The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Danya Fast is an Assistant Professor in the Department of Medicine at the University of British Columbia (UBC) and an Associate Member of UBC’s Department of Anthropology. Her research focuses on tracing the substance use and care trajectories of young people who use drugs in Greater Vancouver, as these individuals navigate ongoing overdose and housing crises. 

What is your article “Staying Together No Matter What: Becoming Young Parents on the Streets of Vancouver” about?

Among young people who use drugs and are experiencing poverty and homelessness, pregnancy is often viewed as an event that can meaningfully change their lives. In this way, youth’s perspectives seem to align with those of various healthcare, criminal justice, and child protection professionals. However, in our article we also describe moments when youth’s desires and decision-making are powerfully at odds with the perspectives of these professionals. For example, we describe how youth’s romantic relationships can shape understandings of right and wrong and the decision to “stay together no matter what” during pregnancy and early parenting, clashing with the demands of professionals that young couples separate for periods of time to attend residential drug treatment prior to or following childbirth. The result among young people can be painful and confusing cycles of loss, defeat, and harm. For Indigenous youth, these cycles often extend across generations.

Tell us a little bit about yourself and your research interests.

I am a medical anthropologist who has spent the past 15 years working closely with young people who use drugs in the context of unstable housing and homelessness in Vancouver, Canada. Across this period, I have been interested in how youth’s possibilities unfold through – but also around – an ever burgeoning and contracting care assemblage (to borrow a term from Andrea López) in the city, as individuals engage with, evade, and refuse state-sponsored programs and services. In my new book The Best Place, I trace the affective intensities that animate these moments of engagement, evasion, and refusal, as well as substance use itself.    

What drew you to this project?

Over the past decade and a half, I have worked closely with many young couples who use drugs, and always been eager to undertake a project focused on their perspectives and experiences surrounding pregnancy and early parenting. It was a pleasure to work with my Master’s student and co-author Reith Charlesworth on this project, which incorporated insights from both my own long-term fieldwork and Reith’s Master’s research with a distinct group of young people and couples.

What was one of the most interesting findings?

The most interesting, or perhaps important, finding in my view is how powerfully romantic relationships anchored young people’s moral worlds and decision-making regarding what was right and wrong in particular moments. The imperative to “stay together no matter what” among young couples was so powerful that it almost always overrode even the strongest warnings from social workers, probation officers, and others that youth must separate from each other for periods of time so that custody of a child could be maintained. This mis-match of perspectives was painfully confusing and frustrating for young people, and had heartbreaking consequences.

What are you reading, listening to, and/or watching right now?

Reservation Dogs (Disney+)

Crackdown Podcast

Johnny Appleseed by Joshua Whitehead

Habeas Viscus by Alexander Weheliye

If there was one takeaway or action point you hope people will get from your work, what would it be?

Young people who use drugs are enmeshed in elaborate moral worlds often anchored by relationships to place and to each other. It is critical that programs and services for pregnant and parenting youth are not just focused on reducing risks and harms, but also on supporting young people’s full humanity and desires for love, family, and homemaking.

Thank you for your time!

Other ways to connect:
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The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Carina Heckert is an Associate Professor of Anthropology in Department of Sociology and Anthropology at The University of Texas at El Paso. Her research focuses on how policies shape illness experiences and experiences seeking healthcare. Her forthcoming book Birth in Times of Despair: Sociopolitical Crises and Maternal Harm on the US Mexico Border (NYU Press) shows how longstanding unjust immigration, health, and social policies both before and during the height of the COVID-19 pandemic produce various forms of maternal harm in the border region.

What is your article “Recalibrating the Scales: Enhancing Ethnographic Uses of Standardized Mental Health Instruments“ about?

We intended for “Recalibrating the Scales” to serve as a way to think about the ways standardized scales are incorporated into anthropological research. Often, anthropologists use scales as a means to generate quantitative data that facilitates conversations in public health and medicine. Through our own use of scales in multiple projects, we found that how people choose to respond to closed ended questions – which often included detailed elaborations, especially when their response could not fit into the confines of a scale – show that scales have more ethnographic potential than what has typically been recognized. The projects informing this article include the Dallas Translating Affect Project, which documented the emotional trajectories of recovery for survivors of intimate partner violence, and the El Paso Maternal Health and Emotional Distress Study, which explored the emotional experience of pregnancy among first- and second-generation immigrants in the US-Mexico border region.

