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Assembling the dominant accounts of youth drug use in Australian harm reduction drug education. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2014; 25:663-72. [PMID: 24882707 DOI: 10.1016/j.drugpo.2014.04.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 04/24/2014] [Accepted: 04/26/2014] [Indexed: 11/22/2022]
Abstract
Education programs are a central element of Australian harm reduction drug policy. Considered less judgmental and more effective than the punitive policies of Australia's past, harm reduction drug education is premised on the goal of reducing 'risks' and harms associated with illicit drug use rather than an elimination of use per se. In this article I analyse two sets of key texts designed to reduce drug related harm in Australia: harm reduction teaching resources designed for classroom use and social marketing campaigns that are targeted to a more general audience. I identify two significant accounts of young people's drug use present in Australian harm reduction drug education: 'damaged mental health' and 'distress'. I then draw on some of Deleuze and Guattari's key concepts to consider the harm reducing potential these accounts may have for young people's drug using experiences. To demonstrate the potential limitations of current drug education, I refer to an established body of work examining young people's experiences of chroming. From here, I argue that the accounts of 'damaged mental health' and 'distress' may work to limit the capacity of young drug users to practice safer drug use. In sum, current Australian harm reduction drug education and social marketing may be producing rather than reducing drug related harm.
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Journal Article |
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Gagnon M, Holmes D. Body-drug assemblages: theorizing the experience of side effects in the context of HIV treatment. Nurs Philos 2016; 17:250-61. [PMID: 27435229 PMCID: PMC5035547 DOI: 10.1111/nup.12136] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Each of the antiretroviral drugs that are currently used to stop the progression of HIV infection causes its own specific side effects. Despite the expansion, multiplication, and simplification of treatment options over the past decade, side effects continue to affect people living with HIV. Yet, we see a clear disconnect between the way side effects are normalized, routinized, and framed in clinical practice and the way they are experienced by people living with HIV. This paper builds on the premise that new approaches are needed to understand side effects in a manner that is more reflective of the subjective accounts of people living with HIV. Drawing on the work of Deleuze and Guattari, it offers an original application of the theory of 'assemblage'. This theory offers a new way of theorizing side effects, and ultimately the relationship between the body and antiretroviral drugs (as technologies). Combining theory with examples derived from empirical data, we examine the multiple ways in which the body connects not only to the drugs but also to people, things, and systems. Our objective is to illustrate how this theory dares us to think differently about side effects and allows us to originally (re)think the experience of taking antiretroviral drugs.
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Abstract
While many aspects of social life possess an emotional component, sociology needs to explore explicitly the part emotions play in producing the social world and human history. This paper turns away from individualistic and anthropocentric emphases upon the experience of feelings and emotions, attending instead to an exploration of flows of 'affect' (meaning simply a capacity to affect or be affected) between bodies, things, social institutions and abstractions. It establishes a materialist sociology of affects that acknowledges emotions as a part, but only a part, of a more generalized affective flow that produces bodies and the social world. From this perspective, emotions are not a peculiarly remarkable outcome of the confluence of biology and culture, but part of a continuum of affectivity that links human bodies to their physical and social environment. This enhances sociological understanding of the part emotions play in shaping actions and capacities in many settings of sociological concern.
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14 |
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Abstract
'Frailty' is increasingly used as a clinical term to refer and respond to a particular bodily presentation, with numerous scores and measures to support its clinical determination. While these tools are typically quantitative in nature and based primarily on physical capacity, qualitative research has revealed that frailty is also associated with a range of social, economic and environmental factors. Here, we progress the understanding of frailty in older people via a new materialist synthesis of recent qualitative studies of frailty and ageing. We replace a conception of frailty as a bodily attribute with a relational understanding of a 'frailty assemblage'. Within this more-than-human assemblage, materialities establish the on-going 'becoming' of the frail body. What clinicians refer to as 'frailty' is one becoming among many, produced during the daily activities and interactions of older people. Acknowledging the complexity of these more-than-human becomings is essential to make sense of frailty, and how to support and enhance the lives of frail older people.
