Objetivo 3. Realizar una valoración geriátrica exhaustiva y analizar su impacto en el manejo y pronóstico en una cohorte de pacientes ancianos no seleccionados con
V. Material y métodos
5.2. Diseño global del proyecto
Since the last half of the nineteenth century, childhood, public education, and economics have been intimately linked with one another. As Foucault (1979) had so well shown, the institution of public education was meant to “discipline” the body to read and write, and cultivate a character of self-control and contemplation through a utility-based curriculum focused on skills and obedience. Disciplining young people’s social and moral values and behaviors meant disciplining the emotions through puritanical religious, sci-entific, and rational discourses. Children of the working poor, it should be noted, continued to labor in the mills and mines. Disciplining the body rigidly, where no questions are raised through the institution of schooling, was pre-cisely the most effective way of instilling the Law of the Superego, of the social order. To install the Law requires it to remain nonsensical, not to be questioned and obeyed by the imperative: “This is the way things are.” Being ignorant of the Law is no excuse for transgressing it. Its authority has to be internalized. To discipline the body through well-defined practices means to frame the mind. From this perspective, belief is not some interior contem-plative phenomenon; rather it is radically exteriorized and embodied in the practical and effective procedures of everyday life. Belief then supports the fantasy that regulates reality.
It is a commonplace saying that the so-called classical school curriculum developed at the turn of the century contributed to the child’s mental disci-pline. Through “faculty psychology” the mind was to be treated like a muscle, exercised through memorization and recitation of biblical passages, for instance. Comprehension was of secondary importance and consideration.
Modernity accorded “divine powers to children” as the Child Study move-ment got underway way in both the United States and Britain. Children’s phy-logenetic artistic development was said to repeat the ontogeny of the human race because children’s art was more “innocent,” “pure,” “free,” and devoid of the rigidity of industrialization. It was compared with “primitive” African art that was such an inspiration to various modernist artistic movements at the turn of the century like Die Brücke, Cubism, Symbolists, and even Surrealism for its formalist simplicity and universality.
The Romantic fantasy of the “pure” child becomes a paradoxical object of both future projections (fullness, without lack) as well as disavowal of a nation’s imperialism and racism. On the one hand the child’s “innocence” and energy as zoé fills the West’s lack. The child was perceived as “the father of man” and the “route to knowledge” (quoted in Burman 1994, 10). This curious and strange reversal identifies precisely the dream of complete creative fulfillment of a nation’s potential, as well as oneself: progress in all its manifestations.
On the other hand, disciplining was a way to disavow all that the nation was afraid would prevent such a realization: feeble-mindedness, the “primitive Other,” and especially “sexuality” that became contained and controlled through a confessional model by the discourses of science—“scientia sexualis”
as Foucault (1980) described them. Disciplining the child through a
pedagogical discourse, in effect, meant disciplining the nation and oneself—
inversely. The child becomes the “father of man” because as a fantasy object it exists outside the Symbolic Order in future anterior, in the time of as if—
an empty (innocent, pure) signifier for the potential of what yet might become. The “route to knowledge” shapes the dream of the imaginary child’s development, so that a secular economic, emancipatory, as well as an eschatological telos might be realized depending on what grand narrative was being promoted: capitalist, Marxist, and Christian respectfully, where the infant Jesus becomes the redeemer of the world. The child as “the father of man” seems to “classically” present Lacan’s contention that the phallus is the privileged signifier in the Real since the trope of this fantasy has oriented modernity (see Zizek 1992, 124–148). The phallic transcendental object, namely the child, takes the place of what both the nation and the subject lack, namely the magical energy (zoë ) of youth to remain progressive and forever young.2
For the middle classes, compulsory schooling in Britain seemed to repeat the same repetitive routine of the factory, with an equal amount of strict rules and regimentation. Authority of the phallic signifier was assured in this way. Elementary schooling provided sufficient knowledge to meet industrial demands of lassez-faire capitalism. From the very first elementary classrooms of the 1870s in Britain, school funding depended on the pupil achievement (“Payment by Results”). In the 1880s, both England and France eventually instituted compulsory education. Being poor, a “pauper,” and criminal were considered genetic traits of character that a strict moral education could help rectify through the inculcating good habits (Hunter 1988). It is no surprise, therefore, that “adolescence” as a category only emerged at the turn of the twentieth century in both Britain and United States with the advent monop-oly capitalism which required a labor force that had to stay in school longer (Friedenberg 1959; Acland 1995, 27). The first junior high schools (inter-mediate school) were established in Columbus, Ohio (1909) and in both Berkeley and Los Angeles in 1910 (Pinar et al. 1995, 93). Nor is it any fur-ther surprise why high schools and vocational education came into existence during the same time. A skilled labor force, past what a public elementary grade school could offer during the previous half of the nineteenth century, was needed as capitalism based on electricity and Fordist principles began to industrialize with research and design playing an ever increasing role in the efficiency of production. This instrumental and vocational model of educa-tion again required the continued measurement of skills as evaluated by psy-chologists. Taylorist behavioral principles of insuring the production of skilled work were applied both on the assembly line and at school to insure effi-ciency and control.