Tell us a little bit about yourself and your research interests.

I am a medical anthropologist with interests in global health, health policy, immigration, reproductive health, gender, and Latin America. My earlier work focused on experiences of navigating global health HIV programs in Bolivia in the context of a national agenda aimed at decolonizing health services. More recently, my work focuses on pregnancy, birth, and postpartum experiences during a series of overlapping public health and social crises in the US-Mexico border region, including draconian enforcement of immigration policies, a mass shooting, and the COVID-19 pandemic.

What drew you to this project?

This current piece draws from multiple projects, including one that I collaborated on with my graduate mentor, Dr. Nia Parson. For me, this article was a fun way for us to bring together multiple projects that shared common themes related to emotions, immigration, and gender inequities. In both of the projects that we discuss, we incorporated standardized mental health scales as a way to produce quantitative data that we could put into conversation with interview narratives. We quickly noticed that many women were not content with providing a Likert-scale response to questions, and instead often provided detailed responses to closed-ended questions. We decided it was worth exploring the content of these responses and how ethnographers might use scales to actively elicit this complementary narrative data.

What was one of the most interesting findings?

I was initially very surprised that closed ended questions were eliciting details that often did not emerge in the interviews where we were actively soliciting longer detailed responses. As we discuss in the article, at times, simply asking questions in a different way can potentially lead to different ways for people to share their experiences.

What are you reading, listening to, and/or watching right now?

My guilty pleasure is Colombian telenovelas on Netflix. I recently finished watching Season 2 of The Queen of Flow. I’m not happy with how that show ended.

If there was one takeaway or action point you hope people will get from your work, what would it be?

As ethnographers are well aware, our interlocutors often have things to say about the research instruments that we are using. The nature of standardized closed ended scales often makes these comments and mutterings invisible, when they should be treated as ethnographic data in their own right.

Thank you for your time!

Other ways to connect:
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The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Neil Armstrong is a Student Mental Health Research Associate, Kings College London and Fellow in Harris Manchester College at University of Oxford. He has a Bachelor of Arts in Philosophy and Theology. Additionally, he has a Master of Science in Teaching and Doctor of Philosophy in Social Anthropology.

What is your article “Is it Still Ok to be Ok? Mental Health Labels as a Campus Technology” about?

Is it Still Ok to be Ok? Mental Health Labels as a Campus Technology is about how students engage with mental health labels in new ways. Our ethnographic data show that although labels can still be a source of stigma, they are also something students use. Labels can facilitate interaction with academics and administrators; be used as a pliable means of negotiating social interaction; be creatively directed towards self-discovery; and can even be a means of promoting sexual capital and of finessing romantic encounters. So rather than being fixed and burdensome, labels emerge as flexible, fluid and contextual. To try to capture the usefulness of labels, we call them ‘campus technologies.’ Our findings give pause to quantitative mental health research that relies on labels having clear and simple meanings. But, equally, concerns about the power of labels to medicalize students also appear undermined.

Tell us a little bit about yourself and your research interests.

I am a medical anthropologist who uses ethnographic methods to make lived experience of mental health problems legible to clinically engaged research.  I am interested in mental health bureaucracy, in particular how ideas like accountability might conflict with care quality. Currently, I am researching student mental health and assessing what it might mean for universities to become compassionate. Collaborative Ethnographic Working in Mental Health was published by Routledge in December 2023.

What drew you to this project?

I became concerned that the social science literature on mental health labels was out of date. Looking around on campus I could see that students engage with labels in creative and productive ways and that the literature had not caught up. The SMarTeN project provided me with an opportunity to work with students to coproduce a paper exploring their experiences with labels and relating this to ideas in the academic literature (https://www.smarten.org.uk/).

What was one of the most interesting findings?

