The Language of Anti-Reductivism

Red Root and Running Cold — two sculptures from Nancy Bowen. Each is made of glass and metal, and loosely mimics a human body (or maybe the nervous system). See more of her work at http://nancybowenstudio.com/.

One of my ongoing projects is to develop a language of anti-reductivism. It’s a project that I share with a number of social scientists and humanities scholars, and has been motivated by the turn to molecular and neurologic explanations in the hard and clinical sciences. Biological reductionism circulates in popular media too — from narratives about the hereditary nature of certain kinds of behavior to science reporting on the discovery of “the gene” or part of the brain that causes a particular disease or set of behaviors. Biological reductionism is alluring — it promises an easy explanation for a complex problem. But anyone paying attention to the influences of society on individual behavior — including the development of research questions and the interpretation of the data produced through scientific practice — would be able to see that context is a powerful factor to consider. Reducing a complex set of behaviors to a gene or part of the brain obscures more than it reveals and serves to pathologize individuals rather than motivate changing social norms and institutions.

Wherever biological reductivism is used, individuals are pitted against dominant institutions and widespread expectations of “normal” behavior and development. One of the points I make in The Slumbering Masses (and I reiterate it all the time) is that certain arrangements of sleep are a problem, not because of their physiological effects or origins, but due to the organizations of work, school, family life, and recreation that make certain schedules (i.e. the 9-to-5 workday) the normative basis to understand human biology. In effect, an individual is made to be at fault, when it is actually the organization of society that preferentially treats some ways of sleeping as “normal” and others as pathological. The same can be said for much more than sleeping behaviors and the temporal organization of society; and re-conceptualizing bioethics might be one avenue for developing new ways to organize institutions and — just maybe — society more generally.

You can following my development of a language of anti-reductivism through a set of pieces in which I develop a couple of interrelated terms, “multibiologism” and the “biology of everyday life.” Multibiologism is my attempt to conceptualize a way to work against normative assumptions about biology, based in no small part upon a history of medicine that takes able-bodied white men as its foundation against which other kinds of bodies are compared (and pathologized). Such an approach brings together thinkers like Georges Canguilhem, Keith Wailoo, Dorothy Roberts, and Lennard Davis, drawing together the philosophy and history of medicine, critical race studies, feminist theory, and disability studies. Multibiologism accepts human physiological plasticity as based in the material reality of the world that we live in, but argues that “biology” is a discursive field that is produced through everyday action (including science & medicine). It’s this everyday action that helps to comprise the “biology of everyday life,” where toxins, diet, exercise, work, and other exposures and practices shape the body and expectations of normalcy. Which is all to say that human biology isn’t a stable or predictable thing, and that it changes over the course of a lifetime, is different between societies, and is not the same as what it was for our ancestors. Making that argument has built upon insights from a century of anthropological research (drawing on Margaret Lock and Patricia Kaufert’s work on “local biologies” and Mary Douglas’ work on disgust, especially, and extends a way of thinking that Marcel Mauss started working on in his “Notion of Body Techniques” lectures) and pairs it with the history of changing attitudes to the body (following Norbert Elias, specifically).

It was my ethnographic experiences in the sleep clinic I spent the most time in during the fieldwork for The Slumbering Masses that led me to thinking about multibiologism. I often described the clinicians I worked with there are “sociological,” in no small part due to their willingness to seek social remedies for sleep disorders (rather than resort to pharmaceuticals or surgeries). It was only when I started spending time in other sleep clinics that I began to realize how sociological they were. That they were more likely to talk to parents and educators about rearranging school expectations than they were to prescribe a sleep drug was motivated by their interests in finding long term solutions to the problems that their patients faced. It also recognized that many of their patients were “normal” in their variation from norms of consolidated nightly sleep, and that reorganizing expectations was a better — and more sustainable — solution than prescribing a drug. But it seemed to me that there needed to be language to do the kind of work they sought to do — and language that provided an ethical framework that was based on the lived realities of scientists, physicians, and patients.

(If you’re keen on following the breadcrumbs, the argument starts in the final chapter of The Slumbering Masses, moves on in ‘“Human Nature”and the Biology of Everyday Life,’ reaches its bioethical point in ‘Neurological Disorders, Affective Bioethics, and the Nervous System,’ and lays the basis for Unraveling.)

