Narrative and Selfhood in the Antidepressant Era
Stepnisky, Jeffrey Nicholas
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This dissertation is a study of the relationship between antidepressant medications, self-understanding, and the narrative construction of self. The analysis relied upon two kinds of empirical data. First, advertisements for antidepressants in popular magazines, television, and online promotional websites were collected. Second, interviews were conducted with 23 people who were taking or had taken antidepressant medications. It is argued that antidepressants are components of the larger social processes of risk, biomedicalization, and individualization. In contrast to a narrative view, which conceives selfhood as a dialogical and embodied achievement, the antidepressants participate in a set of discourses that sustain atomistic conceptions of the self. The analysis emphasizes the personal agency that antidepressant users bring to bear upon their use of antidepressants. Chapter one is an introduction to theories of risk, individualization, and narrative as well as the ways in which narrative and selfhood are potentially transformed through the use of antidepressants. Chapter two offers an analysis of three theoretical conceptualizations of the relationship between biomedicine and selfhood: naturalism, poststructuralism and the narrative-hermeneutic perspective adopted in the dissertation. Chapter three analyzes the advertising materials emphasizing the manner in which relationships are constructed between selfhood, biology, and antidepressant medications. Chapters four, five, and six introduce interview materials in order to examine: a) how people learn to use antidepressants and in doing so come to split-off and manage unwanted elements of their selves, b) the ways in which the popular discourse of authenticity (being a "real" self) is transformed in the encounter with antidepressants, and c) the manner in which the antidepressants are taken up in social institutions such as the family. The dissertation concludes with a reflection upon the implications of a shift from a form of selfhood composed in narrative and relationship, to a form of post-social selfhood composed through the use of technologies such as antidepressants.