Society and psychic suffering: the dominant sociological discourse and Alain Ehrenberg’s sociology of mental health

Abstract

This article analyses the relationship between society and psychic suffering in the dominant sociological discourse and examines Alain Ehrenberg’s position within this debate. First, I trace the contemporary rise of mental health as a social issue and explore the question of the relationship between society and psychic suffering from the classical authors of sociology to more recent perspectives. I then examine Ehrenberg’s most recent sociological work in order to show how he seeks to dissociate himself from the dominant approach and from the idea that psychic suffering is caused by society, even as his sociology continues to be mobilised to substantiate precisely this argument. In this way, the article clarifies the author’s position within this specific field of study and indicates the theoretical, epistemological and political implications of the debate for sociology.

Society; Psychic suffering; Mental health; Sociology; Alain Ehrenberg

Resumo

O artigo analisa a relação entre sociedade e sofrimento psíquico no discurso sociológico dominante e a posição de Alain Ehrenberg no debate. Primeiro, mostramos a ascensão social do tema da saúde mental na atualidade e a questão da relação sociedade e sofrimento psíquico desde autores clássicos da sociologia até perspectivas contemporâneas. Depois, examinamos a produção sociológica mais recente de Ehrenberg, a fim de mostrar como o autor procura se dissociar da abordagem dominante e da ideia de que o sofrimento psíquico é causado pela sociedade, ao passo que sua sociologia continua sendo mobilizada para fundamentar tal argumento. Dessa forma, explicitamos a posição do autor no campo específico de estudo e indicamos as implicações teóricas, epistemológicas e políticas do debate para a sociologia.

Palavras-chave
Sociedade; Sofrimento psíquico; Saúde mental; Sociologia; Alain Ehrenberg

Introduction

The theme of mental health has emerged as an increasingly relevant issue in contemporary societies. Its importance extends across diverse fields of knowledge, ranging from the natural and health sciences to the human and social sciences. The question of the individual’s psychic life has been present in sociology since the discipline’s inception, as made clear by Durkheim’s seminal study of suicide. Interest in the theme within this field increased significantly over the course of the twentieth century and, in particular, during the first quarter of the twenty-first.

However, a significant portion of the sociological research on mental health issues tends to reduce the relationship between society and mental health to a causal explanation, attributing forms of psychic suffering to the society in which we live. This idea is also widespread in the media and in public debate on the topic. Yet, although hegemonic, the causal link between society and psychic suffering is not a matter of consensus within sociological studies of mental health. A notable case of dissent is the sociology of mental health developed by Alain Ehrenberg, whose work constitutes a major reference point in this area. Nevertheless, even though he seeks to distance himself from the dominant approach in sociological studies of mental health, the French sociologist is frequently mobilised to support the claim that the rising incidence of certain forms of psychic suffering is attributable to contemporary capitalist society.

In order to examine the problem in question, I begin by outlining the factors that have contributed to the rise of mental health as a social issue in contemporary societies, as well as the dominant sociological debate on the issue. I then analyse Ehrenberg’s most recent sociological work with the aim of showing how he seeks to dissociate himself from the normative approach in the field of the sociology of mental health. In the process, I aim to foreground dissenting positions that have received little attention within this specific field and whose implications are also theoretical, epistemological and political for sociology in general.

Society and psychological suffering: the rise of mental health as a contemporary social issue and the dominant sociological debate

The theme of mental health has acquired significant social relevance over the past fifty years. Here I consider some of the factors that have contributed to the growing social attention conferred to the issue in contemporary societies.

Since the 1970s and 80s, the existence of an epidemic of mental disorders has been publicly and officially proclaimed, a tendency that intensified noticeably in the 2000s (Angell, 2011; Caponi, 2010; Corbanezi, 2021; Ehrenberg, 1998; Horwitz and Wakefield, 2010; Whitaker, 2017). The paradigmatic transformation (Kuhn, 2001) within psychiatry marked by the publication of the third edition of the Diagnostic and statistical manual of mental disorders (DSM-III) in 1980 (APA, 1980) contributed to the increased attention given to the issue and to the rise in epidemiological data relating to mental disorders in the general population. Under the pretext of rendering the DSM atheoretical in terms of the aetiology of mental disorders and thereby establishing diagnostic reliability (albeit at the expense of diagnostic validity) for the medical and scientific community, a conception and practice of psychiatry were developed based on the description of symptoms without regard for their context, leading to a rise in the detection of mental disorders (Horwitz and Wakefield, 2010).

During the 1980s and 1990s, global transformations related to the implementation and development of processes of neoliberalisation in Western countries resulted in the emergence and re-signification of forms of psychic suffering, giving rise to the so-called pathologies of ideals (depressive, anxiety, compulsive and eating disorders). Unlike modern mental illness, whose “discovery” conferred psychiatry the status of a scientific medicine (Foucault, 2003), contemporary forms of suffering are generally understood as frustrated attempts to realise the social values and ideals of contemporary society – individualism, autonomy, responsibility, initiative, action, performance, communication and adaptability.

