Original in French, in Revue internationale du Travail 164 (3). Translation by the ILR Editorial team. This book review is also available in Spanish, in Revista Internacional del Trabajo 144 (3).
Work is often associated with a decline in health, both physical and mental. However, the starting point for this book, considering the case of France, is the statistical finding that the decline in health among the unemployed is much worse. Indeed, the mortality rate in this group is 60 per cent higher than that for the employed, the risk of suicide is three times higher, and there is a higher incidence of cancers and heart attacks. The outlook for mental health is just as bleak.
The originality of this book, edited by Dominique Lhuillier, Dominique Gelpe and Anne-Marie Waser, lies in this triangulation of work, health and unemployment, based on the testimonies of people in unemployment. Indeed, drawing on the individual and collective life stories of around 100 survey participants, work appears in a different light when seen from this perspective. This approach to unemployment paradoxically brings this book under the publishers’ “Clinique du travail” collection, wherein work is analysed as a form of empowerment, whose expression and development is intrinsically related to people’s health.
The health benefits of work through the lens of unemployment
A structure for individuals’ social lives
From the perspective of unemployment, work is not just a source of constraints derived from the employee’s subordination to the employer but it also creates a “binding contract” (p. 57): an individual’s agreement to organize their life according to a specific management of time. This organization of time is reinforced by an organization of space, in that it expands individuals’ social lives beyond their immediate sphere of family and neighbours. This dimension can be particularly relevant to women, for whom work can be an “instrument of emancipation” (p. 108) in terms of resources, and a way out of the family sphere under a husband’s domination.
This notion is reflected in the identification of a “sex of unemployment” (Chapter 3), characterized, in the case of women, by an attachment to work and the perception of withdrawal into family life as a violent form of deprivation. The pressure of male domination is often at the heart of this withdrawal from work, sometimes going so far as preventing women from seeking employment (as in the case of Nabila, pp. 109–110), when work is seen as a means of emancipation.
The expression of an individual’s capacities and a source validation in the eyes of others
The book finds parallels between unemployment and the experience of employees who have been put on the shelf – often experienced as a deprivation of employment (p. 71). The case of Diego (pp. 72–73) is illuminating in this respect: he experienced a particularly difficult situation when he was sidelined upon his return to work after medical leave due to depression. This further eroded his confidence and aggravated the symptoms of his depression. He thus experienced a “constraint on activity” (p. 74) at work that weighed on all aspects of his life, similar to the experience of an unemployed person.
Paradoxically, while work is presented as a form of submission to the employer’s authority, being sidelined at work and unemployment appear as forms of “imprisonment” (p. 73) in inactivity. The person is no longer exposed to the real world – “with its limitations, but also possibilities” (p. 74). Unemployment takes on this dimension of incarceration by creating processes that reinforce people’s feelings of low self-worth and self-confidence. In French public employment services, for instance, personal contact with agents is being replaced by remote interaction via telephone or online services, with meetings serving no other purpose than to monitor the unemployed person.
From occupational health conditions to self-care work, via unemployment
Contradictions between work and health
Whereas many of the jobless see work as the exercise of an agency that is denied to them, it is also a source of illness that can result in unemployment. Work is thus presented as both a remedy, through the return to work of the unemployed, and a cause of illness (p. 203). Based on mainstream evidence, this book first considers work as a cause of illness, presenting a series of widely varying accounts about well-being at work, before tracing three types of trajectories that lead from work to illness and then to unemployment.
The first trajectory type begins with a stable job and a promising career trajectory, which encourages overinvestment in work to the detriment of self-care. Chapter 1 describes how health can deteriorate owing to physical and psychological exhaustion (burnout) or by ignoring signs of serious illness. This can lead to dismissal when these conditions become apparent, thus becoming the cause of job loss and unemployment.
The second trajectory type refers to cases where workers are worn down by the precarity of a series of short-term jobs in which they overinvest in the hope of securing stable employment. Having been constantly postponed until an uncertain future, permanent employment becomes unattainable when ill health interrupts the precarious worker’s trajectory. The worker could thus be said to have been trapped in precarity, before being trapped in unemployment.
