A R Guy

D I N E S H B H U G R A

Globalization: Mental Health and Social Economic Factors

Keywords:

Several factors associated with globalization have mental health consequences. This article reviews the literature on mental health and inequality, occupational patterns and identity shifts before considering the role of globalization as an acculturative stressor. We argue that a re-evaluation of mental health policy in light of globalization must look further than current studies of migrants to consider indigenous communities where models of social experience and behaviour are changing. k e y wo r d s economic factors, globalization,

Introduction

The increasing social, economic and cultural interconnection between communities has made mobility -social, individual, and that of goods and ideasvery easy. The implications of such a massive transformation in human relations can be seen at various levels: individual, local, national, regional and supra-regional. The changes associated with these processes are key to understanding the responses of individuals and governments. The additional impact of multinational corporations and economic rationalizations on individuals, cultures and the functioning of the body politic have to be understood in the context of globalization. The interaction of cultural beliefs across communities, whether they are in geographical contact or indirectly exposed, can lead to changes in individuals as a result of acculturative processes. These processes change the way people view their own cultural values and those from other parts of the world. It is entirely likely that when two cultures come into contact, either through trade or through media, their expectations of each other and of themselves also change. Altered economic growth can further add to this stress and contribute to mental health problems.

It can be said that we are now accustomed to the 'brave new world of globalization' (Bhugra and Mastrogianni, 2004: 10) and to the discourses that surround it. A very general economic definition of globalization is the 'worldwide process of homogenizing prices, products, wages, rates of interest and profits' (Shariff, 2003: 163-78). Commentators outside the economic discipline define it in even broader terms as 'a process in which the traditional boundaries separating individuals and societies gradually and increasingly recede' [START_REF] Okasha | Editorial: Globalization and Mental Health: A WPA Perspective[END_REF] 1-2). As Grint (2005: 360) points out, the large-scale movement of goods across national boundaries has a long history, involving organizations such as the Muscovy Company (1555) and the East India Company (1600). Manifestations of globalization have been cited as including rapid communication, cheap modes of travel, commercial deregulation, the growth of international political organizations and increasing cross-cultural communication [START_REF] Okasha | Editorial: Globalization and Mental Health: A WPA Perspective[END_REF] 1-2). Importantly, however we choose to define globalization, we should note that the social processes associated with it have direct bearing on both individuals and communities in turn. In this article we discuss some of these interactions and their manifestations in relation to mental health. The American Psychiatric Association's (2000) most current Diagnostic and Statistical Manual defines mental disorder as 'a clinically significant behavioural or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability'. There is no doubt that globalization continues to divide commentators over the benefits and costs it confers on the world in general and on countries in particular. With specific application of these concepts to health, [START_REF] Martin | Editorial: Globalization and Health[END_REF] 1-2) has pointed out that 'the effects of globalization on health (and health systems) are neither universally good nor bad, but context specific'. It is also the case that the health effects of economic changes are likely to be change specific, and that individual economic processes should be addressed separately.

A group of related economic phenomena that include outsourcing, labour market deregulation and the increasing flexibility of work processes has fundamentally altered the individual experience of working life and influenced the mental health environment. The growth of the high technology sector and financial services has paralleled the decline of manufacturing and traditional industries in a so-called deindustrialization pattern. In recent years we have witnessed incidences of downsizing as organizations shift the site of labour from the core of organizations to the periphery, leading to the loss of jobs for reasons other than performance (Capelli, 1999: 96). Rapid economic growth has been associated with large internal migration of workers from rural to urban settings (Li et al., 2006: 2). Organizations based in developed countries have outsourced services to countries where labour is cheaper and the degree to which labour protection mechanisms are in place may be less than in other, often wealthier nations [START_REF] Dicken | Global Shift: Transforming the World Economy[END_REF]. Although productivity has increased as a result of transformed systems of communication and flexible manufacturing, there has been a consequent decrease in dependence on human labour (Winefield et al., 2002: 5).

Our analysis is divided into five sections. We begin by considering the literature on mental health and inequality and then move on to the relationship between mental health and occupational patterns. The third section considers the impact of identity shifts on mental health. The fourth section examines the role of globalization as an acculturative stressor and the implications of this development. The fifth section of the article develops the concluding argument that a re-evaluation of mental health policy in light of globalization must look further than current studies of migrants to consider indigenous communities where modes of social experience and behaviour are changing.

Inequality and Mental Health

In Organisation for Economic Co-operation and Development (OECD) countries, consensus has emerged that globalization, including not only increased trade but international migration and capital flows, has contributed modestly to increased inequality by increasing wage differentials between skilled and unskilled workers. Observers have identified trends in the way that income is distributed within societies; the gap between average earnings for a college graduates and non-college graduates was 38% in 1979 while by 2000 the figure was 78% (The Economist, 2000a). The OECD report Income Distribution in OECD Countries identifies important patterns of wealth distribution. Between the mid-1980s and 1990s, the richest 30% increased their market share in all the OECD countries, while the poorest 30% reduced their income share in all countries except the USA. The overall trend within wealthy countries has leaned therefore towards a widening of income distribution between the rich and the poor. There is no doubt that new economic practices have increased inequality by increasing the spread of wages between skilled and non-skilled workers. This trend has been seen not only in OECD countries but also in some middle income developing countries (Kohl and O'Rourke, 2000: 1). [START_REF] Katz | Converging Divergencies: Worldwide Changes in Employment Systems[END_REF] has suggested that the deregulation of labour markets has similarly played a role in increasing income inequality within nations. As well as affecting wealth distribution within countries, economic liberalization has also affected the distribution of wealth between countries. [START_REF] Kelly | Globalisation and Psychiatry[END_REF] cautions that globalization will have a net result of increasing inequality among the world's population:

Market deregulation favours the dominant, strong economies of the West and fails to offer developing countries an opportunity to strengthen their infrastructure sufficiently to compete in a global economy. Globalization, by this logic, will lead to further poverty, inequality and social injustice. (Kelly, 2003: 465) On the basis of this and other evidence, the view that modern socio-economic processes are exacerbating wealth inequalities instead of diminishing them has been well established by the existing literature.

One can use much of this evidence to argue that globalization has resulted in an increase in social inequality. However, it would be inaccurate to say that globalization has not brought some economic success for countries outside the 'developed world'. For example, the proportion of the global population living on less than US$1 a day fell between 1987 and 1993 from 30% to 29%. In 2001, the UN Human Development Report was able to state for the first time that the majority of the world lived in a developed country, though this probably attests to massive economic migration, rather than economic development in the developing world.

The impact of social inequalities on the health of populations has been contested. Although many studies have reported better health and mortality indices in egalitarian societies (Subramanian and Kawachi, 2004: 89), a smaller number of studies have found no evidence to support an association [START_REF] Deaton | Mortality, Inequality and Race in American Cities and States[END_REF]Lubotsky, 2003: 1147;Lynch et al., 2004a: 386-91;Osler et al., 2002: 3). However, Wilkinson andPickett (2006: 1774-5), in a systematic review of analyses of income inequality, have pointed out that studies which found no association between inequality of income and health tended to be smaller in geographical and population coverage and hence less reflective of social stratification, for which income inequality is a marker. Furthermore, psychosocial problems, namely violence and suicides, tend to be higher in lower income areas (Wilkinson, 2004: 1-12). Given the widespread positive association between income inequality and physical health, an association between mental health and social inequality seems likely. For example, Lynch et al. (2004b: 370) have reported similarity between 100-year trends in suicide and income inequality in the USA. Though they were unable to control for the impact of other social factors, it is still likely on the basis of this evidence that levels of social inequality do have some effect on rates of suicide. Eibner et al. (2004: 167-75) were able to correlate an index of relative deprivation with higher risks of developing depression and anxiety. [START_REF] Kahn | State Income Inequality, Household Income, and Maternal Mental and Physical Health: Cross-Sectional National Survey[END_REF]Kahn et al. ( : 1314) ) have found an association between living in an income unequal area with depression in women, although other studies (Sturm and Gresenz, 2002: 2-5;Weich et al., 2001: 224-7) have found weaker associations, casting doubt on this relationship. Yet the relationship between gender and income inequality means that the social limitations placed on females is likely to lead to a further sense of lowered expectation, achievement incongruence and powerlessness. This in turn is likely to influence self-esteem and result in psychological morbidity.

Although an association between income inequality and mental health is not universally accepted, more recently a positive linear relationship between income inequality (measured by the ratio of the income share of the richest 20% of the population to the poorest 20%) and the prevalence of any mental disorder in developed countries has been observed by Pickett et al. (2006: 646). As more data are gathered on the relationship between psychological functioning and social inequalities in low and high income countries, it will become possible to delineate more precisely the relationship between income inequality, mental disorder and deprivation in the 'developed' and the 'developing' world. There exist a number of putative mechanisms for the association between mental health and income inequality. Among them are differences in levels of social trust and cohesion [START_REF] Wilkinson | The Impact of Inequality: How to Make Sick Societies Healthier[END_REF], the development of a negative view of one's status and worth (Charlesworth et al., 2004: 53-5), and a perceived loss of control over one's work and life (Marmot, 2004: 299-303).

