A Closer Look at Psychopharmaceuticals

As medical anthropology pushes and pries further into the recesses of psychopharmaceutical experience, patient dialogues are being evaluated for critical elements that are involved in shaping universal discourse on psychopharmaceutical usage and for instances of unique reflection that have potential to shape such universals.

A notoriously hard group to study, psychopharmaceutical patients form an amorphous population of entering and exiting members, some being pinched off upon recovery or through non-compliance, some being pushed to the outlying sides likely to be marginalized due to lack of access and many dropped right in the center, with adequate access to and standing prescriptions for medications they will willingly take. With so many subjects slipping interchangeably through the semi-permeable membrane when switching medications, altering treatment regimes, losing access to either prescribing doctors or the drugs themselves, the center becomes opportune for statistically significant findings due to a steady and growing subject pool. I plead for a closer examination of those on the margins, slipping in and out between the confines of the group, as they reflect reflexively upon the vacillating accessibility of psychopharmaceuticals and prescribing professionals to those uninsured as well as the heavy negotiations that must take place when on such medications.
Here are some issues I will approach in the coming months:

1. Non-Compliance. Why don’t mentally ill people just take their meds to get better? Why do people suddenly stop their medications despite doctor’s orders? Why are these medications hard to gain reliable access to? Why do you hear in the news of perpetrators being mentally ill but “off their meds”?
2. Agency and Autonomy in Patienthood. Can the patient really know better than the psychiatrist? Isn’t it dangerous to “play doctor”? Can patients get high off of their meds?
3. The Road to Recovery. Why is it so hard to recover from mental illness despite all the medication options? Can’t people just try harder to get better; i.e. “mind over matter”? Why does it take so long to treat mental illness successfully?
4. The Cocktail. Why do our psychiatrists seem to overmedicate? Do some people really need seven medications a day to function? Are these people just drug addicts? Are “pill-pusher” doctors trying to make money?

These inquiries make up the scaffolding behind my research thesis. I’ve been asked all these questions personally and have seen them addressed by many medical anthropologists. These standing misconceptions persist despite the ever-increasing public exposure biomedical psychiatry has gained in public media as of late. These are also some of the issues that demand attention in order to have productive discussion over the challenges this patient population faces and the ramifications these challenges place on living day-to-day life with a mental illness. The day when my research comes to fruition I hope will prove to be a more hopeful environment for those with mental illness, where there is more understanding and therefore less stigma and, perhaps, a little more lightheartedness surrounding these powerful drugs.

The Anthropologist’s Toolkit

I know some of my readers are non-anthropologists, and I can only hope my writing has illuminated this field at least some to them, so in efforts to demystify the work of a socio-cultural anthropologist, who are often not depicted in the media, I wish to share with you some of the tools and methods behind all the textual material I attempt to put forth.
Of note, before we move on, a socio-cultural anthropologist, while tied to the other fields of anthropology, physical, linguistic and archaeology, employs different methods and materials to produce work. With the number of applied anthropology programs out there in addition to the shifting usages of traditional anthropological mindsets, it is important to distinguish my sub-field from the others.
I primarily do a lot of observational, contextual writings that incorporate little if any quantitative work, although one day, in grad school, I fear this rule may have to bend with a required statistics course, and my subjects are not only people but also spaces and lifescapes. I do not work with bones, pottery, and GPS technology or make use of highly specialized quantitative analysis software. I’m a qualitative gal, through and through and find most pleasure from analyzing semantics, coding narratives and using anthropological language to discuss the characteristics of my subject group. In the past, scientists would most surely scoff at the idea of qualitative researchers wanting a specialized program to organize their data and analyze it in a more systematic way than pouring over field notes and reading articles and so on and so forth until a piece of work is brought forth.

