Book review: The Wellness Syndrome by Carl Cederström and André Spicer

wellness-955796_1920.jpgFor anyone who has ever harboured doubts about the benefit of wearing a Fitbit or adopting the Paleo diet (where you only eat food eaten by early humans) this is the book for you. Carl Cederström and André Spicer explore the ‘wellness syndrome’. It has become a moral obligation, they argue, to constantly strive towards wellbeing. It is a never-ending task, leading to “anxiety, self-blame and guilt”.

The underlying philosophy of wellness programmes is that the individual has the power to overcome obstacles in their personal and professional life through thinking and acting differently. As examples in the book demonstrate, this is presented as the solution for challenges ranging from dealing with cancer to becoming rich.

Shifting responsibility

This form of positive thinking seems benign and useful: if we simply resigned ourselves to an unhappy situation this is likely to prevent us from changing it. Yet the authors detect a more sinister function of wellness. If we have the power to improve our lot just through our individual behaviour, the flipside is that we only have ourselves to blame when we are unwell or unhappy.

The authors suspect this is why wellness has become such an attractive idea for businesses. Wellness programmes at work prod employees into exercising and eating more healthily. This not only makes employees more productive but also offsets responsibility for their health onto them. One might argue that at least if businesses are introducing these programmes they are showing some concern for the wellbeing of their employees; yet wellness programmes can be a convenient way of subtly telling workers to ignore the stress and heavy workload of their jobs and instead look for solutions through yoga and avocado smoothies.

In a study of American jobseekers, Ofer Sharone observes unemployed people in a support group being told that they should focus on “internal obstacles” rather than, for example, paying attention to the unemployment rate. While this may better motivate them to find a job, it may also lead to undeserved guilt and shame because it suggests it is their fault they do not have a job.
Jamie Oliver cooking

The book discusses Jamie Oliver’s campaign to raise nutrition standards in school. While its intentions are benign, the underlying message is that diet is key to improving the life chances of children in underprivileged areas, ignoring all other socioeconomic issues. To change diet requires nothing more than willpower, rather than, say, long-term investment.

The general effect of the wellness philosophy is to centre discourse about wellbeing on the individual, rather than politics, the economy and society. This makes the deficiencies in economic policy appear normal, natural and inevitable – just like bad weather, and just as futile to complain about.


This is related to the shift in employment patterns over the past 50 years. In the old post-war system of capitalism, the employee works for a standard amount of hours in a dull, repetitive, uncreative job (called Fordism after the Ford factories). For the authors this mode of employment is represented by John Brack’s painting Collins St, 5 p.m. which depicts a mass of employees heading home at the same time.

This model of employment was derided in the sixties for being spiritually unfulfilling. Instead, there was a desire for authenticity, flexibility, fluidity and self-expression. Capitalism duly adapted by appropriating these characteristics. Revolutionary ideas were recycled as managerial speak. Employees become artists, who are creative and independent. This is the post-Fordist system.

This mode of thinking is typified in Silicon Valley technology companies with their aquariums and slides instead of stairs, but it pervades how lower-income jobs work too. Zero-hour contracts are justified on the basis of flexibility for employer and employee. The flipside of a workplace which is fluid and ever-changing, and where workers must be flexible and differentiate themselves, is that there is not much stability or job security.

In this new model the boundary between work and private life is erased. The workplace reaches beyond the spatial and temporal barriers which once confined work to the company’s offices. While work is meant to be more fulfilling and pleasurable, it is also always with us. The modern employee is constantly on call via her smartphone.

So, work and pleasure are blurred: we have fun at work, and we work during our leisure time. This means our personal life is inseparable from how we perform at work, and must be measured using the same values of productivity and efficiency. In this way, personal life is treated like a business. We use self-tracking software to measure, and ultimately improve, our eating, sleeping and exercise habits.

Elusive happiness

Positive psychology is linked to ideas about what makes us happy. The authors argue that many of these ideas are scientifically dubious, as are attempts to measure an emotion which is “slippery, fragile and elusive”. Happiness is often presented as an individual choice. It either arrives through the material gains (such as promotions, riches and accumulation of possessions) that positive thinking enables us to access, or (in a more ‘authentic’ and spiritual sense) through undertaking wholesome activities like going to the museum.

The authors are sceptical of David Cameron’s focus on wellbeing as a measure of policy and his introduction of a happiness survey. This conveniently takes the focus away from political choices which affect people’s wellbeing. In this way, happiness studies often serve an ideological purpose which is to suggest that happiness is possible for everyone, regardless of circumstances.

