Medical Anthropology: Toward a Third Moment in Social Science?

This article about medical anthropology was inspired by the work of Pierre Bourdieu, specifically, his efforts to reconcile the antinomy of a "social structuralist" and a "cultural constructivist" perspective. These perspectives are often opposed in the literature, but, in Bourdieu's view, human life cannot be studied without taking into account both how individuals are situated within and constrained by social structures and how those individuals construct an understanding of and impose meaning on the world around them. I argue that the special subject matter of medical anthropology--human health--demands that a synthetic approach be taken in our theory and research. I illustrate this argument with examples from my own research on social and cultural factors associated with blood pressure, and I point to other examples of this synthesis in medical anthropology. The results of this research hold promise for the continuing refinement of culture theory.     

When love meets drugs: pharmaceuticalizing ambivalence in post-socialist China

In this article, I examine the interaction between intimacy and psychiatry to explore the ambivalences in the use of pharmaceuticals in psychiatric practice. Of particular interest is how pharmaceuticals come to constitute in multiple ways what pathology is and what form of life needs to be restored, and how psychiatric medications reconfigure the ambivalence of intimacy in post-socialist China. Following the life of Mei, a female psychiatric patient, for two years, I have made a series of discoveries related to medicine and intimacy in China. Specifically, I show that psychopharmaceuticals indicate a diseased body that threatens the intimate bond. They also highlight a socially suffering subject that is in lack of love from the intimate partner who demands the latter’s redemption. I discuss how these multiple and contradicting meanings of psychopharmaceuticals and intimacy are socio-historically situated. Thus, while previous research in medical anthropology criticizes pharmaceuticalization for reducing the socio-political life (bios) to a biological body (zoē), I argue that these life forms co-exist in a pharmaceutical “zone of indistinction” (Agamben, Homo Sacer: Sovereign Power and Bare Life. Stanford University Press, Stanford, 1998), in which they constitute and contradict each other. This discussion warns researchers against falling back into the usual orientation of either biomedicine or the social sciences.     

Understanding the Rise of Consumer Ethnography: Branding Technomethodologies in the New Economy

ABSTRACT   In this article, I aim to contribute to the ongoing discussion on the changing public role of anthropology by exploring the rise of branded ethnographic practices in consumer research. I argue that a juncture in the "New Economy"—the conjoining of corporate interest in branding, technology, and consumers, with vast social changes—may explain the rapid growth of ethnography for consumer research and predict its future direction. An analysis of branded propaganda from ethnographic vendors that claim their technology-enhanced methods innovate "classic" anthropological practices discloses the way corporations employ technologically mediated means to focus on the reflexive self in consumer research. In this analysis, I reveal that technological methodologies are central to the production of branded ethnographic practices, as forms of branding and technology legitimate consumer–corporate flows of interaction. The conclusion raises awareness to the ways in which modern branding practices reconstruct anthropology in public discourse. [Keywords: branding, consumer research, ethnography, reflexivity, technology]     

The medicalization of "nature" in the "artificial body": surrogate motherhood in Israel

In this article, I draw on anthropological and feminist scholarship on the body and the nature/culture divide as a framework for understanding the place of surrogate mothers in a conceptual ideology that connects motherhood with nature. I explore links between the medicalization of childbirth in Israel and the personal agency of surrogate mothers as relayed through interviews. Taking the patriarchal context of the Israeli surrogacy law of 1996 into consideration, I underscore surrogates' imaginative use of medical metaphors as tools for the subversion of surrogacy's threatening social connotations. By redefining the surrogate body as "artificial" and locating "nature" in the commissioning mother's body, surrogates adopt medical rhetoric to transform surrogacy from a transgressive act into an alternative route toward achieving normative Israeli national reproductive goals.     

Spiritual hair: dreadlocks and the bodies multiple in Rastafari

In anthropology, the body is theorized, manifested, and experienced in multiple ways that impact medical practice, social life, biopolitics, and spirituality. This article considers the role of ‘dreadlocks’ (matted hair) in the Rastafari spiritual body and, guided by the ‘body multiple’ concept, explores how the symbolic and performative nature of hair articulates with age and gender. Ethnographic data from the United Kingdom suggest the ways dreadlocks are groomed and/or covered vary widely, revealing diversity and changing meanings attributed to matted hair. By focusing on the spiritual aspects of hair, our work shows that dreadlocks and baldness are outward (visible) and inward (hidden) manifestations of a covenant with Jah (the Creator), rather than contrasting social or psychological statements. The hair symbolism debate in anthropology reveals limitations of universalist and reductionist approaches to understanding the human body. Our Rastafari material suggests the body multiple provides a better framework for interpreting (African-inspired) spiritual hair.     

