Temporalities of peer support: the role of digital platforms in the 'living presents' of mental ill-health

This paper considers matters of time in online mental health peer support. Significant evidence of the value of peer support exists, with new digital platforms emerging as part of the digitisation of mental health support. This paper draws from a project exploring the impact of digital platforms on peer support through interviews with users of a major UK-based online peer support platform. Drawing on Gilles Deleuze's concept of the 'living present', the paper highlights how notions of past, present and future operate as co-existing dimensions of the present. The analysis highlights how the immediacy of digital platforms elicits expectations of peer support being 'on tap', which creates challenges when support is not received synchronously. Unlike in-person support, digital platforms facilitate the archiving of support, which can (re)enter the present at any moment through asynchronous communication. Anticipations of the future feature as dimensions of the present in terms of feelings regarding when support may no longer be needed. The paper offers potential implications for social scientific understanding of digital peer support, which include valuable insight for mental health services designing and delivering digital peer support.

Shame as a geophilosophical force

In this article, I argue that Deleuze and Guattari's famous trope about "an earth and a people that are lacking" in the Geophilosophy chapter of What Is Philosophy? must be examined through a specific assemblage: the necessity for shame-as a powerful, non-psychological, and nonhuman affect-to enter philosophy itself both to resist stupidity and to include all the disfranchised of classical Reason. I then turn to Isabelle Stengers' work against stupidity to determine how this assemblage can help us give shape to new multispecies apparatuses in the face of the Anthropocene. As a conclusion, I show that, through such apparatuses, shame truly becomes a geophilosophical force.

Response-The Multiple Understandings in the Clinic Do Not Always Need to be Resolved

This article reflects on the assumption underlying the argument of Little et al. that "contested understandings" in the clinic are susceptible to reconciliation within a liberal framework described as "pragmatic pluralism". It is argued that no such reconciliation is possible or desirable because it is of the nature of the clinic that it provides a forum for multiple voices, ethical and cultural perspectives, and conceptual frameworks, and this is the source of its fecundity and creativity. Medicine itself cannot be represented by a single discourse, precisely because it is itself an unruly collection of practices that, despite their heterogeneity, are able to engage in productive dialogues with each other. The heteroglossia of the clinic, therefore, is not a problem to be overcome. Rather, it is a rich resource to be mobilized in accordance with its multiple inherent purposes.

Genuine Movement Learning Through a Deleuzian Approach

The purpose of the article is to outline how Deleuzian concepts, notably the notions of apprenticeship in signs based on a pedagogy of the concept, can stimulate thinking and understanding of movement learning, and provide insights about pedagogical implications in various movement educational settings. Methodologically, the article falls somewhere in between theoretical exposition and presentation of original empirical research, i.e., a "theoreticoempirical" exposition. We borrowed some ideas formulated by Deleuze (and Guattari), which have been further developed by educational researchers, about "an apprenticeship in signs" based on "a pedagogy of the concept," to analyse situations where students explore new movements. We use material generated from pedagogical interventions comprising of exploration of kinescapes. In these interventions, school and university students are encouraged to explore, and learn, juggling, unicycling and dancing. Findings indicate how students pass through interpretative illusions until some of them grasp difference in itself in what could be called its immanent differentiation of the actual, i.e., they learn how to juggle, unicycle or dance. This is what we designate genuine learning. The triadic relation between concepts, percepts and affects offer us clues to what juggling, unicycling or dancing mean to learners (concepts), what learners pay attention to while practising (percepts), and what gets them moving (affects). Importantly, through viewing learning as an apprenticeship in signs, the Deleuzian approach reminds us that the triadic relation is open-ended, meaning that concepts, percepts and affects are never final but always a potential actualisation. Concepts, percepts and affects are constantly in the process of becoming. Since genuine learning is not about narrowing down how a movement should be executed and experienced, the task of a movement educator could, then, be to accompany learners in explorative pursuits. In this way, teachers can help learners escape preconceptions about movements (who can do what and when) and instead explore new movement opportunities.