In economic terms, the profound change in the social and psychological dimensions of work accompanying patterns of globalization has been articulated in terms of the growth of an informal sector of employment, defined by low earnings, the absence of contracts, unstable working conditions, poor access to social services, low rates of union affiliation and growing levels of irregular and quasilegal labour. This trend has been visible in the growing preponderance of temporary and part-time workers within the global labour market. In 1997, regular full-time workers represented 69% of the total workforce in the USA (Upjohn Institute, 1997). Data from the investment bank Morgan Stanley Dean Witter suggested that the majority of new jobs created between the years 1994 and 1998 were either part time or temporary [START_REF] Beneria | Shifting the Risk: New Employment Patterns, Informalization and Women's Work[END_REF][START_REF] Economist | The[END_REF]. In Latin America, 47.9% of total urban employment was informal in nature, while in 1990 it had been 44.4 % (International Labour Organisation, 1999). This evidence leads us to the conclusion that the environment of employment both in wealthy and developing countries has shifted in a fundamental way. A traditional model of stable, reliable employment has given way to a new experience of working life. At the beginning of the 21st century, the average American 32-year-old male had worked for nine different employers -a shift away from the traditional archetype of the slow and steadily ascending career worker who remains with a single employer or very few employers. Average job tenure for 28-year-olds has similarly fallen since 1983. These data raise some important questions -if economic imperatives are transforming the working world, then what impact could this be having on psychological functioning?

Occupation Patterns and Mental Health

A number of studies have shown that adverse features of the psychosocial work environment can affect the rates of mental disorder among individuals (see for a review [START_REF] Stansfeld | Psychosocial Work Environment and Mental Health: A Meta-Analytic Review[END_REF]. However, there have been disagreements over the triggering factors. Some authors (such as [START_REF] Niedhammer | Effort-Reward Imbalance Model and Self-Reported Health: Cross-Sectional and Prospective Findings from the GAZEL Cohort[END_REF]Niedhammer et al., : 1531Niedhammer et al., , 2006: 118) : 118) have asserted the importance of workplace organizational factors such as leadership structure and effort-reward balance. Others, such as Muntaner et al. (2004: 398), have asserted that in the case of low income nursing home staff in the USA, the effects of workplace and organizational factors on mental health could not be isolated from income, i.e. among this group particular types of workplace environment were a source of stress when combined with a low income. The relationship between workplace organizational structure and low income may then be synergistic as regards mental health. In a comparative analysis of psychological morbidity among nursing home staff, Muntaner et al. (2006: 695) found that income inequality and loss of social cohesion were not significant correlates of mental ill health once workplace organizational factors had been accounted for.

There may be a risk, then, in apportioning blame for mental health deficits on the organization of the workplace when low income and poverty play a more direct role in the genesis of mental disorders. Although much of this work has been rather limited in its geographical scope, it has proven useful in delineating the sorts of factors that might be in play as workforces change in response to the forces of globalization. It is probable that organizational factors have a role in exacerbating the stressing effect of the low income state. Even those whose incomes rise as a result of the globalized workplace may find there is a mental health cost. There is recent anecdotal evidence from call centre staff in India that although these young employees are being paid relatively high sums compared to others, their sleep patterns have altered and they are having difficulties with self-identity. At the same time it is likely that those who aspire to but have not attained similar employment may be feeling left behind, while perceiving the country to be marching onward. Helping employees adjust to new working environments as they move from one career to the next is an important and growing responsibility both of corporations and health professionals. Furthermore, social welfare and policies that protect employees do not preclude productive engagement in open international trade and investment, thus new economic processes should be seen as being compatible with social policies to help individuals adjust to new patterns of working. However, the decline of trade union representation (Munck and Waterman, 2002) is likely to have negative effects on the adjustment and selfesteem of workers for whom protection at work is crucial in forming a sense of worth within the work place. For example, occupational patterns are known to play an important role in the formation and maintenance of personal identities [START_REF] Fryers | Work, Identity and Health[END_REF]. One can argue that the social and economic processes that attend globalization have profoundly altered the way in which the working world is experienced, whether in the poorer nations, among large corporations or among low income groups in developed countries.

Identity Shifts

Many commentators have posited cultural cross-communication as a key factor in the breakdown of economic and social boundaries in the world [START_REF] Kelly | Globalisation and Psychiatry[END_REF]. Most commentators agree that globalization as a process incorporates a number of facets that range from the economic (the growth of multinational corporations, the primacy of 24 hour trading), to the cultural (the prominence of English as a lingua franca, the dominance of global brands such as Coke and Nike). The influences of these individual factors on mental health should be addressed separately, while keeping in mind the fact that one group of processes very often amends the other. Modalities such as the Internet, film and television are generating new 'hybrid' identities among the young. Young people outside the West are forging identities in the variegated crucible of global culture, influenced by the Internet, music and television (Bargh and McKenna, 2004: 586). [START_REF] Arnett | The Psychology of Globalization[END_REF] has suggested that this can lead to identity confusion among individuals. Similarly, he argues that the simultaneous possession of a local (more traditional) and a global identity may be a source of stress, especially in the young. Verma and Saraswathi (2002: 105-40) have examined the behaviour of young Indian professionals in this context. They have found that among this group there is both a successful engagement with a widening global workforce and the display of conduct concomitant with traditional rules of behaviour with regard to marriage and family obligations. These behaviours indicate the deployment of two separate rules of behaviour in the spheres of work and home. When one set of identity relationships is made to interact with another, tension and distress may arise, especially if the meanings of these roles are not clear. Anecdotal evidence suggests that the explosion in call-centre employment in India has increased presentations of substance abuse, domestic problems, depression and anxiety to local psychiatrists [START_REF] Basu | The Faces of Globalization: A Dilemma for India[END_REF]. This process may disproportionately affect the young, who are more likely to be faced with the pressures of multiple cultural settings.

The anti-globalization movement has been identified in many quarters with the world's youth (Welti, 2002: 276-306). Patterns of conduct among the young in non-western countries have also changed. Nsamenang (2002: 61-104) has described the loosening of sexual restrictions in sub-Saharan Africa, manifested by increased rates of teenage pregnancy and premarital sex, as examples of the influence of globalization on behavioural norms. The young may be more susceptible to stress from growing up within this milieu of cultural multiplicity and uncertainty, while older individuals may experience a damaging sense of loss at the social and cultural changes being wrought in the wake of globalization. Uncertainty and the sense of feeling like a stranger in strange land are recurring themes among anthropological analyses of modernity. Appadurai (1998: 908) has posited that the phenomenon of ethnic violence can be seen as a manifestation of inherent communitarian tensions wrought by the deforming effect of globalization processes on local and global boundaries. Planes of identity have shifted from the locally sited to the supralocal, and where boundaries between self and other have become unclear, the use of violent behaviour can accompany the process of delineating the other. Bhugra (2003: 473-4), in a commentary on Kelly (2003: 474), suggests that the degradation of traditional individual and kinship identities and norms of behaviour represents the result of an ongoing process of cultural homogenization. Hence, the relationship between individual identity and social expectation must be seen in its broader cultural context and through the overarching lens of globalization. These identities are crucial in understanding the various stressors placed on individuals in daily life.

Identities are also influenced by the type of society in which one resides, whether individualist or collectivist in nature, an approach/model developed by [START_REF] Hofstede | Culture's Consequences[END_REF] and [START_REF] Triandis | Individualism and Collectivism[END_REF] among others. According to Triandis, collectivist societies tend to view individuals 'primarily as part of a whole, and … motivated by the norms and duties imposed by the collective entity', while societies that are individualist tend to be driven by individual preferences and needs. Yet within this general scheme, communities and their individual members may differ in their own orientations -individualist societies may have collectivist individuals, and vice versa -thus creating tension [START_REF] Caldwell-Harris | When Personality and Culture Clash: The Psychological Distress of Allocentrics in an Individualist Culture and Idiocentrics in a Collectivist Culture[END_REF]. Particular orientations are transmitted to members of a community through child-rearing practices and interaction with peers (Asher and Coie, 1990;[START_REF] Rosenthal | Expectations about Development in Greek and Anglo-Australian Families[END_REF]. Globalization and its associated expectations are changing the orientations of people, especially the young, through educational and other institutions as well as through peer pressure, thus creating a culture conflict. As global communication allows the spread of beliefs, narratives and ideas across the globe from their point of origin, they displace previously held ways of seeing and explaining the world, contributing to individual and community tensions. This incongruity between individual self concept and the orientation of the local culture (the 'person-culture fit') has been implicated in the increased rates of mental disorder among migrants [START_REF] Caldwell-Harris | When Personality and Culture Clash: The Psychological Distress of Allocentrics in an Individualist Culture and Idiocentrics in a Collectivist Culture[END_REF]. However, the model may also apply to individuals in collectivist societies whose outlook is at odds with that of their local milieu, and the consequent development of individual stress. The loss of family cohesion as a result of the migration of fathers and husbands may be more harmful in collectivist societies, where evidence suggests that individual satisfaction is correlated with measures of family satisfaction [START_REF] Benet-Martinez | The Interplay of Cultural Syndromes and Personality in Predicting Life Satisfaction: Comparing Asian Americans and European Americans[END_REF].

