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Body &

Society
128

Health Promotion,
Governmentality and
the Challenges of
Theorizing Pleasure
and Desire

The Author(s) 2015


Reprints and permission:
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DOI: 10.1177/1357034X15616465
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Mads Peter Karlsen


Copenhagen Business School

Kaspar Villadsen
Copenhagen Business School

Abstract
The relationship between pleasure and asceticism has been at the core of debates
on western subjectivity at least since Nietzsche. Addressing this theme, this article
explores the emergence of non-authoritarian health campaigns, which do not
propagate abstention from harmful substances but intend to foster a well-balanced
subject straddling pleasure and asceticism. The article seeks to develop the Foucauldian analytical framework by foregrounding a strategy of subjectivation that
integrates desire, pleasure and enjoyment into health promotion. The point of
departure is the overwhelming emphasis in the governmentality literature on
prudence, self-responsibility or risk calculation, such that pleasure and desire
remain largely absent from the framework. Some insights from Zizeks work are
introduced to help us obtain a firmer grasp on the problematic of the wellbalanced subject. The article argues that, in order to analyse the transformation
of interpellation in recent health promotion, we must recognize the mechanism of
self-distance or dis-identification as an integral part of the procedure of
subjectification.
Keywords
asceticism, Foucault, governmentality, health promotion, pleasure, subjectification,
Zizek

Corresponding author: Kaspar Villadsen. Email: k_villadsen@yahoo.com


Extra material: http://theoryculturesociety.org
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Consider three examples of recent campaigns for prudent health


behaviour. In a short film produced by the Danish Psychiatry Foundation, a mental health advocacy group, we are shown a lively party
scene in which young people are dancing and making out to the
sound of trendy rock music with the subversive, and in this context,
ambiguous lyrics (we dont need ropes to climb the walls you
build). On a sofa, two teenagers are trying to sniff cocaine. A hiplooking young man with a hat and fashionable beard suddenly interrupts, Hey! What the hell are you doing?! There is a tense moment
where one awaits the much anticipated warning to not use drugs. The
suspense is cancelled when the young man walks over to the novice
users and says Youre doing it all wrong! He then quickly mixes the
drug correctly and passes it to the astonished teenagers: Here you
go! The short film is followed by the message: Be sure about drugs
and their effects. Check out our homepage (Danish Psychiatry Foundation, 2013). The film is in every detail similar to commercials for
beer, alcohol, music or clothes that target youth culture. It was produced by the advertising agency AdPeople and released in 2013.
Another short campaign film bears the title Remember the Seatbelt, Goose! A girl who appears to be about ten years of age gets into
a car and sits on the front seat next to her mother. The mother asks,
Did you have a nice day, sweetheart? The daughter looks disapprovingly at her mother and says with a deep sigh, as if it were a
recurring incident: Youve been driving without the seatbelt! After
admitting this fact, the mother asserts: This is something that I
decide. I find the seatbelt annoying. Apart from that, Im an elite
driver, twenty years with no accidents. Rolling her eyes, the
daughter shouts out: Im not going to drive you around in some
fucking wheelchair! The mother ridicules her daughter by making
the sound of a duck: Quack, quack, quack! She then starts the car
while the daughter turns her eyes to the roof in despair. The clip is
followed by the text: There was only one silly goose in this film.
The film was produced by the Danish Council for Greater Traffic
Safety (2007a). In another film, issued in the same campaign for seatbelt use, a handicapped young man has a similar conversation with
his self-confident driver, who refuses to wear his seatbelt for just a
short ride. That film is followed by the message There was only one
fool in the car (Danish Council for Greater Traffic Safety, 2007b).

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Karlsen and Villadsen

A campaign film produced by the Danish Cancer Society follows a


related model: an ordinary-looking young man dressed in jeans and a
red sweatshirt with a hood walks down a street on a grey autumn day
and enters a solarium. In the background, rap music by the humoristic
Danish rap group KNA Connected can be heard. Behind the desk we
see a young, good-looking, if somewhat tawdry, blonde woman. Hi,
I would like some skin cancer, the young man says with a smile.
Thatll be 20 kroner (approx. US$3), the attendant replies in an
indifferent tone of voice. Nice! says the young man. If you pay
an extra 15 kroner, you get melanoma cancer included, the attendant
informs him. Thats cool!, the young man exclaims, putting the
money on the desk. Cabin four is free, the attendant says, while the
music gets louder and the lyrics say Im brown, Im delicious. So
long until I die; let it burn now; let it burn now. The short film ends
with the voice-over: Turn off the solarium; it can cost you your life.
It was produced on the basis of a competition for campaign films
against skin cancer and used in a nation-wide campaign in 2008
sponsored by the Danish Cancer Society and the philanthropically
engaged Tryg Foundation.
Compared to more conventional health campaigns, these three
films are noteworthy for several reasons. First, they exhibit a total
lack of any objective data, legal regulations or statistical predictions.
Nor do we encounter any medical or legal authorities warning us
about our behaviour. The films seem to recognize the limits of biomedical approaches to addiction and instead show how drinking and
the use of drugs are socially and culturally shaped. Second, in contrast to conventional public service advertising, with their typical
warnings and prohibitive edicts, the campaigns display postmodern
stylistic traits such as relativism, irony, surrealism, auto-referentiality
and the creative mixing of genres. It seems that conventional (medical)
authority can only be positively expressed insofar as it is immediately
undermined through irony, ridicule, surrealism, etc. Third, there is an
inversion of authority in the films: the conventionally subordinated
subjects (the drug user, the child, the handicapped person) here act as
truth tellers and informed instructors. Fourth, a barefaced pragmatism is evident, especially in the first film, where the goal is not to
compel the target audience to abstain from using illicit drugs but
to encourage them to use them in a more informed way. Sensible
consumption seems to replace prohibition and abstention.
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The campaign films, we contend, are hardly arbitrary incidences