A lot of research into student mental health assumes we can easily understand what people mean when they fill out questionnaires that use mental health labels. Perhaps this was true in the past. But our ethnographic work suggests that today, the meanings of key terms like ‘depression’, ‘anxiety’ and ‘wellbeing’ are not fixed but fluid. Students actively engage with mental health labels to negotiate their life on campus. This suggests we might need to rethink how we conduct research, and particularly our reliance on quantitative data.

What are you reading, listening to, and/or watching right now?

I recently finished John Burnside’s beautiful and heartbreaking memoirs A Lie About My Father and Waking Up in Toytown. I’ve been listening to Blaze Foley and watching Severance.

If there was one takeaway or action point you hope people will get from your work, what would it be?

We need to revisit what we think we know about young people and mental health. Things may not be as they appear.

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Cíntia Engel is a Visitor Scholar at the Institute for Bioethics & Health Humanities, University of Texas Medical Branch. She is a Brazilian medical and social anthropologist working at the intersection of the anthropology of care, Feminist Science and Technology Studies and Health Humanities. Her research interests include geriatric care, dementia, drug complexity in treating dementia, and policies of care in Brazil.

What is your article “Dementia, a Polypharmaceutical Phenomenon: The Intimate Combinations of Dementia Drugs in Brazil” about?

The paper discusses how symptoms of dementia entangle with the multitude of drugs used to treat it. To state that dementia is a complex condition is commonplace. The medical literature typically explains it by the disease characteristics, and social sciences highlight its multiple social and affective consequences. In the paper, I discuss how the complexity also relates to the treatment. Based on an ethnography of one year and a half (2017–2018) in a Brazilian metropolis, within a Public Geriatric center and the households of three families, I argue that dementia is a phenomenon enmeshed in polypharmacy. I open the text presenting the universe of drug consumption and its variety, then, through ethnography, I observe different levels of combination between medication in this complex treatment: (i) between themselves, (ii) with time, and (iii) with social relations, politics, and care practices.

Tell us a little bit about yourself and your research interests.

For as long as I can remember, I have been curious about how life and death keep happening as they do. I grew up in a small town in the interior of southern Brazil. Following the advice of a teacher, I went to the Federal District and graduated in social sciences at the University of Brasilia, where I did my Master’s in Sociology and my Ph.D. in Anthropology. My research intersects medical anthropology, care anthropology, and feminist science and technology studies. I believe that ethnography can enrich exchanges between these fields, expanding the analysis of the socio-material health phenomena, which is my main area of research. In this area, my topics of interest are the socio-material body, dementia, care practices, intersectionality in health, and the drug complexity of chronic treatments. The methodological perspectives of Annemarie Mol and Veena Das and the philosophical imagination of Donna Haraway inspire my thinking and writing.

What drew you to this project?

During my Master’s degree, I researched care and Alzheimer’s disease, observing the exchanges and conversations of support groups for caregivers and newly diagnosed people. The topics of conversations covered dilemmas such as managing symptoms, finding acceptance, and dealing with the challenges of daily care. To my surprise, a recurring theme was drugs prescribed by physicians to deal with dementia and other comorbidities. Caregivers used to mention many drug names and share experiences and agonies about them. The mediators of the groups were social workers, psychologists, and occupational therapists. Despite being very familiar with drug conversations, they did not feel in the proper position to advise about it, so they organized the presence of a pharmacist at a meeting. It was one of the most crowded meetings I witnessed, and many participants spoke that day. At that moment, I was not able to discuss the role of medication in care, but I decided I should study it for my Ph.D.

What was one of the most interesting findings?

Once I started my research with geriatricians, I introduced myself as an anthropologist interested in studying Alzheimer’s disease and its medical treatment. However, they told me that perceiving medicines and diagnoses in isolation were insufficient. They taught me I needed to know the combination of diseases and substances used in each situation to discuss the medical treatment. One of their challenges was to deal with ‘drug interactions’: combinations of substances that could modify effects by intensifying, decreasing, or generating a dangerous side effect. They also taught me that caring for the ‘interactions’ was imperative in complex cases in which dementias combine with a series of other chronic diseases or even with social and financial dilemmas—and most dementia treated there were complex cases. I took this “native” notion of drug interaction and decided to play with it through its multiple consequences in care practice. There is more than one drug at work in most dementia cases, and they interact. By acknowledging the multitude of drug interactions, I argue that a polypharmaceutical phenomenon enacts dementia.