The spread of economic change, including increasing income inequality, further exacerbate these tensions. [START_REF] Gottfredson | A General Theory of Crime[END_REF] suggest that loss of social cohesion has a tendency to increase individual greed and the societal emphasis on individual achievement. There is evidence that the rates of common mental disorders, crime and divorce go up when societies become more individualistic [START_REF] Maercker | Association of Cross-Cultural Differences in Psychiatric Morbidity with Cultural Values: A Secondary Analysis[END_REF].

The capacity for global communication associated with globalization, including the Internet, has created new pressures and expectations in societies, particularly those outside the West, in relation to wealth, identity and other factors. What is more, anecdotal evidence also suggests that the progressive individualization of young people is altering traditional methods of social support and monitoring of those who might go on to develop distress. Changes in modes of social support have similarly been implicated in increasing rates of mental disorders [START_REF] Brown | Social Origins of Depression[END_REF]. The concept of social capital, roughly defined as 'networks of people deriving benefit from common interaction with each other' (World Bank, 2001), describes the diminution of social cohesion within the local community as being linked to adverse mental health outcomes [START_REF] Mckenzie | Social Capital and Mental Health[END_REF]. [START_REF] Boydell | Incidence of Schizophrenia in Ethnic Minorities in London: Ecological Study into Interactions with Environment[END_REF] have used a related concept, anomie, to explain increased rates of schizophrenia among migrant groups. They argue that the progressively more global scale in which political and legislative decisions are made is creating a growing sense of disenfranchisement. [START_REF] Mahadevia | Communal Space Over Life Space; Saga of Increasing Vulnerability in Ahmedabad[END_REF] similarly illustrates the way in which economic practices might bring about the reduction of social capital, as the role of the state changes from being welfare-oriented to profit-oriented.

In commenting on higher rates of suicide among adolescents in a South Indian population, [START_REF] Aaron | Suicides in Young People in Rural Southern India[END_REF] suggest that conflict between generations and between genders is more problematic among agricultural communities undergoing transformation than in developed countries. The impact of 'global culture' is likely to vary from country to country. [START_REF] Arnett | The Psychology of Globalization[END_REF] suggests the concept of cultural distance as a way of characterizing the effect of globalization on individual cultures: the extent to which the culture is different in essence to western culture might determine how problematic global culture is in a particular area. [START_REF] Hofstede | Exploring Culture: Exercises, Stories and Synthetic Cultures[END_REF] suggest a similar approach.

On an epidemiological level, patterns of psychopathology appear to be changing in certain parts of the world secondary to identifiable economic and cultural changes. Data have linked urbanization with a worsening state of local mental health [START_REF] Blue | The Mental Health of Low Income Urban Women[END_REF]. Fijian girls' exposure to television was found to be associated with increased rates of disordered eating behaviour [START_REF] Becker | Television, Disordered Eating, and Young Women in Fiji: Negotiating Body Image and Identity During Rapid Social Change[END_REF]. In India, rates of eating disorders and suicide are on the increase, phenomena many have linked to changes in social and cultural mores among young people [START_REF] Rahim | Epidemiology of Mental Disorders in Young Adults of a Newly Urbanised Area in Khartoum, Sudan[END_REF][START_REF] Shroff | Body Image and Eating Disturbance in India: Media and Interpersonal Influences[END_REF].

Globalization: An Acculturative Stressor?

Another facet of economic change, that of economic migration, has identifiable effects on mental health within certain settings. Li et al. (2006: 5-13) conducted qualitative interviews with rural to urban migrants in Beijing that revealed feelings of hostility, isolation and poor social adjustment. A dominant theme in the psychiatric discourse on globalization has been the impact of physical migration, a manifestation of globalization, on mental disorder. Acculturation has been highlighted as a key model. Acculturation is the process of adapting one's identity to a new cultural environment, which may or may not create stress. In a similar fashion, anthropological models of globalization have tended to focus on the movement of individuals between localities. What these efforts have tended to ignore is the importance of the non-migrant, the static community of individuals around whom cultural symbols move.

It is probable that factors at work among migrants will be similar among those alienated and disenfranchised by globalization. A number of similarities exist between acculturation as it has been applied to migrants and psychological processes that may be occurring among non-migrants resident in communities that are exposed to rapid social and economic change. Both processes entail the apposition of two cultures, with one set of cultural beliefs dominating the other. Globalization has transformed the dynamics of cultural symbols and concepts -the delineation between cultures is less defined than it has ever been. Modes of exposure to different cultures have broadened with new communication methods. Thus acculturation has become a more variegated and complex phenomenon. Increased identity confusion among the young may be entailed by radical changes in the way culture is defined and transmitted from place to place.

We, along with other commentators, have reflected migration as a stressor, and as a mode by which globalization could be exerting negative effects on mental health. However, it should also be kept in mind that migration has had a huge economic impact in the wealth of developing nations -in 2003 money sent home by migrant workers was the largest source of investment in Latin America [START_REF] Glaister | Emigrants Provide Lifeline to Latin America[END_REF]. More generally, while the transformation of economic practice has important social and cultural effects, globalization has offered, and continues to offer, opportunities for mental health improvement. The continued exchange of researchers between countries will ensure dialogue between research communities and maintain the exchange of 'best practice', while improved access to demographic data in low income countries will allow a better understanding of the mental health profiles of these nations. The development of supra-national approaches to mental health headed by organizations such as the World Health Organization (WHO) and the World Psychiatric Association should allow mental health promotion initiatives to take hold in poorer nations that have borne the brunt of economic shifts. However, despite these opportunities, most observers maintain that the mental health of low income countries is getting worse, not better (WHO, 2000).

Implications

Organizations and individuals responsible for providing care need to address the fact that where there may have been family support structures in the past, many people are likely to be coping with distress alone, or with diminished levels of social support. Volunteers and NGOs (non-governmental organizations) will be factors in providing access to individuals displaced from their local environment for economic reasons. In addition, traditional sources of care must be supported and nurtured. We have discussed social capital as a useful model for doing this, and [START_REF] Cullen | The Interrelations of Social Capital with Health and Mental Health: Discussion Paper[END_REF] outline a number of ways in which reserves of social capital can be built. These include the strengthening of social networks, investment in NGOs, improving ties between groups normally divided along ethnic, religious or other grounds, and building awareness on the part of decision makers regarding the social outcomes of economic policy. In the specific context of mental health, interventions that address social norms, an important behavioural component of social capital, are likely to be useful. Improved communication networks between policy makers in different countries is likely to help rather than hinder this process -in this way, the globalization of communication should be seen as a distinct asset in the drive to improve the psychological well-being of the world's population. However, the mechanisms by which social capital affects mental health remain poorly understood, and for this reason strategies for improving stocks of social capital must be tentative. The transformation of communications methods has broadened the dimensions of social networks to include groups of individuals that are geographically dispersed, so that we can now discuss stocks of social capital among 'communities without propinquity'; delineation of the varied dimensions of social capital must continue apace. Communities wherein people feel in control at work are likely to invest more trust in social life both inside and outside of employment settings. We argue that investment in social capital in areas with social inequality could have major effects not only on status perceptions, but also on psychological well-being.

M E N TA L H E A LT H P O L I C Y A N D G L O B A L I Z AT I O N : R E A C H I N G B E Y O N D S T U D I E S O N M I G R A N T S
We argue therefore for a re-evaluation of mental health policy in view of globalization, one that would look further than migrants, on whom the greater part of mental health interest has been focused, and address indigenous communities where modes of social experience and behaviour are changing. For example, [START_REF] Nasser | Culture and Weight Consciousness[END_REF] asserted that the emergence of anorexia nervosa in non-western countries is attributable to the progressive appropriation of western ideals of thinness in these countries. [START_REF] Bemporad | Self-Starvation Through the Ages: Reflections on the Pre-History of Anorexia Nervosa[END_REF] suggested that eating disorders 'are the price paid for Western civilization' while Abouh-Saleh et al. (1998) have blamed increasing westernization for the incidence of anorexia nervosa in Arab cultures. However, [START_REF] Rieger | Cross-Cultural Research on Anorexia Nervosa: Assumptions Regarding the Role of Body Weight[END_REF] have pointed out that studies of non-western individuals have been contradictory in their analysis of the links between westernization and eating psychopathology. While it is likely that increasing exposure to western culture has played a role in changing aspirations and ideals in much of the rest of the world, the nature and substrate of 'westernization' remain unclear, as does the question of whether western culture can ever be dissociated from the material benefits of trade between nations. The appropriation of western patterns of alcohol consumption, in parallel with alterations in traditional systems of authority, has been linked to increased amounts of hazardous drinking in the developing world (WHO, 2002). The epidemic of suicide among farmers in Warangal in the state of Andhra Pradesh in South India was explicitly linked to the liberalization of agriculture and raises important questions of responsibility -who should provide social support for agricultural workers who lose out to global corporations [START_REF] Shiva | The Suicide Economy of Coporate Globalization[END_REF]?

