New SSS: ‘Plasticity Talk’, Dementia Diagnosis

Several articles in the most recent issue of Social Studies of Science may be of interest to AHP readers. Full details follow below.

“Fraught claims at the intersection of biology and sociality: Managing controversy in the neuroscience of poverty and adversity,” by Kasia Tolwinski. Abstract:

In this article, I examine how a subfield of researchers studying the impact of poverty and adversity on the developing brain, cognitive abilities and mental health respond to criticism that their research is racist and eugenicist, and implies that affected children are broken on a biological level. My interviewees use a number of strategies to respond to these resurfacing criticisms. They maintain that the controversy rests upon a fundamental misunderstanding of their work. In addition, they use what I term ‘plasticity talk’, a form of anti-determinist discourse, to put forth what they believe is a hopeful conception of body and brain as fundamentally malleable. They draw attention to their explicit intentions to use scientific inquiry to mitigate inequality and further social justice – in fact, they believe their studies are powerful evidence that add to the literature on the social determinants of health. Though they may be interested in improving lives, they argue that their aims and means have little in common with programs trying to ‘improve’ the genetic stock of the population. I argue that theirs is a fraught research terrain, where any claims-making is potentially treacherous. Just as their studies of development refuse dualistic models, so too do their responses defy dichotomous categorization.

Somaticization, the making and unmaking of minded persons and the fabrication of dementia,” by Alexandra Hillman and Joanna Latimer. Abstract:

This article examines the strategies by which the different and variable signs of failing mental powers become known sufficiently for ‘dementia’ to be made into a stable bio-clinical entity, that can be tested, diagnosed and perhaps one day even treated. Drawing on data from ethnographic observations in memory clinics, together with interviews with associated scientists and clinicians, we document the challenges that clinicians face across the clinical and research domain in making dementia a stable object of their investigation. We illustrate how the pressure for early diagnoses of dementia creates tensions between the scientific representations of early dementia and its diagnosis in the clinic. Our aim is to highlight the extent to which the work of diagnosing dementia involves an intricate process of smoothing out seemingly insurmountable problems, such as the notoriously elusive connections between brain/mind and body/person. Furthermore, we show that a part of this process involves enrolling patients as minded, agentic subjects, the very subjects who are excluded from dementia science research in pursuit of biomarkers for the pre-clinical detection of dementia.

“Fear and anxiety: Affects, emotions and care practices in the memory clinic,” by Julia Swallow and Alexandra Hillman. Abstract:

This paper contributes to the growing recognition in Science and Technology Studies and medical sociology of the significant role of affect in scientific and clinical work. We show how feelings of fear and anxiety associated with dementia not only shape people’s experiences and responses to a diagnosis, but also shape the practices and processes through which assessments and diagnoses are accomplished. What emerges from our research, and provides a distinct contribution to this growing field of study, is the relationship between the uncertainties that pervade the diagnosis of memory problems and the various strategies and practices employed to care for, divert, restrict or manage affective relations. Furthermore, our ethnographic material illustrates the implications of this relationship: on the one hand, it provides opportunities for care work through ‘tinkering’ with diagnostic technologies and extending and opening out diagnostic categories, while on the other, it can form part of healthcare practitioners’ disposal work, restricting opportunities for alternative meanings of dementia to endure.

About Jacy Young

Jacy Young is a professor at Quest University Canada. A critical feminist psychologist and historian of psychology, she is committed to critical pedagogy and public engagement with feminist psychology and the history of the discipline.