Many factors play a role in determining
why certain mood disorders are more prevalent today than thirty years
ago.
In chapter three of The Face Behind The Mask, Carl Elliott breaks down the social, physical and biographical explanations as to why our American culture has seen a huge boom in the interest in social anxiety disorder and prescription drugs. In 1999, aggressive campaigns began to market and sell a message that the “answer” had been found to help heal or rid your symptoms. The message being passed on to the public was, “Your life is waiting,” and our pill will get you there (Elliott, p. 55).By taking this drug, specifically Paxil, a more socially excepted “you” would be discovered. Television advertisements went directly to consumers suggesting, “their worry and anxiety at home and at work might not be because they are just worries but because they are suffering from a treatable condition” (Rose, p. 213). In the late 1990’s GlaxoSmithKline, manufactures of Paxil began their push to relay the message to consumers and the medical field that a disease does exist for these fears, and anxieties, as does available treatment. Driven and supported by pharmaceutical companies, these advertisements that influenced and persuaded individuals into thinking they are abnormal, created a larger network of power to grow within the drug companies. Elliott describes how the literature and articles around social phobia only just recently became a huge interest to people, especially in the mid-1980s.
“What happened in the mid-1980s to bring about such an explosion of interest in social phobia (Elliott, p. 57)?
Carol Elliott talks about two important events, the revision of the (DSM-III-R) and the emergence of antidepressants to improve social phobia. The first revision of the manual used to diagnose disease and disorders legitimized the term ”social phobia,” along with shaping, forming and defining itself. After being revised once more, an alternative to the original wording was used. This time it was called, “social anxiety disorder- a much softer, patient friendly term” (Elliott, p. 57). While psychiatrist worked to help patients with this social/shyness disorder, their challenge to find a drug or treatment that worked without harsh side effects was hard. Once antidepressants became the drug of choice and altering “aspects of character or behavior,” the shift to medicalize these symptoms (shyness), became the new objection (Elliott, p. 58). With these mood disorders affecting so many people, questions arise about what is going on in our culture that enables and presents situations of stress and feelings of anxiety. As our culture continues to find new pathways for technology to grow, information overload and pressure to conform to new ways of communicating becomes the norm. By promoting drugs to help cope with the new stresses that our modern culture has handed us, a market has been created, which continues to sell addictive products without specifically addressing the bigger aspects that might be causing these phobias. These drugs mask or hide the cause, making it easier to live a facade of happiness. Carl Elliott proposes another important question:
What historical circumstances have possibly led us to this point in our present day modern lifestyles, where companies are compelled to spend $91.8 million dollars to advertise for such drugs like Paxil?
The"Clinical Gaze"
During the 19th century, ideas around treating the body were typically based on physical appearance and bodily behavior. Diagnosis was still based on what the “clinical gaze” was able to link up with visual symptoms (Rose, p.193). Images of the “mad” person were connected to a disorder, just as we diagnose individuals based solely on their “shyness,” something we can see. All these decisions are created from powerful networks of institutions, deciding what is considered “normal” and “abnormal.” In the early 1970s-80s, major shifts in technology, medicine and socio-cultural views on life and death began changing. In the 1980’s, and still today, death was viewed as something “invisible,” secretive and tamed. In the early 1900’s death was accepted as part of life, and now it is something our culture tries to avoid, hide and medicalize. Along with the changing views around death, advancements in technology, computers and electronics were on the move. The early 1980s brought video games (Pac-Man arcade) into households, taking away communication between family members, and isolating children more. All of these factors contribute to our present day culture.
In Nikolas Rose’s article, The Politics of Life Itself, he argues that not only do many drugs used in treating certain mental disorders seek to “pacify and normalize” people, but they attempt to control abnormalities in hopes of placing individuals back into “everyday life” (Rose, p. 210). Are we waiting for that “something” in our lives to kick in just to get us through the day? Which direction and path will you choose to "be happy?" These underlying feelings of disconnect, alienation and competition run so deep in our society that they become part of who we “are,” regardless if you have a disorder or not. The institutions that seek to divide and implant our minds with fear and mistrust create an overflow of paranoia, loneliness and social phobias. We are social “creatures,” not desperate individuals who live alone and in isolation.
