Medication by Proxy: The Devolution of Psychiatric Power and Shared Accountability to Psychopharmaceutical Use Among Soldiers in America\u2019s Post-9/11 Wars

Jocelyn Lim Chua

doi:10.1007/s11013-020-09673-7

Jocelyn Lim Chua

Open Access

https://doi.org/10.1007/s11013-020-09673-7

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Abstract

With the United States military stretched thin in the “global war on terror,” military officials have embraced psychopharmaceuticals in the effort to enable more troops to remain “mission-capable.” Within the intimate conditions in which deployed military personnel work and live, soldiers learn to read for signs of psychopharmaceutical use by others, and consequently, may become accountable to those on medication in new ways. On convoys and in the barracks, up in the observation post and out in the motor pool, the presence and perceived volatility of psychopharmaceuticals can enlist non-medical military personnel into the surveillance and monitoring of medicated peers, in sites far beyond the clinic. Drawing on fieldwork with Army personnel and veterans, this article explores collective and relational aspects of psychopharmaceutical use among soldiers deployed post-9/11 in Iraq and Afghanistan. I theorize this social landscape as a form of “medication by proxy,” both to play on the fluidity of the locus of medication administration and effects within the military corporate body, and to emphasize the material and spatial ways that proximity to psychopharmaceuticals pulls soldiers into relationships of care, concern and risk management. Cases presented here reveal a devolution and dispersal of biomedical psychiatric power that complicates mainstream narratives of mental health stigma in the US military.

Highlights

As a light-wheel vehicle mechanic deployed to Iraq in 2006, Alex had a lot to keep track of during his 15- to 18-h workdays
Make sure that they’re in the hole in the ground, their foxhole.’’ By monitoring the other on the medication, and staying awake and alert in the event that the other needed protection in an indisposed state, Shawn and his friend accumulated empirical knowledge of how the other reacted to the medication and at what dose; each was intimately accountable to the welfare and wellbeing of his fellow corporal in ways reconfigured by psychopharmaceutical use
In circumstances of persistent and enduring conflict, the disciplines and technologies of psychology and psychiatry have been increasingly mobilized by Western militaries to enable their personnel to withstand longer and multiple deployments (Gray 2015: 112)

Summary

Introduction

As a light-wheel vehicle mechanic deployed to Iraq in 2006, Alex had a lot to keep track of during his 15- to 18-h workdays. Short of administering the medications themselves, the attempt to calibrate two team members’ distance from ‘‘the line’’ through antidepressant use suggests the devolution of psychiatric power to military peers: in this case, into the material and institutional contexts and social landscape of elite soldiering. This is a type of medication by proxy, wherein team members call upon a combination of lay and expert knowledge in order to shape, and perhaps coerce, the behavioral potentials of peers. Can psychotropic medication diffuse across soldier relations; so, too, can its lived effects

Experiments in Action

Conclusion