Autonomy-Oriented Social Movements and the Politics of Affect

Abstract This dissertation explores damaging tendencies that exist within autonomy-oriented activism in the West. I examine how affect shapes the way that internal conflict is approached and internal strife is dealt with in radical communities. I adopt Sara Ahmed’s proposition “that our emotions are bound up with the securing of the social hierarchy” (Ahmed, 2004b: 4) and given that autonomy-oriented practices are committed to dismantling existing hierarchies, it follows that the less oppressive social configurations sought by autonomous social movements must have different emotional underpinnings. My thesis involves applying critical theory on affect and emotion in social movements to interview data gathered from activists both currently and historically involved in autonomy-oriented social movement communities in Kingston, Ontario. I ask whether anglophone, western-based, autonomy-oriented social movements reproduced understandings of affect/emotions/feelings that underwrite the social order they are working against? I also ask, “how are our emotions conditioned by capitalism?”. The research that I engage with provides responses to these questions by pointing out how the dominant discourse on emotions in the West encourages and informs certain modes of identity production that affect the diminishing and sad practices of autonomy-oriented communities and the (re)production of oppressive practices found in the dominant order. My work critically places this psychologizing view of emotions, and its damaging effects on resistance, within the context of neoliberal capitalism. I argue that the way we understand the politics of affect is an important dimension of radical struggle, and will inform and impact upon our individual and collective capacities to respond to, and refuse to reproduce relations of control and domination. I look for an understanding of “why” and to “what extent” these determinations exists, and look for hope in a politics of affect which supports an autonomy-oriented ethic.

Self-Management of Chronic Pain: Interventions, Strategies, Barriers, and Facilitators

Background & Purpose: Chronic pain is a prevalent chronic condition for which the best management options rarely provide complete relief. Individuals with chronic pain with neuropathic characteristics (NC) report more severe pain and experience less relief from interventions. Little is known about current self-management practices. The purpose of this dissertation was to inform self-management of chronic pain with and without NC at the individual, health system, and policy levels using the Innovative Care for Chronic Conditions Framework. Methods: The study included a systematic search and review and cross-sectional survey. The review evaluated the evidence for chronic pain self-management interventions and explored the role of health care providers in supporting self-management. The survey was mailed to 8,000 randomly selected Canadians in November 2011, and non-respondents were followed-up in May 2012. Screening questions were included for both chronic pain and NC. The questionnaire captured pain descriptions, self-management strategies, and self-management barriers, and facilitators. Results: Findings of the review suggested that self-management interventions are effective in improving pain and health outcomes. Health care professionals provided self-management advice and referred individuals to self-management interventions. The questionnaire was completed by 1,520 Canadians. Those with chronic pain (n=710) identified primary care physicians as the most helpful pain management professional. Overall, use of non-pharmaceutical medical self-management strategies was low. While use positive emotional self-management strategies was high, individuals with NC were more likely to use negative emotional self-management strategies compared to those without NC. Multiple self-management barriers and facilitators were identified, however those with NC were more likely than those without NC to experience low self-efficacy, depression and severe pain which may impair the ability to self-management. Conclusions: Health care professionals have the opportunity to improve chronic pain outcomes by providing self-management advice, referring to self-management interventions, and addressing self-management barriers and facilitators. Individuals with NC may require additional health services to address their greater self-management challenges, and further research is needed to identify non-pharmaceutical interventions effective in relieving chronic pain with NC. Public policy is needed to facilitate health systems in providing long-term self-management support for individuals with chronic pain.