Perspectives on Medical Anthropology

February 7
thetart: One Question on Black AIDS Day: Do We Care Enough To End It?

thetart:

One Question on Black AIDS Day: Do We Care Enough To End It?

August 22
The Spohrs Are Multiplying… | Dollars And Sense

robot-heart:

So the Spohrs are a family who recently lost their daughter, Maddie. When Heather was pregnant with Maddie, she had a lot of very serious complications, and as a result, Maddie was born early and with a series of health problems that ultimately resulted in her death when she was just a little over a year old. The Spohrs are pregnant with another child, and while everything appears to be going much better, Heather is still considered high-risk. Up until this week, she was having an ultrasound done every week in order to make sure nothing was going wrong. However, her insurance is no longer paying for these ultrasounds—everything has gone well with the pregnancy so far, and they no longer deem the ultrasounds “medically necessary”—so they are no longer happening with the same frequency. The Spohrs are, understandably, very upset.

I thought this was relevant to the discussions about a need for healthcare reform. With all the talks of “death panels,” I think it’s incredibly important to remind people that there are insurance companies standing in the way of treatment all of the time. It’s not just some hypothetical horror story in the Wall Street Journal. It’s happening to real people every day.
August 20
600 Ticks (What Therapists Do With Those 10 Minutes) - Psychology Today

psychotherapy:

I live a significant portion of my life in the ten minute gaps between clients. I’ve gotten it down to a science after a dozen years in practice:

  • “Good work today, see you next week.”
  • Write session notes
  • Check voicemail
  • Check email
  • Grab keys, walk 18 paces down the hall to the restroom
  • Find sports drink/Diet Coke/lemon Arrowhead sparkling water in my refreshment drawer (bite of Power Bar optional)
  • Return urgent messages, put the others on my to-do list
  • Pull out file for next client, review previous sessions
  • Gather myself, collect my thoughts, take a deep breath
  • Listen for the waiting room door close
  • “Hi, welcome”

It looks so utilitarian in writing. The list doesn’t do it justice. Those ten minutes are golden.

Don’t get me wrong, I thoroughly enjoy the 50 minutes I’m on the clock - exploring uncharted territory, learning how people think and cope, sharing in “ah ha!” moments. Each work day gives me opportunities for growth, challenge and reward. But those ten minutes between the 10 and the 12 on my clock are vital.

They’re my time to reflect, reset and reload.

As soon as the door closes, I’m at my desk putting into writing the gist of the past 50 minutes. Thorough yet concise, I’m summarizing and evaluating what just happened. Sometimes it’s an emotional breakthrough. Other times it’s gathering data or the client just needed to vent. I’m using a few moments to take stock: where did we go today and where might we go next time, and furthermore, determining how today fits into the overall case conceptualization.

I hit the commode (if nature calls), check messages and evaluate my food/liquid intake because don’t want these needs to intrude upon my sessions. I don’t want to be thinking how much I need to go to the bathroom when a client is grieving his lost childhood. I don’t want to daydream about dinner when someone is deciding whether or not to get a divorce. During sessions, I usually have something to drink on the coaster to my right. Not that I’m dying of thirst, I just don’t want the desire for something to draw away my attention. If it’s there, a muscle-memory away from my right armrest, that much more of my brain can attend to the issue of the moment.

I’m resetting: allowing the last session to pass away, attending to my own needs, re-calibrating my instruments and preparing myself to enter the psychic space of another. It’s like a boxer going back in the corner for some water, a pep talk and a possibly a styptic pen, getting ready for another round. Minus the violence and spit bucket.

Then I reload. I review the file for the next client. I get familiarized with our last few sessions, placing myself back in that mindset. Where are we headed? How did we leave off last time? What unresolved issues are waiting to be addressed? I’ve been blessed with a good memory, so a couple sentences usually trigger all the relationships, events, defenses and assets we’re working on. I have an idea of what we can cover today, but it’s up to the client to chart that course. I find myself eager to get started.

The waiting room door closes. I wait for the big hand to reach 12, and I’m up to open the door. I’m not sure what the next 50 minutes will bring, but I’m excited about the opportunity to reconnect with my client and curious about where we’ll go.

