Electronic Journal of Sociology (2003)

ISSN: 1198 3655

Foucauldian Gerontology: A Methodology for Understanding Aging

Jason L. Powell
University of Salford
Great Britain
j.l.powell@salford.ac.uk

Simon Biggs
Keele University
Great Britain
s.j.biggs@appsoc.keele.ac.uk

Abstract

There has been a rise in recent years of a theoretical current entitled “Foucauldian gerontology”. This broad theory has attempted to understand how aging is socially constructed by discourses used by professions and disciplines in order to control and regulate the experiences of older people and to legitimise powerful narratives afforded to age by such groups. Gerontology too as a discipline and praxis provides the space for the construction and dissemination of knowledge formation. To address this, the paper introduces some of the methodological tools from the scholarship of Michel Foucault. In particular, the paper locates concepts of archaeology, genealogy and technologies of self and highlights the importance and creative impact these have for social gerontology in the USA, UK and Australasia. The paper draws from examples from current gerontological research to illuminate the usefulness of such a Foucauldian approach for researching social gerontology.

Key Words: Aging; Research methods; Foucault; Genealogy; Archaeology; Technologies of Self

Introduction

There has been a rapid intensification in the social science literature that covers theoretical work under the aegis of Foucauldian. Michel Foucault’s concepts and ideas have become significantly influential in a variety of “disciplines”. For example, Foucault has had a “huge impression” on criminological studies and allowed the discipline to develop a new theoretical language. Foucault is yet to have the same “effect” on gerontology. Foucault subverted the most perplexing conventions of human universality and gerontology awaits such Foucauldian interrogation. Only a tiny handful of international gerontologists have used Foucault’s work to shatter “taken for granted” assumptions centred on aging. In USA, Katz (1996) looked at history of American gerontology via Foucault’s (1977) work; Frank (1998) has examined “care of the self” in his seminal work on narrativity and bio-ethics. In the UK, Tulle (1999) has looked at the notion of the body and relationship to Foucauldian theories of embodiment. Powell has applied the “Foucauldian gaze” to understanding the “ageing body” (2001) and governmentality and social policy (2001). The works of Powell and Biggs (2000) and Biggs and Powell (2000, 2001) have developed Foucauldian approaches relating to “medical power and social welfare” (Powell and Biggs, 2000), “care management and elder abuse” (Biggs and Powell, 2000) and genealogies of professional power and ageing (Biggs and Powell, 2001). In addition, Powell and Cook (2000, 2001) have developed perspectives on governmentality and “superaging” in China. Coupled with this, Wahidin and Powell (2001) have used Foucauldian narratives to examine “institutional abuse” in special hospitals with reference to discourses imprinted on offenders “ageing body” (Wahidin and Powell, 2001).

How has Foucault’s overall work influenced researching gerontology? In terms of a Foucauldian contribution to research methodology in Social Gerontology there has been some notable research on discourse analysis (Gubrium, 2000). Both Katz (1999) and McAdams (1994) have attempted to use personal stories or narratives from older people in order to make sense of issues such as “dementia” - deriving conversation and story-telling from older people themselves.

Fundamentally, the use of a “Foucauldian” approach in gerontology is a novel way of interpreting and problematizing knowledge systems - provides new questions, objects of enquiry and epistemological and ontological flexible dimensions of gerontological analysis. Whilst retaining a concern with the dynamics of power and knowledge, embedded within and (re)produced by social policy, a Foucauldian approach shifts attention away from a sole analysis of the state, the logic of capital or patterns of material inequality. Power remains a concept central to any Foucauldian understanding of the social processes and institutional practices but in novel and varying ways.

The effect of this has been to call into question – draw into a field of interrogation – the categories and assumptions standing at the heart of gerontology, understood here as both as disciplinary field of knowledge and practice which focuses on social policy and aging. In raising the question of “knowledge” as a socially constituted category through which “power” is manifested and deployed, a Foucauldian approach can destabilise the notion of a “universal” human subject who needs can be known through the application of bureaucratic procedures, i.e., the subject who is the target of social policy (Katz, 1996). This means that not only does the ontological status of the gerontological “subject” of becomes open to deconstructive scrutiny but also by epistemological discourses by which this subject is categorised and classified.