Works Cited:
Carl Elliot. 2003. “The Face Behind the Mask” AND “Amputees by Choice.” IN Better Than Well: American Medicine Meets the American Dream. New York: W.W. Norton and Company, 2003. Pp. 54-76, 208-236.
Nikolas Rose, 2007. Neurochemical Selves, IN The Politics of Life Itself: Biomedicine, Power, and Subjectivity in the Twenty-First Century. Princeton: Princeton University Press. Pp. 187-223.
Can't Wait for the Valium to Hit. AngelFire, 24. Feb, 2011. <http://sevuhupi.angelfire.com/the-effects-of-paxil.html>.
The Conjurer . Hieronymus Bosch, 24. Feb, 2011. <http://www.ask.com/wiki/Gaze?qsrc=3044>.
Prozac. Ready to Be Happy, 24. Feb, 2011.<http://www.podcasters3241.wordpress.com>.
“Aspects of globalization jeopardize health by eroding family-based social systems, denigrating the environment with pollution of the water, air, and land, and by disseminating consumerism accentuating the gap between the rich and the poor” (Wiedman, p. 46).
As globalization continues to reshape societies, the connections and relationships that communities once had with their health care system, is reorganized. In chapter 2, Globalizing the Chronicities of Modernity Dennis Wiedman discusses how “sociocultural processes at the global, individual, and local community are the causes of” various metabolic disorders known at MetS (Wiedman, p. 51). According to the World Health Organization, MetS (Multiple Metabolic Syndrome) is composed of a cluster of conditions including diabetes, which is now recognized as a public health concern, and generating worldwide research. Rather than looking at these disorders from a genetic and biological standpoint, Wiedman explains that the body’s response to modernity are reflections of the ongoing “limitations and suffering” that are “socially and culturally defined”(Wiedman, p. 38). With recent studies indicating that disorders such as diabetes and hypertension are reversible, the enthusiasm among communities with the resources to implement these “lifestyle changes” seems promising. While some individuals have the ability to choose what they eat, or how they live, many do not. With failing infrastructures, economic inequalities and challenging “daily occupational situations,” certain populations are at a greater risk for disease and stress.
While governments and businesses try to “stabilize, and standardize” the routine of their techniques used to control our health, the institution grows along with the “people involved” (Wiedman, p. 45). These people involved become forced into a standard of what health should look, and feel like. Wiedman proposes that as individuals move in sync with the “globalized time” of modernity, the risk of developing chronic disease increases. These socially assembled patterns of activity challenge the community of health professionals to look further into the “larger parameter of life situations” (Wiedman, p. 48). One important group of professionals that are involved in helping people with chronic diseases are occupational therapist.
Occupational Therapy focuses on "culturally relevant treatments and opportunities to improve health and well-being for all categories of people, in the United States and around the world."
-Gelya Frank
World War I: Occupational Therapy
During World War I hundreds of "reconstruction aids" (occupational therapist) were trained to help with wartime injuries. This was a time in history that OT was forced into clarifying what role they played in the medical field.
Bedridden soldiers work on knitting
while injured.
Toy making in a psychiatric hospital.
How do we “enhance opportunities for people and families with chronic conditions to live meaningful, purposeful lives” (Frank, p. 231)?
In chapter twelve, Chronic Conditions, Health,and Well-Being in Global Context, occupational therapy and medical anthropology are brought together to propose, that a closer relationship between the two is beneficial to each profession, and important in knowing how to work with chronic conditions. Occupational therapy, along with many other professions that participate in helping individuals and populations with debilitating diseases and disabilities, face the challenge of creating treatments that are “tailored to each individual’s unique needs and interest” (Frank, p. 232). While occupational therapy attempts to heal the body by taking into account the “everyday lived experiences and meanings,” and taking a more holistic approach, their ties to the biomedical world are further separated. Although similar in focus, medical anthropology and occupational therapy have different approaches that if brought together could have powerful effects on changing the way chronic conditions effect everyday life. By breaking down the terminology, and looking at the connection between the social environment and the biological individual, new frameworks for occupational therapist to work in are created. Like many professions, this therapy has protocols to follow, “diagnostic categories, reasoning procedures, treatment goals” and unique techniques used for intervention (Frank, p. 234). It focuses on helping people fully participate in activities in spite of physical and mental limitations regardless of age, sex or status. By adding in the knowledge and research that medical anthropology can offer, I believe that occupational therapist will have a more well rounded approach to working with the body. Just like medical anthropology, it can be hard to visually understand what occupational therapy is, and what this profession actually does.
