From rationalities to lifeworlds: analysing the everyday handling of uncertainty and risk in terms of culture, society and identity

Introduction

In this editorial, I introduce the third annual ‘theory special issue’ of Health, Risk & Society. This series is designed to develop social theories of uncertainty and risk through providing a forum and foci for key topics and debates to be considered and refined. The theorising work of authors in these issues typically takes different forms, through guest editorials, review articles and original research articles which combine the empirical and the theoretical in different formats. In introducing the 2016 special issue, I first briefly sketch the background and rationale of the issue before moving to reflect on Zinn’s (2008) influential article on everyday rationalities for managing risk and uncertainty. I will then begin to introduce Zinn’s (2016) guest review in this issue which provides his own reflections on and developments of key themes from the 2008 article. I will then provide an overview of the issue through introducing the five original research articles in the issue.

In doing this, I move to identify some common emerging themes within these analyses which I then develop to consider the lifeworld as a potentially fruitful concept for developing analyses of everyday experiences and handling of uncertainty and vulnerability through various approaches. I present a conceptualisation of lifeworld which I develop out of Schutz (1967) and Habermas (1987) but which I then adapt and consider in relation to everyday handling of uncertainty and risk (Brown, 2016). As the ‘self-evident’ and evolving ‘reality’ through which we experience, understand and interpret the social world (Schutz & Luckmann, 1973:3), the lifeworld also configures our ‘horizon of possibilities’ regarding the future; making certain futures and ways of categorising thinkable, while simultaneously (de)legitimising and (in)authenticating practices of pursuing these futures (Brown, 2016; Habermas, 1987). While this conceptualisation draws significantly on phenomenology and Habermasian thought, I propose lifeworld(s) as an accessible sensitising concept and tool which has many analytical possibilities which are relevant and usable across a broad range of analyses in the interpretivist tradition.

In various senses, the topic of this issue – Dealing with Uncertainty and Risk in Everyday Practice – is a useful and logical development of several themes emerging across earlier volumes of Health, Risk & Society and especially the preceding theory special issue of 2015. Within that double issue (vol 17; 3–4), the chief aim was to develop theories of uncertainty and risk through insights from ‘non-Northwestern’ contexts (see Brown, 2015 for an overview). The various authors of the editorials, review article and original research articles in that issue problematised and nuanced a number of common assumptions which are sometimes explicit but often implicit within risk research, not least: the association of rational approaches to uncertainty with ‘Western-modernity’; the fairly singular linearity of rationalisation tendencies within similar contexts of modernisation; and the tendency towards the secularisation of approaches to uncertainty amid risk cultures. The special issue authors instead emphasised several common themes including complexly interwoven processes of risk, trust, hope, faith and the magical. This interwovenness was as much a contemporary feature of handling uncertainty in Eastern Africa (Desmond, 2015), Indonesia, Singapore and Malaysia (Bastide, 2015) or Burma (Coderey, 2015), as it was in Japan (Armstrong-Hough, 2015; Alaszewska & Alaszewski, 2015), or as was the case of classic studies by Malinowski (the Trobriand Islanders), Evans-Pritchard (the Azande) and Douglas (the Lele) (Alaszewski 2015).

This challenging of earlier assumptions and delineations around rational approaches to risk and an attentiveness to multiple and combined rationalities lay at the heart of Zinn’s (2008) analytical framework. Analytical considerations captured in and/or emerging from that article are the key points of reference for this 2016 special issue collection. I am very grateful to Jens for his cooperation and encouragement in developing this special issue, as well as to Andy Alaszewski for the platform within the journal and his very thorough editorial work and advice to authors on each of the manuscripts.

Reflecting on heading into the unknown

Alongside the common tendencies noted above, what the studies in the 2015 special issue also showed was that the precise dynamics of these interwoven forms of handling uncertainty and vulnerability, alongside the specific meanings of ‘risk’, differed in important ways. As Desmond (2015) argued in her guest editorial, shifts over time in the formats by which technical and magical understandings are drawn upon in negotiating uncertainty can be located within broader processes of societal transformation, not least pertaining to globalisation. In describing and analysing such differing formats or ‘modalities’ (Rodrigues, 2016) of knowing, Zinn’s (2008) article – Heading into the unknown: Everyday strategies for managing risk and uncertainty – in this journal continues to be especially useful.

