In the formative course of civilizations, different forms of life management have been constructed and refined to order human relations. As far as Western civilizations and the capitalist model under which daily life is based and configured are concerned, the study of these forms of management allows us to address power strategies that assume particular formats in certain socio-historical conditions (Elias, 1994; Foucault, 1987). Regarding the management of life in contemporary times, it is important to highlight the transition experienced by Western societies from financial capitalism to cognitive and/or informational capitalism, also called neoliberalism (Han, 2020). Thus, the study presented in this article proposes to elucidate neoliberal strategies of life management in contemporary times, based on themes and questions resulting from an analytical look aimed at understanding how bodily subjectivation processes integrate such strategies.
To address this issue, this article introduces two utterances related to the practice of physical activity in the pandemic context of COVID-19, to analyze how discourses aimed at the institution of health behaviors act in the management of people and life in contemporaneity. To do so, we explain the conception of behaviors and care of body’s health as forms of work, which constitute political investments in bodies, that is, means of instituting behaviors by which it becomes possible to organize and manage people and life itself in certain contexts and conditions. With this analysis, we intend to elucidate functions performed by key concepts strategically ordered in/by entrepreneurial neoliberal rationality in modes of health management. That way, we argue that the exercise of such functions – which we call power operations – promote the incorporation of neoliberal concepts as behavioral values that end up worsening disease states, due to the systemic particularities triggered by the rationality in question.
The analyses we propose in this article are guided by the approach proposed by Byung-Chul Han (2020; 2019; 2017) about the dynamics of power and societies in the present time, in dialogue with authors from the field of knowledge of Industrial and Organizational Psychology. We are also guided the methodological procedures for analytical development by the theoretical-philosophical propositions of Michel Foucault about the development of discourse analysis and power relations (Foucault, 2011; 2008), from which we mobilize the conceptual notions of device, institution, utterances and event as analytical tools. These authors contribute to the discussion of themes that inform the mechanisms and strategies of neoliberal power operation in the bodies, subjectivities and health of contemporary subjects.
Due to these characteristics highlighted in relation to the analyzes, we understand that this is a study result from a fundamentally theoretical and discursive research. This is because the research from which this study unfolds was guided by the use of tools that integrate Foucauldian Discursive Studies. Thus, after carrying out exploratory incursions though synopses, reviews, excerpts and texts by commentators on Han’s theory (Magnelli, 2020; Bontempo, 2019; Brites, 2018. Eccard, 2018), we chose seven works by this author as discursive materiality, that is, as a source for the qualified extraction of statements referring to the body and health, as well as processes of bodily subjectivation and health-illness in contemporary times.
To delve into and analyse the materiality, the use of some tools of Foucaultian Discursive Studies was indispensable, such as: device, utterance, series and enunciative cut, archive, frame and others. Such tools refer to procedures proposed by Foucault (2008) to assist in carrying out analyzes of discourses and utterances, as well as knowledge-power relations, procedures that informed and guided the analytical and descriptive course of the research, such as the writing of this article. It is worth noting that the methodological choice for this theoretical-philosophical foundation for the analytical procedures stems from the previous involvement of the first author of this article with this discursive approach, as well as with the Foucaultian theory. That is, it stems mainly from the research profile and theoretical alignment of the authors, as well as the adequacy of this approach for the treatment of the investigative object discussed in this article.
Thus, for the analyses in this paper, we take as discursive materiality two utterances about the practice of physical activity in the pandemic context of COVID-19 in relation to which the considerations are unfolded. Nonetheless, it is important to note that these utterances are mobilized in this study as illustrative examples regarding the mainly idea around the proposed analysis from the research carried out. So, such considerations are developed through the conception, elucidation and exploration of themes such as: individualization device, bodily subjectivation, individualization of responsibility for health, entrepreneurial neoliberal rationality, psychopolitical techniques, health education and popular health education.