Therapy for rehab can take place at multiple locations. Patients might be seen in inpatient hospital settings, outpatient private clinics, schools or at their own home. Because occupational therapists serve individuals and communities with various health concerns, their work environments change and vary according to the needs of the individual and population. As chronic health problems are disrupting lives, more interventions are needed to help give opportunities back to those with disabilities and illness. “To promote practice with populations ignored or actively oppressed by mainstream institutions,” the Occupational Therapy without Borders group has formed (Frank, p. 239). These therapists collaborate with NGO’s and local community leaders to work on creating a sustainable economy, while focusing on the positive aspects of “health,” instead of the negatives of disease. This is one way OT is beginning to reach outside the standard medical model of focusing on just the individual. As this profession helps to bring “meaningful activity” back into the lives of the chronically ill and disabled, an increase of healthy, able body citizens will start living successful, independent lives again. By enhancing opportunities in communities, and seeking to understand the environmental barriers that contain, and prevent certain groups of people from being successful, occupational therapy will open new doors for empowerment and survival. Dealing with health at the global or local level, takes “deeper conversations” that include professionals in many health fields including nursing, public health and anthropology (Frank, p.244). One of the first steps in understanding the field of occupational therapy is having more knowledge around techniques used in this healing method, and the physical and mental disorders that could benefit from this work. By realizing what the full potential of occupational therapy is, the closer we get to decreasing health disparities among marginalized populations.
The two videos below demonstrate how occupational therapy can be used in outpatient private settings, as well as looking at international work that has been done by graduate students.
Sources:
Dennis Wiedman, 2010. “Globalizing the Chronicities of Modernity: Diabetes and the New Metabolic Syndrome.” In Chronic Conditions, Fluid States: Chronicity and the Anthropology of Illness. Lenore Manderson and Carolyn Smith-Morris, eds. New Brunswick, NJ: Rutgers University Press. Pp.38-53.
Gelya Frank, Carolyn Baum, and Mary Law. 2010. “Chronic Conditions, Health, and Well-Being in Global Contexts: Occupational Therapy in Conversation with Critical Medical Anthropology.” In Chronic Conditions, Fluid States: Chronicity and the Anthropology of Illness. Lenore Manderson and Carolyn Smith-Morris, eds. New Brunswick, NJ: Rutgers university Press. Pp. 230-246.
Otis Historical Archives. Occupational Therapy World War I era. National Museum of Health and Medicine, 14. Feb, 2011. <http://www.flickr.com/photos/27337026@N03>.
Sensory Integration Therapy Part OneYouTube. <www.youtube.com/embed/qtszqdr4GW4>.
UNM Occupational Therapy Students YouTube. <www.youtube.com/embed/ku4sBTnpyF0>.
Does the body really provide a “solid foundation, a causal locus, of the meaning,” of what it is to be female or male (Laqueur, p. 163)? Are women more “malelike” because their genitals look different, or when they are missing ovaries or breast?
Hannah Wilke (Before getting sick with lymphoma) & Mother
What relationship do we have with specific images of the body, knowing that the backbone of our anatomical history was dominated by a distorted language, and corrupt interpretations of women? Although very different than the images presented in both of the articles this week, I wanted to show two very contrasting photos of the female body. Hannah Wilke, the artist and women on the left, is shown with her mother Selma Butler, who is struggling with breast cancer. Butler is wearing a wig to hide her baldness, able to achieve a “normal” appearance from the neck up. “Breasts, consequently, are comparable to masks in that they veil the complex subject (or subjects) behind them, and, like hair, they are largely accepted as constituent parts of a woman’s normative femininity” (Skelly, 2007). A female body that has two breasts is looked at and interpreted very differently than a body with only one. By removing a breast, the female body is viewed as being less feminine, and lacking sexuality. Wilke herself looks healthy, confident and beautiful, although when she becomes very sick the “mask” comes off and our relationship with her body changes. While watching her mother die, she talked about how the medical procedures took her away, hiding her as if death were a personal shame. She was not going to let this happen to her as she faced her own struggle with illness.