So, why use Foucault to investigate social aspects of aging?

It can be argued that it is through “historical investigation” that scholars can understand the present which takes aim at understanding Foucault’s potential use of method to understanding social formations relevant to adult aging. If we use “historical inquiry” we should “use it, to deform it, to make it groan and protest” (Foucault 1980, 54). Historical critique should be used to shatter taken for granted assumptions surrounding aging. The point of Foucault’s (1972; 1977) use of historical inquiry is to use history as a way of diagnosing the present and current social arrangements. In order to understand the use of history as making sense of the present this paper introduces and analyses three concepts which are fundamental to Foucauldian research: archaeology, genealogy and technologies of self. Foucault uses these methodological “tools” to disrupt history at the same time as giving history a power/knowledge re-configuration that makes his approach so distinctive and relevant to social gerontology and research methodology. Genealogy is a way of putting archaeology to practical effect, a way of linking it to current gerontological concerns. For example, genealogy looks at processes of action and the extent to which discontinuities/continuities exist in a given context (Powell and Biggs 2001; Biggs and Powell, 2000). To use a metaphor, several photographs of history can be traced by archaeology but then, the link and discontinuities between those photographs and the present is the work of the genealogist.

What is Gerontology: From Discourse to Process

Before we interrogate the relevance of Foucauldian stuides to gerontology, we problematize the discourse and praxis of gerontology itself. “Gerontology” is a broad discipline which encompasses psychological, biological and social analyses of aging (Longino and Powell, 2002). Since the beginning of the twentieth century, the “bio-medical” study of aging has dominated the disciplinary development of gerontology (Katz, 1996).

The bio-medical model perceives of aging as a pathological “problem” tied to discourses of “decline”, “dependency”, “decay”, “abnormality” and “deterioration” (Phillipson, 1998). Thus, the problem orientation to aging is historically configured in “bio-medical sciences” and discourses which specialise in one terminology of gerontology (Biggs and Powell, 2001).

Recently however, there has been an ambivalent positioning of bio-medical discourses of aging. On one hand, bio-medical gerontology has attempted to legitimise its existence by playing “games of truth” (Foucault, 1980), claiming aging is a “universal” problem but, on other hand, aging could be “cured” by bio-medical intervention1 for potential “ageing consumers” (Biggs and Powell, 2001).

Bio-medical science then has both come to colonise notions of aging and reinforce “problem” discourses which have come to stand for the process of aging itself, and medicine its potential, yet exclusive, “saviour” (Biggs and Powell, 2001; Powell, 2002). As Biggs and Powell (2001, 95) point out:

“It appears … that established and emerging “master narratives” of biological decline on the one hand and consumer agelessness on the other co-exist, talking to different populations and promoting contradictory, yet interrelated narratives to age. They are contradictory in their relation to notions of autonomy, independence, and dependency on others, yet linked through the importance of techniques for maintenance … via medicalized bodily control. However, this focus on medicalization … has tended to obscure another … discourse on aging … the association between old age and social welfare.”

There is then a second definition of gerontology. Gerontology is also the study of social welfare and social policy focused on aging (Biggs, 1999). Social policy for older people in “neo-liberal” capitalist societies is complex and multifaceted. Neo-liberalism considers that a welfare society must reflect only the interplay of social and political structures forged out of self-responsibility and consumerism (Powell, 2001). Older people derive their “care”, individually and collectively, from a range of social policies, institutions and sites, so that the organisation of care involves markets, families, and state and care institutions. Responsibility for the organisation of “care based” social policy has historically been the “social work” profession or the contemporary “care management” institution (Powell, 2001).

Medical discourses and neo-liberal norms of the positioning of older people, are not only about the “therapeutic” nature of “health and care” duality which draws from medical sciences, but also, if not more, those of “management enforcers” (Biggs, 1999) of competition, quality, inspection, and customer demand.

These definitions of gerontology have significant implications for how “aging” is understood both as a discipline of study, and as a social process: as a discipline in interrogating how knowledge in the modern era has been organised and legitimated; as a social process in terms of complex interactions between recent social policy, care institutions and older people. In combination, these definitions refer to the discourses, perceptions, sites and practices that are conditions of possibility for the emergence of gerontological knowledge. By engaging with these possibilities for knowledge construction requires a methodological means and gerontological definitional examples drawn from medical power and care management and their rerlationship to the positioning of older people. The methodological masking of social aspects of aging can be drawn from Foucault’s influential concepts of archaeology, genealogy and technologies of self.