Gilles Deleuze's societies of control: Implications for mental health nursing and coercive community care

Since the era of deinstitutionalisation, many clinical approaches have emerged to enable the care and treatment of people suffering from mental illness. In recent years, the use of coercive approaches in the community (e.g., outpatient commitment or community treatment orders) has also increased internationally. Although nurses' role regarding these coercive approaches is central and significant, few empirical and theoretical writings have tackled this controversial nursing practice. The purpose of this paper is to analyse coercive nursing care through the lens of French philosopher Gilles Deleuze's concept of 'societies of control'. Taking up Michel Foucault's work on disciplinary power, Deleuze explores how the move from the striated spaces of closed institutions to the smooth spaces of societies of control took place since the middle of the 20th century. According to Deleuze, the overall objective of 'societies of control' is no longer simply to govern deviant behaviour in closed environments (e.g., psychiatric hospitals and prisons) but to ensure a regime of unrelentless surveillance in the open spaces of our communities.

A posthuman decentring of person-centred care

In this paper, we examine person-centred care through a Deleuzian posthuman lens with the aim of exploring what becomes possible when the concepts of both person and care are de-centred. We do so through a consideration of the sets of relations that produce 'the client' in health care contexts. Our analysis maps particular entangled material-semiotic forces producing 'M/michael', a young man with a diagnosis of Duchenne muscular dystrophy, within a rehabilitation clinic. Drawing on Deleuzian notions of assemblage, affect, and becoming we explore 'person-care' as an active production that dynamically enacts persons-as-clients through clinical arrangements. Persons are thus reconceptualised in terms of locally produced subject positions and their care relations, rather than pre-existing beings who can be 'centred' within health services. Paradoxically, by de-centring persons and care, we work to conjure ways to strengthen the aspirations of person centredness to humanise health practices. In doing so, we consider different possibilities for re-imagining clinical work and contribute to debates regarding how healthcare conceptualises and addresses disability, health, and wellbeing. We suggest that such posthuman analyses can open up new ways of understanding and re/forming healthcare.

Harnessing the power to bridge different worlds: An introduction to posthumanism as a philosophical perspective for the discipline

Although it is argued that social justice is a core concern for the discipline, nursing has not generally played a leadership role in the responses to many of the greatest social problems of our time. These include the accelerated rate of climate change, pandemic threats, systemic racism, growing health and social inequities, and the regulation of new technologies to ensure an equitable future 'for all.' In nursing codes of ethics, administration, education, policies, and practice, social justice is often claimed to be a core value, yet it is rarely contextualized by philosophical or theoretical underpinnings. It appears that nurses' commitment to social justice may stem more from a penchant for 'doing good' than an attempt to explore, understand, and enact what is meant by social justice from an ontological, epistemological, and methodological perspective. We contend that the dominance of a human science perspective in nursing contributes to a narrow definition of health and relegates many issues central to social justice to the margins of nurses' care. In this article, we explore how the focus on 'the human' in the human science perspective may not only be limiting the capacity of nurses to develop strategies to adequately address social injustice, but in some instances, direct nurses to contribute to their very reproduction. We suggest that a critical interrogation of this human-centric hegemony can identify avenues of rupture and introduce posthumanism as an additional philosophical perspective for consideration to help bridge the human-social divide.