It is worth mentioning that, for the writing of this study, we started from questioning how the health of the body is managed in contemporary societies and which devices and power strategies can be observed in the midst of the discursive network that makes such management possible. In the elaboration of a possible answer to this question, based on the findings of the previous research, we explained how the individualization of responsibility for health composes strategies for managing bodies and living conditions today, notably with regard to discursive investments in health of the body and in processes of bodily subjectivation instituted in the order of entrepreneurial neoliberal rationality. In proposing the answer to the problematizing question, we also evaluated potential contributions of this study, as well as studies that eventually turn to the themes focused here, form interventions that intersect body and health education, especially those aimed at from the Social Sciences and Humanities. Finally, we indicate as a possibility for dialogue and continuity of studies and grounds for the interventions the questioning about possible oppositions to the order of power explained in the course of the article.
Discursive Events About Health And Physical Activity In Life Management In A Pandemic Context
The pandemic outbreak of illness and death due to infection with the new coronavirus (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was an event that accentuated the attention to the agenda of collective and individual health demands at a global level (Zhu et al., 2020; Wu et al., 2020). Unfoldings of this event include the preparation of guidelines and guides aimed at instructing institutions and individuals about safety protocols for facing the generalized state of illness (for examples, see: SBPT, 2020; WHO, 2020; CNS, 2020). This profusion of discourses regarding COVID-19 ranges from its characteristics and how to deal with it, as well as its impacts on social dynamics, including the health sphere, but not limiting itself to it.
However, the conditions of emergence of such discourses reveal that, sometimes, different circumstances, orientations and purposes modulate them. Examples in this regard are the following utterances by, respectively, the Director-General of the World Health Organization (WHO), Tedros Ghebreyesus, and the Director of Health Promotion at WHO, Ruediger Krech. These utterances refer to the new guidelines on physical activity and sedentary behavior (WHO et al., 2020), launched on November 26, 2020, as a result of the COVID-19 pandemic, its social impacts and global measures taken to address it:
Every move counts, especially now as we manage the constraints of the COVID-19 pandemic. We must all move every day – safely and creatively. (OPAS, 2020).
Physical activity of any type, of any duration, can improve health and well-being, but the more exercise the better. (OPAS, 2020).
Two aspects draw attention to these utterances. The first concerns the regularity that indicates the summative/quantifiable logic of the movements, and the second refers to the imperative character oriented to the individual behavioral dimension. These aspects draw attention because they seem to be linked to the device of "individualization" (Braz, 2021) as an operator of a specific mode of people management and bodily subjectivation. This is shown by the mobilization of discursive resources that value the quantification of movements that must be continuously performed and, in a way, accounted for and monitored by the subjects for the improvement of health and well-being. These resources unveil elements that Braz (2021) perceives as components of a managerialist ideology that is hegemonically established today, consecrating it as the era of individualization of the courses, competitiveness and the race for merit.
We understand by device, based on Foucault (2012), "[...] a decidedly heterogeneous set that encompasses discourses, institutions, architectural organizations, regulatory decisions, laws, administrative measures, scientific utterances, philosophical, moral, philanthropic propositions" (p. 364), constituting "[...] strategies of power relations sustaining types of knowledge and being sustained by them [...]" (p. 367). Such strategies act in the production of truths, forging their historical meanings and making them function in a given social reality, especially through the symbolic and discursive dimensions. However, the structuring of socio-historical meanings lacks a control device that puts it into operation, that is, a mechanism that makes the truth effect be identified, appropriated, validated and structurally maintained in relations (Foucault, 2012). In other words, a certain truth needs to establish identification with forms of organization of subjects, and with the subjects themselves, in order to be maintained.
The discussions proposed by Braz (2021) regarding individualization are focused on the conditions of health-disease and suffering experienced by different subjects in the dimension of work. It starts from the conception of work under an expanded perspective in relation to its reduction to employability and wage earning, since work is related to praxis, actions oriented to the act of creation and/or action, and not to mere productivity aimed at generating and accumulating profit (Enriquez, 2014). In this conception, discussions about work, device and individualization help understanding the strategic functions that utterances such as those highlighted earlier exert in the construction of neoliberalism, materializing conditions for all forms of freedom of expression manifested in human actions to be exploited to obtain profit and systemic maintenance of capitalism today (Han, 2020).
