Metric Culture: Ontologies of Self-Tracking Practices 9781787439481, 1787439488

Table of contents :
Front Cover
Metric Culture: Ontologies of Self-Tracking Practices
Copyright Page
Acknowledgements
Contents
List of Figures
List of Tables
List of Contributors
About the Authors
Chapter 1 Introduction: Metric Culture and the Over-examined Life
References
Chapter 2 Performance Management and the Audited Self
Introduction
Performance Indicators and the Rise of NPM
From Managing Professionals to Controlling Populations: Metrics and Biopower
Quantifying and Rating Oneself: Surveillance or Empowerment?
Measuring Performance in China: Citizenship and Social Credit
Conclusions
References
Chapter 3 The Digitisation of Welfare: A Strategy towards Improving Citizens’ Self-care and Co-management of Welfare
Introduction
Health Technologies, ePregnancy and Bio-citizenship
Research Methodology
Digitisation as a Dispositive
Methods
Analysis
Digital Solutions to Welfare Problems
Arguments for Digitisation
The Appointment of Responsibility of Actions Regarding the Process of Digitisation
Descriptions of Ideal Practices and Citizenship Regarding the Digitisation of Welfare
Discussion
The Schism between Technologies as Empowering and Technocratic Governing
New Civic Virtues in the Digital Era
New Health: Digital Health
Concluding Reflections
References
Chapter 4 ‘A Much Better Person’: The Agential Capacities of Self-tracking Practices
Introduction
Details of Our Study
Overall Self-tracking Practices
Agential Capacities
Self-improvement
Exerting Control
Identifying Patterns and Achieving Goals
Discussion
References
Chapter 5 Resonating Self-tracking Practices? Empirical Insights into Theoretical Reflections on a ‘Sociology of Resonance’
Introduction
Rosa’s View on Resonance and Self-tracking
Empirical Results on Mundane Practices of Self-tracking
Methodological Approach: Analytical Graph of World Relationships
Case I: Project or Goal-driven Self-tracking
Case II: Playful Self-tracking
Case III: Failing Self-tracking
Case IV: Digital Diary
Resonant and Mute Self-tracking Practices
Conclusions
References
Chapter 6 The 1-Person Laboratory of the Quantified Self Community
Introduction
QS: A Perspective from the Inside
Inside the 1PL
Exemplifying the 1PL
Instrumentation, Methodological Setup and Operating the 1PL
Reflections on the 1PL
Personal Discovery as Empowering Practice
Beyond the 1PL
Methods and Procedures
Search for Evidence on the Scale of the Individual Person
Requisite Competencies
Knowledge Sharing
Conclusion
References
Chapter 7 Embodiment and Agency through Self-tracking Practices of People Living with Diabetes
Introduction
Methodology
Self-monitoring Blood Glucose Levels through CGM and FGM Systems
The Development of Self-awareness and Reflexivity
Embodied Actions
Surveillance Underpinning the Use of CGM and FGM
Tactics Enacting Micro-powers
Discussion and Conclusion
References
Chapter 8 Doing Calories: The Practices of Dieting Using Calorie Counting App MyFitnessPal
Introduction
Exploring Practices of Eating and Dieting
Understanding Practices of Dieting through STS Perspective
Methods
How Calorie Counting Is Done
Practical Temporality
Practical Precision
Practical Adjustments
Discussion and Conclusion
References
Chapter 9 Sleep App Discourses: A Cultural Perspective
Introduction
Critical Marketing Theory
Sleep, Sleep App and Digital Health Discourses
Discourse Analysis
Data
Analysis
Discussion
Conclusion
References
Chapter 10 Academic Metrics and Positioning Strategies
Introduction
Transformation of the Sector: Judgement of Quality
Changes within Institutions: Promotion and Hiring
Individual Strategies: Presentation of Self
Conclusion
References
Chapter 11 Real-time Grade Books and the Quantified Student
Neoliberalism in Everyday Life
Being Digitally Engaged
Conclusion
References
Chapter 12 A Quantified Self Report Card: Ethical Considerations of Privacy as Commodity
Introduction
Human Data Commons Foundation’s 2017 Quantified Self Report Card
Research Methodology: Evaluating Readability
Research Results: Categorical Comparisons
Research Analysis: Balancing Differences
Ontological Fatigue: A Personal Narrative Shift
Power and Privacy in the Datasphere
2018 HDC Quantified Self Report Card: Encouraging Industry Best Practices
References
Chapter 13 The Limits of Ratio: An Analysis of NPM in Sweden Using Nicholas of Cusa’s Understanding of Reason
Introduction
Nicholas of Cusa
Not-knowing
Ratio
Intellectus
Contemporary Society of Ratio
NPM in Sweden
Concept Imperialism
Empaperment
Remote Controlling Public Services
Conclusion
References
Index

Citation preview

METRIC CULTURE: ONTOLOGIES OF SELF-TRACKING PRACTICES

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METRIC CULTURE: ONTOLOGIES OF SELF-TRACKING PRACTICES

EDITED BY

BTIHAJ AJANA Kings College London, UK

United Kingdom

North America

Japan

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Malaysia

China

Emerald Publishing Limited Howard House, Wagon Lane, Bingley BD16 1WA, UK First edition 2018 Copyright r 2018 Emerald Publishing Limited Reprints and permissions service Contact: [email protected] No part of this book may be reproduced, stored in a retrieval system, transmitted in any form or by any means electronic, mechanical, photocopying, recording or otherwise without either the prior written permission of the publisher or a licence permitting restricted copying issued in the UK by The Copyright Licensing Agency and in the USA by The Copyright Clearance Center. Any opinions expressed in the chapters are those of the authors. Whilst Emerald makes every effort to ensure the quality and accuracy of its content, Emerald makes no representation implied or otherwise, as to the chapters’ suitability and application and disclaims any warranties, express or implied, to their use. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ISBN: 978-1-78743-290-1 (Print) ISBN: 978-1-78743-289-5 (Online) ISBN: 978-1-78743-948-1 (E-Pub)

ISOQAR certified Management System, awarded to Emerald for adherence to Environmental standard ISO 14001:2004. Certificate Number 1985 ISO 14001

Acknowledgements This book project emerged out of the conference ‘Metric Culture: The Quantified Self and Beyond’ organised in June 2017 at the Aarhus Institute of Advanced Studies (AIAS) in Denmark. On behalf of all the contributors in this volume, I wish to thank the Institute for supporting the conference and the subsequent book project. Special thanks to Morten Kyndrup, Lena Bering, Helle Villekold, Tanya Majlund McGregor, Vibeke Moll Sorensen and Dorte Mariager for all their help and support. Many thanks also to all the conference participants for their helpful feedback and stimulating discussions which informed the development of this book. Both the conference and the book project have benefited from the financial support received during the COFUND Marie Curie Fellowship I undertook at AIAS in 2015 2017, supported by European Union’s Seventh Framework Programme under grant agreement no. 609033. The book was also supported by a Publication Grant received from Aarhus University Research Foundation. I wish to thank these institutions for their generous support. I also would like to thank Jen McCall and Rachel Ward from Emerald Publishing for their assistance with the publication of this book. Thanks also to Christine O’Hagan for her meticulous proofreading of the work.

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Contents List of Figures

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List of Tables

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List of Contributors

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About the Authors

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Chapter 1 Introduction: Metric Culture and the Over-examined Life Btihaj Ajana

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Chapter 2 Performance Management and the Audited Self Cris Shore and Susan Wright

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Chapter 3 The Digitisation of Welfare: A Strategy towards Improving Citizens’ Self-care and Co-management of Welfare Nicole Thualagant and Ditte-Marie From

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Chapter 4 ‘A Much Better Person’: The Agential Capacities of Self-tracking Practices Deborah Lupton and Gavin J. D. Smith

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Chapter 5 Resonating Self-tracking Practices? Empirical Insights into Theoretical Reflections on a ‘Sociology of Resonance’ Karolin Eva Kappler, Agnieszka Krzeminska and Eryk Noji

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Chapter 6 The 1-Person Laboratory of the Quantified Self Community Thomas Blomseth Christiansen, Dorthe Broga˚rd Kristensen and Jakob Eg Larsen

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Contents

Chapter 7 Embodiment and Agency through Self-tracking Practices of People Living with Diabetes Giada Danesi, Me´lody Pralong and Vincent Pidoux

117

Chapter 8 Doing Calories: The Practices of Dieting Using Calorie Counting App MyFitnessPal Gabija Didziokaite, ˇ Paula Saukko and Christian Greiffenhagen

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Chapter 9 Sleep App Discourses: A Cultural Perspective Antoinette Fage-Butler

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Chapter 10 Academic Metrics and Positioning Strategies Janet Chan, Fleur Johns and Lyria Bennett Moses

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Chapter 11 Real-time Grade Books and the Quantified Student William G. Staples

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Chapter 12 A Quantified Self Report Card: Ethical Considerations of Privacy as Commodity Chelsea Palmer and Rochelle Fairfield 217 Chapter 13 The Limits of Ratio: An Analysis of NPM in Sweden Using Nicholas of Cusa’s Understanding of Reason Jonna Bornemark

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Index

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List of Figures Chapter 2 Figure 2.1 Figure 2.2 Figure 2.3 Chapter 5 Figure 5.1 Figure 5.2 Chapter 6 Figure 6.1

Diagram of Rockwater’s ‘Balanced Scorecard’ . . . . Diagram of Rockwater’s Individual Scorecard . . . . The University of Auckland’s Leadership Framework Document . . . . . . . . . . . . . . . . . . . . . .

Diagram of Analytical Graph of World Relationships (Own Elaboration) . . . . . . . . . . . . . . . . . . Analytical Graph of World Relationships: Case Study Self-tracking (Own Elaboration) . . . . . . . . . . .

A Whole New Dynamic . . . . . . . . . . . . . . .

Chapter 12 Figure 12.1 Was There a Fixed Link to the Privacy Policy in the Website’s Header or Footer? . . . . . . . . . . . . . Figure 12.2 Was a Dedicated Privacy Contact Named within the Privacy Policy Documentation? . . . . . . . . . . . Figure 12.3 Did the Privacy Policy Documentation Note How Future Changes Would Be Indicated? . . . . . . . . Figure 12.4 Did the Researchers Feel that the Privacy Policy Showed an Attempt at Readable Language? . . . . . Figure 12.5 How Many Points of Direct Contact Did the Average Company Provide? . . . . . . . . . . . . . . . . . .

18 19 20

84 91

108

222 223 223 224 225

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List of Tables Chapter 3 Table 3.1 Table 3.2

Document, Document Type and Year . . . . . . ePregnancy Documents, Document Type and Year

Chapter 9 Table 9.1

Overview of Data . . . . . . . . . . . . . . . .

44 44

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List of Contributors Department of Digital Humanities, King’s College London, UK Lyria Bennett Moses Faculty of Law, UNSW Sydney, Australia Jonna Bornemark Centre for Studies in Practical Knowledge, So¨derto¨rn University, Sweden Janet Chan Faculty of Law, UNSW Sydney, Australia Thomas Blomseth Konsulent Blomseth and TOTTI Labs, Denmark Christiansen Giada Danesi Faculty of Social and Political Sciences, University of Lausanne, Switzerland Gabija Didziokaite ˇ Department of Social Sciences, Loughborough University, UK Antoinette FageDepartment of English, Aarhus University, Butler Denmark Rochelle Fairfield Human Data Commons Foundation (HDC), Canada Ditte-Marie From Department of People and Technology, Roskilde University, Denmark Christian Department of Sociology, The Chinese Greiffenhagen University of Hong Kong, Hong Kong Fleur Johns Faculty of Law, UNSW Sydney, Australia Karolin Eva Kappler Department of Sociology, University of Hagen, Germany Dorthe Broga˚rd Institute for Marketing & Management, Kristensen University of Southern Denmark, Denmark Agnieszka Institute of Culture and Aesthetics of Digital Krzeminska Media, Leuphana University Luneburg, Germany Jakob Eg Larsen Department of Applied Mathematics and Computer Science, Technical University of Denmark, Denmark Btihaj Ajana

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List of Contributors

Deborah Lupton Eryk Noji Chelsea Palmer Vincent Pidoux Me´lody Pralong Paula Saukko Cris Shore

Gavin J. D. Smith William G. Staples Nicole Thualagant Susan Wright

Faculty of Arts & Design, University of Canberra, Australia Department of Sociology, University of Hagen, Germany Human Data Commons Foundation, Canada Faculty of Social and Political Sciences, University of Lausanne, Switzerland Faculty of Social and Political Sciences, University of Lausanne, Switzerland Department of Social Sciences, Loughborough University, UK Department of Social Sciences, University of Auckland, New Zealand and Stockholm Centre for Organisational Research, Stockholm University, Sweden School of Sociology, Australian National University, Australia Department of Sociology, University of Kansas, USA Department of People and Technology, Roskilde University, Denmark Danish School of Education, Aarhus University, Denmark

About the Authors Btihaj Ajana is Senior Lecturer at the Department of Digital Humanities, King’s College London, UK. She was recently a Marie Curie Fellow and Associate Professor at the Aarhus Institute of Advanced Studies in Denmark. Her academic work is international and interdisciplinary in nature, spanning areas of digital culture, media praxis and biopolitics. She is the author of Governing through Biometrics: The Biopolitics of Identity (Palgrave, 2013) and the editor of Self-tracking: Empirical and Philosophical Investigations (Palgrave, 2017). Lyria Bennett Moses is Associate Professor and Director of the Allens Hub for Technology, Law and Innovation in at UNSW Law. She is also Project Leader on the Data to Decisions CRC and PLuS Alliance Fellow. Her research focusses on issues at the intersection of law and technological change. Jonna Bornemark ([email protected]) is Associate Professor in Philosophy, Teacher and Researcher at the Centre for Studies in Practical Knowledge at So¨derto¨rn University, Sweden. She is currently active in several research projects within the theory of practical knowledge and phenomenology where she discusses the limits of calculation, skills of judgement, subjectivity and the concept of Bildung. Janet Chan is Professor at UNSW Law and Key Researcher of the Data to Decisions Cooperative Research Centre. Her research interests include criminal justice, sociology of creativity, organisational studies and science and technology studies. Her current research focuses on the use of big data analytics for security and social policy. Thomas Blomseth Christiansen is Technologist and Entrepreneur with a special interest in personal health data. He has been building technology for self-tracking of complex health conditions since 2009. Thomas has been self-tracking extensively himself and has among other things fixed his pollen allergy. He is best known for his complete seven-year record of his sneezes since 2011 and over 100,000 observations from consciously tracking e.g. food, water and supplement intake, fatigue, and allergies.

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About the Authors

Giada Danesi is Senior Researcher in Social Sciences at the University of Lausanne Switzerland, and Member of the STS Lab. She is working on the project ‘Knowledge Translation through Tool-supported Practices in Health Care: Production and Use of Self-management Tools in Chronic Disease’. Her research focuses on health, illness, body, food, identity, consumption and globalisation. It draws on ethnographic, qualitative and comparative approaches. ˇ Gabija Didziokaite is PhD Candidate at Loughborough University, UK, Social Sciences Department. Her current work looks at practices of selftracking, more specifically at use of calorie counting and diet tracking app MyFitnessPal. She holds an MSc (Research) in Social Sciences, specialising in Medical Anthropology, from University of Amsterdam, Netherlands. Antoinette Fage-Butler is Associate Professor at the Department of English, School of Communication and Culture, Aarhus University, Denmark. Her research lies within online health communication (doctor patient and patient patient), mHealth, women’s health issues, risk communication and ethical aspects of health communication. Rochelle Fairfield ([email protected]) works as Executive Director for the Human Data Commons Foundation (HDC) in Vancouver. Her work spans and integrates academia, project facilitation, adult development, industry governance and ethical praxis in all of these. She has written on gender and power, and co-authored the HDC’s 2017 Quantified Self Report Card. Ditte-Marie From, Associate Professor PhD ([email protected]), is Researcher at the Centre of Health Promotion Research, Department of People and Technology, Roskilde University, Denmark. Her research combines health promotion, welfare technologies and health policies with a special interest in citizens’ engagement in processes of self-optimisation. Christian Greiffenhagen is Assistant Professor at the Department of Sociology at The Chinese University of Hong Kong. Previously, he was Senior Lecturer in Sociology at the Department of Social Sciences at Loughborough University, UK. In his research, he is concerned with understanding the social dimensions of science and technology. Fleur Johns is Professor and Associate Dean of Research at the University of New South Wales, Australia. She works in the areas of public international law and legal theory. She studies patterns of governance on the global plane, employing an interdisciplinary approach

About the Authors

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that draws on the social sciences and humanities and combines the study of public and private law. In recent years, her work has focused on the role of automation in global legal relations, building on her prior research on financial modeling and other non-legal techniques of governance. She is currently working on a three year, collaborative, Australian Research Council-funded project entitled ‘Data Science in Humanitarianism: Confronting Novel Law and Policy Challenges’. Fleur is the author of Non-Legality in International Law: Unruly Law (Cambridge, 2013) and The Mekong: A Socio-legal Approach to River Basin Development (co-authored with Ben Boer, Philip Hirsch, Ben Saul & Natalia Scurrah, Routledge 2016). Karolin Eva Kappler, PhD ([email protected]), is Researcher at the DFG-funded project ‘Taxonomies of the Self: Emergence and Social Generalization of Calculative Practices in the Field of Self-inspection’ at the University of Hagen, Germany. She has published numerous articles in journals and books on the topics of social media, self-tracking, Big Data, calculative practices, network analysis, and violence in everyday life. Dorthe Broga˚rd Kristensen ([email protected]) is Associate Professor at the University of Southern Denmark. Her research interest includes digital health, self-tracking, food and consumption. She has published widely among this in New Media and Society, Journal of Consumer Culture, Critical Health, Health and Journal of Marketing Management. She is currently working on a project on technologies of optimisation funded by the Danish Research Council. Agnieszka Krzeminska is PhD Candidate at the Institute of Culture and Aesthetics of Digital Media at the Leuphana University Luneburg Germany. Her research explores the role of digital technologies for the aim of self-enhancement, self-conception, human-tech co-evolution, mental health and on rethinking influence. Jakob Eg Larsen is Researcher in human computer interaction and Associate Professor at Technical University of Denmark where he is heading the mobile informatics and personal data lab. His research particularly focuses on the Quantified Self phenomenon. He has been developing research systems and instrumentation for self-tracking as well as user interfaces for personal data visualisation and is teaching a master’s level course in personal data interaction. Jakob has presented his research and self-tracking at several Quantified Self conferences.

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About the Authors

Deborah Lupton ([email protected]) is Centenary Research Professor in the News & Media Research Centre, Faculty of Arts & Design, University of Canberra, and a Fellow of the Academy of the Social Sciences in Australia. Her latest books are Digital Sociology (Routledge, 2015), The Quantified Self: A Sociology of Selftracking (Polity, 2016) and Digital Health: Critical and Crossdisciplinary Perspectives (Routledge, 2017). Eryk Noji ([email protected]) is Researcher at the DFGfunded project ‘Taxonomies of the Self: Emergence and Social Generalization of Calculative Practices in the Field of Self-inspection’ at the University of Hagen, Germany. His research focuses on relations between digital technologies, social practices and identities. Chelsea Palmer ([email protected]) is Educator, Community Organiser and Decentralist. After an undergraduate degree focused primarily on Lacanian linguistic theory, she left university to work in the tech sector, from data ethics advocacy to blockchain education. She returned to academic writing to co-author the HDC’s 2017 Quantified Self Report Card, and to compose essays applying critical theory to the Internet age, which are available alongside corresponding educational rap videos at her site www.stuckincyber.space Vincent Pidoux is Sociologist of Science, Technology and Medicine at the University of Lausanne, Switzerland. He is actually working as Senior Researcher at the University of Lausanne on the project ‘Knowledge Translation through Tool-supported Practices in Health Care: Production and Use of Self-management Tools in Chronic Disease’. His research focuses on the study of chronic illness selfmanagement, knowledge translation, translational medicine/research, interdisciplinarity, neurosciences and mental health. Me´lody Pralong is PhD Student in Anthropology at the STS Lab of the University of Lausanne, Switzerland, working on the project ‘Knowledge Translation through Tool-supported Practices in Health Care: Production and Use of Self-management Tools in Chronic Disease’. Her doctoral thesis explores diabetes management in the school setting, and focuses on care practices that occur within the heterogeneous system of humans and non-humans actors. Paula Saukko is Reader in Social Science and Medicine at the Department of Social Sciences, Loughborough University, UK. Her work combines medical sociology and science and technology studies.

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Her long-term research interest is experiences and technologies of diagnosis and her current projects focus on digital health and antimicrobial resistance. Cris Shore is Professor of Social Anthropology at the University of Auckland, New Zealand, and Guest Professor of Public Management at the Stockholm Centre for Organisational Research (Score). His research explores the effects of New Public Management and audit culture on society and human subjectivity. His latest book (edited with Susan Wright) is Death of the Public University? Uncertain Futures for Universities in the Global Knowledge Economy (Berghahn, 2017). Gavin J. D. Smith (@gavin_jd_smith) is Deputy Head of the ANU School of Sociology. His research explores the social impacts of digitech/data and the subjective experiences of watching and being watched. His recent book Opening the Black Box: The Work of Watching (2015) provides an ethnographic account of CCTV camera operation in the UK. His work appears in journals such as Body & Society, The British Journal of Criminology, Critical Public Health, Big Data & Society and Urban Studies. William G. Staples is Professor of Sociology, Chair of the Department of Sociology, and Founding Director of the Surveillance Studies Research Centre at the University of Kansas, USA. Staples is well known for his work in the areas of surveillance, social control and historical sociology. He is the author, most recently, of the second edition of Everyday Surveillance: Vigilance and Visibility in Postmodern Life (2014), considered a foundational work in the interdisciplinary field of Surveillance Studies. Nicole Thualagant, Associate Professor MSc (Sociology) 6 PHD ([email protected]), is Researcher at the Centre of Health Promotion Research, Department of People and Technology, Roskilde University, Denmark. Her research focuses on health policies, the rationale behind policies in relation to welfare states regimes as well as the consequences for ideals of citizenship. Susan Wright is Professor of Educational Anthropology and Director of the Centre for Higher Education Futures (CHEF) at the Danish School of Education, Aarhus University, Denmark. She studies people’s participation in large scale processes of transformation and works with concepts of audit culture, governance, contestation and the anthropology of policy.

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Chapter 1

Introduction: Metric Culture and the Over-examined Life Btihaj Ajana

Abstract Metrics, data, algorithms and numbers play an unmistakably powerful role in today’s society. Over the years, their use and function have expanded to cover almost every sphere of everyday life so much so that it can be argued that we are now living in a ‘metric culture’, a term indicating at once the growing cultural interest in numbers and a culture that is increasingly shaped by numbers, as Beer (2016) also argues. At the same time, metric culture is not only about numbers and numbers alone, but also links to issues of power and control, to questions of value and agency and to expressions of self and identity. Self-tracking practices are indeed a manifestation of this metric culture and a testimony to how measurement, quantification, documentation and datafication have all become important tropes for managing life and the living in contemporary society. In this introductory chapter, I provide a general contextualisation of the topic of this edited collection along with an overview of the different chapters and their key arguments. Keywords: Metric culture; data; metrics; Quantified Self; self-tracking; algorithm; governance

Metric Culture: Ontologies of Self-Tracking Practices, 1 9 Copyright r 2018 by Emerald Publishing Limited All rights of reproduction in any form reserved ISBN: 978-1-78743-290-1

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Btihaj Ajana The unexamined life is not worth living Socrates

Our twenty-first century seems to have taken Socrates’ postulation rather too seriously. Life in the current age has not only become an examined life but one that is highly ‘over-examined’ as we are, at least in Western societies, increasingly becoming reliant on self-help industries, life-coaching strategies, quantifiable techniques of (personal) scrutiny and an avalanche of data and information to manage and dissect all aspects of everyday life. The recent proliferation of self-tracking techniques and fitness-monitoring devices together with the relentless quantification of work, leisure and performance have led to the rise of what became known as the ‘Quantified Self movement’ whose philosophy is ‘self-knowledge through numbers’. Every day, millions of people around the world are routinely recording their activities, calorie intake, sleep patterns and a myriad of other physical and behavioural variables, all with the aim of gaining insights into their habits and improve various domains of their lives. In ‘this data-driven life’ (Wolf, 2010), bodies and minds are turning into measurable machines and information dispensers in the quest for personal development, productivity, health and better performance. As a result of self-tracking activities and the general use of digital technologies, a growing amount of data is being generated daily. According to a recent report by IBM (Loechner, 2016), between the years of 2014 and 2016 alone, 90% of existing data has been created, at 2.5 quintillion bytes of data a day. Being awash with such amounts of data has made our very own existence increasingly shaped, defined and even ruled by data and numbers. Identities and social interactions are becoming more and more perceived in quantitative terms, framed and ranked within a reputation economy (e.g. Facebook ‘likes’). Health, well-being and happiness are now being measured and assessed through a plethora of quantifying tools (e.g. MyMoodTracker app). Performance and productivity at the workplace are also being measured and monitored through various software and tracking devices (e.g. Sapience Analytics software). In fact, even the spheres of play and intimacy have been penetrated by this mentality of measurement and quantification (e.g. Spreadsheet app). And the list goes on. So there is no doubt that we are indeed living in what we can call a ‘metric culture’, a term which indicates at once a growing cultural

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interest in numbers, as well as a culture that is increasingly shaped and populated with numbers, as the sociologist David Beer (2016) also argues. But of course, metric culture is by no means a new phenomenon and this is certainly not the first time that we are witnessing an avalanche of data and a metric colonisation of life itself. For instance, the rise of statistics and its growing use in the nineteenth century has been described by the philosopher Ian Hacking (1990) as an ‘avalanche of numbers’ that had a profound impact on the definition and demarcation between what is normal and what is pathological, and on the organisation of human behaviour in various spheres and practices. Numbers, throughout history, became not only a means of measuring but also a highly politicised tool of governing and disciplining individuals and populations (Rose, 1999). Today, a similar thing is occurring through self-tracking data and the spreading use of metric techniques. New ontologies, new metaphors and new ways of seeing the body and the self are emerging, and in ways that are undoubtedly reconfiguring the relation between individuals and their bodies, between citizens and institutions, between the biological and the social. What is at issue is not simply the volume of the data that is being generated, but also the kind of discourses and rationalities, the styles of thought and strategies that surround these emergent modes of managing the self, the body and everyday activities. Metric culture is therefore not only a matter of numbers and numbers alone, but also links to issues of power and control, to questions of value and agency and to expressions of self and identity, especially in the way metrics and algorithms are often used to justify certain actions and decisions, define what is deemed as worthy, legitimate and valuable, prioritise certain problems over others and confer legitimacy on various forms of authority. What is striking above all about the current metric culture is that not only are governments and private corporations using metrics and data to control and manage individuals and populations, but individuals themselves are now choosing to voluntarily quantify themselves and their lives more than ever before, happily sharing the resulting data with others and actively turning themselves into projects of (self-) governance and surveillance. It is with this awareness in mind that this book attempts to engage with the nuances and multifaceted nature of metric culture, providing empirically based and conceptually informed reflections on the different manifestations of data and algorithms in everyday life and their manifold implications. Although the chapters in this edited collection may seem very different in their approaches, sites of analysis, case studies

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Btihaj Ajana

and geographical backdrops, they all have a common objective: highlighting the transformations that are occurring in various spheres of life as a result of the proliferation of metric culture throughout everyday practices. Therefore, the eclectic nature of this volume should not be regarded as an inconsistency, but as being itself reflective of the diversity, richness and hybridity of metric culture a fact that does not lend itself to ‘totalistic’ or ‘unified’ theorisation but to an appreciation of multiplicity and divergence vis-a`-vis both the subject of analysis (metric culture) and the methods of analysis (the different approaches adopted herein). Chapter 2 in this collection initiates the discussion by tracing the origins of contemporary metric culture. Here the authors, Shore and Wright, contextualise the rise of quantitative performance management systems and tracking techniques in relation to the neoliberalising projects of the 1980s and their ‘audit culture’. They begin by tracing how performance indicators were used in the New Public Management (NPM) of organisations, such as schools, universities and factories, as part of the ‘agencification’ process of government which involved the outsourcing of public services to private contractors and the development of metric techniques for managing targets and monitoring performance. Such techniques were not only confined to the management of organisations as a whole but quickly became applied to individuals themselves for the purpose of measuring and assessing their contribution to a company’s strategic objectives. According to the authors, this push to measure and audit performance at both the organisational and individual level is driven by an ‘ethic of improvement’ and, one could add, an ideology of never-ending development. This is an ideology that lies at the heart of the Quantified Self movement and its ethos of selfknowledge and self-improvement. The final section of Shore and Wright’s chapter turns to the example of China’s recently proposed ‘social credit’ system which would involve scoring and ranking the character, trustworthiness and, even, marriage suitability of each citizen. It is envisaged that this ranking and scoring mechanism will be used to decide on instant loan applications, fast-track visas, retail discounts, among other things. All these developments beg the question as to what kind of subjects and citizens are being constructed and what forms of governmentality are emerging as a result of such an increasing culture of metrification and performance monitoring. Chapter 3 by Thualagant and From addresses such a question focusing on the Nordic context and the digitisation of welfare and health management. In looking at the example of the eGovernment strategy of

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Digital Welfare 2016 2020 in Denmark and ePregnancy programmes, the authors explore how digitisation and metrics are producing ideals and new civic virtues regarding perceptions and practices of citizenship. In the context of health, these virtues are primarily about citizens’ engagement, self-care, self-responsibility and self-sufficiency. Citizens are thereby encouraged to adopt digital techniques of measurement and self-tracking, as is the case with pregnant women, to manage their health, and embrace the seemingly inevitable digitisation of social services. The authors highlight that, at the state level, the increasing introduction of metric and digital technologies for welfare management is often promoted in economic terms (reducing healthcare costs, for instance). As for the individual, it is promoted in terms of patient’s empowerment, emancipation and autonomy (reducing reliance on healthcare professionals). But as the authors point out, there is a very fine line between empowerment and control when it comes to metric culture and its digital strategies. Chapter 4 by Lupton and Smith moves the discussion to a more micro level by drawing on the empirical study they conducted with Australian self-trackers. Through a set of semi-structured interviews, the authors examine participants’ experiences of self-tracking and the ensuing reflexive practices together with, what they call, ‘agential capacities’. Key themes emerging from the study include issues of selfimprovement, control and goal achievement all of which, as mentioned earlier, lie at the heart of self-tracking and Quantified Self practices and objectives. Rather than being a homogenous and static approach to understanding and monitoring the self and one’s activities, self-tracking is shown to be, through this study, as ‘a creative performative act of selfhood’, involving diverse methods, devices and improvisations that are both digital and non-digital. As such, the authors regard selftracking as a form of heterogeneous assemblages subsuming human and non-human actors, technologies and techniques, data and information, as well as the spatial and discursive aspects of self-monitoring practices. This heterogeneity carries also into the socioeconomic aspect in the sense that not everyone is impacted by self-tracking in the same way. For while some might benefit from it, others might be disadvantaged by it, especially in the context of ‘coerced’ rather than voluntary selftracking, as the authors argue. The fact that self-tracking practices are heterogeneous, hybrid and diverse is also one of the key conclusions of Chapter 5 by Kappler, Krzeminska and Noji. Here the authors critically engage with the recent work of Hartmut Rosa and his concept of ‘resonance’, while drawing

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on empirical case studies and interviews. Resonance, as theorised by Rosa, is a way of relating to the world whereby the subject and the world mutually affect and transform one another. Rosa links resonance to the idea of the ‘good life’ itself and sees it as the antidote of accelerated modernity of which self-tracking is an example, according to him. Kappler et al. therefore take upon themselves the task of verifying Rosa’s assertions by empirically exploring the extent to which selftrackers ‘resonate’ or not with their tracking and measuring practices, and by reflecting on the ‘quality’ of the quantified life. The authors’ findings both support and challenge Rosa’s hypothesis, leading to the conclusion that a ‘playful’, rather than purely goal-oriented, approach to self-tracking may result in more resonant relationships. Practices of self-tracking are often described as transforming the self and the body into ‘personal laboratories’ where learning and experimentation can take place. This is a common belief within the Quantified Self community and especially among the more experienced and competent self-trackers. Chapter 6 by Christiansen, Kristensen and Larsen develops the notion of ‘1-Person-Laboratory’ in order to give an account of the practices, methods and procedures which take place at the personal level and extend to the Quantified Self community as a whole through its knowledge-sharing activities. Reflecting on their own experiences as advanced self-trackers and technologists who build their own tracking devices, Larsen and Christiansen, with insights from the ethnographic work of co-author Kristensen, provide a useful insider’s perspective on the kind of experiments pertaining to self-tracking practices and on the way in which the absence of ‘standardised’ methods for self-tracking contribute to stimulating creativity and innovation in this field. Chapter 7 and Chapter 8 focus directly on the relationship between self-tracking practices and health management by addressing this in the context of diabetes and dieting, respectively. In their chapter, Danesi, Pralong and Pidoux discuss the findings of the ethnographic research they conducted in Switzerland on the use of glucose monitoring tools by people living with diabetes. The discussion centres around the ways in which self-tracking creates forms of embodied self-awareness among users and the effect of that on the medical encounter between patients and healthcare providers. The chapter also touches on the surveillance potential of self-tracking as well as the resistance of some patients towards the use of tracking tools. Monitoring food intake and dieting have long been some of the most practiced forms of self-tracking and health management. In their chapter, Didziokaite, ˇ Saukko and Greiffenhagen explore the use of

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MyFitnessPal app for weight management and calorie counting by drawing on a set of interviews involving 31 users of the app. The study shows primarily the level of labour and efforts required to manage weight through tracking tools, such as MyFitnessPal, as well as the diversity of ways through which calorie counting is performed, appropriated and integrated into participants’ daily routine. The study also demonstrates how calorie counting can influence and be influenced by other everyday practices, routines and factors. Sleep is another important health aspect that has become increasingly amenable to tracking and quantification. Recently, a growing number of people have been turning to apps for help with sleep problems and finding alternatives to pharmacological treatments. In Chapter 9, FageButler looks at this rising ‘sleep app culture’ with a particular focus on the marketing discourses and the discursive mechanisms underpinning the promotion and legitimisation of sleep apps. ‘Identity’ is also an important theme featuring in this chapter. The marketing of sleep apps does not only influence sales but also identity and behaviour. This happens through the myriad representations of the potential sleep app user that are mobilised in the marketing campaigns of these apps. By unravelling the different discourses that are deployed in the marketing communication of sleep apps, the author provides useful insights into the idealised constructions of user identity that are present in these promotional strategies. Chapter 10 by Chan, Johns and Moses shifts the focus towards the academic context, looking at how the culture of metrics and selftracking has invaded universities and their practices. From measuring the quantity of academic outputs, citations and ‘read’ counts to evaluating performance and ‘excellence’ through quantitative indicators, academic institutions and their employees are now increasingly being judged through the lens of metrics and a reputation economy. The ‘gamification’ of research achievements through tracking technologies and data-driven processes has led to the intensification of competition both on the institutional as well as on the individual level, promoting what the authors refer to as the ‘celebrification’ of academic life. Another major outcome has been the ‘stripping out’ of narratives in favour of data instead, something that raises various political and ethical questions vis-a`-vis metric power, its reach and consequences within academia and beyond. Remaining within the context of education, Chapter 11 by Staples looks at the adoption of web-based student information systems in American schools as an example of metric culture in educational

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settings. These systems provide teachers, students, school administrators and parents access to a variety of data in ‘real-time’, including attendance records and homework assignments, grades and grading scales, health and immunisation records as well as behaviour and disciplinary notes. Staples argues that such systems represent an example of a neoliberal technology of childhood governance whereby students are drawn into what Lupton calls ‘pushed self-tracking’ to monitor their academic performance metrics and compare their grades to other students. As a result, students end up internalising the self-governing ethos of autonomy, enterprise and self-responsibility while being encouraged to adopt performance-based identities. Amid this academic metric culture, a warning question arises as to what would happen to students who refuse to deploy this neoliberal technology of self-governing. The generation and accumulation of masses of data through metric culture practices also raise important questions vis-a`-vis issues of privacy and data protection. As it stands at the moment, the majority of terms of use agreements in relation to personal data technologies remain ambiguous and, at times, even non-existent. For instance, a recent experimental research project conducted by Symantec (2014) found that a staggering 52% of the self-tracking apps and devices examined did not have privacy policies. For the rest, many did not provide any clear information on how the generated data would be kept private. Such issues are taken up in Chapter 12 by Palmer and Fairfield from Human Data Common Foundation. The authors conducted a thorough qualitative review of the privacy policy documentation of 55 private sector companies in the self-tracking and biometric data industry, producing what they call the Quantified Self Report Card. The Card serves as an assessment of these companies’ user interfaces and privacy documentation. The aim is to measure ‘human readability’ of this documentation and to reveal areas of inconsistency and opacity in the Quantified Self industry, while also highlighting best practices. Based on the findings of their review, the authors make some valuable recommendations as to how privacy can be best managed in this growing ecosystem of Quantified Self data. Chapter 13 in this collection offers a sophisticated philosophical meditation on what has become of ‘reason’ itself in the midst of a rising metric culture. Here the author, Bornemark, looks at the introduction of NPM in Sweden’s healthcare system as an example of the metrification of the public sector whereby reason is reduced to a calculating, rather than reflective, capacity. She refers to this as ‘ratiofication’. Taking cue from the work of the fifteenth century philosopher Nicholas

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of Cusa and his critique of reason and not-knowing, Bornemark identifies three key aspects characterising the ratiofication of the public sector, namely ‘concept imperialism’, ‘empaperment’ and ‘remote controlling’. Cusa’s differentiation between ratio and intellectus enables the author to systematically analyse what is at stake in a metric culture that constantly fetishises intense calculation and documentation, and tries to eradicate not-knowing from the sphere of reason. Ultimately, Bornemark reveals the paradoxes and ironies inherent in ratiofication and metrification: the more we audit and calculate, the less we get to know. And this is perhaps the biggest fallacy of metric culture!

References Beer, D. (2016). Metric power. London: Palgrave Macmillan. Hacking, I. (1990). The taming of chance. Cambridge: Cambridge University Press. Loechner, J. (2016). 90% of today’s data created in two years. Retrieved from https://www.mediapost.com/publications/article/291358/90-of-todays-data-createdin-two-years.html Rose, N. (1999). The power of freedom: Reframing political thought. Cambridge: Cambridge University Press. Symantec. (2014). How safe is your quantified self?. Retrieved from https://www. symantec.com/content/dam/symantec/docs/white-papers/how-safe-is-your-quantified-self-en.pdf Wolf, G. (2010). The data-driven life. Retrieved from http://www.nytimes.com/2010/ 05/16/magazine/16letters-t-THEDATADRIVE_LETTERS.html

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Chapter 2

Performance Management and the Audited Self Cris Shore and Susan Wright

Abstract What counts as evidence of good performance, behaviour or character? While quantitative metrics have long been used to measure performance and productivity in schools, factories and workplaces, what is striking today is the extent to which these calculative methods and rationalities are being extended into new areas of life through the global spread of performance indicators (PIs) and performance management systems. What began as part of the neoliberalising projects of the 1980s with a few strategically chosen PIs to give greater state control over the public sector through contract management and mobilising ‘users’ has now proliferated to include almost every aspect of professional work. The use of metrics has also expanded from managing professionals to controlling entire populations. This chapter focuses on the rise of these new forms of audit and their effects in two areas: first, the alliance being formed between state-collected data and that collected by commercial companies on their customers through, for example loyalty cards and credit checks. Second, China’s new social credit system, which allocates individual scores to each citizen and uses rewards of better or privileged service to entice people to volunteer information about themselves, publish their ‘ratings’ and compete with friends for status points. This is a new development in the use of audit simultaneously to discipline whole populations and responsibilise individuals to perform according to

Metric Culture: Ontologies of Self-Tracking Practices, 11 35 Copyright r 2018 by Emerald Publishing Limited All rights of reproduction in any form reserved ISBN: 978-1-78743-290-1

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new state and commercial norms about the reliable/conforming ‘good’ citizen. Keywords: Performance management; metrics; auditing; ratings; social credit systems; disciplined populations; responsibilised individuals; auditable selves

Introduction What counts as evidence of good performance or character? Two key trends in contemporary societies are particularly relevant to this question. The first is the increasing reliance on numerical indicators and rankings to evaluate phenomena that were previously assessed using qualitative criteria and professional judgements. This is particularly evident in systems of New Public Management (NPM) where numerical indicators are used both to provide evidence of performance and as instruments for stimulating economy, efficiency and effectiveness in organisations. Initially, numerical scores were treated as ‘proxies’ for quality or excellence (e.g. in early UK university research assessment exercises), but these scores have often acquired a life and value of their own. This fetishisation of numbers substitutes the model for the real world so that the proxy becomes the measure, and the measure becomes the target. The second trend is the increasing dislocation between these rankings and the worlds they purport to measure. Quantitative metrics were typically used to measure performance in schools, factories and workplaces, but what is striking today is the extent to which these calculative techniques have been extended into new areas of life. Recent years have witnessed a dramatic expansion in the use of performance indicators (PIs) to measure previously un-measurable phenomena such as corruption, human rights, sex trafficking, domestic violence, democracy and gross national happiness (Merry, 2011, p. S83, 2016). More than this, individuals are using new social media and computer technologies in populist projects of self-management. Often these projects are presented as ways for people to take more control over their own health and lives; but few seem to realise that the personal and intimate data they produce through apps and gadgets (e.g. on consumer spending, personal behaviour, credit worthiness, daily exercise, menstrual cycles, health and fitness) belong to commercial companies and governments. A key feature of this trend is that not only are governments and private companies

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using these data to discipline and manage individuals, but individuals are actively making themselves into new objects of surveillance and exercising new forms of governance on themselves. This is producing novel kinds of governing techniques that combine corporatism and populism in new assemblages of power/knowledge. This chapter is set out in four sections. First, we trace how PIs were used in the management of organisations (schools, universities) and in factories and other kinds of workplaces. Second, we note the post-1970s shift to using individual performance management to drive up productivity in the private and public sectors. That process typically entailed human resource management techniques for objectifying persons and fragmenting them into specific competencies and capacities that can be measured against company objectives. Third, we examine the shift, exemplified in the Quantified Self (QS) movement, in which individuals use hitech wearable gadgets to gain ‘self-knowledge through numbers’, take responsibility for their health and medication and monitor the performance of their own lifestyle. We note how individuals are producing data about themselves that states and private companies are using to measure and manage populations. Finally, we examine the emergence of a new platform for measuring ‘social credit’ in China that uses the personal details of citizens to construct a universal ranking system. By presenting this scheme as an online game, the Chinese state has sought to encourage individuals to market themselves as trustworthy citizens and suitable marriage partners. We ask, what kinds of ‘auditable selves’ are these technologies creating? Can individuals use them to exercise autonomy in ways that transcend the disciplinary logics of surveillance? And to what extent do these new ways of aligning metrics with the construction and management of the self in China represent a new form of governmentality?

Performance Indicators and the Rise of NPM In The Condition of Postmodernity, David Harvey (1990) highlighted the major trends that were reshaping Western capitalism at the end of the 1980s. In particular, the large corporations were reducing their fixed costs notably plant and permanent staff salaries by outsourcing production to peripheral and cheaper sites in an ever more globalised economy. Systems of production were turned into global contract and supply chains, with each contracted party subject to production targets and PIs. While standards have always been used to manage performance, this globalised system hinged on rendering visible and explicit measurable

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indicators of performance. This provided a template for restructuring other sectors. For example, in the 1980s in Britain, Mrs Thatcher’s Conservative government introduced a raft of reforms called ‘The Next Steps’ (Ibbs Report, 1988) and commonly referred to as New Public Management (NPM). These began with the breakup of large government departments into executive agencies, each treated as a separate cost centre with its own PIs and annual objectives. This reform aimed to replace descriptions of work with numerical measures. The rationale for this approach was summed up by the Conservative minister Michael Heseltine: When the literacies of the Civil Service and the generalities of their intentions are turned into targets which can be monitored and costed, when information is conveyed in columns instead of screeds, then objectives become clear and progress towards them becomes measurable and far more likely. (Heseltine, 1987, cited in Pollitt, 1993, p. 58) The next step in this process entailed outsourcing public service functions to private companies, non-governmental organisations or newly privatised parts of the bureaucracy (National Audit Office, 1989). This equivalent of the industrial supply chain was based on what Pollitt, Bathgate, Caulfield, Smullen, and Talbot (2001) termed ‘agencification’ and the idea that the government-as-purchaser of services should be separated from providers in a quasi-market. Contract management was central to the art of governing these outsourced public services. The careful selection of a handful of ‘meaningful indicators’ became even more important in this process. However, ministers found that it was difficult to derive a coherent view of the outsourced agencies’ performance from the target information (Gay, 1997, p. 36) especially when they focused their operations on meeting key performance indicators (KPIs) rather than on overall service (what is elsewhere termed ‘Goodhart’s Law’1). This typically provoked three responses. One was to keep moving the assessment goalposts to prevent those assessed from gaming the system. A second was to increase targets to cover as many aspects of the outsourced service as possible. For example, a recent report found UK health services were so micro-managed through indicators that hospital managers were consumed by a ‘terror of targets’ and were failing to 1

Named after the economist, Charles Goodhart, this is best summed up in formulation: ‘When a measure becomes a target, it ceases to be a good measure’.

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address frontline problems because they were too ‘busy collecting information on how they are doing each week to satisfy regulators, NHS bosses, health commissioners and politicians’ (Meikle, 2015). A third response entailed breaking up professional work into a series of performance objectives, tasks and checklists. This occurred across all sectors but particularly in education. Pre-school teachers in England, for example, currently have to keep a ‘learning journal’ for each child to assess and shape their development. In one example that we have seen the learning journal was 30-pages long and divided into seven sections, each of which involved assessing every child against checklists containing specific criteria. For example, Understanding the World involved 42 criteria; Personal Social and Emotional Development 59 criteria, while Communication and Language had 66 and Physical Development had 79. The Introduction stated these PIs are ‘crucial for igniting children’s curiosity and enthusiasm for learning’ yet many teachers complain they no longer have time to care for children according to their own professional standards. Similar trends occurred in other countries. For example, Denmark’s Ministry of Finance established an agencification process in the 1990s. Contracts were based on a selection of strategic PIs so that service providers could minimise the time spent on reporting and focus their energies on improving services. However, as in England, the number of indicators and measures proliferated. Instead of liberating time and energy, professionals were overwhelmed by the burden of reporting. Many organisations could only cope by hiring additional administrators to deal with the reporting requirements. Even the civil servants who first formulated contract steering publicly protested against the system they helped to create (Gjørup et al., 2007). As one lamented, contract steering was based on in-built mistrust of professionals, and had shifted power to managers and ‘brutally side-lined’ professional judgement (Nissan, 2007). In the UK, this undermining of professional judgement also occurred though other initiatives designed to empower ‘users’, now variously constructed as ‘taxpayers’, ‘citizens’, ‘consumers’, ‘clients’, ‘stakeholders’ and ‘the public’. As Prime Minister Tony Blair proclaimed: We are proposing to put an entirely different dynamic in place to drive our public services; one where the service will be driven not by the government or the manager, but by the user the patient, the parent, the pupil and the law-abiding citizen. (Blair, 2004, cited in Clarke, Newman, Smith, Vidler, & Westmarland, 2007, p. 1)

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Each of these labels implied a different set of relationships between people and the state, as government increasingly sought to implement strategies for ‘governing at a distance’ and outsource responsibility for managing the population to individuals, non-governmental organisations and the private sector. Business interests acquired growing influence over the governing boards of public organisations such as university councils, hospital trusts and school governing bodies and the performance of professionals came to be measured according to a bewildering array of indicators and rankings.

From Managing Professionals to Controlling Populations: Metrics and Biopower Barbara Cruikshank’s (1999) book The Will to Empower highlighted the major shift in the US from ‘government’ towards neoliberal forms of ‘governance’. Instead of government regulating a population from above and through rewards and sanctions, governance entailed mobilising the agency and capacities of individuals so that they themselves actively contributed, not necessarily consciously, to the government’s vision of the social order. This ‘governing at a distance’ is what Foucault (1991) termed the ‘conduct of conduct’ and what Nikolas Rose (1999) called ‘governing through freedom’. As Cruikshank observed, in liberal democracies individuals and communities are interpolated through the rhetoric of empowerment, which paradoxically, had originally been developed by grassroots-activist movements themselves. Since the 1990s, there have been numerous new techniques for enhancing individual self-management. Many were pioneered by the military but quickly moved into private companies and, subsequently, into public organisations. This military-inspired business ethos is exemplified by the transnational consultancy firm McKinney Rogers, which, its website proclaims, ‘applies military philosophy and real-world experience to equip business teams with the tools and capability to deliver high-performance’. Its founder, Damian McKinney, was a British Royal Marine who served for 18 years as an operations commando before becoming a businessman. He discovered that ‘the Royal Marines’ Mission Command approach to talent management, business process redesign, and project planning and execution was directly relatable and transferable to the business world’ (McKinney Rogers, 2016). The company’s oft-quoted ‘Mission Leadership Dashboard’ technique involves each individual

Performance Management and the Audited Self understanding their role in an organisation ment through transparency’.

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what is termed ‘empower-

This clarity drives alignment, instils a sense of personal accountability, and promotes the independent thought and agility necessary to deliver mission-critical results despite obstacles faced. (McKinney Rogers, 2016) The ‘Mission Dashboard’ enables people at all levels to keep track of their contribution to a company’s strategic objectives. Like in a car, the ‘dashboard’ installed on their computer screens gives them a one-page overview of the company’s business targets, setting out each individual’s targets, the indicators used to measure them, and the progress of their performance against the plan (Syrett, 2007). This method builds on initiatives during the 1990s to develop comprehensive, long-term strategies that would align individual behaviour with company missions and targets. In 1993, Kaplan and Norton’s influential article in Harvard Business Review explained how the engineering and construction company, Rockwater, had developed a ‘balanced scorecard’ to drive performance (Figure 2.1). Instead of just focusing on financial indicators, they added three other dimensions deemed crucial to the company’s long-term success: customer perspective, internal management processes and employees’ innovation and learning. Each required its own ‘score-card measures’, and work teams throughout the organisation were expected to translate these into their own ‘critical success factors’ and measures by which performance would be assessed (Kaplan & Norton, 2004, pp. 7 10). Ultimately, these measures were turned into individual scorecards, which would fold up and fit into a (presumably male) employee’s shirt pocket or wallet (Figure 2.2). This scorecard ‘gives managers a way of ensuring that all levels of the organization understand the long-term strategy and that both departmental and individual objectives are aligned with it’ (Kaplan & Norton, 2004, p. 38). In the early 2000s, BT, the UK-based global telecommunications company, developed a further instrument for driving what it called ‘end-to-end process management’ that would align employee performance with the company’s vision and strategic imperatives (Savage, n.d.). After the 2001 ‘dot-com’ collapse and faced with a broadband revolution, they wanted to deliver ‘transformational change’ through ‘distributed leadership’, ‘higher employee engagement’ and ‘enhanced organisational capability’ (Syrett, 2007, p. 71). In their BT People Strategy, first, they defined the company’s five ‘core values’ Trustworthy, Helpful,

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Cris Shore and Susan Wright Rockwater’s ‘Balanced Scorecard’ Model Financial Perspective Return-on-Capital-Employed Cash Flow Project Profitability Profit Forecast Reliability Sales Backlog

Internal Business Perspective

Customer Perspective

Hours with Customers on New Work Tender Success Rate Rework Safety Incident Index Project Performance Index Project Closeout Cycle

Pricing Index Customer Ranking Survey Customer Satisfaction Index Market Share Business Segment, Tier 1 Customers, Key Accounts

Innovation and Learning Perspective % Revenue from New Services Rate of Improvement Index Staff Attitude Survey # of Employee Suggestions Revenue per Employee

Figure 2.1.

Diagram of Rockwater’s ‘Balanced Scorecard’, based on Kaplan and Norton (1993, p. 7).

Inspiring, Straightforward and Heart and the ideal ‘capabilities’ through which each employee would embody and ‘live’ those values (Savage, n.d.). Each team member, four times a year, then had to assess their behaviour under each category. The results were aggregated in an end-of-year Development Performance Review (DPR). Individuals with high scores would be eligible for a bonus payment, but only if their team score was also high. Individual scores were also ‘levelled’ against their peers, officially for fairness (BT, 2010, p. 17) but as one employee told us, scores tended to be ‘levelled down’ below the bonus-earning threshold if management decided that the company’s finances could not support all the bonuses for which employees were eligible. BT’s top management seems to have been exempt from such links between the company’s financial performance and their own pay.2 As a study by the High Pay 2 For example, BT’s Chief Executive Office Sir Peter Bonfield received a remuneration package of £3.1 million when he left the company in 2003, topping The Independent’s (2003) ‘Fat Cat List’. This remuneration package came despite the company having to carry out a £6 billion rescue rights issue in 2001 following a string of bad investments under Bonfield’s leadership.

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Link Measurements to Strategy Statement of Vision 1. Defining Strategic Business Units 2. Mission Statement 3. Vision Statement

What is My Vision of the Future?

If My Vision Succeeds, How Will I Differ?

To My Shareholders

To My Customers

With My Internal Management Processes

With My Ability to Innovate and Grow

Financial Perspective

Customer Perspective

Internal Perspective

Innovation and Learning

What Are the Critical Success Factors?

What Are the Critical Measurements?

Figure 2.2. Diagram of Rockwater’s Individual Scorecard. Based on Kaplan and Norton (1993, p. 10).

Commission (2011, p. 8) found, ‘excessive high pay bears little relation to company success and is rewarding failure’. Many bowdlerised versions of these performance management techniques have been transferred to public sector organisations. Universities have given a particularly novel gloss to these experiments in aligning employee capabilities with strategic goals. The work of Australian ‘change management’ expert Geoff Scott (Fullan & Scott, 2009; Scott, Coates, & Anderson, 2008) echoes BT’s focus on metricised ‘capabilities’ and ‘distributed leadership’ and has been taken up by several Australasian universities including the University of Auckland in 2013, under its so-called ‘Leadership Framework’ programme. Where BT’s model began with five key ‘values’, Auckland University’s model sets out five ‘leadership dimensions’: Personal Leadership, Setting Direction, Enabling People, Innovating and Engaging and Achieving Results each of which is also given a Maori name (Figure 2.3). These leadership dimensions each require particular ‘capabilities’ (13 in total). Each

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Figure 2.3.

The University of Auckland’s Leadership Framework Document.

Performance Management and the Audited Self

(Continued) Figure 2.3.

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‘capability’ is then described in detail. For example, ‘Setting Direction’ (Mana Tohu represented by the five stars of the Southern Cross) is defined as ‘Establishing and committing to plans and activities that will deliver the University’s strategy’ and the capabilities are: Demonstrates an understanding of the competitive global environment and key market drivers […] and uses this understanding to create and seize opportunities, expand into new markets and deliver programmes. The behaviours of a leader who demonstrates global and commercial acumen are: • develops in-depth understanding of the University and tertiary sector; • pursues discipline/market/professional skill set information and maintains global awareness; • recognises impact and opportunity of national and global trends; • leads and inspires innovation; and • pursues ambitious ventures. UoA (2013, p. 8)

The Leadership Framework’s philosophy is that everyone in the organisation must take responsibility for leading and aligning their behaviour with the strategic goals set by senior management. While distributed leadership recalls the tradition of university autonomy where academics relied on their own sense of professionalism to set their direction in teaching and research, this model is top-down, authoritarian and skewed towards a model of the university as a business corporation. However, unlike BT’s ‘end-to-end performance management’, the values and capabilities expected of academics were not converted into precise performance measures. Instead, a separate policy detailing promotion criteria was developed that quantified required outputs for research, teaching and service in very different language to that of the Leadership Framework. For example, for promotion to Professor in the Social Sciences, candidates must have published over 50 articles in leading peer-reviewed journals; supervised at least eight MA and eight PhD students; generated three ‘major’ external research grants (where ‘major’ means in excess of NZ$100,000); and demonstrated ‘outstanding leadership’ consistent with the Leadership Framework’ (UoA, 2016).

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Denmark’s IT University has further adapted these ideas in a model that quantifies performance expectations and individual output targets under a single currency. Academic performance is calculated in a performance points (PPs) system, which is calculated to raise ITU’s performance to that of the average Danish University (ITU, 2014). The performance of a Professor or Associate Professor is calculated at 100 PPs per year. For teaching, 1 PP is equal to 14.5 European Credit and Transfer System (ECTS) points, and a professor must earn 50 points over two years. For research, professors must earn 40 PPs over two years, where 25 PPs are allocated per 2.55 points in the national bibliometric research indicator (BFI). Professors must also earn at least 10 PPs each year on ‘spending external funding’, where 25 PPs are allocated per 1,114,540 DKK (roughly US$167,000). To raise and spend US$167,000 each year is probably impossible for most humanities or social science professors. Even post-doctoral students are expected to produce 55 PPs per year. Should anyone underperform then other colleagues must ensure that their unit meets its members’ combined target. Like the BT model, this relies not just on individual self-management, but compels colleagues to monitor each other’s performance. Those who fail to meet their target have been warned that ‘yes, firing may take place’ (personal communication). In 2015, the Vice Chancellor of Newcastle University in England announced an equally demanding policy on academic performance targets. Titled ‘Raising the Bar’, this catalogued the performance measures expected of all academic staff. Depending on subject area, it required professors to obtain £6 12,000 per year in external funding and to ‘be in the top quartile’ in the national research assessment exercise. For geography, this required professors to generate some £136,000 over three years, produce ‘at least four 3* outputs’ and at least one ‘world-leading (4*) quality output’ in a five-year period. They should also supervise to completion ‘1 post graduate student per annum and provide guidance and mentoring to junior colleagues and show research leadership’ (Newcastle University, 2015). Even junior Lecturers were required to generate £3,000 6,000 a year, publish four ‘3* research outputs’ in the five-year REF period and successfully supervise one post-graduate student per year. University managers defended these draconian measures as merely ‘a set of reference points’ for performance that did ‘not herald some new system of target-driven management’. Liz Morrish described the policy as ‘manufactured instability’, arguing that the measures were neither objective nor objective-setting but rather a process of ‘objectification in which people are treated as a

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tool to meet a goal’ (Morrish, 2015). The local University and College Union branch estimated that between 75% and 85% of staff in some schools would fail to meet all the new criteria (Grove, 2015a) and ultimately their mobilisation of staff and students and an international outcry resulted in the Vice Chancellor dropping this scheme. What connects these stories about ‘mission dashboards’, ‘balance scorecards’, ‘values and capabilities’, ‘distributed leadership’ and ‘Raising the Bar’ on performance expectations? They all highlight management’s attempts to enhance performance through the twin processes of ‘disciplining’ and ‘catalysing’ and its adoption of the popular maxim usually attributed (inaccurately) to management guru Peter Drucker (Zak, 2013) that ‘if you can’t measure it, you can’t improve it’. The drive to measure and audit performance is thus impelled by an ethic of improvement, both of the organisation and the individuals within it. What we see here is the confluence of two different rationalities. The first is a neoliberal emphasis on producing autonomous, self-disciplined, individuals whose behaviour is tailored to programmes of continuous self-monitoring and improvement, or what Mitchell Dean (1999, p. 147) termed neoliberal ‘reflexive projects of the self’. The second rationality is, a calculative and instrumental conception of employees as assets whose capacities must be harnessed and continually expanded by managers so that they become go-getting, risk-taking entrepreneurs. This figure represents modern management’s vision of ideal workers: proactive, unbounded, selfdriven, forever expanding their capacities, willing to take on any challenge, with a seemingly inexhaustible capacity for work (Bovbjerg, 2011; Shore, 2008, p. 285; Wright & Ørberg, 2017, p. 84). According to Emily Martin (1997), such qualities are similar to those of people with Attention Deficit Disorder. As Bovbjerg observed, constructing ideal workers in terms of the virtues of being positive, enthusiastic and entrepreneurially proactive renders it unacceptable for a ‘good employee’ to resist or say ‘no’ to new challenges. By 2016, one in six universities in England had introduced financial performance targets for academics with little overt resistance (Grove, 2015b). However, these technologies of the self are not always so effective. At Newcastle University, ‘Raising the Bar’ provoked industrial unrest as academics argued they were being set up to fail in what looked like a policy of ‘constructive dismissal’. This begs the question: When is self-auditing a form of managerial oppression and when is it a genuine expression of personal autonomy and selfhood?