Lastly, the third trajectory type concerns barriers to accessing unemployment in the first place, where the individual is trapped in a grey area between unemployment and inactivity. This is the case of those not in employment, education or training (“NEET”), who account for close to 13 per cent of youth aged 15 to 25 in France. Health problems are present throughout this trajectory, in the shape of addictions to anything from psychoactive substances to video games.
Finding a healthier balance through unemployment based on the right to free time, self-care and personal reflection
In the case of health conditions that develop under the shadow of work, unemployment can provide individuals with an initial insight into the state of their health, through the diagnosis and treatment of somatic and psychological illness and stress triggered by work. This requires a certain commitment to unemployment, which allows the individual to find their bearings and organize their time to fit their own needs, as Chapter 2 discusses. In the case of unemployed persons who have exited the first trajectory type, work has been a black hole absorbing almost all aspects of their existence. As individuals gradually accept unemployment, they can refocus on essential aspects of their life (such as family and children), which they may have neglected. It may lead them to set new expectations for a future job, in terms of sector (possibly bringing them into contact with others) or duration (considering part-time and different work arrangements). Recovery can thus take place through the capacity to redefine one’s situation and expectations of work.
This approach reflects the care work analysed in Chapter 6, focusing on self-care as part of work itself – an aspect that conventional medicine tends to dismiss when treating patients – or at least considering unemployment as the opportunity to turn one’s attention back on oneself. When faced with illnesses such as cancer or depression, this exercise becomes one of self-reconstruction and reorganizing one’s environment.
In this process, the very circumstances of the dismissal can introduce complications that may not be so easy to overcome. Trauma related to the termination of a contract that has severely shaken the individual’s confidence can make it difficult for them to countenance returning to work. This kind of trauma is also difficult to treat, since the experience of work that led to unemployment ended with a problem which, through the very loss of employment, can no longer be resolved. The unemployed are, as it were, haunted by the more or less insidious forms of violence that they experienced at work, ranging from harassment or exclusion to the brutality of dismissal.
The importance of support during unemployment and the return to work
Accepting unemployment without shame and upholding one’s rights – including to support – is made all the more difficult by any trauma caused by the dismissal itself and may require the unemployed person to rise above victim status. This all requires support. The seventh and last chapter examines the different dimensions of this support, beginning with the observation that unemployment procedures have become dematerialized and subject to abstract monitoring mechanisms. Those providing support should encourage the unemployed person to talk, think and put things in perspective, all while engaging in rehabilitation, training and other steps to enable them to return to work.
After the first chapter analysed the links between work, unemployment and health, as reflected in a collection of life stories, this last chapter highlights the book’s main message. Its conclusion is based on a review of employment policies that we owe to Carole Tuchszirer. She draws attention to the contribution of experimentation through the French project “Territoires zéro chômeur de longue durée”, which is less concerned with productivity than with support for individuals excluded from the working population. Its peer support programme (itself supported by labour force integration experts) proves to be very effective, generating mutual understanding among workers to provide a form of collective coordination.
In concluding this review, it is worth highlighting the book’s contributions, despite the overly bleak picture that it paints of the current world of work on account of the intensification of work and trajectories that funnel individuals away from stable employment. The very term “precariat”, coined by the essayist Guy Standing as a modern analogy of the Marxist “proletariat”, creates more confusion than clarity by amalgamating unstable, informal, part-time and poorly paid work, as well as all “indecent” forms of work. Data from the French labour force survey highlight the prevalence of stable employment (accounting for 65 to 70 per cent of the working population since 1960). Nevertheless, the book makes a strong case for a support approach, presenting the triangular relationship between work, unemployment and health as a life trajectory through which access to stable employment remains possible and likely for the majority of the labour force. However, this relatively common trajectory generates expectation among workers and highlights the extent to which “trial by assessment”1 during unemployment can be particularly cruel for those who have lost a stable job achieved at great cost, often requiring them to abandon a vocation.
Claude Didry
Sociologist, Research Director at the French National Centre for Scientific Research (CNRS),
Centre Maurice Halbwachs/École Normale Supérieur
Notes
- François Eymard-Duvernay, ed., Épreuves d’évaluation et chômage (Toulouse: Octarès, 2012). ⮭