It has taken a long time for a segment of critical scholars to recognize how developmental psychological theories that purport to chart the “normative”
development of children through adolescence into adulthood are but the socio-historical structures of a capitalist logic made legitimate through the institution of public schooling that socializes a captive mandated audience. Developmental
psychology was a key discourse in the construction of the fantasy of a tran-scendent youth. As a technological discourse of the self, developmental psy-chology effectively pathologized those individuals and groups who failed to meet its fantasmatic ideal. Susan Buck-Morss’s seminal essay, written in 1975 and followed shortly by Edward Sullivan in 1977, set the stage for question-ing just how the stress on cognition as reason and rationality in schools, as manifested by Jean Piaget’s stage of concrete operations, assigns the highest value to an Enlightenment philosophy of abstract scientific rationality of capitalist logic. Objectivity, logic, and abstract thinking, autonomy as self-governance and independence as self-direction became the highest values of achievement. Feminists further stressed that these were masculinist assump-tions generalized on an androcentric model of what it meant to act rationally.
Connected and contextualized knowledge as well as care became devalued.
The biologically based theory of “genetic epistemology” as Piaget developed it, was essentially the inherent structuralism of advanced scientism of the time. It seems only a small managerial elite were capable of its achievement as Abraham Maslow, the founding “father” of humanistic psychology and self-actualization was to claim through his notion of “eupsychian manage-ment” (1965). According to Maslow, only 2 percent of the population could self-actualize. It seems that either too many barriers got in the way, or only 2 percent of the population were given the privilege and the chance to do so.
Not coincidentally, it turned out that these 2 percent were by and large busi-nessmen and scientists.
Lawrence Kohlberg’s (1963) hierarchy of moral rational development based on Piagetian tenants was equally exposed for its masculine bias by co-colleague Carol Gilligan (1982), and for its morality based on individual rights and freedoms enshrined in the Western legal system based on property rights. Stage six, based on respect for universal principle and the demands of individual conscience, could only be reached by a select few, and only by those with an individual autonomy of conscience, an anathema to many non-Western cultures whose value system would be ranked low on Kohlberg’s six-point scale. Similarly, “progressive education,” which reached its peak in the post–World War II period, was a child-centered approach attending to a child’s needs and interests. Under the rhetoric of individualism, democracy, and free play, however, a far different outcome emerged. As a number of crit-ical scholars have effectively shown (Walkerdine 1990; Burman 1994), its self-actualizing discourse enabled a much more subtle technology of disci-plinary obedience to develop by having children conform to the rules that appeared to arise out of their own deliberations and choices. The teacher became a governor, intervening only when it seemed that the independent-thinking children had made the “wrong” free choices. More deceptively, per-haps the fantasy of the self-governing innocent child actually policed the fear of encroachment of working-class values that were at odds with this
“norm.” Developmental psychology, as Burman (1994) shows, is used as a universal standard to “globalize childhood” despite cultural differences, a form of cultural imperialism in the name of transcendent progress.
This brief review concerning the constructions of childhood/youth cer-tainly point to the limitations of what appears, at first glance, to be a natural biological process and its categorizations into succinct intergenerational cohorts of the dominant demographic paradigm. “Normative development”
establishes an empty signifier that casts many as “deviant,” “at-risk,” and “defi-cient” in order to preserve and unconsciously maintain an ideology of white middle-class privilege. Effects of racism, classism, and sexism vanish from con-sideration. Critical researchers working within a poststructuralist paradigm of discourse analysis (e.g., usually Foucaultians like Norman Fairclough (1989, 1992) ), make evident the way any hegemonic construction abjects and ignores differences between cultures, sexual preferences, gender, ethnicity, class, and other dominant variables that might be identifiable to be able to assert and maintain its dominance. Stuart Hall (see Slack 1996 for review) cleverly identified such an approach to be an “articulation” as to the way social identity may be formed through a complex fusion of traits. But know-ing this does not solve the way such knowledge is disavowed, nor the way the fantasmatic objects continue to structure fantasies of Western development as spearheaded by the United States today with its New World Order. The sublime fantasy of the innocent child who was invested with an idealized embodiment of transcendent modernity has begun to decenter after a cen-tury. The wish for what the West never had in the first place has come to its own limit. Postmodernism is a time of facing the reality of that wish fulfillment—which, to the dismay of many, has become a horror—the con-sumerist demand to Enjoy!