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一种渴望的问题——瑞典成瘾治疗中复发预防的考古学。

A matter of craving-An archeology of relapse prevention in Swedish addiction treatment.

机构信息

Department of Social Work, Stockholm University, Stockholm, Sweden.

Department of Social Work, Stockholm University, Stockholm, Sweden.

出版信息

Int J Drug Policy. 2022 Mar;101:103575. doi: 10.1016/j.drugpo.2021.103575. Epub 2022 Jan 3.

Abstract

This article concerns how craving is approached and handled, how it is 'made up', in the practice of so-called relapse prevention (RP) for addiction problems. There is a lack of research on what RP in general, and craving in particular, 'is' and can become across settings. Drawing upon science and technology studies (STS) and critical addiction research, we analyze how craving is enacted in manuals and training material related to the intervention, and in interviews with professionals in the Swedish treatment system. Adopting an archeological approach, we scrutinize different layers of craving enactments in RP, in search of assumptions that give rise to what John Law refers to as 'collateral realities'. We identified three collateral realities: 1) 'The materialization of craving'; 2) 'The transcendence of the individual' and 3) 'The merging of treatment and everyday life' The data show that the brain, cognition, emotions and behavior are enacted in RP as demarcated targets of intervention that the individual can transcend and control. This approach, in turn, relies on the more foundational tenet that there are no clear-cut boundaries between different identities (I/me/self; body/brain/cognition), between different settings (inside/outside treatment; real/imagined situations) or between different points in time (now/then/before). We discuss the relevance and usefulness of addiction treatment realities where craving is approached as a stable object that can be effectively treated, and where interventions inaugurate neoliberal governance of responsibilized individuals.

摘要

本文探讨了在所谓的成瘾问题复发预防 (RP) 实践中,如何处理和理解成瘾者的渴求,以及它是如何“构成”的。关于 RP 一般而言,以及特别是渴求本身在不同环境中“是什么”以及可能变成什么,缺乏研究。本研究借鉴科学技术研究 (STS) 和批判成瘾研究,分析了在与干预相关的手册和培训材料中以及在对瑞典治疗系统专业人员的访谈中,是如何表现渴求的。采用考古学方法,我们仔细研究了 RP 中渴求表现的不同层次,以寻找产生约翰·劳 (John Law) 所谓的“附带现实”的假设。我们确定了三个附带现实:1) “渴求的具体化”;2) “个体的超越”和 3) “治疗与日常生活的融合”。数据表明,在 RP 中,大脑、认知、情感和行为被表现为干预的明确目标,个体可以超越和控制这些目标。这种方法反过来又依赖于一个更基本的原则,即不同身份(I/me/self;身体/大脑/认知)、不同环境(治疗内外;真实/想象的情况)或不同时间点(现在/那时/之前)之间没有明确的界限。我们讨论了成瘾治疗现实的相关性和有用性,其中将渴求视为可以有效治疗的稳定对象,并且干预启动了对负责任个体的新自由主义治理。

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