Hannah Wilke dying from lymphoma
Figure 2. Intra Venus Series #4, July 26 and February 19, 1992.
These photographs represent and challenge what it means to be “whole” and female, along with how we “see” the body through our own lens. “Distance from gender and sexuality norms allows us to assess them critically because this distance permits us to suspend or defer our need for them” (Skelly, 2007). What happens when the body is disrupted with disease, and the feminine qualities that we are familiar with disappear? Hannah Wilke used her body as a way to express a message about being a women, and to sometimes critique the "male gaze." While dying from cancer, her performance art and photography took the public closer into the reality of what death looks like. Even though cancer is winning, her photos depict a body still in control, speaking to her audience with power and truth. Her work opened up conversation about identity, gender and sexuality, challenging once again the way women are "objectified by society" and thrown out when they are ill and old. Our history gives insight into the many distorted frameworks created around anatomy, sexuality and gender.
With the “endless new struggles for power and position in the enormously enlarged public sphere of the eighteenth century,” the explanations, and illustrations around the body continued to demonstrate a culturally bound visual (Laqueur, p.152). In chapter 5, Discovery of the Sexes, Thomas Laqueur describes how definitions around the plausible reasons found in the sexual differences between men and women are changing into a new model. “Distant sexual anatomy was adduced to support or deny all manner of claims in a variety of specific social, economic, political, cultural or erotic contexts” (Laqueur, p. 152). As the scientist of this time period began to explore how gender was expressed in reference to biology, the same ideologies around the body succeeded, simply showing the differences in power between men and women. As anatomists begin re-producing illustrations of what the female anatomy should look like, new “complicated constructions,” of the body unfolded (Laqueur, p. 164). The foundations for creating such gender roles seemed drenched in unfinished male dominated observations. Although some photographs are accurate in many ways, the female anatomy carries a sense of presentation with it, marking the time in history and artists responsible for marking their territory. These illustrations are seen through the “varied reality" of the many scientist and artistic interpretations of what the female body should feel and look like (Laqueir, p. 164). The “map” of the body then shows specific features of the female anatomy that they feel are socially acceptable, and suggest a “transcendent norm” (Laqueur, p. 166). Ultimately, this exploration of biological sex has demonstrated ways in which culture has influenced science. With this privileged group of men, making further ideologies around the female body, the cycle of dehumanization continues. Science has been a tool to oppress and legitimize the differences between sex, religion, race and class, only to benefit the most powerful. It has been used to distinguish a “hierarchy” of anatomy, deciding what form is naturally more superior in an attempt to cover up discrimination. By understanding how a certain society of people define what is considered “natural,” and normal, a better knowledge of how this could affect other views on relationships, love and life are seen. Just as the female body was made to look a certain way, so were the ideas around sexual behavior in the late eighteenth century.
By having physicians positioned as “scientific authorities uniquely suited to solving problems confronting the modern world,” acts of sexual behavior were now placed in categories (Terry, p. 40). They were medicalized, and seen as urgent problems to take care of. In Jennifer Terry’s article, Medicalizing Homosexuality, she talks about some of the very same philosophies as Laqueur does concerning sex and gender. Once again it’s easy to see how certain ideas around the body and behavior can, and have led to oppression and inequality. Similar to the explanations of women being inverted men, homosexuals were viewed as having a “condition of inborn sexual inversion,” considered to be unfinished people, and somehow curable (Terry, p.43). With the growing number of medical professionals in the nineteenth century being wealthy, white, comfortable men, the developments around sex grew more powerful only in one direction. This specialization in medicine led to a new language around science that formed even more boundaries and authority around sexuality. Some anatomist in the eighteenth century avoided drawing parts of the body that were “distorted, shriveled, torn or dislocated,” because they failed in meeting the “highest aesthetic standards” (Laqueur, p.167). Visions and illusions of how a particular body part should look like, or what it represents, created a system of power that attempted to contain people that were seen as “abnormal.” By looking back at these perceptions of sexuality during the eighteenth and nineteenth century, many things are revealed that help to breakdown the complex layers of the body and mind.
