{"id":175,"date":"2020-03-12T12:26:58","date_gmt":"2020-03-12T12:26:58","guid":{"rendered":"http:\/\/wp.lancs.ac.uk\/gynae-cancer-narratives\/?p=175"},"modified":"2021-03-15T19:15:38","modified_gmt":"2021-03-15T19:15:38","slug":"beyond-side-effects","status":"publish","type":"post","link":"https:\/\/wp.lancs.ac.uk\/gynae-cancer-narratives\/2020\/03\/12\/beyond-side-effects\/","title":{"rendered":"Beyond \u2018Side\u2019 Effects"},"content":{"rendered":"

In the previous blog post, we discussed how the language of \u2018side\u2019 effects<\/a> is part of structuring the illness experience for patients. While biomedicine tends to separate effects into \u2018therapeutic\u2019 effects – characterised as lasting, if not permanent – and \u2018side\u2019 effects – characterised as temporary and reversible \u2013 the reality of \u2018side\u2019 effects is much messier. Not only because a \u2018side\u2019 effect for one drug, for example, may become the \u2018therapeutic\u2019 effect for another or that a temporary \u2018side\u2019 effect may become a permanent condition. More so, in this blog post, I focus on \u2018side\u2019 effects as being more than a relation to a \u2018primary\u2019 effect, and instead explore the argument that \u2018side\u2019 effects are relational in a variety of ways, for example, they can be personal, social or cultural, and even political too. In the following, I discuss \u2018side\u2019 effects as personal and political.<\/p>\n

\u2018Side\u2019 effects are personal<\/u><\/p>\n

Rachael Eastham (2016), in her PhD thesis on women\u2019s experiences of using contraception, writes about the profound consequences that contraception can have on a woman\u2019s sense of identity. She writes about how effects of hormonal contraceptive use subverted her interviewees from their \u2018normal\u2019 or \u2018natural\u2019 self. For example, some women in her study described how irregular bleedings disrupted their otherwise (more) confident and calm selves. It therefore makes little sense, Eastham argues, to categorise and describe \u2018side\u2019 effects as simply peripheral effects of hormonal contraceptive use, when they can have profound consequences for women\u2019s personal lives.<\/p>\n

Eastham further argues that the cultural context matters too. In Britain and in many other Western and neoliberal societies, the concept of the rational individual who behaves responsibly and makes the \u2018right\u2019 choices figures quite strongly. In this story, she writes, the female reproductive self is positioned as doing the \u2018right\u2019 thing by engaging with contraceptive technologies, such as the contraceptive pill. Yet, Eastham\u2019s study shows that doing the \u2018right\u2019 thing by being intelligible in the female and neoliberal senses of \u2018complying\u2019 with a certain contraceptive regime (e.g. being \u2018on the pill\u2019) easily come to exist in tension with women feeling disconnected from their identities; who they are.<\/p>\n

These findings makes Eastham argue for a re-consideration of the concept of \u2018side\u2019 effect that takes account of the importance of \u2018side\u2019 effects to women\u2019s sense of self. \u2018Side\u2019 effects are not simply peripheral, discrete and measurable events, but instead, Eastham argues, they may cause women to experience what she calls \u2018contraceptive dysphoria\u2019. Eastham characterises this phenomenon as \u2018a holistic experience resulting in distress, confusion and anxiety about a perceived disconnection from the \u2018normal\u2019 self\u2019 (p. 231). As a bodily phenomenon of disconnect, it may then help to explain, Eastham further argues, why some women are liable to stop or switch contraceptive methods, as they seek to \u2018return\u2019 to what they understand to be their \u2018real\u2019 selves.<\/p>\n

\u2018Side\u2019 effects are political<\/u><\/p>\n

The political nature of \u2018side\u2019 effects can present itself in many ways. The anthropologist Emily Martin (2006), for example, has written about the miniaturization and marginalisation of drug effects through a displacement of \u2018side\u2019 effects by pharmaceutical companies into the fine print of packaging and leaflets; whereas the sociologist and psychologist Joan Busfield (2004), in her work on mental health, has written about the labelling of a drug effect as a \u2018side\u2019 effect, and how this process is characterised by an imbalance of power.<\/p>\n

