The Silences of Our Work, Part II: Trauma

Editor’s Note: Today, Points brings you the second in a series of posts on silencing and substance use by Heather Sophia Lee, PhD, LCSW, an Assistant Professor of Family Medicine and Community Health at Rutgers’ Robert Wood Johnson Medical School. You can read the first installment here.

I chose to focus my time as a guest blogger on Points focusing on the Silences of Our Work because, in the academic spaces in which I exist, I am most frustrated by what goes unsaid. The gold standard of “science” calls for ignoring certain variables, so that other variables may be tightly controlled. Our work is silenced by design.

Trauma figures prominently in the lives of many of our clients and their relationship to substances, but is often silenced in our work. I don’t mean that everyone who struggles with alcohol and other drug use has experienced trauma– but many people I’ve worked with have, yet the existence of trauma is largely unacknowledged in mainstream discourse about substance abuse in the United States. In my qualitative interviews and clinical work with participants of harm reduction programs, trauma frequently plays a role in participants’ narratives about their relationship to alcohol and other drugs. Yet in the discourse about these clients, trauma rarely enters the conversation. The “why behind the what” is absent.

Read more

Teaching Points– Ghettos and Prisons: Dynamics of Privilege, Stigma and Segregation in Society

Inside-Out Exchange

Editor’s Note: Continuing our back-to-school series, we today invite you to consider the innovative teaching associated with the Inside-Out Prison Exchange Program. “Ghettos and Prisons” is a class created by Paul Draus, Associate Professor of Sociology and Health Policy Studies in the Department of Behavioral Sciences at the University of Michigan-Dearborn, who for many years was a public health field worker specializing in tuberculosis control, first in New York City and then in Chicago.  Draus is the author of Consumed in the City: Observing Tuberculosis at Century’s End (Temple University Press, 2004), and has written on health issues, behaviors and social contexts related to substance abuse in rural areas.  His current research focuses on community contexts, social networks and work patterns of daily heroin users, former street sex workers and ex-offenders in the city of Detroit.

This course offers a unique opportunity for students at the University of Michigan-Dearborn and students at the Ryan Correctional Facility in Detroit to meet on a weekly basis and explore issues of vital concern to society in a dialogical format.  We will be examining the related issues of segregation and confinement in society, in terms of both processes and places—the ways people are segregated, and the social and physical spaces where they are confined.  As many poets and philosophers have observed, there is more than one way to be imprisoned. According to Rousseau, “man is born free, and everywhere he is in chains.” Or consider the following passage from The Road to Wigan Pier, George Orwell’s account of life in an English coal-mining community, which deals with the oppressive nature of social class in British society:

This business of petty inconvenience and indignity, of being kept waiting about, of having to do everything at other people’s convenience, is inherent in working-class life. A thousand influences constantly press a working man down into a passive role. He does not act, he is acted upon. He feels himself the slave of mysterious authority and has a firm conviction that ‘they’ will never allow him to do this, that, and the other.

In this class we shall consider the case of American ghettos and American prisons, both as social and historical realities in themselves, and as reflections or products of broader tendencies within our society.  In so doing, we will necessarily have to consider the function or purpose of prisons and ghettos, their relationship to other social institutions, their internal cultures and hierarchies, as well as their effects on their inhabitants and on the society as a whole.   Finally, we will consider the question of how segregation and confinement in society may be overcome, and whether or not they should.  In other words, we will ask if change is needed, and if so, what kind?

Read more

Addiction, History and Historians: Ron Roizen’s Response to Courtwright’s Reply

Editor’s Note:  Let’s face it–there was an awful lot to chew on in the recent roundtable on David Courtwright’s essay.  A private exchange between Ron Roizen and David Courtwright has led, with David’s encouragement, to Ron organizing his thoughts as a follow up to David’s reply to our series of commenters.

Nothing Good on, Again.

In a series of recent papers historian David Courtwright has managed to put together some excellent sociology-of-drug-science analyses.(1)  For this he well deserves our congratulations and thanks. Yet, I have reservations about the reply David recently offered to his Points’ commenters.

There’s an echo of Kuhn’s concept of “normal science” in David’s reply – particularly in his optimistic view that future research focused by the “NIDA paradigm” will serve to invite new studies at increasingly complex and interesting levels of inquiry, thus giving rise to new knowledge that might not otherwise have seen the light of day.  The main thrust of David’s reply is that a happy co-existence is possible between NIDA’s reductionist paradigm and the anti-reductionist inclinations of many historians and social scientists.  We in the “softer sciences,” David suggests, should, where appropriate, make use of the brain disease paradigm’s benefits and then turn to our own disciplinary tool kits when our inquiries require them.

I balk at this position for a number of reasons.  First, there is the question of consistency in David’s argument.  I was so taken by the following passage in David’s Addiction article that I fired off the full quotation, via email, to Stanton Peele:

Read more

Stigma on Alcoholism: A Modest Proposal

Erving Goffman: "Spoiled Identity"

It seems to me — and, incidentally, it has seemed to me for a long time — that a key shortcoming in much of the prevailing research and thought surrounding the subject of the stigma on alcoholism stems from a failure to distinguish clearly between the moral and social definition placed upon, on the one hand, the “active alcoholic” and, on the other, that placed upon the successfully abstaining or “recovering alcoholic.”

What I have to offer about this shortcoming and its implications, below, will I’m sure strike more than a few readers as restating the obvious.  Yet, and surprisingly, sometimes even obvious-seeming propositions, when some of their implications are extracted, can generate new conclusions and a counterintuitive perspective on an old topic.  That’s what I have in mind for this post on stigma.  Let’s see how it works out.

Read more