completely unique to the Danish context, since ironic and humorous
health campaigning can be found in other countries as well. Nevertheless, Danish public campaigns are probably particularly receptive
to the use of anti-authoritarian genres such as irony, relativism, and surrealism, due to a culture in which scepticism towards conventional
authorities is pronounced, not least due to the lasting impact of the
1968 youth revolt. The Danish context is the home of anti-hierarchical
learning and management methods like roundtable pedagogy and dialogue-based management (Karlsen and Villadsen, 2008).
Notably, these health campaigns implicitly show respect for the
targeted subject as a subject with certain desires for pleasure, for
personal freedom, for beauty even though such desires do not
always accord with official norms for good health. It is indirectly
communicated in these campaigns that the authorities propagating
them are attentive to the fact that the addressee of the message is herself aware of this discrepancy between the official norm and the
actual message. Hence, as in other contemporary health campaigns,
the aim is not to impose an absolute prohibition in a paternalist way,
nor to enlighten a supposedly ignorant audience, but to encourage a
moderated or controlled consumption of harmful substances. This is
combined with the goal of fostering a more reflexive attitude in relation to health-risk behaviours, encouraging a balancing of these risks
against the pleasures, meaningfulness or beauty that they afford.
Thus, a desirable health promotion must take as its starting point
the acknowledgement not only of our personal freedom and informed
state of mind, but also our conflicting desires.
This is reflected in the form of hailing in operation in these health
campaigns, which has undergone a noteworthy transformation. In
contrast to hailing in its traditional form, analysed by Louis Althusser
(1971) in his classical text on ideological interpellation, the mechanism of hailing or interpellation characterizing the three examples
above leaves open a space for critical distance for the targeted subject
(Karlsen and Villadsen, 2015). This form of interpellation not only
anticipates but actually utilizes the potential resistance of the subject.
The indirect message in all three of these examples seems to be:
Although we [the health authorities] are telling you [the citizen] what
serves your health the best, we do it in a way in which we fully
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Karlsen and Villadsen

acknowledge that you as a subject are already well aware of what you
want and what is best for you.

One could suggest that this form of interpellation attempts to turn


non-compliance into an ally.
Such instances, where a permission or even an injunction to follow your desire by taking a distance, critically interpreting or even
violating the communicated norm that is built into the very message
itself, has so far not been explored in detail through a Foucauldian
framework. We suggest that the issues of desire and pleasure,
themes figuring in Foucaults own work but generally absent in the
focus of governmentality studies of health (Dean, 2012; Race,
2008), can extend the analytical register for exploring contemporary health promotion.1 We emphasize that the campaign films
described above are examples of a broader problematic, the quest
for what we term a well-balanced subject straddling asceticism and
hedonism. They are not comprehensive case studies but merely a
window into a more conceptual discussion of Foucaults framework
for understanding health campaigns and the way they address the
subject.
Mobilizing small campaign ads in order to challenge a conceptual
apparatus broadly reflects Slavoj Zizeks use of examples, by which
he inverts the conventional relationship between theory and empirical case. Instead of analysing an empirical instance in order to confirm or exemplify a theory, one begins with the example which then
serves to effectively display the inherently antagonistic nature of a
concept or a theory. Zizek contrasts the idealist with the materialistic
usage of examples (2008a: xixvi). In the idealist-platonic view, the
example figures as an always imperfect illustration of the idea or the
concept that it exemplifies. Since the example is imperfect, necessarily lacking in relation to that which it exemplifies, there is always a
need for more and more examples. In the material approach, by contrast, the example is conceived as always exceeding itself, constituting something more than what is exemplified. For this reason, the
example cannot serve as a passive illustration or a kind of neutral representation, insofar as it inevitably does something to the exemplified. In Zizeks work, the examples make visible that there is an inner
contradiction or antagonism in the exemplified and hence casts the
observed in a new light, including established theories and concepts.
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That apparently trivial examples can serve in analysing and estranging a theory is well explained by Pfaller (2007: 44): The commercial is not just there in order to be analysed by elaborated theoretical
means; on the contrary, it may very well be used to analyse a given
theory, as its object. By this move, the example shifts status from
being the object we look at and becomes the lens through which
we look at something else. The ambiguity manifest in the example
places the exemplified (for instance a concept) in a new light that
undermines its self-evidence and unambiguousness. Using examples
in this way makes the question of the variety of their specific qualities less urgent, since the main concern is to articulate the example so
that it radically sharpens our view of something else (Pfaller, 2007:
45; see also McGowan, 2014: 69).
The thesis of this article is threefold. First, as exemplified above,
we suggest that something new is happening in the field of health
promotion; a new form of interpellation is emerging which involves
an element of self-distance, and a new subject-figure, a subject balancing between abstention and pleasure. We substantiate this suggestion through a survey of critical research on health promotion
in the first part of the article. The focus of this discussion becomes
more specific when we situate our thesis in relation to existing studies of subjectivation in medicine and health promotion that draw
upon Foucaults concept of governmentality. On this basis we
argue, and this is the second part of our thesis, that although these
studies have offered many critical insights, the new subject of
health promotion calls for a sharper focus on issues of desire and
pleasure. This includes the connection between libidinal investments and subjectivation, which remains underdeveloped in governmentality studies (Butler, 1999; Dean, 2012).2 Arguing this
point involves a critical examination of the status of the subjectfigure in Foucauldian studies of health promotion, which leads us
to introduce some insights in Zizeks work that allow us to get a firmer grip on the problematic of the well-balanced subject. The third
part of our thesis is that to analyse the transformation of interpellation in recent health promotion, we need to take into account the
idea of self-distance or dis-identification as an integral part of the
procedure of subjectification. This last step in our argument will
draw inspiration from Zizeks reformulation of the analysis of ideological interpellation.
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Karlsen and Villadsen

