Ethnographies of the therapeutic
Ethnography is particularly well suited to capturing the complexities and nuances of everyday life that may easily slip under the radar of grand social theory and macro-level indicators. For example, while it may seem plausible to claim that we live in a certain ‘age' - such as therapeutic or neoliberal - the actual meaning of such ‘age' is always interpreted, appropriated, put into effect and challenged in everyday practice. The idea of an overarching 'therapeutic culture’ is a case in point: such a concept can take us only so far in understanding the nuanced functionalities and manifestations acquired by various therapeutic life management discourses and strategies in different contexts. This is mainly because the notion of ‘culture’ tends to invite connotations of a static, monolithic and universal structure of action and thought, and thus overlooks the differences and flexibilities in such structures in personal, national, technological, spatial and historical settings.
Ethnographic sensibility, involving careful contextualisation and attempts to understand other lifeworlds using the self as the instrument of knowing (Ortner, 2006: 42), is thus one of the main threads connecting the contributions of this book. We approach ethnography as an intersubjective practice of ‘engaging in, wrestling with, and being committed to the human relationships’ in the fields we explore (Campbell & Lassiter, 2015: 4-5). In line with recent anthropological discussions (Hannerz, 2003; Huttunen, 2010), we understand the ‘therapeutic’ as a field consisting of multiple sites and social relations, as reflected from many different angles and using different types of research materials in this book.
Through the ethnographic approach, we seek to move away from the ‘epistemology of suspicion' (Illouz, 2008: 4), which tends to posit therapeutics as politically and culturally dubious and its practitioners as politically reactionary and imprisoned by false consciousness, and to explore how people encounter, engage and live with therapeutic practices. Some chapters examine how people narrate and experience therapeutic practices, while others analyse the practices themselves, such as mindfulness or self-tracking - and many chapters tackle both.
Studies drawing on critical analysis of public discourse have tended to underplay agency and overlook the critical capacities of actors (see Illouz, 2008: 4). They often create an impression of therapeutic practitioners as passive receivers of ideological interpellations. This means that the analytical space between discourse and experience has been neglected. The ethnographic approach adopted in this book allows us to address this space. In addition to ethnography, we also align here with the active audience paradigm of cultural studies, and suggest that therapeutic practitioners are not cultural dopes, but active producers of meaning from within their own cultural contexts (Barker, 2000: 269). Therapeutic discourses cany multiple, and sometimes contradictory, meanings; and how practitioners in different social positions make sense of and work with them is an open empirical
6 Stivi Salmenniemi, Harley Bergroth, Johanna Nurmi and Inna Perheentupa question (see Illouz, 2008: 4; Radway, 1984). As the chapters in this book elucidate, practitioners engage with therapeutic practices and discourses in complex ways, which may both challenge and reproduce ideological formations.
This book’s authors use their embodied and sensory experiences to provide rich and empathetic understandings of the therapeutic worlds mapped in their chapters. While emotional detachment and absence of the researcher’s body and affect have often been adopted in pursuit of objectivity, embodied researcher experiences form a different ‘landscape for analytical insight’ (Cerwonka & Malkki, 2007). Throughout this book, the authors create these landscapes through sensory explorations of their field sites and the different therapeutic practices and experiences within them. For instance, Marjo Kolehmainen’s chapter on relationship and sex counselling paints a vivid picture of how the researcher’s body relates to the therapeutic assemblages scrutinised during fieldwork. Her work shows how examining the researcher’s bodily states can strengthen analytical work and help to capture affective atmospheres as they unfold in therapeutic events. In another chapter, Tatiana Tiaynen-Qadir describes her ethnographic process of drawing on her own bodily experiences of Orthodox Christian liturgy to analyse and understand aspects of the sacred and therapeia that her participants attempt to put into words. Throughout her fieldwork, she participated in church services and choir practices, which gave her an embodied perspective on the sensory experiences relating to therapeutic and spiritual practices narrated by her participants.