Zinn (2008) echoed earlier work in underlining how multiple rationalities, or ‘modes of reasoning’ (see, for example, Horlick-Jones, Walls, & Kitzinger, 2007, p. 85), are employed by actors in everyday contexts. These social actors may be those typically classified as ‘experts’ or ‘non-experts’ but, while the precise configurations of knowledge and experiential resources they draw upon may differ (see Baillergeau & Duyvendak, 2016 in this issue), they all share a common tendency to combine multiple forms of reasoning in negotiating complexity, ambiguity and uncertainty (compare with Van Asselt & Renn, 2009). Also common to these processes is the reconfiguring of unknowable futures into highly complex but more controllable futures (Bonß & Zinn, 2005, p. 186). In attending to the ubiquity of multiple rationalities, Zinn (2008) challenges traditional dualisms of rational and irrational responses to risk in at least two key respects: first, he acknowledges that no expert can make a decision purely through calculative and technical/probabilistic means, and moreover that a greater regard for context and coping in everyday settings leads us to acknowledge the reasonableness of a range non-rational/calculative approaches given the uncertainty experienced at a particular moment in time (Gigerenzer, 2007; Keynes, 1936:161; Zinn (2008, p. 447; following); second, Zinn (2008) disrupts the rational–irrational dualism by typifying approaches along a spectrum including rational, ‘in-between’ and non-rational ways of managing uncertainty.

Denoting and elaborating this latter schema is arguably Zinn’s most important contribution in the 2008 article, through the way that he develops a very useful starting point for typifying and relating the different rationalities used across social processes such as hope, trust, faith and rational-calculative techniques. While this delineation is not without its problems and limitations (Zinn, 2016), this typology and the wider analytical framework around it has been influential and widely cited. This framework not only provides important insights into analyses of single processes (such as denoting trust as combining rational and non-rational logics – compare with Möllering, 2001) but also serves as a vital basis of analytical synthesis between expanding literatures on processes of trust, hope, emotions and the like. Whereas these separate literatures tended to include brief notes regarding the presence of other approaches (for example, studies of trust also make reference to hope and trust as an act of faith) but lacked the tools to connect these different approaches (for example, Brown & Calnan 2010), Zinn’s (2008) framework provides a platform and important starting points for such a connection and thus the illumination of interwoven (power) dynamics of hope and trust in more recent work (see Brown, De Graaf, Hillen, Smets, & Laarhoven, 2015).

In his review article for this issue, Zinn (2016) reviews the emerging field of studies considering in-between and multiple rationalities, while also revisiting, re-emphasising, defending and critiquing various features of his 2008 framework. Central here is a clarification of the meaning of the term rationality in its crucial role as the basis of the spectrum delineating the various approaches. While rational and non-rational were used to denote different structures of handling uncertainty – from technical and (more or less) systematic application of understandings of past outcomes to plan for the future, which was contrasted with ‘animal spirits’ that involve a ‘falling back for our motive on whim or sentiment or chance’ (Keynes, 1936, p. 161; Zinn, 2008, p. 441) – there has been a tendency to confuse this description of process with a more evaluative stance. In response to this, Zinn (2016) makes two moves by way of clarification, first he emphasises that non-rational approaches are nevertheless ‘reasonable’ ones. Second he redesigns the schema into a triangular one (in place of a linear spectrum), thus avoiding misinterpretations of a scale of rationality while also further highlighting that actors adopt positions combining these three ideal types.

These developments, alongside various further elaborations are analytically helpful and stimulating. The latter two sections of Zinn’s guest editorial also raise important themes in critically reviewing and considering expanding literature around emotions (Lupton, 2013) and hope (see also De Graaf, 2016). What is furthermore helpful about these two specific avenues of research is that they point analyses of the everyday handling of risk and uncertainty away from individual level analyses and start to focus more on group (see section on emotions) and institutional (see section on hope) dynamics. While mainstream risk theory, via its sociological and anthropological roots, has emphasised the social construction of experiences and understandings of risk and uncertainty, there has nevertheless been a tendency to relate wider changes and processes back to individuals.