Social Identity and Culture Change on the Southern Northwest Coast

Driven by the participation of Native American people in the contemporary political, cultural, and academic landscape of North America, public and academic discussions have considered the nature of contemporary American Indian identity and the persistence, survival, and (to some) reinvention of Native American cultures and traditions. I use a case study—the historical anthropology of the Native American people of the Oregon coast—to examine the persistence of many American Indian people through the colonial period and the subsequent revitalization of "traditional" cultural practices. Drawing on archaeological data, ethnohistorical accounts, and oral traditions, I offer a reading of how, set against and through an ancestral landscape, traditional social identities and relationships of gender and authority were constructed and contested. I then consider how American Indian people negotiated the new sets of social relationships dictated by the dominant society.     

Linguistic Anthropology in 2008: An Election-Cycle Guide

ABSTRACT   Loosely following the structure of the U.S. election cycle, I identify some of the more important institutions and events that have recently served as venues for field-building scholarly practices and processes in linguistic anthropology. I examine various trends and concerns animating recent publications on language and social life. I discuss the ongoing impact on the field of recent major works that attempt to codify methodological and theoretical approaches to the intersection of language and society. I also consider some of linguistic anthropology's emergent ventures, including new collaborative projects and new proposals for interdisciplinary work. Finally, I discuss some of the political implications of academic specialization, disciplinary boundaries, and impending "generational shift," both in the subdiscipline and the academy generally. I close by raising questions about future directions and possibilities for research in linguistic anthropology and other interdisciplinary enterprises. [Keywords: linguistic anthropology, interdisciplinarity, linguistic ideology, semiotic practices, linguistic variation]     

Giving birth to gonolia: "culture" and sexually transmitted disease among the Huli of Papua New Guinea

The "culture concept" has been challenged on a number of fronts, both by medical anthropologists researching AIDS and in the discipline of cultural anthropology more generally. Medical anthropologists have argued against the "etiologization" of culture, and cultural anthropologists have taken issue with the tendency to treat beliefs and practices as static and seamlessly shared. Using the narrative of one Huli woman's shifting explanation of a diagnosis of syphilis, this article argues that, rather than avoid the notion of culture, we should strive for representations that demonstrate how individuals use discourses in expedient, ad hoc, and yet deeply felt ways. This article also argues for the importance of a sociology of knowledge approach to understanding local notions of etiology. The woman's understanding of her situation was strongly influenced by her entry into a new "community" of women who had similarly been diagnosed with a sexually transmitted disease.     

Ethnography and the Meta-Narratives of Modernity

Current attempts to increase the relevance of sociocultural anthropology encourage anthropologists to engage in the study of modernity. In this discourse dominated by sociologists, the contribution of anthropology is often to reveal cultural diversity in globalization, leading to the notion of multiple modernities. Yet such ethnographic accounts draw upon familiar sociological abstractions such as time-space compression, commodification, individualization, disenchantment, and reenchantment. This article shows how an underlying meta-narrative preempts social scientific argument by making shifts in analytical scales look natural, as in the alleged need to "situate" the particular in "wider" contexts. This analytical procedure undermines what is unique in the ethnographic method-its reflexivity, which gives subjects authority in determining the contexts of their beliefs and practices. Two ethnographic case studies are presented to support this argument, one from Melanesia on current interests in white people, money, and consumption and the other from Africa on born-again Christianity and individuality. The article ends by reflecting not only on the limits of metropolitan meta-narratives in returning relevance to anthropology but also on the contemporary conditions of academic work that undermine the knowledge practices of ethnography and render such meta-narratives plausible.     

Claiming respectable American motherhood: homebirth mothers, medical officials, and the state

Based on ethnographic research regarding public policy and grassroots organizing for midwifery in Virginia, this article explores how medical discourses around appropriate health care practices intersect with state discourses about what practices are considered "respectable" versus "pathological" for its citizens. In recent legislative debates about the legalization of direct-entry midwifery, medical officials have extended their criticism of midwifery and homebirth to mothers who resist state-sanctioned childbirth practices. This article examines how medical officials challenge the respectable mothering practices of homebirthers by linking them with women they deem pathological--child abusers, negligent mothers, and drug users--and placing them outside the cadre of "normal" American mothers who acknowledge the "logical" and "natural" superiority of biomedical childbirth practices. I also address homebirth mothers' responses, which assert that their political advocacy for midwives is a respectable mothering practice because they are responsible citizens who desire what they deem the best care for their children.     

