A Thousand Contradictory Ways: Addiction, Neuroscience, and Expert Autobiography

Neuroscientific accounts of addiction are increasingly influential in health and medical circles. At the same time a diverse, if equally scientifically focused, opposition to addiction neuroscience is emerging. In this struggle over the merits of addiction neuroscience are elements of a uniquely 21st-century public engagement with science. No longer trusted by the public as the unerring source of objective knowledge about the world, science is, at least in some contexts, increasingly treated as just one voice among many. Observing the difficulties this loss of faith in science poses for effective action on pressing issues such as climate change, philosopher Bruno Latour develops a different (ecological) approach to scientific knowledge, one that for the first time allows scientists (and other “moderns”) to understand it for what it really is and locate it “diplomatically” alongside other modes of knowing. In this article, I ask whether a similar innovation is needed to allow more effective understanding of addiction. I explore this question by analyzing two recent, widely discussed, popular books (Marc Lewis’s Memoirs of an Addicted Brain: A Neuroscientist Examines His Former Life on Drugs, 2011 and Carl Hart’s High Price: A Neuroscientist’s Journey of Self-discovery that Challenges Everything You Think You Know About Drugs and Society, 2013) as well as reviews of these books. Written by neuroscientists, and drawing heavily on personal memoir to illustrate and ratify their competing views on drugs and addiction, both books crystallize contemporary dilemmas about science, empiricism, and the nature of evidence and truth. How are we to understand their mix of “scientific fact” and individual self-observation, what does this mix suggest about scientific knowledge, and what are its implications for dominant notions of “evidence-based” drug policy and treatment? I argue that these books both trouble and reinforce our taken-for-granted distinctions between science and personal stories, between objectivity and subjectivity, and note the lost opportunities the books represent for a more searching and productive (Latour might say “ecological”) engagement with science

The Work of ‘Crisis’ in the ‘Opioid Crisis’

This commentary is an edited version of discussant comments to the Executive Session panel ‘Anthropological Interventions in the US Opioid Crisis’ organized by Jennifer Carroll at the 117th Annual Meeting of the American Anthropological Association, San Diego, CA, November 14-18, 2018

<italic>Flipping the script</italic>: Language ideology and linguistic strategy in a drug treatment program for homeless women.

Cultural ideas about language, and how it should be spoken by those who are suffering, radically impact people's experiences in clinical institutions. Forging ties between linguistic, medical, and organizational anthropology, this study centers on conventions of speaking in an outpatient drug treatment program for homeless women. Premised on three years of ethnographic research, I document the clinical processes by which clients learned what they could legitimately say about themselves, their circumstances, and their institutional surrounds. My work demonstrates that the program's clinical regimen was grounded in particular ideology of language---that is, the ideology of inner reference---which presumes that healthy talk is an easy, unfettered reflection of its speakers. And while therapists invested in the language of inner reference as an antidote to addiction, this study identifies some of harmful effects of this language on those that the program intended to help. For example, I argue that by prescribing highly personalized ways of speaking, the program hindered clients' ability to critique and challenge institutional practices. Attentive also to the high stakes of talk therapy, I show that a client who adhered to clinical scripts was deemed within reach of the clean and stable self toward which all drug treatment is aimed. This therapeutic reward was tied to the promise of release from the program, return of children from the state, or fulfillment of parole---practical goals to which all clients could relate. Not surprisingly, then, clients strove to decipher the conditions within which they spoke and linguistically maneuver within them. Seasoned clients came to practice the art of what they called flipping the script---spinning a convincingly personalized narrative of willful recovery so as to camouflage a recent relapse or obscure a weekend binge from program staff. Strategically reproducing rather than explicitly resisting the language of inner reference, script-flippers learned that a clean tale, much like a clean screen, would help them garner needed services and avoid institutional sanction. However, in the end, this study demonstrates that flipped scripts, like followed ones, are rooted as much in dynamic opportunities in time and space as they are in narrators' psyches.Ph.D.Cultural anthropologyLanguage, Literature and LinguisticsLinguisticsSocial SciencesSocial workUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/124373/2/3138124.pd

Scale: Discourse and Dimensions of Social Life

Wherever we turn, we see diverse things scaled for us, from cities to economies, from history to love. We know scale by many names and through many familiar antinomies: local and global, micro and macro events. Even the most critical among us often proceed with our analysis as if such scales were the ready-made platforms of social life, rather than asking how, why, and to what effect are scalar distinctions forged in the first place. How do scalar distinctions help actors and analysts alike make sense of and navigate their social worlds? What do these distinctions reveal and what do they conceal? How are scales construed and what effects do they have on the way those who abide by them think and act? This pathbreaking volume attends to the practical labor of scale-making and the communicative practices this labor requires. From an ethnographic perspective, the authors demonstrate that scale is practice and process before it becomes product, whether in the work of projecting the commons, claiming access to the big picture, or scaling the seriousness of a crime.</p

Introduction: Pragmatics of Scale

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Interscaling Awe, De-Escalating Disaster

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