Non-authoritarian Health Promotion


The campaign films described illustrate the recent emergence of a
novel genre in health promotion, which replaces prohibition, cautioning and moralistic appeals with humour, irony and an explicitly
non-authoritarian attitude. This is particularly noticeable in campaigns for alcohol awareness, traffic safety and safer drug use. The
emergence of non-authoritarian campaigns can be situated in the
context of a broader transformation within health provision designated the new public health (Petersen and Lupton, 2002) or late
modern medicine (Bunton and Burrows, 1995). These terms encapsulate a number of broad changes, including the prominence of a
social concept of health that extends beyond the purely medical or
microbiological view; the use of interdisciplinary and decentred
activities moving beyond hospital-centred medicine; the emphasis
on risks and the environment of illnesses, including peoples everyday life; the idea of health as achieved through calculation of consumption choices as inputs to a healthy lifestyle; the view of the
patient as active and self-responsible; the differentiation of health
provision with regard to communities, groups and subcultures; and
the proliferation of harm- or risk-reduction approaches. This new
public health regime is typically said to emerge from the early
1970s across the western world (Greco, 2009: 14; Petersen and Lupton, 2002: 15).
Differentiation of health provision in relation to target groups has
been indicated as a key characteristic of contemporary public health.
Today, official health programmes often propagate health as an arena
of dialogue, and express the need to incorporate multiple voices into
institutions and campaigns (OBrian, 1995: 192). This strategy resonates with social marketing, insofar as health campaigns take account
of factors such as age-group, social class, gender, ethnicity and consumption patterns. The injunction to diversification also reflects the
critical health literature, which contests the expert knowledge monopoly and entrenched moralism of established medicine. This emphasis on diversified cultures also implies an extension of health
calculations to encompass the multiple dimensions of everyday life,
including habits, desires and pleasure factors increasingly considered essential for how individual lifestyles are shaped. In some cases,
health promotion seeks to take cultural, ethnic, gender- or age-related

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factors into account by modifying appeals with regard to such factors. An example are appeals addressed to young men, who are
assumed to carry a particular masculine culture characterized by
disregard for their own health, and risk-taking or outright healthdamaging behaviour (Petersen and Lupton, 2002: 25). Nonauthoritarian health recognizes the need to negotiate or reconcile
itself, at least partially, with cultures of risk-taking or selfdestructive masculinity. Similarly, campaigns may be designed from
the premise that cautioning against the imminent danger of harmful
substances might have adverse effects on consumers for whom precisely risk holds a certain attraction (Bunton and Burrows, 1995:
213). In such cases the rational, authorized goals of health promotion must be balanced with the irrational values and dispositions of
the target group. It is not a matter of eradicating cultures and identities detrimental to health, but rather of keeping their effects within
acceptable levels. Hence, recent diversified health promotion seeks
to contextualize goals and prevention techniques in terms of the
situations within which people entertain practices of consumption
and pleasure.
Strategies of harm reduction and risk reduction emerged in the
mid-1980s, but have roots in the 1960s and 1970s critiques of legal
persecution of drug users as voiced by activists and professionals.
Eventually, harm reduction became less a platform for broader social
change and more a medical strategy for mitigating the harm inflicted
upon individual substance users (Roe, 2005: 243). It has gained
acceptance across areas like alcohol treatment, psychotherapy, sexual education and gambling. As a general approach to health promotion, harm reduction displays a series of characteristics pertinent to
our present discussion: It takes a non-moralized approach which
replaces pathologization with a pragmatic calculus of individual
costs and social consequences. It refuses to make addiction and
abstinence the primary target of harm reduction, or to accept that
public care is conditional on abstinence (Race, 2008: 418). Finally,
pleasure and taste are accepted as key factors in harm reduction, insofar as the conventional psychological and sociological aetiology of
causation is supplanted by the assumption that the relevant motivations are principally generated as a socially acquired taste.
In harm reduction, pleasure is not the antithesis of self-regulation
and safety, but rather a potential medium through which certain
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shared protocols of safety may be practised (Race, 2008). The pragmatics of harm reduction seem to resonate in the design of nonauthoritarian health campaigning. The assumption seems to be that
the subject targeted by campaigning is fundamentally split between
two dispositions: on the one hand, it is amenable to appeals for prudent and rational health behaviour, and, on the other hand, there is
desire and pleasure, an irrational side resistant to such appeals. Here,
the objective of health promotion is not a conversion of the individual into a fanatically committed disciple of healthiness, but rather the
fostering of a well-balanced subject.
Our argument is not that this subject-figure is pervading the entire
domain of health provision and health campaigning. The Danish policy context is, like that of other countries, still marked by disagreements between different convictions with regard to the use of
harmful substances, including the ongoing and often bitter tensions
between harm reduction and demands for abstinence. The campaign
films presented above should be viewed as part of a multi-pronged
strategy of health promotion which encompasses conventional medical treatment, long-standing legal measures and economic incentives. Although the campaign ads are certainly not hegemonic,
they are highly interesting, we contend, in the fundamental ways that
they depart from previous health promotion centred on warnings,
self-control and rationality.
The Rational Health Subject of Governmentality Studies
The governmentality literature that has focused on health issues has
paid much attention to strategies for inculcating prudence, selfresponsibility or risk calculation. Early scholars of critical health
invoked Foucault mainly in order to emphasize rational regulation
of populations and to critically interrogate the dominance of modern
medicine. Particularly, but not exclusively, early followers of Foucault described health services as part of a social strategy to make
individuals conform to entrenched morals of modern medicine. For
instance, Bryan Turner introduced governmentality as a perspective
on medicine by defining it as a regime which links self-subjection
with societal regulation (Turner, 1997: xv). Petersen and Lupton
similarly invoked Foucault to assert that medical institutions were
part of an expanding apparatus of control, discipline and regulation
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that involved micropolitical processes whereby individuals were