Archaeology and Aging

In The Archaelogy of Knowledge Foucault (1972) discusses “archaeology” as the analysis of a statement as it occurs in the historical archive. Foucault further points out that archaeology “describes discourses as practices specified in the element of the archive” (1972, 131), the archive is “the general system of the formation and transformation of statements” (1972, 130). The use of an archaeological method explores the networks of what is said and what can be seen in a set of social arrangements: in the conduct of an archaeology there is a visibility in “opening up” statements. For example, the work of Brooke-Ross (1986) can be shown to illustrate how private residential care as a form of visibility produces statements about old age while statements about aging produce forms of visibility which reinforce residential care. Such visibility and discursive configuration is consolidated by resource allocation. Peace et al. (1997) claim the numbers of residential care places in the UK stood at 536, 000 in the mid 1990s. They also claim that the cost of residential care stood at £8 billion per year - hence the consolidation of statements pertaining to aging reinforces institutions such as residential care and revenue they generate:

“They are run as businesses with the aim of maximising profits by reducing costs” (Nazarko, 1995, 57 cited in Hadley and Clough, 1995).”

In this context, statements and visibilities mutually condition each other – inter-dependent on each other. Furthermore, Powell & Biggs (2000) claim care management as a visible social practice produces statements about older age whilst statements about assessment in community care policy reinforces the power of the professional and decreases the power and voice of the client.

In gerontological research, archaeology can be used to attempt to chart the relationship between statements and the visible; describe “institutions” which acquire authority and provide limits within which discursive objects may exist. If we take these in turn we can illuminate its use to social gerontology. Firstly, the attempt to understand the relation between statements and visibility focuses on those set of statements that make up institutions such as residential care – instructions to care workers, statements about time-tabling of activities for older people and the structure and space of the care institution itself (Powell, 1998; Powell & Biggs, 2000). Knowledge is composed of statements and visibility. In the research example of residential care cited by Powell & Biggs (2000), we need to attend to both of what is said (theories of social work education and caring) and what is visible (building, corridors and singular rooms). The crucial point is that a Foucauldian approach can draw our attention to the dynamic inter-relationship between statements and institutions. Secondly, the attempt to describe “institutions” which acquire authority and provide limits within which discursive objects may act, focuses again on the care institution which delimits the range of activities of discursive objects (Powell & Biggs, 2000) – it is at this point that an exploration of the architectural features of the care institution would be used to understand spatial arrangements. In a similar context, Goffman (1968) wrote about how spatial arrangements of “total institutions” (prisons) operate to provide care and rehabilitation at an official level and capacity, underneath the surface, however, such institutions curtail the rights of its prisoners:

“Many total institutions, most of the time, seem to function merely as storage dumps for inmates ... but they usually present themselves to the public as rational organizations designed consciously, through and through, as effective machines for producing a few officially avowed and officially approved ends” (Goffman 1968, 73).

A Key difference between Goffman and Foucault’s interpretations of institutions would be, however, that whereas Goffman sees total institutions as an aberration, untypical of society as a whole, Foucault’s critique assumes that the carceral element of institutional life encapsulates a core feature of social life. In a similar way, the socio-historical solutions found to the “question of aging”; be they hide the unacceptable face of old age in workhouses and nursing homes, or celebrate active or productive ageing; reflect the ways that power and knowledge combine to shape the experience of adult aging and legitimate a particular and restricted definition of wider human experience.

Genealogy and Ageing

Foucault acquired the concept of “genealogy” from the writings of Nietzsche. Genealogy maintains elements of archaeology including the analysis of statements in the archive (Foucault 1977, 1980 and 1982). With genealogy Foucault (1977) added a concern with the analysis of power/knowledge which manifests itself in the “history of the present”. As Rose (1984) points out, genealogy concerns itself with disreputable origins and “unpalatable functions”. For example, Biggs and Powell’s (1999, 2001) genealogy of psycho-casework and care management points to the origins, functions and practices of social work as a scientific and managerial profession are from benevolent that official histories of professional practice make believe. As Foucault (1980, 109) found in his exploration of psychiatric power: “Couldn’t the interweaving effects of power and knowledge be grasped with greater certainty in the case of a science as “dubious” as psychiatry?”.

