Work-related psychosocial risk factors: a contemporary analysis

Abstract

Introduction:

work-related psychosocial factors have stood out in debates concerning health protection and promotion in occupational contexts.

Objective:

this essay demonstrates how the lack of thematic exploration regarding the antagonism and structural conflict between capital and labor, as well as its co-optation by neoliberal managerial logic, impoverishes the debate and weakens initiatives aimed at transforming the work environment.

Method:

a literature review was conducted using historical materialism as a theoretical framework.

Results:

policies, instruments, and measures formulated to protect workers’ health developed under the ideological framework of capitalist accumulation and neoliberal governmentality become understandings and interventions that, far from transforming actual work situations, mask the role played by work in occupational health. They consecrate actions focused on individuals, dampen social struggles, and increase pressure on workers.

Conclusion:

addressing psychosocial risks should not be limited to mitigating them; rather, it should find its purposes and foundations in a theoretical-practical horizon that unveils the need to overcome the capitalist economy itself.

Keywords:
psychosocial risk factors; occupational health; mental health; work psychology; exploitation of labor

Resumo

Introdução:

nos debates sobre a proteção e a promoção da saúde nos contextos laborais, o tema dos fatores psicossociais relacionados ao trabalho (FPRT) tem se destacado.

Objetivo:

demonstrar que a ausência da tematização do antagonismo e do conflito estrutural entre capital e trabalho, bem como a captura da temática pela lógica gerencialista neoliberal, produz o empobrecimento do debate e o enfraquecimento de iniciativas voltadas para a transformação do contexto laboral.

Método:

a reflexão é realizada a partir de revisão da literatura, tendo como referencial o materialismo histórico.

Resultados:

as formulações de políticas, instrumentos e medidas destinadas à proteção da saúde dos trabalhadores, gestadas nos marcos ideológicos do regime de acumulação capitalista e da governamentalidade neoliberal, convertem-se em compreensões e intervenções que, longe de transformarem as situações concretas de trabalho, mascaram o papel exercido pelo trabalho em relação à saúde dos trabalhadores, consagram as ações voltadas aos indivíduos, arrefecem as lutas sociais e ampliam as pressões sobre os trabalhadores.

Conclusão:

o enfrentamento dos riscos psicossociais não deve se limitar à mitigação desses riscos, mas sim encontrar seus propósitos e seus fundamentos em um horizonte teórico-prático que descortine a necessidade de superação da própria economia capitalista.

Palavras-chave:
fatores de riscos psicossociais; saúde do trabalhador; saúde mental; psicologia do trabalho; exploração no trabalho

Introduction

In the early 21^st century, the World Health Organization (WHO)¹ warned that about 450 million people worldwide were suffering from mental and behavioral disorders. In the workplace contexts, anxiety, stress, and depression have drawn the attention of the International Labour Organization (ILO) to the importance of studying their causes and adopting policies and strategies for preventing illness and promoting workers’ health. Authoritarian management styles, pressure for results, and performance cults are evidenced by scientific analyses as problems linked to the capitalist accumulation^{2), (3), (4} regime and situated in a scenario marked by labor platformization⁵, deregulation of rights, lack of social protection, labor intensification, and unemployment⁶. The impacts of this panorama on workers’ health deserve investigation.

The study of work-related psychosocial factors in such a context holds its importance due to the possibility of revealing the connections between modes of management and organization of work in capitalism, processes of subjectivation, sufferings, and developments of pathologies, especially psychological ones, as well as the feasibility of contributing to the protection of workers’ health. However, formulations of public policies, instruments, and measures aimed at protecting workers’ health, conceived within the ideological framework of the capitalist accumulation regime and neoliberal governmentality, have turned into interventions that, far from transforming work situations, disguise the effects of work-related factors on health, overemphasize actions conducted under individualizing molds, and increase pressures on workers.

In this essay, based on a literature analysis on the subject, we reflect on the matter, highlighting problems in understanding work-related psychosocial factors and in measures for protecting and promoting workers’ health, which are based on an individual and psychologizing bias. Firstly, we briefly review the historical background of psychosocial factors in work. Then, we present the theoretical foundations that we consider relevant for deepening the discussion and an analysis of the theoretical-methodological risks involved in the neoliberal approach to the examined theme. Finally, we offer considerations on the study of psychosocial risks, proposing an expansion of the horizon for their understanding and addressing.