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Holmes D, Hammond C, Orser L, Nguyen H. Assembling bodies-without-organs: A poststructuralist analysis of group sex between men. Nurs Philos 2021; 23:e12374. [PMID: 34729896 DOI: 10.1111/nup.12374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/30/2021] [Accepted: 10/17/2021] [Indexed: 11/30/2022]
Abstract
Group sex among men who have sex with men may be understood as a 'radical' practice insofar as it transgresses dominant social discourses around appropriate sexual relations-prioritizing heteronormative, monogamous and risk-averse sex. These practices are generally defined as steeped in risk, most commonly due to the potential for transmitting human immunodeficiency virus and sexually transmitted infections and accompanied by the possibility of legal and social repercussions. Our ethnographic research study explored the desires, practices and contexts of group sex participants (n = 10) within a popular group sex party destination located in the United States. We employ a poststructuralist perspective (utilizing the work of Deleuze and Guattari) to understand group sex events with the pretext that bodies have no inherent ethics, meaning or essence: they are 'bodies without organs'. We identify group sex as a form of boundary play, in which participants pursue new limits to what their bodies can do but within a carefully constructed environment that establishes norms of interaction meant to secure trust and safety between participants. A variety of risk reduction practices are shown to be promoted and honoured within these eventful sexual(ized) spaces. The application of poststructuralist concepts of 'boundary play' and 'bodies without organs' helped to depict the construction and navigation of pleasure, safety and risk among group sex participants.
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Smith A, Olson RE, da Costa NC, Cuerton M, Hardy J, Good P. Quality of life beyond measure: Advanced cancer patients, wellbeing and medicinal cannabis. SOCIOLOGY OF HEALTH & ILLNESS 2023; 45:1709-1729. [PMID: 37283094 PMCID: PMC10946949 DOI: 10.1111/1467-9566.13684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 05/09/2023] [Indexed: 06/08/2023]
Abstract
Experiences of advanced cancer are assembled and (re)positioned with reference to illness, symptoms and maintaining 'wellbeing'. Medical cannabis is situated at a borderline in this and the broader social domain: between stigmatised and normalised; recreational and pharmaceutical; between perception, experience, discourse and scientific proof of benefit. Yet, in the hyper-medicalised context of randomised clinical trials (RCTs), cancer, wellbeing and medical cannabis are narrowly assessed using individualistic numerical scores. This article attends to patients' perceptions and experiences at this borderline, presenting novel findings from a sociological sub-study embedded within RCTs focused on the use of medical cannabis for symptom relief in advanced cancer. Through a Deleuzo-Guattarian-informed framework, we highlight the fragmentation and reassembling of bodies and propose body-situated experiences of wellbeing in the realm of advanced cancer. Problematising 'biopsychosocial' approaches that centre an individualised disconnected patient body in understandings of wellbeing, experiences of cancer and potential treatments, our findings foreground relational affect and embodied experience, and the role of desire in understanding what wellbeing is and can be. This also underpins and enables exploration of the affective reassembling ascribed to medical cannabis, with particular focus on how it is positioned within RCTs.
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Orser L, Holmes D. The Dimensions of Desire Among Gay, Bisexual, and Other Men Who Have Sex With Men (gbMSM): An Evolutionary Concept Analysis. Res Theory Nurs Pract 2023; 37:40-58. [PMID: 36792314 DOI: 10.1891/rtnp-2022-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background and Purpose: Within nursing discourses, the concept of desire among gay, bisexual, and other men who have sex with men (gbMSM) is not well understood. Among nurses, this concept is often constructed as being synonymous with sexual and other risk-taking behaviors, which can influence the type of care nurses provide to gbMSM and affect how this group engages with nurses - and their health. This misinterpretation of what desire represents has resulted in gbMSM becoming the target of public health campaigns and nursing interventions aimed at curbing their deviant behaviors. Such an approach by nurses, however, overlooks the meaning of desire among gbMSM. Methods: To enhance nursing knowledge about, and improve nursing practice for, gbMSM, a concept analysis of desire specific to this group was undertaken using Rodger's evolutionary model. For this analysis, 90 articles reviewed from the disciplines of nursing and allied health, medicine, and psychology. Results: Findings from this analysis revealed a complexity to desire among gbMSM that extended well beyond engagement in radical sexual practices and into dimensions of desire for connection, freedom, and acceptance. These revelations were applied to demonstrate how nurses' beliefs about desire and subsequent regulations for "good health" can inhibit the ways in which desire is produced among gbMSM. Implications for Practice: Such findings demonstrate a need to develop future approaches for nursing practice that recognize the innate value and individual perspectives about desire held by this group, which can be uniquely tailored to meet their health needs.