Another factor contributing to the contemporary prominence of the issue was the transformation that occurred during the second half of the twentieth century in which psychiatry and the idea of mental illness gave way to mental health, understood simultaneously as both a concept and a multidisciplinary field of activity. The notion of mental health, now widely used in our everyday language, emerged as the effect of a series of factors, including the institutionalisation of human rights, the deinstitutionalisation of mental illness, the critique of traditional psychiatry, and the emergence and development of psychopharmacology (Corbanezi, 2021). In this process, both terminology and practice were transformed: whereas psychiatry dealt specifically with mental illness, the field and concept of mental health encompass both pathology and well-being, in their various degrees. This transformation was consolidated above all in the 2000s. The publication the WHO World health report 2001: Mental health: New understanding, new hope constitutes an important indicator of the global dissemination of the notion of mental health. In Brazil, under the influence of the WHO report, we can also cite the passing that same year of Law 10.216, also known as the Psychiatric Reform Law (Brazil, 2001), which set out key guidelines for mental health policy, including deinstitutionalisation, community-based care, the strengthening of primary care and the reduction of stigma towards people with mental disorders. If psychiatry can be understood as a “local idiom”, insofar as its specialism lies in knowledge of diseases, mental health has become a “global idiom”, encompassing both pathology and well-being and simultaneously enabling a connection to be made between individual problems and social relationships (Ehrenberg, 2012, p. 425). In this way, mental health has become a common language not only within specialised domains of knowledge, but also in public debate and wider society.

The covid-19 pandemic, which was declared in March 2020, rendered the issue even more socially salient due to the forms of psychic suffering associated with isolation, bereavement, economic crisis, viral contagion and its biological and social consequences. In the midst of the pandemic, global and symbolic events – such as the athlete Simone Biles’s decision to withdraw from competition at the Tokyo Olympic Games in 2021 on the grounds of her mental health – also helped bring the issue into sharper public focus (Corbanezi, 2023). In December 2024, the national press widely reported the results of a survey in which the term “anxiety” was elected the “word of the year” in Brazil, thus reflecting the spirit of the times¹. The French government, for its part, designated “mental health” as the grande cause nationale for 2025².

Sociological attention to the issue has been no different: present since the foundation of the discipline, focus on the topic has increased significantly in the recent period. First, I consider how sociology has developed an interest in the psychological condition of individuals in society since its emergence as a science in the modern world. Especially notable in this respect is Durkheim’s (2000) study of suicide, published in 1897, in which he shows how the balance of social integration influences an individual’s psychological quality of life³. Although the language of mental health did not yet exist in the context of Durkheimian sociology, his study of suicide can be said to indirectly anticipate what characterises part of today’s sociological debate on mental health, according to which levels of mental health are defined by the quality of a person’s socialisation and social ties. This conception is not exclusive to sociological debate: in the absence of definitive biological or laboratory data concerning mental disorders, the psychiatric and clinical definition of mental disorders rests on the individual’s capacity to function in society and on the kinds of impairments and suffering associated with the condition (APA, 2013). It is not unreasonable to note how this medical conception approximates Durkheim’s functionalist sociological idea that each individual, like institutions themselves, is a functionary of society (Durkheim, 2000, p. 259; 2010, p. 36). In a founding gesture of sociology, by addressing suicide as a social fact, Durkheim argued that a phenomenon associated with the subjective and psychological condition of individuals could and should be explained sociologically. Through his causal explanation of suicide on the basis of social cohesion, Durkheim’s pioneering approach sought to demonstrate both the viability and the necessity of sociology as a science.

In different ways, the topic of mental life also appears in other classical authors of the discipline, such as Marx’s reflections on suicide (1846) and in Simmel’s analysis of social life in the metropolis and its relation to individual psychological life (1903). In these studies too, what stands out is the emphasis on the social determination of individual psychic suffering. In the annotated translation that Marx (2006) produced of the memoir of Jacques Peuchet – a police archivist at the Paris Prefecture who recounted cases of suicide under his supervision – suicide appears as the tragic individual outcome of diverse forms of oppression in modern capitalist society, including gender oppression within the bourgeois family⁴. In both Durkheim (2000) and Marx (2006), suicide constitutes a social symptom whose cause is traced to society itself: in the former case, an imbalance in social integration; in the latter, various forms of oppression.

Without abandoning the notion of social causality, Simmel’s celebrated lecture (2005) on mental life in the metropolis contends that social life in large cities provokes an “intensification of nervous life” (Simmel, 2005, pp. 577-8), since the excess of stimuli tends to lead to the exhaustion of an individual’s energy – hence the emergence of the “blasé attitude” as a mechanism of individual self-defence. In Simmel’s reasoning, the individual enjoys a degree of freedom in large urban centres that does not necessarily translate into well-being in emotional life.

As we can see, despite their irreducible differences, the analyses of Durkheim, Marx and Simmel converge on the idea that the cause of individual psychological problems lies in society. Marcel Mauss ([1921] 1969) also examined the relationship between society and emotions, drawing on material from Aboriginal peoples of Australia. However, his analysis differs subtly from the idea that society causes a specific emotion. For Mauss, the expression of feelings constitutes a language consonant with social values, rules and context: it is a language at once obligatory and voluntary, socially expected and spontaneous. Rather than suggesting that society causes a particular emotion, he shows that society expects and even compels the manifestation of certain emotions in response to specific events, which, in the cases he analyses, are oral and affective expressions of mourning in funeral rituals. As we shall see, this conception is fundamental to Alain Ehrenberg’s sociology of mental health.

