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"Learning how to deal with feelings differently": Psychotropic medications as vehicles of socialization in
Suparna Choudhury1, Kelly A McKinney2, Laurence J Kirmayer1
1Division of Social and Transcultural Psychiatry, McGill University, 1033 Pine Avenue West, H3A 1A1 Montreal, QC, Canada; Culture and Mental Health Research Unit, Lady Davis Institute for Medical Research, Jewish General Hospital, 4333 Cote Ste Catherine Rd., Montreal, H3T 1E4 QC, Canada.
Abstract:
Drawing from ethnographic research among clinicians working with adolescents at a hospital psychiatric emergency department and outpatient clinic, and with interviews with adolescent psychiatric patients and their parents, we examine how psychiatric medicines function as socializing agents. Although psychiatric medications are thought to exert their main effects through direct biological action on neural circuitry, in fact, their use mobilizes specific kinds of moral discourse and social positioning that may have profound effects on sense of self, personhood, and psychological development. Specifically, our data reveal how clinical discourse around medications aims to enlist adolescents in becoming responsible, emotionally intelligent selves through learning to manage their medications. Among doctors, adolescents and their families, talk about psychiatric medications intertwines narratives of 'growing up' and 'getting well'. Our analysis of case studies from the clinic thus demonstrates that while psychiatric medications are explicitly designed to influence behavior by acting directly on the brain, they also act to structure adolescents' selves and social worlds through indirect, rather than direct causal pathways to the brain.
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