Four key tendencies in risk theory and wider research on risk and uncertainty can be seen as shaping this (socialised) individual analytical orientation. First, theories of reflexive modernisation and governmentality, in analysing phenomena such as individualisation and the making of the subject, emphasise the individual within society while relatively neglecting (or deprioritising) the social group dynamics and interactional features (compare with Elias, 1978). Second, critical social scientists engaging with these theoretical traditions have often been carrying out empirical studies and theoretical reflection within a wider interdisciplinary (or at least multidisciplinary) context, one where engaging with wider theories in economics and psychology (for example, Kahneman & Tversky, 1979; Keynes, 1936) is crucial. Even though much of this interdisciplinary work has emphasised wider social processes (see Kasperson et al., 1988, p. 178), engaging with psychologists and economists tends to orient analyses of social and cultural processes back to the decision-making of the individual. Third, this tendency is further strengthened through the methodological approaches of interpretative (sociological) studies of everyday meanings of risk and uncertainty which, by their rootedness in Schutzian-phenomenological analyses of sense-making, also tend to analyse individual modes of reasoning and ‘action’ (following arguments of Simmel, 1950 as taken up by Schutz, 1967, p. 4). Fourth, and related to the third point, within the analysis of everyday approaches amid uncertainty, the individual specificities of handling risk and the lack of neat clusters of approaches among those from similar socio-structural and cultural backgrounds is seen by some as limiting the explanatory purchase of broader levels of analysis (Zinn, 2016).

These four theoretical and analytical orientations can be also be understood as shaping the conceptual and analytical basis of Zinn’s (2008) article, one where handling uncertainty in everyday contexts is socially shaped but largely located at the individual level; thus, for example, where socialised ‘experiences structure what individuals expect from such experts for the future and the extent to which they are willing to trust’ (Zinn, 2008, p. 447). The confronting of wider cross-disciplinary understandings, engagement with existing social theory, and drawing on everyday sense-making studies are usefully brought together within a conceptual focus on rationalities. What we see glimpses of in the new review article (Zinn, 2016) and what we see emphasised across the five original research articles in this special issue is a shift in theorising somewhat away from the individual and where explanatory foci are located more within institutions, groups and interactions. Though these analytical orientations also involve an attentiveness to (embedded) agency and complex causality, thus avoiding determinist tendencies (see also Zinn, 2016). In the final main section of this editorial, I will move to propose a reworking of the concept of lifeworld as a means of further capturing and extending this analytical shift. But first in the next section I move to introduce the original research articles in the special issue. In doing so, I will further explore some key features of a less individual-oriented analysis.

Overview of the original research articles: coping with risk and uncertainty through sociality

The starting point of Seppola-Edvardsen and colleagues (2016) study of the sharing of uncertainties among people in the aftermath of cancer recovery is a consideration of ‘uncertainty as a state of being, focusing on the symbolic and existential dimension of it’ (Seppola-Edvardsen et al., 2016, p. 368). While this focus and the authors’ use of Whyte’s (1997) work on pragmatic ways of handling uncertainty still suggests some individualist considerations and underlying ontologies, the focus of the analysis is upon how uncertainties are ‘balanced’ within social relations. The authors therefore emphasise that uncertain futures are not merely thought about by individuals drawing upon wider socio-cultural frames, but that the very experience and understanding of futures is commonly worked through amid interactions and relationships.

