The Psychotropic Self/Imaginary: Subjectivity and Psychopharmaceutical Use Among Heroin Users with Co-Occurring Mental Illness

Many people diagnosed with mental illnesses struggle with illicit drug addiction. These individuals are often treated with psychiatric medications, yet little is known about how they experience this treatment. Research on the subjective experience of psychiatric medication use highlights the complex, contradictory, and ambiguous feelings often associated with this treatment. However, for those with mental illness and addiction, this experience is complicated by the need to manage both psychiatric medication and illicit drug use. Using ethnographic data from a study of heroin use in Northeast Ohio, we explore this experience by expanding the pharmaceutical self/imaginary (Jenkins, Pharmaceutical Self: The Global Shaping of Experience in an Age of Psychopharmacology, School for Advanced Research Press, Santa Fe, NM, 2010b) to include psychopharmaceuticals and illicit drugs, what we call the psychotropic self/imaginary. Through this lens we explore the ways participants interpret and manage their psychotropic drug use in relation to sociocultural, institutional, and political–economic contexts. This analysis reveals how participants seek desired effects of legally prescribed and illicit drugs to treat mental illness, manage heroin addiction, and maintain a perceived “normal” self. Participants manage their drug use using active strategies, such as selective use of psychiatric medications, in the context of structural constraints, such as restricted access to mental health care, and cultural contexts that blur distinctions between “good” medicines and “bad” drugs.     

From “Lists of Traits” to “Open-Mindedness”: Emerging Issues in Cultural Competence Education

The incorporation of “culture” into U.S. biomedicine has been increasing at a rapid pace over the last several decades. Advocates for “cultural competence” point to changing patient demographics and growing health disparities as they call for improved educational efforts that train health providers to care for patients from a variety of backgrounds. Medical anthropologists have long been critical of the approach to “culture” that emerges in cultural competence efforts, identifying an essentialized, static notion of culture that is conflated with racial and ethnic categories and seen to exist primarily among exotic “Others.” With this approach, culture can become a “list of traits” associated with various racial and ethnic groups that must be mastered by health providers and applied to patients as necessary. This article uses an ethnographic examination of cultural competence training to highlight recent efforts to develop more nuanced approaches to teaching culture. I argue that much of contemporary cultural competence education has rejected the “list of traits” approach and instead aims to produce a new kind of health provider who is “open-minded,” willing to learn about difference, and treats each patient as an individual. This shift, however, can ultimately reinforce behavioral understandings of culture and draw attention away from the social conditions and power differentials that underlie health inequalities.     

“Girney” vocalizations among Japanese macaque females: Context and function

One vocalization in the Japanese macaque (Macaca fuscata) system of communication is the “girney.” Previous studies indicated that the “girney” is used for short range communication and that it tends to occur when subordinate animals approach and groom dominant ones and when females without infants approach females who have infants. Data were collected on the social behavior of adult female Japanese monkeys of the Arashiyama-A troop in Texas in order to test those results. The study indicates that “girneys” are the most frequently occurring vocalizations of females during and following the birth season and that they occur primarily in two contexts. Those are the proximity of a female to another female with a new infant and the proximity of a lower ranking animal to a higher ranking one. The contexts are ones in which the risk of aggression is high, and the “girneys” appear to function as appeasement gestures to reduce the risk.     

Culture,Stress and Recovery from Schizophrenia: Lessons from the Field for Global Mental Health

This cultural case study investigates one U.S. psychosocial rehabilitation organization’s (Horizons) attempt to implement the recovery philosophy of the U.S. Recovery Movement and offers lessons from this local attempt that may inform global mental health care reform. Horizons’ “recovery-oriented” initiatives unwittingly mobilized stressful North American discourses of valued citizenship. At times, efforts to “empower” people diagnosed with schizophrenia to become esteemed self-made citizens generated more stressful sociocultural conditions for people whose daily lives were typically remarkably stressful. A recovery-oriented mental health system must account for people diagnosed with schizophrenia’s sensitivity to stress and offer consumers contextually relevant coping mechanisms. Any attempt to export U.S. mental health care practices to the rest of the world must acknowledge that (1) sociocultural conditions affect schizophrenia outcomes; (2) schizophrenia outcomes are already better in the developing world than in the United States; and (3) much of what leads to “better” outcomes in the developing world may rely on the availability of locally relevant techniques to address stress.     

