But more, and closer

Taken by N. Y. after midnight as I pumped gas, lost in the Appalachians.

"The Drunkard's Progress" - Part 2: The Vie Libre Movement

At the time Vie Libre was chartered, in 1954 (Vie Libre 2011b), French understandings of alcohol and alcoholism were still predominantly in line with 19th-century beliefs, specifically about the health effects of wine consumption. In 1948, for instance, a poll revealed that 85% of those polled believed that wine was good for the health, while 79% believed it was “nourishing”; as late as 1955, 80% believed this still (Prestwich 1988: 261, 20). Since 1900, wine, beer and cider had been classified as “hygienic drinks,” considered beneficial by doctors, even to the point of being a useful means of lowering rates of alcoholism, which was presumed to be caused by the low quality of “industrial” (distilled) alcohol, specifically, rather than the quantity of alcohol consumed. Beyond the medical legitimacy given to wine, it was tied to the French imaginary in a very real way, with lobbyists and retail groups forging a strong link to both the national tradition and a uniquely “French” style of inebriation, which was cheerful and intelligent. Those who called for anti-alcoholism legislation, or those involved in temperance activism (which in France almost always called for moderation, rather than abstinence), were caricatured as absolute teetotallers who were un-French. Conveying both popular and medical opinion of the time, Henry Turpin, a spokesman on behalf of the alcohol industry, said in 1901:


In our beautiful France, a country of wine, joy, openness, and good humour, let us not talk about abstinence. Your water, your Lenten drinks, your Ceylon tea, fig or acorn coffee, your sparkling milk, your lemonade and camomile be hanged. You are not only bad hygienists, but bad Frenchmen. (ibid.: 24) 

Into this hostile social milieu, Vie Libre sprang forth in a spirit of defiant opposition; it hardly seems accidental that group members ritually drink glasses of water at meetings (Fainzang 1996) and that slang for “teetotallers” is “buveurs d’eau” ("water drinkers"; Prestwich 1988: 24). At the time of its founding, however, things were beginning to change. It had been almost a decade since the state took on the burden of public health care, which forced a gradual recognition of the financial toll of chronic alcohol consumption on the state. By 1954, this knowledge was being used to argue against the once-universal assumption that alcohol production brought wealth to the nation; in that year, a report of the Economic Council on alcoholism made the strong claim that, instead of psychological problems or poverty, alcoholism was being caused by the overproduction of wine and distilled alcohol (ibid.: 264). The movement’s beginnings, then, were at a time of imminent change in official opinion, even if popular sentiments were lagging.

Vie Libre started under the guiding hands of Father André-Marie Talvas, who had once played a formative role for France’s militant workers as chaplain of the Jeunesse Ouvrière Chrétienne (“Young Christian Workers”), and Germaine Campion, who had once been an alcoholic and sex worker (Fainzang 1992; Fainzang 1996). They were later joined, in 1951, by the Amicale de 147, a group of recovered alcoholics, led by a disulfiram-prescribing[1] doctor, all of whom had been treated at the clinic operated by the Ligue nationale contre l’alcoolisme (“National League Against Alcoholism,” henceforth “LNCA”), the national-level umbrella group under whose mantle numerous once-independent anti-alcoholism factions operated (Prestwich 1988; Room 1998). When chartered in 1954, then, the core members brought with them a tradition of worker-based activism, direct experience with the marginalized, including alcoholics and prostitutes, and a commitment to the belief that alcoholism was curable. Perhaps due to their experience with the most alienated and vulnerable, and as likely due to their militant opposition to an alcohol-biased society and the compromises made by other anti-alcoholism groups[2], Vie Libre called for absolute abstinence from its core members. Finally, the influence of a doctor and the use of disulfiram set a precedent for a close working relationship with the medical authorities and a pragmatic use of care options, which persists to this day.

The structure of the movement reflects in part its unionist or syndicalist origins. The smallest Vie Libre groups consist of a minimum of three former drinkers, and are free to determine the schedule of their meetings, the particular style their meetings take (there is some variety, with some groups even segregated by gender), the subjects of discussion, etc. These local sections are organized into regional sections, which usually have a “core team” consisting of a president (and assistant president), secretary (and assistant), treasurer (and assistant) and a communications/information coordinator, who disseminates relevant journal articles, group publications, etc. Finally, these regional sections are guided by the national committee, which consists of elected members who have been sober for at least four years. (Fainzang 1996)