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Quantifying and Rating Oneself: Surveillance or Empowerment? That question lies at the heart of the QS movement, a phenomenon that began in California in 2007 but has gone global. QS enables individuals to audit their daily activities by wearing sensors and using computing technology to monitor their heart rate, mood, stress levels, calorie intake, activity levels, alcohol consumption and sleep patterns. The movement was started in San Francisco by Gary Wolf, author and editor of Wired magazine and co-founder of the QS blog. The movement’s membership is an eclectic mix of ‘early adopters, fitness freaks, technology evangelists, personal-development junkies, hackers and patients suffering from a wide variety of health problems’ (Economist, 2012). From the start, regular meeting groups were formed and, within five years, they had spread to over 50 cities. Accounts of QS meetings highlight the way participants share stories about the positive effects of metricising their everyday lives. The technologies allow individuals not only to observe and improve their own performance, but to share data with friends and compare or compete with others. This reflects what Whitson (2013) calls the ‘gamification’ of everyday life, a process that turns surveillance into something also highly pleasurable. Others highlight the considerable time and anxiety involved in self-quantification, ’leading the individual to be less spontaneous and avoid unknown or unquantifiable situations’ (Lanius, 2015). There is a growing market for these self-monitoring technologies. For example, in 2015 Fitbit led the field in ‘wearable technology’ with total sales topping 4.4 million gadgets (beating Apple Watch, which came second with 3.6 million sales) (Gil, 2015). The data that individuals collect on their head, chest and wrist-band gadgets are transmitted onto personal computers and then to the manufacturers of these devices. For example, data on personal sleep patterns are transmitted to the Zeo website which now boasts the world’s largest database on sleep stages. Wolf (2010) calls this combination of micro and macro data gathering technology a ‘macroscope’ bringing together the best of both a microscope and a telescope by combining systems for gathering small observations in nature with computing technologies that store and analyse these data. Wolf argues that in future, measurement devices that people currently carry on their bodies (belts, wristbands) may be put inside their bodies, and he asks, ‘So what is the macroscope doing to us?’ (Wolf, 2011). Wolf addressed that question in a TED talk in Amsterdam in 2011. The macroscope is both a window to collect data for ‘systematic improvement’ and an inward-looking ‘mirror’ for ‘self-improvement, self-discovery, self-awareness and self-knowledge’ (Wolf, 2011). For

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Wolf, the ‘self’ is ‘our operation centre, our consciousness and our moral compass. If we want to act more effectively in the world, we have to get to know ourselves better’ (Wolf, 2011). This raises an interesting question: Is QS a form of empowerment, or subordination to a new normative order of panoptical control? According to Reyes (2014, p. 372), the QS is ‘an algorithm of an individual’s social networks, interactions, activities, purchases and whereabouts’. Self-quantifiers offer up this data to the life science, health technology and pharmaceutical industries and who owns the data is not always clear. This combination of epidemiological and personal data will also be important for the development of individualised medicine and the future of the pharmaceutical industry. Significantly, many of the QS conferences are organised or sponsored by major corporations such as Intel, Vodafone and Philips the latter has even produced its own QS promotional video (Philips, 2015). Others take a more optimistic view of the advance of quantified selves. Based on their ethnographic work, Nafus and Sherman (2014) propose that QS participants exercise a form of ‘soft resistance’. They argue that because QSers assume multiple roles ‘as project designers, data collectors and critical sense makers’ and ‘are constantly shifting their priorities’, the data sets become fragmented and participants escape the categories created by the biopolitics of the health technology industry. However, their ethnography also shows that one thing that QSers do ‘not keep track of is what [they] are tracking’ (2014, p. 1788). They conclude that the QS movement does not escape the wider biopolitics of late capitalism that rely on radical individualism to drive consumption as a dominant mode of expression and to elide structural inequalities by framing all actions in terms of personal ‘choice’. (Nafus & Sherman, 2014, p. 1793) There seems little concern that companies owning data on individual’s health and welfare could enter commercial partnerships with insurance companies and affect people’s premiums. They could also combine with mega data brokers such as the US corporation Acxiom that tracks people’s online purchases to build psychological profiles for advertisers and marketers to sell products to individuals or with political consultancies such as Cambridge Analytica who use data to target bespoke messages to swing voters (Cadwalladr, 2017). People continue to volunteer information about themselves that can be used against them. In October 2015, an

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app called ‘Peeple’ was about to be launched through the Apple App store. Described by its creators as a ‘positivity app for positive people’, it aimed to let users rate their friends, family members, neighbours, baristas, bosses and other social contacts but without their consent. Use of the app would be free provided a person was 21 and had an established Facebook account and registered their mobile phone number (which would be stored on the company’s data base). Scoring would involve assigning people between one to five stars, like the Michelin restaurant guide or a TripAdvisor hotel rating. According to its promoters, the Peeple app allows us to better choose who we hire, do business with, date, become our neighbours, roommates, landlords/ tenants, and teach our children […] there are endless reasons why we would want this reference check for the people around us. (Hunt, 2015) Following criticism that it would invite cyberbullying and stalkers, 7,000 people signed a petition. The company withdrew the app but relaunched it five months later with minor modifications, attracting 15,000 users in the first two weeks. Now users can only recommend, not rate their social contacts, with a ‘Peeple number’ based on how many recommendations an individual receives. Individuals have to opt-in and approve comments about themselves before they are posted online. They can hide negative comments on their character, but the company plans to launch a ‘truth licence’ that will allow fee-paying subscribers to review all the hidden comments that somebody has received or written about others. In an interview with CCTV, Peeple’s CEO Julia Cordray felt that ‘whether people like it or not, the world was headed towards a place where people would find it valuable to manage their online reputation’.3 So what kinds of citizen-subjects or auditable selves are being created through these voluntary processes of performance measurement and self-tracking?

Measuring Performance in China: Citizenship and Social Credit Our examples of how indicators, rankings and performance metrics are being used to shape subjects have so far only come from Western 3

CCTV interview, 4 April 2016. Retrieved from https://www.youtube.com/watch? v=1WxuUxHxGLo

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societies, suggesting that such individualising and totalising techniques of the self are particular to neoliberalised contexts. However, an even more extreme version of these trends can be seen in contemporary China. In 2015, eight Chinese companies began work on state-approved pilot projects to develop a universal system of ‘social credit’ capable of scoring and ranking the character and ‘trustworthiness’ of each citizen. One such high profile project is Sesame Credit, an Internet-based scoring system built and run by Ant Financial, a subsidiary of Alibaba the Chinese e-commerce giant. Alibaba has over 400 million users and is China’s largest online shopping platform, with more transactions than Amazon and eBay combined. When first listed on the New York Stock Exchange in 2014, its market value was a staggering US$231.4 billion. Together with the IT company Tencent, Alibaba runs the Chinese equivalent of all social networks (Falkvinge, 2015). Sesame’s social credit system allocates each person a score between 350 and 950 based on factors such as their financial, purchasing and spending history. The higher a person’s score, the greater the rewards. For example, 600 points allows an individual the privilege of taking out an instant loan up to $800 when shopping online. Someone with a score of 650 can rent a car from the Chinese companies eHai.com and Car Inc. without leaving a deposit, or get a faster hotel check out (Hodson, 2015). A total of 700 points earns a reduction in the time taken to obtain a travel permit for Singapore, while 750 points enables fast-track treatment in processing a Pan-European Schengen visa. Spending through Alibaba’s payment app (Alipay) or conducting transactions that recruit friends to Sesame Credit can also raise your score. Personal hobbies, interactions with friends, lifestyle and what you buy also influence a person’s score. For example, someone who buys work shoes, local produce or nappies (responsible purchases), receives more points than someone who buys videogames or spends large amounts of the day playing online games (irresponsible). China’s largest matchmaking service, Baihe, has combined with Sesame to promote clients with good credit scores, giving them prominent spots on the company’s website (Hatton, 2015). Users are encouraged to flaunt their good credit scores to friends and potential marriage partners. Another way promoters have tried to stimulate take-up of this system is by presenting it as a game. A mobile phone app designed by Sesame Credit invites users to guess whether their social credit score is higher or lower than their friends’, and encourages everyone to share their ratings. Zheping Huang, a Hong Kong-based journalist, chronicled his own experience with the game in October 2015 saying,

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in the past few weeks I began to notice a mysterious new trend. Numbers were popping up on my social media feeds as my friends and strangers on Weibo and WeChat began to share their 芝麻信用分, or ‘Sesame Credit scores’. (Huang, 2015) According to Huang, Sesame Credit operates independently of government and ‘works more like a loyalty program than a credit rating system’. However, others detect a more sinister agenda and worry that government will allow private companies to gather massive data pools, and extract from them whatever it likes. Oxford University’s China expert Rogier Creemers says the programme is far more than just a credit-tracking method: The government wants to build a platform that leverages things like big data, mobile internet, and cloud computing to measure and evaluate different levels of people’s lives in order to create a gamified nudging for people to behave better. (as cited in Bernish, 2015) Acknowledging this, China’s State Council explains that social credit will ‘forge a public opinion environment that trust-keeping is glorious’ but also warns that the ‘new system will reward those who report acts of breach of trust’ (as cited in Hatton, 2015). Sesame Credit is open about its government links, candidly conceding that it works closely with the Ministry of Public Security, The Supreme People’s Court, the Ministry of Education and the State Administration for Industry and Commerce. At present, the social credit system is voluntary but the Chinese government has announced that it will become mandatory from 2020 (Osborne, 2015). Unlike American mega data brokers, Sesame Credit scores are available to everyone. It also links credit scores to one’s political opinions so that posting comments on for example Chinese dissidents or the Shanghai stock market collapse will lower one’s scores. An individual’s score can also be damaged if their friends post comments on these events. This gamified system of peer pressure adds a new dimension to the Internet as a technology of citizenship and social control. Some authors draw parallels with the KGB and Stasi, whose method for preventing dissent from spreading was to plant agent provocateurs in the general population, inciting others to dissent, then arresting them.

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Cris Shore and Susan Wright As a result, nobody would dare agree that the government did anything bad, and this was very effective in preventing any large-scale resistance from taking hold. The Chinese way here is much more subtle, but probably more effective still. (Falkvinge, 2015)

For Creemers, this massive exercise in individual surveillance goes beyond the ambition of the Stasi; their activities were limited to avoiding revolts against the regime whereas ‘the Chinese aim is far more ambitious: it is clearly an attempt to create a new citizen’ (as cited in Bernish, 2015). Unsurprisingly, the Western media has heavily criticised China’s Sesame Credit system, describing it as ‘terrifying’, ‘totalitarian’ and an attempt to ‘turn obedience to the state into a game’ (Osborne, 2015). The American Civil Liberties Union (ACLU) called it an ‘Orwellian nightmare’ and ‘a warning for Americans’ (Storm, 2015). Even the usually more sober Financial Times headlined it as ‘China: When Big Data meets Big Brother’ (Clover, 2016). However, China’s use of big data as a technology of citizenship reflects trends also occurring in Western countries, as the Edward Snowden and Wikileaks disclosures revealed. Even New Scientist concedes that, as in China: people who live in the West are being tracked and ranked all the time. For now, though, this is serving commercial interests rather than those of the state. (Hodson, 2015) What is striking about the Chinese government’s attempts to shape and control its citizenry is that it seeks to harness all three of the elements of performance and governance identified earlier: that is state control and private companies are combined with big data and popular social media in order to steer individuals towards a constant monitoring and disciplining of their own behaviour, and a performative marketing of their ‘good character’. As Clover (2016) says: China’s Internet is fast becoming a laboratory where the march of technology combined with profit-driven private companies, authoritarian politics and weak civil liberties is creating a toxic cocktail. If unchecked, the ‘social credit’ system […] could be used to assign citizenship scores to everyone based on ‘patriotic’ criteria such as whether they

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buy imported products, or the content of their postings on social media. (Clover, 2016) That system is not yet in place. At the time of writing, the government was still watching and waiting to see how its approved private companies develop their own ‘social credit’ systems. In July 2017, it announced it would not be issuing any licences for the time being after regulators expressed increasing concern about conflicts of interest. The main reason for delaying the licences was not concerns about freedom or privacy, but rather the government’s concerns that the credit companies should be independent third parties and its desire to reign in risky financial behaviours, particularly the ‘systemic risks from the purchase of overseas assets with money raised through high-interest financing products’ (Hornby, 2017). But this is a delay, not a change of policy; China still aims to have the system operating by 2020.

Conclusions We began by asking ‘what counts as evidence of good performance, behaviour and character?’ Perhaps the more interesting question is ‘what are the politics behind projects to measure or construct good citizens and subjects?’ and how are counting or metrics being used as technologies of the self? The examples outlined earlier highlight several key trends in the way that PIs and personal data are being used by companies, by the state and by individuals themselves. But what bigger story do these examples tell? In developing his work on governmentality, Foucault (1991) observed how state authorities made absolutely clear why the subject of power was being disciplined, what the norms were behind these disciplinary regimes and how individuals could use redemptive therapies to align themselves with the normative order. This is particularly evident in the examples of BT, McKinney Rogers and Auckland University, and these organisations even coach staff to improve their performance. But with the QS and Chinese examples, the drivers are less commercially orientated and less overt: instead, individuals are required to measure and rank themselves and their conduct against that of their friends and colleagues. This places them under even greater pressure to monitor and audit themselves, inside as well as outside the workplace and makes the systems even more totalising and individualising. Whether presented as techniques to enhance production and improve

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quality, a game or a vehicle of empowerment, these examples all illustrate ways in which performance metrics are being mobilised as disciplinary instruments to create auditable selves. While these are obvious continuities with the type of governmentality that Foucault analysed in the second-half of the twentieth century, developments such as QS and Sesame Credit are opening up a new terrain for the art of government, providing political rulers and private corporations with immense scope and chilling possibilities for shaping the way individuals construct and conduct themselves.

Acknowledgements The authors would like to extend warm thanks to Isabel Shore for drawing Figures 2.1 and 2.2.

References Bernish, C. (2015). China just launched the most frightening game ever — and soon it will be mandatory. Anti-Media, December 21. Retrieved from http://theantimedia.org/china-just-launched-the-most-frightening-game-ever-and-soon-it-willbe-mandatory/ Bovbjerg, K. M. (Ed.). (2011). Motivation og mismod. [Motivation and despondency] Aarhus: Aarhus University Press. BT. (2010). Our performance approach. London: British Telecommunications plc. Retrieved from file:///C:/Users/au148152/Downloads/2011-01605-AgreementBT-performance-management-agreement-booklet-Version-01-12-2011%20(2).pdf Cadwalladr, C. (2017).The great British Brexit robbery: How our democracy was hijacked. The Observer, May 7. Retrieved from https://www.theguardian.com/ technology/2017/may/07/the-great-british-brexit-robbery-hijacked-democracy Clarke, J., Newman, J., Smith, N., Vidler, E., & Westmarland, L. (2007). Creating citizen-consumers: Changing publics and changing public services. London: Sage. Clover, C. (2016). China: When big data meets big brother. Financial Times, January 19. Cruikshank, B. (1999). The will to empower: Democratic citizens and other subjects. Ithaca, CA: Cornell University Press. Dean, M. (1999). Governmentality. Power and rule in modern society. London: Sage. Economist. (2012). The quantified self. Counting every moment. The Economist, May 3. Retrieved from http://www.economist.com/node/21548493/print Falkvinge, R. (2015). In China, your credit score is now affected by your political opinions And your friends’ political opinions. Privacy News Online, October 3. Retrieved from https://www.privateinternetaccess.com/blog/2015/10/in-china-

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your-credit-score-is-now-affected-by-your-political-opinions-and-your-friendspolitical-opinions/ Foucault, M. (1991). Governmentality. In G. Burchell, C. Gordon, & P. Miller (Eds.), The Foucault effect: Studies in governmentality (87 104). Chicago, IL: University of Chicago Press. Fullan, M., & Scott, G. (2009). Turnaround leadership for higher education. Chichester: Wiley. Gay, O. (1997, January 24). The accountability debate: Next steps agencies. Research Paper 97/4. London: House of Commons Library. Retrieved from http://www.civilservant.org.uk/library/1997_HoC_the%20acccountability%20 debate_next%20steps%20agencies.pdf Gil, L. (2015). Numbers are in. Wearable website, August 27. Retrieved from http:// www.wareable.com/apple-watch/fitbit-top-seller-wearable-tech-1593 Gjørup, J., Hjortdal, H., Jensen, T., Lerborg, L., Nielsen, C., Refslund, N., & Winkel, J. S. (2007). Tilgiv os - vi vidste ikke, hvad vi gjorde [Forgive us we knew not what we did]. Politiken, March 29. Retrieved from http://politiken.dk/ debat/kroniker/article274053.ece Grove, J. (2015a, December 17). Newcastle University staff express fears over new “targets”. Retrieved from https://www.timeshighereducation.com/news/newcastle-university-staff-express-fears-over-new-targets Grove, J. (2015b) Grant income targets set at one in six universities, THE poll suggests. THE, June 11. Retrieved from https://www.timeshighereducation.com/ news/grant-income-targets-set-one-six-universities-poll-suggests. Accessed on May 24, 2016. Harvey, D. (1990). The condition of postmodernity: An enquiry into the origins of cultural change. Oxford: Blackwell. Hatton, C. (2015). China ‘social credit’: Beijing sets up huge system. BBC News, October 26. Retrieved from http://www.bbc.co.uk/news/world-asia-china34592186 High Pay Commission. (2011). Cheques with balances: Why tackling high pay is in the national interest. Final Report of the High Pay Commission (23), 1. London: High Pay Unit. Retrieved from http://highpaycentre.org/files/Cheques_with_ Balances.pdf Hodson, H. (2015). Inside China’s plan to give every citizen a character score. New Scientist, October 14. Retrieved from https://www.newscientist.com/article/ mg22830432-100-inside-chinas-plan-to-give-every-citizen-a-character-score/ Hornby, L. (2017). China changes tack on ‘social credit’ scheme plan. Financial Times, July 5. Retrieved from https://www.ft.com/content/f772a9ce-60c4-11e791a7-502f7ee26895 Huang, Z. (2015). All Chinese citizens now have a score based on how well we live, and mine sucks. QUARTZ, October 9. Retrieved from http://qz.com/519737/allchinese-citizens-now-have-a-score-based-on-how-well-we-live-and-mine-sucks/ Hunt, E. (2015). Peeple review people: The user-review app you didn’t dare ask for. The Guardian, October 1. Retrieved from https://www.theguardian.com/technology/2015/oct/01/peeple-review-people-the-user-review-app-you-didnt-dare-ask-for

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Ibbs Report. (1988). Improving management in government: The next steps. A report to the Prime Minister. London: Hmso. ITU. (2014). A model for measuring teaching and research contribution (draft internal document). Copenhagen: IT University. Kaplan, R., & Norton, D. (1993). Putting the balanced scorecard to work. Harvard Business Review, 71(5) September October, 134 147. Kaplan, R., & Norton, D. (2004). Focusing your organization on strategy-with the balanced scorecard. Cambridge: Harvard Business School Publishing. Lanius, C. (2015). The hidden anxieties of the Quantified Self movement. Cyborgology blog, May 5. Retrieved from https://thesocietypages.org/cyborgology/2015/05/05/the-hidden-anxieties-of-the-quantified-self-movement/ Martin, E. (1997). Managing Americans: Policy and changes in the meanings of work and self. In C. Shore & S. Wright (Eds.), Anthropology of policy. Critical perspectives on governance and power (pp. 239 260). London: Routledge. McKinney, R. (2016). Mission statement accomplished. Retrieved from http://www. mckinneyrogers.com/What_We_Do.aspx Meikle, J. (2015). Focus on targets in NHS poses threat to patient care, says thinktank. The Guardian, March 6. Retrieved from http://www.theguardian.com/society/2015/mar/06/focus-targets-threat-care-nhs-patients-thinktank Merry, S. E. (2011). Measuring the world. Indicators, human rights, and global governance. Current Anthropology, 52, S83 S95. Merry, S. E. (2016). The seductions of quantification: Measuring human rights, gender violence, and sex trafficking. Chicago, IL: University of Chicago Press. Morrish, L. (2015, November 26). Raising the bar? Why we should resist target culture. UCU Lecture given at Newcastle University. [Video file]. Retrieved from https://www.youtube.com/watch?v=1thgkQWV8t8 Nafus, D., & Sherman, J. (2014). Big data, big questions - This one does not go up to 11: The Quantified Self movement as an alternative big data practice. International Journal of Communication, 8, 1784 1794. National Audit Office. (1989). Report by the comptroller and auditor general. The Next Steps Initiative (HC 410) 1988 1989. London: HMSO. Newcastle University. (2015). Faculty of humanities and social sciences research and innovation performance expectations. Retrieved from https://webcache.googleusercontent.com/search?q=cache:etO1vsjJQeQJ:https://academicirregularities. files.wordpress.com/2015/11/newcastle-arts-and-hums.docx+&cd=2&hl=en& ct=clnk&gl=us Nissan, C. S. (2007). Hvad er det, vi har gang i? [What are we doing?] Politiken, September 5. Retrieved from http://politiken.dk/debat/kroniken/ECE374233/ hvad-er-det-vi-har-gang-i/ Osborne, S. (2015). China has made obedience to the State a game. Independent, December 22. Retrieved from http://www.independent.co.uk/news/world/asia/ china-has-made-obedience-to-the-state-a-game-a6783841.html Philips Living Health. (2015). The quantified self. New Scientists, November 30. [Video file] https://www.youtube.com/watch?v=8wqC6ad1V_Q Pollitt, C. (1993). Managerialism and the public services. Cuts or cultural change in the 1990s? (2nd ed.). Oxford: Blackwell.

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Pollitt, C., Bathgate, K., Caulfield, J., Smullen, A., & Talbot, C. (2001). Agency fever? Analysis of an international policy fashion. Journal of Comparative Policy Analysis: Research and Practice, 3, 271 290. Reyes, A. (2014). Linguistic anthropology in 2013: Super-new-big. American Anthropologist, 116(2), 366 378. Rose, N. (1999). Powers of freedom. Cambridge: Cambridge University Press. Savage, M. (n.d.). Strategic HR Briefings and Case Studies: British Telecom. businessintelligence website. Retrieved from http://ss393.fusionbot.com/b/ss_cache? cch=1890447&ck=7920972933&sn=157430325&k= Scott, G., Coates, H., & Anderson, M. (2008). Learning leaders in times of change: Academic leadership capabilities for Australian higher education. Sydney: University of Western Sydney and Australian Council for Educational Research. Shore, C. (2008). Audit culture and illiberal governance: Universities and the politics of accountability. Anthropological Theory, 8(3), 278 299. Storm, D. (2015). ACLU: Orwellian citizen score, China’s credit score system, is a warning for Americans. Computerworld. Retrieved from http://www.computerworld.com/article/2990203/security/aclu-orwellian-citizen-score-chinas-credit-scoresystem-is-a-warning-for-americans.html Syrett, M. (2007). The Economist: Successful strategy execution. How to keep your business goals on target. London: Profile Books. The Independent. (2003, May 19). The fat cat list 2003, part one. Retrieved from http://www.independent.co.uk/news/business/analysis-and-features/the-fat-cat-list2003-part-one-105372.html University of Auckland (UoA). (2013). Guide to the University of Auckland leadership framework. Auckland: University of Auckland: Staff and Organisational Development Unit. Retrieved from https://cdn.auckland.ac.nz/assets/auckland/ about-us/equity-at-the-university/about-equity/what-is-equity/guide-to-the-leadership-framework-capabilities-defined.pdf University of Auckland (UoA). (2016). Academic standards: The University of Auckland HR policy. Retrieved from https://www.auckland.ac.nz/en/about/ the-university/how-university-works/policy-and-administration/human-resources1/ academic-processes-and-standards/academic-standards/academic-standards-other. html Whitson, J. (2013). Gaming the quantified self. Surveillance and Society, 11(1 2), 163 176. Wolf, G. (2010). An interview with Gary Wolf on the quantified self. Institute For The Future (IFTF). Retrieved from http://www.iftf.org/future-now/articledetail/an-interview-with-gary-wolf-on-the-quantified-self/ Wolf, G. (2011). Quantify yourself. TEDx Amsterdam. Retrieved from http://tedx. amsterdam/2011/11/gary-wolf-quantify-yourself/ Wright, S., & Ørberg, J. W. (2017). Universities in the competition state lessons from Denmark. In S. Wright & C. Shore (Eds.), Death of the public university: Uncertain futures for higher education in the knowledge economy (pp. 69 89). New York, NY: Berghahn. Zak, P. (2013, July 4). Measurement myopia. Drucker Institute. Retrieved from http://www.druckerinstitute.com/2013/07/measurement-myopia/

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Chapter 3

The Digitisation of Welfare: A Strategy towards Improving Citizens’ Self-care and Co-management of Welfare Nicole Thualagant and Ditte-Marie From

Abstract Technologies of measurement and self-monitoring of health data have become part of a metric everyday life in Denmark. As part of a change in Nordic Welfare society, Danish citizens are increasingly experiencing a digitisation of welfare services. This chapter explores the rationales behind the eGovernment strategy of Digital Welfare 2016 2020 in regard to health and discusses how this strategy encourages self-measurement and self-improvement through discourses of improvement at both state and citizen levels. By illustrating how performativity is embedded in current conceptions of health, this chapter emphasises how strategies of digitisation lean on a bio-citizenship where individuals with poor health capacities become dependent, not on a supporting welfare system, but paradoxically on their own self-management skills in order to receive health services. Based on the sociology of knowledge approach to discourse (SKAD) analysis, this chapter scrutinises central documents on the strategy of digital welfare. Our exploration provides a critical insight into the current digitisation of health care by illustrating how new virtues of citizenship are demanded in the digital era in relation to digital health, and furthermore represents

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a current challenge for Danish welfare in the schism between technology as empowering and a technocratic form of governance. Keywords: Digitisation; Nordic welfare model; eGovernance; self-care; performative health; bio-citizenship

Introduction In Denmark, as well as in many other European countries, the welfare state is challenged by significant demographic changes in terms of a steadily growing number of unproductive citizens who live longer, and an increasing proportion of citizens who live with chronic diseases (Nordic Council of Ministers, 2007; WHO, 2009). In the political drive for sustaining and optimising existing standards of welfare, these changes have emphasised the need for adjusting public sectors across the Nordic and EU-nations. As a result, governments have been encouraged to implement new political welfare strategies in order to change the role, size and composition of the welfare state (Busse, Blu¨mel, Scheller Kreinsen, & Zentner, 2010; Greve, 2013). Denmark has, since 2001, developed digital strategies with the ambition of modernising the public sector. The efforts have more precisely resulted in four digitisation strategies. The first strategy in 2001 focused on preparing citizens for the network society by, for instance, facilitating the use of digital communication. A second strategy was published in 2004 with clearer targets to be obtained. The third strategy, published in 2007, reduced the number of signposts from the previous strategy to three: better digital services, improved efficiency and effectiveness and stronger commitment and collaboration (Ejersbo & Greve, 2017, p. 272). Subsequently, the Danish government, Local Government Denmark and Danish Regions launched a new common (fourth) public sector strategy for digital welfare 2013 2020, titled Digital Welfare: Empowerment, Flexibility and Efficiency (The Danish Agency for Digitisation, 2013). The overall objective of this strategy is to digitally transform welfare services by increasing the use of technologies in state-funded services in the public sector, and further to ensure higher quality at less cost (The Danish Agency for Digitisation, 2013, p. 3). There are two central objectives within this new strategy for digital welfare: (1) to engage citizens more actively through digital solutions in order to facilitate a shift from providing services for the citizen, to increasingly provide services in

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collaboration with the citizen; and (2) to create a more efficient and cohesive welfare through increased use of technologies. These two objectives can strategically be said to represent the overall national policy effort of building up an efficient digital infrastructure resulting in a transformation of public service delivery. As political scientists, Niels Ejersbo and Carsten Greve state: ‘OECD points to Denmark as one of the leading countries when it comes to digitization in the public sector’ (2017, p. 268). They combine the concept of digital era governance (DEG) and the neo-Weberian state (NWS) in order to describe the current governance tendencies in Denmark (Ejersbo & Greve, 2017). The concept of DEG was originally deployed by Dunleavy, Margetts, Bastow, and Tinkler (2006) who argued that DEG could be characterised as a form of governance in opposition to new public management (NPM), that is the features characterising neoliberal governance based on the incentives of optimisation and competition. This interpretation of current governance points at three features that are believed to be in opposition to NPM’s logic: first, in contrast to disaggregation, that is the splitting up of large public sector hierarchies known under the era of NPM, DEG fosters a reintegration leading to a simplification of the organisation of services. Second, contrary to the feature of competition, DEG is believed to be based on more client-focused services putting the user at the centre of attention. And finally, in contrast to the incentivisation addressing the professionals’ performance, digitisation changes provide solutions where the user/citizen can do the administration themselves (Dunleavy et al., 2006; Ejersbo & Greve, 2017). Ejersbo and Greve comment further on the concept of the NWS in order to describe the digitisation process in Denmark. They rely on the former work of Pollitt and Bouckaert (2011) listing elements of both a Weberian state and its ‘neo’ elements. In brief, the NWS can be characterised as ‘a vision of a modernized, efficient, citizen-friendly state apparatus’ (Ejersbo & Greve, 2017, p. 269). The Danish public sector is thus believed to be governed on the principles of democracy, legality for all, a professional public management, a service-oriented approach to citizens and with the possibility of co-production. As proclaimed by Ejersbo and Greve, ‘[…] digital changes have impact not only inside the public sector, but also directly for citizens’ (2017, p. 268). Most significantly, this is predominant in the new forms of communication between the public sectors and the citizens: from an administration perspective, and with the aforementioned leading public sector Internet usage, Denmark has succeeded in building up an efficient infrastructure. Also,

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the Danes are number one according to ‘[…] the EU’s indicator for “households with access to the Internet at home”’ (Ejersbo & Greve, 2017, p. 274). As such, the second objective of creating a more efficient and cohesive welfare can be said to have been successfully achieved. However, we argue that another light must be shed on the consequences of the digitisation of welfare; more specifically we address our attention to the normativity of the government’s first objective of engaging citizens more actively, as well as the idealisation of a certain citizenship. This objective represents a new significant shift of paradigm with substantial relevance in two regards: for conceptualisations of health and health promotion in terms of enhancing self-monitoring of health; and for the emergence of a new bio-citizenship shaped and structured around individual performance and optimisation. As other studies in Denmark have pointed to (Bovbjerg, Wright, Krause-Jensen, Brorholt, & Moos, 2011; From, 2015; Jensen, 2015), the strategy of digital welfare is constituted around a notion of compulsion, as the only option provided for the citizens is to accept and engage in the appointed directions. This enforced strategy is significant to explore, as we know very little of the implications of a politically decided metric culture in terms of introducing more technology into the public health sector and everyday life. Digital competences as well as a digital culture are being fostered and strengthened, but the mere consequences of such political ambitions on the everyday life of individuals are unknown.

Health Technologies, ePregnancy and Bio-citizenship The use of health technologies in the Danish health care system has for many years improved treatment, diagnostic methods, bodily interventions, surgical procedures, disease prevention and general health care (Hunniche & Olesen, 2014). With the current streams of digitisation strategies, the technology-mediated practices to some extent, however, change not only the role of the health professional, but also the role of the patient, as a range of demands and requirements towards the patient constitute the use of new health technologies. That is, new health technologies such as measurement of blood pressure, blood sugar, oxygen saturation, as well as home dialysis and home monitoring of disease, which traditionally were in the hands of the health professionals, are increasingly trusted to the patients (Hunniche & Olesen, 2014). As a result, collaboration and consultation from a distance are progressively substituting traditional care and treatment. Regarding this development,

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there is a general consensus that the provision of technology in public social services has impacts on individuals (Langstrup, Iversen, Vind, & Erstad, 2013; Lupton, 2013; Oudshoorn, 2011), and there are a number of positive outcomes ascribed to the use of health technology. For example, at a state level, the benefits of introducing more technology in the public sectors are of an economic nature, whereas for the individual in need of health services they may experience feelings of autonomy, empowerment and even emancipation from not having to attend hospitals for clinical encounters (Langstrup et al., 2013). In Denmark, the monitoring of pregnancies from a distance, which is part of the ePregnancy programme, with clinical home monitoring of pregnancy (with or without complications) were on trial in 2012 2014 in two Danish public hospitals (Danish Health Authority, 2015). The overall purpose in the ePregnancy programme was to strengthen patient care, reduce outpatient visits, support treatment cross-sectorial, actively include patients (here: pregnant women) in their own treatment, as well as assessing the labour saving costs involved in the telemedicine solutions. In this chapter, we address the new technologies within the ePregnancy programme and discuss it in regard to the concept of ‘ideal citizenship’. The ePregnancy programme thus provided new positions for the participating pregnant women. It is an example of how state-initiated decisions (what Rose and Novas (2005) refer to as a ‘biologisation of politics’) operate and strive for optimisation at both a structural and an individual level in order to achieve higher quality and higher potentials. From this perspective, citizens are adopting specific subject positions and are encouraged to perform to their fullest potential, and thereby are securing the formation of an ideal state. Rose and Novas argue that the developments within biomedicine and biotechnology have led to an increased role of the citizens’ biology in the definition of an ideal citizenship. With inspiration from Foucault’s (1971, 1994, 2008, 2015) concept of bio-power and bio-politics, contemporary scholars (Halse, 2009; Rich, 2012; Wright, 2009) have discussed the concept of bio-citizenship as a way of governing citizens through governing their bodily practices: ‘The first obligation of the bio-citizen to the common good is to take personal responsibility for the physical care of oneself’ (Halse, 2009, p. 51). In light of the newly implemented strategy for Digital Welfare 2013 2020, the notion of governing citizens and striving for optimal citizenships appeal to a specific kind of citizen engagement. These new kinds of citizen engagements are relevant to explore from a health promoting and health policy point of view, as it not only merges with a sprouting metric culture nationwide and internationally, but also

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represents a significant shift of paradigm in relation to the traditionally understood premises of Nordic welfare ideology. Kvist and Greve (2011) have pointed to how the extents of the current changes within Nordic countries have been underestimated, claiming that: ‘In short, what is missing for the Nordic countries are broad investigations of contemporary changes that may gradually diminish the core traditional understandings of the Nordic welfare model’ (2011, p. 147). The new strategy of digitising welfare through enhanced use of technology, and increased involvement and self-care, can be seen as recent welfare political and health political initiatives within the welfare state of Denmark, as well as representing a new ideal of citizenship. Normativity within welfare technologies as a solution to the sustainability of the Nordic welfare model is central in this chapter, as rationales of the welfare state and good citizenship are undergoing unarticulated changes, which, we argue, call for an investigation.

Research Methodology Although health is well defined by biomedical science, social scientists have further contributed with more holistic definitions of health, health policies and the organisation of health care. Concerned with the ambition of defining what health is outside the field of knowledge, Georges Canguilhem (1943) treats health as a crude concept. Going through philosophers’ treatment of health and the birth of medicine as an exact science, Canguilhem illustrates how health became an object of calculation, here referring to the practice of assessing health by different modes of measurement (Canguilhem, 2008 [2000]). In this light, health can be conceived as a capacity, the capacity to manage the norm that defines the momentary normal (Canguilhem, 2009 [1943]; Thualagant, 2016).

Digitisation as a Dispositive Understanding health as a crude concept has rendered the philosophical pursuit of conceptualising health outside a field of knowledge difficult. Health in many professional settings is often embedded in a web of knowledge extrapolating the many ideals concerning good or better health. Policy documents for example are based on a certain production of knowledge and expertise, and therefore in this chapter become relevant to analyse in order to understand health-related rationales behind

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policies and strategies. The production of knowledge is specifically in focus in the sociology of knowledge approach to discourse (SKAD) developed by the German scholar Reiner Keller (2011). Following the stream of social constructionism, SKAD perceives knowledge as something socially recognised, but also as having a constituting role in relation to a symbolic order of stocks of knowledge. This has brought to our attention the constituting role of discourse, which following the work of Foucault can be examined ‘[…] as performative statement practices which constitute reality orders and also produce power effects in a conflict-ridden network of social actors, institutional dispositifs, and knowledge systems’ (Keller, 2011). We thus see digitisation as a dispositive that is in infrastructure designed to ‘solve a problem’ (Keller, 2011, p. 49). This dispositive performs a discourse production through actors, things and practices that are relevant to analyse in order to perceive the knowledge it produces, as well as the practices it conditions and facilitates. Discourses on eGovernance we understand as attempts of institutionalising ‘[…] a binding context of meaning, values and actions/ agency within social collectives’ (Keller, 2011, p. 51). Social actors are perceived as either statement producers or addressees of the statement practice (Keller, 2011, p. 54). As Keller emphasises, social actors can be interpellated by discourses in several ways, ‘[…] for example, as problem initiators, holders of responsibility, objects of necessary interventions or potential consumers of specific services’ (Keller, 2011, p. 54). In line with a Foucauldian approach to discourse analysis, it becomes apparent how actors, in this chapter, the citizens of the NWS, adopt a specific subject position, and how the dispositive facilitates this subject position through an organisational infrastructure that provides concrete interventions such as courses, laws, codes of practice, or for instance, technologies of the self (Keller, 2011, p. 55). Based on the approach of SKAD, our analysis focuses on the following points: (1) statements regarding the problems which digitisation must solve, (2) presented arguments for implementing digitisation, (3) appointment of responsibility of actions and (4) descriptions of ideal practises and citizenship made available through the digitisation of welfare.

Methods The document analysis in this research study was generated by scrutinising the four most recent digital welfare policy documents presenting the new strategies and initiatives of digitisation (Table 3.1).

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Table 3.1. Document, Document Type and Year. Document Den digitale vej til fremtidens velfærd. Den fællesoffentlige digitaliseringsstrategi 2011 2015 Digital Velfærd en lettere hverdag 2013 2020 Regionernes fælles strategi for digitalisering af sundhedsvæsenet 2013 2019 Lokal og digital. Et sammenhængende Danmark. Fælleskommunal digitaliseringsstrategi 2016 2020

Document Type

Year

eGovernment strategy. (Danish Government, Danish Regions and Local Government Denmark) Digital strategy. (Danish Government, Local Government Denmark, Danish Regions) Strategy for digitisation of the public health sector (Danish Regions) Action plan. The Danish local governments’ joint public visions and strategic prioritisation of digitisation (Local Government Denmark)

2011

2013

2013

2016

Table 3.2. ePregnancy Documents, Document Type and Year. ePregnancy Document Klinisk Integreret Hjemmemonitoring (KIH). Slutrapportering til Fonden for Velfærdsteknologi KIH-projektet: Klinisk Integreret Hjemmemonitoring. Telemedicin til Test. 2012 2014

Document Type Final evaluation. (Lee et al.)

Year 2015

Public brochure, based on the 2015 final evaluation. (Danish Health Authority)

Further, as we specifically address ePregnancy to illustrate a concrete example of implementing digitisation in order to improve health care, we examine two central documents related to a clinical-integrated home monitoring (KIH) project for pregnant women (Table 3.2). All six documents have been selected because of their framing of a new digital development of governance, and because they represent the current rationales behind the modernisation of a public sector. We argue that

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these documents are analytically essential in terms of investigating normativity within contemporary changes and the impact of the digitisation of welfare, and the construction of new virtues of citizenship.

Analysis Digital Solutions to Welfare Problems Regarding the digitisation of welfare services in the public health sector, the documents identify welfare problems and solutions together. The digital solutions to existing welfare problems are at the foreground, and the problems relating to welfare are more indirectly implied in the actual solutions. For example, in terms of the public health sector, the Danish Government (2011) states that: ‘[…] digital solutions or new technology [can] deliver more modern and efficient services’ (2011, p. 3 own translation). The problems inferred indicated within this presented solution are that the current public sector is neither modern nor efficient enough. This ought to be seen in the light of another prevailing discourse, found across the four documents, pointing to a significant shift in public expectations: The citizens have growing expectations to the public service, which occurs simultaneously with the fact that in the forthcoming years we will have to manage with fewer hands [professionals, ed.]. (Danish Government, 2011, p. 3 own translation) The dominant point here is that this specific dilemma is presented by acknowledging the citizens’ growing expectations, and by recognising fewer professional resources as a fact. Subsequently, the digitisation of welfare services is presented as a solution to manage the inevitable outcome of these future predictions. Fewer (health) professionals attending to the citizens’ needs is the result of the previously mentioned demographic changes of a growing number of citizens who will be incapacitated for work. The digitisation of welfare services seeks to accede to this future circumstance by streamlining public welfare solutions across all sectors and achieve economies of scale (Danish Regions, 2013, p. 6). Furthermore, the objective is to reverse state budget deficits and free up 3 billion DKK (Danish Krone) p.a. (Danish Government, 2011, p. 3), as well as releasing 12 billion

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DKR for core welfare tasks (Danish Government, Danish Regions and Local Government Denmark, 2013, p. 12). The crucial factor to succeed with the new digital welfare strategy is to create an active role for citizens (Danish Regions, 2013, p. 9), and provide the opportunity for them to become more engaged in self-care (Danish Government, Danish Regions and Local Government Denmark, 2013, p. 4). Discourses of digitisation provide new active roles and new opportunities for citizens, and through the provision of such new positions for the citizens, they take on a double role; on the one hand representing a welfare burden, and on the other hand representing an important asset for the state. Arguments for Digitisation Engaging citizens in this extensive transformation of welfare services and partly digitally substituting health services traditionally performed by health professionals, the introduction of digitisation technologies must be presented with solid and convincing arguments. This, we argue, is predominantly done by ascribing to discourses of belief in the citizens’ preparedness, motivation and resources to engage in the inevitable changes of welfare embedded in the digitisation strategy. For example, the Danish Government, Danish Regions, and Local Government Denmark (2011) state that technology today has matured in a way that the largest and most treatment intense patient groups are well prepared for engaging in their own treatment. Furthermore, it is claimed that experience has demonstrated that patients with chronic diseases are particularly motivated to apply technology in their treatment (Danish Government, Danish Regions, and Local Government Denmark, 2011, p. 24). Such articulations point to how the digitisation of health services apply to the readiness among citizens to engage in the use of technology in treatment, and additionally serve to argue in favour of why now is a good time to implement the strategy of digitisation. Another fundamental argument to be found in the four documents leans on discourses of believing in the citizens’ capacities. This is done by pointing to how citizens more actively will be able to make use of existing resources (Danish Government, Danish Regions and Local Government Denmark, 2013, p. 4). Focusing on citizens’ resources as opposed to their insufficiencies or deficits in terms of conducting proper health behaviour, which is customary when wanting to change health behaviour (From, 2012), represents a substantial shift in discourse. Describing the Danish

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population as possessing a range of existing resources can be seen as an expression of confidence in the citizens’ capabilities to undergo the forthcoming changes. However, it can also be regarded as an indication of how the health care system hitherto has overlooked valuable, individual resources which the strategies will put in to active use. In light of the demographic changes of increased numbers of citizens with chronic diseases and low labour capacity, such articulations can be seen as a way of nudging the citizens into believing that despite their health status and situation they will be regarded as citizens (patients) with resources to be explored and applied for self-care purposes: the citizens can do it! Finally, a predominant construction of arguments permeating the four documents builds on discourses of higher quality embedded in the digitisation of welfare in and outside the public health system. As such, it is argued that a secure and stable IT-infrastructure will pave the way for both citizens’ and health professionals’ use of the digital solutions, assuring a more active and equal role for the patient. This will strengthen the encounter between health professional and patient (Local Government Denmark, 2016, p. 7). Outside the health system, digital welfare services will create an easier everyday life for citizens at lower costs, and will result in better quality of life, security and flexibility (Danish Government, Danish Regions and Local Government Denmark, 2013, p. 3). The overall founding arguments for introducing digitisation in welfare health services thus rely on a presumed willingness and inherent capability, designing a new role for the citizens to engage with a role containing a certain kind of citizen responsibility. The Appointment of Responsibility of Actions Regarding the Process of Digitisation Digitisation as a dispositive, that is the infrastructure aimed at making a more efficient and cohesive welfare by means of the use of technologies and the engagement of citizens, appoints different levels of responsibilities regarding the actions to be accomplished. The responsibilities towards ensuring a more efficient and cohesive welfare are propagated on a macro-, meso- and micro-level. At a state-level, the documents emphasise the international leading role regarding the development of digitisation. The documents assert that the state must be committed to a development of eGovernance in order to keep on track with its position on the international OECD list. Making all communication between the public sector services and

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citizens digital is for instance a legislative instrument that made digital self-service mandatory from 2015. By referring to a ‘digital highway’ (Danish Government, 2011, p. 36) in regard to the process of digitisation, this development is portrayed as a one-way road to proceed where welfare services can only be smarter. Moreover, the state’s commitment to digitisation involves a tight cooperation with other public institutions such as the regions and the local government, but also ‘partnerships’ between the state, local governments and medical practitioners. The Danish regions and local governments are expected to lead a strong focus on the use of welfare technologies due to the national Government’s more general political focus on growth and ambition to save 12 billion DKR for ‘core welfare’ by 2020. The public sector in general is said to be responsible for the citizens’ experience of a ‘coordinated welfare’. Welfare professionals are expected to work efficiently by using a digital platform for internal communication, which is made visible for the citizen and hereby to make the ‘right decisions’, in cooperation with other professions as well as with the citizens (Danish Government, 2011, p. 24). Here information plays an essential role. Not only information on citizens given digitally between welfare professions (Danish Government, 2013, p. 4) but also information addressed to specific groups in the population in order to help the citizens who are in need of help in using the digital solutions (Danish Government, 2013, p. 5) can be decisive. The involvement of citizens is based on an ambition to make these citizens more ‘self-sufficient’ and as such, effectuate ‘citizen-friendly’ services that motivate and support citizens (Local Government Denmark, 2016, p. 12). Local governments only have a shared responsibility for higher efficiency and better quality via digitisation. Other important actors are citizens and enterprises with whom partnerships could be built (Local Government Denmark, 2016, p. 3). As introduced earlier in this chapter, the first objective of digitisation is to involve citizens more actively in welfare. The responsibility of actions is therefore to a great extent put on the citizens. First and foremost, citizens must use the digital means of communication in relation to welfare services since it was made mandatory in 2015. Citizens must engage themselves in order to acquire an equal role in the given services and as such function as co-producers of welfare. In fact, citizens are portrayed as co-players in the making of welfare. It is for instance argued that using the digital services automatically releases resources for those in need of help (Local Government Denmark, 2016, p. 12). By using the digital services, citizens are believed to contribute to the progress of welfare and to participate actively in society and everyday life

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(Danish Government, 2013, p. 3). Responsibility is given to citizens with regard to minimising costs in the public sector by the use of selfservice but also by the undertaking of the role of an active citizen that participates in society, for instance, as active patients. Patients are appointed responsibility for giving the health professionals the best possibilities for effectuating their tasks by using the digital solutions (Danish Government, 2013, p. 10). It is argued that citizens’ access to health services and citizens’ knowledge of their own health is essential in order to have a healthy population (Danish Regions, 2013, p. 11). Citizens must be able to make choices about health care and treatment based on given knowledge. By simply pro-actively following the course of a given disease and using telemedicine or e-health solutions, the citizen is believed to be able to have an impact on their disease by modifying or adjusting their own behaviour (Danish Regions, 2013, p. 11). Citizens acting as active co-managers are believed to be contributing to digital welfare. This is for instance illustrated in the document on evaluating ePregnancy as an intervention. The evaluation accentuated the positive experiences of ‘personally experienced autonomy’ and ‘personal experienced action competencies’ among pregnant women who have followed the ePregnancy programme (Lee, Sandvei, Hosbond, Petersen, & Christiansen, 2015, p. 113). Health professionals also declared to have experienced pregnant women acting as co-players during the pregnancy (Lee et al., 2015, p. 114). One of the documents characterises the involvement of pregnant women and the disposition of relevant and easily accessible knowledge on pregnancy, birth and early parenthood as a ‘new form of maternity care’ (Lee et al., 2015, p. 105). As one of the documents stresses, it must be citizens and enterprises who at the end of the day ‘make use of’ the technological development for the benefit of all (Local Government Denmark, 2016, p. 3).

Descriptions of Ideal Practices and Citizenship Regarding the Digitisation of Welfare This final analytical section addresses the ideal practices in which health professionals and citizens should engage, as well as the nature of citizenship ascribed in a digital welfare society in the documents. Health professionals do have a responsibility towards improving welfare, but as illustrated earlier, the responsibility is a shared responsibility. Although the digitisation process overall is said to be changing the public sector into a better and more efficient way, the documents articulate demands

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of specific adaptation from professionals and citizens. Regarding the professionals, and in our case the health professionals, the documents emphasise that a readjustment of culture and an adaptation among health professionals is necessary (Danish Government, 2013, p. 3). The health professionals ought to adapt their practises in order to experience the many benefits of the digitisation strategy. According to the selected documents, citizens have expectations of an ‘open’ health care service which involves the patient and delivers better quality in health care (Danish Government, 2011, p. 24). An expected practice from a citizen is thus engagement. Moreover, most citizens are described as willing to control their own life (Local Government Denmark, 2016, p. 25). Another expected practice is therefore ‘codetermination’. Citizens are portrayed as individuals interested in ‘co-management’ and involvement regarding welfare services. Citizens are also depicted as ‘partners’ (Local Government Denmark, 2016, p. 3), ‘fellow players’ (Danish Government, 2013, p. 4), as well as ‘dialogue partners’ (Danish Regions, 2013, p. 11). Overall, these terms regarding citizens’ practices and citizenship construct a notion and a new conceptualisation of an active citizenship.

Discussion The Schism between Technologies as Empowering and Technocratic Governing The documents rely on the principle that ‘[…] digitisation should be for everyone also for individuals with special needs and challenges’ (Danish Government, 2016, p. 47). In fact, the documents consider citizens to be ‘digital Danes’ (Danish Government, 2016, p. 7). Despite the fact that citizens in Denmark are in general considered to be IT-mature, the documents do distinguish between those who are IT-strong and those who are IT-weak. This distinction could insinuate that all citizens are willing to adapt to these changes, taken the many benefits of the strategy into account. However, emphasising the mandatory aspect of this digitisation process, it is necessary to stress that this strategy must be considered a top-down initiated strategy. In other words, it is questionable to what extent the strategy of digitisation and the ambition to put the citizen at the centre of welfare services is democratic. In the documents, focus is put on the infrastructure and the problem of Wi-Fi not reaching all corners of the country. But what about the ‘virtual

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wireless’ citizens, both those who do not have the material, the economic and social resources but perhaps also, those who do not wish to adapt to these changes? How will the digital welfare strategy increase their quality of life, security and explore their health resources? Digitisation is portrayed as a ‘digital highway’, and the four strategies in the policy documents are presented as four waves. This digitisation process is presented as a modernisation that cannot be denied or refused. There seems to be no reasonable ways to say no to or even object to these digital solutions. The metaphors used in order to describe the digitisation process have also been commented on by a Danish anthropologist in her PhD who points at the idea of a technological determinism that cannot be refused (Jensen, 2015). Bekkers and Homburg describe the technological inevitability with regard to a better and new government in their critique on the myths of eGovernment. Analysing myths as hymns to progress, they explore policy documents on eGovernment programmes in Australia, Canada, the UK, Denmark and the Netherlands. In their exploration of documents, they notice a change in the way the citizen is portrayed in Denmark. The citizen is in the earliest documents from the late 1990s believed to be enlightened by the possibility of self-development, but merely reduced to a consumer of public services in the documents from the 2000s (Bekkers & Homburg, 2007, p. 379). The portrait of an ‘[…] intelligent citizen, who uses the possibilities of the Internet in optima forma to improve his or her position as a consumer of government services […]’ (Bekkers & Homburg, 2007, p. 379) is still recognisable in the documents we analysed. However, when further exploring the portrait of the citizen as intelligent in the documents from 2011 up to 2016, we identified a portrait of the compliant citizen leading us to the idea of citizens as co-managers or fellow-players in the production of welfare services. New Civic Virtues in the Digital Era The citizen in the current digital era is not solely a consumer of welfare services; extended responsibilities are given to citizens in order to keep on track with the prominent leading role of Denmark regarding the development of an eGovernment. As proclaimed in one of the documents ‘[…] we must capitalize on our leading position and take the next steps on the way to future welfare services’ (Danish Government, 2011, p. 3). The national responsibility towards a new and better eGovernment also relies on the good will and engagement of each

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citizen. We would thus argue that new civic virtues are demanded in DEG. These are virtues of engagement and co-management, acceptance and self-care. Opposing the strategy is opposing welfare optimisation through digitisation. Inspired by Langstrup et al. (2013) and their study on the virtual clinical encounter, we have been led to question if digitisation is in fact a construct of shared work. Health wise, what is at stake if co-managing cannot be regarded as an outcome of a performative health? If the capacity to manage the norm defines the momentary normal (Thualagant, 2016), where citizens are evaluated on their capacity to manage the requested digital dialogue with public services? Moreover, what are the health consequences if participation is reduced to self-management? As noted in one of the documents, public sector services will be improved by for instance: ‘[…] using digital tools to engage patients and their families in their treatment, resulting in greater compliancy’ (Danish Government, 2011, p. 6). According to the description of an NWS, the ‘neo’ elements of governance imply a ‘[…] shift from internal bureaucratic focus to external orientation towards meeting citizens’ needs and wishes; more consultation with citizens […]’ (Ejersbo & Greve, 2017, p. 269). But does this top-down strategy not appeal to compliance rather than democratic participation? Perhaps one could argue that digital governance has been reduced to a technological ambition, as opposed to a political project where focus is essentially set on the potentiality of healthy citizens. New Health: Digital Health Besides technologies relating to health and medicine, digital health encompasses technologies directed to individuals and on a population level, as well as fosters new modes of interactions, new practices and expectations for citizens (Lupton, 2014). Former research on the imperatives of health (Crawford, 1980; Lupton, 1995) has illustrated the governmental appeal to self-care in the quest for better and more health. What the strategies on digitisation in Denmark also emphasise is the capacity of co-management, that is the capacity to function in partnership with health professionals, and as such with the State. Digital health is not solely about the competence of managing self-care, it is also a solidary gesture with the State’s overall project of modernising the public services. Using digital tools releases economic resources for those who are in real need for accompaniment and facilitates the health professional’s tasks regarding core welfare. The term ‘core welfare’ is not

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explicated or defined in any of the documents analysed; however, based on the evaluation of telemedicine and e-health, health professionals stress the positive experience of having a more individual approach to the course of for example pregnancy (Danish Health Authority, 2015, p. 13). The attention drawn to time- and cost-reducing elements as well as the citizens’ and the health professions’ experiences of telemedicine and e-health in the evaluation makes us believe that core welfare could be about the potential for a more individual dialogue with citizens. The quantitative evaluation of the ePregnancy programme illustrates that health professionals experience that pregnant women more significantly act as fellow-players and express a shared responsibility (Lee et al., 2015, p. 75). Moreover, midwives comment that they experience that women often have more questions than usual because of the level of information the pregnant women acquire through the home monitoring (Lee et al., 2015, p. 115). Professionals point to a possible barrier to this, which consists of the new competencies demanded in specialist nursing management where good questioning techniques must be developed. The use of self-monitoring during pregnancy, we argue, not only entails new competencies for the patients but also for the health professionals.

Concluding Reflections This chapter contributes to general reflections concerning the emergent metric culture, and contributes with a specific insight into how metric cultures for all are nourished through governmental policy efforts. As illustrated in this work, the digitisation process is encouraging selfmeasurement as a common practice and produces ideals on new civic virtues regarding citizenship. Citizens in the digital era are requested to have self-control by means of self-measurement, and are expected to contribute to the modernisation of welfare by participating as comanagers in everyday use of technological services. This exploration seeks to move beyond a critique of the enforced normativity of citizenship by exploring the complexity of such a strategy. Based on our research, we argue that further studies on the consequences of digitisation in everyday life are needed. How can we for instance understand health promotion in an era of digital self-measurement? Is the act of leading citizens to do administration themselves a product of collaboration? Taking the mandatory aspect of digital services into account, to what extent is self-measurement leading to empowerment? Is empowerment

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in this case not merely reduced to an output instead of a means? How should we understand Nordic Welfare in the Danish context where elements of an NWS encourage co-production of welfare? These are the main concluding questions which we would accentuate for future research.

References Bekkers, V., & Homburg, V. (2007). The myths of e-government: Looking beyond the assumptions of a new and better government. The Information Society. An International Journal, 23(5), 373 382. doi:10.1080/01972240701572913 Bovbjerg, K. M., Wright, S., Krause-Jensen, J., Brorholt, G., & Moos, L. (2011). Nye ledelsesrationaler i offentlige organisationer [New management rationales in public workplaces]. In K. M. Bovbjerg (Ed.), Motivation og mismod: effektivisering og stress pa˚ offentlige arbejdspladser [Motivation and discouragement: Efficiency and stress in public workplaces] (Chapter 1, pp. 17 42). A˚rhus: Aarhus Universitetsforlag (Asterisk; No. 6). Busse, R., Blu¨mel, M., Scheller Kreinsen, D., & Zentner, A. (2010). Tackling chronic disease in Europe: Strategies, interventions and challenges. Copenhagen: World Health Organization on behalf of the European Observatory on Health Systems and Policies. Observatory studies series, no. 20. Canguilhem, G. (2008). Health: Crude concept and philosophical question. Public Culture, 20(3), 467 477 (Original work published 2000). Canguilhem, G. (2009). Le normal et le pathologique [The normal and the pathological]. Paris: Quadrige/PUF (Original work published 1943). Crawford, R. (1980). Healthism and the medicalization of everyday life. International Journal of Health Services, 10(3), 365 388. doi:10.2190/3H2H-3XJN3KAY-G9NY Danish Government, Danish Regions and Local Government Denmark. (2011). Den digitale vej til fremtidens velfærd. Den fællesoffentlige digitaliseringsstrategi 2011 2015 [The digital path to future welfare]. Retrieved from https://www.fm. dk/publikationer/2011/den-digitale-vej-til-fremtidens-velfaerd/ Danish Health Authority. (2015). KIH-projektet: Klinisk Integreret Hjemmemonitoring. Telemedicin til Test. 2012 2014 [Clinically integrated home monitoring. Testing telemedicine 2012 2014]. Sundhedsstyrelsen. Copenhagen. Danish Regions. (2013). Regionernes fælles strategi for digitalisering af sundhedsvæsenet 2013 2019 [The regions’ common strategy of digitisation of public health care 2013 2019]. Dunleavy, P., Margetts, H., Bastow, S., & Tinkler, J. (2006). New public management is dead Long live digital-era governance. Journal of Public Administration Research and Theory, 16, 467 494. doi:10.1093/jopart/mui057 Ejersbo, N., & Greve, C. (2017). Digital era governance reform and accountability. The case of Denmark. In T. Christensen & P. Lægreid (Eds.), The Routledge

The Digitisation of Welfare

55

handbook to accountability and welfare state reforms in Europe (Chapter 19, pp. 267 279). Abingdon: Routledge. Foucault, M. (1971). L’ordre du discours [The discourse on language]. Paris: Gallimard. Foucault, M. (1994). Histoire de la sexualite´ I. La volonte´ de savoir [The history of sexuality vol. 1. The will to knowledge]. Paris: Gallimard (Original work published 1976). Foucault, M. (2008). The birth of biopolitics. Lectures at the College de France 1978 1979. New York, NY: Palgrave Macmillan. Foucault, M. (2015). Maladie mentale et psychologie [Mental illness and psychology]. Presses Universitaires de France-PUF (Original work published 1954). From, D-M. (2012). De sunde overvægtige børn. Sundhedspædagogiske potentialer i arbejdet med overvægtige børn. [Healthy, overweight children. Health education potentials in work with obese children]. Roskilde: Roskilde University. From, D-M. (2015). With a little help from a… machine. Digital welfare technology and sustainable human welfare. The Journal of Transdisciplinary Environmental Studies, 14(2), 52 64. Greve, B. (2013). Er velfærdsstaten pa˚ vej ud? [Is the welfare state on its way out?] Retrieved from http://videnskab.dk/politologisk-arbog-2013/er-velfaerdsstatenpa-vej-ud. Accessed on November 3, 2017). Halse, C. (2009). Bio-citizen: Virtue discourses and the birth of the bio-citizen. In J. Wright & V. Harwood (Eds.), Biopolitics and the ‘obesity epidemic’. Governing bodies. New York, NY: Routledge. Hunniche, L., & Olesen, F. (2014). Teknologiforsta˚else og sundhedspraksis. [Technology understanding and health practices]. In L. Hunniche & F. Olesen (Eds.), Teknologi i sundhedspraksis [Technology in health practices]. Denmark: Munksgaard. Jensen, M. S. (2015). It-labyrinter, udestuer og dis/abilities: En undersøgelse af relationen mellem digitalisering og borgere med udgangspunkt i den offentlige sektors digitaliseringsstrategi. [IT-labyrinths, conservatories and dis/abilities A study of the relation between digitisation and citizens based on the public sector’s strategy for digitisation]. Copenhagen: Københavns Universitet, Det Humanistiske Fakultet [Copenhagen University, Faculty of Humanities]. Keller, R. (2011). The sociology of knowledge approach to discourse. Humanistic Studies, 34, 43 65. doi:10.1007/s10746-011-9175-z Kvist, J., & Greve, B. (2011). Has the Nordic welfare model been transformed? Social Policy & Administration, 45(2), 146 160. Langstrup, H., Iversen, L. B., Vind, S., & Erstad, T. L. (2013). The virtual clinical encounter: Emplacing patient 2.0 in emerging care infrastructures. Science and Technology Studies, 26(2), 44 60. Lee, A., Sandvei, M., Hosbond, T., Petersen, J., & Christiansen, K. R. (2015). Klinisk integreret hjemmemonitorering (KIH). Slutrapportering til fonden for velfærdsteknologi [Clinically integrated home monitoring]. Odense: Syddansk Universitet, Socialstyrelsen and Medcom. Local Government Denmark. (2016). Lokal og digital. Et sammenhængende Danmark. Fælleskommunal digitaliseringsstrategi 2016 2020 [Local and digital.