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Review |
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Johansson JA, Turcotte PL, Holmes D. Assembling packs: Outreach nurses, disaffiliated persons, and sorcerers. Nurs Philos 2024; 25:e12486. [PMID: 38853432 DOI: 10.1111/nup.12486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Accepted: 05/29/2024] [Indexed: 06/11/2024]
Abstract
Nurses working in outreach capacities frequently encounter disaffiliated or 'hard to reach' populations, such as those experiencing homelessness, those who use substances, and those with mental health concerns. Despite best efforts, nurses regularly fail to find meaningful engagement with these populations. Mobilizing the work of Deleuze and Guattari, this paper will critically examine conventional outreach nursing practices as rooted in the royal science of psychiatry, which many 'survivors' of psychiatric interventions reject. The field of Mad Studies offers an understanding of patient resistance to outreach nursing interventions. Delueze and Guattari's concepts of packs and sorcerers provide a framework to envision alternative nursing practices as a form of resistance and creativity, where new alliances may be formed outside the coercive confines of traditional practices. In response to patient resistance, outreach nurses themselves must assemble packs and engage in acts of sorcery.
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Johansson JA, Holmes D. "Recovery" in mental health services, now and then: A poststructuralist examination of the despotic State machine's effects. Nurs Inq 2024; 31:e12558. [PMID: 37127936 DOI: 10.1111/nin.12558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/23/2023] [Accepted: 04/11/2023] [Indexed: 05/03/2023]
Abstract
Recovery is a model of care in (forensic) mental health settings across Western nations that aims to move past the paternalistic and punitive models of institutional care of the 20th century and toward more patient-centered approaches. But as we argue in this paper, the recovery-oriented services that evolved out of the early stages of this liberating movement signaled a shift in nursing practices that cannot be viewed only as improvements. In effect, as "recovery" nursing practices became more established, more codified, and more institutional(ized), a stasis developed. Recovery had been reterritorialized. The purpose of this paper is to examine some of the threads of recovery, from its early days of antipsychiatry activism to its codification into mental health-including forensic mental health-institutions through the lens of poststructuralist philosophers Gilles Deleuze and Felix Guattari. We believe that Deleuze and Guattari's scholarship provides the necessary, albeit uncomfortable, framework for this critical examination. From a conceptualization of recovery as an assemblage, we critically examine how we can go about creating something new, caught in a tension between stasis and change.
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Holmes D, Turcotte PL, Adam S, Johansson J, Orser L. Toward an ontology of the mutant in the health sciences: Re/defining the person from Cronenberg's perspective. Nurs Inq 2024; 31:e12599. [PMID: 37718980 DOI: 10.1111/nin.12599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 08/23/2023] [Accepted: 08/25/2023] [Indexed: 09/19/2023]
Abstract
Traditional health sciences (including nursing) paradigms, conceptual models, and theories have relied heavily upon notions of the 'person' or 'patient' that are deeply rooted in humanistic principles. Our intention here, as a collective academic assemblage, is to question taken-for-granted definitions and assumptions of the 'person' from a critical posthumanist perspective. To do so, the cinematic works of filmmaker David Cronenberg offer a radical perspective to revisit our understanding of the 'person' in nursing and beyond. Cronenberg's work explores bodily transformation and mutation, with the body as a fragile and malleable vessel. Cronenberg's work allows us to interrogate the body in all its complexity, contingency, and hybridity and provides avenues of rupture within current understandings of 'the person'. Reinventing the definition of what it means to be human, critical posthumanism offers opportunities to both critique humanist theories and build affirmative futurities. Also drawing on the work of Deleuze and Guattari, specifically, their concept of becoming, we propose a critical posthumanist alternative to the conceptualization of the person in the health sciences, that of the becoming-mutant, so frequently explored in Cronenberg's films. Such a conceptualization permits the inclusion of various technological interventions of the contemporary subject: The postperson. This position offers the health science disciplines a radical reconceptualization of the conceptual and theoretical approaches, extending beyond those trapped within the quagmire of humanistic principles.