The group’s members are classified according to their relation to alcohol, and are given coloured cards that signify their classification: new members have a six-month period of abstinence before they are given their “pink card,” which is indicates full membership; pink cards are awarded to both cured drinkers (those who have abstained for at least six months) and their spouses, who are considered to suffer from the same illness and so are also asked to maintain abstinence (more on this below); finally, the groups include non-alcoholic sympathisers who needn’t choose abstinence and are given a green card – sympathisers usually include doctors, politicians, or academics. “Pink card” members are predominantly lower-middle class, including masons, shop-owners, factory workers, office workers, salesmen, servers, cleaning women, and police officers (ibid.). Compared to A. A. in France, Vie Libre has a higher proportion of older, married members, who are predominantly male, with women making up about 5% of membership (Room 1998). It’s beyond the scope of this paper to outline the progression of the group’s policies and prerogatives; readers interested should see the Vie Libre web site’s “Histoire du mouvement Vie Libre et explications de ses positions” (“History of the Vie Libre Movement and Explanations of its Positions”; 2011). For our purposes here, it suffices to note that the group’s key tenets remain: 1) the power of the group is a necessary support for the drinker who has been enslaved; 2) the group’s work is militancy, guided by their theory of the illness and its causes; 3) the group must have close collaboration with doctors and medical centres in hospitals; and 4) there is a cure for alcoholism (Fainzang 1996). Militancy is the central idea here, as it is what allows for the wielding of the group’s power for the sake of individuals, the use of medical knowledge for their recovery and for the education of the public, and the fight for a cure (which is, in their view, social change). Their militancy has two dimensions: support for drinkers, which consists of visits to schools, hospitals, places of work, and prisons to provide information and counseling; and the general social struggle, which consists of educational campaigns, calls for legislative reform, literacy training for movement volunteers, and above all, abstinence, which is considered a rejection of a social enemy (Fainzang 1996; Vie Libre 2011a).

---

[1] Disulfiram is a pharmaceutical that causes prohibitively acute sensitivity to alcohol, often prescribed under the trade name Antabuse.

[2] For instance, the LNCA called for moderation, and made no criticism of the consumption of wine, beer and cider, believing this middle road to be the most practical policy (Prestwich 1988).

"The Drunkard's Progress" - Part 1: Placing the Blame, Some Epistemological Caveats

Placing the Blame

In her account of French portrayals of drunkenness (1991), Véronique Nahoum-Grappe recounts a 13th-century moral tale from Provence: In a fit of anger, a monk tells his superior that he wishes him dead. As punishment, the superior tells the monk that he must either drink alcohol, fornicate with a woman, or murder a man; the monk is free to choose from amongst these three wrongs. Thinking he is choosing the least of the three, the monk gets drunk. Crazed by drink, he flirts with a woman, eventually ravishing her, at which time the woman’s husband discovers them. Confronted by the man, the monk kills him, thus inadvertently committing all three evils after having willingly indulged in only the one. The moral, it seems, is clear: regardless of one’s intentions, the decision to get drunk pushes one onto a slippery slope towards evil. The question, though, is whether the monk is responsible, in the eyes of the law and his God, for his wrongdoing. Is he less so because of his lack of intention, his compromised reason, and the irrationality of his violence? Or does the fact of his sobriety at the time he chose to drink, the fact of its having been a decision made when he was of clear mind, make him responsible for all of his actions? Finally, a question that seems to sit slightly to the side of the first two, or beyond them: Does the fact that he was told to drink, that his drinking, while intentional, was a choice made of three awful options, reduce his culpability? Is his superior not as much or more to blame?

The work you are reading is an attempt to outline some of the ways in which these questions have been answered by a group of former drinkers in France called Vie Libre, “Free Life,” a support group with a very specific conception of alcoholism and its relation to society. Their focus is the illness (I follow the group’s doctrine in using this term), its origins, its causes, the forces responsible for its perpetuation and the ways in which individuals can fight against it. Though their concern is chronic drinking, rather than the sort of binge undertaken by the ill-fated monk, the issues at stake are the same: who is ultimately responsible for the drinker’s condition, actions and recovery?