Two other chapters also draw on long-term ethnographic involvement in the lives of research participants. Julia Lerner has studied women’s religious practice and how it is informed by therapeutic self-management in a transnational context, combining in-depth interviews with ethnographic knowledge of her research participants’ everyday lives. Inna Perheentupa has participated in the activities of feminist and LGBTQ groups in Russia as part of her fieldwork, and also conducted virtual ethnography on feminist online sites. This has allowed her to gain deeper insights into the everyday political struggles in which her interlocutors are engaged and to appreciate the therapeutic dimensions of these struggles.
Sensory and embodied experiences are also an important starting point for the chapter by Steven Stanley and Ilmari Kortelainen. It uses audiovisual recordings and Stanley’s experience of a mindfulness training event, as well as the authors’ own practices of mindfulness and meditation, to analyse the affective discursive practices of mindfulness from an ‘insider-outsider’ position. In a similar vein, the chapter by Suvi Salmenniemi, Johanna Nurmi and Joni Jaakola makes use of insights derived from Salmenniemi's participant observation in various therapeutic events and treatments. The chapter by Harley Bergroth and Upo Helén, analysing discourses and experiences of self-tracking technologies, is also affected and shaped by Bergroth’s personal experimentation with everyday fitness tracking devices during the course of the research.
Virve Peteri and Felix Freigang make use of ethnographic methods to understand the role of technologies and spaces in shaping subjectivities and emotional realms. Peteri examines how new forms of office decoration and spatial planning in the workplace connect with the therapeutic ethos and regulate bodies,
From culture to assemblages 7 moods and emotions. She describes how her own profoundly embodied sense of uneasiness during fieldwork sensitised and helped her to relate to her interlocutors’ experiences of these spaces and the ideological dilemmas with which they wrestled. Freigang’s chapter, in turn, traces ways in which mood-tracking applications do or do not work to combat mental illness in the context of inadequate mental health sendees, and highlights the contradictory effects and reactions to which they may give rise.
Finally, the chapters by Ariel Yankellevich and by Kia Andell, Harley Bergroth and Marja-Liisa Honkasalo, while not rooted in participant observation, adopt an ethnographically inspired approach through comprehensive immersion in their research settings and careful fleshing out of the embodied, sensory and affective experiences emerging in the research materials.
The bottom-up, embodied and sensory research practices used in this book also invite us to rethink notions of participation in ethnographic fieldwork. Conducting interviews and observation using a number of sensory experiences can, in itself, constitute participation (Pink, 2009). As our focus in this book is on plugging gaps in the ‘sociology of therapeutic cultures’ (Swan, 2010), these rich ethnographic practices help form understandings of people’s ways of experiencing and making sense of their worlds and may provide routes to knowledge and memories that would otherwise be hard to reach. Thus, ethnographic perspectives create new ways to understand how and why people choose to engage with various therapeutic practices, and what makes therapeutic practices meaningful for them.
In addition to advancing an ethnographic approach to therapeutic practices, this book also paves the way for an alternative theorisation of therapeutic engagements through the concept of assemblage. In so doing, it seeks to decentre ‘culture’ as a deterministic ‘force’ that is massive, enclosing and sometimes almost invincible. We propose that the therapeutic can be conceptualised as an assemblage of ideas, practices, spaces, objects and bodies yielding multiple, contextually specific and sometimes contradictory effects. This helps to highlight the multifarious and processual nature of the therapeutic, which defies any universalising and totalising effects.
The concept of an assemblage is an open-ended collage of sorts. According to McFarlane (2011: 206), it is usually mobilised to connote ‘indeterminacy, emergence, becoming, processuality, turbulence and the sociomateriality of phenomena’, and it has become part of the vocabulary of contemporary social theory. For example, French philosophers, Gilles Deleuze and Felix Guattari (1987) approached it as a ‘general logic’ of thinking about the world as being in perpetual flux, and French sociologist, Michel Callon (2005) has employed it to develop actor-network theoretical accounts of the functioning of sociotechnical systems. However, the French term preferred by such thinkers is agencement. While agencement is typically translated into English as ‘assemblage’, the two terms actually come from different etymological roots and mean different
8 Suvi Salmenniemi, Harley Bergroth, Johanna Nurmi and Inna Perheenttipa things, since the word assemblage also exists in the French lexicon. Simply put, agencement is a play on words that is sensitive to both the idea of ‘an arrangement’ (un agencement) and ‘agency’ (agence). Caliskan and Callon (2010: 9) elaborate that ‘agencies and arrangements are not separate. Agencements denote socio-technical arrangements when they are considered from the point [of] view of their capacity to act.’ Assemblage denotes a rather narrower meaning, that of ‘a bringing or coming together’ (see also Nail, 2017; Hardie & Mackenzie, 2007).