When I was finishing The Slumbering Masses — and was articulating these ideas for myself before incorporating them into the book — I began to think about what the next project would be. What I wanted to do was develop a research agenda that focused on an expression of human physiology that explicitly challenged how humans are thought about as humans. That led me to consider communication, and linguistic capacity more specifically, which neuroscientists, social scientists, and philosophers (and probably others too) still identify as the defining feature of humans (i.e. only humans have language). What about humans that didn’t speak (or at least didn’t speak in ways that were recognized as normative communication)? That led me first to thinking about the then-newish discourse of “neurodiversity,” which developed, in time, into a project that focused on families wherein a family member communicates in a non-normative way. That project eventually became Unraveling, which develops a set of terms — connectivity, facilitation, animation, and modularity — that seek to provide ways for thinking about individuals, families, communities, and institutions that strike against biologically reductive ways of conceptualizing brains and behavior.

So much of bioethical thinking reinforces reductive ways of conceptualizing the individual. But what the families at the heart of Unraveling show is that disorders of communication — and neurological disorders more generally — are disorders not strictly because of some physiological difference on the part of the individual, but because of the ordering of American society and the expectations that shape what it means to be a “normal” speaker and “neurotypical.” That might be a fairly easy point to convince most social scientists of — and maybe even many physicians — but beyond this diagnostic contribution, I wanted to provide tools for reconfiguring how we talk about what the aims of bioethical intervention are, and how we might achieve them.

It has long been apparent to me that any systemic change in the way that we conceptualize medical disorders requires alliances between social scientists and clinical practitioners. Social scientists — and anthropologists especially — often make recourse to the language of complication (“it’s complicated!” or “it’s complex!”) without having the precise analytic language to describe what those complexities are comprised of and how they make lives livable. What Unraveling seeks to do is provide that language, drawing from the histories of psychiatry and neuroscience as well as the lived experiences of individuals with “neurological disorders.” In the lead up to Unraveling being released, I’ll profile some of the ideas integral to the text — connectivity, facilitation, animation, and modularity — and how they undergird a cybernetic theory of subjectivity and affective bioethics.

Biological reductivism ultimately lets those in power off the hook. Being able to target individuals through pathologization (which supports the logic of medical intervention and undergirds expectations of “compliance”) enables institutional actors — physicians, educators, parents, administrators, managers, law enforcement agents, judges, etc. — to ignore the social contexts in which particular behaviors or ways of being in the world are accepted as disorderly. As disability studies scholars and anthropologists have been arguing for decades, changing social orders can many more lives livable. A robust language of anti-reductivism is one step in the direction of reordering society and social expectations, but there is work to be done in building supple institutions and relations to support the diverse ways that human inhabit the world.

School start times: Why so rigid?

Here’s the latest from the UMN Press blog, on school start times:

Over the past thirty years, there’s been a mounting body of evidence regarding changes in long-term sleep needs. Infants need a lot of sleep; children less so; adolescents need more; and adults, less, until our later years, when many require even less sleep.

So over the life course, it’s perfectly normal to sleep as much as twelve hours (even more for infants) and as little as four in a day. Along with these changes in sleep needs are changes in the time of sleep onset: as infants, most of us fall asleep earlier than we will as teenagers or adults; in our later years, we’ll wake up well before we do as children or adults. Sometimes we think about these differences in our sleep as pathological and seek out medical help, especially adults who start sleeping less than they used to, who often complain of insomnia despite feeling well rested.

But before we’re adults, we’re often at the mercy of other people’s interpretations of our sleep. And no one has a harder time garnering respect for their sleep needs than teenagers.

As a teenager, I started high school at 7:30 a.m. (yep, Rochester Adams still hasn’t changed its start time since then.) I would often get to sleep around 11 p.m. or later – not because I was playing video games or texting, which didn’t exist in 1991, but because my circadian cue for sleep onset was later than it had been when I was a child. I would have to wake up around 6:30 a.m. to be to school on time, which often meant that I was sleeping 6 or fewer hours each night. I don’t think I remember anything from my first two periods throughout high school. I would sleepwalk through my morning and “wake up” around midday. I would often nap in the afternoon. And still my daily sleep wouldn’t add up to nine or more hours.