What are you reading, listening to, and/or watching right now?

I am reading a beautiful book that teaches me about vulnerability and the complex relationships of love and care. The Vietnamese American and Queer poet Ocean Vuong writes “On Earth, We’re Briefly Gorgeous” as if it was a letter to his mother, who cannot read. He harbors the violent outbursts of a mother traumatized by war and immigration while finding a way to embrace himself fully. It is a strong, sensitive, hurtful, and hopeful book.

I recently moved to the United States, and I am feeling a bit homesick, I have been listening on repeat the album Canto de Praya, by Hamilton de Holanda and Mestrinho. It is Chorinho, a musical genre that warms my heart.

If there was one takeaway or action point you hope people will get from your work, what would it be?

The most direct takeaway would be assuming that drugs are social beings that interact and probably rethinking dementia medical treatment to deal carefully with these relations.

I would also state the known yet necessary point that caring for dementia should be a collective concern, not centered on families, drugs, or institutions alone. We need more infrastructure of care and awareness for people with dementia to be themselves and live the best life possible.

Other places to connect:
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ResearchGate

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Ida Marie Lind Glavind is a PhD candidate in Anthropology, at the Department of Anthropology at the University of Copenhagen and at the Danish Alzheimer Association. In her dissertation, Ida followed people with Alzheimer’s disease living in Denmark, exploring how the disease affected their social life.

What is your article “Temporal Belonging: Loss of Time and Fragile Attempts to Belong with Alzheimer’s Disease” about?

In the article, I explore how a changing conception of time affects the social relations of people with Alzheimer’s disease living in Denmark. I argue that although the loss of sense of time is clinically defined as a “subjective loss of time,” it is rather an intersubjective loss. As people with Alzheimer’s break out of the shared rhythms and pace of everyday life – due to difficulties keeping track of dates and managing numbers – they challenge their closest relations. Secondly, I argue that from studying the ruptures and conflicts arising from the different conceptions of time, we learn that belonging as a sense of attachment is very much contingent on temporality.

Tell us a little bit about yourself and your research interests.

In my research project, I explore the lifeworlds of people with Alzheimer’s disease and their families through ethnographic methods. I have found it exciting – and challenging –  to conduct research among people whose conception of time and vocabulary is undergoing a radical change due to their illness.

What drew you to this project?

Before starting my Ph.D. project, I worked at the Danish Alzheimer Association, a patient organization for people with dementia. Here, I was repeatedly struck by how media coverage of dementia often excluded or left out the patients’ experience and instead focused on the caregivers’ perspective. This motivated me to formulate a research project taking its point of departure in the lifeworlds of people with dementia.

What was one of the most interesting findings?

Paying attention to the experiences of people with dementia offers us surprising and nuanced insights into how dementia is not only about loss, decay, and death but also about continuing care and social relations.

What are you reading, listening to, and/or watching right now?

Currently, I am reading Anna Karenina by Leo Tolstoy.

If there was one takeaway or action point you hope people will get from your work, what would it be?

I hope the article can give scholarly attention to the role of temporality in social life and illness. For families affected by dementia, I hope the article can give a new perspective about how the loss of sense of time befalls not only the person with dementia but also the rest of the family.

Other places to connect:
LinkedIn

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Iben Gjødsbøl is Assistant Professor at University of Copenhagen, Denmark. In her PhD, she explored questions of life’s worth and personhood in the face of dementia. Her current research explores how data-intensive medical technologies transform care and clinical practices, and how health professionals, researchers, and patients experience these transformations.    

What is your article ‘Intangible Cultural Heritage: ‘Curating’ the Human‘ about?

My article is about the everyday care for people who suffer from very progressed dementia. It draws upon ethnographic fieldwork I did in a Danish nursing home specialized in dementia care as part of my PhD research. In the article, I attend to the ways in which nursing home staff care for residents who have lost their capacities for memory, agency, and communication and thus are pushed to the margins of conventional personhood. Demonstrating how caregivers during mundane care practices such as feeding and dressing uphold the residents as biographical human beings in belonging, I argue that dementia care should be recognized as a curatorial practice, preserving not only individual but also collective memories of what it takes to be human and belong in society.

