Rethinking hope and work in psychosocial rehabilitation: a case study from Bangalore, India

In this thesis I present a person-centred ethnography of the ‘work of hope’ in a psychosocial rehabilitation (PSR) centre for people with schizophrenia and/or bipolar disorder in Bangalore, India. The thesis is structured around a critique of three shortcomings in the psychosocial rehabilitation (PSR) literature: first, the overly monotonic, positive inflection of hope; second, the narrow, rigid definition of ‘meaningful’ work as full-timed, waged labour; and third, the overly individualized conceptualization of hope as a purely internal emotional state. As I show, hope is an emotion that is developed, nurtured, and sustained by many people within the therapeutic community—not just the residents. Similarly, due to its cultural significance, ‘work’ (understood as full-time, waged labour) is the object of many PSR clients’ hopes, and many rehabilitative and therapeutic activities are vocation-oriented. However, a number of clients expressed more nuanced visions of what ‘meaningful work’ meant to them. Such narrow conceptualisations of hope and work—both of which serve as central constructs in therapeutic settings—are problematic because they fail to consider the person- and context-specific ways in which these terms are defined. ‘Meaningful work’ need not entail waged labour and could involve different activities, such as volunteering. Furthermore, the work of hope in PSR is laden with equally compelling negative emotions, such as fear, dread, and pessimistic fatedness. Hope is not just an individually-based emotion; it involves socially distributed emotional labour to create and sustain hopefulness among PSR service users.