Emotion (or Life,the Universe,Everything)

Emotions are fundamental to human life; they define its quality and motivate action. In the past, social scientists who have studied emotions have treated them as biological, cultural or social phenomena. These approaches have tended to fall on either side of the culturally recognised division between nature and culture, and so have failed to recognise that emotions bridge this division, that they are thought of as both biological and cultural, as consisting of both physical feeling and cultural meaning. In this article, an alternative approach is presented in which emotions are treated as ecological mechanisms that operate in the relationship between an individual human being and their environment. In this approach, which draws on models of emotion proposed by William James and Antonio Damasio, emotions connect individual human beings to their surroundings and play an important role in learning. A focus on the individual as the centre of analytical attention—often referred to as ‘methodological individualism’—is a logical consequence of the ecological approach to emotion, which also has significant implications for the relationships between ecological anthropology and other branches of the discipline, and between anthropology and other disciplines. In the face of an ecological understanding of emotion, all relations, including social relations, become ecological and social anthropology melts into and is subsumed by ecological anthropology. At the same time, anthropology tends to lose its distinctiveness from biology, psychology and other disciplines by focusing on a phenomenon that is of common interest to all the human sciences.     

On the Limits of Life Stages in Ethnography: Toward a Theory of Vital Conjunctures

This article argues for a new anthropology of the life course, one founded in indeterminacy and innovation. The fact that vital life events are rarely coherent, clear in direction, or fixed in outcome dramatically limits the usefulness of the life cycle model. In its place, I propose a unit of social analysis based in aspiration rather than event. I call this the vital conjuncture—integrating the "vital" of demographic vital events with Bourdieu's conception of the conjuncture of structure and action. Vital conjunctures suggest a new way of aggregating life history experiences and thus working between the individual and the social, free from the stultifying assumption of Stapes de vie. To illustrate the usefulness of the concept of "vital conjuncture, I focus on motherhood among young, educated Beti women in southern Cameroon. I demonstrate that rather than a clear threshold into female adulthood, here motherhood is a loosely bounded, fluid status. Contrary both to folk intuition and to the assumptions of a life cycle framework, Beti motherhood is not a stable status. Beti women who have borne children are not necessarily mothers, at least not all the time. Motherhood, instead, constitutes a temporary social status, an agent position that can be inhabited in specific forms of social action. The material offers perhaps an extreme example of what I argue is a more general phenomenon: "life stages" emerge only as the result of institutional projects, their coherence should be an object, rather than an assumption, of ethnographic inquiry. [Keywords: life course, Africa, demography, vital conjuncture]     

Introduction to "Anthropology and Human Rights in a New Key"

In this "In Focus" introduction, I begin by offering an overview of anthropology's engagements with human rights following the American Anthropological Association's (AAA) 1947 "Statement on Human Rights." After offering a rereading of the Statement, I describe the two major anthropological orientations to human rights that emerged in the 1980s and 1990s, following several decades of relative disengagement. Finally, I locate the articles in relation to this history and indicate how, when taken as a whole, they express a new key or register within which human rights can be studied, critiqued, and advanced through anthropological forms of knowledge. This "In Focus" is in part an argument for an essentially ecumenical anthropology of human rights, one that can tolerate, and indeed encourage, approaches that are both fundamentally critical of contemporary human rights regimes and politically or ethically committed to these same regimes.     

"Actually, I don't feel that bad": managing diabetes and the clinical encounter

A major issue for persons treating and managing adult-onset diabetes (NIDDM) is the "problem of compliance." I consider the clinical encounter in the overall context of diabetes management as a punctuated experience focused on the cultivation of an ideal self whose "technologies" and "ethics of self-care" mimic a capitalist logic that links self-discipline, productivity, and health. Both clinicians and their patients share and identify with many of the cultural referents and social values that circulate through medical advice and practice. However, using individual examples, I show how this shared logic can produce idiosyncratic regimes of self-care and clinical practice that result in hybrid medical practices incorporating differing objectives and emphases concerned with a tolerable present or an ideal future. Rather than organizing principles for research and medical practice, I suggest that medical compliance and noncompliance should be considered part of the rhetoric to be explained within the regimes of a pursuit of health.     