More than half a century after the institutional foundation of sociology, the American sociologist C. Wright Mills (1969), in his likewise classic The sociological imagination [1959], foregrounded the basic sociological idea that when a personal disturbance affects a significant proportion of individuals within a given society, it is not merely an individual problem. Setting out from this premise, Mills was already, in the 1950s, criticising the psychiatric and psychoanalytic reduction of mental pathologies to individual problems, attributing to sociology the task of examining them as social issues.

It is not my intention to survey the entirety of sociological production related to this theme. What I wish to emphasise is that, directly or indirectly, the relationship between society and mental health has always been present in sociological debate, albeit with varying terminologies. More than establishing a relationship, a substantial portion of sociological thought on the subject highlights a causal correlation between society and psychic suffering⁵. This kind of approach is also found in the fields of social, clinical and philosophical studies on the topic, becoming consolidated during the second half of the twentieth century, particularly in studies of a critical orientation. In the 1950s and 60s, for example, Frantz Fanon (2020) demonstrated the effects of colonialism on the psyche. During the 1960s and 70s, various anti-psychiatric and critical perspectives on psychiatry argued, each in its own way, that mental pathology resulted from processes of social alienation. Among the authors who may broadly be classified along these lines are Basaglia (1985), Laing (1978), Cooper (1973), Szasz (1979), Foucault (2003), Goffman (2007) and Deleuze and Guattari (2010). More recently, the South Korean philosopher Byung-Chul Han (2017) has argued that the production of psychic suffering (depression, anxiety, burnout syndrome) stems from the demands of the achievement society (Corbanezi 2018). Without downplaying the theoretical, epistemological and political differences at stake in these analyses, the idea that mental pathology derives from the social dimension – often associated with the view that psychiatry functions as a form of social control – is also present, to varying degrees, in contemporary authors such as Dejours (1998), Dardot and Laval (2016), Honneth (2003), Rosa (2010), de Gaulejac and Hanique (2024), Rose (2013) and Conrad (2007). The contemporary notion of social suffering dominant in France (Ehrenberg, 2012; Ota, 2014), which posits that psychic suffering results from the impact of capitalism on individual life, is likewise informed by this idea, from which part of Brazilian sociological production on the subject appears to be directly or indirectly derived. This is the prevailing tone, for example, of two recent special issues on mental health in the area of the social sciences and sociology published in leading national academic journals. These dossiers include Brazilian and international specialists (Nunes and Almeida, 2020; Corbanezi, Caponi and Mazon, 2024). It is worth emphasising that the idea that life in society causes psychic suffering is also the view that appears in the media with almost daily frequency⁶.

However, although sociological explanations of mental health issues establish connections with society – unsurprisingly, given the discipline’s specialism – they do not always reduce these to relations of causality. Alain Ehrenberg’s sociology of mental health is an emblematic case whose divergence from this mainstream view does not appear to have been fully recognised within the field of critical studies on the topic in Brazil. While his early work could initially be read to imply the existence of a social causality behind the emergence of depression – as may be inferred from a particular reading of La fatigue d’être soi: dépression et société ([1998] 2000) – his more recent sociology of mental health emphatically rejects any such relationship, even refusing this imputation in relation to his now classic sociological study of depression. This is what I shall analyse below, looking to show how the author seeks to distinguish himself from the dominant sociological approach to the relationship between society and mental health, according to which society causes forms of psychic suffering. In so doing, we shall see that the mobilisation of his work to criticise contemporary capitalist society, and more specifically neoliberalism, as is also evident in some of the Brazilian intellectual production on the theme, is not without its problems.

Alain Ehrenberg’s sociology of mental health: a counterpoint to the dominant discourse

Alain Ehrenberg’s sociology of mental health constitutes an indispensable point of reference for studies in this area of knowledge. A substantial part of his research has been translated into several languages and his book La fatigue d’être soi: dépression et société is regarded as a foundational sociological study of depression in contemporary societies. His work is frequently mobilised to support the claim that contemporary social transformations, including those arising from processes of neoliberalisation, are one of the causes of the high incidence of mental disorders paradigmatic of our time, such as depression, anxiety, burnout syndrome, social phobia, compulsive disorders and hyperactivity. It is true that Ehrenberg argues that the shift from a regime of prohibition and obedience characteristic of disciplinary society to a regime centred on individual initiative in post-disciplinary society is a central dimension to understanding depression: in this sense, depression is not sadness per se, but rather an incapacity for action within a new form of sociability whose normative paradigm is autonomy. Nonetheless, Ehrenberg categorically rejects the idea of a causal relationship between contemporary capitalist society and psychic suffering. This argument becomes explicit in La société du malaise (2010) where he makes use of the notions of “collective representation” (Durkheim), the “obligatory expression of feelings” (Mauss) and “language games” (Wittgenstein) to argue that the contemporary vocabulary of mental health is the form through which individualistic societies elaborate and represent to themselves good and evil, justice and injustice, success and misfortune. In other words, as a “global idiom”, the contemporary vocabulary of mental health comprises a language – whose meanings are socially shared – through which negative and positive aspects of the individual-society relationship are expressed in ways intelligible to members of contemporary individualistic societies. This emotional vocabulary of mental health has thus been constituted as an expression that is at once spontaneous and obligatory (Mauss), a language game (Wittgenstein) shaped by specific social contexts and rules, whose meaning exists in accordance with our collective social representations of life in society (Durkheim).