The answer to this question is complicated by the practical difficulties of accessing and modeling the beliefs and organizing principles of a heterogeneous group of people, unified partly by adherence to a formalized group doctrine but also drawn apart by idiosyncratic interpretations of this doctrine and the numerous ways it can be put into practice. With that in mind, this paper will focus on the doctrine itself, the comparatively formalized way in which it has been interpreted, integrated and contested by its adherents (as explored and theorized by French anthropologist Sylvie Fainzang, the foremost ethnographic authority on the group), and the various continuities and discontinuities this doctrine has with the broader social context, both historical and contemporary. For the moment, then, constrained by my present reliance on literature rather than fieldwork, I will have to bracket certain questions, the most interesting (to me) being: how do group members balance competing or alternative models of alcoholism, holding them simultaneously or sequentially “in their heads” while tactically employing one or the other, situation by situation? It is my hope that this restraint in focus will allow for a more thorough exploration of the central question that I shall address here: for Vie Libre and its members, who is responsible for an individual’s alcohol dependence?

Some Epistemological Caveats

Michael Lambek, through his range of ethnographic studies and as summed up in his article How To Make Up One’s Mind (2010), points to the ways in which the unified coherence and boundedness of the individual – that is, the unity of reason and its direct and determining relationship with action – that is presumed in Western discourse is fractured, particularly through spirit possession. He notes the importance of decisiveness, consistency and constancy to Western conceptions of mind and ethical accountability. Webb Keane (2010) ties this view to the creedal and evangelistic moral universe, which followed the northern Reformation and had its apex in the Enlightenment, in which one’s moral agency depends upon the ability to reason and deliberate, to give explanations for one’s actions; in short, to be able to “objectify” one’s reasons or justifications in propositional form, and so to make them available for ethical evaluation. Yet human experience, in Western society as in all others, regularly falls short of this ideal, whether through the hidden machinery of the individual subconscious, the penetrating or structuring effects of social structure, or whatever relation might hold between them.[1] As a result, coherent accounts or explanations of one’s actions (“objectifications” of experience) are often constructive in that they contribute to the sense of there being an enduring and deliberate agent at their root, which in turn enters into later objectifications; as noted by Keane, “People are shaped as publicly known moral characters over the course of their interactions with others – this becomes part of the frame through which subsequent actions are interpreted” (2010: 75). This framing is an important part of social life, but this shouldn’t block our sensitivity to that which lies out of frame: the irrational, the inexplicable, that which is beyond the reach of post hoc explanation and doesn’t fit into these constructive accounts.

In an earlier examination of Alcoholics Anonymous (Pettit 2011), I found a tendency in the sociological literature about the movement to overemphasize the “drunkalogue” (Rudy 1986), each individual’s highly structured and moralizing account of their chronic drinking trajectory. Often, studies of members’ conversion to the tenets of the group took for granted that individuals adopted the A. A. model of alcoholism as a piece, that this adoption was profound and wholly altered their understanding of their drinking past, and that the members’ ritualized public story-telling serves as proof of this deep change (e.g. Cain 1991; Rudy 1986; Yeung 2007). Yet the tension between such moral accounts and the simultaneously held belief that alcoholism is an organic illness (which mitigates one’s responsibility and so strips one’s biography of its incriminating moral dimension) suggests an obscured ambivalence between what is said and what is, at least at times, deeply felt. Similarly, Valverde (1998) notes that, while the movement’s doctrine and the public “drunkalogue” emphasize a change of identity and a shift in consciously-held self-perceptions, the mottos, posters and conversational advice that permeate one’s experience in the program are largely based on the tradition of American pragmatism, which focuses on habit as opposed to identity, and the importance of repeated and quotidian efforts as opposed to single, dramatic moments of deep conversion. It is my belief that a focus on ethical objectifications, in particular the “drunkalogue,” has excluded issues of great importance, particularly the deep ambivalence and doubts of members, as well as the enormously important (though less spectacular) daily practice in which group members involve themselves. In the introduction to Illness and Irony, Lambek writes:

Thought and agency run up against constraints, external ones of fate and circumstance and internal ones of ignorance, confusion, and contradiction. External and internal constraints on knowledge force us to speak with an assurance we do not have. (2003: 5) 

This is the caveat I want to stress here: that a study of Vie Libre’s doctrinal model, while useful, mustn’t be taken as exhaustively or authoritatively representative of the wealth of the individual members’ experience of alcohol dependence, their understanding of its etiology or treatment, nor the balance of values and considerations that enter into individual treatment pathways. It is my hope that this present work will help measure the span between doctrinal model and individual interpretation, without appearing to close it. I note this not as an effort to hedge my bets, but because I believe it is vital to the study of this subject; taking for granted either the bounded, rational unity of members-as-agents or the immediate proximity of doctrinal and individual conceptions of alcoholism will prevent a proper understanding of the dynamics of blame and responsibility within Vie Libre.