The relationship between migrants and other, non-migratory individuals in the global world is complex. On one level, the process of acculturation may also be at work as egocentric individuals struggle to come to terms with collectivist orientations in their local culture, in the same way that migrants are exposed to acculturative stress when they reach the new country. In fact, many of the stressors described among new migrants are identical to those likely to be operating among individuals in low income countries exposed to the loss of social cohesion and social capital. A feeling of isolation from the prevalent cultural mores is likely to be present in many cases in both situations, among the migrant and non-migratory individual, particularly the young, outside the West. Added to this will be a possible lack of previously relied-upon safety nets, such as extended family and religious communities for individuals who find themselves in distress. In the West, the work of Galea et al. (2001) has supported the role of social support in protecting against psychiatric morbidity. In particular, the awareness of cultural differences in health belief models should be accounted for in policy making. Locally, social networks, such as voluntary counselling services, religious groups, Internet groups and extended family networks should be identified and nurtured in the face of rapid social and economic transformation.

A shift of emphasis towards occupational mental health issues is also necessary in order to account for the undoubted effects of patterns of employment and income on mental health. The role of multinational corporations in providing mental health support for its employees and their families needs to be addressed. From a national point of view, mental health professionals need to be in a position to advise governments about the psychological effects of economic change and remind them of the universal human rights with respect to mental illness [START_REF] Kelly | Globalisation and Psychiatry[END_REF]. Beyond the implementation of financially viable mental health interventions in low income countries [START_REF] Patel | Efficacy and Cost-Effectiveness of Drug and Psychological Treatments for Common Mental Disorders in General Health Care in Goa, India: A Randomised Controlled Trial[END_REF][START_REF] Sumathipala | Randomized Controlled Trial of Cognitive Behaviour Therapy for Repeated Consultations for Medically Unexplained Complaints: A Feasibility Study in Sri Lanka[END_REF], the specific character of appropriate psychological therapies may also need to acknowledge and adapt factors that have been shaped by globalization phenomena -such as changing patterns of social support and increasing disenfranchisement, as well as increasing financial worries. This could entail an improved awareness on the part of individual caregivers, or changes in the ways therapeutic encounters are integrated into wider care plans. However, incorporating and working alongside traditional health belief models and systems of care will also be important. [START_REF] Schoenbaum | Cost-Effectiveness of Practice-Initiated Quality Improvement for Depression: Results of a Randomized Controlled Trial[END_REF] showed that two quality improvement interventions performed to ameliorate management of depression in a primary care setting in the USA were able to improve work attendance and reduce the total burden of depression. These interventions were found to be cost-effective for employers purchasing the health care. Interventions that incorporated training for health professionals, enhanced educational resources and therapeutic follow-up, in the form of cognitive behavioural therapy or psychotherapy, had statistically significant effects on labour supply, providing one additional month of employment over a two-year period. While this American study does not replicate the conditions of the developing world, the economic argument for investment in the treatment of mental disorders needs to be based on further research into the possible cost benefits to corporations of mental health care for their workforce. In an era of transforming working environments with potentially damaging effects on mental health, there needs to be detailed consideration of the balance between productivity and good psychological functioning and health professionals must be at the forefront of this debate. In an Australian review, [START_REF] Dollard | Mental Health: Overemployment, Underemployment, Unemployment and Heathy Jobs[END_REF] have pointed out the high cost of stress-related problems in the form of employee compensation claims. The significant cost of stress-related claims could be offset by an increased focus on reducing stressful conditions at work.

Not only should we reflect on the impact of increasing levels of international migration on national and community identities, but also the impact of social and cultural transformation on lived experience in low income countries, where the speed of such change appears to be greatest. Economic liberalization should be embraced insofar as it is a way of generating wealth and productivity for the world's poorest nations, but with it should come an acute awareness of the wider effects of economic transformation on the way in which we work and live. In addition, a new understanding of the role of family support and the social impact of displacement needs to be fashioned.

Observers from a range of disciplines have portrayed a globalized world becoming progressively more populated by 'strangers', in the form of political refugees, economic migrants, guests and so on. However, we also know that transformed channels of communication have altered the social experience for people outside the developed world, especially the young [START_REF] Arnett | The Psychology of Globalization[END_REF]. Could it be that indigenous individuals and the communities that support them are feeling as delocalized as those who migrate? There is also responsibility therefore to think more broadly about the effects of globalization on all individuals, not only those located in low income countries, or those who have migrated.

Much of this discussion has involved issues of identity, but as western illness models and therapies spread, what effect will the globalization of psychiatry have on the provision of a framework of care that respects and accommodates different orientations? [START_REF] Timimi | Effect of Globalisation on Children's Mental Health[END_REF] has argued that the notion of 'psychiatry' is an intrinsically western construct and its application to populations outside the West amounts to an unhealthy imposition of a 'problematic' health belief system. Would a psychiatry applied to the non-western world risk exacerbating the problems of identity formation that it seeks to treat? It remains difficult to say whether culturally appropriate modes of mental health care are being provided in cultures outside the West [START_REF] Ohaeri | The Opinion of Caregivers on Aspects of Schizophrenia and Major Effective Disorders in a Nigerian Setting[END_REF][START_REF] Pereira | The Explanatory Models of Depression in Low Income Countries: Listening to Women in India[END_REF]. In a qualitative investigation of women with depression in Goa, [START_REF] Pereira | The Explanatory Models of Depression in Low Income Countries: Listening to Women in India[END_REF] found that interviewees typically expressed their problems through somatic complaints. Somatization of psychological distress has been characterized in a number of developing country settings [START_REF] Aidoo | The Exploratory Models of Mental Health Amongst Low-Income Women and Health Care Practitioners in Lusaka, Zambia[END_REF][START_REF] Turkson | A Study of the Social and Clinical Characteristics of Depressive Illness Among Ghanaian Women (1988-1992[END_REF] and should therefore be at the forefront of any coherent mental health policy in these countries. Policy on mental health must be joined up to that of physical health in a holistic strategy to address the often confusing and porous boundaries between the two.

Concluding Remarks

Globalization, if it is anything, is a multidimensional phenomenon. While the potential disadvantages of economic change for mental health are clear, this needs to be considered in the context of an individual's identity and the orientation of their local community. Economic transformations, manifest in the transformation of labour markets, the rise of the informal sector and increasing inequalities will continue to have a stressing influence unless there are mechanisms and policies put in place to help communities to adjust to new realities. Support should come from governments and NGOs as well as employers themselves. However, these stress factors do not operate in a vacuum. Any interventions should be underpinned by an integrated understanding of 'globalization' as a disparate array of enmeshed social, economic and cultural processes. For example, the vulnerability of individuals to occupational stress will depend on the nature of their social support networks and the fit between an individual's identity and the orientation of their local community. It could be that we are seeing manifestations of social and cultural transition in the increased rates of particular mental disorders outside the West. A programme for ongoing research is needed in order to fully comprehend the complexity of these shifting identities and patterns of experience, both on the individual and community level, and to ensure that local contexts are not lost in the morass of bottom line calculations.

  a c k n ow l e d g e m e n t s The authors acknowledge financial support from the Department of Health via the National Institute for Health Research (NIHR) Specialist Biomedical Research Centre for Mental Health Award to South London and Maudsley NHS Foundation Trust (SLaM) and the Institute of Psychiatry at King's College London.

Bhugra & Bhavsar: Globalization: Mental Health and Social Economic Factors

Global Social Policy 8(3)


clearer about how they relate. There may be all kinds of pragmatic reasons against introducing new laws or policy directives that have little or nothing to do with normative issues. It may be, for example, that legislating against a particular practice drives it underground and makes it harder than ever to detect; it may be (as in the case discussed here) that it proves impossible to restrict a practice without restricting other practices no one intended to curtail; or it may just be that the costs of policing a new law take away resources from policing an older one. It helps to know whether the objections are normative or pragmatic, if only because these require different kinds of solution; and my own preference is to separate out the issues that need to be addressed in determining what justice requires from those to be addressed in determining which policy mechanisms will best achieve this. In her otherwise compelling treatment of the issue of sex-selective abortion, Saharso mixes up the 'moral' and 'non-moral' considerations in ways that make this more difficult to do. Oddly, the effect is that she ends up with a more exclusively pragmatic argument than seemed to be implied at the start.