These discussions about individualization and work inform about the general character of human resource management models operated by social organizations of capitalist order: the strategic orientation of human behaviors to work as a way to enhance productivity and profitability (Fischer, 2002). In this type of social organization, work, reduced to paid work, is understood as the totality of the human essence and hyper-valued to the detriment of other attributes that constitute it, such as religion, war, leisure and language (Enriquez, 2014). However, the management of people by/in capitalist organizations becomes possible through investments that mobilize such attributes to operate and sediment the neoliberal rationality, especially through language and transformations in the social ideology, impacting forms of communication and production of life (Grohmann, 2020).
The models of human resource management refer to the ways of managing and guiding the behavior of the subjects, based on how different institutions –among them, business, school, administrative – are structured. This occurs through the determination of internal and external factors to the organizations, established in the relationship (historical and/or sectorial) with key concepts defined from principles, strategies, policies or practices common to the subjects that integrate such organizations (Fischer, 2002). This means that the modes of institutional organization of the subjects as individuals in collectivity, whether in micro or macro-social contexts, impact the determination of their behavior, and this organization is modulated by key concepts that order them in relation to a given rationality and ideals.
Key Concepts For Neoliberal Entrepreneurial Rationality'S Investments In Bodies, Behaviors And Subjectivities
The neoliberal entrepreneurial rationality referred to in this article is mainly characterized by the updating of capitalist ideals, or rather, by the "[...] generalization of competition as a conduct regulation and the company as a model of subjectivation [...]" (Dardot and Laval, 2016). Neoliberalism expresses the contemporary reason for capitalism and represents its form of appearance, in the present day, in distinction to its original and historically preceding forms, consolidating capitalism as the general rule of life even today (Han, 2020; Dardot and Laval, 2016). Neoliberalism promotes ruptures, changes and enhancements in the ways of living and making oneself a subject today, especially with regard to techniques and strategies of power (Han, 2020). According to Dardot and Laval (2016), neoliberalism is presented by a "[...] set of discourses, practices and devices that determine a new mode of government of men according to the universal principle of competition".
Examples of key concepts that normalize behavior and life in contemporary capitalist societies are: freedom, productivity, competitiveness, performance, efficiency, reward, success and profit (Han, 2020; Fischer, 2002). Such concepts compose different strategies of investments in the behaviors of the subjects in order to adapt them to certain ideals oriented to entrepreneurial neoliberal rationality (Enriquez, 2014). With this, factors such as, for example, uses of technologies, strategies to stimulate expected behaviors in certain spaces and/or situations, and the manufacture of a culture that reinforces and reproduces assumptions linked to such expectations (Fischer, 2002), contribute to materialize and structure the desired rationality – in the case of this study, the neoliberal rationality –, conditioning and modulating behaviors and actions and, therefore, subjectivity itself.
Among the different strategies of investments in the subjects' behaviors, there is the bodily subjectivation, which refers to investments in the subjects' bodies, in the ways of educating and learning with/about the bodies, their movements, their physical particularities, their social markers, among other elements. The bodily subjectivation is a conceptual expression that we conceive to refer to the processes by which the subjects embody knowledge arising from power relations ordered in/by certain institutions and conditions of experiences and life (Marques et al., 2021; Marques et al., 2020). Such processes permeate the dimensions of language, education, culture and economy, including everyday and institutionalized bodily practices, such as greeting gestures, the representation of social roles, hygiene and body care habits, games and leisure, dances, sports, among other manifestations. Hence the attention directed to the two aspects highlighted in relation to the utterances initially mentioned about the new WHO guidelines for physical activity and sedentary behaviors.
We observe that such utterances strategically act in the bodily subjectivation by activating devices that operate investments of the order of entrepreneurial neoliberal rationality in behaviors that seek to be stimulated by the guidelines in question. Even if the discourse subjects are not necessarily positioned in this order, conscious and/or intentionally, utterances of this and in this rationality express a concern to health and body education professionals because they tend to increase the suffering of subjects in the search for health maintenance as they trigger the individualization device and, with it, operate, subjectively and discursively, key concepts such as those mentioned above (Braz, 2021; Seligmann-Silva, 2013). Thus, such utterances centralize in the subjects the responsibility for the conditions of their states of health-disease. However, a centralization that extends to all factors that determine the style and quality of life, given that neoliberalism, as a principle of reason for everyday relations, tends to the totalitarianism of the individual to the detriment of ideas and values of collectivity/society (Rago and Pelegrini, 2019).