Psychosocial factors related to work: a brief contextualization

At the end of the 1970s, the World Health Organization (WHO) convened an Interdisciplinary Forum in Stockholm, Sweden, to discuss the influence of psychosocial factors on health, develop measures and propose inclusive health policies based on these factors. This was an important historical step towards broadening the focus on work contexts, including in relation to the health processes and illnesses of workers⁷.

In the 1980s, both the WHO and the International Labour Organization (ILO) published a document drawing attention to the adverse effects of psychosocial factors related to work on workers’ health⁸. Both organizations agreed at this time that “economic growth and progress depended not only on production, but also on the living and working conditions, health, and well-being of workers and their families” (p. 401)⁹. Decades later, the European Union established guidelines for a program to manage psychosocial risks at work, considering the high prevalence of work-related health problems, such as stress, violence, and harassment⁹.

This represents a significant advancement in the field of occupational health, as prevention actions and health promotion, in addition to physical, biological, ergonomic, and chemical risks, must also consider psychosocial risks in their subjective and objective dimensions.

According to the ILO, psychosocial factors at work

refer to interactions between work and among work environment, job content, organisational conditions and workers’ capacities, needs, culture, personal extra-job considerations that may, through perceptions and experience, influence health, work performance and job satisfaction.⁸ (p. 3)

According to Fischer⁹, the nature of psychosocial factors at work is complex, “encompassing issues associated with workers, the general environment, and the work environment” (p. 401).

In the current scenario, it is also necessary to consider the flexibilization of labor relations, which subtracts rights and social protection, as well as intensifies work, demanded by current management models, along with issues such as the “Uberization” of work^{10), (11}. We believe it is essential to add remote work to this panorama, which has been established more intensively during and after the COVID-19 pandemic context.

The theoretical foundations necessary for a critical reflection on psychosocial risks

In this essay, it is considered that psychosociological and sociological analyses, based on assumptions of Marxist philosophy-which engage with Marxist critiques and readings of the foundations of capitalist production and/or with reflections on neoliberal management-, constitute central contributions to reframe the discussion regarding psychosocial risk factors from another perspective to capture their dimensions.

In “Capital,” Marx¹² reveals the commodity as the atom of capitalist production. At the same time, the German philosopher observes and analyzes the relentless movement of capital, which appropriates natural resources and labor power, converting them into commodities, in an infinite accumulation process that feeds on surplus value. In the commodity-producing society, the struggle between oppressors and the oppressed is established and (re)organized from the antagonism between bourgeoisie and proletarians¹³. The former, owners of the means of production, live off the expropriation and exploitation of the labor power of a mass of workers deprived of means, leaving them with the alternative of selling their commodity-labor power-as a fragile condition to ensure their survival¹³. In capitalism, relations of production establish specific modes of sociability that permeate all social relations, thus building a foundation of processes of labor and production organization, as well as of intersubjective and subjective ones. The social being is, essentially, the ensemble of social relations, as Marx stated in his thesis against Ludwig Feuerbach¹³. Neglecting or underestimating class antagonism or the incessant repercussions of capitalist sociability for societal life, especially for work experiences, results in idealistic, individualizing, and psychologizing theories and propositions, which theorize only on the surface of social relations, without revealing or understanding their foundations.

The theoretical contributions of Marxist criticism are important for understanding contemporary phenomena in labor contexts and society. They are notably, and in many ways, incorporated into reflections that unveil the processes of exploitation and oppression, which are linked to structural¹⁴ and intersectional subordinations¹⁵, especially class, race, and gender. However, these contributions are presented to society as if they were the result of a natural evolution of human-societal life and not of power relations woven over centuries.