Genealogy also establishes itself from archaeology in it approach to discourse. Where archaeology provides gerontology with a snapshot, a slice through the discursive nexus, genealogy focuses on the processual aspects of the web of discourse – its ongoing character (Foucault, 1980). Foucault (1980) did attempt to make the difference between both methodological concepts explicit:

“If we were to characterise it in two terms, then “archaeology” would be the appropriate methodology of this analysis of local discursiveness, and “genealogy” would be the tactics whereby, on the basis of the descriptions of these local discursivities, the subjected knowledges which were thus released would be brought into play” (Foucault 1980, 85).

Foucault is claiming that archaeology is a systematic method of investigating official statements such as policy documents. Genealogy is a way of putting archaeology to practical effect, a way of linking it to current gerontological concerns. For example, genealogy disrupts narratives of “choice” – language which is embedded in community care policy in the UK (Powell and Biggs, 2000). Furthermore, as Biggs and Powell (2001) point out, a genealogical argument as relates professional power works to:

“ ... uncloaking these power relations [and] is characterised, by Foucault, to set out to examine the “political regime of the production of truth” (Davidson, 1986: 224). The effects of the reflexive relationship between power and knowledge that is implied here, would include the tendency for professional power to be reinforced by the sort of questions professionals ask and the data they collect. This knowledge then progresses a certain definition of a problem area which then feeds back to stabilise the original formulation of the “problem” itself. By the same token, different policy positions point professionals to seek out certain forms of knowledge which tend to reinforce the ideological position of that policy and its associated discourses. As part of this process, certain powerful voices increase their legitimacy, whilst other, often dissenting, voices become de-legitimised” (Biggs, & Powell, 2001, 97).

The genealogical gerontologist can illuminate that such statements of choice have a contingent origin by revealing professional practices which are detrimental to the policy statements. At the same time, the voices of professionals become louder and older people’s voices become more soft in the landscape of power/knowledge and the politics of social relations. To exemplify this, Clough (1988) completed a study of abuse at a residential care home in England. Many staff had neglected older residents including neglecting to bathe residents; punishing those residents leaving hot water running in bathrooms; opening windows for air; and staff removed blankets from residents leading to pneumonia and subsequently many deaths. Vousden (1987 cited in Hadley and Clough, 1995) claimed that professionals destroyed the positive identity of many older people in such a repressive residential regime:

“It is self evident that when elderly, often confused residents are made to eat their own faeces, are left unattended, are physically man-handled or are forced to pay money to care staff and even helped to die, there is something seriously wrong” (Vousden, 1987 quoted in Hadley and Clough, 1995, 55).

Hence, the power/knowledge twist of professional “carers” was detrimental to policy statements concerning “choice” and “quality of life” in residential care. Such care action was a powerful and repressive mechanism used to indent and strip the identities of residents. Biggs & Powell (2001) claim a Foucauldian approach highlights such professions retain a powerful position in UK care policy not only in terms of what they do but what they say:

“Foucault identified discourses as historically variable ways of specifying knowledge and truth. They function as sets of rules, and the exercise of these rules and discourses in programmes which specify what is or is not the case - what constitutes “old age”, for example. Those who are labelled “old” are in the grip of power. This power would include that operated by professionals through institutions and face to face interactions with their patients and clients. Power is constituted in discourses and it is in discourses such as those of “social work”, that power lies” (Biggs & Powell, 2001, 97).

The interplay between discourse and subjectivity highlights a problematic for older people in terms of their sense of self. The next section on “technologies of self” problematizes gerontological contributions to self-subjectification.

Technologies of Self: Going “Beyond Theory’?

What has not been delineated sufficiently is Foucault’s (1978) later work of “technologies of self”. Foucault contextualised the value of subjectivity as a pivotal mode of analysis. Subjectivity is a core idea which “goes beyond theory” (Dreyfus and Rabinow, 1983) and a delineation of its ramifications for sociological study in this paper is a useful way to “problematize” the explanatory value of a Foucauldian analysis based on “technologies of self”.