ANNE PHILLIPS is Professor of Gender

The morality of freedom and the patriarchal bargain

A response to Sawitri Saharso

MONICA MOOKHERJEE

University of Keele

One of the important and welcome aims of Saharso's sensitive treatment of sex-selective abortion (SSA) is to question the oppositions often assumed in political theory between 'tradition' and 'modernity', and between 'liberal' and 'illiberal' cultures. On Saharso's reading, SSA does not signal a conflict between gender equality and cultural diversity. Rather, it exemplifies how gender oppression, culture, and modernity can work together. While I am in sympathy both with this particular point and with Saharso's project as a whole, I am doubtful that her moral-theoretical perspective delivers the conclusions that it claims to generate, or at least that it generates them for the right reasons. I also have broader concerns about its utility as an ethical standpoint in issues pertaining to minority politics. Saharso claims that, even if SSA is morally wrong, this does not mean that the women who choose it are irrational; and neither does it entail that access to abortion should be legally restricted. The different strands of her argument leave me uneasy about the conceptual relationship that she assumes between women's freedom and the question of morality (that is, both the morality of legal intervention and the morality of women's choices). Briefly, my concern is that, where women act in the context of deeply patriarchal social structures, contextual morality as it is presented here does not supply a sufficiently determinate ethical basis for the protection of women's free agency.

CONTEXTUAL MORALIT Y: CONSEQUENTIALIST OR INTRINSICALIST?

I would like to begin by clarifying the moral basis of 'contextual morality'. This is important because it appears counter-intuitive that 'non-moral considerations' should (co)-determine the right answer in cultural practices. While moral considerations are usually those relating to interpersonal standards of justice, in 'contextual morality' it seems that the determinant is pragmatic desire to maximize the overall well-being of women as a social group. Given the limited extent to which SSA occurs in the Netherlands, and therefore the limited number of women who are harmed by this practice, Saharso argues that on balance strong intervention into women's reproductive freedom is unjustified. She appeals to [START_REF] Carens | Culture, Citizenship and Community[END_REF] as a fellow proponent of a 'contextual' approach. However, while Carens does urge political philosophers to attend to 'context', this is because he believes that certain contextual issues might help policy-makers to better implement principles such as the equality and liberty of persons (2000: 1). Carens' 'contextualism' therefore constitutes a principled moral position, whereas Saharso's appears to be pragmatic and utilitarian.

The consequentialist perspective that she generates on SSA appears (paradoxically) overly simplistic, or even rather harsh. It might be too simplistic in assuming that the right answer in ethically problematic debates becomes clear from their contextual features. This is in spite of the fact, which Saharso recognizes explicitly, that these different considerations may leave us in a fundamental moral dilemma: there may be no answer that comes without high moral cost. Alternatively, the solution that contextual morality proposes in regard to SSA might seem too harsh in the sense that the approach advocates no change to the existing 'weak' restrictions on pre-natal diagnostic (PND) testing in the Netherlands. However, such a position offers little or no protection to a woman whose cultural norms and wider life-conditions combine to pressurize her into 'choosing' SSA. It is unclear why paying attention to context entails that the basic human interests of a few women -perhaps those of minority cultures -are less worthy ethically than the good of preserving women's general reproductive rights. In essence, the difficulty is that in seeking to maximize women's overall freedom, contextual morality does not enquire into the social conditions under which particular women make, or fail to make, effective use of those freedoms. The paradoxical result is that, while women are treated equally (that is, in the same way), the apparent egalitarianism of this consquentialist position trades precariously upon the presumed status of all women as equally self-responsible, autonomous moral agents. 1 The matter is no easier if we search within contextual morality for an intrinsic, Kantian respect for the moral dignity of women of all cultural backgrounds. Saharso is rightly concerned that legislation, whether on abortion or on PND, might not ultimately protect diverse women's agency. This is not only because such legislation is paternalistic with regard to the majority of women, but also because it is ineffective in the case of the minority. Therefore, she claims, in India as in the Netherlands, social initiatives are needed to address the systemic abuse of some women's moral rights. While Saharso's claim in this regard appears convincing, we should notice that her main argument justifying stronger PND legislation in India is that women's 'exit-options' are more limited in the Subcontinent than in the Netherlands. In Saharso's view this consideration renders Indian women less 'free'. It is true that the previous absence of strict PND legislation had particularly left poorer Indian women open to exploitation by those who administer sex-determinative testing such as amniocentesis and ultrasound under clinically unsafe conditions (Ramamanna and Bambawale, 1980). Nonetheless, it is not clear that such exploitation would be eradicated by the existence of women's 'exit-options'. At a general level it is problematic to assume that a person's capacity to exit from their culture is the measure of their real freedom; and it is not clear how an individual can 'exit' from her inherited culture without incurring a disproportionate emotional personal cost. Ultimately, the use of 'exitoptions' to sustain a moral distinction between a person's freedom and unfreedom trades upon an untenable dichotomy between her cultural context and her free agency.

An analysis of both the consequentialist and Kantian readings, then, suggests that 'contextual morality' reaches its conclusions on SSA for the wrong reasons. Each reading exposes a problematic narrative within 'contextual morality' regarding the relationship between women's freedom and their wider context of choice. In fact, both readings tend to expose Saharso's presupposition of an agent whose actions are curiously dislocated from her cultural and material context. It is, however, exactly the assumption of the self-determining, self-responsible agent that should be questioned when thinking about the predicament of a woman who chooses SSA [START_REF] Weiss | Sex-selective Abortion: A Relational Approach[END_REF].

'MORAL MISTAKES' AND THE PATRIARCHAL BARGAIN

Saharso is worried about the strong paternalism involved in regulating women's freedom to make choices that are antithetical to 'popular' (western, liberal) morality. She thus defends women's rights to act for their own culturally specific reasons. However, against Saharso, it seems to me that attention to the context in which some women choose SSA justifies a more strongly interventionist state than she recommends. This is because, in context, SSA does not constitute an immoral but free choice, as Saharso believes. It is worth examining why. While Saharso convincingly emphasizes the distinction between external autonomy ('acting freely in the world') and internal, 'intrapsychic' autonomy, this distinction does not easily support her view that if a woman has internal reasons for choosing SSA, one can therefore presume that her choice is free. I agree that, if a woman fears for her marriage and even her life, and on that basis chooses SSA, her decision is neither random nor capricious; rather, it is instrumentally rational. It would be imperialistic to assume that the woman is a mere 'cultural dupe'. The woman might have cultural reasons for preferring male sons, reasons which are ultimate and compelling for her in her situation. However, women can surely be rational and unfree at the same time. [START_REF] Kandiyotti | Bargaining with Patriarchy[END_REF] coined the term 'patriarchal bargain' to describe how women 'strategize' when confronted with severe constraints in patriarchal societies. On this view, a woman's option for SSA may constitute the most rational and even most empowering decision that she could possibly make. By choosing to abort a female foetus she addresses the problem of gender inequality directly, not only by protecting herself from a loss of social status within her community, but also by saving her unborn child from a life of sexual subordination.

While SSA could constitute a rational, empowering and thus a moral choice, the ethical problem is whether such a choice is genuinely free. Saharso, by contrast, suggests that the difficulty is that, while SSA is 'immoral' (since it expresses norms of gender inequality), nonetheless we should separate this consideration from the woman's freedom to choose. In so doing, however, she relies on a heavily overdrawn public-private dichotomy. While 'political' liberals might insist on this distinction, feminist thinkers often insist with good reason that norms in the 'private' or cultural sphere might seriously limit a woman's freedom. This problem seems acute, since SSA is directly tied to community beliefs that may make it appear to a woman 'the only viable' option (Weiss, 1995: 202). I share with Saharso a deep resistance to the notion that, if a woman acts for reasons that differ from those of the majoritarian culture, her standing as a moral being may be questioned. I nonetheless believe that Saharso's use of a public-private distinction sidesteps the causal relation between the woman's decision and her wider cultural and social context. Related questions arise with regard to practices such as widow-immolation, which women sometimes appear to choose autonomously. One might argue that since the effects of widow-immolation are physiologically extreme (insofar as the practice results in death or serious disability), the practice differs essentially from SSA. However, both practices raise similar questions regarding women's effective freedom where they are constrained to 'bargain' with patriarchal structures. It is unclear how contextual morality responds to the harder cases. [START_REF] Weiss | Sex-selective Abortion: A Relational Approach[END_REF] is correct to maintain that women do not make immoral choices in such situations. Rather, they make a moral mistake. For example, a woman might 'choose' SSA in good faith, in the sense that the elimination of a female foetus represents her genuine attempt to contain the conflicts generated by patriarchy. However, she makes a mistake because the choice is not made freely, and neither is it liberatory in its outcomes. The woman's participation in the practice results in reinforcing the very conditions of female subordination which gave rise to the conflict (Weiss, 1995: 297). The problem with widow-immolation and SSA is, then, that they sustain the conditions of unfreedom that preclude a renegotiation of the woman's interests and community norms. The more difficult question is, therefore: if certain women do not choose SSA freely, can their unfreedom be explained by the content of their culture's moral norms? I learned a great deal from Saharso's detailed exploration of SSA. Contextualism is compelling precisely because of the dissatisfaction that feminists, amongst others, have expressed with the abstract disembodiment of much modern ethical reasoning. While human beings surely always act within historically specific frameworks [START_REF] Macintyre | Whose Justice? Which Rationality[END_REF], I am nonetheless concerned that this contextualism might not provide the ethical ground for fostering minority women's effective freedom in the context of the patriarchal structures in which they are embedded.