In this way, La société du malaise addresses the fundamental sociological question of the individual-society relationship, examining the epistemological and political implications of this relationship in the present. In concrete terms, it involves a comparative analysis of how US and French societies represent autonomy, taken as the value and norm par excellence of contemporary individualistic societies. The approach thus aligns with the main thread of Ehrenberg’s work, which has been concerned with the transformations of contemporary individualism at least since Le culte de la performance ([1991] 2011)⁷.

In summary, in La société du malaise the author argues that autonomy possesses different social meanings in the two societies under analysis. Americans conceive it through the centrality of the self, in which personality functions as an institution, such that autonomy signifies independence, competition and cooperation simultaneously. For the US social imaginary, the problem is not an excess of individualism and its attributes (opportunity, initiative, responsibility, action) but rather their subtraction – for example, through excessive state interference in individuals’ lives. By contrast, Ehrenberg argues, the French conceive autonomy solely as independence, since the French institutional ethos tends to reject its other dimension, which involves individual action, responsibility and competition. For the French social imaginary, unlike the American one, equality does not lie in individual opportunities, but in social protection through state action. Through a meticulous and well-documented analysis, Ehrenberg thus advances the thesis that autonomy is a norm and condition that, on the one hand, unites Americans and, on the other, divides the French⁸. In this sense, the pendulum of the individual-society relationship tends more towards the pole of the individual/personality in United States society, whereas in French society it rests on the pole of society/institution. The political implication of Ehrenberg’s study concerns how to balance this pendular relationship⁹, which translates into the dichotomy between individual opportunity and social protection, the social representations of which are opposed in the two societies analysed. For the author, achieving a balance in this relationship becomes necessary in the face of a new social configuration whose guiding principle is autonomy and, consequently, a shared social ethos of individual action.

Proceeding in this fashion, Ehrenberg develops a critique of critical sociological discourse, particularly its French variant, which mobilises concepts such as neoliberalism, precarisation, social suffering, deinstitutionalisation, psychologisation and the privatisation of contemporary social relations in order to argue that the “real society”, as the author formulates this critical stance (Ehrenberg, 2012, pp. 15, 362, 397, 411), existed in the past under the welfare state¹⁰. According to these analyses – which he also terms “individualist sociologies” – the supposed dissolution of social ties by exacerbated contemporary individualism constitutes the fundamental cause of individuals’ psychic suffering. Against this French thesis of “declinology”, according to which the rise of individualism implies the decline of society, Ehrenberg argues, following Durkheim, that the individual is first and foremost social. Drawing also on Louis Dumont, he maintains that attributing priority to the individual does not imply the disappearance of interdependence or even of society itself. The growth of individualism is an intrinsic feature of the modern social process, which does not mean that it is not a source of unease and disquiet, as can be observed, it is worth noting, from the politically opposed analyses of Durkheim and Marx¹¹. However, distancing himself from what he calls the “paradigm of affliction” (Ehrenberg, 2012, p. 176) and from “passionate denunciation” (Ehrenberg, 2012, pp. 314, 339), which see the alleged crisis of the social bond as a signal of the end of society and the cause of generalised malaise – including, of course, psychic suffering – Ehrenberg contends that contemporary individualistic society is merely a historical configuration of society in which specific forms of psychic suffering exist, as in any other society¹². In contemporary individualistic societies, there is neither the end of society nor of social obligation, which is simply transformed. While autonomy may have once been constrained, today the person is obliged to develop it. If, in disciplinary societies, the question was “what can I do?” in the society of autonomy – which the author in his more recent work describes as “capacity-based individualism” (Ehrenberg, 2021, p. 50) – the question becomes “what am I capable of doing?” (Ehrenberg, 2024). For the author, therefore, what we observe is a normative reorganisation in which passivity (discipline) becomes subordinated to activity (autonomy), not the dissolution of the social fabric¹³.

Without delving deeper in the analysis and the political implications involved, what I wish to emphasise is that Ehrenberg insists that his work be dissociated both from the predominant normative approaches within the sociological analysis of mental health and from the idea that psychic suffering is causally produced by contemporary capitalist society. The purpose of La société du malaise is, above all, to dispel the widespread idea that the sheer volume of psychic suffering signifies that we no longer live in a “real society”, as well as to move beyond the notion that society causes suffering (Ehrenberg, 2012, pp. 17, 411).