encouraged to conform to the morals of society (Petersen and Lupton, 2002: 14). Robert Castels (1991) influential study demonstrated
that the increased availability of scientific risk calculation was
accompanied by demands for risk-minimizing conduct by the
affected individuals. In Mitchell Deans (1999: 1668) diagnosis of
the new prudentialism in contemporary welfare policy, groups that
manifest high risk are targeted by technologies that aim to make them
active citizens capable of managing their own risk. Seminal work on
this theme was published by Marianna Valverde and Monica Greco.
Valverdes (1996, 1997) early work addressed the problems of alcoholism, free will and morality, while Greco (1993) focused on the
psychosomatic subject and the modalities of knowledge defining it.
In discussing the liberal conception of the rational subject, Valverde (1996) begins with the discourse on alcoholism and then suggests, more broadly, that liberal government often implies illiberal
modes of moral governance in its core. Valverde observes that within
liberal regimes, the division of subjects into different groups and differential treatment of these groups are often carried out with reference to the elusive faculty of rational willpower or the lack
hereof. Coercive interventions into poor, youth, degenerate and indigenous populations are justified by reference to a binary opposition
between passion and reason, and the general idea of a rational will
that must dominate irrational impulses (Valverde, 1996: 362). Reading influential liberal philosophers, Valverde finds that they all work
with some concept of the reasonable man, who is master of his passions, desires and tendencies towards excesses. This figure is emblematic for liberal thought, and in the case of Habermass ideal speech
situations, it turns out that free men can only undertake reasoned
debate about values once they have despotically suppressed their
own desire for the not unconnected pleasures of rhetorical persuasion
and erotic interchange (Valverde, 1996: 364). The key problem is
not lack of intellect but a defective will in the unreasonable subjects. In Valverdes analysis, the distinction between reasonable and
unreasonable individuals reflects an alleged internal division inside
the liberal subject:
The distinction between the self that controls and the (immature,
lower) self that is controlled presupposed by the term self-control
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is in some ways a naturalized distinction between two things, between


passion and reason, but could also be regarded as a spatial division
between two psychic spaces. (Valverde, 1996: 369)

Monica Greco (1993, 2009) has offered a supplementary analysis


to that of Valverde. Greco begins with the problem of how it has
become possible to envisage health as a domain of individual appropriation through rational choice (Greco, 1993: 357). Her key observation is that within contemporary strategies of health promotion,
health is viewed as contingent upon the will of individuals (Greco,
1993: 369). However, Greco arrives at this conclusion by focusing
on psychosomatic knowledge as having major significance in defining health and illness.
In the prism of psychosomatics, the riskiness of a given
environment or social circumstance is not objectively given but is
co-produced by the individuals dispositions and the way he or she
relates to the environment: The pathogenic value of a given environment is only ever a function of an individuals interpretation of it
(Greco, 1993: 360). Greco suggests that psychosomatics entails the
moralistic idea that each individual can (and should) acquire a personal preventive capacity that includes greater self-knowledge, bodily
awareness and self-regulation of lifestyle. A failure to exercise prudence constitutes irrationality, a kind of disease antecedent to symptoms, manifested in particular behavioural, psychological and
cognitive patterns (Greco, 1993: 361). For the neoliberal individual,
Greco (2009: 19) asserts, health has thus come to represent an objective witness to his or her ability to function (and to be addressed) as a
free, rational and moral agent. Health becomes something chosen, a
sign of strength of rational will, underpinned by good moral attitudes.
Their differences aside, Valverde and Greco diagnose the emergence of a concept of health that is dependent upon the wilful choice
of persons rather than health as received by heritage, social conditions or the medical system. Across a broad range of medical and philosophical literature, they identify the idea of a conflict-ridden, split
subject who should become the bearer of a single, rational willpower.
Both Valverde and Greco offer valuable perspectives for rendering
contemporary health promotion intelligible. However, their analysis
has certain limitations as a framework for analysing nonauthoritarian health campaigns. First, they both observe that liberal
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governance conceptualizes illnesses as partly or entirely due to moral