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A coherent Denmark. Common public strategy of digitisation]. KL. Retrieved from https://www.kl.dk/ImageVaultFiles/id_73854/cf_202/Lokal_og_digital_-_ et_sammenh-ngende_Danmark.PDF Lupton, D. (1995). The imperative of health. Public health and the regulated body. London: Sage. Lupton, D. (2013). The digitally engaged patient: Self-monitoring and self-care in the digital health era. Social Theory and Health, 11(3), 256 270. doi:10.1057/ sth.2013.10 Lupton, D. (2014). Critical perspectives on digital health technologies. Sociology Compass, 8(12), 1344 1359. doi:10.1111/soc4.12226 Nordic Council of Ministers, Copenhagen. (2007). What lies ahead for the Nordic model? A discussion paper on the future of the Nordic welfare model in a global competition economy. Copenhagen. Oudshoorn, N. (2011). Telecare technology and the transformation of healthcare. Basingstoke: Palgrave Macmillan. Pollitt, C., & Bouckaert, G. (2011). Public management reform : A comparative analysis. New public management, governance, and the neo-weberian state. Oxford: Oxford University Press. Rich, E. (2012). Beyond school boundaries: New health imperatives, families and schools. Discourse: Studies in the Cultural Politics of Education, 33(5), 635 654. Rose, N., & Novas, C. (2005). Biological citizenship. In A. Ong & S. Collier (Eds.), Global assemblages: Technology, politics, and ethics as anthropological problems. Malden, MA: Blackwell. The Danish Agency for Digitisation. (2013). Digital velfærd. En lettere hverdag. Fællesoffentlig strategi for digital velfærd 2013 2020 [Digital welfare. Empowerment, flexibility and efficiency]. København, Regeringen, KL, Danske Regioner [The Danish Government, Local Government Denmark, Danish Regions]. Retrieved from http://regioner.dk/media/3263/rsi-regionernes-faellesstrategi-for-digitalisering-af-sundhedsvaesenet-2013-2019.pdf Thualagant, N. (2016). Body management and the quest for a performative health. Social Theory and Health, 14(2), 189 206. doi:10.1057/sth.2015.28 WHO. (2009). Global health risks: Mortality, burden of disease attributable to selected major risks. Geneva: WHO Press. Wright, J. (2009). Biopower, biopedagogies and the obesity epidemic. In J. Wright & V. Harwood (Eds.), Biopolitics and the ‘Obesity Epidemic’: Governing bodies (pp. 1 14). New York, NY: Routledge.

Chapter 4

‘A Much Better Person’: The Agential Capacities of Self-tracking Practices Deborah Lupton and Gavin J. D. Smith

Abstract In this chapter, we draw on our study involving interviews with Australians who identify as current self-trackers to discuss why and how they monitor themselves. Our approach for analysing selftracking practices is based on a sociomaterial perspective, viewing enactments of voluntary self-tracking as shifting heterogeneous assemblages, bringing together diverse actors who are both human and non-human. We use vignettes to illustrate the ways in which our participants enacted self-tracking and to identify some of the diverse meanings and motivations that mediate decisions to selftrack and resultant uses of the information thus generated. We found that a varied range of self-tracking practices were taken up by our interviewees, including not only digital devices and methods, but also recording their details using pen-and-paper, or simply maintaining mental awareness and using memory. We identified several agential capacities in our participants’ accounts of why and how they monitor themselves. These capacities are interrelated, but can be loosely grouped under the headings of ‘self-improvement’, ‘exerting control’ and ‘identifying patterns and achieving goals’. They are motivators and facilitators of monitoring practices. The broader sociocultural contexts in which monitoring of the body/self is undertaken were also revealed in the participants’ accounts. These include ideas about the moral virtues of self-responsibility and the individual management of life circumstances to avoid chaos

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and risk, and the notion that monitoring practices can successfully achieve these virtues. Keywords: Self-tracking; sociomaterialism; agential capacities; moral virtues; embodiment; selfhood

Introduction An increasing number of elements of people’s everyday lives have become quantified via their encounters and interactions with digital technologies. Many devices and software are now available for people to engage in detailed monitoring of their bodies and routines. In response to high levels of media attention to the phenomenon of ‘the quantified self’ (Lupton, 2013; Ruckenstein & Pantzar, 2017) and the expansion of the promotion of self-tracking in social domains such as medicine and public health, the workplace, the insurance industry and schools (Lupton, 2016a), a growing literature exploring the sociocultural dimensions of self-tracking has emerged. Contributors to this scholarship (e.g. Crawford, Lingel, & Karppi, 2015; Fox, 2017; Lupton, 2013, 2016b, 2016c; Moore & Robinson, 2015; Ruckenstein & Pantzar, 2017) have identified some central themes and discourses which provide the meaning and context for these practices. They have demonstrated that the ideals of entrepreneurial selfhood, where states of empowerment are ascribed and derived from independently managing and optimising one’s health, well-being and physical fitness, emotional equilibrium, social relationships, financial affairs and work productivity, are central to concepts and practices of contemporary self. Indeed, they can be used as performances or (following Foucault) technologies of selfhood. Self-tracking repertoires can also be broadly embedded within what Beck, Giddens, and Lash (1994) call the age of reflexive modernisation, a context in which subjects become increasingly individualised and introspective, assuming responsibility for the project of crafting their own self-identities from a marketplace of lifestyle commodities. Aside from intensifying cultures of individualism and consumption, reflexive modernisation is characterised by a proliferation of risks (which the sovereign state is unable to eradicate) and the consequent requirement for citizens to manage their own risk via the production and absorption of knowledge, the uptake and use of technologies and the exercise of prudence. The growing representation of metricisation and datafication

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as superior, and more trustworthy, frames of analysis/forms of knowledge (Beer, 2016; Shore & Wright, 2015) are also major contributors to the institutionalisation of self-tracking cultures. Self-tracking apps and wearables have capitalised on and contributed to these kinds of discourses and assumptions, seeking to provide users with a capacity to identify and contain risk and engender better self-knowledge through detailed monitoring and measurement of their lives (Lupton, 2016b; Smith, 2016; Smith & Vonthethoff, 2017). Several recent qualitative research studies have focused on people who have voluntarily taken up self-tracking. Those who identify themselves as part of the Quantified Self (QS) movement have been the subject of numerous studies (Barta & Neff, 2016; Nafus & Sherman, 2014; Sharon, 2017; Sharon & Zandbergen, 2017; Smith & Vonthethoff, 2017). This is partly because these people are viewed as occupying the most public and arguably ‘extreme’ end of the self-tracking spectrum, and also because they are comparatively easy to locate via the official QS website and the regular meetups and conferences this organisation hosts. QS-affiliated self-trackers tend to be very interested in, and passionate about, ‘life-hacking’ and ‘life-logging’ and often use advanced digital techniques and customised devices and software to monitor and analyse themselves. Many enjoy engaging in public ‘show-and-tell’ presentations at QS events, or on the QS website, and positioning themselves as pioneers or active members of the QS community. While QS enthusiasts have received a high level of media and research attention, they represent only a very small, albeit exceptional, subset of self-trackers. Another set of studies have researched the more mundane aspects of self-tracking cultures and practices by those who do not tend to identify with the QS community. Some researchers have addressed how people with chronic illnesses and other health problems engage in self-tracking largely at the behest of their doctors or as part of research studies (Fiore-Gartland & Neff, 2015; Lynch & Cohn, 2016; Piras & Miele, 2017; Ruckenstein, 2015). Other studies have included people who have taken up using exercise, weight-loss and other healthpromoting apps and wearables on their own accord (Depper & Howe, 2017; Didziokaite, ˇ Saukko, & Greiffenhagen, 2018; Fors & Pink, 2017; Fotopoulou & O’Riordan, 2017; Niva, 2017; Rooksby, Rost, Morrison, & Chalmers, 2014). The practices of people who use fitness tracking apps and platforms designed to create social networks and competitive data comparisons have also been investigated (Lupton, Pink, LaBond, & Sumartojo, 2018; Smith & Treem, 2017; Sumartojo, Pink, Lupton, & LaBond, 2016). This research has identified several

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dimensions of everyday self-tracking, including the benefits people gain from learning more about themselves and meeting objectives such as becoming fitter, losing weight, managing a chronic illness or improving their health. However, it has also uncovered people’s generalised frustrations or disappointments if the technologies they use do not work effectively, or their data do not offer much of value to them. Furthermore, regular self-trackers who use digital methods are in the minority. Global market research has shown that most people do not engage in this mode of monitoring (Accenture Consulting, 2016; PwC, 2016). Research has also shown that it is also common for people to try using digital technologies such as apps or wearables to monitor themselves for a time, but to then relinquish their use (Krebs & Duncan, 2015; Ledger & McCaffrey, 2014). There remains much scope for further investigation, including uncovering the rationales and practices of people who engage in self-tracking for a range of reasons and using diverse (and often multiple) methods to do so. In this chapter, we draw on our study involving Australian self-trackers that sought to address these questions. We discuss our participants’ experiences as they were recounted in semi-structured interviews. We use vignettes to illustrate the ways in which our participants enacted self-tracking and to identify some of the diverse meanings and motivations that mediate decisions to self-track and resultant uses of the information thus generated. We were interested in focusing our study on people who self-identified as self-trackers in any context, used any method or a combination of methods and were continuing to monitor themselves. Our approach for analysing self-tracking practices is based on a sociomaterial perspective, viewing enactments of voluntary self-tracking as shifting heterogeneous assemblages, bringing together diverse actors who are both human and non-human (Fox, 2017; Fox & Alldred, 2015; Lupton, 2016b). In the case of self-tracking, these assemblages include humans, other humans with whom they engage, the technologies they take up to monitor themselves (which may be digital or non-digital), the information that is generated by these technologies, the spaces and places in which they enact their practices and the broader discourses and ideas that animate and motivate their practices. This approach seeks to avoid a dualistic perspective in which humans are positioned on one side and technologies on the other. Instead, it views humans and technologies as working together to productively generate certain types of agential capacities (Bennett, 2004). In taking up and developing this approach, we acknowledge that people actively enact the possibilities of

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self-tracking as well as respond to the limitations of the technologies they have to hand to engage in these practices. Agency is distributed relationally between the humans and non-humans involved in the processes, and different agential capacities are generated via their interactions. This concept of agency draws on Barad’s idea that: ‘Agency is not an attribute but the ongoing reconfigurings of the world’ (Barad, 2003, p. 818). Our analysis of the participants’ accounts is focused on identifying the agential capacities that enactments of self-tracking generate across a range of contexts and technologies.

Details of Our Study Forty participants from around Australia who engaged in some form of self-tracking completed a qualitative semi-structured telephone interview. The study was approved by the University of Canberra’s human ethics committee. The participants were drawn from people who had volunteered to join the panels of a major Australian market research company. Panel members were recruited by the company, who sent out an invitation to participants aged 18 years and over with the screening question: Do you self-track any aspect of your life? We kept this question deliberately general, as we wanted to see how people interpreted the notion of self-tracking and applied it to their lives. To ensure an even gender and age spread, and to give the sample better diversity, sub-quotas were set of 20 men and 20 women, 20 participants aged 40 or under and 20 aged over 40 (the oldest participant was aged 75). The vast majority of participants who agreed to participate resided in the most populous states of Victoria (45%) and New South Wales (48%), and in the capital cities of those states. Of the participants, 80% came from either Sydney or Melbourne, with the others hailing from Adelaide, Brisbane or regional cities in New South Wales or Victoria. More than half held a university undergraduate or postgraduate degree (53%). As these participants were already volunteers from pre-established panels initiated by the market research company, we make no claims as to their representativeness in terms of the Australian population or the generalisability of our findings. The interview schedule included questions about what people were self-tracking, the methods they were using, why and when they took up self-tracking, what benefits they gained from it, any frustrations or disappointments they had experienced, how accurate they thought the

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information they gathered was, whether they shared it with anyone else and whether they had any concerns about the privacy or security of the personal data generated. The interviews took an average of 30 minutes to complete. Participants were provided with a gift card worth AU$50 as a token of appreciation for completing the interview. They were all given pseudonyms to protect their anonymity. The interviews were transcribed and analysed using a social theorydriven thematic analysis. Based on our knowledge of the critical literature on self-tracking, we sought to locate participants’ narratives in the broader contexts of the social meanings that are attributed to the reflexive monitoring of selfhood in Australia and in other wealthy nations. Both authors independently read and re-read the transcripts, noting emergent themes and discourses (recurring ways of describing phenomena using certain words or phrases) that were shared across the participants’ responses when they described their rationales and practices or that were idiosyncratic to particular respondents. We then discussed our emergent analyses with each other and each contributed to the final writing of our analyses. We were sensitised to identifying these themes by our theoretical approach, outlined earlier, which focuses attention on the ways in which the participants performed and articulated notions of embodiment and selfhood in their accounts. We looked for the ways in which our participants justified their self-tracking practices and habits in terms of how these repertoires of personal data capture provided value and simultaneously inspired and allayed anxieties about the body/self. We were especially attentive to the participants’ accounts of what purposes their self-tracking practices serve in the context of their biographies and lifeworlds and the meanings they attributed to their practices. Taken together, these inquiries assisted us to identify the agential capacities generated as part of our participants’ self-tracking practices.

Overall Self-tracking Practices We began the interview with some closed-ended questions to establish what elements of their bodies and lives the participants were tracking and how they did so. Most said that they were monitoring bodily functions or activities such as their diet or calorie intake, body weight, physical activity and sleep, but many also tracked such features of their lives as their finances, work productivity, home energy use and social relationships. It was common for people to be monitoring several of these

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details simultaneously, using different methods and with contrasting intensities of effort. Several people (more than a third of the group) were managing chronic health conditions, and many of their selftracking efforts were directed at monitoring bodily functions and indicators related to their condition, such as blood glucose levels and blood pressure using digital medical devices. While most people reported employing digital technologies to aid their self-monitoring, more than half also used pen-and-paper records to document details, while twofifths said that they remembered at least some of their information without using any extra/technical form of recording other than the archive of memory. Diane, a 47-year-old manager, is one example. She monitors her food and alcohol intake on a daily basis, her heart rate and exercise activities each time she visits the gym and her finances weekly to fortnightly. Diane uses several different methods and devices: For food intake, the Weight Watchers app. At the gym it’s in the gym equipment, but I also keep track of the exercises that I do, to keep up on it. So, I keep a spreadsheet. Alcohol is just in my mind, keeping track of it that way. Sometimes I use Notes [app] on my phone. The length of time Dianne has been monitoring these aspects also differs. She said that she began by keeping track of her expenditure about eight years ago, and realised how beneficial this was. She has been maintaining her awareness of her alcohol intake for most of her adult life, but began tracking her weight only recently (in the past 10 months) and her gym activities for only three weeks. For most of the participants, self-tracking practices had become incorporated into their everyday routines, although they sometimes involved juggling quite complicated temporal frameworks and approaches, as well as dealing with the complexities of tracking and analysing input on several media. At 75, Patricia, a retired librarian, was the oldest participant in our study. She records elements of her life such as her finances and expenditure, her weight, her shopping expenditure and details of her visits to doctors. Patricia uses the Google Calendar to keep track of her appointments and meetings, including details of their content and outcomes, and uses a paper diary for recording other details. Monitoring aspects of her life, she said, has been a practice she has engaged in since she was 18.

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Rob, 52 and self-employed, explained that he had been self-tracking for at least 10 years, and he described gradually developing routines for tracking, learning from trial and error, so that now, ‘It is part of myself’. He recounted how he monitors many experiences daily (food consumption, exercise, sleep, nutrition, alcohol and weight), but others on a weekly (expenditure and work productivity) and monthly (energy use) basis. Rob uses a range of devices and software for these purposes: Fitbit for sleeping and for exercise. Internet monitors expenses and banking and putting it into Excel and working on a graph and things like that. I do lists for work and productivity. Most of them I do electronically. Very rarely do I do a manual thing. I use my mobile every day with all different apps. As these examples demonstrate, it was common for people to use a combination of digital and non-digital methods for the purposes of event capture. Many participants described their self-tracking practices in accord with a metricised discourse, an approach involving regularly noting details of their bodies and lives in quantified formats that render bodily flows into numbers for arithmetical and moral analysis. This was particularly the case for health and fitness and financial monitoring. Other elements were tracked using an ‘awareness’ approach, which involved individuals taking mental notes of how they were feeling, what their thoughts were or how stressed they felt. This type of self-tracking was rarely quantified, but instead required people to make assessments of their well-being, mood or health by using emotional and sensory cues, connecting these sentiments to the wider environment and context in which they were situated and the stimuli and events they were experiencing.

Agential Capacities We identified several agential capacities in our participants’ accounts of why and how they monitor themselves. These capacities are interrelated, but can be loosely grouped under the headings of ‘self-improvement’, ‘exerting control’ and ‘identifying patterns and achieving goals’.

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Self-improvement The use of self-tracking technologies and systems to engage in selfimprovement featured prominently in people’s accounts. This was not simply because self-tracking could help improve aspects of their lives, such as their health, well-being, work productivity or financial situation, but also because their monitoring practices were represented as enhancing their capacity to achieve their particularised version of the ideal self. For many people, participating in self-tracking meant that they could engage in care of the self; but also, more performatively, they could be seen to be caring for the self, using the most effective and advanced methods and practices. Overall, said Michael, a 35-year-old IT consultant: ‘I think self-tracking has helped me to be a much better person’. Greg, 57 and a workplace trainer, similarly observed that his self-tracking practices ‘make me feel as if I’m doing something positive. I’m making a positive contribution to my wellbeing’. Rob noted that in his experience others tend to look favourably on those who manage their lives by self-tracking: ‘they think this person can do things better’. Several people made a direct link between tracking for health and tracking for productivity, an approach which supports the ideal of the ‘healthy productive worker’ (Lupton, 2016b), or the entrepreneurial and responsibilised citizen who is working to manage and improve their health, in turn contributing to their achievements and capacities as a worker. Amy, a 29-year-old clerical worker, described these intersections in her interview. She had become frustrated about not being able to maintain her weight-loss efforts, and began self-tracking on the advice of her GP, who suggested that it could be a way of ‘working out what was going on’. She uses a diary and apps to track her nutrition, body weight, exercise and work productivity, and outlined the intersections she perceived between being healthy and being a good worker: Obviously, like if my health is good, then I can concentrate more on work and so I’m keeping in mind that the thing is to be healthy so that I will give more and more, like I will focus on my work. And if I’m not healthy then I’m unable to do that. For some people, the desire to take charge of their finances was also part of their view of self-tracking as facilitating productivity. Glenda, a 57-year-old carer, described how she had first taken up selftracking after she and her husband had purchased investment properties

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about 15 years ago. She tracks her financial affairs every day, using an Excel spreadsheet to note down her expenses. Glenda noted that until she took up close monitoring of her expenses, she and her husband found themselves in financial difficulties. Taking up monitoring helped with this problem by rendering their finances more visible, and thus more controllable: fostering a more pre-emptive approach to managing the complexities and uncertainties of the housing and financial markets. Many people noted that it was very important to them that they ‘take responsibility’ for managing their bodies and lives. For example, Paul mentioned that he has a young family, and an important part of his motivation to manage his health condition is to ‘do the best’ for himself and his family. Michael said he had begun monitoring aspects of his body and life about nine years ago. Like Paul, one important reason was wanting to achieve his ideal of responsible fatherhood. He took up self-tracking after becoming a father for the first time, and developing a chronic pain condition. Michael observed that his tracking has helped him become more efficient in his use of time, so he has more dedicated time to spend with his children. He very overtly expressed his ideals of using self-tracking practices in instrumental ways as technologies of responsibilised selfhood, using the word ‘responsible’ several times in emphasising this point: I’m responsible for myself. I can’t ask anyone else to look after me. To be a responsible husband, father and son, I need to track things, whether it be health or finances, I have to do that to have a balanced life and think beyond what is now. I need to think of the future and retirement. To be responsible I think self-tracking is very important. Exerting Control At the age of 23, Chloe, a recruiter, is already closely monitoring her expenses. She said that the PocketBook app she uses to track her spending helps her to ‘sort out’ the financial aspects of her life, and mitigates the risk of her inadvertently and unconsciously overspending. For Chloe, self-tracking is a way of ‘keeping your life in order’, with the devices making it much easier to monitor herself in semi-automated ways. As was evident in Chloe’s account, the biographical elements of people starting to self-track often centred around key aspects of their lives over which they feel they need to exert control.

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Self-tracking for some people meant keeping a close eye on their calendar appointments and ensuring that they met their deadlines and obligations and attended meetings on time, had their car serviced, attended medical appointments or paid bills by the due date. These people frequently described self-tracking as part of ‘being organised’, again illuminating the importance of a reflexive and responsibilised self-equipped and responsive to deal with the uncertainties, complexities and contingencies generated by everyday life and relations. As Bella, a 20-year-old university student put it when discussing using a calendar to track her appointments, university deadlines and timetabling: I need to make sure that I don’t forget about it, so I need to keep track of it. And I like doing it visually so that I know I can see my week in front of me. I like that, that’s a benefit of actually being able to visually see what my week is going to look like. And then I guess the benefit of it is I feel more organised in myself. I feel more prepared for things when I know what’s happening, and I feel better and more on top of things and organised when I have it all down in front of me. Maria, 40 years old, who describes her occupation as ‘home duties’, recounted several different life experiences that had contributed to the uptake of her current self-tracking practices. She first described how, as a teenager, she had begun helping her financially struggling mother with monitoring her expenses. She said she had developed valuable financialmonitoring skills at that time that she has continued to bear: ‘Well, it’s mother nature to me, to keep an eye on finances, track my finances and stuff, ‘cause I’m good at doing that’. Second, Maria talked about wanting to lose a great deal of weight, and how closely monitoring her weight and diet was an important part of trying to achieve that goal. Finally, she mentioned that her daughter has severe asthma, and Maria has had to learn to keep a close eye on her daughter’s health and medication as part of caring for her. This continual vigilance meant that: ‘It’s just something that you just know in your head you have to do it’. Maria said she is trying to teach her own two children to take a similar approach to their lives, ‘so they can be very independent people’. Rob has learnt from self-tracking that just as share values fluctuate, so do aspects such as body weight. He has successfully lost a significant amount of weight using self-tracking, and through monitoring has noticed how his weight loss relates to other aspects of his life, such as

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his finances. Rob interestingly uses self-tracking knowledge to make connections between weight and debt. Consistency in measuring and recording is key to gaining value from his data. It is a way, he notes, of taking control over some of the elements of his complicated life: I definitely feel like I’m in much more control compared to others. I can keep track where things are likely to go out or are out already and make changes very quickly. It takes a lot to manage the different fields of my life. These accounts of the value of self-tracking underline the individualised and responsibilised ideal of selfhood, in which keeping wellorganised, productive, healthy and afloat financially is a matter of personal management. Identifying Patterns and Achieving Goals It was common for our participants to comment that they derived satisfaction from setting goals for themselves and striving to achieve them via the medium of datafied statistics. These aspects, for Michael, were central to his practices and motivations: Basically, to keep a target for yourself for something. And you have to decide your action plan, it is very important to track. I kept a target for weight reduction and I started seeing that I could drop 300 grams, then 500 grams, then kilos. Suddenly you can chart, and if you start reflecting that in on your other monitoring things, including diet and exercise, when I try to change something then monitoring it is a good thing. I love celebrating the things and seeing the target. That’s the reason I like monitoring. Paul also noted that he has goals that he has set himself, and selftracking helps him observe how to achieve these goals: and whether or not he needs to innovate or intensify efforts. He has complex demands to deal with in managing his condition, and self-tracking makes me feel a lot better that you’re heading down the right path and you’ve got the right sort of figures, and meeting the goals that you’re gaining for. Better and satisfied in myself.

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Several people talked about the importance of reflecting on the information they collected over time, and trying to discern patterns. For these participants, one of the values of sustained self-tracking was being able to take a long-term perspective and having a record (whether digital or handwritten) available to help them engage in this reflection. For some of our participants, self-tracking involved regular checks on the stock market or their bank accounts and noting details of their expenditure or home energy use. This approach to self-tracking was about managing finances by paying close attention to circulations of money and other resources. For others who were attempting to discern how various health-related practices contributed to their well-being, identifying patterns could be a significant contributor to improving their health. Self-tracking, therefore, can work both as a reflective practice and a planning tool for future action. Glenda described how she devoted considerable effort to discerning patterns in her social relationships and emotional well-being via her monitoring repertoires: In my relationships through the tracking I became aware of some types of relationships I was entering into that were not very positive. And I began to see patterns in behaviour from other people and myself, and that helped me to step out of it. It all comes from a course that I studied that was all about self-awareness. Rob also tried to trace the connections between some of his tracked data and the situated bodily and affective states he was experiencing. He grouped several threads together and looked to see relationships: for example, the data he collected on his body weight, food consumption, exercise, sleep and blood pressure, and between his home energy use, expenses and financial planning. Rob is self-employed and plays the share market. He describes noting changes in his tracked data as: like being in the share market, you can look at the figures and periods of where you’re going up and down […] Sometimes I’m thinking that I’ve made a loss today, but then looking at the bigger picture, I see ‘Oh no, look, I haven’t made many losses!’ And you can afford to have that loss today, so psychologically it gives me a boost. That helps definitely a lot. It’s extremely important about the investment of time, being consistent in measuring the

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Rob built on this argument by observing that one has to take a long and wide view when monitoring aspects of one’s life. He is able to observe changes over time and this helps him to remember what he was doing at different stages in a specific time period and to reflect on and learn from how and why things changed. He said that he finds that setting and working towards personal targets is highly motivating and pleasurable. The practices of recording elements of one’s life can also be enjoyed for their own sake, whether or not the details are used to improve aspects that are framed as problems. This was evident in the case of Patricia, for example. She commented that she is the type of person who enjoys recording details and reviewing them. She has kept all the diaries she has filled with details about her life. Before she retired, she worked as a librarian, and this occupation both reflects and augmented her punctilious nature and desire for making and keeping documentation: I’m interested in recording facts of what’s happening. And my life is a reflection of others’ lives as well. I also like statistics. I like to look for patterns. And if you don’t keep records it all just goes into a blank after days or years, you know. But I like to be able to go back and look at what happened […] I just find [it] interesting. I know others don’t, but I do.

Discussion Our study was able to achieve a broader perspective on self-tracking than is often undertaken in current research. It was evident from their descriptions of their practices that our participants, who all identified as people who actively self-track, interpreted this term as meaning not only quantifying aspects of their lives using digital technologies, but also using pen-and-paper to record such details as their thoughts, appointments, engagements with doctors, social interactions and the outcomes of meetings, as well as metrics such as their body weight, calorie intake, heart rate or financial expenditure over time. Several

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people described practicing a self-monitoring approach that involved maintaining mental awareness and remembering details about themselves. The complexity of people’s monitoring practices their use of several different techniques and media to track different aspects was also highlighted in their accounts. As we have shown, self-tracking assemblages generate multiple agential capacities, each of which encompasses the potential to affect and be affected. Self-tracking is a form of making and doing (Ingold, 2013), a creative and performative act of selfhood that involves continual improvisations as people experiment with different methods and objects to record, but also manipulate, their bodies and lives. Our interviews were able to uncover the different approaches and devices, both digital and non-digital, that self-trackers may adopt and the rationales for taking up and desires for continuing their monitoring practices. The capacities that self-tracking assemblages generate are motivators and facilitators of monitoring practices. Self-tracking offered value to our participants at both the practical level (improving aspects of their lives, discerning patterns, meeting goals, being more productive, recording details for further reflection and life management skills) and the existential level of selfhood and identity (performing idealised models of self-responsibility and feeling reassured about a world defined by uncertainty, complexity, intensity and liquidity). In other words, the narrative and experience of exercising control through documentation and reflexive awareness (of being able to gaze backwards and forwards) is critical to understanding everyday projects of self-tracking. Our participants’ accounts emphasise the biographical, contextual and situated nature of self-tracking, and its embedding into their lifeworlds as a practice of introspection, reflection, comparison and preemption. With the exception of some of the participants who were living with chronic illness, nearly all had taken up self-tracking voluntarily, rather than having been overtly pushed into doing it by others. They had independently identified a compelling reason for monitoring aspects of their bodies or lives and found methods that were presently suited to them and had become habits of everyday practice. The people in our study had invested mental, emotional and physical labour in identifying problems they wanted to solve or chaotic elements of their lives they wanted to bring under control, and then designing self-tracking solutions in a way that served both practical and existential ends. In some cases, having experienced the value of monitoring one aspect of their lives, people proceeded to identify other details they wanted to track.

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The broader sociocultural contexts in which monitoring of the body/self is undertaken were also revealed in the participants’ accounts. As we have shown, the ways in which our participants described their self-tracking motivations and practices are strongly underpinned by concepts of morality, and are related to contemporary articulations of ideal selfhood and embodiment in western societies. Overwhelmingly, self-tracking was positioned as an autonomous, rational calculative practice, involving individual actors working to problematise, refine and improve their lives. In most people’s accounts, self-tracking was strongly tied to performing as a responsible, entrepreneurial citizen, intent on taking control of her or his life and seeking to become a ‘much better person’. All the participants perceived these technologies of selfhood as morally virtuous and individually advantageous, regardless of their age, gender or education level, and they were closely associated with the rationales the participants expressed for why they had begun and continued their self-tracking practices. They were articulating and reifying in their everyday routines and performances of identity the dominant notions about the value and meaning of self-tracking that, as we noted in the Introduction, are routinely represented in popular forums and medical and public health. They also attested an understanding of the embodied self and its internal mechanisms of intuition and restraint as inherently flawed, unruly and untrustworthy, in need of technical augmentation and surveillance. Our study was able to demonstrate the agential capacities created by self-tracking assemblages of humans technologies data. It is important to acknowledge that the participants were those for whom these capacities had value, contributing to their needs to manage and control their lives and bodies and stage desirable identities. For all our participants, to a greater or lesser degree, self-tracking practices had, for all intents and purposes, become incorporated into routinised technologies of selfhood. They engaged in monitoring practices to acquire knowledge about themselves and to use this knowledge to deal with problems they saw as existing and emerging in their lives: to become more aware of their daily habits, health, relationships, work productivity or finances, improve aspects of their lives or manage health conditions. Further research needs to be directed at the socioeconomic factors that may productively generate, or instead close off, the agential capacities of self-tracking, such as people’s contrasting levels of access to the appropriate resources. The rationales and imperatives of self-tracking are spreading into many social domains in which people may have less choice over whether or not to take them up. For many people, engaging

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in self-tracking may not be beneficial or valuable; it may in fact adversely impact on their lives, specifically if those doing the watching are agents of law enforcement, employers or insurance actuaries. The ways in which techniques of monitoring the self may exacerbate existing socioeconomic disadvantage and how people deal with situations in which they are nudged or coerced into self-tracking remain areas to be more fully investigated both empirically and critically.

References Accenture Consulting. (2016). Accenture 2016 consumer survey on patient engagement. Accenture Consulting. Retrieved from https://www.accenture.com/ t20160629T045304Z__w__/us-en/_acnmedia/PDF-15/Accenture-Patients-WantA-Heavy-Dose-of-Digital-Research-Global-Report.pdf Barad, K. (2003). Posthumanist performativity: Toward an understanding of how matter comes to matter. Signs, 28(3), 801 831. Barta, K., & Neff, G. (2016). Technologies for sharing: Lessons from Quantified Self about the political economy of platforms. Information, Communication & Society, 19(4), 518 531. Beck, U., Giddens, A., & Lash, S. (1994). Reflexive modernization: Politics, tradition and aesthetics in the modern social order. Cambridge: Polity Press. Beer, D. (2016). Metric power. Houndmills: Palgrave Macmillan. Bennett, J. (2004). The force of things: Steps toward an ecology of matter. Political Theory, 32(3), 347 372. Crawford, K., Lingel, J., & Karppi, T. (2015). Our metrics, ourselves: A hundred years of self-tracking from the weight scale to the wrist wearable device. European Journal of Cultural Studies, 18(4 5), 479 496. Depper, A., & Howe, P. D. (2017). Are we fit yet? English adolescent girls’ experiences of health and fitness apps. Health Sociology Review, 26(1), 98 112. Didziokaite, ˇ G., Saukko, P., & Greiffenhagen, C. (2018). The mundane experience of everyday calorie trackers: Beyond the metaphor of Quantified Self. New Media & Society, 20(4), 1470 1487. Fiore-Gartland, B., & Neff, G. (2015). Communication, mediation, and the expectations of data: Data valences across health and wellness communities. International Journal of Communication, 9, 1466 1484. Fors, V., & Pink, S. (2017). Pedagogy as possibility: Health interventions as digital openness. Social Sciences, 6(2). Retrieved from http://www.mdpi.com/20760760/6/2/59/htm Fotopoulou, A., & O’Riordan, K. (2017). Training to self-care: Fitness tracking, biopedagogy and the healthy consumer. Health Sociology Review, 26(1), 54 68. Fox, N. J. (2017). Personal health technologies, micropolitics and resistance: A new materialist analysis. Health, 21(2), 136 153.

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Fox, N. J., & Alldred, P. (2015). New materialist social inquiry: Designs, methods and the research-assemblage. International Journal of Social Research Methodology, 18(4), 399 414. Ingold, T. (2013). Making: Anthropology, archaeology, art and architecture. London: Routledge. Krebs, P., & Duncan, D. (2015). Health app use among US mobile phone users: A national survey. Journal of Medical Internet Research, 3(4). Retrieved from http://mhealth.jmir.org/2015/4/e101/ Ledger, D., & McCaffrey, D. (2014). Inside wearables: How the science of human behavior change offers the secret to long-term engagement. Retrieved from http:// endeavourpartners.net/assets/Wearables-and-the-Science-of-Human-BehaviorChange-EP4.pdf Lupton, D. (2013). Understanding the human machine. IEEE Technology & Society Magazine, 32(4), 25 30. Lupton, D. (2016a). The diverse domains of quantified selves: Self-tracking modes and dataveillance. Economy and Society, 45(1), 101 122. Lupton, D. (2016b). The Quantified Self: A sociology of self-tracking. Cambridge: Polity Press. Lupton, D. (2016c). You are your data: Self-tracking practices and concepts of data. In S. Selke (Ed.), Lifelogging: Digital self-tracking and lifelogging - between disruptive technology and cultural transformation (pp. 61 79). Munich: Springer. Lupton, D., Pink, S., LaBond, C. H., & Sumartojo, S. (2018). Personal data contexts, data sense and self-tracking cycling. International Journal of Communication, 12. Retrieved from http://ijoc.org/index.php/ijoc/article/view/5925/2268. Lynch, R., & Cohn, S. (2016). In the loop: Practices of self-monitoring from accounts by trial participants. Health, 20(5), 523 538. Moore, P., & Robinson, A. (2015). The quantified self: What counts in the neoliberal workplace. New Media & Society, 18(11), 2774 2792. Nafus, D., & Sherman, J. (2014). This one does not go up to 11: The Quantified Self movement as an alternative big data practice. International Journal of Communication, 8, 1785 1794. Niva, M. (2017). Online weight-loss services and a calculative practice of slimming. Health, 21(4), 409 424. Piras, E. M., & Miele, F. (2017). Clinical self-tracking and monitoring technologies: Negotiations in the ICT-mediated patient provider relationship. Health Sociology Review, 26(1), 38 53. PwC. (2016). The wearable life 2.0: Connected living in a wearable world (PwC Ed.). PwC. Retrieved from http://www.pwc.com/us/en/industry/entertainment-media/ assets/pwc-cis-wearables.pdf. Rooksby, J., Rost, M., Morrison, A., & Chalmers, M. C. (2014). Personal tracking as lived informatics. Proceedings of the SIGCHI conference on human factors in computing systems (pp. 1163 1172). Toronto: ACM Press. Ruckenstein, M. (2015). Uncovering everyday rhythms and patterns: Food tracking and new forms of visibility and temporality in health care. In L. Botin, C. Nohr, & P. Bertelsen (Eds.), Techno-anthropology in health informatics (pp. 28 40). Amsterdam: IOS Press.

The Agential Capacities of Self-tracking Practices

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Ruckenstein, M., & Pantzar, M. (2017). Beyond the Quantified Self: Thematic exploration of a dataistic paradigm. New Media & Society, 19(3), 401 418. Sharon, T. (2017). Self-tracking for health and the quantified self: Re-articulating autonomy, solidarity, and authenticity in an age of personalized healthcare. Philosophy & Technology, 30(1), 93 121. Sharon, T., & Zandbergen, D. (2017). From data fetishism to quantifying selves: Self-tracking practices and the other values of data. New Media & Society, 19(11), 1695 1709. Shore, C., & Wright, S. (2015). Governing by numbers: Audit culture, rankings and the new world order. Social Anthropology, 23(1), 22 28. Smith, G. J. D. (2016). Surveillance, data and embodiment: On the work of being watched. Body & Society, 22(2), 108 139. Smith, G. J. D., & Vonthethoff, B. (2017). Health by numbers? Exploring the practice and experience of datafied health. Health Sociology Review, 26(1), 6 21. Smith, W. R., & Treem, J. (2017). Striving to be king of mobile mountains: Communication and organizing through digital fitness technology. Communication Studies, 68(2), 135 151. Sumartojo, S., Pink, S., Lupton, D., & LaBond, C. H. (2016). The affective intensities of datafied space. Emotion, Space and Society, 21, 33 40.

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Chapter 5

Resonating Self-tracking Practices? Empirical Insights into Theoretical Reflections on a ‘Sociology of Resonance’ Karolin Eva Kappler, Agnieszka Krzeminska and Eryk Noji

Abstract Nowadays there are many digital tools and mediatised ways for self-tracking for the sake of gaining self-knowledge through numbers. In his recent book ‘Resonance’, Hartmut Rosa suggests that artefacts can indeed resonate with people (Rosa, 2016, p. 381ff.) by affecting emotion, intrinsic interests and self-efficacy expectations. In contrast, Rosa characterises self-tracking as an attempt to measure the resource potential of individuals, confounding it with the good life itself (Rosa, 2016, p. 47). That is why we want to challenge Rosa’s concept of a good life and enhance the assertion of individual and social practices that can generate resonance. With several case studies, we want to study empirically how people ‘resonate’ (or not) with and in self-tracking practices and to which degree Rosa’s hypothesis is verifiable or not. By empirically contrasting the quantifying practices and metric culture of self-tracking with the recently emerging sociological field of ‘world relationships’ and ‘resonance’, new insights on the embedding of the quantified with the qualified self will be gained. Keywords: Resonance; alienation; self-tracking practices; self-efficacy; affect-emotion; world relationships

Metric Culture: Ontologies of Self-Tracking Practices, 77 95 Copyright r 2018 by Emerald Publishing Limited All rights of reproduction in any form reserved ISBN: 978-1-78743-290-1

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Introduction Many accounts about self-tracking and the quantified self refer to the aspect of self-optimisation (Duttweiler, Gugutzer, Passoth, & Stru¨bing, 2016; Kristensen, Bode, & Lim, 2015; Lupton, 2014, 2016; Ruckenstein & Pantzar, 2017; Selke, 2016). On the one hand, certain expectations of normality, health and self-optimisation are immanent to self-tracking technologies (Ruckenstein, 2014). On the other hand, self-tracking technologies seem to be germane to the contemporary disposition of selfoptimisation as part of an ‘individual management agenda’ (Klauser & Albrechtslund, 2014, p. 282) which produces new forms and formats of subjectivity. Foucault’s (1988) notion of the technologies of the self encompasses practices of self-care which in turn establish a mode of governing the self. Foucault argues that individuals are morally required to engage in practices by which they can achieve happiness, health and well-being. As Nikolas Rose (2007) describes, individuals act for their own sake but these outcomes are also desired results for social and entrepreneurial order which in turn encourages people to utilise self-optimising strategies. From this perspective, self-tracking may be seen as ‘part of the panoply of strategies for the government of the self’ (Lupton, 2014). Self-tracking practices then appear as partly voluntary for example in a playful and pleasurable mode (Lupton, 2014; Nafus & Sherman, 2014; Ruckenstein, 2014; Whitson, 2013) but partly as obligations. People are responsible for maximising their resources in order to make first the best decisions within a range of options in order to configure the best possible life and second to be able to match the requirements of the current emotional (Illouz, 1997), entrepreneurial (Bro¨ckling, 2002) or societal markets. Collecting data about one’s bodily values, working productivity, sports activities, mood states and others allows one to gain better insights in order to attain more control over these strategies. Recent studies reveal that people feel higher influence over their lives through self-tracking, since it helps them achieve their initial goals (Choe, Lee, Lee, Pratt, & Kientz, 2014; Li, Dey, & Forlizzi, 2010; Nafus & Sherman, 2014). Many improved their health, created healthy habits, such as losing weight and being physically active, or improved their working productivity. At the same time, Choe et al. (2014) show, beside the prevalent demand to improve health, the wish to maximise work performance is only one of 13 motives named.

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However, other results suggest that activity monitors may not change behaviour in the expected way. Dieting adults who used activity trackers in addition to behavioural therapy for 18 months lost almost half as many (40% less) pounds over that time as those who did only behavioural therapy (Jakicic et al., 2016). According to another survey (n = 6,223) from the consulting firm Endeavour Partners in 2014, more than half of individuals in the United States who purchased a wearable device abandoned it and, of these, one-third did so within six months of receiving it (McCaffrey, 2014). Besides user experience difficulties (Li et al., 2010), several studies reveal a small or even contradictory effect of using self-tracking gadgets for example for the aim of losing weight. Consequently, Stefan Meißner (2016a) undertook the endeavour to analyse the adoption of the quantified self with regards to the notion of self-optimisation in the popular press as well as in academic literature. He points out that self-trackers are mostly seen and figured as self-optimising in the sense of increasing their self-efficiency and effectiveness often as a result of societal or cultural obligations. Regarding the self-descriptions of self-trackers, he argues that another picture may evolve: self-optimisation as an attempt to self-enhance in terms of undetermined goals in a rather explorative and playful manner. Hereby, his perspective yields two possibilities of self-enhancement that are not necessarily bound to a logic of growth. First, self-tracking may lead to new experiences of oneself, to an exploration of new possibilities within one’s traits, as Meißner claims. But equally, measuring and tracking certain outcomes can lead to insights that encourage selflimitation. He shows this with an example of a self-tracker who tracked working hours and discovered that a lower number of working hours (in his case 6) resulted in higher output quality than a greater amount, which subsequently lead to a reduction in the imposed working hours amount of that self-tracker (Meißner, 2016a). In contrast to the often claimed normalising and standardising effects of self-tracking, an effect on emancipation from socially established norms can also result. A self-tracker who experimented with different patterns of light and deep sleep phases indicated that despite only a small gain of extra time he felt much better on the polyphasic sleep schedule than monophasic (Meißner, 2016b). Hence one’s own feeling is set against economically motivated self-tracking endeavours. These examples point to a narrative about self-tracking that is more about well-being than about self-optimisation. Indeed, there is a growing trend of merchandising self-tracking tools not only for performance

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enhancements, but also for well-being and self-knowledge. Martin Berg (2017) relates such design imaginaries to the complex temporalities of late modernity. He refers to Hartmut Rosa’s theory of social acceleration (2005, 2013), in which Rosa states an accelerating circle composed of technical acceleration, acceleration of social change and acceleration of the pace of life that mutually reinforce each other. Against this background, Rosa argues that technical innovations, which actually should make life easier and save time, more often than not lead to further time shortages powering the accelerating circle even more. The washing machine, for example, indeed does save the time you need to do the laundry. But at the same time people tend to do their laundry more often so actually no time was saved (Rosa, 2005, pp. 120 121). Such arguments lead Berg to the conclusion: In light of Rosa’s argument, it seems that these devices result from the social acceleration processes that characterise late modern society and this insight challenges the idea of self-tracking as a useful tool to measure ourselves in order to increase our self-understanding and as a means to make everyday life more liveable. (Berg, 2017, p. 8) Having said that, later Rosa (2016, p. 381ff.) indicates that artefacts indeed can resonate with people (Rosa, 2016, p. 381ff.), which means that people can have life-enhancing relationships to artefacts. Although Rosa clearly does not rank self-tracking among such life-enhancing artefacts since he sees them as a rather alienating approach to maximising resources instead of living a good life, we want to study empirically how people ‘resonate’ (or not) with and in self-tracking practices and to which degree Rosa’s hypothesis is verifiable or not. By empirically contrasting the quantifying practices and metric culture of self-tracking with the recently emerging sociological field of ‘world relationships’ and ‘resonance’, new insights on the embedding of the quantified with the qualified self will be gained.

Rosa’s View on Resonance and Self-tracking In his most recent book, Rosa drafts a ‘sociology of good life’, based on his previous work on ‘acceleration’ (2005). He proposes a sociology of ‘world relationships’, a phenomenologically grounded, relational sociology, which focuses on the relationships between subject and the world,

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both constituted through this specific process. The world is understood as everything which can relate to a subject. The world constitutes the horizon, where events take place and things are located (Rosa, 2016, p. 65). Such forms of world relationships depend on collective circumstances, as they are formed in practices and institutions and are deeply rooted in the thinking and actions of individuals (Rosa, 2016, pp. 33 34). Following Rosa, world relationships are alienated, when subject and world face each other indifferently or as enemies (repulsively) and, hence, internally unrelated. […] Alienation defines a condition, in which the ‘adaptation of the world’ fails, so that the world seems to be cold, rigid, repellent and non-responsive. (Rosa, 2016, p. 316)1 In contrast, Rosa develops the concept of ‘resonance’, based on its physical meaning. Resonance is a ‘specific relationship between two oscillatory entities in which the oscillation of one entity stimulates the self-oscillation of the other entity’ (Rosa, 2016, p. 282). Rosa emphasises that this must not entail a mechanical tie that forces the vibration of the other entity. So as a relational concept, resonance describes a relationship in which two elements touch each other. These two elements respond to each other, keeping their own voice (Rosa, 2016, p. 285). Hence, resonance is not an echo but a response relationship, because an echo does not have its own voice. So resonance is a form of being related to the world in which the ‘subject and world touch and transform each other’ (Rosa, 2016, p. 298). For this to be possible, both entities have to be open enough to reach each other, but closed enough to keep their own voice. Such resonant relationships are constituted by affect and emotion, intrinsic interests and self-efficacy expectation. On the one hand, relating to the world in a resonant way means that you let the world touch you and in this regard, get affected by the world. On the other hand, this gives you the possibility to express yourself and turn your emotions outward. And this is only possible where strong values are touched or in other words where something is valued as intrinsically good. Strong values provide information about the desirability of desires, in this sense information about what is good or bad. So they indicate what has the value to 1

Since Resonance is not published in English yet, all citations referring to Rosa (2016) are translated by the authors.

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be pursued and tracked, following intrinsic interests. Furthermore, resonance requires a self-efficacy expectation, as without this expectation nobody can expect to really touch or transform anything. In addition, resonance implies a moment of unavailability that means that you allow the world to surprise you with its own voice (Rosa, 2016, p. 298). These are the main categories that Rosa mentions and describes as relevant for determining if a relationship is prone more towards alienation or resonance. Hence, we will use these categories for our empirical study, but before that, we would like to briefly expand on Rosa’s view on self-tracking. Rosa locates self-tracking in the context of an accelerated modernity. This project of modernity can be seen as an attempt to constantly increase its reach and in this sense autonomy via acceleration. On the one hand, this spiral of acceleration has generated remarkable achievements, for example, the increase of resources for many members of society, which in turn enabled many types of world relationships in the first place. But on the other hand, it is this mode of raising autonomy by constantly increasing reach that is problematic, because it fosters cold, instrumental and in this sense alienating world relationships. Hence, Rosa tends to understand both the increase of autonomy as well as moments of submission as alienation. Concerning the dichotomy of autonomy and alienation that is contained in the discussion about self-tracking as self-optimisation (Sharon, 2017), the opposition of resonance and alienation also means a shift of perspective, as Rosa does not simply substitute the concept of autonomy through resonance but interprets both autonomy and submission as potentially alienating. For Rosa, this logic of acceleration and increase in autonomy extends into daily life, where he sees a radical cultural shift in that what should ensure the chances for a good life (necessary resources) is now not only confounded with the good life itself, rather it has to bind lifestyle energies and strategies because of the structural imperatives of acceleration (Rosa, 2016, p. 47). It is this context which guides Rosa’s view on self-tracking. For him, the Quantified Self movement is about the idea that you can quantify the quality of life, but what is quantified is nothing but the resource potential of individuals (Rosa, 2016, p. 47). Even if self-tracking were somehow related to resonance, Rosa would still see it in line with various attempts to render resonance calculable, controllable and in this regard to expand one’s reach even to resonance. Since making resonance calculable and controllable would lack the component of unavailability, this would be a reification of resonance.

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Thus, Rosa sees self-tracking as an alienating practice that should be avoided. But since he does not use any empirical data on self-tracking, we can object that he is taken in by the Quantified Self narrative about transparency, optimisation, feedback loops and biohacking that is ˇ Saukko, described by Ruckenstein and Pantzar (2017). As Didziokaite, and Greiffenhagen (2018) have shown in their study about users of MyFitnessPal, looking at cases of everyday self-tracking may draw quite a different picture. Additionally, Rosa acknowledges that ‘empirically […] nearly all forms of bodily world-relationships [are] hybrid forms, which contain all possible overlaps and diverse interactions between mute and resonant moments’ (Rosa, 2016, p. 149f.). Consequently, the self and bodily experiences of a subject can never be completely resonant or completely mute. Following Rosa, the task of a sociology of world relationships is to describe the existential, contextual, institutional and situational differences in their specific weighting in each moment.

Empirical Results on Mundane Practices of Self-tracking Methodological Approach: Analytical Graph of World Relationships Following the previously outlined claims, it is necessary to operationalise Rosa’s notion of resonance. This endeavour can be seen as an attempt to give the opposition between autonomy and alienation in selftracking (Meißner, 2016a; Sharon, 2017) a new perspective, since for Rosa the increase of autonomy by expanding one’s reach could nonetheless mean an increase in alienated world relationships. Hence, based on Rosa’s core categories outlined earlier, we have developed the graph (Figure 5.1). Rosa defines resonance as a specific manner to establish a relationship between the self and world; consequently, this reciprocal relationship determines the two main axes of the analytical graph: on the x-axis, the world gets in touch with the self; and on the y-axis, the self gets in touch with the world. To be able to touch the self (x-axis), the world has to be unavailable to some degree. If the world is fully controlled, then there is no possibility of an independent voice, which is a precondition for resonance. Hence, there would be nothing that can surprise the self, representing a case on the far left side of the graph. This lack of affection by rendering the world controllable and available may be seen as the reason why Rosa claims self-tracking is alienating.

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Case I

World

Case II

World

Case III

Self

Case IV

Figure 5.1. Diagram of Analytical Graph of World Relationships (Own Elaboration). The self reaching out towards the world (y-axis) depends on the expectation of self-efficacy, since the self does not reach out if the self does not expect to be able to do something out there. Self-efficacy allows one to transform and even express one’s self emotionally. For Rosa, this is the axis which is promoted by modernity: to expand one’s reach by keeping the world controlled. These two axes of coordinates plot four boxes that depict four core types of self-tracking practices, each characterised by specific self → world and world → self relationships. Please note that strong values and intrinsic interests can be seen as preliminary conditions for the establishment of world relationships. Hence, they are not plotted in this graph and can be seen as working in the background. According to Rosa, ‘resonant’ self-tracking could be understood as a practice which helps the self as an expressive entity as well as an entity which experiences effects from the world to establish a relationship to the world. In its ideal case, it would be plotted in the upper right box of the graph (Case II). Consequently, completely ‘mute’ practices of self-tracking would be situated to the bottom left (Case III), while the other positions represent mixed-forms (Case I and Case IV). To fill the boxes with empirical case studies, the chapter bases its secondary qualitative content analysis on 15 interviews with people engaged in self-tracking practices, both members of the Quantified Self community and mundane self-trackers. The interviews were originally collected for two separate projects: first, the German Research Foundation DFG-funded project ‘Taxonomies of the self. Emergence

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and social generalization of calculative practices in the field of selfinspection’2 at the University of Hagen and the PhD project ‘The Selfenhancing Self-tracker A Me´nage a Trois between Technology, Economy And User’ at Leuphana University. In joint coding sessions, the authors not only elaborated the empirical approach to Rosa’s rather theoretical concepts by operationalising the dimensions of resonant and mute relationships in the Analytical Graph of World Relationships, but they also coded, interpreted and summarised the interviews, condensing them into four ideal type cases. Case I: Project or Goal-driven Self-tracking The first case depicts self-tracking practices that in many respects correspond to Rosa’s understanding of self-tracking: project or goal-driven self-tracking. The users’ high intrinsic motivations and strong valuations are defined by the specific individual goals. In one case, it is an athlete who aims to run an Ironman triathlon in under 10 hours, organising his life around the training for his goal. His self-efficacy expectation is very high, as he uses various tools and metrics to integrate his body in an optimised training regime by controlling progress, forecasting expected values and reacting to deviations. Hence, Sven is plotted on the upper part of the y-axis. In contrast, the affect dimension is rather unresponsive as selftracking aids an instrumental framework to achieve his goal. His body should be ideally transparent and fully controlled as well as every other technical part in his technology-body-assemblage. Ideally there is nothing unavailable and surprising left. As an example, the athlete rigidly adheres to the advice of his selftracking devices based on his VO2 max values. Sven explains that even if he feels ill but the device tells him to go for a long and intensive training session, he follows the advice and after a couple of kilometres he feels that it works. The body is there, but the mind tells you something different. (Sven)3 2 For more information on the project: http://www.fernuni-hagen.de/soziologie/lg2/ forschung.shtml 3 For reasons of anonymisation, the names of the interviewees have been changed. As all interviews and other materials were collected in German, the quotes included in this chapter were translated by the authors.

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Sven seems to represent a rather prototype case. As is the case for many other athletes, he is meticulous in planning, measuring and controlling his own and partly externally defined ambitious goal of physical performance. In the field of work, entreployees follow a very similar scheme: they often use self-tracking practices to improve their job-performance, evaluated on a monetary basis, such as Robert, another interviewee, who works for a technology company. His job performance is permanently measured by means of his yearly turnover, which is not only visible for his superiors, but also for his colleagues. As a classic entreployee, he is in charge of organising his agenda and work-load. Therefore, he uses various selftracking gadgets to monitor for example his time spent on different tasks, such as emailing, Skype meetings, to control his stress level or to increase his physical activity. Robert describes this as follows in the interview: I have quite a big interest, both in new technologies, new gadgets, but also a big interest in seeing how these tools bring real added value for myself, for my let’s say self-enhancement. (Robert) By this, Robert follows the classic discourse of self-enhancement, that is the human desire to enhance the positivity of the self-concept by means of advancing one or more self-components (Alicke & Sedikides, 2009). But at the same time, he also shows a kind of gadget-driven and rather playful handling of technology and gadgets, which he further develops in other parts of the interview. Case II: Playful Self-tracking Case II deviates from Rosa’s view of self-tracking, which is limited to maximising resource potential. We call this case ‘playful self-tracking’. It is guided by curiosity with the aim of exploring rather than controlling. So numbers are used to give the world a voice which may surprise the user, not so much to render it controlled and silenced. To illustrate this, let’s become more familiar with Conrad, a prototype of a playful self-tracker. He runs a small company and his intrinsic motivation is to be flexible. Therefore, he plays with gadgets, numbers and his self-tracking practices, which he describes as follows: Really, as I’ve got a scale which analyses body fat and weight and every day I use the scale, this is registered.

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That’s why I do not use it on Mondays, that is too shocking, because you have just passed the weekend (laughing), and that causes such a peak, which is not realistic; but on Tuesday I exercise, I had a reasonable Monday, and on Wednesday morning I can reuse my scale without further concerns, everything is normal again (laughing). (Conrad) By adjusting the times he steps on the scale, he avoids ‘bad’ results, which he describes as ‘not realistic peaks’. In other parts of the interview, he explains how he plays around with measurements and conventions, comparing the body mass index, kilograms, body fat, etc. He sees his self-tracking as an experiment, as he for example buys seemingly interesting gadgets, which he does not even unpack but keeps them for years in the cupboard. Or he temporarily engages in specific selftracking practices, such as diet or step tracking, and then quits the practice, when something more interesting shows up, he has gained enough personal insights or it simply gets too boring. To some degree, the apps represent black boxes to him. Consequently, there is always the possibility for something unexpected to occur to which Conrad and other playful self-trackers can react. For example, another self-tracker, Kate aims for aesthetic results in her self-tracking practices. If for example, her step-tracker shows an undesired number in the evening, she gets up and walks around the block, in order to obtain a ‘beautiful’ round figure. You automatically walk more, because in the evening at quarter to 12, when 2,000 steps are missing to have 20,000 or 25,000 or 15,000, however many, to round up there is always a reason to go out and walk twice around the block. (Kate) She also uses her geolocalisation tools to depict ‘nice’ shapes on the maps, which means that she tries to walk ‘nicely shaped forms’ and to never walk the same path twice, because that generates ‘silly pictures’. Arno represents another playful approach to self-tracking. With his background in engineering, fitness instruction and management, he does not engage with one practice of self-tracking over a long(er) period of time, such as the tracking of his ketogenic-vegan diet.

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According to his attitude of ‘simply trying out and testing’, Arno regularly engages in and disengages from different subjects and forms of self-tracking in a playful way. In contrast to the following examples, he does not consider that ceasing to track is a moment of ‘failure’.

Case III: Failing Self-tracking The third case is one which is quite often forgotten: failing self-tracking. And here, we come back to one of our previous examples: Conrad. He measures his weight constantly, but he failed to measure his sleep. It was problematic, because I was just in a phase of my life, in which I permanently slept restlessly; and then the gadget simply told me what I knew anyway: I have slept badly and too little. It was not really meaningful and anyway I do not like sleeping with clocks or jewellery. That’s another reason, why I did not like it and quit it. (Conrad) Some time ago, he did not sleep well. Hence, Conrad was intrinsically motivated to improve his sleeping habits. But, the measurements and numbers simply confirmed his bodily feelings and the results and visualisations did not really tell him anything new. That is why his selfefficacy expectation was quite high in the beginning, but then he was disappointed by the sleep-tracking gadgets, as he did not understand at all what the numbers tried to tell him. The tracking did not provide him with any added value. Consequently, self-efficacy disappeared and the world translated and mediated through numbers did not touch Conrad. Consequently, a person engaged in self-tracking can combine different practices, more resonant and more mute ones.4

4

More on this in the section ‘Resonant and Mute Self-tracking Practices’.

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In other ‘failing’ cases, the self-tracking practitioners do not feel comfortable with the results. After a radical diet-change, Bettina uses diet-tracking to control calories, macro- and micronutrients to prevent possible malnutrition. But after a while, she notices that the focus on numbers shifts her attention to the programme and its decisions, instead of towards the body and its needs. Well, concerning food and listening to your body, that does not work at all, when you focus on numbers and a program decides or suggests that you are eating too little or that something is missing. I have unlearned something that I had already learned, painstakingly learned. Well, listening to what my body needs and when it is too much and these things. (Bettina) During some weeks, Bettina follows the ‘wrong’ results and recommendations, suggested by the self-tracking programme, but she feels uncomfortable, as she forces herself to eat much more than usually. B: And then you think, I should have a defect. And you look for symptoms [...] Well, and I simply turned off my own thinking. I: Yeah. B: Yes, and my knowledge, what I already had […] and I completely trusted that what was presented there, reflected what was really wrong with me. And that was not true. (Bettina) In this sense, the self-tracking programme affects her negatively. By following the numbers regardless of contradicting bodily feelings, the relationship between body and numbers became more of an echo. Because of this disparity and similar to Conrad’s case, the numbers cannot be understood and what they represent stays incomprehensible and the relationship to those numbers can be interpreted as repulsive and in this regard as alienated. In the end, Bettina stops her self-tracking in order to get back to her bodily feelings which is the way she thinks nutrition should work.