Perhaps owing to these complexities, in the social scientific literature, assemblage has appeared as a protean concept employed in various ways. For example, it has served as a conceptual tool to explore philosophical questions about ontology, existence and agency, and to argue for a rhizomatic understanding of the social, highlighting complex processes of ‘becoming’ rather than any fixed underlying ‘essences’ of things (Deleuze & Guattari, 1987; DeLanda, 2006; Introna, 2013). In new materialist social research, it has been widely drawn on to highlight processes of human-technology co-construction; object-oriented accounts of social life and power; and the effects, possibilities, restrictions and (unexpected) consequences imposed by the material and technical worlds on human thought and action when human and non-human entities come together to inter- and intra-act (Coole & Frost, 2010; Bennett, 2010; Latour. 2005; Mol. 2002; Lupton, 2016). Yet others, especially in anthropological research, have employed the concept to highlight the active labour of pulling together and sustaining diverse, sometimes apparently incompatible elements that have no inherent allegiance with one another (see Collier & Ong, 2005; Li, 2007; Zigon, 2011a, 2011b). For example, in their highly influential work, Collier and Ong (2005; 4) examine how ‘global forms’, such as neoliberalism, science and expert systems, are territorialised in assemblages, defining new material, collective and discursive relationships. They approach assemblages as ‘the product of multiple determinations that are not reducible to any single logic’ (ibid.: 12).
Assemblage theorisation has also been taken up in the methodological literature, as an idea suggesting that social research and scientific knowledge production are always situated and contingent - craftwork in themselves - and should acknowledge the pitfalls of overreliance on scientific rationalism (see Law, 2004; Fox & Alldred, 2015). What unites these different ways of working with assemblage is a sensitivity to processuality rather than stability, and a focus on challenging the persistent binaries (such as human/non-human, social/material, order/ chaos, rational/emotional) present in everyday thought.
In this book, we draw insights from these debates on assemblages to analyse and theorise therapeutic practices. The concept of assemblage here denotes not so much a coherent theoretical framework as such, but rather a theoretical-methodological ‘lens of inquiry’ and a ‘style of thought’. On the one hand, the chapters in the book look at the therapeutic as contingent arrangements situated in specific personal, political, material, spatial and discursive contexts. That is to say, ‘the therapeutic’ is never one but many; it is effectively a different entity with different effects and repercussions in different contexts. On the other hand, we focus on the ongoing work of ‘assembling’ the therapeutic. This means that
From culture to assemblages 9 we look at the active work conducted by human and non-human beings, technological applications, political ideas and various other actants in making the therapeutic happen in everyday lives. Thus, the chapters in this book also suggest, in various ways, that different kinds of practices, beliefs and everyday arrangements are therapeutic only in the sense that they are made therapeutic.
The specific theoretical contribution of this book to the discussion of therapeutic culture is its approach to the therapeutic as a kind of active craftwork (see McFarlane, 2011) in everyday life. Each chapter looks at how people and other-than-people participate in crafting and maintaining therapeutic assemblages, that is, make sense of and act upon themselves, and make promises, paths and possibilities for a good (or at least better) life to happen. The therapeutic happens through a coming together of many different elements: different technologies, beliefs, programmes, discourses, metaphors and beings, whether ‘real' or ‘imaginary’ (another persistent binary to overcome). This work of ‘assembling therapeutics’ reveals the multiplicity of the therapeutic, and how the meaning of ‘the therapeutic’ itself shifts with shifting assemblages. In this spirit of assembling and craftwork, the chapters in this book also combine assemblage thinking with a number of other theoretical resources, including affect theory, metaphor theory, anthropological and sociological study of religion and spirituality, Foucauldian analytics of power, queer theory and Critical Theory, to provide a nuanced understanding of therapeutic practices.