Acquisition and transfer of visual Go/No-go discrimination by a chimpanzee

An adolescent female chimpanzee was trained to press a key in the presence of a computer-graphic geometric figure (“Go” stimulus) within 5 sec and not to press the key during 5-sec presentations of another figure (“No-go” stimulus) with food reinforcement. In the acquisition training, the accuracy of performance increased primarily as a result of learning to inhibit key presses in No-go trials. The chimpanzee acquired this “Go/No-go” visual discrimination task in 1,260 trials. She was then given 14 successive transfer problems. The results for these problems suggested that learning-set formation and repeated use of the same discriminative stimuli both influenced transfer to new problems.     

Iota-carrageenan from a newly farmed, rare variety of eucheumoid seaweed—“endong”

A seaweed with the local name “endong” is a rare eucheumoid variety that has recently been farmed in Tawi-Tawi, southern Philippines. Local farmers describe it as “eel-like” because of its long, slender and smooth thalli. Being somewhat similar in appearance to the dominantly farmed seaweed “tambalang” (Kappaphycus alvarezii var. tambalangii), farmers mix their harvests of “endong” with those of “tambalang”. We analyzed the hydrocolloid extract from “endong” using spectroscopic and chemical techniques. The extract’s infrared and nuclear magnetic resonance (¹H and ¹³C) spectra, and sulfate and 3,6-anhydrogalactose contents revealed carrageenan of the iota-type, similar to extracts from another farmed species, Eucheuma denticulatum. This result implies that “endong” carrageenan exhibits physico-chemical properties different from those of kappa-carrageenan of “tambalang”. The findings of this study are of significance to the seaweed industry, as carrageenan quality problems could potentially arise from a mixed harvest. Seaweed farmers are advised to separate their harvests of “endong” and “tambalang”. Presented at the 19th International Seaweed Symposium, Kobe, Japan     

The Construction of “Cultural Difference” and Its Therapeutic Significance in Immigrant Mental Health Services in France

Since the early 1970s, the French public health system has been accorded considerable responsibility for immigrants identified by the educational, judicial or social service authorities as psychologically distressed or socially disruptive. In this paper we discuss three models of healing embedded in constructs of “cultural difference” and addressed at specialized mental health-care centers catering to immigrants in Paris: “cultural mediation,” transcultural psychiatry/ethnopsychiatry and clinical medical anthropology. Based on observations and interviews at three specialized mental health centers in Paris, we explore how these clinical approaches address migrant wellbeing and seek to resolve crises in migrant families, especially those of West African origin. We suggest that the prevalent approaches to therapy creatively blend concepts and practices of anthropology, psychiatry and psychology but, at the same time, confront challenges inherent in the use of a generic “African” healing modality. Cases studies demonstrate that in order for such interventions to be perceived as effective by patients, “cultural difference” must be acknowledged but also situated in broader social, political and economic contexts.

Caring Through Restraint: Violence,Intimacy and Identity in Mental Health Practice

In this article, I discuss the meanings of “restraints,” or physical intervention strategies that are used at a total institution for mentally ill adolescents in the United States. This paper argues that this particularly complex form of mental health treatment is simultaneously a violent and an intimate way in which men relate to one another and also takes on complex meanings about trust and identity in mental health recovery. Using data from 18 months of ethnographic fieldwork at one residential treatment center, this article examines what restraints reveal and embody about intimate interpersonal staff/client relationships, how Black men relate to one another in this setting and how staff members use physical interventions to link institutional mental health treatment with street violence in the outside world. I conclude that understanding these meanings of restraints provides a valuable way of understanding local knowledge in mental health practice, treatment and recovery.     