Today, qualitative researchers have many software programs to choose from, based not off of their discipline per se, but based on their data sets and the materials they must work with to produce work. I knew I wanted to gain access to one of these programs before grad school so I can familiarize myself with the way official (i.e. funded) research is managed, not only to make the first semester or two of my program easier but to also have a little bit of an idea on how research outcomes are arrived at and presented based on what tools are at hand. Atlas.ti was the program I found many anthropologists praised and with some of the usual defending of my stance as student, however unofficial, my husband managed to snag me a student license.

Before coming upon this resource, I handled my PDF database of articles shamefully in folders on my desktop with labels I’m sure would’ve made no sense long term. Some of my folder labels included, “current stuff” and “articles I’ve read”, clearly not the most efficient nomenclature. More and more PDFs are downloaded each day (thanks to ever increasing open access sources) and I am at a loss as to how to work effectively and intimately with them without printing them out and taking an old-fashioned highlighter to them. While books and other materials that do not have an accompanying e-format cannot be managed under Atlas, I am glad for that as the highlighter method is elegantly nostalgic.

Atlas has allowed a better management for my articles, sortable by title, publications, author, keywords ect. Excerpting quotes involves no pen scribbles on the back pages of books and the highlights are easily applied and removed. To be so understood by software programmers relays a feeling of acceptance. Anthropologists have long struggled with the distinction of where we belong, in science, the social sciences, humanities, a mix? While the answer I personally land on is the mix concept, being accepted for producing qualitative research is heartening, especially in a climate of poor respect for qualitative work and eminent trust, and therefore funding, in statistics and correlations. This is a sore-spot for me, as I assume it is with other anthropologists, as I feel qualitative data holds its own form of value; I love it and I truly believe in its capacity to cause great change in our world. Here I fight the urge to set a diatribe against the hard sciences and instead I will return to the management of the anthropologist’s tool kit. I anticipate much defense and debate over this matter in the years to come.
Now, Atlas is the only qualitative software I’ve tried; the costs of these programs are often, understandably considering usage, outrageous and schools don’t always have licenses for all the general use computers and rather save this pricey resource for individual discipline’s computer labs. As a non-student, I’ve not had access to any specialized software other than the open access resource Mendeley which has done a fine job of being a holding place for articles stored online and a way to cursorily organize them but in terms of capacity and attributes, it is no more than an article “app” compared to Atlas. Mendeley is free, again, so I am impressed with its standing capabilities none the less.

So, as you have gathered, managing qualitative works is my most pragmatic research concern and methods to organize articles and work with them intimately and easily are gems indeed. Thus far, Atlas has been fun to play around on. Instead of calling new documents “new documents” or “new projects”, they are called Hermeneutic Units! Qualitative nerd bliss! I feel more understood than ever! Coming from the Humanities as an English major into Anthropology, with a substantial background in psychology and philosophy, I never quite felt settled with social scientist as an identity. I’ve read many profound anthropological works that employed no part of the scientific method and the only quantitative data sets were perhaps the ages of the subjects. Furthermore, there isn’t always an element of sociality within a particular project. Regardless, though I feel somewhat liminal academically and not quite fully understood publically, I know qualitative research holds answers to many societal problems that seem to persist despite decades long eradication efforts. Awareness of anthropology’s value is there, however obscured.
Having a tool kit is part of every discipline, and field of work for that matter. I am thrilled I am building one of my own and continuing my professionalization data set by data set, citation by citation and blog by blog.

Many thanks to Atlas.ti for providing me a student license. I would never be able to afford it otherwise and the resources I've gained have helped my studies immensely. Thank you for being one of the entities that have made exceptions and bent rules so I could continue my studies unhindered and still make rent. Next year, in grad school, I will once again have my education expenses subsidized. These years of continuing studies have taught me a wealth of respect for the value of education and, unfortunately, brought a realization that many simply do not have access to higher educational materials, which is disheartening to say the least. I don't hypothesize on the answer to solving this; my future job prospects hinge on the cost of all these resources, but I hope to see things change to allow those either finished with college or not at a point to continue formal education to still have opportunities to learn whatever they want, not what is limited to public libraries and commercial websites.