defects, and that cure accordingly involves inculcating an ethical
despotism in the subject. The non-moralizing approach of current
anti-authoritarian health campaigns challenges these assumptions.
These campaigns display no illusions of eradicating corrupt morality or the savage within. Rather, they seek only to negotiate it, to
establish a balance between desire and rationality. Second, rather
than the inculcation of inner guilt as the driver for abandoning
unhealthy behaviour, it is through exercising practices and acquiring
new tastes that a healthy lifestyle change will take place. Third,
whereas Valverdes and Grecos analyses foreground Victorian
values of rational control, suppression and asceticism, they ignore the
fact that recent health campaigns express more hedonistic values of
enjoyment, self-fulfilment and pleasure. Their emphasis on control
and asceticism as solutions to health problems conflicts with the contemporary identity projects which focus on leisure, experimentation
and self-actualization (Bunton and Burrows, 1995: 208).
In the following sections, we turn to Zizek in order to further elaborate the connections between libidinal investments and subjectivation
and, in particular, the emergence of the new health subject balancing
between hedonistic pleasure-seeking and rational abstinence. Following Zizek, this subject-figure can be linked to a general antiauthoritarian tendency, which involves a new form of subjectivation.
We are, of course, not the first to draw on Lacanian concepts to supplement a Foucauldian framework and to challenge ideas of a subject
characterized first of all by rationality. The authors of the book Changing the Subject (Henriques et al., 1984) seek to establish a framework
that transgresses the dual model of society and the unitary subject.
From Foucault they take the view that the subject is positioned in
diverse discursive practices that are culturally and historically specific. They combine this with Lacans theorization of subjectivity as
non-unitary and fundamentally contradictory. The result is, in brief,
an approach to subjectivity as shaped by practices that are always
already locked in power-knowledge relations, and the production of
desire is inextricably intertwined in them (Henriques et al., 1984:
226). The editorial group behind the journal Subjectivity pursues a
similar project insofar as they criticize Foucauldian approaches for
viewing the subject as a mere epi-phenomenon of operations of
power-knowledge. Here, psychoanalysis is also enlisted among the
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answers to the question of how the subject can be viewed as other than
a product of textual, material, institutional and historical factors
(Blackman et al., 2008: 8; see also Butler, 1997; Hook, 2007).
Common to these contributions is that they seek to theorize the
conditions under which subjectivity is possible. We do not oppose
such a theoretical project, but have a different emphasis here. Our
objective is smaller in scale and guided by the diagnostic concern for
better understanding a novel form of health campaign that foregrounds mechanisms of identification/dis-identification rather than
internalization. The psychoanalytical vocabulary becomes pertinent
to a health promotion which addresses its target audience as subjects
who dis-identify and never are at one with discursive positions.
The Well-balanced Subject between Asceticism
and Hedonism
Zizek presents at various places a narrative of a recent mutation in the
structure of subjectivity in western capitalist societies (from Oedipal
to post-Oedipal, from hysteric to perverse), which he sees as closely
connected to a general postmodern decline of paternal authority and a
related scepticism towards symbolic mandates in these permissive
societies. Interestingly, Zizek (1999b) thematizes this mutation
through the well-known Nietzschean figure of the Last Man, a
post-metaphysical subject that enters the historical scene after the
death of God. According to Nietzsche (1999), the Last Man lives
without any illusions of a beyond, without transcendent, absolute
or eternal values, but also without any desires to transcend himself.
Emblematic of western passive nihilism, the Last Man is no longer
marked by a tension between what he is and what he might become;
he is wholly satisfied by continuing to be what he is. The Last Man is
the subject that corresponds to what Zizek (2001: 10) terms our postideological era, or the end of history, echoing the title of Francis
Fukuyamas influential book, an era in which the liberal, capitalist
consumer society has been entirely naturalized, and radical political projects are immediately deemed morally suspect or potentially
totalitarian.
Nietzsches figure of the Last Man is invoked by Zizek in a manner that relates explicitly to our problematic. Zizek connects the Last
Man to contemporary concerns about health care and politics. Given
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that the Last Man is not willing to take any real chances, seeking
merely comfort, small pleasures and security, he is, on Zizeks
account, a figure who prefers politics without politics, revolutions
without revolution, love without commitment, but also on a smaller
scale beer without alcohol, chocolate without fat and (electrical)
cigarettes without tobacco. In short, he wants enjoyment without
paying the price for it. However, this permissive attitude of the Last
Man is paradoxically accompanied by an endless number of prohibitions to secure a comfortable life for oneself and ones neighbours
(Zizek, 2000a: 173). This is also why the real consequence of the
death of God is not that everything is permitted as allegedly
claimed by Dostoevsky, but that everything is prohibited as suggested by Lacan: God is dead, says Zizek, and we live in a permissive universe, you should strive for pleasures and happiness but, in
order to have a life full of happiness and pleasures, you should avoid
dangerous excesses, so everything is prohibited if it is not deprived of
its substance (Zizek, 2003: 96).
Accordingly, Zizek (2003: 957, 2008b: 76) describes the survivalist behaviour of the Last Man as hedonistic asceticism, precisely
because it combines pleasure and constraint in a reactionary equilibrium the only goal of which is not to die, or to die as comfortably
as possible. This hedonistic asceticism of the Last Man, combining
pleasure and constraint, can be further elucidated by invoking a
Lacanian understanding of the superego which espouses an obscene,
permanent imperative to enjoy: The concept of the superego designates precisely the interzone in which these two opposites overlap: in
which the command to enjoy doing your duty overlaps with the duty
to enjoy yourself (Zizek, 2000a: 135, emphasis in original). The Last
Man is thus a subject not only characterized by having to enjoy doing
his duty, but also by having the duty to enjoy. Thus, the allusion to
the figure of the Last Man conveys to our discussion not just the
theme of nihilism but, more importantly, the issue of the possible
inseparability of enjoyment and obligation, pleasure and prevention.
Zizek (2003: 95) connects the subject-figure of the Last Man to the
notion of biopolitics. Biopolitics, argues Zizek (2008b: 34), is precisely post-ideological insofar as biopolitics designates the regulation of the security and welfare of human lives as its primary goal
(Zizek, 2008b: 34). Hence, it must abandon the biologically risky and
costly ideological struggles inherent to passionate political projects.
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However, another important insight follows from Zizeks discussion


of the figure of the Last Man and biopolitics, namely that the expert
rule of biopolitics is grounded in and conditioned by the crisis of
investiture; this crisis generated the postmetaphysical survivalist
stance of the Last Man (Zizek, 2004a: 505).3 As a consequence, the
Last Man is a subject for whom it is no longer possible to fully
assume his received symbolic mandates and who thus needs to constantly express an ironic-reflexive distance with regard to the socialsymbolic roles he performs (Zizek, 2002: 70).
The implication for contemporary analysis of power is that effective technologies of power must take their point of departure in this
crisis of investiture and integrate the self-reflexive distance that
characterizes the Last Man. Accordingly, contemporary biopolitical
strategies of subjectivation, for instance in health promotion, will be
directed towards individuals who cannot be expected to fully identify
with the positions to which they are subjected. This means that
biopolitics must invoke a form of authority which is inherently antiauthoritarian (Zizek, 2006: 923). The difference between the traditional authoritarian form of authority and this anti-authoritarian form
of authority parallels the difference between the ways that symbolic
law functions and the way the superego functions. While the symbolic
law tells you to just do your duty, the superego says: Dont just take
orders, do what you have to do, because you think you should do it;
that is: do your duty because you enjoy doing it (Zizek, 2000a: 134).
Notably, this ambiguous reflexivity undermines the commonplace
notion of the postmodern subject free to choose and reshape his identity (Zizek, 1999a). Zizeks point is that we need to recognize this selfreflexive dimension of the superego, and more broadly the libidinal
investment involved in the exercise of power, when studying power
relations.
Linking biopolitics with the figure of the Last Man and introducing the Lacanian notion of the obscene superego, Zizek connects
pleasure and enjoyment to the theme of biopolitics. Following Tim
Dean (2012), we consider this move to hold a significant potential for
the development of the analytics and notion of biopolitics.4 Zizeks
reflections on biopolitics help render intelligible the advent of health
activities that do not rest upon eternal (health) values and temper
their aspirations to simply reducing harm and prolonging life. They
are also pertinent to technologies and programmes of health
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promotion which, in their form of hailing depart from compliance,