There’s a nice piece on the CBC about experiments with changing school start times that includes an interview with the principal of the Canadian schools involved. It reviews the science of adolescent sleep, which shows that sleep onset at adolescence is later – sometimes as late as 11 p.m. or midnight. Alongside that later onset is a need for greater sleep, on average ten hours each night. The school day for students participating in this program runs from 10 a.m. until 4 p.m., no shorter than for those peers who start at 8 a.m. or earlier. And there’s some anecdotal evidence that it improves grades and attendance. What’s most interesting about the story – as is so often the case – is the comments. Adults weighing in on this change in start times refer to teenagers as lazy, point to their distraction by media technologies and lack of daily labor, and generally dismiss the science of sleep.

Was I just lazy as a teenager?
Are today’s teenagers more easily distracted away from sleep with the proliferation of media technologies?

The science says no. But why might adults be so rigid in their thinking about the social obligation of the school day? Many commenters on the CBC article fall into a slippery slope fallacy, assuming that today’s “lazy” teenagers will be tomorrow’s “lazy” workers and demand that work times shift to later in the day as well. The science doesn’t point to the need to change our work days – though there have been some movements towards flextime and workplace napping – but many of the adult commenters don’t even appear to buy the premise that sleep needs change throughout the life course.

As I discuss at length in The Slumbering Masses, the basis of modern school start times lies in the 19th century, when public schools were developed to care for the children of day laborers—meanwhile, the elite would send their children to boarding schools. The school day developed alongside the industrial workday to allow parents to drop off their children while they worked. There’s nothing natural about it—it isn’t based on some agrarian past where we were more in balance with nature. Instead, it had everything to do with the need to fill factories with able-bodied adults from dawn until dusk and to keep their children busy. Only slowly did this change, as American work schedules changed. Now science can support the organization of our daily obligations – or at least support the advocacy for more flexible institutions, that take things like variations in sleep need seriously.

But why be so rigid in thinking about teenagers being lazy and school start times being just fine as they are?

One of the things that comes through in the comments to the CBC story is that many adults feel as if they did just fine in high school, and that today’s youth should be just fine as well. In one commenter’s language, changing school start times amounts to “molly coddling” teenagers and playing into their entitlement. High school, it seems, is hazing for entry into the “real” world of adulthood, emblematized by work. While this is surely part of what school is intended to do – it models the demands of the workday with deadlines and expectations of outcomes – it is primarily intended to produce competent citizens. If changing the start time to slightly later in the day leads to more engaged citizens and more capable workers, shouldn’t we change our school days?

More insidious and less obvious is that many people have come to think of our social arrangements of time as being based in some innate human nature. If we accept the basic premise that sleep changes over the life course, that alone would nullify any standard of time usage. But many people tend to rely on small sample sizes to think about what’s natural and what’s not; just because modern social formations work for you – or seem to – doesn’t mean that they’re natural or that they work for everyone. How many cups of coffee do you drink each day? Or how much caffeinated soda? Have you eaten a snack today to offset sleepiness? Or taken a nap? Could you have gotten through your day a little easier if you slept in an extra hour?

There’s nothing natural about alarm clocks. And many sleep researchers and physicians would say that they’re one of the worst things for good sleep. But we use them anyway. Maybe it’s time we start to take the science of sleep a little more seriously and begin to rethink how we want our days to be organized. If we could be happier and healthier workers and students, it’s worth the investment in change and thinking past our expectations of nature and norms.

Is a good night’s sleep even legitimately possible?

This was originally posted at the UMN Press blog, here.

Slate & Survey Monkey just published the results of a poll on sleep, most of which is pretty innocuous. The two findings that work pretty well together — from my perspective — are those on average time of length asleep (respondents come in around 7 hours or less — some 65% are between 6-7 hours nightly) and the non-use of pharmaceuticals (~62% say they never use pharmaceuticals).

When you put these two findings together, they pretty much prove that our consolidated sleep patterns are the result of regular, daily fatigue. That is, when people sleep in unconsolidated fashion (like nightly sleep and a nap — which Slate unfortunately didn’t ask about), they’re less likely to be fatigued at the end of the day; that is, when you get to take a nap midday, you aren’t quite as exhausted when you finally get to bed at 10-11 PM. When you don’t get that nap — when you need 8 or more hours of sleep to be well rested and only get 6-7 — by the time you get to bed at night, you’re totally wiped out. Of course you don’t need pharmaceuticals to help you sleep when you’re that exhausted. I write about this both in The Slumbering Masses, but also in a historical article on the invention of modern sleep. And, Roger Ekirch has a lot to say about it in pre-industrial Britain.