In this sense, these authors contrast the individual-rationality basis of Zinn’s (2008) concept of ‘risk balancing’ with a more socio-interactive conceptualisation of balancing which ‘unfolds in a series of practices and reflections on issues such as inclusion vs protection, managing emotions in the presentation of self, and disclosure vs listening’ (Seppola-Edvardsen et al., 2016, p. 369). The undermining of ontological security can therefore be analysed as impacting on the family – its existence, functioning and being – and workplace as much as the individual self (compare with Giddens, 1990). Meanwhile the coping and working on the self for these post-cancer participants was similarly a profoundly collaborative endeavour. Earlier studies around risk and identity have acknowledged these social processes (for example, ‘centre work’ in Alaszewski, Alaszewski, & Potter, 2006) but with this ultimately as a tool in the individual’s coping. Seppola-Edvardsen and colleagues’ analysis of collaborative experiences and handling of uncertain futures shows how these shared processes in turn give rise to new forms of uncertainty, such as around disclosure. The particular format of Norwegian healthcare with regard to medical ethics privileges professionals’ information disclosure to individual patients (in contrast to other cultural models of care, for example, China – Chen, Komaromy, & Valentine, 2015) which tends to individualise the coping with uncertain futures. Yet this knowledge is then shared, with the parameters of this sharing negotiated collectively rather than being individually determined (Seppola-Edvardsen et al., 2016).

Rodrigues’ (2016) study of everyday medicines use in Maputo, Mozambique places a similar emphasis on the collective and negotiated handling of uncertainty and risk, though in this study the analysis pays particular attention to processes and modalities of trust. Within the trust literature regarding healthcare, researchers have typically considered the individual patient and his or her trust as emerging out of the interpreting of interactions with professionals amid wider understandings of the system(s). In such analyses (see Calnan & Rowe, 2008 for a wide-ranging overview), researchers have tended to see wider social networks as a source of information and understandings on hospitals or professionals, but overlooked the collective process by which patients come to (dis)trust in collaboration with others. Whether this role of family (especially mothers), friends and others within these trust processes is peculiar to the sociocultural context being studied, for example, where trust in and cooperation with professionals in Mozambican healthcare is relatively low, requires further investigation. However, Rodrigues’ (2016) analysis lays a very useful basis for further analyses of trust and healthcare which breach the standard patient–professional–system triad.

The importance of thinking beyond typical patient relations with biomedicine is further highlighted by Rodrigues’ (2016) attentiveness to the multiple systems of knowledge, medicines production and advice upon which her participants were drawing. These different systems included transnational pharmaceutical products, nationally administrated healthcare organisations and local traditional healers with their more ‘natural’ remedies. Important tensions involving uncertainty and risk existed across these medicines use contexts, with some participants referring to a wariness of synthetic substances alongside positive considerations regarding their stability and dosing. More natural substances were thus seen as less risky, due to being less ‘effective’, yet also more difficult to dose consistently, especially over time. Use of medicines across different systems of manufacturer and care, and in relation to different cosmologies (those of ‘modern man’, religious faith and traditional healing), were highly visible in Rodrigues’ (2016) study. Similarly varied and syncretic approaches of products and underlying understandings are also common in Northern Europe (Krause, 2014; Raffaetà, 2013). Rodrigues (2016) goes further to consider different ‘modalities’ of trust in handling risk and uncertainty around medicines in terms of different ways by which knowledge – of systems, ‘organisations and providers’, and embodied ‘personal and socially shared experiences’ – are related to one another. This provides a useful elaboration and extension of earlier phenomenological work on trust (compare with Brown & Calnan, 2012).

Themes of knowing through shared experiences and knowing ‘otherwise’ than hegemonic science are further explored in the work of Baillergeau and Duyvendak (2016). In considering experiential knowledge and its relationship to professional knowledge and scientific knowledge (usefully delineated from one another), these authors provide a very useful synthesis of analytical approaches to alternative ways of knowing, while also exploring the developing policy and institutional contexts by which these different forms of knowing have become more legitimate within the Dutch welfare state. Baillergeau and Duyvendak trace how experiential knowledge first became more recognised through ‘peer work’ and ‘self help’, as located outside the public sector, before these approaches have gradually been more prominently incorporated within the mainstream due to their value in dealing with complex and multidimensional forms of vulnerability and uncertainty; where the limits of expert knowledge systems are most apparent (Baillergeau and Duvendak, 2016). Eight key ways by which experiential knowledge is able to know in ways which go beyond expert knowledge are highlighted, before the authors move to refer to specific research around how local interventions and policymakers hold ambivalent positions towards ‘experiential experts’.