abstention and rationality and signal elements of dis-identification,
pleasure and irrationality.
The Pleasure of Power and Self-distancing Subjectification
We now wish to elaborate on this matter of dis-identification and the
related issues of pleasure and desire by paying attention to Zizeks
critical engagement with Foucaults analytics of power. It has
already been noted that the analysis of the construction of subjectivity may be enriched by supplementing Foucault with psychoanalytic
conceptions, insofar as psychoanalysis can extend the Foucauldian
approach with notions of desire and pleasure. In turn, Foucaults
view of power in historically specific formations can counter psychoanalysis premise of a universal, albeit contradictory, subject who is
not situated historically (Henriques et al., 1984: 217). Our ambition
of combining the two traditions is not to extend Foucaults discursive
construction of subject positions with extra-discursive, psychoanalytical dimensions. For present purposes, we find a more restricted
point of congruence in the psychoanalytical notion of disidentification, particularly as articulated by Zizek, and Foucaults
concept of subjectivation as the conduct of conduct.
For Zizek, Foucaults analytics of power leaves out of consideration . . . the process by means of which the power mechanism itself
becomes eroticized (Zizek, 1999b: 254). To illustrate his point,
Zizek deploys the example of the Christian ascetic subject. What
Foucaults analytics of power neglects, according to Zizek, is how
the ascetic who flagellates himself in order to resist temptation finds
sexual pleasure in this very act of inflicting wounds on himself
(Zizek, 1999b: 254). In other words, the Christian subject is not
merely subjected to the ascetic arrangements of pastoral power but
is in this very process also involved in some kind of pleasureseeking or hedonism. Zizeks critical point is that there is always
an element of pleasure involved in the exercise of power; not only
in regard to the one who exercises power over someone else, but also
in regard to the one over whom power is exercised: When we are
subjected to a power mechanism, this subjection is always and by
definition sustained by some libidinal investment: the subjection
itself generates a surplus-enjoyment of its own (Zizek, 2004b:
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253). In short, Zizek criticizes Foucaults analytics of power for not


considering this libidinal investment or surplus-enjoyment innate
to the exercise of power, a critique similar to Zizeks objection to
Althussers theory of interpellation (Zizek, 1989: 124).
On the one hand, Zizeks critique of Foucault is completely unfair.
For one thing, in History of Sexuality, vol. 1, Foucault (1990: 8190)
embarks upon a detailed analysis of the intimate relationship
between a certain form of power and the concept of desire, demonstrating how theories of desire, from Christianity to psychoanalysis,
served as a precondition for strategies of power.5 On the other hand,
Zizek nevertheless has a point, as evidenced by Deans (2012)
detailed discussion of the role of pleasure in Foucaults work. Here
Dean observes how pleasure figures principally as an object of theoretical reflections (mostly in interviews) and not as an operative analytical concept in specific analyses, contrasting with Foucaults
analyses of self-practice in which pleasure was a key analytical
notion.6
Zizek also raises this critique of Foucaults analytics of power in a
slightly different vocabulary, focusing on the concept of the subject
rather than the issue of enjoyment and pleasure. More precisely, he
criticizes Foucault for neglecting the Lacanian (libidinal) subject
of the unconscious, which is simultaneously that which ties the individual to the subjection to power and that which escapes it. This subject is the excess which resists or remains after the process of
subjectivation. Or, as Zizek says:
Production . . . does not stand for the result of the discursive operation, but rather for its indivisible remainder, for the excess that
resists being included in the discursive network that is, for what the
discourse itself produces as the foreign body in its very heart. (Zizek,
2004a: 506)

As a corollary to this, Zizek claims that the Foucauldian analysis


of power overlooks the fact that the process of subjection involves
not only a moment of identification, but also always involves a
moment of dis-identification, of not being fully subjected (Zizek,
2000b: 218). Another word for the Lacanian subject this particular
excess which is produced in and resists the process of subjection is
very appropriately surplus-enjoyment.

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Zizeks critique requires some modification, however. One reason


is that Foucaults concept of subjectification actually resembles
Zizeks notion of ideological interpellation in one significant aspect
which, to our knowledge, remains unnoticed in the commentaries. As
is well known, Foucaults rendering of modern government as conduct of conduct implies that the governed subject must always be
granted a fundamental, inviolable freedom (Foucault, 1982). Zizeks
moment of dis-identification is comparable to the problem of governing subjects who are assumed to exercise ethical self-practice, insofar as they autonomously, perhaps critically, relate to the
governmental objectives in their self-conduct. In this reading, Foucaults dictum about freedom as a fundamental condition of government could imply that the subject must be able to maintain the
assumption that it enjoys a space of freedom in relation to power and
acts on his own. Supplementing governmentality analytics with
Zizeks concept of dis-identification can thus help us to specify contemporary strategies of subjectivation, including appeals for sensible or responsible consumption of harmful substances. In this
perspective, health promotion rarely aspires to a one-to-one adoption
of health values by those targeted, but assumes that individuals will
take on (ideological) identities only when an explicit space for manoeuvre is communicated in relation to the official mandates. We suggest, then, that Zizeks concept of dis-identification (unintentionally)
can enrich and extend the analytical framework for understanding
what it means to govern through freedom. This includes, as a key
component, appeals to maintain a distance from the governmental
objectives.
The parallel observation in Zizek and Foucault that modern power
operates through the freedom of the subjects can be applied to issues
of contemporary consumerism and neoliberalism. We noted at the
beginning of the article that the campaign films address their audience by using formats similar to commercials for young people, insofar as they invoke markers from youth culture. The choice of music,
clothes, language and postures would certainly seem to take account
of the identities of the targeted age-group and the values that are
assumed to inform their lifestyle choices. In this regard, the films are
comparable to social marketing, since they differentiate and shape
their messages according to the lifestyles of their audience, including
their habits, desires and pleasures. They reflect a kind of health
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promotion which seeks to integrate goals and preventive calculations


