Posts Tagged With: Medicalization

Shattered Illusions: ‘Intervention’ and How A&E Got Rich Off of Recovery

Do these faces look familiar?

These are the faces of A&E’s hit reality television series, Intervention.

Each of them are white and every one of them has their own story to tell, or rather has a version of their story told for them – by friends, family and the show’s network narrators. I have been watching this series on and off for a couple of years now. It is very intriguing and, needless to say, has brought its network (A&E) so much success, that can be measured in both dollars as well as credibility. In fact, Intervention reports a 70% success rate for its “participants” – using a method of intervention known as the Johnson style. This traditional model typically yields a 30% – 40% success rate, meaning that those who undergo one such style of intervention report sobriety one year after treatment. But the folks down at A&E have separate standards by which they measure success. In her lecture earlier today, Professor Daniels shared with our class that several people have died since their episode featured on A&E, but were counted as “successes” simply for having completed their 30-day-or-so treatments.

But aside from revealing those not-so-inspiring truths about Intervention’s so-called-success rates, Professor Daniels lecture and article on, “INTERVENTION: REALITY TV, WHITENESS, AND NARRATIVES OF ADDICTION,” did work to truly deconstruct those narratives told by A&E’s Intervention, exposing their representative biases. The show is predominantly heteronormative, in that it almost exclusively deals with heterosexual individuals – rarely featuring those identifying as gay, lesbian or bisexual. Furthermore, the show is totally cisgender in that it has not featured transgender individuals or those identifying as genderqueer (i.e gender identities other than man or woman, which do not adhere to binary categories of cisgender normativity). In terms of sexual diversity, Intervention consistently ignores the wide ranging reality of sex-gender variance among ‘substance abusers’ alike.

So what are the dangers in framing representations solely along heteronormative lines? It occludes differences among what substances impact which communities (and how). It undermines the legitimacy of human variance. How can something (or someone) be regarded with any real validity if it (or s/he) continues to go unrecognized? But those blind spots (unfortunately) do not stop at sex, gender and/or sexuality. Intervention features [cisgender] men and women equally on their program – meaning 50% of the episodes feature men and 50% feature women. However, this seemingly non-biased representation of addiction is skewed. Real life statistics paint a very different picture pertaining to substance abuse and gender.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA):

  • Any use of alcohol is reported by 58% of males and only 48% of females
  • Binge drinking is reported by 31% of males and only 15% of females
  • Heavy alcohol use is reported by 11% of males and only 3% of females

In all cases, males accounted for more or heavier usage of alcohol, which just happens to be the predominant substance featured on A&E’s Intervention as the abused drug of choice. But in the case for alcohol consumption/abuse, women are being over-represented, as such 50/50 narratives of addiction do not properly mirror reality. Daniels further elaborates on such (mis)representations in her piece on, “INTERVENTION: REALITY TV, WHITENESS, AND NARRATIVES OF ADDICTION,” as she deconstructs the show’s deployment of medicalization, biopower, and governmentality. These Foucaultian buzz words indicate certain regulated processes of policing bodies that are racialized as they are gendered, according to strict standards of health and morality.

We have discussed some of the ways in which A&E’s Intervention disproportionately features women as addicts, and furthermore how the show systemically constructs a heteronormative binary world of just men and just women; failing to mirror reality on both accounts. Daniels also focuses on the series’ depiction of addiction as whiteness in crisis. That is, social privilege being wasted: “wasted whiteness,” as the show rarely features men and women of color. This works to reify certain punitive measures surrounding race and addiction that are present in society at large; that is to say that the State penal system punishes racial/ethnic minorities while “self-sufficient [white] citizens” are subjected to more “neoliberal regimes” of bodily regulation.