Foucault’s final works (1988) on “technologies of self” and sexuality focuses on individual self-subjectification practices which challenge dominant discursive representations of idiographic types. Here, Powell and Biggs (2002) develop this by pointing to interplay of “resistance” with domination in light of bio-ethics. Foucault himself never explicitly talks about “resistance” examples as practices in power relations, but technologies of self are ways of “subverting” disciplinary power (Powell and Biggs, 2002). Hence, Foucault notes that the subject of power has changed, as well as the ways in which power works. Foucault (1978) claims that self-subjectification entails technologies of the self:

“Techniques that permit individuals to affect, by their own means, a certain number of operations on their own bodies, their own souls, their own selves, modify themselves, and attain a certain state of perfection, happiness, purity, supernatural power” (Foucault, 1978, 74).”

Examples of how technologies are deployed in managing old age can be found in the work of Frank (1998) on stories of illness, Katz (2000) on active ageing and “busy bodies” and in Biggs” (2001) critique of contemporary social policy. In each case, macro social practices have become translated into particular ways of growing old that not only shape what it is to age successfully, but are also adopted by older adults, modified to fit their own life circumstances and then fed back into wider narratives of aging well.

For Frank (1998) the personal experience of illness is mediated by bio-medical procedures which shape and contribute to how the older patient recognises their own process of ill health and recover. For Katz (1999) the maxim of “activity for its own sake” as a means of managing later life not only reflects wider social values concerning work and non-work, it also provides personal means of control and acts as grounds for resistance. Biggs (2001) argues that change in policy interest has occurred from seeing old age as a burden to seeing it as an opportunity to promote productive ageing. This reflects an attempt to shape acceptable forms of ageing whilst encouraging older adults to self-monitor their own success at conforming to the new paradigm. A common thread throughout relies on the adoption of values and the availability of technologies that facilitate self-scrutiny and self-modification.

Conclusion

What makes Foucault’s overall methodological work compelling, is how he problematizes systems of knowledge and social processes as microphysical dimensions of the wider contest between modernity and construction of subjects. Three directions in particular warrant summation.

Firstly, gerontology as a “human science” is an archaeological domain where discourse, knowledge and subjectivity engender each other. The “apparatuses” used to disperse gerontological knowledge – discourses, theories, and policies, for example – can be seen as disciplinary techniques that constitute knowledge of subjects/objects.

Secondly, by downplaying the individual subject, Foucault’s genealogies show how “bodies” and “populations” are sites were “human beings are made subjects” by “power/knowledge” practices (Foucault,1977, 44). The “ageing body” and “elderly populations” have become a central foci of scientific knowledge, cultural images, political rationalities and institutional practices – have organised the positioning of later life.

Thirdly, there is an ontological reflexivity within Foucault’s later work whereby he insists on the reversibility of discourses by subjects through technologies of self and “resistance”. Older people are subjects of power who are also “agents” who could strategically mobilise disjunctures of structural discourses through “technologies of self” (Foucault, 1978; Biggs and Powell, 2001).

Indeed, by using such distinctive methodologies of archaeology and genealogy, and technologies of self, reveals relations of power and power relationships between professionals, institutions and subjects of study while demonstrating the relevance to uncovering discourses relating to construction of knowledge about the nature of individuality and control of such knowledge bases.

References

Allen, I (et. al.) (1992) Elderly People: Choice, Participation and Satisfaction, Policy Studies Institute, (PSI).

Armstrong, D (1983) Political Anatomy of the Body: Medical Knowledge in Britain in the Twentieth Century, Cambridge, Cambridge University Press.

Biggs, S. (1993). Understanding Ageing. Milton Keynes: OUP.

Biggs, S. (1999). The Mature Imagination. Milton Keynes: OUP.

Biggs, S & Powell, J (2000) “Surveillance and Elder Abuse: The Rationalities and Technologies of Community Care” in Journal of Contemporary Health, 4, 1, 43-49.

Biggs, S & Powell, J (2001) “A Foucauldian Analysis of Old Age and the Power of Social Welfare”, Journal of Aging & Social Policy, 12, 2, 93-112.

Biggs, S. (2001) “Toward critical narrativity: stories of aging in contemporary social policy”, Journal of Aging Studies 15, 1, 303-316.