From a psychosociological perspective, for example, Vincent de Gaulejac⁴ discusses the violence engendered by human action in hypermodern society organizations. Gaulejac⁴ conceptualizes managerial management^b as a technology of power that operates by mediating the conflict between capital and labor, aiming to gain the “adherence of employees to the demands of the company and its shareholders” (p. 27). The managerialist ideology aims to legitimize an “instrumental, utilitarian, and accounting approach to the relations between man and society”⁴ (p. 27; our translation). This form of management is presupposed as rational and pragmatic; and such ideology, based on deceptive neutrality, serves to justify a constant economic war, expressed, among other forms, by the struggle for places in the world. Under such pressures, there is a resurgence of work-related malaise, suffering, psychological disturbances, and even suicides resulting from demands from work contexts. Beyond disciplinary power, managerial power, asserts Gaulejac, “[...] mobilizes the psyche towards production goals. It sets in motion a set of techniques that capture desires and anxieties to put them at the service of the company”⁴ (p. 39; our translation). The obsession with financial profitability, put forward as imperative, occupies leaders and is imposed on workers. In managerialism, the logic of a schizophrenic management is evident, obsessed with measures and figures, which worships performance and often leaves workers feeling that their productions are insufficient, even if they are deeply mobilized. In this direction, Gaulejac states: “Faced with the demands of managerial management, workers feel that they are not doing enough. As if the work done were never satisfactory”⁴ (p. 219; our translation).

Based on a thorough analysis of neoliberalism, Franco et al.¹⁶ reflect on the neoliberal conception of the subject and its effects on subjectivity and the health of individuals in contemporary times. The authors emphasize that the neoliberal doctrine, serving as a response to the crises of capital and attempting to perpetuate the economic regime and the law of valorization of value, harbors a rationality that “presses the self to act upon itself in the direction of its own reinforcement to continue in competition”¹⁶ (p. 48; our translation). In this way, Franco et al.¹⁶ assert that:

When the individual is placed at the center of the dynamics, in reality, the external law of capital valorization weighs upon them with maximum vigor. By internalizing it, the individual themselves begins to demand from themselves to be a successful entrepreneur, seeking to ‘optimize’ the potential of all their attributes capable of being ‘valued,’ such as imagination, motivation, autonomy, responsibility. This illusorily inflated subjectivity inevitably provokes, at the moment of its absolute emptiness, frustration, anguish associated with failure, and self-blame; the typical pathology in this context is depression. (p. 48; our translation)

Far from being a spontaneous or free action, the rationale of markets guides action in a way that reproduces capitalism within human action¹⁶. Notably, the freedom implied in managerial discourses and practices consists of coercive freedom, to borrow the terms of the South Korean philosopher Byung-Chul Han¹⁷. The society of performance, in Han’s terms, operates through a “violence of positivity,” exalting individual “power” and establishing, as the order of life, the premise that the subject can (and should) do everything¹⁷. Thus, the contemporary subject is urged to function as “a performance-machine that is supposed to function without disturbance and maximize achievement”¹⁷ (p. 70). The outcomes of convulsive activity and self-exploitation, to which the subject is summoned, are professional exhaustion and self-destruction. In Han’s understanding,

The coercion of performance forces one to produce more and more. Thus, they never reach a point of gratification’s rest. They constantly live in a feeling of lack and guilt. And since, ultimately, they are competing with themselves, they seek to surpass themselves until they succumb. They suffer a psychological collapse, which is called burnout. The subject of performance realizes themselves in death. To realize oneself and to self-destruct coincide here¹⁷. (p. 85-6; our translation)

In the world of work, important phenomena are observed that accentuate modes of labor precariousness and exploitation of the workforce. Outsourcing, platformization of society and work⁵, and intensification of labor are carried out by instrumentalizing technology in the service of capital and, at the same time, by psychopolitical and ideological devices that summon individuals to recognize themselves as “free entrepreneurs”, but which actually operate within the logic of “subordinated self-management.”¹¹ On one hand, there are increasing demands, tight deadlines, and scarce resources; on the other hand, feelings of guilt and shame are observed as a result of failures and inadequacies attributed to each individual, based on the ideological assumption of meritocratic fallacy that exalts the individual and their performance, concealing the real conditions of work and life.

Furthermore, Saffioti¹⁵ alerts, from a Marxist perspective, on the importance of considering the inequalities derived from the intersections of class, race, and gender. In addition to being subjected to the laws of the market, which only configure formal freedom for workers, it is important to perceive how gender and race disparities operate within capitalism. Saffioti¹⁵ emphasizes that the structure of patriarchy is not only responsible for ideological and political domination but also constitutes a “system of exploitation.” Furthermore, it reveals that the effects of structural racism manifest in different ways-for example, by reproducing stereotypes that belittle Black people-, restricting opportunities and perpetrating violence, especially against women, who continue to experience profound inequalities in life and work.