Sacred materialism: Things and relations in a US Pagan community

Ever since Marcel Mauss wrote The Gift, the notion that things exchanged as gifts take a personalised social form, and that they partake of and mediate relational sociality, has held an important place in anthropology. Examining material practices among contemporary Pagans in the Reclaiming tradition, this article shows how they seek to imbue things with personhood, exploring the sacredness of things as alive, active and participating in social relations. In doing so, these Pagans work to forge an alternative economy founded on gift exchange and generous labour, which they hope might form a basis for a different kind of sociality from the capitalist system dominant in the United States. In practice, the encounter between gift and commodity forms in this community is a source of both conflict and emergent forms of sociality, as these alternative economic practices are fashioned around the margins of mainstream economic life.     

From "Rights" to "Ritual": AIDS Activism in South Africa

In this article, I investigate how the moral politics of HIV/AIDS activism in South Africa is contributing toward new forms of citizenship that are concerned with both rights-based struggles and with creating collectively shared meanings of the extreme experiences of illness and stigmatization of individual HIV/AIDS sufferers. I argue that it is precisely the extremity of the "near death" experiences of full-blown AIDS, and the profound stigma and "social death" associated with the later stages of the disease, that produce the conditions for HIV/AIDS survivors' commitment to "new life" and social activism. It is the activist mediation and retelling of these traumatic experiences that facilitates HIV/AIDS activist commitment and grassroots mobilization. It is also the profound negativity of stigma and social death that animates the activist's construction of a new positive HIV-positive identity and understanding of what it means to be a citizen–activist and member of a social movement.     

Post-socialism and notions of context in St Petersburg

The anthropology of post-socialism has largely been framed around a suspension of judgement of the so-called 'transition to market capitalism'. In this article I explore this theme as an ethnographic question and ask how social context is marked locally. I argue that while suspending judgements about the nature of context is nearly impossible in a sustained fashion – marriages must be planned, universities attended, etc. – in many ways people have a practical disposition that does in fact resemble the anthropological hesitance to pass judgement. I argue that ways of imagining context have more to do with historically informed practices of personhood and 'pretence' than with crisis and chaos.     

Critical therapeutics: cultural politics and clinical reality in two eating disorder treatment centers

Recent studies suggest that eating disorders are increasing in Mexico and that this seems to correspond with Mexico's push to modernization. In this respect, Mexico exemplifies the acculturation hypothesis of eating disorders, namely, that anorexia and bulimia are culture-bound syndromes tied to postindustrial capitalist development and neoliberalist values, and that their appearance elsewhere is indicative of acculturation to those values. Available evidence for this claim, however, is often problematic. On the basis of five years of comparative fieldwork in eating disorder clinics in Mexico City and a small Midwestern city in the United States, I reframe this as an ethnographic question by examining how specific clinical practices at each site entangle global diagnostic categories with local social realities in ways that problematize existing epistemologies about culture and illness. In this regard, debates about acculturation and the global rise of eating disorders foreground issues of central epistemological and practical importance to contemporary medical anthropology more generally.     

Afterword to "Anthropology and Human Rights in a New Key": The Social Life of Human Rights

In this article, I argue for an ethnographic approach to human rights that recognizes the plural and fragmentary nature of the international rights regime and the ideological promiscuity of rights talk. Instead of determining in advance the social or political character of rights, anthropologists could profitably draw from the insights of early-20th-century "legal realists" and look closely at the underlying assumptions and hidden practices of political and legal processes. Studying the "social life of human rights" would involve focusing on, inter alia, the performative dimensions of human rights, the dynamics of social mobilization, and the attitudinal changes of elite and nonelite social actors towards formulations of "rights" and "justice," both inside and outside the legal process. I conclude with a review of recent anthropological research on human rights epistemology and evaluate its implications for human rights policy.     

An ethics of enchantment: forming affect and information in experimental paediatric medicine

Science and medicine have been cast as disenchanted arenas of modernity, even as scholars have illustrated the many enchantments of everyday life. Taking these conversations into the context of experimental paediatric medicine, I explore the dis/enchantments produced through the research ethics systems that govern interactions between medical practitioners and patients’ families. Research ethics enact forms of disenchantment, aiming to produce the informed patient-subject who can knowingly submit to the unknowns of experimental medicine. However, by following one young patient's emotive disruption of the consent process, I suggest that we instead consider an ethics of enchantment: one that recognizes the affective logics of patienthood alongside the informatic. Elaborating how ethical practice is both institutionally structured and interpersonally improvised, I develop key conversations from the anthropology of ethics, and highlight the interplay of enchantment and disenchantment that constitutes modern medical subjects.