Saving camels from straws: how propagule pressure-based prevention policies can reduce the risk of biological invasion

Nonnative species that harm or have the potential to cause harm to the environment, economy, or human health are known as invasive species. Propagule pressure may be the most important factor in establishment success of nonnative species of various taxa in a variety of ecosystems worldwide, and strong evidence is emerging that propagule pressure determines both the scale of invasion extent and impact. In a limited way, the US government is applying a “propagule pressure approach” in a variety of prevention policy contexts aimed at minimizing the impact of harmful organisms. However, there are also readily apparent opportunities for enacting propagule pressure-based measures to fill current gaps in invasive species prevention and control at national, state, and local levels. An explicit focus on propagule pressure-based policies could substantially increase the effectiveness of US efforts to prevent the introduction of invasive species through by intentional and unintentional introductions. The views expressed in this paper are solely those of the authors and do not necessarily reflect those of the US government. “As the last straw breaks the laden camel’s back...” -Charles Dickens, Dombey and Son     

Are Animals Just Noisy Machines?: Louis Boutan and the Co-invention of Animal and Child Psychology in the French Third Republic

Historians of science have only just begun to sample the wealth of different approaches to the study of animal behavior undertaken in the twentieth century. To date, more attention has been given to Lorenzian ethology and American behaviorism than to other work and traditions, but different approaches are equally worthy of the historian’s attention, reflecting not only the broader range of questions that could be asked about animal behavior and the “animal mind” but also the different contexts in which these questions were important. One such approach is that represented by the work of the French zoologist Louis Boutan (1859–1934). This paper explores the intellectual and cultural history of Boutan’s work on animal language and the animal mind, and contextualizes the place of animal behavior studies within late-nineteenth-and early-twentieth-century French biology. I explore the ways in which Boutan addressed the philosophical issue of whether language was necessary for abstract thought and show how he shifted from the idea that animals were endowed with a purely affective language to the notion that of they were capable of “rudimentary” reasoning. I argue that the scientific and broader socio-cultural contexts in which Boutan operated played a role in this transition. Then I show how Boutan’s linguistic and psychological experiments with a gibbon and children provide insights into his conception of “naturalness.” Although Boutan reared his gibbon at home and studied it in the controlled environment of his laboratory, he continued to identify its behavior as “natural.” I specifically demonstrate the importance of the milieu of the French Third Republic in shaping Boutan’s understanding not only of animal intelligence and child education, but also his definition of nature. Finally, I argue that Boutan’s studies on the primate mind provide us with a lens through which we can examine the co-invention of animal and child psychology in early-twentieth-century France.     

Ecological explanations for successful invasion of exotic plants

The intentional introduction of exotic species can increase the level of local biodiversity, enrich people’s material lives, and bring significant social and economic benefits that are also the symbols of human progress. However, along with the frequent intercourse among countries and regions, the frequency of uncontrolled crossregional migration of species is increased and there is a lack of scientific management strategy for the intentional introduction of exotic species. Exotic species invasion, which is behind habitat fragmentation, has become the second largest threatening factor to the maintenance of the global-scale level of biological diversity. Exotic species invasion can destroy the structure of an ecosystem, disturb the economic life of a society, and do harm to human health. In this paper, the authors review some of the ecological explanations for issues such as “what causes or mechanisms have led to the successful invasion of exotic species”, including the “ideal weeds characteristics”, “biodiversity resistance hypothesis”, “enemies release hypothesis”, “evolution of increased competitive ability hypothesis”, “niche opportunity hypothesis”, and “novel weapon hypothesis”. The authors also analyze and evaluate the background and theoretical basis of the hypotheses, providing explanations for some phenomena, as well as the deficiencies of these explanations.     

Magical Flight and Monstrous Stress: Technologies of Absorption and Mental Wellness in Azeroth

Videogame players commonly report reaching deeply “immersive” states of consciousness, in some cases growing to feel like they actually are their characters and really in the game, with such fantastic characters and places potentially only loosely connected to offline selves and realities. In the current investigation, we use interview and survey data to examine the effects of such “dissociative” experiences on players of the popular online videogame, World of Warcraft (WoW). Of particular interest are ways in which WoW players’ emotional identification with in-game second selves can lead either to better mental well-being, through relaxation and satisfying positive stress, or, alternatively, to risky addiction-like experiences. Combining universalizing and context-dependent perspectives, we suggest that WoW and similar games can be thought of as new “technologies of absorption”—contemporary practices that can induce dissociative states in which players attribute dimensions of self and experience to in-game characters, with potential psychological benefit or harm. We present our research as an empirically grounded exploration of the mental health benefits and risks associated with dissociation in common everyday contexts. We believe that studies such as ours may enrich existing theories of the health dynamics of dissociation, relying, as they often do, on data drawn either from Western clinical contexts involving pathological disintegrated personality disorders or from non-Western ethnographic contexts involving spiritual trance.     