In a footnote to his book, Ehrenberg (2012, p. 335) stresses his rejection of the social causality of psychic suffering by criticising the social pathology perspective of Axel Honneth – as is well known, one of the leading contemporary exponents of the so-called Frankfurt School Critical Theory – and the (in the view of the author of La fatigue d’être soi) mistaken appropriation that Honneth makes of his work. It should be noted that, for Ehrenberg, the social pathology approach is part of the dominant normative sociological discourse concerning the relationship between society and mental health.¹⁴ Engaging critically with the categories of work, social suffering, recognition and precarisation, in particular the argument that “decline of the social bond” has caused contemporary psychic suffering – Ehrenberg (2012, pp. 481-2, note 78) states: “Honneth very kindly refers to my work, and I owe him the German translation of my book on depression, for which he honoured me with a preface”. However, he emphasises: “There is a misunderstanding, probably due to some hasty formulations on my part, and it concerns the following point: for me, symptoms are not caused by society, whereas Honneth thinks the opposite”. Yet this misunderstanding was not Honneth’s alone. The idea that contemporary forms of psychic suffering stem from social transformations, based explicitly on Ehrenberg’s sociology of mental health, also appears, directly or indirectly, in numerous other works of different scopes and aims. Among these, we can highlight Bauman (2008: 121), Dardot and Laval (2016, p. 366), Rosa (2010, pp. 303-5), and, in Brazil, Safatle (2012, 2021, pp. 26-7, note 14; 43-4), Dunker (2021, p. 79), Kehl (2009, pp. 248, 271), as well as my own earlier reading of the author in my doctoral research (Corbanezi, 2021), among many other scholars in the area.

Indeed, Pierre-Henri Castel maintains that Ehrenberg’s work is subject to a series of misunderstandings. One of these, the author argues in the text “Lire Alain Ehrenberg: une tâche impossible?” consists of attributing to Ehrenberg, if not the paternity, then at least the notable talent for describing the idea that the increase in depression in contemporary societies is due to the major social transformations underway since the 1960s (Castel 2012). Castel himself had already highlighted this common misreading of Ehrenberg’s thesis in his book L’Esprit malade: cerveau, folies et individus, published in 2009. Also in a footnote, Castel states: “Contrary to a widespread misunderstanding, Alain Ehrenberg’s thesis is not that a new depressive illness is truly emerging under current social conditions. Rather, it is that, around depression, an original collective representation of malaise is taking shape, one inseparable from the mutations of contemporary individualism” (Castel, 2009, p. 137, my emphasis). The argument, therefore, is that depression has become a language, a form of obligatory expression of malaise, just as positive mental health functions as an expression of individual well-being in social life¹⁵. Ehrenberg himself (2010: n.p.) warns of this prevalent misunderstanding of his work in response to Robert Castel’s (2010) critique at the time of publishing La société du malaise¹⁶. His global hypothesis regarding psychic suffering, he insists, relates to a change in the social status of psychic suffering, not a worsening of people’s psychological condition as a result of a particular society. For Ehrenberg, mental health has become the contemporary language through which individuals express their social relations and their degrees of autonomy¹⁷. In line with Castel’s observation, it should also be noted that, in La société du malaise, Ehrenberg (2012) frequently criticises the insistence on identifying neoliberalism as the cause of the malaise of contemporary society¹⁸.

On one hand, it is true that the misunderstanding surrounding his work may stem, as Ehrenberg himself (2012, p. 482) acknowledges, from not entirely unambiguous formulations on his part regarding the problem of the social causality of contemporary forms of psychic suffering. This argument may appear plausible in relation to readings of the trilogy Le culte de la performance ([1991] 2011), L’individu incertain ([1995] 2003) and La fatigue d’être soi ([1998] 2000). It should be noted, however, that the author himself rejects this attribution of causal argument to his study of depression, as is evident both in the above-mentioned passage concerning Honneth’s interpretation and in Pierre-Henri Castel’s warnings regarding the sociological interpretation of Ehrenberg’s work on this pathology.

On the other hand, I would emphasise that this position is explicit in the author’s more recent sociological production – especially in La société du malaise (2010), whose thesis is also taken up again in La mécanique des passions: cerveau, comportement, société (2018)¹⁹ – and yet he continues, notwithstanding this, to be mobilised as a reference for critiques of capitalist society on the grounds of mental health problems. According to Ehrenberg (2024, p. 4), “the idea that society makes us suffer is a social idea; it is not a sociological one”²⁰.

As becomes clear, the debate on this issue is traversed by theoretical, epistemological and political questions that are fundamental to sociology. In making explicit the opposition between a normative and a descriptive approach, Ehrenberg himself (2012, p. 360) warns that the “decisive point” resides in the fact that political and moral analysis differs significantly depending on the type of epistemology employed to analyse the reality of the relationship between mental health and society. Theoretically, what is in play is the classical individual-society relationship and everything that derives from it (subjectivism-objectivism, interiority-exteriority, action-structure, micro-macro). Epistemologically, sociological and scientific criteria compete to describe, explain and evaluate the relationship between mental health and society today. Politically, on the basis of the theme of mental health and the idea of causality, what is debated is the proper way of living in society and, in this sense, more or less conservative and more or less radical perspectives on social transformation come into contention. Consequently, when debated sociologically, the theme of society and mental health makes visible the broadly accepted idea that dissent is endemic in the human and social sciences in general, and in sociology in particular (Alexander, 1987). The same holds true in the subfield of the sociology of mental health, even though diverse arguments continue to prevail about the social causation of psychic suffering.