I know some colleagues who see clients back-to-back, no break. They must know something I don’t, because that would never work for me. I believe those ten minutes between sessions are essential for client care and my own mental health. Sometimes clients wonder if they can go overtime a few minutes to finish their thought, or they might want to know if I care enough to bend the rules. What they might not understand is by keeping that ten minutes sacred I am caring for them. I’m modeling good boundaries and self-care, reflecting on their session and making time for the tasks that keep my practice rolling.

Without those 600 ticks, I might not be able to help them as much.

————————

Add check/update silly Tumblr account to that list - and replace ‘diet drink or sports drink’ with ‘coffee’ - and you’ve got me to a tee.
June 22
“ One of the effects of the domination of medical science by men was the adoption of the male body as normal and of the female body as aberrant and less perfect. The female body was always contrasted with the perfect male body and the things that women’s bodies did differently were understood as being not ‘normal’ or not ‘right’. As a result, everything that women did differently was understood as illness. The female body became pathologically unwell (and there is some really interesting work on the way that Victorian women use illness as a means opting out of social normativity- like the being too constitutionally ill to ever marry and so justifying their life of singleness). Pregnancy in particular was understood as an illness and if you read Victorian newspapers, court cases or even literature you frequently come across references to women’s illness, like she was in bed unwell, or she was by the fire ill, and what they mean is she was pregnant, or occasionally in the period shortly after childbirth. As an illness, pregnancy became the domain of doctors (much like woman’s bodies more generally) and woman’s experiences or desires became less relevant as they were not the experts on illness. In this sense, women became completely detached from their pregnancy, which was no longer seen as a natural part of life for many women, but an aberration. A rather wordy history of childbirth. [via] (via anthropophagous)
June 16
sexismandthecity: Enforcement. Acrylic on paper, 16.5” x 30.375” ©1996 Lilith Adler. All rights reserved. “Of course this image is obscene. It’s not intended to be erotic. I painted it to talk about the role of sex in power dynamics. The real question is why is it obscene. Although images of nude women are ubiquitous in Western art, there are relatively few corresponding images of nude men. Of these, most follow the convention established by the Greeks that if a man’s penis must be rendered in art — that is, if it cannot be hidden by cloth or clouds or flying putti — it must be shown baby-sized. The rule is very strict. Mapplethorpe broke this rule — for instance, his Man in the Polyester Suit shows a crotch shot of an enormous black dong sticking out of a fly, and while the blackness of the penis brings up a whole set of other issues, the fact that Mapplethorpe trod on this forbidden ground pushed some people’s buttons in a big way. It made him a pariah and to the new Right, a symbol of what is wrong with art today. I think this hysteria (if I may borrow the word from its etymological description of women) at the sight of an erect male penis has everything to do with men’s fear of rape. Now, I’ve asked men about this. They each categorically denied entertaining any such fear. But a couple of years ago, I saw an article in the Boston Globe about men raped in prison. On describing his experiences, one prisoner said, “It made me feel they could do anything to me they wanted. It made me feel like a woman.” Well that stuck in my mind. The extent to which men fear rape is evident in their curses. Most obvious is “Fuck you,” where the “I” is understood: “I fuck you” or “I fuck you over”. It brings to mind natural history, since this behavior is commonplace among many social mammals. You have just to go to a park to see dominance rituals among dogs: one male will hump another and thereby establish himself as literally a “top dog”. So the object of the game is to be the top dog. A subtlety of this is the expression “blow me!”, which intimates that the man being serviced “has it over” the man performing the service. The expression “I really got fucked” means I got a raw deal: I was the fuckee, not the fucker. To be the fucker is to be in power. To be the fuckee is to submit. Sweet submission. Expected behavior from women, to seek to be dominated, to enjoy submission. It’s in all the songs. A normal woman has been socialized to be masochistic; i.e., neurotic is normal. A woman who is not masochistic just hasn’t met the right man yet. Now, the image in this painting comes about of course because I’ve lived it, but didn’t think much of it until I saw an almost identical quote in a copy of the magazine Deneuve. What I had thought was an ideosyncratic, particular experience turns out to be a kind of underground cliché. A lot of women have heard this line, maybe some men but who would admit? So over the years I’ve given a lot of thought to the idea that a good stiff prick will straighten me out. I’ve found echoes of it in high literature: Ayn Rand’s The Fountainhead, Shakespeare’s The Taming of the Shrew. I see it in James Bond movies, Sharon Stone movies. The notion behind it is that if a woman has her own agenda and therefore is not controllable, it is only because she has not found a man dominant enough to master her. Translation, a woman wants to be raped, that tired old saw. With this ideology, sex has nothing to do with love. Its purpose is to enforce and maintain the social hierarchy within a relationship. The missionary subdues the natives, etc. This recontextualizing act which turns a penis from an instrument of affection to one of domination — from a caress to a bludgeon — is probably the worst perversion you can have between two people. The iron hand in a velvet glove, so to speak. About once a month a murder case is plastered all over the Boston tabloids. Some man has killed his girlfriend. His wife. There was a restraining order out on him, but the police can only do so much… The situation got so bad that the governor (Weld) instituted some legislation to try to combat this epidemic. But the fact that we had a rash of murders is the logical conclusion of the notion that a woman needs to be dominated, broken, controlled. It’s the same impetus that lead John Salvi to shoot up a Brookline abortion clinic. Murder is the ultimate means of control. And that brings me back to my image. You might ask, why did I choose to paint such a handsome man? Well, because he is the romantic hero. He is Cinderella’s Prince, Mary Poppins’s Bert, the savior who finally came — the Protector. And what do you do when you find out this is what your Protector is really about? Who will protect you from your protector? You’re on your own.”