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Whyke TW, Brown MS. Becoming-Perverse: Queering Sworn Brotherhood in the Non/Human Realm of Songzhuxuan's Hailiwa and Daokousu. JOURNAL OF HOMOSEXUALITY 2022; 69:1185-1203. [PMID: 33872137 DOI: 10.1080/00918369.2021.1912556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This article examines the pornographic representation of Hailiwa and Daokousu, from Songzhuxuan's novel Yaohu Yanshi, where a sworn brotherhood incorporates an egalitarian homosexual relationship, something highly unusual in the Qing context in which sexual acts, including same-sex ones, were intelligible only via unequal hierarchies. In so doing we explore the queer potentialities of sworn brotherhood, signifying fraternity, friendship and a sexual relationship simultaneously. Drawing on Deleuze and Guattari, queer theory, and Giffney and Hird's concept of the non/human, we argue this tale and its wider genre enriches the scope of what we might term "queer literatures" in offering us historically and culturally situated stories of desire that refuse to confine themselves to the binaries that supported conventional premodern Chinese understandings of gender and sexuality-including the Confucian model of the heterosexual family unit, but also the highly hierarchical notions of sexual status underpinning Qing conceptualizations of sexual acts.
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Gordon R, Harada T, Spotswood F. The body politics of successful ageing in the nexus of health, well-being and energy consumption practices. Soc Sci Med 2022; 294:114717. [PMID: 35033799 DOI: 10.1016/j.socscimed.2022.114717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 01/04/2022] [Accepted: 01/08/2022] [Indexed: 10/19/2022]
Abstract
In this paper, we introduce the idea of the bio-socio-material body to think through the body politics that emerge within the nexus of health, well-being and domestic energy consumption as people age. Our work draws upon an ethnographic study with older Australians in regional New South Wales, Australia. We enrich social practice theory conceptualisations by foregrounding the body as a dynamic bio-socio-material entity that shapes and is shaped by practices. In doing so, we draw attention to the body politics of managing health, well-being and energy consumption while trying to age successfully. We identify that the bio-socio-material dimensions of the body play an important role in how health, well-being and energy practices are performed. Energy practices are bound up in understandings of health and well-being as an ongoing and contingent process. Here, the use of energy and appliances becomes integral to how people negotiate and work towards successful ageing. We found that embodied practices of health, well-being and energy consumption are linked to biological, emotional, affective, social and material concerns that create body politics. These include tensions and challenges relating to health and vitality, caring for the sick and the dying, maintaining good mental health, the affordances of buildings and appliances, energy affordability and billing anxiety, social connectedness, and pleasures and pains. We raise questions emerging from our research on the implications for successful ageing. We call for attention to how health, well-being and energy are imbricated and for policy and programmes that better support older people to navigate the nexus of health, well-being and energy consumption as they age.
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Keating TP, Williams N. Geophilosophies: towards another sense of the earth. SUBJECTIVITY 2022; 15:93-108. [PMID: 36120081 PMCID: PMC9471036 DOI: 10.1057/s41286-022-00138-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 06/15/2023]
Abstract
The relationship between 'philosophy' and the 'geo' has received renewed attention with the rise of the terrestrial and the planetary as leitmotifs for thinking about the collective subjectivation of particular kinds of world. In some of these conversations, this relationship is developed to consider how social collectives emerge with the production of particular kinds of territorial abstraction. Three decades since Gilles Deleuze and Félix Guattari published What is Philosophy?, book that has a lasting legacy in developing geophilosophy as a particular mode of transcendental empirical enquiry, this special issue revisits the relationship between geophilosophy and the production of an alternative sense of the earth. In this introduction, we approach geophilosophy in its pluralism by showing how the concept does not only concern the question of how to retain a sense of difference and contingency in thought, but also concerns a mode of enquiry that presents opportunities to experiment with alternative forms of collective subjectivation. Assaying the legacy of Deleuze and Guattari's geophilosophy on contemporary forms of earth-thinking, the article identifies the unique demands and geophilosophical possibilities taken up by the contributors to this issue that question how to recuperate another sense of the earth.
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Editorial |
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