MONICA MOOKHERJEE is a lecturer at the University of Keele. Address: SPIRE -Politics, International Relations and Philosophy, Keele University, Staffordshire, ST5 5BG, UK. [email: m.mookherjee@ keele.ac.uk]

Sex-selective abortion

A reply

SAWITRI SAHARSO

Free University, Amsterdam Sex-selective abortion (SSA) is a subject that raises troubling questions about multiculturalism, gender and autonomy that defies a definitive answer. My article was a step towards addressing this complex issue. I am grateful therefore to my discussants for their thoughtful comments on my article.

Before I respond to what I take to be their major criticisms, let me correct a factual misunderstanding. The Netherlands does not have, as Miriam Ticktin thinks, a policy of free access to pre-natal diagnostics (PND), nor am I arguing that it should have.

Ticktin claims that I am taking a culturalistic perspective that would prevent me from seeing what is really at stake. SSA is a practice that, according to her, is shaped by state violence against and discrimination of

  Theory in the Gender Institute and Government Department, London School of Economics. Address: Gender Institute, London School of Economics, Houghton Street, London WC2A 2AE, UK. [email: a.phillips@lse.ac.uk]

The argument also seems to be counter-intuitive on 'contextualist' grounds themselves. The appeal to maximizing overall outcomes complicates any justification for the special protection of minorities, because, presumably, minority interests are (quantitatively) outweighed by those of the majority on any given issue.

Notes


Sawitri Saharso
email: s.saharso@fsw.vu.nl

MONICA MOOKHERJEE is a lecturer at the University of Keele. Address: SPIRE -Politics, International Relations and Philosophy, Keele University, Staffordshire, ST5 5BG, UK. [email: m.mookherjee@ keele.ac.uk]

Sex-selective abortion

A reply

SAWITRI SAHARSO

Free University, Amsterdam Sex-selective abortion (SSA) is a subject that raises troubling questions about multiculturalism, gender and autonomy that defies a definitive answer. My article was a step towards addressing this complex issue. I am grateful therefore to my discussants for their thoughtful comments on my article.

Before I respond to what I take to be their major criticisms, let me correct a factual misunderstanding. The Netherlands does not have, as Miriam Ticktin thinks, a policy of free access to pre-natal diagnostics (PND), nor am I arguing that it should have.

Ticktin claims that I am taking a culturalistic perspective that would prevent me from seeing what is really at stake. SSA is a practice that, according to her, is shaped by state violence against and discrimination of immigrant minority groups. I have no problem in acknowledging that the Netherlands' policy towards immigrant groups is harsh and that the racist prejudice the Dutch display against immigrants is alarming. Yet they do not constitute the cause of SSA. At the root of the problem is a cultural son preference and we should be prepared to acknowledge this.

This sex preference is linked to the tradition of providing a daughter with a dowry when she marries. In my article, I explained that, due to a process of commodification of the tradition, some families now demand very expensive consumer goods for a dowry gift and therefore a daughter's marriage may economically ruin a family. This is an important background to this sex preference. I think, therefore, that I deploy a more materialist notion of culture than Ticktin thinks.

Monica Mookherjee believes that I leave women in the cold who are pressurized into 'choosing' SSA, because I do not pay enough attention to the social conditions under which these women make their choice. According to her I herewith display a non-relational view on autonomy that sees all of us as equally free to determine our lives, while Ticktin suggests that I see western women as fully autonomous and the rest of us as non-autonomous victims of our culture. I agree that I did not discuss at length how Asian women's autonomy can be enhanced, as my focus was on whether measures to ban SSA should include restricting access to abortion. I consider both Dutch and Asian women as capable of autonomy, yet both as also constrained in exercising their autonomy, albeit by different social and cultural conditions. Making the abortion law more restrictive does not lift these constraints. Social policy may, however, and therefore this is what I see as a better way to offer protection to women who are pressurized to undergo a SSA. Anne Phillips's main worry, which she shares with Monica Mookherjee, is that my contextualism will end in pure pragmatism. Phillips expresses the classical philosophical preference: first we determine whether a practice is morally right or wrong (the philosopher's job), and once we know what justice requires, the policymaker decides on the implementation of actual policy. The actual policy-outcome may be co-determined by pragmatic concerns, but these fall outside the philosophical analysis. I do not believe in this neat job delineation, moreover, I think that what to do as a matter of policy is a question that normally also involves moral considerations.

To illustrate my point let me bring forward Stephen Macedo's discussion of the Mozert and the Yoder cases. In Mozert v. Hawkins, a conflict over public education and religious diversity, orthodox Christian parents objected to the school's mandatory basic reading program that exposed their children to a variety of worldviews. The parents claimed a right to exempt their children from the reading program, while remaining in the public schools (Macedo, 1995: 472). Macedo decided that on principled grounds the Mozert families should not be accommodated. He added to this that there are also prudential reasons that might be considered -school administrators might anticipate that the families would otherwise withdraw their children altogether from the public school system and for that reason accommodate them -but these come secondary, and he even doubted whether courts should at all examine these 'additional grounds', as he called them (1995: 487, 488). Hence, Macedo distinguished between principlebased and pragmatic arguments while arguing that we should take into account the former only. Yet, note that Macedo, whilst against accommodating the Mozert parents, thought it right to accommodate the more radical claim of Amish' parents (the Yoder case) to altogether withdraw their school-aged children from high school, since the Amish, because of their small number, pose no threat to public order (1995: 472, 489). Hence, it was ultimately a pragmatic argument about numbers (sic!) that settled for Macedo whether to accommodate or not. Contextual arguments interpenetrate with principled arguments. In a contextual approach, this is acknowledged and considered as inescapable. Principles are generic and as such underdetermined. To make sense of them and to be able to make a judgement in specific cases we need contexts.

This being said, I do share Phillips's worry that there is the risk to Carens's -and as I follow his approach (Carens, 2000), also my -contextualism that we end up with a kind of 'moral casuistry', as Seyla Benhabib so aptly phrases it (2002: 125). By this she means the risk that we confuse 'the normatively right' with 'the institutionally feasible ' (2002: 125). The problem with Carens's contextual approach is that pragmatic arguments may co-determine our moral deliberation, yet it remains unclear to what extent. I think Benhabib touches the sore spot in Carens's approach, yet I do not see a ready solution. New rules of lexical priority? Which ones? Besides, they seem to go against the grain of the approach. In the meantime, unsatisfactory as it may seem, we have no choice but to contextually argue it out.

The argument also seems to be counter-intuitive on 'contextualist' grounds themselves. The appeal to maximizing overall outcomes complicates any justification for the special protection of minorities, because, presumably, minority interests are (quantitatively) outweighed by those of the majority on any given issue.


as an unfolding diacritical process that determines us makes us realize that we cannot preexist our relation to what we come to 'know' (or 'choose' or 'fight') in any sense that gives comfort or security. Difference remains a critical resource insofar as it addresses this productive relation that cannot be known in advance. Difference is demonized in its troubling form as a determining power.

Consider the repeated warning in the US after the 9/11 attacks: if Americans change as a result of the attack -if we stop shopping or visiting Orlando -the terrorists have won. Defeating terrorism was curiously presented as a matter of remaining as we were, going on with our 'normal' lives; terrorism, we were warned, must make no difference. This exhortation coexisted with the insistence that everything had changed, post-9/11; we must live with new 'realities'. Difference is abjected; differences -in our civil liberties law, in our conduct of war, in our public life -abound.

ELLEN ROONEY is Professor of Modern Culture and Media, English and Gender Studies at Brown University. Address: Department of Modern Culture and Media, Box 1957, Brown University, Providence RI 02912, USA.

[email: Ellen_Rooney@brown.edu]

Insufficient difference

LISA LOWE

University of California, San Diego

I understand the proposed 'predicament of difference' to be a provocation to think through the reasons that our projects directed toward social transformation currently confront a certain analytic exhaustion, or even banality, in the term 'difference'. The complexity of societies -so layered with multiple cultures of historical encounter, colonialism, indigeneity, cross-border migrations, transnational, multilingual communities, and syncretic religious cultures -is evidently inadequately understood through the analytic resources of the concept of 'difference'. There is, I think, something to be learned both by observing the reasons for the continuing desire to 'work' the term to its limits, and moreover, by generating suggested alternatives to this repetitive insistence. To this end, I make several observations. The first observation is that the current limitations of the model for conceiving modern race, culture, and ethnicity in terms of the concept of 'difference' -whether in university study, in social or state discourses of multiculturalism, or in some cultural representations themselves -derives from Weberian sociology and its comparative method. This is not to say that philosophers, poets, and geographers did not compare one thing to another in the ancient or early modern worlds, but rather to emphasize that it was with Weber that such comparisons became an institutionalized method for producing modern knowledge about social and cultural forms. Weber is well known for having observed that social behavior in modern western society of the early 20th-century had come to be dominated more and more by goal-oriented rationality and instrumental reason, and less and less by traditional values and forms of sociality. Rational action within modern western industrial society constituted the ideal type, a heuristic proposition that founded Weber's Verstehen, or 'interpretative' sociology, against which the difference, variance, or convergence of specific social and historical instances were measured. 'For the purposes of a typological scientific analysis', he wrote, 'it is convenient to treat all irrational, affectually determined elements of behavior as factors of deviation from a conceptually pure type of rational action' (Weber, 1968(Weber, [1922]]: 6). This ideal-typical construction of 'pure rational action' presumed the individual within the context of modern western industrial society, and measured the different degrees of rationalization as 'deviations', by comparing concrete social instances to this normative regulatory type.