Through its emergence within a movement, its application within multidisciplinary (mental healthcare) teams or its role within interactions between role models and vulnerable young people, Baillergeau and Duyvendak (2016) provide several examples of how ‘knowing otherwise’ is collectively negotiated and applied. Such collaborative ways of handling uncertainty, as (de)legitimised within broader policy, institutional and stakeholder contexts, further draws the analytical centre of gravity away from the role of individual rationalities in the face of risk and uncertainty. Drawing on the work of Shiner (1999), Baillergeau and Duyvendak (2016) contrast individual-led ‘peer delivery’ with more collaborative ‘peer development’ work. The value of this latter approach is apparent where experiential experts assist mainstream professionals ‘… to engage with service-users in such a way which makes it possible to take better account of their personal histories, including positive as well as negative experiences of care’ (Baillergeau & Duyvendak, 2016: ??).

Despite the original call for papers not focusing on alternatives to an individual-based analytical paradigm, and with no reference to collaborative approaches, this common theme is furthermore visible within Hall’s (2016) contribution. Hall draws on qualitative interviews with workers across different backgrounds in Canada to explore how these workers cope with everyday workplace safety hazards. Considering the approaches of those born in Canada and migrants, alongside differences between union members and non-members, Hall notes how:

workers are actively balancing and negotiating some measure of control over both hazards and security in their employment in a context of considerable uncertainty, which includes a complex combination of compromises, coping responses and strategic efforts through which they build knowledge and trust with other workers, supervisors and line managers. (Hall, 2016, p. ??)

Amid working conditions which were both physically risky and precarious regarding continuing employment, participants furthermore referred to individual experiences of vulnerability alongside individualising social processes. Yet difficulties and problematic relations with managers seemingly encouraged (or required) coping responses among colleagues in sharing experiences and developing collaborative responses such as warning each other, whereby ‘there are avenues for worker mobilisation and organisation despite the unbalanced power relations of temporary employment’ Hall (2016, p. ??). In Hall’s data and analysis we see that it was the specific possibilities for handling uncertainty – such as trusting colleagues as a means of dealing with risks involving management decisions – that led in some instances to more collaborative processes amid uncertainty. Yet hope and resignation in the midst of risk and uncertainty could also lead to more individualised or estranged approaches (see also Zinn, 2016). In this sense it is vital, in shifting the analysis away from individual agency in the face of uncertainty, that we do not overlook wider social processes which leave some individuals experiencing profound isolation.

The processes by which social-biographical contexts and cultural tools combine to leave (young) workers experiencing and tackling risks amid experiences of individualised trajectories (see also Zinn, 2005), as the result of structures of power and as understood through a peculiar cultural vocabulary (Mills, 1940), is further and very effectively elaborated by Fassari’s (2016) study of young people auditioning for the Italian version of Big Brother. Fassari’s (2016) core concept of ‘realtyism’ helps grasp these processes by which the Big Brother audtionees:

… seemed to have absorbed flexibility, adaptability and permanent mobility, following the imperatives of the new spirit of capitalism. They employed a rhetoric of openness that produces individuals, at once dominated yet free to express their own subjectivity. (Fassari, 2016, p. ??)

Like the post-cancer participants in the study of Seppola-Edvardsen and colleagues (2016), existential challenges were palpable in the narratives of these young people. However, whereas in the former (Norwegian) case, the dilemmas and risks of uncertain futures were narrated in relation to friends and family, the narratives of Fassari’s young auditionees painted a much more atomised social portrait, where authenticity was struggled for but out of reach. The three ideal-typical narrative structures which Fassari elegantly elucidates in her analysis – camouflage and vertigo; jouissance and the blues; and social chance – were each a tool for handling biographical vulnerabilities and uncertainties, as is often reflected upon in the reflexive-modernisation tradition (Beck, 2009; Giddens, 1990). But Fassari’s analysis goes further to cover new analytical terrain, showing how the presentation of the body and emotional labour – especially within precarious service-sector work – are used in pursuing various contradictory goals. Semblances of ‘authenticity’ are achieved through simulacrum while the loss of a coherent inner selfhood is tackled through external-oriented aesthetic experiences:

In all three logics, the reality show appears as a sort of proximal system, to compensate for their real lives. Rather than trusting in traditional social institutions, perceived as ambivalent, contradictory and hypocritical, such as school or any generally emancipating institutionalised discourses … these young people take advantage of a repertoire of aesthetic references. Indeed ‘Realityism’ is a syncretic, independent, malleable culture that has the virtue of belief in happy endings. On the whole, ‘realityism’ emerges as a stratagem for coping with the fragmentation of social experience. But it indicates the renunciation of the idea that the social can be transformed. (Fassari, 2016, p. ??)