Bloor, M and McIntosh, J (1990) “Surveillance and concealment”, in Cunningham Burley, S and McKegany, N (Eds.) Readings in Medical Sociology, London: Routledge

Brooke-Ross, R (1986) quoted in Langan, M and Lee, P (Eds.) (1988) Radical Social Work Today, London: Unwin Hyman.

Clough, R (1988) Practice, Politics and Power in Social Service Departments, Aldershot: Gower

Hadley, R and Clough, R (1996) Care in Chaos, London: Cassel

Davidson, A. (1986). “Archaeology, Genealogy, Ethics” in Hoy, D (Ed.). Foucault: a critical reader. Oxford: Basil Blackwell.

Foucault, M (1965) Madness and Civilization, London: Tavistock.

Foucault, M (1973) The Birth of the Clinic, London: Routledge.

Foucault, M (1977) Discipline and Punish, London: Penguin.

Foucault, M (1978) The History of Sexuality, Vol.1, London: Penguin.

Foucault, M (1980) “The subject of Power” in Dreyfus, H and Rabinow, P (Eds.) Michel Foucault: beyond structuralism and hermeneutics, Brighton: Harvester.

Frank, A.W. (1998). “Stories of illness as care of the self: a foucauldian dialogue”, Health, 2, 3, 329-348

Gilleard, C. and Higgs, P. (2000) Cultuires of Ageing, London: Prentice Hall

Goffman, E (1968) Total Institutions

Gubrium, J.F. (1992). Out of Control: Family Therapy and Domestic Disorder, Thousand Oaks, CA: Sage.

Katz, S (1996) Disciplining Old Age: The formation of gerontological knowledge, Charlottesville: University of Virginia.

Katz, S. (2000). “Busy Bodies: Activity, Aging and the Management of Everyday Life”, Journal of Aging Studies, Vol. 14, Number 2, 135-152.

Longino, C.F. and Powell, J.L. (2002). “Embodiment and the study of Aging” chapter in Berdayes, V (Ed.) The Body in Human Inquiry: Interdisciplinary Explorations of Embodiment, New York: Routledge.

May, C (1992) “Individualised care? Power and subjectivity in therapeutic relations”, Sociology, 26, 589-602.

McAdams, D. (1994). The Stories We Live By, New York: Morrow.

Nettleton, S (1992) Power, Pain and Dentistry, Buckingham: OUP.

Nettleton, S (1995) “From the hospital to community care: Foucauldian analyses”, in Heyman, B (Ed.) Researching User Perspectives in Health Care, London: Chapman and Hall

Porter, S (1996) “Contra-Foucault: soldiers, nurses and power”, Sociology, 30 (1), 59-79.

Powell, J (1998) “The Us and The “Them’: Connecting Foucauldian and Political Economy insights into ageing bodies” paper presented to the British Sociological Association Annual Conference, University of Edinburgh.

Powell, J.L and Biggs, S (2000) “Managing Old Age: The Disciplinary Web of Power, Surveillance and Normalization”, Journal of Aging & Identity, 5 (1), 3-13

Powell, J.L. and Cook, I. (2000). ““A Tiger behind and coming up fast”: Governmentality and the politics of population control in China’, Journal of Aging & Identity, 5, 2, pp.79-90.

Powell, J.L. and Cook, I. (2001). “Understanding Foucauldian Philosophy: The case of the Chinese State and the Surveillance of Older People”, International Journal of Language, Society and Culture, 8, 1, pp.1-9.

Powell, J.L (2001) “Theorizing Gerontology: The Case of Old Age, Professional Power and Social Policy in the United Kingdom”, Journal of Aging & Identity, 6, 3, 117-135

Powell, J.L and Cook, I. (2001) “Understanding Foucauldian Philosophy: The case of the Chinese State and the Surveillance of Older People”, International Journal of Language, Society and Culture, 8, 1, 1-9

Powell, J.L (2001) “The Loss of Aging Identity: Social theory, old age and the power of special hospitals”, Journal of Aging & Identity, 6, (1), 31-49. ISSN 1087 – 3732 (with A. Wahidin)

Endnotes

1. Such intervention could include swapping organs from one body to the next; plastic surgery; hip replacements; cyborgic facilitation of bodily parts and functions (cf. Powell, 2001b).