sexismandthecity:

Enforcement. Acrylic on paper, 16.5” x 30.375” ©1996 Lilith Adler. All rights reserved.

“Of course this image is obscene. It’s not intended to be erotic. I painted it to talk about the role of sex in power dynamics.

The real question is why is it obscene. Although images of nude women are ubiquitous in Western art, there are relatively few corresponding images of nude men. Of these, most follow the convention established by the Greeks that if a man’s penis must be rendered in art — that is, if it cannot be hidden by cloth or clouds or flying putti — it must be shown baby-sized. The rule is very strict. Mapplethorpe broke this rule — for instance, his Man in the Polyester Suit shows a crotch shot of an enormous black dong sticking out of a fly, and while the blackness of the penis brings up a whole set of other issues, the fact that Mapplethorpe trod on this forbidden ground pushed some people’s buttons in a big way. It made him a pariah and to the new Right, a symbol of what is wrong with art today.

I think this hysteria (if I may borrow the word from its etymological description of women) at the sight of an erect male penis has everything to do with men’s fear of rape. Now, I’ve asked men about this. They each categorically denied entertaining any such fear. But a couple of years ago, I saw an article in the Boston Globe about men raped in prison. On describing his experiences, one prisoner said, “It made me feel they could do anything to me they wanted. It made me feel like a woman.” Well that stuck in my mind.

The extent to which men fear rape is evident in their curses. Most obvious is “Fuck you,” where the “I” is understood: “I fuck you” or “I fuck you over”. It brings to mind natural history, since this behavior is commonplace among many social mammals. You have just to go to a park to see dominance rituals among dogs: one male will hump another and thereby establish himself as literally a “top dog”.

So the object of the game is to be the top dog. A subtlety of this is the expression “blow me!”, which intimates that the man being serviced “has it over” the man performing the service. The expression “I really got fucked” means I got a raw deal: I was the fuckee, not the fucker. To be the fucker is to be in power. To be the fuckee is to submit.

Sweet submission. Expected behavior from women, to seek to be dominated, to enjoy submission. It’s in all the songs. A normal woman has been socialized to be masochistic; i.e., neurotic is normal. A woman who is not masochistic just hasn’t met the right man yet.