The enunciative functions performed by key concepts, which constitute discourses such as those mentioned above, result from the conditions that allow them to emerge and act strategically from events (speeches, normative guidelines, public appearances, among many others), and this strategic performance is an integral part of a network of forces under which life and the daily relationships established are ordered, scrutinized and standardized (Foucault, 2011; 2008). The conditions for this ordering express the ways of managing life in different contexts and socio-historical conjunctures, as well as the models of subjectivity gestated. Currently, the norms of conduct of neoliberal Western societies, based on the business and mercantile economy, represent the hegemonic model of subjectivation exercised on the subjects (Han, 2020).
The efficiency of power strategies of discursive character stands out in the institution and materialization of the subjective entrepreneurial model, especially due to the value of information and communication for neoliberalism (cognitive/informational capitalism) and the inclination of power techniques of this system of relations to the psychological dimension (Han, 2020). In this sense, the study of the techniques and strategies that operationalize the embodiment of such model by the subjects, as well as its dissemination and social materialization by everyday relationships, contributes to identify the ‘subtle’ and ‘intelligent’ forms (Han, 2020) that make it possible to achieve goals such as instituting the individualization of responsibility for health as reinforcement to the extension of market ideology to all dimensions of life.
Embodiment of the neoliberal management model and institution of the individualization of responsibility for health care
The advance of entrepreneurial neoliberal rationality in public and governmental spheres of health, through the discursive update of this order by subjects who occupy strategic positions in these spheres, ignores the need for interventions that consider their social determinants, which ends up worsening the states of disease as they constitute policies based on behaviorist interventions (Safai, 2017; Crawford, 2006). Health interventions, from this perspective, are aimed at changing behaviors considered risky, based on prescriptive models aimed at the embody, by the subjects, of habits predictively considered healthy. With this, willpower, desires, motivation and individual responsibility are presented as key concepts that trigger the individualization device, co-opting subjects to the entrepreneurial neoliberal rationality and promoting the embodiment of signs and values of health not as a human right, but as a merit resulting from individual effort.
Absent from this mechanism – which we understand as an operator of the nominated in this article how device of individualization of responsibility for health – is attention to the existence of social determinants of health-disease states and their impacts on the subjects' own behaviors. According to Safai (2017) and Crawford (2006), this absence constitutes strategic action that fertilizes the soil in which neoliberal public policies germinate, favoring and strengthening their advance in the dynamics of contemporary life, as well as the institutionalization of neoliberal rationality in the social imaginary, in subjectivities and in the bodies of subjects. Such strategy integrates the systemic mechanism to which the individualization device is linked, through which it seeks to hold subjects fully responsible for their living conditions and existence, especially by weakening and dispersing collective actions, with potentials for reflections, debates and propositions of social changes (Han, 2020; Safai, 2017; Crawford, 2006).
In other words, the individualization of responsibility for health, as a strategic device, absents from public spaces debates about the management of social determinants of health, such as: decent working conditions, housing, education, sanitation, safety and consumption. To this relates part of the concern about the utterances initially highlighted in this section, because, as forms of political investment in the bodies and, specifically, in the health of the subjects, they express a link with a discursive network which disregards the weight of circumstances in the actions that the subjects are supposed to do for themselves. This discursive network echoes utterances such as those focused by Palma (2009) in relation to discourses that casually associate the practice of physical activity to fighting sedentary lifestyles and health promotion. As well as those observed by Abib et al. (2020) in relation to advice for a healthy life, which update discourses associating self-care with a physically active lifestyle transported to the private dimension, individualized, as advocated by the entrepreneurial neoliberal rationality (Dardot and Laval, 2016).
