.
It is more than economic deprivation, it's about constantly looking up or down at each
other to see who is superior or inferior to us . . . the most devastating blows fall on
working-class people.
Perhaps the greatest difficulty for clinical and community psychologists who wish to
take account in their work of the operation of power is to find ways of doing so
which do not merely empty out into political posturing, or, more likely perhaps,
result in their becoming general-purpose community workers and benefits advisers,
trying to negotiate the bureaucratic environment of social power in which their
clients are entangled, but with little more effectiveness. It is particularly with this
problem in mind that we have developed the notion of `power-mapping'.
Further impetus has been given to the need to take explicit account of power in
clinical work by the renewed interest in appropriate measures of outcome in mental
health stimulated by purchasers' insistence on evidence of health gain. We need thus
to develop measures which do justice to the dependence of improved outcome on the
individual's ability to access power. The Radical Statistics Health Group (1991) are
not the only commentators to be concerned that those most able to benefit from
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Power-mapping I: basic methodology 261
service provision, i.e. those with most resources, will become preferentially targeted
for resource allocation and those least able to benefit abandoned.
The task confronting us in the broadly clinical field is, thus, to find ways of
conceptualizing and measuring power which will actually clarify the experience of
individual clients. Although the clinician may appreciate the importance to the
general welfare of the kinds of socio-economic and political observations with which
sociologists concern themselves, it is often hard to see how these can be translated
into personally relevant factors for the individuals at the receiving end of their
influence. It is our belief that an appreciation of the centrality of the operation of
social power to individual experience does more than offer an alternative perspective
on clients' difficulties: it actually helps to make sense of a wide range of clinically
relevant phenomena and unify them within a single coherent paradigm.
As schematized in Figure 1, individual distress is the outcome of a social process
whose originsÐwhether in time, space, or bothÐmay lie far beyond the individual's
ability to identify them. Clinicians are inevitably able to help clients with only the
most proximal of the influences upon them, and need therefore to bear in mind that
possibilities for change may be strictly limited by the influence of more powerful,
distal factors which neither client nor clinician can affect.
As already indicated, it is of course widely (though not universally) acknowledged
that the less powerful members of society are more susceptible than others to mental
health problems (Thornicroft, 1991). Children, members of disadvantaged socio-
economic groups, ethnic minorities and women are all, in varying proportions, likely
to be subjected to oppressive social forces creating individual distress. Although we
are focally concerned with the psychological consequences of this process, it is
important to bear in mind that the operation of these forces is not itself a matter of
psychology but of material power. One of the dangers of working proximally with
such groups is to be seduced into correspondingly proximal explanations of distress,
making reference, for example, to supposed internal psychological attributes of the
#1997 by John Wiley & Sons, Ltd. J. Community Appl. Soc. Psychol., Vol. 7, 257±267 (1997)
262 T. Hagan and D. Smail
Figure 2 sketches out the social terrain in which the play of powers and resources
takes place in the individual's proximal world; the representation of the four main
sources of powerÐhome and family, social, personal and material resourcesÐis
conceptual. Their division into four equal quadrants, and the division of those
quadrants into a number of equal sub-sections or segments, is not intended to
suggest an empirical equivalence of importance. The intention here is to outline the
terrain within which more precise estimates of power may be made.
J. Community Appl. Soc. Psychol., Vol. 7, 257±267 (1997) #1997 by John Wiley & Sons, Ltd.
Power-mapping I: basic methodology 263
provide a source of solidarity and support. Family support may thus be regarded as
an asset of which individuals may make use. There may also, of course, be liabilities
in this area which can significantly impair their ability to deal effectively with their
problems.
Social life
The ability to involve and influence others, to obtain solidarity with them in the
achievement of desired goals, is definitive of power (see, e.g., Lukes, 1986). As
private individuals, forms of association in which a degree of solidarity may be
established are for most of us limited to the contacts we make in informal social and
recreational activities. In some cases, of course, more formal associations may be
established which extend our personal power into more distal regions than would be
available to the individual aloneÐFreemasonry would be an obvious example.
Personal resources
Perhaps the most `proximal' resources of all are those which `come with' the
individual, either as biological acquisitions or as the result of interaction of biology
with social valuation. Clinical and therapeutic psychology tend to have a somewhat
ambivalent attitude towards embodied characteristics such as intelligence, race,
health and even physical attractiveness, not least because these areas have at times
been colonized by those with political axes to grind. None of these characteristics
could, of course, be viewed as assets or liabilities per se, but will always be related to
proximal social evaluation. However, in the last analysis the properties of their own
bodies may be all that the most disadvantaged members of society have to fall back
on, and failure to take account of this could lead to serious lacunae in psychological
understanding.