The Patient’s View: Issues of Theory and Practice

Almost all the knowledge now produced about psychiatry includes what is called “the patient’s or client’s perspective.” This paper analyzes how this notion has been framed in the discourses on mental health over the last two decades, particularly in mental health research and in anthropology. The very concept of the “patient’s perspective” is a social and historical construct. Despite its remarkable prevalence, the notion remains vague. Mental health research pictures it as a stable attribute of the individual. Anthropologists integrate the contextual nature of the patient view; but they still largely envision the psychiatric patient as a rational actor producing narratives based on common sense. However, in psychiatric practice, the client’s perspective is not something the patient individually produces; it is rather shaped by and in a context. To explore this process, my research investigated interactions between staff and patients in a French community mental health center, and showed that the client’s perspective is the result of a collective process. Further analysis demonstrates that eliciting or producing the patient’s view is sometimes considered a therapeutic goal in itself, since being granted the status of a rational and narrative actor gives access to the most valued model of care, one that is based on partnership. Being an outcome that is negotiated between patients and care providers, the “patient’s view” then becomes a new resource in mental health settings.

Spiritist Psychiatric Hospitals in Brazil: Integration of Conventional Psychiatric Treatment and Spiritual Complementary Therapy

In Brazil, during the XX century, dozens of Spiritist psychiatric hospitals emerged seeking to integrate conventional medical treatment with complementary spiritual therapy. This combined inpatient treatment is largely found in Brazil, where many psychiatric hospitals stem from the Spiritist movement. The present report describes the use of these spiritual practices, their operating structure, health professionals involved, modalities of care, and institutional difficulties in integrating spiritual practices with conventional treatment in six leading Brazilian Spiritist psychiatric hospitals. These hospitals combine conventional psychiatric treatment with voluntary-based spiritual approaches such as laying on of hands (“fluidotherapy”), lectures regarding spiritual and ethical issues, intercessory prayer, spirit release therapy (“disobsession”) and “fraternal dialogue”. The non-indoctrination and optional nature of these spiritual complementary therapies seem to increase acceptance among patients and their family members. In conclusion, the Spiritist psychiatric hospitals in Brazil have, for more than half a century, provided an integrative approach in the treatment of psychiatric disorders, associating conventional and spiritual treatments, more specifically Spiritist therapy. The lack of standardized treatment protocols and scientific studies remain a barrier to assessing the impact of this integrative approach on patients’ mental health, quality of life, adherence, and perceived quality of treatment.     

Two types of using of space in the resident common shrews <Emphasis Type="Italic">Sorex araneus</Emphasis> L.

The home range of resident animals is considered as “familiar area” including a “foraging area.” It has been revealed that the activity of an average animal unit in the “foraging area” could be approximated by normal distribution. Estimation of activity distribution in the “familiar area” (beyond the “foraging area”) was impeded by means of marking since it might be difficult to record distant movements, and the method does not provide an essential body of data. In the case of the common shrew Sorex araneus, the “familiar area” was estimated using pitfall as animals evade them in the known areal. The “foraging area” radius of the average shrew was taken to be 30 m (95% of the animal unit activity), the radius of “familiar area” was within the range of 180–240 m. The “foraging area” was expected to provide the animal with vital resources, and the “familiar area” reflects its need for exploratory activity.     