Policy interventions grounded in the entrepreneurial neoliberal rationality, even if in the discursive dimension of language and communication, tend to worsen states of illness, because they nurture the logic of social failure, whose only responsible for the failure is the subject himself. As Han (2020, p. 16) comments, "[...] those who fail in the neoliberal performance society, instead of questioning society or the system, consider themselves as responsible and are ashamed of it [...]" (Han, 2020, p. 16). Failure is also a key concept of neoliberal rationality and which, in the subjective dimension, operates feelings such as shame and guilt, which weaken the subjects and potentiate the lived suffering arising from the alleged inability to self-control and to succeed in controlling the determining factors of their lives. However, this concept integrates strategies of affect management in neoliberalism, especially through psychopolitical techniques for exercising power (Han, 2020).
According to Han (2020; 2019), psychopolitical techniques operate a type of power that is exercised over the human psyche, modulating subjects' desires, thoughts, inclinations and impulses at a pre-reflexive level, aimed at the very systemic maintenance of neoliberalism. With this, these power techniques subtly, intelligently and efficiently institute and materialize the enterprise model of subjectivation referred to by Dardot and Laval (2016). In this type of subjectivation, the behavior of charging for constant performance, productivity, efficiency and optimization is instituted and maintained by the subject himself who, however, does not perceive himself as a subject, subjected to external factors that condition and normalize his actions, ordering his life.
On the other hand, as Han (2020; 2019) make understanding, the embody of neoliberal corporate subjectivity and the maintenance of behaviors associated with it resonate in contemporary subjects as synonymous with freedom. This, oftentimes, described and understood in economic and market terms. This means that there is an epistemological change in the way contemporary subjects begin to interpret the condition of subjection. This interpretation is based on key concepts structured in the psyche from the management of life in/by neoliberal rationality. Thus, the subjection becomes understood as freedom to constitute oneself as an autonomous project in constant improvement and that, for this, must be a constant and uninterrupted target of self-monitoring and self-investment.
The contemporary subject, by embody ideals of entrepreneurial neoliberal rationality, becomes "[...] an entrepreneur of himself who self-exploits. At the same time, he is a self-inspector. The self-exploiting subject brings with him a forced labor camp, in which he is both executioner and victim." (Han, 2020, p. 85). Ontologically and paradoxically, the rationality that feeds the neoliberal system makes the very freedom of the subject a producer of coercion, so that "[...] the subject of performance, who thinks he is free, is in reality a servant: he is an absolute servant, insofar as, without a master, he voluntarily exploits himself." (Han, 2020, p. 10). This self-exploitation, operated by a process of subjectivation inherent to neoliberal rationality, also encompasses health-illness processes, as they coerce subjects to monitor behaviors understood as being risky/healthy and to undertake their own health, as it is possible to exemplify from the utterances highlighted initially, and from the perspective of bodily subjectivation.
Health Care And Behavior As Individualized Ways Of Working And Managing Survival
Sharing the considerations of Enriquez (2014) about the extend comprehension of the forms of work, we start from the understanding that actions involving habits and behaviors in health, as well as professional and governmental interventions in health, also refer to forms of work. This understanding consider that these deal with actions developed by subjects and are oriented to a specific purpose, whether it is the search/maintenance of individual health or the management of collective health, for instance. From this perspective, the proposition of practicing any kind of physical activity every day encourages subjects to incorporate into their daily lives a work dynamic that aims to meet the need to govern the bodies and subjects’ conducts (Foucault, 1987), expressed by the imperative of regular movement and "the more, the better" (OPAS, 2020). It is valid to note the relationship between the utterances in question and the dimension of the work, because they unveil a certain historical regularity regarding the discursive mobilization of health as a means to exercise the government of the bodies (and) of the subjects, especially in relation to investments in routines of body health care as a way to enhance efficiency and bodily performance, revitalizing and strengthening it for the labor actions systemically instituted in/by the capital order (Marques, 2019; Marques and Navarro, 2019; Foucault, 1987).