Fassari’s (2016) analysis has a strong Frankfurt school sensibility, one which reworks reflexive modernisation tendencies (which themselves have their roots – via Beck – in Habermasian themes (Van Loon, 2013)) through insights from Freudian, Lacanian and Žižekian critiques of current cultural frameworks and the impossibilities of authentic identity within these.

Analysing lifeworlds in place of rationalities

Even within Fassari’s (2016) study of alienating experiences within ‘fragmented’ existences amid sociality, her analysis shows that the participants typically handled their uncertainty and existential vulnerabilities in interaction, and quasi-cooperation, with others. Whether this was an attempt to galvanise the self through flirtation, or adhering to the ‘social imperative’ of ‘jouissance’ (Fassari, 2016, p. ??), the narratives of the participants indicated processes of (attempted) authentication and legitimisation among particular social networks and hierarchies; with these social exchanges and processes given meaning by drawing upon wider cultural discourses. The deep constraints of culture in contexts where the truth of its underlying knowledge structures and assumptions lie beyond critique and question (Fassari, 2016; Mills, 1940) – where ‘the interests of participants are systematically excluded behind their backs’ (Power, 1990:114; drawing on Habermas 1987) – is an important qualification of analytical approaches considering individual rationality and logics for handling uncertainty which tend to imply a high level of agency, conscious choice and reflexivity. A greater emphasis on the extent to which possibilities to address uncertainty are constrained within social processes is much needed. Furthermore a perspective is needed which reflects how the handling of uncertainty – through combinations of hope, trust and/or probabilities – is as much a moral negotiation and performance as it is a practical solving problems of knowing (Brown, 2016; Douglas, 1992; Montelius & Nygren, 2014).

With its emphasis on processes of sociocultural framing and legitimating, while also recognising possibilities for (highly embedded) agency, the concept of lifeworld (already briefly introduced near the start of this editorial) can be seen as a very useful conceptual alternative to concerns of individual reasoning and rationalities. As a horizon of future possibilities (Habermas, 2001: 46) through which uncertainties, vulnerability, risk and hope (among other processes) are experienced, understood and handled (Brown, 2016), the lifeworld provides an insightful basis for sociological analysis. My own conceptualisation of lifeworld processes, influenced by Möllering (2001), Horlick-Jones and colleagues (2007) and Zinn (2008) among others, departs from Habermas in pointing to the extent to which individual agency makes possible the reworking of lifeworlds through, for example, the bracketing off of uncertainty (Brown, 2016). Though this latter agency, achieved through processes such as trust and hope, is nevertheless limited by broader cultural narratives and social obligations.

Analysing, for example, a hopeful orientation towards a highly uncertain future shaped by the spectre of cancer (Brown et al., 2015) can be carried out in relation to the three dimensions of Habermas’ lifeworld (culture, society and identity): where a vocabulary of hope is made possible by a wider cultural discourse through which notions of truth are considered and upon which categorisations are based (Brown et al., 2015; following Mills, 1940; Good, 2001); where hopes may also be legitimated, demanded or undermined amid interactions and wider socialising experiences (Habermas’ society); and where hoping within a particular setting feels (in)authentic in light of a person’s socialised identity, as rooted within their socio-biography. It is here that the very possibility of any form of ‘individual’ rationality is thrown into doubt.

Similarly, we can consider how processes of trusting are rooted in wider cultural understandings where, for example, particular systems of knowledge are seen as more or less valid and where various generalised truths pertaining to health systems and professions are drawn upon in making sense of interactions with individual professionals and when handling medicines (Rodrigues, 2016). As Rodrigues’ (2016) study insightfully illuminates, this is only part of the story as practicing trust and/or distrust is (de)legitimised within particular social settings, networks and interactions (see also Brown & Meyer, 2015). Meanwhile Rodrigues’ focus group narratives show how a particular socialised identity, such as that of a highly educated student, entails that only some ‘modalities’ of trust – oriented towards ‘modern’ systems and interpreted in particular ways – resonate as authentic (Rodrigues, 2016, p. ??).