Connections built and broken: The ontologies of relapse

'Relapse prevention' has become a familiar concept and practice for those engaged with drug treatment services. The ways that 'relapse prevention' is currently practised and talked about departs primarily from research produced within the discipline of psychology, and especially by researchers and practitioners adopting cognitive behavioural (Marlatt & Donovan, 2005; Witkiewitz & Marlatt, 2009) and neurocognitive approaches (Tapert et al., 2004). The outcome has been the production of 'tools' and 'mechanisms', put in place to 'prevent' people from relapsing. This way of thinking about relapse has generated the assumption that once access to these 'tools' has been granted, relapse becomes a problem of the individual, a personal 'success' or 'failure', depending on how these tools are used, a measurement of how much one 'really' wants to recover. This system of thought reproduces longstanding discourses of blame against AOD users and fuels the discussion on the 'revolving doors' of recovery (White & Kelly, 2010), holding treatment services accountable for 'failing' to produce and maintain 'recovered' bodies. In this paper my aim is to challenge the production of relapse as a 'threat' and to rethink it as a desire to connect, a desire that can be either enhanced, or broken. Drawing on empirical data produced in two recovery services, one in Liverpool (UK) and one in Athens (Greece), analysed through a Deleuzo-Guattarian system of thought, I discuss relapse in two different ways: (a) as part of the temporality of recovery, a way to start building connections with services; as the expression of an emerging desire under exploration, and(b) as the consequence of broken and interrupted connections when policy fails to support the encounters emerging in the recovery space, disrupting thus the recovery process.

Putting the "where" in HIV care: Unpacking narratives of antiretroviral therapy adherence among HIV-Positive men who have sex with men

This study explores the spatial constitution of adherence to antiretroviral therapy (ART) by recasting therapeutic landscapes (Gesler, 1992) and how it structures the exercise of expressive agency (Bowden, 2014). Engagement in antiretroviral therapy among HIV-positive men who have sex with men (MSM) is contextualized within the discursive-materiality of emplaced assemblages for HIV Care in the Philippines. Combining qualitative data from field visits and semi-structured interviews, three key spatial narratives were derived illustrating how adherence to ART unfolds in place: (a) an unwelcoming treatment hub, (b) an unsafe and safe home, and (c) a constraining workplace. The results illustrate the spatial, multilayered barriers to ART adherence proposing insights for the theorization of adherence as an emplaced process and the implications of using of place-based interventions in resource-limited countries beyond the discourse of free service and availability.

Art-making and lived experience of schizophrenia: a vitalist materialist analysis

BACKGROUND

This paper responds to calls for more lived experience research with a vitalist-materialist style of analysis inspired by Deleuze and Guattari. It challenges traditional understandings of art as a therapy associated with medical and psychological perceptions of schizophrenia, which have been found to be reductive.

METHODS

Using Deleuze and Guattari's relational assemblages, the flows of affect are mapped as bodies and things, ideas and sensations connect and disconnect through the community arts sense-event "Schizy Jam".

RESULTS

Opening a much broader territory for understanding the many ways that art can express, affirm and communicate difference, enables exploration of new ways in which art-makers are activating changes in feeling and thinking about schizophrenia.

CONCLUSIONS

Art-makers can be supported to connect with others with shared experience to find expression for things that have previously been inexpressible and create a world that is more inclusive of them.

Living the intensive order: Common sense and schizophrenia in Deleuze and Guattari

In Anti‐Oedipus, Deleuze and Guattari aim to describe schizophrenia in a positive manner. According to them, the schizophrenic lives on the intensive order. To fully comprehend what this means, it is key to address some of Deleuze's insights regarding the notion of intensity in relation to experience and cognition. This is why I will combine ideas from Anti‐Oedipus with theory from Difference and Repetition, in order to explain Deleuze and Guattari's conception of intensity in its relation to common sense and to schizophrenia. According to this conception (a), intensity is the condition of possibility and limit for the sensible; (b) it becomes covered over by the organizing principles of common sense, which make our affects more workable and recognizable; and (c) this process of organization must hang together with the codification of desire through Oedipus, the main organizational principle of the socius. On the back of these theoretical considerations, I will explain what it means to say that the schizophrenic lives amongst intensities: (a) this involves a lack of codification of desire and thus of common sense, meaning an absence of organizational principles; and (b) this perspective leads to a different understanding of the schizophrenic's experience and expression, with very concrete implications for a clinical approach to schizophrenia.

