Psychiatry, bio-epistemes and the making of adolescence in southern Brazil

Abstract Drawing on an ethnographic study in southern Brazil, this paper explores how therapists’ attempts to “resist bioreductionist” pharmaceutical use both succeed and crumble. Using a comparative framing, I show that pharmaceuticalization can become an anesthetizing “lid” that interacts with young people’s polarizing micro-politics and is an outgrowth of multi-generational medico-political family histories. This lid, however, is not air-tight and exceptionalities are born out of these very same histories. I argue that both pharmaceuticalization and exceptions to it emerge not through “resistance” to biopsychiatric logics but from the transformative possibilities that the patterned co-production of social, political, and psychiatric life affords

The shaping of adolescent psychopathology in the wake of Brazil's new democracy /

This thesis explores how concepts of "adolescence" and "adolescent psychopathology" have become salient among medical and lay communities in Pelotas, a small town in Rio Grande do Sul, Brazil's southernmost state. The concept of adolescence emerged throughout the 20th century in Western Europe and North America from various specialized fields, including evolutionary medicine, psychiatry, and developmental psychology. Within these sub-fields, adolescence came to refer to a transitional phase in the life span, and specifically, to the psychopathologies and psychological opportunities ensuing from what could potentially become a life-altering transformation. In the past two decades, this concept of adolescence has been adopted by a number of global health agencies, who depict the adolescent phase as an opportunity for addressing the underlying causes of multiple psychopathologies and accordingly, for improving the developmental "health" of nations. Concepts and practices relating to the management of adolescent psychopathology readily took hold in Pelotas in the 1990s, not only because local professional communities have been seeped in a psychoanalytic tradition dating back to the early 20th century, but also because of a recent growing community-based health care movement that prompted the expansion of publicly funded mental health services. This expansion widened definitions of "therapy" to include preventive care and social mobilization, and impacted significantly the identity, social role and political inclinations of practitioners. Due to these changes, psychiatrists and psychologists are showing greater interest in adolescent patients and their various common mental disorders, including "aggressiveness," nervos, anxiety, and learning and school achievement problems. Yet several social and class struggles ensue when practitioners, many of whom seek to maintain their psychodynamic models relatively intact, shift the focus of their work

Anthropology and Epidemiology: learning epistemological lessons through a collaborative venture.

Collaboration between anthropology and epidemiology has a long and tumultuous history. Based on empirical examples, this paper describes a number of epistemological lessons we have learned through our experience of cross disciplinary collaboration. Although critical of both mainstream epidemiology and medical anthropology, our analysis focuses on the implications of addressing each discipline's main epistemological differences, while addressing the goal of adopting a broader social approach to health improvement. We believe it is important to push the boundaries of research collaborations from the more standard forms of "multidisciplinarity," to the adoption of theoretically imbued "interdisciplinarity." The more we challenge epistemological limitations and modify ways of knowing, the more we will be able to provide in-depth explanations for the emergence of disease-patterns and thus, to problem-solve. In our experience, both institutional support and the adoption of a relativistic attitude are necessary conditions for sustained theoretical interdisciplinarity. Until researchers acknowledge that methodology is merely a human-designed tool to interpret reality, unnecessary methodological hyper-specialization will continue to alienate one field of knowledge from the other

Psychiatry and military conscription in Brazil: the search for opportunity and institutionalized therapy.

Since the fall of the Brazilian military dictatorship in 1984, a number of structural and ideological changes associated with demilitarization and democracy have changed the face of psychiatric theory and practice. Around the country, pockets of innovative, politically sensitive and Marxist-inspired community-based forms of "psi" practice are developing. This emergent psi movement is making a range of positive contributions to the lives of average citizens, including those of poor disenfranchized youth. This paper, however, explores one particular dimension of the work of psi practitioners that has proven antithetical to the psi community's current politicized community-based aims. Based on qualitative and quantitative longitudinal ethnographic fieldwork with therapists and young men in Pelotas, this paper analyzes how certain kinds of psi interventions being carried out in schools for a subset of lower-class young men during their early teen years are encouraging some youth to seek military training as a life option. Although these young men initially had quite captivating, engaged and politicized-if also conflicting-interactions with therapists, their eventual disillusionment with their therapeutic and scholastic experiences resulted in high levels of social alienation and de-politicization. In these young men's search for what can best be described as formulaic solutions to troubling psychological experiences associated with a tumultuous institutionalized transition to adulthood, military training came to represent a form of self-cultivation and self-therapy. Several youth also hoped military training would enable them to actively disengage with local political processes and find shelter from troubling social inequities and injustice. The paper ends by reviewing the implications of these results for the future of psi knowledge and practice in Brazil