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.

How Natural is Human Sleep?

Here’s the first of the blog entries for Psychology Today:

You’re sitting at your desk, slowly reading through your response to a friend’s email, when you feel the sudden tug of sleepiness. The next thing you know, you’re waking up with your head on the desk, your hands folded under you in a makeshift pillow. Or, your riding on the train, playing a game on your iPhone, when the next thing you know you’re waking up and reaching under your seat to fish for your phone. You haven’t been napping long, so hopefully nobody noticed. Maybe it’s just incidental sleepiness – you haven’t been sleeping well lately – but it happens with more and more regularity. Maybe it’s time to see a doctor about it?

Over the last decade or so, Americans have become more and more aware of sleep and its disorders. One way to think about this change in public awareness is that it’s due to the new recognition of sleep disorders – that science has discovered new pathologies, their causes and cures. This might appear to be the case with narcolepsy, the sudden onset of sleep, often associated with momentary heightened emotions, which has been diagnosed more commonly since the 1970s. In fact, we’ve had a reasonably well-articulated sense of narcolepsy since the 1820s, thanks to Scottish physician Robert Macnish, who described it as ‘drowsiness’ in his Philosophy of Sleep. We still don’t really know what causes narcolepsy, but we do have treatments for it that are reasonably well tolerated by narcoleptics. And this might be the reason why we’re paying so much more attention to sleep these days: changes in pharmaceuticals. But that’s not strictly true either, since throughout history we’ve have suitable if not wholly effective treatments for a number of sleep disorders – we just prefer pharmaceuticals to changes in lifestyle these days. Rather, our heightened interest in sleep has everything to do with our disconnection from history and the many changes that American sleep and society have gone through over the last two centuries, which make a lot of phenomena seem new, when we’ve been living with them for centuries.

About a year ago, I was on a conference panel with a laboratory scientist who specializes in developing technology for the assessment of sleep disorders; he gave a presentation on the state of the art in sleep science and medicine, a talk designed for his audience, which was largely comprised of scholars in the humanities and social sciences. Meanwhile, I gave a presentation focused on a minor event in the history of sleep science, an experiment led by Nathaniel Kleitman — then a professor of physiology at the University of Chicago — aboard a U.S. Navy submarine to ascertain the ideal arrangement of sleep while at sea – which I discuss in my book, The Slumbering Masses: Sleep, Medicine & Modern American Life. During the question and answer period, an audience member asked my co-panelist about changes in scientific conceptions of sleep, to which he answered – and I’m paraphrasing here – ‘That’s not my job, it’s yours.’

I’ve heard similar sentiments from scientists and physicians before – they’re busy on the frontline, dealing with the demands of patients, writing grants, and conducting their own research, and don’t have the time to do investigative social research. At one conference where I was talking about the history of the sleepwalking defense for murder cases in the U.S., I saw more audience members – scientists, physicians and other medical professionals – take more notes on my quick discussion of the history of narcolepsy than on the changing conceptions of intent in American law, both of which, I was attempting to convince my audience, you can’t fully appreciate without understanding the U.S. in the 19th century.

Although social scientists are sometimes seen as lobbying groundless critiques at laboratory scientists, one of the things that social scientists are especially good at is debunking things that we’ve come to accept as natural. This process is often referred to as denaturalization – showing how what we take to be natural is the result of a history of human action that has moved something from being understood as social to natural. One of the cases I discuss at length in my book is that of consolidated sleep in the U. S. The eight hours of sleep so many of us seek out each night is not based in nature, but instead is the invention of many doctors, scientists, and business owners, and began in the 19th century to only be fully realized in the 20th.

Previous to the mid-1800s, many Americans slept in what’s referred to as biphasic fashion. That is, they would fall asleep around dusk, wake up a few hours later for a couple hours, and then sleep for a few more hours before waking around sunrise. Or, they would sleep for a few hours at night and a few more during the day. We have evidence of this in England, thanks to historian Roger Ekirch, and, as I discuss in The Slumbering Masses, American medical literature in the 19th century is full of references to these kinds of sleep patterns. When you think about it, our nights are often much longer than eight hours, so even if our sleep is determined by our environments, we would assume that humans would sleep much more than they do; instead, humans need less than a full night’s sleep as reckoned by the sun. We need somewhere between 6-10 hours each night, a figure that changes over the life course, with children and adolescents needing more and the elderly needing less. How we manage to get that sleep is up to us, or, rather, it’s often up to social norms.

In the U.S., we tend to prefer nightly, consolidated sleep – eight straight hours, with no nap during the day. For preschoolers it might be different, with longer nightly sleep and naps to boot. But, elsewhere and over the course of history, sleep arrangements have been different. In their efforts to understand biological phenomena, scientists can sometimes substitute what they believe for scientifically deduced fact. This is the case with American models of sleep, where early researchers in the 20th century used the consolidated model of nightly sleep for the basis of their scientific research (which I discuss in Chapter 2 of The Slumbering Masses). If they had used different models – say models that favor biphasic sleep – contemporary sleep science and medicine might look a lot different than they currently do.

Social scientists then, and cultural anthropologists especially, work hard to denature the facts that have come to be taken for granted – by scientists and the public. Critique of this sort is important for a number of reasons. First, it serves as a corrective when beliefs come to be taken as facts. Secondly, it opens up science to be a dialogue. When science is only happening in labs, it’s liable to be susceptible to the biases of researchers and the expediencies of grants, publication and promotion – hence the recent increased awareness about the prevalence of fraud in scientific publishing. And, most importantly, it infuses science with the lived experiences of individuals – which is why we do science in the first place: to make our individual and collective lives better. So when we take scientific fact as the basis of our lives – whether it be something we read on the internet or a pill we’re prescribed – we should always consider whether it helps us make sense of our life. And if it doesn’t, we should keep looking for answers. Some of those answers might be found in history or in other societies, where we might come to see that our sleep hasn’t always been what it is or that we might arrange our days and nights differently. This isn’t so much debunking science as helping bring it to life.