In contexts which can be described as involving multiple approaches to uncertainty or ‘bricolage’ (Horlick-Jones et al., 2007), we can also discern various ways in which these approaches are limited by the ‘cultural resources and arguments at hand’, the need to provide an account ‘in terms of the norms associated with this activity’ (Horlick-Jones et al., 2007, p. 99), as well as the ongoing management of one’s selfhood in light of biography and (uncertain) futures:

[The doctor] named, I think, a half-per cent [likelihood of a successful surgery], and that is of course very slim, but yeah, you want to hold on to that tightly …. Such a remark gives hope. (Brown & de Graaf, 2013, p. 551)

As this excerpt from an interview conducted by Sabine de Graaf indicates, the patient, ‘Thijs’ who had a ‘poor prognosis’ or very high probability of imminent death reworked a future framed through probability (risk) using hope. While our earlier analysis of this fragment emphasised Thijs’ creative agency to recast futures through hope (Brown & de Graaf, 2013), we would also argue that his vulnerable position and limited prognosis rendered a trust in this senior doctor indispensable, which alongside wider assumptions of medical expertise appeared to affirm the veracity of this half-per cent possibility (Brown et al., 2015). Such a small probability did not automatically grant hope, but rather Thijs seemingly felt obliged to ‘cling on’ – as presumably shaped by a wider ‘culture of hope’ (Good, 2001) amid a late-modern cultural context where a narrative for accepting the end of life is problematically ‘missing’ (Habermas, 2010, p. 15); a ‘bio-technical embrace’ (Good, 2001) through which the ongoing pursuit of health via trust in particular professionals becomes increasingly hard to leave, the further this path is followed (Brown and Meyer, 2015); and where the damage to identity and ontological security of losing all hope would be potentially devastating.

In this section, I have draw attention to the extent to which ‘modalities’ of handling uncertainty through hope, trust and combinations of such processes are profoundly social modalities. Agency continues to exist but only in the sense of deeply ‘forced options’ (Barbalet, 2009) where vulnerability and the need to cope are driving forces (Meyer & Ward, 2013). The dimensions of Habermas’ (1987) lifeworld – culture, society, identity – are, respectively, reproduced and refined (‘rationalised’) through processes pertaining to truth, legitimacy and authenticity. These processes are apparent in the example above by which Thijs implicitly works to maintain his fragile lifeworld, especially in the face of fateful moments which would undermine his ontological security (Giddens, 1990). Hope could be interpreted as a pragmatic ‘rationality’ for coping but any ascriptions of agency or choice around this approach must be qualified by the way in which Thijs’ hopes are deeply embedded in cultural assumptions around medical truths and the legitimation and undermining of his hopes in interactions with others. In this way, the interrelated dimensions of the lifeworld can be seen as comprising multiple processes by which discourses of truth as analysed by governmentality scholars (for example, O’Malley, 2008), different ways of handling knowledge as shaped by relative hierarchy and solidarity (Douglas, 1992:107), or the identity work inherent to reflexive modernity (Beck, 2009; Giddens, 1991) interact with one another.

The concept of lifeworld is therefore useful in integrating different core features of classic social theories of risk and uncertainty, while enabling fairly detailed and multidimensional analyses of micro-level data. The ways in which Habermas (1987) deepens earlier conceptualisations of ‘life-world’ (Schutz, 1967; Schutz & Luckmann, 1973) – moving beyond a mere cultural basis of knowledge and sense-making into processes pertaining to the legitimation of practices, socialisation of identity and wider maintenance and reproduction of society – resonates especially strongly with Douglas’ (Douglas, 1992; Douglas & Wildavsky, 1982) work (see Brown, 2016 for a more detailed consideration of the commonalities between Habermas and Douglas).