[1] As theorized, for instance, by Avery Gordon (1997), who pointed to the ways in which repressed forces bear significant impact on social life, or Judith Butler’s (1997) reflections on the ways in which subjection always falls short of social roles and norms, causing gaps or slippage that language must gloss over.

Summer's end, so another Babstock poem to quicken your heart

This is what comes; shuck your oysters now, children.

"Marram Grass"

These boardwalk slats intermittently
visible where the sand, like an hourglass’s
pinch, seeps between chinks, free-
handing straight lines that stop without fuss —

then fill again, as the wind wills it.
The beach path cuts through undulate
dune land where wild rose, marram grass
cover the scene like a pelt

of shifting greens, or rippled sea of bent
and tapered stalks. To step off
the path’s to severely threaten
what a modest plaque declares ‘this fragile balance.’ If

my affection’s bending toward you seems
or feels ever just a blind, predetermined
consequence of random winds,
think of here: our land’s end, streams

of ocean mist weighed down your curls,
spritzed your cheeks and lids, made both
our jeans sag and stick. The shore birds’
reasons blow through us too, but underneath

or way above our range of
understanding . . . even caring. I’ll
pass this sight of you — soggy, in love
with me, bent to inspect and feel

the petals of something tiny, wild, nestled
among the roots and moss — over
the projector of my fluctuating self if ever
life’s thin, rigid narrowness

requests my heart be small. You taught
and teach me things. Most alive when grit
makes seeing hard, scrapes the lens
through which what’s fixed is seen to weaken.

Great, now read it again and thank yourself in the morning.

The dead, risen

Ah, hello, my few dear readers. Lay your worries to bed, I'm back from one and a half months of academic grind, and not (as many may have suspected) putrefying in a boggy pit somewhere. So yes, relax. Take a breath. Hold it. Release. Better? Very good.

Have finished the last of my M.A. coursework, a large paper about the French alcoholism-recovery group Vie Libre - their causal model of alcoholism (quite unlike A. A., they place the blame for alcoholism on society and broader patterns of class exploitation), the ways they place and limit responsibility for the illness, the ways in which individual members may hold different models from the doctrinal, and what this might imply about the authenticity of our knowledge and the foundations of ethical action. I await my final mark in this, my dark corner, cloistered and grim, though some initial feedback bodes well. With that behind me, I've started on with my PhD, which'll keep on with those same themes just mentioned.

And that's enough about me. For any who may be interested, I'll be posting the paper in sections over the next little while; each section has at least minimal thematic coherence on its own, but I'd encourage those intrigued to read them in order.

I think I'll take a break and watch Tommy Carcetti lose his way for a few hours. All the best, hypocrite lecteurs.

Academics Pen Manifesto: "The End of Medical Anthropology in Canada?"

In February, a number of Canadian medican anthropologists signed off on a manifesto decrying the decline in funding for their discipline, which could dramatically undermine, as they rightly describe it, "one of the most vibrant, high-demand and policy-relevant health disciplines."

The Social Sciences and Humanities Research Council (SSHRC) has traditionally provided funding for medical anthropological research and training, but there is a perception that, for a health-oriented discipline, the funding mandate of SSHRC overlaps with that of the Canadian Institutes of Health Research (CIHR), which does invite applications from anthropologists whose work deals with "social, cultural, environmental and population health." However, CIHR has a demonstrably thin commitment to funding the sort of ethnographically-rich, socioculturally-centered work that anthropologists offer; instead, they tend to fund projects with more proximate and concrete consequences for the health of Canadians or domestic policy concerns (undermining the possibility of international fieldwork or collaboration, or comparative work). Their funding mandate and selection process simply isn't designed to accommodate anthropological work, while SSHRC's is - in the words of the manifesto writers, SSHRC has always understood that "health is inherently social and cultural."

For my own funding applications, I was very anxious - about whether SSHRC would reject my work as being under CIHR's mandate, and forward my application to CIHR, who would then reject it as being too socially-oriented. And this is the problem: medical anthropology's strength is that it straddles the humanities and the sciences. This prevents it from being wholly either, which is administratively awkward. But given the choice between funding from the one agency, which has a history of supporting long-term, theoretically broad, ethnographically rich and international projects, and funding from the other, which favors short-term, narrowly hypothesis-driven and domestic projects, it's clear which is best for our work and, by extension, the furthered understanding of social, cultural and individual health.

At any rate, the manifesto is here - The End of Medical Anthropology in Canada? - and I recommend reading it. It's a bit sad and a bit scary, particularly in that this shift in funding priorities reflects broader trends we're all familiar with. But it's a good read, and with a few big names signed off on it (incl. Margaret Lock and Sandra Hyde from my own alma mater), it's a very good start.