Has time come for a re-assessment of spa therapy? The NAIADE survey in Italy

Goal of this study was to investigate whether appropriately applied spa therapy in several indications could be associated with a subsequent fall in the need for costly health services and missed working days due to sick-leave. The Naiade project was a multicenter observational, longitudinal, questionnaire-based study comparing an “entry” inquiry addressed to patients before an entry thermal cycle, and a “return” inquiry after 1 year. Routine statistical methods were used for comparisons. The study was carried out in 297 of the 340 certified Italian spa centers. Inquiries were managed by the spa doctor(s), with the collaboration of family doctors, and when necessary, hospitals, other health services, labour offices and employers. After exclusion of regular customers and of patients with acute disease phases or severe health conditions, 39,943 patients divided into eight diseases subgroups (rheumatic, respiratory, dermatologic, gynaecologic, otorhynologic, urinary, vascular and gastroenteric) underwent entry inquiry and appropriate spa treatment. Patients who returned for treatment after 1 year (“index year”) were 23,680 (59.2%) and received return inquiry. Outcomes considered were: frequency and duration of hospitalisation periods; missed working days; regular use of disease-specific drugs; and resort to “non-spa” rehabilitation therapies. The data collected at return inquiry were compared with those of entry inquiry. All the considered outcomes appeared to be significantly reduced in the index year in seven of the eight disease subgroups in comparison with the previous year. In conclusion, disease-appropriate spa treatments were followed by a reduction in the need of subsequent health interventions in most disease subgroups. The health promoting value of spa treatments should therefore undergo more rigorous assessment with randomised controlled studies.     

Genomic medicine and neurological disease

“Genomic medicine” refers to the diagnosis, optimized management, and treatment of disease—as well as screening, counseling, and disease gene identification—in the context of information provided by an individual patient’s personal genome. Genomic medicine, to some extent synonymous with “personalized medicine,” has been made possible by recent advances in genome technologies. Genomic medicine represents a new approach to health care and disease management that attempts to optimize the care of a patient based upon information gleaned from his or her personal genome sequence. In this review, we describe recent progress in genomic medicine as it relates to neurological disease. Many neurological disorders either segregate as Mendelian phenotypes or occur sporadically in association with a new mutation in a single gene. Heritability also contributes to other neurological conditions that appear to exhibit more complex genetics. In addition to discussing current knowledge in this field, we offer suggestions for maximizing the utility of genomic information in clinical practice as the field of genomic medicine unfolds.     

Source-sink landscape theory and its ecological significance

Exploring the relationships between landscape pattern and ecological processes is the key topic of landscape ecology, for which, a large number of indices as well as landscape pattern analysis model were developed. However, one problem faced by landscape ecologists is that it is hard to link the landscape indices with a specific ecological process. Linking landscape pattern and ecological processes has become a challenge for landscape ecologists. “Source” and “sink” are common concepts used in air pollution research, by which the movement direction and pattern of different pollutants in air can be clearly identified. In fact, for any ecological process, the research can be considered as a balance between the source and the sink in space. Thus, the concepts of “source” and “sink” could be implemented to the research of landscape pattern and ecological processes. In this paper, a theory of sourcesink landscape was proposed, which include: (1) In the research of landscape pattern and ecological process, all landscape types can be divided into two groups, “source” landscape and “sink” landscape. “Source” landscape contributes positively to the ecological process, while “sink” landscape is unhelpful to the ecological process. (2) Both landscapes are recognized with regard to the specific ecological process. “Source” landscape in a target ecological process may change into a “sink” landscape as in another ecological process. Therefore, the ecological process should be determined before “source” or “sink” landscape were defined. (3) The key point to distinguish “source” landscape from “sink” landscape is to quantify the effect of landscape on ecological process. The positive effect is made by “source” landscape, and the negative effect by “sink” landscape. (4) For the same ecological process, the contribution of “source” landscapes may vary, and it is the same to the “sink” landscapes. It is required to determine the weight of each landscape type on ecological processes. (5) The sourcesink principle can be applied to non-point source pollution control, biologic diversity protection, urban heat island effect mitigation, etc. However, the landscape evaluation models need to be calibrated respectively, because different ecological processes correspond with different source-sink landscapes and evaluation models for the different study areas. This theory is helpful to further study landscape pattern and ecological process, and offers a basis for new landscape index design. __________ Translated from Acta Ecologica Sinica, 2006, 26(5): 1444–1449 [译自: 生态学报]