Chua Jocelyn Lim
University of North Carolina at Chapel Hill, Chapel Hill, USA.
Cult Med Psychiatry. 2020 Dec;44(4):565-585. doi: 10.1007/s11013-020-09673-7.
With the United States military stretched thin in the "global war on terror," military officials have embraced psychopharmaceuticals in the effort to enable more troops to remain "mission-capable." Within the intimate conditions in which deployed military personnel work and live, soldiers learn to read for signs of psychopharmaceutical use by others, and consequently, may become accountable to those on medication in new ways. On convoys and in the barracks, up in the observation post and out in the motor pool, the presence and perceived volatility of psychopharmaceuticals can enlist non-medical military personnel into the surveillance and monitoring of medicated peers, in sites far beyond the clinic. Drawing on fieldwork with Army personnel and veterans, this article explores collective and relational aspects of psychopharmaceutical use among soldiers deployed post-9/11 in Iraq and Afghanistan. I theorize this social landscape as a form of "medication by proxy," both to play on the fluidity of the locus of medication administration and effects within the military corporate body, and to emphasize the material and spatial ways that proximity to psychopharmaceuticals pulls soldiers into relationships of care, concern and risk management. Cases presented here reveal a devolution and dispersal of biomedical psychiatric power that complicates mainstream narratives of mental health stigma in the US military.
由于美国军队在“全球反恐战争”中兵力分散，军事官员开始使用精神药物，以使更多部队能够“执行任务”。在部署的军事人员工作和生活的亲密环境中，士兵们学会留意他人使用精神药物的迹象，因此，他们可能会以新的方式对服药的人负责。在车队、营房、观察哨和车场，精神药物的存在及其被感知到的易变性，会让非医疗军事人员在远离诊所的地方，参与对服药同伴的监视和监测。本文基于对陆军人员和退伍军人的实地调查，探讨了2001年9月11日后部署到伊拉克和阿富汗的士兵使用精神药物的集体和关系层面。我将这种社会现象理论化为一种“代理用药”形式，既利用军事集体机构内用药地点和效果的流动性，也强调靠近精神药物使士兵卷入护理、关切和风险管理关系的物质和空间方式。这里呈现的案例揭示了生物医学精神病学权力的下放和分散，这使美国军队中关于心理健康污名的主流叙述变得复杂。