Alongside macro-social readings, French perspectives, focused on the analysis of work activity and processes of subjectivation and health, have also contributed to a deeper understanding of psychosocial risks in the workplace.

When it comes to studying the relationships between processes of mental illness, psychosocial risks, and living and working conditions, the contributions of the French psychiatrist Louis Le Guillant¹⁸ seem fundamental to us. Inspired by the concrete psychology of Georges Politzer and the reflections of Karl Marx, Le Guillant taught that the individual and their environment form an “indissoluble” historical and dialectical unity, which is a “fundamental law, from which neither normal nor sick psyche, nor the patient themselves, can escape”¹⁸ (p. 41; our translation). Notably, for the French psychiatrist, it is not the social condition itself that is pathogenic, but rather “its discrepancies, the conflicts it contains and imposes on the individual”¹⁹ (p. XI; our translation). In this approach, therefore, the interaction between subjective and objective spheres is a requirement for analyzing the relationships between work and illness²⁰.

Activity Ergonomics has revealed that work activity can never be reduced to protocols and prescriptions. Activity, in a real situation, requires dealing with unforeseen events and demands management of variability, or more broadly, “environmental infidelities”, by workers²¹. This management of variability always implies, from an ergological perspective, a management of “self-uses” at work, which stems from debates about norms and values²². The construction of health is thus based on an effort of re-normalization by the individual, and in this process, the individual tries to recreate the environment around their norms and values²³.

From the perspective of Clinic of Activity, Yves Clot²⁴ highlights that activity is only realized as that which prevails among a set of possibilities and potential destinies. He reveals how work activity, far from being an individual product, is forged within a circuit of social relations. He considers the importance of thinking about health with reference to the concept of the power to act. Drawing on the philosophy of Georges Canguilhem, Clot²⁴ asserts that health consists of “a power to act on oneself and on the world, acquired alongside others” (p. 111; our translation). In failing to develop the power to act, truncated activity can result in processes of suffering and illness.

The set of reflections presented allows us to advance further and, in this sense, allows us to identify the pitfalls present in current debates on psychosocial risk factors related to work, especially concerning “psychosocial risk management.” It also guides us to discover other horizons for the analysis and prevention of these risks.

The pitfalls in the traditional debate on psychosocial risk factors related to work

Strategies for mitigating and managing psychosocial risks and worker illness processes are often associated with quality of work life (QWL) programs. These programs reduce the individual to a variable adjusted to production. This assertion is supported by studies focused on worker health, which criticize the prevention and health promotion models adopted by organizations^{25), (26}. In these models, the lack of discussion over modes of work management and organization, as well as conflicts between capital and labor, leads to discussions on the individual level, isolated from psychosocial and economic processes².

Reflections on the logic of valorization of value, which governs capitalism¹², on the antagonism between capital and labor, and on neoliberal governmentality¹⁶, place the analysis of psychosocial factors under a different light. They warn about the risk of capturing and addressing the theme in individualizing molds that operate in favor of capital profitability, although they present themselves as measures aimed at the well-being and health of workers.

As previously seen, the workforce as a commodity for capitalism is expected to function regularly, allowing the employer to extract from it as much as is convenient¹². Therefore, modes of work management and organization are configured, far from any romantic perspective, as the materialization of capital control: they are produced and reproduced in work and have a significant impact on workers’ health²⁷. The emphasis on the individual dimension of work-related psychosocial factors implies relevant theoretical and practical problems:

- The association with the term “stress” often implies a focus on individuals’ mechanisms and resources to cope with work situations, rather than considering the objective conditions of the work itself. The trends in this line of thought tend to center the approach to the problem on the lack of personal resources, thus blaming the individual. These trends, as previously identified²⁸, give rise to a set of welfare practices commonly linked to quality of work life (QWL) programs, offering therapeutic practices such as workplace gymnastics, meditation, yoga, and others on their “menu,” disregarding the concrete experiences of workers and sidelining work activity, modes of work management and organization, and work itself^{25), (26}. According to Ferreira²⁶, this constitutes a hegemonic model of QWL, characterized by a welfare nature aiming to restore “body-mind,” focusing on the individual and their productivity. Workers remain disconnected from the process, being objects and targets of interventions, besides being held responsible for failures at work and in managing their emotions, and being pressured to take care of themselves so they can be fit to work.