Works Cited:
Laqueur, Thomas Walter. “New Science, One Flesh.” Making Sex: Body and Gender from the Greeks to Freud. Cambridge, MA: Harvard UP, 1992. 63-148.
Terry, Jennifer. “Medicalizing Homosexuality.” IN As American Obsession: Science, Medicine and, Homosexuality in Modern Society. Chicago: University of Chicago Press, 1999. 40-73.
Goddard, Donald. So Help Me Hannah series1978-81. Ronald Feldman Fine Arts, New York, 10 Feb. 2011 <http://www.thirdspace.ca/journal/article/viewArticle/skelly/48>.
Goddard, Donald. Intra Venus Series # 4 1992. Ronald Feldman Fine Arts, New York, 10 Feb. 2011 <http://www.thirdspace.ca/journal/article/viewArticle/skelly/48>.
Born on the Gamtoos River in the Eastern Cape of South Africa, Sarah Baartman was part of the Khoisan family, currently named the Khoi people. In the Khoisan culture, the body stores more fat around the buttocks and thighs, and Sarah carried even more of it than the others. Although her body looked different, within her culture it was seen as normal, healthy and viewed as something natural. To others, the white upper-class Europeans, the extra fat around her thighs and huge buttocks were seen as something less than human. In 1810 at the age of 20, Sarah was shipped off to London to be paraded around like a circus animal. Her body was seen as “grotesque,” and her genitals described like “skin that hangs from a turkey’s throat.” Not only was she treated like an animal, but her female anatomy was seen as something non-human and said to be the “highest form of animal life and the lowest form of human life.” Her body was viewed by hundreds of 19th century European audiences like a freak show. She was dehumanized over and over again, and looked upon as some kind of ape-like creature.
The ideas, theories and racist images around Sarah Baartman’s journey cannot, and should not be forgotten. The language and power surrounding the body is nothing but dehumanizing in her story, crossing over boundaries, and creating stereotypes that still continue to survive today. I am sure that Sarah had no idea of what her body and mind would have to go through when she left her homeland and stepped on the ship to London. Why is the image of a black woman, in this case Sarah, portrayed as inferior and displayed because of “unusual” features? The dominant European culture was obsessed with having power and authority over others, especially blacks. Sarah’s Khoisan features were said to be of “scientific curiosity,” and considered to represent an oversexed body. Along with these “white” ideals of superiority and sexuality, the center of her story also includes issues surrounding racism and colonialism. Baartman’s journey ties into the article for this week as we look at the historical pathways science has tried to pursue, while searching for the “truth” about the human body. Just as Sarah was put on display for others to gawk at, the female anatomy has a long history of male-dominated ideologies and assumptions.
The history of anatomy during the late Middle Ages and Renaissance is explained through the language and imagery depicted by the dominant culture specific to that time and place. These descriptions and stories are trapped in the institution of “Renaissance medical and physiological theory” (Laqueur, p. 69). They are tied up in “political and cultural order,” and completely leaving out evidence about organs, specifically facts involving the sexual differences between men and women (Laqueur, p. 69). In Thomas Laqueur’s article, Making Sex, Body and Gender from the Greeks to Freud, the practices of looking at the female body during the sixteenth-century represented a powerful and somehow convincing belief that women were simply “inverted men” (Laqueur, p.70). As males dominated the culture, the language behind anatomy was surrounded by a “one-sex body” image, powerful enough to be able to reveal the “inner mysteries” of the genitals, and even the soul (Laqueur, p.74). Even though most images showed the human body with enormous errors and illustrations of distorted female genitalia, the general public at the time in history viewed this to be normal. It was not just one image that turned the clitoris into looking like a penis; it became a serious of ideas taken from multiple representations, not from nature itself. These historical thoughts about anatomy were completely separate from the actual structure and function of what was known about the sexual organs. As ideology instead of fact was determining how the female body was seen, it is easy to see what sexual differences actually mattered and were chosen to be emphasized during this time. The female body did not have a unique language that gave exact anatomical classification for the genitals or for the reproductive system.