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Case IV: Digital Diary The fourth case is described by Rosa as an ‘oasis of resonance’ (Rosa, 2016, p. 198ff.). It is characterised by the lack of the self to reach out and to generate resonance on its own. The self is only touched by the world and is reduced to the experiences, without being able or willing to fulfil self-efficacy. Watching a rock concert on television can be seen as an example of such an ‘oasis of resonance’, as the spectators may be highly affected by the music, but they are not able to participate actively in the situation. Although self-tracking seems rather unlikely to be an ‘oasis of resonance’, as self-efficacy is expected to be rather high, there seem to be cases of self-tracking in which the expectations of self-efficacy are quite low. In one of our empirical examples, Michael is a sports enthusiast, who loves to be active and to exercise as often as his demanding job and family allow. He used to do team sports and has been running and cycling, partly two times a day, for some time now. Starting to train for a marathon in 2004, he began to track his runs and distances manually. I have started putting markers in the woods, in order to know more exactly, how long and fast I run there. And that’s how it started, that I somehow tracked. And that’s also why I know approximately since 2004[…] not only approximately[…] I know exactly (laughs) how much I ran per year, how much I cycled[…] how much I should have swum and did not do so. (Michael) The new gadgets, in the beginning GPS trackers and heart rate monitors, simply help him keep track of his physical activities. He strives for transparency and wants to know the covered distance and speed. For me, it is simply important to see what I have done and how much I have actually done […] and that’s why I always carry the tracker and the phone with me. (Michael) In this sense, Michael just looks for transparency through registering his runs and other physical activities. In this sense, he uses self-tracking as a digital diary, without wanting to change anything. Hence, selftracking becomes a practice of reception.

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World

Case I: project/goal-driven self-tracking

Case II: playful self-tracking

affect: rather unresponsive self-efficacy expectation: high unavailability: ideally none

affect: playing with numbers self-efficacy expectation: experimentation unavailability: possibility of unexpected

World Case III: failing self-tracking

Case IV: digital diary

affect: negative self-efficacy expectation: in the beginning middle/high disappointed unavailability: high

affect: positive self-efficacy expectation: rather low unavailability: high

Self

Figure 5.2. Analytical Graph of World Relationships: Case Study Self-tracking (Own Elaboration). Resonant and Mute Self-tracking Practices As seen earlier, the outlined cases are not mutually exclusive, but selftracking practices can include dimensions of different cases, such as Robert, who combines motivations and practices of being goal-driven as well as playful self-tracking practices, or Conrad, who has experience both with playful and failing self-tracking practices. In this, the empirical cases confirm Rosa’s expectation: empirically, world relationships tend to be hybrids in which mute and resonant relationships overlap and intertwine and are never resonant or mute in their totality either (Figure 5.2). The final graph, which depicts the four empirical cases, shows the diversity of self-tracking practices analysed by our framework based on resonance. Although self-tracking in general tends to imply the idea of rendering the world available by numbers and in this regard to extend the user’s reach which is the reason why Rosa tends to see selftracking as an alienating practice our empirical cases of everyday trackers show that self-tracking can be integrated into practices in quite different ways. Although we are not quite sure if Rosa himself would agree, it seems to us that a playful approach to self-tracking may even result in relationships that you could call resonant. But even a goal-driven approach to self-tracking does not necessarily imply an alienating world

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relationship. For example, people with chronic diseases do not alienate resonant relationships in advance. Rather they repair or at least control their bodily conditions, so they hopefully are able to build resonant relationships in other areas. For example, Harry is a self-tracker who was diagnosed with high blood pressure. Since he does not want to be dependent on medicine, but has to be worried about blood pressure crises while doing sports, self-tracking is a way for him to calm himself and control his health conditions while doing something he really wants to do: As soon as I get this dim feeling that I could have high blood pressure, I have to ease my panic and look: what are my actual numbers? (Harry) Consequently, the empirical examples have confirmed the hybridity of self-tracking practices combining both mute and resonant moments.

Conclusions Drawing on Rosa’s sociology of world relationships, we undertook a shift of perspectives, moving away from the very common dichotomy of autonomy and alienation, since for Rosa autonomy through instrumental means may still be alienating. Instead, we focused on the notion of resonance as counterpart to alienation. Therefore, and in order to operationalise resonance, we carved out elements central for a world relationship to be resonant: emotional expressivity, getting affected, the expectation of self-efficacy and the level of unavailability. The Analytical Graph of World Relationships allowed us to distinguish four ideal type cases: goal-driven, playful and failing self-tracking as well as self-tracking as a digital diary. These cases are not meant to be exclusive. As shown in Conrad’s example, even one and the same person can be involved in multiple cases and even the same practices of self-tracking can change their status over time. In the end, it seems that a playful approach to self-tracking may be the most promising in light of resonance. Interestingly, this result resonates with other accounts on relationships with technology. For example, in his postphenomenological work on non-humanist ethics, Verbeek (2011) also links an empowering technology-use with a notion of playfulness. But as outlined in the previous paragraphs, this does not mean that all other types of self-tracking practices are necessarily to be

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considered as bad. Even for Rosa, there cannot be total resonance. Resonance needs its counterpart of alienation to exist and instrumental approaches to self-tracking, for example, extending one’s reach as in the case of chronically ill people, can be interpreted as making resonant relationships possible in the first place. So, goal-oriented self-tracking practices may very well lead to the possibility of resonant relationships in other fields. In conclusion, focusing on self-tracking practices and their relational impact following Rosa’s sociology of world relationships, a new classification of self-tracking usage and users has emerged. New analytical categories such as intrinsic motivation, self-efficacy (expectation), affect, emotion and unavailability gain ground and shift the attention towards the transformation of the relational dimension, focusing among other things on the mutual interplay between the self and the world and the permeable boundaries in between. This new perspective might for example help to understand failing and unsuccessful tracking, based on the unresponsiveness and unavailability of the gadgets, as well as of the world that is translated into numbers.

References Alicke, M. D., & Sedikides, C. (2009). Self-enhancement and self-protection: What they are and what they do. European Review of Social Psychology, 20(1), 1 48. Berg, M. (2017). Making sense with sensors: Self-tracking and the temporalities of wellbeing. Digital Health, 3, 2055 2076. doi:10.1177/2055207617699767 Bro¨ckling, U. (2002). Das unternehmerische Selbst und seine Geschlechter [The entrepreneurial self and his genders]. Leviathan, 30(2), 175 194. Choe, E. K., Lee, N. B., Lee, B., Pratt, W., & Kientz, J. A. (2014, April). Understanding quantified-selfers’ practices in collecting and exploring personal data. Proceedings of the 32nd annual ACM conference on human factors in computing systems, 1143 1152. https://doi.org/10.1145/2556288.2557372 Didziokaite, ˇ G., Saukko, P., & Greiffenhagen, C. (2018). The mundane experiences of everyday calorie trackers: Beyond the metaphor of Quantified Self. New Media & Society, 20(4), 1470 1487. doi:10.1177/1461444817698478 Duttweiler, S., Gugutzer, R., Passoth, J. H., & Stru¨bing, J. (Eds.). (2016). Leben nach Zahlen: Self-Tracking als Optimierungsprojekt? [Life by numbers. Selftracking as an optimization project?] (Vol. 10). Bielefeld: transcript Verlag. Foucault, M. (1988). Technologies of the self: A seminar with Michel Foucault. In L. H. Martin, H. Gutman, & P. H. Hutton (Eds.). London: Tavistock. Illouz, E. (1997). Consuming the romantic utopia: Love and the cultural contradictions of capitalism. Berkeley, Los Angeles & London: University of California Press.

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Jakicic, J., Davis, K., Rogers, R., King, W., Marcus, M., & Helsel, D. (2016). Effect of wearable technology combined with a lifestyle intervention on long-term weight loss. JAMA, 316(11), 1161. doi:10.1001/jama.2016.12858 Klauser, F. R., & Albrechtslund, A. (2014). From self-tracking to smart urban infrastructures: Towards an interdisciplinary research agenda on big data. Surveillance & Society, 12(2), 273. Kristensen, D. B., Bode, M., & Lim, M. (2015). The optimizing self. In Workshop on interpretive consumer research (Vol. 8). European Institute for Advanced Studies in Management. Li, I., Dey, A., & Forlizzi, J. (2010). A stage-based model of personal informatics systems. Proceedings of the SIGCHI conference on human factors in computing systems, ACM, pp. 557 566. https://doi.org/10.1145/1753326.1753409 Lupton, D. (2014). Self-tracking cultures: Towards a sociology of personal informatics. Proceedings of the 26th Australian computer-human interaction conference on designing futures: The future of design, ACM, pp. 77 86. https://doi.org/10. 1145/2686612.2686623 Lupton, D. (2016). The quantified self. Malden & Cambridge: Polity Press. McCaffrey, D. (2014). Inside wearables: How the science of human behavior change offers the secret to long-term engagement [Web log blog]. Endeavour Partners. Retrieved from https://blog.endeavour.partners/inside-wearable-how-the-science-ofhuman-behavior-change-offers-the-secret-to-long-term-engagement-a15b3c7d4cf3. Accessed on July 18, 2017. Meißner, S. (2016a). Effects of quantified self beyond self-optimization. In S. Selke (Ed.), Lifelogging: Digital self-tracking and lifelogging-between disruptive technology and cultural transformation (pp. 235 248). Wiesbaden: Springer Fachmedien Wiesbaden. Meißner, S. (2016b). Der vermessene Schlaf. Quantified Self in der Spannung von Disziplinierung und Emanzipation [The measured sleep. Quantified Self in the tension of discipline and emancipation]. In S. Duttweiler, R. Gugutzer, J. H. Passoth, & J. Stru¨bing (Eds.), Leben nach Zahlen: Self-Tracking als Optimierungsprojekt? [Life by numbers. Self-tracking as an optimization project?] (Vol. 10, pp. 319 340). Bielefeld: transcript Verlag. Nafus, D., & Sherman, J. (2014). Big data, big questions This one does not go up to 11: The quantified self movement as an alternative big data practice. International Journal of Communication, 8, 11. Rosa, H. (2005). Beschleunigung. Die Vera¨nderung der Zeitstrukturen in der Moderne [Acceleration. Changes of time structures in modernity]. Frankfurt am Main: Suhrkamp. Rosa, H. (2013). Social acceleration: A new theory of modernity. New York, NY: Columbia University Press. Rosa, H. (2016). Resonanz. Eine Soziologie der Weltbeziehung [Resonance. A sociology of world relationship to the world]. Berlin: Suhrkamp. Rose, N. (2007). The politics of life itself. Biomedicine, power, and subjectivity in the twenty-first century. Princeton, NJ: Princeton University Press. Ruckenstein, M. (2014). Visualized and interacted life: Personal analytics and engagements with data doubles. Societies, 4, 68 84. doi:10.3390/soc4010068

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Ruckenstein, M., & Pantzar, M. (2017). Beyond the quantified self: Thematic exploration of a dataistic paradigm. New Media & Society, 19(3), 401 408. doi:10.1177/1461444815609081 Selke, S. (Ed.). (2016). Lifelogging: Digital self-tracking and lifelogging-between disruptive technology and cultural transformation. Wiesbaden: Springer Fachmedien Wiesbaden. Sharon, T. (2017). Self-tracking for health and the quantified self: Re-articulating autonomy, solidarity and authenticity in an age of personalized healthcare. Philosophy & Technology, 30(1), 93 121. doi:10.1007/s13347-016-0215-5 Verbeek, P. P. (2011). Moralizing technology. Understanding and designing the morality of things. Chicago, IL: University of Chicago Press. Whitson, J. R. (2013). Gaming the Quantified Self. Surveillance & Society, 11(1 2), 163 176.

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Chapter 6

The 1-Person Laboratory of the Quantified Self Community Thomas Blomseth Christiansen, Dorthe Broga˚rd Kristensen and Jakob Eg Larsen

Abstract This chapter provides an insider perspective on the Quantified Self (QS) community. It is argued that the overall approach and methods used in the QS community have not been adequately described. Consequently, the aim of the chapter is to give an account of the work performed by self-trackers in what we coin the 1-PersonLaboratory (1PL). Additionally, the chapter describes other aspects of the 1PL, for example the methods, procedures and instrumentation that are being used and the knowledge sharing taking place in the QS community. With a point of departure in empirical cases it is demonstrated how QS self-trackers put their own questions, observations and subjective experience front and centre by using their own instrumentation and data sets in their personal laboratories. In the 1PL, the causalities that are looked for are not aimed at generalisation to an entire population; on the contrary, the causal connections on the level of the person are essential for discovery by the individual. Keywords: Quantified Self; digital self-tracking; scientific method; self-experimentation; 1-person laboratory

Metric Culture: Ontologies of Self-Tracking Practices, 97 115 Copyright r 2018 by Emerald Publishing Limited All rights of reproduction in any form reserved ISBN: 978-1-78743-290-1

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Introduction Contemporary, digital self-trackers act as scientists conducting personal experiments with their own bodies and everyday lives. They collect data about themselves that can be used as the basis for acquiring new knowledge. The aim of this chapter is to provide an analysis and an inside perspective on the work performed by experienced self-trackers in the Quantified Self (QS) community. An example may serve to get us started. To be able to extract all the data he needed out of his biosensing Basis smartwatch, co-author Jakob had to use software1 written by Bob Troia2 (a fellow New York City-based member of the QS community), modify it and use it in analysis of the data with regard to his specific questions. However, as the software did not extract all data needed, he furthermore, on a regular basis, had to use the accompanying smartphone app to read out values manually and add them to the rest of the extracted data that were stored in files and a spreadsheet. Intel, the vendor of the Basis smartwatch, did not provide any facilities for the users to export the raw data collected by the smartwatch. Therefore, only the analysis and visualisations built into the product were available to the user unless the raw data were extracted by some other means.3 This opening example serves as an illustration of a few of the facilities and activities which are part of what we call the 1-Person Laboratory (1PL) that is characteristic of self-tracking in the QS community. It also points to the work required and competencies needed to be able to operate a 1PL to truly benefit from self-tracking in these still early days of digital self-tracking. Regularly, the methods of QS are being referred to as analogous to the N-of-1 (cf. Greenfield, 2016). The ‘N’ in N-of-1 refers to the number of participants in a clinical trial, that is only a single participant. The N-of-1 eschews the traditional, biomedical requirement of a large number of participants in a clinical trial for statistical validity and suggests an alternative scientific epistemology i.e. that useful clinical knowledge can be gained at the level of the individual. In that sense, N-of-1 is a minority position in biomedicine. We 1

Utility that exports your Basis device’s data https://github.com/btroia/basis-dataexport 2 Bob Troia’s personal website https://www.quantifiedbob.com/ 3 Not until Intel out of the blue mid-2016 announced that the Basis smartwatch would be discontinued did the company provide a facility for the user to export the raw data.

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want to introduce the concept of the 1PL as we believe describing QS self-tracking practices that way is more comprehensive than that of Nof-1 experiments. By introducing the term 1PL, we wish to capture the methodology of QS through the presentation of distinctive characteristics and elements of this kind of contemporary self-tracking. We also want to stress that the self-tracking practices of QS generate a new kind of knowledge and evidence that takes place in the context of the QS community through an approach that does not necessarily in all cases adhere to the requirements of N-of-1 or single-subject research design as it is performed in biomedical research. While N-of-1 is predominantly concerned with clinical research and the development of clinical interventions, the 1PL is concerned rather with making it possible to use the experimental, scientific method in everyday life. In our analysis, the concept of N-of-1 comes with a strong clinical research bias that is skewing the assessment and understanding of what is taking place in the QS community. By imposing expectations and an interest of knowledge from clinical research, the major innovations and main contributions from the self-tracking practices of the QS community are partly occluded, that is novel ways of reliably making accurate observations of everyday phenomena to answer questions that are relevant for an individual. This chapter builds on the co-authors Jakob Eg Larsen’s and Thomas Blomseth Christiansen’s combined participation in all QS conferences (in the US and Europe 2011 2017), participation in numerous QS meetups in the United States and Europe, organisation of the QS Copenhagen meetup group, as well as their own self-tracking experiences and work as technologists building self-tracking devices and solutions. In addition, the chapter is based on Dorthe Broga˚rd Kristensen’s participation in QS meetings and conferences, and interviews with practitioners of self-tracking from the QS Copenhagen meetup group during the years 2012 2017. Together, the authors offer an insider’s perspective on the practices of the QS community. The chapter is in itself an experiment as Jakob and Thomas provide several of the empirical examples to illustrate the self-tracking practices in the QS community but they also analyse their practices and data about themselves, facilitated by Dorthe’s perspective as a participant-observer.

QS: A Perspective from the Inside Self-tracking projects are prototypically individual and the self-tracking projects undertaken by members of the QS community are as such

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highly diverse. The self-tracking experimentation that has been documented in more than a 1,000 recorded ‘Show&Tell’ talks4 since the inaugural QS meeting on 10 September 20085 represents a creative exploration of a diverse set of phenomena of interest and data collection methods. The minimum, recommended structure for a QS Show & Tell talk is to answer the three questions: What did you do? How did you do it? And: What did you learn? Contrary to what appears to be commonly believed about the QS community, very little sharing of actual data takes place. The sharing in the community is predominantly about self-tracking approaches for specific areas of interest, instrumentation and about the loosely formalised methods and procedures that have been used that is answers to the ‘how did you do it’ question. These considerations may then serve as inspiration for other self-trackers who want to engage in self-tracking experiments as opposed to a strict formula for how others should carry out their self-tracking experiments. In recent years, several articles have been published that deal with the lived experience of self-tracking. The literature on the selftracking practices and experiences of practitioners within the QS community itself is, however, surprisingly scarce. In some cases, the use of the term ‘QS’ does not necessarily reflect what is going on inside the QS community. There are, however, some notable exceptions. Nafus and Sherman (2014) and Sharon and Zandbergen (2017) venture into an analysis of QS community talks and propose to use the term ‘quantifying selves’ instead of ‘QS’ (Sharon & Zandbergen, 2017). From within the QS community Anne Wright (2018) and Dana Greenfield (2016) both use their own self-tracking experiences as point of departure for inside perspectives. Anne Wright introduces her own experiences of finding correlations between food intake and the state of her bodily system, the experience of building the BodyTrack system for aggregation of self-tracking data, and setting up partnerships with device vendors. Dana Greenfield takes as a starting point her participation in the QS 2013 Global Conference and experience of her mother being hospitalised in a coma for an analysis of the epistemology and practice of QS (Greenfield, 2016). She uses the N-of-1 as an overarching metaphor and argues that everyday life in the context of that operates as the site for individual 4

https://vimeo.com/groups/quantifiedself https://www.meetup.com/quantifiedself/events/8526229/

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exploration and experimentation where the subject is invited to turn inward, becoming both subject and object of their own data-driven inquiry. In this chapter, part of our background is the discussions within the QS community during the last seven years up until the most recent at the QS conference in Amsterdam 2017 that has showed how both the internal discourse and external presentation are undergoing change, something we believe has received little attention in the existing literature. Our aim is to contribute an analysis of how the practice of self-tracking in QS can be equated to the work of a scientist in a laboratory as the experienced self-trackers engage in collecting and using data for self-discovery. Self-tracking in the QS sense often involves not only a concern of how best to collect, visualise and understand data, but also how to take control over the use and interpretation of data flows. Also, based on voluntary engagement with the collected data, it relies on a willingness to follow and learn from the data. Two points about the concept of the ‘QS’ need to be stressed. The first is that the term QS was initially mentioned by the QS founders Kevin Kelly and Gary Wolf in passing as part of a conversation (Kelly, 2016). Then the term became popular and widely used. It was not meant as a programmatic statement nor as a prescription for how people should live their lives. It was meant as a ‘placeand holder’ until a better term might have surfaced.6 However that is the other point it is as if those two words, ‘Quantified Self’, struck a kind of natural frequency in the internal discourse of the social sciences and played into long-standing discussions about the qualitative versus the quantitative, and the status of the self in late modernity. The research appeared to focus on the term ‘QS’ as a concept as opposed to research what was actually going on within the QS community. It appears as if the concept of ‘QS’ has been used in some research literature as a part of arguments about larger societal and political developments but without attending much to the actual self-tracking practices among the members of the community from which the name of the concept has been appropriated. With this chapter, we would like to offer a corrective.

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Personal communication with Gary Wolf (2017).

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Inside the 1PL The word laboratory originates from the medieval Latin laboratorium and laborare that is ‘to labor’7 work is being done in a laboratory. In the modern understanding of the term, a laboratory is a place where experiments are carried out and in the popular image that might very well involve chemicals, pipettes and lab coats. However, a laboratory is often a place not only for conducting experiments but also for building the experimental setup to be able to run the experiments as it is done in, for example, experimental physics. Also, laboratories are places for experimenting with and building new technology, for example, Thomas Edison’s industrial research lab. In a similar way, experienced self-trackers in the QS community set out to answer questions through experimentation in a laboratory. They formulate hypotheses and design and conduct their own experiments. This includes the apparatus used for measuring or making observations, where they either use off-the-shelf devices, modify existing devices for personal use or simply make their own instruments from the ground up as part of building the experimental setup. They conduct the experiments and the analysis of the data themselves to arrive at results, get answers to their questions and gain new insights. Unlike a traditional laboratory setup in a definite physical place, for the 1PL, the ‘place’ is the person’s everyday life. This is both the place where experiments are conducted and part of the object of research. A particular experiment might be initiated as a product of a question, curiosity or interest in an aspect of life which the self-tracker wants to improve and/or get insights into. However, the non-stationary, roaming trait of the 1PL adds additional complexity in terms of the continuous operation of the 1PL across changing geographical locations and social situations. With regard to the time dimension, the projects of the 1PL are often characterised by the longitudinal. The investigations and experiments going on in the 1PL are often taking place over longer periods of time (months, years, even decades) relative to institutionalised human subjects research (days, weeks, months) (Mehl & Conner, 2012). A notable epistemological characteristic of the 1PL is that the selftracker is both the object under investigation and the subject that observes the object (themselves in their everyday life) and through the use of analytical skills strives to gain knowledge. 7

New Oxford American Dictionary.

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Exemplifying the 1PL As the 1PL is based in everyday life and about personal learning, the practice of it may best be explained through the presentation of a case. The recurring case will serve to illustrate several of the activities and facilities involved in the 1PL. Even though one particular case of selftracking is used as the main example, we also feature other examples of self-tracking from the QS community for a more comprehensive description. This part of the exploration of the 1PL combines an outside analytical perspective taken on by Dorthe and combined with insights from Thomas and Jakob. From there, we move to an inside perspective and analysis on how the 1PL is operationalised within the QS community. The recurring example of an experimental self-tracking project is provided by co-author Thomas who is an experienced self-tracker and known in the QS community for his work with his allergies and his unique data set. Thomas presents himself as a technologist and entrepreneur with a special interest in personal health data and has been an active self-tracker since 2008 (although his self-experimentation with health issues started around 2005). During the last seven years since 2011, he has actively made more than 110,000 observations and by estimate spent more than 500 hours recording these observations in addition to collecting reams of passively sensed data from mobile and wearable devices. In his early thirties, Thomas was suffering from allergies (esp. grass pollen since his childhood), eczema, fatigue and gut issues that got worse. However, he did not find any convincing solutions in the Danish healthcare system. Based on the belief that he could probably find better and more sustainable solutions himself using his experience from ‘debugging’ software systems and knowledge about industrial process improvement methods, he ventured into a long-running selftracking and self-experimentation project. Consequently, he has among other things for the duration of years been tracking such phenomena as sneezes, freezing, fatigue and eczema as well of intake of food, water, beverages and supplements. As demonstrated by Thomas’ case, a key activity in the process of running a 1PL is to identify an area of interest that the self-tracker wants to get insights into or improve. The design of the methodological and experimental setup in the 1PL can take different points of departure and the setup is likely to be constantly evolving in an exploratory learning process and often features multiple, interrelated experiments of different durations running at the same time. It can, for example,

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be based on curiosity about getting insights through data, wanting to try out self-tracking technology, or the testing of explicitly stated hypotheses. In the case of Thomas, his original area of interest was his health issues and the point of departure was his decision to test the hypothesis that if he could condition his immune system through lifestyle changes, especially dietary, the reaction from his immune system towards grass pollen would not be as strong. His hypothesis was a challenge to the dominant theory about allergy in immunology, namely that allergy is a misfiring of the immune system. Thomas’ idea was that his immune system did not shoot in the blind but responded to the grass pollen because it had at some time in his past made an association between grass pollen and problematic bodily states. Thomas thought he potentially could influence his immune system to reverse its decision about classifying grass pollen as a threat by keeping his body in as good a shape as possible during and especially at the onset of the pollen season.8 In order to be able to make that happen, Thomas, as part of creating the experimental setups, has also been designing his own interventions based on extensive online research to generate ideas about what might be worth trying out in his particular case at a particular point in the progression. Thomas’ interventions have predominantly been centred around diet as one of his overall ideas has been that that would be the area of his life where he potentially could get the most leverage with the lowest risk and lowest cost of doing things differently. Co-author Jakob also started out with an interest in health, but unlike Thomas, this was not due to a particular health issue, but rather with a research interest in what one could learn about personal health from self-tracking. His initial interests were three key factors: physical activity, sleep and food. In the beginning, focus was on the first two as he did not find any suitable instrument for food tracking until later when he developed his own. As illustrated in the opening example, Jakob was at some point using an instrument for physical activity and sleep tracking that also provided data on resting heart rate. While he was not interested in this phenomenon initially, the availability of the data got him curious which led him to form hypotheses on the relation between resting heart rate data changes and illness and other factors.9

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Christiansen (2011). Larsen (2017).

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Interviewing Danish self-tracker Simon Bentholm, Dorthe learned that he tracked his sleep patterns in order to find ways to be more effective and sleep less. He found himself becoming increasingly aware of the role of feeling guilty and time spent with social relations.10 Similarly, Dutch self-tracker Justin Timmer describes how tracking happiness made him become aware of the quality and character of different types of experiences and that he gradually realised that experiences of flow11 made him happier than, for example, the experience of being very productive at work.12 His experiments inspired him to be less disciplined and to leave more room for experiences of flow. The examples show the variety in phenomena that can be tracked, but do also underline the nonlinear characteristics of the self-tracking process and that the point of departure in a self-tracking experiment can both be hypothesis- and data-driven. In what follows, we will describe the general characteristics of the methodological setup, that is in all cases characterised by (1) the collection of data through instrumentation and correlation of data (2) analytical insights gained through the use of conscious reflection.

Instrumentation, Methodological Setup and Operating the 1PL Generally, instrumentation in the 1PL may consist of any apparatus that can be used to acquire and store observations made during the selftracker’s everyday life. That includes smartphones and a wide range of wearable devices with biosensors. The measurements include physical activity, step counting, mobility (GPS), weight, heart rate, sleep, temperature, blood pressure, etc. However, such apparatus can also be pen-and-paper or a spreadsheet on a computer for manually registering observations of different phenomena, typically subjectively perceived ones such as pain, fatigue or mood (Drake, Csipke, & Wykes, 2013) that cannot be measured or assessed by passive, automatic sensors. Regardless of the source of the data, it is common to store it in some persistent media in an organised way for later retrieval and analysis.

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Interview with Simon Bentholm (2016). Justin Timmer defined flow as ‘being engaged in something you do and just living in the moment while you are doing it’. This implies that one is immershed in the moment without keeping track of time. 12 Interview with Justin Timmer (2017). 11

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When experienced self-trackers present their work, they often have an impressive record of observations, graphs and other visualisations. For this reason, many self-trackers are concerned about the accuracy of the sensors and often go to great lengths in testing different technologies, recognising that self-tracking technology and the data produced cannot be trusted blindly. Thereby considering measurement errors and error margins as with any other scientific instrument. As an example, Jakob has done extensive comparisons of different sleep tracking products by concurrently wearing several wrist-worn and finger-worn devices for years on end. In the case of Thomas, over the years, he has been using changing instrumentation and experimental setups to be able to investigate his overall hypothesis about his immune system. He started out by collecting observations in mind maps in 2008. Then in 2009, he began using a mobile phone to take photos of, for example, food and eczema accompanied by timestamped notes saved in the filesystem of his laptop. From 2011, he switched to using a smartphone app he was part of developing as a co-founder of a start-up. The smartphone app was superseded by a smartwatch app in late 2015 and along with that he started using a onebutton wearable instrument mid-2016. These wearable instruments were developed by Thomas and Jakob to allow them to make observations of subjectively perceived phenomena with the press of a button (Larsen, Eskelund, & Christiansen, 2017). In addition to the instrumentation Thomas has been developing either by himself or together with collaborators, he has also been using commercially available self-tracking products such as the Zeo sleep tracker, the Lumo Back posture tracker, the Lapka environmental sensors, the Fitbit Blaze activity and sleep tracking watch, the Apple Watch and heart rate and exercise monitors from, for example, Polar and Wahoo. Building their own instrumentation for the 1PL is not an unusual practice among experienced self-trackers. Through interviews with selftrackers in the QS Copenhagen group, Dorthe found several examples beyond those of Thomas and Jakob. This includes Jan, a student of mathematics, who developed his own EKG sensing device. Another example is that of Ian who suffered from diabetes and for that reason developed a blood glucose monitoring device and a tool to visualise numbers on his smartphone and connect to a lamp with a light that would switch on in case of ‘bad numbers’ from the blood glucose readings. Not only do-it-yourself instrumentation requires maintenance and operational efforts. As the cases illustrate, also commercially available

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wearable products need quite some effort to be kept operational typically through regular recharging and synchronisation of the collected sensor data. The opening example illustrated some of the efforts needed in order to keep Jakob’s experiment operational and to avoid discontinuities in the collected data. In a similar way, Thomas’ case highlights the many ‘moving parts’ in his 1PL and the efforts needed in order to keep it operational and structure, store, analyse and present data. Let alone the estimated more than 500 hours he likely has spent on recording these actively made observations as mentioned above. What the operational effort led to, however, was that observations from the summer of 2011 showed that every time he moved geographically during the grass pollen season he had an initial reaction when he arrived at a new location. However, after a few days at each of the locations, the allergic reactions faded even though the grass pollen level in the air was constant or even rose. These observations he interpreted as support for his hypothesis. As speculated, Thomas observed that his immune system reacted to the grass pollen as a registered threat, but then diminished its reaction after a few days based on the overall good bodily condition that did not indicate any intrusive viruses or microorganisms. He perceives this behaviour of his body as evidence that questions immunology’s theory of allergies being a misfiring of the immune system. The evidence of that is a chart (Figure 6.1) that shows how Thomas’ total number of sneezes increased in 2012 after going back to a less strict diet and decreased during the following years after implementing a change back to a more restrictive diet based on his learnings and additional hypotheses. It’s worth observing that Thomas also created these data visualisations himself as there were no commercial tools available to support the presentation of data and learnings from the specific experiments he was carrying out. This illustrates the number of different operational issues Thomas had to deal with throughout the whole experimental pipeline in the 1PL.

Reflections on the 1PL Having described several cases of self-tracking in 1PLs among experienced self-trackers, we now turn to a reflective discussion of the notion of the 1PL, as well as the emergence of personal discoveries.

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A Whole New Dynamic. Figure 6.1.

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As demonstrated by the above cases and based on the observations made while being part of the QS community, self-tracking among experienced self-trackers is likely to take a point of departure in the wish to learn about themselves through personal experiments based on as accurate data as possible. It is well-known that humans have a limited capacity to recall and reflect on their own actions from memory alone and even a tendency to deny inconvenient truths. Self-tracking experiments serve as a way for self-trackers to overcome these cognitive biases and understand phenomena otherwise inaccessible to wellfounded self-inspection and reflection. In other words, they voluntarily become ‘outside observers’ of aspects of themselves and their own lives. Self-tracking technology serves to record important details, provide an overview of these and make them visible to oneself by accumulating quantities of data that would otherwise be impossible for the individual to reliably recall without the supporting technology. This way, a part of everyday existence is turned into something concrete and quantifiable that makes it possible to capture aspects of the self in the moment and exert influence over or perhaps even control phenomena or processes that previously had been black boxes or had escaped deliberate manipulation, knowing that such goals in themselves are provisional and might already change the next day. Building on these personal observations and analysis of the data, testable hypotheses may be formed. Instead of looking at a symptom in isolation, potential causes and solutions may be found in the context of multiple data sets and individual contextual knowledge, which reflect the individual as a unique system. While self-tracking might take as a point of departure a one-dimensional goal, like sleeping better or sneezing less, it might very well foster the realisation that the goal forms part of a network, for example, that sleeping less decreases productivity or affects mood negatively. Hence, it might further lead to an awareness that if you ‘optimise’ one parameter, it will affect other parts of your life. As Thomas found in his case, if he had been blinkered and simply wanted to decrease the amount of sneezes no matter the cost, the outcome would possibly only have been marginal. If a person aims at arriving at a perceived optimum, at some point, there are likely to be diminishing returns. Then it would require a lot of effort to achieve such full optimisation. On the other hand, there are all kinds of constraints and factors that influence the phenomena of interest in a network. A fulfilling quantified-self process is typically concerned with exploring these connections. Rather than isolating one element, to quantify the exploration of connections between elements and factors

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can be crucial. By engaging in a self-tracking process, it might lead to an awareness about constraints related to other factors. It is a constantly moving target so that what one thought might be the cause of problems, for example, allergic reactions or sleep quality, could turn out to be closely related to other areas of life and may themselves be effects of other causes. This is illustrated by the interviews Dorthe has conducted among self-trackers, where they report that they started out with a particular intention and goal in mind, but the experimental process led them to explore other areas of their lives to get a fuller picture which made all of them end up in a completely different place than they had anticipated. When self-trackers engage in self-tracking, through data they increasingly become more aware of connections and causalities which is reflected in their own personal data journal. As a consequence, what starts as a process of externalisation observing and producing data also becomes an internal one. Self-trackers experience how their awareness in regard to the phenomena they track becomes heightened, and paying attention to the data serves to fine tune their senses. So while some self-trackers might set out with an idea of an area of everyday life they particularly want to address, for instance, to improve sleep or become more productive, in that process they become aware that these data relate to other areas of everyday life and other types of problems. In the case of sleeping, they might become aware that it not only revolves around the amount of hours of sleep they get, but also the hours they are awake. As an example, co-author Jakob found from his experience with food tracking that the very act of tracking was at least as important as the data itself in increasing awareness. In Thomas’ case, he relates how he now has developed a ‘sneezing sense’, that is similar to the description of the development and sharpening of senses in training of ‘noses’ for the perfume industry (Latour, 2004; Pink & Fors, 2017). The systematic observation and the feedback loop from the data create a flow and learning that sharpen the awareness, which has also been referred to in the literature as ‘intro-sensing’ (Mol & Law, 2004). As a consequence of tracking his own sneezes, Thomas now also pays attention to people sneezing around him as an ‘extended human sensor network’. These findings echo the findings of Sharon and Zandbergen (2017) who describe that tracking facilitates the development of a ‘sixth sense’ and give the example of a self-tracker who learned to tell how many calories that are in a given serving of food and how much the food weighs just by looking at it. Thus, numerical data are not the end goal of

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self-tracking but may act as a means towards more augmented senses (Sharon & Zandbergen, 2017, p. 6). Personal Discovery as Empowering Practice For the self-tracker, the subjective experience is crucial, as well as the systematic and accurate registration of occurrences of phenomena of interest. The actual personal discovery emerges from reflection on the data in the context of the lived experience. Contrary to popular perception, in this process, consciousness plays a crucial role. Analytical and machine learning tools for so-called ‘Big Data’ have shown themselves inadequate in identifying useful patterns in individual lives and making personal discoveries as there might not be enough contextual data available for these kinds of tools to work. In some cases, only human consciousness can notice possible correlations and identify blind spots by drawing on the individual’s contextual knowledge of what is going on in their everyday life besides the explicitly tracked and available data. The writing or inscription becomes an empowering practice as authority and expertise are gained by the self-trackers. The collected data and subsequent visualisation serve as a kind of inscription of their own personal example, that is also analysed at an individual level. As in the example of Thomas who describes himself as ‘a hunter following a trail’ and acts as a scientist searching for the underlying causes of his health issues. Through tracking and visualisation, he produces a data narrative of himself that makes it possible to find the ‘traces’ in his everyday bodily experiences. Throughout the process, self-tracking relies on the subjective self-awareness and consciousness of the self-tracker to identify the ‘triggers’ in the bodily system, in this way being capable of improving his own bodily processes. The data thereby become empowering as the self-tracker is transformed from being an object, a source of data and/or patient to a self-efficacious subject actively reflecting on, acting and taking charge of their own health and well-being. In that sense, the analytical practice in QS is a kind of double movement where the self-tracker becomes both object and subject of their own data.

Beyond the 1PL The continuous and everyday data collection concerning these personal phenomena which are characteristic of the vast majority of the

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self-tracking experiments in QS has increased by leaps and bounds compared to the data collection in traditional, institutionalised human subjects research. The ‘labor’ performed in the 1PL has to a large degree enabled self-trackers to pursue a creative exploration of new grounds for knowledge creation which departs from scientific experiments in the traditional laboratory with regard to the following aspects. Methods and Procedures In established, quantitatively oriented research fields, there are usually a set of fairly well-defined methods and procedures for how one would conduct a quality experiment in order to enable others to replicate the experiments and the results from experiments to be compared with prior work and results. Such standards and procedures do not exist in the QS community as individual self-trackers typically tailor their experiments for their particular situation and to answer the specific and personal questions they have. No two self-trackers are the same or have the same needs, purposes or questions that might be answered through selftracking, thus no two self-tracking experiments are the same. Even though self-trackers might find inspiration in the 1,000 + collection of video recorded QS Show & Tell talks, these reflect personal approaches to self-tracking rather than a standard method or procedure. Search for Evidence on the Scale of the Individual Person In contrast to a traditional, scientific research lab, the output from the 1PL differs as the aim is not necessarily to find evidence for explanations or theories that can be generalised, a phenomenon or a certain diagnosis. The results are personal and unique and serve a practical or exploratory purpose for the individual. In particular, the search for correlations and potential causation differs qualitatively from the procedures of inference in biomedicine that are based on statistical correlation and pattern recognition with a different purpose and interest of knowledge. Here, a possibility could be to look for certain biomarker and/or genetic composition as a sign or a probability. An example could be the probability of developing diabetes. In the 1PL, the causalities that are looked for cannot be generalised to an entire population; on the contrary, the causal connections on the level of the person are essential. A key reason is that the experiments are driven by a personal motivation, question and/or hypothesis.

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In this light, we argue that the use of the N-of-1 concept as a description of the practices of QS is problematic and might lead to imposing methodological criteria and constraints from biomedical, clinical research that would be counterproductive to the work in the 1PL and the exploration of the epistemic frontier of everyday life that is taking place in QS. Requisite Competencies A notable aspect that we have observed over the years and demonstrated in the cases is that many of the pioneering QS self-trackers have engineering and data analysis skills that enable them to address the limitations of the present technology. They either develop their own self-tracking instruments or modify existing devices and software for their 1PL. One of the reasons is that a set of assumptions are built into the commercially available self-tracking products, which introduce limitations on the utility of the instrumentation. A particular mode of use of the products is presumed, which may not support what the experienced self-tracker wants to do. It is typically the case that the vendor has decided on behalf of the user how the collected data are analysed and presented. This limits the set of questions the user can seek answers to and ultimately if they are able to validate or reject their hypotheses. In the QS community, one way to modify the products is to extract the data from the commercial services and wearable devices to escape the boundaries set by the data analysis and visualisation capabilities provided by the vendors as illustrated in the opening example. This way, the self-trackers can perform their own data analysis driven by their own questions. Moreover, they can aggregate the data with data from other sources, which may be needed in order to obtain knowledge on complex issues that go beyond what vendors have imagined and designed the products for. Knowledge Sharing Consequently, the goal from an individual perspective is not necessarily to produce evidence to support a body of generalised knowledge but to explore and test ideas and potentially share experiences and methodological setups with the broader QS community.

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It’s noteworthy that the lack of strictly formalised and standardised methods and procedures has enabled an individual freedom to act. Thus it can be difficult to make any meaningful generalisations about selftracking in the QS community without oversimplifying or making a caricature. However, we believe that a workable, generalised way to describe and analyse the practice is through the lens of the 1PL. As diverse these individuals and their self-tracking projects are, the property they have in common is the experimental approach involving a set of activities and facilities in a 1PL. One could, however, argue that this freedom and the ability to think freely without the restrictions of specific methods and procedures have sparked a lot of creativity in terms of what to self-track and how to design and carry out the selftracking experiments.

Conclusion In this chapter, we have presented the concept of the 1PL as a model to describe and understand the activities and facilities used by experienced self-trackers in the QS community in their endeavours to obtain knowledge and insights about their own lives. The self-tracking experiments in the QS community take inspiration in scientific experimental methods, but may also be characterised by less rigor and less formalised methods compared to established scientific research. On the other hand, this allows for a new type of knowledge creation where the selftracking experiments escape the narrative of the traditional, linear process and may take place as an exploration characterised by an iterative process where the approach can be continually adapted as the selftracker learns as part of the experimentation. Furthermore, the longitudinal properties of self-tracking projects and data sets with relatively high temporal resolution typically sets the 1PL apart from traditional human subjects research. As we have seen in multiple examples, the 1PLs allow self-trackers to obtain new knowledge and insights. We have consequently argued that the absence of standardised methods for self-tracking experiments in the QS community have played a pivotal role in stimulating the creativity, innovation and findings that have occurred at the frontier of self-tracking and self-experimentation in the QS community in the past decade. We suggest that the concept of the 1PL captures distinctive characteristics of the developing phenomenon of digital self-tracking and the specific kind of knowledge and

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evidence that it generates, which we find existing frameworks, such as the N-of-1, fail to sufficiently reflect.

References Christiansen, T. B. (2011). Debugging my allergy. QS Show&Tell. Retrieved from https://vimeo.com/33126338 Drake, G., Csipke, E., & Wykes, T. (2013). Assessing your mood online: Acceptability and use of Moodscope. Psychological Medicine, 43(7), 1455 1464. Greenfield, L. (2016). Deepdata: Notes on the n of 1. In D. Nafus (Ed.), Quantified: Biosensing technologies in everyday life (pp. 123 146). Cambridge, MA: MIT Press. Kelly, K. (2016). The inevitable: Understanding the 12 technological forces that will shape our future. New York, NY: Penguin. Larsen, J. (2017). Tracking my sleep and resting heart rate. QS show & tell. Retrieved from https://vimeo.com/227295338 Larsen, J., Eskelund, K., & Christiansen, T. B. (2017). Active self-tracking of subjective experience with a one-button wearable: A case study in military PTSD. In Proceedings of workshop in computational mental health at CHI 2017. Latour, B. (2004). How to talk about the body? The normative dimension of science studies. Body & Society, 10(2 3), 205 229. Mehl, M. R., & Conner, T. S. (2012). Handbook of research methods for studying daily life (pp. 89 107). New York, NY: Guilford Press. Mol, A., & Law, J. (2004). Embodied action, enacted bodies: The example of hypoglycaemia. Body & Society, 10, 43 62. Nafus, D., & Sherman, J. (2014). Big data, big questions| This one does not go up to 11: The QS movement as an alternative big data practice. International Journal of Communication, 8, 1784 1794. Pink, S., & Fors, V. (2017). Being in a mediated world: Self-tracking and the mindbody-environment. Cultural Geographies, 24(3), 375 388. Sharon, T., & Zandbergen, D. (2017). From data fetishism to quantifying selves: Self-tracking practices and the other values of data. New Media & Society, 19(11), 1695 1709. Wright, A. (2018). Self-tracking: Reflections from the bodytrack project. Science and Engineering Ethics, 24(3), 999 1021.

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Chapter 7

Embodiment and Agency through Self-tracking Practices of People Living with Diabetes Giada Danesi, Me´lody Pralong and Vincent Pidoux

Abstract Drawing on ethnographic observations of diabetes (self-)management in French-speaking Switzerland and semi-structured interviews with healthcare practitioners, people living with diabetes and their relatives, the chapter aims at shedding light on self-tracking practices of people living with diabetes. It explores the ways people with diabetes measure and learn to recognise body symptoms of hypo- and hyperglycaemia through self-quantification, and act consequently. In particular, the chapter investigates recent medical devices continuous and flash glucose monitoring systems that reconfigure the work of health providers and self-care practices. It shows the self-monitoring practices and the resulting self-awareness people living with diabetes develop in interaction with technology and caregivers in order to undertake embodied actions. By pointing out that new technologies have facilitated the access to personal body information and the sharing of it, self-monitoring is also questioned as a form of surveillance, opening up issues of power and control over patients’ behaviours. With regard to this, the chapter illustrates that, occasionally, people with diabetes resist ‘docility’ through micro-powers at the level of everyday life by refusing to engage in their use and by developing personal strategies or ‘tactics’. Keywords: Self-management; diabetes; medical devices; CGM; FGM; subjectivity; resistance Metric Culture: Ontologies of Self-Tracking Practices, 117 135 Copyright r 2018 by Emerald Publishing Limited All rights of reproduction in any form reserved ISBN: 978-1-78743-290-1

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Introduction The emergence of mobile digital devices and Web 2.0 health-related apps enabling self-tracking of health and illness ‘mHealth’ technologies (Lupton, 2013a) has a major impact on healthcare, public health and self-care (Lupton, 2014). Today, several body functions, everyday activities and health-related indicators can be measured, monitored and visually represented using portable wearable and internal sensors devices, apps and online platforms (Ajana, 2017; Lupton, 2013a). Healthcare professionals use these technologies to collect data on health, deliver healthcare, share medical information, build network and monitor patients. Digital technologies offer new ways of tracking outbreaks of diseases and offer new means for health education about disease prevention (Lupton, 2014). An imminent revolution in healthcare, preventive medicine and public health supported by digital health-related technologies is frequently announced in medical and public health literature adopting a ‘techno-utopian’ perspective (Lupton, 2013b). New models of healthcare (e.g. mHealth, eHealth, Health 2.0) embracing digital technologies to find solutions for healthcare issues are thus explored (Ajana, 2017). The development of new personalised and mobile technologies, such as biosensors that became smaller, cheaper and more manageable, has made possible the transition of health monitoring activities from the professional sphere to the personal one (Ajana, 2017). The increasing interest of lay people in numbers and self-analysis is not only spurred by the development of technology but also by the major shift towards neoliberalism that promotes the discourse of ‘healthism’ (Lupton, 2013a, p. 397) and personal responsibility. As Lupton (2013b) highlights in addressing the concept of ‘digitally engaged patient’: lay people are expected and encouraged to develop routines to regularly assess these physiological markers and thus to develop the type of expertise in monitoring their bodies that was once the preserve of healthcare providers. (p. 260) Public health policies and, at the same time, movements like the Quantified Self prompt individuals and societies to embrace a ‘metric culture’, that is to say the culture of measuring and analysing an increasing number of everyday activities through self-tracking devices that drive the conduct of their lives (Ajana, 2017; Lupton, 2016).

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Self-tracking devices for health not only enable a visual representation of the body and health states but ‘are also based on quantification’ (Lupton, 2013a, p. 399) and encourage people to rely ‘on algorithms and data to manage all aspects of everyday activities’ (Ajana, 2017, p. 1). Changes in technologies aimed at monitoring and regulating bodies and health entail transformations in how bodies are conceptualised, understood, treated and managed from the perspective of both healthcare professionals and lay people. These technologies encourage people to think about their bodies and their selves through numbers that appear ‘clean’, ‘contained’, ‘unemotional’ (Lupton, 2013b, p. 266), thus ‘scientifically neutral’ (Lupton, 2013a, p. 399). By fostering ‘an intense focus on and highly detailed knowledge of the body’ (Lupton, 2013a, p. 396), biometric self-tracking is represented as enabling prevention of diseases and self-care. The ‘digitally engaged and active patient’ (Lupton, 2013b; Pickard & Rogers, 2012) incorporates the medical gaze and brings healthcare into domestic and private spaces (Lupton, 2013b; Oudshoorn, 2011; Pols, 2012). These shifts into the domestic sphere and patients’ engagement in self-care have important implications for chronically ill people, such as those living with diabetes. The number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014 (WHO, 2016). People living with diabetes have high blood sugar due to inadequate insulin production or body cells that do not respond properly to insulin. Type 1 diabetes is characterised by deficient insulin production and requires daily administration of insulin. Type 2 diabetes results from the body’s ineffective use of insulin. It is the most frequent form of diabetes around the world, and it is largely the result of excess body weight and physical inactivity (WHO, 1999). The three main pillars of diabetes treatment are: food, physical activity and medical treatment (insulin and/or antidiabetic agents). People with insulin-dependent diabetes have to take up diagnostic and therapeutic functions usually reserved to physicians. They have to monitor their blood glucose level and consequently inject insulin. Selfmanagement heavily relies on the acquisition of various knowledge and technical skills as well as experience. So far, medical and technological devices (e.g. glucometers, insulin pumps, self-monitoring journals, apps) have strongly supported these activities and enabled ‘self-knowledge through numbers’. Self-tracking involves practices in which people collect information about themselves and then individually apply them to the conduct of their lives (Lupton, 2016). As Mol (2000) points out, the

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simple use of a diagnostic device, such as the glucometer, is not simply a matter of getting to know something but ‘also implies something is done’ (p. 10) and these devices ‘actively intervene in the situations in which they are put into use’ (p. 9). Mol (2000) distinguishes two steps in diabetes self-management: selfmonitoring and self-regulation. The first step demands lay people to become one’s own laboratory technician and adopt the necessary skills for measuring, writing down numbers properly and so on. The second one requires that patients acquire more professional skills and to gain autonomy vis-a`-vis professionals to calculate and inject insulin according to the body’s needs. She suggests a third step that is strongly related to self-regulation: self-moralising. According to Mol (2000), the hardest part for the patient’s autonomy is to know when to be severe and when to stop self-moralising and to do that, the patient needs to ‘internalize the medical acquiescence in relation to the erratic character of life’ (p. 19). On the one hand, people living with diabetes are encouraged to live in a calculative mode; on the other hand, they have to learn to accept that ‘their bodies never behave according to the rules and refuse to completely fit into carefully made calculations’ (Mol, 2000, p. 19). This chapter explores new forms of monitoring, measuring and visualising human embodiment within self-tracking practices of people living with diabetes in French-speaking Switzerland by focusing on the analysis of the uses of recent medical devices for measuring blood glucose levels: Continuous Glucose Monitoring (CGM) and Flash Glucose Monitoring (FGM) systems.1 The users are people living with diabetes, but also their relatives and the professionals involved in their healthcare. Since about 10 years, there are several different CGM systems 1

Thanks to a sensor inserted under the skin, these systems measure glucose levels in tissue fluid throughout the day and night. They are connected to a transmitter that sends the information via wireless radio frequency to a monitoring and display device, including smartphones. MiniMed® insulin pumps have built-in CGM so the information can be seen on the pump screen. The FSL does not have hypo- or hyperglycaemia alarms and will only provide a trend graph if it has been swiped in the past eight hours. When the reader device is swiped close to the sensor, the sensor transmits both an instantaneous glucose level and eight-hour trend graph to the reader. The FSL has a factory calibration and does not require fingerstick calibration (for CGM it is a 12 hours calibration). The FSL’s sensor should be changed each 14 days, for CGM, this should be approximately seven days. Sources: https:// www.medtronicdiabetes.com/treatments/continuous-glucose-monitoring, https:// www.dexcom.com/continuous-glucose-monitoring, https://www.freestylelibre.co.uk/ libre/

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(e.g. Dexcom® and Guardian®) available. In 2014, Abbott brought a new option in glucose monitoring to the market, which is a FGM named the FreeStyle Libre® (FSL). In Switzerland, the FSL has been available since May 2016. The study draws on the sociomaterial approach (Coole & Frost, 2010; Fenwick, 2014; Gillespie, Boczkowski, & Foot, 2014; Oudshoorn & Pinch, 2003) to analyse the intersections of human and non-human actors in creating digital assemblages (Lupton, 2014). Specifically, we draw attention to the roles played by digital health technologies in configuring and enacting concepts and experiences of embodiment, selfhood and social life in the context of diabetes (self-)management. Technologies will be considered as actors (or ‘actants’ in STS) imbricated in a heterogeneous network in order to explore how they confer meanings and subjectivity upon their users, and at the same time how users shape and give them meanings to fit their domestic or work practices (Lupton, 2013a, 2014). In doing so, the chapter sheds light on how and why people living with diabetes, their relatives and healthcare professionals use or do not use these self-tracking devices and the data they produce. The incorporation of these technologies into the everyday life and practices of people with diabetes, their relatives and practitioners is addressed to explore how they are domesticated and transformed to fit into routines, as well as how they create new knowledge or ways of thinking, feeling and being. By pointing out that new technologies have facilitated the access to personal body information and the sharing of it, self-monitoring is also questioned as a form of surveillance, opening up issues of power and control over patients’ daily activities. The chapter illustrates that, occasionally, people with diabetes resist ‘docility’ through micro-powers at the level of everyday life by refusing to engage in their use and by developing personal strategies or ‘tactics’ (De Certeau, 1984).

Methodology This chapter draws on qualitative and ethnographic research carried out in French-speaking Switzerland on the (self-)management of diabetes through tools. The findings selected for this chapter are part of a case study on the FSL. The case study investigated how the participants used or did not use this new technology in the everyday practices of managing diabetes. While engaging in ‘a phenomenological analysis of the experiences people have in the context of medical care’ (Lupton,

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1997, p. 108) and in paying attention to the ways new medical devices are put to use, the study relies on an ‘ontology of affective bodies’ (Danholt, 2013) in order to capture practices of the self and clinical practices. We conducted ethnographic observations in different contexts: associative events and institutional training for caregivers and patients, a summer camp for young people living with diabetes and a paediatric diabetes and endocrinology hospital service. In 2016, two of us took part in a summer camp for young people living with diabetes as members of the medical staff for a study on the FSL that was conducted that year at the camp. The president of the Foundation organising the camp who is a paediatric diabetologist and endocrinologist asked the two of us to complement this study with an ethnographic approach on the use of this new medical device by people living with diabetes and healthcare professionals during the summer camp. Most of them discovered the device at the camp as it had only been sold in Switzerland for two months. At the camp, there were about 30 participants aged between 12 and 17 (all have type 1 diabetes); 15 healthcare professionals (doctors, nurses and dieticians); 13 monitors. Most of the monitors live with type 1 diabetes and took part in the camp once or more times when they were younger. In 2017, for a period of four months, the same researchers visited a paediatric diabetes and endocrinology hospital service weekly, and observed diabetes consultations with the practitioners working in this service (diabetologists, nurses and dieticians). Detailed field notes were made and annotated on the observations and specifically on issues discussed, social interactions’ dynamics, and accounts of the uses of medical devices. We have also conducted in-depth and semi-structured interviews with 25 healthcare practitioners of six professions involved in diabetes care (diabetologists, diabetes and home care nurses, dieticians, general practitioners and pharmacists) working in different contexts (hospital, office, clinic and association) and with 8 people living with type 1 diabetes (aged between 20 and 45) that we had already met during the fieldwork. Questions at interviews with people living with diabetes aimed at exploring the history of their illness trajectory, medical care, self-care practices, knowledge, techniques and tools they use in the daily management of diabetes. Questions with practitioners aimed at collecting medical and clinical knowledge, clinical practices with patients with diabetes, tools they use or do not use in their work practices. All the interviews have been audio-recorded and transcribed.

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We did a thematic and narrative analysis of the data (Greenhalgh et al., 2011; Greenhalgh & Swinglehurst, 2011; Hinder & Greenhalgh, 2012). We presented and discussed the data in team meetings and with a few practitioners of the summer camp and the paediatric service to chart the data and iteratively refine analytic categories by comparing the data (Glaser & Strauss, 1967). For this chapter, we focused our analysis on key issues and stories with a particular attention on choices, actions and broadly, on what people do or had done in relation to diabetes management within the use of these new medical devices for measuring blood glucose in the context of real-life and daily activities. Ethical approval was gained from the Ethics Committee of the canton of Vaud (439/15). Interviewees gave written consent and people observed during consultations gave oral consent for the presence of the researchers. All names used in the following are pseudonyms.

Self-monitoring Blood Glucose Levels through CGM and FGM Systems I will say we can live our lives as you but we still have a different life, we are not spontaneous. We cannot ‘Come on, let’s have dinner!’ (she laughs), to drink a glass of wine, we have to calculate a lot, or maybe I’m very disciplined, I don’t know, I will not concede to myself everyday excess. I say ‘4 days strict, 2 days cool, 4 days strict’. This is my way (she laughs) of managing my illness. (Rachel, 45, type 1 diabetes for 6 years) Rachel highlights how the life of people living with diabetes is far from being as spontaneous as the life of a person who does not have to matter about his/her glycaemia. Their life deeply depends on measuring and calculating to maintain a normal blood sugar level and a balance between food intake, physical activity and insulin level. Devices enabling self-measurement assist blood sugar regulation. CGM and FGM systems simplify this task by providing continuous measurement. As Pickard and Rogers (2012) underline, ‘illness leads to a state of “dys-embodiment”’ (p. 106) and to restore ‘a sense of continuity or normality’ (p. 107), people living with chronic illness deal with an ongoing work to achieve a new ‘re-embodiment’. People with diabetes learn to recognise the body’s symptoms of hypo- and hyperglycaemia through the use of these devices. In addition to a regular check of their blood

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glucose levels to decide the dose of insulin to inject before meals, if they feel strange, they should check their glucose level on their device to verify if it is too high or too low and then act accordingly, or to be sure the sensations are not related to diabetes. However, when subjective sensations associated with too high or too low blood sugar level do not match with the objective findings displayed on the device, this could be perceived as a problem for some people, especially if they completely trust the numbers and alerts provided by these tools. Practitioners, people with diabetes and their relatives often question the devices in term of the accuracy and reliability of the data produced for choosing the one that fits their needs the best. CGM and FGM have been strongly concerned with this questioning because they measure the glucose in the interstitial fluid not in the blood as traditional glucometers do. For me, the Guardian it’s not precise enough, when I experience hypoglycaemia I feel bad and then I measure my glycaemia and I’m at 3 […] and then 5 minutes later it tells me ‘A hypoglycaemia will arrive’ and then I tell myself ‘Ok, it is already there’ […] They say about 30 min of delay […] with the FSL the diabetologist said me 10 minutes, we will see! […] It will not alert when you have hypo, however the diabetologist told me that the FSL when we scan, it shows trends if we are going down or going up, but I don’t have the experience yet. (Rachel, 45, type 1 diabetes for 6 years) Rachel has worn the Guardian for the last year and when we met her, she was waiting for an FSL because she wished to profit from a more precise system enabling her to anticipate hypoglycaemia in her daily life, or to avoid eating unnecessary sugar before work meetings because she is afraid of having ‘hypo’ in this context. Cle´mence also wears the Guardian because this system is connected with her insulin pump but also because her health insurance does not cover the FSL. She highlights the reasons why the FSL will be a better fit for her: You have the curve like on the FSL and then what is good is when you define by yourself the zone where you would like to be and when you go down, then the pump stops by itself or by yourself, if you insert an alarm. […] It rings all the time! […] Sometimes you know I just check the time

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on my pump and then I see that I’m in hyper, it bothers me. I just want to know what time it is! (Cle´mence, 21, type 1 diabetes for 13 years) The CGM’s sound signal alerting her of a low level of blood glucose adds to the other signals of the two systems she wears, which alert her if, for example, the insulin cartridge will be shortly finished or the battery level is low. Over the years, she got used to checking the time on her pump and now that the pump also displays the blood glucose level, she feels she has to consider if her blood glucose is too high and act accordingly, which she would not necessarily have considered on her own.

The Development of Self-awareness and Reflexivity Wearable devices measuring blood glucose reinforce embodied selfawareness due to the experience of comparing physical sensations to numbers and foster inner sensitivity by ‘practising self-awareness’ (Mol & Law, 2004, p. 48). Thus, they enable people with diabetes to become aware of what happens in their body, which might push people to act more. What we can observe with the FSL is that people become aware of their diabetes. What we could not see before, what we could not imagine, we see it in front of us with the curve. It is what is great with the curve […] there is an awareness at the level of what is going on in our organism. […] My diabetologist told me, and I found that very illustrative, that one of her patients said to her ‘But my diabetes is completely decompensated because I’m always above 8 mmol’. She said to her ‘It is just that now you objectify it, you see it on a screen, but it was always like that’ because the HbA1c2 has not changed. (Fabienne, 24, type 1 diabetes for 6 years)

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HbA1c refers to glycated haemoglobin, which is a measure of the average blood sugar level over approximately 90 days.