…whites make up 63.7% and Latinas/os make up 16.3% of the general U.S. population, 4 yet Latinas/os only appear as characters in 6% of episodes of Intervention. African Americans make up 12.6% of the U.S. population, while only 4% of those appearing on Intervention are black. Asian and Pacific Islanders make up 5% of the U.S. population and appear on Intervention as main characters 1% of the time (Daniels 7)…

We can draw parallels from the show’s narratives of addiction to the ways by which we conceive of race and addiction in our every day lives. By constructing addiction as both badness as well as sickness, A&E’s Intervention effectively justifies popular notions of moralizing health that are the productive rhetoric of biopower (hard at work). The show’s representations of race, ethnicity, sex, sexuality and gender contribute to hegemony, as they are skewed. It is imperative that we remain critical of these makeover reality television series, which aim to construct certain capitalist qualities as desirable (i.e. heterosexual relationships, and in the case for women, beauty).

Let us unpack these narratives, so as to reveal the neoliberal mechanisms by which they have been articulated.

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The Business of [Westernized] Healing

Me (center) with my two older sisters, Angela (right) and G (left) Galotti

I am the proud little sister of two brilliant future doctors: Angela and G. Galotti, my sisters and closest friends.  Angela is a third year medical student here in New York City at NYU and G. is a second year medical student at Stony Brook, on Long Island – where we three grew up.  Their experiences of working at two different teaching hospitals has educated me on the various cultures of medical schools and of hospitals.  Last week’s class discussion about health care in America and women’s relationships to the health care system prompted me to write this blog post, as I felt that certain important points of discussion were otherwise occluded.

Some of the students in class on Thursday expressed a sentiment of grief with doctors, or rather doctors’ tendencies to pathologize what could potentially be viewed as natural.  It would be unfair of me to assume what other people meant by their reinstating frustrations with doctors, but – from what I gathered – there was a particular sense of resentment towards the medicalization of bodies in the diagnostic/treatment process.  This speaks to the precious relationship of doctor-patient that is all about healing.  I agree with most of those who feel that there is, more often than not, a disconnect between the healer (i.e. physician) and the healing (i.e. patient).

from Google Images

But where might that disconnect stem from?  And is it fair to place sole blame and responsibility on the part of the physician, or rather can we locate the source of such frustrations in the overlapping system of health care in America itself?  Okay, so these questions are obviously leading, to say the least.  But I want to make clear that we cannot discuss physicians as a monolithic group – just as we cannot discuss women as a monolith, sharing in like experiences, when we know that simply is not true.  Analyses, or rather respectable ones, always include context; it is imperative to understand an individual’s physical, social and historical location.  Just ask any Transnational Feminist.

Those physicians who decide to go into primary care (i.e. the doctor you visit annually for a check-up, or your ‘family doctor’) most likely value that doctor-patient relationship.  How is this a safe assumption?  1.)  Primary care physicians adopt further responsibilities/burdens of owning and running their own business as opposed to working for a hospital & 2.) Primary care physicians, on the whole, earn considerably less than those who choose to go into surgery or other specialized fields.  This is why so many mid-level practitioner positions are becoming more and more popular (i.e. nurse practitioners and physician’s assistants (PA’s).

I have been told by my sisters and by other medical students alike that it is less and less enticing for a medical student to pursue primary care, as the overwhelming costs reap underwhelming benefits.  If time is equal to money and patients are a source of money, then more money is obtained by and through seeing more patients in one working day as opposed to seeing less patients per day with whom more time and attention was spent.  So one’s ideals of nurturing that precious doctor-patient-healing-relation tend to diminish by virtue of the cold hard facts that running a [health service] business will inevitably yield.

The problem with the health care industry in America is just that: it is an industry by which to obtain profit.  Health care is viewed as a responsibility of the welfaristic State in many communistic or socialized national states, and not as a business – as it is often viewed here in this country by insurance companies and citizens alike.  This is not to reify yet another false dichotomy of the capitalistic United States versus the socialist Europe and elsewhere, but rather it is to draw attention to this money making business we call healing.  And frankly, many people have [more than] the right to be fed up.  But in crafting one’s argument around the issue of doctors, it is necessary to understand the various factors which contribute to the lack of resources faced by both patients and, believe it or not, primary care physicians on the whole as well.

Me (center) again with my sisters, Angela (right) and G (left) Galotti with our beautiful, late dog, Sandy (yellow dog with the cute face).

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