Meat as a Pharmakon: An Exploration of the Biosocial Complexities of Meat Consumption

In contemporary dietary advice, meat is depicted as a pharmakon: it is believed to either heal or poison the human body (and mind). Often, it also serves as a scapegoat for a wide range of public health issues and other societal problems. Related attitudes, practices, and beliefs pertain to a demarcated mode of thinking or episteme that is characteristic for the so-called post-domestic or industrialized societies. The latter are not only typified by an abundant yet largely concealed production of meat, but increasingly also by moral crisis and confusion about its nutritional meaning. For an improved appreciation of the ambiguous position of meat in human health and disease, as well as the concomitant scattering into different subject positions (e.g., the omnivore, flexitarian, vegetarian, vegan, permaculturalist, and carnivore position), an interdisciplinary approach is required. To this end, the current study tentatively combines food research with a selection of (post-structuralist) concepts from the humanities. The aim is to outline a historical and biosocial need for meat (as well as its rejection) and to analyze how its transformative effects have contributed to a polarized discourse on diet and well-being in academia and society at large. Excessive categorization (for instance with respect to meat's alleged naturalness, normalness, necessity, and niceness) and Manichean thinking in binary opposites are among the key factors that lead to impassioned yet often sterile debates between the advocates and adversaries of meat eating in a post-truth context.

Contending with the minimum data set: Subjectivity, linearity and dividualising experiences in Improving Access to Psychological Therapies

Improving Access to Psychological Therapies has lead to a huge increase in the delivery of psychological therapy within the United Kingdom over the past 10 years. Central to the culture of Improving Access to Psychological Therapies is outcome monitoring, brought into every therapeutic encounter through the compulsory collection of the minimum data set in each session. This article explores the role of compulsory outcome monitoring in service users' experiences of using Improving Access to Psychological Therapies, with a focus on how these forms are folded into distress, therapy and recovery. Data from a small-scale qualitative study are drawn upon. Thematic analysis was conducted on multimodal interviews with current service users. The article explores the ways in which the minimum data set acted as a 'quasi object', exploring three main roles of the minimum data set: as an authorising mediator, an alienating adversary and a deferring gatekeeper. Pictures of therapeutic progress, as presented via outcome measures, often ran counter to users' reported experience of distress. We conclude that far from being a neutral and objective assessment tool, the minimum data set functions as a living actant in the therapeutic encounter.

Robot life: simulation and participation in the study of evolution and social behavior

This paper explores the case of using robots to simulate evolution, in particular the case of Hamilton's Law. The uses of robots raises several questions that this paper seeks to address. The first concerns the role of the robots in biological research: do they simulate something (life, evolution, sociality) or do they participate in something? The second question concerns the physicality of the robots: what difference does embodiment make to the role of the robot in these experiments. Thirdly, how do life, embodiment and social behavior relate in contemporary biology and why is it possible for robots to illuminate this relation? These questions are provoked by a strange similarity that has not been noted before: between the problem of simulation in philosophy of science, and Deleuze's reading of Plato on the relationship of ideas, copies and simulacra.

Psychedelic pleasures: An affective understanding of the joys of tripping

BACKGROUND

This paper considers the pleasures of psychedelic drugs and proposes a Deleuzian understanding of drugged pleasures as affects. In spite of a large body of work on psychedelics, not least on their therapeutic potentials, the literature is almost completely devoid of discussions of the recreational practices and pleasures of entheogenic drugs. Yet, most people do not use psychedelics because of their curative powers, but because they are fun and enjoyable ways to alter the experience of reality.

METHODS

In the analytical part of the paper, I examine 100 trip reports from an internet forum in order to explore the pleasures of tripping.

RESULTS

The analyses map out how drugs such as LSD and mushrooms - in combination with contextual factors such as other people, music and nature - give rise to a set of affective modifications of the drug user's capacities to feel, sense and act.