Throughout Lagueur’s article the language, imagery and explanations of the female anatomy shifted around, creating a map of the body that was inaccurate, but at the same time powerful enough to continue to deliver a message encouraging the belief of the “one-sex body” model. Clearly it seems most of these white males were caught up in only looking and seeing the body in one way, through a “male centered system” (Laquerur, p. 97). The hierarchy within this male dominated society determined how power and resources were distributed, including language. These relationships around the body are culturally created in ways that place emphasis on women’s social status and the “unique qualities of a woman’s body” (Laquerur, p.108). Already embedded into the dominant language of science was the language of gender, one that was dehumanizing. Like the anatomy maps of the past, illustrations focused their attention on specific features, leaving out certain parts, and placing emphasis on others. Laquerur points out how one of the most compelling features of talking about sex during this time in history was completely contextualized. As women were deprived of existing and separated into someone, or something less human, they entered into the conversations surrounding the body as the subject.
“If you touch that part of the uterus while women are eager for sex and very excited as if in a frenzy, and aroused to list they are eager for a man, you will find it rendered a little harder and oblong……………(Laquerur, p. 113)
Not only does this demonstrate how culturally and politically bound our language was, but how it is still rooted in our everyday communication with each other. I believe today, that there still exist a “man-made fabric which impinges” on most of our experiences (Laquerur, p. 69). I would just add in a “white man-made fabric….” into that sentence. Although I found the article to be somewhat fascinating, I thought it left out other important historical ideologies about the body that are shaping our relationships with the female image today.
Works Cited:
Thomas Laqueur, New Science, One Flesh, IN making Sex, Body and Gender from the Greeks to Freud. Cambridge: havard University Press, 1990. Pp. 63-113
"Formations of Race and Ethnicity." segue.middlebury.edu. 3, Feb 2011. <https://segue.middlebury.edu/view/html/site/amst0227a-f07/node/1361398>.
"Angry Black Women Watch." ABWW Heroine of the Day: Sarah (Saartjie) Baartman. abww.wordpress.com. 3, Feb 2011. <http://abww.wordpress.com/tag/sarah-baartman/>.
In chapter three of The Face Behind The Mask, Carl Elliott breaks down the social, physical and biographical explanations as to why our American culture has seen a huge boom in the interest in social anxiety disorder and prescription drugs. In 1999, aggressive campaigns began to market and sell a message that the “answer” had been found to help heal or rid your symptoms. The message being passed on to the public was, “Your life is waiting,” and our pill will get you there (Elliott, p. 55). By taking this drug, specifically Paxil, a more socially excepted “you” would be discovered. Television advertisements went directly to consumers suggesting, “their worry and anxiety at home and at work might not be because they are just worries but because they are suffering from a treatable condition” (Rose, p. 213). In the late 1990’s GlaxoSmithKline, manufactures of Paxil began their push to relay the message to consumers and the medical field that a disease does exist for these fears, and anxieties, as does available treatment. Driven and supported by pharmaceutical companies, these advertisements that influenced and persuaded individuals into thinking they are abnormal, created a larger network of power to grow within the drug companies. Elliott describes how the literature and articles around social phobia only just recently became a huge interest to people, especially in the mid-1980s.
In Nikolas Rose’s article, The Politics of Life Itself, he argues that not only do many drugs used in treating certain mental disorders seek to “pacify and normalize” people, but they attempt to control abnormalities in hopes of placing individuals back into “everyday life” (Rose, p. 210). Are we waiting for that “something” in our lives to kick in just to get us through the day? Which direction and path will you choose to "be happy?" These underlying feelings of disconnect, alienation and competition run so deep in our society that they become part of who we “are,” regardless if you have a disorder or not. The institutions that seek to divide and implant our minds with fear and mistrust create an overflow of paranoia, loneliness and social phobias. We are social “creatures,” not desperate individuals who live alone and in isolation.