Now, the image in this painting comes about of course because I’ve lived it, but didn’t think much of it until I saw an almost identical quote in a copy of the magazine Deneuve. What I had thought was an ideosyncratic, particular experience turns out to be a kind of underground cliché. A lot of women have heard this line, maybe some men but who would admit? So over the years I’ve given a lot of thought to the idea that a good stiff prick will straighten me out. I’ve found echoes of it in high literature: Ayn Rand’s The Fountainhead, Shakespeare’s The Taming of the Shrew. I see it in James Bond movies, Sharon Stone movies. The notion behind it is that if a woman has her own agenda and therefore is not controllable, it is only because she has not found a man dominant enough to master her. Translation, a woman wants to be raped, that tired old saw.

With this ideology, sex has nothing to do with love. Its purpose is to enforce and maintain the social hierarchy within a relationship. The missionary subdues the natives, etc. This recontextualizing act which turns a penis from an instrument of affection to one of domination — from a caress to a bludgeon — is probably the worst perversion you can have between two people. The iron hand in a velvet glove, so to speak.

About once a month a murder case is plastered all over the Boston tabloids. Some man has killed his girlfriend. His wife. There was a restraining order out on him, but the police can only do so much… The situation got so bad that the governor (Weld) instituted some legislation to try to combat this epidemic. But the fact that we had a rash of murders is the logical conclusion of the notion that a woman needs to be dominated, broken, controlled. It’s the same impetus that lead John Salvi to shoot up a Brookline abortion clinic. Murder is the ultimate means of control.

And that brings me back to my image. You might ask, why did I choose to paint such a handsome man? Well, because he is the romantic hero. He is Cinderella’s Prince, Mary Poppins’s Bert, the savior who finally came — the Protector. And what do you do when you find out this is what your Protector is really about? Who will protect you from your protector?

You’re on your own.”

+
sexismandthecity: tryingtofollow: No Future do something

sexismandthecity:

tryingtofollow:

No Future

do something

June 15
African "Pleasure Hospital" Will Heal Victims of Female Genital Mutilation

sexismandthecity:

morningyerba:

sexisnottheenemy:

The words “pleasure” and “hospital” aren’t joined together very often. On the contrary, they’re usually thought of as mutually contradictory. But in the town of Bobo-Diolasso in the West African nation of Burkina Faso, the new hospital under construction has made that very connection in hundreds of minds. The “pleasure hospital” which is planned to open later this year, will specialize in free clitoral reconstruction surgery to victims of female genital mutilation.
Mariam Banemanie, the president of Voices of Women, says that the operation, in which surgeons recover a few centimeters of embedded clitoris, takes about 20 minutes and about six weeks of recovery. “FGM strips a woman of her ability to enjoy sex,” she says. “The surgery will restore women’s sex lives and confidence in themselves.”
June 9
"Manifesto for Ethnography" by Paul Willis and Mats Trondman

(via anthropophagous)
May 28
Major Changes Loom for Bible of Mental Health

psychotherapy:

Some familiar disorders may be dropped and diagnostic criteria for others are in line for substantial revision in the forthcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V).

Schizoaffective disorder and gender identity disorder are among those that may be on the chopping block, according to members of the working groups leading the revision who spoke here at the American Psychiatric Association annual meeting.

Perhaps more significantly, they said, DSM-V is likely to include dimensional assessments in addition to the familiar symptom checklists from past versions of the “psychiatrist’s bible.”

Since it was first published in 1952, the DSM has provided the definitive word on what is and is not mental illness, with enormous influence within medicine and on the world beyond.

The elimination of homosexuality as a mental illness in the third DSM edition issued in the 1970s, for example, is now widely viewed as a watershed development in changing society’s view from outright hostility to varying degrees of acceptance.

DSM-V is on track to be published in 2012, capping 13 years of literature reviews, commissioned research, and intensive discussions among more than 160 mental health professionals.

(I’d recommend reading the whole article by following the link above - especially if you’re in the psychology/social work/medical field.)
May 22
Anthropology is Not Ethnography

anthropophagous:

My thesis is that anthropology and ethnography are endeavours of quite differet kinds. This is not to claim that the one is more important than the other, or more honourable. Nor is it to deny that they depend on one another in significant ways. It is simply to assert that they are not the same.

Tim Ingold’s 2007 Radcliffe-Brown Lecture at the British Academy [via]