Final remarks

We have seen that the relationship between society and psychic suffering, notwithstanding the diverse terminologies used, has been present in sociological debate since the foundation of sociology as a modern science, intensifying during the second half of the twentieth century and in the first quarter of the twenty-first, partly as a result of the contemporary prominence of mental health as a social issue. I have sought to show how this debate is largely dominated by a causal framing of the relationship between society and psychic suffering, in which the former is posited as the cause of individual suffering.

Notwithstanding the hegemony of the thesis of the social causality of individual psychic suffering within the sociology of mental health, I have looked to show that this correlation is not absolute through an analysis of the recent production by Alain Ehrenberg on the sociology of mental health. This discussion can help clarify his position within this specific field of research, given that his work is frequently mobilised to substantiate arguments concerning causality and critiques of neoliberalism – positions that the author himself explicitly rejects. The debate also matters to sociology more widely due to the theoretical, epistemological and political questions and dissensions under dispute, as well as the fact that this area of knowledge is increasingly asked to participate in contemporary discussions on mental health problems.

In this sense, given the complexity of the phenomenon of mental health, the theoretical discussion of the topic may also indicate that an exclusively causal explanation risks producing a sociological reductionism methodologically analogous to the biological reductionism of the psychiatry criticised by sociology. Notwithstanding the unequivocal inclination towards the social dimension apparent since the discipline’s classical authors – and the unavoidable critique of the biological reductionism practised by dominant psychiatry – the controversy under analysis should not make us forget Marcel Mauss’s notion of the “total man” (2003a), according to which we are simultaneously biological, psychological and social beings²¹. This offers another way of alluding to the biopsychosocial unity so in fashion in contemporary mental health discourse – even if, in practice, it proves far less interdisciplinary.

