From Magical Thinking to Being ‘pragmagic’: Narratives of Wellbeing in Health and Care in England

Accounts of wellbeing are traditionally understood as ‘rooted in social, caring relationships and traditional virtues of compassion, altruism and duty’ (Cieslik, Not smiling but frowning’: Sociology and the ‘problem of happiness’. Sociology, 49(3), 422–437, 2015, p. 430). Versions of this narrative also underpin discussions of wellbeing in the health and care sector in the UK. This chapter presents our ethnographic experiences of working with two different health and care settings in England’s National Health Service (NHS) that aim to reduce health inequalities. We explore the differences in how narratives of wellbeing are interpreted and enacted in these settings. We suggest that where the intention behind ‘saying’ and ‘doing’ become dissociated, narratives are disrupted and at odds with experience. By contrast, where narratives are entwined with an ethic of care and empathic listening, a way of being in practice emerges that fosters compassion. This, we propose, can be called ‘pragmagic’.