I have noted already that truth, legitimacy and authenticity are key to the reproduction and refinement of the lifeworld; however, Habermas (1987) also warns of the possibilities that the refinement of the lifeworld is impeded and therefore where truth, legitimacy and authenticity are no longer reflected upon critically. This colonisation of the lifeworld, when applied to risk and uncertainty, resonates strongly with Douglas’ work with Lianos. Lianos and Douglas (2000) denote problems of the dangerisation of the sociocultural sphere where wider critical discussion and possibilities for acting differently are increasingly curtailed through the normative regulation and control imposed amid heightened sensitivity to danger. Under such impediments to reflection on truth, legitimacy and authenticity (see empirical examples in Baillergeau & Duyvendak, 2016; Fassari, 2016), the lifeworld is merely reproduced in line with hegemonic interests (Habermas, 1987; see also Douglas & Wildavsky, 1982; Good, 2001). While I have pointed to lifeworld analyses which suggest agency to rework lifeworlds amid these power structures (Brown, 2016), it is vital that such agency is understood as deeply embedded within social and cultural processes (Good, 2001).

Conclusion

This wider-scale and more critical lens further underlines that when analysing the experiences and approaches of individuals such as Thijs, or indeed any individual, the reasonableness of their everyday coping with uncertainty through hope, trust and other means is better understood in relation to wider processes of lifeworld reproduction and the limiting of possibilities for thinking, practice and being (Fassari, 2016) than as modes of individual coping. Though above all, I have aimed to draw attention to possibilities for linking these through analyses of how processes of culture, society and identity play out at the micro level.

The leanings of both Habermas (1987) and Douglas (1992) towards analyses of the orientation of action within wider processes of social integration and solidarity (through their shared interest in Durkheim) represent a useful reorientation away from analytical individualism. Earlier in the editorial I noted reasons for this latter analytic tradition within risk research as well as apparent shifts within Zinn’s work (see Zinn, 2008, 2016) away from the individual through social processes of emotions and hope. This reorientation of analysing everyday handling of uncertainty and risk has been taken yet further by the original research articles within this issue where the most apparent common theme across them is the inherently social, collaborative and interactional basis for handling uncertainty.

Latterly, I have explored various possibilities for capturing and developing this more sociological analytical approach through Habermas’ concept of lifeworld. I have suggested that considering multiple processes such as risk, trust and hope in relation to the three dimensions of the lifeworld opens up useful explanatory insights, not least the constraints imposed on handling uncertainty in terms of truth, legitimacy and authenticity. Agency still exists and processes such as trust and hope can be seen as being used to bracket off uncertainties and risks within a ‘horizon of possibilities’ (Habermas, 2001, p. 46). In this sense, the lifeworld is perhaps more malleable than Habermas (1987) generally accounts for (Brown, 2016); however, these possibilities for reworking the lifeworld – for example, to protect from, or rebuild after, a lifeworld ruptured through fateful moments (compare with Giddens, 1990) – are in turn regulated by ongoing processes of culture and society. Further conceptual work is needed in this area, partly in developing further existing themes around lifeworlds – for example, regarding system colonisation or stocks-of-knowledge – and also departing in new directions, for instance, in deepening these analytical perspectives to consider emotions and the body.

These themes of everyday handling of risk and potential tensions and impacts on identity will be further developed within the 2017 theory special issue on ‘risk work’ (which I am co-editing with Nicola Gale). The focus here will be on various professionals but especially health and social care professionals who are required to handle uncertainty through probabilistic approaches within their everyday work. We argue (Brown & Gale, 2016; Gale, Thomas, Thwaites, Greenfield, & Brown, 2016) that working between population-based knowledge and individual risk assessment or risk communication leads to several forms of tensions relating to how risk knowledge is understood and worked with, how interventions are negotiated and how social relations with patients/clients/service-users are protected or strained. How risk work ‘gets done’ in spite of these tensions and the impact of this everyday work on identities of professionals will be the key foci of the issue. Insights reviewed in this editorial, especially those of Zinn (2005, 2008, 2016) and Horlick-Jones and colleagues (2007), will surely be of relevance to these analyses.

Disclosure statement

No potential conflict of interest was reported by the author.