in the subcultures and situations within which people exercise their
lifestyle choices.
It would be possible to consider how this kind of health campaigning resonates with the discourses and techniques of neoliberalism
that Foucault (2008) analysed in his lectures on biopolitics. There,
Foucault describes neoliberal forms of governing that operate not primarily by eliminating otherness but rather by fabricating otherness
and proliferating differences. Biopolitics, on his account, does not
work principally by excluding and correcting individuals with reference to rock-hard norms like discipline. It rather produces a multiplicity of distinct types, which become objects of (economic)
calculation and intervention. In a concluding remark, Foucault
(2008: 260) says that neoliberalism entails the idea of a society in
which there is an optimization of systems of difference, in which the
field is left open to fluctuating processes, in which minority individuals and practices are tolerated. This observation would seem highly
pertinent to forms of power that allow space for singularities and difference by avoiding sovereign commands and disciplinarity. It would
be possible to insert within this analysis of neoliberalism forms of
health promotion that substitute legal regulation and demands for
abstention with more permissive messages. In non-authoritarian
health promotion, it is not a matter of eradicating cultures and identities detrimental to health, but rather of keeping their effects within
acceptable levels. The well-balanced subject would be the subjectification that corresponds to a diversified, non-authoritarian and
pleasure-permitting health promotion.
It would also be possible to examine the health campaigns attention to diversified cultures, individual choices and tolerance by drawing on Zizeks analysis of contemporary capitalism. In particular, this
analysis highlights the antagonistic position of the self-managing
subject who is expected to perform a series of practices that are at the
same time jouissif, or fun-filled, and socially conformist. On this
view, current health promotion is less a matter of correcting and normalizing behaviours (as in Foucauldian discipline) than of encouraging practices of consumption and pleasure that remain within
certain sensible limits, by being neither too puritan or fanatic, nor
sliding into what is considered to be outright health-damaging behaviour. We notice, then, that despite their different epistemologies,
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Foucault and Zizek offer compatible observations regarding the permissive and balance-seeking rationality of the health campaigns, and
the form of subjectivation involved.
It should be noted, however, that Zizek would undoubtedly insert
the postmodern, culturist-consumerist traits in the campaign films
within a more explicit and encompassing critique of globalized capitalism than Foucaults localized, analytical critique permits. In fact,
Zizek often argues that post-structuralists, including Foucauldians,
adhere to a politics of difference that has become too timely in its privileging of multiplicity, differentiation and creative self-formation.
Instead of unveiling the antagonisms of contemporary capitalism,
they produce a form of knowledge that constitutes no fundamental
challenge but is in fact productive within a system which itself operates through differences and multiplicities. If we accept Zizeks critical diagnosis of the compatibility between contemporary capitalism
and the post-structuralist politics of difference, we are afforded an
additional argument for why we need to develop the conventional
concept of subjectification.
Conclusion
The article started from the observation that the subject in recent
health campaigns is increasingly characterized by a newly discovered pragmatism, irony, self-subversion, inversion of traditional
authority, anticipation of viewers dissociation and noncompliance, and attempts at alignment with the cultural identifiers
of the target groups. We then discussed to which extent the framework developed by governmentality analytics can make intelligible
this new subject-figure.
The key project of governmentality analysis has been to interrogate technologies and concepts that align what is presumed to be
healthy at the level of the individual, desirable at the social level, and
normal at the statistical level (Rose, 1988: 196). Responsibilization,
psychosomatic knowledge, risk calculation and lifestyle choices
are among such registers at the intersection of population regulation
and the disciplining of the body. However, recent non-authoritarian
health campaigns complicate the conceptual framework of governmentality analysis in terms of its rendering of health, risk, responsibility, subjectivation and healthy balance. The emerging campaigns
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are much more tempered and pragmatic in their attempt to influence


individual behaviour towards desirable social ends. This is evident in
the explicitly communicated discontinuity and discordance between
official (conventional) health values and the choices of the target
audiences. The campaigns do not act, then, like the technologies of
power discovered by Foucault and governmentality scholars, emblematically represented by the technology of sexuality, a formidable
tool of control and power.
Another challenge arises in terms of the function that rationality is
ascribed in the government of health subjects. Governmentality writers have demonstrated how interventions of illiberal character can be
justified with reference to the existence of a defective will in the subjects. On this account, passions, desires and erotic pleasure need to be
despotically suppressed in order for subjects to become responsible
protectors of health. The entrenched moralism involved in this strategy implies that to become an ill person who is not deemed morally
defective requires responsible and compliant behaviour. However,
the analytical emphasis on the role of pleasure or enjoyment in
todays health campaigns challenges interpretations that univocally
emphasize demands for rational risk calculation, calls for abstention
and suppression of irrational pleasures. In fact, contemporary health
promotion seems to have incorporated certain incitements to enjoyment or even transgression. In Zizeks (1999b: 345) terminology,
we could say that health campaigning reminds us not so much of
an authoritarian father figure who forbids you to enjoy but of an
anti-authoritarian, obscene father figure who enjoins you to enjoy
your pleasure. In todays health campaigns, these two father figures
seem to merge in the imperative to enjoy ourselves, but to do so in a
healthy and responsible way.
This antagonistic subject-figure is paralleled in the format of the
campaign films that articulate the antagonistic message of ascetic
hedonism. Notably, the films do not employ rational argument but
take the form of jokes, surprise and surrealism. They constitute
examples in the sense discussed at the beginning of the article. Contrary to the argument in our case, for instance, you have to realize
that if you go to the solarium three times per week, youll increase
your statistical risk of skin cancer by 25 per cent the example has
the advantage that it is capable of containing an excess of signification. Furthermore, the example is capable of bringing forth inherent
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contradictions and impossibilities, something that the argument is


restricted from doing. The problem is the difficulty of putting antagonisms into argumentative form. As soon as one attempts to articulate an antagonism in propositional language, one ends up
concealing the antagonism under the cover of assertions (McGowan,
2014: 68). The superiority of the example over argumentation lies in
the fact that the latter cannot formulate its own antagonistic premises
and structure. By contrast, the example can articulate its own failure
and inherent contradictions: It has the capacity to successfully indicate that which it fails to state directly (McGowan, 2014: 70). What
the example can indicate is the antagonism which lies underneath an
argument, for instance the dual appeal for irrational fulfilment of
desire and rational moderation of desire. The choice of examples
(in Zizeks sense) answers to the health campaigns assumptions
about their addressee that he/she is a fundamentally antagonistic
subject, stretched out between the contradictory rationalities of asceticism and hedonism.
The argument here is not that this exercise of power, a power that
revolves around the rationality and self-responsibility of the subject,
has ceased to exist, nor is it that demands for compliance with medical authority are completely abandoned. Nonetheless, todays health
promotion witnesses the emergence of a reconfigured objective that
does not involve a conversion of the individual into a wholehearted disciple of healthiness. The problem mutates from being one
of lack of self-mastery to being what we term a problem of balancing
self-control and desire, rationality and pleasure. This figure, which
we attempted to capture by drawing on Zizeks term ascetic hedonism, represents a subjectivation that integrates desire, pleasure and
enjoyment. The well-balanced subject that todays health promotion
seeks to produce is someone who certainly may indeed is enjoined
to enjoy, but within reasonable limits, that is, in a controlled manner, so as not to damage her own or others well-being too much.
Both too much pleasure and too little might threaten to ruin our physiological as well as our psychological health. In this perspective,
intense exercise training or extreme dieting is considered indisputably unhealthy. This is also evident in regard to lifestyle more broadly.
It is now considered unhealthy to completely give up all unhealthy
elements of ones lifestyle: by doing that, one risks becoming a
health fanatic. Thus, having a healthy lifestyle does not mean that
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all we ever do is (or should be) concerned with leading a healthy life;
indeed such a lifestyle might in fact be quite unhealthy.
Perhaps, this intertwining of pleasures and vital functions is not
something completely new but rather a readjustment of the deeprooted tension in western culture between the technical, biological
and psychological body and the political body (Agamben, 1998).
This readjustment directly impacts on what is understood by prudent
lifestyle choices and, more specifically, the formation of the categories through which risk and safety become intelligible, and according to which groups and individuals are deemed compliant or
noncompliant. Undertaking analytical reconstruction will hopefully open up further interrogation into how libidinal investments are
intertwined with the exercise of power and, specifically, with strategies of subjectivation. This article has merely begun expanding our
analytical possibilities in the light of the present context and its hopes
for pleasures within the limits of reason.