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For Fabienne, the visualisation of the curve on the FSL’s reader is a great tool to develop self-awareness. Youri sees things differently. He does not express any interest in using the FSL because he believes the device does not give him any additional information than what he already knows by thinking about what he did during the day and the impact it will have on his blood glucose. I will see how the technology develops but now I will keep going with the glucometer because it does not bother me to prick myself. […] The FSL gives an indication, but often simply by thinking of what we had before, at the swimming pool for example I measured blood glucose after having moved and the arrow was going down but I knew it was because I did sport. (Youri, 24, type 1 diabetes for 12 years) Variations in the perceptions of people with diabetes about the utility of wearing this device to develop self-awareness are noticeable. Conversely, healthcare professionals strongly agree on the benefit of wearing this device. During consultations, training sessions and interviews with practitioners several reasons have emerged as to why, for most of them, CGMs, and more specifically the FSL, are great tools to improve diabetes’ therapeutic education. It is the first time the patient has a graphical representation of his diabetes. […] The patient sees what he is doing! And if you use this as a tool that says ‘you did wrong’, it is completely nuts! It aims at saying ‘But why?’, it is the first didactic tool. And as you know, in pedagogy a schema is much better than 2 hours of explanations! (Edgar) For Edgar a diabetologist working in an office the graphical representation of the glucose fluctuations, mainly in relation to the time of the day, is beneficial to teaching and exchanges with people with diabetes as well as other healthcare professionals. Thanks to the details patients can give on their daily life, the fluctuations can also be related to food intakes, the insulin dose, daily activities, etc. The objective is to become aware of what is going on and use it as a resource for enhancing self-care.

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Lia a diabetes nurse working in a hospital’s paediatric service valued the importance of having patients who learn to look at the wholeness and not only at a number when practicing self-care. They follow trends and it is a different […] it has changed, we do not work anymore on a current result, we work with a trend, with a wholeness, and this is an asset because it is what we are trying to work […] to transmit to patients, to say ‘Do not be set only on a given value’ […] ‘It’s important when you have a value, you have to think what happened before, what will happen after’ […] and here, with the arrows and the trends I think it is this that will be awesome! (Lia) These devices help people living with diabetes think of their body as a whole with complex configurations thanks to the trends displayed with curves and arrows on the screen. Lia also emphasised how these tools represent a crucial challenge for people living with diabetes and at the same time for the professionals involved in diabetes care. Self-awareness and self-reflexivity on bodily sensations, glucose fluctuations, effects of the treatment on the body and illness management thus emerge as crucial aspects in willingness and practices of self-care.

Embodied Actions We showed that devices act on the experiences of embodiment of people with diabetes by training them to inner sensitivity and knowledge of their body. The actions people with diabetes undertake are strongly connected to these new experiences and knowledge. However, as Mol and Law (2004) highlight, the point of dealing with hypo- or severe hyperglycaemia episodes ‘is not to gather knowledge but to intervene […] to counteract it’ (p. 49). In order to do that, they mobilise what they ‘measured’, ‘felt’, ‘countered’, ‘avoided’ and what is ‘produced’ when they postpone long-term complications (Mol & Law, 2004, p. 50). The case of Sandrine illustrates how the decision to start using a new technology the FSL has enhanced the self-management of her illness. As I was never measuring my glycaemia, my doctor said, when this tool came out, ‘Definitely, you should wear it,

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Before wearing the FSL, she never brought the tools she needed to measure her blood glucose level and inject insulin with her during the day because she did not want her colleagues to know she has diabetes and to do the daily actions she has to undertake to manage it. Therefore, she used to inject insulin only once when she got home. With the data produced by the FSL, she became aware that if she does not inject enough insulin during the day, there will be concrete effects on her blood glucose during the night. This statement motivates her to inject more insulin during the day. Marie is an interesting example of embodied actions in relation to the use of the FSL. For me it is really the visualisation of the curve […] there is a psychological effect, it means that in general I have never limited myself for snacking and so on, if I’m hungry, I’m hungry, and then I inject at worst a small dose of insulin […] but it’s true that it is always a bit random […] With the FSL, if I see a curve that it is on the arrow going up, then I will feel less like eating because I say to myself ‘then it will continue on the going up arrow’ […] so we have a very strong psychological effect with the curve and then when we see that it is stable, there you are incredibly proud and it motivates you to always do well. (Marie, 23, type 1 diabetes for 8 years) Marie is a young woman who apparently was already doing well in managing her diabetes. The use of this new technology motivates her to do even better, on the one hand due to the improvement of the HbA1c of her friend who has been wearing this tool from the very beginning since it was commercialised. On the other hand, her will to have a nice curve pushed her in limiting her snacking.

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Visualising the curves may also enable diabetic people to better adjust and manage technical aspects of their treatment, as Remy explains: It is much simpler to regulate the basal rate, instead of doing your capillary blood glucose control, to print them, to compare your blood glucose numbers with the doses of insulin you put and so on […] you have the curve under your eyes, you look ‘ah here I did that, it was not enough etc.’, so you can much more easily manage your diabetes. (Remy, 22, type 1 diabetes for 18 years) Remy’s experience with the FSL is emblematic of the way the data it produces facilitate the reflexions he needs to undertake in order to adapt his treatment. Without this device, the work he had to do was timeconsuming and tedious, and he might not have done it on a regular basis.

Surveillance Underpinning the Use of CGM and FGM A few CGM devices ease the possibility to share data with caregivers, including members of the family and friends. Once owners install the app on their smartphone, they can invite people to start following them. During a medical consultation, Tania (a diabetologist), Adrian (a 15-year-old man who has had diabetes for 5 years) and his mother discussed whether to choose one of the CGM systems or the FSL. Due to his unbalanced diabetes, Adrian tried to wear the FSL for the last two weeks before the consultation. Since Tania discovered that Adrian’s health insurance does not pay for the FSL, she presented to them two CGM systems: the Dexcom G5 and the Guardian Connect. In doing so, she tried to provide them with good reasons for opting for one of them rather than to risk that Adrian would choose to go back to traditional glucometers. She mentioned the possibility of sharing data with people Adrian would like to, highlighting that it would be both helpful to him and reassuring for his mother when he would go to school camps or to a friend’s house. As Adrian said that he would prefer the FSL because he prefers to scan instead of simply looking at the device to check his glycaemia as for CGMs, his mother showed a real interest in the other CGM systems. They finally left the consultation without having taken a decision because, on the one hand, Adrian was not convinced about the arguments given to him, especially the sharing of data, and on the other

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hand, his mother was reluctant about the costs associated with the FSL that she would have to incur. The data produced by these self-tracking devices are shared with healthcare practitioners and the discussion around them replaces the one that was taking place before their commercialisation, mostly around the blood glucose journal that was filled out more or less carefully by the patients or their relatives. When patients wearing this device arrive at the consultation, one of the first tasks of the practitioner is to download the data and then subsequent exchanges are based on them. Concerning her feelings of having to share the data with her diabetologist, Rachel said: Frankly, I tell you frankly it’s great to have security but then it affects me that the doctor can see with his computer the excesses I did. I feel very controlled. […] I think we are dependent on companies producing insulin, we are dependent on machines and then we are monitored! I mean when you drink a glass of wine, it does not matter to anyone which glycaemia you had (she laughs) but I have to justify myself. I have to justify myself for the glycaemia I had, do you see that? […] Sometimes I say to my diabetologist ‘Are you done Big Brother?!’ (Rachel) After she became diabetic, for a few months Rachel used a logbook where she noted her blood glucose and specific events that could have an influence on her glucose level. She admitted that if she had particular evenings where she conceded to food or wine excesses, she voluntary omitted to write the numbers in her journal. With the self-tracking device she was wearing when we met her, this is not possible and she felt very controlled and felt that she had to justify herself if she does not follow medical prescriptions.

Tactics Enacting Micro-powers The data produced by the devices cannot be hidden. However, in consultations, we observed that part of the data was missing from patients’ readers. To explain that, the patients reported different reasons to practitioners. Sandrine, for example, told us she did not wear the FSL when she went for holiday in Central America because she knew humidity

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and heavy sweating would have limited the number of days of the sensor’s lifetime as it would have fallen off easily. A mother of a 12-year-old woman with diabetes said to the doctor she did not use the FSL when they were on holiday because the data were not representative of her daughter’s normal values. Therefore, on the one hand these devices enable more surveillance of patients’ behaviours and on the other hand, people use tactics to avoid sharing all the data with practitioners. For example, Cle´mence usually checks the time on her pump and since she wears the Guardian she sees her glucose level at the same time. I saw I was in hyper and then I did nothing because I said to myself ‘If I did not have the Guardian, well I would not have done something, so I will not inject myself now, I will wait until the next blood glucose control’. (Cle´mence) She wishes to feel free to care about her diabetes at specific moments of the day as she did when she was not wearing the Guardian, and not every time a device shows her a bad number. Emile’s way of managing his diabetes is another interesting example of a patient’s agency in relation to medical norms and technology. For years, my HbA1c has been around 6 […] My diabetologist thought every time that 6 is too low because it’s true I did always have a lot of hypos. […] But I really want to avoid hyperglycaemia because I know that it causes long term complications, too much insulin and all, so I prefer to be in hypo than in hyper. It’s a bit, I don’t want to say a dangerous attitude because until now I have always managed well. (Emile, 22, type 1 diabetes for 10 years) Emile’s strategy is to favour hypoglycaemia episodes rather than having the HbA1c too high, which in the long term could damage his body. The use of the FSL has not changed his way of thinking about what is best for him, but it has enabled him to limit unnecessary sugar. In fact, the FSL allows him to check his blood glucose before consuming sugar because he feels sensations he associates with hypoglycaemia. With traditional glucometers, he had to eat sugar each time he felt ‘hypo’s symptoms’, because checking his blood glucose would not have been as practical as it is with the FSL.

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Discussion and Conclusion The numbers produced by CGM and FGM devices orient the sensations and the actions of people with diabetes, and the exchanges they have with their caregivers and peers. The novelty with self-tracking devices is the visual representation of the body, which enhances the communicating dimensions of the self. At the same time, the data sharing builds objective and quantified norms of the fleshly body (Lupton, 2016). Another key aspect of these technologies is that the number is no longer a given value at a specific moment but it is inscribed into a trend. This provides a more detailed picture of blood glucose fluctuations and the factors that could influence them. These elements have major implications for diabetes self-management, the medical encounter and therapeutic education. The body and the self are transformed by the experiences people live through when interacting with this technology and with the other actors involved in its use, such as caregivers and peers. The ‘lived body’ approach of Pickard and Rogers (2012) suggests that self-care expertise does not lie in a technology or rational understanding but in the embodied and practical act of doing self-care (p. 117). Technologies acquire subjective meanings and specific uses in relation to the practical experience of the users practicing (self-) care, which involves experiences of embodiment and selfhood and knowing as a practice (Mol & Law, 2004; Pickard & Rogers, 2012; Pols, 2013). As Danholt (2013) emphasises, ‘an active patient is not something you are, but something you become’ (p. 376), because in chronic illness management there is always action and all the actors and entities involved ‘do things to one other and they make each other do’ (p. 376). This ‘faire-faire’ activity (Gomart & Hennion, 1999 in Danholt, 2013, p. 378) takes subjects in a ‘continuous distribution and configuration of agency’ between the entities and actors that are mutually engaged in an ongoing process of affecting each other (p. 376). People living with chronic illness ‘are not finite, determinate beings, but affective bodies engaged in the ongoing process of affecting and being affected, and thus assembled in still-novel ways’ (Danholt, 2013, p. 388), such as by a new technology and the data it produces. The ontology of affective bodies establishes a space for action and incites the continuous work of assembling good relations (Danholt, 2013). Therefore, as Pols (2012) points out self-care work is always distributed among the different actors involved including the devices and the self is shaped by all of them together. In order to consider these interdependencies, she suggests

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substituting self-management or self-care with ‘together-management’ (p. 76). Each individual can choose to resist wearing these devices in light of the specific interactions constituting his/her personal and subjective experience. Simultaneously, the meanings they attribute to this technology, the ways of using it and the sense-making processes of the data it produces are shaped by the situations in which he/she is taken, the contexts of use and the interactions with the different actors involved. These aspects set particular and unique configurations, assembled through the actors’ encounters (Lupton, 2013b). A few salient points emerge from this research and need to be further investigated. These are strongly connected to the ways in which healthcare professionals use digital technologies and the data they produce in their clinical practices, and, at the same time, to how patients are trained in using them. What will be the role of patients’ own accounts of their bodies, their sensations and their feelings when they learn directly to self-manage their diabetes through the use of these tools? What will be the space given to bodily sensations in therapeutic education using these new technologies? In addition, to use the information produced by these devices, healthcare professionals should ‘re-embed’ it into the context of its use (Lupton, 2013b, p. 265). Physicians’, public policies’ and health insurances’ indiscretion about patients’ private life and the potential increasing surveillance of patients’ behaviours should also be questioned as a major concern of our times.

Acknowledgements This research has been supported by the Swiss National Science Foundation (SNSF 156509). The authors would like to thank the persons who took part in the research, the supervisors of the project Professor Miche`le Grossen (PI), Professor Francesco and Professor Bernard Burnand (co-applicants) for their suggestions, and Dr Luca Chiapperino for the proofreading.

References Ajana, B. (2017). Digital health and the biopolitics of the quantified self. Digital Health, 3, 1 18. doi:10.1177/2055207616689509

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Coole, D., & Frost, S. (2010). Introducing the new materialism. In D. Coole & S. Frost (Eds.), New materialisms: Ontology, agency, and politics (pp. 1 43). Durham: Duke University Press. Danholt, P. (2013). Factish relations: Affective bodies in diabetes treatment. Health, 17(4), 375 390. doi:10.1177/1363459312460698 De Certeau, M. (1984). The practices of everyday life. Berkeley, CA: University of California Press. Fenwick, T. (2014). Sociomateriality in medical practice and learning: Attuning to what matters. Medical Education, 48(1), 44 52. doi:10.1111/medu.12295 Gillespie, T., Boczkowski, P. J., & Foot, K. A. (Eds.). (2014). Media technologies. Essays on Communication, materiality, and Society. Cambridge, MA: MIT Press. Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory (Chapter V: The constant comparative method of qualitative analysis). Chicago, IL: Adline. Gomart, E., & Hennion, A. (1999). A sociology of attachment: Music amateurs, drug users. The Sociological Review, 47(S1), 220 247. doi:10.1111/j.1467-954X. 1999.tb03490.x Greenhalgh, T., Collard, A., Campbell-Richards, D., Vijayaraghavan, S., Malik, F., Morris, J., & Claydon, A. (2011). Storylines of self-management: Narratives of people with diabetes from a multiethnic inner city population. Journal of Health Services Research & Policy, 16(1), 37 43. doi:10.1258/jhsrp.2010.009160 Greenhalgh, T., & Swinglehurst, D. (2011). Studying technology use as social practice: The untapped potential of ethnography. BMC Medicine, 9, 45. doi:10.1186/ 1741-7015-9-45 Hinder, S., & Greenhalgh, T. (2012). ‘This does my head in’. Ethnographic study of self-management by people with diabetes. BMC Health Services Research, 12(1), 83. doi:10.1186/1472-6963-12-83 Lupton, D. (1997). Foucault and the medicalisation critique. In A. Petersen & R. Bunton (Eds.), Foucault, health and medicine (pp. 94 110). London: Routledge. Lupton, D. (2013a). Quantifying the body: Monitoring and measuring health in the age of mHealth technologies. Critical Public Health, 23(4), 393 403. doi:10.1080/ 09581596.2013.794931 Lupton, D. (2013b). The digitally engaged patient: Self-monitoring and self-care in the digital health era. Social Theory & Health, 11(3), 256 270. doi:10.1057/ sth.2013.10 Lupton, D. (2014). Critical perspectives on digital health technologies. Sociology Compass, 8(12), 1344 1359. doi:10.1111/soc4.12226 Lupton, D. (2016). The quantified self. Malden, MA: Polity Press. Mol, A. (2000). What diagnostic devices do: The case of blood sugar measurement. Theoretical Medicine and Bioethics, 21(1), 9 22. doi:10.1023/A:1009999119586 Mol, A., & Law, J. (2004). Embodied action, enacted bodies: The example of hypoglycaemia. Body & Society, 10(2 3), 43 62. Oudshoorn, N. (2011). Telecare technologies and the transformation of healthcare. Basingstoke: Palgrave Macmillan. Oudshoorn, N., & Pinch, T. (Eds.). (2003). How users matter: The co-construction of users and technology. Cambridge, MA: MIT Press.

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Pickard, S., & Rogers, A. (2012). Knowing as practice: Self-care in the case of chronic multi-morbidities. Social Theory Health, 10(2), 101 120. doi:10.1057/ sth.2011.24 Pols, J. (2012). Care at a distance. Amsterdam: Amsterdam University Press. Pols, J. (2013). The patient 2. Many. About diseases that remain and the different forms of knowledge to live with them. Science & Technology Studies, 26(2), 80 97. WHO. (1999). Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: Diagnosis and classification of diabetes mellitus. (No. WHO/ NCD/NCS/99.2). Geneva: World Health Organization. WHO. (2016). Global report on diabetes. Geneva: World Health Organization.

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Chapter 8

Doing Calories: The Practices of Dieting Using Calorie Counting App MyFitnessPal Gabija Didziokaite_, ˇ Paula Saukko and Christian Greiffenhagen

Abstract The existing literature on fatness has critically discussed meanings and morals associated with body weight and explored people’s experiences of weight loss attempts. However, little attention has been paid to the practices of dieting how it is ‘done’. Based on an interview study involving 31 participants, who shared their selftracking experience of using the MyFitnessPal calorie counting app, we focus on the practices of ‘doing’ calories. First, we discuss the practices of temporality of logging food, showing that the use of MyFitnessPal not only has to be fitted into daily routines but can also transform them. Then, we look at the practices of precision or users’ various ways of turning the ‘messiness’ of food into precise numbers. Lastly, we explore users’ practices of adjustments their attitudes to adherence to their daily calorie goal and ways of dealing with going above it. Based on our findings we suggest calorie counting is not a straightforward data collection, but one that involves constant practical strategies and negotiations, and can both influence and be influenced by other everyday practices. Keywords: Self-tracking; dieting; calorie counting; quantified self; self-monitoring; practices

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Introduction Fat, perceptions of it and ways of tackling it are popular topics addressed by diverse disciplines. Historical studies have outlined how corpulence became a social problem from the nineteenth century onwards (Schwartz, 1986). Today this vilification continues with ‘war on obesity’ fought by governments and medical professionals (Gard & Wright, 2005). Researchers have discussed the different moral evaluations associated with fatness and thinness, such as body/mind, lack of control/self-control and gluttony and greed/restraint (Bordo, 1993; Gilman, 2010). Likewise, it has been shown that eating and food have for a long time been morally evaluated (Coveney, 2006). Researchers have looked at the representation of fat people in the media and shown that the portrayals are mainly negative (Contois, 2013). Consequently, with all the negativity attached to ‘excessive’ eating and fatness, pressures to control eating habits and get thinner coming from governments and media, many resort to dieting and other means of weight loss. Studies have explored the experiences of such endeavours by exploring diet groups such as Weight Watchers (Heyes, 2006; Stinson, 2001), online dieting (Niva, 2015) and surgical weight management (Throsby, 2008). We thus have some knowledge about attitudes towards fatness, the role of the media in changing and sustaining these attitudes, and the feelings and opinions of those engaged in dieting. In short, researchers have focused on what people think, feel and know about body weight, calories and dieting. However, despite the interest in fatness and pursuits of weight loss, the practices of dieting, what people do when they wish to lose fat and otherwise manage their weight have been little explored. Guided by the practice-oriented traditions of science and technology studies (STS), in this chapter we aim to fill this gap by exploring the ‘doings’ of calorie counting. Researchers working in STS have highlighted the importance of observing the everyday practices of scientists as well as users of technology. This is essential for noting the efforts required to establish a fact, in the case of scientists, or to adopt a technology. This ‘invisible work […] outside formal work relations’ (Oudshoorn, 2008, p. 275) is, thus, the focus of this chapter. We explore what using MyFitnessPal requires its users to do to count the calories they consume. We explore the practical temporality, precision and cheating that constitute calorie counting with MyFitnessPal. We show that each of these aspects requires efforts from MyFitnessPal users if they wish to establish a correct calorie

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count, and these efforts, in turn, affect users’ eating habits. However, despite the constraints imposed by calorie counting, users are negotiating their use and adopting MyFitnessPal to suit their lives.

Exploring Practices of Eating and Dieting While perceptions and experiences of eating and dieting attracted significant attention, the same cannot be said about their practices. Comber, Hoohout, Van Halteren, Moynihan, and Olivier (2013) investigated food practices, exploring how the practices of buying, preparing and eating food are managed. These practices are affected by time (time available to shop, cook, eat and the time available food stays fresh) and people (children and guests influence what food the family eats). Comber et al. (2013) showed that people do not have precise meal plans and follow routines for both buying and preparing food. Eating out was providing freedom to think more about taste than the healthiness of the food. Similarly, Kerr, Tan, and Chua (2014) researched practices of food preparation to understand cooking needs. They too found that people do not plan meals much and usually buy similar foods. People usually weigh ingredients only when they bake. While food is usually cooked alone, social elements such as advice, sharing and feedback influence the process. Food practices related to dieting have been explored by De la Rocha (1985, 1986), who has looked at everyday food measuring and counting practices evoked and guided by participation in Weight Watchers weight loss group. She interviewed and observed measuring practices of 10 females participating in the Weight Watchers programme. At the time, Weight Watchers required dieters to consume a certain number of portions of different foods during a week. All foods were allowed if the amount that was eaten followed the recommendation. Hence, weightwatchers needed to engage in a lot of measuring. De la Rocha notes that based on their approach to dieting, there were two groups of dieters the meticulous controllers of food intake and others who relied on previous dieting experiences and tried to eat very little and used the Weight Watchers programme only as a rough guide. De la Rocha’s (1986) focus was not so primarily on dieting, but on ‘everyday arithmetic’. Thus, she focused on participants’ practical ways of measuring food without employing scales or measuring cups. For example, they would measure the amount of food that is considered as a portion by Weight Watchers once and, for example, note a decorative

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marking on the dish to which the food is filled, so that next time they could use this as a reference for the required quantity.

Understanding Practices of Dieting through STS Perspective To unpack and understand the practices and implications of everyday usage of weight loss technology, we adopt an STS perspective of technology and quantification. STS researchers argue that numbers used by various tools are not stable, already-existing entities, but rather are produced through commensuration and measurement, which change ‘qualities into quantities’, and this change ‘creates new things and new relations among things’ (Espeland & Stevens, 2008, p. 412). Martin and Lynch (2009), for example, show that counting chromosomes and people is not a matter of simply ascribing a number to quantity but rather involves negotiations of practicalities to, first of all, make those things countable. Following this, we wanted to explore and highlight how people used MyFitnessPal as a dieting technology, and how they made the food and calories countable in their daily practices of food planning, preparation and eating. In what follows we present the results of the exploration of practices of dieting from an STS perspective. We show that, even though calorie counting is ostensibly ‘automated’ in that users do not count, that is add and subtract the numbers of calories, they still need to put a lot of effort to transform the foods they eat into numbers of calories. Moreover, calorie counting, as a practice directly linked to food, is infused with moral undertones, which can influence what is counted and how. Methods We conducted 31 interviews with users of MyFitnessPal; the participants fell into three basic groups. The participants include 12 men and 19 women, and their age ranged from 22 to 53 years. Most participants were based in the UK, East Midlands area. Ethical clearance was obtained from the authors’ university before commencing recruitment and interviewing. To ensure anonymity, we use pseudonyms when quoting participants. Our recruitment was informed by a desire to include everyday selftrackers people who started tracking on their own and were not part

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of any self-tracking community and, hence, to avoid studying members of the Quantified Self community, which has been researched a lot. Thus, we approached personal trainers in the East Midlands area, some of whom referred us to their clients, who used MyFitnessPal. We also posted recruitment ads on a participant recruitment website callforparticipants.com, on local sports Facebook groups and on the bulletin board for local university staff and students. The sole criterion for participation was a previous or present use of MyFitnessPal. The interviews were semi-structured and consisted of questions about the history of MyFitnessPal use, usual use practices, and evaluation of the app. The interviews were conducted by the first author mostly (n = 28) face to face, with few (n = 3) done through Skype video calls. The interviewer recorded and transcribed all the interviews, and conducted a thematic analysis. How Calorie Counting Is Done Practical Temporality One of the first things one must decide when using MyFitnessPal is when to log the food eaten. There is no prescribed time of doing it, and thus users can decide whether they log before, during or after eating. These choices have their different advantages and disadvantages that are connected to individual routines and aim for precision of the food log. However, decision, when to log, can also influence the eating habits. Logging during meals disturbs eating habits as cooking or eating is being interrupted to enter all the foods into MyFitnessPal. Logging in advance highlights the reactivity of calorie counting as measurement instead of counting the calories they (Espeland & Sauder, 2007) consume, participants are planning their meals and adjusting them according to the calories suggested by the app. It not only changes the calorie counting as a measurement but also affects participants’ eating behaviours requiring them to be regulated in advance. Logging food for calorie counting could be quite time-consuming and needed to fit in sometimes very busy schedules. So most often participants would log food during their breaks at work or at the end of the day, after work and dinner, when they had more free time to sit down, remember and log all the things eaten: Eve: I mean I had my breakfast at home, and then I get to work I put in while I’m having a coffee, before the

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Gabija Didziokait ˇ ˙e_ et al. morning meeting, then after lunch, I put it in, then after dinner, I put it in. Lilian: It can be time-costly […] I tend to do when […] my son’s gone to bed because you can just sit there and work it all out, but you do have to have the patience.

Some participants knew that logging ‘long after’ a meal may be problematic and were explicit about avoiding logging foods only at the end of the day because it made it easy to forget what was eaten: Samantha: I think if I remember I’d put it in after I’ve eaten the food, I think if you tried to at the end of the day you’d forget half the things you’ve eaten. I used to do food diary when I was training as a swimmer, so I was aware that if you did it at the end, you forget everything. [our emphasis] Samantha echoes the nutrition scientists who use food diaries and note that participants forgetting and therefore not logging eaten foods is a frequent issue (Macdiarmid & Blundell, 1998). This concern was mentioned by some other participants as they underlined the importance of timing for the ‘reliability’ of their records. In addition to issues of remembering, counting calories at the end of the day or long after the food was eaten was posing a risk of going above the calorie norm, because you would lose the possibility of reflecting on what you are eating prior or during consumption: Alex: I would tend to be putting in food kind of afterwards. So, you’d have Subway, when I’ve been out, I’d grab a subway or something, out in town, and then an hour later you come to put it in and see that that was about 800 calories bloody hell, didn’t know that. So, not logging before a meal could lead to an unpleasant surprise and possibly going over the calorie limit. Yet as the earlier quotes show, many participants were logging long after eating despite the potential of ‘unreliable’ data. This indicates that in many instances convenient use of MyFitnessPal that fits with one’s own life is more important than ‘perfect’ use that generates ‘reliable’ insights. This indicates that often

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convenient use that fits with owns life is more important than ‘perfect’ use that generates ‘reliable’ insights. Some participants addressed the problem of ‘reliability’ by logging while eating or cooking as they could weigh and search for the ingredients or meals straight away, so there was less chance of forgetting: Julie: Usually […] I put my breakfast in as I’m eating my lunch [laughs]. But then tea, I would put it while everything is cooking, I know I’ve got it ready and it’s fresh in my mind, if I do forget. Gemma: I’d probably enter it while I was cooking and then mend it, say if I haven’t eaten it all, I’d mend it afterwards, but I would put it in while I was cooking so that I knew exactly what was in there. Logging while cooking helped to remember all the ingredients and made it possible to scan the barcodes of packets, making the log more accurate and precise. Logging inevitably interrupted the eating or cooking and made participants focus on the calorie values of food. Others were even more determined to get the numbers right and to be in control and therefore counted calories before eating, often logging in the morning all the items they were going to eat during the day: Georgina: And then either I see what calories I’ve got left for dinner, or I know what I’m having, and I put that as well. So, I do it, I do it as much as I can first thing, so kind of like you know what you can have the rest of the day. [our emphasis] In addition to safeguarding from going above their calorie limit, logging in advance enabled participants to determine if any other food in addition to the planned meals could be consumed. And for sports enthusiasts, like Barney, logging in advance also helped to ensure that all the required nutrients will be consumed: Barney: Sometimes I know what I’m going to eat for the day, and I might just put it all in at once […] for example, yesterday evening I was going to have sweet potato with steak, I put in the steak, I put in the sweet potatoes. I will

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Gabija Didziokait ˇ ˙e_ et al. look on MyFitnessPal oh, that’s, if I was like I said […] I want a hundred grams [of] sweet potato, I realise that’s not really enough, so I can use it to add, use MyFitnessPal to sort of help me prepare my meal. [our emphasis]

Georgina’s and Barney’s quotes point to the reactivity (Espeland & Sauder, 2007) of calorie counting. Participants were not just making a record of their food as they ate but aimed to regulate their eating by planning and counting calories in advance. Hence, counting calories with MyFitnessPal as other kinds of self-tracking has a prospective character (Rooksby, Rost, Morrison, & Chalmers, 2014). The quotes also confirm the STS argument that measuring is never neutral or passive, but rather performative since it can ‘cause people to think and act differently’ (Espeland & Stevens, 2008, p. 412). Participants were not just tracking their calories but regulating their eating according to them. Moreover, the need to measure log calories sometimes was interrupting the eating. Hence, the timing of logging affected their eating habits. Exploring the timing of calorie logging not only reveals the practical considerations that need to be taken when deciding when to log but also shows different ways that calorie counting influences eating practices. Practical Precision Measuring food intake is not straightforward. Apples, for example, come in different types and sizes, and to get a correct calorie count for the eaten apple one needs to find the exact type, its size or if being more precise, its weight. This gets even more complicated when eating meals that have many different ingredients. Hence, food and calories have to be constituted (Potter, Wetherell, & Chitty, 1991) as countable through practical negotiations. The participants of the present study were not scientists wanting to know exactly how many calories every item they ate had. They usually wanted to know ‘roughly’ how much they were eating and therefore adopted appropriate attitudes to their calorie counting. As Gemma put it: I mean you’re never going to get this exact calorie, I don’t think. But as long as you’ve got an educated guess as to what you’re eating, I think it works very well. Participants’ stories reveal different ways they achieved the desired precision, which indicate that attitudes to the precision range on a

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continuum from approximations to very precise counting. Hence, the calorie count a number that appears to be exact and objective is approximate and arrived at in messy and individual ways. Moreover, whether measured by grams or approximated by handfuls, food becomes estimated in a more constricting manner, requiring attention to the quantities that might not have been given before. Some of the participants did not measure but rather guessed the weight of their food items. Some, like Vijay, did not have kitchen scales. Others, simply thought that weighing food in addition to logging it would have been too bothersome and, like Joe, they could not do the food logging if it had required that much effort: Joe: I wouldn’t [weigh Ready Brek out], no I don’t go to that length. A Hundred millilitres is very very little. I wouldn’t go to the extent of actually weighing or measuring it out. Cause I think if I did that I don’t think I would be able to maintain. These participants argued that not measuring resulted only in small inaccuracies (especially of less calorific foods), and did not affect the overall calorie count much. Therefore, it is not essential to measure precisely. Some participants who were reluctant to measure food argued that the imprecisions would average out over time: Stacey: I just put in twenty [grapes], I could weigh them up, but I never do that, just make my lunch and just eat twenty. I sort of go on, some days, some weeks they’ll be really big, and I probably wouldn’t be putting enough in, but other weeks they probably be a lot smaller, so I guess over the year I average out. Here we can see that participants were not so much interested in keeping a precise ‘daily record’, but more in having an aggregate log. Some participants, similarly to those in the De la Rocha (1986) study, found practical ways of gaining at least some precision without overburdening themselves with constant measuring. One method was measuring the foods they used to eat often once and then using that as a template for the future.

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Gabija Didziokait ˇ ˙e_ et al. Gemma: So, I’d always, if it’s something new I’d always measure it first, first time I used it, and then afterwards just try and remember what it was that I had last time. Anamaria: Because we bought a really small kitchen scale, I weigh, I used it once to weigh like a pear once, to weigh an apple once and I’m just using that.

Those who used the app more frequently or were familiar with calorie counting often learned to estimate weight from the size or volume: Georgina: And I know these measurements, I used to put my bowl on a set of scales and zero it and measure, and now I know I have a scoop, how many spoonfuls that makes, and the blueberries is well under 100 grams. These techniques were helpful, as most participants said they routinely ate the same food items. By using such methods, participants established a middle ground, as they avoided both just guessing the weight of their food or/and constantly measuring it, and instead created ways of approximation. To help with precision, MyFitnessPal has a scanner so that users can scan the barcodes of packed foods straight into the app, which reads their calorie content. However, often the food that participants ate neither had a barcode nor could be found on the database. Hence, participants encountered a special difficulty of recording eating (and being precise) if they could not find items in the database. In those cases, they might have to ‘guess’ what would be a similar item: Lilian: And half the time it’s there but if it isn’t there I would just look for the best fit, so even if it’s not a complete precise, there’s an estimate, I choose the most, the nearest thing, you know what I mean. Roy: So, if I’d been out, I don’t know, if I’d been to Franky and Benny’s or something, where there was a Harvester equivalent, and you kind of think ‘well I’ve been to both of those places, they’re roughly about the same amount’.

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I would pick the one that’s in MyFitnessPal, rather than just try and build something. With complex items, that is those that consisted of several ingredients, this would involve more complex ‘guesswork’: Q: So, but then I imagine, if you put like a roast dinner plate, it probably has something like from 400 to 1000 calories. So how did you choose between? Georgina: Well I knew I had cauliflower cheese, I knew how many roast potatoes I had, and whether they were cooked in fat. Cause I’ve been observing for so long, I suppose I had an idea. I knew that plate of dinner wasn’t 400 […] I know there’s a temptation to put in 400 and think oh, I’ve got another 800 to go, but I err on the side of going too much, rather than too few calories. Hence, in calorie counting as in other counting practices, to count at least approximately right, the user needs to know what they are counting, and be aware which numbers are wrong (Martin & Lynch, 2009). These quotes show that measuring calories for a long time enabled participants to estimate them based on prior experience. Thus, calories become integrated into their eating practices they can ‘guess’ calories based on prior experience. Despite recognising that calorie counting as measuring could not be very precise, a few participants wanted at least to do their part ‘correct’ they aimed to be precise and weighed everything they were eating. For many, this was done to get the ‘correct’ portion as defined by the app or food package. Alex explained how the meaning of the ‘correct’ amount of food changed when he was dieting: Well because, maybe because I was using it on sort of weight loss aim, was always kind of choosing to go for sort of portion size that it says on the packet, rather than just pouring until you reckon that’s about right. So yeah it would be sort of 50 gram, whatever would be just poured out, I could probably because it was 50 gram, it’s not because it’s the amount that I wanted or anything like that, or because it was the amount that I need to, to the

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Gabija Didziokait ˇ ˙e_ et al. target, sort of, if I was able to sort of meet the target by going to 35 grams or something.

When Alex was tracking his diet, the portion size was regulated by the weight loss aim, rather than by a whim, as it was when he was not tracking. Hence, because he was aiming to lose weight, he needed to eat the ‘right’ portion and, therefore, measure the ‘correct’ amount. Similarly, Barney explained that it was easy to get the weight and portion wrong by just estimating: And like if I was weighing out fruit or something, you don’t quite get an appreciation like, 80 grams you can actually get it quite wrong, you don’t realise how wrong you can get it, so [weighing] is useful. So, measuring was presented as a way to get the ‘right’ amount and as an opposition to ill-informed guessing, where it was easy to not ‘realise how wrong you can get it’ and damage your weight loss. Hence, precise logging of food with MyFitnessPal affected what participants perceived as a portion, and consequently their eating practices. Power (2004, p. 769) argues that we expect measurement to ‘not to depend on who is doing it’ and therefore be replicable. However, as the discussed examples show such expectations are hard to meet when it comes to calorie counting. Different users approach measurement differently, depending on their commitment to precision and control of their diet. There seemed to be no unified way of how food logging for calorie counting should be done. The stories signal the messiness of the ways the precision was being achieved and the subjective side of the calorie values. Practical Adjustments Participants often had a routine diet that they established as fitting under their calorie limit. However, as for dieters in Niva’s (2015) study, events, such as socialising, would make participants deviate from the routine and eat more calorific meals. These were referred to by some as ‘cheat’ or ‘treat’ meals, highlighting that food consumption was fraught with complex social evaluations associated with doing the wrong thing or rewarding oneself (Coveney, 2006; Lupton, 1996). Calorie counting added another dimension to these evaluations as participants not only morally evaluated these actions but also had to deal with the ‘excess’ consumption practically. While

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some participants aimed to minimise the influence of ‘excess’ consumption to the calorie limit by eating less beforehand, others would stop counting calories altogether if they anticipated the ‘excess’. MyFitnessPal was not a tool to keep a perfect record of calorie consumption, but rather an aide to help lose weight. Thus, manipulation of the app’s use indicates that despite the rigidness MyFitnessPal required, its use had to fit the users’ lives, and sometimes that meant ‘cheating’. Some participants, especially the sports enthusiasts, would actively avoid going over the calorie limit. If they wanted to abandon the planned diet and eat something more calorific, they would try to build a calorie deficit either eating less during the week before or on the day. To do this, they would need to engage in the earlier mentioned planning of meals, so that they could compensate their ‘cheat’ or ‘treat’ meal by being more austere in advance. This kind of ‘allowance’, especially the weekly one, is not in any way encouraged or supported by the app, so participants came up with this idea themselves and needed to keep these ‘saved’ calories in mind. For example, Freddie, who was engaged in body building and aimed to get leaner before his annual photo shoot, would calculate the calorie and nutrient allowance he needs to ‘save up’ in advance and which meals to cut those calories out before going out: […] that meals gonna be a thousand calories, those 1000 calories need to come out of somewhere, ok how can you use 200 calories out of my evening meal, or 400 calories, so that’s 600 calories I need to find elsewhere in the week, to make sure I hit under. Similar strategies were used by participants, who only wanted to lose weight. They might not be as elaborate as Freddie, but would simply try to eat less before going out for a meal: Lilian: Something that was gonna take my calories, say in the evening meal, went out to the pub for dinner, then I make sure that in the mornings I was eating, I don’t know a little bit of fruit for breakfast or you know, yoghurt, or you know, something smaller. This confirms the argument made earlier that calorie tracking is prospective, as people anticipated ‘excess’ calories. Participants

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often talked about these negotiations, reflections and preparations in moral undertones, describing the eating out occasions as ‘naughty’, which highlights the way in which the moral understandings of consuming excess food and the use of the app supported each other: Q: But then, as you mentioned now, so if you go for a meal or have a birthday or something like that, do you try then to cut out calories before, you know, by exercising or by eating less? Eve: Yes, I would do. I would probably eat less, I would sort of try and make sensible choices. Q: So, like an allowance for you to […] Eve: Be a bit naughty. Yeah. Similarly, the participants referred to the austere regimes adhered to prior to eating out or more, as being ‘good’: Stephen: If I knew that meal was coming up, I would try and be good that week, I try and be good the week afterwards, be better than I would normally […] I wasn’t too hard on myself. I can see how people could be hard on their selves on this, it could make people paranoid, erm, and I felt like I was probably getting a bit that way towards the end. Coveney (2006) argues that nutrition provides an ethical framework through which to construct ourselves as certain kind of persons. Hence, there seemed to be a moral difference between strict and regulated diet (‘be good’) and the occasional meal out (‘be a bit naughty’). This echoes the religious language used by the weight loss industry (Contois, 2015) and commercial weight loss groups (Bacon, 2015), with ‘good’ and ‘bad’ foods constituting sin or salvation. However, Stephen recognised that it is easy to get ‘paranoid’ while logging food, suggesting that too much strictness was not welcomed. This goes hand in hand with Crawford’s (1984) findings that people find both control and release essential for health.

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Another way of dealing with ‘excess’ is by stopping calorie tracking altogether. For example, Ruth would stop logging if a breach of calorie limit could be anticipated: No. Erm. When I first started, when I was kind of enthusiastic about it, and I was trying to lose weight for a holiday for the summer, and I then was quite good about making sure that I’m putting everything in every day. But even then, still at the weekends if I had more than one glass of wine, I was like there’s no point of putting it in, cause I’ll just be well over. Erm. I always log my exercise cause that makes me feel better, but I don’t always log, if I know that I had a day where I went over, sometimes I just won’t put it in. This illustrates the way in which excess calories are manipulated out of existence by not logging them in. Ruth tells that initially she was ‘good’ and logged everything, but over time she learned to be more selective in accordance to what makes her feel ‘better’. Georgina too omitted weekends when the consumed wine will tip over the calorie limit: Georgina: […] it’s a day like a Saturday, and I’m out, and I’m drinking lots of glasses of wine, I won’t even bother that day, I just think I can’t even think about [logging food on MyFitnessPal]. And I know it’s about 4000 calories today, so. I don’t bother putting that in because it doesn’t, I can’t see any gains in putting that in. I know I’ve gone over [the calorie limit], MyFitnessPal doesn’t do anything to make me think ‘I might as well fill in 4000 calories today’. It’s when I know I’m gonna stick under it, I fill it in properly, if I know I’ve gone over it, and the food’s too difficult to log, I just don’t bother, because it’s too much hassle for what. Like Ruth, Georgina finds some calories like the calories of wine not worth the effort of logging as the knowledge that calorie limit has been breached when she is socialising is not helpful in her weight loss attempt. Measurements are reactive, as they intervene and often discipline the world they depict (Espeland & Stevens, 2008). Ruth’s and

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Georgina’s examples indicate that sometimes participants did not find the ‘reactivity’ of all calorie counts useful, and therefore sometimes chose which numbers to ‘make’. Only the ‘successful’ days below the limit were logged as they made participants feel good about themselves and helped them be motivated and continue with calorie counting. In contrast, there was no use in seeing the numbers of ‘unsuccessful’ days when calorie limit was breached, and which would only reflect ‘failure’. The stories of participants might not exactly indicate the ‘soft resistance’ (Nafus & Sherman, 2014) found among other self-tracking activities. Yet, they reveal defiance of the scenarios of use embedded in the app (i.e. log everything that you eat) as users negotiated control and release (Crawford, 1984) for calorie counting that would be useful and comfortable to them.

Discussion and Conclusion Current literature on weight loss practices does not focus much on the practices of dieting, or how they influence daily lives or practices rather than the body or self-image. We explored the practices of dieting by calorie counting, and the findings emphasise three points. First, calorie counting, even if somewhat automated with such apps as MyFitnessPal, is not effortless, nor done without some planning. Earlier research on online dieting (Niva, 2015), commercial weight loss groups (Stinson, 2001) and surgical weight loss (Groven, Ra˚heim, & Engelsrud, 2015) has shown these activities as also requiring considerable effort. The present study supplements this common finding by ‘unboxing’ the efforts. Instead of investigating the attitudes and/or feelings towards calorie counting, we have explored the ‘doing’ of calorie counting. Calorie counting, as any other practice of counting, involves ‘procedures for assigning numbers to objects’ (Martin & Lynch, 2009, p. 261), and people using technologies such as MyFitnessPal have to put a lot of effort to ‘make’ the numbers of calories. It requires finding the time, tools such as scales, and knowledge, not to mention skills, to employ all these correctly. Therefore, second, the present exploration of practical aspects of calorie counting shows that there is no unified way to count calories and, thus, the objective number of a calorie count was achieved in messy ways. Each user responded differently to the practical and ‘ethical’ considerations, and negotiations involved in calorie counting. De la Rocha

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(1986) divided her participants into two groups based on their way of dieting. However, we found that the participants of the present study could not be classified that categorically. They ranged on a continuum between relaxed and very precise counting, with some switching places depending on the practices (e.g. would log food in advance, but would not measure). As they were not looking to build a precise record of their calorie consumption, participants did calorie counting in the way that best fitted their goals, lifestyle (sports enthusiasts needing more precision or people wanting to lose weight needing approximation) and practical arrangements. This leads to the third point. Earlier research has noted that dieting (Bordo, 1993; Heyes, 2006) or weight loss surgeries (Throsby, 2008) can affect not only the body but also the experience of self. We want to extend this argument, as a close look at the practices of calorie counting lets us see how calorie counting both influences routines of people doing it and is influenced by them. Needing to log food eaten affects eating practices. Compared to usual food practices, food practices when dieting are more regulated as food needs to be standardised, classified and counted. People rarely measure foods and ingredients (Kerr et al., 2014). However, dieters needed to know how much they are eating and, therefore, measure food before eating, which sometimes affected the meaning of portions. Many related to food through its calories as often they dictated in advance what could be ‘safely’ eaten to fit in the daily goal or indicated that less food needs to be eaten in the morning to be able to enjoy a dinner in the restaurant. Nonetheless, calorie counting with MyFitnessPal needs to be appropriated by the user so that it becomes feasible and blends into daily life. The participants knew that the best time to log food was when it was eaten, but they often logged whenever it suited them best. They knew that to be precise they need to measure food, but this often was seen as too burdensome or unnecessary, and participants resorted to more suitable ways of determining quantities of food eaten. Similarly, they knew that according to MyFitnessPal, if they wanted to lose weight they need to stick to the daily calorie limit, but sometimes they would still digress from it to be able to enjoy social meals out. Thus, the use of MyFitnessPal shows dieters’ negotiations between what was needed and what was convenient, rather than a blind following of the suggestions of the app. Overall, exploration of the so far overlooked practical aspects of dieting provides us with a better understanding of the relationship

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between the practice of dieting (as well as technologies used) and those engaged in it.

References Bacon, H. (2015). Fat, syn, and disordered eating: The dangers and powers of excess. Fat Studies, 4(2), 92 111. Bordo, S. (1993). Unbearable weight: Feminism, Western culture, and the body. Berkeley and Los Angeles, CA: University of California Press. Comber, R., Hoohout, J., Van Halteren, A., Moynihan, P., & Olivier, P. (2013, April). Food practices as situated action: Exploring and designing for everyday food practices with households.. In Proceedings of the SIGCHI conference on human factors in computing systems (pp. 2457 2466). ACM. Contois, E. J. H. (2013). Food and fashion: Exploring fat female identity in drop dead diva. Fat Studies, 2(2), 183 196. Contois, E. J. H. (2015). Guilt-free and sinfully delicious: A contemporary theology of weight loss dieting. Fat Studies, 4(2), 112 126. Coveney, J. (2006). Food, morals and meaning: The pleasure and anxiety of eating (2nd ed.). New York, NY: Routledge. Crawford, R. (1984). A cultural account of “health”: control, release, and the social body. In J. B. McKinlay (Ed.), Issues in the political economy of health care (pp. 60 103). New York, NY: Tavistock Publications. De la Rocha, O. L. (1985). The reorganization of arithmetic practice in the kitchen. Anthropology & Education Quarterly, 16(3), 193 198. De la Rocha, O. L. (1986). Problems of sense and problems of scale: An ethnographic study of arithmetic in everyday life. Irvine, CA: University of California. Espeland, W. N., & Sauder, M. (2007). Rankings and reactivity: How public measures recreate social worlds. American Journal of Sociology, 113(1), 1 40. Espeland, W. N., & Stevens, M. L. (2008). A sociology of quantification. European Journal of Sociology, 49(3), 401 436. Gard, M., & Wright, J. (2005). The obesity epidemic. London: Routledge. Gilman, S. L. (2010). Obesity: The biography. Oxford: Oxford University Press. Groven, K., Ra˚heim, M., & Engelsrud, G. (2015). Changing bodies, changing habits: Women’s experiences of interval training following gastric bypass surgery. Health Care for Women International, 36(3), 276 302. Heyes, C. J. (2006). Foucault goes to weight watchers. Hypatia, 21(2), 126 149. Kerr, S. J., Tan, O., & Chua, J. C. (2014). Cooking personas: Goal-directed design requirements in the kitchen. International Journal of Human-Computer Studies, 72(2), 255 274. Lupton, D. (1996). Food, the body and the self. London: Sage. Macdiarmid, J., & Blundell, J. (1998). Assessing dietary intake: Who, what and why of under-reporting. Nutrition Research Reviews, 11(2), 231 253. Martin, A., & Lynch, M. (2009). Counting things and people: The practices and politics of counting. Social Problems, 56(2), 243 266.

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Nafus, D., & Sherman, J. (2014). This one does not go up to 11: The quantified self movement as an alternative big data practice. International Journal of Communications, 8, 1784 1794. Niva, M. (2015). Online weight-loss services and a calculative practice of slimming. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 21(4), 409 424. Oudshoorn, N. (2008). Diagnosis at a distance: The invisible work of patients and healthcare professionals in cardiac telemonitoring technology. Sociology of Health & Illness, 30(2), 272 288. Potter, J., Wetherell, M., & Chitty, A. (1991). Quantification rhetoric - Cancer on television. Discourse and Society, 2(3), 333 365. Power, M. (2004). Counting, control and calculation: Reflections on measuring and management. Human Relations, 57(6), 765 783. Rooksby, J., Rost, M., Morrison, A., & Chalmers, M. C. (2014). Personal tracking as lived informatics. In Proceedings of the SIGCHI conference on human factors in computing systems (pp. 1163 1172). ACM Press. Schwartz, H. (1986). Never satisfied: Social history of diets, fantasies and fat. New York, NY: The Free Press. Stinson, K. (2001). Women and dieting culture: Inside a commercial weight loss group. New Brunswick, NJ: Rutgers University Press. Throsby, K. (2008). Happy re-birthday: Weight loss surgery and the ‘new me’. Body & Society, 14(1), 117 133.

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Chapter 9

Sleep App Discourses: A Cultural Perspective Antoinette Fage-Butler

Abstract Sleep apps installed on smartphones are increasingly being used to help people overcome sleep problems. The purpose of this chapter is to identify the discourses that underpin discursive constructions of the potential sleep app user in sleep app marketing communication. According to critical marketing theory, discursive constructions of the potential consumer in marketing communication promote the potential consumer’s identification and alignment, priming the potential consumer to consider positively the product being marketed. In that sense, marketing (of sleep apps, or indeed anything) is culturally significant, as it provides templates for forms of identity, and affects the meanings and objects that circulate within a culture. A data set consisting of the promotional material that was used to market acclaimed sleep apps was analysed using Foucauldian discourse analysis (FDA). The following discourses were identified in the data: disempowerment, pathologisation, ignorance, behaviourism, responsibilisation, mindfulness, seduction, convenience or common sense, empowerment and individualisation. These discourses indicate how sleep apps are legitimised as technical appendages to be installed into people’s phones and integrated into their lives. They also underpin the discursive identities that summon potential consumers into alignment. This chapter contributes to our understandings of the discursive mechanisms that lie behind the growing uptake of

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sleep apps. It also demonstrates the value of combining discourse analysis with relevant critical theory to gain insights into the emerging phenomenon of app culture. Keywords: Sleep apps; critical marketing theory; consumer alignment; discourse analysis; potential sleep app user; app culture

Introduction Lack of sleep is considered a significant public health problem (WHO, 2004). It has been associated with numerous health problems, including cardiovascular disease, obesity and cancer (Hillman & Lack, 2013), lack of general well-being (Henry, Knutson, & Orzech, 2013; NHS, 2015) and health and safety risks caused by sleep deprivation (Kroll-Smith & Gunter, 2005; Williams, 2002). According to recent estimates, around one in three people in the UK and in the US suffer from poor sleep (CDC, 2016; NHS, 2015). Sleep disturbances are expensive; in Australia, for example, the total cost of sleep deficit in 2004 was estimated to be 0.8% of the national gross domestic product (Hillman, Murphy, & Pezzullo, 2006). As poor sleep can trigger health and safety risks to oneself and others and results in poorer concentration and effectiveness, it is often constructed as ‘a personal and moral failing’ (Kroll-Smith & Gunter, 2005, p. 364). There has also been criticism of overuse of pharmacology and underuse of behavioural therapies to treat sleeplessness (Moloney, Konrad, & Zimmer, 2011). A growing trend in our increasingly digitised culture is that people are turning to sleep apps for help with sleep problems (Ko et al., 2015; So, 2014). Sleep apps have multiple purposes, including ‘sleep induction, wake induction, self-guided sleep assessment, entertainment, social connection, information sharing, and sleep education’ (Ko et al., 2015, p. 1455). Sleep apps are among the most popular consumer health products (Ko et al., 2015), although digital technology use has paradoxically been associated with poor sleep (Murdock, Horissian, & Crichlow-Ball, 2017; Woods & Scott, 2016). The turn to non-pharmacological approaches to sleep hygiene, which sleep app use represents, has been attributed to disillusionment with the medical profession and growing consensus that sleep deficit is a matter that can be addressed by the individual himself or herself, where behavioural,

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dispositional and lifestyle changes can make a profound difference (Hislop & Arber, 2003). In this chapter, I present a cultural approach to the marketing of sleep apps, drawing on critical marketing theory (Alvesson & Willmott, 1996; Moisander, Markkula, & Era¨ranta, 2010; Ska˚le´n, Fouge`re, & Fellesson, 2008). Specifically, I explore the discursive constructions of potential sleep app users employed in the marketing of sleep apps, focusing on the discourses that underpin these constructions, as these discourses provide meanings and values that legitimise sleep apps as technical appendages to be integrated into people’s routines and be allowed to monitor and quantify aspects of their lives. Sleep apps warrant scrutiny, like other digital innovations that blur the interface between the corporal and technological (Lupton, 2014a). Indeed, the increasing integration of digital technologies in our lives is considered to be changing what it means to be human (Hansen, 2006). From a phenomenological perspective, as Merleau-Ponty (2014 [1974]) pointed out well before the digital revolution, ‘my own body is the primodial habit’ (p. 93); the world is experienced only through the ‘phenomenal body’ (Svanæs, 2013, p. 11) that encounters the world using perception and whole body engagement with artefacts (such as mobile phones). The importance of critically investigating popular sleep apps is also underlined in Chun’s (2016) point that ‘our media matter most when they seem not to matter at all’ (p. 1). Moreover, Williams, Coveney, and Meadows (2015) state that the advent of digital apps raises important ‘questions of selfhood, sociality and governance’ (p. 1050), typically Foucauldian themes, indicating the appropriateness of the discursive approach adopted in this chapter. Sleep has mainly received research attention as a biological, psychological and, in the case of dreams, psychoanalytical issue (Williams, 2002). Sociological aspects of sleep have until recent years been relatively neglected, possibly, as Williams (2008) suggests, because sleep seems to be ‘a blank or non-event: a more or less radical form of withdrawal from society’ (p. 640). However, as revealed in recent studies (Henry et al., 2013; Williams, 2002, 2008; Williams et al., 2015), sleep has considerable sociocultural significance. With its focus on discourse and identity, this chapter brings a cultural/discursive approach to the study of sleep apps. ‘Culture’, as it used in this chapter, refers to ‘systems of representation through which people make sense of their everyday life’ (Moisander & Valtonen, 2006, p. 8). These systems of representation are discursively generated and present and reaffirm culturally sanctioned meanings, practices and identities (Barker & Jane,

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2016; Foucault, 1982). In line with the cultural/discursive approach adopted in this chapter, the identity of the potential sleep app user that is projected in the marketing of sleep apps is analysed using FDA (Willig, 2013). This chapter addresses significant research gaps. So far, there has been little investigation of the cultural implications of sleep apps, also a tendency within app research, more generally. Lupton (2014b), for example, has observed that most previous studies of apps focus on their effectiveness, rather than considering their ‘social, cultural and political roles’ (p. 607) in contemporary health care and public health, or what they mean for evolving understandings of issues such as health, illness and embodiment. As will be demonstrated in this chapter, a cultural/ discursive approach helps to indicate the senders’ (here, company) perspectives on their products and consumers. This is valuable as there is little knowledge of the ‘practices and tacit assumptions of app developers and designers and the companies that commission apps’ (Lupton, 2014b, p. 618). Also, Williams et al. (2015) have specifically called for research that empirically examines ‘the ways in which new digital sleep apps are produced and promoted’ (p. 1050), with particular attention being paid to how user-technology relationships are configured and reconfigured in the process and the way this links to wider patterns and practices of e-health care, self-governance and optimisation in the digital age. (p. 1050) This chapter attends to these aspects by examining how potential sleep app users are constructed in sleep app marketing communication. The remainder of the chapter outlines critical marketing theory, provides an overview of discourses that have previously been associated with sleep, sleep apps and digital health, and presents the analytical method and data, before reporting on and discussing the findings.

Critical Marketing Theory Critical marketing theory represents an alternative to mainstream marketing theory, which tends to be characterised by an instrumental, positivist approach (Alvesson & Willmott, 1996; Burton, 2001; Hunt, 2003). Critical marketing studies is an umbrella term for a range of critical approaches within the field of marketing (Firat & Tadajewski, 2011).

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The approach to critical marketing theory adopted in this chapter focuses on cultural meanings in a marketing context, and is inspired by post-structuralism and cultural studies (Moisander & Valtonen, 2006). In terms of method, discourse analysis is often chosen in critical marketing research for its ability to ‘ontologically de-naturalise’ (Fitchett & Caruana, 2015, p. 9) the field of marketing studies (Ska˚le´n, 2010; Ska˚le´n et al., 2008). The particular value of examining the consumer identities that are projected in marketing communication is clarified by Moisander et al. (2010) as follows: marketing is geared at producing and providing consumers with certain kinds of subjectivity intelligible and acceptable forms of being through which they are hoped to govern themselves. Consequently, the power exercised by the marketers ultimately functions through consumers’ practices of self-control. (p. 74) In other words, the construction of consumer identities has a cultural effect, as specific forms of identity, with associated subjectivities and practices, have a disciplining, normalising impact. The hope is that these identities are assumed, as they provide subjectivities that help to ensure that the products in question will be consumed. As Moisander et al. (2010) explain: marketing as a practice of government is geared at providing consumers with a number of acceptable identities acceptable ways of being, thinking and acting that are defined by certain rights, responsibilities and social relationships. (pp. 76 77) What is important here is that marketing does not rely on directly persuading the consumer to buy a product; instead, it generates alignment, ‘orchestrating the everyday life of consumers in a way that their “lifestyle” links up a particular complex of subjective tastes and allegiances with a particular product’ (Moisander et al., 2010, p. 77). Consumers identify with subjectivities that are promoted in marketing communication and that in turn link to particular products. In the context of the present study, it is relevant to point out that commercial enterprises have capitalised on ‘poor sleep as a potential health risk’ (Hislop & Arber, 2003, p. 819). This too is reflected in

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critical marketing theory which theorises how marketing suggests ‘particular identity projects in which particular consumption activities are connected to ideas of good life and role-appropriate behaviour’ (Moisander et al., 2010, p. 76). In this regard, marketing of sleep apps leads to self-governance as consumers shape their identities in relation to constructs that promote normative, positively valorised identities, such as the responsible, risk-avoiding and well-rested citizen. As Moisander et al. (2010) conclude, marketing involves ‘the “ethical government of the self” […] through which citizens are governed as consumers’ (p. 77). In relation to Foucauldian discourse theory, these constructions of subjectivities of app users in marketing communication matter are idealised or ‘phantasmatic’ (Foucault, 1972, p. 68) projections where potential app users have the scope for identification, at the same time as they provide moral legitimisation for the installation of the app in people’s phones and its integration in their lives. In brief, critical marketing research that analyses the consumer identities projected in marketing communication exposes idealised consumer identities which constitute templates for normative forms of subjectivity. Moreover, analysing discursive constructions of the idealised consumer in marketing communication helps to indicate the cultural contours of the marketing environment for specific products, produced by marketing discourses.