Since body health care and behavior are a form of work, and health as a human attribute is conditioned to determinants that are not reduced to the individual and/or behavioral sphere, the failure to undertake it in the neoliberal society of performance becomes imminent. To this imminence can be referred, for instance, the prevalence of psychological illnesses, such as depression and burnout, which are understood as pathological symptoms that express the coercive condition that freedom sometimes assumes in the way of managing life, that is characteristic of this society (Han, 2020; 2017). Together with the considerations of Abílio et al. (2021, p. 41) about the subordinate self-management that is established in the forms of organization and control of work in contemporaneity, we observe, associated with the advance of entrepreneurial neoliberal rationality, a movement that the authors describe as being of "[...] generalization of structuring elements of peripheral ways of life [...]":
One can affirm that in these decades of labor flexibility and neoliberal policies, the worker is becoming solely responsible for the management of his own social reproduction, at the same time that the technical and political means for the efficient and informalized use of workforce are being improved. The socially established and regulated guarantees and limits, which operate in the determination of working time, salary, health and safety, are giving way to an individualized management of survival, which today appears as self-entrepreneurship. (Abílio et al., 2021, p. 41).
It is worth noting that utterances that trigger the device of individualization of responsibility for health in the sphere of public policy management, such as those mobilized for analysis in this article, open precedents for interventions that operate this individualized management of survival. In this regard, interventions with assistencialist forms of appearance stand out, which, according to Teixeira et al. (2000, p. 8), reproduce conflicts that are characteristic of hegemonic assistencialist models, constituted by the "[...] privatist medical-assistance care model (emphasis on medical-hospital care and diagnostic and therapeutic support services) and by the sanitarian assistance model (campaigns, special programs and epidemiological and sanitary surveillance actions) [...]". Such models are subordinated to the sanitarian model (Teixeira et al., 2000), that is, they are premised on “sanitary education” (MOREL, 2021).
This educational conception is based on the authoritarian transmission of “hygienic habits” to the subjects, since it assumes ignorance as the main cause of diseases, so as to turn to the confrontation of epidemics from strategies of social order and control (Morel, 2021), as the discursive and semantic management of key concepts that inform about the ways and styles of life and that permeates utterances about body health care, for instance. In this perspective, the considerations of Morel (2021) regarding policies based on sanitary education reinforce the importance of this proviso, because they point out that they tend to keep the subjects away from public spaces of healthcare and health education, since interventions of this order seem to disregard popular needs in relation to life in its complexity and systemic dynamics, which impact on health, well-being and lifestyle, among other elements. As the author comments,
Sanitary education disregards the social and environmental conditions in which people are involved, and ends up blaming the lower classes for not being able to put certain habits into practice. At the present moment, by considering the fight against the [corona]virus a matter of individual habit, this strategy ends up distancing those who are not able to practice all the precautions. [...] The distance created can open space for negationism among the population: when I realize that scientific knowledge brings indications that do not fit my reality, I look for other references, further deepening the “deficit of common practices”. The “professional denialists” make use of this kind of fact to introduce articulated confusion with a view to silencing, for example, the claim for rights such as water, sanitation and soap in vulnerable populations. (Morel, 2021, p. 8).
Based on this consideration of the author, we interpret that, in individualistic and behaviorist interventions, marked by the assistentialist model, the performance and success in the adoption and maintenance of prescribed habits prevail over meeting the needs of the people. This condition is rooted in today's predominant managerialist ideology (Braz, 2021), in which advances in technological and economic investments prevail over the confrontation of undignified and unequal conditions of access to fundamental rights to life and human existence. Therefore, we consider it important for popular health actions and interventions to raise awareness about the scenario and the mechanisms and devices described and exemplified in this article, especially to raise awareness about the elements that constitute entrepreneurial neoliberal rationality and offer possible forms of resistance to its advance and strategies, from educational and/or pedagogical perspective. In this regard, it is valid to resume the considerations of Bonetti (2021, p. 1) about the importance of reflections and discussions involving popular education in health in the national scenario experienced by Brazilians, marked by the "[...] real dismantling of the Welfare State project, governed by the preaching of a social-political culture of a fascist nature [...] in favor of a project for a few, an ultraneoliberal conservative project".