Notes
1. However, as part of what has been termed the affective turn there
seems to be an incipient interest in these issues in governmentality studies as well (Bjerg and Stauns, 2011; DAoust, 2014; Lupton, 2013).
2. Throughout this article we use concepts such as desire, pleasure
and enjoyment. We are aware of the multiple and diverse meanings
of these heavily loaded concepts, and of the important theoretical discussions concerning these concepts in the literature that we draw on
Foucault studies as well as psychoanalysis. However, it is beyond the
scope of this article to engage in these discussions. In the following we
use the terms desire and pleasure in a broad, or common, sense,
not confined to either a specific Foucauldian or psychoanalytical
definition.
3. In several of his books Zizek refers to this idea of a crisis of symbolic
investiture which he derives from Eric L. Santners reading of Schrebers Memoirs in his book My Own Private Germany: Daniel Paul
Schrebers Secret History of Modernity. According to Santner (1996:
xixii, 2011: xii), a general crisis of investiture exemplified in Schreber
occurs in the late 19th century in terms of the failure of subjects to
assume and perform the mandate of symbolic authority that they are
given. In Schrebers case, this crisis occurred when he, as Zizek
(1997: 73) puts it:
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was unable to come to terms with the stain of obscenity which formed an
integral part of the functioning of symbolic authority: the crisis of
investiture breaks out when the enjoying underside of the paternal
authority . . . traumatically affects the subject.

4. Agamben and Sinnerbrink argue, like Dean, that pleasure was largely
overlooked by Foucault as a factor functional to biopolitics (Agamben,
1998: 187; Sinnerbrink, 2005: 249). Similarly, to our knowledge, the
potential for examining instances of biopolitics which explicitly invoke
pleasure and desire remains underdeveloped in the vast literature on biopolitics, medicine and health promotion.
5. It should be mentioned that Foucault viewed pleasure as a possible mode
of de-subjectivation (rather than merely subjection), and hence as harbouring a potential for resistance against the biopolitical regime of
sex-desire (Foucault, 1990: 157). This idea has subsequently come to
play an important role in feminist theory and queer studies (Butler,
1999; Grosz, 2013; McNay, 1992; McWhorter, 1999). The notion of
pleasure as developed by Foucault might serve as a fruitful starting point
for a dialogue with Zizeks psychoanalytical position, while a reconciliation of the two approaches would still involve serious challenges (see
Dean, 2012).
6. We do not imply that Foucault offers no resources for addressing questions of desire, excess, risk, or the balance between hedonism and pleasure. In History of Sexuality, vols 2 and 3, Foucault excavates principles
for the regulation of self and others which are not prohibition centred but
rather seek for a balanced cultivation and use of pleasures. Similarly,
Foucaults (2000) comments on transgression and limit experiences,
through which the subject escapes himself, hold potential for discussing
the subject of present health campaigns.

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Zizek S (2001) On Belief. London: Routledge.
Zizek S (2002) Welcome to the Desert of the Real. London: Verso.
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Zizek S (2003) The Puppet and the Dwarf: The Perverse Core of
Christianity. Cambridge, MA: MIT Press.
Zizek S (2004a) From politics to biopolitics . . . and back. The South
Atlantic Quarterly 103(2/3): 501521.
Zizek S (2004b) Revolution at the Gates: Zizek on Lenin: The 1917
Writings. London: Verso.
Zizek S (2006) How to Read Lacan. New York: Norton.
Zizek S (2008a) Enjoy Your Symptom! Jacques Lacan in Hollywood
and Out. London: Routledge.
Zizek S (2008b) Violence. London: Profile Books.
Kaspar Villadsen is Professor at the Department of Management, Politics
and Philosophy, Copenhagen Business School. He is the author of the
books Power and Welfare: Citizens Encounters with State Welfare (coauthored with Nanna Mik-Meyer, Routledge, 2013) and Statephobia and
Civil Society: The Political Legacy of Michel Foucault (co-authored with
Mitchell Dean, Stanford University Press, forthcoming). He has published
on Foucault, organizations, biopolitics and welfare policy in Economy and
Society, Theory, Culture & Society, Organization, Constellations, Social
Theory and Health and more. His current research is on governmental technologies, health promotion, and the problem of state and civil society.
Mads Peter Karlsen is Assistant Professor at the Department of Management, Politics and Philosophy, Copenhagen Business School. He did his
PhD thesis on Alain Badiou and Slavoj Zizek. He is the author of the book
Pastoralmagt: Om velfrdssamfundets kristne arv (2008) and the editor
(with Lars Sandbeck) of the books Religionskritik efter Guds dd (2009)
and Kristendom og engagement: Peter Kemps teologi til debat (2014).
He has published on Foucault, Badiou and Zizek in New Political Science,
Journal for Critical Research on Religion and the International Journal of
Zizek Studies. His current research is on the interrelationship between theology and psychoanalysis.

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