Under the wellness philosophy we are urged to have fun all the time: in the permissiveness of a liberal democracy the superego no longer restrains us from this, but implores us to enjoy. Yet this enjoyment is different to what the novelist Zadie Smith described as joy – a sort of ephemeral moment of complete elation, often involving for her love or drugs.

It is instead a moderated, rational, purposeful form of pleasure, exemplified at a ‘nightclub’ in London, which is open in the morning for city workers to dance to deep house. There are no drugs or alcohol, and the exercise sets them up perfectly for the day. We look for constant, restrained pleasure and happiness, and we look for it inside rather than outside ourselves. In the end, this brings us anxiety and self-absorbed isolation.

What is the solution?

At the end of the book the authors discuss two movements which seemingly challenge the moral rigour of wellness culture. Firstly, the Fat Acceptance movement, which fights against the discrimination and disregard the obese face. However, to combat it the obese point to other more healthy aspects of their life, such as excelling in their work and being outgoing. This is an inadequate challenge to the wellness syndrome, because it shows they remain attached to the idea of wellness.

The second movement is ‘barebacking’: where gay men have sex without a condom. Some wish to become infected with HIV. This subverts the wellness ideology of safe, responsible sex which is seen to sanitise and desexualise homosexuality. For the authors this response is again inadequate, because it still involves a fixation with the self to become authentic and different.

As for what is to be done, it is difficult to find a way to change the status quo. The idea of wellness is so pervasive its messages are accepted as natural truths. Even if we dislike these message, we are forced as individuals to self-monitor in order to survive and compete in our professional and personal lives.

The book ultimately implores us to end the demand for an authentic self; to recognise that always being happy and healthy is neither possible nor desirable; and to look beyond our own individual bodies. This is, in practical terms, rather vague, and as the remedies are to do with individuals they perhaps fall foul of the book’s own message that we should look for societal solutions rather than personal ones.


While the book offers a critical take on the economy and society, it remains rather too abstract and imprecise. Like many British books, it draws on plenty of examples from the United States and the United Kingdom, neglecting the rest of Europe and the West. It is not clear whether the book is meant to be about the whole of the West or this limited part of the Anglosphere.

The book blames Tony Blair for the “birth of this fundamentalism” where the individual becomes completely responsible for themselves, and for attacking the welfare state. This is a rather bizarre argument given the percentage of GDP spent on welfare payments only declined from 11% in 1997/98 to 10.9% in 2007/08.

The authors use isolated examples to make wider points. For example, they make a comparison between contemporary employment trends and an episode of the drama Black Mirror where the only chance of escaping a bleak daily grind is by paying to enter an X factor-style competition, because in real life there have been several occasions where work experience has been bought. It then goes on to talk as if this is the norm: “while there is no guarantee that you will ever be chosen, you still have the chance, provided you start by paying the 15,000,000 merit points to appear on a talent show [as in Black Mirror] or the $42,500 for a stint at Vogue”.

Of course, the vast majority of people do not have to pay $42,500 for work experience, which undermines the authors’ point. This is frustrating, because there is no need to exaggerate – many internships are unpaid or underpaid because it is assumed the employee has more to gain than the employer. So why not provide a statistic about this rather than focus on an extreme case?

The book discusses at some length companies introducing wellness programs. The reader would assume this is a very common aspect of being a 21st century employee. So it is a surprise to read buried away in one paragraph that “One study pointed out that there is a limited take-up” of these programmes. Similarly, for all the pervasiveness of the wellness ideology, the fact that the rate of obesity in England increased from 15% to 26% between 1993 and 2014 surely casts doubt on its effectiveness.

Is it all bad?

While the focus on wellness clearly legitimises unfair policies and neglects the external impact of the economy on people’s lives, it is not clear how it is all without merit. For example, the authors complain that smoking is now seen as a moral defect, pointing to the restrictions on smokers at work and elsewhere. There has been a transition from smoking as an activity being the problem to smokers as people being the problem.
Cigarette smoking

Treating smokers as immoral is unfair, but is there an argument that if it reduces the level of smoking, it is justified? Smoking comes down to personal choice more than other issues discussed in the book like obesity and employment. The problem with treating wellness as a moral obligation, the authors argue in the book, is that it leads to an insatiable need to improve, causing anxiety and misery. Yet the health problems caused by smoking cause considerable misery to smokers and their friends and family (smoking may kill up to two in three smokers).

More broadly, it seems that the argument is about whether the material benefits of the wellness philosophy (in terms of improved health), and more generally of the current economic system, are outweighed by the negative psychological and spiritual effects of this system and the inequality it legitimises. In this sharp analysis of modern economics, society and culture it’s clear which way Cederström and Spicer lean. Exactly what system could replace it remains less clear.

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