When commenting on the National Policy of Popular Education in Health of the Unified Health System (PNEPS-SUS), Bonetti (2021, p. 4) states that, since its conception and implementation, this public policy is oriented to "[...] a project of society and human being that opposes the one that currently dominates the national political space [...]". The author points out that the defense of PNEPS-SUS converges with the defense of democratization of health, policies and social relations, because its perspective aims at a critical reading of reality, problematizing it to identify social determinants of health and issues that impact them. Moreover, Bonetti (2021, p. 4) emphasizes the importance of rethinking health from the perspective of popular education facing the current national scenario, highlighting that this perspective can "[...] help us break barriers, overcome fears and frustrations that this chaotic period may cause us, contributing to stimulate us to continue strengthening our practices and to hope, instigated by the power of our actions and practices."
Among such fears and concerns is the scientific denialism that branches out from neoliberal rationality, instituting unthinking radical positions that deny the search for spaces and effective public interventions to improve social health conditions, such as the anti-vaccine movement – a historical regularity that erupts as a contemporary event along with the COVID-19 pandemic. In this sense, when discussing popular education in health confronting the denialism experienced in the pandemic period of COVID-19, with special attention to the Brazilian reality, Morel (2021) points out as the main challenge to be overcome the association between conflict and dialogue in communication with the other – not only the other like me (Self), with whom I identify, but also the other different from me, which generates strangeness, doubts and questioning in relation to beliefs, truths and personal values.
According to Morel (2021), there is a fundamental work in the health sectors that precedes the population's illness and that must be jointly performed, both in the preventive sense and in the sense of popular engagement and mobilization in the construction and approximation of scientific knowledge. It is an educational work focused on actions that "[...] favor the transformation of scientific knowledge into culture, practice and people's reality, as well as help raise questions made based on different realities and popular knowledge to science itself [...]"(Morel, 2021, p. 8). In this sense, the author recalls that public health policies, especially those developed after the Vaccine Revolt, although they took education as a pillar, they did so under the perspective of a sanitary education, that is, focused on fighting epidemics related to hygienic habits through authoritarian actions centered on the subjects. Therefore, as the author points out, it is necessary to ask whether the proposed educational practices actually dialogue with the population or just contribute to keep them away from spaces of attention, care and health education.
Final Considerations
From these considerations, we emphasize the importance and the lack of health professionals to pay attention to the social determinants of this component of human life, especially regarding the impacts resulting from operations of entrepreneurial neoliberal rationality. This implies looking at popular demands related to the health dimension in a non-reductionist or individualizing way, considering its complexity and systemic dynamics, in order to make it possible to resist and face the advance of this rationality in the ways of existing and living. For this, an initial posture that can be exercised is the sensitization to the forms of appearance and manifestation of elements of this rationality in everyday relationships. In this sense, we aspire to contribute to the issues and themes addressed in this research, especially those regarding the notions of individualization of responsibility for health, bodily subjectivation and ways of managing life in contemporary times, diluted in the proposed reflections.
It is worth noting that the premise of individualization of life, or rather, of individualized management of survival (Abílio et al., 2021) is contradictory to the very psychic and social structure of the subjects, historically and contingently formed in the evolutionary course of humanity by the collective constitution of subjects and their relationships (Rossler, 2004; Leontiev, 1978). However, this premise spreads in the imaginary and in the daily actions of the subjects, especially with the advancement of entrepreneurial neoliberal rationality, so as to worsen conditions of inequality, injustice and social exploitation, as well as processes of illness and suffering. Because by propagating and updating key concepts such as performance, merit, achievement and competitiveness in an individual-centered way, dislocated from social factors, this rationality ends up maintaining and updating the strategies and mechanisms of the capitalist exploitation system and worsens the hierarchical disparities in the organizational relations of societies.
In this sense, the utterances now focused on the new WHO guidelines for physical activity and sedentary behavior in the pandemic context of COVID-19, can be mobilized as illustrative examples of forms of appearance of this rationality, which occur in relation to contexts, subjects and discursive orders that need analytical attention, as we aim to demonstrate. Specifically, we direct an analytical look, although limited, to the understanding of the enunciative functions strategically operated by such utterances in ways of managing people and life, as well as bodily subjectivation and individualization of responsibility for health, seeking to elucidate, through these themes, the perception of how such utterances are linked to the maintenance and structuring of what we call in this study entrepreneurial neoliberal rationality, or neoliberalism.