I would like to focus on the work of the anthropologist Jocelyn Lim Chua (2018), who in her study on the lived tensions and contradictions of psychoactive drugs in and after war, is exploring how veterans\u2019 experiences of drugs and their \u2018side\u2019 effects can bring new meanings and values to what it means to make and be in war. In her paper, Chua reports on one veteran\u2019s experiences of psychotropic medication use, having witnessed, during deployment, his sergeant being medicated after her attempted suicide, and himself being prescribed psychiatric medication after leaving the military. Chua\u2019s analysis of his experiences draws on the notion of \u2018side\u2019 effects, but not in its biomedical meaning. Instead, she pushes the boundaries of the notion of \u2018side\u2019 effect to include moral and political meanings.<\/p>\n

In making her argument, she draws on the experiences of her interviewee, who since his deployment and return from Iraq, has been experiencing moral contradictions towards the use of drugs in and after war. Having witnessed what drugs can do to other people and after his own experiences of psychoactive drugs that left him suicidal, he develops a strong resistance towards the US military and its institutional culture. Chua argues that such transformation in himself should be seen as a form of \u2018side\u2019 effect. More generally, she views such \u2018side\u2019 effects as being \u2018collateral\u2019 effects of medication in and after war. Her study then challenges the notion that \u2018side\u2019 effects are stable and inherent in drugs themselves, but instead, she argues and concludes that people\u2019s relationships with medications are themselves living things: \u2018drugs come alive to those who consume them in ways that may transform as life circumstances, personal values, and subjectivity change\u2019 (p. 19).<\/p>\n

What all the studies share is then the recognition and understanding that \u2018side\u2019 effects are much more than subordinates to \u2018primary\u2019 and intended therapeutic effects \u2013 as understood in biomedicine, but that \u2018side\u2019 effects can also matter politically and morally in the world.<\/p>\n

References<\/u><\/p>\n

Busfield, Joan (2004), \u2018Mental health problems, psychotropic drug technologies and risk\u2019 in Health, Risk and Society 6 (4): 361-375<\/p>\n

Chua, Jocelyn Lim (2018), \u2018Fog of War: Psychopharmaceutical \u201cside effects\u201d and the United States Military\u2019 in Medical Anthropology 37 (1): 17-31<\/p>\n

Eastham, Rachael (2016) Negotiating the Fertile Body: Women\u2019s life history experiences of using contraception<\/em>. PhD Thesis. Lancaster University, UK.<\/p>\n

Martin, Emily (2006), \u2018The Pharmaceutical Person\u2019 in BioSocieties <\/em>1: 273-288<\/p>\n","protected":false},"excerpt":{"rendered":"

In the previous blog post, we discussed how the language of \u2018side\u2019 effects is part of structuring the illness experience for patients. While biomedicine tends to separate effects into \u2018therapeutic\u2019 effects – characterised as lasting, if not permanent – and \u2018side\u2019 effects – characterised as temporary and reversible \u2013 the reality of \u2018side\u2019 effects is […]<\/p>\n","protected":false},"author":96,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[3],"tags":[],"class_list":["post-175","post","type-post","status-publish","format-standard","hentry","category-blog"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/wp.lancs.ac.uk\/gynae-cancer-narratives\/wp-json\/wp\/v2\/posts\/175","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wp.lancs.ac.uk\/gynae-cancer-narratives\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wp.lancs.ac.uk\/gynae-cancer-narratives\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wp.lancs.ac.uk\/gynae-cancer-narratives\/wp-json\/wp\/v2\/users\/96"}],"replies":[{"embeddable":true,"href":"https:\/\/wp.lancs.ac.uk\/gynae-cancer-narratives\/wp-json\/wp\/v2\/comments?post=175"}],"version-history":[{"count":2,"href":"https:\/\/wp.lancs.ac.uk\/gynae-cancer-narratives\/wp-json\/wp\/v2\/posts\/175\/revisions"}],"predecessor-version":[{"id":177,"href":"https:\/\/wp.lancs.ac.uk\/gynae-cancer-narratives\/wp-json\/wp\/v2\/posts\/175\/revisions\/177"}],"wp:attachment":[{"href":"https:\/\/wp.lancs.ac.uk\/gynae-cancer-narratives\/wp-json\/wp\/v2\/media?parent=175"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wp.lancs.ac.uk\/gynae-cancer-narratives\/wp-json\/wp\/v2\/categories?post=175"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wp.lancs.ac.uk\/gynae-cancer-narratives\/wp-json\/wp\/v2\/tags?post=175"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}