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• 1
  . The survey in question was conducted by the Instituto Ideia in partnership with the company Cause and the PiniOn app. “‘Ansiedade’ é eleita a palavra do ano de 2024 no Brasil”. (09/12/2024), Cause, https://www.cause.net.br/palavra-do-ano-2024/, accessed on 28 July 2025. The survey was reported by mainstream Brazilian media outlets, including Folha de S.Paulo, O Globo, CNN Brasil, CBN, Exame, Terra and G1, among others.
• 2
  . “La santé mentale, Grande cause nationale en 2025”. (11 octobre 2024), Gouvernement.Fr., https://www.info.gouv.fr/actualite/la-sante-mentale-grande-cause-nationale-en-2025, accessed on 28 July 2025. Discussing this issue, the journal Esprit in December 2024 published the dossier ‘Trouble dans la santé mentale,’ coordinated by Alain Ehrenberg, Marie Jauffret-Roustide and Aurélie Tinland (2024). see https://esprit.presse.fr/tous-les-numeros/trouble-dans-la-sante-mentale/936, accessed on 28 July 2024.
• 3
  . This aspect is alluded to, for example, by Isabelle Coutant (2021), who analyses the relevance of mental health as a theme for the social sciences in the context of the covid-19 pandemic.
• 4
  . Marx (2006) selects four cases from Peuchet’s memoir, three of which concern women (two from bourgeois families and one from a working-class family). In this way, the text ultimately shows that suffering in capitalist society is not limited to the working class. As Löwy observes in the introductory essay to the Brazilian edition, the text constitutes a passionate protest against the oppressive violence of the bourgeois family towards women, making it a singular production within Marx’s oeuvre. At the same time, the notions of oppression and private property to which women are subjected within the conjugal relationship are recurrent concerns in Marx’s thought.
• 5
  . Here, I use the expression ‘sociological thought’ to encompass studies from different fields of knowledge that focus on mental health issues in relation to society.
• 6
  . It would be superfluous here to enumerate journalistic pieces of this kind. The way in which the corporate media reported the selection of the term “anxiety” as the “word of the year” – that is, as an expression of the spirit of the times in the society in which we live – is by itself a relevant indicator in this regard (see note 2).
• 7
  . In 2023, the conference ‘Les métamorphoses de l’individualisme. Colloque autour des travaux d’Alain Ehrenberg’ was held at Université Saint-Louis, Brussels, Belgium. As the title of the colloquium indicates, the question of the transformations of individualism forms the leitmotif of Ehrenberg’s work. The programme of the event is available at https://coachingrituals-usaintlouis.be/2023/03/13/colloque-les-metamorphoses-de-lindividualisme/, accessed on 4 August 2025.
• 8
  . In this sense, Ehrenberg (2010) states that La société du malaise is a Durkheimian title that seeks to understand the way in which each society represents to itself the idea of autonomy and the relationship between individual and social malaise. From the author’s remarks it may also be inferred that the title alludes to French society in particular, given his claim that reference to the Freudian notion of civilisational malaise is recurrent among French psychoanalysts, whereas their American counterparts tend to ignore it. While French society perceives a crisis of the institution, such that appeals to personality are understood as the “deinstitutionalisation”, “privatisation” and “psychologisation” of social relations, American society perceives a crisis of the self, which itself constitutes a hallmark of American social sciences (Ehrenberg, 2010).
• 9
  . On the pendular movement in the individual-society relationship, see Alexander (1987). The new theoretical movement advocated by the author consists precisely in a synthesis of this relationship, which, at the theoretical-methodological level, has unfolded in social theory since the 1980s. It should also be noted that Elias (2011) had already sought such a theoretical–methodological balance in The civilizing process (1939), as attested by his 1968 introduction to the work. Influenced by Elias, Ehrenberg appears to update the discussion of the individual–society relationship at a political level as well, through his comparative analysis of representations of malaise in contemporary societies.
• 10
  . The critical allusion to the idea that ‘true society’ existed prior to the new social configuration based on autonomy and individual action appears repeatedly in Ehrenberg’s study. The following is an emblematic passage in which he criticises the critical discourse according to which “[s]ufferings would be caused by this disappearance of real society – a society in which there were real jobs, real families, a real school and a real politics, one in which the individual was dominated, but protected, neurotic, but structured” (Ehrenberg, 2012, p. 15, author’s emphasis). This reading provoked a vigorous critical response from Robert Castel (2010) when the book was published. In broad terms, while acknowledging the relevance of Ehrenberg’s study, Castel rejects what he sees as its supposed attempt to promote an Americanisation of French society. Rebutting this accusation, Ehrenberg (2010) responds that no there is no such evaluation his study, whose purpose is to describe two societies comparatively so as to highlight the diverse social meanings of autonomy and thereby foster an authentic intellectual debate beyond the labels of “left and right” and “good and evil” that surround the notions of social protection and individual initiative. Indeed, in conducting his descriptive and comparative analysis, Ehrenberg explicitly emphasises the fact that his aim is not to rank the two societies, which lend themselves to neither praise nor condemnation: each is coherent within its own national context (Ehrenberg, 2012, p. 416). This idea is made clear throughout the study. On the other hand, it is equally true that the investigation seeks to problematise the mismatch between French society and the new social ethos that has instituted autonomy as both condition and norm. Arguing that each society assigns an opposite value to the concepts of opportunity and protection – without, however, ignoring either – Ehrenberg (2012, p. 416) states: “It is probably the crucial question in France today to explain the relationship between equality of opportunity and equality of protection, so that the value of the former may increase”. In this way, the author ends up criticising the excess of social protection in France, which hinders a genuine politics of autonomy, while nonetheless recognising the importance of protection for the most vulnerable populations, who in fact suffer from social inequalities and are prevented from developing individual capacities for action within the society of autonomy.
• 11
  . Positioning himself within the debate on Ehrenberg’s work, Pierre-Henri Castel (2012, p. 134) states that “malaise is not contested by Ehrenberg or by his adversaries: what is disputed is the grammar of its expression”. Castel reiterates that individualistic societies face a serious problem constantly emphasised by Ehrenberg: their social form is one of increasing individualisation. To describe the new pathologies, Castel continues, there is “no need for any extraordinary conjecture about the death of the ‘social” under the blows of contemporary individualism. It suffices to recognise that every individualistic society, ever since it has existed, transforms without ever attaining an ideal equilibrium, which inevitably gives rise to troubling anxieties among its members. In sum, almost the same thing, minus the apocalypse…”. These observations seek to underscore that, notwithstanding the recognition of malaise, Ehrenberg’s reading does not conceive individualism and neoliberalism in accordance with an apocalyptic critical discourse.
• 12
