Abstract
In the late 1990s researchers in Pelotas Southern Brazil began documenting what they considered to be unacceptably high rates of licensed psychotropic use among individuals of all ages, including youth. This came as a surprise, since the vast majority of psychiatrists in Pelotas draw on psychoanalytic theory and approach pharmaceutical use, especially for children and adolescents, in a consciously tempered way. Drawing from a longitudinal ethnographic sub-study, part of a larger 1982 birth cohort study, this paper follows the circuitous trajectories of emergent pharma-patterns among “shantytown” youth over a ten-year period, exploring the thickly layered and often moralized contingencies in which psychodynamic psychiatrists' intention to resist excessive pharmaceuticalization both succeed and crumble. I juxtapose these trajectories with the growing salience of an “anti-biologizing” explanatory framework that psychiatrists and researchers are using to pre-empt the kind of diagnostics-driven “biopsychiatrization” so prevalent in North America. My analysis suggests that psychiatrists' use of this framework ironically contributes to their failed attempts to “resist” pharmaceuticalization.
Highlights
In the 1990s researchers in Pelotas, Southern Brazil, began documenting what they considered to be unacceptably high rates of psychotropic use among individuals of all ages (Rodrigues et al, 2006)
Data suggested that much of this use resulted from prescriptions written by psychiatrists, yet the vast majority of psychiatrists in Pelotas are psychodynamic in orientation and though they have been prescribing medications since the 1950s, they have always done so in a consciously tempered and temporary way, subservient to the deeper work of psychodynamic therapy
The narrative reconstructions that Juliane, Rosane, and their therapists ended with e narratives of the resilient powers of psychoanalytic self-making on the one hand and of the reductionist powers of bioepistemic authority on the other e represent an explanatory model that many in the social sciences share
Summary
In the 1990s researchers in Pelotas, Southern Brazil, began documenting what they considered to be unacceptably high rates of psychotropic use among individuals of all ages (Rodrigues et al, 2006). Of the various ways of knowing that are at play, I give specific attention the increasingly salience of an anti-biopsychiatric episteme. Among the many consequences produced by this entanglement is this one: reliance on explanatory models of how biopsychiatric logics hold sway (or can be resisted) diverts attention from the broader moral, social, structural, and economic contingencies that drive (or circumvent) pharmaceuticalization. This reliance paradoxically contributes to psychiatrists' failed attempts to “resist” pharmaceuticalization, helping to produce an emergent biotherapeutic form
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