George Lakoff on Metaphors, Brain, Framing

Madvillain "Great Day" - Four Tet remix

Some Thoughts About Habit

"The great thing, then, in all education, is to make our nervous system our ally instead of our enemy. It is to fund and capitalize our acquisitions, and live at ease upon the interest of the fund. For this we must make automatic and habitual, as early as possible, as many useful actions as we can, and guard against growing into ways that are likely to be disadvantageous to us, as we should guard against the plague. The more of the details of our daily life we can hand over to the effortless custody of automatism the more our higher powers of mind will be set free for their own proper work.... If there be such daily duties not yet ingrained in any one of my readers, let him begin this very hour to set the matter right." (William James, "Habit," from Selected Papers on Philosophy.)

I had a conversation yesterday about actions and character, running along the usual lines of "you are who you are" vs. "you are what you do." As is always the case when trying to talk of these things, whatever balance between the two apparent options we might have had was lost as slight disagreement led to dramatic opposition, and we were both reactively taking positions neither would probably want to defend. I hate watching a talk fumble, but there didn't seem to be a way out - once you enter into talk that cleaves between identity/actions, you can't pull them back together. There's very little language for it. (It becomes as impossible as not thinking about a white elephant just became. [Sorry for that.])

Sun Ra / Moondog

Another O'Hara for an afternoon downtown

Heat-stricken, I offer this and only this as today's contribution - another beauty by Frank O'Hara, who unfortunately remains quite dead.

"Poem"

Light   clarity   avocado salad in the morning

after all the terrible things I do how amazing it is

to find forgiveness and love, not even forgiveness

since what is done is done and forgiveness isn't love

and love is love nothing can ever go wrong

though things can get irritating boring and dispensable

(in the imagination) but not really for love

though a block away you feel distant the mere presence changes

everything like a chemical dropped on a paper and all thoughts

disappear in a strange quiet excitement

I am sure of nothing but this, intensified by breathing

(1959)

Degrees of degradation - love, bodies, blood and more! P1

Part 1 of 2, pending commentary sufficient to establish a relevant direction for the rest.


There is a scene in Yoshihiro Nishimura’s 2008 film Tokyo Gore Police in which the sadist villain, peering down twin gun barrels that have replaced his eyes, power drills into the shin bone of a screaming man strapped to a chair. This is followed by a scene of staggeringly extravagant gore, all in the back halls of a fetish club whose performers, genetically modified and mutated, include a snail woman with tentacle-mounted eyes and a breathing, heaving, flesh-and-bone chair, presumably sentient, though doomed to a chair's-life-long sentence of inner imprisonment à la Johnny Got His Gun. 

The Neuroscience of Justice, or, the Tumour as Agent

I've just finished reading David Eagleman's recent article "The Brain on Trial" (The Atlantic, July/August 2011, available online here), and feel... threatened, I suppose. I strongly suggest reading it - which is why it threatens, because its logic is fair and its intent agreeable; certainly the effort has my sympathies. But looked at closely, this picture of justice and culpability has many faultlines, and building a new judicial system on its terrain is, at best, unwise and, at worst, a guarantee of the unacceptable triumph of the who over the what in sentencing. (Of course, neither is ideal - but replacing one inadequate extreme with its equally or more problematic opposite is preposterous.)

Two poems about the barbed ineffable

This is quickly becoming the day of posting things I like. Don't blame me for having heart, reader. So, for your sympathy or amusement, a Babstock and a Millay.

Ken Babstock - "Carrying Someone Else's Infant Past a Cow in a Field near Marmora, Ont."

Summer gnats colonized her molasses black eyes, her flicking,

conical ears. She moaned, a badly tuned

tuba, and tassels of ick dripped

from her black-

on-pink nostrils like strings of weed sap. Waking from a rhythmic

nap in my arm, you wobbled your head upright

and stared at the great hanging skin-

bag, teats, dry-docked

hull of her ribs, anvil head, and the chocolate calm in her eyes

that gazed back as I carried you closer, wading

through goldenrod, mulleins, thistle

all artfully bent

clear of your soft exposed feet. Ants worried the punky

tops of knotted fence posts, and caution flags

of gossamer and milkweed fluff

marked each rust-twist

of barb, but that was all that divided you and her. I felt briefly

happy to be prop, peripheral in this exchange,

this unfolding bundle of knowing that

was you in

an overgrown ditch where the air swelled, shaking itself dry

in the sumac. What was I shown that I haven't retained?