What’s maybe most important to note about all of this is that, at least according to William Dement, the father of American sleep medicine, this fatigue is totally necessary to get a good night’s sleep. Dement suggests that unless we get to bed with a little fatigue in us, a consolidated night’s sleep is hard to come by. One might rightly ask if that’s the kind of sleep we want, when exhaustion is its motor. Maybe some other model of sleep would do us better?

There’s been some recent interest in things like workplace naps, but the secondary literature on this shows that often it’s cloaked in pro-worker sentiment, but ultimately in the service of employers. That is, when people nap at work they tend to work longer since they aren’t so tired when the end of the work day rolls around. So maybe that isn’t the answer. There’s also a fair amount of research at this point that flextime is both only good for the managerial class, and that it’s underused, since people are afraid of seeming lazy or delinquent to their co-workers. So that might not be the answer either. Maybe shorter work and school days would solve the problem of not enough sleep?

I’m a full subscriber to the goldfish theory of labor, i.e., labor will expand to fill any container that you give it, much like a goldfish will grow to its environment. Shrink the work and school days, and people will find a way to get as much work and learning done, they just won’t have to spend so much time in their institution. This might mean that work and school demands creep into family life — but they’re already there. If we can be more efficient and stress-free working and schooling with our families and friends, it might also mean that we get more done and have more time to play. And have more time to sleep at night.

The dangerous side of this less institutional work and school is that they’ll both take up more and more time — like I’m doing right now as I write this, work can come to expand in all sorts of ways. But given that how we balance our lives has increasingly been a ‘devil take the hindmost’ situation in relation to our institutional demands, maybe it’s time to push back on our institutions a bit and leave the development of that balance up to us, as workers and students. There are other ways to arrange our days, and we just need to think creatively and sensitively about our needs.

Time is Alien, or Why I Slept through High School

I keep this old issue of Worlds of Tomorrow (an old pulp magazine) in my office with a nice article from Robert M. W. Dixon about the relative nature of number. He imagines what a species with six fingers on each hand might do with counting, and proposes that they would develop a number system with less weight on 5, 10, and 100 and more on 6, 12, and 144. His argument is that given a different physiology, a species might develop a radically different number system, and that there’s no real natural basis to number — an argument pretty similar to Brian Rotman’s, Helen Verran’s and Stephen Chrisomalis’ work. Time, like number, is a social invention, and given different environmental conditions, we might have a very different system of time. Like Stan Robinson’s Mars Trilogy, the day on Mars is necessarily going to be ordered differently than the day on Earth. Our day is measurable and predictable, but it doesn’t necessarily fit in well with our calendar system (hence the need for Leap Days).

Image

There’s a nice piece in the New York Times Magazine from about a week ago that reviews a new book about chronobiology and the frictions that society produces for individuals. One of the points that both the book and article authors make is that individual clocks vary significantly from one another and over the life course — so the same person has radically different sleep needs at infancy, through childhood, during adolescence, young adulthood, and so on. And, added to that, are the clocks of those around us — those we share beds with and care for, which I talk about at length in The Slumbering Masses. The problem that so many of us face, especially during our teen years, is that our clocks are radically at odds with the institutions that shape our lives, especially school.

The debates around changing school start times have been going on for a long time now, and the evidence seems pretty compelling. Scientists can show that our cues for sleep tend to move later in the day and our need for sleep is longer, e.g. during your teens you might not be able to fall asleep until 11 PM and you might need 9 hours of sleep, making an 8 AM (or earlier) school time especially difficult to make. As a result, students end up falling asleep in class, have short attention spans, consume too much sugar and caffeine, act testy, and perform poorly in their school work. The schools that have recognized this have started to move school days later for middle and high schoolers, and have moved the school day up for elementary schoolers (who tend to wake up early). Unfortunately, there’s still a lot of resistance to changing school time, and it has a lot to do with social uses of time.

Parents tend to want to have earlier school days for their children, to ensure that they’re watched while parents work. And they don’t want buses to interfere with their morning commutes. Meanwhile, sports teams prefer to practice at the end of the school day, but want day light in order to conduct themselves. As a result, the school day remains relatively static, continuing to ensure that many students are chronically sleep deprived.