It is important to emphasize that we intend to demonstrate, with the considerations herein weaved, the implications of the institution of concepts such as performance, competitiveness, self-entrepreneurship as values that organize the ways of relating, being, existing and living of individuals in contemporary times. Instead of contributing to better health, actions that embody such concepts end up worsening the conditions of inequality, exploitation and social injustice, negatively impacting health. This occurs, for instance, when leaders or educators disregard the existence of deficits and limitations with regard to popular education in health, that is, the formation of health knowledge that dialogues with the specificities of scientific and professional knowledge and with popular demands and knowledge, including practices and logics of their own order (Bonetti, 2021; Morel, 2021). Instead, as we sought to demonstrate, such concepts operate health policies designed and ordered for the systemic maintenance of such conditions, a system that meets hegemonic demands and interests, especially economic ones, superimposed and enforced on the popular ones.
Thus, the analysis outlined in this article aimed to highlight ways in which entrepreneurial neoliberal rationality – a form of appearance of the power of domination – is mobilized and makes use of utterances such as those referred to about the practice of physical activity in the pandemic context by and to operate ways for subjects to constitute themselves as such in contemporary times. Also, the analysis sought to demonstrate ways in which health integrates and configures itself in this context, put into perspective by the conception of work. We assume that this is an analytical reading of the current reality that is relevant to deal with, even if in a limited, partial and/or incipient way, health education aimed from the perspective of reflexivity and social transformation, aimed at reducing inequalities and injustices and improving the living conditions and existence of vulnerable populations by social structuring based on exploitation and radical capitalization of life.
Aiming to contribute to this perspective of health education, the analytical construction of this study intended to stimulate reflection on entrepreneurial neoliberal rationality and its impacts on health – thought in relation to popular and labor demands –, notably by addressing issues that inform the bodily subjectivation and health-disease processes related to the neoliberal system. This is a theoretical effort that invites us to the reflective and analytical exercise of the modes of education of the bodies and government of life in contemporary times, specifically in relation to health, seeking to "[...] give meaning to the political debate, undoing confusions, concretely naming movements and words, seeking to 'pronounce' the world [...]" (Morel, 2021, p. 9) in an attempt to have a dialogue, even if analytically and theoretically limited, but that can be collectively established, transforming people and their surroundings.
It is worth emphasizing the need for attention and care in relation to discourses that update and put into operation strategies of power and neoliberal subjectivation, given the worsening of the living conditions of vulnerable subjects and/or in situations of subordination and social exploitation. To this posture, we consider it contributive to stimulate reflexivity and debate on elements such as the device of individualization of responsibility for health, the individualized management of survival, or the culture of blaming the subject, potentiated by the political management of fear. In other words, individualization reduces the political space for action and, consequently, the power of subjects (Han, 2020; Caniato, 2009). The individualized and isolated subject is solitary, with reduced space of power, because there is not a group that supports him or her, nor that gives legitimacy and possible conditions for affirmation (Han, 2020; 2019; Caniato, 2009). In this sense, it is essential to occupy and use spaces such as those of production of academic and scientific knowledge to stimulate the involvement with these issues.
Finally, as Han (2020, p. 148) points out, "[...] appearing is more than existing. It is acting in an emphatic sense [...] only power produces a 'sense of reality' beyond the 'sense of being alive' [...]". This appearance, that is, the creation of a ‘space of appearance’, also means creating a space of power in the dimension of language, according to the author, because "[...] the space of appearance is a space that illuminates itself in action and in joint conversation with each other [...]" (Han, 2020, p. 147). However, Han (2020, p. 152) warns about the need to "[...] add something for the space of appearance to become the space of power [...]." This something refers to a minimal subjectivity, inherent in every form of power (Han, 2019). In this sense, a relevant question to be thought from this study and that presents itself as a possible starting point for new dialogues is: what is the desired subjectivity in resistance and/or counterposition to that of the self-entrepreneur subject operated by neoliberal power, and how to materialize it? Based on the study of Ferreira Neto and Araújo (2014), it is possible to envision a counter-hegemony in this sense by the production of subjectivities and critical collectivities, active, solidary and involved with democratic management of life, so that these are presented as fundamental characteristics for the construction of spaces of power that resist and eventually subvert the established order.