The second observation is that while the conditions of contemporary globalization have made evident the insufficiency of 'difference' as a critical analytic, perhaps the point is not only to evaluate 'difference' in terms of its adequacy, but more to situate it within the 20th-century duration of its institutionalization, to understand the reasons for its role within modern technologies of racial administration. Centering western industrial society as the normative ideal type against which 'difference' was conceived mediated a racial epistemology emerging out of an earlier conjunction of European colonialism and slavery in the 'new world'. We might understand Weber's comparative method as the institutionalization of 'difference' as a modern apparatus for apprehending and disciplining otherness, or what Michel [START_REF] Foucault | Governmentality[END_REF] would term a governmentality, according to which other groups, societies, and formations were studied either as analogues destined to assimilate to western classifications, or as 'pathological' deviants to be eliminated or suppressed [START_REF] Calhoun | Critical Social Theory: Culture, History and the Challenge of Difference[END_REF]. Modernization studies [START_REF] Levy | Modernization and the Structure of Societies[END_REF][START_REF] Levy | Modernization: Latecomers and Survivors[END_REF][START_REF] Parsons | The Evolution of Societies[END_REF] epitomized the western-centered developmentalism that cast other societies as culturally different 'latecomers'. Oftentimes, the Asiatic or 'oriental' has been cast as a homology to the West, in relation to the African or Muslim deviance. Sociologists of religion [START_REF] Bellah | Beyond Belief: Essays on Religion in a Post-Traditional World[END_REF] differentiated between the 'this-worldly asceticism' of Protestant Christianity in the industrial West, and the less modern, 'world-rejecting' belief systems of non-Christian societies, going so far as to argue that the social and economic development in China and Japan was due to a 'Protestant ethic analogy in Asia'. Despite the many critiques of orientalist knowledge productions by Edward Said (1977), James [START_REF] Clifford | The Predicament of Culture[END_REF], Talal [START_REF] Asad | Genealogies of Religion: Discipline and Reasons of Power in Christianity and Islam[END_REF], and others, the contemporary 'clash of civilizations' thesis [START_REF] Huntington | The Clash of Civilizations and the Remaking of World Order[END_REF] demonizes Islam as an irrational 'culture of violence' antagonized by the pressures of modernization. Comparative sociologists of religion (Jurgensmeyer, 2000) recur to the cultural difference model, casting Islam as a resurgent religious fundamentalism in critical protest to the current materialism of globalization. The legacy of the comparative model was firmly established in the US sociological study of race and ethnicity, as well. As Henry Yu (2001) and Roderick [START_REF] Ferguson | Aberrations in Black: Toward a Queer of Color Critique[END_REF] have observed, Chicago School sociologists in the early and mid 20th-century studied 'orientals' as ethnic groups who could become an assimilable 'model minority', in relation to negro racial difference constructed as irremediably, or 'pathologically', deviant. Insofar as increased international immigration in the late 20thcentury has rendered the US national discussion of race and ethnicity more global and diversified, we might also say that a pluralistic discourse of 'difference' continues to work through a governmentality that assimilates immigrant newcomers who resemble the normative ideal type and 'racializes' those whose 'cultural differences' seem too 'different' -whether the alleged cultural difference inheres in a lack of literacy or education, or a perceived threat to national security.

The third observation is that important work in the last three decadesfrom US ethnic studies, British cultural studies, French critical theory, transnational feminism, postcolonial theory -has strategically elaborated 'difference' as more than what was assimilated or excluded by the ideal type and its normative regulations and suppressions. Scholars in US ethnic studies [START_REF] Omi | Racial Formation in the United States: From the 1960s to the 1990s[END_REF] and in Black British politics [START_REF] Hall | New Ethnicities[END_REF] theorized 'racial formation' as an ongoing dialectical process of negotiation between the state and social groups, providing for the importance of oppositional social movements and practices in actively transforming the state's definitions of both the 'whiteness' of normative citizenship and the 'difference' of racialized groups. French post-structuralism [START_REF] Derrida | Of Grammatology, trans[END_REF] elaborated 'différance' as a operation dynamically revealing the means through which every paradigm or organizing structure -whether epistemological, aesthetic, social, political -constituted itself through the exclusion of 'difference'; the constitutive exclusion leaves a trace through which the difference returns and unsettles the apparent closure of the established model. Postcolonial and transnational feminist theories have evinced the manners in which the figure of third world women has been constituted as the 'difference' both marking and enacting the limits of a range of modern universalisms (Spivak, 1987;Mohanty and Alexander, 1991).

However, alongside this critical work, it remains urgent to explore alternatives to the concept of 'difference', which nonetheless reinscribes the sociological method of 'comparison' and its normative governmentality that disciplines race, religion, gender, sexuality, and nation. As an alternative, we might consider a genealogical study that would both situate 'difference' within the modern apparatus of comparison and attempt to retrieve the fragments of mixture and convergence that are 'lost' through modern comparative procedures. We might excavate what has been suppressed under the rubric of 'difference', by considering the varieties of 'entanglements', 'imbrications', 'intimacies', or 'encounters' out of which the normative and the different have emerged as classes for modern racial understanding. In contrast to the comparative study of racial and ethnic groups as separate, comparable entities within singular histories, we might inquire instead into the historical purposes of such notions of discrete identity or necessary analogy, and would attempt to explain their emergence. A genealogical study would not only locate comparison as a paradigm coterminous with the purposes of colonialism and the modern division of labor, but it would also interpret the subjugated remainders of encounter, the foreclosed traces of mixture or creolization. Foucault referred to genealogy as an attempt 'to desubjugate historical knowledges, to set them free, or in other words, to enable them to oppose and struggle against the coercion of a unitary, formal, and scientific theoretical discourse' (Foucault, 2003: 11).

To study both the history of the modern apparatus of unitary formal theoretical discourse, and the 'entanglements' or 'imbrications' that the discourse has classified and suppressed, would entail excavating cultural geographies of encounter and mixture, not as 'origins' of singular subjects, but as epistemes, as ways of inhabiting and knowing various divisions of the social at given times. The study of the black diaspora may, for example, as Robin D.G. Kelley provocatively suggests, provide an occasion to chart more than black identities and political movements, mapping what Kelley calls 'other streams of internationalism not limited to the black world' (Kelley, 2002: 124). A study that emphasized these 'other streams' would involve a genealogy of the hemispheric conjunction of 'new world modernity', linking the forcible and voluntary migrations of black Africans with, on the one hand, the extermination of native peoples and the colonial importation of Asian contract labor at the 'end' of the slave trade to supplement the 'emancipation' of slaves, and, on the other, the rise of modern capitalism and the emergence of European modernity. It is, as Fernando [START_REF] Ortiz | Cuban Counterpoint: Tobacco and Sugar[END_REF][START_REF] Ortiz | Cuban Counterpoint: Tobacco and Sugar[END_REF]) observed, to understand that sugar was 'mulatto' from the start. Or as Stuart Hall comments, referring to several centuries of Asian presence in the Caribbean: 'when you visit Guyana or Trinidad, you see symbolically inscribed in the faces of their peoples, the paradoxical 'truth' of Christopher Columbus' mistake: you can find 'Asia' by sailing west, if you know where to look!' (Hall, 1994: 395). The temporalizing of difference

CHRISTINE HELLIWELL AND BARRY HINDESS

The Australian National University, Canberra

In his inaugural lecture as Professor of History at the University of Jena in 1789, Freidrich von Schiller observed that European voyages of discovery had provided his audience with a spectacle which is as instructive as it is entertaining. They show us societies arrayed around us at various levels of development, as an adult might be surrounded by children of different ages, reminded by their example of what he himself once was and whence he started. A wise hand seems to have preserved these savage tribes until such time as we have progressed sufficiently in our own civilization to make useful application of this discovery, and from this mirror to recover the lost beginning of our race. (1972[1789]: 325)

The most striking features of this passage are, first, its suggestion that many of Schiller's contemporaries, living in distant parts of the world, were really anachronisms, people who belonged to an earlier time, and, second, its reference to children, as if to say that these people were less than fully mature, that their intellectual and moral capacities were relatively undeveloped. This developmental view of humanity was widely shared by educated Europeans of the Enlightenment era, and it has since remained remarkably influential in western social and political thought. It fosters the apprehension of at least two kinds of difference: that between and within peoples who are seen as being at roughly the same level (between and within, say, the English, French and Germans) and that between peoples who are seen as