Sleep, Sleep App and Digital Health Discourses Sleep apps are, of course, not marketed in a discursive vacuum. It is therefore important to identify the discourses relating to sleep, sleep apps and digital health that may be drawn on by sleep app producers in their marketing of sleep apps; these discourses also indicate the broader cultural backdrop against which sleep apps are marketed. Williams (2008) notes that sleep features prominently within contemporary discourses of health, risk and lifestyles, and is promoted not only as a means of achieving a good and happy life, but also in relation to citizens’ moral responsibility to be ‘well-slept’. In line with sleep’s high premium even fetishisation (Williams, 2002) in western societies, sleep has been medicalised (defined as a medical problem), as is evident in the proliferation of ‘sleep disorders’ (e.g. narcolepsy, sleep apnoea, restless leg syndrome, shift work sleep disorder), pharmaceuticalised (associated with pharmacological treatment for sleep disorders), and healthised (associated with self-improvement projects that promote

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positive health behaviours) (Williams, 2002). Expert discourses about sleep deficiency proliferate, with professional sleep experts or somnologists as well as alternative therapists providing professional services to help individuals manage their sleep problems. As Williams (2002) points out: ‘Sleep […] becomes caught up in a tangled web of health and illness, morality and risk, safety and danger, across the lay/professional divide’ (p. 189). Williams et al. (2015) focus on sleep apps within the context of the ‘quantified self’ movement with its associated discourses of ‘“improvement” or “optimisation” in performance and health’ (p. 1045). Lupton (2013) notes that self-tracking technologies for health are associated with an empowerment discourse, and that people are reminded of the importance of taking responsibility for their health. Williams et al. (2015) describe sleep apps as reflecting ‘prevailing neoliberal, if not bioliberal […] mandates associated with identity and selfhood, individualisation and responsibilisation’ (p. 1040). Apps are examples of digital health technologies, so digital health or mHealth (mobile technology health) discourses, which have mainly been analysed from a sociological perspective, are also relevant to the marketing of sleep apps. These discourses include responsibilisation of the individual for his/her health (Kivits, 2013; Trnka, 2016), healthism (Lupton, 2013, 2014b), symbiosis between human and digital (Haraway, 2013; Lupton, 2017), cyberbole (Ajana, 2005; Woolgar, 2002) and the pathologisation of human existence (Barker, 2014; Rose, 2007).

Discourse Analysis Discourse analysis is a much-used analytical approach within cultural studies (Barker & Jane, 2016) and critical marketing studies, as noted earlier. In this chapter, I employ FDA using Willig (2013) who developed ‘procedural guidelines’ (p. 131) that draw on Foucauldian discourse theory as presented in The Archaeology of Knowledge (Foucault, 1972). In Foucauldian discourse theory, the statement is the unit of analysis; a statement is long enough to construct discursively an object of analysis. As Foucault (1972) explains, ‘That man!’ (p. 81) is not long enough to be a statement, as it does not construct ‘that man’ in relation to existing discourses. The first stage of Willig (2013), discursive constructions, involves finding discursive constructions in statements that illustrate the various ways in which a particular discursive object is constructed in the text. The second stage, discourses, associates the

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identified constructions with relevant discourses. The third stage, action orientation, involves closer examination and discussion of what is achieved by the various constructions in context. This stage focuses on the intersection between discourse and practice. More concretely applying the three stages to the present object of analysis, FDA (Willig, 2013) identifies the discourses (stage 2) that underpin the constructions of the potential sleep app user (stage 1). Considering the strategic purpose of the included discursive constructions (stage 3) helps to provide critical purchase on the discourses that promote sleep apps.

Data In order to identify relevant, up-to-date data, I used Healthline’s (2017) webpage, The Best Insomnia Apps, published 18 May 2017. Healthline’s list of 12 apps for smartphones (iPhones and Androids) was put together on the basis of the apps’ ‘quality, user reviews, and overall reliability as a source of support for people who suffer with insomnia’. The apps are presented in Table 9.1; the data set was put together in July 2017. Web links are provided for both Android and iPhone apps as both were included in the analysis, and there were, in some cases, differences between the marketing of apps for iPhones and Androids. As can be seen from Table 9.1, three of the apps were available for Android devices only at the time of data collection. The content of the webpages promoting the apps on the Google Play website or Apple’s iTunes website is analysed in the Section Analysis.

Analysis In this section, the primary focus is on identifying the discourses (Stage 2 of Willig, 2013) that underpin the discursive constructions of the potential sleep app user. Statements that illustrate the various discursive constructions of the potential sleep app user (Stage 1 of Willig, 2013) in the promotional material from the data set are included in this section as they indicate on what basis the discourses were identified. I end the analysis section with a discussion of what is gained by strategically including the identified discourses (Stage 3 of Willig, 2013).

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Table 9.1. Overview of Data. App Name

Date of Last Update

Webpage

25 August https://play.google.com/store/apps/ details?id=com.hivebrain.andrewjohnson. 2015 deepsleep&hl=en 19 https://itunes.apple.com/us/app/ September deep-sleep-with-andrew-johnson/ 2016 id337349999?mt=8 Digipill 28 https://play.google.com/store/apps/ February details?id=com.yuza.digipill.droid& 2017 hl=en 19 March https://itunes.apple.com/us/app/ 2017 digipill-sleep-relaxation-andmindfulness/id578068250?mt=8 Nature Sounds 24 June https://play.google.com/store/apps/ Relax and Sleep 2016 details?id=com.zodinplex. naturesound&hl=en Pzizz 6 March https://play.google.com/store/apps/ 2017 details?id=com.pzizz.android&hl=en 4 July https://itunes.apple.com/us/app/pzizz2017 sleep-at-the-push-of-a-button/ id915664862?mt=8 Relax & Sleep Well 12 July https://play.google.com/store/apps/ by Glenn Harrold 2016 details?id=com.imobilize. relaxsleepwell&hl=en 1 June https://itunes.apple.com/us/app/relax2017 sleep-well-by-glenn-harrold/ id412690467?mt=8 Sleep as Android 24 July https://play.google.com/store/apps/ 2017 details?id=com.urbandroid.sleep&hl= en Sleep Cycle 28 May https://play.google.com/store/apps/ 2017 details?id=com.northcube.sleepcycle& hl=en 1 June https://itunes.apple.com/us/app/sleep2017 cycle-alarm-clock/id320606217?mt=8 Deep Sleep with Andrew Johnson

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Table 9.1. (Continued ) App Name

Sleep Easily by Shazzie

Sleep Genius

Sleep Well Hypnosis

Sleepo White Noise

Date of Last Update

Webpage

9 February https://play.google.com/store/apps/ details?id=com.Arkenea. 2017 SleepEasilyMeditatation&hl=en 12 October https://itunes.apple.com/us/app/sleep2016 easily-by-shazzie-a-guidedmeditation/id458059886?mt=8 27 https://play.google.com/store/apps/ February details?id=com.mobile.sleepgenius& 2017 hl=en 22 https://itunes.apple.com/us/app/sleepDecember genius-revive-cycle-alarm-nap2016 relaxation/id873376319?mt=8 24 May https://play.google.com/store/apps/ 2017 details?id=com.surfcityapps. sleepwell&hl=en 14 https://itunes.apple.com/us/app/sleepFebruary well-hypnosis-insomnia-sleeping2017 sounds/id720652207?mt=8 8 May https://play.google.com/store/apps/ 2017 details?id=net.relaxio.sleepo&hl=en 2 Jun 2017 https://play.google.com/store/apps/ details?id=com.tmsoft.whitenoise. full&hl=en 25 April https://itunes.apple.com/us/app/ 2017 white-noise/id289894882?mt=8

A discourse of disempowerment is used to construct potential sleep app users as overwhelmed by the pressures of life: • The pace of life and change can be overwhelming. We all need to slow down sometimes, to relax, to unwind yet after a hectic day at

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work, a terrible commute, or a nightmare shopping trip it may seem impossible. (Deep Sleep with Andrew Johnson iPhone) Potential sleep app users are constructed using a discourse of pathologisation as being in need of psychological/mental healing which the app can provide: • At the deepest point in the session, you are given a number of posthypnotic affirmations and direct suggestions to help you with the healing process relating to the title of the recording. (Relax & Sleep Well by Glenn Harrold iPhone) • Solve insomnia, get stress relief, boost energy. (Pzizz Android; iPhone) Similarly, potential sleep app users can be suffering from a range of psychological and physical ailments: • People use nature sounds relaxation techniques for the following reasons, among others: Anger management [….] Cardiac health […] Depression therapy […] General well-being […] Headache therapy […] High blood pressure […] Immune system support […] Insomnia therapy […] Pain management […] Stress management […] (Nature Sounds Relax and Sleep Android) The app has curative potential for the potential sleep app user: • […] we actually help you sleep. We are the first app offering treatment for sleep deprivation. (Sleep Genius Android; iPhone) Potential sleep app users are constructed as being sick and unhealthy, and insomnia is constructed as a global public health issue: • Health Magazine: ‘Help you turn off your brain, fall asleep faster, and get the rest you desperately need’. (White Noise Android; iPhone) • Sleep is one of the biggest factors to your health. A total of 25% of the population is taking sleeping pills. A total of 55% of people who sleep less than 5.5 hours a night are overweight. We developed Sleep Genius to address one of the largest health issues on the planet. (Sleep Genius iPhone) The discourse of pathologisation is also evident in the construction of potential sleep app users as patients and the app as a ‘pill’ that can help

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them achieve better sleep. The app is a form of non-pharmacological ‘medication’ that draws on sciences such as neurolinguistics and psychoacoustics: • Digipill is the #1 Health & Fitness App around the World. Each pill is a guided meditation voiced by Brian Colbert, a leading expert in NLP, and psychoacoustic director of Digipill. (Digipill iPhone) A discourse of ignorance is used to construct the potential app user as lacking knowledge or training in relation to sleep hygiene, which the app can help them with: • The vast majority of people have never had any relaxation training and therefore find it difficult to switch off, be still and fall deeply asleep. (Deep Sleep with Andrew Johnson iPhone) • Learn to reduce anxious thoughts and sleep calmly after listening daily for just 1 3 weeks. (Sleep Well Hypnosis iPhone) A behaviourist discourse is also evident in the construction of the potential sleep app user as a biological being who responds to external stimuli: • This deeply relaxing and powerful method of delivering multiple suggestions simultaneously to the unconscious mind can facilitate positive changes very quickly. (Relax & Sleep Well by Glenn Harrold iPhone) The discourse of responsibilisation is also evident. Potential app users are reminded that they have a responsibility both to themselves and those they care about for getting sufficient rest: • A good night sleep is vital for your health and well-being, affecting not only you but also the loved ones around you. Play this Deep Sleep program and get the rest that you deserve. (Deep Sleep with Andrew Johnson iPhone) The discourse of mindfulness is also present in the data. The app can help to take people on a journey within their consciousness, resulting in heightened engagement with the world: • The first of the free tracks, Relax & Sleep Well, is a full 29-minute hypnotherapy session that will take you on a relaxing journey into

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the deepest levels of self-hypnosis. (Relax & Sleep Well by Glenn Harrold Android) • This meditation will leave you refreshed, renewed and resonating so much more from your heart and a place of stillness. (Sleep Easily by Shazzie Android; iPhone) A discourse of seduction, which is common in much marketing communication (Bauman, 2000), is also evident in the discursive construction of the potential sleep app user: • Relax into her soothing words and let go fully into a deeply relaxing sleep. During this 26-minute recoding, you’ll be gently guided every step of the way to relax your whole body and mind. (Sleep Easily by Shazzie Android; iPhone) • Throughout this beautiful recording, you’ll be held by the music and sounds created by Ali Calderwood. Ali is an accomplished musician and healer who also produces the exquisite music of Anima. (Sleep Easily by Shazzie Android; iPhone) A discourse of convenience or common sense (Fage-Butler, 2017) is also used to construct the potential sleep app consumer as desiring simple solutions and choosing the best options: • Sleep at the push of a button. Unlike other sleep solutions, you don’t have to change your behaviour, keep a sleep diary or limit your activities. Just listen to Pzizz, and enjoy incredible sleep. (Pzizz Android; iPhone) • Sleepo does not require internet connection so you can use it anywhere without worrying about the data. (Sleepo Android) • Our only side effect is sleep! Unlike medications or supplements, you’ll never have to worry about adverse effects (Pzizz Android; iPhone) A discourse of empowerment is also evident in the data. Sleep apps can help users achieve greater self-knowledge and control as they facilitate the tracking of the physical signs of sleep and the production of individualised quantified data on sleep patterns: • Sleep notes see how events such as drinking coffee, eating too much or having a stressful day affect your sleep quality. (Sleep Cycle Android; iPhone)

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A discourse of individualisation is evident in the way in which the potential sleep app user is represented as someone who values variation and customisation: • Every time you tap ‘Start’, Pzizz creates a slightly different session for you to enjoy. This ensures your brain doesn’t get fatigued from hearing the same things over and over again, and helps ensure effectiveness over time. (Pzizz Android) • Adjust sleep duration, volumes, switch voice on or off or add a 3D effect for a fully personalized listening experience. (Pzizz Android) The discourse of individualisation is also associated with an existentialist search for meaning, identity and self-fulfilment: • As an acclaimed author of five books, the creator of several life transformation programmes and an international speaker and workshop facilitator her quest is always the same: to help you on your journey back to the centre of your own heart. (Sleep Easily by Shazzie Android; iPhone) • This meditation will leave you refreshed, renewed and resonating so much more from your heart and a place of stillness. From there, you’ll be able to attract towards you everything your heart desires, without your head getting in the way. (Sleep Easily by Shazzie Android; iPhone) Stage 3 of Willig (2013) explores the question ‘what is gained by constructing the object in this way at this particular point within the text?’ (p. 132). The main point here is that the discourses that underpin the discursive constructions in the text ‘get things done’ in the real world (Said, 1986, p. 152), and choices about discourses are strategic, not innocent. All of the discourses that underpin the constructions of the potential sleep app user are intended to help sell the product. They construct the potential sleep app user in ways that are familiar (suffering from poor sleep and looking for remedies) and the product as attractive to the user (it is straightforward, centred on individual needs, potentially seductive; you learn about yourself, master your life and become a responsible agent). Identification with these elements may be quite unproblematic, making the product, the sleep app, attractive. There are also less positive identities that the potential app user is asked to identify with; these relate to lack of knowledge, and being incapable of dealing with the day-to-day challenges of living. However, the app can help

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users to overcome exactly such positions of ignorance and ineptitude; apps promise ‘(h)appiness’ (Matviyenko, 2014, p. xvii).

Discussion This chapter was written from a position of curiosity: as more and more spheres of our lives become digitised and ‘appified’, how are sleep apps being legitimised, particularly as sleep intuitively seems such a private activity? To answer this question, I coupled the theoretical framework of critical marketing theory with the analytical approach of discourse analysis. One of the contributions of this chapter is exactly this framework: it shows how by using discourse analysis and a critical marketing approach, it is possible to shed light on discursive mechanisms that legitimise greater uptake of sleep apps. This combination of discourse analysis and critical marketing theory is likely to be equally valuable for exploring the legitimisation of other aspects of app culture in a marketing context, particularly as apps colonise hitherto private spheres of our lives, such as dating, gynaecological health and sexual performance. This chapter also makes significant empirical contributions in that it lays bare the discourses that promote the adoption of apps through representations of the potential sleep app user, in line with critical marketing theory. Analysis of the data revealed that the following discourses served to legitimise sleep apps: disempowerment, pathologisation, ignorance, behaviourism, responsibilisation, mindfulness, seduction, convenience or common sense, empowerment and individualisation. A number of these discourses were evident in previous research on sleep and digital health, noted earlier, such as individualism, responsibilisation of the individual for his/her health and pathologisation of human existence. In the present data as well as in previous research, empowerment is particularly associated with the assumed benefits of quantification and monitoring. This recycling of discourses in a marketing context is not surprising as the legitimising discourses that relate to a particular field at any one time and context are limited (Fage-Butler, 2017; Foucault, 1972). Additional discourses were also identified. The integration of discourses of disempowerment, ignorance, behaviourism and seduction in the data reflects the marketing context, where a problemsolution approach (Sawhney, 2015), particularly in advertising, is commonplace. The problem that sleep apps purport to address is psychological frailty which negatively affects people’s ability to sleep, and behaviourism legitimises the technical approach of sleep apps which

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provide sensory stimulation and metric data to address insomnia. The discourse of convenience or common sense observed in the data has been identified in other health contexts where decision-taking was central (Fage-Butler, 2017); here, the decision is whether to install the app or not. The inclusion of the discourse of mindfulness also serves to legitimise sleep apps, as mindfulness is increasingly culturally mainstream (Kirmayer, 2015), and its association with positive mental health makes it a relevant choice. All in all, analysis reveals that the discourses constructing the potential sleep app user in sleep app marketing communication present the potential sleep app user both in relation to the problem (insomnia) as well as the solution (what the app provides: a good night’s sleep). As such, the analysis provides empirical substantiation of Matviyenko’s (2014) point that problems and solutions are marketed together in apps: ‘The “needs” come with apps as part of the package, which means the “solutions” are being sold to us along with the “problems” they are meant to resolve’ (p. xxvii). In terms of understanding apps and their marketing, this is an important finding. Further empirical studies of apps and how they ‘sell’ problems and solutions would be very valuable, particularly for theory-generating purposes. This chapter adds empirically to understandings of app culture, and its implications for identity. According to critical marketing theory, the idealised constructions of user identity that are evident in the marketing communication of sleep apps provide identities that potential sleep app users ideally should align with so that installing and using the app seems a good idea, and they progress from being potential users of a sleep app to becoming actual sleep app users. The qualities of the potential sleep app user projected in the marketing communication explored in this chapter can be characterised as disempowered, pathological, lacking in knowledge about sleep, easily affected by stimuli, needing to take responsibility for poor sleep, potentially affected by the promises of a more spiritual life and appeals to the senses and positively disposed to arguments about convenience, common sense, customisation and the value of logging quantified personal data. To a large extent, app culture seems to rely on a deficit, behaviouristic model of human nature. The identification of negative qualities in the discursive construction of the potential sleep app user and the fact that app users themselves may not problematise representations of their needs and weaknesses as Matviyenko (2014) observes, ‘we seem to enjoy the idea that the production of human needs has been delegated to the machine’ (p. xxvii) suggests the need for further research into the reception of app

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marketing communication, focusing on issues such as acceptance, resistance, indifference and ambivalence. It is increasingly common to define users of health apps as mpatients, patients who rely on mobile technologies (mHealth) (WHO, 2011), though the term ‘patient’ in the present context can, of course, be problematised. Very little research has been conducted to date on the discursive construction of the m-patient. However, if we consider the potential sleep app user in the present data to be an m-patient, it is noteworthy that the qualities of the potential sleep app user/m-patient in the data resonate with the biomedical model of the patient as lay, in need of expert help and as a set of physiological signs, a model that has been challenged particularly by proponents of patient centredness (Balint, 1969) and patient empowerment (Feste & Anderson, 1995); more recent challenges have come in the form of the motivated, empowered and (semi-)expert e-patient (Ferguson, 2007). The seemingly regressive qualities of the discursive construction of the m-patient in the present data may reflect the ‘problem-solution’ structure embedded in the apps themselves, and the fact that app users rarely provide any input in the design of apps (McCurdie et al., 2012). Further research into the m-patient, both from an emic and etic perspective, is certainly warranted.

Conclusion Sleep apps are increasingly being used to address sleep problems. Given the upsurge in popularity of sleep apps, this chapter explores app culture, in particular, interrogating techniques of legitimisation and the issue of identity. By looking ‘upstream’ to explore how the potential sleep app user is discursively constructed in marketing communication, this chapter sheds valuable light on how spaces are freed up for digital colonisation, and reveals new discursive identities of the app user.

References Ajana, B. (2005). Disembodiment and cyberspace. Electronic Journal of Sociology, 7, 1 10. Alvesson, M., & Willmott, H. (1996). Making sense of management: A critical introduction. London: Sage.

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Balint, E. (1969). The possibilities of patient-centered medicine. Journal of the Royal College of General Practitioners, 17(82), 269 276. Barker, C., & Jane, E. A. (2016). Cultural studies: Theory and practice (5th ed.). London: Sage. Barker, K. K. (2014). Mindfulness meditation: Do-it-yourself medicalization of every moment. Social Science & Medicine, 106, 168 176. doi:10.1016/j. socscimed.2014.01.024 Bauman, Z. (2000). Liquid modernity. Cambridge: Polity. Burton, D. (2001). Critical marketing theory: The blueprint? European Journal of Marketing, 35(5/6), 722 743. doi:10.1108/03090560110388187 CDC. (2016, February 16). 1 in 3 adults don’t get enough sleep. [Press Release]. Retrieved from https://www.cdc.gov/media/releases/2016/p0215-enough-sleep.html Chun, W. H. K. (2016). Updating to remain the same: Habitual new media. Cambridge, MA: The MIT Press. Fage-Butler, A. (2017). Risk resistance: Constructing home birth as morally responsible on an online discussion group. Health, Risk & Society, 19(3 4), 130 144. doi:10.1080/13698575.2017.1327038 Ferguson, T. (2007). E-patients: How they can help us heal health care [White paper]. Retrieved from http://e-patients.net/e-Patients_White_Paper.pdf Feste, C., & Anderson, R. M. (1995). Empowerment: From philosophy to practice. Patient Education and Counseling, 26, 139 144. Firat, A. F., & Tadajewski, M. (2011). Critical marketing Marketing in critical condition. In P. Maclaran, M. Saren, B. Stern, & M. Tadajewski (Eds.), The Sage handbook of marketing theory (pp. 127 150). London: Sage. Fitchett, J., & Caruana, R. (2015). Exploring the role of discourse in marketing and consumer research. Journal of Consumer Behaviour, 14(1), 1 12. doi:10.1002/ cb.1497 Foucault, M. (1972). The archaeology of knowledge. New York, NY: Pantheon. Foucault, M. (1982). The subject and power. Critical Inquiry, 8(4), 777 795. Hansen, M. B. N. (2006). Bodies in code: Interfaces with digital media. New York, NY: Routledge. Haraway, D. (2013). Simians, cyborgs, and women: The reinvention of nature. Abingdon: Routledge. Healthline. (2017, May 18). The best insomnia apps. Retrieved from http://www. healthline.com/health/healthy-sleep/top-insomnia-iphone-android-apps Henry, D., Knutson, K. L., & Orzech, K. M. (2013). Sleep, culture and health: Reflections on the other third of life. Social Science & Medicine, 79, 1 6. doi:10.1016/j.socscimed.2012.11.023 Hillman, D. R., & Lack, L. C. (2013). Public health implications of sleep loss: The community burden. The Medical Journal of Australia, 199, S7 S10. doi:10.5694/ mja13.10620 Hillman, D. R., Murphy, A. S., & Pezzullo, L. (2006). The economic cost of sleep disorders. Sleep, 29(3), 299 305. Hislop, J., & Arber, S. (2003). Understanding women’s sleep management: Beyond medicalization-healthicization? Sociology of Health & Illness, 25(7), 815 837. doi:10.1046/j.1467-9566.2003.00371.x

Sleep App Discourses: A Cultural Perspective

175

Hunt, S. D. (2003). Controversy in marketing theory: For reason, realism, truth, and objectivity. New York, NY: M. E. Sharpe. Kirmayer, L. J. (2015). Mindfulness in cultural context. Transcultural Psychiatry, 52(4), 447 469. doi:10.1177/1363461515598949 Kivits, J. (2013). E-health and renewed sociological approaches to health and illness. In K. Orton-Johnson & N. Prior (Eds.), Digital sociology: Critical perspectives (pp. 213 226). Basingstoke: Palgrave Macmillan. Ko, P. R. T., Kientz, J. A., Choe, E. K., Kay, M., Landis, C. A., & Watson, N. F. (2015). Consumer sleep technologies: A review of the landscape. Journal of Clinical Sleep Medicine, 11(12), 1455 1461. doi:10.5664/jcsm.5288 Kroll-Smith, S., & Gunter, V. (2005). Governing sleepiness: Somnolent bodies, discourse, and liquid modernity. Sociological Inquiry, 75(3), 346 371. doi:10.1111/ j.1475-682X.2005.00126.x Lupton, D. (2013). Quantifying the body: Monitoring and measuring health in the age of mHealth technologies. Critical Public Health, 23(4), 393 403. doi:10.1080/09581596.2013.794931 Lupton, D. (2014a). App-ography: A critical perspective on medical and health matters. Retrieved from http://ethnographymatters.net/blog/2014/09/23/app-ography-a-critical-perspective-on-medical-and-health-apps/ Lupton, D. (2014b). Apps as artefacts: Towards a critical perspective on mobile health and medical apps. Societies, 4(4), 606 622. doi:10.3390/soc4040606 Lupton, D. (2017). Personal data practices in the age of lively data. In J. Daniels, K. Gregory, & T. M. Cottom (Eds.), Digital sociologies (pp. 339 354). Bristol: Policy Press. Matviyenko, S. (2014). Introduction. In P. D. Miller & S. Matviyenko (Eds.), The imaginary app (pp. xvii xxxvi). Cambridge, MA: MIT Press. McCurdie, T., Taneva, S., Casselman, M., Yeung, M., McDaniel, C., Ho, W., & Cafazzo, J. (2012). mHealth consumer apps: The case for user-centered design. Biomedical Instrumentation & Technology, 46(2), 49 56. doi:10.2345/0899-820546.s2.49 Merleau-Ponty, M. (2014). Phenomenology of perception (D. A. Landes, Trans.). Abingdon: Routledge (Original work published 1974). Moisander, J., Markkula, A., & Era¨ranta, K. (2010). Construction of consumer choice in the market: Challenges for environmental policy. International Journal of Consumer Studies, 34(1), 73 79. doi:10.1111/j.1470-6431.2009.00821.x Moisander, J., & Valtonen, A. (2006). Qualitative marketing research: A cultural approach. London: Sage. Moloney, M. E., Konrad, T. R., & Zimmer, C. R. (2011). The medicalization of sleeplessness: A public health concern. American Journal of Public Health, 8(101), 1429 1433. doi:10.2105/AJPH.2010.300014 Murdock, K. K., Horissian, M., & Crichlow-Ball, C. (2017). Emerging adults’ text message use and sleep characteristics: A multimethod, naturalistic study. Behavioral Sleep Medicine, 15(3), 28 241. doi:10.1080/15402002.2015.1120203 NHS. (2015, June 15). Why lack of sleep is bad for your health. Retrieved from http://www.nhs.uk/Livewell/tiredness-and-fatigue/Pages/lack-of-sleep-healthrisks.aspx

176

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Rose, N. (2007). The politics of life itself: Biomedicine, power, and subjectivity in the twenty-first century. Princeton, NJ: Princeton University Press. Said, E. (1986). Foucault and the imagination of power. In D. C. Hoy (Ed.), Foucault: A critical reader (pp. 149 156). Oxford: Blackwell. Sawhney, M. (2015). Going beyond the product: Defining, designing and delivering customer solutions. In R. F. Lusch & S. L. Vargo (Eds.), The service-dominant logic of marketing: Dialog, debate, and directions (pp. 365 381). Abingdon: Routledge. Ska˚le´n, P. (2010). A discourse analytical approach to qualitative marketing research. Qualitative Market Research: An International Journal, 13(2), 103 109. doi:10.1108/13522751011032566 Ska˚le´n, P., Fouge`re, M., & Fellesson, M. (Eds.). (2008). Marketing discourse: A critical perspective. Abingdon: Routledge. So, C. (2014). Doctor prescribes mobile apps to patients. ITBusiness, January 29. Retrieved from http://www.itbusiness.ca/news/doctor-prescribes-mobile-app-thesame-way-he-prescribes-pills/46505 Svanæs, D. (2013). Interaction design for and with the lived body: Some implications of Merleau-Ponty’s phenomenology. ACM Transactions on ComputerHuman Interaction (TOCHI), 20(1), 1 30. Trnka, S. (2016). Digital care: Agency and temporality in young people’s use of health apps. Engaging Science, Technology, and Society, 2, 248 265. doi:10.17351/ests2016.119 WHO. (2004). WHO technical meeting on sleep and health Copenhagen: World Health Organization Regional Office for Europe. WHO. (2011). mHealth: New horizons for health through mobile technologies. Geneva: World Health Organization. Williams, S. J. (2002). Sleep and health: Sociological reflections on the dormant society. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 6(2), 173 200. doi:10.1177/136345930200600203 Williams, S. J. (2008). The sociological significance of sleep: Progress, problems and prospects. Sociology Compass, 2(2), 639 653. doi:10.1111/j.1751-9020.2007.00088.x Williams, S. J., Coveney, C., & Meadows, R. (2015). ‘M-apping’ sleep? Trends and transformations in the digital age. Sociology of Health & Illness, 37(7), 1039 1054. doi:10.1111/1467-9566.12283 Willig, C. (2013). Introducing qualitative research in psychology (3rd ed.). Maidenhead: Open University Press. Woods, H. C., & Scott, H. (2016). #Sleepyteens: Social media use in adolescence is associated with poor sleep quality, anxiety, depression and low self-esteem. Journal of Adolescence, 51, 41 49. doi:10.1016/j.adolescence.2016.05.008 Woolgar, S. (2002). Virtual society?: Technology, cyberbole, reality. Oxford: Oxford University Press.

Chapter 10

Academic Metrics and Positioning Strategies Janet Chan, Fleur Johns and Lyria Bennett Moses

Abstract Since the 1980s, higher education institutions in many developed Western countries have been facing competition for resources, have undergone economic rationalisation, adopted a New Public Management style of performance management and aspired to meet global standards of quality. This chapter explores the selftracking practices of academic institutions and workers as they negotiate a field that has moved away from a quality evaluation system based primarily on social reputation towards one based increasingly on quantified outcome indicators. Universities typically measure research performance not only in terms of quantity of outputs but also the ‘attention capital’ they receive, for example, the number of citations or awards and prizes. These metrics and the emphasis on attention capital generally encourage a culture of competition rather than collaboration, while promoting the ‘celebrification’ of academic life. We argue that this trend has been intensified by technologies that gamify research achievements, continuously update citation and ‘read’ counts, and promote networked reputation. Under these conditions, academic institutions and workers have attempted to pursue a variety of positioning strategies that represent different degrees of conformity, resistance and compromise to the power of metrics. Keywords: Academic performance; metric power; attention capital; presentation of self; celibrification; assessing academic quality

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Introduction [W]e are created and recreated by metrics; we live through them, with them, and within them. Metrics facilitate the making and remaking of judgements about us, the judgements we make of ourselves and the consequences of those judgements as they are felt and experienced in our lives. We play with metrics and we are more often played by them. Beer (2016, loc. 135)

The above observation by David Beer in his book Metric Power highlights the dominance and embeddedness of metrics in contemporary life, especially in developed nations. While metrics (or quantitative measurements) are not new, with counting and the use of statistics going back a number of centuries (Hacking, 1990), there has been a clear shift in recent decades towards measurement ‘as a replacement or substitute for more qualitative judgement’ (Beer, 2016, loc. 515). Not surprisingly, such a shift has become evident in the higher education sector. Since the 1980s, universities in many developed nations,1 facing competition for resources, have undergone economic rationalisation, adopted a New Public Management style of performance management, and aspired to meet global standards of quality (Paradeise & Thoenig, 2013). As a result, the evaluation of academic research has moved away from a system based primarily on social reputation towards one based increasingly on quantified outcome indicators. Universities typically measure research performance not only in terms of quantity of outputs but also the ‘attention capital’ (Franck, 2002) they receive, for example the number of citations or awards and prizes. This chapter explores the self-tracking practices of academic institutions and workers as they negotiate this trend towards metrification of performance evaluation. The analysis is developed in three parts. Part 1 describes changes in the field of higher education at the macro level, focusing on the transformation of how the quality of universities is assessed. Part 2 analyses changes at the meso level, noting a shift in how universities evaluate academic staff for promotion. Part 3 discusses changes at the micro level, observing how academic workers position themselves in this 1

Paradeise and Thoenig’s (2013) analysis suggests that international ranking systems developed by academic institutions, the media, governments and international accreditation associations have widespread influence, spanning both European and other OECD countries.

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reconfigured world. We argue that the dominance of performance metrics and the emphasis on attention capital generally encourage a culture of competition rather than collaboration, while promoting the ‘celebrification’ of academic life. This trend has been intensified by technologies that ‘gamify’2 research achievements, continuously update citation and ‘read’ counts, and promote networked reputation. Under these conditions, academic institutions and workers have attempted to pursue a variety of positioning strategies that represent different degrees of conformity, resistance and compromise to the power of metrics.

Transformation of the Sector: Judgement of Quality The transformation of higher education in developed nations in recent decades has been the subject of numerous academic analyses. Shore and Wright (2017) have identified seven key trends in what they refer to as the ‘seemingly unending series of reforms’ in public universities in the UK, Australia and New Zealand since the 1980s. These include the ‘divestment’ of government support for higher education; the creation of new regimes to promote competition between universities (such as university rankings); the growth of performance measures to improve accountability; the ‘bloat’ of university managers and administrators or the shift in power to the ‘administeriat’; the rise of the ‘entrepreneurial university’ and the ‘recasting [of] university education as a private and positional investment rather than a public good’ (Shore & Wright, 2017, pp. 3 10). Other researchers have pointed to evidence of the ‘accelerated rationalization’ that the higher education and research sectors have faced since the 1980s: International influences, such as private or public evaluations and league tables for universities, research journals, research institutes and diplomas, are increasingly driving national developments. The use of references and tools inspired by New Public Management (NPM) converges with the dissemination of national and international soft law indicators and rankings […] They foster the vision that there is one good way, and only one, to produce and 2

By gamification, we mean the introduction to non-game contexts for our purposes, academic performance management of design features, principles and practices drawn from games; that is, from technologies and activities designed for amusement, diversion and entertainment.

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Janet Chan et al. judge quality in higher education and research. Such apparently voluntary soft law instruments nevertheless are to a large extent out of the discretionary control of local and national public authorities, and are effectively mandatory. Contingent on the expanding use of indicators as reliable traces of academic activity, quality is ontologically supposed to be what is summed up by the measure of ‘excellence’. (Paradeise & Thoenig, 2013, pp. 190 191)

Employing ideal types, Paradeise and Thoenig (2013, pp. 194 195) have contrasted this style of judging quality (what they call ‘excellence’ or ‘expert evaluation’) with an alternative style (‘Reputation’ or ‘Social evaluation’) as follows: while the former is explicit, based on actual outcomes (e.g. a basket of indicators), a-contextual and ordinal (numerical), the latter is implicit, linked to image or brand awareness (e.g. through social or personal networks), contextual and cardinal. The fact that ‘excellence’ or ‘expert evaluation’ judgements are designed to facilitate comparison across institutions or units means that they are ‘the preferred tools for new rationalizing institutional management and governance’ (2013, p. 195). In spite of these pressures to rationalise and conform to a uniform standard of ‘excellence’ using (predominantly) quantitative indicators, it should not be assumed that all universities have uncritically pursued high rankings and followed the path towards uniform standards. Paradeise and Thoenig’s (2013) 27 case studies of departments in different countries and research fields have uncovered a range of positioning strategies, from those giving high attention to both international standards of ‘excellence’ and ‘reputation’, to those giving emphasis to one or the other, or neither of these judgement standards. They create four ideal types of institutional positioning depending on their emphasis on ‘excellence’ and ‘reputation’: (1) ‘The top of the pile’ (High, High), universities or units that give high strategic priority to both ‘excellence’ (expert evaluation) and ‘reputation’ (social evaluation); (2) ‘The wannabes’ (High, Low), those that give high priority to meeting the international standards of ‘excellence’ at the risk of undermining the reputational basis of its quality; (3) ‘The venerables’ (Low, High), those that pay low attention to quantitative indicators but high attention to collegiality and established reputation; and (4) ‘The missionaries’, those that pay low attention to both quantitative indicators and social evaluation but are committed to egalitarianism and educational outcomes (2013, pp. 198 209). In practice, universities do not fall neatly into one

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of these ideal types, but often adopt hybrid strategies. Similarly, many mechanisms of institutional assessment hybridise expert evaluation and social evaluation. Even within one university, different strategies or practices can co-exist without necessarily leading to detrimental consequences.3 The emergence of global measures and uniform quality standards does not always lead to homogeneity and the demise of local orders. Nevertheless, one of the ‘collateral consequences’ of emphasising quantitative indices and rankings is that many universities feel obliged to follow a set of quality judgements imposed by external parties and processes, often resulting in a shift of attention away from the knowledge content of their academic work to the attention ‘allocated to the signals number of articles, status of the journals in which they are published, number of citations, etc.’ (2013, p. 15).

Changes within Institutions: Promotion and Hiring While individual universities or departments may choose not to conform to external demands for quantitative metrics, the history of processes and criteria used by universities in making decisions about promotion helps illustrate the attraction of quantitative measures. Particularly in the 1960s and 1970s, concerns were expressed by faculty members in some Anglophone nations about the arbitrary and nontransparent nature of promotions decisions. There were specific concerns about bias, particularly against women, which were difficult to prove or resolve in the absence of accepted measures of quality. The introduction of quantitative measures was thus sometimes perceived as a necessary reform by academics generally, and particularly by those concerned about equity. A brief survey of studies4 that focus on promotion practices in universities helps illustrate how such practices have evolved in recent 3 The University of California, Berkeley, was cited as an example where ‘a department in the humanities which is ranked academically at the very top internationally constructs its own quality references even when they are in opposition to the standards dominating the discipline internationally’ (Paradeise & Thoenig, 2013, p. 210). 4 This brief survey draws on studies focussed on a number of narrowly defined populations in different countries from the late 1960s to 2015. It is not a comprehensive review of this literature but provides an indication of prevailing practices during these years.

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decades. In some cases, these look at promotion together with other matters (such as hiring practices or salaries). Hiring practices and promotion policies were often blurred in Australian universities where professorial appointments were made following the death, resignation or retirement of an incumbent, rather than through an internal promotion process (Over, 1985). Studies in the 1960s and 1970s suggest that promotion criteria were often unclear and non-transparent. Luthans’ survey (1967, p. 388), which covered the discipline of business in 47 large public universities, revealed that 5% of faculty members stated that there were ‘absolutely no policies whatsoever’ dealing with promotion and an additional 26% stated that any policy was ‘so nebulous and confused that it could not be communicated to anyone’. Katz’s (1973, p. 469) study of nine departments within one US university observed that ‘little is known about the process of evaluating and rewarding university professors’5 given the ‘difficulty of obtaining good data’. Only two of the nine departments had a written policy regarding promotion that was available to faculty members, resulting in promotion and salary processes that ‘are usually cloaked in secrecy’. Assessment of faculty members in the course of promotion processes often relied on beliefs and intuition, particularly with regard to teaching. For example, Katz (1973, p. 470) describes how teaching was only evaluated on the basis that ‘[administrators] thought they knew who were the “good” and “bad” teachers’. Ultimately, teaching quality was found to be of minimal relevance in predicting who would be promoted (Katz, 1973, p. 471). Luthans’ (1967) survey revealed that a substantial publication record was not always necessary to obtain a promotion. In particular, just under one-third of full professors and half of associate professors in Business had a maximum of three articles and no books. Further, assessments often relied on qualitative rather than quantitative assessments of the quality of the publications themselves (directly or indirectly) or the quality of proxies such as journals. For example, Katz (1973, p. 470) states that ‘department chairmen and heads agreed that they could easily evaluate research ability by examining the quality of journals (usually refereed) in which articles appeared and by reading book reviews’. Nevertheless, measures of quality were emerging during this period, including those based on

5

The term ‘professor’ in American universities covers the full range of academic staff, from junior to senior ranks.

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citation counts (Cole & Cole, 1967, pp. 379 380) and perceptions of journal quality (Oncken, 1971, pp. 41 42). At the time, there was evidence of considerable dissatisfaction with promotion practices. Luthans’ (1967, p. 388) survey of Business schools found that one-third (34%) of professors rated the promotion system as ‘poor’ or ‘very poor’ while one-quarter (26%) rated it as ‘not very good’. The survey also found large differences between central administrators, 85% of whom believed that they could evaluate research activities, while the vast majority of faculty members (80%) believed that central administrators could not evaluate research. Jolson (1974, p. 151) similarly noted differences in the preferred rankings of six factors of appraisal between administrator and some important faculty segments. Katz (1973, p. 477) argued that the ‘arbitrary and chaotic’ process of rewarding professors, through promotion and salaries, should be replaced with a more equitable system. Luthans (1967, p. 393) also called for ‘improved promotions policies’, ‘more objective methods of evaluation’ and greater transparency, including through the use of journal rankings. Not everyone agreed with this proposition. Jolson (1974, p. 154), for example, argued that due to the differing goals of academic institutions and the difficulty of establishing objective measures, appraisal (for promotion and tenure) should ‘include a strong personal dimension’ based on frequent conversations with department heads so that the latter could ‘know him [sic] and his work intimately’. Several studies in the 1970s attempted to identify factors correlated with promotion outcomes. Katz (1973), for example, noted the reputation of the department from which a graduate degree was obtained as having a long-standing impact on promotion prospects.6 The difficulty of determining the reason why particular factors are correlated with promotion becomes particularly controversial when looking at the role of gender in promotion outcomes and for related processes such as salary determination. For example, Katz (1973) detected a difference in the salaries paid to women and men, but again his methodology did not enable inferences to be drawn as to the reasons for this. He suggested that this difference in salaries could be explained partly by the policy of hiring a professor’s wife to convince him to accept a job at the university. The same gender 6 It is difficult to tell from Katz’s study whether this was merely a question of correlation (those who get accepted to prestigious graduate schools also perform well as academics), causation without bias (a prestigious graduate education provides better training for an academic career) or causation with bias (candidates for promotion with prestigious graduate degrees are consciously or unconsciously preferred).

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differences were evident in Australia in the 1980s, with Over (1985, p. 505) noting that the numerical inequality of women did not constitute proof of discrimination, although he also cited self-report survey evidence of bias against women in recruitment and promotion. A more explicit promotions policy was thus perceived as potentially advantageous to female academics, as illustrated through the events at one Australian university. The Bramley-Ward Report to the Council of the Australian National University had recommended a more explicit promotion policy based on concerns that the vaguely worded policy disadvantaged women (Sawer, 1984). The University responded by changing its policy for promotion to senior lecturer, which had referred only to ‘educational attainments, professional recognition of standing as a scholar, contribution and service to the University’, to a more explicit list with weightings for different dimensions7 of academic work that could be adjusted by the applicant (within defined bounds). As well as providing greater clarity around expectations, this allowed applicants to ensure that teaching performance played a role in promotion decisions. More quantitative approaches seemed to gain ground in the 1980s and 1990s, particularly in Australia where a number of the relevant studies were conducted. For example, Moses (1986) found that the majority of interviewed staff in an Australian university believed that they were advantaged in promotion processes by pursuing quantity over quality. Allen (1988) described a movement in Australia towards greater accountability within the university sector. In particular, the Universities’ Council of Commonwealth Tertiary Education Commission (CTEC) conducted a Review of Efficiency and Effectiveness in Higher Education in 1986 that recommended that universities develop regular procedures for evaluating academic performance. Thus, by 1988, there were formal procedures through which Australian academics could apply for promotion, with the focus primarily on research and publication (Allen, 1988). Promotion came to be correlated with criteria that are recognisable today applications for research grants, published articles, average rates of citation, PhD examinations, academic networking and attendance at international conferences and prioritising research over teaching (Over, 1993). There were no longer significant differences based on academic 7

The dimensions were teaching performance, research achievement and professional recognition (including educational attainment), administrative and committee work and community activities related to profession and which reflect favourably on the University.

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background (other than obtaining a PhD degree), age, sex, marital status, number of children or age when first child was born although there were personality differences (Over, 1993, p. 321). A recent Australian study has also linked promotion with a quantitative measure, in particular the number of papers and books published (Dobele & Rundle-Theile, 2015). The quantification of academic performance measurement has historically been made necessary and expedited by government-funding policies. In Australia, for example, allocation of university funding has been based on a combination of student enrolment and research performance indicators. The collection of detailed information on research grant incomes and outputs has been mandatory from the early 1990s (see University Australia website: https://www.universitiesaustralia.edu. au/australias-universities/key-facts-and-data/Research-Intensity—Output#. WY_zn9OGMUE). While the introduction of research quality assessment exercises8 was not meant to be used to rank Australian universities by research quality, ERA ratings were nevertheless interpreted as such. The ERA in Australia, and its counterparts in the UK and New Zealand, prompted high-rating universities to adopt a flexible, market-oriented approach to hiring and promotion that bypasses established procedures. For example, universities engaged in the strategic appointment of high-performing academics and research teams from other universities9 to improve ratings, as well as introducing nonstandard promotion or salary increases to retain researchers being ‘poached’ by others. The definition of high performance in this context has often been based on quantified metrics. This brief review suggests that universities have generally moved towards providing greater clarity in promotion criteria and increased reliance on quantitative measures over time. This move is consistent with the macro imperative described in the Section ‘Transformation of the Sector: Judgement of Quality’ above for universities to move away from an implicit, contextual and social reputation-based judgement of quality towards a more explicit, ordinal and metrics-based judgement. Our analysis shows that such a shift was originally justified for reasons of equity and transparency, but more recently driven by the competition for funding, market and prestige. 8 This was initially proposed as the Research Quality Framework, or RQF, for 2008 2009 implementation, but eventually introduced as the Excellence in Research for Australia ERA, beginning in 2010 see http://www.arc.gov.au/ excellence-research-australia 9 See Lewis and Shore (2017) on ‘strategic hiring’ in New Zealand.

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Individual Strategies: Presentation of Self In the context of promotion and elsewhere, one of the many ways in which academics navigate the presentation and packaging of professional self for imagined audiences of various kinds is in the preparation and circulation of curriculum vitae (CVs), re´sume´s and short professional biographies. As in the other areas on which we focus, this is a context in which the uptake and reproduction of metric culture have become subtly apparent since physicist Jorge Hirsch first proposed the h-index in 2005 (Hirsch, 2005). This may be discerned from reading a small sample of the immense amount of scholarly and popular literature offering guidance on the navigation of academic recruitment processes, and on academic career success more broadly, published from the late 1980s to the late 1990s, alongside more recent examples of the same, published since 2010 (Ale Ebrahim et al., 2013; Boden, Epstein, & Kenway, 2011; Drezner, 1998; Gordley, 1993; Piwowar & Priem, 2013; Zillman, Angel, Laitos, Pring, & Tomain, 1988). In each case, our focus has been on English language writings, with examples mostly referring to US, UK and, to a lesser extent, Australian higher education institutions and pertaining mainly to the legal, humanities, social sciences and education fields. Reading these sorts of writings from two or three decades ago is a little like studying images of the extraordinary wall paintings in the Chauvet-Pont-d’Arc Cave. The images of horses, deer, lions and other animals in the latter are some 30,000 years old (Clottes, 2003). In both content and style, they seem contemporary, apt and compelling; they still seem right. Yet they unmistakably bespeak a time that has passed. The CV is, of course, by its Latin name already historically out of joint in contemporary usage. The Oxford English Dictionary traces its prevalence back to 1902 (OED, 2017). One Swedish-based researcher claims that its ‘professional use […] has its roots in the late 1400s, when it was introduced by Leonardo da Vinci’, but concedes that ‘it was not until the second half of the twentieth century that the modern CV took on a more definite shape’ (Forsberg, 2016). Another pair of Britishbased researchers likewise date ‘the arrival of the CV as an essential adjunct to academic careers’ to the second half of the twentieth century (Miller & Morgan, 1993). Whatever its provenance, the CV has long been a critical medium for academics ‘crafting a disciplinary aligned presence’ individually and in a range of collective configurations (those of department, school, faculty, university, scholarly association, conference, journal and so forth) (Tse, 2012). How academics craft this

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presence in CVs and cognate genres of writing has not been untouched by, and indeed may have contributed significantly to, the changes that we have canvassed so far. It is by no means the case that metrics have come to dominate CV writing. Many have cautioned against the numerical embellishment of CVs (Wildgaard, 2014). Current, popular guides to academic CV writing do not generally recommend their inclusion (Boden et al., 2011; Vitae, 2017). Moreover, to the extent that CVs do invite and provide data for quantitative evaluation, this may long have been the case to some degree; Metcalfe wrote, for example, in 1992 of the familiar scene of members of appointments committees nodding their heads ‘as they count publications’ (Metcalfe, 1992). Nonetheless, there has been a discernible shift in the style and tone that academic CV writers are encouraged or socialised to adopt. This shift makes it not entirely surprising that some would report a growing propensity of candidates to include h-indexes on their CVs (Ball, 2007). Throughout the period under consideration, CVs have straddled multiple sites and modes of appraisal, the regularity of appraisal being one of the characteristic features of contemporary academic life (Knights & Clarke, 2014). The writing and tweaking of a CV is at once an exercise in self-appraisal, a response to past appraisal, and a task undertaken in anticipation of future appraisal (Metcalfe, 1992). It is also a practice that straddles seemingly incommensurable ways of understanding and evaluating scholarly corpora. As Miller and Morgan have written: Production of a CV takes place […] between two worlds. On the one hand there is the traditional academic world where quality is supposed to elude quantification and where the mysteries of a craft are embedded in sets of inter-personal understandings and invisible colleges. On the other hand, there are the increasing pressures to emphasise quantity, whether it be in terms of the number of publications, the size of research grants or the number of ‘all expenses paid’ international gatherings. (Miller & Morgan, 1993, p. 137) Both in their earlier (1980s and 1990s) incarnations and more recently (since 2005), writings counselling for success in the academic ‘marketplace’ keep both these registers of value in circulation. Nonetheless, what has shifted, between these two periods, is the composition of the ‘inter-personal understandings’ considered most

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significant in the first (qualitative) of these registers. So too have the inputs characteristic of the second (quantitative) of these registers changed, albeit subtly, over this time. In 1980s and 1990s-era advice on self-presentation for academic recruitment (in CVs and otherwise), emphasis was placed on a candidate’s relations with scholarly peers or would-be peers, especially with those from whom ‘favorable comment’ might be drawn (Gordley, 1993, p. 367). Even in the absence of European-style scholarly apprenticeships, it was ‘former professors’ who were, in large part, expected to direct one’s CV into the right hands (Zillman et al., 1988, p. 347). Relatively little, if anything, was expected of academic entrants by way of scholarly publications (Drezner, 1998). In 1993, Gordley wrote that US law schools, for instance, had ‘no standard for hiring other than mere brilliance […] [or] raw brainpower’ as deduced from recommendations, interviews and examples of written work (Gordley, 1993, p. 383). ‘[A] candidate can possess top-notch credentials without writing much’, Gordley explained, ‘or indeed, anything’ (Gordley, 1993, p. 368). Similarly, in 1998, Carter and Scott stressed the importance of personalised recommendation letters alongside some albeit limited evidence of writing and research capacity (‘a record of conference paper presentations and some pieces under review’) (Carter & Scott, 1998, pp. 616 617). They also cautioned those navigating the (US) academic job market as follows: ‘it is imperative that you do not engage in overselling yourself’ (Carter & Scott, 1998, p. 618). By the second decade of the 2000s, however, those looking to enter or build an academic career were advised to devote considerable effort to preparing and maintaining their CVs as ‘a collaborative, interactive and iterative process’ (Boden et al., 2011, p. 4). Boden et al.’s (2011) discussion of the publications section of an academic CV conveyed an expectation that candidates would likely have multiple types of scholarly publication to report, and that they should be able to ‘give an indication as to any impact’ of their research (Boden et al., 2011, p. 17). Likewise, candidates of this era were encouraged to report on their contributions to public debate, media appearances and details of any efforts to ‘[p]opularise [their] discipline or subject’, as well as using Altmetrics (metrics measuring scholarly impact in an online environment) to ‘capture social media references […] and reflect public engagement’ (Boden et al., 2011; Piwowar & Priem, 2013, p. 10). ‘Most researchers’, a group of Malaysian and Iranian researchers wrote in 2013, ‘are evaluated based upon their publications as well as the numbers of citations their publications receive’ (Ale Ebrahim et al., 2013, p. 93). This may be truer

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in some research fields than others, and less true of entry-level scholars than later-stage candidates. Nevertheless, there did appear to be a discernible shift, between these two periods, from implicit to explicit ‘impression management’ in CV writing (Knouse, 1994). If one understands the CV as an invitation to applicants to present themselves ‘as certain sorts of subjects, whether “actually” as they appear, or […] as if they were’, then candidates for academic jobs seem recently to have been encouraged towards far more assertive and voluble sorts of subjectivity than in the earlier era described earlier (Grey, 1994, p. 485). Far from being counselled away from ‘overselling’ themselves, academic CV writers are now encouraged to sell as many ‘products’ as possible and to provide evidence of those products’ appeal to the broadest possible market of consumers. Thus, a far wider range of relationships become significant for and evoked by the contemporary CV than earlier iterations of the same. Alongside the assurance of brilliance that referees are supposed to provide, more impersonal relations such as relations with the media and the general public have been brought to the fore. For this purpose, it is important that the evidence in question be as accessible and universalisable as possible; hence the propensity to rely on quantitative metrics alongside or over subjective assessments. As historian Theodore Porter has observed, reliance on quantitative measures is crucial in maintaining ‘impersonal’ exchange as the ‘ideal’ form of human-to-human transaction on which most other relations are modelled, including relations in which scholars are embedded. In such transactional settings, faith in numbers often supplants personal trust (Porter, 1996, pp. 23 24). This reflection on the evolution of the CV suggests that over the past three decades there has been a more than subtle shift from relying on an interpersonal, contextual and reputation-based presentation of self to one employing more explicit use of metrics and impersonal indicators of achievements. In the past, this approach would have had to depend on individual academic worker’s vigilance in monitoring and documenting their latest publications and citation counts. However, advances in digital technology have made the collection of academic metrics much easier, with some exceptions, and more systematic. Moreover, the gamification of academic performance has led to a host of new websites and data services that act as a kind of Facebook for academic researchers (Duffy & Pooley, 2017). These services help to escalate the game-like quality of surveillance and self-governance by introducing virtual rewards and reputation scores at no costs to the users (Whitson, 2013). Researchers are lured to join these services in order to showcase their

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research to a global audience in the hope of improving their citation counts. These data services in turn send regular updates to researchers about new citations, new ‘followers’ and new requests for copies of their publications. Artificial milestones are set up so that researchers are ‘congratulated’ for reaching a landmark number of citations. The dominance of digital communication has in some ways made the CV redundant. Most academics have their own webpages, usually within their institutions, detailing their academic achievements, often with hyperlinks to full-texts of their publications or webpages of their media stories. The Internet has also made possible the ‘celebrification’ of academic researchers and the ‘celebritization’ of academic life10 (Driessens, 2012; Van Krieken, 2012). That academics are increasingly chasing after ‘celebrity capital’ (Driessens, 2013) is evident in the pressure they feel to promote themselves as brands (Duffy & Pooley, 2017). The imperative for self-promotion and ‘strategic impression management’ is, of course, not new in business circles and especially among workers in the creative industries whose job security is as precarious as it is dependent on self-branding. However, as Duffy and Pooley (2017, p. 2) point out, ‘discourses of self-branding have mushroomed over the last decade, in parallel with the rapid ascension of social media sites, which are especially propitious platforms for the curated self’. This ‘logic of self-branding among scholars’, as Duffy and Pooley have argued, is amplified and accelerated by academic research sharing websites such as Academia.edu: Even as the site’s feedback and ‘recommendation’ features encourage expressions of reciprocal validation, the fixation on analytics reinforces a culture of incessant selfmonitoring one already encouraged by university policies designed to measure quantifiable ‘impact’. If academics are experiencing a ‘metric tide’ (Wilsdon et al., 2015) imposed from above, Academia.edu is prodding us to internalize its analytics mindset. (Duffy & Pooley, 2017, p. 2)

10

Driessens (2012) has advocated a distinction between ‘celebrification’ and ‘celebritisation’. Celebrification refers to the ‘process by which ordinary people or public figures are transformed into celebrities’, whereas celebritisation is a ‘meta-process that points to certain changes in the nature of celebrity and its societal and cultural embedding’ (2012, pp. 643 644).

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How individual academic workers negotiate this pressure to conform to standards of achievement set by indicators of ‘excellence’ is uncertain. It is possible that individuals just as the academic departments in Paradeise and Thoenig’s (2013) case studies have adopted different positioning strategies. For example, so-called ‘academic stars’ would be comfortable pursuing both quantitative measures of ‘excellence’ while maintaining reputation through interpersonal and social networks. Other academics might join together to find ways of fighting or resisting these developments.11 Still others might engage in ‘secondary adjustments’12 (Goffman, 1961, p. 189) that ‘get around’ institutional pressures.

Conclusion The dominance of a metricised approach to judging academic quality has often been attributed to the rise of neoliberalism and the audit culture which imposes the practices of business and accounting on academic life (Strathern, 2000). While the usefulness of neoliberalism as a concept has been debated in recent years, Beer, (2016, loc. 368) has argued that since competition is central to neoliberal thinking, neoliberalism is still useful for showing how metrics can be linked to the ‘political formations of the day and to the historical genealogy that has led to these connections’. This is because ‘[m]etrics are the very mechanisms and apparatus by which competition can be realised; metrics afford differentiations to be created and inequalities to be cemented’ (2016, loc. 431). Yet the use of metrics has its own appeal. As Power (2004) points out, quantification has positive as well as negative attributes. It enables commensurability, thus potentially reducing cronyism, 11

The Analogue University (2017) reported the success in 2015 of academics at Newcastle University in the UK in resisting the launch of a performance-based regime (‘Raising the Bar’) that attempted to reposition the university in the Research Excellence Framework audit and other ranking systems. 12 Goffman (1961, p. 189) coined the term ‘secondary adjustments’ to capture ‘any habitual arrangement by which a member of an organization employs unauthorised means, or obtains authorized ends, or both, thus getting around the organization’s assumptions as to what he should do and get and hence what he should be’. They represent ways in which a member of an organisation ‘[reserves] something of oneself from the clutch of an institution’ (1961, p. 319). They represent ‘a special kind of absenteeism, a defaulting not from prescribed activity but from prescribed being’ (1961, p. 188).

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subjectivity or bias in the assessment of academic quality. On the other hand, metricisation simplifies a complex product and may lead scholars to narrow their ‘outputs’ to those that are recognised and rewarded in the measurement process. More generally, as Beer points out: […] measurement, calculation and numbers have the power to force us to overlook aspects of the social world. The visibility created by numbers is narrow even as the scope of measurement [expands]. Metrics lead to particular ‘lines of sight’ (Amoore, 2013, p. 93). Hence measurement is powerful not just for what it captures and the way it captures it, it is also powerful because of what it conceals, the things it leaves out, devalues, or ignores. (2016, loc. 1263) As we have shown in this chapter, the use of quantified, decontextualised indicators have led to the ‘stripping out’ of narratives, in effect ‘leaving a vacuum to be filled by new narratives based solely on the data’ (Beer, 2016, loc. 1645; Espeland, 2015). A pessimistic reading of the current condition is that the power of metrics is already too deeply entrenched in academic institutions for resistance to be effective. It may be that the rise of performance metrics has already generated among academics new ‘structures of feelings’ that internalise market values (Burrows, 2012). More insidiously, it has been suggested that it is the emergence of the ‘Data University’ that is changing academic life. As a pseudonymous collective of geographers and other scholars at Newcastle University in the UK have written: Influenced by Deleuze’s (1992) work on new societies of control, we argue that the genesis of the ‘Data University’ lies in our active desire for data and its potential to mediate human relations and modulate our freedoms. […] [T]oday individuals both desire and are controlled through the active generation of proliferating data streams. […] [I]t is academics themselves who seek out new forms of freedom, and are therefore controlled, through our own generation of proliferating data streams. (The Analogue University, 2017) The very fact that the argument earlier has been advanced pseudonymously is revealing of how institutionally treasonous these kinds of arguments, against metric culture on the whole, may appear in some

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higher education settings. Yet any resistance to metrics if confined to the terms already defined by metrics risks expanding or perpetuating their power (Beer, 2016). It may be that, as Beer (2016, loc. 3676) suggests, we need to ‘re-tell the stories’ that got stripped out by metricisation. In Australia, we may have reclaimed some power from metricisation when the second round of research assessment exercise (ERA, 2012) abandoned the use of a list of ranked journals and relied instead on expert peer review to assess the quality of research outputs.

References Ale Ebrahim, N., Salehi, H., Embi, M. A., Habibi, F., Gholizadeh, H., Motahar, S. M., & Ordi, A. (2013). Effective strategies for increasing citation frequency. International Education Studies, 6(11), 93 99. Allen, N. (1988). Aspects of promotion procedures in Australian universities. Higher Education, 17, 267 280. Ball, P. (2007). Achievement index climbs the ranks. Nature, 448, 737. Beer, D. (2016). Metric power. Basingstoke: Palgrave Macmillan. Boden, R., Epstein, D. E., & Kenway, J. (2011). Presenting yourself: Vita statistics. In Building your academic career. London: Sage. Burrows, R. (2012). Living with the h-index? Metric assemblages in the contemporary academy. The Sociological Review, 60(2), 355 372. Carter, R. G., & Scott, J. M. (1998). Navigating the academic job market minefield. Political Science and Politics, 31(3), 615 622. Clottes, J. (2003). Chauvet cave: The art of earliest times (P. G. Bahn, Trans.). Salt Lake City, UT: University of Utah Press. Cole, S., & Cole, J. R. (1967). Scientific output and recognition: A study of the operation of reward system in science. American Sociological Review, 32(3), 377 390. Dobele, A. R., & Rundle-Theile, S. (2015). Progression through academic ranks: A longitudinal examination of internal promotion drivers. Higher Education Quarterly, 69(4), 410 429. Drezner, D. W. (1998). So you want to get a tenure-track job. Political Science and Politics, 31, 609 614. Driessens, O. (2012). The celebritization of society and culture: Understanding the structural dynamics of celebrity culture. International Journal of Cultural Studies, 16(6), 641 657. Driessens, O. (2013). Celebrity capital: Redefining celebrity using field theory. Theory and Society, 42, 543 560. Duffy, B. E., & Pooley, J. D. (2017). “Facebook for academics”: The convergence of self-branding and social media logic on Academia.edu. Social Media + Society, 3(1), 1 11.