Tell us a little bit about yourself and your research interests.

I’m employed as a Professor at the Department of Public Health, University of Copenhagen. Since my dementia care research, I have moved on to investigate how precision medicine is being realized in the field of cardiology in Denmark. Next year, I will do fieldwork to study how the clinical implementation of an algorithm as a support tool for decision-making transforms the care for patients with ischemic heart disease. I am always drawn to explore how the local practices and understandings, I study during my ethnographic engagements in clinical and care practices, should be understood in the context of the Danish welfare state.

What drew you to this project?

I was drawn into the project on dementia care through my outstanding research leader, Professor Mette Nordahl Svendsen. In 2013, she received a prestigious grant for a research project entitled: A Life Worth Living: Negotiating Worthiness in Human and Animal (LifeWorth). In this project, we collaboratively investigated questions of personhood and life’s worth across the very beginnings and ends of life and across human and animal with empirical fields as diverse as neonatology, dementia diagnostics and care, and experimental animal studies. Being raised as a scholar in the LifeWorth project was an invaluable experience for me.     

What was one of the most interesting findings?

I was so impressed by the skills and persistence of the staff in the nursing home’s specialized unit. Every day, they tirelessly upheld the life stories, the social relations, and the agency of the very fragile residents who could only minimally respond to their care. These caregivers did everything they could to create lives worth living for the residents. Yet in the face of the residents’ profound disabilities and too little time and resources to provide proper care, caregivers also endured moral perils by sustaining the lives of the residents. 

What are you reading, listening to, and/or watching right now?

I’ve just embarked on an ethnographic research project about the implementation of artificial intelligence in clinical care for patients with ischemic heart disease, so I’m trying to delve into the growing social science literature on AI and algorithms in healthcare.

If there was one takeaway or action point you hope people will get from your work, what would it be?

With my article and the argument that we should recognize dementia care as a curatorial practice, I hope to voice and draw attention to the impressive work carried out in nursing homes every day. Caregivers who care for people at the margins of conventional human personhood are constantly upholding culturally specific notions of what it takes to be human and to belong. Yet nursing home caregiving is poorly paid, and it remains some of the least acclaimed and appreciated professions in our society. With the article, I hope to flag up dementia care as an essential yet morally challenging task fundamental for curating our human heritage, and thus for maintaining the cultural and societal imaginaries of the Danish welfare state.

Other places to connect:
University of Copenhagen

The next few months we’ll be highlighting authors who have published in Culture, Medicine, and Psychiatry.

Ben Belek, Head of Impact and Policy Analysis, Israel Society of Ecology and Environmental Science is a social and medical anthropologist with a PhD (2016) from the University of Cambridge.His research focused on identity, activism, and expertise among autistic adults. In a different project he explored the shifting economic and cultural values of blood constituents. Currently, he helps design sustainable, science based and climate conscious public policies.

What is your article “‘A Smaller Mask’: Freedom and Authenticity in Autistic Space” about?

The article is about the lengths some people go to present themselves in a certain way. Society has very strict expectations on how to behave, and many of us typically abide by these expectations, if only to keep ourselves out of trouble. But the case with many autistic people is that these expectations are completely out of synch with their natural inclinations. The result is that they need to work hard to appear to fit in; not even necessarily because they want to, but because the sanctions laid against those who don’t are often ruthless. Autscape is a distinctive social setting where the rules of social conduct are unusual because they were actively and explicitly designed for autistic people, by autistic people. I did fieldwork in Autscape and learned how its autistic attendees take advantage of this unique setting to reflect on such matters as autonomy, authenticity, and freedom.

Tell us a little bit about yourself and your research interests.