Our internal clocks tend to be rather stable within each life stage,* and so are our social cues (e.g. work starts at 9 AM or school at 7:15). But when we’re chronically sleep deprived, we tend towards earlier sleep throughout the week. And if we have social obligations blocking our ability to sleep — child or elder care, take-home work, chores — our sleep debt grows and grows. As a result, we crash and catch up on the weekends, only to start the whole cycle over again the following week. We pay off our debt only to build it up again — a nice synecdoche for American life more generally. And, sometimes, we end up seeing doctors for our sleep complaints, which can result in being prescribed a medication for problems that are largely socially determined – which I write about everywhere.

There are two solutions to these problems: First, our policy makers need to spend a little more time talking to scientists and physicians (and the occasional social scientist), and to take what they have to say about our biological drives more seriously when it comes to instituting social times. And, more importantly, our institutions need to be made more flexible. I think back on my time in high school, and I know some of my teachers didn’t want to be there at 8 AM any more than I did. Why not have a staggered school day, and allow students to start at 10 AM and end at 4 PM, or 7 AM and end at 1 PM? Flexibility like this would attend to the broad variation of physiological and social experiences, and help minimize our negative reactions to the requirements of everyday life. And it might just help us sleep better at night — or whenever the urge hits us. After all, there’s nothing strictly natural about our everyday schedules — they could be ordered radically differently — but it’s up to us to re-imagine the possibilities.

* I’ll write more about ways to change your clock some other time — it all has to do with your liver…

Paging Dr. Kellogg

One of the things I’ve become really interested in — thanks to our toddler son Felix, and our time abroad in India — is the recent movement towards early potty training, or what some people refer to as Elimination Communication (which, like any contemporary parenting movement, is rife with ideological rhetoric). This dovetails with my increasing research interests around excrement in the United States, which, in its contemporary moment, ties together parenting debates with the science and medicine of right living — a tradition that extends back to at least the turn of the 20th century, thanks to thinkers like John Harvey Kellogg.

Dr. Steve Hodges gives a pretty good example of the state of this kind of thinking right now, as he’s taken childhood constipation as his site of activism. He’s written a couple pieces for the Huffington Post recently, and they’re worth reading. Hodges points out that tons of children are woefully constipated in the U.S., and points to a few causes: the American diet (especially the American kids’ diet, with chicken nuggets and hamburgers), social shame, and early potty training. I’m not entirely sure why early potty training gets picked out, but he cites it as a cause since children have spent more time learning to hold ‘it,’ and so they just continue to do it. It seems rather counter intuitive, since it would actually seem that children who have been potty trained early would be more confident about going to the bathroom when sent to elementary school. When I think about our time in India, where Elimination Communication is just a way of life, and little kids don’t necessarily wear diapers (who needs to when your floors are marble or concrete and can just be sprayed off?) — kids are, in other words, potty trained very early by American standards — childhood constipation doesn’t seem like it should be the same issue.

In the service of making early potty training the problem, Hodges backs away from making a more pointed critique of American eating. Maybe it’s a tired critique to make; maybe parents don’t want to fight with their kids about the latter’s desire for white bread. But there’s something to learn from Kellogg, and that’s that the process of digestion isn’t strictly limited to the food itself, but also its preparation. Cultural geographer Nicholas Bauch has been working on this distributed view of digestion for a while, and it’s worth thinking about how the long chain of processing events to make our food might also make it harder to excrete. Taking this distributed view of digestion seriously might mean leaving the foodstuff itself aside and taking seriously how that food gets made — and what it gets made with. There might be room for a little more fiber in those chicken nuggets…

And, more importantly, Hodges leaves aside the question of social shame, which might be the biggest problem for young non-poopers, and possibly also the easiest to fix. Often, especially in elementary schools (which Hodges uses as his example), kids are waiting in line with one another, and intensely aware of what each other is doing in the bathroom. American experiences, in this respect, are pretty different from Chinese examples (like in Preschool in Three Cultures), where the kids are squatting over a trough together (I love that little kids face one another and chat through their time on the trough). Americans have so much shame about their bodily processes that it’s no wonder kids can’t perform when presented with semi-public excretion. Maybe, then, we should start thinking about a different infrastructure for excretion in the U.S.? Would replacing communal bathrooms with many small, individual bathrooms be so difficult? Stalls, clearly, aren’t private enough for many Americans. Individual bathrooms sure sound better than having a grapefruit-sized lump in your colon. Randy Marsh aside, of course.