What peered back long before the cracked

bell of its name

came sounding off a tongue's hammer and fenced it forever? Know

that it happened, though - you were a drooling lump

of living in the verdant riddle. That heifer

remembers

nothing of you. Let chicory, later in life, be bothersome blue

asterisks footnoting one empty, unrecoverable

hour of your early and

strange.

Edna St. Vincent Millay - "Assault"

I

I had forgotten how the frogs must sound

After a year of silence, else I think

I should not so have ventured forth alone

At dusk upon this unfrequented road.

II

I am waylaid by Beauty. Who will walk

Between me and the crying of the frogs?

Oh, savage Beauty, suffer me to pass,

That am a timid woman, on her way

From one house to another!

[I hope this isn't copyright infringement; with authors duly credited, if you find fault with this, kindly go suck an egg.]

O'Hara's "A Step Away From Them"

Lovely poem by Frank O'Hara. I post this because I'm working this week in Toronto's sun-steeped downtown and it is scorching and bright, which brought the below to mind. Though at 12:40 I'll be packing Babstock, not Riverdy.

A STEP AWAY FROM THEM

It's my lunch hour, so I go
for a walk among the hum-colored
cabs. First, down the sidewalk
where laborers feed their dirty
glistening torsos sandwiches
and Coca-Cola, with yellow helmets
on. They protect them from falling
bricks, I guess. Then onto the
avenue where skirts are flipping
above heels and blow up over
grates. The sun is hot, but the
cabs stir up the air. I look
at bargains in wristwatches. There
are cats playing in sawdust.
On
to Times Square, where the sign
blows smoke over my head, and higher
the waterfall pours lightly. A
Negro stands in a doorway with a
toothpick, languorously agitating.
A blonde chorus girl clicks: he
smiles and rubs his chin. Everything
suddenly honks: it is 12:40 of
a Thursday.
Neon in daylight is a
great pleasure, as Edwin Denby would
write, as are light bulbs in daylight.
I stop for a cheeseburger at JULIET'S
CORNER. Giulietta Masina, wife of
Federico Fellini, è bell' attrice.
And chocolate malted. A lady in
foxes on such a day puts her poodle
in a cab.
There are several Puerto
Ricans on the avenue today, which
makes it beautiful and warm. First
Bunny died, then John Latouche,
then Jackson Pollock. But is the
earth as full as life was full, of them?
And one has eaten and one walks,
past the magazines with nudes
and the posters for BULLFIGHT and
the Manhattan Storage Warehouse,
which they'll soon tear down. I
used to think they had the Armory
Show there.
A glass of papaya juice
and back to work. My heart is in my
pocket, it is Poems by Pierre Reverdy.

[1956]

Taking Them at their Word

Am posting a paper written a while ago, which I think raises some useful questions about agency while also exploring the limits of traditional approaches to Alcoholics Anonymous and similar mutual-help groups. If you think of A. A. as a "Christian" group or "cult," you're likely drawing conclusions based on their creedal conventions - that is, their repeated statements of belonging, or higher powers, etc. Things are, as always, not nearly so simple. This one runs a bit long, but I'm just happy to throw it out there.

Psychiatric caricature and Luhrmann's "Of Two Minds"

Seems appropriate to start with the caveat that this is meant to be a personal exercise, rather than any sort of public presentation - I'm trying to get some ideas straight, and writing online somehow seems less of a confrontation with the abyss than writing in a journal. If you're reading this, be charitable, but know that commentary or discussion about any of it would most certainly help in whatever secret enterprise of mine this feeds.

With the above said, and with two hours left in this, my second day as a temporary receptionist in Toronto, I'll begin with some rambling about psychiatric suspicion and Tanya Luhrmann's fantastic book "Of Two Minds: The Growing Disorder in American Psychiatry" (available here).

The book - a multi-site ethnography drawing on fieldwork in medical schools, psychiatric residency programs, in-patient treatment institutions, and hospitals - deservedly won both the Victor Turner Prize for Ethnographic Writing and the Boyer Prize for Psychological Anthropology. It traces the origins of the gulf between the psychodynamic and the biomedical models of mental suffering and psychiatric treatment, as well as the ascendance of the latter as "managed care" insurance programs came to dominate the funding of mental health interventions (and, as a result, to leverage decreases in time, cost and consistency of care). I won't synopsize further; rather, I'd like to stress the subtlety and respect (albeit critical) with which she treats her subject matter.