- The direction of debates and the formulation of health protection policies and measures are then observed in these individualizing patterns, in the repeated attempt to promote an adjustment and adaptation of the individual to work, as if the subject were a gear to be lubricated to “run better,” without significant changes in work and contrary to what should be done. The fetishization of coaching and other practices aimed at personal and professional improvement is, in our view, imbued with the logic of neoliberal governmentality, which promotes and encourages “freedom,” but whose rationality is linked to the “reasons of the market”¹⁶ and the mechanisms of capital reproduction, aiming at maximizing results. We are moving towards a “doping society,” which progressively turns the subject into “a performance-machine that is supposed to function without disturbance and maximize achievement”¹⁷ (p. 70).

- The “management of psychosocial risks” is, in this perspective, often conducted by different social actors, such as private companies, state bodies, experts, worker representative entities, international organizations; however, they are conducted lacking advancements in the analysis and transformation of work, thus avoiding dealing with the real problems and contradictions generated by capitalist accumulation^{7), (10}. The implemented measures, despite advocating the softening of contradictions and the cooling of conflicts, fail to reach the roots of work-related malaise. Lima²⁸ had already highlighted, in a critical analysis of the debate regarding psychosocial risks, based on the reflections of the French psychologist Yves Clot, that associating psychosocial risks with the term “stress” leads the discussion to the individual level, with dangerous implications for the prevention of these risks.

- Measures to prevent illness, often touted as solutions, following the quantophrenic dogma of managerialist and neoliberal management⁴, are based on a hygienist perspective, and their applications and evaluations are subordinated to quantitative parameters distant from the experiences and feelings of the workers^{7), (10}. The latter are generally considered merely as “objects” or “targets” of these actions.

As a result of the foregoing, instead of actions capable of benefiting workers collectively and broadly, the adoption of strategies that individualize processes of suffering and illness is observed, disconnecting them from the economic, sociocultural, and intersubjective aspects that underlie them. At the same time, organizational strategies, represented in the form of “illness prevention policies”, guided by economic interests and mediated by psychopolitical and organizational devices, individualize performance and sophisticate methods of evaluation and coercion, urging individuals into constant self-exploitation and a fictitious freedom that results in work intensification. In our view, these are decorative measures for preventing health disorders, which are not based on an accurate diagnosis of the problems and, therefore, do not achieve effective resolutions.

By neglecting to reflect on work in the different contexts generated by the capitalist mode of production and the state’s alignment with neoliberal policies, the approach to the discussion has primarily focused on individuals and their coping mechanisms with work adversities. Organizations have developed strategies and resources, alongside consultants and companies, to mitigate harm to workers’ health, with strategies that resemble, in colloquial terms, “chasing after ice.” Such strategies are presented as addressing the problems but operate in a way that produces a context in which workers are held responsible for their illness. And those who do not fall ill live under pressure to adapt to environments and jobs marked by demands and pressures that are rarely questioned. Thus, the “management” and “prevention” of psychosocial risks are announced, but workers are compelled toward uninterrupted activities, under increasingly precarious and unstable conditions. The strategies used by companies-and also by the state, conceived as an indispensable cog in capitalist accumulation¹⁴ via “palliative” actions and the issuance of legal norms-promote in workers the sensation that much is already being done for them and that if they become ill, it is because they are fragile and/or incapable, being held responsible for their problems.