  Said, E. (1977) Orientalism. New York: Random House. Spivak, G.C. (1987) In Other Worlds: Essays in Cultural Politics. New York: Methuen. Weber, M. (1968[1922]) Economy and Society: Volume I. New York: Bedminster. Yu, H. (2001) Thinking Orientals: Migration, Contact, and Exoticism in Modern America. Oxford: Oxford. LISA LOWE is Professor of Comparative Literature in the Department of Literature at University of California, San Diego. Address: Department of Literature, 0410, University of California, San Diego, 9500 Gilman Drive, La Jolla CA 92093, USA. [email: lmlowe@ucsd.edu]


LISA LOWE is Professor of Comparative Literature in the Department of Literature at University of California, San Diego. Address: Department of Literature, 0410, University of California, San Diego, 9500 Gilman Drive, La Jolla CA 92093, USA. [email: lmlowe@ucsd.edu]

The temporalizing of difference CHRISTINE HELLIWELL AND BARRY HINDESS

The Australian National University, Canberra

In his inaugural lecture as Professor of History at the University of Jena in 1789, Freidrich von Schiller observed that European voyages of discovery had provided his audience with a spectacle which is as instructive as it is entertaining. They show us societies arrayed around us at various levels of development, as an adult might be surrounded by children of different ages, reminded by their example of what he himself once was and whence he started. A wise hand seems to have preserved these savage tribes until such time as we have progressed sufficiently in our own civilization to make useful application of this discovery, and from this mirror to recover the lost beginning of our race. (1972[1789]: 325)

The most striking features of this passage are, first, its suggestion that many of Schiller's contemporaries, living in distant parts of the world, were really anachronisms, people who belonged to an earlier time, and, second, its reference to children, as if to say that these people were less than fully mature, that their intellectual and moral capacities were relatively undeveloped. This developmental view of humanity was widely shared by educated Europeans of the Enlightenment era, and it has since remained remarkably influential in western social and political thought. It fosters the apprehension of at least two kinds of difference: that between and within peoples who are seen as being at roughly the same level (between and within, say, the English, French and Germans) and that between peoples who are seen as being more and those who are seen as less mature or, as in Schiller's case, between those who are understood as belonging to the present and those who are understood as remaining at various points in the past. Difference, in this last case, is seen as a deficiency to be overcome. This view underlies the widely observed discrepancy between the universal principles advanced by both liberal and cosmopolitan thinkers and their decidedly particularistic proposals for the government of the subject peoples in European imperial possessions. James Mill's 1825 'Essay on Government', for example, makes what seems to be a universalistic case for the claim that representative government is the only effective means of keeping the ruling elite under control [START_REF] Mill | Essays on Government, Jurisprudence, Liberty of the Press, and Law of Nations[END_REF](Mill, [1825]]. Yet a few years later, giving evidence to a Parliamentary Committee in 1831, Mill presents a radically different view, arguing that there is no reason for the people of India to play any part in their own government. So long as the business of government is well and cheaply performed, he argues, it is of little or no consequence who are the people performing it. Here, as so often in western political thought, it seems that universal principles appropriate to the government of mature peoples are not seen as appropriate to the government of their less mature contemporaries.

The relegation of whole peoples and ways of life to the status of anachronisms, so clearly displayed in Schiller's lecture and again in many western reflections on colonial rule, is of more than merely historical interest. The familiar social scientific discourse of modernity is predicated on a similar move, dividing the contemporary world into portions which are fully of our time, those which have yet to reach it and even, in some versions of the discourse, those which have moved on to a postmodern condition. Nor is the problem confined to academia. While direct colonial rule has long since been abandoned by western states, the developmental perspective which dominated much of its practice continues to inform the work of major development agencies, the human rights and other international regimes that constitute the contemporary equivalent of the older, European standard of civilization in international affairs, and other aspects of the West's interactions with the non-western world. Susan Rose-Ackerman, who has worked closely with the World Bank, observes in her Corruption and Government (1999) that what counts as corruption often depends on context: 'one person's bribe is another person's gift'. Yet, while not denying the reality of such cultural differences she aims to show 'as an economist . . . when the legacy of the past no longer fits modern conditions' (p. 5).

Here, the development economist presumes to pass judgement over contemporary cultures and practices, dividing them into elements that belong in the modern world and those that belong in the past. An example of a different kind appears in many American perceptions of the Islamic world. Here is the New York Times columnist, Thomas Friedman, writing on the need for the West to win support from moderate Muslims:

America and the West have potential partners in these [Islamic] countries who are eager for us to help move the struggle to where it belongs: to a war within Islam over its spiritual message and identity, not a war with Islam . . . [but] a war between the future and the past, between development and underdevelopment, between authors of crazy conspiracy theories versus those espousing rationality . . . Only Arabs and Muslims can win this war within, but we can openly encourage the progressives. (2002) This passage brings out another aspect of the temporalizing of difference. Not only is Islam divided into elements that belong to the present and those that belong to the past, but the latter is seen as distinctly irrational.

We argue that the temporalizing of difference also infects the government of western states themselves. Much discussion of the politics of difference starts with the claim that liberal democratic politics pays too little attention to the significance of difference. Will Kymlicka's Multicultural Citizenship, for example, notes that the liberal and democratic currents of modern political thought have 'operated with an idealized model of the polis in which fellow-citizens share a common descent, language and culture' (1995: 2). Similarly, Jim Tully's Strange Multiplicity (1995) argues that received understandings of the constitutional framework of government tend to assume that a uniform set of laws and conventions for their interpretation should apply to all members of the population. These works belong to an influential body of literature which suggests that indigenous peoples, ethnic minorities and other groups might be oppressed by precisely the equality of citizenship which the rule of uniformity seems to require, that is, by the assumption that there is, or should be, a single overarching way of life among the citizens as a whole.

We prefer a more complex view [START_REF] Helliwell | The "Empire of Uniformity" and the Government of Subject Peoples[END_REF]. Of course, there are important contexts in which people are discriminated against because their distinctive needs and concerns are not acknowledged, but there are others in which, far from being ignored, their distinctive character is both acknowledged and stigmatized. The contemporary stigmatization of difference takes many forms, of course, but among the most pervasive are those which, like the cosmopolitan views of the European Enlightenment, associate many kinds of difference with a lack of civilization or maturity. It even appears in some versions of multiculturalism. Consider the case of Will Kymlicka, who makes a powerful liberal case for the collective rights of indigenous peoples and other minorities. His claim is not simply that participation in a culture is required to provide people with a meaningful context for individual choice, but that they must participate in a culture of a very special kind, which he calls a 'societal culture': that is, a culture which provides its members with meaningful ways of life across the full range of human activities, including social, religious, recreational and economic life, encompassing both public and private spheres. (1995: 76) On the one hand, he argues that each of America's indigenous groups, at the time of their forcible incorporation into American society, 'constituted an ongoing societal culture. . . . encompassing all aspects of social life' (p. 79). At this point in his argument, there is no necessary connection between societal culture and modernity. On the other hand, he draws on Ernest Gellner's treatment of nationalism and modernity to argue that societal cultures and the individual liberty which, in his view, they alone can sustain are essentially features of modern -that is, liberal democraticstates (76-7). Here, it seems, societal culture is essentially a product of 'modernization', and the features Kymlicka attributes to societal culture are simply not to be found either in pre-modern conditions or, indeed, in many contemporary cultures, including those of indigenous minorities.

The perception that some groups are considerably less advanced than others, and consequently that the individuals who belong to them (and perhaps even their descendants in other parts of the world) may not yet be fit to govern themselves, clearly plays a significant part in the politics of all modern democracies, especially in the treatment accorded to non-western immigrants and indigenous peoples. This point allows us to suggest a more nuanced perspective on the situation of indigenous and other disadvantaged minorities in contemporary western states. While, as Tully so clearly demonstrates, their difference is effectively denied by the liberal rule of uniformity, it is at the same time powerfully affirmed by liberalism's historical and developmental perspective. Not only are these minorities subjected in important respects to the damaging rule of uniformity, but they are also treated in other respects as inferior, as not yet capable of properly managing their own affairs.

Any solution to the problem posed by the modern experience of cultural diversity must involve significantly more than a recognition and accommodation of difference; it must also involve a reform of attitudes towards, and practices for dealing with, the commonplace view that certain types of person and ways of life are caught in the past.

When difference becomes an instrument of social regulation CHUA BENG-HUAT

National University of Singapore

The histories of discrimination and exclusion of non-white migrant communities in developed countries of the West have given rise to the following demands: (a) recognition of the different groups' contributions to the respective nation's past; (b) respect for cultural differences of the different groups to be legally recognized and instituted through; (c) 'multiculturalism' as national cultural policy. All these demands can be justified within the liberal democratic promise of social equality and justice. 'Difference', especially ethnic-cultural differences, is thus a code word for the larger issue of redressing historical injustices.

The demands are often resisted. Simplistic arguments against 'multiculturalism' suggest that it undermines national unity which is, supposedly, built on 'shared' values. In reality shared values are insufficient for national unity. On the other hand, value differences between groups do not necessarily lead to national disunity. More sophisticated arguments find common ground within the liberal principle of equality of individuals. This demands that the state and its public policies be 'difference blind' to avoid