CONCLUSION

In conclusion it is argued that taking seriously the large group of recreational users of hallucinogens is important not only because it broadens our understanding of how entheogenic drugs work in different bodies and settings, but also because it may enable a more productive and harm reductive transmission of knowledge between the scientific and recreational psychedelic communities.

The Politics of Attachment: Lines of Flight with Bowlby, Deleuze and Guattari

Research on attachment is widely regarded in sociology and feminist scholarship as politically conservative - oriented by a concern to police families, pathologize mothers and emphasize psychological at the expense of socio-economic factors. These critiques have presented attachment theory as constructing biological imperatives to naturalize contingent, social demands. We propose that a more effective critique of the politically conservative uses of attachment theory is offered by engaging with the 'attachment system' at the level of ontology. In developing this argument we draw on Deleuze and Guattari, making use of the common language of ethology which links their ideas to that of attachment theory. The attachment system can and has been reified into an image of the infant returning to their caregiver as an image of familial sufficiency. This has offered ammunition for discourses and institutions which isolate women from health, social and political resources. Yet Deleuze and Guattari can help attachment theory and research to be recognized as a powerful ally for progressive politics, for reflection on the movement of human individuation, and for arguing for the meaningful resourcing of those who care for someone else.

Structuralism's Afters: Tracing Transdisciplinarity through Guattari and Latour

This article analyses Guattari's and Latour's bodies of work as radical developers of a processual and ontological transdisciplinarity. These works impose a definitive break from the history that, in the 1960s, had drawn upon structuralism in order to oppose philosophy with an epistemological revolution from the perspective of a scientific problematization and first transdisciplinary reconfiguration of the sciences de l'homme. It is shown that the second anti-structuralist transdisciplinarity affirms as its raison dêtre "the necessity to return to Pragmatics" (Guattari), to enact the new significance of the transversal constructions liberated by the rhizomatic monism of a hybrid social ontology (Latour). Between Guattari, Latour, and the ecologization they share, a total de-epistemologization and re-ontologization is engaged. It leads to the fall of the 'Ontological Iron Curtain' erected by the philosophical tradition between mind and matter, nature and society. The article concludes by critically addressing the final statements of both Guattari and Latour towards a new aesthetic paradigm and a new diplomacy of institutional forms respectively.

Salutogenic Education? Movement and Whole Child Health in a Waldorf (Steiner) School

Waldorf education, an independent alternative to public schooling, aims to produce holistically healthy graduates in a formulation that rejects the conventional distinction between education and health. Also striving to bridge that divide, this article characterizes the pedagogically salutogenic techniques Waldorf teachers use in pre-kindergarten (pre-K) and lower grade classes and explicates the ethnomedical understandings underlying them. Waldorf teachers position children as budding participants in a unified field of spiritual and other forces, prioritizing whole-child activities that keep these forces healthfully motile. Their work entails a critique not only of mainstream public schooling's ostensibly pathogenic "head-to-head" focus, but also of the biomedical approach to pediatric health. My analysis of this conjoined critique takes into account the cultural, structural, and existential realities within which Waldorf education's salutary pedagogy is daily framed and fabricated. Further, it explores the implications for anthropology of attending to movement as a key feature of healthful human experience.

Creativity and health: an anti-humanist reflection

Many studies suggest that health benefits from engaging with the creative arts, but explanations of the association remain tenuous. This article explores both creativity and health from an anti-humanist perspective and develops a Deleuze-inspired analysis to supply the theoretical framework for creativity and health. In this view, creativity is an active, experimenting flow within a network or assemblage of bodies, things, ideas and institutions, while health is understood as the capacity of a body to affect and be affected by this assemblage. It is consequently unsurprising that there is a relationship between creative activity and health. This analysis is used to explore how creative production and reception can affect health, and to assess the implications for sociology and for arts in health-care practice.