  . Two excerpts help elucidate this claim: “Social pathologies are social insofar as they link individual ill and common ill. Yet this is what every human society does and, in this sense, contrary to what individualist sociologies postulate, individualism is by no means exceptional, it is merely a particular form of humanity” (Ehrenberg, 2012, p. 421). “The American and French language games suggest that our societies are an exception, insofar as they produce psychic sufferings linked to deregulations of the social relationship. Seized by a passion for grand words, they give the impression that traditional societies were psychological paradises” (Ehrenberg, 2012, p. 419). My emphasis here is intended to highlight the reason why the author characterises “declinology” as a “passionate” discourse. He makes this allusion repeatedly, as in the passage in which he states that critical discourse expresses itself “not without emotion […]” (Ehrenberg, 2012, p. 355). Criticising these discourses of the sociology of domination – including authors such as C. Dejours, D. Linhart, V. de Gaulejac, E. Renault, L. Boltanski and E. Chiapello – Ehrenberg (2012, p. 329) argues that such works typically present their conclusions by appealing to a ‘political somersault.’ It should also be emphasised that, in response to Castel, Ehrenberg (2010, n.p.) explicitly states that his analysis is presented as “an alternative sociology to that of P. Bourdieu and R. Castel, free from hypercritical pessimism”.
• 13
  . Maintaining that we no longer live in the disciplinary societies described by Foucault, Ehrenberg (2012, p. 405) argues that we are “in a world where the aim is always to mobilise and enhance personal resources by fostering public policies that allow individuals to become the agents of their own change”. Criticising what he sees as the nostalgia of declinological discourse, he concludes: “Nothing obliges us to remain prisoners of our grand memories”. This inference alludes directly to the epigraph of the chapter on the precarisation of existence. In opposition to the critical discourse he characterises as passionate and nostalgic, Ehrenberg chooses as an epigraph a passage from Marx’s letter to César de Paepe, in which the leading figure of critical theory states: “The misfortune of the French and even of the working men, is to hark back to great things. It is essential that events should once and for all destroy this reactionary worship of the past!” (Marx [14 September 1870], quoted in Ehrenberg, 2012, p. 361).
• 14
  . This is how the author defines the debate surrounding the notion of “social pathology” from which he seeks to distance his own analysis: “The sociological, but also political, debate concerns the relationships between the widespread concerns over mental health and the transformations of social norms – in other words, the social meanings of these forms of suffering and the nature of the society in which they develop. For issues of mental health and psychic suffering have been employed, since the 1970s, to formulate a critique of society: people speak of the decline of the social bond, the weakening of social ties, the crisis of collective solidarity, the precarisation of existence, the privatisation of life. This debate appears under the label of social pathology”. The argument of this normative sociological and philosophical approach, he continues, is that “society is invaded by the individuals” ego [moi], and social bonds lose their strength’ (Ehrenberg 2024, p. 2). In order to describe this rise of the moi/self at the expense of society, Ehrenberg (2012) analyses the displacement of the concept of narcissism from psychoanalysis to sociology, with its particular configurations in the United States and France. Ehrenberg opposes the dominant normative approach with his own descriptive analysis. This terminology appears in Ehrenberg (2024), an unpublished text kindly shared with me by the author during a postdoctoral fellowship under his supervision. In La Société du malaise, the normative approach appears as “individualist sociology” to which Ehrenberg (2012) counterposes his “sociology of individualism”.
• 15
  . Making explicit how Ehrenberg distances himself from critiques of neoliberalism conceived as “the Evil” (le Mal), Castel (2012, pp. 131-2) explains the author’s approach: “Mental health is the sounding board of the malaise constitutive of individualist malaise, the place where it now gives shape to the mishaps that affect the fabric of moral sentiments. Hence, there are no more depressions or traumas than in the past. ‘In the past’, Ehrenberg often mocks, ‘when there was a real society, a real job, a real politics!’. Instead, depression has become an imperative ‘idiom of despair’ for those who wish effectively to address others and obtain their help – just as before 1914 people invoked neurasthenia, or melancholy in the Renaissance. The characterisation and history of these idioms are fundamental. […] Depression, to cite Mauss, is thus a case of the ‘obligatory expression of emotions’”.
• 16
  . See notes 11 and 13.
• 17
  . This is the central hypothesis of La société du malaise: “The hypothesis, then, is that mental health has become the contemporary language, the obligatory form of expression not only of malaise and well-being, but also of conflicts, tensions or dilemmas within a social life organised with reference to autonomy, which prescribes ways of speaking and acting to individuals” (Ehrenberg, 2012, p. 19, author’s emphasis).
• 18
  . This critique runs through the book and is found especially in the final two chapters, entitled respectively “Work, suffering, recognition” and “The precarisation of existence: A new distribution of inequality between mental health and politics”, as well as in the conclusion of the work. See also, for example, the interview granted to Robert Maggiori in 2021: “Malaises avec Alain Ehrenberg: Qu’est-ce qui nous arrive?”. Philomonaco, https://www.youtube.com/watch?v=cf4Kf32TveQ, accessed on 09/01/2025.
• 19
  . While La société du malaise explores the problem of the individual-society relationship, La mécanique des passions engages with the natural-social dichotomy through an analysis of the relationship between the scientific concepts of the cognitive neurosciences and social representations in the society of autonomy, characterised by individual action and capacities. In this work as well, Ehrenberg (2021, pp. 14-15) proposes to move beyond the political debate represented by “critical currents in the social sciences and philosophy inspired by the thought of Michel Foucault and Pierre Bourdieu”, which conceive the neurosciences as instruments of social control and biopolitical domination in the service of neoliberalism. His aim is to describe the coherence and connection between scientific concepts and social ideas within mass individualistic societies.
• 20
  . This formulation appears in Ehrenberg (2024). In La Société du malaise, it is imbued with a slightly different nuance: “[…] the idea that society makes us suffer is a social idea and, consequently, an object for sociology” (Ehrenberg, 2012, pp. 17-18). It is precisely this object that the author analyses critically.
• 21
  . In an ample sense, the object of mental health can be regarded as a “total social fact” insofar as it is simultaneously biological, psychological and social (Mauss 2003b). It is worth noting that Mauss (1969, p. 278) concludes his essay on “The Obligatory Expression of Feelings” by invoking the idea that the expression of emotions constitutes a field of study around which “psychologists, physiologists and sociologists can and must meet”.
• Data availability:
  data-in-article.
• Trabalho realizado com apoio da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (Capes) – Código de Financiamento 001.

• Editora:
  Ana Paula Hey

Data availability

data-in-article.

Publication Dates

• Publication in this collection
  29 June 2026
• Date of issue
  2026

History

• Received
  26 Aug 2025
• Accepted
  11 Feb 2026