Since starting my PhD about ten years ago, my main research interest was autism. My vision was to make use of the tools and insights of social anthropology to explore the aspects of autism that aren’t usually talked about in other disciplines – like what it means for people on the spectrum to be autistic, what sense they make of it, and how their ideas about autism differ from those of experts. During my postdoc I began exploring quite a different topic, which is how the medical benefits of blood proteins make them the basis of economic exchange, despite the fact that in the most part they were given freely by blood donors. So these blood constituents constantly shift between being a gift and being a commodity, with all the cultural weight placed on blood – sanctity and defilement, strength and kinship, life and death. These days I’m doing something very different – I no longer do academic research, but work with the government to help it design public policies geared towards mitigating greenhouse gas emissions and adapting to climate change. It sounds technical but it’s not – public policy is the most applied form of social science, as it’s really just about people through and through.

What drew you to this project?

By now there are loads of exciting material about autism that take a critical perspective, but when I just got started, there honestly weren’t that many. My partner was a speech therapist, and she worked a lot with autistic children. She would tell me about her patients’ difficulties and preferences, which got me curious. But the only interpretations that were out there were those given by medical professionals and mental health experts. I found it to be a very medicalized and positivistic approach to human behavior, which did not sit right. Where were the subjective experiences? I wanted to understand how autistic people themselves make sense of their condition, and so I decided to go out and study it the way I thought was most appropriate – through ethnographic fieldwork.

What was one of the most interesting findings?

I’m not sure it’s a finding as such, but I thought my interlocutors’ frequent use of the mask motif was fascinating. A mask is of course a very rich metaphor, which is partly why masking is such a deep-rooted practice in so many cultural contexts around the world. Western social theory also has quite a rich tradition of musings over the meaning of masking in the more metaphorical sense, as with Goffman etc., and these infiltrated popular conceptions over impression management and the portrayal of oneself as if on a theatre stage. In that sense, there’s nothing particularly surprising about people invoking this image of unmasking. But what I thought was especially interesting in Autscape was the fact that the proverbial mask was not seen by its participants as a tool of self-expression, but rather as an instrument of oppression. So unlike in various festivals and carnivals where masks are donned to express freedom and rebellion, Autscape is a festival (arguably) where the removal of masks is what symbolizes liberation. I thought this was a very clever reversal of the typical mask metaphor on their part.

What are you reading, listening to, and/or watching right now? (Doesn’t have to be anthropological!)

I’m tempted to go on about House of the Dragon, but I’ll mention instead a book that I’m currently reading (well, listening; I have the audio version). This one is also about politics and governance, though it’s slightly less well-known than the HBO series. Admittedly, it does have fewer dragons. It’s a book titled The Sustainable State, by Chandran Nair. Nair offers a very well-argued and quite provocative roadmap for a sustainable economy, one in which consumption is reduced to a reasonable scale and where the state claims significantly higher authority over the free market. It’s a challenging read: Nair can be extremely persuasive, and while the enormous challenges of mitigating climate change and adapting to it undoubtedly require radical reforms in the economy, his proposition for a sustainable state goes against so many of the norms and values many of us currently live by. Listening through the book, I find myself shifting between enthusiastic support and stern objection to his ideas. To what extent does the climate crisis warrant taking risks with people’s rights and liberties? I don’t pretend to know the answer, but I definitely agree it’s a question worth asking.

If there was one takeaway or action point you hope people will get from your work, what would it be?

There are a lot of stereotypes about autism. Many of them are well meaning, but like all misconceptions, they ultimately do more harm than good. I think the main takeaway from my work is that autism is a very broad and diverse category, and upon meeting a person on the spectrum, it’s nearly impossible to know what to expect. But on top of that, autism is just a very dynamic concept, in the sense that it’s constantly ascribed different meanings by different people. And autistic people also do that work of charging the concept of autism with meaning, based on their own experiences, impressions, and ideas. The scientific discourse on autism is constantly pushing towards unambiguous claims and strict definitions; this has value, and it makes sense in some respects. But what my work demonstrates is that autism is as much a political category as it is a medical one. That’s not to say it’s any less real, or that the difficulties often endured by autistic people and those who love them are any less painful. It does however open up a space for a conversation about how changing the terms of the discussion on autism and designing appropriate accommodations might help make autistic people’s lives easier and more fulfilling. The way to do this is by listening to what people on the spectrum have to say, and taking that into account when decisions – about treatment, diagnosis, education, welfare, health, employment etc. – are made.

Other places to connect:
The Autism Anthropologist
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