Traumatic landscapes: Two geographies of addiction. (May 2019)

• Record Type: Journal Article
• Authors: Proudfoot, Jesse
• Is Part Of: Social science & medicine. Volume 228(2019)
• Page Start: 194
• Page End: 201
• Publication Date: 2019-05
• Subjects: United States -- Drug addiction -- Therapeutic landscapes -- Health geography -- Trauma -- Case history method -- Psychoanalysis; Social medicine -- Periodicals; Medical anthropology -- Periodicals; Public health -- Periodicals; Psychology -- Periodicals; Medicine -- Periodicals; Medicine -- Periodicals; Médecine sociale -- Périodiques; Anthropologie médicale -- Périodiques; Santé publique -- Périodiques; Psychologie -- Périodiques; Médecine -- Périodiques; Electronic journals; 362.105
• DOI: 10.1016/j.socscimed.2019.03.020
• Languages: English
• ISSNs: 0277-9536

Abstract

Abstract: The confluence of the contemporary opioid crisis and the Great Recession has renewed interest in theories of addiction that can account for the relationship between individual symptoms and large-scale socio-political forces. Gesler's (1992) theory of 'therapeutic landscapes' examines the ways that social, political, and cultural forces, embedded in place, contribute to health and wellbeing. This article considers the inverse of the therapeutic landscape: the traumatic landscape that harms its inhabitants, proposing it as one way of understanding how addiction is related to place. I draw on research in health geography, medical anthropology, and critical psychology to develop a novel theorization of the relationship between place, trauma, and addiction. Drawing on eighteen months of ethnographic fieldwork with drug users exiting the prison system in Chicago, Illinois, the article considers the life histories of two men whose addictions to drugs and alcohol are profoundly related to place. Through close readings of these cases, I develop two readings of addiction-in-place, one in which addiction is the result of environmental stresses that produce a need to use drugs as a form of self-medication, and another in which the landscape acts as a container for histories of trauma and produces an addiction resembling a psychoanalytic symptom, expressed in self-destructive acts. Finally, through my use of the case history method, I contribute to methodological debates about how to research experiences of place and health, arguing that close attention to lived experience is necessary to draw links between macro-level arguments about structural violence and the subjective experience of trauma that lies at the heart of addiction. Highlights: Case histories illustrate the ways that socio-political forces produce addictions. "Addictogenic landscapes" are environments that traumatize and encourage addiction. "Landscapes of trauma" describe personal geographies of addiction, trauma, and place. Addictions can be understood as self-medication and as symptoms of the unconscious. Treatment should focus on the traumas and oppressive forces that produce addiction.