194

Janet Chan et al.

Espeland, W. (2015). Narrating numbers. In R. Rottenburg, S. E. Merry, S. J. Park, & J. Mugler (Eds.), The world of indicators: The making of governmental knowledge through quantification (pp. 56 75). Cambridge: Cambridge University Press. [Cited by Beer 2016]. Forsberg, E. (2016). Curriculum vitae The course of life. Nordic Journal of Studies in Educational Policy, 2, 33742. Franck, G. (2002). The scientific economy of attention: A novel approach to the collective rationality of science. Scientometrics, 55(1), 3 26. Goffman, E. (1961). Asylums: Essays on the social situation of mental patients and other inmates. New York, NY: Anchor Books. Gordley, J. (1993). Mere brilliance: The recruitment of law professors in the United States. American Journal of Comparative Law, 41, 367. Grey, C. (1994). Career as a project of the self and labour process discipline. Sociology, 28(2), 479 497. Hacking, I. (1990). The taming of chance. Cambridge: Cambridge University Press. Hirsch, J. E. (2005). An index to quantify an individual’s scientific research output. Proceedings of the National Academy of Sciences, 102, 16569 16572. Jolson, M. A. (1974). Criteria for promotion and tenure: A faculty view. The Academy of Management Journal, 17(1), 149 154. Katz, D. A. (1973). Faculty salaries, promotions and productivity at a large university. The American Economic Review, 63(3), 469 477. Knights, D., & Clarke, C. A. (2014). It’s a bittersweet symphony, this life: Fragile academic selves and insecure identities at work. Organization Studies, 35, 335 357. Knouse, S. B. (1994). Impressions of the resume: The effects of applicant education, experience, and impression management. Journal of Business and Psychology, 9, 33 45. Lewis, N., & Shore, C. (2017). Managing the third mission: Reform or reinvention of the public university? In C. Shore & S. Wright (Eds.) Death of the public university? Uncertain futures for higher education in the knowledge economy (pp. 47 68). New York, NY: Berghahn Books. Luthans, F. (1967). Faculty promotions: An analysis of central administrative control. The Academy of Management Journal, 10(4), 385 394. Metcalfe, A. (1992). The curriculum vitae: Confessions of a wage-labourer. Employment and Society, 6, 619 641. Miller, N., & Morgan, D. (1993). Called to account: The CV as an autobiographical practice. Sociology, 27, 133 143. Moses, I. (1986). Promotion of academic staff: Reward and incentive. Higher Education, 15(1 2), 135 149. OED. (2017). “Curriculum vitae, n.” OED online. Oxford University Press, June 2017. Web. 3 August 2017. Oncken, G. R. (1971). The relationship of control structure to faculty productivity and satisfaction in university departments. Doctoral dissertation. Retrieved from https://search.proquest.com/docview/302467059 Over, R. (1985). Career prospects for academics in Australian universities. Higher Education, 14(5), 497 512.

Academic Metrics and Positioning Strategies

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Over, R. (1993). Correlates of career advancement in Australian universities. Higher Education, 26(3), 313 329. Paradeise, C., & Thoenig, J.-C. (2013). Academic institutions in search of quality: Local orders and global standards. Organization Studies, 34(2), 189 218. Piwowar, H., & Priem, J. (2013). The power of altmetrics on a CV. Bulletin of the American Society for Information Science & Technology, 39(4), 10 13. Porter, T. (1996). Trust in numbers: The pursuit of objectivity in science and public life. Princeton, NJ: Princeton University Press. Power, M. (2004). Counting, control and calculation: Reflections on measuring and management. Human Relations, 57(6), 765 783. Sawer, M. (1984). Towards equal opportunity: Women and employment at the Australian National University. Canberra: Australian National University. Shore, C., & Wright, S. (2017). Introduction: Privatizing the public university. In C. Shore & S. Wright (Eds.) Death of the public university? Uncertain futures for higher education in the knowledge economy (pp. 1 30). New York, NY: Berghahn Books. Strathern, M. (Ed.). (2000). Audit cultures: Anthropological studies in accountability, ethics, and the academy. New York, NY: Routledge. The Analogue University. (2017, March 31). Control, resistance and the ‘data university’: Towards a third wave critique. Antipode. Retrieved from https://antipodefoundation.org/2017/03/31/control-resistance-and-the-data-university/ Tse, P. (2012). Stance in academic bios. In K. Hyland & S. G. Carmon (Eds.), Stance and voice in written academic genres (pp. 69 84). Basingstoke: Palgrave Macmillan. Van Krieken, R. (2012). Celebrity society. London: Routledge. Vitae. (2017). Creating an effective academic CV. Retrieved from https://www.vitae. ac.uk/researcher-careers/pursuing-an-academic-career/how-to-write-an-academiccv/how-to-write-an-academic-cv Whitson, J. R. (2013). Gaming the Quantified Self. Surveillance & Society, 11(1 2), 163 176. Wildgaard, L. (2014). Just pimping the CV? The feasibility of ready-to-use bibliometric indicators to enrich Curriculum Vitae. In iConference 2014 proceedings, pp. 954 958. Retrieved from https://doi.org/10.9776/14326 Zillman, D., Angel, M., Laitos, J., Pring, G., & Tomain, J. (1988). Uncloaking law school hiring: A recruit’s guide to the AALS faculty recruitment conference. Journal of Legal Education, 38, 345.

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Chapter 11

Real-time Grade Books and the Quantified Student* William G. Staples

Abstract School districts across the United States have adopted web-based student information systems (SIS) that offer parents, students, teachers and administrators immediate access to a variety of data points on each individual. In this chapter, I offer findings from in-depth interviews with school stakeholders that demonstrates how some students, typically ‘high performers’, are drawn into ‘pushed self-tracking’ (Lupton, 2016) of their academic achievement metrics, obsessively monitoring their grades and other quantified measures through digital devices, comparing their performance to other students and often generating a variety of affective states for themselves. I suggest that an SIS functions as a neoliberal technology of childhood government with these students internalising and displaying the self-governing capacities of ‘enterprise’ and ‘autonomy’ (Rose, 1996). These capacities are a product of and reinforce the metric culture of the school. Keywords: Student information systems; quantified self; self-tracking; neoliberal governmentality; metric culture; information asymmetry

* A previous version of this chapter was presented at Metric Culture: The Quantified Self and Beyond, 7 9 June 2017, Institute of Advanced Studies, Arhus University, Arhus, Denmark.

Metric Culture: Ontologies of Self-Tracking Practices, 197 216 Copyright r 2018 by Emerald Publishing Limited All rights of reproduction in any form reserved ISBN: 978-1-78743-290-1

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William G. Staples There was an app so students could check their grades. As soon as they get quizzes, tests, essays back, they checked. Everyone whipped out their phones to make sure it was in Student View. Yeah, it was the bible of high school. (Rebecca, 19 years old)

Although the stated purpose of the school is to disseminate knowledge to students, it has long been involved in ritualised knowledge gathering about them, as well. School is an institution brimming with incessant examinations, assessments and the ritualised collection of information about its pupils. Taking this project to new levels, school districts across the United States have adopted web-based student information systems (SIS) that offer parents, students, teachers and administrators immediate access to a variety of data points on each individual. The most sophisticated SISs can provide parents access to attendance records and homework assignments, confirm that student work was handed in and view a teacher’s gradebook, all in ‘real-time’. Students are also given login credentials so they can view these data themselves. The school administrator’s portal provides a comprehensive view of each child’s and teacher’s classroom metrics including grades, rubrics and grading scales, class rosters, student demographic data, behaviour and disciplinary notes, as well as prescription drug use, immunisation and health screenings, family configurations and home address. Purveyors of these systems assert that their products operate as a form of ‘social capital’ (Dika & Singh, 2002), facilitating cooperative relations among school stakeholders.1 However, despite the widespread adoption of these systems and their alleged benefits, we know little about how school stakeholders in fact use and experience these systems and what effects their use might have on the complex relationships among them. In this chapter, I report on the results of in-depth interviews with a sample of school stakeholders, centred on how some students, typically ‘high performers’, are drawn into ‘pushed self-tracking’ (Lupton, 2016, p. 107) of their academic achievement metrics, obsessively monitoring their grades and other quantified measures through digital devices, comparing their performance to other students and often generating a variety of emotional and affective states for themselves. I argue that an SIS 1

Student Growth (2017). Retrieved from https://www.powerschool.com

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is a neoliberal technology of childhood government (Gallagher, 2008), in which students internalise and display the self-governing capacities of ‘enterprise’ and ‘autonomy’ as they struggle to take an ethical stance towards their lives (Foucault, 2009; Rose, 1996, 1999). These selfgoverning qualities are a product of and reinforce the metric culture of the school, as well as the students’ ‘quantified selves’ (Lupton, 2013a, p. 26) and performance-based identities. The approach I take for this study builds on my previous analyses of forms of governance, surveillance and social control as they manifest themselves in the everyday lives of individuals (Staples, 2009, 2014; Staples & Decker, 2008, 2010). My project begins at the commonplace, relational points where technologies of governance and bodies traverse. These intersections are what Foucault called ‘smallscale models of power’ (Foucault, 1995, p. 136), sites where bodies are watched and measured; activities, habits and movements are monitored; and behaviours if governance is attuned are modified and adapted to suit the prevailing ethos. My intent is not to make normative judgements about one strategy or another, or dwell on the intentions of those who put them in place. Rather, I am interested in the actual effects of the tactics and the experiences of those enmeshed in them. The relationship to be examined at these sites of power, then, is ‘the government of others (subjectification) and the government of one’s self (subjectivation)’, the latter being, ‘the work that individuals perform upon themselves in order to become certain kinds of subjects’ (Hamann, 2009, p. 38).2

Neoliberalism in Everyday Life Much has been written about the investiture of neoliberalism around the globe over the last half-century or so (Centano & Cohen, 2012; Dicken, 2015; Harvey, 2005). Michel Foucault recognised this development early on as he traced the shifts from the despotic power of 2 To paraphrase Hamann (2009, p. 39), ‘subjectification’ are the ways that others are governed and objectified into subjects through processes of power/knowledge. ‘Subjectivation’ are the ways that individuals govern and fashion themselves into subjects on the basis of what they take to be the truth. Subjectivation can take either the form of self-objectification in accord with processes of subjectification or it can take the form of a subjectivation of a true discourse produced through practices of freedom in resistance to prevailing apparatuses of power/knowledge.

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sovereigns, through the emergence of modern disciplinary institutions, on to the advance of ‘governmentality’, which he called the ‘conduct of conduct’ (Foucault, 2009). Government refers broadly to power exercised in the management of various groups from families, organisations and institutions such as schools, workplaces, religious congregations to entire populations. Governmentality denotes the practices of governing, the techniques and technologies of governing, the rationalities and strategies invested to shape, guide and direct the conduct of others, and that which makes human life a domain of power/knowledge. In the context of secondary schools in the United States, I contend that an SIS is a form of neoliberal technology of childhood government (Gallagher, 2008) that functions as both a disciplinary and ‘responsibilization’ mechanism. That is, the SIS is a ‘dataveillance’ infrastructure (Clarke, 1988; Raley, 2013; van Dijck, 2014), used by adults to closely monitor student behaviour and performance. Through the ensuing ‘information asymmetry’, (Staples, 2014) adults can hold young people accountable and, if necessary, mete out sanctions to those unwilling to submit to the school’s subjectification or to cooperate in their own subjectivation (Staples, 2017). By surveilling students, the system assists adults in the production of disciplined, ‘docile’ teenage bodies (Foucault, 1995). For the SIS to be truly effective as a neoliberal governance strategy, however, students need to actively participate in and use the system to monitor themselves (Albrechtslund & Lauritsen, 2013; Gallagher, 2008). Furthermore, rather than being coerced into submission, they must be persuaded to participate in their own subjugation as responsibilised subjects and bring their conduct into alignment with adult expectations, thereby reducing the need for constant supervision and sanctioning. The attainment of uncoerced self-monitoring further enhances the performance metrics of the school itself, which is why we see in the discourse concerning the SIS notions of empowerment and the call for students to take responsibility for their own behaviour, learning and performance. As the company referenced earlier puts it, ‘PowerSchool helps students understand their own learning: show them their progress, give real-time feedback and scores, and foster engagement in learning through content and assignments’. Such discourse is ‘imbued with aspirations for the shaping of conduct in the hope of producing certain desired effects and averting certain undesired ones’ (Rose, 1999, p. 52), Rose (1996) characterises as these effects as (1) the self-governing capacities of Enterprise, or the array of rules for the conduct of one’s everyday existence, including energy, initiative, ambition, calculation and personal responsibility;

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(2) Autonomy, or the taking control of activities, defining a set of goals, and planning a course of action to satisfy the needs of existence through one’s own powers; and (3) Ethics, understood as the domain of practical advice as to how we conduct ourselves in the various aspects of our everyday existence and the ways by which we come to construe, decipher and act upon ourselves in relation to the desirable and undesirable (pp. 30, 153 154). Raised with lofty parental expectations and middle/lower-middle class aspirations for upward social mobility, a number of the adolescents I interviewed appear to have internalised the imperative to perform well in their studies and to act appropriately. Moreover, I learned that school personnel induce these students to engage the SIS and to play their part in what Lupton (2016, p. 107) calls ‘pushed self-tracking’. With this form of self-measurement, ‘the initial incentive for engaging in dataveillance of the self comes from another actor or agency’ (Lupton, 2016, p. 107) and ‘persuasive technologies’ (Jespersen, Albrechtslund, Øhrstrøm, Hasle, & Albretsen, 2007) are deployed to ‘nudge’ target groups into behaving in ways that meet goals or expectations set for them (Purpura, Schwanda, Williams, Stubler, & Sengers, 2011). Inducement is common in encouraging patient self-care in health promotion and preventive medicine contexts where: the personal data generated from self-tracking are represented as pedagogical and motivational, a means of encouraging self-reflection or emotional responses such as fear, guilt or shame that will then lead to the advocated behavior changes. (Lupton, 2016, p. 107) Similarly, I find that as ‘high performing’ students become ‘digitally engaged’ (Lupton, 2013b), frequently accessing their performance metrics through the SIS portal sometimes obsessively so through portable digital devices, they exhibit analogous emotional states (See Nemorin, 2017). Since the SIS reports key quantitative data class grades, overall Grade Point Average, the number of ‘Not Turned In’ assignments, the tally of Advanced Placement courses taken, absences, tardies and standardised test scores the system epitomises the ‘metric culture’ of the school and fosters the performance-based identities, or ‘quantified selves’, (Lupton, 2013a, 2013b, 2016) of the students as ‘high achievers’. Students are thus engaging the SIS as a ‘technology of the self’ (Foucault, 1988), which has been created by technical experts and ‘proposed, suggested and imposed on them by one’s culture, society and

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social group’ (Foucault, 1991, p. 11). It is through the SIS that students conjure self-discipline and build a form of subjectivity by which they come to experience, understand, judge and conduct themselves, developing the self-governing capability that brings their conduct into alignment with broader moral and social objectives (Barry, Osborne, & Rose, 1996; Rose, 1996). In what follows, I present examples from and offer an interpretive analysis of a number of in-depth interviews with recent high school graduates, parents, teachers and administrators focused on the notion of ‘pushed self-tracking’ (Lupton, 2016) of performance metrics.3 My examination describes the ways in which students engaged the SIS in their schools, how that engagement shaped the ways they thought about, judged and acted upon themselves, and how other participants observed and understood that engagement. In doing so, I will highlight the strategies and tactics that students used to both discipline themselves and to develop and display the self-governing capacities of ‘enterprise’, ‘autonomy’ and ‘ethics’ (Rose, 1996).

Being Digitally Engaged All the administrators and a number of teachers and parents I interviewed encouraged the use of the information system by students and extolled the virtues of it as an effective means of what I consider to be responsibilisation and self-governance. ‘Joe’, a middle school principal said: I think it helps them see their work and performance and keep track of it […] part of that is teachers encouraging 3 In the fall of 2016, I conducted face-to-face, open-ended interviews with a quota (eight from each group) and convenience sample of school stakeholders: first-year university students who were months out of high school, parents who were not related to these students and school teachers and administrators (N = 32) in the Midwest region. I took a post-positivist epistemological stance towards the interviews. Rather than attempt to limit the role of the interviewer from the process in an attempt to reliably extract information from respondents, this approach allows the interviewer to contribute to the process and views the interview as a joint accomplishment between the interviewer and the interviewee. The interviews took approximately 30 40 minutes and I used an interview guide of about a dozen general questions centered on their use of and experiences with their school’s SIS. The interviews were recorded and transcribed and results analysed using interpretive coding to identify pronounced and recurring themes.

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students. And we have really tried to push goal setting and goal tracking. And so, it aids with that as well. I asked assistant high school principal ‘Kurt’ if he thought the system helped students and he said: I would say the vast majority that use it on a regular basis, and some fanatically so, particularly when you get to the valedictorian stuff and we’re starting to look at, you know, edging out by points and fractions and decimals. But I think that it’s given students a good insight, too. When asked if she thought that the SIS helped make students more responsible for their schoolwork and performance, middle school vice principal ‘Misty’ said, Yes. I truly do. That missing work report has been terrific. A teacher prints that and, there you go, this is everything that you have to do. And they ask for it. ‘Hey, can you print me that report so that I can get some of that stuff done?’ And especially when we are coming up to a dance, or an assembly, or one of those big motivating things for them, they’re like, ‘I gotta get all this stuff done!’ Kurt offers an additional responsibilisation element when he suggests that a student’s individual behaviour supports the larger governance goals and performance metrics of the entire school. He told me: One of our components in our evaluation system is student goal setting, individually and as a class. And so, they can see right there, how they’re contributing either to their own self-improvement, academically, or to the class’s, like if we’re all going to be able to say class-wise we’re scoring above seventy-five percent on each major test, well here’s where I factor in. I’m not meeting not only my individual goal but my class goal. When high school social studies teacher ‘Jake’ is asked by students about their grades, he puts the onus on them and equates their access to his: ‘“Well, log on to your Skyward, and go to your account, and look,” he tells me, “See what you’re missing.” And put that responsibility back

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onto them because they have the same access that I do’. Teacher ‘Jessica’ says that the system: helps the student tremendously. They can always get on, and they get on every day. And sometimes when I enter something, and I say, ‘Okay, guys, I’ve entered whatever. Can we get out our phones and check?’ That feedback helps their work ethic because they see, ‘Oh I’ve gone down three percent’. [It] helps them keep motivated […] with their grade. ‘Rachel’ who teaches English says, ‘It gives [students] more ownership, I think’. Schools spend considerable resources to make sure that students have access to the system. ‘And every one of our kids is going to have one of these [points to his laptop] soon’, Principal Joe says, ‘to have access to [the SIS], and to keep track of [goals], and to see and make that connection’. Eighteen-year-old ‘Betsy’, who attended private high school, reported that, ‘Our school provided us all with a MacBook Air. So, everybody would just pull out their laptops and check their grades’. In her late teens, ‘Riesa’ told me that: I remember one day at the beginning of the year, they shortened classes so everybody could figure out what their login was, and kind of learn how to use it […] everybody’s on their phone or whatever trying to figure out how to do it. ‘Rebecca’, a 19-year-old and a first-year student at university attended a public high school in a wealthy suburb. She tells me: There was an app [for mobile phones] so students could check [their grades]. So, as soon as they get quizzes, tests, essays back, they checked. Everyone whipped out their phones to make sure it was in Student View. Rebecca’s school encouraged the use of digital devices and provided the network infrastructure for students to connect to the system. And that’s why they implemented a program called, ‘Bring Your Own Device’. And they made a special Wi-Fi because they knew once this program was there, kids

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would want to check. In some rooms, the Wi-Fi wasn’t strong, so I was like, ‘I know in my fourth hour it doesn’t get good signal, so I’m going to bring my laptop so I can check my grades by plugging in’. Following up on Betsy’s description of her involvement with the SIS she considered herself a frequent user I asked, ‘So, you’d walk into a class and see laptops open and someone says, “Chemistry grades are posted”?’ ‘Uh-huh’, Betsy responded, ‘and then everybody gets on and starts checking, yep’. ‘Jena’, 18-year-old, echoed this experience with: And so you just walk into English and people would be, like, ‘Oh, have they put in the grades yet?’ And someone would just pull out their phone and check, and yell, ‘I got my grades’. So, then everyone was, ‘Oh, what did I get?’ All together. ‘Peter’, another first-year university student who attended private school said: It was pretty much only like a reference thing, and if I really wanted to keep track of my grades specifically, because I didn’t want them to give me a quiz back, and say ‘You’ve got a B in the class now’. At least for me personally, getting the immediate feedback on what I have and what my grade is is a lot more incentivising than, you know, having to put six weeks of work in and then saying, ‘Here I am’. When asked to describe her frequency in using the SIS, ‘Kacey’ said: Probably like two or three times a day. Depending on if I had just taken a test or not. Somebody lets out the word that the grades are posted [and everyone was] on their phone app. I’ve always been pretty concerned about my grades. ‘Paige’, a former public school attendee said, when asked to describe her use of the SIS: Like, every day [laughs]. Yeah, I was one of those people. A lot of my friends were like this, too. You’re just

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William G. Staples checking every day. And a lot of times, I just would get on and check because other people in my class would be checking. ‘Oh, they put in the physics test grades’. And we’d be like, ‘Okay, let’s go check’.

‘Dave’, a high school principal reported that: My own kids have the Skyward app on their smartphones and they know. My daughter’s grades are pretty well tied to her car freedom, so, (laughs) so she keeps a pretty close watch on that. As Lupton (2016) suggests, ‘pushed self-tracking’ often promotes a variety of emotions in targeted groups and the SIS was no exception for those I interviewed. These students reported obsessive self-measurement and self-surveillance through the system, sometimes generating reactions such as affirmation, anxiety, guilt, shame and resentment. For example, ‘Rebecca’ told me: Rebecca: Like, you check it by the hour. And it becomes this instant feedback loop. You’re like, ‘I turned it in. Is it in? I turned it in. Is it on Student View?’ And it’s just this constant like, ‘Yay it’s in there. Oh, I got a bad grade. Oh, it’s in there. Oh, I didn’t turn this in’. It’s just this constant feedback loop of panicking and then satisfaction and then panic, then satisfaction, then panic, and it doesn’t end until you graduate! We were a high-strung group. Staples: High strung? Rebecca: Yeah, and I was definitely a part of that, mostly because you kind of get sucked into this world of checking your grades by the second because you never know that your first period teacher, its seventh period, maybe they put in the grades. She continued: [The system] would show whether or not you turned in assignments. So, parents could also see whether or not you missed a quiz, what grade you got on that quiz, whether or not, how many, ‘Not-handed-Ins’. It’s like, I wrote a little poem, ‘I log into Student View, and then I cry, because

Real-time Grade Books and the Quantified Student I see the letters, NHI’. It’s the truth. When you see those letters NHI, you just break down. Because you know everyone sees it. The administrators can see it. The teacher sees it. The parent sees it. Everyone knows that you didn’t turn that in. When there’s something like Student View, everyone looks at you is like, ‘I see that you’re not turning in your work’. It’s just a constant reminder that you’re not doing what you’re supposed to be doing, and that you’re not living up to the standards your teachers have for you. Sometimes there’s disappointment, or just resentment. Or teachers will be like, ‘Oh you’re not living up to your potential’. And then parents just get upset, they’re like, ‘I know you can do better than this. I know you’re a smart kid’. Paige offered several observations of the SIS at her school: Paige: I kind of had a love/hate relationship with PowerSchool [laughs]. I feel like the work I was doing was for a good grade because I received some sort of satisfaction for making good grades. But I think at the same time, it’s sort of like equating yourself to that. Like, when I got my first B in high school ever, like it kind of brought me down, but then I had to work to realize that’s not a bad grade […] that a B is okay. It’s not, like, the end of the world. And later she added: Paige: I do think there is something that should be addressed about how it is stressful to get the immediate feedback and also I think it makes you in a grade-focused society. Everyone’s focusing on the grade and really that’s not what life’s all about. Like, you can still live and be a C-average student. I had a friend who wanted to make 97[%] or higher in all of his classes. And one semester he made a 99[%] in all his classes. PowerSchool will show you your percentage grade, it doesn’t just say ‘A’. So, people get that precise with it, and I think maybe it shouldn’t show that. It kind of makes people a little bit obsessive I think [laughs]. In my senior year, I found out that teachers can actually see how much you log in to PowerSchool. And I never wanted to know what mine was!

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Another aspect of SIS self-tracking is the comparison of one’s metrics to others, sometimes intentionally, sometimes not. This encouraged various forms of competition and self-definitions of being ‘in’ or ‘out’ of the high performing group. I asked Rebecca if there was competition among students: Rebecca: Oh yeah, Student View also showed your GPA for all four years, your weighted GPA and if you had AP classes. You could show it. There was proof that you took so many such and such AP classes. Yeah, it just created a culture of, ‘Are you above the 4.0 or are you below the 4.0?’ Because that was certainly a note of arrogance for certain kids, me being one of them. Staples: So, a status thing? Rebecca: Uh-huh, especially when we got into the testing period of our lives: SATs, ACTs, and others. And Student View was certainly a facilitator. I asked Paige if there was a lot of comparing of grades and other metrics produced through the SIS and she said: Paige: Oh, yes. Lots of that. People were like, ‘How did you do?’ and then you’re like trying to turn your computer so people don’t see it if you did bad, or if you did good you’re like, ‘Look how good I did’. I did the international baccalaureate and people who did that program were all pretty academically driven, so PowerSchool was kind of like a way of life. Yeah like, whenever Power School would crash or be down, everyone would be talking about it. It’s like, ‘Why are we talking about the grading system?’(laughs). Kacey told me: My friends were all, like, gifted students. And so, if I didn’t have an A, I didn’t feel like I fit into that group. And so, I would keep track of my grades in order to, I don’t know, feel a part of my friend group essentially.

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Asked if her friends checked their grades all the time as well, and she said: It was a little bit, it seemed competitive, in a sense. Like, I know none of us bragged about our grades or anything, but we would compare and be like, ‘Oh, well I must have done poorly on this’. Betsy declared that: At my school, everybody competed with each other. So, it was always, ‘Oh you have a B + ? I have an A−’. It’s like, ‘I am one step ahead of you’. So, it also helped us compete with each other in a sense. A parent of both a middle and a high school student, ‘Leslie’, reported on the metric culture of schooling, and how the SIS and associated testing systems facilitated and prompted fast communication and comparisons among students: Leslie: The second, so they’re in school, you know, and [child] would text me from in school about her grades, like when the ACT dropped. The second that ACT makes the scores available, they’re logging on to their phones to find out what their ACT score is. And then, back when they used to do […] MAP testing. [It] tells you your score instantaneously. Like it says, ‘You got a 216’. And I’m telling you, I know every single one of my kids’ friends’ scores. They’re like, ‘Oh, [Jenny] got a 264, she’s super smart’. And, ‘Oh, I’m like in the top part of that, but so and so, I beat so and so by one point’. They all know it, and since kindergarten. The effectiveness of the SIS as a governance tool may be measured, to some extent, by students’ display of ‘self-governing capacities’ such as ‘enterprise’ and ‘autonomy’ and their development of an ethical stance towards their lives (Rose, 1996). Rebecca seemed to epitomise these characteristics as she expressed an enterprising posture, selfsufficiency and her principled stance towards school and her conduct when I asked whether the SIS helped with communication between her and her mother, a single parent. She replied:

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William G. Staples Rebecca: I know my mom wasn’t actively using her part of the account, mostly because she trusted me enough to know that I was checking my own grades. I was doing my own work. I was turning in everything, which I’m really proud of myself for. My Mom saw me at the kitchen table for hours, because I was taking all AP [advanced placement] classes.

As others cite later, Rebecca also reflected on the metric culture of school and how it reinforced the enterprising traits of initiative, ambition, calculation and personal responsibility, stating that the SIS was important. Rebecca: Because it also calculates your final grade including curves. Students didn’t have to wait for teachers to manually calculate things with curves. So, the second your grades were posted, that was it. Kids wanted to see their grades before their parents, just so they could have an explanation ready just in case! Jena offered that, ‘School was a priority. And so, they [parents] really pushed me into being a “go-getter”, almost. PowerSchool definitely made it easier to keep on top of my grades’. Assistant high school principal ‘Carl’ suggested that the ‘motivated students were always wanting to know, “When’s that grade going in the gradebook”, [and they would be saying], “I’ve got to maintain my ninety-seven percent”’. ‘John’, another 18-year-old who had used an SIS extensively at two different schools said, ‘I would check it, make sure I had good grades. If not, get on top of it, get them better, and made sure I wasn’t falling behind and keep studying’. Asked why she spent so much time checking her SIS, Paige offered: Because I wanted to know, like, my standing in the class, and you know, if you take a test that you thought was really hard, I would want to know, ‘Oh my gosh, did I do really bad on it? Or did I actually do good and just thought it was hard? […] PowerSchool was kind of like a way of life. After a few interviews, I began to hear about students using the SIS as a way of helping them be strategic about their metrics and where

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they should focus their efforts, displaying, again, the self-governing capacities of ‘energy, initiative, ambition, calculation, and personal responsibility’ as well as ‘taking control of activities, defining a set of goals, and planning a course of action’ (Rose, 1996, pp. 30, 153 154). For example, I asked Betsy if the system helped her be a better student and she said: Yeah. I have this grade in this class. There’s no way that, calculating what you could get on the final, I could raise it, so what’s the point? But then another class you’re like B + area, ‘Oh, I’ve got to do really well on that final so I can get that grade up’. Likewise, Jena offered that: Jena: It can be convenient in that you know, the syllabus always has the weighting on it, and then that would be on PowerSchool also, so at the end of the semester you know if you’ve got an A and you want to keep your A or B and you’re trying to bump it up, you can see which classes you’re going to need to focus on, what kind of grade you need to pull that end grade. Peter echoed this strategy with, ‘So, I’d check online and see how [a test] affected it, and near finals week add up what points I need to get X grade’, while John added: I know at my high school, there were always kids who were like, ‘Oh, I need exactly this many points to move up from a B to an A in this class and move my GPA’. When I asked Administrator Carol if their SIS helped students be more responsible for their schoolwork and performance, she told me that: Carol: Um, the one aspect I think that it might help is just that immediacy of always knowing their specific grade. Because you have different types of students. You have students who have to have all A’s, and so they’ll watch it, and they’ll balance it. You have students like my son who

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William G. Staples will go into Skyward to notice the point allotment, and this assignment is, you know, only twenty points, and I know that’s not going to matter, so I’m not going to do it. You know, your top twenty percent who are constantly monitoring their grades and making sure everything is in, double checking the points.

Betsy, who attended private high school, highlighted her personal responsibility, the deployment of her own powers, her ability to plan a course of action, and to transform herself when I asked her if the student information system helped her be a better student: Betsy: I liked being able to always check my grades and always be on top of it and know everything. And then if you get a bad grade, you can go straight to the teacher and be like, ‘Okay, let’s talk about it. Let’s figure it out. What did I do wrong? How can I improve next time?’ If you’re not doing well in the beginning, automatically going and trying, figuring out the next steps to raise your grade and do better, and kind of seeing the progress of the grade. Like Rebecca, academic stand-outs reported that their parents ‘trusted’ them to do their work and to excel, suggesting the effectiveness of the mode of governance at getting students to monitor their own behaviour and thereby reduce the need for constant supervision. Asked if the system increased communication between her and her parents, Kacey said, I know my parents didn’t really check it a whole lot because I would get a bad grade and I would come home and I’d be like, ‘Oh my god, I got a bad grade. What am I going to do?’ So, I really kind of reported to them what my grades were by myself. Responding to the same question, Betsy said: My parents had their own login and also asked me about my grades or whatever, they’d be like, ‘How’d you do on that one test?’ And I’d be like ‘Oh, fine’. And they would check my grades every once in a while.

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Conversely, students who were under-performing were less ‘trusted’ by parents and those parents were more likely to use the system to surveil those children’s work. Parents discussed this dynamic, even within their own families. For example, ‘Janice’, a mother of two students stated: Janice: I use it [the SIS] differently, my younger son is the one for whom, I don’t want to say it’s a negative use, but it’s more of a ‘You need to step it up here’. My older son is hyperconscious about grades, and, you know, a dedicated older child. And I know he’s got all A’s. He’s the one on Skyward. You know, like, ‘It’s been an hour since my test was turned in, I wonder if it’s graded’. So, he checks it constantly. ‘Leslie’, also the parent of two children stated: Leslie: For the eighth grader, the missing assignments thing has come in handy, because she doesn’t, I mean [child #1] comes home and does her homework and is very focused on her academic stuff and is very, you know, she knows exactly when things are due and has a planner, and all those kinds of things. [Child #2] is a little less concerned about those things.

Conclusion In this chapter, I have argued that the SIS deployed in US schools operate as a neoliberal technology of childhood government (Gallagher, 2008) that encourages the self-tracking of performance metrics by academically driven students. My intent is not to judge this form of governance as ‘good’ or ‘bad’, rather my aim is to understand the mechanisms of how it operates and to examine the effects of subjectification that are produced in everyday life. Following Foucault, this form of power is not about the repression of subjectivity or the negation of the vitality and capacities of individuals but [is about] the creation, shaping and utilization of human beings as subjects. Power, that is to say, works through, and not against, subjectivity. (Rose, 1996, p. 151)

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We observe students, then, being infused with and displaying a neoliberal ethos, one that valorises the self-governing, enterprising and autonomous individual. Of course, urging adolescents to adopt these tenets towards their schooling and behaviour can be considered effective socialisation. After all, these are the idealised qualities of adulthood that young people will need to survive as they later join the ‘metric cultures’ of neoliberal universities (Chan & Moses, 2017), workplaces (Moore & Robinson, 2015) and other organisations. Indeed, it would seem that their focused use of the SIS readies them for adult lives of over-stimulation and attentive stress. But what of the students who resist the requisite process of subjectivation and refuse to deploy this neoliberal technology of the self? Or ‘[…] the percentage of kids who have never been on [the SIS] and don’t care’, as teacher Carol put it. These youths are more likely to be subjected to the school’s disciplinary forms of governance and their academic failures to be considered, in neoliberal parlance, a consequence of their own ‘mismanaged’ lives. Captured in the words of teacher Jake when I asked him if the SIS helped students be more responsible for their school work, he replied: It should, it’s there for them to use. I don’t know how often they use it, but it’s not an excuse not to know because you’ve got the access to it. It’s there, it’s available.

Acknowledgements I would like to thank the organiser of the conference and editor of this volume, Dr Btihaj Ajana, for her efforts. This project was funded by the Spencer Foundation Grant #10004989. I thank them for their support.

References Albrechtslund, A., & Lauritsen, P. (2013). Spaces of everyday surveillance: Unfolding an analytical concept of participation. Geoforum, 49, 310 316. doi:10.1016/j.geoforum.2013.04.016 Barry, A., Osborne, T., & Rose, N. (1996). Foucault and political reason: Liberalism, neo-liberalism and rationalities of government. Chicago, IL: University of Chicago Press.

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Centano, M. A., & Cohen, J. N. (2012). The arc of neoliberalism. Annual Review of Sociology, 38, 317 340. Chan, J., & Moses, L. B. (2017). Making sense of big data for security. British Journal of Criminology, 57(2), 299 319. doi:10.1093/bjc/azw059 Clarke, R. (1988). Information technology and dataveillance. Communications of the ACM, 31, 498 511. Dicken, P. (2015). Global shift. New York, NY: Guilford. Dika, S. L., & Singh, K. (2002). Applications of social capital in educational literature: A critical synthesis. Review of Educational Research, 72(1), 31 60. Retrieved from doi:10.3102/00346543072001031 Foucault, M. (1988). Technologies of the self: A seminar with Michel Foucault. Amherst, MA: University of Massachusetts Press. Foucault, M. (1991). The ethic of care for the self as a practice of freedom: An interview with Michel Foucault on January 20, 1984. In J. Bernauer & D. Rasmussen (Eds.), The final Foucault (pp. 1 20). Cambridge, MA: The MIT Press. Foucault, M. (1995). Discipline and punish: The birth of the prison. A. Sheridan (Trans.). New York, NY: Vintage Books. Foucault, M. (2009). Security, territory, population lectures at the College De France, 1977 78. In A. Davidson (Ed.), Basingstoke: Palgrave Macmillan. Gallagher, M. (2008). Foucault, power and participation. International Journal of Children’ Rights, 16, 395 406. doi:10.1163/157181808X311222 Hamann, T. (2009). Neoliberalism, governmentality, and ethics. Foucault Studies, 37 59. doi:10.22439/fs.v0i0.2471 Harvey, D. (2005). A brief history of neoliberalism. Oxford: Oxford University Press. Jespersen, J., Albrechtslund, A., Øhrstrøm, P., Hasle, P., & Albretsen, J. (2007). Surveillance, persuasion, and panopticon. In Y. De Kort, W. IJsselsteijn, C. Midden, B. Eggen, & B. Fogg (Eds.), Proceedings of the 2nd international conference on persuasive technology (pp. 109 120). Berlin: Springer-Verlag. Lupton, D. (2013a). Understanding the human machine [Commentary]. IEEE Technology and Society Magazine, 32(4), 25 30. doi:10.1109/MTS.2013.2286431 Lupton, D. (2013b). The digitally engaged patient: Self-monitoring and self-care in the digital health era. Social Theory & Health, 11(3), 256 270. doi:10.1057/ sth.2013.10 Lupton, D. (2016). The diverse domains of quantified selves: Self-tracking modes and dataveillance. Economy and Society, 45(1), 101 122. doi:10.1080/ 03085147.2016.1143726 Moore, P., & Robinson, A. (2015). The quantified self: What counts in the neoliberal workplace. New Media & Society, 18(11), 2774 2792. doi:10.1177/ 1461444815604328 Nemorin, S. (2017). Affective capture in digital school spaces and the modulation of student subjectivities. Emotion, Space and Society, 24, 11 18. doi:10.1016/j. emospa.2017.05.007 Purpura, S., Schwanda, V., Williams, K., Stubler, W., & Sengers, P. (2011). Fit4life: The design of a persuasive technology promoting healthy behavior and ideal

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weight. Proceedings of the SIGCHI conference on human factors in computing systems (pp. 423 432), Vancouver, Canada. Retrieved from https://dl.acm.org/citation.cfm?doid=1978942.1979003 Raley, R. (2013). Dataveillance and countervailance. In L. Gitelman (Ed.), “Raw data” is an oxymoron (pp. 121 145). Cambridge, MA: MIT Press. Rose, N. (1996). Governing enterprising individuals. In N. Rose (Ed.), Inventing our selves: Psychology, power, and personhood (pp. 150 168). Cambridge, MA: Cambridge University Press. doi:10.1017/CBO9780511752179.008 Rose, N. (1999). Powers of freedom: Reframing political thought. Cambridge, MA: Cambridge University Press. Staples, W. (2009). ‘Where are you and what are you doing?’ Familial ‘back up work’ as a collateral consequence of house arrest. In M. Nelson & A. Garey (Eds.), Who’s watching: Daily practices of surveillance among contemporary families (pp. 33 53). Nashville, TN: Vanderbilt University Press. Staples, W. (2014). Everyday surveillance: Vigilance and visibility in postmodern life. (2nd ed.). Lanham, MD: Rowman & Littlefield Publishers. Staples, W. (2017). Student information systems: Infrastructures of communication, accountability, and surveillance. Unpublished manuscript. Staples, W., & Decker, S. (2008). Technologies of the body, technologies of the self: House arrest as neoliberal governance. In M. Deflem (Ed.), Surveillance and governance: Crime control today sociology of crime, law and deviance (Vol. 10, pp. 131 149). Bingley: Emerald Group Publishing Limited. Staples, W., & Decker, S. (2010). Between the ‘home’ and ‘institutional’ worlds: Tensions and contradictions in the practice of house arrest. Critical Criminology, 18, 1 20. doi:10.1007/s10612-009-9089-5 van Dijck, J. (2014). Datafication, dataism and dataveillance: Big data between scientific paradigm and ideology. Surveillance & Society, 12(2), 197 208.

Chapter 12

A Quantified Self Report Card: Ethical Considerations of Privacy as Commodity Chelsea Palmer and Rochelle Fairfield

Abstract In June 2017, The Human Data Commons Foundation released its first annual Quantified Self Report Card. This project consisted of a qualitative review of the privacy policy documentation of 55 private sector companies in the self-tracking and biometric data industry. Two researchers recorded their ratings on concrete criteria for each company’s website, as well as providing a blend of objective and subjective ratings on the overall ease of readability and navigability within each site’s documentation. This chapter explains the unique context of user privacy rights within the Quantified Self tracking industry, and summarises the overall results from the 2017 Quantified Self Report Card. The tension between user privacy and data sharing in commercial data-collection practices is explored and the authors provide insight into possibilities for resolving these tensions. The self-as-instrument in research is touched on in autoethnographic narrative confronting and interrogating the difficult process of immersive qualitative analytics in relation to such intensely complex and personal issues as privacy and ubiquitous dataveillance. Drawing upon excerpted reflections from the Report Card’s co-author, a few concluding thoughts are shared on freedom and choice. Finally, goals for next year’s Quantified Self Report Card are revealed, and a call extended for public participation. Keywords: Data ethics; user rights; biometric tracking; autoethnography; research narrative; technological unconscious

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Introduction Disruptive innovation in the technology sector reshapes the way that government and corporate entities aggregate information about individuals and communities, as well as the way that those individuals and communities choose to represent themselves. In the age of Quantified Self (QS) devices and analytics, informed consent for end users becomes even more crucial. Massive databases provide exhaustive pictures of users’ biometric statistics mapped to their geocoded locations. These reserves of information are too often siloed, with their company’s data practices hidden from the public (Lupton & Michael, 2017). If effectively de-identified, and shared, these data could be used for good, via consensual contribution to medical and academic research. However, under current industry norms, these data are vulnerable to be used for any number of unidentified purposes. The omnipresent technological environments which some have designated ‘ubiquitous computing’ further complicate questions of user privacy and autonomy, because when sensor-laden devices blend into our surroundings, it becomes easy to forget that they are always on, and always potentially recording data for later (Beckwith, 2003). Beer highlights the ‘increasingly powerful and active technological environments that operate without the knowledge of those upon whom they are taking an effect’ in his discussion of the ‘technological unconscious’ (2009, p. 990). Just as these ubiquitous technologies impact our environments, the totalising flow of data from ourselves to our surroundings will surely reshape our relationships with those environments. One relatively obvious change enacted by the rise of QS tracking technology is the exponential increase in dataset sizes. Another less obvious change, however, is more conceptual than concrete: the QS movement is driven by an enthusiastic desire to remove constraints to ubiquitous tracking, which could appear to conflict with the core principles of classic data privacy frameworks (Leibenger, Mollers, Petrlic, Petrlic, & Sorge, 2016). Additionally, the QS community’s fondness for gamification and sometimes competition brings individuals’ data into intertwined relationships and configurations. Another distinct shift presented by the QS context is the heightened degree of personal identifiability when it comes to biometric data: even with specific location tracking turned off, an individual’s geographic location can be reconstructed relatively easily by analysing the patterns of their movement data (Haddadi & Brown, 2014). In light of this, data privacy concerns move towards a more tangible threat to the

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individual’s well-being, rather than just an annoyance or overstep. There are existing regulatory frameworks that are supposed to protect citizens and consumers from this sort of abuse, but they are often either archaic relics of a pre-digital age, or patchwork pieces of policy that are difficult or impossible to enforce. An annual ethical Report Card provides the opportunity to highlight best practices and progressive privacy policies while also exposing some tendencies to opacity and inconsistency in QS industry practices. This is a logical next step to informing consumers and encouraging them to make mindful choices about what devices and services to use, while encouraging the commercial sector to adopt the higher range of standards relating to user rights.

Human Data Commons Foundation’s 2017 Quantified Self Report Card The Human Data Commons Foundation (HDC), founded in 2016 in Vancouver, British Columbia, champions user-centric data privacy practices in the age of QS data collection. The Foundation’s 2017 Quantified Self Report Card serves primarily as an early qualitative assessment of the user interfaces and written content of the documents presented to a user upon first exploration of a company’s website. By highlighting and encouraging notable best practices in transparency and comprehensibility, the HDC’s Report Card serves to reinforce clarity, simplicity and power balance within websites and privacy policies. After all, for users to feel any degree of agency in their use of tech devices and platforms, they must be able to easily navigate and understand their rights and responsibilities. Though labyrinthine legal language might feel like a necessary evil in contemporary society, it is possible for companies to adequately protect their liability in dense contract terms, while still providing an accompanying summary which is more straightforward and easy to parse.

Research Methodology: Evaluating Readability There are myriad ways to try to measure the construct of a document’s ‘human readability’. Much of the machine learning research focusing on readability of privacy policies relies upon automated text analysis, such as the counting and extraction of keywords indicating ‘choice instances’ which indicate a point of agency for the reader or end user (Ermakova,

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Baumann, Fabian, & Krasnova, 2014). Other studies have gone so far into the realm of Quantifying the Self that their metrics of comprehension and attention hinge upon the subject’s eye movements during reading (Steinfeld, 2016). It would require an entire chapter, or perhaps an entire book, to review the diverse methodologies for evaluating this construct. The Human Data Commons Foundation’s small-scale operation and grassroots mentality led us to measure the documents’ ‘human readability’ in a straightforward fashion: by having two human beings read them. It may seem blasphemous in the context of QS tracking to readily embrace the presumed imprecision of individuals’ opinions in this manner. However, user’s stories still thrive at the heart of all our technological explorations, and it is still always a human being clicking through these privacy policies. If ‘Privacy by Design’ isn’t for the people who will peruse these web pages, who exactly is it for? With this in mind, co-researchers Chelsea Palmer and Rochelle Fairfield developed a methodology for replicating an ‘average Joe or Jane’ real-life user, of which they are an example, having little to no legal background, and being relatively new to QS devices and platforms. They read through each website’s Privacy and Terms and Conditions policy, as users are asked to do before they agree to them. Each website was scanned for links to the policies, which were then read through at a brisk pace. Time spent on each was proportional to the length of the policy and density of language: for example, approximately 5 8 minutes for a medium length, medium density policy document of 2 4 pages. Report Card categories were at hand in a spreadsheet and Google Form formats. Each field was filled in presence, absence, quality on a scale, etc. as the researchers read through the site and policy at a brisk pace, as a real-life user might do. If a field was not readily found, a brief effort would be made to find it, again as a real-life user might do. There was also room for comments for each field, where themes and patterns that emerged could be noted, as well as further insights and information to aid design of next year’s Quantified Self Report Card.

Research Results: Categorical Comparisons The Report Card results shall be presented as simply as possible, to lay the foundation for a more reflective discussion that follows. Additionally, in order to lend more dimensions to the 2017 Quantified

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Self Report Card, these results will be presented from a different angle than they are presented within the existing 2017 Report (Palmer & Fairfield, 2017). In the original report, the detailed outcomes of each research question are grouped into categories of companies. Here, they will be grouped instead by research question. However, to aid sorting and comparison, it is helpful to understand the four categories into which companies are grouped. The first, ‘Devices’ referred to the most classic category of QS companies: those who manufactured hardware devices and equipment for self-tracking. Next, ‘User Platforms’ refers to companies that provide websites or applications to collect, view, organise or analyse raw data from tracking devices. ‘Middleware Analytics’ refers to companies that develop algorithms and analytic tools upon which other user-facing companies can build platforms. ‘Conglomerates’ refers to large technology companies that pre-existed the current QS industry, and that provide a large range of products or services outside of the field. The clustering of reviewed companies within these four broad categories happened as a force of organic necessity during the ‘sensemaking’ portion of qualitative data analysis. By separating the companies in this manner, it was easier to watch for conflating issues of size, longevity and overall purpose. After all, the documentation standards expected from a brand new start-up vary wildly from those expected from a long-time transnational corporation. Similarly, the security standards of companies that directly store users’ data would differ significantly from companies that design and sell analytic algorithms without actually interacting with users. With these four categories of companies defined, it is now possible to trace the patterns of their results for each of the core scoring criteria in the HDC’s 2017 Quantified Self Report Card. These core criteria represent foundational pillars of user access to basic information about the company’s practices. Before reading a Privacy Policy, the user must be able to find it, so it was a crucial criterion that each company provided a fixed hyperlink to this documentation in the header or footer of its website. This was clearly the highest performer among all of the criteria, with a near perfect performance across all categories. Overall, only four companies of the 55 surveyed lacked a fixed link: three from the Devices category and one from the Middleware category. All four of these companies’ websites were missing noticeable amounts of content in addition to these absent links, suggesting that the sites were not yet finished, or had perhaps been abandoned during production (Figure 12.1).

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Figure 12.1. Was There a Fixed Link to the Privacy Policy in the Website’s Header or Footer? It is increasingly common for data collection companies to name a specific Privacy Officer to contact with questions or requests related to users’ personal information. This expedites the process of inquiry and account deletion requests. As this practice is not yet fully ubiquitous, for the purposes of the Report Card the criterion was considered to be met if a dedicated privacy contact of any sort was provided, including a ‘privacy@’ email address. Even with this allowance made, the results were rather weak for this question. Only one company category, the User Platforms, showed a significant amount of companies providing such a contact, and even then, just barely half of them did so (53%) (Figure 12.2). Another crucial element of informed user consent regarding data collection and use is the ability to track future changes to a company’s stated policies. For the purposes of this criterion, the measurement was whether or not the company’s documentation indicated how the end user would be notified about future policy changes. In most cases, the policy merely stated that it was the user’s own responsibility to check back periodically for updates to the policy. On the more proactive end of the spectrum, some policies went so far as to reference that the user would be directly notified of ‘material changes’ to the policy, but even in these cases the concept of ‘material changes’ was not clearly defined. Perhaps because of the conservative framing of this third criterion, nearly all of the companies across the four categories successfully met

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Figure 12.2. Was a Dedicated Privacy Contact Named within the Privacy Policy Documentation?

Figure 12.3.

Did the Privacy Policy Documentation Note How Future Changes Would Be Indicated?

its conditions. Only the Middleware Analytics companies lagged significantly behind, with four out of 10 companies failing to mention future policy changes (Figure 12.3). This criterion was the most subjective, but at the same time it was the most vital element of our qualitative methodology. Before undertaking

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Figure 12.4.

Did the Researchers Feel that the Privacy Policy Showed an Attempt at Readable Language?

the research, much time was spent debating the constructs underlying the question of apparent ease of readability. The consensus reached was that a company would be judged as having exhibited this apparent effort if their Privacy Policy documentation included at least some relatively plain language sections or summaries of denser legalese terminology. However, even with this agreement, there were differences between the researchers’ reported perspectives for this criterion. This is likely reflective of real-life conditions in that users likely also vary on how readable they find the language based on their unique propensities and capacities in reading, and with language more generally. Still, of the companies reviewed, 80% of Conglomerates, 70% of Devices, 60% of Middleware Analytics and 53% of User Platforms were perceived by the researchers to display some effort towards easily readable language in their Privacy Policy documents (Figure 12.4). The ability to directly reach out to a human being, rather than navigating through what can sometimes be a labyrinth of Frequently Asked Questions, is a significant benefit when specific concerns arise for the end user. The final core judgement criterion returned was readily quantified: how many points of direct human contact were made available to visitors of the company’s website? These were counted out of four possible options: a phone number, a physical address, an email address or a submission form upon the page itself. The Middleware Analytics and Devices categories performed well in this regard, with a respective

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Figure 12.5.

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How Many Points of Direct Contact Did the Average Company Provide?

average of 3.2 and 2.65 points of contact per company. Processing the data in other ways, it becomes clear that 100% of Middleware Analytics companies and 80% of Devices companies provided at least two out of four possible points of contact. In contrast, the User Platforms and Conglomerates showed a weak performance in terms of direct outreach opportunities. User Platform companies provided an average of 2.47 points of contact, and only 67% of the companies provided two or more points of contact. Even worse, Conglomerates provided an average of only 1.3 points of contact, with three out of 10 companies providing none at all, and only 50% providing two or more. Though larger and better-established companies may have more user-facing resources, they clearly have a dearth of avenues to direct outreach (Figure 12.5).

Research Analysis: Balancing Differences In designing research forms to evaluate the above criteria, multiple fields for open-entry data capture and commentary were included to try to take full advantage of multiple analytic perspectives. During the data review and analysis process, when the two researchers’ opinions differed on a subjective question, in-depth commentary would be compared, and between them the more conservative side of judgement prevailed. For

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example, if one reviewer felt the documentation showed a fair effort towards ease of readability, but the other encountered difficulty understanding it, the result was marked as lacking apparent ease of readability. Inevitably, this binary rating loses some of the subtlety of an individual’s perspective, so these have been captured in an Appendix consisting of detailed analyses of each company’s qualitative reviews. This appendix, Appendix A of the 2017 Quantified Self Report Card provides a significant amount of context from the researchers’ in-depth qualitative methodology. It was a strenuous task, taking weeks of microscopically zoomed focus, which highlights the utility of offloading this sort of detailed textual analysis to machine learning.

Ontological Fatigue: A Personal Narrative Shift As researchers, it became clear that immersion in reading many Privacy and Terms documents requires pacing and a respect for the human brain and body as research instrument. The researchers were careful not to mechanically march through the alphabetic index of the companies’ data points, because as they had established in their initial review rounds, pushing oneself through too many hours of repetitive analysis eventually dulls or scatters the mind, and the details can begin to blend together. Each researcher aimed to take advantage of her human reflexivity, while striving to keep cognitive states and capacities fresh enough to be consistent while engaging and assessing the datasets at hand. These reflections lead to the insight that in future report card research design may include tracking researchers’ sleep patterns, rates of eye movements while reading, brain-wave activity and such like metrics during the policy document reading portion of the research. For this edition, the researchers essentially assessed the benchmarks of a new world with the trusty tools of the old one. One researcher had something of a personal epiphany after the Privacy and Terms and Conditions part of the research was completed. She realised it was the norm for her to move endlessly through an embedded world of information technology, and was now even more uncomfortably aware of each tracked movement. For a month after completing this part of the research, she had limited access to technology, and she did her best to shed the forever-electrified connectivity that typically binds her to devices and their measurements, seeking escape from the context collapse that her mobile phone had once instilled in her every moment (Marvin, 2013).

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Power and Privacy in the Datasphere Immersed in the initial process of company review, both researchers experienced a strange mix of fatigue and revelation. They were constantly paying attention to the ‘technological unconscious’ that engulfs us (Beer, 2009). Revisiting the datasets after her time away, one researcher was challenged with her task of trying to invent from scratch a representational framework that could highlight its elusive patterns. This is one of the reasons that R. Fairfield’s introspective Post-Script to the 2017 HDC Report Card should be absorbed in its entirety. She provides valuable meta-level reflections on data in the broader context of human evolution, power relations, resource flows and the unique opportunities of data collection and the QS field: Human evolution arguably depends to some degree on seizing opportunities and resources. If we can follow the line of thinking that data represents a kind of raw resource, which data analytics then refines into useful information, there are many upsides to how masses of this raw material might be refined to fuel human health and well-being. There is of course a downside as well. Human beings have a tendency to hoard resources, thus creating wealth for some and poverty for others. Our history of colonialism and natural resource extraction across borders is one example, and arguably is still very much practiced. It’s plausible, likely even, that this spirit of imperialism will live on in the world of data resource extraction and trade. A new socio-economic category, that of data baron, is currently in the making. We have a chance now to influence and nudge the practices in data collection towards a brighter future, be it Quantified Self or any form of data collection. (Palmer & Fairfield, 2017, p. 76) There is an undeniable asymmetry in power between those who collect and mine data, and those from whom it is collected (Andrejevic, 2013). In practice, legal agreements between user and provider are oneway ultimatums, where the user agrees or else cannot use the product, service or platform. They are neither welcome nor readily able to negotiate terms on their own behalf. This asymmetric power is accompanied, inevitably, by an asymmetric transparency, in which the data barons know so very much about their end users, while the users know little to

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nothing about even the most core policies of the service providers (Marvin, 2013). However, whether they know it or not, users are increasingly the subjects of dataveillance, a constant and totalising process of surveillance through the many and omnipresent points of access (Lupton & Michael, 2017). At the dystopian end of the spectrum of imaginable futures, the archives of our personal data could be wielded as a weapon against us, for example with predictive measures taken to judge and punish those who seem to present risk of societal transgression (Schinkel, 2011). Or a tamer fear could be realised, one that is already materialising: the feedback loop of our data streams is funnelled back by algorithms to shape an echo chamber, showing us only what we’ve already seen, telling us only what we think we already know. This is most prominent in the targeted advertising and self-fulfilling prophecies presented in consumer culture, especially in advertising on social media sites, for example. Consumer culture seems to surge forward to control the game at every turn of technological development, at least once a movement towards mass adoption is reached. Quirky basement experiments first prove sustainable, and then they prove profitable. Suddenly it is no longer about solving puzzles, it is about how many units can be crammed into one tractor trailer and shipped to stock shelves. Consumerism and economic drivers, being what they are, raise the question as to how one can preserve the pioneering spirit behind the QS field’s biohacking origins while decades-old conglomerate corporations rush to build the hip new activity tracker? (Ajana, 2017). When startupsMehlman (2015) are no longer lean, will they remember what it feels like to be starving? To what extent is corporate social responsibility used as a convenient phrase that can be cashed in for tax breaks, or else a true societal value that is being robustly practiced and implemented? What are our measures for success in these endeavours? Mehlman (2015) points out that it would be counterproductive to try to topple the data brokerage industry, because the current practices of data collection and analysis have many positive effects on the technological ecosystem. Instead, she suggests that we apply strategic effort to ensure that the processes of data collection, control and utilisation operate in as transparent a fashion as possible. This will allow end users to make informed choices about which systems they want to cooperate with, and which they’d rather avoid. Additionally, it maintains the healthy economy of data exchange to flow without unchecked monopolies. In other words, there is a way we could find a participatory,

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collaborative and consensus-driven means to regulate the currently unchecked flurry of data imperialism: Along with these societal level concerns, increasing metrification points to a more existential question: what is a good life? This is a qualitative question that may include quantitative measures as part of the answer, but to mistake measurement for a good life […] can easily lead to over commodification of human sentience […] Qualities such as freedom and affiliation mean vastly different things to different peoples. The freedom to liberate some and oppress others, or the insistence that everyone enjoy the same freedoms, for example, suggest that different metrics would be required for the same concept as it is expressed through the multitudes of human expression. Leading us to inquire into the value also of freedom from measurement, and what right humans might have to that freedom. (Palmer & Fairfield, 2017, p. 76) The reminder that we may deserve an inherent freedom from measurement calls to mind the concept of ‘the right not to be identified’ which is at the core of one approach to privacy theory (Woo, 2006). This transcends the mere right to be ‘left alone’, and moves instead towards communal access to opportunities for anonymity. In examining the possibilities for large dataset research, perfecting the ability to truly anonymise datasets makes the most sense for sustainable, long-term use of information. This is perhaps a kind of core right, or baseline, worth striving for in future databases. This is where the concept of privacy by design is of vital importance: our systems for data collection can, and should as a minimum cautionary approach, be structured for inherent protection of the user, as well as ease of navigation and orientation (Schaub, Balebako, Durity, & Cranor, 2016). What might this freedom from measurement look like? It would be intertwined with transparent access to the bigger picture of our data flows, and anchor itself in informed and context-specific user consent scenarios (Vayena, Mastroianni, & Kahn, 2013). The individual’s increased freedom would result from an increased responsibility on the part of the data brokers, requiring them to maintain reciprocity, rather than imposing unilateral agreements upon the users. A modular design to privacy preferences management would allow users to design their own preferred permissions structures, leaving the data collection agents

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to make appropriate changes if they wish to do business with them (Lederer, Dey, & Mankoff, 2002). With vision and gentle influence from the public, QS companies can begin to defer to their end users’ requests and input in order to design more exciting and participatory opt-in data collection practices.