Factors such as confidence, understanding of the past and development of desire
(i.e. the extent to which people know and understand what they want) are again
characteristics which individuals embody as part of the history of their exposure to
social influence. Such characteristics are often seen as psychological attributes (e.g.
`attitudes') amenable to specific forms of therapy (e.g. cognitive), but in our view
they cannot be abstracted from the net of social power which shaped them and the
biological processes through which they become, so to speak, `wired in'.
Material resources
Traditional clinical and therapeutic psychology have paid least attention to what we
consider the most important aspect of people's ability to influence the factors which
bear down upon them to cause their distress: money and the benefits and comforts it
can buy. Although Schofield (1964) long ago pointed to the attraction to and for
psychotherapists of `YAVIS' (young, attractive, verbal, intelligent and successful)
clients, and while it has long been recognized that well-resourced, more educated and
middle-class clients are likely to be able better to `make use' of therapy than those
less privileged, the real significance of this has been neither fully assimilated nor
elaborated. It is not so much that these clients understand, appreciate or resonate
more harmoniously with the therapy offered them, but that they have available to
them powers and resources which make it possible for them to operate on their
proximal environment. To bring this into direct and unambiguous focus is, of
course, precisely our intention.
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264 T. Hagan and D. Smail
For the purpose of clarifying with individuals the extent of powers and resources
available to them, as well as the severity of pressures to which they may be subjected,
it may not be necessary to cover all those aspects considered in the above `terrain'.
What we are proposing is not an exhaustive or standardized measure of power, but
an heuristic tool by means of which people may clarify and up to a point objectify for
themselves the nature of their predicament and the extent of their possibilities of
influencing it. The drawing of power maps, although certainly possible as a
generalized research procedure, is likely in clinical use to vary from individual to
individual (see Hagan and Smail, 1997, for detailed examples of the clinical
application of power mapping). However, some suggestions as to possible factors
for consideration may be made here.
Each quadrant in Figure 3 contains three notional segments; these could obviously
vary in both content and number according to clinical or research needs. The
introduction of concentric rings converts each segment into a five-point scale, in
which the level of resource available to an individual could be represented by filling
in the appropriate area from the centre outwards. It would of course be possible
either to attempt to anchor each point in a scale according to an objective definition
or simply to leave them as an intuitive numerical judgement.
It may be important in clinical work to take account not only of the amount of
power available to individuals, but also of their having to deal with damaging
powers bearing down upon them from within their proximal worlds. If one regards
the possession of positive powers as `assets' and subjection to negative powers as
`liabilities', it is possible to represent the operation of the latter in any given segment
by filling in the appropriate area in red. In effect, this extends the scale linearly from
5 to 10 points. For example, a segment for `husband' in the upper right quadrant
could be shown black to the extent to which positive help, support and advice was
available, red where spousal demands, obstruction or abuse were more in evidence.
It may also be important to qualify the availability of power within a given
segment. In this respect the use of shading has proved useful for indicating the extent
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Power-mapping I: basic methodology 265
to which someone's access to powers which are in principle available may be limited
by factors which are not under their control. For example, financial resources might
be represented on a map as in Figure 4.
While in practice there is likely to be a degree of positive correlation between level
and availability of resources, the use of shading can thus represent the degree to
which access to power is qualified by the demands or restrictions of the proximal
social environment; even potentially wealthy individuals, for example, may be
subjected to oppressive parental restrictions on whether and how they can spend
their money.
The essential point to emphasize about power-mapping is that it is not a
psychometrics of the individual but a flexible method for representing important
aspects of his/her social environment, in terms both of the powers and resources
available to him/her (assets) and the extent to which he/she is subjected adversely to
the proximal powers of others (liabilities). In this important respect it can be
contrasted with other attempts to construct multidimensional mental health
measures (see Avon Mental Health Measure, 1996). Maps may be used to:
1. Guide the helper and client to map current circumstances.
2. Provide a visual summary of clients' current/past position.
3. Target areas for concerted action to increase power.
4. Monitor progress.
5. Measure outcomes in mental health interventions.
6. Compare client groups.
Mapping the proximal powers bearing down upon people and the resources
available to them focuses our attention on those aspects of their material situation
which (a) lie at the root of their difficulties, and (b) may offer them some possibility
of modifying their circumstances. Unlike mainstream psychotherapy, the central
#1997 by John Wiley & Sons, Ltd. J. Community Appl. Soc. Psychol., Vol. 7, 257±267 (1997)
266 T. Hagan and D. Smail
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