Horizons for Protecting and Promoting Workers’ Mental Health

The exploration of new horizons for protecting and promoting workers’ health entails a theoretical approach vastly different from that practiced in corporate and organizational settings. Health is not merely the absence of illness, nor is it merely about adapting to work situations. Following the ergological perspective, health arises from active transformation possibilities, from re-normalizations conducted by workers²², from individual and collective constructions stemming from concrete experiences, and debates on norms and values, never reducible to the law of value valorization or to the criterion of “profitability or death.”⁴ Regarding the construction of health, we agree with the following statements by Yves Schwartz:

To be merely a point acting at the intersection of determinations from an anonymous, ecological, but much more profoundly human environment is to lead a life without heritage, one that is sick. Health begins with the attempt to partially redesign the environment in which one lives, according to its own norms, elaborated by its history²². (p. 139; our translation)

Workers are not akin to variables or pieces to be “adjusted” or “lubricated” for maximum performance. What is advocated here is a conception of health intricately linked to the power to act²⁴ and to the subject’s re-normalizations²². After all, as Canguilhem²⁹ reminds us, the subject does not receive influences from the environment without first appreciating them. The subject is not equivalent, therefore, to a device of physical-chemical reactions that responds to environmental inputs. Human beings are never indifferent to their environment²⁹. In Canguilhem’s terms²⁹, “to live is to take a position,” with life being an “activity of opposition to inertia and indifference.” The involvement of workers and the consideration of their values, experiences, and interests are, therefore, fundamental in the construction of any kind of intervention. Actions must be conducted, from start to finish, with the workers and not imposed upon them.

Furthermore, the reading of work situations should consider the modes of management and organization of work, as well as working conditions from the perspective of workers and the broader framework of economic, sociocultural (patriarchy, racism, sexism, LGBTQ+ discrimination, and intersecting violence), political, and legal structures and processes, in addition to observing the interaction of these processes with technologies. Therefore, actions to understand and address psychosocial risks require that these processes be conceived as relative to the interactions between workers and work, which are affected by multiple dimensions and correlations of power established in these interactions, as synthesized in Figure 1:

Figure 1
Analysis of psychosocial risks in the workplace across different dimensions

The metaphor of the iceberg can be didactically useful for understanding that psychosocial risks should not be “substantialized” or considered autonomous elements, meaning linked only to individuals and dissociated from the social processes observed at different levels of depth.

As we consider the experiences of workers in real work situations, we can identify the different mediations that intervene in the processes of health and illness^{7), (10}, as illustrated in Figure 2.

Figure 2
Analysis of health and illness processes at work

Indeed, it is evident that an individualized and psychologized analysis of psychosocial risks, following the patterns of capitalist and neoliberal management, overlooks crucial dimensions involved in the production of these risks, thereby impeding their effective prevention.

Conclusion

In this essay, we have highlighted the theoretical and methodological pitfalls inherent in the current debate on psychosocial risk factors within the framework of capitalist and neoliberal management. The lack of consideration of the structural antagonism and conflict between capital and labor, as well as the co-optation of the psychosocial factors related to work by managerial logic, leads to both an impoverishment of the debate and a weakening of initiatives aimed at transforming the work environment.

The ideological and managerial devices we have examined in the handling of debates on work-related psychosocial risk factors and in the formulation of policies for the protection and promotion of worker health constitute, in our view, contemporary domination strategies that go hand in hand with the exploitation of labor. We emphasize the importance of the category of work in the analysis and prevention of psychosocial risks, conceived here as products of the interaction between workers and their respective jobs, as well as the need to consider, when analyzing, both dimensions of conflict between capital and labor and the sociocultural, political, legal, and technological processes.

Policies established by states and international organizations may be relevant to some extent in today’s times, serving as mitigators of suffering in the workplace and as compensatory measures for the harmful effects of capitalism. However, considering all that has been discussed, we emphasize that addressing psychosocial risks should not be limited to their mitigation. Rather, it should find its purposes and foundations in a theoretical-practical horizon that reveals the need to overcome capitalism itself.

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• b
  We understand that Vincent de Gaulejac uses the term “managerial management” as a concept that focuses on psychosocial dimensions, criticizing the increasingly excessive emphasis on economic efficiency at the expense of human well-being in organizations.

• Presentation at a scientific event:

  the authors report that the study has not been presented at a scientific event.

• Data availability:

  the author declares that the entire dataset supporting the findings of this study was published in the article itself.

• Funding:

  the authors declare that the study was not funded.

Edited by

Editor-in-Chief:

José Marçal Jackson Filho.

Data availability

the author declares that the entire dataset supporting the findings of this study was published in the article itself.

Publication Dates

• Publication in this collection
  26 Apr 2024
• Date of issue
  2024

History

• Received
  27 Sept 2022
• Accepted
  11 Jan 2023