Using Foucault: Genealogy, Governmentality and the Problem of Chronic Illness

Ann Reich,Margo Turnbull

doi:10.3390/genealogy2020013

Ann Reich, Margo Turnbull

Open Access

https://doi.org/10.3390/genealogy2020013

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Abstract

This article explores the unique contribution that Foucault’s work on genealogy and governmentality can make to the analysis of contemporary programs of government. The article uses an Australian study of the ‘problem’ of chronic illness to argue that this perspective offers valuable insights into how ‘problems’ such as chronic illness have become linked to advanced liberal discourses and practices of self-governing and self-responsibility. These insights are particularly valuable in fields such as primary health care that have a noted shortage of critical and reflective studies that explore the links between people and changing ideas of health and disease. This article details how taking up an analytics of governmentality and political genealogy informed by Foucault, facilitated the tracing of the dominant discourses and practices, and the connections to the day-to -day lives of the clients with chronic diseases. Importantly, this approach opened up a more critical consideration of the ways in which dispersed approaches to governing through programs, such as integrated care, shape and influence the lives of individuals. These dispersed ways of governing are not linear but rather unfold through ongoing relays, connections and the (re)production of discourses.

Highlights

Research inspired by Foucault’s work on political genealogy and an analytics of governmentality (Foucault 2007a) has occurred in many disciplines and fields of study
As a contribution to this Special issue on political genealogy, this article focuses on the utility and contribution an analytics of governmentality and genealogy make to a study of chronic illness
The article draws on data from a research study, Governing chronic illness through integrated care (Turnbull 2017), which used this approach to understand the ways in which the problem of chronic disease became linked to advanced liberal discourses and practices of self-governing and self-responsibility

Summary

Introduction

Research inspired by Foucault’s work on political genealogy and an analytics of governmentality (Foucault 2007a) has occurred in many disciplines and fields of study. The analytic perspective and genealogical approach used in this study enabled the tracing of the translation and movement of these discourses of health and disease from policy texts and everyday practices of those involved in HealthOne. To illustrate how an analytics of governmentality and genealogy were used and the utility of such an approach, this article focuses on three aspects of the research study—first, the assembling of a crisis and emergence of a programmatic ‘solution’; second, the translations of advanced liberal notions of self-responsibility and self-care into the programmatic logic of community-based integrated care (Rose and Miller 1992); and third, the assembling of the patient as a ‘client’—the responsible and self-caring chronically ill client—through technologies of government such as education, training and advice

Governmentality and Political Genealogy

Illustration One—Chronic Illness

Findings

Conclusions