2018 HDC Quantified Self Report Card: Encouraging Industry Best Practices The most crucial next steps for the Human Data Commons Foundation’s Quantified Self Report Card are to increase visibility of the existing 2017 findings, and stir participation in designing and producing next year’s edition. The first draft of the 2017 Report Card research design included a strong crowdsourced data collection element, in which a wide range of input from existing QS device users would be obtained and integrated in the data analysis process. Given the available resources, it proved difficult to successfully engage the larger community for such a task. However, the successful release of the 2017 Report Card has created a base level for more modular and decentralised future research. For 2018, the hope is to invite technology enthusiasts and sceptics alike to peruse the Report Card and provide recommendations based upon their own engagement with, and where relevant, suspicions of QS tracking devices. Additionally, the intention is to exert friendly yet substantial influence within the QS industry in order to encourage widespread adaptation of best practices among participating enterprises. Having identified some significant strengths and weaknesses within each of the categories defined, the Report Card’s conclusion includes suggestions for collaborative improvement across the private sector. For example, monolithic conglomerate companies could ‘open source’ their substantial collections of informative privacy documentation for universal hyperlinking from smaller startups. This would allow previously siloed corporate ‘privacy portals’ to function as more of a public good resource, supporting informed consumer consent and helping to standardise definitions of privacy and security terminology. Of course, these resources would have to be monitored for consistency and neutrality, but this monitoring would be made easier by such a transparent and standardised method of sharing. Though the ontological issues surrounding the data privacy field are complex, some of the stopgap solutions to these problems are

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relatively simple. It will take very little work for any established QS company to review our 2017 Report Card and upgrade their practices according to the concrete core criteria. Additionally, even the more visionary future of policy design reform can be built upon some straightforward advances. The notion of using universal visual cues to quickly summarise privacy practices has been broached by multiple parties, including a recent proposal to build icons based on recognisable pie-chart structures to indicate an application’s data privacy norms (Alohaly & Takabi, 2016). Another group suggested a similarly organic visual presentation of such information borrowing from the traditional ‘nutrition label’ format (Kelley, Bresee, Cranor, & Reeder, 2009). There is a powerful thread binding these ideas: build the next generation of privacy practice interfaces upon familiar ground, basing future representations on already comprehensible models. There are exciting opportunities afoot to actively shape the practices and policies of a nearly new-born industry. Discussions around surveillance and privacy are often quite macabre, but there are as many reasons to hope as there are to despair. The mass size of datasets that are available now through QS devices will undoubtedly lead to medical and health breakthroughs that will be of great benefit to humans. Further in favour of technology aiding humans, the review of industry privacy policies made it clear that there are some workloads that would be a relief to outsource to Artificial Intelligence robots. And, there are still valuable discoveries to be made by observing and analysing this field in human form. While bots may not experience strain, it took some effort to keep human courage afloat while these researchers were suspended within the fine filaments of a technological spiderweb. This process shone such a bright light upon the ubiquitous data tracking environment all around us, and being constantly cognisant of these processes grew quite uncomfortable in the particularly human way we have of feeling too aware of being ‘watched’, or tracked. So much so that both researchers have revised their behaviours in relation to technology use, from deleting some applications from their phones to censoring participation in online platforms, and so on. The researcher in QS research cannot help but be caught up at times in the refractive nature of this particular task […] and if you gaze too long into a database, remember the database will also gaze into you, as perhaps Nietzsche might have said were he alive today.

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References Ajana, B. (2017). Digital health and the biopolitics of the Quantified Self. Digital Health, 3, 1 18. doi:10.1177/2055207616689509 Alohaly, M., & Takabi, H. (2016). Better privacy indicators: A new approach to quantification of privacy policies. Symposium on usable privacy and security (SOUPS), June 22 24, 2016, Denver, Colorado. Retrieved from https://www. usenix.org/conference/soups2016/workshop-program/wpi/presentation/alohaly Andrejevic, M. (2013). The big data divide. International Journal of Communication, 8, 1673 1689. Retrieved from http://ijoc.org/index.php/ijoc/article/view/2161/ 1163 Beckwith, R. (2003). Designing for ubiquity: The perception of privacy. IEEE Pervasive Computing, 2(2), 40 46. doi:10.1109/MPRV.2003.1203752 Beer, D. (2009). Power through the algorithm? Participatory web cultures and the technological unconscious. New Media & Society, 11(6), 985 1002. doi:10.1177/ 1461444809336551 Ermakova, T., Baumann, A., Fabian, B., & Krasnova, H. (2014). Privacy policies and users’ trust: Does readability matter? In: Twentieth America’s conference on information systems (AMCIS 2014), Savannah, USA. Retrieved from https:// www.researchgate.net/publication/262563357_Privacy_Policies_and_Users%27_ Trust_Does_Readability_Matter Haddadi, H., & Brown, I., (2014). Quantified Self and the privacy challenge. SCL Technology Law Futures Forum, August 2014. Retrieved from http://www.eecs. qmul.ac.uk/~hamed/papers/qselfprivacy2014.pdf Kelley, P., Bresee, J., Cranor, L., & Reeder, R. (2009). A “nutrition label” for privacy. Symposium on usable privacy and security (SOUPS), July 15 17, 2009, Mountain View, CA. https://doi.org/10.1145/1572532.1572538 Lederer, S., Dey, A., & Mankoff, J. (2002). A conceptual model and a metaphor of everyday privacy in ubiquitous computing environments. Report No. UCB/ CSD-2-1188. Group for User Interface Research, University of California, Berkeley. Leibenger, D., Mollers, F., Petrlic, A., Petrlic, R., & Sorge, C. (2016). Privacy challenges in the Quantified Self movement - An EU perspective. Proceedings on privacy enhancing technologies, ISSN (Online) 2299-0984. https://doi.org.10.1515/ popets-2016-0042 Lupton, D., & Michael, M. (2017). ‘Depends on who’s got the data’: Public understandings of personal digital dataveillance. Surveillance & Society, 15(2), 254 268. Retrieved from http://library.queensu.ca/ojs/index.php/surveillanceand-society/index Marvin, C. (2013). Your smart phones are hot pockets to us: Context collapse in a mobilized age. Mobile Media & Communication, 1(1), 153 159. doi:10.1177/ 2050157912464491 Mehlman, J. N. (2015). If you give a mouse a cookie, it’s going to ask for your personally identifiable information. 81 Brook. L. Rev. Retrieved from http:// brooklynworks.brooklaw.edu/blr/vol81/iss1/9

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Palmer, C., & Fairfield, R. (2017). 2017 Quantified Self report card: User rights in the age of biometric tracking. Human Data Commons Foundation, Retrieved from https://humandatacommons.org/2017QSreportcard Schaub, F., Balebako, R., Durity, A., & Cranor, L. (2016). A design space for effective privacy notices. USENIX Association: Symposium on usable privacy and security (SOUPS). July 22 24, 2015, Ottawa, Canada. Retrieved from https:// www.usenix.org/conference/soups2015/proceedings/presentation/schaub Schinkel, W. (2011). Prepression: The actuarial archive and new technologies of security. Theoretical Criminology, 15(4), 365 380. doi:10.1177/1362480610395366 Steinfeld, N. (2016). “I agree to the terms and conditions”: (How) do users read privacy policies online? An eye-tracking experiment. Computers in Human Behavior, 55(B), 992 1000. doi:10.1016/j.chb.2015.09.038 Vayena, E., Mastroianni, A., & Kahn, J. (2013). Caught in the web: Informed consent for online health research. Science Translational Medicine Magazine, 5(173), 1 3. doi:10.1126/scitranslmed.3004798 Woo, J. (2006). The right not to be identified: Privacy and anonymity in the interactive media environment. New Media & Society, 8(6), 949 967. doi:10.1177/ 1461444806069650

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Chapter 13

The Limits of Ratio: An Analysis of NPM in Sweden Using Nicholas of Cusa’s Understanding of Reason Jonna Bornemark

Abstract What happens when we limit our understanding of reason to a calculating competence? In this chapter, I will approach the contemporary introduction of New Public Management (NPM) in the Swedish public sector from the point of view of the fifteenth century philosopher Nicholas of Cusa and his critical analysis of reason and notknowing. Cusa emphasises not-knowing as something which we cannot and should not avoid. As such it is central to every creation of knowledge. Reason, as the process to gaining knowledge also includes the capacity to relate to not-knowing. In modernity, the understanding of not-knowing has decreased and accordingly changed our understanding of reason. Reason became a calculating capacity, what Cusa calls ratio, rather than a reflecting capacity, what Cusa calls intellectus. The introduction of NPM in the Swedish public sector can, from this point of view, be seen as a kind of ratioorganisation, and I will point out three characteristics of this ratiofication: First, it includes a ‘concept imperialism’, as concepts from outside of the public service-activities displaces concepts that come from within. In this displacement, easily measurable concepts and concepts that frame a measurement-culture displace concepts that belong to the intellect. Second, we can see an ‘empaperment’ when every act has to be documented in order to be counted as complete, and where the empapered world of ratio becomes more central than

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the lived world with its constant presence of not-knowing. Third, this also results in a ‘remote controlling’ of activities when the acts of the staff are governed from the outside, and the competence to listen to the not-knowing of each situation is not valued. Keywords: Reason; Nicholas of Cusa; intellect; not-knowing; situation; New Public Management

Introduction Reason is mostly understood today as a calculating capacity. Even if we can find critical perspectives in, for example, Michel Foucault’s discussion about the relation between power and knowledge, or on biometrics and biopolitics, we rarely think about what kind of acts that are, or should be, included in that which we call reason. In this chapter, I will explore the fifteenth century philosopher Nicholas of Cusa, who has a broader understanding of reason, and analyse some aspects of contemporary metric culture by means of his philosophy. My example will be New Public Management (NPM) in elderly care and health care in Sweden. There is 600 years between our time and Cusa’s fifteenth century, but I would like to argue that this time gap can show us what has happened with a western understanding of reason and provide us with tools for a critical analysis. The analysis provided here is thus philosophical and even normative, to the extent that it points towards what is missing in modern rationality. There is a certain rationality in NPM, a rationality that many experience as problematic, but also difficult to criticise since rationality is at the centre of western civilization. But by going back to Cusa, we can gain a clearer understanding of what it is that is missing in this rationality without giving into irrationality.

Nicholas of Cusa Not-knowing Nicholas of Cusa was not only a philosopher, but as an early renaissance man, also a theologian, mathematician, politician, etc. Here, I will

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define him as a philosopher and outside of his theological context. He is most well known for his work on ‘learned ignorance’, explored specifically in De docta ignorantia (DI) (Cusa, 1440/2005a), which together with De coniecturis (DC) (Cusa, 1442-3/2005b) are the most central texts here.1 Today, not-knowing is most often understood as a missing piece in a puzzle, something not-yet-known, but where the shapes and contours of the missing knowledge is present. But rather than being a missing piece of a puzzle, not-knowing according to Cusa is a horizon that surrounds everything. We never know what the future holds, we never know everything about another person or living being, and we don’t even fully know ourselves. Cusa’s philosophy is closely connected to the tradition of negative theology, where God is beyond every thought and every word. But in his philosophy, not-knowing is not limited to God or the infinite, but also the concrete and the smallest thing, what he calls minima. The minima, it is important to note, is not mainly concerned with the physical smallest an atom or string but rather the particular, that is the unique situation, event or individual whose essence cannot be fully generalised. The reason for this not-knowing is that knowledge is always formed in relation to what we already know. But as the minima always has a uniqueness to it, it can never be fully known through concepts since they formulate something that is repeated in our experience. Two situations are never the same in time and position and therefore one of them cannot be the measure of the other. Nothing can therefore be used as a complete measure for something else (Cusa, 1440/2005a, (DI) pp. 52 63, 85 86, 130). Cusa claims that the closer we come to this not-knowing, the closer we come to truth. Not knowing is so precise that an infinitely greater precision would not be possible. We can perceive regularities and formulate them in a mathematical way in order to understand certain structures of the world, but such knowledge is never final and does not provide us with knowledge about the unique situation, nor about infinity (Cusa, 1440/2005a, (DI) pp. 56, 63). Nevertheless, knowledge is possible ‘between’ maximum and minima, between the infinite and the unique concrete situation or individual and this knowledge is reached through two intertwined kinds of reason: ratio and intellectus.

1

But I will also use Dialogus de ludo globi (LG), De quaerendo Deum (QD), Idiota de mente (IM) and Sermon 124.

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Ratio Ratio deals with the material given through the senses. In itself, sense perception is chaotic, always overflowing with what we can categorise, and thus belongs to the horizons of not-knowing. It is through ratio that a world is organised, a cosmos possible to live in. In order to create this cosmos, ratio divides the sense perception into groups and categories and organises similarities, proportions and connections between these groups. Through a conceptual and generalising understanding, each object or event gains clear limits and can be defined. This organisation demands units. A unit means something possible to count, that it is exactly one, but also that there are several of the same unit, of the ‘same kind’, we say. All knowledge is dependent upon the separating and connecting function of numbers (Cusa, 1463/2005e (LG) pp. 324, 331 333). For example, we know what a tree is, and can therefore count how many trees there are in a certain area. Numbers are central to ratio, Cusa claims, since it is what makes it possible to bring several experiences under one and the same concept. To bring many experiences under one concept is what happens when you learn a language, and the categories and definitions of a certain culture. Cusa claims that there is a central ambiguity of reality; we always create categories with a starting-point in that which exists, but we thereby do not exhaust reality. To Cusa, the discussion on quidditas, that is on whatness, qualities or essences is central. The stream of experiences is infinite as there is an infinite stream of whatness but these are whatnesses not yet made into calculable concepts with strict definitions. But these types of quidditas are what the ratio uses when it creates its unities. But since it is impossible for the human being to experience all quidditas at once, it also means that that which is different from another point of view becomes similar. When we count trees we ignore the difference between a pine tree and a leafy tree, we ignore similarities based on colour, or shape, and we need to draw a limit between bush wood and tree a limit that could be drawn elsewhere, and we ignore similarities between what we conceptualise as bushes and trees. Sense perception is multifaceted, but just as when many people speak to you at one time, you only understand the voice which your attention is drawn towards. This directionality is the light of ratio, which thereby separates and ties together (Cusa, 1445/2005c, (QD) p. 214). Knowledge, as pieces in a puzzle, belongs to ratio’s way of understanding the world. It is through ratio we define the pieces in the puzzle,

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see how they belong together and thereby reduce not-knowing to not-yet-known. Through ratio, knowledge is formed in dichotomies or opposites and thus as either/or. Ratio takes place between maxima and minima, the place within which we live our lives, an area formed through mathematics, as without numbers there is no differences or order, and thus no ‘many’ of the same (Cusa, 1440/2005a, (DI) p. 57). But there is also a danger in mathematics; it provides us with knowledge and truth, but it has an inherent risk: that we understand mathematics as Truth, that is, that everything can be calculated and in that way controlled. Mathematics is a measure, but its own value cannot be measured. Cusa here understands mathematics in two different ways: on the one hand, he means that it takes us closer to the highest truth as it points to patterns perceived by the spirit rather than by the senses. On the other hand, he continues, it tends to make us think that we can have a complete overview of the hidden patterns of the world, and thus deceive us. The human being can, through mathematics, explore a world beyond sense perception, but can neither exhaust sense perception, nor the structure beyond it, or the divine (Cusa, 1450/1995, (IM) p. 62; Cusa, 1440/2005a, (DI) pp. 203, 347; Cusa, 1442-3/2005b, (DC) p. 43; Cusa, 1463/2005e, (LG)). Cusa claims that ratio, logic and mathematics still have to deal with quiddities that are digital, that is, have clear definitions and come in opposing pairs, and are informed by the worldcreating power of ratio, and does not perfectly mirror a reality beyond this world. Ratio should thus not be understood as a neutral mirror that mirrors an outer world. Ratio needs to fix its categories, definitions and dichotomies: in order to start calculating one needs to fix that which is counted. This need for fixation ignores the movement through which ratio itself is formed. Nor can ratio itself perceive new or transformed quidditas, this is one of the tasks of the intellect. Intellectus As we have seen, at the centre of ratio, there is the capacity to catch or relate to quidditas. Upon closer inspection, this is the work of another part of reason, a part Cusa calls intellectus, which I for reasons of intelligibility here will call intellect. (It is interesting to note that even if the intellect is part of our rationality, rationality has become the dominant category. Everyone is expected to be rational, but to be an intellectual is often perceived as somewhat snobbish or elite, and associated with a

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certain group of authority. It is not seen as a capacity important to all reasoning.) The intellect is considerably different from ratio. No matter how much ratio calculates, it will never through its own movement turn into intellect. Where ratio is directed towards shaping, fixating and defining categories, in order to be capable of starting to count, the intellect is directed towards the horizons of not-knowing. Standing in this relation means that the intellect is aware of overflowing horizons, but at this limit it has a sensitivity for quiddity, it perceives qualities in the sensible, in relation to the infinite and in relation to unique situations and individuals. These quiddities are then treated by ratio as I just described (A´lvarez-Go´mez, 2006, pp. 219 220; Cusa, 1442-3/2005b, (DC) p. 177). By apprehending quidditas, the intellect also gives the measurements, or the tools, to ratio: just as the seeing of colours is not the seeing of a colour on its own, but a higher order. That is, ratio differentiates between different colours, but the intellect perceives colour as such, as a quality of reality within which we can perceive differences. Through ratio we can differentiate between white and black, hot and cold, sharp and diffuse. But these contraries are tied together in the intellect as light, temperature and sharpness. The intellect apprehends that which holds the two sides together. The intellect provides measurement so the ratio can measure accordingly. The concepts formed by the intellect thus provide a different level than the concepts of ratio. The concepts of ratio can be measured, but the concepts of the intellect formulate the values that give our perception a certain direction. So, the intellect perceives that which ratio can calculate, but it also works the other way around, the intellect is a reflection upon the categories of ratio. It brings them to the horizon of not-knowing, questions them and examines if their quiddity still holds as the most important element in a certain situation. Considering a question such as ‘Is this good care?’ ratio wants to answer by either a ‘yes’ or a ‘no’, but the intellect wants to investigate the category ‘good’ and ‘care’ and understand how they are related, and thus in what ways it can be said to be true and in what ways it can be said to be false in relation to the horizons of not-knowing. It sees the complexity, and that there are no simple definitions. What is good care in one situation can be bad care in another. But it also perceives values that direct care, for example, empathy or a capacity to listen. The intellect realises that the definitions and categories of ratio do not exhaust the sensibility, there is more in sensibility and thus in each situation and each individual than what can be caught by ratio. Counting and

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measuring are, as we have seen, dependent upon already fixed units, and the intellect is thus also the self-reflection of this calculation, a reflection that shows the limits of calculation and where the one counting and his/her concepts and rules become visible and possible to change. It could always be different; sensibility is always richer than our categories. The intellect in this way relates to what we cannot know. It loves what we do not yet know, but only have a first hunch of and desire towards. It has faith, and it receives its own will. Faith is thus one part of the intellect, as it is the beginning of knowledge. If one, for example, wants to gain scientific knowledge, we have to believe in its basic categories. Science gains its direction through faith, and faith gains its development through science. Where there is no faith there is no knowledge. Faith is thus according to Cusa, among other things, consciousness’ capacity for knowledge (Cusa, 1454-7/2005d (Sermon 124)). But as it is not yet knowledge it is a relation to not-knowing. The intellect thereby also gives ratio its founding direction and values, through its own relation to that which cannot be known. The intellect is also a judgement, judging the calculus: Is this reasonable? Are the categories right? Are the measurements right? What can we not reach through these categories? To what are we blind? Is that which we cannot measure important? Through its work, the intellect thus also changes the categories and how we value them.

Contemporary Society of Ratio Cusa’s distinction between ratio and intellectus is a premonition of how reason was to be understood in modernity. It is not without reason he has been called the first modern man (Cassirer, 1927, p. 10). In understanding the role of calculation in reason he also prepared the way for a modern understanding of reason with its focus on pure calculation. Such focus is deeply intertwined with the Cartesian separation of cogito (thinking) and res extensa (matter), through which matter could be understood as pure extension, and thus as something that follows the rules of mathematics and that can be exhausted. In late modernity, the cogito or consciousness, has increasingly been understood as something that through neuroscience can be reduced to extended matter. Through this development, ratio comes into the foreground and the intellect tends to be misunderstood and underestimated.

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Modernity is the historical period that Max Weber characterised as the time when everything should be possible to know, that is, what we do not know is not-yet-known, and the horizons of not-knowing are thus transformed into not-yet-known: The increasing intellectualization and rationalization do not, therefore, indicate an increased and general knowledge of the conditions under which one lives. It means something else, namely, the knowledge or belief that if one but wished one could learn it at any time. Hence, it means that principally there are no mysterious incalculable forces that come into play, but rather that one can, in principle, master all things by calculation. This means that the world is disenchanted. One need no longer have recourse to magical means in order to master or implore the spirits, as did the savage, for whom such mysterious powers existed. Technical means and calculations perform the service. This above all is what intellectualization means. (Weber, 1946, p. 139) Here we can see that the word ‘intellect’ is connected to Cusa’s term ‘ratio’ rather than ‘intellectus’, and this also shows exactly how the intellect as a capacity to relate to horizons of not-knowing is made invisible. Nevertheless, Weber points out several patterns that are central to modernity and the metric society: an increasing calculating rationality, a faith in the possibility to make everything known and, as a consequence, a disenchantment of the world. Weber describes a calculating bureaucracy with its fixed and unmovable categories, losing itself in a world of regularities and generalities: a civilization that loses its capacity to relate to the uniqueness and concreteness of each situation and individual. Weber thus characterises modernity as the time of disenchantment, faith in the ratio and the conviction that there is no area that withdraws from knowledge. In that way it is tone-deaf to horizons of not-knowing. But he also describes how this expanded knowledge at the same time creates an iron cage of rationality. Forgetting about the intellect we are at risk of being locked up in an isolated ratio. As Weber also points out, this creates a belief and trust in numbers. Numbers are understood to unveil realities beyond human life worlds and temporary sense perceptions. Such an approach is, as we have seen, not totally different from Cusa’s understanding of mathematics; Cusa also thought of mathematics as showing layers of reality beyond sense

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perception. But according to Cusa, mathematics does not show reality ‘as it is’ and should not make us insensitive to the horizons of notknowing. Cusa provides us with tools through which we can investigate contemporary society and examine how ratio-focused activities on one side, and intellectus-focused activities on the other side are given different roles, different positions and different amounts of power. We could for example point out that art and human and social sciences emphasise the intellect which is given less value than sciences of strict measurability. It is also in humanities, social science and in art that we find the home of ‘intellectuals’. And these areas are today under constant pressure from more ratio-oriented practices that call for a ratio-based ordering and governing of these practices. In this way the intellect is marginalised into a few practices that are put under the guardian eye of ratio. In a culture of measurability, the calculating ratio is predominant over the fields of the intellect. The intellect is also under constant risk of being reduced to pure faith, emotion or subjectivity. What was held together in Cusa’s understanding of the intellect is thus separated in modernity. In modernity, a rift is in this way created between objectivity subjectivity, reason emotion and knowledge faith. Modern ratio formulates dichotomies where we need to choose one or the other, rather than examine how they belong together. To sum up, modernity could, in line with Weber, be understood as a growing trust in ratio and a misunderstanding of the intellect, to such an extent that ratio becomes synonymous with reason. Let me now turn to a specific kind of ratiofication of the twenty-first century, one that influences large parts of the organisation of communal life. I will turn my attention to the ways NPM has influenced the public sector in Sweden and my examples will come from health care and elderly care. NPM in Sweden In Sweden during the 1970s and 1980s, criticism of the public sector for being too bureaucratic, rigid and high-handed was growing stronger. The public sector was governed through tight control, and rarely gave any feedback to the performing organisation. The state was no longer only seen as the solution to political and social problems, but also as a source of them. From leftists, criticism was growing against the failure of the public sector to even out class differences and they claimed that a

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bureaucratic class that puts their own interests first had sprung up. From the right, it was claimed that the public sector was ineffective, rigid, costly and not user-friendly. The left wanted to democratise the public sector and the right was looking for cut-backs and potentiation. The solution was one and the same: the state should retreat and the market should offer solutions. In the 1990s, decentralisation and delegation of services took place, mainly through privatisation. And, by giving citizens an increased possibility to choose the executors (utfo¨rare), more power was supposed to be given to the citizens and those using public services (brukare) (Ahlba¨ck O¨berg & Widmalm, 2016, pp. 9 11). Privatisation was thought to give a larger variety of forms and ideas in care, education and medicine. It should increase flexibility and responsiveness to existing needs, and by bringing profit into the picture, waste of resources should be avoided. There were also calls for a more pervasive quality work where the capacities of the personnel were developed, and where the activities could be guided more by the professional knowledge of the staff (Socialstyrelsen, 1994, p. 13). Quality work is here focused on the activities themselves, and in elderly care, on the relation between the elderly and the staff. In these times of change, different driving forces abounded. Many of them could be characterised as belonging to the intellect: especially the calls to develop new ideas, develop and pay more respect to professional knowledge and give more influence to those using the services. These calls pay respect to the capacity to listen to new quiddities, and often include a greater sensibility to what Cusa called the minima. Furthermore, they sketched a reflective discussion on quality and had the development of the activities at the centre. But, as I will point out, those sides that we could understand as belonging to the intellect had to stand back for those that belong to a ratio. In breaking up from a state bureaucracy another kind of ratio was created, now under a profit-driven heading. Initially, there was no great public discussion about these changes, but when the system was implemented a raft of problems appeared, and the system came under growing criticism from the public. One problem has been that since profit became a central driving force the need to audit the system became important, and thus the audit society emerged (Power, 1999). And just like an audit society, the ratiofication of contemporary Swedish society has taken form. In the following paragraphs, I will focus on three different but connected characteristics of this kind of ratiofication, and try to understand them further through Cusa’s analysis of reason. These three

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characteristics I will call ‘concept imperialism’, ‘empaperment’ and ‘remote controlling’ and I will discuss these in relation to elderly care and health care. Concept Imperialism When the public sector was to be reorganised the ideas had to come from somewhere else. Even if ideas of democratisation played a role in the criticism of the old system, the ‘new’ in NPM did not come from this area. Instead the ideas were fetched from the business world and especially from economy. Concepts such as ‘result units’, ‘systems of internal charge’, ‘competition’, ‘customers’ and ‘management by objectives’ became central (Forssell & Ivarsson Westerberg, 2014, p. 200; Hemmingsson, 2014, p. 208). In such management systems numbers rule and form the basic structures of audition, control and accountability, all in need of simple facts and calculable concepts (Forssell & Ivarsson Westerberg, 2014, p. 135). Here, a word such as ‘quality’ changes its content. If ‘improvement of quality’ earlier was focused on the skills of the professionals and how the activities in social services were performed, in the audit society, it is taken over by Taylorism and control systems from an industrial perspective. As such, it is about controlling and making each step of the process more effective. The difference between, for example, building cars and taking care of human beings is thus ignored when the system and concepts from one area are transferred to another. Quality in, for example, care of the elderly is about empathy, capacity to listen and being attentive to a certain individual or situation (Alsterdal, 2011). As such, it belongs to an intellect that relates to values that give the situation a certain direction. These concepts point us towards something that is not possible to measure and streamline without twisting. But in NPM quality is increasingly reduced to controlling a minimal level: that the elderly are fed and clean, and the task of quality work is to avoid relapsing into an overly profit-driven organisation. This auditing demands simple categories that can be measured and compared over time and between different units. ‘Quality’ as a sensibility for the intrahuman thus changes its meaning to control systems and an industrial perspective on efficiency. Through this kind of colonisation from one area to another, knowledge disciplines such as nursing get a more peripheral role. Working life scientist Lotta Tillberg points out that the language that is developed

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through this colonisation creates a distance to embodied direct care work, and also results in a twisted focus on knowledge where documentation work in front of the computer gets higher status than facing the elderly and developing the skills needed to perform care work (Tillberg, 2007, pp. 164 165). Here the minima of each situation tends to become invisible since status and the conceptual framework situates the personnel in a ratio-dominated environment. In this kind of ratio-system, concepts that are easily defined and thus calculable become a centre of gravity that the whole discourse leans towards. Here, there is limited possibility for the staff to relate to a minima a specific person or situation. When there is little possibility to move into the intellect, concepts become locked and rigid and the quiddities that are seen are already fixated. The simple direction of where the concepts come from, and which domains that yields to these, shows the direction of power here. It shows how areas that are easily measured gain an advantage over those that are not, to the extent that concepts from within intra-human activities are mostly said to be important (and are often used in marketing), but not given any influence on how work is organised, developed, reported or valued. The gravitation of ratio concepts risks a conceptual imperialism that allows the easily measurable to dominate concepts of the intellect, a tendency we here find from industry to intra-human professions, medical sciences to care science and natural science to humanities.

Empaperment This conceptual imperialism is closely related to another characteristic of this development. When concepts move from one area to another, there is a risk that the new concepts are not in touch with the everyday life in the new area. This is also what we have seen in care of the elderly. The new concepts, focused on measurability, are not there mainly to develop and support the activities on their own terms, but rather to control them and to show to others outside of the activities that they reach a minimal standard. They are, for example, not there in order to develop the competence of the staff in elderly care, but to show politicians and state government that minimal standards are reached, and to market the organisation for possible future consumers. The aim of these concepts is thus to show the activities to upper management tiers and to the outside world.

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Several researchers have therefore been discussing how two parallel realities are developed. One everyday reality for staff and the users of the services, and one paper exercise of quality accounting, result reports, etc. In care research, this has been formulated as patient-oriented logic versus a structural and administrative logic (Tillberg, 2007, p. 163). This paper exercise has also been called ‘empapering’, where everything has to be conducted through and in papers. A certain action thereby has to be performed twice: first in the lived reality and then in the paper exercise. First you have to help the elderly person to have a shower and then you have to write it down. If you do not write it down, you have not done it at all in the eyes of the administrative logic (Hall, 2012a, 2012b). Social relations have to take place too in the documentation, and some researchers have even pointed to the risk that the papers even replace social relations (Hofvendahl, 2006). Witnesses from within elderly care also point out that as more and more details are discovered as missing in the papers, more and more details are called for (Hemmingsson, 2014, p. 145). The gap between everyday life and the administrative logic also creates a paper world that is apprehended as window dressing, as organisations wants to show the best results possible. The administrative logic creates a ratio that tends to be locked up in itself as it is cut off from the activities of the intellect, whereas the patient-oriented logic of everyday experiences constantly is in need of the intellect in reflections on problematic situations and in relating to the not-known in other persons and each minima. This also shows how ‘quality work’ has become irrelevant to the development of the quality of the work, and now instead plays a role in controlling and managing the work. This organisation also results in the huge addition of administration. There is no comprehensive research on how large this addition is: a lot of it is hidden in smaller tasks performed by the staff in the core business, rather than by administrators. One example though is an orthopedist clinic in Linko¨ping, a middle-sized Swedish city, where 10 days of care in 1993 resulted in four pages of documentation, whereas 10 years later in 2003, the same number of days of care resulted in 75 pages (Forssell & Ivarsson Westerberg, 2014, p. 115). The same researchers estimate that 25% of the total personnel cost in health care today is used to create material that can be audited and to make oneself auditable. There is also a risk of overdocumentation as the organisations and staff want to ensure that they are safeguarded through making everything they do accountable

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(Forssell & Ivarsson Westerberg, 2016, p. 21). It also remains an open question as to how much of all these papers is actually read. A significant part of empaperment should thus maybe be seen as a form of ritualistic behaviour. Empaperment also becomes a way to solve problems. Each action should be governed, which demands routines and systems for every detail. And this goal demands commissions, meetings, plans, guide lines, routines and manuals. Staff in elderly care testify to how many managers showed their ability to act by making sure that someone wrote a routine that was then filed in a certain binder, each time a problem arose. But since they were often understaffed, it has been impossible to follow all these routines (Hemmingsson, 2014, pp. 81 82, 209). The quality work was often dealt with in the form of documentation and checklists and in writing routines. And it is this material that is audited (Hemmingsson, 2014, p. 106). In this way, the paper exercise lives its own life alongside the everyday world. There is a strong belief in the world of ratio here and thus a pursuit towards transparency. Everything that can be visible, that is moved into the paper world, should be. Forssell and Ivarsson Westerberg point out that this pursuit of transparency belongs to the driving forces that create most administration (2014, p. 223). But since this urge for transparency is grounded in an understanding of reason as mere calculating ratio, the process of questioning, understanding anew and developing activities is hindered. The capacity to question includes a moment of not-knowing, and not-knowing is not included in the accepted competences here. Focus instead lies on showing the perfect image towards the municipal and the customer. Whistleblowers are thus often given a hard time (Erlingsson, 2006; Erlingsson & Linde, 2011). The pursuit towards transparency cuts off the ratio, with its clearly defined concepts, from a not-knowing and intellect, as that which cannot be transparent is simply ignored. Remote Controlling Public Services The movement from the experienced world to the paper world also affects the everyday activities more directly. That which is auditable and measurable, starts to organise the whole activity. The logic of the administration is easily internalised and in the worst cases, the whole activity is built upon it. Hemmingsson describes how such internalisation at a retirement home can result in the staff neglecting a patient

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suffering from anxiety and instead organises a parlour game in order to boost the activity numbers. Numbers rule the activity instead of an empathetic listening to the minima of the situation. This is experienced as a control over the thoughts of the staff, and as a way to set the agenda (Hemmingsson, 2014, p. 222). Such experiences are also backed up by researchers who state that the risk is obvious that the work is directed towards quantifiable activities that are identified in the economical compensation model, rather than being directed towards the needs of the patients (Forssell & Ivarsson Westerberg, 2014, p. 224). In this way, the whole situation is controlled and directed from the outside, rather than from the needs existing within the situation. Here the split between an experienced reality and a paper reality also includes the power of the paper world over the experienced world; the map becomes more real than the terrain. A tendency Tillberg has called a categorical mistake (2007, p. 169). What becomes invisible when the activities are remote controlled in this way is also implicit values hidden in measurable activities. In home care services, providing breakfast or doing the dishes are economically compensated, but while the staff engage in these activities they may give comfort, build trust or ease anxiety and this part of the job becomes invisible. But such emotional work might be necessary in order to carry out those parts that are compensated. It might be through the action of drinking a coffee together that confidence is built up and this enables the carer to perform other tasks such as helping the elderly person to shower (Tillberg, 2007, pp. 163 164). In a logic that does not understand these implicit values, the competences of the staff, such as a capacity for care, providing the elderly with a sense of security, and having a sensitivity for the situation, are not valued, and thus not developed. The focus on routines, manuals and checklists is also part of an ambition to make the personnel exchangeable, a cog in a machinery that is predictable and obeying. To think creatively with the patients or the elderly is not encouraged when the controlling system limits the activities. An outer framework provides the rules for what there is that should be done, when it is to be done and how it should be done. Those involved in the concrete situation, at a retirement home; the elderly, the staff and sometimes relatives, become more circumscribed. An anonymous ‘other’ outside of the situation controls it and the possibility to be a reflecting, autonomous and acting subject is diminished. Those present in the situation are thus remote controlled by outer actors. The staff

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become micromanaged executors (Sundstro¨m, 2016, p. 146). And the possibilities for the staff to do what they feel is necessary in a particular situation decreases. Here we find a blossoming culture of ratio, where many categories become rigid, lose contact with the experienced reality, and lead their own life in the world of papers and documentation a world that also in its language differs from everyday life and exercises a great and growing influence over it. In inter-human labour a central competence is to be able to act, in the midst of not-knowing. We don’t know how the other person experiences the world, and know it even less when the other is suffering from dementia, is very sick or is a young child. But there is no room for notknowing in this kind of NPM, on the contrary, every not-knowing is understood as a weakness that immediately should be covered up. In this way, the intellect and the ratio are kept apart. Work for improving the quality, called securing quality, takes place in the rigid categories of ratio rather than including a development of a sensibility towards the minima of unique situations. Quality is not about forcing an elderly patient to take a shower in order to make a cross in a checklist. Quality is about developing a sensibility for each situation, to develop a proximity to not-knowing and a reflective intellectus that has its own relation to the minima of each situation. This is also what research in practical knowledge keeps pointing out (Tillberg, 2007). It demands an intellect’s approach to the fixed categories that come to the situation from the outside. It demands a judgemental subject and not a remote-controlled cog. The categories of ratio are generalisations from earlier situations, but not all experiences as the experiences always overflow the concepts but sorted out with a starting-point in what is considered important. We need such categories in order to learn from experience. But, as Cusa points out, we also need an intellect in order to relate to these categories and be in contact with not-knowing in order to be sensitive to that which is important in each situation.

Conclusion Through ‘concept imperialism’, ‘empaperment’ and ‘remote controlling’, the intellect is ignored in this kind of ratio-culture. When the ratio is cut off from the intellect and its relation to not-knowing, paradoxes arise.

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In the audit society at least two paradoxes become apparent for a reflecting intellect: (1) The more we audit, the more we notice that we do not know (in a measurable way). (2) When there is less trust in the activities, the trust in the audit processes needs to increase (Power, 1999). The first paradox shows that there is no self-evident imperative to make everything transparent in documents. Instead we need to reflect upon the limits of knowledge and we need to reflect upon which knowledge is important, to whom and when. The second paradox shows that we can move the limit of trust, but not get rid of the need to trust. In the face of such an insight, we need to ask ourselves what the consequences are of our lack of trust in the first instance. The ratio tries to cut itself off from being in touch with not-knowing, which is reduced to a not-yet-known in the quest for full transparency. The ratio therefore also cuts itself off from the intellect, as the intellect has a different relation to not-knowing. The ratio is a capacity to build and organise a world to live in, but without the intellect, it loses contact with reality as it loses the capacity to listen carefully to the newness of each situation.

References Ahlba¨ck O¨berg, S., & Widmalm, S. (2016). Att go¨ra ra¨tt a¨ven na¨r ingen ser pa˚ (To do the right thing, even when no one is watching). Statsvetenskaplig tidskrift, 118(1), 7 17. Alsterdal, L. (2011). Omtankar: Praktisk kunskap i a¨ldreomsorg (Caring thoughts: Practical knowledge in elderly care). Stockholm: So¨derto¨rn Studies in Practical Knowledge, So¨derto¨rn University. A´lvarez-Go´mez, M. (2006). Die Lehre vom menschlichen Geist (intellectus/ Vernunft) in den Sermones des Nikolaus von Kues (The docrine of human spirit (intellectus/Vernunft) in the sermons of Nicholas of Cusa). In K. Kremer, K. Reinhardt, & P. Trier (Eds.) Mitteilungen und Forschungsbeitra¨ge der CusanusGesellschaft 31, XXIX, 333, 211 243. Cassirer, E. (1927). Individuum und kosmos in der philosophie der Renaissance (The individual and the cosmos in Renaissance philosophy). In M. Domandi (Trans.). Leipzig: Teubner.

252

Jonna Bornemark

Cusa, Nicholas of. (1995). Idiota de mente (IM) (The layman on wisdom and the mind). G. Santinello & F. Mainer (Trans.). Complete philosophical and theological treatises of Nicholas of Cusa. Verlag: Hamburg (Original work 1450). Cusa, Nicholas of. (2005a). De docta ignorantia (DI) (On learned ignorance). In E. Do¨ring German (Trans.). Nicolas Cusanus, philosophische und theologische schriften, studienausgabe (Complete philosophical and theological treatises of Nicholas of Cusa). Wiesbaden: Marix Verlag (Original work 1440). Cusa, Nicholas of. (2005b). De coniecturis (DC) (On Surmises). In E. Do¨ring German (Trans.). Nicolas Cusanus, philosophische und theologische schriften, studienausgabe (Complete philosophical and theological treatises of Nicholas of Cusa). Wiesbaden: Marix Verlag (Original work 1442 1443). Cusa, Nicholas of. (2005c). De quaerendo Deum (QD) (On seeking God). In E. Do¨ring German (Trans.). Nicolas Cusanus, philosophische und theologische schriften, studienausgabe (Complete philosophical and theological treatises of Nicholas of Cusa). Wiesbaden: Marix Verlag (Original work 1445). Cusa, Nicholas of. (2005d). Sermon 124. In E. Do¨ring German (Trans.). Nicolas Cusanus, philosophische und theologische schriften, studienausgabe. Wiesbaden: Marix Verlag (Original work 1454 1457). Cusa, Nicholas of. (2005e). Dialogus de ludo globi (LG) (The bowling game). In E. Do¨ring German (Trans.), Nicolas Cusanus, philosophische und theologische schriften, studienausgabe. Wiesbaden: Marix Verlag (Original work 1463). Erlingsson, G. (2006). Organisationsfo¨ra¨ndringar och o¨kad kommunal korruption Existerar ett samband? (Organizational changes and increased municipal corruption: Is there a connection?). Kommunal ekonomi och politik, 10(3), 7 40. Erlingsson, G., & Linde, J. (2011). Det svenska korruptionsproblemet (The Swedish problem of corruption). Ekonomisk debatt, 8(11), 5 18. Forssell, A., & Ivarsson Westerberg, A. (2014). Administrationssamha¨llet (The society of administration). Lund: Studentlitteratur. Forssell, A., & Ivarsson Westerberg, A. (2016). Granskningens (glo¨mda) kostnader ((Hidden) costs of audit). Statsvetenskaplig tidskrift, 118(1), 19 36. Hall, P. (2012a). Quality improvement reforms, technologies of government, and organizational politics: The case of a Swedish women’s clinic. Administrative Theory and Praxis, 4, 578 601. Hall, P. (2012b). Managementbyra˚krati organisationspolitisk makt i svensk offentlig fo¨rvaltning (Management bureaucracy: organizational-political power in Swedish public administration). Malmo¨: Liber. Hemmingsson, O. (2014). Fra˚n mitt ho¨rn av a¨ldreomsorgen (From my corner of elderly care). Sandared: Recito. Hofvendahl, J. (2006). Fo¨rpapprade samtal och talande papper (Empapered conversations and talking papers). In E. Forsberg & E. Wallin (Eds.), Skolans kontrollregim ett kontraproduktivt system fo¨r styrning? (pp. 77 98). Stockholm: HLS Fo¨rlag. Power, M. (1999). The audit society. Rituals of verification. Oxford: Oxford University Press.

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253

Socialstyrelsen. (1994). Utva¨rdering av kvalitet. Om motiv och va¨gar fo¨r praktikers kvalitetsarbete och om kvalitetsstudier av hemtja¨nst/hemsjukva˚rd (Quality audit. On motives and ways for practitioners’ work on quality and on studies on quality in home care). SoS-report 1994, p. 13. Sundstro¨m, G. (2016). Strategisk styrning bortom NPM (Strategical governance beyond NPM). Statsvetenskaplig tidskrift, 118(1), 145 170. Tillberg, L. V. (2007). Konsten att va˚rda och ge omsorg (The art of nursing and providing care). Stockholm: Dialoger. Weber, M. (1946). Science as vocation. In H. H. Gerth & C. Wright Mills (Trans. & Eds.), From Max Weber: Essays in sociology (pp. 129 156). New York, NY: Oxford University Press.

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Index Abbott, 121 Academic institutions, 178 changes within, 181 185 judgement of quality, 179 181 presentation of self, 186 191 promotion and hiring, 181 185 Academic metrics and positioning strategies changes within institutions, 181 185 individual strategies, 186 191 judgement of quality, 179 181 presentation of self, 186 191 promotion and hiring, 181 185 transformation of the sector, 179 181 Academic performance gamification and, 179, 189 quantification of, 185 Accelerated rationalization, 179 Acxiom, 26 Agential capacities exerting control, 66 68 identifying patterns and achieving goals, 68 70 self-improvement, 65 66 self-tracking practices, 64 70 Alibaba, 28 Alipay (Alibaba’s payment app), 28 Amazon, 28 American Civil Liberties Union (ACLU), 30 The Analogue University, 191 Android, 164

Ant Financial, 28 Apple Watch, 25, 106 The Archaeology of Knowledge (Foucault), 163 Arguments for digitisation, 46 47 Artificial Intelligence robots, 231 Auckland University, 31 Audit culture, 4 Autoethnography, 217 Autonomy defined, 201 self-governing capacities of, 197, 200, 202, 209 Baihe (Chinese matchmaking service), 28 Barad, K., 61 Basis smartwatch, 98 Bastow, S., 39 Bathgate, K., 14 Beck, U., 58 Beer, David, 1, 3, 178, 191 193, 218 Bekkers, V., 51 Bentholm, Simon, 105 Berg, Martin, 80 The Best Insomnia Apps, 164 ‘Big Data’, 111 Bio-citizenship, 40 42, 41 Biometrics, 236 Biometric tracking, 218 219 Biopolitics, 41, 236 Biopower, 16 24, 41 Blair, Tony, 15 Boden, R., 188

256

Index

Bouckaert, G., 39 Bovbjerg, K. M., 24 Bramley-Ward Report, 184 BT, 17 18, 23, 31 Development Performance Review (DPR), 18 ‘end-to-end performance management’, 22 People Strategy, 17 Calorie counting practical adjustments, 148 152 practical precision, 144 148 practical temporality, 141 144 Cambridge Analytica, 26 Canguilhem, Georges, 42 Capitalism, 13 Car Inc., 28 Carter, R. G., 188 Caulfield, J., 14 Celebrification, 190 Celebritisation, 190 Chauvet-Pont-d’Arc Cave paintings, 186 China citizenship and social credit, 27 31 measuring performance in, 27 31 Sesame Credit system, 30 social credit system, 4, 11 State Council, 29 universal ranking system, constructing, 13 Choe, E. K., 78 Chua, J. C., 139 Chun, W. H. K., 159 Citizenship big data as a technology of, 30 China, 27 31

digitisation of welfare and, 49 53 Internet as a technology of, 29 Civic virtues in the digital era, 51 52 Clinical-integrated home monitoring (KIH) project, 44 Clover, C., 30 Comber, R., 139 Computer technologies, 12 Concept imperialism, 235, 245 246 The Condition of Postmodernity (Harvey), 13 Conglomerates, defined, 221 Consumerism, 228 Contemporary society of ratio, 241 243 Continuous Glucose Monitoring (CGM), 120 self-monitoring blood glucose levels through, 123 125 surveillance underpinning the use of, 129 130 Contract management, 14 Cordray, Julia, 27 Corruption, 12 Council of the Australian National University, 184 Coveney, C., 159 Coveney, J., 150 Crawford, R., 150 Creemers, Rogier, 29 30 Critical marketing theory, 160 162 Cruikshank, Barbara, 16 Culture audit, 4 defined, 159

Index Danholt, P., 132 Danish University, 23 Data digital technologies and, 2 metric culture and, 8 ‘real-time’, 8 self-tracking activities and, 2 Data brokerage industry, 228 Data ethics, 217 231 Data imperialism, 229 Dean, Mitchell, 24 De coniecturis (DC) (Cusa), 237 De docta ignorantia (DI) (Cusa), 237 De la Rocha, O. L., 139, 145, 152 Democracy, 12 Denmark current governance tendencies in, 39 digital strategies and, 38 digitisation process in, 39, 52 eGovernment programme in, 51 eGovernment strategy of Digital Welfare, 2016-2020, 4 5 ePregnancy programme in, 41 42 IT University, 23 Ministry of Finance, 15 public sector Internet usage in, 39 40 welfare state in, 38, 42 Diabetes insulin-dependent, 119 treatment of, 119 type, 1, 119 type, 2, 119 Didziokaite, G., 83 Dieting calorie counting, 141 152

257

exploring practices of, 139 140 food practices related to, 139 understanding practices through STS perspective, 140 152 Digital era governance (DEG), 39 Digital health, 52 53 sleep and, 162 163 sleep apps and, 162 163 Digital health technologies, 163 Digitally engaged students, 202 213 Digital technologies, 2 Digital Welfare: Empowerment, Flexibility and Efficiency (The Danish Agency for Digitisation), 38 Digitisation of welfare appointment of responsibility of actions regarding, 47 49 arguments for, 46 47 bio-citizenship, 40 42 citizenship and, 49 53 descriptions of ideal practices, 49 53 digital health, 52 53 as ‘digital highway’, 51 digital solutions to welfare problems, 45 46 digitisation as a dispositive, 42 43 dispositive, 42 43 ePregnancy, 40 42 health technologies, 40 42 new civic virtues in the digital era, 51 52 overview, 38 40 schism between technologies as empowering and technocratic governing, 50 51

258

Index

Domestic violence, 12 ‘dot-com’ collapse, 17 Driessens, O., 190 Drucker, Peter, 24 Duffy, B. E., 190 Dunleavy, P., 39 Eating, exploring practices of, 139 140 EBay, 28 Edison, Thomas, 102 EGovernment programmes, 51 EHai.com, 28 EHealth, 118 Ejersbo, Niels, 39 Empaperment, 246 248 Empowerment, 25 27 ‘end-to-end process management’, 17 Enterprise, 200 defined, 200 self-governing capacities of, 197, 200, 202, 209 EPregnancy programme, 4 5, 40 42 Ethics, 201 European-style scholarly apprenticeships, 188 Facebook, 27, 189 Failing self-tracking, 88 89 Fairfield, Rochelle, 220 Financial Times, 30 Fitbit, 25 Fitbit Blaze activity and sleep tracking watch, 106 Flash Glucose Monitoring (FGM), 120 self-monitoring blood glucose levels through, 123 125

surveillance underpinning the use of, 129 130 Forssell, A., 248 Foucauldian discourse analysis (FDA), 157 Foucauldian discourse theory, 163 Foucault, Michel, 16, 41, 163, 199, 213, 236 ‘conduct of conduct’, 200 on governmentality, 31 32 ‘smallscale models of power’, 199 technologies of the self, 78 Freestyle Libre® (FSL), 121 Giddens, A., 58 Goal-driven self-tracking, 85 86 Goffman, E., 191 ‘Goodhart’s Law’, 14 Google Play, 164 Governing through freedom, 16 Governmentality, 200 Great Britain Conservative government in, 14 McKinney Rogers and, 16 NPM, 14 ‘The Next Steps’, 14 Greenfield, Dana, 100 Greiffenhagen, C., 83 Greve, Carsten, 39, 42 Gross national happiness, 12 Hacking, Ian, 3 Hamann, T., 199 Harvard Business Review, 17 Harvey, David, 13 Health 2.0, 118 Healthcare eHealth, 118 Health 2.0, 118 mHealth, 118 models of, 118

Index Healthline, 164 Health technologies, 40 42 Hemmingsson, O., 248 Heseltine, Michael, 14 Higher education ‘accelerated rationalization’ in, 179 institutions, 177 High Pay Commission, 18 19 Hirsch, Jorge, 186 Homburg, V., 51 Hoohout, J., 139 Human Data Commons Foundation, 217 founded in, 219 grassroots mentality, 220 small-scale operation, 220 Human rights, 12 IBM, 2 Individuals quantifying, 25 27 rating, 25 27 surveillance or empowerment, 25 27 Insulin-dependent diabetes, 119 Intel, 26 Intellectus, 235, 239 241 Internet, 190 IPhones, 164 Jolson, M. A., 183 Kaplan, R., 17 19 Katz, D. A., 182 183 Keller, Reiner, 43 Kelly, Kevin, 101 Kerr, S. J., 139 KGB, 29 Knowledge sharing, 113 114

259

Kristensen, Dorthe Broga˚rd, 99 Kvist, J., 42 Langstrup, H., 52 Lapka environmental sensors, 106 Lash, S., 58 Law, J., 127 Leuphana University, 85 Lumo Back posture tracker, 106 Lupton, D., 118, 160, 163, 201, 206 Luthans, F., 182 183 Lynch, M., 140 Margetts, H., 39 Martin, A., 140 Martin, Emily, 24 Matviyenko, S., 172 McKinney, Damian, 16 McKinney Rogers, 16, 31 Meadows, R., 159 Mehlman, 228 Meißner, Stefan, 79 Merleau-Ponty, M., 159 Metcalfe, A., 187 ‘metric culture’, 1 9 Metric Power (Beer), 178 Metrics, 16 24 and biopower, 16 24 controlling populations by using, 16 24 managing professionals by using, 16 24 quantitative, 11, 12 MHealth (mobile technology health), 118, 163 Micro-powers, 130 131 Miller, N., 187 ‘Mission Leadership Dashboard’ technique, 16 17 Modernity, 242

260

Index

Moisander, J., 161 162 Mol, A., 119 120, 127 Morgan, D., 187 Morrish, Liz, 23 Moses, I., 184 Moynihan, P., 139 MyFitnessPal, 7, 83, 137 calorie counting, 141 152 exploring practices of dieting, 139 140 understanding practices of dieting through STS perspective, 140 152 Nafus, 100 Nafus, D., 26 Neoliberal governmentality, 197, 200 See also Governmentality Neoliberalism, 199 in everyday life, 199 202 Foucault on, 199 Neo-Weberian state (NWS), 39 Newcastle University, 23, 191, 192 ‘Raising the Bar’, 24 New Public Management (NPM), 4, 12, 14 Nicholas of Cusa and, 235 250 performance indicators and rise of, 13 16 privatisation and, 244 quality in, 245 rationality in, 236 in Sweden, 243 245 New Scientist, 30 New York Stock Exchange, 28 ‘The Next Steps’, 14 NHS, 15 Nicholas of Cusa, 8 9, 235, 236 250 concept imperialism, 245 246

contemporary society of ratio, 241 243 empaperment, 246 248 intellectus, 239 241 ‘learned ignorance’, 237 not-knowing, 236 237 NPM in Sweden, 243 245 ratio, 238 239 remote controlling public services, 248 250 Nietzsche, Friedrich, 231 Niva, M., 148 Non-governmental organisations, 14, 16 Nordic welfare ideology, 42 Nordic Welfare society, 37 Norton, D., 17 Not-knowing, Nicholas of Cusa, 236 237 Novas, C., 41 OECD, 47 Olivier, P., 139 1-Person-Laboratory (1PL) of QS community beyond, 111 114 exemplifying, 103 105 inside, 102 107 instrumentation, 105 107 knowledge sharing, 113 114 methodological setup, 105 107 operating, 105 107 overview, 98 99 personal discovery as empowering practice, 111 reflections on, 107 111 requisite competencies, 113 search for evidence on scale of individual person, 112 113 Online dieting, 138 Organisations, NPM of, 4

Index Over-examined life, 2 Oxford English Dictionary, 186 Oxford University, 29 Palmer, Chelsea, 220 Pantzar, M., 83 Paradeise, C., 180 Peeple app, 27 People living with diabetes embodied actions, 127 129 individual strategies enacting micro-powers, 130 131 overview, 118 121 self-awareness and reflexivity, 125 127 self-monitoring blood glucose levels through CGM and FGM systems, 123 125 surveillance underpinning the use of CGM and FGM, 129 130 Performance indicators (PIs), 11 expansion in, 12 and the rise of NPM, 13 16 Philips, 26 Pickard, S., 123, 132 Playful self-tracking, 86 88 Pollitt, C., 14, 39 Pols, J., 132 Pooley, J. D., 190 Populations, controlling, 16 24 Porter, Theodore, 189 Power, in datasphere, 227 230 Power, M., 148, 191 PowerSchool system, 200, 210 Presentation of self, 186 191 Privacy in the datasphere, 227 230 ‘ubiquitous computing’ and, 218 user-centric data, 219

261

Professionals, managing, 16 24 Project-driven self-tracking, 85 86 Promotion and hiring, 181 185 Public health policies, 118 Public services, remote controlling, 248 250 Pushed self-tracking, 201, 206 QS 2013 Global Conference, 100 QS companies ‘Conglomerates’, 221 225 ‘Devices’, 221 225 ‘Middleware Analytics’, 221 225 ‘User Platforms’, 221 225 QS Copenhagen meetup group, 99 QS Show & Tell talks, 112 Quantified self, 58, 197, 199, 201 Quantified Self (QS) community, 6, 99 101 Quantified Self (QS) movement, 2, 4, 13, 59, 82 Quantified Self practices, 5 Quantified Self Report Card (HDC), 8, 217 for, 2018, 230 231 balancing differences, 225 226 categorical comparisons, 220 225 encouraging industry best practices, 230 231 evaluating readability, 219 220 ‘human readability’ of, 219 220 ontological fatigue, 226 power and privacy in datasphere, 227 230 Quantitative metrics, 12 Ratio contemporary society of, 241 243 Nicholas of Cusa, 238 239

262

Index

Real-time grade books, 197 214 Reason, 235 as calculating capacity, 235, 236 intellectus, 239 241 ratio and, 235 western understanding of, 236 Reflexivity, development of, 125 127 Research academic, 178, 190 ‘accelerated rationalization’ in, 179 positioning strategies of, 180 teaching and, 184 185 Research narrative, 226 Resonance, 5 6 defined, 81, 83 Rosa’s view on, 80 83 ‘Resonance’ (Rosa), 77 Resonant and mute self-tracking practices, 91 92 Reyes, A., 26 Rockwater, 17 Balanced Scorecard, 18 Individual Scorecard, 19 Rogers, A., 123, 132 Rosa, Hartmut, 5 6, 77, 80 on resonance, 80 83 on self-tracking, 80 83 Rose, Nikolas, 16, 41, 78, 200 Royal Marines’ Mission Command, 16 Ruckenstein, M., 83 Sapience Analytics software, 2 Saukko, P., 83 Science and technology studies (STS), 138 Scott, Geoff, 19 Scott, J. M., 188

Secondary adjustments, 191 Self -branding, 190 curated, 190 -governance, 189 presentation of, 186 191 professional, 186 -promotion, 190 Self-awareness, development of, 125 127 Self-improvement, 65 66 Self-monitoring blood glucose levels through CGM and FGM systems, 123 125 Self-tracking analytical graph of world relationships, 83 85 apps, 59 data, 3 digital diary, 90 91 empirical results on mundane practices of, 83 92 failing self-tracking, 88 89 playful self-tracking, 86 88 project or goal-driven selftracking, 85 86 resonant and mute self-tracking practices, 91 92 Rosa’s view on, 80 83 Self-tracking practices, 5 agential capacities, 64 70 exerting control, 66 68 identifying patterns and achieving goals, 68 70 mute, 91 92 overview, 58 61 resonant, 91 92 self-improvement, 65 66 Self-tracking techniques, 2 Sesame Credit, 28, 29 Sex trafficking, 12

Index Shanghai stock market collapse, 29 Sharon, T., 100, 110 Sherman, J., 26, 100 Shore, C., 179 Sleep digital health discourses and, 162 163 lack of, 158 poor, 158 sleep apps and. See Sleep apps Sleep apps analysis, 164 171 critical marketing theory, 160 162 cultural perspective, 157 173 data, 164 and digital health discourses, 162 163 discourse analysis, 163 164 overview, 158 160 Sleep disorders, 162 Sleep notes, 169 Smartphones, 164 Smullen, A., 14 Snowden, Edward, 30 Social acceleration, 80 Social capital, 198 Social constructionism, 43 Social credit, 4 China, 27 31 Social media, 12 Sociology of knowledge approach to discourse (SKAD) analysis, 37 Sociology of resonance, 77 92 See also Resonance Socrates, 2 Stasi, 29 30 Students digitally engaged, 202 213

263

‘high performing’, 201 quantified selves, 197, 199, 201 Subjectification, defined, 199 Surgical weight management, 138 Surveillance, 25 27 underpinning the use of CGM and FGM, 129 130 Sweden NPM in, 243 245 public sector in, 243 245 Symantec, 8 Talbot, C., 14 Tan, O., 139 Technological unconscious, 218, 227 Tencent, 28 Thatcher, Margaret, 14 Thoenig, J.-C., 180, 191 Tillberg, Lotta, 245, 249 Timmer, Justin, 105 Tinkler, J., 39 Troia, Bob, 98 Type 1 diabetes, 119 Type 2 diabetes, 119 Universities’ Council of Commonwealth Tertiary Education Commission (CTEC), 184 University of Auckland, 19, 22 University of Canberra, 61 University of Hagen, 85 User-centric data privacy, 219 User privacy. See Privacy User rights, 219 Van Halteren, A., 139 Verbeek, P. P., 92 ‘virtual wireless’ citizens, 50 51 Vodafone, 26

264

Index

War on obesity, 138 Wearable technology, 25 Web 2.0 health-related apps, 118 Web-based student information systems (SIS), 197 as ‘dataveillance’ infrastructure, 200 effectiveness of, 209 as neoliberal governance strategy, 200 as neoliberal ‘technology of childhood government’, 197, 199 portal, 201 Weber, Max, 242 243 Weight Watchers, 138, 139 Welfare problems, digital solutions to, 45 46

Westerberg, Ivarsson, 248 Western capitalism, 13 Western societies, 2, 27 Whistleblowers, 248 Whitson, J., 25 Wikileaks, 30 Williams, S. J., 159, 160, 162 163 Willig, C., 163, 170 The Will to Empower (Cruikshank), 16 Wired magazine, 25 Wolf, Gary, 25, 101 Wright, Anne, 100 Wright, S., 179 Zandbergen, D., 100, 110 Zeo sleep tracker, 106 Zheping Huang, 28 29